bluuebunny/crossref_metadata_2025_split huggingface dataset:
Type 2 Diabetes and Cancer: An Umbrella Review of Observational and Mendelian Randomization Studies
Authors: Pearson-Stuttard Jonathan , Papadimitriou Nikos , Markozannes Georgios , Cividini Sofia , Kakourou Artemisia , Gill Dipender , Rizos Evangelos C. , Monori Grace , Ward Heather A. , Kyrgiou Maria , Gunter Marc J. , Tsilidis Konstantinos K. 
Published: March 2021

Abstract

Background:
Type 2 diabetes mellitus (T2DM) has been associated with an increased risk of developing several common cancers, but it is unclear whether this association is causal. We aimed to summarize the evidence on T2DM and cancer and evaluate the validity of associations from both observational and Mendelian randomization (MR) studies.

Methods:
We performed an umbrella review of the evidence across meta-analyses of observational studies that examined associations of T2DM with risk of developing or dying from site-specific cancers, and MR studies that explored the potential causal association of T2DM and associated biomarkers with cancer risk.

Results:
We identified eligible observational meta-analyses that assessed associations between T2DM and cancer incidence for 18 cancer sites, cancer mortality for seven sites, and cancer incidence or mortality for four sites. Positive associations between T2DM and six cancers reached strong or highly suggestive evidence. We found eight MR studies assessing the association of genetically predicted T2DM and seven and eight studies assessing the association of genetically predicted fasting insulin or fasting glucose concentrations, respectively, upon site-specific cancers. Positive associations were found between genetically predicted T2DM and fasting insulin and risk of six cancers. There was no association between genetically predicted fasting plasma glucose and cancer except for squamous cell lung carcinoma.

Conclusions:
We found robust observational evidence for the association between T2DM and colorectal, hepatocellular, gallbladder, breast, endometrial, and pancreatic cancers.

Impact:
Potential causal associations were identified for genetically predicted T2DM and fasting insulin concentrations and risk of endometrial, pancreas, kidney, breast, lung, and cervical cancers.
Concentrations of Cotinine and 4-(Methylnitrosamino)-1-(3-Pyridyl)-1-Butanol (NNAL) in U.S. Non-Daily Cigarette Smokers
Authors: Gutiérrez-Torres Daniela S. , Wang Lanqing , Blount Benjamin C. , Xia Baoyun , Sosnoff Connie S. , Shiels Meredith S. , Inoue-Choi Maki , Etemadi Arash , Freedman Neal D. 
Published: March 2021

Abstract

Background:
Accumulating evidence suggests that non-daily smokers have higher disease and mortality risks than never smokers. Yet, the accuracy of self-reported non-daily cigarette smoking is poorly understood.

Methods:
We examined the concordance between self-reported non-daily smoking and serum cotinine in 18,835 adult participants (20 years or older) of the 2007 to 2014 National Health and Nutrition Examination Surveys, in comparison with daily smokers and nonsmokers. We also analyzed concentrations of the urinary biomarker 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) by smoking status.

Results:
In the study sample, 77.8% (14,660) reported currently not smoking (nonsmokers), 18.3% (3,446) smoked every day (daily smokers), and 3.9% (729) smoked on some days of the past month (non-daily smokers). Just 2.1% of nonsmokers had cotinine concentrations in the active smoking range (&gt;10 ng/mL), compared with 70.4% of non-daily and 98.8% of daily smokers. Non-daily smokers reported smoking a median of 24 cigarettes per month [interquartile range (IQR) = 9–60] and had substantially higher concentrations of NNAL (median = 72.5; IQR = 14.8–211.0 pg/mL) than nonsmokers (median = 0.4; IQR = 0.4–2.1 pg/mL), although lower than daily smokers (median = 294.0; IQR = 148.0–542.0 pg/mL). Among non-daily smokers, concentrations of cotinine and NNAL were positively correlated with days and cigarettes smoked per month (P &lt; 0.001).

Conclusions:
We observed excellent concordance between self-reported non-daily cigarette smoking and concentrations of serum cotinine.

Impact:
These results provide evidence for the validity of self-reported non-daily smoking and indicate that non-daily smokers are exposed to substantial concentrations of carcinogenic nitrosamines regardless of the low number of cigarettes they smoke per month.
Circulating Protein Biomarkers for Use in Pancreatic Ductal Adenocarcinoma Identification
Authors: Lindgaard Sidsel C. , Sztupinszki Zsófia , Maag Emil , Chen Inna M. , Johansen Astrid Z. , Jensen Benny V. , Bojesen Stig E. , Nielsen Dorte L. , Hansen Carsten P. , Hasselby Jane P. , Nielsen Kaspar R. , Szallasi Zoltan , Johansen Julia S. 
Published: March 2021

Abstract

Purpose:
Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal solid tumors. Most patients are diagnosed at an advanced stage where curative surgery is not an option. The aim of this study was to identify a panel of circulating proteins that could distinguish patients with PDAC from non-PDAC individuals.

Experimental Design:
We investigated 92 proteins known to be involved in inflammation, development, and progression of PDAC using the Olink immuno-oncology panel in serum samples from 701 patients with PDAC (stage I–IV), 102 patients with nonmalignant pancreatic diseases, and 180 healthy blood donors. Patients were included prospectively between 2008 and 2018. Plasma carbohydrate antigen 19-9 (CA19-9) was measured in all samples. The protein panels with the best diagnostic performances were developed by two bioinformaticians working independently, using LASSO and Ridge regression models.

Results:
Two panels of proteins (index I, containing 9 proteins + CA19-9, and index II, containing 23 proteins + CA19-9) were identified. Index I was able to discriminate patients with PDAC from all patients with non-PDAC, with a ROC AUC value of 0.92 [95% confidence interval (CI), 0.89–0.96] in the discovery cohort and 0.92 (95% CI, 0.87–0.97) in the replication cohort. For index II, the AUC value was 0.96 (95% CI, 0.95–0.98) in the discovery cohort and 0.93 (95% CI, 0.90–0.96) in the replication cohort. All nine serum proteins of index I were found in index II.

Conclusions:
This study identified two circulating protein indices with the potential to discriminate between individuals with and without PDAC.
Coronary Collateral Flow Index Is Correlated With the Palmar Collateral Flow Index
Authors: Hollander Maurits R. , Jansen Matthijs F. , Schumacher Stefan P. , Stuijfzand Wijnand J. , van Leeuwen Maarten A.H. , van de Ven Peter M. , Horrevoets Anton J. , Nap Alex , Knaapen Paul , van Royen Niels 
Published: March 2021

Objective:
The extent of the collateral circulation varies between individuals which affects morbidity and mortality. Experimental data show that collateral coherence between different organs is strain-dependent. Whether this interrelation is also present in humans is unknown. This study investigates the relation between the palmar and the coronary circulation in patients with coronary artery disease and which factors possibly influence collateral development.

Approach and Results:

In 50 patients with a chronic total occlusion, both the coronary collateral flow index (CFI) and the palmar CFI was measured. The correlation between both indices was determined, together with the relation to clinical variables. Mean coronary CFI was 0.51±0.16, and mean palmar CFI was 0.82±0.13. The coronary and palmar CFI were significantly correlated (ρ=0.48,
P
=0.001). Coronary CFI was 22% lower in low palmar CFI patients (<0.82) as compared with high palmar CFI patients (0.43±0.12 versus 0.57±0.18,
P
=0.03). In multivariable analysis, coronary CFI was significantly correlated with the palmar CFI and the duration of angina pectoris. Coronary CFI was inversely correlated with peripheral artery disease and systolic blood pressure.

Conclusions:
The coronary CFI and palmar CFI are significantly correlated, implicating collateral coherence between vascular beds in humans.
Impact of Reactive Oxidative Metabolites Among New Categories of Nonischemic Heart Failure
Authors: Nishihara Taiki , Yamamoto Eiichiro , Sueta Daisuke , Fujisue Koichiro , Usuku Hiroki , Oike Fumi , Takae Masafumi , Tabata Noriaki , Ito Miwa , Yamanaga Kenshi , Kanazawa Hisanori , Arima Yuichiro , Araki Satoshi , Takashio Seiji , Nakamura Taishi , Suzuki Satoru , Sakamoto Kenji , Izumiya Yasuhiro , Kaikita Koichi , Tsujita Kenichi 
Published: March 2021

Background
We investigated the clinical significance of derivatives of reactive oxygen metabolites (DROMs), a new marker of reactive oxygen species, in patients with nonischemic heart failure (HF) and compared them among new categories of HF.

Methods and Results
We recruited 201 consecutively hospitalized patients with HF and measured DROM under stable conditions. Then, we divided them according to new categories of HF (HF with reduced ejection fraction [EF], HF with midrangeEF, and HF with preserved EF) without coronary artery disease. In subgroup analysis, we followed EF changes in patients with HF with reduced EF and classified them into HF with recovered EF or nonrecovered EF according to whether EF had improved to >40%. DROMs are significantly and independently associated with HF‐related events in patients with NIHF. There were no significant differences in DROM and the probability of HF‐related events among HF categories in Kaplan–Meier analysis. However, patients with HF with reduced EF and HF with preserved EF but not HF with midrange EF with HF‐related events had higher DROM than those without HF‐related events. In subgroup analysis, Kaplan–Meier analysis demonstrated that the probabilities of HF‐related events in HF with recovered EF were dramatically decreased. DROM were significantly higher in patients with HF with nonrecovered EF than in HF with recovered EF. In receiver operating characteristic analysis, the cutoff level of DROM for predicting improvements in HF with recovered EF was 347 Carratelli units. Furthermore, the C‐statistic value for predicting EF improvement for the DROM levels was 0.703. In multivariable logistic regression analysis, DROM was independently and significantly associated with the prediction of HF with recovered EF.

Conclusions
DROM measurements can provide important prognostic information for risk stratification in any category of NIHF.

Registration

URL:
https://www.umin.ac.jp/ctr/
; Unique identifier: UMIN000035827.
Tuberculosis and the Heart
Authors: López‐López José Patricio , Posada‐Martínez Edith L. , Saldarriaga Clara , Wyss Fernando , Ponte‐Negretti Carlos I. , Alexander Bryce , Miranda‐Arboleda Andrés Felipe , Martínez‐Sellés Manuel , Baranchuk Adrian ,   the Neglected Tropical Diseases, Other Infectious Diseases Affecting the Heart (the NET‐Heart Project)
Published: March 2021

Abstract
Acquired tuberculosis continues to be a challenge worldwide. Although tuberculosis has been considered a global public health emergency, it remains poorly controlled in many countries. Despite being primarily a pulmonary disease, tuberculosis could involve the heart. This systematic review is part of the "Neglected Tropical Diseases and Other Infectious Diseases Involving the Heart" (the NET‐Heart Project) initiative from the Interamerican Society of Cardiology. This project aims to review the cardiovascular involvement of these heterogeneous diseases, advancing original algorithms to help healthcare providers diagnose and manage cardiovascular complications. In tuberculosis, pericardium involvement is relatively common, especially in AIDS, and tuberculosis is the most common cause of constrictive pericarditis in endemic countries. Myocarditis and aortitis by tuberculosis are rare. Clinical manifestations of cardiovascular involvement by tuberculosis differ from those typically found for bacteria or viruses. Prevailing systemic symptoms and the pericarditis diagnostic index should be taken into account. An echocardiogram is the first step for diagnosing cardiovascular involvement; however, several image modalities can be used, depending on the suspected site of infection. Adenosine deaminase levels, gamma interferon, or polymerase chain reaction testing could be used to confirm tuberculosis infection; each has a high diagnostic performance. Antituberculosis chemotherapy and corticosteroids are treatment mainstays that significantly reduce mortality, constriction, and hospitalizations, especially in patients with HIV. In conclusion, tuberculosis cardiac involvement is frequent and could lead to heart failure, constrictive pericarditis, or death. Early detection of complications should be a cornerstone of overall management.
The Impact of Noah-MP Physical Parameterizations on Modeling Water Availability during Droughts in the Texas-Gulf Region
Authors: Wu Wen-Ying , Yang Zong-Liang , Barlage Michael 
Published: March 2021

AbstractTexas is subject to severe droughts, including the record-breaking one in 2011. To investigate the critical hydrometeorological processes during drought, we use a land surface model, Noah-MP, to simulate water availability and investigate the causes of the record drought. We conduct a series of experiments with runoff schemes, vegetation phenology, and plant rooting depth. Observation-based terrestrial water storage, evapotranspiration, runoff, and leaf area index are used to compare with results from the model. Overall, the results suggest that using different parameterizations can influence the modeled water availability, especially during drought. The drought-induced vegetation responses not only interact with water availability but also affect the ground temperature. Our evaluation shows that Noah-MP with a groundwater scheme produces a better temporal relationship in terrestrial water storage compared with observations. Leaf area index from dynamic vegetation is better simulated in wet years than dry years. Reduction of positive biases in runoff and reduction of negative biases in evapotranspiration are found in simulations with groundwater, dynamic vegetation, and deeper rooting zone depth. Multi-parameterization experiments show the uncertainties of drought monitoring and provide a mechanistic understanding of disparities in dry anomalies.
Use of Vandenberg and Kuse Mental Rotation Test to Predict Practical Performance of Sinus Endoscopy
Authors: Rogister Florence , Pottier Laurence , El Haddadi Ilyas , Monseur Justine , Donneau Anne-Françoise , Diep Anh Nguyet , Camby Séverine , Defaweux Valérie , Bonnet Pierre , Tombu Sophie , Lefebvre Philippe , Poirrier Anne-Lise 
Published: March 2021

Objectives: The aim of this study was to assess the predictive value of the Vandenberg and Kuse Mental Rotation Test (MRT) on performance of novice medical students for manipulation of a nasal endoscope on a cadaveric model. Material and Method: We randomly selected 39 medical students who had never handled a nasal endoscope and subjected them to the MRT. General information including experience in manual, technical, or surgical activities and testing of anatomical knowledge were collected to exclude possible confounding factors. They were then asked to perform series of cadaveric model exercises using a nasal endoscope. Their cadaver performance was evaluated by 2 blinded observers, using a standardized scale. Results: We found that medical students with higher mental rotation skills had significantly increased endoscopic sinus performance ( P = .0002 using multivariate regression adjusted for specialty choice, previous surgical exposure, and anatomy knowledge). Higher anatomy knowledge was also associated with better endoscopic sinus performance ( P = .0141). Other parameters had no impact on endoscopic sinus performance measured by the endoscopic scale ( P > .05). Conclusion: The score obtained on the MRT was correlated with the practical performance of manipulating the nasal endoscope in cadaver. It could therefore be a useful spatial ability tool for directing targeted training in rhinology.
Gender Norms and Household Labor: Time Use in the Context of Social Class Differentiation in Transitional China
Authors: Zhang Wei , Xu Zhun 
Published: March 2021

This paper studies the historical evolution of China’s gender relations through the lens of housework time allocation. In particular, we highlight the role played by social class and income. Drawing upon data from the Chinese Health and Nutrition Survey, we find that during the period 1991–2011, being a peasant or earning less than the spouse was increasingly associated with a higher share of housework. The market process appears to have indirectly improved the social status of women (most likely rural women) married to peasant husbands as measured by the former’s declining housework share. Such changes, however, have not challenged traditional patriarchal norms in the countryside and have even facilitated the rise of a new market-based patriarchy. Policy makers should empower women by tackling the different faces of patriarchy as a whole. JEL Classification: B51, J16, P16
Too Much of a Good Thing: Quality-Differentiated Demand and Monopoly Bias
Authors: Adams Charles F. 
Published: March 2021

Previous teaching notes focused on the logic and mechanics of a quality-differentiated linear demand structure. This note takes up the question of potential bias in how markets respond to quality-related aspects of consumer choice. Earlier examples demonstrated instances where monopoly interests might conflict with those of consumers in matters of quality choice. This article points to a more general propensity toward excessively high levels of quality under a monopoly market structure. JEL Classifications: D4, D41, D42
Cardiovascular Risk Assessment in the Older Athlete
Authors: Moorman Alec J. , Dean Larry S. , Yang Eugene , Drezner Jonathan A. 
Published: March 2021

Context: Limited data are available to guide cardiovascular screening in adult or masters athletes (≥35 years old). This review provides recommendations and the rationale for the cardiovascular risk assessment of older athletes. Evidence Acquisition: Review of available clinical guidelines, original investigations, and additional searches across PubMed for articles relevant to cardiovascular screening, risk assessment, and prevention in adult athletes (1990-2020). Study Design: Clinical review. Level of Evidence: Level 3. Results: Atherosclerotic coronary artery disease (CAD) is the leading cause of exercise-induced acute coronary syndromes, myocardial infarction, and sudden cardiac death in older athletes. Approximately 50% of adult patients who experience acute coronary syndromes and sudden cardiac arrest do not have prodromal symptoms of myocardial ischemia. The risk of atherosclerotic cardiovascular disease (ASCVD) can be estimated by using existing risk calculators. ASCVD 10-year risk is stratified into 3 categories: low-risk (≤10%), intermediate-risk (between 10% and 20%), and high-risk (≥20%). Coronary artery calcium (CAC) scoring with noncontrast computed tomography provides a noninvasive measure of subclinical CAD. Evidence supports a significant association between elevated CAC and the risk of future cardiovascular events, independent of traditional risk factors or symptoms. Statin therapy is recommended for primary prevention if 10-year ASCVD risk is ≥10% (intermediate- or high-risk patients) or if the Agatston score is >100 or >75th percentile for age and sex. Routine stress testing in asymptomatic, low-risk patients is not recommended. Conclusion: We propose a comprehensive risk assessment for older athletes that combines conventional and novel risk factors for ASCVD, a 12-lead resting electrocardiogram, and a CAC score. Available risk calculators provide a 10-year estimate of ASCVD risk allowing for risk stratification and targeted management strategies. CAC scoring can refine risk estimates to improve the selection of patients for initiation or avoidance of pharmacological therapy.
“I Felt I Was Reaching a Point with My Health”: Understanding Reasons for Engagement and Acceptability of Treatment Services for Unhealthy Alcohol Use in Primary Care
Authors: O’Grady Megan A. , Conigliaro Joseph , Levak Svetlana , Morley Jeanne , Kapoor Sandeep , Ritter Melanie , Marini Christina , Morgenstern Jon 
Published: March 2021

Introduction/Objectives: Despite increasing need, there are large gaps in provision of care for unhealthy alcohol use. Primary care practices have become increasingly important in providing services for unhealthy alcohol use, yet little is known about the reasons patients engage in these services and their views on acceptability of such programs. The purpose of this study was to examine primary care patients’ reasons for engagement, experiences with, and acceptability of a primary care practice-based program for treating unhealthy alcohol use. Methods: This qualitative study was conducted in a primary care practice that was developing a collaborative care model for treating unhealthy alcohol use in primary care. Semi-structured interviews were conducted with 24 primary care patients. Data were analyzed using conventional qualitative content analysis. Results: Findings suggest that patients engaged for both internal (concerns about drinking and health) and external reasons (family or provider concern). Patient experiences in the program were shaped by their affective responses (enjoyable, enlightening), as well as therapeutic benefits (gaining new insights about drinking; staff/provider support). Acceptability was driven by core program elements (medication, therapy, integration) as well as positive impacts on drinking cognition and behavior and flexible, patient-centered approaches. Conclusions: Offering flexible and comprehensive programs with mutiple elements and both abstinence and moderation goals could also improve patient engagement and views on acceptability. Primary care practices will need to be thoughtful about the resources needed to implement these programs in terms of staffing, training, and program support.