bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence, clinical outcomes, and transmission dynamics of severe coronavirus disease 2019 in California and Washington: prospective cohort study
Authors: Lewnard Joseph A , Liu Vincent X , Jackson Michael L , Schmidt Mark A , Jewell Britta L , Flores Jean P , Jentz Chris , Northrup Graham R , Mahmud Ayesha , Reingold Arthur L , Petersen Maya , Jewell Nicholas P , Young Scott , Bellows Jim 
Published: May 2020

AbstractObjectiveTo understand the epidemiology and burden of severe coronavirus disease 2019 (covid-19) during the first epidemic wave on the west coast of the United States.DesignProspective cohort study.SettingKaiser Permanente integrated healthcare delivery systems serving populations in northern California, southern California, and Washington state.Participants1840 people with a first acute hospital admission for confirmed covid-19 by 22 April 2020, among 9 596 321 healthcare plan enrollees. Analyses of hospital length of stay and clinical outcomes included 1328 people admitted by 9 April 2020 (534 in northern California, 711 in southern California, and 83 in Washington).Main outcome measuresCumulative incidence of first acute hospital admission for confirmed covid-19, and subsequent probabilities of admission to an intensive care unit (ICU) and mortality, as well as duration of hospital stay and ICU stay. The effective reproduction number (RE) describing transmission dynamics was estimated for each region.ResultsAs of 22 April 2020, cumulative incidences of a first acute hospital admission for covid-19 were 15.6 per 100 000 cohort members in northern California, 23.3 per 100 000 in southern California, and 14.7 per 100 000 in Washington. Accounting for censoring of incomplete hospital stays among those admitted by 9 April 2020, the estimated median duration of stay among survivors was 9.3 days (with 95% staying 0.8 to 32.9 days) and among non-survivors was 12.7 days (1.6 to 37.7 days). The censoring adjusted probability of ICU admission for male patients was 48.5% (95% confidence interval 41.8% to 56.3%) and for female patients was 32.0% (26.6% to 38.4%). For patients requiring critical care, the median duration of ICU stay was 10.6 days (with 95% staying 1.3 to 30.8 days). The censoring adjusted case fatality ratio was 23.5% (95% confidence interval 19.6% to 28.2%) among male inpatients and 14.9% (11.8% to 18.6%) among female inpatients; mortality risk increased with age for both male and female patients. Reductions in RE were identified over the study period within each region.ConclusionsAmong residents of California and Washington state enrolled in Kaiser Permanente healthcare plans who were admitted to hospital with covid-19, the probabilities of ICU admission, of long hospital stay, and of mortality were identified to be high. Incidence rates of new hospital admissions have stabilized or declined in conjunction with implementation of social distancing interventions.
Refinement and validation of the IDIOM score for predicting the risk of gastrointestinal cancer in iron deficiency anaemia
Authors: Almilaji Orouba , Smith Carla , Surgenor Sue , Clegg Andrew , Williams Elizabeth , Thomas Peter , Snook Jonathon 
Published: May 2020

ObjectiveTo refine and validate a model for predicting the risk of gastrointestinal (GI) cancer in iron deficiency anaemia (IDA) and to develop an app to facilitate use in clinical practice.DesignThree elements: (1) analysis of a dataset of 2390 cases of IDA to validate the predictive value of age, sex, blood haemoglobin concentration (Hb), mean cell volume (MCV) and iron studies on the probability of underlying GI cancer; (2) a pilot study of the benefit of adding faecal immunochemical testing (FIT) into the model; and (3) development of an app based on the model.ResultsAge, sex and Hb were all strong, independent predictors of the risk of GI cancer, with ORs (95% CI) of 1.05 per year (1.03 to 1.07, p<0.00001), 2.86 for men (2.03 to 4.06, p<0.00001) and 1.03 for each g/L reduction in Hb (1.01 to 1.04, p<0.0001) respectively. An association with MCV was also revealed, with an OR of 1.03 for each fl reduction (1.01 to 1.05, p<0.02). The model was confirmed to be robust by an internal validation exercise. In the pilot study of high-risk cases, FIT was also predictive of GI cancer (OR 6.6, 95% CI 1.6 to 51.8), but the sensitivity was low at 23.5% (95% CI 6.8% to 49.9%). An app based on the model was developed.ConclusionThis predictive model may help rationalise the use of investigational resources in IDA, by fast-tracking high-risk cases and, with appropriate safeguards, avoiding invasive investigation altogether in those at ultra-low predicted risk.
Arts-based approaches to promoting health in sub-Saharan Africa: a scoping review
Authors: Bunn Christopher , Kalinga Chisomo , Mtema Otiyela , Abdulla Sharifa , Dillip Angel , Lwanda John , Mtenga Sally M , Sharp Jo , Strachan Zoë , Gray Cindy M 
Published: May 2020

IntroductionArts-based approaches to health promotion have been used widely across sub-Saharan Africa (SSA), particularly in public health responses to HIV/AIDS. Such approaches draw on deep-rooted historical traditions of indigenous groups in combination with imported traditions which emerged from colonial engagement. To date, no review has sought to map the locations, health issues, art forms and methods documented by researchers using arts-based approaches in SSA.MethodsUsing scoping review methodology, 11 databases spanning biomedicine, arts and humanities and social sciences were searched. Researchers screened search results for papers using predefined criteria. Papers included in the review were read and summarised using a standardised proforma. Descriptive statistics were produced to characterise the location of the studies, art forms used or discussed, and the health issues addressed, and to determine how best to summarise the literature identified.ResultsSearches identified a total of 59 794 records, which reduced to 119 after screening. We identified literature representing 30 (62.5%) of the 48 countries in the SSA region. The papers covered 16 health issues. The majority (84.9%) focused on HIV/AIDS-related work, with Ebola (5.0%) and malaria (3.3%) also receiving attention. Most studies used a single art form (79.0%), but a significant number deployed multiple forms (21.0%). Theatre-based approaches were most common (43.7%), followed by music and song (22.6%), visual arts (other) (9.2%), storytelling (7.6%) and film (5.0%).ConclusionsArts-based approaches have been widely deployed in health promotion in SSA, particularly in response to HIV/AIDS. Historically and as evidenced by this review, arts-based approaches have provided a platform to facilitate enquiry, achieved significant reach and in some instances supported demonstrable health-related change. Challenges relating to content, power relations and evaluation have been reported. Future research should focus on broadening application to other conditions, such as non-communicable diseases, and on addressing challenges raised in research to date.
Enhanced long-term dietary change and adherence in a nutrigenomics-guided lifestyle intervention compared to a population-based (GLB/DPP) lifestyle intervention for weight management: results from the NOW randomised controlled trial
Authors: Horne Justine , Gilliland Jason , O'Connor Colleen , Seabrook Jamie , Madill Janet 
Published: May 2020

BackgroundAdherence to nutritional guidelines for chronic disease prevention and management remains a challenge in clinical practice. Innovative strategies are needed to help optimise dietary behaviour change.ObjectiveThe objective of this study was to determine if a nutrigenomics-guided lifestyle intervention programme could be used to motivate greater dietary adherence and change in dietary intake short-term, moderate-term and long-term compared to the gold-standard population-based weight management intervention (Group Lifestyle Balance (GLB)/Diabetes Prevention Programme (DPP)).DesignThe Nutrigenomics, Overweight/Obesity, and Weight Management (NOW) randomised controlled trial is a pragmatic, parallel-group, superiority clinical trial (n=140), which was conducted at the East Elgin Family Health Team (EEFHT). GLB weight management groups were prerandomised 1:1 to receive either the standard GLB programme or a modified GLB+nutrigenomics (GLB+NGx) programme. Three 24-hour recalls were collected at baseline, 3, 6 and 12 months using the validated multiple pass method. Research assistants collecting the three 24-hour recalls were blinded to the participants’ group assignments. Statistical analyses included split plot analyses of variance (ANOVAs), two-way ANOVAs, binary logistic regression, χ2and Fisher’s exact tests. Using the Theory of Planned Behaviour as guidance, key confounding factors of behaviour change were considered in the analyses. This study was registered with clinicaltrials.gov (NCT03015012).ResultsOnly the GLB+NGx group significantly reduced their total fat intake from baseline to 12-month follow-up (from 36.0%±4.8% kcal to 30.2%±8.7% kcal, p=0.02). Long-term dietary adherence to total fat and saturated fat guidelines was also significantly (p<0.05) greater in the GLB+NGx group compared to the standard GLB group.ConclusionsWeight management interventions guided by nutrigenomics can motivate long-term improvements in dietary fat intake above and beyond gold-standard population-based interventions.
Protocol for a randomised controlled trial of Subacromial spacer for Tears Affecting Rotator cuff Tendons: a Randomised, Efficient, Adaptive Clinical Trial in Surgery (START:REACTS)
Authors: Metcalfe Andrew , Gemperle Mannion Elke , Parsons Helen , Brown Jaclyn , Parsons Nicholas , Fox Josephine , Kearney Rebecca , Lawrence Tom , Bush Howard , McGowan Kerri , Khan Iftekhar , Mason James , Hutchinson Charles , Gates Simon , Stallard Nigel , Underwood Martin , Drew Stephen 
Published: May 2020

IntroductionShoulder pain due to irreparable rotator cuff tears can cause substantial disability, but treatment options are limited. A balloon spacer is a relatively simple addition to a standard arthroscopic debridement procedure, but it is costly and there is no current randomised trial evidence to support its use. This trial will evaluate the clinical and cost-effectiveness of a subacromial balloon spacer for individuals undergoing arthroscopic debridement for irreparable rotator cuff tears.New surgical procedures can provide substantial benefit to patients. Good quality randomised controlled trials (RCTs) are needed, but trials in surgery are typically long and expensive, exposing patients to risk and the healthcare system to substantial costs. One way to improve the efficiency of trials is with an adaptive sample size. Such methods are well established in drug trials but have rarely, if ever, been used in surgical trials.Methods and analysisSubacromial spacer for Tears Affecting Rotator cuff Tendons: a Randomised, Efficient, Adaptive Clinical Trial in Surgery (START:REACTS) is a participant and assessor blinded, adaptive, multicentre RCT comparing arthroscopic debridement with the InSpace balloon (Stryker, USA) to arthroscopic debridement alone for people with a symptomatic irreparable rotator cuff tear. It uses a group sequential adaptive design where interim analyses are performed using all of the 3, 6 and 12-month data that are available at each time point. A maximum of 221 participants will be randomised (1:1 ratio), this will provide 90% power (at the 5% level) for a 6 point difference in the primary outcome; the Oxford Shoulder Score at 12 months. A substudy will use deltoid-active MRI scans in 56 participants to assess the function of the balloon. Analysis will be on an intention-to-treat basis and reported according to principles established in the Consolidated Standards of Reporting Trials statement.Ethics and disseminationNRES number 18/WM/0025. The results will be disseminated via peer-reviewed publications, presentations at conferences, lay summaries and social media.Trial registration numberISRCTN17825590
Investigating the potential for seizure prediction in dogs with idiopathic epilepsy: owner‐reported prodromal changes and seizure triggers
Authors: Finnegan Sarah Louise , Volk Holger Andreas , Asher Lucy , Daley Monica , Packer Rowena Mary Anne 
Published: May 2020

BackgroundCanine idiopathic epilepsy (IE) is characterised by recurrent seizure activity, which can appear unpredictable and uncontrollable. The purpose of this study was to investigate the potential for seizure prediction in dogs by exploring owner‐perceived seizure prediction abilities and identifying owner‐reported prodromal changes (long‐term changes in disposition that indicate forthcoming seizures) and seizure triggers (stimuli that precipitate seizures) in dogs with IE.MethodsThis is an online, international, cross‐sectional survey of 229 owners of dogs diagnosed with IE, meeting the International Veterinary Epilepsy Task Force tier I diagnostic criteria.ResultsOver half (59.6 per cent) of owners believed they were able to predict an upcoming seizure in their dog, of whom nearly half (45.5 per cent) were able to do so at least 30 minutes before the seizure commenced. The most common ‘seizure predictors’ were preseizure behavioural changes including increased clinginess (25.4 per cent), restlessness (23.1 per cent) and fearful behaviour (19.4 per cent). Nearly two‐thirds of owners reported prodromal changes (64.9 per cent), most commonly restlessness (29.2 per cent), and nearly half (43.1 per cent) reported seizure triggers, most commonly stress (39.1 per cent).ConclusionsThe relatively high prevalence of owner‐reported prodromal changes and seizure triggers shows promise for utilising these methods to aid seizure prediction in dogs, which could open a window of time for pre‐emptive, individualised drug interventions to abort impending seizure activity.
Antibiotic resistance in bacteria associated with equine respiratory disease in the United Kingdom
Authors: Fonseca Joana D , Mavrides Daphne E , Morgan Alice L , Na Jea G , Graham Peter A , McHugh Timothy D 
Published: May 2020

IntroductionRespiratory diseases account for the highest number of clinical problems in horses compared with other body systems. While microbiological culture and sensitivity testing is essential for certain cases, knowledge of the most likely bacterial agents and their susceptibilities is necessary to inform empirical antibiotic choices.MethodsA retrospective study of microbiological and cytological results from upper and lower respiratory samples (n=615) processed in a commercial laboratory between 2002 and 2012 was carried out. A further study of lower respiratory samples from horses with clinical signs of lower respiratory disease from May to June 2012 was undertaken.ResultsBoth studies revealedStreptococcus equisubspecieszooepidemicus,Pseudomonas aeruginosa,Pasteurellaspecies,Escherichia coliandBordetella bronchisepticaas the most frequently isolated species.S equisubspecieszooepidemicusand subspeciesequiwere susceptible to ceftiofur (100 per cent) and erythromycin (99 per cent). Resistance to penicillin (12.5 per cent ofS equisubspeciesequifrom upper respiratory tract samples) and tetracycline (62.7 per cent) was also detected. Gram‐negative isolates showed resistance to gentamicin, trimethoprim‐sulfamethoxazole and tetracycline but susceptibility to enrofloxacin (exceptPseudomonasspecies, where 46.2 per cent were resistant). Multiple drug resistance was detected in 1 per cent of isolates.ConclusionResistance to first‐choice antibiotics in common equine respiratory tract bacteria was noted and warrants continued monitoring of their susceptibility profiles. This can provide information to clinicians about the best empirical antimicrobial choices against certain pathogenic bacteria and help guide antibiotic stewardship efforts to converse their efficacy.
Starting strong: Dietary, behavioral, and environmental factors that promote “strength” from conception to age 2 years
Authors: Murray Robert 
Published: May 2020

Beginning with conception and continuing through childhood and adolescence, the word “strength” connotes the totality of optimal early bone and tissue growth; neural wiring of the brain; and acquisition of fine motor, gross motor, language, and socioemotional skills. The robustness of each of these attributes depend on 3 critical epigenetic (external) factors: the quality of nutrition; positive adult nurturing; and experiences acquired within a stimulating, safe environment that affords free exploration. This review highlights the relationship between the epigenetic factors in the period of conception to age 2 years and a child’s future health, cognitive capacity, and social aptitude, which collectively comprise their “strength”. This paper was presented as part of the 2018 Strength Summit conference entitled, The Role of Strength in Optimal Health and Well-being.Novelty Strength in infants signifies the totality of optimal early growth and neural wiring of the brain. Strength at this life stage also includes the acquisition of motor, language, and socioemotional skills. Three epigenetic factors are critical during birth to 24 months: nutrition, nurturing, and free exploration.
Weed control and crop safety in sulfonylurea/glyphosate-resistant soybean
Authors: Ganie Zahoor A. , Jhala Amit J. 
Published: May 2020

A soybean trait resistant to sulfonylurea herbicides along with glyphosate (Bolt™ soybean) has been developed. Information is needed to determine herbicide programs for weed control and crop safety in this new multiple herbicide–resistant soybean trait. The objectives of this study were to evaluate weed control and crop safety in sulfonylurea/glyphosate-resistant soybean with herbicide programs, including but not limited to acetolactate synthase (ALS) inhibitors. Field experiments were conducted near Clay Center, NE, USA, in 2016 and 2017. Herbicide programs with multiple sites-of-action including rimsulfuron/thifensulfuron in mixture with flumioxazin, flumioxazin/chlorimuron, pyroxasulfone, chlorimuron/metribuzin, or saflufenacil/imazethapyr plus dimethenamid-P provided 91%–97% control of common waterhemp, velvetleaf, and common lambsquarters. Rimsulfuron and (or) thifensulfuron resulted in 92%–97% control of velvetleaf and common lambsquarters and 81%–87% common waterhemp control at 21 d after pre-emergence (PRE) (DAPRE) herbicide application. Soybean injury was transient and varied from 3% to 11% at 21 DAPRE and 14 d after post-emergence (POST) (DAPOST) herbicide application without causing yield loss. At 30 and 60 DAPOST, 87%–97% velvetleaf control and 92%–98% common lambsquarters control was achieved with herbicide programs tested (PRE, POST, or PRE followed by POST). Common waterhemp control at 30 and 60 DAPOST was not consistent between years. Weed density and biomass reduction were mostly similar to weed control achieved. Untreated control resulted in the lowest soybean yield (1811 kg ha−1) in 2016 compared with 3406–4611 kg ha−1 in herbicide programs.
EVOLVE: A Multicenter Open-Label Single-Arm Clinical and Translational Phase II Trial of Cediranib Plus Olaparib for Ovarian Cancer after PARP Inhibition Progression
Authors: Lheureux Stephanie , Oaknin Ana , Garg Swati , Bruce Jeffrey P. , Madariaga Ainhoa , Dhani Neesha C. , Bowering Valerie , White Justin , Accardi Sarah , Tan Qian , Braunstein Marsela , Karakasis Katherine , Cirlan Iulia , Pedersen Stephanie , Li Tiantiam , Fariñas-Madrid Lorena , Lee Yeh Chen , Liu Zhihui (Amy) , Pugh Trevor J. , Oza Amit M. 
Published: May 2020

AbstractPurpose:PARP inhibitors (PARPi) are standard-of-care therapy for high-grade serous ovarian cancer (HGSOC). We investigated combining cediranib (antiangiogenic) with olaparib (PARPi) at emergence of PARPi resistance.Patients and Methods:The proof-of-concept EVOLVE study (NCT02681237) assessed cediranib–olaparib combination therapy after progression on a PARPi. Women with HGSOC and radiographic evidence of disease progression were enrolled into one of three cohorts: platinum sensitive after PARPi; platinum resistant after PARPi; or progression on standard chemotherapy after progression on PARPi (exploratory cohort). Patients received olaparib tablets 300 mg twice daily with cediranib 20 mg once daily until progression or unacceptable toxicity. The coprimary endpoints were objective response rate (RECIST v1.1) and progression-free survival (PFS) at 16 weeks. Archival tissue (PARPi-naïve) and baseline biopsy (post-PARPi) samples were mandatory. Genomic mechanisms of resistance were assessed by whole-exome and RNA sequencing.Results:Among 34 heavily pretreated patients, objective responses were observed in 0 of 11 (0%) platinum-sensitive patients, 2 of 10 (20%) platinum-resistant patients, and 1 of 13 (8%) in the exploratory cohort. Sixteen-week PFS rates were 55%, 50%, and 39%, respectively. The most common grade 3 toxicities were diarrhea (12%) and anemia (9%). Acquired genomic alterations at PARPi progression were reversion mutations in BRCA1, BRCA2, or RAD51B (19%); CCNE1 amplification (16%); ABCB1 upregulation (15%); and SLFN11 downregulation (7%). Patients with reversion mutations in homologous recombination genes and/or ABCB1 upregulation had poor outcomes.Conclusions:This is currently the largest post-PARPi study identifying genomic mechanisms of resistance to PARPis. In this setting, the activity of cediranib–olaparib varied according to the PARPi resistance mechanism.
Genomic Methods Identify Homologous Recombination Deficiency in Pancreas Adenocarcinoma and Optimize Treatment Selection
Authors: Park Wungki , Chen Jiapeng , Chou Joanne F. , Varghese Anna M. , Yu Kenneth H. , Wong Winston , Capanu Marinela , Balachandran Vinod , McIntyre Caitlin A. , El Dika Imane , Khalil Danny N. , Harding James J. , Ghalehsari Nima , McKinnell Zoe , Chalasani Sree B. , Makarov Vladimir , Selenica Pier , Pei Xin , Lecomte Nicolas , Kelsen David P. , Abou-Alfa Ghassan K. , Robson Mark E. , Zhang Liying , Berger Michael F. , Schultz Nikolaus , Chan Timothy A. , Powell Simon N. , Reis-Filho Jorge S. , Iacobuzio-Donahue Christine A. , Riaz Nadeem , O'Reilly Eileen M. 
Published: May 2020

AbstractPurpose:Genomic methods can identify homologous recombination deficiency (HRD). Rigorous evaluation of their outcome association to DNA damage response–targeted therapies like platinum in pancreatic ductal adenocarcinoma (PDAC) is essential in maximizing therapeutic outcome.Experimental Design:We evaluated progression-free survival (PFS) and overall survival (OS) of patients with advanced-stage PDAC, who had both germline- and somatic-targeted gene sequencing. Homologous recombination gene mutations (HRm) were evaluated: BRCA1, BRCA2, PALB2, ATM, BAP1, BARD1, BLM, BRIP1, CHEK2, FAM175A, FANCA, FANCC, NBN, RAD50, RAD51, RAD51C, and RTEL1 HRm status was grouped as: (i) germline versus somatic; (ii) core (BRCAs and PALB2) versus non-core (other HRm); and (iii) monoallelic versus biallelic. Genomic instability was compared using large-scale state transition, signature 3, and tumor mutation burden.Results:Among 262 patients, 50 (19%) had HRD (15% germline and 4% somatic). Both groups were analyzed together due to lack of difference in their genomic instability and outcome. Median [95% confidence interval (CI)] follow-up was 21.9 (1.4–57.0) months. Median OS and PFS were 15.5 (14.6–19) and 7 (6.1–8.1) months, respectively. Patients with HRD had improved PFS compared with no HRD when treated with first-line (1L) platinum [HR, 0.44 (95% CI: 0.29–0.67); P &lt; 0.01], but not with 1L-non-platinum. Multivariate analysis showed HRD patients had improved OS regardless of their first-line treatment, but most had platinum exposure during their course. Biallelic HRm (11%) and core HRm (12%) had higher genomic instability, which translated to improved PFS on first-line platinum (1L-platinum) versus 1L-non-platinum.Conclusions:Pathogenic HRm identifies HRD in patients with PDAC with the best outcome when treated with 1L-platinum. Biallelic HRm and core HRm further enriched benefit from 1L-platinum from HRD.