bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ability of triage nurses to predict, at the time of triage, the eventual disposition of patients attending the emergency department (ED): a systematic literature review and meta-analysis
Authors: Afnan Michael Anis Mihdi , Netke Tejas , Singh Parminder , Worthington Helena , Ali Fatima , Kajamuhan Changavy , Nagra Arjan 
Published: June 2020

IntroductionExit block is the most significant cause of poor patient flow and crowding in the emergency department (ED). One proposed strategy to reduce exit block is early admission predictions by triage nurses to allow proactive bed management. We report a systematic review and meta-analysis of the accuracy of nurse prediction of admission at triage.MethodologyWe searched MEDLINE, Cochrane, Embase, CINAHL and grey literature, up to and including February 2019. Our criteria were as follows: prospective studies analysing the accuracy of triage nurse intuition—after gathering standard triage information—for predicting disposition for adult ED patients. We analysed the results of this test—nurse prediction of disposition—in a diagnostic test analysis review style, assessing methodology with the Quality Assessment of Diagnostic Accuracy Studies 2 checklist. We generated sensitivity, specificity and likelihood ratios (LRs). We used LRs and pretest probability of admission (baseline admission rate) to find positive and negative post-test probabilities.ResultsWe reviewed 10 articles. Of these, seven had meta-analysable data (12 282 participants). The studies varied in participant selection and admission rate, but the majority were of moderate quality and exclusion of each in sensitivity analyses made little difference. Sensitivity was 72% and specificity was 83%. Pretest probability of admission was 29%. Positive and negative post-test probabilities of admission were 63% and 12%, respectively.ConclusionTriage nurse prediction of disposition is not accurate enough to expedite admission for ED patients on a one-to-one basis. Future research should explore the benefit, and best method, of predicting total demand.
Stress and sleep: a survey based on wearable sleep trackers among medical and nursing staff in Wuhan during the COVID-19 pandemic
Authors: Zhuo Kaiming , Gao Cunyou , Wang Xiaohui , Zhang Chen , Wang Zhen 
Published: June 2020

BackgroudCOVID-19 pandemic has significantly affected the sleep health of local medical and nursing staff.AimWe used wearable pulse oximeters to monitor and screen the medical and nursing staff working in hospitals designated for COVID-19 in the Wuhan area. This study aimed to establish a reliable basis to provide sleep intervention for the medical and nursing staff.MethodsThirty medical and nursing staff members with symptoms of insomnia were instructed to wear medical ring-shaped pulse oximeters to monitor their sleep overnight. We also used the Insomnia Severity Index (ISI) and the Chinese version of the Self-Reporting Questionnaire (SRQ-20) to evaluate the severity of insomnia and mental health status, respectively, for each participant.ResultsAmong the 30 participants, only 26 completed the screening. Ten cases (38.5%) demonstrated moderate to severe sleep apnoea–hypopnea syndrome (SAHS) when using an oxygen desaturation index ≥15 times/hour as the cut-off value. Participants with comorbid moderate to severe SAHS had significantly higher ISI and SRQ scores (p values 0.034 and 0.016, respectively) than those in the insomnia group. Correlation analysis revealed that ISI was positively correlated with total sleep time (TST) (r=0.435, p=0.026), and negatively correlated with deep sleep (r=−0.495, p=0.010); furthermore, patient SRQ scores were positively correlated with TST, sleep efficiency (SE) and REM (rapid eyes movement) sleep % (r=0.454 and 0.389, 0.512; p=0.020, 0.050 and 0.008, respectively). Stepwise logistic regression indicated that SRQ-20 and sex were risk factors for insomnia with comorbid SAHS, and their OR values were 1.516 and 11.56 (95% CI 1.053 to 2.180 and 1.037 to 128.9), respectively.ConclusionMedical and nursing staff with insomnia showed clear signs of comorbid sleep apnoea attributable to stress. The wearable pulse oximeters accurately monitored the participants’ breathing when asleep.
Cancer diagnostic rates during the 2020 ‘lockdown’, due to COVID-19 pandemic, compared with the 2018–2019: an audit study from cellular pathology
Authors: De Vincentiis Ludovica , Carr Richard A , Mariani Maria Paola , Ferrara Gerardo 
Published: June 2020

AimsWe performed an audit to evaluate the impact of the COVID-19 pandemic-related delay in the diagnosis of major cancers at a Pathology Unit of a Secondary Care Hospital Network in Italy.MethodsA comparison was made among the number of first cellular pathological diagnoses of malignancy made from the 11th to the 20th week of the years 2018–2020.ResultsCancer diagnoses fell in 2020 by 39% compared with the average number recorded in 2018 and 2019. Prostate cancer (75%) bladder cancer (66%) and colorectal cancer (CRC; 62%) had the greatest decrease. CRC was identified as carrying a potentially important diagnostic delay.ConclusionsFor CRC corrective procedures (continuing mass screening tests; patient triage by family physicians; diagnostic procedures alternative to colonoscopy; predictive evaluation on biopsy samples) were advised. Our simple audit model is widely applicable to avoid pandemic-related delay in clinical diagnosis of cancer.
Earlier treatment initiation is associated with a decreased number of HIV-1 subtype A1 transmissions in Greece
Authors: Kostaki Evangelia Georgia , Hodges-Mameletzis Ioannis , Magiorkinis Gkikas , Adamis Georgios , Xylomenos Georgios , Nikolopoulos Georgios , Lazanas Marios , Chini Maria , Mangafas Nikos , Skoutelis Athanasios , Papastamopoulos Vasileios , Antoniadou Anastasia , Papadopoulos Antonios , Protopapas Konstantinos , Psichogiou Mina , Basoulis Dimitrios , Chrysos Georgios , Paraskeva Dimitra , Paparizos Vasileios , Kourkounti Sofia , Sambatakou Helen , Sipsas Nikolaos V , Lada Malvina , Panagopoulos Periklis , Maltezos Efstratios , Hatzakis Angelos , Paraskevis Dimitrios 
Published: June 2020

Objectives
Subtypes A1 and B are the most prevalent HIV-1 clades in Greece. Subtype A1 epidemic is highly monophyletic and corresponds to transmissions that occurred locally. Our aim in this molecular epidemiology analysis was to investigate the role of early treatment in preventing new HIV-1 transmissions.

Methods
Our analysis focused on 791 subtype A1 sequences from treatment-naïve individuals in Greece. Estimation of infection dates was performed by molecular clock calculations using Bayesian methods. We estimated the time interval between (1) the infection and sampling dates (linkage to care window), (2) the sampling dates and antiretroviral therapy (ART) initiation (treatment window), and (3) the infection dates and ART initiation (transmissibility window) for the study population. We also inferred the putative source of HIV infections between individuals of different groups divided according to the length of treatment, linkage to care or transmissibility window.

Results
A significant decline was detected for the treatment window during 2014–2015 versus the 2 previous years (p=0.0273), while the linkage to care interval remained unchanged during the study period. Inference of the putative source of HIV infections suggested that individuals with a recent diagnosis or narrow transmissibility window (time period between HIV infection and ART initiation) were not sources of HIV infections to other groups. Contrarily, a significant number of HIV infections originated from individuals with longer transmissibility window interval.

Conclusions
Our findings showed that the treatment window is decreasing over time, presumably due to the updated treatment guidelines. Our study also demonstrates that people treated earlier after infection do not transmit at high rates, thus documenting the benefits of early ART initiation in preventing ongoing HIV-1 transmission.
Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update of clinical management of ischaemic cerebrovascular diseases
Authors: Liu Liping , Chen Weiqi , Zhou Hongyu , Duan Wanying , Li Shujuan , Huo Xiaochuan , Xu Weihai , Huang Li"an , Zheng Huaguang , Liu Jingyi , Liu Hui , Wei Yufei , Xu Jie , Wang Yongjun 
Published: June 2020

Aim
Stroke is the leading cause of disability and death in China. Ischaemic stroke accounts for about 60%–80% of all strokes. It is of considerable significance to carry out multidimensional management of ischaemic cerebrovascular diseases. This evidence-based guideline aims to provide the latest detailed and comprehensive recommendations on the diagnosis, treatment and secondary prevention of ischaemic cerebrovascular diseases.

Methods
We had performed comprehensive searches of MEDLINE (via PubMed) (before 30 June 2019), and integrated the relevant information into charts and distributed to the writing group. Writing group members discussed and determined the recommendations through teleconference. We used the level of evidence grading algorithm of Chinese Stroke Association to grade each recommendation. The draft was reviewed by the Guideline Writing Committee of Chinese Stroke Association Stroke and finalised. This guideline is fully updated every 3 years.

Results
This evidence-based guideline is based on the treatment, care and prevention of ischaemic cerebrovascular diseases, which emphasises on pathogenesis evaluation, intravenous thrombolysis, endovascular therapy, antiplatelet therapy, prevention and treatment of complications, and risk factor management.

Conclusions
This updated guideline presents a framework for the management of ischaemic cerebrovascular diseases. Timely first-aid measures, professional care in the acute stage, and proactive secondary prevention will be helpful to patients.
Examining the decay in serum ferritin following intravenous iron infusion: a retrospective cohort analysis of Olympic sport female athletes
Authors: McKay Alannah K.A. , Goods Paul S.R. , Binnie Martyn J. , Goodman Carmel , Peeling Peter 
Published: June 2020

The long-term decay rate of serum ferritin post-iron infusion in athletic populations is currently unknown. Here, we modelled the decay rate of serum ferritin in female athletes after an intravenous iron infusion (n = 22). The post-infusion serum ferritin response and the rate of decay was highly variable between athletes; however, we demonstrate that follow-up blood testing at 1 (154 μg/L; 77–300 μg/L) and 6 months (107 μg/L; 54–208 μg/L) post-infusion is appropriate to observe treatment efficacy and effectiveness. Novelty Female athletes should have serum ferritin assessed at 1 and 6 months following an intravenous iron infusion to determine efficacy and effectiveness.
Connecting light dirac neutrinos to a multi-component dark matter scenario in gauged $$B-L$$ model
Authors: Nanda Dibyendu , Borah Debasish 
Published: June 2020

AbstractWe propose a new gauged$$B-L$$B-Lextension of the standard model where light neutrinos are of Dirac type, naturally acquiring sub-eV mass after electroweak symmetry breaking, without any additional global symmetries. This is realised by choosing a different$$B-L$$B-Lcharge for right handed neutrinos than the usual$$-1$$-1so that the Dirac Yukawa coupling involves an additional neutrinophilic scalar doublet instead of the usual Higgs doublet. The model can be made anomaly free by considering four additional chiral fermions which give rise to two massive Dirac fermions by appropriate choice of singlet scalars. The choice of scalars not only helps in achieving the desired particle mass spectra via spontaneous symmetry breaking, but also leaves a remnant$$Z_2 \times Z'_2$$Z2×Z2′symmetry to stabilise the two dark matter candidates. Apart from this interesting link between Dirac nature of light neutrinos and multi-component dark matter sector, we also find that the dark matter parameter space is constrained mostly by the cosmological upper limit on effective relativistic degrees of freedom$$\Delta N_{\mathrm{eff}}$$ΔNeffwhich gets enhanced in this model due to the thermalisation of the light right handed neutrinos by virtue of their sizeable$$B-L$$B-Lgauge interactions.
Non-zero torsion and late cosmology
Authors: Cruz Miguel , Izaurieta Fernando , Lepe Samuel 
Published: June 2020

AbstractIn this work, we study some thermodynamical aspects associated with torsion in a flat FLRW spacetime cosmic evolution. By implementing two Ansatze for the torsion term, we find that the model admits a phantom regime or a quintessence behavior. This scheme differs from the$$\Lambda $$ΛCDM model at the thermodynamical level. The resulting cosmic expansion is not adiabatic, the fulfillment of the second law of thermodynamics requires a positive torsion term, and the temperature of the cosmic fluid is always positive. The entropy of the torsion phantom scenario is negative, but introducing chemical potential solves this issue. For a Dirac-Milne type Universe, the torsion leads to a growing behavior for the temperature of the fluid but has no incidence on the rate of expansion.
Circulating Proteoglycan Endocan Mediates EGFR-Driven Progression of Non–Small Cell Lung Cancer
Authors: Yang Yi-Chieh , Pan Ke-Fan , Lee Wei-Jiunn , Chang Jer-Hwa , Tan Peng , Gu Chia-Chi , Chang Wei-Min , Yang Shun-Fa , Hsiao Michael , Hua Kuo-Tai , Chien Ming-Hsien 
Published: June 2020

Abstract

Although new generations of EGFR-tyrosine kinase inhibitors (EGFR-TKI) have been developed for the treatment of patients with non–small cell lung cancer (NSCLC) with EGFR-mutant tumors, TKI resistance often returns as a result of additional EGFR mutations. In addition to seeking for next-generation EGFR-TKI, developing novel EGFR-targeting strategies may hold the key to overcome the vicious cycle of TKI resistance. Endocan is known as a receptor tyrosine kinase ligand enhancer in tumorigenesis, but the impact of endocan on EGFR-driven NSCLC progression remains unknown. In this study, higher endocan levels were found in lung tumors compared with cancer-free tissues and correlated with poor prognosis in patients with NSCLC harboring mutant EGFR; circulating endocan levels were also significantly higher in patients with mutant EGFR. Endocan facilitated EGFR signaling via direct binding and enhancing of the EGF–EGFR interaction and supported the growth of tumors driven by mutated EGFR. Activated EGFR in turn upregulated expression of endocan via JAK/STAT3 and ERK/ELK cascades, thus forming a positive regulatory loop of endocan-EGFR signaling. On the basis of the binding region between endocan and EGFR, we designed therapeutic peptides and demonstrated promising therapeutic effects in xenografts harboring EGFR mutations including TKI-resistant T790M. Together, our findings highlight the novel interaction between endocan and EGFR and new opportunities to effectively target endocan-EGFR regulatory axis in patients with TKI-resistant NSCLC.

Significance:
Endocan is a novel and critical regulator of EGF/EGFR signaling and serves as an alternative target of EGFR-TKI resistance in NSCLC.
Pharmacokinetic Profiles Determine Optimal Combination Treatment Schedules in Computational Models of Drug Resistance
Authors: Irurzun-Arana Itziar , McDonald Thomas O. , Trocóniz Iñaki F. , Michor Franziska 
Published: June 2020

Abstract

Identification of optimal schedules for combination drug administration relies on accurately estimating the correct pharmacokinetics, pharmacodynamics, and drug interaction effects. Misspecification of pharmacokinetics can lead to wrongly predicted timing or order of treatments, leading to schedules recommended on the basis of incorrect assumptions about absorption and elimination of a drug and its effect on tumor growth. Here, we developed a computational modeling platform and software package for combination treatment strategies with flexible pharmacokinetic profiles and multidrug interaction curves that are estimated from data. The software can be used to compare prespecified schedules on the basis of the number of resistant cells where drug interactions and pharmacokinetic curves can be estimated from user-provided data or models. We applied our approach to publicly available in vitro data of treatment with different tyrosine kinase inhibitors of BT-20 triple-negative breast cancer cells and of treatment with erlotinib of PC-9 non–small cell lung cancer cells. Our approach is publicly available in the form of an R package called ACESO (https://github.com/Michorlab/aceso) and can be used to investigate optimum dosing for any combination treatment.

Significance:
These findings introduce a computational modeling platform and software package for combination treatment strategies with flexible pharmacokinetic profiles and multidrug interaction curves that are estimated from data.
Prognostic Value of EndoPredict in Women with Hormone Receptor–Positive, HER2-Negative Invasive Lobular Breast Cancer
Authors: Sestak Ivana , Filipits Martin , Buus Richard , Rudas Margaretha , Balic Marija , Knauer Michael , Kronenwett Ralf , Fitzal Florian , Cuzick Jack , Gnant Michael , Greil Richard , Dowsett Mitch , Dubsky Peter 
Published: June 2020

Abstract

Purpose:
Invasive lobular carcinoma (ILC) accounts for approximately 5%–15% of all invasive breast cancer cases. Most of the correlations between multigene assays and patient outcome were derived from studies based on patients with invasive ductal carcinoma (IDC) or without distinction between the subtypes. Here, we investigate the prognostic value of EndoPredict (EPclin) in a large cohort of ILCs pooled from three phase III randomized trials (ABCSG-6, ABCSG-8, TransATAC).

Experimental Design:
The primary objective of this analysis was to determine the prognostic value of EPclin for distant recurrence (DR) in years 0–10 in postmenopausal women with ILC. The primary outcome was DR.

Results:
470 women (17.9%) presented with ILC, 1,944 (73.9%) with IDC, and 216 (8.2%) with other histologic types. EPclin was highly prognostic in women with ILC [HR = 3.32 (2.54–4.34)] and provided more prognostic value than the Clinical Treatment Score [CTS; HR = 2.17 (1.73–2.72)]. 63.4% of women were categorized into the low EPclin risk group and they had a 10-year DR of 4.8% (2.7–8.4) compared with 36.6% of women in the high-risk group with a 10-year DR risk of 26.6% (20.0–35.0). EPclin also provided highly prognostic information in women with node-negative disease [HR = 2.56 (1.63–4.02)] and node-positive disease [HR = 3.70 (2.49–5.50)].

Conclusions:
EPclin provided highly significant prognostic value and significant risk stratification for women with ILC. Ten-year DR risk in the EPclin low-risk groups were similar between ILC and IDC. Our results show that EPclin is informative in women with ILC and suggest that it is equally valid in both histologic subtypes.
The Long Noncoding RNANEAT1Promotes Sarcoma Metastasis by Regulating RNA Splicing Pathways
Authors: Huang Jianguo , Sachdeva Mohit , Xu Eric , Robinson Timothy J. , Luo Lixia , Ma Yan , Williams Nerissa T. , Lopez Omar , Cervia Lisa D. , Yuan Fan , Qin Xiaodi , Zhang Dadong , Owzar Kouros , Gokgoz Nalan , Seto Andrew , Okada Tomoyo , Singer Samuel , Andrulis Irene L. , Wunder Jay S. , Lazar Alexander J. , Rubin Brian P. , Pipho Krista , Mello Stephano S. , Giudice Jimena , Kirsch David G. 
Published: June 2020

AbstractSoft-tissue sarcomas (STS) are rare malignancies showing lineage differentiation toward diverse mesenchymal tissues. Half of all high-grade STSs develop lung metastasis with a median survival of 15 months. Here, we used a genetically engineered mouse model that mimics undifferentiated pleomorphic sarcoma (UPS) to study the molecular mechanisms driving metastasis. High-grade sarcomas were generated with Cre recombinase technology using mice with conditional mutations in Kras and Trp53 (KP) genes. After amputation of the limb bearing the primary tumor, mice were followed for the development of lung metastasis. Using RNA-sequencing of matched primary KP tumors and lung metastases, we found that the long noncoding RNA (lncRNA) Nuclear Enriched Abundant Transcript 1 (Neat1) is significantly upregulated in lung metastases. Furthermore, NEAT1 RNA ISH of human UPS showed that NEAT1 is upregulated within a subset of lung metastases compared with paired primary UPS. Remarkably, CRISPR/Cas9-mediated knockout of Neat1 suppressed the ability of KP tumor cells to colonize the lungs. To gain insight into the underlying mechanisms by which the lncRNA Neat1 promotes sarcoma metastasis, we pulled down Neat1 RNA and used mass spectrometry to identify interacting proteins. Interestingly, most Neat1 interacting proteins are involved in RNA splicing regulation. In particular, KH-Type Splicing Regulatory Protein (KHSRP) interacts with Neat1 and is associated with poor prognosis of human STS. Moreover, depletion of KHSRP suppressed the ability of KP tumor cells to colonize the lungs. Collectively, these results suggest that Neat1 and its interacting proteins, which regulate RNA splicing, are involved in mediating sarcoma metastasis.Implications:Understanding that lncRNA NEAT1 promotes sarcoma metastasis, at least in part, through interacting with the RNA splicing regulator KHSRP may translate into new therapeutic approaches for sarcoma.
Endoscopic History and Provider Characteristics Influence Gastric Cancer Survival in Asian Americans
Authors: Jeon Christie Y. , Lin Yu-Chen , Klempner Samuel J. , Wu Bechien U. , Kim Sungjin , Waters Kevin M. , Haile Robert W. 
Published: June 2020

Abstract

Gastric carcinoma (GC) disproportionately affects Asian Americans. We examined whether history of upper gastrointestinal (GI) endoscopy was associated with lower stage at GC diagnosis among Asian Americans and whether origin of providers influenced referral for endoscopy. We employed Surveillance Epidemiology and End Results–Medicare data on Asian Americans diagnosed with GC in 2004–2013 (n = 1,554). Stage distribution, GI conditions at diagnosis, and history of endoscopy were compared between Asian ethnic groups. Multivariate logistic regression adjusting for age, sex, poverty level, tumor location, and histology was used to examine the association of ethnicity and endoscopic history with stage I disease at diagnosis of GC. Koreans were more likely to be diagnosed with stage I, T1a GC and have prior history of endoscopy, compared with other Asian ethnicities (24% vs. 8% for stage I, T1a; 40% vs. 15% for endoscopy). Patients with primary care providers of concordant ethnic origin were more likely to have history of endoscopy. Asian American patients with GC with history of endoscopy were more likely to be diagnosed with GC at stage I disease (adjusted OR, 3.07; 95% confidence interval, 2.34–4.02). Compared with other Asian Americans, Koreans were diagnosed with GC at earlier stages owing to common history of endoscopy, which was more often undergone by patients with primary care providers of concordant ethnic origin. Overall, upper GI endoscopy was associated with early detection of GC in Asian Americans. Novelty and Impact. It is well-established that Asian Americans in the United States are disproportionately affected by gastric cancer. In our study we found that Asian American patients treated by physicians of similar ethnic background are more likely to undergo upper GI endoscopy in the United States, leading to early detection of gastric cancer and longer survival. Given this, targeted endoscopic screening in Asian Americans should be considered for early detection of GC.