bluuebunny/crossref_metadata_2025_split huggingface dataset:
Joint associations of accelerometer-measured physical activity and sedentary time with all-cause mortality: a harmonised meta-analysis in more than 44 000 middle-aged and older individuals
Authors: Ekelund Ulf , Tarp Jakob , Fagerland Morten W , Johannessen Jostein Steene , Hansen Bjørge H , Jefferis Barbara J , Whincup Peter H , Diaz Keith M , Hooker Steven , Howard Virginia J , Chernofsky Ariel , Larson Martin G , Spartano Nicole , Vasan Ramachandran S , Dohrn Ing-Mari , Hagströmer Maria , Edwardson Charlotte , Yates Thomas , Shiroma Eric J , Dempsey Paddy , Wijndaele Katrien , Anderssen Sigmund A , Lee I-Min 
Published: November 2020

ObjectivesTo examine the joint associations of accelerometer-measured physical activity and sedentary time with all-cause mortality.MethodsWe conducted a harmonised meta-analysis including nine prospective cohort studies from four countries. 44 370 men and women were followed for 4.0 to 14.5 years during which 3451 participants died (7.8% mortality rate). Associations between different combinations of moderate-to-vigorous intensity physical activity (MVPA) and sedentary time were analysed at study level using Cox proportional hazards regression analysis and summarised using random effects meta-analysis.ResultsAcross cohorts, the average time spent sedentary ranged from 8.5 hours/day to 10.5 hours/day and 8 min/day to 35 min/day for MVPA. Compared with the referent group (highest physical activity/lowest sedentary time), the risk of death increased with lower levels of MVPA and greater amounts of sedentary time. Among those in the highest third of MVPA, the risk of death was not statistically different from the referent for those in the middle (16%; 95% CI 0.87% to 1.54%) and highest (40%; 95% CI 0.87% to 2.26%) thirds of sedentary time. Those in the lowest third of MVPA had a greater risk of death in all combinations with sedentary time; 65% (95% CI 1.25% to 2.19%), 65% (95% CI 1.24% to 2.21%) and 263% (95% CI 1.93% to 3.57%), respectively.ConclusionHigher sedentary time is associated with higher mortality in less active individuals when measured by accelerometry. About 30–40 min of MVPA per day attenuate the association between sedentary time and risk of death, which is lower than previous estimates from self-reported data.
Standardised protocol for a prospective cross-sectional multicentre clinic-based evaluation of two dual point-of-care tests for the screening of HIV and syphilis in men who have sex with men, sex workers and pregnant women
Authors:   The ProSPeRo Network
Published: November 2020

IntroductionDual point-of-care tests (POCTs) for detecting antibodies to HIV and syphilis have been developed for use with venous whole blood, serum/plasma or finger-prick capillary whole blood. Several tests are commercially available showing encouraging performance compared with ‘gold-standard’ reference tests in laboratory-based studies. However, data on their performance in the field are limited. This prospective cross-sectional study will conduct a clinic-based evaluation to assess the performance characteristics and acceptability to end-users of two dual HIV/syphilis POCTs for the screening of HIV and syphilis among men who have sex with men (MSM), sex workers (SWs) and pregnant women (PW). This master protocol outlines the overall research approach that will be used in seven countries.Method and analysisMSM, SWs and PW presenting at clinic evaluation sites in high, low and middle-income countries will be enrolled. The (WHO preapproved) POCTs to be evaluated are SD Bioline HIV/Syphilis Duo (Abbott) and Dual Path Platform HIV-Syphilis Assay (Chembio). Finger-prick blood will be collected to perform POCTs and compared with laboratory results (venepuncture blood). Procedures will be carried out by trained healthcare staff and tests performed according to the manufacturers’ directions. Sample size was calculated based on local prevalence of HIV and syphilis. The sensitivity, specificity, positive and negative predictive values for each POCT will be calculated. The study is ongoing with recruitment expected to be completed in all countries by mid to late 2021.Ethics and disseminationThis core protocol was independently peer reviewed and approved by the Research Project Review Panel (RP2) of the WHO Department of Sexual and Reproductive Health and Research and by the WHO Ethics Review Committee (ERC). The protocol has been adapted to individual countries and approved by RP2, ERC and institutional review boards at each site. Results will be disseminated through peer-reviewed journals and relevant conferences.
Novel facial characteristics in congenital rubella syndrome: a study of 115 cases in a cardiac hospital of Bangladesh
Authors: Begum Nurun Nahar Fatema 
Published: November 2020

ObjectiveTo establish novel facial characteristics unique to congenital rubella syndrome (CRS) as prediagnostic criteria to supplement disease diagnosis in patients with or without a history of maternal rubella infection.DesignAn analysis of 115 CRS case series (2018–2020) based on the presence of any of the triad features.SettingOutpatient department of a tertiary care referral cardiac hospital in Dhaka, Bangladesh.ParticipantsIn total, 115 participants (53.1% men) were enrolled. Participants underwent echocardiography if they presented with suspected cardiac symptoms along with deafness, cataract or microcephaly.Main outcome measuresAge, sex and socioeconomic status of the participants; history of maternal vaccination and infection; facial characteristics unique to CRS (triangular face, prominent nose, wide forehead and a whorl on either side of the anterior hairline) named ‘rubella facies’ and frequency of systemic involvements in CRS.ResultsThe median patient age was 2 years. The income of 50.4% of the participating families was <US$1500. Further, 32 mothers (27.8%) were infected with rubella during the first trimester of pregnancy, 15 (13.0%) during the second trimester and 3 (2.6%) during the third trimester. The remainder (65.2%) recalled no history of infection during pregnancy. Rubella facies presented as a triangular-shaped face in 95 (82.6%) cases, a broad forehead in 88 (76.5%) and a prominent nose in 75 (65.2%). A rubella whorl was present on the right or left side of the anterior hairline in 80% and 18.2% of cases, respectively. IgG and IgM antibodies were present in 91.3% and 8.6% of children, respectively. Cataract, deafness, microcephaly, and congenital heart disease were detected in 53.0%, 75.6%, 68.6% and 98.2% of cases, respectively.ConclusionsRubella facies, a set of unique facial characteristics, can support early CRS diagnosis and treatment and may supplement the existing CRS triad.
Oxygen therapy and inpatient mortality in COPD exacerbation
Authors: Echevarria Carlos , Steer John , Wason James , Bourke Stephen 
Published: November 2020

BackgroundIn hospitalised patients with exacerbation of Chronic Obstructive Pulmonary Disease, European and British guidelines endorse oxygen target saturations of 88%–92%, with adjustment to 94%–98% if carbon dioxide levels are normal. We assessed the impact of admission oxygen saturation level and baseline carbon dioxide on inpatient mortality.MethodsPatients were identified from the prospective Dyspnoea, Eosinopenia, Consolidation, Acidaemia and Atrial Fibrillation (DECAF) derivation study (December 2008–June 2010) and the mixed methods DECAF validation study (January 2012 to May 2014). In six UK hospitals, of 2645 patients with COPD exacerbation, 1027 patients were in receipt of supplemental oxygen at admission. All had a clinical history of COPD and obstructive spirometry. These patients were subdivided into the following groups: admission oxygen saturations of 87% or less, 88%–92%, 93%–96% or 97%–100%. Inpatient mortality was calculated for each group and expressed as ORs. The DECAF score and National Early Warning Score 2 (excluding oxygen saturation) were used in binary logistic regression to adjust for baseline risk.ResultsIn patients with COPD receiving supplemental oxygen, oxygen saturations above 92% were associated with higher mortality and an adverse dose–response. Compared with the 88%–92% group, the adjusted risk of death (OR) in the 93%–96% and 97%–100% groups was 1.98 (95% CI 1.09 to 3.60, p=0.025) and 2.97 (95% CI 1.58 to 5.58, p=0.001). In the subgroup with normocapnia, the mortality signal remained significant in both the 93%–96% and 97%–100% groups.ConclusionsInpatient mortality was lowest in those with oxygen saturations of 88%–92%. Even modest elevations in oxygen saturations above this range (93%–96%) were associated with an increased risk of death. A similar mortality trend was seen in both patients with hypercapnia and normocapnia. This shows that the practice of setting different target saturations based on carbon dioxide levels is not justified. Treating all patients with COPD with target saturations of 88%–92% will simplify prescribing and should improve outcome.Trial registration numberUKCRN ID 14214.
Psychological distress during the COVID-19 pandemic in France: a national assessment of at-risk populations
Authors: Chaix Benjamin , Delamon Guillaume , Guillemassé Arthur , Brouard Benoît , Bibault Jean-Emmanuel 
Published: November 2020

BackgroundLockdowns were implemented to limit the spread of COVID-19. Peritraumatic distress (PD) and post-traumatic stress disorder have been reported after traumatic events, but the specific effect of the pandemic is not well known.AimThe aim of this study was to assess PD in France, a country where COVID-19 had such a dramatic impact that it required a country-wide lockdown.MethodsWe recruited patients in four groups of chatbot users followed for breast cancer, asthma, depression and migraine. We used the Psychological Distress Inventory (PDI), a validated scale to measure PD during traumatic events, and correlated PD risk with patients’ characteristics in order to better identify the ones who were the most at risk.ResultsThe study included 1771 participants. 91.25% (n=1616) were female with a mean age of 32.8 (13.71) years and 7.96% (n=141) were male with a mean age of 28.0 (8.14) years. In total, 38.06% (n=674) of the respondents had psychological distress (PDI ≥14). An analysis of variance showed that unemployment and depression were significantly associated with a higher PDI score. Patients using their smartphones or computers for more than 1 hour a day also had a higher PDI score (p=0.026).ConclusionPrevalence of PD in at-risk patients is high. These patients are also at an increased risk of developing post-traumatic stress disorder. Specific steps should be implemented to monitor and prevent PD through dedicated mental health policies if we want to limit the public health impact of COVID-19 in time.Trial registration numberNCT04337047.
Time for time off? Secondary public holiday shows minimal net hospitalisation benefit
Authors: Telfar Barnard Lucy Frances 
Published: November 2020

BackgroundWe aimed to use New Zealand’s Anzac Day to test the public health effect of secondary public holidays; and to use weekly hospitalisation counts to identify which dates were more health suitable for a potential new public holiday.MethodsWe conducted a retrospective population cohort study of hospital admissions in New Zealand between 23 April and 27 May 1988–2018. We compared acute and arranged hospitalisation and mortality rates in holiday (Anzac Day Monday to Friday) and non-holiday (Anzac Day Saturday or Sunday) years, for mid-week holidays and long weekends; and measured total weekly average acute and arranged hospitalisation counts.ResultsHospitalisation rates were lower in holiday years than non-holiday years (rate ratio (RR) 0.96, 95% CI 0.95 to 0.96, p<0.001), with fewer arranged admissions (RR 0.93, 95% CI 0.93 to 0.94, p<0.001), but no significant difference for acute admissions (RR 1.00, 95% CI 0.99 to 1.00, p=0.087). Holiday year acute admission rates were lower than non-holiday years for children aged 0–4 years, but higher for adults aged 15–44 years. Holidays reduced arranged admissions most in children and areas of higher socioeconomic deprivation. There was no significant difference for mortality. Average weekly acute hospitalisations were higher than arranged admissions between 10 June and 7 October.ConclusionSecondary holidays do not reduce deaths; or acute hospital admissions except in the holiday week; and may delay elective treatment. However, if New Zealand is to add a new public holiday, it would have least detrimental health effect scheduled between 10 June and 7 October.
Local IFNα enhances the anti-tumoral efficacy of systemic anti-PD1 to prevent tumor relapse
Authors: Guerin Marion v , Regnier Fabienne , Thoreau Maxime , Vimeux Lene , Benard Matthieu , Dransart Estelle , Penny Hweixian L , Johannes Ludger , Trautmann Alain , Bercovici Nadege 
Published: November 2020

BackgroundTumor relapse constitutes a major challenge for anti-tumoral treatments, including immunotherapies. Indeed, most cancer-related deaths occur during the tumor relapse phase.MethodsWe designed a mouse model of tumor relapse in which mice transplanted with E7+TC1 tumor cells received a single therapeutic vaccination of STxB-E7+IFNα. Unlike the complete regression observed after two vaccinations, such a treatment induced a transient shrinkage of the tumor mass, followed by a rapid tumor outgrowth. To prevent this relapse, we tested the efficacy of a local administration of IFNα together with a systemic therapy with anti-PD1 Ab. The immune response was analyzed during both the tumor regression and relapse phases.ResultsWe show that, during the regression phase, tumors of mice treated with a single vaccination of STxB-E7 + IFNα harbor fewer activated CD8 T cells and monocytes than tumors doomed to fully regress after two vaccinations. In contrast, the systemic injection of an anti-PD1 Ab combined with the peri-tumoral injection of IFNα in this time frame promotes infiltration of activated CD8 T cells and myeloid cells, which, together, exert a high cytotoxicity in vitro against TC1 cells. Moreover, the IFNα and anti-PD1 Ab combination was found to be more efficient than IFNα or anti-PD1 used alone in preventing tumor relapse and was better able to prolong mice survival.ConclusionsTogether, these results indicate that the local increase of IFNα in combination with an anti-PD1 therapy is an effective way to promote efficient and durable innate and adaptive immune responses preventing tumor relapse.
Plasma microRNA signature in presymptomatic and symptomatic subjects with C9orf72-associated frontotemporal dementia and amyotrophic lateral sclerosis
Authors: Kmetzsch Virgilio , Anquetil Vincent , Saracino Dario , Rinaldi Daisy , Camuzat Agnès , Gareau Thomas , Jornea Ludmila , Forlani Sylvie , Couratier Philippe , Wallon David , Pasquier Florence , Robil Noémie , de la Grange Pierre , Moszer Ivan , Le Ber Isabelle , Colliot Olivier , Becker Emmanuelle 
Published: November 2020

ObjectiveTo identify potential biomarkers of preclinical and clinical progression in chromosome 9 open reading frame 72 gene (C9orf72)-associated disease by assessing the expression levels of plasma microRNAs (miRNAs) in C9orf72 patients and presymptomatic carriers.MethodsThe PREV-DEMALS study is a prospective study including 22 C9orf72 patients, 45 presymptomatic C9orf72 mutation carriers and 43 controls. We assessed the expression levels of 2576 miRNAs, among which 589 were above noise level, in plasma samples of all participants using RNA sequencing. The expression levels of the differentially expressed miRNAs between patients, presymptomatic carriers and controls were further used to build logistic regression classifiers.ResultsFour miRNAs were differentially expressed between patients and controls: miR-34a-5p and miR-345-5p were overexpressed, while miR-200c-3p and miR-10a-3p were underexpressed in patients. MiR-34a-5p was also overexpressed in presymptomatic carriers compared with healthy controls, suggesting that miR-34a-5p expression is deregulated in cases with C9orf72 mutation. Moreover, miR-345-5p was also overexpressed in patients compared with presymptomatic carriers, which supports the correlation of miR-345-5p expression with the progression of C9orf72-associated disease. Together, miR-200c-3p and miR-10a-3p underexpression might be associated with full-blown disease. Four presymptomatic subjects in transitional/prodromal stage, close to the disease conversion, exhibited a stronger similarity with the expression levels of patients.ConclusionsWe identified a signature of four miRNAs differentially expressed in plasma between clinical conditions that have potential to represent progression biomarkers for C9orf72-associated frontotemporal dementia and amyotrophic lateral sclerosis. This study suggests that dysregulation of miRNAs is dynamically altered throughout neurodegenerative diseases progression, and can be detectable even long before clinical onset.Trial registration numberNCT02590276.
Impact of timing of atrial fibrillation, CHA2DS2-VASc score and cancer therapeutics on mortality in oncology patients
Authors: Hussain Muzna , Misbah Rabel , Donnellan Eoin , Alkharabsheh Saqer , Hou Yuan , Cheng Feixiong , Crookshanks Michael , Watson Chris J , Toth Andrew J , Houghtaling Penny , Moudgil Rohit , Budd G Thomas , Tang W H Wilson , Kwon Deborah H , Jaber Wael , Griffin Brian , Kanj Mohamad , Collier Patrick 
Published: November 2020

ObjectivesTo investigate timing and age distribution of atrial fibrillation (AF) in selected oncology patients, and the impact of AF timing, CHA2DS2-VASc score and cancer therapeutics on mortality.MethodsThis is a retrospective cohort study of oncology patients referred to the cardio-oncology service from 2011 to 2018 for echocardiographic cardiosurveillance and/or pre-existing cardiovascular risk factor/disease management. Rates of first AF diagnosis was assessed using a parametric multiphase hazard model (predictive modelling) and non-parametrically by Kaplan-Meier with transformations tested using a bootstrap methodology.ResultsAmong 6754 patients identified, 174 patients had their first AF diagnosisbeforecancer while 609 patients had their first diagnosis of AFaftercancer. Most first AF diagnosis occurred at/early after cancer diagnosis. Increasing AF prevalence at time of cancer diagnosis was seen across older age groups ranges. Diagnosis of cancer at an older age and exposure to cardiotoxic treatment (anthracyclines, HER2-neu inhibitors, tyrosine kinase inhibitors including ibrutinib and radiation) were associated with an increased risk of AF.Modelling of the hazard function of AF identified a high left-skewed peak within 3 years after cancer diagnosis (‘early phase’), followed by a gradual late slight rise 3 years after cancer diagnosis (‘late phase’). AF diagnosis was only associated with death in the early phase (p<0.001), while CHA2DS2-VASc score was only associated with death in the late phase (p<0.001).ConclusionsThis study reports a nuanced/complex relationship between AF and cancer. First diagnosis of AF in patients with cancer was more common at/early after cancer diagnosis, especially in older patients and those exposed to cardiotoxic treatment. Pre-existing AF or a diagnosis of AF within 3 years after cancer diagnosis carried a negative prognosis. CHA2DS2-VASc score did not relate to mortality in those that developed AF within 3 years of cancer diagnosis.
Hourly staircase sprinting exercise “snacks” improve femoral artery shear patterns but not flow-mediated dilation or cerebrovascular regulation: a pilot study
Authors: Caldwell Hannah G. , Coombs Geoff B. , Rafiei Hossein , Ainslie Philip N. , Little Jonathan P. 
Published: November 2020

Healthy males (n = 10; age: 24 ± 4 years; body mass index: 24 ± 2 kg·m−2) completed 2 randomized conditions separated by ≥48 h involving 6–8.5 h of sitting with (“stair snacks”) and without (sedentary) hourly staircase sprint interval exercise (∼14–20 s each). Resting blood flow and shear rates were measured in the femoral artery, internal carotid artery, and vertebral artery (Duplex ultrasound). Flow-mediated dilation (FMD) was quantified as an index of peripheral endothelial function in the femoral artery. Neurovascular coupling (NVC; regional blood flow response to local increases in cerebral metabolism) was assessed in the posterior cerebral artery (transcranial Doppler ultrasound). Femoral artery hemodynamics were higher following the active trial with no change in the sedentary trial, including blood flow (+32 ± 23% vs. −10 ± 28%; P = 0.015 and P = 0.253, respectively), vascular conductance (+32 ± 27% vs. −15 ± 26%; P = 0.012 and P = 0.098, respectively), and mean shear rate (+17 ± 8% vs. −8 ± 28%; P = 0.004 and P = 0.310, respectively). The change in FMD was not different within or between conditions (P = 0.184). Global cerebral blood flow (CBF), conductance, shear patterns, and NVC were not different within or between conditions (all P > 0.05). Overall, exercise “stair snacks” improve femoral artery blood flow and shear patterns but not peripheral (e.g., FMD) or cerebral (e.g., CBF and NVC) vascular function following prolonged sitting. The study was registered at ClinicalTrials.gov (NCT03374436). Novelty: Breaking up 8.5 h of sitting with hourly staircase sprinting exercise “snacks” improves resting femoral artery shear patterns but not FMD. Cerebral blood flow and neurovascular coupling were unaltered following 6 h of sitting with and without hourly exercise breaks.
The secrets of writing a truly useful executive summary
Authors: Yaffe Philip 
Published: November 2020

Each "Communication Corner" essay is self-contained; however, they build on each other. For best results, before reading this essay and doing the exercise, go to the first essay "How an Ugly Duckling Became a Swan," then read each succeeding essay.
The purpose of an executive summary is not to summarize, but to direct the reader's interest. The wider the intended audience, the wider will be their range of specific interests. But however diverse the readership, they want the document to clearly direct them to what they must read, leaving any additional text they may wish to also peruse to their own judgement.
MODERN APPROACHES TO THE TREATMENT OF ENDOMETRIOID CYSTS BEFORE CONTROLLED OVARIAN STIMULATION PROTOCOLS
Authors: Khmil S. V. , Pidhaina I. Ya. , Kulyk I. I. 
Published: November 2020

The article is devoted to the current problem of endometriosis-associated infertility. In recent years, a great deal of information has been accumulated on the etiology, diagnosis and treatment of genital endometriosis and endometriosis-associated infertility. According to world studies, endometriosis remains one of the most pressing problems in modern gynecology. This is evidenced by statistics showing that the disease occurs in every 10 women of fertile age, and a total of 176 million women worldwide. Approximately 20–50 % of women included in this number have a problem of infertility. Hence, the problem of this disease is not only a medical but also a social problem.
Conclusions. The tactics of treatment of patients with endometriosis who are planning a pregnancy and are included in the ART protocols are significantly different from the tactics of treatment of patients who believe that they have performed reproductive function.