bluuebunny/crossref_metadata_2025_split huggingface dataset:
International clinical practice guidelines for gender minority/trans people: systematic review and quality assessment
Authors: Dahlen Sara , Connolly Dean , Arif Isra , Junejo Muhammad Hyder , Bewley Susan , Meads Catherine 
Published: April 2021

ObjectivesTo identify and critically appraise published clinical practice guidelines (CPGs) regarding healthcare of gender minority/trans people.DesignSystematic review and quality appraisal using AGREE II (Appraisal of Guidelines for Research and Evaluation tool), including stakeholder domain prioritisation.SettingSix databases and six CPG websites were searched, and international key opinion leaders approached.ParticipantsCPGs relating to adults and/or children who are gender minority/trans with no exclusions due to comorbidities, except differences in sex development.InterventionAny health-related intervention connected to the care of gender minority/trans people.Main outcome measuresNumber and quality of international CPGs addressing the health of gender minority/trans people, information on estimated changes in mortality or quality of life (QoL), consistency of recommended interventions across CPGs, and appraisal of key messages for patients.ResultsTwelve international CPGs address gender minority/trans people’s healthcare as complete (n=5), partial (n=4) or marginal (n=3) focus of guidance. The quality scores have a wide range and heterogeneity whichever AGREE II domain is prioritised. Five higher-quality CPGs focus on HIV and other blood-borne infections (overall assessment scores 69%–94%). Six lower-quality CPGs concern transition-specific interventions (overall assessment scores 11%–56%). None deal with primary care, mental health or longer-term medical issues. Sparse information on estimated changes in mortality and QoL is conflicting. Consistency between CPGs could not be examined due to unclear recommendations within the World Professional Association for Transgender Health Standards of Care Version 7 and a lack of overlap between other CPGs. None provide key messages for patients.ConclusionsA paucity of high-quality guidance for gender minority/trans people exists, largely limited to HIV and transition, but not wider aspects of healthcare, mortality or QoL. Reference to AGREE II, use of systematic reviews, independent external review, stakeholder participation and patient facing material might improve future CPG quality.PROSPERO registration numberCRD42019154361.
Area under the expiratory flow-volume curve: predicted values by regression and deep learning methods and recommendations for clinical practice
Authors: Ioachimescu Octavian C , Ramos José A , Hoffman Michael , Stoller James K 
Published: April 2021

BackgroundIn spirometry, the area under expiratory flow-volume curve (AEX-FV) was found to perform well in diagnosing and stratifying physiologic impairments, potentially lessening the need for complex lung volume testing. Expanding on prior work, this study assesses the accuracy and the utility of several models of estimating AEX-FV based on forced vital capacity (FVC) and several instantaneous flows. These models could be incorporated in regular spirometry reports, especially when actual AEX-FV measurements are not available.MethodsWe analysed 4845 normal spirometry tests, performed on 3634 non-smoking subjects without known respiratory disease or complaints. Estimated AEX-FV was computed based on FVC and several flows: peak expiratory flow, isovolumic forced expiratory flow at 25%, 50% and 75% of FVC (FEF25,FEF50and FEF75, respectively). The estimations were based on simple regression with and without interactions, by optimised regression models and by a deep learning algorithm that predicted the response surface of AEX-FV without interference from any predictor collinearities or normality assumption violations.ResultsMedian/IQR of actual square root of AEX-FV was 3.8/3.1–4.5 L2/s. The per cent of variance (R2) explained by the models selected was very high (>0.990), the effect of collinearities was negligible and the use of deep learning algorithms likely unnecessary for regular or routine pulmonary function testing laboratory usage.ConclusionsIn the absence of actual AEX-FV, a simple regression model without interactions between predictors or use of optimisation techniques can provide a reasonable estimation for clinical practice, thus making AEX-FV an easily available additional tool for interpreting spirometry.
Advanced cancer and COVID-19 comorbidity: medical oncology-palliative medicine ethics meetings in a comprehensive cancer centre
Authors: Thery Laura , Vaflard Pauline , Vuagnat Perrine , Soulie Ophélie , Dolbeault Sylvie , Burnod Alexis , Laouisset Céline , Marchal Timothée , Massiani Marie-Ange , Bozec Laurence , Bidard François-Clément , Cottu Paul , Angellier Elisabeth , Bouleuc Carole 
Published: April 2021

ObjectivesIn managing patients with cancer in the COVID-19 era, clinical oncologists and palliative care practitioners had to face new, disrupting and complex medical situations, challenging the quality of the shared decision-making process. During the first lockdown in France, we developed an onco-palliative ethics meeting to enhance the quality of the decision-making process for patients with advanced cancer treated for COVID-19.MethodsA least one of the institutional ethics committee members was present along with oncologists, palliative care teams, psycho-oncologists, radiologists and intensive care specialists. Specific medical parameters were systematically collected to form a standardised framework for the discussions.ResultsThe main raised issues were the definition of new criteria for the implementation of invasive resuscitation techniques, optimal ways to adapt or delay anticancer treatment and best procedures to address terminal respiratory failure and end-of-life care. The main clinical and ethical guidelines that emerged during these debates are presented. The palliative care team played a major role in assessing and reporting patients’ awareness of cancer-related prognosis and their wishes concerning invasive therapies or transfer to intensive care units, enabling an individualised benefit–risk balance assessment. The ethics committee members ensured continuous monitoring during the discussions. Their function was to recall the main ethical principles including dignity, which is conferred on people when there are treated as having equal status.ConclusionsThe onco-palliative ethics meeting provided a powerful avenue for improvement of collegiality and reinforcement of teamwork, which could be a major protection against burnout for healthcare professionals facing an epidemic onslaught.
Interplay between diet and gut microbiome, and circulating concentrations of trimethylamine N-oxide: findings from a longitudinal cohort of US men
Authors: Li Jun , Li Yanping , Ivey Kerry L , Wang Dong D , Wilkinson Jeremy E , Franke Adrian , Lee Kyu Ha , Chan Andrew , Huttenhower Curtis , Hu Frank B , Rimm Eric B , Sun Qi 
Published: April 2021

ObjectivesGut-produced trimethylamine N-oxide (TMAO) is postulated as a possible link between red meat intake and poor cardiometabolic health. We investigated whether gut microbiome could modify associations of dietary precursors with TMAO concentrations and cardiometabolic risk markers among free-living individuals.DesignWe collected up to two pairs of faecal samples (n=925) and two blood samples (n=473), 6 months apart, from 307 healthy men in the Men’s Lifestyle Validation Study. Diet was assessed repeatedly using food-frequency questionnaires and diet records. We profiled faecal metagenome and metatranscriptome using shotgun sequencing and identified microbial taxonomic and functional features.ResultsTMAO concentrations were associated with the overall microbial compositions (permutational analysis of variance (PERMANOVA) test p=0.001). Multivariable taxa-wide association analysis identified 10 bacterial species whose abundance was significantly associated with plasma TMAO concentrations (false discovery rate <0.05). Higher habitual intake of red meat and choline was significantly associated with higher TMAO concentrations among participants who were microbial TMAO-producers (p<0.05), as characterised based on four abundant TMAO-predicting species, but not among other participants (for red meat, P-interaction=0.003; for choline, P-interaction=0.03). Among abundant TMAO-predicting species, Alistipes shahii significantly strengthened the positive association between red meat intake and HbA1c levels (P-interaction=0.01). Secondary analyses revealed that some functional features, including choline trimethylamine-lyase activating enzymes, were associated with TMAO concentrations.ConclusionWe identified microbial taxa that were associated with TMAO concentrations and modified the associations of red meat intake with TMAO concentrations and cardiometabolic risk markers. Our data underscore the interplay between diet and gut microbiome in producing potentially bioactive metabolites that may modulate cardiometabolic health.
Going beyond ‘regular and casual’: development of a classification of sexual partner types to enhance partner notification for STIs
Authors: Estcourt Claudia S , Flowers Paul , Cassell Jackie A , Pothoulaki Maria , Vojt Gabriele , Mapp Fiona , Woode-Owusu Melvina , Low Nicola , Saunders John , Symonds Merle , Howarth Alison , Wayal Sonali , Nandwani Rak , Brice Susie , Comer Alex , Johnson Anne M , Mercer Catherine H 
Published: April 2021

ObjectivesTo develop a classification of sexual partner types for use in partner notification (PN) for STIs.MethodsA four-step process: (1) an iterative synthesis of five sources of evidence: scoping review of social and health sciences literature on partner types; analysis of relationship types in dating apps; systematic review of PN intervention content; and review of PN guidelines; qualitative interviews with public, patients and health professionals to generate an initial comprehensive classification; (2) multidisciplinary clinical expert consultation to revise the classification; (3) piloting of the revised classification in sexual health clinics during a randomised controlled trial of PN; (4) application of the Theoretical Domains Framework (TDF) to identify index patients’ willingness to engage in PN for each partner type.ResultsFive main partner types emerged from the evidence synthesis and consultation: ‘established partner’, ‘new partner’, ‘occasional partner’, ‘one-off partner’ and ‘sex worker’. The types differed across several dimensions, including likely perceptions of sexual exclusivity, likelihood of sex reoccurring between index patient and sex partner. Sexual health professionals found the classification easy to operationalise. During the trial, they assigned all 3288 partners described by 2223 index patients to a category. The TDF analysis suggested that the partner types might be associated with different risks of STI reinfection, onward transmission and index patients’ engagement with PN.ConclusionsWe developed an evidence-informed, useable classification of five sexual partner types to underpin PN practice and other STI prevention interventions. Analysis of biomedical, psychological and social factors that distinguish different partner types shows how each could warrant a tailored PN approach. This classification could facilitate the use of partner-centred outcomes. Additional studies are needed to determine the utility of the classification to improve measurement of the impact of PN strategies and help focus resources.
Nocturnal hypoxaemia in interstitial lung disease: a systematic review
Authors: Khor Yet Hong , Ng Yvonne , Sweeney Duncan , Ryerson Christopher J 
Published: April 2021

BackgroundPatients with interstitial lung disease (ILD) are at risk of developing nocturnal hypoxaemia due to ventilatory restriction and impaired gas exchange that worsen with supine posture and reduced ventilatory drive during sleep. This systematic review synthesised literature on the diagnostic evaluation, epidemiology, associations, management and prognosis of nocturnal hypoxaemia in ILD.MethodsOvid MEDLINE, Embase and CENTRAL databases were searched for eligible studies. Meta-analyses with subgroup analyses were conducted, where possible.ResultsFifty-three studies were included (total participant number=2590). The most common definition for clinically significant nocturnal hypoxaemia was ≥10% of total sleep time with oxyhaemoglobin saturation <90%, with pooled prevalence of 37%. There were no significant differences in pooled prevalence according to ILD subtype and comorbid obstructive sleep apnoea status. Study heterogeneity precluded meta-analysis of associations and prognosis. Diffusing capacity for carbon monoxide (DLCO) and echocardiographic features for pulmonary hypertension were consistently associated with nocturnal hypoxaemia. There were inconsistent associations between nocturnal hypoxaemia with ILD subtype and severity. Multivariable analyses in most studies demonstrated significant associations of nocturnal hypoxaemia with survival. Two small short-term intervention studies demonstrated that supplemental oxygen of 1–3 L/min corrected nocturnal hypoxaemia, with improved heart rate control during in-laboratory observation and increased serum antioxidant levels after 1 month of therapy.ConclusionNocturnal hypoxaemia is common, associated with DLCO impairment and markers suggestive of pulmonary hypertension, and a potential prognostic factor in patients in ILD. There is a need to establish a consensus definition of nocturnal hypoxaemia and evaluate long-term effects of nocturnal supplemental oxygen in ILD.
Non-comoving cold dark matter in a $$\varLambda $$CDM background
Authors: Nájera Sebastián , Sussman Roberto A. 
Published: April 2021

AbstractWe examine the evolution of peculiar velocities of cold dark matter (CDM) in localized arrays of inhomogeneous cosmic structures in a$$\varLambda $$ΛCDM background that can be identified as a frame comoving with the Cosmic Microwave (CMB). These arrays are constructed by smoothly matching to this cosmological background regions of Szekeres-II models whose source is an imperfect fluid reinterpreted as non-comoving dust, keeping only first order terms inv/c. Considering a single Szekeres-II region matched along two comoving interfaces to a$$\varLambda $$ΛCDM background, the magnitudes of peculiar velocities within this region are compatible with values reported in the literature, while the present day Hubble expansion scalar differs from that of the$$\varLambda $$ΛCDM background value by a 10% factor, a result that might provide useful information to the ongoing debate on the$$H_0$$H0tension. While the models cannot describe the virialization process, we show through a representative example that structures of galactic cluster mass reach the onset of this process at redshifts around$$z\sim 3$$z∼3.
Gravitational resonances on f(T)-branes
Authors: Tan Qin , Guo Wen-Di , Zhang Yu-Peng , Liu Yu-Xiao 
Published: April 2021

AbstractIn this work, we investigate the gravitational resonances in various f(T)-brane models with the warp factor $$\text {e}^{A(y)}=\tanh \big (k(y+b)\big )-\tanh \big (k(y-b)\big )$$

e

A
(
y
)

=
tanh

(

k

(
y
+
b
)

)

-
tanh

(

k

(
y
-
b
)

)

, where f(T) is an arbitrary function of the torsion scalar T. For three kinds of f(T), we give the solutions to the system. Besides, we consider the tensor perturbation of the vielbein and obtain the effective potentials by the Kaluza–Klein (KK) decomposition. Then we analyze what kind of effective potential can produce the gravitational resonances. The effects of different parameters on the gravitational resonances are analyzed. The lifetimes of the resonances could be long enough as regards the age of our universe in some ranges of the parameters. This indicates that the gravitational resonances might be considered as one of the candidates for dark matter. Combining the current experimental observations, we constrain the parameters for these brane models.
FGFR2Extracellular Domain In-Frame Deletions Are Therapeutically Targetable Genomic Alterations That Function as Oncogenic Drivers in Cholangiocarcinoma
Authors: Cleary James M. , Raghavan Srivatsan , Wu Qibiao , Li Yvonne Y. , Spurr Liam F. , Gupta Hersh V. , Rubinson Douglas A. , Fetter Isobel J. , Hornick Jason L. , Nowak Jonathan A. , Siravegna Giulia , Goyal Lipika , Shi Lei , Brais Lauren K. , Loftus Maureen , Shinagare Atul B. , Abrams Thomas A. , Clancy Thomas E. , Wang Jiping , Patel Anuj K. , Brichory Franck , Vaslin Chessex Anne , Sullivan Ryan J. , Keller Rachel B. , Denning Sarah , Hill Emma R. , Shapiro Geoffrey I. , Pokorska-Bocci Anna , Zanna Claudio , Ng Kimmie , Schrag Deborah , Jänne Pasi A. , Hahn William C. , Cherniack Andrew D. , Corcoran Ryan B. , Meyerson Matthew , Daina Antoine , Zoete Vincent , Bardeesy Nabeel , Wolpin Brian M. 
Published: April 2021

AbstractWe conducted next-generation DNA sequencing on 335 biliary tract cancers and characterized the genomic landscape by anatomic site within the biliary tree. In addition to frequent FGFR2 fusions among patients with intrahepatic cholangiocarcinoma (IHCC), we identified FGFR2 extracellular domain in-frame deletions (EID) in 5 of 178 (2.8%) patients with IHCC, including two patients with FGFR2 p.H167_N173del. Expression of this FGFR2 EID in NIH3T3 cells resulted in constitutive FGFR2 activation, oncogenic transformation, and sensitivity to FGFR inhibitors. Three patients with FGFR2 EIDs were treated with Debio 1347, an oral FGFR1/2/3 inhibitor, and all showed partial responses. One patient developed an acquired L618F FGFR2 kinase domain mutation at disease progression and experienced a further partial response for 17 months to an irreversible FGFR2 inhibitor, futibatinib. Together, these findings reveal FGFR2 EIDs as an alternative mechanism of FGFR2 activation in IHCC that predicts sensitivity to FGFR inhibitors in the clinic.Significance:FGFR2 EIDs are transforming genomic alterations that occur predominantly in patients with IHCC. These FGFR2 EIDs are sensitive to FGFR inhibition in vitro, and patients with these alterations benefited from treatment with FGFR inhibitors in the clinic.This article is highlighted in the In This Issue feature, p. 2355
Image encryption under spatial domain based on modify 2D LSCM chaotic map via dynamic substitution-permutation network
Authors: Mohammed Rana Saad , Jabbar Khalid Kadhim , Hilal Hussien Abid 
Published: April 2021

Image encryption has become an important application aspect of information security. Most attempts are focused on increasing the security aspect, the quality of the resulting image, and the time consumed. On the other hand, dealing with the color image under the spatial domain in this filed is considered as another challenge added to the proposed method that make it sensitivity and difficulty. The proposed method aims to encode a color image by dealing with the main color components of the red (R), green (G), and blue (B) components of a color image to strengthen the dependence of each component by modifying a two dimensional logistic- sine coupling map (2D- LSCM). This is to satisfy the statistical features and reduce time-consumption, and benefit from a mixing step of the second of advanced encryption standard (AES) candidates (serpent block cipher) and modified it to achieve in addition of confusion and diffusion processes. The experimental results showed that our proposed method had the ability to resist against statistical attacks and differential attacks. It also had a uniform histogram, a large key space, complex and faster, closer Shannon entropy to 8, and low correlation values between two adjacent pixels compared with other methods.
Effect of Denosumab or Alendronic Acid on the Progression of Aortic Stenosis: A Double-Blind Randomized Controlled Trial
Authors: Pawade Tania A. , Doris Mhairi K. , Bing Rong , White Audrey C. , Forsyth Laura , Evans Emily , Graham Catriona , Williams Michelle C. , van Beek Edwin J.R. , Fletcher Alison , Adamson Philip D. , Andrews Jack P.M. , Cartlidge Timothy R.G. , Jenkins William S.A. , Syed Maaz , Fujisawa Takeshi , Lucatelli Christophe , Fraser William , Ralston Stuart H. , Boon Nicholas , Prendergast Bernard , Newby David E. , Dweck Marc R. 
Published: April 2021

Background:
Valvular calcification is central to the pathogenesis and progression of aortic stenosis, with preclinical and observational studies suggesting that bone turnover and osteoblastic differentiation of valvular interstitial cells are important contributory mechanisms. We aimed to establish whether inhibition of these pathways with denosumab or alendronic acid could reduce disease progression in aortic stenosis.

Methods:

In a single-center, parallel group, double-blind randomized controlled trial, patients >50 years of age with calcific aortic stenosis (peak aortic jet velocity >2.5 m/s) were randomized 2:1:2:1 to denosumab (60 mg every 6 months), placebo injection, alendronic acid (70 mg once weekly), or placebo capsule. Participants underwent serial assessments with Doppler echocardiography, computed tomography aortic valve calcium scoring, and
18
F-sodium fluoride positron emission tomography and computed tomography. The primary end point was the calculated 24-month change in aortic valve calcium score.

Results:

A total of 150 patients (mean age, 72±8 years; 21% women) with calcific aortic stenosis (peak aortic jet velocity, 3.36 m/s [2.93–3.82 m/s]; aortic valve calcium score, 1152 AU [655–2065 AU]) were randomized and received the allocated trial intervention: denosumab (n=49), alendronic acid (n=51), and placebo (injection n=25, capsule n=25; pooled for analysis). Serum C-terminal telopeptide, a measure of bone turnover, halved from baseline to 6 months with denosumab (0.23 [0.18–0.33 µg/L] to 0.11 µg/L [0.08–0.17 µg/L]) and alendronic acid (0.20 [0.14–0.28 µg/L] to 0.09 µg/L [0.08–0.13 µg/L]) but was unchanged with placebo (0.23 [0.17–0.30 µg/L] to 0.26 µg/L [0.16–0.31 µg/L]). There were no differences in 24-month change in aortic valve calcium score between denosumab and placebo (343 [198–804 AU] versus 354 AU [76–675 AU]; P=0.41) or alendronic acid and placebo (326 [138–813 AU] versus 354 AU [76–675 AU];
P
=0.49). Similarly, there were no differences in change in peak aortic jet velocity or
18
F-sodium fluoride aortic valve uptake.

Conclusions:
Neither denosumab nor alendronic acid affected progression of aortic valve calcification in patients with calcific aortic stenosis. Alternative pathways and mechanisms need to be explored to identify disease-modifying therapies for the growing population of patients with this potentially fatal condition.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02132026.