bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between triglyceride levels and ischaemic stroke in elderly hypertensive patients
Authors: Huang Yu-Qing , Huang Jia-Yi , Liu Lin , Chen Chao-Lei , Yu Yu-Ling , Tang Song-tao , Zhang Bin , Feng Ying Qing 
Published: October 2019

AbstractBackgroundAlthough hyperlipidaemia was a well-known risk factor for ischaemic stroke, the association between triglyceride and first ischaemic stroke remains uncertain.ObjectivesThe present study attempted to explore the relationship between triglyceride and first ischaemic stroke in a Chinese community elderly patients with hypertension.Methods and resultsThis was a retrospective cohort study. We enrolled 3249 consecutive elderly patients with hypertension from a community in China between January 2010 and December 2011. Patients were divided into four groups based on the quartiles of triglyceride. Multivariate Cox regression analysis, subgroup and interaction test were performed to evaluate the relationship between triglyceride and first ischaemic stroke. There were a total of 3249 participants including 1455 male and 1794 female, with a mean age of 71.36±7.18 years. At an average follow-up of 5.5 years, 205 patients were identified to have first ischaemic stroke. After adjustment for potential confounders, using the lowest quartiles of triglyceride as the reference, multivariable HR (95% CI) for first ischaemic stroke increased in parallel with the quartiles of triglyceride (HRs were 1.56 (95% CI 1.07 to 2.51), 1.74 (95% CI 1.07 to 2.84) and 1.85 (95% CI 1.05 to 2.89)) from the second to the fourth quartiles, respectively (p=0.002 for trend). Subgroup and interaction analysis showed that there was no interactive effect on triglyceride and first ischaemic stroke.ConclusionTriglyceride was an independent risk factor for first ischaemic stroke among Chinese elderly patients with hypertension.
Biomarkers of iron metabolism facilitate clinical diagnosis in Mycobacterium tuberculosis infection
Authors: Dai Youchao , Shan Wanshui , Yang Qianting , Guo Jiubiao , Zhai Rihong , Tang Xiaoping , Tang Lu , Tan Yaoju , Cai Yi , Chen Xinchun 
Published: October 2019

BackgroundPerturbed iron homeostasis is a risk factor for tuberculosis (TB) progression and an indicator of TB treatment failure and mortality. Few studies have evaluated iron homeostasis as a TB diagnostic biomarker.MethodsWe recruited participants with TB, latent TB infection (LTBI), cured TB (RxTB), pneumonia (PN) and healthy controls (HCs). We measured serum levels of three iron biomarkers including serum iron, ferritin and transferrin, then established and validated our prediction model.ResultsWe observed and verified that the three iron biomarker levels correlated with patient status (TB, HC, LTBI, RxTB or PN) and with the degree of lung damage and bacillary load in patients with TB. We then built a TB prediction model, neural network (NNET), incorporating the data of the three iron biomarkers. The model showed good performance for diagnosis of TB, with 83% (95% CI 77 to 87) sensitivity and 86% (95% CI 83 to 89) specificity in the training data set (n=663) and 70% (95% CI 58 to 79) sensitivity and 92% (95% CI 86 to 96) specificity in the test data set (n=220). The area under the curves (AUCs) of the NNET model to discriminate TB from HC, LTBI, RxTB and PN were all >0.83. Independent validation of the NNET model in a separate cohort (n=967) produced an AUC of 0.88 (95% CI 0.85 to 0.91) with 74% (95% CI 71 to 77) sensitivity and 92% (95% CI 87 to 96) specificity.ConclusionsThe established NNET TB prediction model discriminated TB from HC, LTBI, RxTB and PN in a large cohort of patients. This diagnostic assay may augment current TB diagnostics.
Evaluating tobacco retailer experience and compliance with a flavoured tobacco product restriction in Boston, Massachusetts: impact on product availability, advertisement and consumer demand
Authors: Kephart Lindsay , Setodji Claude , Pane Joseph , Shadel William , Song Glory , Robertson Jennifer , Harding Nikysha , Henley Patricia , Ursprung Wannakuwatte Waduge Sanouri 
Published: October 2019

BackgroundFlavoured tobacco products are widely available in youth-accessible retailers and are associated with increased youth initiation and use. The city of Boston, Massachusetts restricted the sale of flavoured tobacco products, including cigars, smokeless tobacco and e-cigarettes, to adult-only retailers. This paper describes the impact of the restriction on product availability, advertisement and consumer demand.MethodsBetween January and December 2016, data were collected in 488 retailers in Boston at baseline and 469 retailers at 8-month follow-up, measuring the type, brand and flavour of tobacco products being sold. Process measures detailing the educational enforcement process, and retailer experience were also captured. McNemar tests and t-tests were used to assess the impact of the restriction on product availability.ResultsAfter policy implementation, only 14.4% of youth-accessible retailers sold flavoured products compared with 100% of retailers at baseline (p<0.001). Flavoured tobacco product advertisements decreased from being present at 58.9% of retailers to 28.0% at follow-up (p<0.001). Postimplementation, retailers sold fewer total flavoured products, with remaining products often considered as concept flavours (eg, jazz, blue). At follow-up, 64.0% of retailers reported that customers only asked for flavoured products a few times a week or did not ask at all. Retailers reported that educational visits and the flavoured product guidance list aided with compliance.ConclusionTobacco retailers across Boston were largely in compliance with the regulation. Availability of flavoured tobacco products in youth-accessible retailers declined city-wide after policy implementation. Strong educational and enforcement infrastructure may greatly enhance retailer compliance.
Altered RNA Processing in Cancer Pathogenesis and Therapy
Authors: Obeng Esther A. , Stewart Connor , Abdel-Wahab Omar 
Published: October 2019

Abstract

Major advances in our understanding of cancer pathogenesis and therapy have come from efforts to catalog genomic alterations in cancer. A growing number of large-scale genomic studies have uncovered mutations that drive cancer by perturbing cotranscriptional and post-transcriptional regulation of gene expression. These include alterations that affect each phase of RNA processing, including splicing, transport, editing, and decay of messenger RNA. The discovery of these events illuminates a number of novel therapeutic vulnerabilities generated by aberrant RNA processing in cancer, several of which have progressed to clinical development.

Significance:
There is increased recognition that genetic alterations affecting RNA splicing and polyadenylation are common in cancer and may generate novel therapeutic opportunities. Such mutations may occur within an individual gene or in RNA processing factors themselves, thereby influencing splicing of many downstream target genes. This review discusses the biological impact of these mutations on tumorigenesis and the therapeutic approaches targeting cells bearing these mutations.
Understanding of European Cold Extremes, Sudden Stratospheric Warming, and Siberian Snow Accumulation in the Winter of 2017/18
Authors: Lü Zhuozhuo , Li Fei , Orsolini Yvan J. , Gao Yongqi , He Shengping 
Published: October 2019

AbstractIt is unclear whether the Eurasian snow plays a role in the tropospheric driving of sudden stratospheric warming (SSW). The major SSW event of February 2018 is analyzed using reanalysis datasets. Characterized by predominant planetary waves of zonal wave 2, the SSW developed into a vortex split via wave–mean flow interaction. In the following two weeks, the downward migration of zonal-mean zonal wind anomalies was accompanied by a significant transition to the negative phase of the North Atlantic Oscillation, leading to extensive cold extremes across Europe. Here, we demonstrate that anomalous Siberian snow accumulation could have played an important role in the 2018 SSW occurrence. In the 2017/18 winter, snow depths over Siberia were much higher than normal. A lead–lag correlation analysis shows that the positive fluctuating snow depth anomalies, leading to intensified “cold domes” over eastern Siberia (i.e., in a region where the climatological upward planetary waves maximize), precede enhanced wave-2 pulses of meridional heat fluxes (100 hPa) by 7–8 days. The snow–SSW linkage over 2003–19 is further investigated, and some common traits among three split events are found. These include a time lag of about one week between the maximum anomalies of snow depth and wave-2 pulses (100 hPa), high sea level pressure favored by anomalous snowpack, and a ridge anchoring over Siberia as precursor of the splits. The role of tropospheric ridges over Alaska and the Urals in the wave-2 enhancement and the role of Arctic sea ice loss in Siberian snow accumulation are also discussed.
Comparison of Wind Speed and Wave Height Trends from Twentieth-Century Models and Satellite Altimeters
Authors: Meucci Alberto , Young Ian R. , Aarnes Ole Johan , Breivik Øyvind 
Published: October 2019

AbstractThe trends in marine 10-m wind speed U10 and significant wave height Hs found in two century-long reanalyses are compared against a model-only integration. Reanalyses show spurious trends due to the assimilation of an increasing number of observations over time. The comparisons between model and reanalyses show that the areas where the discrepancies in U10 and Hs trends are greatest are also the areas where there is a marked increase in assimilated observations. Large differences in the yearly averages call into question the quality of the observations assimilated by the reanalyses, resulting in unreliable U10 and Hs trends before the 1950s. Four main regions of the world’s oceans are identified where the trends between model and reanalyses deviate strongly. These are the North Atlantic, the North Pacific, the Tasman Sea, and the western South Atlantic. The trends at +24-h lead time are markedly weaker and less correlated with the observation count. A 1985–2010 comparison with an extensive dataset of calibrated satellite altimeters shows contrasting results in Hs trends but similar U10 spatial trend distributions, with general agreement between model, reanalyses, and satellite altimeters on a broad increase in wind speed over the Southern Hemisphere.
Influence of Subseasonal Variability on the Diurnal Cycle of Precipitation on a Mountainous Island: The Case of New Caledonia
Authors: Specq Damien , Bellon Gilles , Peltier Alexandre , Lefèvre Jérôme , Menkes Christophe 
Published: October 2019

Abstract
The relationship between the large-scale intraseasonal variability, synoptic wind regimes, and the local daily variability of precipitation over the main island of New Caledonia (southwest tropical Pacific) is investigated with a focus on the austral summer wet season (November–April). The average diurnal cycle of precipitation over the island is characterized by a sharp afternoon maximum around 1600 local time, with significant differences between the windward east coast, the leeward west coast, and the mountain range. The afternoon peak is related to the afternoon sea-breeze circulation and to the diurnal cycle of convection over land. In general, its magnitude follows the same evolution as the daily mean. In agreement with past studies, a clear modulation of the Madden–Julian oscillation (MJO) on both the diurnal cycle of precipitation and the probability of occurrence of four robust wind regimes can be identified in the New Caledonia region during the wet season. From the evidence that there is a qualitative correspondence between the effects of both the MJO phases and the wind regimes on features in the diurnal cycle of precipitation, a simple model is proposed to inspect the MJO forcing mediated by wind regimes on the diurnal variability of rain. The complete decomposition of the MJO impact shows that the modulation of diurnal cycle by the MJO relies on complex interactions between the MJO and synoptic winds that involve both large-scale MJO convective anomalies and MJO-induced modification of wind patterns.
Using Question & Answer Forums as a Platform for Improving Transport-Related Information for Tourists
Authors: Gal-Tzur Ayelet , Bar-Lev Shirly , Shiftan Yoram 
Published: October 2019

Providing relevant, complete, and coherent information to travelers wishing to get from one destination to another is a fundamental responsibility of transport authorities. This study explored the characteristics of information desired by tourists seeking travel instructions through Question & Answer forums, particularly TripAdvisor’s city forums, with the aim of developing guidelines to improve answers. Three categories of travel information were defined, and a scenario-based survey was conducted among 558 tourists. Based on its results, a novel multidimensional model for assessing the quality of information posted in response to questions was developed. The study yielded several main conclusions. Shorter answers of up to four information items are preferred over longer ones, and diverse information types are preferred over several of the same category. Given an accurate basic existing answer, our model suggests that information should be added only when one or more of the three information categories is not already represented.
End-of-life care and place of death in adults with serious mental illness: A systematic review and narrative synthesis
Authors: Wilson Rebecca , Hepgul Nilay , Higginson Irene J , Gao Wei 
Published: October 2019

Background: People with serious mental illness have greater mortality risk than the general population. They experience health care inequalities throughout life; it is not clear if this persists to end of life. Aim: Assess the empirical evidence describing end-of-life care and place of death for people with serious mental illness. Design: A systematic review of original, peer-reviewed research, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were analysed using a narrative synthesis approach. Data sources: Five online databases (Embase, PsycArticles, PsycINFO, Medline, PubMed) and additional sources were searched (without time restriction) for primary research reporting health care utilisation in the last year of life or place of death in adults with serious mental illness. Results: After full-text screening, 23 studies were included. We found studies reporting hospital admissions, emergency department care, palliative care, and general practitioner (GP) visits at end of life. We found conflicting evidence for the association between serious mental illness and end-of-life care, although different patient groups, settings and measures were used across studies. People with serious mental illness were more likely to die in care homes than the general population. There were no patterns for other places of death. Conclusions: The evidence was sparse and heterogeneous, demonstrating variability in patterns and reporting of health care use and with little consensus on where people with serious mental illness are likely to die. Given that people with serious mental illness have increased mortality risk, this gap in the knowledge around end-of-life care outcomes is concerning; this area of research needs further development.
Bilingual effects on cognitive shifting and prefrontal activations in young children
Authors: Moriguchi Yusuke , Lertladaluck Kanda 
Published: October 2019

Aims and objectives: Bilingual children constantly experience spontaneous switching between languages in everyday settings, and some researchers suggest that this experience leads to an advantage in task performance during executive function tasks. Neural processing during executive function tasks remains largely unknown, especially in young bilingual children. Methodology: Using functional near-infrared spectroscopy, this study examined whether young children who attended an immersion second-language program demonstrated enhanced cognitive shifting and lateral prefrontal activation. Data and analysis: We recruited children ( N = 24) who attended an international nursery school, and examined whether their performance on cognitive shifting, and whether the oxygenated hemoglobin changes in the prefrontal regions during the task, were correlated with the children’s second-language verbal age and the length of time the children had been speaking the second language. Findings: Results revealed that the verbal age of the second language and the length of time speaking it were significantly correlated with behavioral performances of cognitive shifting tasks. However, they were not correlated with the activations in the lateral prefrontal regions. Originality: We examined the neural correlates of bilingual effects on cognitive shifting and prefrontal activations in young children. Implications: The results suggest that second-language experience may not be directly related to neural processing in the lateral prefrontal cortex, at least in young children.
Readability and Understandability Analysis of Online Materials Related to Abdominal Aortic Aneurysm Repair
Authors: Scott Benjamin B. , Johnson Anna Rose , Doval Andres F. , Tran Bao N. , Lee Bernard T. 
Published: October 2019

Background: Patients commonly use online materials as a source of health information. Since poor health literacy has been shown to correlate with negative outcomes, it is recommended that patient-directed materials be written at a sixth-grade reading level. This study evaluates the readability and understandability of commonly accessed online materials pertaining to both endovascular and open repair of abdominal aortic aneurysm. Methods: Searches for “endovascular repair abdominal aortic aneurysm” and “open repair abdominal aortic aneurysm” were performed on both Google and Bing, and the top 10 websites from each search engine were identified. Relevant websites (total N = 28, endovascular n = 15, open n = 15, and 2 redundant sites) with patient-directed content were analyzed. Readability was assessed using 9 established methods, and understandability was assessed using the Patient Education Materials Assessment Tool scoring system. Results: The average reading grade level for all sites was 12.8. Endovascular sites averaged a reading grade level of 13.6 with a range from 11.5 to 15.6. Open-repair websites had a grade-level average of 12.1 with a range from 9.9 to 14.1. Readability was found to be inversely related to understandability, with a Pearson correlation coefficient of −0.551 ( P = .003). No website was written at or below the recommended sixth-grade reading level. Conclusions: Patient-directed online health information pertaining to open and endovascular repair of abdominal aortic aneurysm exceeds the recommended sixth-grade reading level. Increasing complexity of health literature correlates with poor understandability. Modifications such as shorter sentences, fewer words with more than 6 letters, and increasing usage of clear visual aids can increase readability and understandability.
Reliability of thermocautery-assisted circumcision: retrospective analysis of circumcision performed voluntarily in countries of low socioeconomic status
Authors: Cakiroglu Basri , Gozukucuk Ali , Arda Ersan , Tas Tuncay 
Published: October 2019

Objective: The objective of this study was to evaluate the reliability of thermocautery-assisted circumcision performed voluntarily in patients of poor countries. Material and methods: Between 2016 and 2019, 32,000 children aged 7 days to 17 years were circumcised in multiple countries. The patients’ urological examinations were done before the administration of local anaesthesia. Patients revealed to have undescended testicle, inguinal hernia, hypospadias, varicocele, penile rotation anomaly, epispadias and infection were not circumcised. All procedures were performed under local anaesthesia by using thermocautery. Afterwards, mucosa and skin were sutured using absorbable suture and the circumcised penis was dressed. Patients were instructed to remove the dressing after 3 days. Results: Bleeding, requiring surgical intervention and drug reactions were not observed. The most observed complication was mucosal oedema, which occurred in approximately one-quarter of patients (26%, 8320/32,000) and continued for 3–5 days after the surgery. The most serious complication was a trapped penis, which occurred in 25 patients (0.078%). In six (0.018%) cases, meatal stenosis developed. Wound infection developed in only 10 (0.03%) cases, through the formation of an aseptic environment. Penile adhesion was seen in 35 cases (0.1%) and improved with anti-inflammatory treatment without any surgical intervention. Conclusion: Thermocautery-assisted circumcision can be used as an effective, safe and useful technique with few complications and rapid healing rates.
Prognostic value of PD-L1 expression for surgically treated localized renal cell carcinoma: implications for risk stratification and adjuvant therapies
Authors: Chipollini Juan , da Costa Walter Henriques , Werneck da Cunha Isabela , de Almeida e Paula Felipe , Guilherme O. Salles Paulo , Azizi Mounsif , Spiess Philippe E. , Abreu Diego , Zequi Stênio de Cássio 
Published: October 2019

Background: We aimed to evaluate the prognostic role of programmed-death receptor ligand (PD-L1) in a multinational cohort of patients with localized renal cell carcinoma (RCC). Methods: Formalin-fixed paraffin-embedded blocks of 1017 patients from the Latin American Renal Cancer Group were analyzed. Tissue microarrays were immunostained for PD-L1 using a commercially available monoclonal antibody. Expression of PD-L1 in ⩾5% tumor cells was considered positive. PD-1 expression in immune cells was also assessed. All cases were reviewed twice based on antibody expression and compared with a positive control. Cox proportional hazard regression models were used to identify predictors of recurrence-free survival (RFS) and overall survival (OS). Results: A total of 738 cases with complete follow up met criteria. Median age was 57 [interquartile range (IQR): 49–64] years, and median follow up was 34 (IQR: 15–62.9) months. Median tumor size was 5 cm (IQR: 3.0–7.5 cm). Approximately 8.2% and 7.6% of tumors were PD-L1 and programmed cell-death 1 (PD-1) positive, respectively. PD-L1 and PD-1 positivity were significantly associated with higher tumor stage (both p < 0.001), and presence of tumor necrosis and lymphovascular multivariable analyses; PD-L1 positivity was found as a predictor of worse RFS [hazard ratio (HR) = 2.08, p = 0.05] and OS (HR = 2.61, p = 0.02). Conclusions: PD-L1 positivity was significantly associated with worse outcomes for patients with localized RCC at intermediate follow up. This marker may help stratify patients for stricter surveillance after surgical treatment and provide a basis for checkpoint-inhibitor therapy in the adjuvant setting.