bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of chronic kidney disease Stages 3–5 on pregnancy outcomes
Authors: Wiles Kate , Webster Philip , Seed Paul T , Bennett-Richards Katy , Bramham Kate , Brunskill Nigel , Carr Sue , Hall Matt , Khan Rehan , Nelson-Piercy Catherine , Webster Louise M , Chappell Lucy C , Lightstone Liz 
Published: September 2020

Abstract

Background
Contemporaneous data are required for women with chronic kidney disease (CKD) Stages 3–5 to inform pre-pregnancy counselling and institute appropriate antenatal surveillance.

Methods
A retrospective cohort study in women with CKD Stages 3–5 after 20 weeks’ gestation was undertaken in six UK tertiary renal centres in the UK between 2003 and 2017. Factors predicting adverse outcomes and the impact of pregnancy in accelerating the need for renal replacement therapy (RRT) were assessed.

Results
There were 178 pregnancies in 159 women, including 43 women with renal transplants. The live birth rate was 98%, but 56% of babies were born preterm (before 37 weeks’ gestation). Chronic hypertension was the strongest predictor of delivery before 34 weeks’ gestation. Of 121 women with known pre-pregnancy hypertension status, the incidence of delivery before 34 weeks was 32% (31/96) in women with confirmed chronic hypertension compared with 0% (0/25) in normotensive women. The risk of delivery before 34 weeks doubled in women with chronic hypertension from 20% [95% confidence interval (CI) 9–36%] to 40% (95% CI 26–56%) if the gestational fall in serum creatinine was &lt;10% of pre-pregnancy concentrations. Women with a urinary protein:creatinine ratio &gt;100 mg/mmol prior to pregnancy or before 20 weeks’ gestation had an increased risk for birthweight below the 10th centile (odds ratio 2.57, 95% CI 1.20–5.53). There was a measurable drop in estimated glomerular filtration rate (eGFR) between pre-pregnancy and post-partum values (4.5 mL/min/1.73 m2), which was greater than the annual decline in eGFR prior to pregnancy (1.8 mL/min/1.73 m2/year). The effect of pregnancy was, therefore, equivalent to 1.7, 2.1 and 4.9 years of pre-pregnancy renal disease in CKD Stages 3a, 3b and 4–5, respectively. The pregnancy-associated decline in renal function was greater in women with chronic hypertension and in those with a gestational fall in serum creatinine of &lt;10% of pre-pregnancy concentrations. At 1 year post-partum, 46% (58/126) of women had lost ≥25% of their pre-pregnancy eGFR or required RRT. Most women with renal transplants had CKD Stage 3 and more stable renal function prior to pregnancy. Renal transplantation was not independently associated with adverse obstetric or renal outcomes.

Conclusions
Contemporary pregnancies in women with CKD Stages 3–5 are complicated by preterm delivery, low birthweight and loss of maternal renal function. Chronic hypertension, pre- or early pregnancy proteinuria and a gestational fall in serum creatinine of &lt;10% of pre-pregnancy values are more important predictors of adverse obstetric and renal outcome than CKD Stages 3–5. Pregnancy in women with CKD Stages 3–5 advances the need for dialysis or transplantation by 2.5 years.
COVID-19 and the Cross-Section of Equity Returns: Impact and Transmission
Authors: Bretscher Lorenzo , Hsu Alex , Simasek Peter , Tamoni Andrea 
Published: September 2020

Abstract
Using the first reported case of COVID-19 in a given U.S. county as the event day, we find that firms headquartered in an affected county experience, on average, a 27-bps lower return in the 10-day post-event window. This negative effect nearly doubles in magnitude for firms in counties with a higher infection rate (−50 bps). We test a number of transmission channels. Firms belonging to labor-intensive industries and those located in counties with a large mobility decline have worse stock performance. Firms sensitive to COVID-19-induced uncertainty also exhibit more negative returns. Finally, more negative stock returns are associated with downward revisions in earnings forecasts.
EVALUATION OF SPECIFIC ABSORPTION RATE IN THE FAR-FIELD, NEAR-TO-FAR FIELD AND NEAR-FIELD REGIONS FOR INTEGRATIVE RADIOFREQUENCY EXPOSURE ASSESSMENT
Authors: Liorni Ilaria , Capstick Myles , van Wel Luuk , Wiart Joe , Joseph Wout , Cardis Elisabeth , Guxens Mònica , Vermeulen Roel , Thielens Arno 
Published: September 2020

AbstractThe specific absorption rate (SAR) induced by wireless radiofrequency (RF) systems depends on different parameters. Previously, SAR was mainly assessed under conditions of a single frequency and technology and for a limited number of localized RF sources. The current and emerging mobile systems involve a wider range of usage scenarios and are frequently used simultaneously, leading to combined exposures for which almost no exposure evaluation exists. The aim and novelty of this study is to close this gap of knowledge by developing new methods to rapidly evaluate the SAR induced by RF systems in such scenarios at frequencies from 50 MHz to 5.5 GHz. To this aim, analytical methods for SAR estimation in several usage scenarios were derived through a large-scale numerical study. These include subject-specific characteristics, properties of the RF systems and provide an estimation of the SAR in the whole body, tissues and organs, and different brain regions.
Fundamental Rights and Democratic Sovereignty in the EU: The Role of the Charter of Fundamental Rights of the EU (CFREU) in Regulating the European Social Market Economy
Authors: Gerstenberg Oliver 
Published: September 2020

Abstract
The EU, in its present configuration, has often been accused of a persistent and deep structural bias in favour of economic integration to the detriment of the democratic and social values of its Member States. In response to that accusation, can the Charter of Fundamental Rights of the EU (CFREU) come to the rescue and be mobilized, ultimately before a judicially-activist Court of Justice of the EU (CJEU), as a vehicle of social justice, in an effort to correct bias and to counter-balance the expansive economic liberties of the European single market?
Exploring this question is a timely topic given a clearly discernable new constitutional turn in the jurisprudence of the CJEU’s Grand Chamber, especially now under the current presidency of Koen Lenaerts. The ‘Lenaerts-Court’, as this article will argue, has embarked on a new EU fundamental-rights jurisprudence, visibly aimed at strengthening the dignitarian-social dimension of EU integration and at adding flesh to the bones of the commitment to a European social market economy in Article 3(3) of the Treaty of European Union (TEU).
Yet proposals in support of greater reliance on the substantive, but open-textured, provisions of the CFREU, in the pursuit of a ‘fair balance’ between the EU’s economic and dignitarian-social dimensions, immediately run into democratic-minded concerns about sovereignty passing from the Member States to the courts, and ultimately to the CJEU itself. The persistent worry is that democratic sovereignty over constitutionally sensitive—but morally and politically divisive—choices is being turned into a ‘sovereignty of law’—in ways that not only risk foreclosure of democratic debate over yet unsettled key societal matters but gives up democratic legitimation as a central element of modern constitutionalism (‘over-constitutionalisation’, Dieter Grimm). Thus, the CJEU is being simultaneously criticized for its alleged economic bias and for its efforts to overcome that bias.
In an effort to address—and disarm—this democratic-minded concern, this article argues that judicial emphasis on the CFREU’s dignitarian-social values need not per se lead to the consequence of over-constitutionalisation. Rather, this article proposes to look at the Grand Chamber’s new fundamental-rights jurisprudence in the single-market context as creating a framework for plural and inclusive democratic deliberation on key societal choices and values. To that end, the article proposes a new reading of the Grand Chamber’s jurisprudence on the efficacy of fundamental rights in the economic sphere and, in particular, on the horizontal direct effect of CFREU rights.
The efficacy of microsurgical varicocelectomy as a salvage option for grade 1 varicocele: a retrospective study
Authors: Kuroda Shinnosuke , Usui Kimitsugu , Mori Kohei , Sanjo Hiroyuki , Takeshima Teppei , Kawahara Takashi , Uemura Hiroji , Yumura Yasushi 
Published: September 2020

Introduction:
Varicocele is an abnormal dilation and tortuosity of the pampiniform venous plexus within the spermatic cord. Although varicocele repair is recommended for male infertile patients with palpable varicocele, it is controversial whether varicocele repair should be performed in patients with low-grade varicocele. This study aimed to evaluate the efficacy of varicocelectomy as a salvage option for patients with grade 1 varicocele.

Methods:
We retrospectively analyzed data of 38 male infertility patients with grade 1 varicocele who visited the Reproduction Center, Yokohama City University Medical Center, between April 2013 and July 2017 and could be followed up for more than 6 months after treatment. Patients were divided into 2 groups: those treated with an oral antioxidant and traditional herbal medicine alone and those who additionally underwent microsurgical varicocelectomy. Patients’ characteristics and pretreatment and posttreatment semen parameters were compared between the groups using unpaired t and χ2 tests.

Results:
Twenty-four patients were treated with oral medication alone, and 14 underwent surgery in addition to receiving medication. Six months after the start of treatment, motile sperm concentrations were 4.939±6.257×106/mL and 9.853±16.8×106/mL in the medication and surgery groups, respectively (P=0.26). The amount of change in the motile sperm concentration was significantly higher in the surgery group than in the medication group (−0.94±5.82×106/mL vs. 4.33±5.46×106/mL, P=0.029).

Conclusions:
Motile sperm concentration significantly improved in patients who additionally underwent surgery. Microsurgical varicocelectomy is an effective salvage option for patients with grade 1 varicocele.
Low back pain and the social determinants of health: a systematic review and narrative synthesis
Authors: Karran Emma L. , Grant Ashley R. , Moseley G. Lorimer 
Published: September 2020

Abstract
The social determinants of health (SDH) are known to differentially impact outcomes from many noncommunicable diseases; however, their potential role in low back pain (LBP) is poorly defined. This review endeavours to comprehensively inform the field of their relevance. Our research question was: “How do the broad range of SDH and chronic LBP (CLBP) relate?” The primary aim of this review was to synthesise evidence of relationships between SDH and the frequency or severity of CLBP. Secondary aims were to identify relationships between SDH and LBP-related disability, work absenteeism, and opioid prescription. We included studies involving adult participants that evaluated relationships between one or more of the SDH and CLBP frequency or LBP outcomes (beyond 3 months). Two reviewers screened studies, extracted data, and assessed risk of bias. We synthesized the results narratively and applied PROGRESS to organise our findings. Database searches identified 7018 records. Forty-one studies were included, containing data from 2,161,617 adults from 17 countries. Twenty-four percent and 19% of the relationships included were classified as having a high risk of bias due to confounding and missing data, respectively. We reported 166 relationships representing the majority of the PROGRESS domains. An array of independent and interdependent relationships between the SDH and CLBP were identified with the strongest evidence for associations related to educational attainment and socioeconomic status. Our findings suggest that greater recognition of the contribution of SDH to disparities in LBP outcomes is warranted and this has the potential to usefully inform strategies to impact burden.
Characterization of gut microbiota in patients with primary hepatocellular carcinoma received immune checkpoint inhibitors
Authors: LI Lili , Ye Jiajian 
Published: September 2020

Abstract
Hepatocellular carcinoma (HCC) is one of the most common neoplasms encountered, and its incidence is increasing worldwide. In this study, we explored the characteristics of gut microbiota in patients with primary hepatocellular carcinoma in advanced stage who received immune checkpoint inhibitors (ICIs) based on a large population with hepatitis B virus infection. An initial cohort of 65 patients with metastatic melanoma were included in this study. All patients were treated with ICIs at Fujian provincial geriatric hospital between August 2016 and June 2018. The 16S rDNA V4 region was amplified by Polymerase chain reaction and sequenced on the MiSeq platform. We found that the diversities of the gut microbiota in HCC who received ICIs were obviously increased. Negative feedback, which is controlled by interplay between microbial metabolic activities and host pathways, is thought to promote high bacterial diversity. We focused on the Faecalibacterium genus in response group, and Bacteroidales order in non-response group, and stratified patients into high versus low categories based on the median relative abundance of these taxa in the gut microbiome. Patients with high Faecalibacterium abundance had a significantly prolonged PFS versus those with a low abundance. Conversely, patients with a high abundance of Bacteroidales had a shortened progressive free survival compared to those with a low abundance. In summary, the present study examined the oral and gut microbiome of HCC patients undergoing immune checkpoint inhibitors immunotherapy. Significant differences were observed in the diversity and composition of the patient gut microbiome of responders versus non-responders.
Viscossuplementation for the treatment of osteoarthritis of the knee
Authors: Ferreira de Andrade Carlos Augusto , Genov Isabel Ruguê , Pereira Sara Regina Neto , Barreto Joao Mauricio , Ramos Max Rogério Freitas , da Silva Eduardo Costa Freitas , de Oliveira Liszt Palmeira 
Published: September 2020

Abstract

Background:
Knee osteoarthritis (KOA) is a common chronic disease with worldwide prevalence of 10% to 79%, with costs ranging from $560 to $635 billion for year in United States of America. The main guidelines recommend interventions with undesirable adverse events (AE) or highly dependent on the patient's persistence. Thus, intra-articular (IA) therapies appear to be attractive in patients with KOA, as well as a valid therapy by maximizing effects locally in the joint and limiting systemic AE. Presently, the main available IA therapies are corticosteroids and hyaluronic acid.
As several meta-analyses about the efficacy of intra-articular hyaluronic acid (IAHA) for treatment of KOA with discordant results were published, we decided to conduct an umbrella review to summarize this efficacy

Methods:
We will search MEDLINE/PubMed, EMBASE, Cochrane Library, and Virtual Health Library (BVS) from inception to February 2020 for systematic reviews with meta-analyses of randomized clinical trials that investigate IAHA for therapy of KOA. Grey literature will be searched in Opengray platform, Research Gate, and Google Scholar. The reference lists of eligible studies will be screened. The search will be performed without language restriction.
We will include any type of IAHA as experimental intervention and different types of oral or intra-articular placebo or medications as controls. The primary outcome will be measures of efficacy as the Western Ontario and McMaster Universities Osteoarthritis Index.
A synthesis of the evidence will be conducted and data will be presented in tables.
Two reviewers will independently appraise the quality of included meta-analyses using the Assessment of Multiple Systematic Reviews 2 (AMSTAR 2) tool and will classify the included systematic reviews into high, moderate, low, or critically low levels of confidence.

Results:
The results of this study will be published in a peer-reviewed journal.

Ethics and dissemination:
No ethical approval is required since this study data is based on published literature.

Protocol registration number:
PROSPERO CRD42019120269 (https://www.crd.york.ac.uk/PROSPERO/#joinuppage).
Usefulness of computed tomography venography in gynecologic cancer patients with lower extremity edema
Authors: Kim Won Jun , Kim JaYoung , Kang Minsoo , Park Dae Hwan , Jeon Jae Yong 
Published: September 2020

Abstract
Lower extremity (LEx) edema is a common complication in gynecologic cancer patients. There are 2 main causes of edema in these patients such as deep vein thrombosis (DVT) and lymphedema. Early diagnosis and treatment of DVT are certainly important, but it is often difficult to evaluate proximal DVT by using ultrasound. The aim of this study is to demonstrate the usefulness of computed tomography venography of the lower extremity (CTV LEx) for the diagnosis of the DVT and investigate predictive factor of DVT in gynecologic cancer patients with LEx edema.
The medical records of 415 gynecologic cancer patients who were referred to the department of rehabilitation medicine with LEx edema were retrospectively reviewed in this case-controlled study. We categorized CTV LEx findings as follows: DVT proximal to the inguinal ligament (inferior vena cava or iliac vein thrombosis) and DVT distal to the inguinal ligament (femoral, popliteal, or calf vein thrombosis). We also evaluated patient characteristics including d-dimer level. We analyzed the correlation of each factor with DVT frequency and used receiver operating characteristic curve analysis to determine the appropriate d-dimer threshold.
Sixty-six patients were diagnosed with DVT; of them, 35 (53%) had DVT proximal to the inguinal ligament. Twenty-two patients were diagnosed with pulmonary embolism, of whom 15 had proximal DVT. Patients with proximal DVT tended to have pulmonary embolism (P < .001). Distal organ metastasis (odds ratio [OR], 2.88; P = .002) and a high D-dimer level (OR, 1.13; P = .001) were correlated with DVT.
CTV LEx is a useful diagnostic tool for gynecologic cancer patients with LEx edema, particularly high-risk patients, that should be performed at the initial evaluation.
Wandering spleen with splenic torsion in a toddler
Authors: Wang Zhijun , Zhao Qiang , Huang Yuanyuan , Mo Zhanhao , Tian Zhisen , Yang Fan , Wang Yuanyi , Yao Liyu 
Published: September 2020

Abstract

Rationale:
Wandering spleen (WS) is a rare clinical entity characterized by splenic hypermobility caused by absent or abnormal laxity of the suspensory ligaments, which fix the spleen in its normal position. Due to abnormal attachment, the spleen is predisposed to torsion and a series of complications. Pediatric WS is mostly reported in children aged <10 years, especially among infants aged <1 year; it is uncommon among toddlers between 1 and 3 years. To the authors’ knowledge, only seven cases of WS have been described previously. Herein, we present the case of a 3-year-old toddler with WS and splenic torsion.

Patient concerns:
A 3-year-old boy was presented to the pediatric emergency room with a 2-day history of abdominal pain and vomiting. The ultrasonographic examination revealed a mass in the left upper abdomen cavity and absence of spleen in its normal position. Computed tomography showed an enlarged displaced spleen occupying the left abdomen cavity with an elongated splenic vascular pedicle (whirl sign), suggesting splenic torsion.

Diagnoses:
The patient was diagnosed that had WS and splenomegaly, with or without complications due to splenic torsion.

Interventions:
The patient underwent emergency laparotomy and splenectomy due to nonviability after detorsion.

Outcomes:
The postoperative course was uneventful, and the patient was discharged on the 7th day postoperatively without complications. The patient had favorable outcome over a 1-year follow-up.

Lessons:
Herein, we reported the case of a toddler with WS with splenic torsion. Moreover, after reviewing relevant studies in literature, we presented our findings on the diagnosis and treatment of toddlers with WS. Toddlers with WS are characterized by acute abdominal pain, unclear history description, examination restrictions, and high rates of life-threatening complications. High level of suspicion, careful physical examination, detailed history collection, and objective investigation are crucial in the management of toddlers with WS.
Long-term effects of phacoemulsification and intraocular lens implantation in a patient with pathologic myopia and extremely long axial length
Authors: Yang Yu , Chen Hao , An Jingqi , Fan Wei 
Published: September 2020

Abstract

Rationale:
To report a rare case of phacoemulsification cataract surgery and intraocular lens implantation that improved visual acuity and capsular stability in a patient with pathologic myopia and axial length >38 mm.

Patient concerns:
A 51-year-old Chinese man with high myopia since childhood who had lost sight in his left eye at the age of 25 due to retinal detachment. He was referred for ophthalmological assessment due to decreased vision in the right eye, in which the best-corrected visual acuity at distance was hand motion.

Diagnoses:
The patient was diagnosed with cataract, high myopia, subluxated lens, and loose zonules in the right eye. The left eyeball showed atrophy.

Interventions:
The patient underwent uneventful phacoemulsification. An intraocular lens (Sensar AR40M) and capsular tension ring were implanted within the capsular bag. After surgery, the patient was given eye drops containing tobramycin and dexamethasone eye drops for 1 month and eye drops containing 0.1% sodium diclofenac for 2 months.

Outcomes:
There were no postoperative complications. During 1-year follow-up, uncorrected visual acuity was 20/80 and the manifest refraction was −2.50DS/−1.00DC∗80, with corrected distance visual acuity of 20/60. Cataract surgery maintained adequate vision for daily living.

Lessons:
Implantation of specific lens and capsular tension ring as well as prolonged use of non-steroidal anti-inflammatory drugs may help prevent capsular contraction and posterior capsule opacification in patients with pathologic myopia and extremely long axial length.
The eighth version of American Joint Committee on Cancer nodal classification for high grade pancreatic neuroendocrine tumor should be generalized for the whole population with this disease
Authors: Li Mu-xing , Wang Hang-yan , Yuan Chun-hui , Ma Chao-lai , Jiang Bin , Li Lei , Zhang Li , Zhao Hong , Cai Jian-qiang , Xiu Dian-rong 
Published: September 2020

Abstract
Several indexes evaluating the lymph node metastasis of pancreatic neuroendocrine tumor (pNET) have been raised. We aimed to compare the prognostic value of the indexes via the analysis of Surveillance, Epidemiology, and End Results (SEER) database.
We identified pNETs patients from SEER database (2004–2015). The prognostic value of N classification which adopted the 8th American Joint Committee on Cancer (AJCC) N classification for well differentiated pNET, revised N classification (rN) which adopted the AJCC 8th N classification for exocrine pancreatic cancer (EPC) and high grade pNET, lymph node ratio and log odds of positive nodes were analyzed.
A total of 1791 eligible patients in the SEER cohort were included in this study. The indexes N, rN, lymph node ratio, and log odds of positive nodes were all significant independent prognostic factors for the overall survival. Specifically, the rN had the lowest akaike information criterion of 4050.19, the highest likelihood ratio test (χ2) of 48.87, and the highest C-index of 0.6094. The rN was significantly associated with age, tumor location, tumor differentiation, T classification and M classification (P < .05 for all).
The 8th version of AJCC N classification for high grade pNET could be generalized for the pNET population.