bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors influencing the implementation of cardiovascular risk scoring in primary care: a mixed-method systematic review
Authors: Muthee Tonny B. , Kimathi Derick , Richards Georgia C. , Etyang Anthony , Nunan David , Williams Veronika , Heneghan Carl 
Published: July 2020

AbstractBackgroundCardiovascular disease (CVD) such as ischemic heart disease and stroke is the leading causes of death and disability globally with a growing burden in low and middle-income countries. A credible way of managing the incidence and prevalence of cardiovascular diseases is by reducing risk factors. This understanding has led to the development and recommendation for the clinical use of cardiovascular risk stratification tools. These tools enhance clinical decision-making. However, there is a lag in the implementation of these tools in most countries. This systematic review seeks to synthesise the current knowledge of the factors influencing the implementation of cardiovascular risk scoring in primary care settings.MethodsWe searched bibliographic databases and grey literature for studies of any design relating to the topic. Titles, abstracts and full texts were independently assessed for eligibility by two reviewers. This was followed by quality assessment and data extraction. We analysed data using an integrated and best fit framework synthesis approach to identify these factors. Quantitative and qualitative forms of data were combined into a single mixed-methods synthesis. The Consolidated Framework for Implementation Research was used as the guiding tool and template for this analysis.ResultsTwenty-five studies (cross-sectionaln= 12, qualitativen= 9 and mixed-methodsn= 4) were included in this review. Twenty (80%) of these were conducted in high-income countries. Only four studies (16%) included patients as participants. This review reports on a total of eleven cardiovascular risk stratification tools. The factors influencing the implementation of cardiovascular risk scoring are related to clinical setting and healthcare system (resources, priorities, practice culture and organisation), users (attributes and interactions between users) and the specific cardiovascular risk tool (characteristics, perceived role and effectiveness).ConclusionsWhile these findings bolster the understanding of implementation complexity, there exists limited research in the context of low and middle-income countries. Notwithstanding the need to direct resources in bridging this gap, it is also crucial that these efforts are in concert with providing high-quality evidence on the clinical effectiveness of using cardiovascular risk scoring to improve cardiovascular disease outcomes of mortality and morbidity.Trial registrationPROSPERO registration number: CRD42018092679.
The diagnostic value of D-dimer with simplified Geneva score (SGS) pre-test in the diagnosis of pulmonary embolism (PE)
Authors: Fu Zhihui , Zhuang Xibin , He Yueming , Huang Hong , Guo Weifeng 
Published: July 2020

AbstractBackgroundPulmonary embolism (PE) is the third most common cardiovascular syndrome with an average annual incidence rate of 77 per 100,000 population in the worldwide. The diagnose algorithms for suspected PE are generally include clinical scoring assessment and plasma D-dimer evaluation, patients with high risk of PE require computed tomographic pulmonary angiogram (CTPA) detection for confirmation.MethodsIn this retrospective analysis, 1035 patients with suspected PE were recruited. All the patients were clinically received simplified Geneva score (SGS) pre-test, determination of plasma D-dimer level, and CTPA detection. All enrolled patients were grouped according to the CTPA results: PE patients and non-PE patients. Then, receiver operating characteristic (ROC) curve were constructed to determine the optimal D-dimer cutoff point value which is based on Yonden’s index (YI).Results294 (28.4%) patients were confirmed with PE and 741(71.6%) individuals were regarded as non-PE cases by CTPA detection. Using the SGS pre-test, 829 (80.1%) patients were classified PE-unlikely (SGS ≤ 2) and 206 (19.9%) patients were PE-likely (SGS ≥ 3). Patients with D-dimer levels above 1.96 mg/L had a significant risk to suffer from PE (area under curve (AUC), 0.707; 95% CI, 0.678–0.735;p < 0.05). Meanwhile, in patients with SGS ≥ 3, the D-dimer cutoff point value moved to 2.2 mg/L (AUC, 0.644; 95% CI, 0.574–0.709;p < 0.05).ConclusionD-dimer test in combination with SGS pre-test could improve the accuracy of PE diagnosis. Patients with D-dimer levels over 1.96 mg/L (4 times of the normal level) have a significant risk for PE. In patients with SGS ≥ 3, the D-dimer cutoff point concentration for PE risk moves to the levels of 2.2 mg/L.
Clear cell tumor of the lung could be aggressive: a case report and review of the literature
Authors: Shen Leilei , Lin Jixing , Ren Zhipeng , Wang Bailin , Liu You , Yuan Jing , Zhan Lianbin 
Published: July 2020

Abstract
Background
Clear cell tumors of the lung (CCTLs) are rare and mostly benign pulmonary neoplasms arising from perivascular epithelioid cells. Only approximately 100 cases have been reported, and half of them were in China. Limited details about CCTLs often cause diagnostic or therapeutic problems.

Case presentation
We describe a case of a 28-year-old woman with multiple gradually replicating and enlarging nodules in the left lower lobe. The patient underwent fine-needle aspiration biopsy and was diagnosed with CCTL. A left lower lobectomy and mediastinal lymph node dissection were performed. The gradual changes in size (1.4 cm to 2.8 cm) and quantity (10 to 49) of the CCTLs in this case were the biggest differences from previously reported cases.

Conclusions
CCTLs are very uncommon and mostly benign PEComatous tumors with no specific morphologic features. We present a case of CCTL with multiplicity and rapid growth, which may indicate its aggressive nature. The accumulation of similar cases will help clarify the exact nature and improve our understanding of the disease.
Are supplemental appraisal/reimbursement processes needed for rare disease treatments? An international comparison of country approaches
Authors: Nicod Elena , Whittal Amanda , Drummond Michael , Facey Karen 
Published: July 2020

Abstract
Background
There is increasing recognition that conventional appraisal approaches may be unsuitable for assessing the value rare disease treatments (RDTs). This research examines what supplemental appraisal/reimbursement processes for RDTs are used internationally and how they can be characterised. A qualitative research design was used that included (1) documentation of country appraisal/reimbursement processes for RDTs via questionnaires, desk research and iterative interactions with country experts to produce country vignettes, and (2) a cross-country analysis of these processes to identify and characterise features in supplemental processes for RDTs, and compare them to countries without supplemental processes.

Results
Thirty-two of the 37 invited countries participated in this research. Forty-one percent (13/32) use supplemental processes for RDTs. Their level of integration within standard processes ranged from low to high, characterised by whether they are separate or partially separate from the standard process, adapted or accelerated standard processes, or standard processes that may be applied to RDTs. They are characterised by features implemented throughout the appraisal process. These features are mechanisms that allow application of different standards to assess the value of the medicine, support to the appraisal/decision-making process, overcome the issues of lack of cost-effectiveness, or exempt from part of/the full appraisal/reimbursement process. They increase the likelihood of reimbursement by adjusting and/or foregoing part of the assessment process, or accepting to pay more for the same added benefit as for common conditions. A large proportion of countries with standard processes include one or more of these features (formally or informally) or are discussing potential changes in their systems.

Conclusions
Results suggest revealed preferences to treat RDTs differently than conventional medicines. Some of the challenges around uncertainty and high price remain, but supplemental process features can support decision-making that is more flexible and consistent. Many of these processes are new and countries continue to adjust as they gain experience.
Epidemiological trends of tracheal, bronchus, and lung cancer at the global, regional, and national levels: a population-based study
Authors: Deng Yujiao , Zhao Peng , Zhou Linghui , Xiang Dong , Hu Jingjing , Liu Yu , Ruan Jian , Ye Xianghua , Zheng Yi , Yao Jia , Zhai Zhen , Wang Shuqian , Yang Si , Wu Ying , Li Na , Xu Peng , Zhang Dai , Kang Huafeng , Lyu Jun , Dai Zhijun 
Published: July 2020

Abstract
Background
Investigations of disease incidence, mortality, and disability-adjusted life years (DALYs) are valuable for facilitating preventive measures and health resource planning. We examined the tracheal, bronchus, and lung (TBL) cancer burdens worldwide according to sex, age, and social development index (SDI) at the global, regional, and national levels.

Methods
We assessed the TBL cancer burden using data from the Global Burden of Disease (GBD) database, including 21 regions, 195 countries, and territories in the diagnostic period 1990–2017. The data of TBL cancer-related mortality and DALYs attributable to all known risk factors were also analyzed. Age-standardized rates (ASRs) and their estimated annual percentage changes (EAPCs) were calculated.

Results
Incident cases, deaths, and DALYs of TBL cancer increased worldwide (100.44%, 82.30%, and 61.27%, respectively). The age-standardized incidence rate (ASIR) was stable (EAPC = 0.02, 95% confidence interval [CI] − 0.03 to 0.08), but the age-standardized death (EAPC = − 0.34, 95%CI − 0.38 to − 0.3) and DALY rate decreased generally (EAPC = − 0.74, 95%CI − 0.8 to − 0.68). However, the change trend of ASIR and ASDR among sexes was on the contrary. China and the USA always had the highest incidence, mortality, and DALYs of TBL cancer. Significant positive correlations between ASRs and SDI were observed, especially among females. High (36.86%), high-middle (28.78%), and middle SDI quintiles (24.91%) carried the majority burden of TBL cancer. Tobacco remained the top cause of TBL cancer death and DALYs, followed by air pollution, the leading cause in the low-middle and low-SDI quintiles. Metabolic risk-related TBL cancer mortality and DALYs among females increased but was stable among males. The main ages of TBL cancer onset and death were > 50 years, and the DALYs concentrated in 50 − 69 years.

Conclusions
To significantly reduce the growing burden of TBL cancer, treatment resources need to be skewed according to factors such as risks and geography, especially for high-risk groups and high-burden areas. Asia had the greatest TBL cancer burden, followed by high-income North America. Tobacco remains the leading cause of death and DALYs, followed by air pollution. Effective prevention measures against tobacco and air pollution should be strengthened.
circRNA-UBAP2 promotes the proliferation and inhibits apoptosis of ovarian cancer though miR-382-5p/PRPF8 axis
Authors: Xu Qin , Deng Bo , Li Manlin , Chen Yang , Zhuan Li 
Published: July 2020

Abstract
Objective
circular RNAs (circRNAs) have been reported to be essential regulators of multiple malignant cancers. However, the functions of circRNAs in ovarian cancer need to be further explored. The aim of our study is to explore the role of circRNA-UBAP2 in ovarian cancer and its mechanism.

Results
circRNA-UBAP2 was upregulated in ovarian cancer tissues and cell lines. Knockdown of circRNA-UBAP2 inhibited cell proliferation and promoted cell apoptosis, but circRNA-UBAP2 overexpressed got opposite results. In addition, circRNA-UBAP2 targeted miR-382-5p and downregulated its expression, PRPF8 was a target gene of miR-382-5p. Furthemore, circRNA-UBAP2/miR-382-5p/PRPF8 axis affected the proliferation, apoptosis and cell cycle of ovarian cancer through the mechanism of competing endogenous RNAs (ceRNA).

Conclusion
circRNA-UBAP2 acted as a ceRNA to sponged miR-382-5p, increased the expression level of PRPF8, and prompted proliferation and inhibited apoptosis in ovarian cancer cells.
The multiagency approach to Sudden Unexpected Infant Deaths (SUID): eleven years’ experience in the Tuscany Region
Authors: Piumelli Raffaele , Nassi Niccolò , Buccoliero Annamaria , Occhini Rossella , Nardini Vincenzo , Toti Paolo , Salvatori Cristina , Peruzzi Marta , Arzilli Cinzia 
Published: July 2020

Abstract
Background
The Sudden Unexpected Infant Death Syndrome (SUID) is one of the leading causes of mortality in the first year of life. The aim of this work was the retrospective evaluation of the incidence of SUID and the effectiveness of the multiagency approach to this phenomenon in the Tuscany Region.

Methods
Data were obtained from the regional registry of SUID cases in the period 2009–2019. The registry contains both sudden unexpected deaths in the first week of life (Sudden Unexpected Early Neonatal Deaths - SUEND), and those occurring after the first week up to 1 year of age (SUID).

Results
In this timeframe a total of 73 sudden unexpected deaths occurred in our region; 32 were Unexplained (i.e. Sudden Infant Death Syndrome - SIDS), 24 Explained, 10 Undetermined, and 7 SUEND. Autopsies were performed in 91% of cases, and in 95% of these by three groups of selected pathologists according to our protocol.
We found a low incidence of SUID (0.21 ‰), and SIDS deaths accounted for 0.1‰ of live births (48% of cases) with a high prevalence of infants of non-Italian ethnicity (38% of cases). Bereaved families were able to receive psychological support from mental health professionals and have contact with the family association, Seeds for SIDS. Audits were organized when post-mortem examinations were not carried out or carried out incorrectly in procedural terms, and when the diagnosis was particularly uncertain.

Conclusions
This paper first provides data on SUID mortality based on complete post-mortems in an Italian region. According to these findings we can state that our approach is effective both in terms of correctly performed autopsies and support for bereaved families. Future efforts are necessary to further reduce the incidence of SUID especially among non- Italian infants. An improvement action is also recommended for ensuring a more accurate and consistent picture of the circumstances of death.
The final approval of the National Protocol for the management of SUID cases is therefore strongly advocated in order to improve surveillance in this specific field and abolish disparities among the Italian regions.
Carbon migration and metagenomic characteristics during anaerobic digestion of rice straw
Authors: Chen Dadi , Zuo Xiaoyu , Li Juan , Wang Xitong , Liu Jie 
Published: July 2020

Abstract
Background
Considerable interest has been expressed in the development of anaerobic digestion (AD) of straw to solve the environmental problems caused by the dumping and burning of straw and to generate clean energy. However, the poor biodegradability of straw and the low efficiency of energy generation achieved during its AD are problematic. Studying the parameter changes involved in the process of AD is helpful for clarifying its micro-mechanisms and providing a theoretical basis for improving its efficiency. Currently, most research into process parameters has focused on gas production, methane content, pH, and volatile fatty acid (VFA) content; limited research has focused on carbon migration and functional gene changes during the AD of straw.

Results
Carbon migration and changes in metagenomic characteristics during the AD of rice straw (RS) were investigated. Accumulated biogas production was 388.43 mL/g VS. Carbon in RS was consumed, and the amount of carbon decreased from 76.28 to 36.83 g (conversion rate 51.72%). The degree of hydrolysis rapidly increased during the first 5 days, and a large amount of carbon accumulated in the liquid phase before migrating into the gas phase. By the end of AD, the amount of carbon in the liquid and gas phases was 2.67 and 36.78 g, respectively. According to our metagenomic analysis, at the module level, the abundance of M00357, M00567, M00356, and M00563 (the modules related to the generation of methane) during AD were 51.23–65.43%, 13.96–26.88%, 16.44–22.98%, and 0.83–2.40%, respectively. Methyl-CoM, 5-methyl-5,6,7,8-tetrahydromethanopterin, and Acetyl-CoA were important intermediates.

Conclusions
Carbon was enriched in the liquid phase for the first 5 days and then gradually consumed, and most of the carbon was transferred to the gas phase by the end of AD. In this study, AD proceeded mainly via aceticlastic methanogenesis, which was indicated to be a dominant pathway in methane metabolism. Batch AD could be divided into three stages, including initiation (days 1–5), adaptation (days 6–20), and stabilization (days 21–50), according to biogas production performance, carbon migration, and metagenomic characteristics during AD.
Torque-producing capacity is affected by moment arm in the human knee extensors
Authors: Hori Miyuki , Suga Tadashi , Terada Masafumi , Miyake Yuto , Nagano Akinori , Isaka Tadao 
Published: July 2020

Abstract
Objective
The torque-producing capacity can be assessed as maximal isometric torque per muscle size. Nevertheless, the factors contributing to this capacity remain poorly understood. In general, the magnitude of joint torque production is determined not only by muscle size but also by joint moment arm (MA). Based on this background, we hypothesized that longer MA would be related to higher torque-producing capacity despite a given muscle size. To test this hypothesis, we examined the relationship between MA and toque-producing capacity in the knee extensors. The quadriceps femoris muscle volume (MV) and knee extensor MA in 30 healthy young men were measured using magnetic resonance imaging. The knee extensor isometric torque was measured using a dynamometer. The knee extensor torque-producing capacity was calculated as the knee extensor isometric torque per quadriceps femoris MV.

Results
The quadriceps femoris MV and knee extensor MA correlated significantly with the knee extensor isometric torque (r = 0.785 and 0.790, respectively, both Ps < 0.001). Furthermore, the knee extensor MA correlated significantly with the knee extensor torque-producing capacity (r = 0.635, P < 0.001). These findings suggest that longer MA is an important factor for achieving higher torque-producing capacity in the human knee extensors.
The commercially available STAT3 inhibitor 5,15-diphenylporphyrin (5,15-DPP) does not directly interact with STAT3 core residues 127–722
Authors: Mtwebana Siphokazi Sinethemba , Prinsloo Earl 
Published: July 2020

Abstract
Objective
Target specific small molecule inhibitors has driven signaling pathway discovery and are used as common positive controls in drug discovery screens. During a biophysical screen, using surface plasmon resonance spectroscopy, of a novel small molecule library for the Signal Transducer and Activator of Transcription 3 Src Homology 2 (STAT3-SH2) low molecular weight interactors we evaluated commercial inhibitors S3I-201 and 5,15-diphenylporphyrin (5, 15-DPP) as positive controls.

Results
Here, we show using surface plasmon resonance spectroscopy that a common STAT3-SH2 inhibitor, 5,15-diphenylporphyrin (5, 15-DPP), does not bind STAT3 core amino acid residues 127 to 722 relative to another commercially available SH2 inhibitor, S3I-201. This finding should provide caution in data interpretation when using 5,15-DPP in in vitro and in vivo laboratory investigations.
CSF levels of the BACE1 substrate NRG1 correlate with cognition in Alzheimer’s disease
Authors: Mouton-Liger François , Dumurgier Julien , Cognat Emmanuel , Hourregue Claire , Zetterberg Henrik , Vanderstichele Hugo , Vanmechelen Eugeen , Bouaziz-Amar Elodie , Blennow Kaj , Hugon Jacques , Paquet Claire 
Published: July 2020

Abstract
Background
The presynaptic protein neuregulin1 (NRG1) is cleaved by beta-site APP cleaving enzyme 1 (BACE1) in a similar way as amyloid precursor protein (APP) NRG1 can activate post-synaptic receptor tyrosine-protein kinase erbB4 (ErbB4) and was linked to schizophrenia. The NRG1/ErbB4 complex is neuroprotective, can trigger synaptogenesis and plasticity, increases the expression of NMDA and GABA receptors, and can induce neuroinflammation. This complex can reduce memory formation. In Alzheimer’s disease (AD) brains, NRG1 accumulates in neuritic plaques. It is difficult to determine if NRG1 has beneficial and/or detrimental effects in AD. BACE1 levels are increased in AD brains and cerebrospinal fluid (CSF) and may lead to enhanced NRG1 secretion, but no study has assessed CSF NRG1 levels in AD and mild cognitive impairment (MCI) patients.

Methods
This retrospective study included 162 patients suffering from AD dementia (54), MCI with progression to AD dementia (MCI-AD) (27), non-AD MCI (30), non-AD dementias (30), and neurological controls (27). All patients had neurological examinations, brain MRI, and neuropsychological evaluations. After written informed consent and using enzyme-linked immunosorbent assays (ELISAs), CSF samples were evaluated for Aβ1–42, Aβ1–40, total tau (T-tau), phosphorylated tau on threonine 181 (P-tau), BACE1, growth-associated protein 43 (GAP 43), neurogranin (Ng), and NRG1.

Results
Levels of NRG1 were significantly increased in the CSF of AD (+ 36%) and MCI-AD (+ 28%) patients compared to neurological controls and also non-AD MCI and non-AD dementias. In addition, in AD and MCI-AD patients, NRG1 levels positively correlated with Aβ1–42 but not with T-tau, P-tau, and BACE1 levels and negatively correlated with MMSE scores. A longitudinal follow-up study of AD patients revealed a trend (p = 0.08) between CSF NRG1 levels and cognitive decline. In the overall population, NRG1 correlated with MMSE and the synaptic biomarkers GAP 43 and neurogranin.

Conclusions
Our results showed that CSF NRG1 levels are increased in AD and MCI-AD as compared to controls and other dementias. CSF NRG1 levels are associated with cognitive evolution, and a major outcome of our findings is that synaptic NRG1 could be involved in the pathophysiology of AD. Modulating brain NRG1 activity may represent a new therapeutic target in AD.
Parasitic diseases as a cause of acute abdominal pain: imaging findings
Authors: Ünal Emre , Arslan Sevtap , Onur Mehmet Ruhi , Akpinar Erhan 
Published: July 2020

AbstractAcute abdominal pain can be seen in cases with parasitic diseases delivered to emergency departments. The diagnosis of the parasitic disease can be delayed because of the similar clinical signs encountered in other frequently seen causes of acute abdomen. Nevertheless, the features detected in imaging scans can be helpful in the diagnosis. The present study aims to raise awareness about abdominal parasitosis in emergency conditions and also to underline the association between imaging findings and the life cycle of parasites with illustrative cases.