bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in the Incidence of Young-Onset Colorectal Cancer With a Focus on Years Approaching Screening Age: A Population-Based Longitudinal Study
Authors: Howren Alyssa , Sayre Eric C , Loree Jonathan M , Gill Sharlene , Brown Carl J , Raval Manoj J , Farooq Ameer , De Vera Mary A. 
Published: January 2021

Abstract

Background
With recent evidence for the increasing risk of young-onset colorectal cancer (yCRC), we had the objective to evaluate the incidence of yCRC in 1-year age increments, particularly focusing around the screening age of 50 years.

Methods
We conducted a longitudinal study using linked administrative health databases in British Columbia, Canada, including a provincial cancer registry, inpatient and outpatient visits, and vital statistics from January 1, 1986, to December 31, 2016. We calculated incidence rates per 100 000 at every age from 20 to 60 years and estimated annual percent change in incidence (APCi) of yCRC using joinpoint regression analysis.

Results
We identified 3614 individuals with yCRC (49.9% women). The incidence of CRC steadily increased from 20 to 60 years, with a marked increase from 49 to 50 years (incidence rate ratio = 1.19, 95% confidence interval [CI] = 1.04 to 1.34). Furthermore, there was a trend of increased incidence of yCRC among women (APCi = 0.79%, 95% CI = 0.22% to 1.36%) and men (APCi = 2.17%, 95% CI = 1.59% to 2.76%). Analyses stratified by age yielded APCis of 2.49% (95% CI = 1.36% to 3.63%) and 0.12% (95% CI = −0.54% to 0.79%) for women aged 30-39 years and 40-49 years, respectively, and 2.97% (95% CI = 1.65% to 4.31%) and 1.86% (95% CI = 1.19% to 2.53%) for men.

Conclusions
Our findings indicate a steady increase over 1-year age increments in the risk of yCRC during the years approaching and beyond screening age. These findings highlight the need to raise awareness as well as continue discussions regarding considerations of lowering the screening age.
Spatially Resolved and Quantitative Analysis of the Immunological Landscape in Human Meningiomas
Authors: Yeung Jacky , Yaghoobi Vesal , Aung Thazin N , Vesely Matthew D , Zhang Tianxiang , Gaule Patricia , Gunel Murat , Rimm David L , Chen Lieping 
Published: January 2021

Abstract
The immunological status of human meningiomas is not well understood, hindering the development of rational immunotherapeutic strategies. We measured the levels of PD-L1, PD-L2, and immune cell subsets using multiplex quantitative immunofluorescence in a tissue microarray composed of 73 human meningiomas (56 WHO Grade 1, 13 WHO Grade 2, and 4 WHO Grade 3). We analyzed tumor-infiltrating immune cell populations, T-cell activation/dysfunction, and macrophage phenotypes. PD-L1 and PD-L2 were detected in 5.8% and 68.7% of cases, respectively. There was a higher PD-L1 expression in CD68+ macrophages compared with tumor cells (p &lt; 0.001). There was a weak positive correlation between PD-L1 expression and CD3+ T-cell infiltration. The level of CD3+ cells and T-cell activation/proliferation in human meningiomas were highly variable with an increased CD4-to-CD8 ratio in higher grade tumors (p &lt; 0.05). There was a stronger correlation between GZMB/Ki67 with PD-L2 than PD-L1. We found that 15.23%, 6.66%, and 5.49% of macrophages were CD163+, CD68+, and CD163+CD68+, respectively. In cases where there is high CD3+ T-cell infiltration, 23.5% and 76.5% had dormant and activated T-cell phenotypes, respectively. We conclude that human meningiomas are either PD-L1low TILlow or PD-L1low TILhigh tumors and harbor variable TIL infiltration and phenotypes.
Tranexamic acid use in a patient with sickle cell disease undergoing posterior scoliosis correction surgery: safely mitigating bleeding and vaso-occlusive crises
Authors: Newall Millie , Hamdan Thamer A , Ajayi Bisola , Weil Simon , Bishop Timothy , Lui Darren F 
Published: January 2021

Abstract
A 15-year-old female with 2-year post-menarchal adolescent idiopathic scoliosis and sickle cell disease (SCD) underwent posterior scoliosis correction surgery. SCD is associated with higher rates of surgical complications, and these patients require careful management to prevent vaso-occlusive sickle cell crises (VOSCC); scoliosis correction surgery can be associated with high morbidity and mortality, including significant blood loss.
Multiple techniques were employed to successfully prevent VOSCC in this patient including a preoperative transfusion, meticulous haemostasis at osteotomy sites, not performing a costoplasty despite presence of a rib hump, maintenance of intraoperative mean arterial pressure below 70 mmHg, aggressive postoperative hydration and the use of intraoperative tranexamic acid (TXA). This is the first reported case of the use of TXA in a patient with SCD and scoliosis correction surgery.
A satisfactory correction was achieved with a longer than average inpatient stay due to non-sickle cell pain and protracted wound ooze.
Unusual case of delayed congenital diaphragmatic hernia in Loeys-Dietz syndrome: a case report
Authors: Lobaton Gilberto O , Chen Y Julia , Jelin Eric , Garcia Alejandro V 
Published: January 2021

Abstract
Congenital diaphragmatic hernias rarely present after 2 months of age and are typically diagnosed in the perinatal period. Moderate to severe diaphragmatic hernias present with respiratory symptoms, while late-onset hernias have a more varied presentation, depending on the age and content of the hernia. Very rarely, such hernias are found on incidental imaging, in which surgical repair is frequently recommended. A young girl with Loeys-Dietz syndrome and prior abdominal surgeries presents with 1-year history of increasingly severe, intermittent, abdominal and left shoulder pain. Prior imaging incidentally revealed a left diaphragmatic hernia with omentum protruding into the thoracic cavity. This was managed expectantly due to her other medical and surgical issues. Serial imaging revealed that the herniated omentum was increasing in size and symptoms began to develop. An uncomplicated primary thoracoscopic repair was performed. We report the first case of a congenital diaphragmatic hernia in a patient with Loeys-Dietz syndrome.
Jejunal rupture resulting from a collision in soccer
Authors: Yau Ho-Cing Victor 
Published: January 2021

Abstract
Small bowel rupture in blunt force trauma usually results from high-velocity and high-energy forces. The occurrence of this following collision in sport is a rare event that requires urgent surgical intervention. This is the case of a 27-year-old male who sustained a jejunal rupture following a collision during a game of soccer.
Usefulness of Internet Surveys to Identify People with Disabilities: A Cautionary Tale
Authors: Houtenville Andrew J , Phillips Kimberly G , Sundar Vidya 
Published: January 2021

AbstractDisability is an important characteristic to consider in survey research. However, people with disabilities are a hard-to-reach population. Internet survey methods offer tremendous potential to expand researchers’ ability to reach and learn about people with disabilities. The goal of this study is to examine potential bias when using nonprobability Internet samples to investigate demographics and socioeconomic outcomes of people with disabilities. We compare the findings based on a national employment and disability survey instrument fielded to four samples: (1) a random-digit dial (RDD) sample, (2) a prescreened sample from a nonprobability Internet access panel, for which screening was based on the presence of 139 previously reported health conditions, (3) an unscreened sample from another nonprobability Internet access panel (without previously prescreened health conditions), and (4) a mixed nonprobability self-recruited (river and snowball) sample. Each sample was weighted on four demographic variables (gender, age, race/ethnicity, and region) using benchmarks from the American Community Survey (ACS). Three dichotomous outcome variables of interest (level of education, household income, and current employment status) were contrasted with weighted population estimates from the ACS. Results showed that the sample resulting from the RDD and all three nonprobability Internet samples differed significantly from ACS population estimates on all three outcome variables. Reweighting to include type of functional disability did not significantly reduce dissimilarities with ACS for any of the four samples. Nonprobability Internet survey methods offer relatively low-cost, easy-to-use avenues for disability-related research. Yet, researchers must proceed with caution to reduce or avoid known sources of bias in both the methodology and the interpretation of results.
Pretest Symptom Duration and Cycle Threshold Values for Severe Acute Respiratory Syndrome Coronavirus 2 Reverse-Transcription Polymerase Chain Reaction Predict Coronavirus Disease 2019 Mortality
Authors: Miller Emily Happy , Zucker Jason , Castor Delivette , Annavajhala Medini K , Sepulveda Jorge L , Green Daniel A , Whittier Susan , Scherer Matthew , Medrano Nicola , Sobieszczyk Magdalena E , Yin Michael T , Kuhn Louise , Uhlemann Anne-Catrin 
Published: January 2021

Abstract

Background
The relationship between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load and patient symptom duration in both in- and outpatients, and the impact of these factors on patient outcomes, are currently unknown. Understanding these associations is important to clinicians caring for patients with coronavirus disease 2019 (COVID-19).

Methods
We conducted an observational study between March 10 and May 30, 2020 at a large quaternary academic medical center in New York City. Patient characteristics, laboratory values, and clinical outcomes were abstracted from the electronic medical records. Of all patients tested for SARS-CoV-2 during this time (N = 16 384), there were 5467 patients with positive tests, 4254 of which had available cycle threshold (Ct) values and were included in further analysis. Univariable and multivariable logistic regression models were used to test associations between Ct values, duration of symptoms before testing, patient characteristics, and mortality. The primary outcome is defined as death or discharge to hospice.

Results
Lower Ct values at diagnosis (ie, higher viral load) were associated with significantly higher mortality among both in- and outpatients. It is interesting to note that patients with a shorter time since the onset of symptoms to testing had a worse prognosis, with those presenting less than 3 days from symptom onset having 2-fold increased odds of death. After adjusting for time since symptom onset and other clinical covariates, Ct values remained a strong predictor of mortality.

Conclusions
Severe acute respiratory syndrome coronavirus 2 reverse-transcription polymerase chain reaction Ct value and duration of symptoms are strongly associated with mortality. These 2 factors add useful information for clinicians to risk stratify patients presenting with COVID-19.
Accelerating ESD-induced gastric ulcer healing using a pH-responsive polyurethane/small intestinal submucosa hydrogel delivered by endoscopic catheter
Authors: Zhao Long-Mei , Gong Mei , Wang Rui , Yuan Qi-Juan , Zhang Yi , Pi Jin-Kui , Lv Xiu-He , Xie Yan , Xie Hui-Qi 
Published: January 2021

Abstract
Endoscopic submucosal dissection (ESD) is the standard treatment for early-stage gastric cancer, but the large post-operative ulcers caused by ESD often lead to serious side effects. Post-ESD mucosal repair materials provide a new option for the treatment of post-ESD ulcers. In this study, we developed a polyurethane/small intestinal submucosa (PU/SIS) hydrogel and investigated its efficacy for accelerating ESD-induced ulcer healing in a canine model. PU/SIS hydrogel possessed great biocompatibility and distinctive pH-sensitive swelling properties and protected GES-1 cells from acid attack through forming a dense film in acidic conditions in vitro. Besides, PU/SIS gels present a strong bio-adhesion to gastric tissues under acidic conditions, thus ensuring the retention time of PU/SIS gels in vivo. In a canine model, PU/SIS hydrogel was easily delivered via endoscopy and adhered to the ulcer sites. PU/SIS hydrogel accelerated gastric ulcer healing at an early stage with more epithelium regeneration and slight inflammation. Our findings reveal PU/SIS hydrogel is a promising and attractive candidate for ESD-induced ulcer repair.
A Hierarchy of Interests: Discursive Practices on the Value of Particle and High-Energy Physics
Authors: Yeh Chih-Wei 
Published: January 2021

AbstractCurrent science policy emphasizes practical outcomes. In this article, I explore how a fundamental research community addresses the value of research, an area that has received a little attention. In the wake of the discovery of the Higgs boson, I analyse how particle physicists interpret the values of their research in interviews and a strategic document. The result indicates a hierarchy of interests that coordinates different values of particle physics in discourse: the status of scientific and cultural value is higher than that of societal and material value. This finding implies that value propositions are inseparable from the articulation of interests, and qualitative discourse analysis can approach a combined understanding of the two. In science policy studies, there is not yet sufficient studies on how scientists appraise different values of research. The hierarchical discursive practice on values shed lights on a culture different from policy trends.
Effect of preshipment preconditioning and injectable antioxidant trace elements (Cu, Mn, Se, Zn) and vitamins (A, E) on plasma metabolite and hormone concentrations and growth in weaned beef cattle
Authors: Galarza Esteban M , Lizarraga Raul M , Mattioli Guillermo A , Parker Anthony J , Relling Alejandro E 
Published: January 2021

Abstract
Weaning and transport represent a high stress time for calves. Preconditioning (PC) by weaning before the transport separate these stressors. The stressors generate oxidative stress, which can be reduced by mineral and vitamin supplementation (MVS) with an antioxidant capacity. Our objective was to evaluate the effect of PC and MVS on performance of steers. The experiment used a 2 × 2 factorial arrangement design, considering a 26-d PC treatment from weaning to transport to the feedlot (day 0), and injectable MVS on days −45, −26, and 0. The MVS consisted of Cu, Zn, Mn, Se, vitamin E (0.2, 0.8, 0.2, 0.1, and 1 mg/kg body weight [BW], respectively), and vitamin A (1,190 IU/kg). Sixty Angus-crossbred steers (186.4 ± 27.6 kg) were randomly assigned to the four treatments (MVS+PC; N+PC; MVS+N; N+N; n = 15 per treatment). BW was recorded on days −45, −26, 0, 8, 15, and 29. On day 0, an additional BW was taken 30 min after the 5-h transportation (day 0.5). Between days 0 and 29, dry matter intake (DMI) and average daily gain (ADG) to DMI ratio (G:F) were measured. Between days −26 and 29 plasma concentrations of glucose, nonesterified fatty acids (NEFA), cortisol, insulin, total antioxidant status (TAS), and thiobarbituric acid-reactive substances were evaluated. Data were analyzed using the MIXED procedure of SAS with repeated measures, using treatment, time, and treatment × time as fixed effects and steer as a random effect. Between days −26 and 0, there was an interaction of MVS × PC (P ˂ 0.01) for ADG. From days −26 to 0, N+N and N+PC had the greatest and lesser ADG, respectively. On day 0.5, no-PC steers tended to lose BW, whereas the PC steers tended to gain BW (P = 0.09). In the period days 0 to 8, there were no differences (P ≥ 0.27) in DMI, but the PC steers had greater G:F and ADG (P &lt; 0.01) compared with no-PC steers. Plasma NEFA concentration on day 0 was affected by MVS × PC (P &lt; 0.01) because MVS decreased plasma NEFA concentration in no-PC steers, but it increased in the PC steers. Plasma concentrations of glucose, insulin, and cortisol did not differ among treatments (P ≥ 0.23). There was an MVS × PC interaction (P = 0.09) for TAS on day 0; N+N had the greatest TAS concentrations and MVS+N had the lowest TAS concentrations. In conclusion, a 26-d PC decreased steers BW compared with no-PC steers. The BW loss during PC was not recovered 29 d after feedlot entry. Despite this BW loss, MVS treatment decreased BW loss in the steers allocated to PC treatment on the day of transport.
The Anatomic Relevance of the Iliopectineal Fascia for Acetabular Surgery
Authors: Moreno Gabriela , Ponce de León Jorge G. , Rickman Mark 
Published: January 2021

Objective:
To describe in detail the variability of the attachments of the iliopectineal fascia (IPF) and its relation to the external iliac vessels to inform surgical approaches and help prevent injury to the adjacent vascular structures.

Methods:
A cadaveric study was performed on 16 specimens. The IPF was identified from the lateral and medial perspectives of the II and anterior intrapelvic approaches, respectively, and its anatomic characteristics were described.

Results:
The IPF originates in the fascia of the psoas muscle, it has variable attachments in the pelvic brim, and it inserts in the medial surface of the iliac bone where it is continuous with the obturator internus fascia. Two variants were found in relation to the external iliac vessels. In one variant found in 4 cadavers, the IPF formed a sail-like structure that surrounds the external iliac vessels. In the other variant observed in 4 cadavers, the IPF overlaid the iliac fossa, under the external iliac vessels which laid free in the iliac fossa.

Conclusions:
The anatomic variants of the attachment of the IPF to the pelvic brim and its variants in relation to the external iliac vessels must be accounted for when performing acetabular surgery to prevent vascular injury and attain adequate exposure.
Does Malrotation After Minimally Invasive Plate Osteosynthesis Treatment of Distal Tibia Metaphyseal Fractures Effect the Functional Results of the Ankle and Knee Joints?
Authors: Çepni Şahin , Yaman Fırat , Veizi Enejd , Fırat Ahmet , Çay Nurdan , Tecimel Osman 
Published: January 2021

Objectives:
To investigate whether rotational malalignment of tibia, after fracture management with minimally invasive plate osteosynthesis technique (MIPO), leads to impaired results in knee and ankle joint functional scores.

Design:
Prospectively collected data were retrospectively analyzed for this study.

Setting:
Level III academic trauma center.

Patients/Participants:
Sixty-five consecutive patients who applied between October 2010 and January 2014 with a unilateral distal tibia fracture and had full bone union at their last visit were analyzed. Patients were excluded if they had a pathologic fracture, Gustilo–Anderson type II or III open fracture, additional ligamentous trauma, were pregnant, or had any deformity. A total of 27 patients were accepted into the study.

Intervention:
All patients were treated with a MIPO technique after a mean of 2.8 days. The fibular fracture, when present, was fixed first.

Main Outcome Measurements:
The main outcome of this study was the relation between tibial malrotation after a MIPO procedure, and Lower Extremity Functional Scale, American Orthopedic Foot and Ankle Society, KOOS scores, and range of motions of adjacent joints.

Results:
Fourteen patients (51.8%) had a rotation higher than 10 degrees. The mean malrotation angle was 14.6 degrees. Concomitant fibular fractures were present in 13 patients, which did not seem to have a significant influence on malrotation. There was no significant difference between groups regarding functional scores and range of motions of the knee and ankle joints.

Conclusions:
Despite high rates of malrotation after tibial metaphyseal–diaphyseal fractures treated with MIPO technique, this finding does not seem to have a significantly negative effect on knee and ankle joint functions. Meticulous intraoperative evaluation, through a range of different techniques, should be performed to avoid malrotation.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Degree for weakly upper semicontinuous perturbations of quasi-m-accretive operators
Authors: Kryszewski W. , Maciejewski M. 
Published: January 2021

In the paper, we provide the construction of a coincidence degree being a homotopy invariant detecting the existence of solutions of equations or inclusions of the formAx ∈ F(x),x ∈ U, whereA:D(A)⊸Eis anm-accretive operator in a Banach spaceE,F:K⊸Eis a weakly upper semicontinuous set-valued map constrained to an open subsetUof a closed setK ⊂ E. Two different approaches are presented. The theory is applied to show the existence of non-trivial positive solutions of some nonlinear second-order partial differential equations with discontinuities.This article is part of the theme issue ‘Topological degree and fixed point theories in differential and difference equations’.
A phase I/II trial to treat massive Africanized honeybee (Apis mellifera) stings using the new apilic antivenom
Authors: Barbosa Alexandre Naime , Ferreira Rui Seabra , de Carvalho Francilene Capel Tavares , Schuelter-Trevisol Fabiana , Mendes Mônica Bannwart , Mendonça Bruna Cavecci , Batista José Nixon , José Trevisol Daisson , Boyer Leslie , Chippaux Jean-Philippe , Medolago Natália Bronzatto , Cassaro Claudia Vilalva , Rigotto Carneiro Márcia Tonin , de Oliveira Ana Paola Piloto , Pimenta Daniel Carvalho , da Cunha Luís Eduardo Ribeiro , dos Santos Lucilene Delazari , Barraviera Benedito 
Published: January 2021

ABSTRACTSafety, optimal minimum dose, and, preliminary effectiveness of a new generation Africanized honeybees (Apis mellifera) antivenom (AAV) were evaluated. A phase I/II, multicenter, non- randomized, single-arm clinical trial involving 20 participants showing multiple stings were studied. Participants have received either 2 to 10 vials of AAV based on the stings number together with a predefined adjuvant, symptomatic, and complementary treatment schedule. The primary safety endpoint was the presence of early adverse reactions within the first 24 hours after treatment. Preliminary efficacy through clinical evolution, including laboratory tests, was assessed at baseline and over the following four weeks. ELISA assays and mass spectrometry estimated the venom pharmacokinetics before, during, and after treatment. Twenty adult participants, 13 (65%) males, and 7 (35%) females, with a median age of 44 years and a mean body surface of 1.92 m2 (median = 1.93 m2) were recruited. The median number of stings was 52.5 ranging from 7 to more than 2,000. Envenoming severity was classified as 80% mild, 15% moderate, and 5% severe. According to the protocol, 16 (80%) participants received two AAV vials, 3 (15%) six vials, and one (5%) 10 vials. There was no discontinuation of the treatment due to acute adverse events and there were no late adverse reactions. Two patients showed mild adverse events with only transient itchy skin and erythroderma. All participants completed the infusion within two hours and there was no loss of follow-up after discharge. ELISA assays showed venom concentrations varying between 0.25 ng/mL and 1.479 ng/mL prior to treatment. Venom levels decreased in all cases during the hospitalization period. Surprisingly, in nine cases (45%), despite clinical recovery and without symptoms, the venom levels increased again during outpatient care 10 days after discharge. Mass spectrometry showed melittin in eight participants 30 days after the treatment. Considering the promising safety results of the investigational product for the treatment of massive Africanized honeybee attacks, added to efficacy in clinical improvement and immediate decrease in blood venom level, the AAV has shown to be safe for human use.Trial registrationUniversal Trial Number (UTN): U1111-1160-7011, Register Number: RBR-3fthf8 (http://www.ensaiosclinicos.gov.br/rg/RBR-3fthf8/).