bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting the risk of future diabetic foot ulcer occurrence: a prospective cohort study of patients with diabetes in Tanzania
Authors: Naemi Roozbeh , Chockalingam Nachiappan , Lutale Janet K , Abbas Zulfiqarali G 
Published: May 2020

ObjectivesThe aim of this study was to identify the parameters that predict the risk of future foot ulcer occurrence in patients with diabetes.Research design and methods1810 (male (M)/female (F): 1012/798) patients, with no foot ulcer at baseline, participated in this study. Data from a set of 28 parameters were collected at baseline. During follow-up, 123 (M/F: 68/55) patients ulcerated. Survival analyses together with logistic regression were used to identify the parameters that could predict the risk of future diabetic foot ulcer occurrence.ResultsA number of parameters (HR (95% CI)) including neuropathy (2.525 (1.680 to 3.795)); history of ulceration (2.796 (1.029 to 7.598)); smoking history (1.686 (1.097 to 2.592)); presence of callus (1.474 (0.999 to 2.174)); nail ingrowth (5.653 (2.078 to 15.379)); foot swelling (3.345 (1.799 to 6.218)); dry skin (1.926 (1.273 to 2.914)); limited ankle (1.662 (1.365 to 2.022)) and metatarsophalangeal (MTP) joint (2.745 (1.853 to 4.067)) ranges of motion; and decreased (3.141 (2.102 to 4.693)), highly decreased (5.263 (1.266 to 21.878)), and absent (9.671 (5.179 to 18.059)) sensation to touch; age (1.026 (1.010 to 1.042)); vibration perception threshold (1.079 (1.060 to 1.099)); duration of diabetes (1.000 (1.000 to 1.000)); and plantar pressure at the first metatarsal head (1.003 (1.001 to 1.005)), temperature sensation (1.019 (1.004 to 1.035)) and temperature tolerance (1.523 (1.337 to 1.734)) thresholds to hot stimuli and blood sugar level (1.027 (1.006 to 1.048)) were all significantly associated with increased risk of ulceration. However, plantar pressure underneath the fifth toe (0.990 (0.983 to 0.998)) and temperature sensation (0.755 (0.688 to 0.829)) and temperature tolerance (0.668 (0.592 to 0.0754)) thresholds to cold stimuli showed to significantly decrease the risk of future ulcer occurrence. Multivariate survival model indicated that nail ingrowth (4.42 (1.38 to 14.07)); vibration perception threshold (1.07 (1.04 to 1.09)); dry skin status (4.48 (1.80 to 11.14)); and temperature tolerance threshold to warm stimuli (1.001 (1.000 to 1.002)) were significant predictors of foot ulceration risk in the final model. The mean time to ulceration was significantly (p<0.05) shorter for patients with: dry skin (χ2=11.015), nail ingrowth (χ2=14.688), neuropathy (χ2=21.284), or foot swelling (χ2=16.428).ConclusionNail ingrowth and dry skin were found to be strong indicators of vulnerability of patients to diabetic foot ulceration. Results highlight that assessments of neuropathy in relation to both small and larger fiber impairment need to be considered for predicting the risk of diabetic foot ulceration.
Facial protection for healthcare workers during pandemics: a scoping review
Authors: Garcia Godoy Laura R , Jones Amy E , Anderson Taylor N , Fisher Cameron L , Seeley Kylie M L , Beeson Erynn A , Zane Hannah K , Peterson Jaime W , Sullivan Peter D 
Published: May 2020

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has led to personal protective equipment (PPE) shortages, requiring mask reuse or improvisation. We provide a review of medical-grade facial protection (surgical masks, N95 respirators and face shields) for healthcare workers, the safety and efficacy of decontamination methods, and the utility of alternative strategies in emergency shortages or resource-scarce settings.MethodsWe conducted a scoping review of PubMed and grey literature related to facial protection and potential adaptation strategies in the setting of PPE shortages (January 2000 to March 2020). Limitations included few COVID-19-specific studies and exclusion of non-English language articles. We conducted a narrative synthesis of the evidence based on relevant healthcare settings to increase practical utility in decision-making.ResultsWe retrieved 5462 peer-reviewed articles and 41 grey literature records. In total, we included 67 records which met inclusion criteria. Compared with surgical masks, N95 respirators perform better in laboratory testing, may provide superior protection in inpatient settings and perform equivalently in outpatient settings. Surgical mask and N95 respirator conservation strategies include extended use, reuse or decontamination, but these strategies may result in inferior protection. Limited evidence suggests that reused and improvised masks should be used when medical-grade protection is unavailable.ConclusionThe COVID-19 pandemic has led to critical shortages of medical-grade PPE. Alternative forms of facial protection offer inferior protection. More robust evidence is required on different types of medical-grade facial protection. As research on COVID-19 advances, investigators should continue to examine the impact on alternatives of medical-grade facial protection.
Physicians’ perceptions of the uptake of biosimilars: a systematic review
Authors: Sarnola Kati , Merikoski Merja , Jyrkkä Johanna , Hämeen-Anttila Katri 
Published: May 2020

ObjectivesTo examine physicians’ perceptions of the uptake of biosimilars.DesignSystematic review.Data sourcesMedLine Ovid and Scopus databases at the end of 2018.Eligibility criteriaOriginal scientific studies written in English that addressed physicians’ perceptions of the uptake of biosimilars.Data extraction and synthesisThe search resulted in altogether 451 studies and 331 after removing duplicates. Two researchers examined these based on the title, abstract and entire text, resulting in 20 studies. The references in these 20 studies were screened and three further studies were included. The data of these 23 studies were extracted. All the publications were quality assessed by two researchers.ResultsMost of the selected studies were conducted in Europe and commonly used short surveys. Physicians’ familiarity with biosimilars varied: 49%–76% were familiar with biosimilars while 2%–25% did not know what biosimilars were, the percentages varying from study to study. Their measured knowledge was generally more limited compared with their self-assessed knowledge. Physicians’ perceptions of biosimilars also varied: 54%–94% were confident prescribing biosimilars, while 65%–67% had concerns regarding these medicines. Physicians seemed to prefer originator products to biosimilars and prescribed biosimilars mainly for biologic-naive patients. They considered cost savings and the lower price compared with the originator biologic medicine as the main advantages of biosimilars, while their doubts were often related to safety, efficacy and immunogenicity. 64%–95% of physicians had negative perceptions of pharmacist-led substitution of biologic medicines.ConclusionsPhysicians’ knowledge of and attitudes towards biosimilars vary. Although physicians had positive attitudes towards biosimilars, prescribing was limited, especially for patients already being treated with biologic medicines. Perceptions of pharmacist-led substitution of biologic medicines were often negative. Education and national recommendations for switching and substitution of biologic medicines are needed to support the uptake of biosimilars.
Cell-bound complement activation products associate with lupus severity in SLE
Authors: Arriens Cristina , Alexander Roberta Vezza , Narain Sonali , Saxena Amit , Collins Christopher E , Wallace Daniel J , Massarotti Elena , Conklin John , Kalunian Kenneth C , Putterman Chaim , Ramsey-Goldman Rosalind , Buyon Jill P , Askanase Anca , Furie Richard A , James Judith A , Bello Ghalib A , Manzi Susan , Ahearn Joseph , O"Malley Tyler , Weinstein Arthur , Dervieux Thierry 
Published: May 2020

ObjectivesTo evaluate the association between lupus severity and cell-bound complement activation products (CB-CAPs) or low complement proteins C3 and C4.MethodsAll subjects (n=495) fulfilled the American College of Rheumatology (ACR) classification criteria for SLE. Abnormal CB-CAPs (erythrocyte-bound C4d or B-lymphocyte-bound C4d levels >99th percentile of healthy) and complement proteins C3 and C4 were determined using flow cytometry and turbidimetry, respectively. Lupus severity was estimated using the Lupus Severity Index (LSI). Statistical analysis consisted of multivariable linear regression and groups comparisons.ResultsAbnormal CB-CAPs were more prevalent than low complement values irrespective of LSI levels (62% vs 38%, respectively, p<0.0001). LSI was low (median 5.44, IQR: 4.77–6.93) in patients with no complement abnormality, intermediate in patients with abnormal CB-CAPs (median 6.09, IQR: 5.31–8.20) and high in the group presenting with both abnormal CB-CAPs and low C3 and/or C4 (median 7.85, IQR: 5.51–8.37). Odds of immunosuppressant use was higher in subjects with LSI ≥5.95 compared with subjects with LSI <5.95 (1.60 vs 0.53, p<0.0001 for both). Multivariable regression analysis revealed that higher LSI scores associated with abnormal CB-CAPs—but not low C3/C4—after adjusting for younger age, race and longer disease duration (p=0.0001), which were also independent predictors of disease severity (global R2=0.145).ConclusionAbnormalities in complement activation as measured by CB-CAPs are associated with increased LSI.
Detection of unknown atrial fibrillation by prolonged ECG monitoring in an all-comer patient cohort and association with clinical and Holter variables
Authors: Jawad-Ul-Qamar Muhammad , Chua Winnie , Purmah Yanish , Nawaz Mohammad , Varma Chetan , Davis Russell , Maher Abdul , Fabritz Larissa , Kirchhof Paulus 
Published: May 2020

ObjectivesProlonged ECG monitoring is clinically useful to detect unknown atrial fibrillation (AF) in stroke survivors. The diagnostic yield of prolonged ECG monitoring in other patient populations is less well characterised. We therefore studied the diagnostic yield of prolonged Holter ECG monitoring for AF in anunselectedpatient cohort referred from primary care or seen in a teaching hospital.MethodsWe analysed consecutive 7-day ECG recordings in unselected patients referred from different medical specialities and assessed AF detection rates by indication, age and comorbidities.ResultsSeven-day Holter ECGs (median monitoring 127.5 hours, IQR 116 to 152) were recorded in 476 patients (mean age 54.6 (SD 17.0) years, 55.9% female) without previously known AF, requested to evaluate palpitations (n=241), syncope (n=99), stroke or transient ischaemic attack (n=75), dizziness (n=29) or episodic chest pain (n=32). AF was newly detected in 42/476 (8.8%) patients. Oral anticoagulation was initiated in 40/42 (95.2%) patients with newly detected AF. Multivariate logistic regression, adjusted for age, sex and monitoring duration found four clinical parameters to be associated with newly detected AF: hypertension OR=2.54, (1.08 to 8.61) (adjusted OR (95% CI)), p=0.034; previous stroke or TIA OR=4.14 (1.81 to 13.01), p=0.001; left-sided valvular heart disease OR=5.07 (2.48 to 18.70), p<0.001 and palpitations OR=2.86, (1.33 to 10.44), p=0.015.ConclusionsOpen multispeciality access to prolonged ECG monitoring, for example, as part of integrated, cross-sector AF care, can accelerate diagnosis of AF and increase adequate use of oral anticoagulation, especially in older and symptomatic patients with comorbidities.
Rac Signaling Drives Clear Cell Renal Carcinoma Tumor Growth by Priming the Tumor Microenvironment for an Angiogenic Switch
Authors: Goka Erik T. , Chaturvedi Pallavi , Lopez Dayrelis T. Mesa , Lippman Marc E. 
Published: May 2020

Abstract
Clear cell renal cell carcinoma (ccRCC) remains a common cause of cancer mortality. Better understanding of ccRCC molecular drivers resulted in the development of antiangiogenic therapies that block the blood vessels that supply tumors with nutrients for growth and metastasis. Unfortunately, most ccRCC patients eventually become resistant to initial treatments, creating a need for alternative treatment options. We investigated the role of the small GTPase Rac1 in ccRCC. Analysis of ccRCC clinical samples indicates that Rac signaling drives disease progression and predicts patients with poorer outcomes. Investigation of Rac1 identifies multiple roles for Rac1 in the pathogenesis of ccRCC. Rac1 is overexpressed in RCC cell lines and drives proliferation and migratory/metastatic potential. Rac1 is also critical for endothelial cells to grow and form endothelial tubular networks potentiated by angiogenic factors. Importantly, Rac1 controls paracrine signaling of angiogenic factors including VEGF from renal carcinoma cells to surrounding blood vessels. A novel Rac1 inhibitor impaired the growth and migratory potential of both renal carcinoma cells and endothelial cells and reduced VEGF production by RCC cells, thereby limiting paracrine signaling both in vitro and in vivo. Lastly, Rac1 was shown to be downstream of VEGF receptor (VEGFR) signaling and required for activation of MAPK signaling. In combination with VEGFR2 inhibitors, Rac inhibition provides enhanced suppression of angiogenesis. Therefore, targeting Rac in ccRCC has the potential to block the growth of tumor cells, endothelial cell recruitment, and paracrine signaling from tumor cells to other cells in the tumor microenvironment.
New genus of Muscidae: Coenosiinae (Diptera) from the Mexican Transition Zone and its phylogenetic position based on morphological evidence
Authors: Gomes Lucas Roberto Pereira , Fogaça João Manuel , de Carvalho Claudio José Barros 
Published: May 2020

Abstract
A new monotypic genus, Aztecamyia gen. nov., is proposed for a new species of muscid fly, Aztecamyia tlaloc sp. nov., found in highland localities from the Mexican Transition Zone (Mexico, Michoacan, Morelos and Puebla). Additionally, a morphology-based phylogenetic analysis of Coenosiini is presented. The new genus has some unique characters, such as katepisternal setae 0+1+1 in males, while females are the typically Coenosiini 1+1+1; the mid and hind tibia have many long and fine setae on the apical half, from the anterior to posterior surface; and the preapical setae on all femora are absent on all surfaces. The morphology of the male and female terminalia is a typical Coenosiini shape.
Use of Observing System Simulation Experiments in the United States
Authors: Zeng Xubin , Atlas Robert , Birk Ronald J. , Carr Frederick H. , Carrier Matthew J. , Cucurull Lidia , Hooke William H. , Kalnay Eugenia , Murtugudde Raghu , Posselt Derek J. , Russell Joellen L. , Tyndall Daniel P. , Weller Robert A. , Zhang Fuqing 
Published: May 2020

AbstractThe NOAA Science Advisory Board appointed a task force to prepare a white paper on the use of observing system simulation experiments (OSSEs). Considering the importance and timeliness of this topic and based on this white paper, here we briefly review the use of OSSEs in the United States, discuss their values and limitations, and develop five recommendations for moving forward: national coordination of relevant research efforts, acceleration of OSSE development for Earth system models, consideration of the potential impact on OSSEs of deficiencies in the current data assimilation and prediction system, innovative and new applications of OSSEs, and extension of OSSEs to societal impacts. OSSEs can be complemented by calculations of forecast sensitivity to observations, which simultaneously evaluate the impact of different observation types in a forecast model system.
Defining Essential Services for Deaf and Hard of Hearing Children during the COVID‐19 Pandemic
Authors: Pattisapu Prasanth , Evans Sean S. , Noble Anisha R. , Norton Susan J. , Ou Henry C. , Sie Kathleen C. Y. , Horn David L. 
Published: May 2020

COVID‐19 is a rapidly growing global pandemic caused by a novel coronavirus. With no vaccine or definitive treatment, public health authorities have recommended a strategy of “social distancing,” reducing individual interaction, canceling elective procedures, and limiting nonessential services. Health care providers must determine what procedures are considered “elective,” balancing risk of treatment delays with that of coronavirus exposure to patient, family, and providers. Given critical periods for language development and the long‐term impact of auditory deprivation, some audiologic and otologic services should be considered essential. In this article, we describe the experience of a quaternary referral pediatric hospital in Seattle, the epicenter of COVID‐19 in the United States, and share strategies for risk minimization employed by Seattle Children’s Hospital. We hope that this work can be a reference for other centers continuing care for children who are deaf and hard of hearing during the COVID‐19 and future resource‐limiting crises.
Olfactory Dysfunction: A Highly Prevalent Symptom of COVID‐19 With Public Health Significance
Authors: Sedaghat Ahmad R. , Gengler Isabelle , Speth Marlene M. 
Published: May 2020

ObjectiveCoronavirus disease 2019 (COVID‐19) is a global pandemic affecting millions of individuals, killing hundreds of thousands. Although typically described with characteristic symptoms of fever, cough, and shortness of breath, greater understanding of COVID‐19 has revealed myriad clinical manifestations. Olfactory dysfunction (OD)—hyposmia and anosmia—has recently been recognized as an important symptom of COVID‐19 and increasingly gained traction as a public health tool for identifying COVID‐19 patients, in particular otherwise asymptomatic carriers who, unawares, may be major drivers of disease spread. The objective of this study is to review the scientific evidence about anosmia in COVID‐19.Data SourcesPubMed, Google Scholar, and Web of Science.Review MethodsComprehensive literature search of primary studies pertinent to the objectives of this review using the chosen data sources.ConclusionsCurrent evidence shows that OD is highly prevalent in COVID‐19, with up to 80% of patients reporting subjective OD and objective olfactory testing potentially showing even higher prevalence. OD is frequently accompanied by taste dysfunction. Up to 25% of COVID‐19 patients may experience sudden‐onset OD as the first symptom. A large proportion of COVID‐19 OD cases may resolve over the period of a few weeks.Implications for PracticeSudden anosmia should be considered a symptom of COVID‐19. Assessing for sudden‐onset anosmia may increase sensitivity of COVID‐19 screening strategies, in particular for identifying patients at the earliest stages of disease. Since many cases of OD due to COVID‐19 may resolve in the short term, conservative management, including observation, is reasonable, while advanced imaging is unnecessary.
Does the Dog-Ear or Bird-Beak Deformity Remodel After Rotator Cuff Repair?
Authors: Park Yong Bok , Park Jung Ho , Lee Seung Won , Jung Tae Wan , Koh Kyoung Hwan , Yoo Jae Chul 
Published: May 2020

Background: Dog-ear and bird-beak deformities are common after transosseous-equivalent repair (suture bridge technique). The natural course of deformities after rotator cuff (RC) repair using the suture bridge technique is unclear. The remodeling potential of these deformities has not been investigated. Purpose: To evaluate remodeling and retear rates associated with deformities after RC repair. Study Design: Cohort study; Level of evidence, 3. Methods: Between November 2011 and February 2012, we studied 99 consecutive shoulders. All patients underwent arthroscopic RC repair via the suture bridge technique with or without additional sutures. Two groups were formed: no deformity (n= 46) and deformity (n = 53). Deformity was defined as marginal detachment and protrusion of the RC after repair, involving inappropriate compression of the suture limbs from the anchors. Tendon height was measured from the highest point of the most protruding portion of the cuff to the cortex on semi-coronal magnetic resonance imaging (MRI) scan. Change in tendon height was evaluated on MRI scan at 1 week and 6 months postoperatively. Clinical assessment at every patient visit included the American Shoulder and Elbow Surgeons (ASES) score, Constant shoulder score, and visual analog scale for pain (pVAS) score. Results: No significant differences were found in age, sex, symptom duration, tear size, and preoperative ASES, Constant, and pVAS scores ( P > .05) between the 2 groups. The initial tendon height was 7.4 ± 1.5 mm in the no-deformity group and 9.3 ± 2.0 mm in the deformity group. Follow-up height was 6.3 ± 2.1 mm in the no-deformity group and 6.4 ± 1.6 mm in the deformity group. Mean postoperative tendon heights were 90.1% ± 23.8% of the initial height in the no-deformity group and 73.2% ± 15.1% in the deformity group. Clinical scores (ASES, Constant, and pVAS) were not significantly different between the groups at 6 months. There were 4 shoulders in each group that experienced retearing (types 4 and 5 according to the Sugaya classification) at 6 months postoperatively. There was no difference in retear rate ( P > .999). Conclusion: Most deformities after RC repair were remodeled with no effect on retears. Clinical outcomes were not affected by deformities.
Local response in health emergencies: key considerations for addressing the COVID-19 pandemic in informal urban settlements
Authors: Wilkinson Annie , Ali Harris , Bedford Juliet , Boonyabancha Somsook , Connolly Creighton , Conteh Abu , Dean Laura , Decorte Filiep , Dercon Bruno , Dias Sonia , Dodman David , Duijsens Raimond , D’Urzo Sandra , Eamer Gwendolen , Earle Lucy , Gupte Jaideep , Frediani Alex Apsan , Hasan Arif , Hawkins Kate , Herbst Natalia , Kadihasanoglu Aynur , Keil Roger , Kibuchi Eliud , Leach Melissa , Lilford Richard , Macarthy Joseph , Mitlin Diana , Napier David , O’Donnell Ian , Oyebode Oyinlola , Ozano Kim , Perera Laxman , Rashid Sabina , Ringwald Beate , Ripoll Santiago , Saleem Amjad , Satterthwaite David , Sellu Sudie Austina , Siddique Omar , Soesilo Cynthia , Sommer Kerstin , Steege Rosie , Sverdlik Alice , Tacoli Cecilia , Taylor John , Theobald Sally , Tolhurst Rachel , Walnycki Anna , Watson Samuel , Whittaker Lana 
Published: May 2020

This paper highlights the major challenges and considerations for addressing COVID-19 in informal settlements. It discusses what is known about vulnerabilities and how to support local protective action. There is heightened concern about informal urban settlements because of the combination of population density and inadequate access to water and sanitation, which makes standard advice about social distancing and washing hands implausible. There are further challenges to do with the lack of reliable data and the social, political and economic contexts in each setting that will influence vulnerability and possibilities for action. The potential health impacts of COVID-19 are immense in informal settlements, but if control measures are poorly executed these could also have severe negative impacts. Public health interventions must be balanced with social and economic interventions, especially in relation to the informal economy upon which many poor urban residents depend. Local residents, leaders and community-based groups must be engaged and resourced to develop locally appropriate control strategies, in partnership with local governments and authorities. Historically, informal settlements and their residents have been stigmatized, blamed, and subjected to rules and regulations that are unaffordable or unfeasible to adhere to. Responses to COVID-19 should not repeat these mistakes. Priorities for enabling effective control measures include: collaborating with local residents who have unsurpassed knowledge of relevant spatial and social infrastructures, strengthening coordination with local governments, and investing in improved data for monitoring the response in informal settlements.