bluuebunny/crossref_metadata_2025_split huggingface dataset:
Offering patients a choice for colorectal cancer screening: a quality improvement pilot study in a quality circle of primary care physicians
Authors: Martin Yonas , Braun Leo Alexander , Janggen Marc-Andrea , Tal Kali , Biller-Andorno Nikola , Ducros Cyril , Selby Kevin , Auer Reto , Rohrbasser Adrian 
Published: October 2019

BackgroundGuidelines recommend primary care physicians (PCPs) offer patients a choice between colonoscopy and faecal immunochemical test (FIT) for colorectal cancer (CRC) screening. Patients choose almost evenly between both tests but in Switzerland, most are tested with colonoscopy while screening rates are low. A quality circle (QC) of PCPs is an ideal site to train physicians in shared decision-making (SDM) that will help more patients decide if they want to be tested and choose the test they prefer.ObjectiveSystematically assess CRC screening status of eligible 50–75 y.o. patients and through SDM increase the proportion of patients who have the opportunity to choose CRC screening and the test (FIT or colonoscopy).MethodsWorking through four Plan-Do-Study-Act (PDSA) cycles in their QC, PCPs adapted tools for SDM and surmounted organisational barriers by involving practice assistants. Each PCP included 20, then 40 consecutive 50–75 y.o. patients, repeatedly reported CRC status as well as the proportion of eligible patients with whom CRC screening could be discussed and patients’ decisions.Results9 PCPs initially included 176, then 320 patients. CRC screening status was routinely noted in the electronic medical record and CRC screening was implemented in daily routine, increasing eligible patients’ chance to be offered screening. Over a year, screening rates trended upwards, from 37% to 40% (p=0.46) and FIT use increased (2%–7%, p=0.008). Initially, 7/9 PCPs had no patient ever tested with FIT; after the intervention, only 2/8 recorded no FIT tests.ConclusionsThrough data-driven PDSA cycles and significant organisational changes, PCPs of a QC systematically collected data on CRC screening status and implemented SDM tools in their daily routine. This increased patients’ chance to discuss CRC screening. The more balanced use of FIT and colonoscopy suggests that patients’ values and preferences were better respected.
Snapshot of current carotid artery stenting practice and accreditation in the USA
Authors: Sacks David , Farrell Mary Beth , Katzen Barry T , Lally Mary , Matsumura Jon S , Merrill Nancy 
Published: October 2019

ObjectiveThe aim of this exploratory study was to compare the performance of carotid artery stenting (CAS) best practices between Intersocietal Accreditation Commission (IAC) accredited facilities and non-accredited facilities certified by the Centers for Medicare and Medicaid Services (CMS).MethodsA random, anonymous survey was sent to CMS and IAC accredited facilities querying facility routine performance of 16 CAS procedure components found in published guidelines and utilised during clinical trials.ResultsThere were 28 responses (response rate=17%). Significant differences were found between the CMS and the IAC facilities for four of 16 procedure measures: determination of modified Rankin Scale score prior to stenting (p=0.012, 95% CI 20% to 80%), accurate measurement of per cent stenosis using electronic callipers (p=0.005, 95% CI 24% to 84%), confirmation of anticoagulation with activated clotting time greater than 250 s prior to crossing the lesion (p=0.03, 95% CI 7% to 69%), and comparison of facility outcomes to accepted benchmarks for stroke and death (p=0.03, 95% CI 7% to 69%). Overall, IAC facilities performed all 16 procedures more frequently (97%) than CMS facilities (66%) (p<0.001, 95% CI 24% to 36%).ConclusionsAlthough the sample size was small, the results demonstrated IAC accredited facilities are more likely to follow best practices, to use quantitative tools to select appropriate patients, and quantitively measure patient-centred clinical outcomes compared with CMS certified facilities. The findings raise the question as to the value of CMS certification versus IAC accreditation as a requirement for reimbursement.
Comparing targeted thrust manipulation with general thrust manipulation in patients with low back pain. A general approach is as effective as a specific one. A randomised controlled trial
Authors: McCarthy Christopher J , Potter Louise , Oldham Jackie A 
Published: October 2019

BackgroundSpinal manipulation is commonly used to treat back pain. The application of spinal manipulation has traditionally involved an element of targeting the technique to a level of the spine where the proposed movement dysfunction is sited. We evaluated the effects of a targeted manipulative thrust versus a thrust applied generally to the lumbar region.MethodsA randomised controlled clinical trial in patients with low back pain following CONSORT (Consolidated Standards of Reporting Trials) guidelines. Sixty subjects were randomly allocated to two groups: one group received a targeted manipulative thrust (n=29) and the other a general manipulation thrust (GT) (n=31) to the lumbar spine. Thrust was either localised to a clinician-defined symptomatic spinal level or an equal force was applied through the whole lumbosacral region. We measured pressure-pain thresholds (PPTs) using algometry and muscle activity (magnitude of stretch reflex) via surface electromyography. Numerical ratings of pain and Oswestry Disability Index scores were collected.ResultsRepeated measures of analysis of covariance revealed no between-group differences in self-reported pain or PPT for any of the muscles studied.SummaryA GT procedure—applied without any specific targeting—was as effective in reducing participants’ pain scores as targeted approaches.Trial registration numberISRCTN11994230.
METTL3-mediated m6A modification of HDGF mRNA promotes gastric cancer progression and has prognostic significance
Authors: Wang Qiang , Chen Chen , Ding Qingqing , Zhao Yan , Wang Zhangding , Chen Junjie , Jiang Zerun , Zhang Yan , Xu Guifang , Zhang Jingjing , Zhou Jianwei , Sun Beicheng , Zou Xiaoping , Wang Shouyu 
Published: October 2019

ObjectiveN6-methyladenosine (m6A) RNA methylation and its associated methyltransferase METTL3 are involved in tumour initiation and progression via the regulation of RNA function. This study explored the biological function and clinical significance of METTL3 in gastric cancer (GC).DesignThe prognostic value of METTL3 expression was evaluated using tissue microarray and immunohistochemical staining analyses in a human GC cohort. The biological role and mechanism of METTL3 in GC tumour growth and liver metastasis were determined in vitro and in vivo.ResultsThe level of m6A RNA was significantly increased in GC, and METTL3 was the main regulator involved in the abundant m6A RNA modification. METTL3 expression was significantly elevated in GC tissues and associated with poor prognosis. Multivariate Cox regression analysis revealed that METTL3 expression was an independent prognostic factor and effective predictor in human patients with GC. Moreover, METTL3 overexpression promoted GC proliferation and liver metastasis in vitro and in vivo. Mechanistically, P300-mediated H3K27 acetylation activation in the promoter of METTL3 induced METTL3 transcription, which stimulated m6A modification of HDGF mRNA, and the m6A reader IGF2BP3 then directly recognised and bound to the m6A site on HDGF mRNA and enhanced HDGF mRNA stability. Secreted HDGF promoted tumour angiogenesis, while nuclear HDGF activated GLUT4 and ENO2 expression, followed by an increase in glycolysis in GC cells, which was correlated with subsequent tumour growth and liver metastasis.ConclusionsElevated METTL3 expression promotes tumour angiogenesis and glycolysis in GC, indicating that METTL3 expression is a potential prognostic biomarker and therapeutic target for human GC.
Potential of ‘stacking’ early childhood interventions to reduce inequities in learning outcomes
Authors: Molloy Carly , O'Connor Meredith , Guo Shuaijun , Lin Colleen , Harrop Christopher , Perini Nicholas , Goldfeld Sharon 
Published: October 2019

BackgroundEarly childhood interventions are critical for reducing child health and development inequities. While most research focuses on the efficacy of single interventions, combining multiple evidence-based strategies over the early years of a child’s life may yield greater impact. This study examined the association between exposure to a combination of five evidence-based services from 0 to 5 years on children’s reading at 8–9 years.MethodsData from the nationally representative birth cohort (n=5107) of the Longitudinal Study of Australian Children were utilised. Risk and exposure measures across five services from 0 to 5 years were assessed: antenatal care, nurse home-visiting, early childhood education and care, parenting programme and the early years of school. Children’s reading at 8–9 years was measured using a standardised direct assessment. Linear regression analyses examined the cumulative effect of five services on reading. Interaction terms were examined to determine if the relationship differed as a function of level of disadvantage.ResultsA cumulative benefit effect of participation in more services and a cumulative risk effect when exposed to more risks was found. Each additional service that the child attended was associated with an increase in reading scores (b=9.16, 95% CI=5.58 to 12.75). Conversely, each additional risk that the child was exposed to was associated with a decrease in reading skills (b=−14.03, 95% CI=−16.61 to −11.44). Effects were similar for disadvantaged and non-disadvantaged children.ConclusionThis study supports the potential value of ‘stacking’ early interventions across the early years of a child’s life to maximise impacts on child outcomes.
Optimised molecular genetic diagnostics of Fanconi anaemia by whole exome sequencing and functional studies
Authors: Bogliolo Massimo , Pujol Roser , Aza-Carmona Miriam , Muñoz-Subirana Núria , Rodriguez-Santiago Benjamin , Casado José Antonio , Rio Paula , Bauser Christopher , Reina-Castillón Judith , Lopez-Sanchez Marcos , Gonzalez-Quereda Lidia , Gallano Pia , Catalá Albert , Ruiz-Llobet Ana , Badell Isabel , Diaz-Heredia Cristina , Hladun Raquel , Senent Leonort , Argiles Bienvenida , Bergua Burgues Juan Miguel , Bañez Fatima , Arrizabalaga Beatriz , López Almaraz Ricardo , Lopez Monica , Figuera Ángela , Molinés Antonio , Pérez de Soto Inmaculada , Hernando Inés , Muñoz Juan Antonio , del Rosario Marin Maria , Balmaña Judith , Stjepanovic Neda , Carrasco Estela , Cuesta Isabel , Cosuelo José Miguel , Regueiro Alexandra , Moraleda Jimenez José , Galera-Miñarro Ana Maria , Rosiñol Laura , Carrió Anna , Beléndez-Bieler Cristina , Escudero Soto Antonio , Cela Elena , de la Mata Gregorio , Fernández-Delgado Rafael , Garcia-Pardos Maria Carmen , Sáez-Villaverde Raquel , Barragaño Marta , Portugal Raquel , Lendinez Francisco , Hernadez Ines , Vagace José Manue , Tapia Maria , Nieto José , Garcia Marta , Gonzalez Macarena , Vicho Cristina , Galvez Eva , Valiente Alberto , Antelo Maria Luisa , Ancliff Phil , Garcia Francisco , Dopazo Joaquin , Sevilla Julian , Paprotka Tobias , Pérez-Jurado Luis Alberto , Bueren Juan , Surralles Jordi 
Published: October 2019

PurposePatients with Fanconi anaemia (FA), a rare DNA repair genetic disease, exhibit chromosome fragility, bone marrow failure, malformations and cancer susceptibility. FA molecular diagnosis is challenging since FA is caused by point mutations and large deletions in 22 genes following three heritability patterns. To optimise FA patients’ characterisation, we developed a simplified but effective methodology based on whole exome sequencing (WES) and functional studies.Methods68 patients with FA were analysed by commercial WES services. Copy number variations were evaluated by sequencing data analysis with RStudio. To test FANCA missense variants, wt FANCA cDNA was cloned and variants were introduced by site-directed mutagenesis. Vectors were then tested for their ability to complement DNA repair defects of a FANCA-KO human cell line generated by TALEN technologies.ResultsWe identified 93.3% of mutated alleles including large deletions. We determined the pathogenicity of three FANCA missense variants and demonstrated that two FANCA variants reported in mutations databases as ‘affecting functions’ are SNPs. Deep analysis of sequencing data revealed patients’ true mutations, highlighting the importance of functional analysis. In one patient, no pathogenic variant could be identified in any of the 22 known FA genes, and in seven patients, only one deleterious variant could be identified (three patients each with FANCA and FANCD2 and one patient with FANCE mutations)ConclusionWES and proper bioinformatics analysis are sufficient to effectively characterise patients with FA regardless of the rarity of their complementation group, type of mutations, mosaic condition and DNA source.
Recurrent homozygous damaging mutation in TMX2, encoding a protein disulfide isomerase, in four families with microlissencephaly
Authors: Ghosh Shereen Georges , Wang Lu , Breuss Martin W , Green Joshua D , Stanley Valentina , Yang Xiaoxu , Ross Danica , Traynor Bryan J , Alhashem Amal M , Azam Matloob , Selim Laila , Bastaki Laila , Elbastawisy Hanan I , Temtamy Samia , Zaki Maha , Gleeson Joseph G 
Published: October 2019

BackgroundProtein disulfide isomerase (PDI) proteins are part of the thioredoxin protein superfamily. PDIs are involved in the formation and rearrangement of disulfide bonds between cysteine residues during protein folding in the endoplasmic reticulum and are implicated in stress response pathways.MethodsEight children from four consanguineous families residing in distinct geographies within the Middle East and Central Asia were recruited for study. All probands showed structurally similar microcephaly with lissencephaly (microlissencephaly) brain malformations. DNA samples from each family underwent whole exome sequencing, assessment for repeat expansions and confirmatory segregation analysis.ResultsAn identical homozygous variant in TMX2 (c.500G>A), encoding thioredoxin-related transmembrane protein 2, segregated with disease in all four families. This variant changed the last coding base of exon 6, and impacted mRNA stability. All patients presented with microlissencephaly, global developmental delay, intellectual disability and epilepsy. While TMX2 is an activator of cellular C9ORF72 repeat expansion toxicity, patients showed no evidence of C9ORF72 repeat expansions.ConclusionThe TMX2 c.500G>A allele associates with recessive microlissencephaly, and patients show no evidence of C9ORF72 expansions. TMX2 is the first PDI implicated in a recessive disease, suggesting a protein isomerisation defect in microlissencephaly.
Feasibility of repeat transradial access for neuroendovascular procedures
Authors: Chen Stephanie H , Brunet Marie-Christine , Sur Samir , Yavagal Dileep R , Starke Robert M , Peterson Eric C 
Published: October 2019

IntroductionTransradial artery access (TRA) for cerebrovascular angiography is increasing due to decreased access site complications and overwhelming patient preference. While interventional cardiologists have reported up to 10 successive TRA procedures via the same radial access site, this is the first study examining successive use of the same artery for repeat procedures in neurointerventional procedures.1MethodsWe reviewed our prospective institutional database for all patients who underwent a transradial neurointerventional procedure between 2015 and 2019. Index procedures were defined as procedures performed via TRA after which there was a second TRA procedure attempted. Reasons for conversion to a transfemoral approach (TFA) for subsequent procedures were identified.Results104 patients underwent 237 procedures (230 TRA, 7 TFA). 97 patients underwent ≥2 TRA procedures, 20 patients >3, four patients >4, three patients >5, and two patients >6 TRA procedures. The success rate was 94.7% (126/133) with 52% (66/126) of successive procedures performed via the same radial access site (snuffbox vs antebrachial) while the alternate radial artery segment was used for access in 48% (60/126) of subsequent procedures. There were seven (5.3%) cases requiring crossover to TFA, six cases for radial artery occlusion (RAO) and one for radial artery narrowing.ConclusionSuccessive TRA is both technically feasible and safe for neuroendovascular procedures in up to six procedures. The low failure rate (5.3%) was primarily due to RAO. Thus, even without clinical consequences, strategies to minimize RAO should be optimized for patients to continue to benefit from TRA in future procedures.
Impact of depressive symptoms on worklife expectancy: a longitudinal study on Danish employees
Authors: Pedersen Jacob , Thorsen Sannie Vester , Andersen Malene Friis , Hanvold Therese N , Schlünssen Vivi , Bültmann Ute 
Published: October 2019

ObjectiveDepressive symptoms are associated with sickness absence, work disability and unemployment, but little is known about worklife expectancy (WLE). This study investigates the impact of depressive symptoms on the WLE of a large sample of Danish employees.MethodsWe used occupational health survey data of 11 967 Danish employees from 2010 and linked them with register data on salary and transfer payments from 2010 to 2015. Depressive symptoms were self-reported using the Major Depression Inventory. We used multistate data and a life table approach with Cox proportional hazard modelling to estimate the WLE of employees, expressed by time in work, unemployment and sickness absence. Separate analyses were conducted for sex and employees with a voluntary early retirement pension scheme. Using age as time axis, we used inverse probability weights to account for differences in educational level, sector, body mass index, smoking habits and loss of employment during sickness absence.ResultsThe WLE of employees reporting depressive symptoms was shorter compared with those not reporting depressive symptoms; that is, the expected time in unemployment and sickness absence was longer, while the expected time in work was shorter. The shorter WLE was most pronounced in women; for example, a 40-year-old woman with depressive symptoms can expect 3.3 years less in work, 0.8 years more in unemployment and 0.7 years more in sickness absence. Employees with a voluntary early retirement pension scheme showed an even lower WLE.ConclusionsOur study showed a meaningful impact of depressive symptoms on the WLE of Danish employees using a multistate framework.
Rise and fall of the new variant ofChlamydia trachomatisin Sweden: mathematical modelling study
Authors: Smid Joost H , Althaus Christian L , Low Nicola , Unemo Magnus , Herrmann Bjőrn 
Published: October 2019

ObjectivesA new variant ofChlamydia trachomatis(nvCT) was discovered in Sweden in 2006. The nvCT has a plasmid deletion, which escaped detection by two nucleic acid amplification tests (Abbott-Roche, AR), which were used in 14 of 21 Swedish counties. The objectives of this study were to assess when and where nvCT emerged in Sweden, the proportion of nvCT in each county and the role of a potential fitness difference between nvCT and co-circulating wild-type strains (wtCT).MethodsWe used a compartmental mathematical model describing the spatial and temporal spread of nvCT and wtCT. We parameterised the model using sexual behaviour data and Swedish spatial and demographic data. We used Bayesian inference to fit the model to surveillance data about reported diagnoses of chlamydia infection in each county and data from four counties that assessed the proportion of nvCT in multiple years.ResultsModel results indicated that nvCT emerged in central Sweden (Dalarna, Gävleborg, Västernorrland), reaching a proportion of 1% of prevalent CT infections in late 2002 or early 2003. The diagnostic selective advantage enabled rapid spread of nvCT in the presence of high treatment rates. After detection, the proportion of nvCT decreased from 30%–70% in AR counties and 5%–20% in counties that Becton Dickinson tests, to around 5% in 2015 in all counties. The decrease in nvCT was consistent with an estimated fitness cost of around 5% in transmissibility or 17% reduction in infectious duration.ConclusionsWe reconstructed the course of a natural experiment in which a mutant strain ofC. trachomatisspread across Sweden. Our modelling study provides support, for the first time, of a reduced transmissibility or infectious duration of nvCT. This mathematical model improved our understanding of the first nvCT epidemic in Sweden and can be adapted to investigate the impact of future diagnostic escape mutants.
Arte, poder e tradição
Authors: Libório Douglas De Souza 
Published: October 2019

Inaugurado como sede do Congresso Nacional em 1926, o Palácio Tiradentes tornou-se um símbolo político nacional na cidade do Rio de Janeiro e se consolidou como um dos edifícios mais representativos do ecletismo na década de 1920. Este artigo tem por finalidade analisar a construção de uma representação histórica por meio da tradição clássica presente na decoração do palácio. Em específico, busca-se compreender o papel da arte como meio de inserção do palácio em determinada narrativa política e o papel da visualidade para a difusão de imaginários sociais.
Revealing Vertical Distribution of Precipitation in the Glacierized Upper Indus Basin Based on Multiple Datasets
Authors: Shafeeque Muhammad , Luo Yi , Wang Xiaolei , Sun Lin 
Published: October 2019

AbstractThe quality and vertical distribution of precipitation are of utmost importance in hydrological modeling studies in glacierized catchments, which have been facing known challenges in the quality, distribution, and magnitude of observed as well as gridded precipitation due to complex topography. The purpose of the study is to reveal the vertical distribution of precipitation based on multiple datasets and evaluate the suitability of these datasets for hydrological applications and in the upper Indus basin (UIB). The performance of five gridded precipitation datasets, that is, APHRODITE, CFSR, Princeton Global Meteorological Forcing Dataset for Land Surface Modeling (PGMFD), TRMM, and High Asia Refined analysis (HAR), was evaluated against the observed precipitation (OBS) during 2001–07. A corrected reference precipitation dataset was constructed based on the water and mass balance using inverse modeling methods. TRMM was identified as the best dataset to represent the spatial and temporal distribution of OBS precipitation. The runoff coefficients for OBS, APHRODITE, TRMM, and PGMFD were greater than 1, indicating that these datasets were underestimated and unable to close the water balance in UIB. The mean annual corrected precipitation was estimated as 593 mm yr−1, while the main water-producing elevation zone was located between 3900 and 6600 m. CFSR had the highest correlation and lowest bias with corrected precipitation along the vertical profile. It is concluded that the OBS and most of the gridded precipitation are insufficient to sustain the water and mass balance in UIB. It is recommended to correct the precipitation based on mass balance at high altitudes (especially along the main water-producing zone) in glacierized catchments before its application in hydrological modeling studies.