bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bone mineral density and mortality in end-stage renal disease patients
Authors: Iseri Ken , Dai Lu , Chen Zhimin , Qureshi Abdul Rashid , Brismar Torkel B , Stenvinkel Peter , Lindholm Bengt 
Published: April 2020

Abstract
Osteoporosis characterized by low bone mineral density (BMD) as assessed by dual-energy X-ray absorptiometry (DXA) is common among end-stage renal disease (ESRD) patients and associates with high fracture incidence and high all-cause mortality. This is because chronic kidney disease-mineral bone disorders (CKD-MBDs) promote not only bone disease (osteoporosis and renal dystrophy) but also vascular calcification and cardiovascular disease. The disturbed bone metabolism in ESRD leads to ‘loss of cortical bone’ with increased cortical porosity and thinning of cortical bone rather than to loss of trabecular bone. Low BMD, especially at cortical-rich bone sites, is closely linked to CKD-MBD, vascular calcification and poor cardiovascular outcomes. These effects appear to be largely mediated by shared mechanistic pathways via the ‘bone–vascular axis’ through which impaired bone status associates with changes in the vascular wall. Thus, bone is more than just the scaffolding that holds the body together and protects organs from external forces but is—in addition to its physical supportive function—also an active endocrine organ that interacts with the vasculature by paracrine and endocrine factors through pathways including Wnt signalling, osteoprotegerin (OPG)/receptor activator of nuclear factor-κB (RANK)/RANK ligand system and the Galectin-3/receptor of advanced glycation end products axis. The insight that osteogenesis and vascular calcification share many similarities—and the knowledge that vascular calcification is a cell-mediated active rather than a passive mineralization process—suggest that low BMD and vascular calcification (‘vascular ossification’) to a large extent represent two sides of the same coin. Here, we briefly review changes of BMD in ESRD as observed using different DXA methods (central and whole-body DXA) at different bone sites for BMD measurements, and summarize recent knowledge regarding the relationships between ‘low BMD’ and ‘fracture incidence, vascular calcification and increased mortality’ in ESRD patients, as well as potential ‘molecular mechanisms’ underlying these associations.
Electrolyte disorders secondary to venetoclax
Authors: van der Lubbe Nils , Lugtenburg Pieternella J , Hoorn Ewout J 
Published: April 2020

Abstract
Emerging cancer drugs introduce new forms of nephrotoxicity that may also present as electrolyte disorders. Here, we report a patient with non-Hodgkin lymphoma who developed severe hypokalaemia with concurrent hypophosphataemia, hypocalcaemia and hypomagnesaemia secondary to venetoclax. Although electrolyte disorders have been reported during treatment with venetoclax, these were ascribed to tumour lysis prophylaxis. Based on the temporal relationship and urinary studies, we show that venetoclax can cause these electrolyte disorders, likely through an effect on the proximal and distal convoluted tubule. In patients treated with venetoclax, we recommend close monitoring of electrolytes and avoiding co-medication that can contribute to electrolyte disorders.
Early lactate changes improve the outcome prediction for extracorporeal membrane oxygenation
Authors: Lin Ting-Tse , Lin Ming-Hsien , Wu Cho-Kai , Lin Lian-Yu , Lin Jou-Wei , Lin Shien-Fong , Hwang Juey-Jen , Chen Yih Sharng 
Published: April 2020

Abstract

OBJECTIVES
Serial lactate (clearance) data are commonly used for risk stratification in patients receiving veno-arterial extracorporeal life support (ECLS).

METHODS
We retrospectively analysed 855 patients who had undergone ECLS due to cardiac (n = 578) and non-cardiac (n = 277) aetiologies between 2002 and 2013 at National Taiwan University Hospital. Serial lactate (clearance) data were collected before ECLS and at 8, 16, 24, 48 and 72 h after ECLS. To investigate the impact of lactate (clearance) levels on 180-day survival, we performed linear mixed model and joint model analyses using the Bayesian approach.

RESULTS
Among the 855 patients, 564 (65.9%) patients died within 180 days after ECLS cannulation. The joint model showed that the effect of lactate on survival was null in both the reduced model and the fully adjusted model. However, an effect of lactate clearance on survival was observed in the reduced model [estimate 0.004; 95% confidence interval (CI) 0.002–0.006] and the fully adjusted model (estimate 0.003; 95% CI 0.001–0.005). In a further secondary analysis, lactate clearance (hazard ratio 0.861; 95% CI 0.813–0.931) at 16 h after ECLS cannulation was determined to be a risk factor for mortality. According to a receiver operating characteristic curve analysis, the SAVE score combined with lactate clearance (area under curve = 0.881) showed good outcome discrimination.

CONCLUSIONS
Incorporating lactate clearance at 16 h after ECLS cannulation into the SAVE system improved the predictive value for mortality in patients receiving ECLS.
Implementing the new European Regulations on medical devices—clinical responsibilities for evidence-based practice: a report from the Regulatory Affairs Committee of the European Society of Cardiology
Authors: Fraser Alan G , Byrne Robert A , Kautzner Josef , Butchart Eric G , Szymański Piotr , Leggeri Ilaria , de Boer Rudolf A , Caiani Enrico G , Van de Werf Frans , Vardas Panagiotis E , Badimon Lina 
Published: April 2020

Abstract
The new European Union (EU) law governing the regulatory approval of medical devices that entered into force in May 2017 will now take effect from 26 May 2021. Here, we consider how it will change daily practice for cardiologists, cardiac surgeons, and healthcare professionals. Clinical evidence for any high-risk device must be reported by the manufacturer in a Summary of Safety and Clinical Performance (SSCP) that will be publicly available in the European Union Database on Medical Devices (Eudamed) maintained by the European Commission; this will facilitate evidence-based choices of which devices to recommend. Hospitals must record all device implantations, and each high-risk device will be trackable by Unique Device Identification (UDI). Important new roles are envisaged for clinicians, scientists, and engineers in EU Expert Panels—in particular to scrutinize clinical data submitted by manufacturers for certain high-risk devices and the evaluations of that data made by notified bodies. They will advise manufacturers on the design of their clinical studies and recommend to regulators when new technical specifications or guidance are needed. Physicians should support post-market surveillance by reporting adverse events and by contributing to comprehensive medical device registries. A second law on In Vitro Diagnostic Medical Devices will take effect from 2022. We encourage all healthcare professionals to contribute proactively to these new systems, in order to enhance the efficacy and safety of high-risk devices and to promote equitable access to effective innovations. The European Society of Cardiology will continue to advise EU regulators on appropriate clinical evaluation of high-risk devices.
Apolipoprotein E and Health in Older Men: The Concord Health and Ageing in Men Project
Authors: Le Couteur David G , Stanaway Fiona , Waite Louise M , Cullen John , Lindley Richard I , Blyth Fiona M , Naganathan Vasi , Cumming Robert G , Handelsman David J 
Published: April 2020

Abstract
APOE genotype has been associated with various age-related outcomes including Alzheimer’s disease, frailty, and mortality. In this study, the relationship between health, particularly cognitive function, and APOE was investigated in older men from the Concord Health and Ageing in Men Project (n = 1,616; age 76.9 ± 5.5 years [range 70–97 years]; Australia). Baseline characteristics and survival up to 12 years were determined. Frailty was measured using Cardiovascular Health study (CHS) criteria and Rockwood frailty index, and cognition using Mini-Mental State Examination (MMSE) and Addenbrookes Cognitive Examination. APOE ε4 was less common in the oldest men and those born in Mediterranean countries. APOE ε2 was beneficially associated with cholesterol, creatinine, gamma-glutamyl transaminase, glucose, and HDL cholesterol while APOE ε4 was adversely associated with cholesterol and albumin. APOE ε4 was associated with a clinical diagnosis of Alzheimer’s disease when adjusted for age and region of birth (ε4 homozygotes Odds ratio (OR) 7.0; ε4 heterozygotes OR 2.4, p &lt; .05), and APOE ε2 had a small positive association with cognition. On multivariate regression, overall cognitive function in the entire cohort was associated with age, country of birth, education, and frailty (all p &lt; .001). APOE was not associated with frailty or survival. In conclusion, age and region of birth influenced distribution of APOE genotype in older men. Although APOE ε4 was associated with Alzheimer’s disease, overall cognitive function in the cohort was associated more strongly with frailty than APOE genotype.
Strengthening human and physical infrastructure of primary healthcare settings to deliver hypertension care in Vietnam: a mixed-methods comparison of two provinces
Authors: Meiqari Lana , Nguyen Thi-Phuong-Lan , Essink Dirk , Wright Pamela , Scheele Fedde 
Published: April 2020

Abstract
In Vietnam, the overall prevalence of hypertension (HTN) was 21%, with lower estimates for the prevalence of HTN awareness and treatment. The health systems, like other low- and middle-income countries, were designed to provide acute care for episodic conditions, rather than a chronic condition where patients need long-term care across time and disciplines. This article describes the delivery and organization of HTN care at primary healthcare (PHC) settings in both urban and rural areas at Hue Province of Central Vietnam in comparison with Thai Nguyen province in Northern Vietnam based on the infrastructure capacity and patients’ and providers’ perspectives and experiences We used mixed-methods design that included in-depth semi-structured interviews with patients and healthcare providers at purposively selected PHC facilities in two districts of each province and a modified version of the service availability and readiness assessment inventory at all PHC facilities. We found that HTN patients in both provinces can access healthcare services to diagnose, treat and control their HTN condition at the PHC level with a focus on district facilities. Health services in Hue have allowed commune health stations (CHSs) to provide routine monitoring and prescription refills for HTN patients while maintaining periodical visits to a higher level of care to monitor the stability of the disease. Such provision of care at CHSs remained restricted in Thai Nguyen. Further improvements are necessary for referral procedures, information system to allow for longitudinal follow-up across levels of care and defining a basic health insurance or benefits package, which meets patients’ preferences with a monthly timespan for prescription refills.
Gaining insight into the implementation of an e-learning smoking cessation course in Latin American countries
Authors: Vides-Porras Ana , Cáceres Paula , Company Assumpta , Guillen Olga , Arrien Martha Alicia , Castellano Yolanda , Margalef Mercè , Yantuche Wendy , Fernández Esteve , Martínez Cristina ,   the Group of Hospital Coordinators in the Fruitful Project
Published: April 2020

Abstract
Continuous medical education focused on health problems emerging in low- and middle-income countries (LMICs) is scarce. Although tobacco consumption is increasing in LMICs, there is a lack of tobacco cessation training programs in these countries. To promote smoking cessation interventions in Bolivia, Guatemala and Paraguay, we adapted an e-learning program developed in Catalonia (Spain). This process evaluation study reports on reach, dose and satisfaction of participants with the course, as well as the contextual factors of its application. We conducted a multiple method evaluation, which included a survey and several focus groups, each one specific to the same type of healthcare professional (nurses, doctors, other professionals). Two hundred and ninety-two participants registered into the online course. The motivation for undertaking the course was different between doctors and nurses. The main sources of difficulty in enrolling and finishing the course were the technical problems experienced when accessing the platform, and lack of acquaintance with computers and the Internet in general. Our results show that implementing e-learning education in hospitals from LMICs is feasible, especially when there are similarities between participating countries and the country in which the original program was developed. However, several elements such as strong organizational commitment, technical support and resources and adequate communication channels should be provided to facilitate enrollment and training completion. Efforts to improve Internet access should be made to avoid jeopardizing students’ motivation to enroll and complete online training.
Central Extensions of Lie Groups Preserving a Differential Form
Authors: Diez Tobias , Janssens Bas , Neeb Karl-Hermann , Vizman Cornelia 
Published: April 2020

AbstractLet $M$ be a manifold with a closed, integral $(k+1)$-form $\omega $, and let $G$ be a Fréchet–Lie group acting on $(M,\omega )$. As a generalization of the Kostant–Souriau extension for symplectic manifolds, we consider a canonical class of central extensions of ${\mathfrak{g}}$ by ${\mathbb{R}}$, indexed by $H^{k-1}(M,{\mathbb{R}})^*$. We show that the image of $H_{k-1}(M,{\mathbb{Z}})$ in $H^{k-1}(M,{\mathbb{R}})^*$ corresponds to a lattice of Lie algebra extensions that integrate to smooth central extensions of $G$ by the circle group ${\mathbb{T}}$. The idea is to represent a class in $H_{k-1}(M,{\mathbb{Z}})$ by a weighted submanifold $(S,\beta )$, where $\beta $ is a closed, integral form on $S$. We use transgression of differential characters from $ S$ and $ M $ to the mapping space $ C^\infty (S, M) $ and apply the Kostant–Souriau construction on $ C^\infty (S, M) $.
Longitudinal Change of Severe Acute Respiratory Syndrome Coronavirus 2 Antibodies in Patients with Coronavirus Disease 2019
Authors: Zhang Guoxin , Nie Shuke , Zhang Zhaohui , Zhang Zhentao 
Published: April 2020

Abstract

Background
A novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has recently emerged and caused the rapid spread of coronavirus disease 2019 (COVID-19) worldwide.

Methods
We did a retrospective study and included COVID-19 patients admitted to Renmin Hospital of Wuhan University between 1 February and 29 February 2020. Antibody assay was conducted to detect COVID-19 envelope protein E and nucleocapsid protein N antigen.

Results
One hundred twelve patients were recruited with symptoms of fever, cough, fatigue, myalgia, and diarrhea. All patients underwent antibody tests. Fifty-eight (51.79%) were positive for both immunoglobulin M (IgM) and immunoglobulin G (IgG), 7 (6.25%) were negative for both antibodies, 1 (0.89%) was positive for only IgM, and 46 (41.07%) were positive for only IgG. IgM antibody appeared within a week post–disease onset, lasted for 1 month, and gradually decreased, whereas IgG antibody was produced 10 days after infection and lasted for a longer time. However, no significant difference in levels of IgM and IgG antibodies between positive and negative patients of nucleic acid test after treatment was found.

Conclusions
Our results indicate that serological tests could be a powerful approach for the early diagnosis of COVID-19.
A reform too few or a reform too many: Judicial review, appeals or a prosecutorial system under the UK Competition Act 1998?
Authors: Nazzini Renato 
Published: April 2020

Abstract
This article discusses the Competition and Markets Authority’s (CMA) proposals to lower the standard of review of certain antitrust decisions in the Competition Appeal Tribunal (CAT) from a merits appeal to judicial review principles or some other limited basis, while retaining the CAT’s ‘full jurisdiction’ over fines, and to amend the CAT’s rules of procedure to restrict the admissibility of new evidence on appeal and the use of oral testimony. The argument developed in this article is that such proposals are: (i) in conflict with the constitutional principle of the rule of law; (ii) incompatible with the Human Rights Act 1998 (HRA98); (iii) a step back even from the often criticized standard of review applied by the Union Courts in respect of European Commission’s decisions; (iv) inappropriate as a matter of policy. If the current regime needs improving to reduce the cost and length of the proceedings, then three options should be considered: (i) moving from a merits appeal to a merits review (Option 1); (ii) strengthening the independence of the decision-making panel within the CMA (Option 2), while lowering the standard of review to judicial review principles; (iii) establishing a prosecutorial model (Option 3). Option 3 is the most radical but should be given serious consideration as it is likely to be the best suited to achieving the policy objective of reducing the cost and length of competition proceedings while at the same time retaining rigorous scrutiny of the facts and economic evidence, which is key to ensuring not only the fairness, and therefore the legitimacy, of the system, but also its effectiveness.
sureLDA: A multidisease automated phenotyping method for the electronic health record
Authors: Ahuja Yuri , Zhou Doudou , He Zeling , Sun Jiehuan , Castro Victor M , Gainer Vivian , Murphy Shawn N , Hong Chuan , Cai Tianxi 
Published: April 2020

Abstract

Objective
A major bottleneck hindering utilization of electronic health record data for translational research is the lack of precise phenotype labels. Chart review as well as rule-based and supervised phenotyping approaches require laborious expert input, hampering applicability to studies that require many phenotypes to be defined and labeled de novo. Though International Classification of Diseases codes are often used as surrogates for true labels in this setting, these sometimes suffer from poor specificity. We propose a fully automated topic modeling algorithm to simultaneously annotate multiple phenotypes.

Materials and Methods
Surrogate-guided ensemble latent Dirichlet allocation (sureLDA) is a label-free multidimensional phenotyping method. It first uses the PheNorm algorithm to initialize probabilities based on 2 surrogate features for each target phenotype, and then leverages these probabilities to constrain the LDA topic model to generate phenotype-specific topics. Finally, it combines phenotype-feature counts with surrogates via clustering ensemble to yield final phenotype probabilities.

Results
sureLDA achieves reliably high accuracy and precision across a range of simulated and real-world phenotypes. Its performance is robust to phenotype prevalence and relative informativeness of surogate vs nonsurrogate features. It also exhibits powerful feature selection properties.

Discussion
sureLDA combines attractive properties of PheNorm and LDA to achieve high accuracy and precision robust to diverse phenotype characteristics. It offers particular improvement for phenotypes insufficiently captured by a few surrogate features. Moreover, sureLDA’s feature selection ability enables it to handle high feature dimensions and produce interpretable computational phenotypes.

Conclusions
sureLDA is well suited toward large-scale electronic health record phenotyping for highly multiphenotype applications such as phenome-wide association studies .
A Validated Real-Time PCR Method for the Specific Identification of Probiotic Strain Lactobacillus rhamnosus GG (ATCC 53103)
Authors: Shehata Hanan R , Newmaster Steven G 
Published: April 2020

Abstract

Background
Strain Lactobacillus rhamnosus GG is one of the best-studied and most widely used probiotic strains, with various health benefits. Because probiotic health benefits and safety are strain specific, the availability of a reliable assay for specific identification of Lactobacillus rhamnosus GG is vital to ensure probiotic efficacy.

Objective
To design and validate a probe-based real-time PCR assay for specific identification of strain Lactobacillus rhamnosus GG.

Method
Rapid Annotation using Subsystem Technology (RAST) was used to find a unique sequence region in the genome of Lactobacillus rhamnosus GG. A probe-based assay was designed and evaluated for specificity, sensitivity, efficiency, repeatability, and reproducibility.

Results
RAST identified a unique gene coding for a hypothetical protein in the genome of Lactobacillus rhamnosus GG. The assay successfully amplified all 22 target samples and did not amplify any of the 28 non-target strains, achieving 100% true positive and 0% false positive results. The Limit of Detection (LOD) was determined to be 0.001 ng. Reaction efficiency values, from three dilution series, were 96.4%, 93.3%, and 96.8% with R square values of 0.9974, 0.9981, and 0.9998, respectively. Relative standard deviation (RSD, %) of repeatability was below 1% and RSD of reproducibility was below 4%.

Conclusions
This Lactobacillus rhamnosus GG specific assay proved to be specific, sensitive, efficient, and reproducible. Since the assay was evaluated on two real-time PCR platforms, including a portable one, the assay can be used for onsite testing throughout the supply chain.

Highlights
The availability of validated and reliable assays for strain-specific identification plays a vital role in achieving compliance in probiotic products.
Occurrence of Organochlorine Pesticides in Human Tissues Assessed Using a Microextraction Procedure and Gas Chromatography–Mass Spectrometry
Authors: Pastor Belda Marta , González-Franco José Antonio , Rubio Ricardo , Campillo Natalia , Hernández-Córdoba Manuel , Torres Carmen , Pérez-Cárceles María Dolores , Viñas Pilar 
Published: April 2020

Abstract
This work focuses on the development, validation and application of an analytical method for the determination of twenty organochlorine pesticides (OCPs) in human tissues using salting-out liquid–liquid extraction and dispersive liquid–liquid microextraction for sample preparation and gas chromatography–mass spectrometry to analyze the obtained extracts. Measurement of the concentration levels of these toxics in tissues can be used to assess the risk of the population to exposure. The linearity of the proposed method was verified in the 10–1,000 ng/g range. The sensitivity was evaluated calculating the limits of detection (LODs) for 20 OCPs (α-, β-, γ- and δ-hexachlorocyclohexane (HCH), α- and β-endosulfan, endosulfan sulfate, aldrin, dieldrin, endrin, endrin ketone, endrin aldehyde, α- and γ-chlordane, 4,4′-dichlorodiphenyltrichloroethane, 4,4′-dichlorodiphenyldichloroethylene (DDE), 4,4′-dichlorodiphenyldichloroethane, heptachlor, heptachlor epoxide and methoxychlor), most of them being found between 1.0 and 16 ng/g. The intra- and interday precisions were &lt;12% for relative standard deviation values. The accuracy of the method was evaluated by recovery studies, which gave recovery percentages in the 85–109% range. Seven different tissues (liver, kidney, heart, spleen, lung, brain and abdominal fat) from eight autopsies were analyzed, and only three cases were seen to have β-HCH and 4,4′-DDE in abdominal fat, while 4,4′-DDE was also detected in the heart of one case. The rest of the samples were free of the studied OCPs at least above the corresponding LODs.