bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oestradiol and the risk of myocardial infarction in women: a cohort study of UK Biobank participants
Authors: Peters Sanne A E , Woodward Mark 
Published: December 2020

Abstract

Background
It is commonly assumed that high oestradiol levels in women are cardioprotective. We assessed the association between oestradiol and the risk of incident myocardial infarction (MI) in women.

Methods
We used data from 263 295 female UK Biobank participants [mean age 56.2; standard deviation (SD) 8.0 years] without previous cardiovascular disease (CVD). Associations of oestradiol with age and other cardiovascular risk factors were assessed. Cox proportional hazards models estimated crude, ag- and multiple-adjusted hazard ratios (HR) for MI associated with oestradiol levels.

Results
After a mean follow-up of 9 years, 2206 incident cases of MI had been recorded, including 230 events among the 57 204 women (mean age 48) with detectable oestradiol levels. In the unadjusted analyses, a unit higher in log-transformed oestradiol was associated with an HR [95% confidence interval (CI) for MI of 0.73 (0.58; 0.92)]. After adjusting for age, this HR became 0.94 (0.75; 1.17), and after further adjusting for classical CVD risk factors, it was 1.05 (0.83; 1.31. Results were similar in subgroup analyses defined by age, menopausal status, socioeconomic status, contraceptive pill use and the use of hormone replacement therapy. The multivariable-adjusted HR for the 171 431 women (mean age 59) with undetectable levels of oestradiol, compared with those with detectable levels, was 0.97 (0.92; 1.02).

Conclusions
Higher levels of oestradiol were not associated with a decreased risk of MI. The presumed cardioprotective effects of oestradiol seem to be largely confounded by age and further confounded by other cardiovascular risk factors.
Factors Affecting Image Quality and Lesion Evaluability in Breast Diffusion-weighted MRI: Observations from the ECOG-ACRIN Cancer Research Group Multisite Trial (A6702)
Authors: Whisenant Jennifer G , Romanoff Justin , Rahbar Habib , Kitsch Averi E , Harvey Sara M , Moy Linda , DeMartini Wendy B , Dogan Basak E , Yang Wei T , Wang Lilian C , Joe Bonnie N , Wilmes Lisa J , Hylton Nola M , Oh Karen Y , Tudorica Luminita A , Neal Colleen H , Malyarenko Dariya I , McDonald Elizabeth S , Comstock Christopher E , Yankeelov Thomas E , Chenevert Thomas L , Partridge Savannah C 
Published: December 2020

Abstract

Objective
The A6702 multisite trial confirmed that apparent diffusion coefficient (ADC) measures can improve breast MRI accuracy and reduce unnecessary biopsies, but also found that technical issues rendered many lesions non-evaluable on diffusion-weighted imaging (DWI). This secondary analysis investigated factors affecting lesion evaluability and impact on diagnostic performance.

Methods
The A6702 protocol was IRB-approved at 10 institutions; participants provided informed consent. In total, 103 women with 142 MRI-detected breast lesions (BI-RADS assessment category 3, 4, or 5) completed the study. DWI was acquired at 1.5T and 3T using a four b-value, echo-planar imaging sequence. Scans were reviewed for multiple quality factors (artifacts, signal-to-noise, misregistration, and fat suppression); lesions were considered non-evaluable if there was low confidence in ADC measurement. Associations of lesion evaluability with imaging and lesion characteristics were determined. Areas under the receiver operating characteristic curves (AUCs) were compared using bootstrapping.

Results
Thirty percent (42/142) of lesions were non-evaluable on DWI; 23% (32/142) with image quality issues, 7% (10/142) with conspicuity and/or localization issues. Misregistration was the only factor associated with non-evaluability (P = 0.001). Smaller (≤10 mm) lesions were more commonly non-evaluable than larger lesions (p &lt;0.03), though not significant after multiplicity correction. The AUC for differentiating benign and malignant lesions increased after excluding non-evaluable lesions, from 0.61 (95% CI: 0.50–0.71) to 0.75 (95% CI: 0.65–0.84).

Conclusion
Image quality remains a technical challenge in breast DWI, particularly for smaller lesions. Protocol optimization and advanced acquisition and post-processing techniques would help to improve clinical utility.
How Do Consumers React to Company Moral Transgressions? The Role of Power Distance Belief and Empathy for Victims
Authors: Xu Haiyue (Felix) , Bolton Lisa E , Winterich Karen Page 
Published: December 2020

Abstract
This research proposes that consumers vary in their response to company moral transgressions as a function of power distance belief (PDB), which is the extent that consumers accept inequality (a prominent moral principle). Specifically, consumers with lower PDB tend to feel more empathy for victims, which in turn heightens harm perceptions and negative moral emotions, leading to less favorable reactions toward the transgressing company. A series of nine studies and four supplementary experiments provides converging evidence for the PDB effect and underlying empathy-based process, while identifying victim salience and company crisis response strategy as theoretically and pragmatically relevant moderators. Specifically, the PDB effect emerges when victim salience is high (evoking greater empathy among lower-PDB consumers) but is attenuated when victim salience is low (and empathy is not evoked). Likewise, the PDB effect on company evaluations can be mitigated when the transgressing company offers both an apology and remedy, which together signal the company’s empathy for victims and remedy for harm that are salient to low-PDB consumers. Together, these findings shed light on how consumer reactions to company moral transgressions vary by culture, transgression characteristics, and company response strategies, providing guidance to companies in crisis.
Perceptual Facilitators for and Barriers to Career Progression: A Qualitative Study With Female Early Stage Investigators in Health Sciences
Authors: Fernandez Sofia B. , Clarke Rachel D. , Sheehan Diana M. , Trepka Mary Jo , Rose Suzanna M. 
Published: December 2020

Purpose
Despite efforts to increase the representation of women in the national scientific workforce, results still lag. While women’s representation in health-related sciences has increased substantially, women remain underrepresented in senior leadership roles. This study was conducted to elucidate influences at the individual, interpersonal, organizational, and societal levels that present as barriers to and facilitators for advancement in research careers for women, with the goal of promoting and retaining a more diverse leadership.

Method
The authors conducted individual, 1-hour, in-depth, semistructured interviews with 15 female early stage investigators pursuing careers in health sciences research at a large minority-serving institution in Florida in 2018. Interview guides were designed by using a social ecological framework to understand the influence of multilevel systems. Employing a qualitative approach, drawing from a phenomenological orientation, 2 researchers independently coded transcripts and synthesized codes into broad themes.

Results
Barriers and facilitators were reported at all ecological levels explored. Illustrative quotations reflect the unequal distribution of familial responsibilities that compete with career advancement, family members’ lack of understanding of the demands of a research career, the importance of female mentors, perceived differences in the roles and expectations of female and male faculty at institutions, and normative upheld values that influence early career progression.

Conclusions
Achieving pervasive and sustained changes that move toward gender equity in research requires solutions that address multilevel, explicit and implicit influences on women’s advancement in science. Suggestions include shifting familial and institutional norms, creating support systems for women with female mentors, and enforcing consistent policies regarding the roles and expectations of faculty. Findings shed light on the influence of gender on career progression by providing context for the experiences of women and underscore the importance of addressing pervasive societal and structural systems that maintain inequities hindering women’s progress in the scientific workforce.
Gastroenterologists’ attitudes on the detection and management of gastric premalignant conditions: results of a nationwide survey in Spain
Authors: Delgado-Guillena Pedro Genaro , Morales-Alvarado Victor Jair , Elosua-González Alfonso , Murcia Pomares Oscar , Pérez-Aisa Angeles , Córdova Henry , Alcedo Javier , Calvet Xavier , Fernández-Esparrach Gloria 
Published: December 2020

Introduction
Gastric premalignant conditions (GPC) surveillance has been proposed to improve the prognosis of gastric cancer (GC), but the early GC detection rate remaining low, and missing GC during an esophago-gastro-duodenoscopy is still a problem. We aimed to explore the gastroenterologists’ attitudes on the detection and management of GPC

Methods
A cross-sectional study was designed based on a survey among gastroenterologists from Asociación Española de Gastroenterología.

Results
The participation rate was 12% (146/1243). Eighty-one percent worked at secondary or tertiary-care hospitals with the capability to perform mucosectomy (80%), but with a lesser availability of endoscopic submucosal dissection (35%). Most respondents had high-definition endoscopes (88%), and virtual chromoendoscopy (86%), but during performing an upper endoscopy, 34% never or rarely use chromoendoscopy, and 73% apply a biopsy protocol often/very often when atrophy or intestinal metaplasia (IM) is suspected. Half of the respondents self-reported their ability to recognize atrophy or IM ≤7 (on a scale from 0 to 10), whereas ≤6 for dysplasia or early GC. Helicobacter pylori infection is eradicated and verified by ≥90%. Endoscopic surveillance of atrophy/IM is performed by 62%. An immediate endoscopy for dysplasia is not always performed. For low-grade dysplasia, 97.6% consider endoscopic management, but for high-grade dysplasia, 23% regard gastric surgery.

Conclusion
There is a wide variability in the detection and management of GPC among Spanish gastroenterologists, and compliance with guidelines and biopsy protocols could be improved. Performance of high-quality gastroscopies including use of virtual chromoendoscopy, that might allow an improvement in the GPC detection, needs also to be generalized.
Calcium intake, levels and supplementation and effect modification by genetic variation of calcium homeostasis on the risk of colorectal cancer: the Rotterdam study
Authors: Araghi Sadaf Oliai , Jayakkumaran Abi , Mulder Marlies , Stricker Bruno H. , Ruiter Rikje , Kiefte-de Jong Jessica C. 
Published: December 2020

Objectives
Previous studies showed that high calcium intake may be associated with the reduced colorectal cancer (CRC) risk, but results were inconclusive. In this study, we evaluated whether calcium intake from diet and supplements, as well as the calcium levels itself, were associated with the CRC risk in middle-aged and older individuals. Also, we evaluated whether these associations were modified by genetic variation of calcium homeostasis.

Design
This study was embedded in the Rotterdam study, a prospective cohort study among adults aged 55 years and older without CRC at baseline, from the Ommoord district of Rotterdam, The Netherlands (N = 10 941). Effect modification by a predefined polygenetic risk score (PRS) from seven loci known to be associated with calcium concentrations, was evaluated.

Results
The incidence rate of CRC in the study population was 2.9 per 1000 person-years. Relative to the recommended dietary calcium intake, only higher than the recommended dietary calcium intake (≥1485 mg/day) was associated with a reduced risk of CRC [hazard ratio (HR), 0.66; 95% confidence interval (CI), 0.44–1.00]. No significant associations were found for calcium supplementation and only in the subgroup analysis, albumin-adjusted calcium levels were associated with an increased risk of CRC (HR = 1.11; 95% CI, 1.00–1.23). PRS showed effect modification in the association between calcium intake and CRC (P for interaction = 0.08). After stratification of PRS into low, intermediate and high, we found a lower CRC risk for low-weighted PRS per increase in calcium intake.

Conclusion
There is no consistent association between calcium indices on CRC. However, the association between calcium intake and CRC may be modified by genetic variation associated with serum calcium concentrations that deserves further replication in other studies with different population.
Microbial Contamination Risk and Disinfection of Radiation Protective Garments
Authors: Balter Stephen , Rodriguez Michelle A. , Pike Janett A. , Kleiman Norman J. 
Published: December 2020

Abstract
Healthcare-associated infections are a major public health concern for both patients and medical personnel. This has taken on greater urgency during the current COVID-19 pandemic. Radiation Personal Protective Equipment (RPPE) may contribute to risks of microbial contamination. This possibility was tested in 61 personal or shared-use lead aprons and thyroid collars at Columbia Presbyterian Irving Medical Center. Fifty percent tested positive for either bacterial or fungal contamination, mostly around the neckline of lead vests and thyroid collars. Repeated testing of garments some weeks to months later confirmed continued presence of microbial contamination. The possibility that hospital-approved disinfection agents could degrade the radio-protective features of these garments was also examined. Samples of identical construction to garments in regular use were subjected to either daily or weekly wipes with hypochlorite or alcohol-based hospital-approved cleaning agents for 6 mo. A third group of samples was maintained in contact with the cleaning agents for 6 mo. All samples were fluoroscoped four times during the study. None demonstrated any degradation in radioprotection. All samples were photographed monthly. Physical degradation of the outer plastic covering by concentrated hypochlorite and limited mechanical damage around stitched seams of the samples cleaned daily with alcohol was noted. Based on the high prevalence of microbial contamination, regular cleaning and disinfection protocols should be implemented. Regular cleaning with medical-facility-approved cleaning and disinfecting agents is likely to be effective at reducing the microbial load and unlikely to result in significant reduction in radioprotective properties of these garments.
Ink Retention and Endothelial Cell Viability After the Application of an Orientation Stamp Over an Air Bubble During Descemet Membrane Endothelial Keratoplasty Graft Preparation
Authors: Straiko Megan M. W. , Odell Kelly , Dye Philip K. , Hikes Matthew T. , Andersen Allison , Trolli Giulia , Tsering Dolkar T. , Galloway Joshua D. , Tran Khoa D. 
Published: December 2020

Purpose:
To investigate stamp visibility and endothelial cell loss (ECL) after the application of an orientation mark to Descemet membrane endothelial keratoplasty (DMEK) grafts supported by an air bubble.

Methods:
Eighteen DMEK grafts were prepared at an eye bank using a technique where an orientation mark was applied to the stromal surface of a DMEK graft that was supported by a small air bubble placed at the edge of the 2 endothelial surfaces of the graft. Grafts were evaluated at 2 and 5 days for stamp visibility and at 5 days with calcein-AM staining for ECL. Nine grafts underwent cross-country shipping, and the ECL of shipped and nonshipped grafts was compared using unpaired t test.

Results:
All 18 DMEK grafts exhibited a single, solid, readily visible orientation mark 2 and 5 days after preparation with a mean ECL of 13.5% ± 4.9%. Shipping conditions had no effect on stain retention or ECL.

Conclusions:
The application of an orientation stamp to a DMEK graft over an air bubble in an eye bank setting results in a single, solid orientation mark that is readily visible within the period in which most eye bank-prepared tissue is used. This technique produces no further ECL compared with the methods where the orientation stamp is applied through a stromal window. Eye bank technicians and surgeons can be confident that this modified preparation technique results in transplant-quality DMEK grafts with the additional benefit of conserving the stromal cap for use in other anterior lamellar procedures, thereby making efficient use of donor tissue.
Is There Evidence That Stimulus Parameters and Electrode Placement Affect the Cognitive Side Effects of Electroconvulsive Therapy in Patients With Schizophrenia and Schizoaffective Disorder?
Authors: Cicek Mustafa , McCall William V. , Yao Zhixing , Sackeim Harold A. , Rosenquist Peter , Youssef Nagy A. 
Published: December 2020

Abstract
Seventy percent of patients with treatment-resistant schizophrenia do not respond to clozapine. Electroconvulsive therapy (ECT) can potentially offer significant benefit in clozapine-resistant patients. However, cognitive side effects can occur with ECT and are a function of stimulus parameters and electrode placements. Thus, the objective of this article is to systematically review published clinical trials related to the effect of ECT stimulus parameters and electrode placements on cognitive side effects. We performed a systematic review of the literature up to July of 2020 for clinical studies published in English or German examining the effect of ECT stimulus parameters and/or electrode placement on cognitive side effects in patients with schizophrenia or schizoaffective disorder. The literature search generated 3 randomized, double-blind, clinical trials, 1 randomized, nonblinded trial, and 1 retrospective study. There are mixed findings regarding whether pulse width and stimulus dose impact on cognitive side effects. One study showed less cognitive side effect for right unilateral (RUL) than bitemporal (BT) electrode placement, and 2 studies showed a cognitive advantage for bifrontal (BF) compared with BT ECT. Only 1 retrospective study measured global cognition and showed post-ECT cognitive improvement with all treatment modalities using Montreal Cognitive Assessment in comparison to pre-ECT Montreal Cognitive Assessment scores. Current data are limited, but evolving. The evidence suggests that RUL or BF ECT have more favorable cognitive outcomes than BT ECT. Definitive larger clinical trials are needed to optimize parameter and electrode placement selection to minimize adverse cognitive effects.
Bias reduction and inference for electronic health record data under selection and phenotype misclassification: three case studies
Authors: Beesley Lauren J. , Mukherjee Bhramar 
Published: December 2020

AbstractElectronic Health Records (EHR) are not designed for population-based research, but they provide access to longitudinal health information for many individuals. Many statistical methods have been proposed to account for selection bias, missing data, phenotyping errors, or other problems that arise in EHR data analysis. However, addressing multiple sources of bias simultaneously is challenging. Recently, we developed a methodological framework (R package, SAMBA) for jointly handling both selection bias and phenotype misclassification in the EHR setting that leverages external data sources. These methods assume factors related to selection and misclassification are fully observed, but these factors may be poorly understood and partially observed in practice. As a follow-up to the methodological work, we explore how these methods perform for three real-world case studies. In all three examples, we use individual patient-level data collected through the University of Michigan Health System and various external population-based data sources. In case study (a), we explore the impact of these methods on estimated associations between gender and cancer diagnosis. In case study (b), we compare corrected associations between previously identified genetic loci and age-related macular degeneration with gold standard external estimates. In case study (c), we evaluate these methods for modeling the association of COVID-19 outcomes and potential risk factors. These case studies illustrate how to utilize diverse auxiliary information to achieve less biased inference in EHR-based research.
Macrolevel Association of COVID-19 with Non-Communicable Disease Risk Factors in India
Authors: Gaur Kiran , Khedar RS , Mangal Kishore , Sharma Arvind K , Dhamija Rajinder K , Gupta Rajeev 
Published: December 2020

ABSTRACTObjectiveGreater COVID-19 related mortality has been reported among persons with various non-communicable diseases (NCDs). We performed an ecological study to determine the association of state-level cases and deaths with NCD risk factors and healthcare and social indices.MethodsWe obtained cumulative national and state-level data on COVID-19 cases and deaths from publicly available database www.covid19india.org from February to end November 2020. To identify association with major NCD risk factors, NCDs, healthcare related and social variables we obtained data from public sources. Association was determined using univariate and multivariate statistics.ResultsMore than 9.5 million COVID-19 cases and 135,000 deaths have been reported in India at end November 2020. There is significant positive correlation (Pearson’s r) of state-level COVID-19 cases and deaths per million, respectively, with NCD risk factors- obesity (0.64, 0.52), hypertension (0.28, 0.16), diabetes (0.66, 0.46), literacy, NCD epidemiological transition index (0.58, 0.54) and ischemic heart disease mortality (0.22, 0.33). Correlation is also observed with indices of healthcare access and quality (0.71, 0.61), urbanization (0.75, 0.73) and human (0.61, 0.56) and sociodemographic (0.70, 0.69) development. Multivariate adjusted analyses shows strong correlation of COVID-19 burden and deaths with NCD risk factors (r2=0.51, 0.43), NCDs (r2=0.32, 0.16) and healthcare related factors (r2=0.52, 0.38).ConclusionsCOVID-19 disease burden and mortality in India is ecologically associated with greater state-level burden of NCDs and risk factors, especially obesity and diabetes.KEY MESSAGESThere is significant state-level variability in COVID-19 cases and deaths in India.In a macrolevel statistical analysis we find that Indian states with better human and sociodemographic indices, more literacy, longer age, greater burden of non-communicable diseases and risk factors have greater COVID-19 case burden and mortality.Non-communicable disease risk factors- obesity and diabetes are the most important determinants on multivariate analyses.