bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chest pain in general practice: a systematic review of prediction rules
Authors: Harskamp Ralf E , Laeven Simone C , Himmelreich Jelle CL , Lucassen Wim A M , van Weert Henk C P M 
Published: February 2019

ObjectiveTo identify and assess the performance of clinical decision rules (CDR) for chest pain in general practice.DesignSystematic review of diagnostic studies.Data sourcesMedline/Pubmed, Embase/Ovid, CINAHL/EBSCO and Google Scholar up to October 2018.Study selectionStudies that assessed CDRs for intermittent-type chest pain and for rule out of acute coronary syndrome (ACS) applicable in general practice, thus not relying on advanced laboratory, computer or diagnostic testing.Review methodsReviewers identified studies, extracted data and assessed the quality of the evidence (using Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2)), independently and in duplicate.ResultsEight studies comprising five CDRs met the inclusion criteria. Three CDRs are designed for rule out of coronary disease in intermittent-type chest pain (Gencer rule, Marburg Heart Score, INTERCHEST), and two for rule out of ACS (Grijseels rule, Bruins Slot rule). Studies that examined the Marburg Heart Score had the highest methodological quality with consistent sensitivity (86%–91%), specificity (61%–81%) and positive (23%–35%) and negative (97%–98%) predictive values (PPV and NPV). The diagnostic performance of Gencer (PPV: 20%–34%, NPV: 95%–99%) and INTERCHEST (PPV: 35%–43%, NPV: 96%–98%) appear comparable, but requires further validation. The Marburg Heart Score was more sensitive in detecting coronary disease than the clinical judgement of the general practitioner. The performance of CDRs that focused on rule out of ACS were: Grijseels rule (sensitivity: 91%, specificity: 37%, PPV: 57%, NPV: 82%) and Bruins Slot (sensitivity: 97%, specificity: 10%, PPV: 23%, NPV: 92%). Compared with clinical judgement, the Bruins Slot rule appeared to be safer than clinical judgement alone, but the study was limited in sample size.ConclusionsIn general practice, there is currently no clinical decision aid that can safely rule out ACS. For intermittent chest pain, several rules exist, of which the Marburg Heart Score has been most extensively tested and appears to outperform clinical judgement alone.
Norrie disease gene polymorphism in Indonesian infants with retinopathy of prematurity
Authors: Siswanto J Edy , Ronoatmodjo Sudarto , Sitorus Rita S , Soemantri Ag , Setijaningsih Iswari , Sauer Pieter J J 
Published: February 2019

ObjectiveRetinopathy of prematurity (ROP) is a major cause of blindness in newborn infants, which also occurs in low-income and middle-income countries. Why ROP progresses in some infants while it regresses in others is still presently unknown. Studies suggest that genetic factors might be involved. Mutations in the Norrie disease (ND) gene are suspected to be related to advanced ROP development. Indonesia is a country with relatively high incidence of ROP, yet the role of these genetic factors in the pathogenesis of ROP cases is still unknown. The study aimed to investigate the presence of mutations in ND on the X chromosome in infants with both non-advanced and advanced ROP in Indonesia.Methods and AnalysisThis is a case–control study of polymorphisms in six variants within the ND gene in exon 3, C597A, L108P, R121W, A105T, V60E and C110G, in preterm newborn infants in four major hospitals in Greater Jakarta, Indonesia.ResultsWe included 162 preterm newborn infants. ROP was diagnosed in 83 infants, and 79 infants served as controls. Among those with ROP, 57 infants had type 2, while others had type 1. We did not find any gene polymorphisms in any of the infants with ROP nor in the control group.ConclusionWe conclude that it is very unlikely that the six polymorphisms in exon 3 of the ND gene studied in this paper are involved in the development or progression of ROP in preterm infants in our population sample in Indonesia.
Prevalence and causes of childhood blindness in Huidong County, South China, primary ascertained by the key informants
Authors: Li Yanping , Yan Jianhua , Wang Zhonghao , Huang Wenyong , Huang Shengsong , Jin Ling , Zheng Yingfeng , Tan Xuhua , Yi Jinglin , Yip Jennifer , Xiao Baixiang 
Published: February 2019

PurposeThe aim of this study is to ascertain the prevalence and causes of childhood blindness and severe visual impairment (BL/SVI) in Huidong, South China.MethodsThis cross-sectional study was conducted in early 2017 in areas of 139 816 children at the age of 0–15 as the study subjects. We used the trained key informants (KIs) to do preliminary visual test in the communities and refer those children suspected with blindness or unable to count fingers with both eyes at 5 m to hospital for further examination by paediatric ophthalmologist for causes. The WHO’s definition of BL/SVI was used, as blindness is best-corrected visual acuity worse than 0.05 in better eye and SVI is equal to or better than 0.05 but worse than 0.1 in better eye.ResultsThree hundred and fourteen KIs were trained. In total, 42 children with BL/SVI were found, and among them over half (22, 52.4%) were due to posterior segment disorders by anatomic site and 18 (42.9%) children were potentially preventable; these included BL/SVI caused by factors at children’s development in intrauterine and after birth. This established the prevalence of BL/SVI was at 0.31/1000 (95% CI 0.28 to 0.34/1000).ConclusionA low prevalence of childhood blindness was documented in this study. Establishment of surveillance system for disabled children including those with BL/SVI and better health education on eye care to the public according to the surveillance outcomes would help to reduce avoidable children’s BL/SVI further in China.
Safety and efficacy of ambulatory management of secondary spontaneous pneumothorax: a case series
Authors: Khan Fasih , Vali Yusuf , Naeem Muhammad , Reddy Raja 
Published: February 2019

IntroductionThe optimal management of pneumothorax remains undefined. There is a growing consensus that patients with spontaneous pneumothorax can be considered for ambulatory management with the use of a one-way valve. Despite this, there is little data on the outcomes of outpatient management of secondary spontaneous pneumothorax (SSP).MethodsAt our institution, selected patients with primary and secondary spontaneous pneumothorax who meet the predefined local criteria are managed on an ambulatory pathway. We prospectively evaluated our practice over a 3-year period and explore outcomes of patients with SSP using primary spontaneous pneumothorax (PSP) as a comparator group.Results163 consecutive patients presenting to our hospital between September 2014 and July 2017 were evaluated using a predefined protocol. 111 (49 SSP and 62 PSP) were deemed suitable for outpatient management. Resolution on day 5 was similar between the two groups (65% in the SSP vs 79% in the PSP group; p=0.108). The mean drainage time was 5.84 days in SSP compared with 5.69 days in PSP, representing a difference of 0.15 days (95% CI −2.47 to 2.16; p=0.897). Complications such as infection and drain blockage/falling-out were scarce, with comparable pain and satisfaction scores across both groups. There were no deaths during this period. An estimated £86 796 ($113 920) was saved over the study period, equating to £1118.80 ($1550) per patient.DiscussionThis study suggests that outpatient management of selected patients with SSP may be effective, safe and cost-saving.
Reducing delay in patients with acute coronary syndrome and other time-critical conditions: a systematic review to identify the behaviour change techniques associated with effective interventions
Authors: Farquharson Barbara , Abhyankar Purva , Smith Karen , Dombrowski Stephan U , Treweek Shaun , Dougall Nadine , Williams Brian , Johnston Marie 
Published: February 2019

BackgroundTime to treatment in many conditions, particularly acute coronary syndrome, is critical to reducing mortality. Delay between onset of symptoms and treatment remains a worldwide problem. Reducing patient delay has been particularly challenging. Embedding behaviour change techniques (BCTs) within interventions might lead to shorter delay.ObjectiveTo identify which BCTs are associated with reductions in patient delay among people with symptoms or conditions where time to treatment is critical.MethodsThe data sources were Cochrane Library, MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO. Study eligibility criteria include intervention evaluations (randomised controlled trials, controlled clinical trials and cohort studies) involving adults (aged >18 years) and including an outcome measure of patient delay up to August 2016. Study appraisal and synthesis methods include screening potential studies using a transparent, replicable process. Study characteristics, outcomes and BCTs were extracted from eligible studies.ResultsFrom 39 studies (200 538 participants), just over half (n=20) reported a significant reduction in delay. 19 BCTs were identified, plus 5 additional techniques, with a mean of 2 (SD=2.3) BCTs and 2 (SD=0.7) per intervention. No clear pattern between BCTs and effectiveness was found. In studies examining patient delay specifically, three of four studies that included two or more BCTs, in addition to the two most commonly used additional techniques, reported a significant reduction in delay.ConclusionsAround half of the interventions to reduce prehospital delay with time-critical symptoms report a significant reduction in delay time. It is not clear what differentiates effective from non-effective interventions, although in relation to patient delay particularly additional use of BCTs might be helpful.Trial registration numberCRD42014013106.
Contact round surgery and Lutz twists
Authors: Adachi Jiro 
Published: February 2019

From the viewpoint of contact round surgery, the Lutz twist and the Giroux torsion on contact [Formula: see text]-manifolds are studied in this paper. It is proved that the Lutz twist along a transverse knot and that along a pre-Lagrangian torus are realized by contact round surgeries of index [Formula: see text] and [Formula: see text] of contact [Formula: see text]-manifolds. This construction gives an important perspective on the Lutz twists. Both can be regarded as fiberwise connected sums with the compactified Lutz twist elements.
Object Detection Using Multiview CCA-Based Graph Spectral Learning
Authors: Guo Peng , Xie Guoqi , Li Renfa 
Published: February 2019

Recent years have witnessed a surge of interest in semi-supervised learning-based object detection. Object detection is usually accomplished by classification methods. Different from conventional methods, those usually adopt a single feature view or concatenate multiple features into a long feature vector, multiview graph spectral learning can attain simultaneously object classification and weight learning of multiview. However, most existing multiview graph spectral learning (GSL) methods are only concerned with the complementarities between multiple views but not with correlation information. Accurately representing image objects is difficult because there are multiple views simultaneously for an image object. Thus, we offer a GSL method based on multiview canonical correlation analysis (GSL-MCCA). The method adds MCCA regularization term to a graph learning framework. To enable MCCA to reveal the nonlinear correlation information hidden in multiview data, manifold local structure information is incorporated into MCCA. Thus, GSL-MCCA can lead to simultaneous selection of relevant features and learning transformation. Experimental evaluations based on Corel and VOC datasets suggest the effectiveness of GSL-MCCA in object detection.
A geometric interpretation of the normal closure of the braid group Bn in the braid group of the torus Bn(T)
Authors: Pang Liming 
Published: February 2019

It had been proved by Birman and Goldberg that the normal closure of the pure braid group [Formula: see text] in the pure braid group of the torus [Formula: see text] is the commutator subgroup [Formula: see text]. In this paper, we are going to study the case of full braid groups: i.e. the normal closure of [Formula: see text] in [Formula: see text], which turns out to have an interesting geometric description.
Impact Load Buffering Method Based on Stress Wave Attenuation Principle
Authors: Gan Lin , Zhang He , Zhou Cheng , Liu Lin 
Published: February 2019

Rotating scanning motor is the important component of synchronous scanning laser fuze. High emission overload environment in the conventional ammunition has a serious impact on the reliability of the motor. Based on the theory that the buffer pad can attenuate the impact stress wave, a new motor buffering Isolation Method is proposed. The dynamical model of the new buffering isolation structure is established by ANSYS infinite element analysis software to do the nonlinear impact dynamics simulation of rotating scanning motor. The effectiveness of Buffering Isolation using different materials is comparatively analyzed. Finally, the Macht hammer impact experiment is done, the results show that in the experience of the 70,000[Formula: see text]g impact acceleration, the new buffering Isolation method can reduce the impact load about 15 times, which can effectively alleviate the plastic deformation of rotational scanning motor and improve the reliability of synchronization scanning system. A new method and theoretical basis of anti-high overload research for Laser Fuze is presented.
Antidiabetic Medications and the Risk of Endometrial Cancer in Patients
Authors: Tian Jing , Liang Yuan , Qu Pengpeng 
Published: February 2019

<b><i>Background:</i></b> Recent epidemiological studies suggest that antidiabetic medications (ADMs) may reduce the risks of cancer and cancer mortality among patients with type 2 diabetes. However, data on its effect on endometrial cancer (EC) are unclear. In this systematic review and meta-analysis, we evaluated the association between metformin, sulfonylureas (SUs), insulin, and the risk of EC in patients with diabetes mellitus (DM). <b><i>Methods:</i></b> Studies were identified from PubMed and EMBASE database through October 2017. Observational studies reporting relative risks OR or provided data for their estimation were selected. Summary OR estimates with 95% CIs were estimated using the random-effects model. <b><i>Results:</i></b> Six studies (2 retrospective cohorts and 4 case-control trials) reported 4,739 cases of EC in 510,344 patients with DM. Meta-analysis of observational studies showed no significant association between metformin (<i>n</i> = 6 studies; unadjusted OR 1.15; 95% CI 0.70–1.88; <i>p</i> = 0.59), SUs (unadjusted OR 1.11, 95% CI 0.94–1.32, <i>p</i> = 0.23), or insulin (<i>n</i> = 3 studies; unadjusted OR 1.15; 95% CI 0.93–1.40; <i>p </i>= 0.19) use and risk of developing EC. However, when we do heterogeneity and sensitivity analysis, the use of metformin was associated with an increased incidence of endometrial EC compared to no metformin use (unadjusted OR 1.29; 95% CI 1.16–1.44; <i>p</i> &#x3c; 0.01). <b><i>Conclusion:</i></b> Our data indicate that metformin, SUs, and insulin did not meaningfully affect the risk of EC. Further investigation is warranted.
Serum miR-192 Is Related to Tubulointerstitial Lesion and Short-Term Disease Progression in IgA Nephropathy
Authors: Fan Qichen , Lu Renhua , Zhu Mingli , Yan Yucheng , Guo Xiangjiang , Qian Yingying , Zhang Lulu , Dai Huili , Ni Zhaohui , Gu Leyi 
Published: February 2019

<b><i>Background/Aims:</i></b> Clinical manifestation and renal histology serve as the current “gold standard” for evaluation of renal lesions in IgA nephropathy. MiR-192 is regarded as a potential noninvasive biomarker for kidney disease. We sought to elucidate a relationship between intrarenal, serum, and urinary exosomal miR-192 with renal lesions and disease progression in IgA nephropathy. <b><i>Methods:</i></b> Serum and urinary exosomal miR-192 were detected and correlated with clinical and pathological parameters from consecutive IgA nephropathy patients (<i>n</i> = 50) and healthy control patients (<i>n</i> = 25). Patients then received a follow-up of 24 months after biopsy. Disease progression was defined as a 40% reduction in estimated glomerular filtration rate. Expression of miR-192 was quantified by Taqman RT-PCR. Intrarenal ­miR-192 was detected in 8 IgA nephropathy patients and 4 matched patients receiving kidney nephrectomy as controls via in situ hybridization. TGF-β1 and E-cadherin expression in renal tissue was evaluated using immunohistochemistry. <b><i>Results:</i></b> Intrarenal miR-192 was correlated with serum miR-192 (<i>r</i> = 0.690, <i>p</i> = 0.013). Both intrarenal and serum miR-192 decreased in IgA nephropathy patients and were correlated with estimated glomerular filtration ratio. Patients with lower intrarenal and serum miR-192 levels had a higher interstitial fibrosis and tubular atrophy score, more severe lesions in tubular atrophy, and interstitial inflammation. Renal E-cadherin expression was correlated (<i>r</i> = 0.484, <i>p</i> = 0.004) and TGF-β1 was inversely correlated (<i>r</i> = –0.527, <i>p</i> &#x3c; 0.001) with serum miR-192 in IgA. Patients with higher serum miR-192 had a lower disease progression rate over the course of 2 years (0 vs. 16%, <i>p</i> = 0.028). No correlation was found in urinary exosomal miR-192 with the clinical and pathological parameters mentioned earlier. <b><i>Conclusions:</i></b> Lower serum miR-192 in IgA nephropathy patients indicates lower intrarenal miR-192 expression, more severe tubular atrophy, interstitial inflammation, and fibrotic tendency (with higher TGF-β and E-cadherin in renal miR-192). IgA nephropathy patients with higher serum miR-192 are less likely to have renal function decline over the course of 2 years.
DKK3 (Dikkopf-3) Transdifferentiates Fibroblasts Into Functional Endothelial Cells—Brief Report
Authors: Chen Ting , Karamariti Eirini , Hong Xuechong , Deng Jiacheng , Wu Yutao , Gu Wenduo , Simpson Russell , Wong Mei Mei , Yu Baoqi , Hu Yanhua , Qu Aijuan , Xu Qingbo , Zhang Li 
Published: February 2019

Objective—
To determine the role of a cytokine-like protein DKK3 (dikkopf-3) in directly transdifferentiating fibroblasts into endothelial cells (ECs) and the underlying mechanisms.

Approach and Results—
DKK3 overexpression in human fibroblasts under defined conditions for 4 days led to a notable change in cell morphology and progenitor gene expression. It was revealed that these cells went through mesenchymal-to-epithelial transition and subsequently expressed KDR (kinase insert domain receptor) at high levels. Further culture in EC defined media led to differentiation of these progenitors into functional ECs capable of angiogenesis both in vitro and in vivo, which was regulated by the VEGF (vascular endothelial growth factor)/miR (microRNA)-125a-5p/Stat3 (signal transducer and activator of transcription factor 3) axis. More importantly, fibroblast-derived ECs showed the ability to form a patent endothelium-like monolayer in tissue-engineered vascular grafts ex vivo.

Conclusions—
These data demonstrate that DKK3 is capable of directly differentiating human fibroblasts to functional ECs under defined media and provides a novel potential strategy for endothelial regeneration.
Endothelial TFEB (Transcription Factor EB) Restrains IKK (IκB Kinase)-p65 Pathway to Attenuate Vascular Inflammation in Diabetic
db/db
Mice
Authors: Song Wencong , Zhang Cheng-Lin , Gou Lingshan , He Lei , Gong Yao-Yu , Qu Dan , Zhao Lei , Jin Nana , Chan Ting Fung , Wang Li , Tian Xiao Yu , Luo Jiang-Yun , Huang Yu 
Published: February 2019

Objective—

TFEB (transcription factor EB) was recently reported to be induced by atheroprotective laminar flow and play an anti-atherosclerotic role by inhibiting inflammation in endothelial cells (ECs). This study aims to investigate whether TFEB regulates endothelial inflammation in diabetic
db/db
mice and the molecular mechanisms involved.

Approach and Results—

Endothelial denudation shows that TFEB is mainly expressed in ECs in mouse aortas. Western blotting shows TFEB total protein level decreases whereas the p-TFEB S142 (phosphorylated form of TFEB) increases in
db/db
mouse aortas, suggesting a decreased TFEB activity. Adenoviral TFEB overexpression reduces endothelial inflammation as evidenced by decreased expression of vascular inflammatory markers in
db/db
mouse aortas, and reduced expression of a wide range of adhesion molecules and chemokines in human umbilical vein ECs. Monocyte attachment assay shows TFEB suppresses monocyte adhesion to human umbilical vein ECs. RNA sequencing of TFEB-overexpressed human umbilical vein ECs suggested TFEB inhibits NF-κB (nuclear factor-kappa B) signaling. Indeed, luciferase assay shows TFEB suppresses NF-κB transcriptional activity. Mechanistically, TFEB suppresses IKK (IκB kinase) activity to protect IκB-α from degradation, leading to reduced p65 nuclear translocation. Inhibition of IKK by PS-1145 abolished TFEB silencing-induced inflammation in human umbilical vein ECs. Lastly, we identified KLF2 (Krüppel-like factor 2) upregulates TFEB expression and promoter activity. Laminar flow experiment showed that KLF2 is required for TFEB induction by laminar flow and TFEB is an anti-inflammatory effector downstream of laminar flow-KLF2 signaling in ECs.

Conclusions—
These findings suggest that TFEB exerts anti-inflammatory effects in diabetic mice and such function in ECs is achieved by inhibiting IKK activity and increasing IκBα level to suppress NF-κB activity. KLF2 mediates TFEB upregulation in response to laminar flow.
Abstract 422: Recognition of Pharyngeal Pain as an Angina Equivalent
Authors: Grevious Salih N , Fernandes Marcelo , Rivera Manuel 
Published: February 2019

A 64-year-old man presented to his physician with a 5-day history of throat pain and hoarseness. An initial diagnosis of pharyngitis was made, and the patient was sent home with a 7-day course of antibiotic therapy. He returned 6 days after his initial visit with persistent symptoms, which he now described as worsening on exertion such as when lifting weights. He was sent for a neck computed tomography to evaluate cervical soft tissues: No masses, enhancing lesions, lymphadenopathies, or imaging findings suggesting vocal cord paresis were noted. An ECG was ordered by the patient’s primary care physician and demonstrated new lateral T-wave inversions. The patient was also referred to ENT, and via direct laryngoscopy normal true vocal cords and questionable evidence of laryngopharyngeal reflux were visualized. He was then recommended to begin lifestyle modifications and start empiric treatment with omeprazole twice daily.
Due to the ECG findings, an exercise stress test was ordered. During the exercise stress test, He developed throat tightness and the study was converted to a Lexiscan nuclear stress test. The stress test revealed inferior wall ischemia of moderate severity. Consequently, a coronary cath demonstrated quadruple vessel disease with 75% occlusion of left main, 70% stenosis of proximal LAD, 60% stenosis of the first diagonal, and total occlusion of the mid RCA. After undergoing quadruple coronary bypass surgery, the patient experienced a total resolution of his throat pain.

Discussion:
When approaching craniofacial pain elicited with exertion, it is essential for the clinician to consider ischemic heart disease as an etiology. Furthermore, the link of pain with physical activity and, additionally, pain relief with rest should drive the physician to consider cardiac ischemia. Isolated craniofacial pain or sole pharyngeal pain of cardiac origin are infrequent indicators of significant coronary artery disease. In a prospective multicenter study, only 6% of patients with confirmed ischemic cardiomyopathy presented with craniofacial pain as the only complaint.

This case illustrates the importance of a thorough history and physical examination as well as a broad differential diagnosis when evaluating patients with throat pain and hoarseness.