bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longitude Position in a Time Zone and Cancer Risk in the United States
Authors: Gu Fangyi , Xu Shangda , Devesa Susan S. , Zhang Fanni , Klerman Elizabeth B. , Graubard Barry I. , Caporaso Neil E. 
Published: April 2017

Abstract
Background: Circadian disruption is a probable human carcinogen. From the eastern to western border of a time zone, social time is equal, whereas solar time is progressively delayed, producing increased discrepancies between individuals' social and biological circadian time. Accordingly, western time zone residents experience greater circadian disruption and may be at an increased risk of cancer.
Methods: We examined associations between the position in a time zone and age-standardized county-level incidence rates for total cancers combined and 23 specific cancers by gender using the data of the Surveillance, Epidemiology, and End Results Program (2000–2012), including four million cancer diagnoses in white residents of 607 counties in 11 U.S. states. Log-linear regression was conducted, adjusting for latitude, poverty, cigarette smoking, and state. Bonferroni-corrected P values were used as the significance criteria.
Results: Risk increased from east to west within a time zone for total and for many specific cancers, including chronic lymphocytic leukemia (both genders) and cancers of the stomach, liver, prostate, and non-Hodgkin lymphoma in men and cancers of the esophagus, colorectum, lung, breast, and corpus uteri in women.
Conclusions: Risk increased from the east to the west in a time zone for total and many specific cancers, in accord with the circadian disruption hypothesis. Replications in analytic epidemiologic studies are warranted.
Impact: Our findings suggest that circadian disruption may not be a rare phenomenon affecting only shift workers, but is widespread in the general population with broader implications for public health than generally appreciated. Cancer Epidemiol Biomarkers Prev; 26(8); 1306–11. ©2017 AACR.
Factor VIIIa-mimetic cofactor activity of a bispecific antibody to factors IX/IXa and X/Xa, emicizumab, depends on its ability to bridge the antigens
Authors: Kitazawa Takehisa , Esaki Keiko , Tachibana Tatsuhiko , Ishii Shinya , Soeda Tetsuhiro , Muto Atsushi , Kawabe Yoshiki , Igawa Tomoyuki , Tsunoda Hiroyuki , Nogami Keiji , Shima Midori , Hattori Kunihiro 
Published: April 2017

SummaryEmicizumab, a humanised bispecific antibody recognising factors (F) IX/IXa and X/Xa, can accelerate FIXa-catalysed FX activation by bridging FIXa and FX in a manner similar to FVIIIa. However, details of the emicizumab–antigen interactions have not been reported so far. In this study, we first showed by surface plasmon resonance analysis that emicizumab bound FIX, FIXa, FX, and FXa with moderate affinities (K D = 1.58, 1.52, 1.85, and 0.978 μM, respectively). We next showed by immunoblotting analysis that emicizumab recognised the antigens’ epidermal growth factor (EGF)-like domains. We then performed K D-based simulation of equilibrium states in plasma for quantitatively predicting the ways that emicizumab would interact with the antigens. The simulation predicted that only a small part of plasma FIX, FX, and emicizumab would form antigen-bridging FIX–emicizumab–FX ternary complex, of which concentration would form a bell-shaped relationship with emicizumab concentration. The bell-shaped concentration dependency was reproduced by plasma thrombin generation assays, suggesting that the plasma concentration of the ternary complex would correlate with emicizumab’s cofactor activity. The simulation also predicted that at 10.0–100 μg/ml of emicizumab–levels shown in a previous study to be clinically effective–the majority of plasma FIX, FX, and emicizumab would exist as monomers. In conclusion, emicizumab binds FIX/FIXa and FX/FXa with micromolar affinities at their EGF-like domains. The K D-based simulation predicted that the antigen-bridging ternary complex formed in circulating plasma would correlate with emicizumab’s cofactor activity, and the majority of FIX and FX would be free and available for other coagulation reactions.Institution where the work was carried out: Research Division, Chugai Pharmaceutical Co., Ltd.Supplementary Material to this article is available online at www.thrombosis-online.com.
Relationship Between Lifelong Exercise Volume and Coronary Atherosclerosis in Athletes
Authors: Aengevaeren Vincent L. , Mosterd Arend , Braber Thijs L. , Prakken Niek H.J. , Doevendans Pieter A. , Grobbee Diederick E. , Thompson Paul D. , Eijsvogels Thijs M.H. , Velthuis Birgitta K. 
Published: April 2017

Background:
Higher levels of physical activity are associated with a lower risk of cardiovascular events. Nevertheless, there is debate on the dose-response relationship of exercise and cardiovascular disease outcomes and whether high volumes of exercise may accelerate coronary atherosclerosis. We aimed to determine the relationship between lifelong exercise volumes and coronary atherosclerosis.

Methods:
Middle-aged men engaged in competitive or recreational leisure sports underwent a noncontrast and contrast-enhanced computed tomography scan to assess coronary artery calcification (CAC) and plaque characteristics. Participants reported lifelong exercise history patterns. Exercise volumes were multiplied by metabolic equivalent of task (MET) scores to calculate MET-minutes per week. Participants’ activity was categorized as <1000, 1000 to 2000, or >2000 MET-min/wk.

Results:

A total of 284 men (age, 55±7 years) were included. CAC was present in 150 of 284 participants (53%) with a median CAC score of 35.8 (interquartile range, 9.3–145.8). Athletes with a lifelong exercise volume >2000 MET-min/wk (n=75) had a significantly higher CAC score (9.4 [interquartile range, 0–60.9] versus 0 [interquartile range, 0–43.5];
P
=0.02) and prevalence of CAC (68%; adjusted odds ratio [OR
adjusted
]=3.2; 95% confidence interval [CI], 1.6–6.6) and plaque (77%; OR
adjusted
=3.3; 95% CI, 1.6–7.1) compared with <1000 MET-min/wk (n=88; 43% and 56%, respectively). Very vigorous intensity exercise (≥9 MET) was associated with CAC (OR
adjusted
=1.47; 95% CI, 1.14–1.91) and plaque (OR
adjusted
=1.56; 95% CI, 1.17–2.08). Among participants with CAC>0, there was no difference in CAC score (
P
=0.20), area (
P
=0.21), density (
P
=0.25), and regions of interest (
P
=0.20) across exercise volume groups. Among participants with plaque, the most active group (>2000 MET-min/wk) had a lower prevalence of mixed plaques (48% versus 69%; OR
adjusted
=0.35; 95% CI, 0.15–0.85) and more often had only calcified plaques (38% versus 16%; OR
adjusted
=3.57; 95% CI, 1.28–9.97) compared with the least active group (<1000 MET-min/wk).

Conclusions:
Participants in the >2000 MET-min/wk group had a higher prevalence of CAC and atherosclerotic plaques. The most active group, however, had a more benign composition of plaques, with fewer mixed plaques and more often only calcified plaques. These observations may explain the increased longevity typical of endurance athletes despite the presence of more coronary atherosclerotic plaque in the most active participants.
Taxonomy and evolutionary diversification of the Central European endemic Spergularia echinosperma (Caryophyllaceae)
Authors: KÚR PAVEL , AMARELL UWE , JAGE HORST , ŠTECH MILAN 
Published: April 2017

The patterns of morphological variation and distribution of the rare Central European endemic Spergularia echinosperma were investigated. Morphometric analyses revealed the existence of two distinct morphotypes differing each other mainly in seed color, which is either brown or black. Other differences are in density of the seed surface papillae, height and shape of the papillae, seed width, pedicel/capsule and internode/leaf ratios, and leaf length. A geographic separation of the morphotypes also exists. The black-seeded morphotype occurred nearly exclusively in drained fishponds in the south-western part of the Czech Republic, the brown-seeded morphotype was found in drained fishponds in the eastern part of the Czech Republic and in alluvial pools and river deposits of the Elbe River (Germany). We hypothesize that the black-seeded morphotype may have been indigenous in former natural lakes which were widespread in the SW-Czech Republic and they were frequently transformed into fishponds. The brown-seeded morphotype may have its origin in river alluvia of the Elbe (Germany) and possibly also of other rivers in the Czech Republic. Since the two morphotypes are morphologically and geographically well separated, we propose to describe the brown-seeded morphotype as a new subspecies for science, S. echinosperma subsp. albensis subsp. nov.
Comparison of TRMM-Derived Rainfall Products for General and Extreme Rains over the Maritime Continent
Authors: Sekaranom Andung Bayu , Masunaga Hirohiko 
Published: April 2017

AbstractProperties of the rain estimation differences between Tropical Rainfall Measuring Mission (TRMM) Precipitation Radar (PR) 2A25, TRMM Microwave Imager (TMI) 2A12, and TRMM Multisatellite Precipitation Analysis (TMPA) 3B42 are investigated with a focus on distinguishing between nonextreme and extreme rains over the Maritime Continent from 1998 to 2014. Statistical analyses of collocated TMI 1B11 85-GHz polarization-corrected brightness temperatures, PR 2A23 storm-top heights, and PR 2A25 vertical rain profiles are conducted to identify possible sources of the differences. The results indicate that a large estimation difference exists between PR and TMI for the general rain rate (extreme and nonextreme events). The PR–TMI rain-rate differences are larger over land and coast than over ocean. When extreme rain is isolated, a higher frequency of occurrence is identified by PR over ocean, followed by TMI and TMPA. Over land, TMI yields higher rain frequencies than PR with an intermediate range of rain rates (between 15 and 25 mm h−1), but it gives way to PR for the highest extremes. The turnover at the highest rain rates arises because the heaviest rain depicted by PR does not necessarily accompany the strongest ice-scattering signals, which TMI relies on for estimating precipitation over land and coast.
Effect and placental transfer of dexmedetomidine during caesarean section under epidural anaesthesia
Authors: Wang Changsheng , Liu Shijiang , Han Chuanbao , Yu Min , Hu Youli , Liu Cunming 
Published: April 2017

Objective To investigate the neonatal effect and placental transfer of dexmedetomidine during caesarean section under epidural anaesthesia. Methods Forty parturients with a single newborn who were scheduled for caesarean section were enrolled. Patients received 0.5 µg/kg dexmedetomidine 10 min after epidural anaesthesia, followed by 0.5 µg/kg/h until abdominal closure (Dex group) or infusion of normal saline (NS group). Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were monitored before infusion (T0), 10 min after infusion (T1), at delivery (T2), and at the end of the operation (T3). Umbilical vein and artery blood was collected. Apgar scores were evaluated at 1 and 5 min after delivery. Results SBP, DBP, and HR in the Dex group were decreased at T3 compared with T0 (116 ± 10.4 vs 111 ± 9.2 mmHg, 74 ± 6.7 vs 66 ± 7.9 mmHg, 91 ± 12.1 vs 71 ± 8.4 beats/min, respectively, P < 0.05). HR was lower at T1, T2, and T3 in the Dex group compared with the NS group ( P < 0.05). There were no significant differences in blood gases and Apgar scores between the groups ( P > 0.05). Conclusion Dexmedetomidine during caesarean section under epidural anaesthesia is beneficial to parturients. The placental transfer rate is 0.68.
Telerehabilitation after arthroscopic subacromial decompression is effective and not inferior to standard practice: Preliminary results
Authors: Pastora-Bernal Jose M , Martín-Valero Rocío , Barón-López Francisco J , Moyano Noelia G , Estebanez-Pérez María-José 
Published: April 2017

Background Telerehabilitation promises to improve quality, increase patient access and reduce costs in health care. Physiotherapy with exercises is generally recommended to restore function after surgery in patients with chronic subacromial syndrome. Relatively few studies have investigated the feasibility of telerehabilitation interventions in musculoskeletal and orthopaedic disorders. The aim of this study was to evaluate the feasibility and effectiveness of a customizable telerehabilitation intervention and compare with traditional care. Methods This research includes 18 consecutive patients with subacromial impingement who underwent arthroscopic subacromial decompression in a controlled clinical prospective study. Patients were randomized to either a 12-week telerehabilitation programme or the usual face-to-face physical therapy for immediate postoperative rehabilitation. We have developed a telerehabilitation system to provide services to patients who have undergone shoulder arthroscopy. An independent blinded observer performed postoperative follow-up after 4, 8, and 12 weeks. Results The preliminary efficacy of this telerehabilitation programme in terms of both physical and functional objective outcome measures was assessed on eight patients. Using the Constant–Murley score to evaluate functional outcome, patients in the telerehabilitation group were shown to have improved from a mean 43.50 ± 3.21 points to a mean 68.50 ± 0.86 points after 12 weeks. The physical and functional improvements in the telerehabilitation group were similar to those in the control group ( p = 0.213). There was a non-significant trend for greater improvements in the telerehabilitation group for most outcome measurements. Conclusion The results of this study provide evidence for the efficacy of telerehabilitation after shoulder arthroscopy in shoulder impingement syndrome. A telerehabilitation programme with range of motion, strengthening of the rotator cuff and scapula stabilizers exercises seems to be similar and not inferior to traditional face-to-face physiotherapy after subacromial arthroscopic decompression. Through this study, we are developing our preliminary dataset to evaluate the efficacy of telerehabilitation programmes following surgical procedures in musculoskeletal injuries and for comparison with more traditional interventions.
Medical treatment or revascularisation as the best approach for spontaneous coronary artery dissection: A systematic review and meta-analysis
Authors: Martins José Luís , Afreixo Vera , Santos Luís , Costa Marco , Santos José , Gonçalves Lino 
Published: April 2017

Introduction: Patients presenting with spontaneous coronary artery dissection (SCAD) may receive either conservative medical management or a revascularisation strategy. There is still a lack of consensus with respect to the best treatment approach for SCAD. Objectives: We sought to determine whether outcomes differ between the first-line treatment approaches (conservative versus revascularisation) in patients with SCAD. Methods: We searched Medline, EMBASE and the Cochrane Library for studies published from January 1990 to November 2016 that compared first-line treatments for patients with SCAD. We conducted a pooled risk ratio meta-analysis for four main outcomes: mortality, myocardial infarction (MI), SCAD recurrence and target vessel revascularisation (TVR). Results: We identified 11 non-randomised studies that included a total of 631 patients. A pooled meta-analysis showed no significant difference between conservative management and revascularisation approaches in mortality (risk difference [RD] = 0.01; 95% confidence interval [CI] = −0.01 to 0.04; I2 = 0%; p = 1), MI (RD = −0.01; 95% CI = −0.04 to 0.03; I2 = 0%; p = 0.5) or SCAD recurrence (RD = −0.01; 95% CI = −0.06 to 0.05; I2 = 0%; p = 0.74). Revascularisation as an initial first-line approach was associated with an estimated additional risk of TVR of 6.3% (RD = 0.06; 95% CI = 0.01−0.11; I2 = 0%; p = 0.96). Conclusion: The results demonstrate an increased risk of TVR when revascularisation was used as the initial first-line treatment approach. The treatment decision must be individualised and be based on both clinical and angiographic factors, but conservative therapy should prevail in most cases.
Risk factors of late cardiogenic shock and mortality in ST-segment elevation myocardial infarction patients
Authors: Obling Laust , Frydland Martin , Hansen Rikke , Møller-Helgestad Ole Kristian , Lindholm Matias Greve , Holmvang Lene , Ravn Hanne Berg , Wiberg Sebastian , Thomsen Jakob Hartvig , Jensen Lisette Okkels , Kjærgaard Jesper , Møller Jacob Eifer , Hassager Christian 
Published: April 2017

Background: The incidence of cardiogenic shock (CS) in patients with ST-segment elevation myocardial infarction (STEMI) is as high as 10%. The majority of patients are thought to develop CS after admission (late CS), but the incidence in a contemporary STEMI cohort admitted for primary percutaneous intervention remains unknown. Aim: The aim of this study was to assess the incidence and time of CS onset in patients with suspected STEMI admitted in two high-volume tertiary heart centres and to assess the variables associated with the development of late CS. Methods: We included consecutive patients admitted for acute coronary angiography with suspected STEMI in a 1-year period. Cardiogenic shock was based on clinical criteria and subdivided into patients with shock on admission, patients developing shock during catheterisation and patients developing shock later during hospitalisation. Follow-up for all-cause mortality was done using registries. Results: A total of 2247 patients with suspected STEMI were included, whereof 225 (10%) developed CS. The majority (56%) had CS on admission, 16% developed CS in the catheterisation laboratory and 28% developed late CS. Thirty-day mortality was 3.1% versus 47% in non-CS versus CS patients ( plogrank < 0.0001). Age, stroke, time from symptom onset to intervention, anterior STEMI, heart rate/systolic blood pressure ratio and being comatose after resuscitation from cardiac arrest were independently associated with the development of late CS. Conclusion: In this study, 10% of patients admitted with suspected STEMI for acute coronary angiography presented with or developed CS. Most were in shock on admission. Irrespective of the timing of shock, mortality was high.
A Prospective, Randomized, Clinical Trial on the Effects of a Valveless Trocar on Respiratory Mechanics During Robotic Radical Cystectomy: A Pilot Study
Authors: Covotta Marco , Claroni Claudia , Torregiani Giulia , Naccarato Alessia , Tribuzi Susanna , Zinilli Antonio , Forastiere Ester 
Published: April 2017

BACKGROUND:
Prolonged pneumoperitoneum and Trendelenburg positioning for robot-assisted radical cystectomy (RARC) are essential for optimizing visualization of the operative field, although they worsen hemodynamic and respiratory function. Our hypothesis is that the use of a valveless trocar (VT) may improve respiratory mechanics.

METHODS:
In this prospective, 2-arm parallel trial, patients ASA II to III undergoing RARC were randomly assigned into 2 groups: in the VT group, the capnoperitoneum was maintained with a VT; in the control group, the capnoperitoneum was maintained with a standard trocar (ST group). Inspiratory plateau pressure (Pplat), static compliance (Cstat), minute volume (MV), tidal volume (Vt), and carbon dioxide (CO2) elimination rate were recorded at these times: 15 minutes after anesthesia induction (T0), 10 minutes (T1) and 60 minutes (T2) after first robot docking, 10 minutes before first undocking (T3), 10 minutes (T4) and 60 minutes (T5) after second docking, 10 minutes before second undocking (T6), and 10 minutes before extubation (T7). The primary end point of the study was the assessment of Pplat mean value from T1 to T6.

RESULTS:
A total of 56 patients were evaluated: 28 patients in the VT group and 28 in the ST group. VT group had lower Pplat (means and standard error, VT group 30 [0.66] versus ST group 34 [0.66] cm H2O, with estimated mean difference and 95% confidence interval, −4.1 [−5.9 to −2.2], P < .01), lower MV (means and standard error, VT group 8.2 [0.22] versus ST group 9.8 [0.21] L min−1, P < .01), lower CO2 elimination rate (means and standard error, VT group 4.2 [0.25] versus ST group 5.4 [0.24] mL kg−1 min−1, P < .01), lower end-tidal CO2 (etco
2) (means and standard error, VT group 28.8 [0.48] versus ST group 31.3 [0.46] mm Hg, P < .01), and higher Cstat (means and standard error, VT group 26 [0.9] versus ST group 22.1 [0.9] mL cm H2O−1, P < .01). Both groups had similar Vt (P = .24).

CONCLUSIONS:
During RARC, use of a VT was associated with a significantly lower Pplat and improvement in other respiratory parameters.
Arterial Pressure and the Rate of Elimination of Crystalloid Fluid
Authors: Hahn Robert G. 
Published: April 2017

Excretion of crystalloid fluid is slow during general anesthesia. The distribution and elimination of buffered Ringer’s solution were analyzed to determine whether the rate of elimination correlates with a hemodynamic factor, consciousness, patient posture, or the type of general anesthesia. Data were derived from 4 separately published studies in which 30 volunteers and 48 anesthetized patients had received 0.833 (1 series 0.667) mL/kg/min of lactated or acetated Ringer’s solution over 30 minutes. Frequent measurements of the blood hemoglobin and mean urinary excretion were used as input in a kinetic analysis according to a 2-volume model and covariates, using microconstants and mixed-effects modeling software.
The results show that rate of elimination of crystalloid fluid decreased with the mean arterial pressure (MAP) and patient age, but was unaffected by consciousness and inhalational or intravenous anesthesia. The elimination rate constant was 6.5 (95% confidence interval, 5.2–7.9) × 10−3 × (MAP/mean MAP)5.2 × (Age/mean Age)−1.5. The mean MAP for the 2108 data points was 81.3 mm Hg and the mean age was 40 years. The central fluid space that was expanded by infused fluid (V
c, plasma volume) increased with body weight but decreased with general anesthesia and with reductions of MAP.
Simulations revealed a more than 10-fold difference in the excreted fluid volume after a theoretical 30-minute infusion, depending on whether the MAP was 50 or 100 mm Hg.
In conclusion, the rate of elimination of crystalloid fluid decreased in proportion to MAP but was independent of general anesthesia and moderate-sized surgery.
Open Online Courses in Public Health: experience from Peoples-uni
Authors: Heller Richard F. , Zurynski Robert , Barrett Alan , Oaiya Omo , Madhok Rajan 
Published: April 2017

Open Online Courses (OOCs) are offered by Peoples-uni at http://ooc.peoples-uni.org to complement the courses run on a separate site for academic credit at http://courses.peoples-uni.org. They provide a wide range of online learning resources beyond those usually found in credit bearing Public Health courses. They are self-paced, and students can enrol themselves at any time and utilise Open Educational Resources free of copyright restrictions. In the two years that courses have been running, 1174 students from 100 countries have registered and among the 1597 enrolments in 14 courses, 15% gained a certificate of completion. Easily accessible and appealing to a wide geographical and professional audience, OOCs have the potential to play a part in establishing global Public Health capacity building programmes.