bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of type 1 diabetes mellitus, glucose levels, and glycemic control on sleep in children and adolescents: a case–control study
Authors: Macaulay Grace C , Galland Barbara C , Boucher Sara E , Wiltshire Esko J , Haszard Jillian J , Campbell Angela J , Black Stephanie M , Smith Claire , Elder Dawn , Wheeler Benjamin J 
Published: October 2019

AbstractStudy ObjectivesTo assess differences in habitual sleep patterns and sleep states between children and adolescents with type 1 diabetes mellitus (T1DM) and control subjects, and to explore the relationships between sleep, glucose levels, and glycemic control.MethodsParticipants included 82 children (5–18 years); 41 with T1DM (cases), and 41 healthy control subjects group matched for age and sex. Sleep was measured by 7-day actigraphy and single-night home-based polysomnography (PSG) recordings. Hemoglobin A1c (HbA1c) and 7 days of continuous glucose monitoring (CGM) data were collected in cases. Regression analyses were used to model all within- and between-group comparisons adjusted for age, sex, and BMI z-scores.ResultsThere were no significant differences in sleep duration, efficiency, or awakenings as measured by actigraphy and PSG between cases and controls, nor sleep states measured by PSG. However, cases had significantly later sleep onset and offset than controls (both p < 0.05), partially moderated by age. Cases with suboptimal glycemic control (HbA1c ≥ 58 mmol/mol [≥7.5%]) had significantly shorter actigraphy-derived total sleep time (TST) (mean difference = −40 minutes; 95% confidence interval = −77, −3), with similar differences in TST measured by PSG. Cases with mean CGM glucose levels ≥10 mmol/L (≥180 mg/dL) on PSG night had significantly more stage N3 (%) sleep and less stage REM (%) sleep (both p < 0.05).ConclusionsShort- and long-term suboptimal glycemic control in T1DM children appears to be associated with sleep alterations. Pediatric diabetes care teams should be aware of potential interrelationships between sleep and T1DM, including management and glycemic control.
Deciphering Adverse Outcome Pathway Network Linked to Bisphenol F Using Text Mining and Systems Toxicology Approaches
Authors: Rugard Marylène , Coumoul Xavier , Carvaillo Jean-Charles , Barouki Robert , Audouze Karine 
Published: October 2019

Abstract
Bisphenol F (BPF) is one of several Bisphenol A (BPA) substituents that is increasingly used in manufacturing industry leading to detectable human exposure. Whereas a large number of studies have been devoted to decipher BPA effects, much less is known about its substituents. To support decision making on BPF’s safety, we have developed a new computational approach to rapidly explore the available data on its toxicological effects, combining text mining and integrative systems biology, and aiming at connecting BPF to adverse outcome pathways (AOPs). We first extracted from different databases BPF-protein associations that were expanded to protein complexes using protein-protein interaction datasets. Over-representation analysis of the protein complexes allowed to identify the most relevant biological pathways putatively targeted by BPF. Then, automatic screening of scientific abstracts from literature using the text mining tool, AOP-helpFinder, combined with data integration from various sources (AOP-wiki, CompTox, etc.) and manual curation allowed us to link BPF to AOP events. Finally, we combined all the information gathered through those analyses and built a comprehensive complex framework linking BPF to an AOP network including, as adverse outcomes, various types of cancers such as breast and thyroid malignancies. These results which integrate different types of data can support regulatory assessment of the BPA substituent, BPF, and trigger new epidemiological and experimental studies.
Evaluating the Effect of Training Along With Fit Testing on Premolded Earplug Users in a Chinese Petrochemical Plant
Authors: Liu Yufei , Gong Wei , Liu Xin , Li Ling 
Published: October 2019

Objectives:
To gain insight into the current practice of hearing protection of Chinese workers and the value of hearing protection device (HPD) fit testing.

Design:
HPD fit testing was conducted on workers (N = 774) in a petrochemical plant in Eastern China who were on duty during the period of this study. The 3M E-A-Rfit Dual-Ear Validation System was used to measure the personal attenuation ratings (PARs) of a premolded earplug used at the work site. Repeated fit testing was conducted at approximately 6- or 12-month intervals. Wilcoxon signed rank tests were conducted to analyze the pairwise differences between the baseline, postintervention, and follow-up visit PARs, and Mann–Whitney tests were used to compare the PARs obtained by two follow-up groups.

Results:
The median PAR baseline was 11 dB; significant improvement was shown on the postintervention PARs (p < 0. 001). No significant difference was shown between PARs obtained during the 6- and 12-month follow-up visits (p > 0.05). Comparing PARs of follow-up visits with the baseline PAR demonstrated a significant improvement (p < 0. 001), but revealed a significant decline (p < 0. 001) comparing with the postintervention PARs.

Conclusions:
HPD fit testing showed value added as to verify the sufficiency of attenuation. The training along with fit testing showed contributions to improve PARs, maintained effectiveness over time, and assisted in HPD selection. Follow-up is believed to be important to ensure that the HPDs are continually used correctly. There was no significant difference in the sustained effectiveness of the follow-up when observe 6- and 12-month subsequent to intervention.
Definitive Radiation Treatment Patterns and Outcomes for Low and Intermediate Risk Prostate Cancer Patients
Authors: Asamoah Francis A. , Yarney Joel , Awasthi Shivanshu , Vanderpuye Verna , Dadzie Mary A. , Fink Angelina , Naghavi Arash O. , Abrahams Afua , Mensah James E. , Sasu Evans , Tagoe Samuel N. , Dhillon Jasreman , Johnstone Peter A.S. , Yamoah Kosj 
Published: October 2019

Purpose:
To evaluate early-stage prostate cancer (PCa) radiotherapy treatment patterns and outcomes among Ghanaian men (GM) compared with US men (USM).

Materials and Methods:
This retrospective study consists of 987 National Comprehensive Cancer Network low risk, favorable intermediate risk, and unfavorable intermediate risk PCa patient subgroups; GM (173) and USM (814). Differences in baseline covariates and clinical characteristics between GM and USM were analyzed using χ2 and Mann-Whitney test while Cox Proportional Hazards model was used to assess freedom from biochemical failure differences between the study groups.

Results:
Median follow-up for this study was 40 months. GM were diagnosed at a younger median age (64 vs. 68 y, P<0.001) with heavier unfavorable intermediate risk disease burden (32.4% vs. 19.2%) compared with USM. Significant differences were identified in median external beam radiotherapy dose (72.4 vs. 78 Gy, P<0.001); brachytherapy utilization (49.7% vs. 80.6%, P<0.001) and androgen deprivation therapy for intermediate risk disease (48.4% vs. 21.0%, P<0.001) between GM and USM, respectively. GM with low risk and favorable intermediate risk PCa were at increased risk of biochemical recurrence compared with USM with adjusted hazard ratio: 5.15 (1.27 to 20.7), P=0.02 and 4.64 (1.20 to 17.92), P=0.02, respectively.

Conclusions:
Compared with USM, GM with low and favorable intermediate risk PCa may experience less durable disease control following standard treatment recommendations. Results suggest differences in radiation treatment and possible inherent differences between the 2 populations. This data will aid in developing research strategies to improve treatment outcomes in GM.
Neonatal effects of intrauterine metoprolol/bisoprolol exposure during the second and third trimester: a cohort study with two comparison groups
Authors: Kayser Angela , Beck Evelin , Hoeltzenbein Maria , Zinke Sandra , Meister Reinhard , Weber-Schoendorfer Corinna , Schaefer Christof 
Published: October 2019

Objectives:
Our aim was to evaluate the effects of beta-blockers during the second and third trimester on fetal growth, length of gestation and postnatal symptoms in exposed infants.

Methods:
The current prospective observational cohort study compares 294 neonates of hypertensive mothers on metoprolol or bisoprolol during the second and/or third trimester with 225 methyldopa-exposed infants and 588 infants of nonhypertensive mothers. The risks for reduced birth weight, prematurity, neonatal bradycardia, hypoglycaemia and respiratory disorders were analysed.

Results:
The rate of small-for-gestational-age children was significantly higher in long-term beta-blocker exposed infants (24.1%) compared with the methyldopa cohort [10.2%, odds ratio (OR)adj 2.5, 95% confidence interval (CI) 1.2–5.2] and the nonhypertensive cohort (9.9%, ORadj 4.3, 95% CI 2.6–7.1). The risk for preterm birth was significantly increased compared with nonhypertensive pregnancies (ORadj 2.2, 95% CI 1.3–3.8) but not compared with the methyldopa cohort. Neonatal adverse outcomes occurred more frequently in the study cohort (11.5%) compared with the nonhypertensive comparison group (6.5%) and the methyldopa cohort (8.4%), but without statistical significance (ORadj 1.5, 95% CI 0.7–3.0 and ORadj 1.5, 95% CI 0.7–3.3, respectively).

Conclusion:
Long-term intrauterine exposure to metoprolol or bisoprolol may increase the risk of being born small-for-gestational-age. It is still a matter of debate to which extent maternal hypertension contributes to the lower birth weight. Serious neonatal symptoms are rare. Altogether, metoprolol and bisoprolol are well tolerated treatment options, but a case-by-case decision on close neonatal monitoring is recommended.
Muscle strength is a major determinant of the blood pressure response to isometric stress testing: the Asklepios population study
Authors: Van daele Caroline M. , Chirinos Julio A. , De Meyer Tim , De Buyzere Marc L. , Langlois Michel R. , Bekaert Sofie , Segers Patrick , Gillebert Thierry C. , Rietzschel Ernst R. 
Published: October 2019

Aim:
Maximal handgrip strength is a strong predictor of cardiovascular mortality in economically and socioculturally diverse countries, yet the main determinants of cardiovascular response to change in afterload during handgrip are not well known. We examined the blood pressure (BP) responses during submaximal handgrip (at 25% of grip strength) and the determinants of grip strength.

Methods:
We studied 2215 participants from a population-based random sample without overt clinical disease (Asklepios Study; mean age 56.2 years). Handgrip testing was performed using a modified Jamar dynamometer with direct visual feedback. Simultaneously, a validated finger plethysmographic device measured continuous BP and heart rate.

Results:
During handgrip, SBP and DBP rose by, respectively, 20 ± 13 and 10 ± 6 mmHg. These changes were normally distributed and consistently higher in men. The main independent determinants of mean arterial pressure response during handgrip were: grip strength (F = 191.4; P < 0.001), baseline pulse pressure (F = 32.0; P < 0.001), height (F = 16.4; P < 0.001) and age (F = 12.8; P < 0.001). Grip strength was associated with muscle mass, better metabolic health, but also with higher baseline DBP. There was a significant graded increase in maximum pressure achieved and in the magnitude of pressure change during handgrip with increasing BP categories (P for trend <0.001).

Conclusion:
The population BP response to handgrip is variable and its predominant determinant turned out to be grip strength itself, which should be accounted for in future analyses. Higher baseline BP, even within the normotensive range, acted as an independent and graded predictor of BP increase during handgrip.
Visit-to-visit blood pressure variation and outcomes in heart failure with reduced ejection fraction: findings from the Eplerenone in Patients with Systolic Heart Failure and Mild Symptoms trial
Authors: Monzo Luca , Ferreira João Pedro , Abreu Paula , Szumski Annette , Böhm Michael , McMurray John J.V. , Pitt Bertram , Swedberg Karl , van Veldhuisen Dirk J. , Girerd Nicolas , Vincent John , Zannad Faiez , Rossignol Patrick 
Published: October 2019

Background:
Visit-to-visit office blood pressure (BP) variability (BPV) has been associated with morbidity and mortality outcomes in several cardiovascular conditions. The aim of this study was to evaluate the association between BPV and outcomes in patients with heart failure and reduced ejection fraction and the effect of eplerenone on BPV.

Methods and results:
We evaluated the associations between BPV, calculated as SBP coefficient of variation (SBP-CoV = SD/mean × 100%), and the primary composite endpoint of cardiovascular mortality or heart failure hospitalization (HFH), and its components, in 2549 patients from the Eplerenone in Patients with Systolic Heart Failure and Mild Symptoms trial. Lower SBP-CoV was independently associated with a higher risk of all the studied outcomes, while higher as well as lower SBP-CoV were associated with a higher risk of cardiovascular death. After a median follow-up period of 21 months the risk of the composite outcome of cardiovascular death or HFH was almost double in the lower SBP-CoV tertile as compared with the intermediate tertile [adjusted hazard ratio: 2.01, 95% confidence interval (1.62–2.51), P < 0.001]. The relationship between SBP-CoV and outcomes was not modified by eplerenone (P value for interaction = 0.48). An interaction was detected between mean SBP and SBP-CoV for the primary outcome (P = 0.048) and for HFH (P = 0.018). The effect modification was slight, but lower SBP-CoV was associated with worse outcomes in patients with both low and high SBP, while this interaction was less clear for patients with SBP in the ‘normal’ range.

Conclusion:
In our patients with heart failure and reduced ejection fraction and mild symptoms, both a lower and higher SBP-CoV were associated with worse outcomes. SBP-CoV did not modify the benefit of eplerenone. Further studies are warranted to clarify the role of BPV in heart failure.

ClinicalTrials.gov identifier:
NCT00232180.
Cancer patients with potential eligibility for vascular endothelial growth factor antagonists use have an increased risk for cardiovascular diseases comorbidities
Authors: Liu Fei , Hidru Tesfaldet H. , Gao Ruiyuan , Lin Yajuan , Liu Ying , Fang Fengqi , Liu Jiwei , Li Huihua , Yang Xiaolei , Xia Yunlong 
Published: October 2019

Background:
Recent studies have reported the prevalence of cardiovascular diseases (CVDs) among cancer patients following the use of the vascular endothelial growth factor (VEGF) signaling inhibitors. However, data for patients with a history of cancer before active cancer treatment are lacking. This study aims to investigate the distribution of CVD-related comorbidities before cancer treatment in potential VEGF antagonists candidates.

Methods:
A total of 22 500 newly diagnosed cancer patients registered from 1 January 2011 to 31 December 2017 were included. Cancer patients with colorectal cancer (CRC), renal cell carcinoma (RCC), thyroid cancer, hepatocellular carcinoma (HCC), and lung cancer were selected.

Results:
Hypertension (HTN), coronary heart diseases, atrial fibrillation, and heart failure were top CVD comorbidities among studied cancers. HTN was the most prevalent CVD (26.0%). The prevalence of HTN in RCC, CRC (33.5 and 29.4% respectively) was significantly higher than that in HCC, lung cancer, and thyroid cancer patients (25.1, 24.5, and 23.1%, respectively). Among cancer patients with HTN, the majority of cancer patients fall in grade III (75.7%) and very high cardiovascular risk level (85.4%). Out of the 5847 HTN patients, 26% were not in antihypertensive use, and 34.2% failed to achieve the target blood pressure.

Conclusion:
Cancer patients carry a high burden of CVD-related comorbidities before the application of VEGF antagonists. HTN is the most prevalent comorbid condition, and cancer patients with HTN constitute substantial cardiovascular risks and a higher co-prevalence of other CVDs.
Translating Data From an Electronic Prescribing and Medicines Administration System Into Knowledge
Authors: Van Wilder Astrid , Spriet Isabel , Van Eldere Johan , Peetermans Willy E. , Vanhaecht Kris , Vandersmissen Jo , Artois Martine , Gilis Karin , Vanautgaerden Pieter , Balcaen Koen , Rademakers Frank E. , Bruyneel Luk 
Published: October 2019

Background:
Electronic Prescribing and Medicines Administration (EPMA) systems are being widely implemented to facilitate medication safety improvement. However, translating the resulting big data into actionable knowledge has received relatively little attention.

Objective:
The objective of this study was to use routinely collected EPMA data in the study of exact time discrepancy between physicians’ order and nurses’ administration of systemic antibiotics. We evaluated first and follow-up dose administration and dose intervals and examined multifactorial determinants in ordering and administration explaining potential discrepancy.

Methods:
We conducted an observational study of electronic health records for all medical patient stays with antibiotic treatment from January to June 2018 (n=4392) in a large Belgian tertiary care hospital. Using an EPMA system with Barcode Medication Administration, we calculated time discrepancy between order and administration of first doses (n=6233), follow-up doses (n=87 960), and dose intervals. Multiple logistic regression analysis estimated the association between time discrepancy and various determinants in ordering and administration.

Results:
Time discrepancy between physician order and nurse administration was <30 minutes for 48.7% of first doses and 61.7% of follow-up doses, with large variation across primary diagnoses. Greater dose intervals, oral versus intravenous administration, and order diversion from regular nurse administration rounds showed strongest association with less timely administration.

Conclusions:
EPMA systems show huge potential to generate actionable knowledge. Concerning antibiotic treatment, having physicians’ orders coincide with regular nurse administration rounds whenever clinically appropriate, further taking contextual factors into account, could potentially improve antibiotic administration timeliness.
Persistent Disparities in Medicare’s Annual Wellness Visit Utilization
Authors: Lind Kimberly E. , Hildreth Kerry L. , Perraillon Marcelo Coca 
Published: October 2019

Introduction:
The Medicare Annual Wellness Visit (AWV) is a preventive care visit introduced in 2011 as part of the Affordable Care Act provided without cost to beneficiaries. The AWV is associated with higher preventive services utilization. Although AWV utilization increased during 2011–2013, utilization was lower among ethnoracial minority beneficiaries who may benefit the most.

Objectives:
To determine if AWV utilization disparities have persisted using the most recent data available.

Research Design:
The authors analyzed AWV utilization in 2011–2013 and 2015–2016 by beneficiary-reported race and ethnicity, adjusting for potential confounders.

Subjects:
Weighted sample of 78,639,501 fee-for-service Medicare beneficiaries aged 66 years and older who participated in the Medicare Current Beneficiary Survey 2011–2013 or 2015–2016.

Measures:
AWV utilization was identified using Medicare claims.

Results:
AWV utilization increased from 8.1% to 23.0% of all beneficiaries between 2011 and 2016. Compared with non-Hispanic white beneficiaries, utilization was significantly lower among non-Hispanic Black and non-Hispanic other race beneficiaries in both the minimally and fully-adjusted models. Hispanic/Latino beneficiaries had lower utilization in the minimally adjusted model, but not in the fully-adjusted model. In 2016, compared with non-Hispanic white beneficiaries, AWV utilization was 10.2 points lower for non-Hispanic black, 11.6 points lower for Hispanic/Latino, and 8.6 points lower for non-Hispanic other race beneficiaries, and these differences were attenuated after adjusting for all covariates to 6.8 points lower, 9.4 points lower, and 7.2 points lower, respectively.

Conclusions:
The AWV has the potential to increase the use of preventive care, improve health, and reduce ethnoracial disparities among Medicare beneficiaries, but realizing these goals will require increasing utilization by minority groups. If ethnoracial minority beneficiaries had used the AWV at the same rate as non-Hispanic white beneficiaries during the study period, then ~1.6 million additional AWVs would have been used.
Intraobserver and interobserver agreement for the interpretation of 68Ga–prostate-specific membrane antigen-I&T positron emission tomography/computed tomography imaging
Authors: Gültekin Aziz , Yaylalı Olga , Şengöz Tarık , Yüksel Doğangün , Şahin Beyza 
Published: October 2019

Objectives
The use of 68Ga–prostate-specific membrane antigen positron emission tomography/computed tomography is spreading due to its clinical benefits. In this study, we aim to determine the intra- and interobserver agreement levels of 68Ga– prostate-specific membrane antigen-I&T positron emission tomography/computed tomography according to molecular imaging tumor-lymph node-metastases reporting system.

Materials and methods
Eighty prostate cancer patients and underwent 68Ga– prostate-specific membrane antigen positron emission tomography/computed tomography were blindly evaluated twice by four nuclear medicine specialists at intervals of 4 weeks. The evaluations were performed according to molecular imaging tumour-lymph node-metastases (miTNM) classification. We used Cohen’s Kappa and Fleiss’ Kappa analysis to analyse intra- and interobserver agreements.

Results
When 68Ga–prostate-specific membrane antigen positron emission tomography/computed tomography findings were evaluated according to miTNM classification, the obtained kappa values were as follows. The intraobserver Cohen’s kappa coefficient was found to be 0.79 (substantial agreement), 0.93 (almost perfect agreement), and 0.94 (almost perfect agreement) for miT, miN, and miM, respectively. During interobserver evaluation between the four observers, the kappa coefficient was 0.52 (moderate agreement) for miT, 0.74 (substantial agreement) for miN, and 0.84 (almost perfect agreement) for miM.

Conclusion
There is no research on the intraobserver agreement analysis of 68Ga–prostate-specific membrane antigen positron emission tomography/computed tomography in the literature. Our findings are the first ones. The intraobserver agreement was almost perfect. Moreover, although 68Ga–prostate-specific membrane antigen I&T positron emission tomography/computed tomography had moderate interobserver evaluation compliance of the primary tumour, it had excellent interobserver agreement levels in local lymph node metastasis and distant metastasis evaluation.4012501255