bluuebunny/crossref_metadata_2025_split huggingface dataset:
Guideline-directed medical therapy in elderly patients with heart failure with reduced ejection fraction: a cohort study
Authors: Seo Won-Woo , Park Jin Joo , Park Hyun Ah , Cho Hyun-Jai , Lee Hae-Young , Kim Kye Hun , Yoo Byung-Su , Kang Seok-Min , Baek Sang Hong , Jeon Eun-Seok , Kim Jae-Joong , Cho Myeong-Chan , Chae Shung Chull , Oh Byung-Hee , Choi Dong-Ju 
Published: February 2020

Objectives and designGuideline-directed medical therapy (GDMT) with renin–angiotensin system (RAS) inhibitors and beta-blockers has improved survival in patients with heart failure with reduced ejection fraction (HFrEF). As clinical trials usually do not include very old patients, it is unknown whether the results from clinical trials are applicable to elderly patients with HF. This study was performed to investigate the clinical characteristics and treatment strategies for elderly patients with HFrEF in a large prospective cohort.SettingThe Korean Acute Heart Failure (KorAHF) registry consecutively enrolled 5625 patients hospitalised for acute HF from 10 tertiary university hospitals in Korea.ParticipantsIn this study, 2045 patients with HFrEF who were aged 65 years or older were included from the KorAHF registry.Primary outcome measurementAll-cause mortality data were obtained from medical records, national insurance data or national death records.ResultsBoth beta-blockers and RAS inhibitors were used in 892 (43.8%) patients (GDMT group), beta-blockers only in 228 (11.1%) patients, RAS inhibitors only in 642 (31.5%) patients and neither beta-blockers nor RAS inhibitors in 283 (13.6%) patients (no GDMT group). With increasing age, the GDMT rate decreased, which was mainly attributed to the decreased prescription of beta-blockers. In multivariate analysis, GDMT was associated with a 53% reduced risk of all-cause mortality (HR 0.47, 95% CI 0.39 to 0.57) compared with no GDMT. Use of beta-blockers only (HR 0.57, 95% CI 0.45 to 0.73) and RAS inhibitors only (HR 0.58, 95% CI 0.48 to 0.71) was also associated with reduced risk. In a subgroup of very elderly patients (aged ≥80 years), the GDMT group had the lowest mortality.ConclusionsGDMT was associated with reduced 3-year all-cause mortality in elderly and very elderly HFrEF patients.Trial registration numberNCT01389843.
Evaluating quality of overall care among older adults with diabetes with comorbidities in Ontario, Canada: a retrospective cohort study
Authors: Petrosyan Yelena , Kuluski Kerry , Barnsley Jan , Liu Barbara , Wodchis Walter P 
Published: February 2020

ObjectivesThis study aimed to: (1) explore whether the quality of overall care for older people with diabetes is differentially affected by types and number of comorbid conditions and (2) examine the association between process of care measures and the likelihood of all-cause hospitalisations.DesignA population-based, retrospective cohort study.SettingThe province of Ontario, Canada.ParticipantsWe identified 673 197 Ontarians aged 65 years and older who had diabetes comorbid with hypertension, chronic ischaemic heart disease, osteoarthritis or depression on 1 April 2010.Main outcome measuresThe study outcome was the likelihood of having at least one hospital admission in each year, during the study period, from 1 April 2010 to 3 March 2014. Process of care measures specific to older adults with diabetes and these comorbidities, developed by means of a Delphi panel, were used to assess the quality of care. A generalised estimating equations approach was used to examine associations between the process of care measures and the likelihood of hospitalisations.ResultsThe study findings suggest that patients are at risk of suboptimal care with each additional comorbid condition, while the incidence of hospitalisations and number of prescribed drugs markedly increased in patients with 2 versus 1 selected comorbid condition, especially in those with discordant comorbidities. The median continuity of care score was higher among patients with diabetes-concordant conditions compared with those with diabetes-discordant conditions, and it declined with additional comorbid conditions in both groups. Greater continuity of care was associated with lower hospital utilisation for older diabetes patients with both concordant and discordant conditions.ConclusionsThere is a need for focusing on improving continuity of care and prioritising treatment in older adults with diabetes with any multiple conditions but especially in those with diabetes-discordant conditions (eg, depression).
Hyperosmolar therapy for acute brain injury: study protocol for an umbrella review of meta-analyses and an evidence mapping
Authors: Badenes Rafael , Hutton Brian , Citerio Giuseppe , Robba Chiara , Aguilar Gerardo , Alonso-Arroyo Adolfo , Taccone Fabio Silvio , Tornero Carlos , Catalá-López Ferrán 
Published: February 2020

IntroductionAcute brain injury is a challenging public health problem worldwide. Elevated intracranial pressure is a common complication after acute brain injury. Hyperosmolar therapy is one of the main therapeutic strategies for the management of intracranial hypertension. This study protocol outlines an umbrella review of meta-analyses which will investigate the benefits and harms of hyperosmolar therapy routinely used for the management of acute brain injury in the intensive care.Methods and analysisWe will search PubMed/MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews. We will include meta-analyses of primary research studies (eg, randomised controlled trials, observational studies or both) that evaluate one or more hyperosmolar solutions (including hypertonic saline and/or mannitol) for the treatment of adult patients with acute brain injury of any severity. Two researchers will independently screen all citations, full-text articles and abstract data. Potential conflicts will be resolved through discussion with a third researcher. Primary outcomes will be mortality and neurological outcomes at discharge. Secondary outcomes will include control of intracranial pressure, cerebral perfusion pressure, length of stay (in hospital an intensive care unit) and any adverse event. Quality of the included meta-analyses will be assessed using the AMSTAR-2 tool. An overall summary of methods and results will be performed using tabular and graphical approaches and will be supplemented by narrative description. We will analyse whether published meta-analyses present an outline of available evidence (eg, cited, described and discussed any previous meta-analysis). Where objectives from two or more meta-analyses overlap, we will assess the causes of any noted discrepancies between meta-analyses.Ethics and disseminationNo ethical approval will be required. Findings from this study will be published in a peer-reviewed journal. All data will be deposited in a cross-disciplinary public repository.PROSPERO registration numberCRD42019148152.
Interleukin-22 orchestrates a pathological endoplasmic reticulum stress response transcriptional programme in colonic epithelial cells
Authors: Powell Nick , Pantazi Eirini , Pavlidis Polychronis , Tsakmaki Anastasia , Li Katherine , Yang Feifei , Parker Aimee , Pin Carmen , Cozzetto Domenico , Minns Danielle , Stolarczyk Emilie , Saveljeva Svetlana , Mohamed Rami , Lavender Paul , Afzali Behdad , Digby-Bell Jonathan , Tjir-Li Tsui , Kaser Arthur , Friedman Joshua , MacDonald Thomas T , Bewick Gavin A , Lord Graham M 
Published: February 2020

ObjectiveThe functional role of interleukin-22 (IL22) in chronic inflammation is controversial, and mechanistic insights into how it regulates target tissue are lacking. In this study, we evaluated the functional role of IL22 in chronic colitis and probed mechanisms of IL22-mediated regulation of colonic epithelial cells.DesignTo investigate the functional role of IL22 in chronic colitis and how it regulates colonic epithelial cells, we employed a three-dimentional mini-gut epithelial organoid system, in vivo disease models and transcriptomic datasets in human IBD.ResultsAs well as inducing transcriptional modules implicated in antimicrobial responses, IL22 also coordinated an endoplasmic reticulum (ER) stress response transcriptional programme in colonic epithelial cells. In the colon of patients with active colonic Crohn’s disease (CD), there was enrichment of IL22-responsive transcriptional modules and ER stress response modules. Strikingly, in an IL22-dependent model of chronic colitis, targeting IL22 alleviated colonic epithelial ER stress and attenuated colitis. Pharmacological modulation of the ER stress response similarly impacted the severity of colitis. In patients with colonic CD, antibody blockade of IL12p40, which simultaneously blocks IL12 and IL23, the key upstream regulator of IL22 production, alleviated the colonic epithelial ER stress response.ConclusionsOur data challenge perceptions of IL22 as a predominantly beneficial cytokine in IBD and provide novel insights into the molecular mechanisms of IL22-mediated pathogenicity in chronic colitis. Targeting IL22-regulated pathways and alleviating colonic epithelial ER stress may represent promising therapeutic strategies in patients with colitis.Trial registration numberNCT02749630.
British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England post-polypectomy and post-colorectal cancer resection surveillance guidelines
Authors: Rutter Matthew D , East James , Rees Colin J , Cripps Neil , Docherty James , Dolwani Sunil , Kaye Philip V , Monahan Kevin J , Novelli Marco R , Plumb Andrew , Saunders Brian P , Thomas-Gibson Siwan , Tolan Damian J M , Whyte Sophie , Bonnington Stewart , Scope Alison , Wong Ruth , Hibbert Barbara , Marsh John , Moores Billie , Cross Amanda , Sharp Linda 
Published: February 2020

These consensus guidelines were jointly commissioned by the British Society of Gastroenterology (BSG), the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and Public Health England (PHE). They provide an evidence-based framework for the use of surveillance colonoscopy and non-colonoscopic colorectal imaging in people aged 18 years and over. They are the first guidelines that take into account the introduction of national bowel cancer screening. For the first time, they also incorporate surveillance of patients following resection of either adenomatous or serrated polyps and also post-colorectal cancer resection. They are primarily aimed at healthcare professionals, and aim to address:Which patients should commence surveillance post-polypectomy and post-cancer resection?What is the appropriate surveillance interval?When can surveillance be stopped?two or more premalignant polyps including at least one advanced colorectal polyp (defined as a serrated polyp of at least 10 mm in size or containing any grade of dysplasia, or an adenoma of at least 10 mm in size or containing high-grade dysplasia);orfive or more premalignant polypsThe Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument provided a methodological framework for the guidelines. The BSG’s guideline development process was used, which is National Institute for Health and Care Excellence (NICE) compliant.two or more premalignant polyps including at least one advanced colorectal polyp (defined as a serrated polyp of at least 10 mm in size or containing any grade of dysplasia, or an adenoma of at least 10 mm in size or containing high-grade dysplasia);orfive or more premalignant polypsThe key recommendations are that the high-risk criteria for future colorectal cancer (CRC) following polypectomy compriseeither:two or more premalignant polyps including at least one advanced colorectal polyp (defined as a serrated polyp of at least 10 mm in size or containing any grade of dysplasia, or an adenoma of at least 10 mm in size or containing high-grade dysplasia);orfive or more premalignant polypsThis cohort should undergo a one-off surveillance colonoscopy at 3 years. Post-CRC resection patients should undergo a 1 year clearance colonoscopy, then a surveillance colonoscopy after 3 more years.
Where is geoscience going?
Authors: Ludden John 
Published: February 2020

Abstract
This short article provides my views – and not necessarily views that are shared by the British Geological Survey, where I was executive director from 2006–19, or by the Earth science community in general. I have outlined some of the trends that I see as important for the geosciences, largely from a solid-Earth perspective. I stress that fundamental discovery science in this sector must be, and will largely continue to be, led by the academic community but that Earth sciences research needs to be more focused on problem solving rather than refining our knowledge of the problems that face the Earth system. Academics and government laboratories have distinct but complementary roles in the pursuit of discovery and in applied geoscience research and training of geoscientists.
A Flexible Parameterization for Shortwave and Longwave Optical Properties of Ice Crystals and Derived Bulk Optical Properties for Climate Models
Authors: van Diedenhoven Bastiaan , Cairns Brian 
Published: February 2020

AbstractWe provide a parameterization of the extinction efficiency, single-scattering albedo, and asymmetry parameter of single ice crystals with any combination of particle volume, projected area, component aspect ratio, and crystal distortion at any wavelength between 0.2 and 100 μm. The parameterization is an extension of the one previously published by van Diedenhoven et al. In addition, the parameterized optical properties are integrated over size distributions yielding bulk extinction efficiencies, single-scattering albedos, and asymmetry parameters for large ranges of effective radii, particle component aspect ratios, and crystal distortion values. The parameterization of single-particle optical properties is evaluated with a reference database. The bulk optical properties are evaluated against the ice model selected for the Moderate Resolution Imaging Spectroradiometer (MODIS) collection 6 products, for which accurate optical properties are available. Mean absolute errors in parameterized extinction efficiency, asymmetry parameter, and single-scattering albedo are shown to be 0.0272, 0.008 90, and 0.004 68, respectively, for shortwave wavelengths, while they are 0.0641, 0.0368, and 0.0200 in the longwave. Shortwave and longwave asymmetry parameters and single-scattering albedos are shown to vary strongly with particle component aspect ratio and distortion, resulting in substantial variation in shortwave fluxes, but relatively small variations in longwave cloud emissivity. The parameterization and bulk optical properties are made publicly available.
A Dual-Polarization Radar Synthetic QPE for Operations
Authors: Zhang Jian , Tang Lin , Cocks Stephen , Zhang Pengfei , Ryzhkov Alexander , Howard Kenneth , Langston Carrie , Kaney Brian 
Published: February 2020

AbstractA new dual-polarization (DP) radar synthetic quantitative precipitation estimation (QPE) product was developed using a combination of specific attenuation A, specific differential phase KDP, and reflectivity Z to calculate the precipitation rate R. Specific attenuation has advantages of being insensitive to systematic biases in Z and differential reflectivity ZDR due to partial beam blockage, attenuation, and calibration while more linearly related to R than other radar variables. However, the R(A) relationship is not applicable in areas containing ice. Therefore, the new DP QPE applies R(A) in areas where radar is observing pure rain, R(KDP) in regions potentially containing hail, and R(Z) elsewhere. Further, an evaporation correction was applied to minimize false light precipitation related to virga. The new DP QPE was evaluated in real time over the conterminous United States and showed significant improvements over previous radar QPE techniques that were based solely on R(Z) relationships. The improvements included reduced dry biases in heavy to extreme precipitation during the warm season. The new DP QPE also reduced errors and spatial discontinuities in regions impacted by partial beam blockage. Further, the new DP QPE reduced wet bias for scattered light precipitation in the southwest and north central United States where there is significant boundary layer evaporation.
Impact of the Hydrometeor Vertical Advection Method on HWRF’s Simulated Hurricane Structure
Authors: Bao Shaowu , Bernardet L. , Thompson G. , Kalina E. , Newman K. , Biswas M. 
Published: February 2020

Abstract
The impact of different hydrometeor advection schemes on TC structure and intensity forecasts is examined through the evaluation of HWRF’s simulation of tropical cyclones using the operational Ferrier–Aligo (FA) microphysics that uses total condensate advection versus the same scheme but with separate hydrometeor advection (FA-adv). Results showed that FA-adv simulated larger storms. Idealized simulations revealed that the cause of the simulation differences is the characteristics of the vertical profile of cloud water (Qc), which has a sharp gradient near 850 hPa, and rainwater (Qr), which is vertically uniform below the melting layer. In FA, the resultant total condensate profile has a gradient near 850 hPa that is smaller than that of Qc but larger than that of Qr. In FA when the total condensate is advected and partitioned back to Qc and Qr, the advection of Qc is underestimated and that of Qr is overestimated than that in FA-adv. The separate advection of hydrometeors in the FA-adv scheme corrected this problem and caused the difference in microphysics and dynamics fields between the two schemes. The greater vertical advection of Qc in FA-adv represents a continual source of extra diabatic heating that leads to a greater integrated kinetic energy (IKE) in the storm simulated by FA-adv than FA. However, the radial distribution of the azimuthally averaged additional diabatic heating in FA-adv caused a sea level pressure adjustment that leads to a weaker maximum wind speed. The warming in the outer rainbands strengthens wind away from the inner core, which causes the simulated storm size to increase.
Melanoma Characteristics in Patients with a History of UV Tanning Bed Usage
Authors: Truong Kristy , Milhem Mohammed , Pagedar Nitin A. 
Published: February 2020

Objective: The purpose of this study was to evaluate the effect of tanning bed use on the behavior of subsequent melanomas. Methods: Cases of invasive cutaneous melanoma who completed a baseline questionnaire within 1 year of biopsy were ascertained using an institutional registry. Patients were categorized into one of two groups: (1) no history of UV tanning bed usage or (2) any history of tanning bed usage. Data analysis looked for group differences on the following variables: TNM staging, mitotic rate, family history of melanoma, and basic demographic variables. Results: Among 141 cases, a higher percentage of women (48.28%) reported tanning bed usage compared to men (26.51%, P < .01). Additionally, the average age at biopsy for people who reported tanning bed usage was significantly lower compared to those who had not reported using a tanning bed. There was no significant difference in stage at presentation ( P = .56). Those with tanning bed usage presented significantly less often with melanoma of unknown primary (MUP). After controlling for the effects of gender and nodal status, tanning bed usage was not a significant independent predictor of 5 year overall survival. Conclusions: If we remove the subject with MUP on the basis that more of these are mucosal in origin, lower TNM stage at presentation are found in patients with no tanning bed melanoma compared to those with history of tanning bed usage. In addition, tanning bed patients are younger and more likely female but with an equivalent mortality rate. Level of Evidence: Case Series
Survival Outcomes and Prognostic Factors of Open Partial Laryngeal Surgery: A Thirty Years’ Experience
Authors: Gallo Oreste , Cannavicci Angelo , Bruno Chiara , Maggiore Giandomenico , Locatello Luca Giovanni 
Published: February 2020

Background: Open partial laryngeal surgery (OPLS) represents a wide array of procedures that can be fitted to treat different types of laryngeal cancer (LC). We would like to present our 30-years’ institutional experience, to analyze survival outcomes and to critically discuss prognostic factors. Methods: We reviewed all cases of OPLS performed at our Institution from 1982 to 2016 for LC. Survival analysis by Kaplan–Meier estimate was performed and prognostic variables by multivariate analysis were identified. Results: Mean follow-up time was 68.3 months, 30-day mortality 0.2%, subsequent functional total laryngectomy (TL) was 1.01%. Over 80% of cases were stage I to II. We had 25 local, 62 regional and eight distant recurrences. Local control was 94.9%, overall survival (OS) was 83.4% and disease-specific survival (DSS) was 87.7%. The two major risk factors significantly associated with the risk of death were cT and cN stage. CONCLUSIONS: We have confirmed that OPLS represents an oncologically sound option in the treatment of LC despite the emergence of non-surgical strategies and new transoral mininvasive techniques. Our results highlight that accurate staging, correct selection of the patient and a strong surgical expertise are of paramount importance in this type of surgery.
Congenital Midline Cervical Cleft: First Report and Genetic Analysis of Two Related Patients
Authors: Masood Maheer M. , Mieczkowski Piotr , Malc Ewa P. , Foreman Ann Katherine M. , Evans James P. , Clark J. Madison , Rose Austin S. 
Published: February 2020

Objectives: Congenital midline cervical cleft (CMCC) is a rare congenital anterior neck anatomical anomaly. We present the case of two related patients (grandchild and maternal grandmother) who were both born with a congenital midline cervical cleft along with genetic analysis. Methods: Clinical examination of both patients and surgical excision of the grandchild was performed. Genetic analysis with exome sequencing (ES) was conducted for both patients. Results: Genetic analysis with exome sequencing (ES) revealed apparently novel single nucleotide variants in 66 genes present in both proband and grandmother. Five of these variants are predicted to cause frameshifting in the coding region of the respective genes and truncated proteins ( OVGP1, TYW1B, ZAN, SSPO, FOLR3). Two of these genes ( TYW1B and SSPO) have homozygous indel mutations in both patients. Conclusions: To our knowledge, this is the first case of two related patients with a congenital midline cervical cleft. The results of our genetic analysis reveal potential relevance to CMCC development.
Use of Patient Portals of Electronic Health Records Remains Low From 2014 to 2018: Results From a National Survey and Policy Implications
Authors: Hong Y. Alicia , Jiang Shaohai , Liu Piper Liping 
Published: February 2020

Purpose: To investigate the trend of patient portal use in the general population and the barriers to adoption. Participants: We analyzed 3 iterations of the Health Information National Trends Survey (HINTS) collected in 2014, 2017, and 2018. Measures: Patient portal use, high-speed Internet access, data safety confidence, prior experience of online patient provider communication (OPPC), and demographic variables. Analysis: Logistic regression analyses were conducted separately for the 3 iterations of HINTS. Results: The use of patient portals increased from 25.6% in 2014 to 30.5% in 2017, and 31.4% in 2018. These users were more likely to be white female with higher levels of education or income. Meanwhile, high-speed Internet access, prior experience of OPPC, and data safety confidence were positive predictors of patient portal use in all 3 iterations. Conclusion: The use of patient portals in the general public remains low and a significant digital divide persists, presenting a major challenge on meaningful use of electronic health record. We call for more effective interventions to address these gaps. Such interventions should target people of low socioeconomic status and focus on improving eHealth literacy and patients’ confidence in data safety.