bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relative burden of lung and pleural cancers from exposure to asbestos: a cross-sectional analysis of occupational mortality in England and Wales
Authors: Harris Elizabeth Clare , D'Angelo Stefania , Darnton Andrew , Coggon David 
Published: April 2020

ObjectivesTo explore the extent to which asbestos-exposed jobs vary in the ratio of excess mortality from lung cancer to deaths from pleural cancer.DesignUsing data on underlying cause of death and last full-time occupation for 3 688 916 deaths among men aged 20–74 years in England and Wales during 1979–2010, we calculated proportional mortality ratios (PMRs), standardised for age and social class, with all occupations combined as reference. For each of 22 asbestos-exposed job groups with significantly elevated PMRs for pleural cancer, we calculated excess mortality from lung cancer (observed minus expected deaths) and its ratio to number of deaths from pleural cancer. To reduce confounding effects of smoking, we adjusted expected deaths from lung cancer in each job group, according to a formula based on its PMR for chronic obstructive pulmonary disease.SettingEngland and Wales.Participants3 688 916 men who died aged 20–74 years during 1979–2010.Outcome measuresRatios of excess mortality from lung cancer to deaths from pleural cancer by job group.ResultsAdjusted PMRs for lung cancer were elevated in all but 4 of the 22 asbestos-exposed job groups, but the ratio of excess lung cancer to deaths from pleural cancer varied widely between job groups, being significantly greater than the overall ratio in six, and significantly less in seven. Analysis for 2001–2010, when (because of changes in coding) ascertainment of pleural tumours was more reliable, showed similar variation between job groups, and indicated an overall ratio of 0.28.ConclusionsExcess lung cancer in asbestos-exposed jobs is not in a simple proportion to deaths from pleural cancer, and the ratio may vary importantly according to intensity of exposure to different types of asbestos and concomitant smoking habits. The current burden of lung cancer from occupational exposure to asbestos in Britain may not be so high as previously thought.
Neuronal pentraxin 2: a synapse-derived CSF biomarker in genetic frontotemporal dementia
Authors: van der Ende Emma L , Xiao Meifang , Xu Desheng , Poos Jackie M , Panman Jessica L , Jiskoot Lize C , Meeter Lieke H , Dopper Elise GP , Papma Janne M , Heller Carolin , Convery Rhian , Moore Katrina , Bocchetta Martina , Neason Mollie , Peakman Georgia , Cash David M , Teunissen Charlotte E , Graff Caroline , Synofzik Matthis , Moreno Fermin , Finger Elizabeth , Sánchez-Valle Raquel , Vandenberghe Rik , Laforce Jr Robert , Masellis Mario , Tartaglia Maria Carmela , Rowe James B , Butler Christopher R , Ducharme Simon , Gerhard Alex , Danek Adrian , Levin Johannes , Pijnenburg Yolande AL , Otto Markus , Borroni Barbara , Tagliavini Fabrizio , de Mendonca Alexandre , Santana Isabel , Galimberti Daniela , Seelaar Harro , Rohrer Jonathan D , Worley Paul F , van Swieten John C 
Published: April 2020

IntroductionSynapse dysfunction is emerging as an early pathological event in frontotemporal dementia (FTD), however biomarkers are lacking. We aimed to investigate the value of cerebrospinal fluid (CSF) neuronal pentraxins (NPTXs), a family of proteins involved in homeostatic synapse plasticity, as novel biomarkers in genetic FTD.MethodsWe included 106 presymptomatic and 54 symptomatic carriers of a pathogenic mutation inGRN,C9orf72orMAPT, and 70 healthy non-carriers participating in the Genetic Frontotemporal dementia Initiative (GENFI), all of whom had at least one CSF sample. We measured CSF concentrations of NPTX2 using an in-house ELISA, and NPTX1 and NPTX receptor (NPTXR) by Western blot. We correlated NPTX2 with corresponding clinical and neuroimaging datasets as well as with CSF neurofilament light chain (NfL) using linear regression analyses.ResultsSymptomatic mutation carriers had lower NPTX2 concentrations (median 643 pg/mL, IQR (301–872)) than presymptomatic carriers (1003 pg/mL (624–1358), p<0.001) and non-carriers (990 pg/mL (597–1373), p<0.001) (corrected for age). Similar results were found for NPTX1 and NPTXR. Among mutation carriers, NPTX2 concentration correlated with several clinical disease severity measures, NfL and grey matter volume of the frontal, temporal and parietal lobes, insula and whole brain. NPTX2 predicted subsequent decline in phonemic verbal fluency and Clinical Dementia Rating scale plus FTD modules. In longitudinal CSF samples, available in 13 subjects, NPTX2 decreased around symptom onset and in the symptomatic stage.DiscussionWe conclude that NPTX2 is a promising synapse-derived disease progression biomarker in genetic FTD.
Left Ventricular Global Longitudinal Strain Is Associated With Long-Term Outcomes in Moderate Aortic Stenosis
Authors: Zhu Dan , Ito Saki , Miranda William R. , Nkomo Vuyisile T. , Pislaru Sorin V. , Villarraga Hector R. , Pellikka Patricia A. , Crusan Daniel J. , Oh Jae K. 
Published: April 2020

Background:
Left ventricular global longitudinal strain (GLS) is associated with long-term outcomes of patients with severe aortic stenosis. However, its prognostic value in patients with moderate aortic stenosis remains unknown.

Methods:

Patients diagnosed with moderate aortic stenosis (1.0< aortic valve area ≤1.5 cm
2
) and left ventricular ejection fraction ≥50% were identified. GLS was assessed by 2-dimensional strain imaging using speckle-tracking method. All-cause mortality was assessed according to the median GLS value.

Results:

Two hundred eighty-seven patients were included (median age 76 years; 47% male). Mean aortic valve area was 1.25 cm
2
, left ventricular ejection fraction 62%, and median GLS −15.2%. During a median follow-up of 3.9 years, there were 103 deaths (36%). Mortality was higher in patients with GLS>−15.2% (hazard ratio 2.62 [95% CI 1.69–4.06]) compared with patients with GLS ≤−15.2% even after adjusting for confounders. Mortality rates at 1, 3, 5 years were 21%, 35%, 48%, respectively, in patients with GLS >−15.2%, and 6%, 15%, 19% in those with GLS ≤−15.2%. Even among those with left ventricular ejection fraction ≥60%, GLS discriminated higher-risk patients (
P
=0.0003). During follow-up, 106 (37%) patients underwent aortic valve replacement with median waiting-time of 2.4 years, and their survival was better than patients without aortic valve replacement. Among those patients undergoing aortic valve replacement, prognosis was still worse in patients with GLS >−15.2% (
P
=0.04). Mortality rates at 1, 3, 5 years were 2%, 10%, 20%, respectively, in patients with GLS >-15.2% and 2%, 5%, 6% in those with GLS ≤−15.2%.

Conclusions:
Impaired GLS in moderate aortic stenosis patients is associated with higher mortality rates even among those undergoing aortic valve replacement.
Change in Body Weight and Long-Term Risk of Stroke and Death in Healthy Men
Authors: Prestgaard Erik , Mariampillai Julian , Engeseth Kristian , Erikssen Jan , Bodegård Johan , Liestøl Knut , Kjeldsen Sverre , Grundvold Irene , Berge Eivind 
Published: April 2020

Background and Purpose—
The importance of weight change for the risk of stroke is not well known. We examined the associations between early- and mid-life weight change and risks of stroke and death during long-term follow-up of healthy men.

Methods—
We recruited healthy men aged between 40 and 59 years and performed a cardiovascular examination at baseline and again at 7 years. We collected data on weight change since the age of 25 (early-life weight change) and measured weight change from baseline to the visit at 7 years (mid-life weight change). For both weight change periods, participants were divided into the following categories: weight loss, weight gain 0 to 4.9 kg, weight gain 5 to 9.9 kg, and weight gain ≥10 kg. Data on stroke and death were collected up to 35 years, from study visits, hospital records, and the National Cause of Death Registry. We used Cox regression to analyze the associations between weight change during early-life and mid-life and risks of stroke and death.

Results—
Of the 2014 participants, 2014 (100%) had data on early-life weight change and were followed for a median of 30.1 years, while 1403 had data on mid-life weight change and were followed for a median of 24.6 years. During early-life, compared with those who had weight gain 0 to 4.9 kg, hazard ratio for stroke was 1.46 (95% CI, 1.09–1.95) among those with weight gain 5 to 9.9 kg, 1.39 (95% CI, 1.03–1.87) for those with weight gain ≥10 kg, and 1.46 (95% CI, 0.99–2.11) among those with weight loss. For all-cause death, the hazard ratios were 1.08 (95% CI, 0.92–1.23), 1.14 (95% CI, 0.98–1.33), and 1.29 (95% CI, 1.06–1.56), respectively. During mid-life, there were no significant differences in risk of stroke or death between the groups.

Conclusions—
Weight increase during early-life, but not mid-life, seems to be associated with increased long-term risk of stroke in healthy men. If these findings can be confirmed, efforts to prevent weight increase should target the younger population.
Outer Rainbands–Driven Secondary Eyewall Formation of Tropical Cyclones
Authors: Wang Yi-Fan , Tan Zhe-Min 
Published: April 2020

AbstractSecondary eyewall formation (SEF) could be considered as the aggregation of a convective-ring coupling with a tangential wind maximum outside the primary eyewall of a tropical cyclone (TC). The dynamics of SEF are investigated using idealized simulations based on a set of triplet experiments, whose differences are only in the initial outer-core wind speed. The triplet experiments indicate that the unbalanced boundary layer (BL) process driven by outer rainbands (ORBs) is essential for the canonical SEF. The developments of a secondary tangential wind maximum and a secondary convective ring are governed by two different pathways, which are well coupled in the canonical SEF. Compared with inner/suppressed rainbands, the downwind stratiform sectors of ORBs drive significant stronger BL convergence at its radially inward side, which fastens up the SEF region and links the two pathways. In the wind-maximum formation pathway, the positive feedback among the BL convergence, supergradient force, and relative vorticity within the BL dominates the spinup of a secondary tangential wind maximum. In the convective-ring formation pathway, the BL convergence contributes to the ascending motion through the frictional-forced updraft and accelerated outflow associated with the supergradient force above the BL. Driven only by inner rainbands, the simulated vortex develops a fake SEF with only the secondary convective ring since the rainband-driven BL convergence is less enhanced and thus fails to maintain the BL positive feedback in the wind-maximum pathway. Therefore, only ORBs can promote the canonical SEF. It also infers that any environmental/physical conditions favorable for the development of ORBs will ultimately contribute to SEF.
Observational Constraint on Greenhouse Gas and Aerosol Contributions to Global Ocean Heat Content Changes
Authors: Charles Elodie , Meyssignac Benoit , Ribes Aurélien 
Published: April 2020

AbstractObservations and climate models are combined to identify an anthropogenic warming signature in the upper ocean heat content (OHC) changes since 1971. We apply a new detection and attribution analysis developed by Ribes et al. that uses a symmetric treatment of the magnitude and the pattern of the climate response to each radiative forcing. A first estimate of the OHC response to natural, anthropogenic, greenhouse gas, and other forcings is derived from a large ensemble of CMIP5 simulations. Observational datasets from historical reconstructions are then used to constrain this estimate. A spatiotemporal observational mask is applied to compare simulations with actual observations and to overcome reconstruction biases. Results on the 0–700-m layer from 1971 to 2005 show that the global OHC would have increased since 1971 by 2.12 ± 0.21 × 107J m−2yr−1in response to GHG emissions alone. But this has been compensated for by other anthropogenic influences (mainly aerosol), which induced an OHC decrease of 0.84 ± 0.18 × 107J m−2yr−1. The natural forcing has induced a slight global OHC decrease since 1971 of 0.13 ± 0.09 × 107J m−2yr−1. Compared to previous studies we have separated the effect of the GHG forcing from the effect of the other anthropogenic forcing on OHC changes. This has been possible by using a new detection and attribution (D&A) method and by analyzing simultaneously the global OHC trends over 1957–80 and over 1971–2005. This bivariate method takes advantage of the different time variation of the GHG forcing and the aerosol forcing since 1957 to separate both effects and reduce the uncertainty in their estimates.
Comparison of Single-Valued Forecasts in a User-Oriented Framework
Authors: Foley Michael , Loveday Nicholas 
Published: April 2020

Abstract
We compare single-valued forecasts from a consensus of numerical weather prediction models to forecasts from a single model across a range of user decision thresholds and sensitivities, using the relative economic value framework, and present this comparison in a new graphical format. With the help of a simple linear error model, we obtain theoretical results and perform synthetic calculations to gain insights into how the results relate to the characteristics of the different forecast systems. We find that multimodel consensus forecasts are more beneficial for users interested in decisions near the climatological mean, due to their reduced spread of errors compared to the constituent models. Single model forecasts may present greater benefit for users sensitive to extreme events if the forecasts have smaller conditional biases than the consensus forecasts and hence better resolution of such events. The results support use of consensus averaging approaches for single-valued forecast services in typical conditions. However, it is hard to cater for all user sensitivities in more extreme conditions. This underscores the importance of providing probability-based services for unusual conditions.
Radiation-resistance increased by overexpression of microRNA-21 and inhibition of its target PTEN in esophageal squamous cell carcinoma
Authors: Peng Jun , Lv Yinxiang , Wu Chaochao 
Published: April 2020

Objective Overexpression of microRNA-21 (miR-21) increases the radiation resistance of esophageal squamous cell carcinoma (ESCC). However, the molecular mechanism responsible for this action is still unclear. In the present study, we investigated the role of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) in miR-21-enhanced radiation resistance in patients with ESCC. Methods We evaluated the association between miR-21 levels and radiation resistance in patients with ESCC. We also investigated the role of PTEN in the proliferation and apoptosis of ESCC cells transfected with miR-21 inhibitor during irradiation, using PTEN small interfering RNA (siRNA). Results MiR-21 levels were significantly higher in radiation-resistant patients. Downregulation of miR-21 during irradiation suppressed the radiation resistance of ESCC cells, demonstrated by decreased cell proliferation and increased cell apoptosis. PTEN siRNA attenuated miR-21-induced suppression of radiation resistance in ESCC cells. Conclusions These results suggest that miR-21 enhanced the radiation resistance of ESCC by inhibiting PTEN. MiR-21 and PTEN are potential therapeutic biotargets for ESCC.
Identifying End-of-Life Preferences Among Chinese Patients With Cancer Using the Heart to Heart Card Game
Authors: Li Tong , Pei Xianbo , Chen Xiaoli , Zhang Shuqin 
Published: April 2020

Background: Understanding the preferences for end-of-life (EOL) care is imperative in providing quality care to patients with life-threatening illness. However, it is difficult for patients, families, and health-care providers to initiate EOL conversations in China. An easy-to-use tool that could help health-care providers initiate EOL discussions is the Heart to Heart Card Game (HHCG), originally designed for Chinese Americans. Objective: To evaluate the EOL preferences among Chinese patients with cancer using the HHCG. Methods: We conducted a descriptive study to assess EOL preferences using HHCG among patients at the oncology chemoradiotherapy department of a Chinese tertiary hospital. Results: We recruited 58 patients in total of which 40 (69%) patients completed HHCG. The most frequently selected card was “I want my family to get along,” followed by “I don’t want to be a burden to my family,” and “I want to maintain my dignity.” Among the 3 cards selected, social needs were rated as the most important (36.7%), followed by spiritual needs (35.8%), physical needs (20.0%), and financial needs (7.5%). The evaluation of the HHCG revealed that more than 70% of the participants highly valued HHCG. Conclusion: The HHCG can be used as a communication tool to encourage EOL discussions between cancer patients and health-care providers in China. Moreover, Chinese patients with cancer attach significant importance to their family and maintaining dignity at the EOL.
#Cleftlip/Palate: What Is the World Talking About?
Authors: Hudson Alexandra S. , Morzycki Alexander D. , Guilfoyle Regan 
Published: April 2020

Objective: Studies have begun analyzing how the world converses on social media platforms about medical/surgical topics. This study’s objective was to examine how cleft lip and palate, two of the most common birth defects in the world, are discussed on the social media platform Twitter. No study to date has analyzed this topic. Methods: Tweets were identified using any of the following: cleft, cleft lip, cleft palate, #cleft, #cleftlip, #cleftpalate. Eight months between 2017 and 2018 were analyzed. Main Outcome Measures: The primary outcome was the tweet subject matter. Secondary outcomes were author characteristics, tweet engagement, multimedia, and tweet accuracy Results: A total of 1222 tweets were included. #Cleft was the most common hashtag (71%), and it was significantly associated with more retweets ( P = .03). Twenty-seven countries tweeted, with the United States (34%) and India (27%) producing the most. Charities (36%), hospitals (14%), and physicians (13%) were the most common authors. Over three-quarters of tweets were self-promotional. The top content included charity information (22%) and patients’ cleft stories (14%). Tweets about patient safety/care and surgical service trips generated the most engagement. The accuracy of educational tweets was 38% low accuracy and 1% inaccurate. One hundred forty-nine tweets (12%) discussed a published research article, but 41 tweets did not share a link. Conclusions: Charities dominate the cleft lip/palate “Twitterverse.” Most tweets were self-promotional, and over a third of educational tweets were low accuracy. As the cleft social media community continues to grow, we recommend using the hashtag #cleft to reach a wider audience.
Long-Term Outcome of Chimney Technique Using a Balloon-Expandable Bare-Metal Stent to Preserve Supra-Arch Branches in Type B Aortic Dissection
Authors: Sun Guoyi , Ge Yang-yang , Guo Wei , Jia Xin , Rong Dan , Liu Xiao-ping , Xiong Jiang , Zhang Hong-peng , Ma Xiao-hui 
Published: April 2020

Purpose: This study was performed to investigate the long-term effect of chimney technique using balloon-expandable bare-metal stents (BMSs) to preserve the supra-arch branches in type B aortic dissection (TBAD). Methods: Fifty patients with TBAD treated by thoracic endovascular aortic repair with the chimney technique (chTEVAR) using balloon-expandable BMSs from July 2009 to December 2013 were retrospectively assessed. Follow-up computed tomography angiography was performed to assess the postoperative outcomes. The primary end point was a persistent type Ia endoleak (ELIa). The secondary endpoints were chimney stent (CS)-based complications (stenosis, occlusion, fracture, or transposition), all-cause mortality, reintervention, and stroke. Results: Fifty supra-arch branches (left common carotid artery, n = 11; left subclavian artery, n = 39) were preserved via the chimney technique with 50 balloon-expandable BMSs. The technical success rate was 100%. An immediate ELIa was discovered in 9 (18%) patients. The median survival duration during follow-up was 77.3 months. Five (10%) patients had a persistent ELIa; 3 of these patients had an immediate ELIa. Asymptomatic CS-based complications were found in 3 (6%) patients. The all-cause mortality rate was 8% (4/50); 2 deaths were aortic-related deaths. Five (10%) patients underwent a reintervention. During the estimated 36-month survival period, the survival rate, the rate of freedom from persistent ELIa, and the rate of freedom from reintervention were 93.87%, 89.48%, and 95.56%, respectively. Conclusions: The long-term outcomes showed that chTEVAR using balloon-expandable BMSs was safe and feasible for preservation of the supra-arch branches. Evaluation of more patients with a longer follow-up period is needed.
Opioid Use After Common Sports Medicine Procedures: A Systematic Review
Authors: Sheth Ujash , Mehta Mitesh , Huyke Fernando , Terry Michael A. , Tjong Vehniah K. 
Published: April 2020

Context: The prescription of opioids after elective surgical procedures has been a contributing factor to the current opioid epidemic in North America. Objective: To examine the opioid prescribing practices and rates of opioid consumption among patients undergoing common sports medicine procedures. Data Sources: A systematic review of the electronic databases EMBASE, MEDLINE, and PubMed was performed from database inception to December 2018. Study Selection: Two investigators independently identified all studies reporting on postoperative opioid prescribing practices and consumption after arthroscopic shoulder, knee, or hip surgery. A total of 119 studies were reviewed, with 8 meeting eligibility criteria. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: The quantity of opioids prescribed and used were converted to milligram morphine equivalents (MMEs) for standardized reporting. The quality of each eligible study was evaluated using the Methodological Index for Non-Randomized Studies. Results: A total of 8 studies including 816 patients with a mean age of 43.8 years were eligible for inclusion. A mean of 610, 197, and 613 MMEs were prescribed to patients after arthroscopic procedures of the shoulder, knee, and hip, respectively. At final follow-up, 31%, 34%, and 64% of the prescribed opioids provided after shoulder, knee, and hip arthroscopy, respectively, still remained. The majority of patients (64%) were unaware of the appropriate disposal methods for surplus medication. Patients undergoing arthroscopic rotator cuff repair had the highest opioid consumption (471 MMEs), with 1 in 4 patients receiving a refill. Conclusion: Opioids are being overprescribed for arthroscopic procedures of the shoulder, knee, and hip, with more than one-third of prescribed opioids remaining postoperatively. The majority of patients are unaware of the appropriate disposal techniques for surplus opioids. Appropriate risk stratification tools and evidence-based recommendations regarding pain management strategies after arthroscopic procedures are needed to help curb the growing opioid crisis.