bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum Iodine and Breast Cancer Risk: A Prospective Nested Case–Control Study Stratified for Selenium Levels
Authors: Manjer Jonas , Sandsveden Malte , Borgquist Signe 
Published: May 2020

Abstract

Background:
Iodine has been suggested to protect against breast cancer, but there are no epidemiologic studies on individual risk. An interesting finding is that in areas where the exposure to both selenium and iodine are high (e.g., Japan), the risk of breast cancer is lower than in areas where selenium is high and iodine low (e.g., United States), or in areas where both are low (e.g., Northern Europe). The aim of this study was to investigate the association between prediagnostic serum iodine levels and subsequent breast cancer risk, and to investigate if this potential association was modified by selenium levels.

Methods:
The Malmö Diet and Cancer Study provided prediagnostic serum samples and the current analysis included 1,159 breast cancer cases and 1,136 controls. Levels of baseline serum iodine and selenium were analyzed. A logistic regression analysis yielded ORs with 95% confidence intervals adjusted for potential confounders.

Results:
There was no evidence of an overall association between iodine levels and risk of breast cancer. Among women with high selenium levels (above the median), high iodine levels were associated with a lower risk of breast cancer; the OR for above versus below the median was 0.75 (0.57–0.99). The corresponding OR for women with low selenium was 1.15 (0.87–1.50), and the Pinteraction was 0.06.

Conclusions:
The combination of high serum iodine levels and high selenium levels was associated with a lower risk of breast cancer.

Impact:
A high iodine and selenium exposure may decrease the risk of breast cancer.
Occurrence of Fulgoraecia (= Epiricania) melanoleuca (Lepidoptera: Epipyropidae) as a parasitoid of sugarcane lophopid planthopper Pyrilla perpusilla in Tamil Nadu (India) with brief notes on its life stages
Authors: H. Sankararaman  , G. Naveenadevi  , S. Manickavasagam  
Published: May 2020

Seasonal incidence of sugarcane planthopper Pyrilla perpusilla Walker (Hemiptera: Lophopidae) and its natural enemies was investigated at Cuddalore District, Tamil Nadu during 2018. In this study, Fulgoraecia melanoleuca, a parasitoid of sugarcane planthopper Pyrilla perpusilla was observed in large numbers in the field. Brief notes on its biology, life stages, and extent of parasitism on the host were studied. Per cent parasitization in nymph and adult was 47.54 and 45.09, respectively, during the month of August. High resolution images of all life stages are provided to help in identification.
Species in peril: assessing the status of the trade in pangolins in Nepal
Authors: Ghimire Prayash , Raut Nirjala , Khanal Prajna , Acharya Suman , Upadhaya Suraj 
Published: May 2020

Pangolins are among the most widely traded taxa in the southeastern Asian illegal wildlife trade because of which they are at great risk of extinction. Yet, little is known of their trade status in Nepal. This research was carried out to unfold the status of pangolin trade in Sankhuwasava District of Nepal. We used mixed methods such as semi-structured questionnaire (n=75) and, focus group discussion (n=4) and key Informant Interview, (n=30) to assess the trade status. Seizure data (2009–2017) were gathered from law enforcement agencies to predict major trade routes. The major threat perceived was hunting especially by unemployed local youth and children. The majority of hunters were opportunistic. Sankhuwasava District has become both source and transit for the illegal pangolin trade rather than for local use. The involvement of non-timber forest product traders was high in the illegal trade business, however, there seems a rapid decline in the seizure of pangolin in the last two years, mainly because of the deployment of the Nepal army in the Makalu Barun National Park, which had long served as a major route to China. Thus, we recommend continuation of strong border security. Our study calls for capacity building of enforcement agencies for detailed investigation of seizure data. For sustainable conservation of pangolin and its habitat we recommend sustained conservation awareness programs in addition to alternative livelihood opportunity. Furthermore, formation of community based anti-poaching units followed by motivation, anti-poaching trainings, security assurance, and incentives for worthy conservation outcomes in pangolin-rich communities might aid in conservation.
Role of Spirituality on the Association Between Depression and Quality of Life in Stroke Survivor–Care Partner Dyads
Authors: Pucciarelli Gianluca , Vellone Ercole , Bolgeo Tatiana , Simeone Silvio , Alvaro Rosaria , Lee Christopher S. , Lyons Karen S. 
Published: May 2020

Background:
Little is known about the protective effect of spirituality on the association between known risk factors such as depression and quality of life (QOL) in stroke survivor-care partner dyads. Therefore, the aim of this study was to evaluate the moderating role of spirituality on the association between depressive symptomatology and QOL in stroke survivor–care partner dyads.

Methods and Results:

Longitudinal design with 223 stroke survivor–care partner dyads enrolled at survivor discharge from rehabilitation hospitals. Data collection was performed over 12 months. We measured survivors’ and care partners’ depression, quality of life, and spirituality. Examining the moderating role of spirituality on the association between depressive symptoms and QOL within survivor-care partner dyads, we used a traditional Actor-Partner-Interdependence Model and a basic Actor-Partner-Interdependence Model moderation model for a mixed variable. Survivors (51% male) and care partners (66% female) were 70.7 and 52.3 years old, respectively. The survivor’s spirituality significantly moderated the association between care partner depressive symptomatology and survivor psychological QOL (B=0.03,
P
<0.05) and moderated the association between care partner depressive symptoms and care partner physical (B=0.05,
P
<0.001) and psychological (B=0.04,
P
<0.001) QOL. The care partner’s own level of spirituality was significantly positively associated with their physical QOL (B=0.28,
P
<0.001).

Conclusions:
The findings from this study have broad implications for the role of spirituality in relation to QOL in medical-health contexts and the importance of examining such concepts within a dyadic framework. Greater awareness of the importance of spirituality among clinicians and nurses may improve cultural competence in healthcare services.
Regional Assimilation System for Transformed Retrievals from Satellite High-Resolution Infrared Data
Authors: Antonelli Paolo , Cherubini Tiziana , Businger Steven , de Haan Siebren , Scaccia Paolo , Moncet Jean-Luc 
Published: May 2020

AbstractSatellite retrievals strive to exploit the information contained in thousands of channels provided by hyperspectral sensors and show promise in providing a gain in computational efficiency over current radiance assimilation methods by transferring computationally expensive radiative transfer calculations to retrieval providers. This paper describes the implementation of a new approach based on the transformation proposed in 2008 by Migliorini et al., which reduces the impact of the a priori information in the retrievals and generates transformed retrievals (TRs) whose assimilation does not require knowledge of the hyperspectral instruments characteristics. Significantly, the results confirm both the viability of Migliorini’s approach and the possibility of assimilating data from different hyperspectral satellite sensors regardless of the instrument characteristics. The Weather Research and Forecasting (WRF) Model’s Data Assimilation (WRFDA) 3-h cycling system was tested over the central North Pacific Ocean, and the results show that the assimilation of TRs has a greater impact in the characterization of the water vapor distribution than on the temperature field. These results are consistent with the knowledge that temperature field is well constrained by the initial and boundary conditions of the Global Forecast System (GFS), whereas the water vapor distribution is less well constrained in the GFS. While some preliminary results on the comparison between the assimilation with and without TRs in the forecasting system are presented in this paper, additional work remains to explore the impact of the new assimilation approach on forecasts and will be provided in a follow-up publication.
The Trach Trail: A Systems‐Based Pathway to Improve Quality of Tracheostomy Care and Interdisciplinary Collaboration
Authors: Cherney Rebecca L. , Pandian Vinciya , Ninan Ashly , Eastman Debra , Barnes Brian , King Elizabeth , Miller Brianne , Judkins Samantha , Smith Alfred E. , Smith Nan M. , Hanley Julie , Creutz Eileen , Carlson Megan , Schneider Kevin J. , Shever Leah L. , Casper Keith A. , Davidson Patricia M. , Brenner Michael J. 
Published: May 2020

ObjectiveTo implement a standardized tracheostomy pathway that reduces length of stay through tracheostomy education, coordinated care protocols, and tracking patient outcomes.MethodsThe project design involved retrospective analysis of a baseline state, followed by a multimodal intervention (Trach Trail) and prospective comparison against synchronous controls. Patients undergoing tracheostomy from 2015 to 2016 (n = 60) were analyzed for demographics and outcomes. Trach Trail, a standardized care pathway, was developed with the Iowa Model of Evidence‐Based Practice. Trach Trail implementation entailed monthly tracheostomy champion training at 8‐hour duration and staff nurse didactics, written materials, and experiential learning. Trach Trail enrollment occurred from 2018 to 2019. Data on demographics, length of stay, and care outcomes were collected from patients in the Trach Trail group (n = 21) and a synchronous tracheostomy control group (n = 117).ResultsFifty‐five nurses completed Trach Trail training, providing care for 21 patients placed on the Trach Trail and for synchronous control patients with tracheostomy who received routine tracheostomy care. Patients on the Trach Trail and controls had similar demographic characteristics, diagnoses, and indications for tracheostomy. In the Trach Trail group, intensive care unit length of stay was significantly reduced as compared with the control group, decreasing from a mean 21 days to 10 (P <. 05). The incidence of adverse events was unchanged.DiscussionIntroduction of the Trach Trail was associated with a reduction in length of stay in the intensive care unit. Realizing broader patient‐centered improvement likely requires engaging respiratory therapists, speech language pathologists, and social workers to maximize patient/caregiver engagement.Implications for PracticeStandardized tracheostomy care with interdisciplinary collaboration may reduce length of stay and improve patient outcomes.
An Analysis of 1‐Year Charges for Head and Neck Cancer: Targets for Value‐Based Interventions
Authors: Pang John , Crawford Kayva , Faraji Farhoud , Ramsey Celia , Kemp Aaron , Califano Joseph A. 
Published: May 2020

ObjectiveTo identify the dominant clinical factors associated with increased 1‐year charges in treating head and neck cancer.Study DesignRetrospective review.SettingSingle academic institution.Subjects and MethodsWe retrospectively reviewed 1‐year charges for 196 consecutive patients with head and neck cancer (HNC) who were treated exclusively at our institution. We analyzed charges by department as well as factors associated with increased charges per multivariable regression.ResultsThe mean age was 59.6 years (SD, 14.9). Most of the population was male (64%), white (70%), and commercially insured (46%). The most common primary sites were the oropharynx (25%; 76%, HPV positive), skin (19%), and thyroid (17%). Eighty‐three percent of total charges were due to standard‐of‐care treatment for HNC: surgery ($16 million), radiation therapy ($22 million), or chemotherapy ($11 million). The median total charge per patient was $212,484 (interquartile range, $78,630‐$475,823). Multivariable regression demonstrated that the following were associated with increased charges: nasopharynx subsite ($250,929 [95% CI, $93,290‐$408,569]; effect size in US dollars, P =. 002), advanced stage (American Joint Committee on Cancer, seventh edition; $80,331 [$22,726‐$137,936], P =. 007), therapeutic surgery ($281,893 [$117,371‐$446,415], P =. 001), chemotherapy ($183,331 [$125,497‐$241,165], P <. 001), radiation ($203,397 [$143,454‐$263,341], P <. 001), surgical complication requiring return to the operating room ($147,247 [$37,240‐$257,254], P =. 009), emergency department visits ($89,050 [$23,811‐$154,289], P =. 008), and admissions ($140,894 [$82,895‐$198,893], P <. 001; constant, –$233,927 [–$410,790 to –$57,064]). The top quartile accrued 55% of the total charges.ConclusionRadiation, followed by surgery and chemotherapy, were the most expensive components of HNC care. In this analysis, we identified the dominant clinical factors associated with increased charges.
Surgical Field Visualization during Functional Endoscopic Sinus Surgery: Comparison of Propofol‐ vs Desflurane‐Based Anesthesia
Authors: Gollapudy Suneeta , Gashkoff Drake A. , Poetker David M. , Loehrl Todd A. , Riess Matthias L. 
Published: May 2020

ObjectiveTo assess if the type of general anesthetic affects bleeding and field visualization during endoscopic sinus surgery.Study DesignProspective, randomized, controlled trial.SettingAcademic teaching hospital and Veterans Affairs hospital in the United States.Subjects and MethodsSeventy patients were randomized to 1 of 3 anesthetic regimens: (1) the volatile anesthetic desflurane (n = 22), (2) intravenous anesthesia with propofol (n = 25), or (3) a combination of propofol and desflurane (n = 23). Intravenous remifentanil was titrated to decrease the mean arterial pressure to 60 to 70 mm Hg but not ≥30% from baseline. Surgical bleeding scores were recorded along with bleeding rates and hemodynamic parameters, including cardiac output and systemic vascular resistance through pulse contour analysis from a radial arterial line. Statistics: multiple comparison tests and regression analyses; α =. 05.ResultsThere were no differences in bleeding rate (median, 0.58, 0.85, 0.57 mL min–1), bleeding score (2.1, 2.0, 2.0), surgery duration (79, 81, 86 minutes), extubation time (9, 7, 8 minutes), recovery room time (65, 61, 61 minutes), or any hemodynamic parameters among groups 1 through 3, respectively. Group 1 required lower remifentanil infusions than group 2 (0.11 vs 0.26 µg kg–1 min–1; P =. 01). The bleeding score correlated positively with height (P =. 014) and the Lund‐MacKay score (P =. 013). Bilateral vs unilateral surgery led to longer surgery duration (P =. 001) and recovery room time (P =. 004).ConclusionWhen remifentanil is used for controlled hypotension, propofol has no advantage over desflurane to improve surgical field visualization during functional endoscopic sinus surgery.
Impact of Smoking on Survival Outcomes in HPV‐Related Oropharyngeal Carcinoma: A Meta‐analysis
Authors: Ference Ryan , Liao David , Gao Qi , Mehta Vikas 
Published: May 2020

ObjectiveCharacterize the survival impact of smoking on HPV‐related (human papillomavirus) oropharyngeal squamous cell carcinoma.Data SourcesArticles from 2000 to 2019 in the PubMed, Embase, and Cochrane Library databases were systematically reviewed for content and inclusion/exclusion criteria.Review MethodsTwo reviewers independently analyzed the databases for eligibility and quality of the articles. Demographic data, smoking history, and survival outcomes were recorded. Hazard ratios and 95% CIs were collectively analyzed through a random effects meta‐analysis model.ResultsFifteen articles were included in the meta‐analysis for overall survival, disease‐specific survival, disease‐free survival, progression‐free survival, and locoregional recurrence outcomes. The overall survival hazard ratio was 2.4 for ever having smoked (95% CI, 1.4‐4.0; P =. 0006, I2 =. 384) and 3.2 for current smoking (95% CI, 2.2‐4.6; P <. 0001, I2 = 0). The hazard ratio for disease‐specific survival in current smokers was 6.3 (95% CI, 1.3‐29.3; P =. 0194, I2 = 0). Ever smoking had a larger impact on overall survival and disease‐specific survival than the 10–pack year smoking threshold.ConclusionSmoking negatively affects survival in patients with HPV‐related oropharyngeal carcinoma across all outcomes. Current smoking during treatment is associated with the greatest reduction in survival, possibly secondary to diminished radiation therapy efficacy.
Airborne Aerosol Generation During Endonasal Procedures in the Era of COVID‐19: Risks and Recommendations
Authors: Workman Alan D. , Jafari Aria , Welling D. Bradley , Varvares Mark A. , Gray Stacey T. , Holbrook Eric H. , Scangas George A. , Xiao Roy , Carter Bob S. , Curry William T. , Bleier Benjamin S. 
Published: May 2020

ObjectiveIn the era of SARS‐CoV‐2, the risk of infectious airborne aerosol generation during otolaryngologic procedures has been an area of increasing concern. The objective of this investigation was to quantify airborne aerosol production under clinical and surgical conditions and examine efficacy of mask mitigation strategies.Study DesignProspective quantification of airborne aerosol generation during surgical and clinical simulation.SettingCadaver laboratory and clinical examination room.Subjects and MethodsAirborne aerosol quantification with an optical particle sizer was performed in real time during cadaveric simulated endoscopic surgical conditions, including hand instrumentation, microdebrider use, high‐speed drilling, and cautery. Aerosol sampling was additionally performed in simulated clinical and diagnostic settings. All clinical and surgical procedures were evaluated for propensity for significant airborne aerosol generation.ResultsHand instrumentation and microdebridement did not produce detectable airborne aerosols in the range of 1 to 10 μm. Suction drilling at 12,000 rpm, high‐speed drilling (4‐mm diamond or cutting burs) at 70,000 rpm, and transnasal cautery generated significant airborne aerosols (P <. 001). In clinical simulations, nasal endoscopy (P <. 05), speech (P <. 01), and sneezing (P <. 01) generated 1‐ to 10‐μm airborne aerosols. Significant aerosol escape was seen even with utilization of a standard surgical mask (P <. 05). Intact and VENT‐modified (valved endoscopy of the nose and throat) N95 respirator use prevented significant airborne aerosol spread.ConclusionTransnasal drill and cautery use is associated with significant airborne particulate matter production in the range of 1 to 10 μm under surgical conditions. During simulated clinical activity, airborne aerosol generation was seen during nasal endoscopy, speech, and sneezing. Intact or VENT‐modified N95 respirators mitigated airborne aerosol transmission, while standard surgical masks did not.
A Synthetic Graft With Multilayered Co-Electrospinning Nanoscaffolds for Bridging Massive Rotator Cuff Tear in a Rat Model
Authors: Cong Shuang , Sun Yaying , Lin Jinrong , Liu Shaohua , Chen Jiwu 
Published: May 2020

Background: Graft bridging is used in massive rotator cuff tear (MRCT); however, the integration of graft-tendon and graft-bone is still a challenge. Hypothesis: A co-electrospinning nanoscaffold of polycaprolactone (PCL) with an “enthesis-mimicking” (EM) structure could bridge MRCT, facilitate tendon regeneration, and improve graft-bone healing. Study Design: Controlled laboratory study. Methods: First, we analyzed the cytocompatibility of the electrospinning nanoscaffolds, including aligned PCL (aPCL), nonaligned PCL (nPCL), aPCL–collagen I, nPCL–collagen II, and nPCL-nanohydroxyapatite (nHA). Second, for the EM condition, nPCL–collagen II and nPCL-nHA were electrospun layer by layer at one end of the aPCL–collagen I; for the control condition, the nPCL was electrospun on the aPCL. In 40 mature male rats, resection of both the supraspinatus and infraspinatus tendons was performed to create MRCT, and the animals were divided randomly into EM and control groups. In both groups, one end of the layered structure was fixed on the footprint of the rotator cuff, whereas the other end of the layered structure was sutured with the tendon stump. The animals were euthanized for harvesting of tissues for histologic and biomechanical analysis at 4 weeks or 8 weeks postoperatively. Results: All scaffolds showed good cytocompatibility in vitro. The graft-tendon tissue in the EM group had more regularly arranged cells, denser tissue, a significantly higher tendon maturing score, and more birefringence compared with the control group at 8 weeks after operation. Newly formed fibrocartilage could be observed at the graft-bone interface in both groups by 8 weeks, but the EM group had a higher graft-bone healing score and significantly more newly formed fibrocartilage than the control group. An enthesis-like structure with transitional layers was observed in the EM group at 8 weeks. Biomechanically, the values for maximum failure load and stiffness of the tendon-graft-bone complex were significantly higher in the EM group than in the control group at 8 weeks. Conclusion: The co-electrospinning nanoscaffold of aPCL–collagen I could be used as a bridging graft to improve early graft-tendon healing for MRCT in a rat model and enhance early enthesis reconstruction in combination with a multilayered structure of nPCL–collagen II and nPCL-nHA. Clinical Relevance: We constructed a graft to bridge MRCT, enhance graft-tendon healing and graft-bone healing, and reconstruct the enthesis structure.
Interaction Between Low-Dose Aspirin and Nonsteroidal Anti-Inflammatory Drugs Can Compromise Aspirin’s Efficacy in Preventing Venous Thrombosis Following Total Joint Arthroplasty
Authors: Krauss Eugene , Cronin MaryAnne , Dengler Nancy , Segal Ayal 
Published: May 2020

Total joint arthroplasty is a rapid recovery procedure with patients optimized quickly in preparation for discharge. Two significant postoperative goals are effective pain management and prevention of postoperative venous thromboembolism (VTE). Low-risk patients receive aspirin 81 mg twice daily for VTE prophylaxis; this dosing regimen has been reduced over the past few years from 325 mg to 162 mg to 81 mg twice daily. Unless contraindications exist, all patients receive multimodal pain management that includes the use of celecoxib or meloxicam. Upon reduction of the aspirin dose to 81 mg twice daily, we rapidly identified 2 patients who developed a pulmonary embolus when celecoxib or meloxicam was administered concurrently with aspirin. The interaction between nonsteroidal anti-inflammatory drugs (NSAIDs) and low-dose aspirin varies among the different NSAIDs. It is also highly dependent on numerous factors, including time of administration, dose of aspirin, and both pharmacodynamics and dose of the NSAID. Real-world outcomes of concomitant administration of NSAIDs with low-dose aspirin led to increased incidence of VTE, possibly due to competitive inhibition of aspirin at platelet receptor sites. This interaction was mitigated by altering the administration times of both agents.