bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of psychotropic drugs and drugs with anticholinergic properties among residents with dementia in intermediate care facilities for older adults in Japan: a cohort study
Authors: Hamada Shota , Kojima Taro , Hattori Yukari , Maruoka Hiroshi , Ishii Shinya , Okochi Jiro , Akishita Masahiro 
Published: April 2021

ObjectivesTo evaluate the prescription and discontinuation of psychotropic drugs (PD) and drugs with anticholinergic properties (DAP) in residents with dementia admitted to Roken, a major type of long-term care facility in Japan.DesignCohort study.SettingA nationwide questionnaire survey across 3598 Roken in Japan in 2015 (up to five randomly selected residents per facility).ParticipantsThis study included 1201 residents from 343 Roken (response rate: 10%). We determined the presence and severity of dementia using a nationally standardised measure.Primary and secondary outcome measuresPrescriptions of PD and DAP at admission and 2 months after admission were evaluated. Multivariable logistic regression was used to evaluate the associations of residents’ baseline characteristics with prescriptions or discontinuation.ResultsPrescription rates decreased for antidementia drugs (19.4% to 13.0%), hypnotics (25.1% to 22.6%) and anxiolytics (12.3% to 10.7%), whereas those for other PD, such as antipsychotics (13.2% to 13.6%), antidepressants (7.4% to 6.7%), antiepileptic drugs (7.1% to 7.8%) and DAP (35.2% to 36.6%) did not statistically significantly decrease. Some factors were associated with the prescriptions, for example, for antipsychotics, older age (≥85 years) (adjusted OR (aOR), 0.60; 95% CI 0.43 to 0.85) and being bedridden (aOR 0.67; 95% CI 0.47 to 0.97) were associated with a lower use of antipsychotics, whereas severe dementia was associated with a higher use of antipsychotics (aOR 3.26; 95% CI 2.26 to 4.70). At an individual level, a quarter of residents prescribed PD or DAP at admission had discontinued at least one PD or DAP, respectively, 2 months after admission. Antidementia drug use in severe dementia (aOR 1.86; 95% CI 1.04 to 3.31) and PD use in older age (aOR 1.61; 95% CI 1.00 to 2.60; in residents with disabling dementia) were associated with discontinuation.ConclusionsThere is possible scope for deprescribing PD and DAP in Roken residents with dementia to mitigate the risks of adverse events.
Treatment preferences for preventive interventions for rheumatoid arthritis: protocol of a mixed methods case study for the Innovative Medicines Initiative PREFER project
Authors: Falahee Marie , Simons Gwenda , DiSantostefano Rachael L , Valor Méndez Larissa , Radawski Christine , Englbrecht Matthias , Schölin Bywall Karin , Tcherny-Lessenot Stephanie , Kihlbom Ulrik , Hauber Brett , Veldwijk Jorien , Raza Karim 
Published: April 2021

IntroductionAmidst growing consensus that stakeholder decision-making during drug development should be informed by an understanding of patient preferences, the Innovative Medicines Initiative project ‘Patient Preferences in Benefit-Risk Assessments during the Drug Life Cycle’ (PREFER) is developing evidence-based recommendations about how and when patient preferences should be integrated into the drug life cycle. This protocol describes a PREFER clinical case study which compares two preference elicitation methodologies across several populations and provides information about benefit–risk trade-offs by those at risk of rheumatoid arthritis (RA) for preventive interventions.Methods and analysisThis mixed methods study will be conducted in three countries (UK, Germany, Romania) to assess preferences of (1) first-degree relatives (FDRs) of patients with RA and (2) members of the public. Focus groups using nominal group techniques (UK) and ranking surveys (Germany and Romania) will identify and rank key treatment attributes. Focus group transcripts will be analysed thematically using the framework method and average rank orders calculated. These results will inform the treatment attributes to be assessed in a survey including a discrete choice experiment (DCE) and a probabilistic threshold technique (PTT). The survey will also include measures of sociodemographic variables, health literacy, numeracy, illness perceptions and beliefs about medicines. The survey will be administered to (1) 400 FDRs of patients with RA (UK); (2) 100 FDRs of patients with RA (Germany); and (3) 1000 members of the public in each of UK, Germany and Romania. Logit-based approaches will be used to analyse the DCE and imputation and interval regression for the PTT.Ethics and disseminationThis study has been approved by the London-Hampstead Research Ethics Committee (19/LO/0407) and the Ethics Committee of the Friedrich-Alexander-Universität Erlangen-Nürnberg (92_17 B). The protocol has been approved by the PREFER expert review board. The results will be disseminated widely and will inform the PREFER recommendations.
Using a behavioural approach to explore the factors that affect questionnaire return within a clinical trial: a qualitative study based on the theoretical domains framework
Authors: Lawrie Louisa , Duncan Eilidh M , Dunsmore Jennifer , Newlands Rumana , Gillies Katie 
Published: April 2021

ObjectivesTo identify barriers and enablers to participant retention in trials requiring questionnaire return using the theoretical domains framework (TDF).Study design and settingWe identified and subsequently invited participants who did not return at least one questionnaire during their participation in a clinical trial for one-to-one semi-structured telephone interviews. We used a behavioural framework (TDF) to explore whether any of the behavioural domains (eg, beliefs about consequences, emotion) affected questionnaire return. Thereafter, we generated a series of belief statements which summarised the content of participants’ main responses and coded these under separate themes.ParticipantsWe distributed invites to 279 eligible individuals and subsequently interviewed 9 participants who took part in the C-Gall trial. The C-Gall trial required participants to complete five postal questionnaires during their participation.ResultsNine participants were interviewed. We developed 7 overarching themes which were relevant for returning postal questionnaires and identified both barriers and enablers from 11 core domains: knowledge; beliefs about consequences; environmental context and resources; reinforcement; emotion; beliefs about capabilities; behavioural regulation; social professional role and identity; skills; intentions and goals. Relevant content coded under these salient domains were categorised into seven key themes: unclear expectations of trial participation, personal attributes for questionnaire return, commitment to returning questionnaires given other priorities, sources of support in returning the questionnaires, individual preferences for presentation mode and timing of the questionnaires, internal and external strategies to encourage questionnaire return and the significance of questionnaire non-return.ConclusionWe demonstrate how a behavioural approach may be useful for clinical trials associated with significant participation burden (e.g. trials that require multiple questionnaire responses), acting as the essential groundwork for the development of appropriate evidence-based solutions to combat retention issues.Trial registration number55215960; Pre-results.
Impact of stem lean on estimation of Douglas-fir (Pseudotsuga menziesii) diameter and volume using mobile lidar scans
Authors: Garms Cory G. , Strimbu Bogdan M. 
Published: April 2021

The value of Douglas-fir (Pseudotsuga menziesii (Mirb.) Franco), which is the predominant commercial species in the Pacific Northwest, depends on tree verticality; trees with the same dimensions can differ substantially in value due to lean. The objective of this study was to assess the impact of tree leaning on estimation of stem dimensions using high-density terrestrial mobile lidar point clouds. We estimated lean with two metrics: the horizontal distance between stem centers at 1.3 m and 18 m, and the mean of seven successive lean angles along the tree bole (at 1, 3, 5, 7, 10, 12, and 15 m). For modeling, we used four existing taper equations and three existing volume equations. For trees leaning >2°, we enhanced the existing volume models by including lean as a predictor. Because lean estimates depend on the distribution and number of points describing the stem, we found that including the distance from scanner to tree improved the computed volume. When diameter at breast height was replaced with diameter at heights between 7 and 10 m, the volume models for leaning trees improved significantly, whereas the vertical trees had favorable results with heights between 5 and 15 m. Our study suggests that lean magnitude improves the estimation of stem volume when lean is >2°.
Detecting human impacts: non-pollen palynomorphs as proxies for human impact on the environment
Authors: Gauthier Emilie , Jouffroy-Bapicot Isabelle 
Published: April 2021

Abstract
Non-pollen palynomorphs (NPPs) are widely used to detect human activities, in addition to the anthropogenic indicators used in palynology. This paper first tries to determine the best way to approach most probable number (MPN) counting for young scientists. It then looks at the anthropogenic indicators and the different types of human activity that can reveal the studied taxa. Among the different fungal spores, coprophilous fungi are very useful to evidence pastoral activities and grazing pressure. Numerous taxa related to dung are also indicators of decaying organic matter and deserve our attention. Erosion processes due to human activities increase the representation of fungal spores. Development of carbonicolous fungal spores in association with fire and algal assemblages due to eutrophication are also considered. Indeed, studies focusing on modern analogues have greatly improved our understanding of spore taphonomy, and the relationship between spore abundance and local livestock biomass and composition.
Remnant Cholesterol and Common Carotid Artery Intima-Media Thickness in Patients With Ischemic Stroke
Authors: Qian Sifan , You Shoujiang , Sun Yaming , Wu Qiuyi , Wang Xianhui , Tang Weiting , Dong Xiaofeng , Liu Chun-feng , Xu Tan , Cao Yongjun , Zhong Chongke 
Published: April 2021

Background:
Remnant cholesterol makes great contribution to residual risk of cardiovascular disease, but population-based evidence on the relationship between remnant cholesterol and atherosclerosis is rare. Common carotid artery intima-media thickness (cIMT) is an imaging marker of subclinical atherosclerosis. We aimed to explore the association between remnant cholesterol levels and cIMT in patients with ischemic stroke.

Methods:
One thousand four hundred ninety-six ischemic stroke patients with baseline serum lipids and carotid artery imaging data were included in this analysis. Fasting remnant cholesterol was calculated as total cholesterol minus HDL (high-density lipoprotein) cholesterol minus LDL (low-density lipoprotein) cholesterol. Abnormal cIMT was defined as mean cIMT and maximum cIMT value ≥1 mm. Logistic regression and restricted cubic spline models were used to assess the relationships between remnant cholesterol levels and abnormal cIMT.

Results:

The multivariable-adjusted odds ratios (95% CIs) for the highest versus lowest quartile of remnant cholesterol were 2.06 (1.46–2.91) for abnormal mean cIMT and 1.70 (1.23–2.35) for abnormal maximum cIMT. There were linear associations between remnant cholesterol levels and both abnormal mean cIMT (
P
for linearity, <0.001) and abnormal maximum cIMT (
P
for linearity, 0.003). Moreover, the remnant cholesterol–cIMT association remained significant in the subsample of patients with optimal LDL cholesterol levels (n=179).

Conclusions:
Elevated fasting remnant cholesterol levels were positively associated with mean cIMT and maximum cIMT in patients with ischemic stroke, even in patients with optimal LDL cholesterol levels. Future prospective studies are needed to verify our findings and to assess the effect of remnant cholesterol–lowering interventions in patients with ischemic stroke.
Association of antiphospholipid antibodies with clinical activity and renal pathological activity in patients with lupus nephritis
Authors: Zhang Jianna , Zhang Ji , Zhou Qiongxiu , Lu Guoyuan , You Xiaohan 
Published: April 2021

Objectives This study aimed to investigate the association of antiphospholipid antibodies (aPL) with clinical activity and renal pathological activity in patients with lupus nephritis (LN). Methods Levels of anticardiolipin () antibodies, anti-β2-glycoprotein I (anti-β2-GPI) antibodies and lupus anticoagulant (LAC) were measured, and other clinical and pathological data were also obtained during the same period before renal biopsy. Results A total of 83 patients with LN were included in this study, 40 patients (48.2%) in the s positive group and 43 patients in the aPL negative group. LN patients with positive aPL had significantly higher SLEDAI (p = 0.012), more hematuria (p = 0.043), lower serum C3 (p = 0.003) and C4 (p = 0.014), and a higher pathological activity index (p = 0.012), more micro-thrombosis (p = 0.046) and more C3 deposits (p = 0.038) in the glomerulus than patients with negative aPL The level of IgG- was significantly correlated with SLEDAI and serum level of C3 (r = 0.44, p < 0.001; r = −0.39, p = 0.003, respectively). The level of IgM- was significantly correlated with SLEDAI, and serum levels of C3 and C4 (r = 0.27, p = 0.014; r = −0.22, p = 0.041; r = −0.23, p = 0.035, respectively). Conclusions Our work suggests that aPL, especially, are correlated with both clinical activity and renal pathological activity in patients with LN.
Management of renal tumors during pregnancy: case reports
Authors: Zhao Yi , Yang Ziyi , Xu Weifeng , Ji Zhigang , Dong Jie 
Published: April 2021

Abstract
Background
Renal tumors during pregnancy are rare and the treatment requires evaluation of both the patient and the fetus. No consensus or guidelines has been proposed or verified in this field. We successfully managed three renal tumor cases during pregnancy and reviewed the relative literature.

Case presentation
In the first renal cell carcinoma case diagnosed in the 21st week of pregnancy, laparoscopic retroperitoneoscopic partial nephrectomy was performed in the 26th week of pregnancy. In the second renal cell carcinoma case diagnosed in the 3rd week of pregnancy, laparoscopic retroperitoneoscopic radical nephrectomy was carried out after the abortion. In the third angiomyolipoma case who was diagnosed before pregnancy but received no treatment, we performed laparoscopic retroperitoneoscopic partial nephrectomy during the 17th week of pregnancy due to the rapid enlargement of the tumor.

Conclusion
Although no consensus or guidelines for the management of renal tumors in pregnant patients has been proposed or verified, the general rules of kidney tumor management in non-pregnant patients and the guidelines for surgery in pregnancy could be referred to. Renal tumors found in pregnant patients require an individualized treatment regimen involving surgical timing, routes, techniques, and excision ranges, which should be decided by both the patients and the surgical teams.
Effects of elevated CO2 levels on lung immune response to organic dust and lipopolysaccharide
Authors: Schneberger David , Pandher Upkardeep , Thompson Brooke , Kirychuk Shelley 
Published: April 2021

AbstractWorkplaces with elevated organic dust levels such as animal feed barns also commonly have elevated levels of gasses, such as CO2. Workers exposed to such complex environments often experience respiratory effects that may be due to a combination of respirable factors. We examined the effects of CO2 on lung innate immune responses in mice co-exposed to the inflammatory agents lipopolysaccharide (LPS) and organic dust. We evaluated CO2 levels at the building recommended limit (1000 ppm) as well as the exposure limit (5000 ppm). Mice were nasally instilled with dust extracts or LPS and immediately put into chambers with a constant flow of room air (avg. 430 ppm CO2), 1000 ppm, or 5000 ppm CO2 enriched air. Results reveal that organic dust exposures tended to show decreased inflammatory responses with 1000 ppm CO2 and increased responses at 5000 ppm CO2. Conversely, LPS with addition of CO2 as low as 1000 ppm tended to inhibit several inflammatory markers. In most cases saline treated animals showed few changes with CO2 exposure, though some changes in mRNA levels were present. This shows that CO2 as low as 1000 ppm CO2 was capable of altering innate immune responses to both LPS and organic dust extracts, but each response was altered in a different fashion.
Undifferentiated colonic neoplasm with SMARCA4 germline gene mutation and loss of SMARCA4 protein expression: a case report and literature review
Authors: Duan Huanli , Gao Wei , Wang Leiming , Cao Feng , Teng Lianghong 
Published: April 2021

Abstract
Background
Nonsense mutation or inactivation of SMARCA4 (BRG1) is associated with a monomorphic undifferentiated histological appearance in tumors at different sites. The association between SMARCA4 alteration and undifferentiated colonic carcinoma needs to be further elucidated.

Methods
A 61-year-old male patient presented to the hospital with intermittent epigastric pain in the right upper abdomen and abdominal distension. The enhanced computed tomography detected a mass in the hepatic flexure of the colon and multiple liver metastases.

Results
The right hemicolectomy contained a 4.5-cm undifferentiated malignancy with cells arranged in sheets, abundant necrosis, and areas showing rhabdoid morphology. The immunohistochemistry result showed that these tumor cells were focally positive for cytokeratin (CK), CK8, and CK18; however, diffusely positive for vimentin, P53, Fli-1, and SALL-4. Notably, tumor cells showed a heterogeneous loss of SMARCA4 expression pattern and intact SMARCB1 expression. Next-generation sequencing showed a germline SMARCA4 c.3277C>T(p.R1093*)mutation, somatic APC mutation, and no abnormal SMARCB1 gene. The tumor exhibited microsatellite stability, negative PD-L1 expression, and few infiltrating CD8 + T cells. The patient died a month later after surgery.

Conclusions
We presented a rare case of undifferentiated colonic neoplasm with loss of SMARCA4 protein expression and germline SMARCA4 mutation. Moreover, the role of SMARCA4 alterations in tumor diagnosis and treatment was also summarized.
The impact of different preanalytical methods related to CA 15-3 determination in frozen human blood samples: a systematic review
Authors: Coppola Luigi , Cianflone Alessandra , Pane Katia , Franzese Monica , Mirabelli Peppino , Salvatore Marco 
Published: April 2021

Abstract
Background
The determination of CA 15-3 is useful for monitoring breast cancer patients. Several retrospective studies determined CA 15-3 levels in frozen samples to evaluate the sensitivity and specificity of novel biomarkers in relation to breast cancer; however, freeze-thaw cycles, as well as preanalytical variables before sample storage, are not always reported. Here, we analyzed the current scientific literature to identify possible critical aspects related to CA 15-3 determination in frozen-stored human serum/plasma samples.

Methods
We obtained data from 4 different bibliographic databases: Web of Science, Embase, PubMed, and Cochrane Library. We followed the PRISMA guidelines to screen and select the eligible articles discussed in the final revision.

Results
Initially, 674 scientific papers were evaluated, and after the application of the screening and eligibility criteria, 18 studies were included in the qualitative synthesis. The analysis reported an important level of heterogeneity concerning the preanalytical phase before sample storage.

Conclusion
Although advances in healthcare have been achieved using certified workflows in medical diagnostics, standardized preanalytical processes are not always applied when referring to frozen-stored biosamples. Biobanks will guarantee the best possible conditions for the storage of human biological samples to be used in clinical research. The use of certified bioresources will favor the optimal development and introduction of new disease biomarkers.
Infant and young child feeding practices in Ethiopia: analysis of socioeconomic disparities based on nationally representative data
Authors: Geda Nigatu Regassa , Feng Cindy Xin , Janzen Bonnie , Lepnurm Rein , Henry Carol J. , Whiting Susan J. 
Published: April 2021

Abstract
Background
Undernutrition among children is a priority area of public health concern in Ethiopia. The purpose of this study was to examine disparities in Infant and Young Child Feeding (IYCF) practices among children 6–23 months.

Method
Data were drawn from the 2016 Ethiopian Demographic and Health Surveys (EDHS). A total of 3240 children aged 6–23 months were used for the present analysis. The outcome variable was IYCF practice score (ranging 0–7) which was constructed based on the linear and combined effects of four sets of variables: breastfeeding, avoidance of bottle feeding, diet diversity score and minimum feeding frequency. IYCF practice score was further recoded into three categories. Proportional odds regression was used to assess the determinants of IYCF category.

Results
The proportional odds regression analysis showed that IYCF scores significantly decreased by 5% (Adjusted Odds Ratio (AOR) = 0.95; 95% CI: 0.93–0.97) for every unit increase in the child’s age. Households with fathers of primary and secondary and above level education were 1.37 times (95% CI: 1.14–1.66) and 1.67 times (95% CI: 1.26–2.23) more likely to be in the high IYCF category than in the poor IYCF category. The likelihood of being in the high IYCF practice category decreased for non-working mothers by 30% (AOR = 0.70; 95% CI: 0.59–0.83) compared to those working in gainful employment. The chance of being in the high IYCF practice category decreased by 29% for households with no access to radio (AOR = 0.71; 95% CI: 0.59–0.85). Those with medium and rich/richer wealth category were 1.54 times (95% CI: 1.22–1.94) and 1.40 times (95% CI: 1.11–1.75) more likely to belong to high IYCF practice category than being in poor IYCF category. For every unit increase in health service utilization, the chance of falling in higher IYCF category increases by 1.15 times (95% CI: 1.08–1.23). The chance of falling in higher IYCF practice category decreases for rural residents by 37% (AOR = 0.63; 95% CI: 0.47–0.84) compared to those residing in urban areas.

Conclusion
For a child, the first two years is the time span during which linear faltering of growth is most prevalent and the period when the process of becoming stunted is almost complete. This study recommends improving access to women for gainful employment, provision of economic support to poor rural women, education and promotion of nutrition messages using most accessible media and boosting the positive role of fathers in child feeding practices.