bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spontaneous vaginal birth varies significantly across US hospitals
Authors: Clark Rebecca R. S. , Lake Eileen T. 
Published: November 2020

AbstractBackgroundBirth is the most common reason for hospitalization in the United States. Hospital variation in maternal outcomes is an important indicator of health care quality. Spontaneous vaginal birth (SVB) is the most optimal birth outcome for the majority of mothers and newborns. The purpose of this study was to examine hospital‐level variation in SVB overall and among low‐risk women in a four‐state sample representing 25% of births in the United States in 2016.MethodsWomen giving birth in California, Pennsylvania, New Jersey, and Florida were identified in 2016 state discharge abstracts. Patient data were merged with hospital data from the American Hospital Association's (AHA) 2016 Annual Survey. Overall and low‐risk SVB rates were calculated for each hospital in the sample and stratified by bed size, teaching status, rurality, birth volume, and state.ResultsOur final sample included 869 681 women who gave birth in 494 hospitals. The mean overall SVB rate in the sample was 61.1%, ranging from 16.8% to 79.9%. The mean low‐risk SVB rate was 78% and ranged from 34.6% to 93.3%. Variation in SVB rates cut across all the hospital structural characteristic strata.DiscussionThe wide variation in SVB rates indicates significant room for improvement in this maternal quality metric. Our finding, that hospitals of all types and locations had both low and high SVB rates, suggests that excellent maternal outcomes are possible in all hospital settings. The variation in SVB rates across hospitals warrants research into modifiable hospital factors that may be influencing SVB rates.
Patterns and trends in eczema management in UK primary care (2009–2018): A population‐based cohort study
Authors: de Lusignan Simon , Alexander Helen , Broderick Conor , Dennis John , McGovern Andrew , Feeney Clarie , Flohr Carsten 
Published: November 2020

AbstractBackgroundDespite the high disease burden of eczema, a contemporary overview of the patterns and trends in primary care healthcare utilization and treatment is lacking.ObjectiveTo quantify primary care consultations, specialist referrals, prescribing, and treatment escalation, in children and adults with eczema in England.MethodsA large primary care research database was used to examine healthcare and treatment utilization in people with active eczema (n = 411,931). Management trends and variations by age, sex, socioeconomic status, and ethnicity were described from 2009 to 2018 inclusive.ResultsPrimary care consultation rates increased from 87.8 (95% confidence interval [95% CI] 87.3–88.3) to 112.0 (95% CI 111.5–112.6) per 100 person‐years over 2009 to 2018. Specialist referral rates also increased from 3.8 (95% CI 3.7–3.9) to 5.0 (95% CI 4.9–5.1) per 100 person‐years over the same period. Consultation rates were highest in infants. Specialist referrals were greatest in the over 50s and lowest in people of lower socioeconomic status, despite a higher rate of primary care consultations. There were small changes in prescribing over time; emollients increased (prescribed to 48.5% of people with active eczema in 2009 compared to 51.4% in 2018) and topical corticosteroids decreased (57.3%–52.0%). Prescribing disparities were observed, including less prescribing of potent and very potent topical corticosteroids in non‐white ethnicities and people of lower socioeconomic status. Treatment escalation was more common with increasing age and in children of non‐white ethnicity.Conclusion and clinical relevanceThe management of eczema varies by sociodemographic status in England, with lower rates of specialist referral in people from more‐deprived backgrounds. There are different patterns of healthcare utilization, treatment, and treatment escalation in people of non‐white ethnicity and of more‐deprived backgrounds.
Validation study of a new chemiluminescent singleplex IgE assay in a set of Italian allergic rhinitis patients
Authors: Potapova Ekaterina , Bauersachs Daniel , Villella Valeria , Meneguzzi Giorgia , Scala Enrico , Sfika Ifigenia , Tripodi Salvatore , Panetta Valentina , Dramburg Stephanie , Skevaki Chrysanthi , Matricardi Paolo Maria 
Published: November 2020

AbstractBackgroundThe measurement of specific IgE to allergenic extracts and molecules in patients with allergic rhinitis (AR) is crucial for a precise diagnosis and further immunotherapy. Companies providing in vitro diagnostic methods in allergology continuously strive for the optimization and modernization of such methods. A new generation of automated allergy tests based on chemiluminescence detection and paramagnetic microparticles is now available, with possible advantages in sample volume, cost‐effectiveness and avoidance of sample‐related interference.ObjectivesTo test whether sIgE antibody levels obtained with a new singleplex chemiluminescent method have a good agreement with the corresponding results obtained with a “gold standard” test.MethodsWe tested sera from 368 AR patients. Specific IgE sera levels (kU/L) to a comprehensive panel of 15 allergen extracts and 6 molecules were tested with ImmunoCAP® (Thermo Fisher Scientific Inc, Phadia AB, Uppsala, Sweden) and NOVEOS™ (HYCOR® Biomedical, Garden Grove, CA, USA). We evaluated the qualitative and quantitative performance of the new NOVEOS system in matching the outcome of ImmunoCAP to each of the examined allergens.ResultsIn relation to ImmunoCAP, the overall diagnostic sensitivity and specificity of sIgE tests with NOVEOS were 90.8% (95% CI = 88.6–92.7) and 96.2% (95% CI = 93.9–97.8), respectively. These values were higher when only molecules were considered (sensitivity = 98.7% [95% CI = 96.4%–99.7%]; specificity = 94.2% [95% CI = 88.4%–97.6%]) and lower when only extracts were considered (sensitivity = 87.6% [95% CI = 84.7%–90.2%]; specificity = 97% [95% CI = 94.4%–98.6%]). Spearman's correlation between the data set of both methods for a ≥ 0.1 kU/L cut‐off was 0.84 (p < .001).ConclusionsThe new singleplex NOVEOS system presented good results for qualitative and quantitative comparisons when testing specific serum IgE antibodies against a range of 21 allergens. This novel immunoassay system using only 4 µl of sample per test appears to be robust and reliable and can, therefore, be used as an aid in allergy diagnosis.
Evidence for increasing human‐wildlife conflict despite a financial compensation scheme on the edge of a Ugandan National Park
Authors: Braczkowski Alexander , Fattebert Julien , Schenk Ralph , O'Bryan Christopher , Biggs Duan , Maron Martine 
Published: November 2020

AbstractThe conflict of large carnivores and agro‐pastoral communities is a key driver of carnivore decline globally. The East African state of Uganda relies heavily on tourism as a GDP contributor and large carnivores are important for generating visitor revenue in its national parks. African leopards, spotted hyenas and African lions are three species that draw significant tourist attention but also cause damage to the livestock of human communities living on Ugandan national park edges. A private safari lodge in the Lake Mburo National Park has been using a financial compensation scheme in an attempt to stem conflict between these species and human communities living in the region since 2009. Financial compensations have produced mixed results with some studies reporting successes in reducing carnivore deaths, while others warn against their use, citing moral hazard, financial unsustainability and weakened protection of livestock by farmers. We sought to assess the characteristics of this compensation scheme and the patterns of conflict between Bahima pastoralist communities and carnivores that the scheme aims to mitigate. Using a dataset of 1,102 leopard and hyena depredation events (January 2009–December 2018) we found that spotted hyenas were responsible for the overwhelming majority of livestock depredation (69%) around Lake Mburo. Depredations occurred mostly at night (97% and 89% of all depredation for spotted hyenas and leopards respectively) and inside livestock protective pens (bomas). Depredation was more likely to occur in rugged areas, closer to human settlements, and the national park border, and further away from water. We could find no evidence of seasonality in depredation events. Our most important, albeit worrying result was that conflict had increased dramatically over time and the number of depredation claims had tripled in the period from 2014–2018 when compared to 2009–2013, risking financial unsustainability of the scheme. Our results are important for future conservation stakeholders attempting to implement financial compensation in the broader Ugandan landscape. They suggest that careful thought needs to be placed into fund sustainability, increasing claims over time and the development of clear rules that underpin compensation claims.
Urgent desensitization in patients bridged to heart transplantation under extracorporeal membrane oxygenation support: A preliminary experience
Authors: Guihaire Julien , D'Avino Serena , Stephan Francois , Kloeckner Martin , To Ngoc Tram , Potier Agathe , Gaillard Maïra , Ramadan Ramzi , Taupin Jean‐Luc , Le Pavec Jerome , Deleuze Philippe 
Published: November 2020

AbstractAntihuman leukocyte antigen (HLA) antibodies restrict the access to cardiac allografts. Desensitization therapy is a major challenge in patients with cardiogenic shock waiting for urgent heart transplantation (HT). We retrospectively reviewed six patients (mean age of 37.5 years [16–70]) who underwent plasmapheresis (PP) under extracorporeal membrane oxygenation (ECMO) before transplant between January 2017 and September 2018. The average duration of follow‐up was 25 months [20–32]. Mean fluorescence intensity (MFI) of HLA‐specific antibodies was reported as follows: score 4 for MFI < 1000, score 6 for 1000 < MFI < 3000 and score 8 for MFI > 3000. The mean duration of ECMO support was 29 days [1–74] and 6.8 [1–29] PP sessions were performed per patient before transplant. The mean number of HLA‐specific antibodies before HT was 9.6 for score 6 [4–13] and 5.8 for score 8 [1–12]. Four patients had major complications after transplantation (2 hemorrhagic shocks, 5 infectious events). Mean MFI reduction rate was 94% [79–100] for Class I and 44.2% for Class II [0–83]. Hospital survival was 100%, and early antibody‐mediated rejection was diagnosed in one patient at 7 days after HT. Plasmapheresis under ECMO support was associated with favorable early outcomes in highly sensitized candidates for urgent heart transplantation.
Impaired left atrial stiffness in patients with corrected congenital left ventricular outflow obstructions
Authors: Labombarda Fabien , Mulet Benoit , Maragnes Pascale , Beygui Farzin 
Published: November 2020

AbstractObjectiveWe examined the left atrial stiffness index (LA Stiff) on echocardiography and its determinants in adults and adolescents with repaired congenital left ventricular outflow obstructions (c‐LVOOs), including isolated subaortic stenosis (SAS), stenotic bicuspid aortic valve (BAV), and aortic coarctation (CoA).MethodsSeventy‐two patients (43 males, age: 31 ± 15 years) with repaired c‐LVOOs (SAS: n = 12; BAV: n = 27; CoA: n = 33) were compared to 72 age‐ and sex‐matched controls. 2D strain imaging was performed to assess left ventricular (LV) and LA function, including peak positive longitudinal LA strain (LAS), late diastolic LA strain (LDS), and LV global longitudinal strain (GLS). The (E/Ea)/LAS ratio was used to calculate LA Stiff.ResultsLA Stiff was significantly higher in the c‐LVOO group than in the control group. Among the c‐LVOO patients, the CoA group had the lowest GLS and the highest LA Stiff; no significant differences were found with respect to sex, hypertension history, smoking status, or repeated repair among c‐LVOO subtypes. Multivariable regression analysis with the variables “BMI” and “c‐LVOO subtype” revealed that BMI and c‐LVOO subtypes were independently associated with LA Stiff (b = 0.290, P = .009 and b = 0.353, P = .002, respectively).ConclusionsWe documented abnormal LA Stiff values in adults and adolescents after c‐LVOO repair. Patients with CoA demonstrated the most impaired LA Stiff values. Overweight may contribute to worse LA Stiff values. Further studies are required to determine the prognostic implications of LA Stiff in patients with repaired c‐LVOOs.
Altered ioflupane single‐photon emission computed tomography in anti‐IgLON5 disease: A new case mimicking probable progressive supranuclear palsy and review of the literature
Authors: González‐Ávila Carmen , Casado Laura , Muro García Inés , Villacieros‐Álvarez Javier , Vivancos José , Quintas Sonia 
Published: November 2020

AbstractBackground and purposeAnti‐IgLON5 disease is a rare disorder characterized by a heterogeneous myriad of symptoms that may include sleep disorders, bulbar dysfunction, gait problems, movement disorders, cognitive impairment, oculomotor abnormalities, and nervous system hyperexcitability. Its physiopathology remains unknown, with a combination of both autoimmune and neurodegenerative findings.MethodsWe describe clinical, cerebrospinal fluid (CSF), and ioflupane single‐photon emission computed tomography (SPECT) findings of a positive case of anti‐IgLON5 disease mimicking probable progressive supranuclear palsy (PSP). We performed a literature review of previous publications reporting on anti‐IgLON5 disease and ioflupane SPECT.ResultsWe report the case of a 66‐year‐old male who met clinical criteria for probable PSP, in whom ioflupane SPECT showed an alteration of the left presynaptic dopaminergic pathway. However, the presence of atypical neurological symptoms for PSP led to further complementary tests, and IgLON5 antibodies were detected in CSF. According to our literature review, ioflupane SPECT findings have been previously described in only three other patients with anti‐IgLON5 disease, with a reduced uptake in the striatum in two of them.ConclusionsIoflupane SPECT abnormalities, though scarcely described, are not uncommon in anti‐IgLON5 disease. They could be related to nigrostriatal dopaminergic degeneration in the context of the tauopathy component of the disease, but further case descriptions are necessary.
Meta‐analysis of genotype and phenotype studies to confirm the predictive role of the RNF213 p.R4810K variant for moyamoya disease
Authors: Wang Yue , Yang Luping , Wang Xiaotong , Zeng Fanxin , Zhang Kaili , Zhang Qian , Liu Mengwei , Liu Shan , Shang Mengke , Li Qian , Yang Yuetian , Liang Man , Liu Wanyang 
Published: November 2020

AbstractBackground and PurposeThe aim of this meta‐analysis study was to assess the predictive effects of RNF213 p.R4810K on phenotype in moyamoya disease (MMD).MethodsElectronic databases (e.g., Pubmed and EMBASE) were searched, and relevant articles published up to August 2020 were retrieved. Review Manager 5.3 and Stata 12.0 were used for all statistical analyses. Pooled odds ratios, with 95% confidence intervals, and three comparison models were evaluated to analyze the association between RNF213 pR4810K variant and clinical characteristics of MMD patients using a fixed‐effects model.ResultsA total of 2798 patients with MMD were selected and the effects of the heterozygous or homozygous RNF213 p.R4810K variant on 18 clinical features were identified. There were more patients aged <15 years in the GA and AA groups (AA vs GA: p = 0.009; AA vs GG: p = 0.003; GA vs GG: p = 0.001). Among homozygous patients, the majority experienced MMD onset before the age of 4 years (AA vs. GA: p < 0.00001; AA vs GG: p < 0.00001). The frequency of infarctions and transient ischemic attack was significantly higher in homozygotes and heterozygotes，respectively. However, the frequency of intracerebral/intraventricular hemorrhage was lower in patients with the GA than the GG genotype. More MMD patients with AA and GA genotypes had a family history of the disease (p = 0.003, p < 0.00001, respectively). Posterior cerebral artery involvement was more common in patients with the GA genotype (p < 0.00001).ConclusionThe homozygous or heterozygous RNF213 variant may be an efficient biomarker with which to classify different clinical phenotypes of MMD.
Prognostic significance of uric acid change in acute ischemic stroke patients with reperfusion therapy
Authors: Wang Changyi , Cui Ting , Wang Lu , Zhu Qiange , Wang Anmo , Yuan Ye , Hao Zilong , Wu Bo 
Published: November 2020

AbstractBackgroundUric acid (UA) is an important endogenous free radical scavenger that has been found to have a neuroprotective effect. However, there is uncertainty about the relationship between UA change and outcome in acute ischemic stroke (AIS) patients with reperfusion therapy.MethodsWe consecutively enrolled AIS patients with reperfusion therapy. UA was measured upon admission and during hospitalization. The change in UA levels (ΔUA) was determined by calculating the difference between admission UA and the lowest UA among all follow‐up measurements, with a positive ΔUA suggesting a decrease in UA levels. Functional outcome was assessed by modified Rankin Scale (mRS) at 3 months. Poor outcome was defined as mRS >2.ResultsA total of 361 patients were included (mean age 68.7 ± 13.9 years, 54.3% males). The mean UA on admission was 355 ± 96.1 μmol/L. The median ΔUA was 121 μmol/L (IQR 50–192 μmol/L) and 18 (5%) patients had increased UA levels. UA on admission was positively associated with good outcome (p for trend = 0.017). When patients were classified into quartiles by ΔUA, patients with the largest decrease in UA (Q4: 199–434 μmol/L) had a higher risk of poor outcome at 3 months compared to patients with the least decrease in UA (Q1: 0–57 μmol/L) (OR 2.55, 95% CI 1.09–5.98, p = 0.031). The risk of poor outcome increased with ΔUA (p for trend = 0.048).ConclusionsIn patients with reperfusion therapy, high UA on admission was associated with a good 3‐month outcome, while a greater decrease in UA was associated with poor outcome.
Low prevalence of radiographic hip osteoarthritis and its discordance with hip pain: A nationwide study in Korea
Authors: Park Jae Hyeon , Lee Jung Soo , Lee Soong Joon , Kim Yeo Hyung 
Published: November 2020

AimThis study aimed to evaluate the prevalence and associated factors of radiographic hip osteoarthritis (OA) in the Korean community‐dwelling population.MethodsThis study included 11 814 individuals (5025 men and 6789 women) ≥50 years of age from the Korea National Health and Nutrition Examination Surveys. Radiographic hip OA was defined as having a Kellgren–Lawrence grading scale score ≥2. Painful hip OA was defined as radiographic hip OA with the presence of hip pain. The prevalence of radiographic hip OA was evaluated with respect to age group, sex and presence of hip pain. The associations of sociodemographic and clinical variables with hip OA and hip pain were assessed using multivariable logistic regression analyses.ResultsThe weighted prevalence of radiographic hip OA and painful hip OA was 1.1% and 0.2%, respectively, in Korea. Older age (≥75 years) and male sex were independently associated with radiographic hip OA and painless hip OA. Comorbid musculoskeletal pain (knee pain) was independently associated with painful hip OA. The difference between painful and painless hip OA was the presence of comorbid musculoskeletal pain (knee pain and low back pain). Although hip pain was more common in women than in men, it was associated with the severity of hip OA only in men.ConclusionsRadiographic hip OA is rare in Korean middle‐aged and elderly people. Furthermore, hip pain is infrequent in radiographic hip OA. Geriatr Gerontol Int 2021; 21: 20–26.
Widespread underfilling of the potential ranges of North American trees
Authors: Seliger Benjamin J. , McGill Brian J. , Svenning Jens‐Christian , Gill Jacquelyn L. 
Published: November 2020

AbstractAimClimatic equilibrium is a foundational principle in ecological theory and models used in conservation, but has been challenged by growing evidence of disequilibrium, particularly for long‐lived, sessile organisms like trees. Here, we calculated range filling for North American trees to detect the degree to which trees are filling their potential climatic niches, and to assess climatic and non‐climatic drivers of underfilling.LocationNorth America (22°N–72°N).TaxonTrees and shrubs.MethodsWe modelled the potential ranges of 447 North American tree and shrub species with species distribution models using bioclimatic variables, and calculated the occupied proportion of each potential range. Results were compared to a null model using simulated ranges generated by a spreading‐dye algorithm. We further used range shape ratios (latitude/longitude) to detect the drivers of disequilibrium.ResultsThe potential ranges of North American trees and shrubs are broadly underfilled (mean = 48%). Furthermore, range filling is positively correlated with geographic range size. Large‐ranged species have higher range filling than the null model, and shape ratios indicative of climatic restrictions. Small‐ranged species showed a stronger influence of dispersal limitation.Main conclusionsClimate explains only about half of tree species' ranges, and the signal of climatic equilibrium increases with range size. Small‐range species show high levels of climatic disequilibrium, which is likely be driven by combinations of dispersal lags, and undetected environmental factors or biotic interactions. These results highlight the importance of conserving small‐ranged species and the difficulty of forecasting how their distributions will shift in the coming centuries.
HNF1B inhibits cell proliferation via repression of SMAD6 expression in prostate cancer
Authors: Lu Wei , Sun Jian , Zhou Huihui , Wang Fei , Zhao Chunchun , Li Kai , Fan Caibin , Ding Guanxiong , Wang Jianqing 
Published: November 2020

AbstractProstate cancer is the most common malignancy in men in developed countries. In previous study, we identified HNF1B (Hepatocyte Nuclear Factor 1β) as a downstream effector of Enhancer of zeste homolog 2 (EZH2). HNF1B suppresses EZH2‐mediated migration of two prostate cancer cell lines via represses the EMT process by inhibiting SLUG expression. Besides, HNF1B expression inhibits cell proliferation through unknown mechanisms. Here, we demonstrated that HNF1B inhibited the proliferation rate of prostate cancer cells. Overexpression of HNF1B in prostate cancer cells led to the arrest of G1 cell cycle and decreased Cyclin D1 expression. In addition, we re‐explored data from ChIP‐sequencing (ChIP‐seq) and RNA‐sequencing (RNA‐seq), and demonstrated that HNF1B repressed Cyclin D1 via direct suppression of SMAD6 expression. We also identified CDKN2A as a HNF1B‐interacting protein that would contribute to HNF1B‐mediated repression of SMAD6 expression. In summary, we provide the novel mechanisms and evidence in support HNF1B as a tumour suppressor gene for prostate cancer.