bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accessing surgical care for esophageal cancer: patient travel patterns to reach higher volume center
Authors: Diaz Adrian , Burns Sarah , D’Souza Desmond , Kneuertz Peter , Merritt Robert , Perry Kyle , Pawlik Timothy M 
Published: February 2020

SUMMARYWhile better outcomes at high-volume surgical centers have driven the regionalization of complex surgical care, access to high-volume centers often requires travel over longer distances. We sought to evaluate the travel patterns among patients undergoing esophagectomy to assess willingness of patients to travel for surgical care. The California Office of Statewide Health Planning database was used to identify patients who underwent esophagectomy between 2005 and 2016. Total distance traveled, as well as whether a patient bypassed the nearest hospital that performed esophagectomy to get to a higher volume center, was assessed. Overall 3,269 individuals underwent an esophagectomy for cancer in 154 hospitals; only five hospitals were high volume according to Leapfrog standards. Median travel time to a hospital that performed esophagectomy was 26 minutes (IQR: 13.1–50.7). The overwhelming majority of patients (85%) bypassed the nearest providing hospital to seek care at a destination hospital. Among patients who bypassed a closer hospital, only 36% went to a high-volume hospital. Of the 2,248 patients who underwent esophagectomy at a low-volume center, 1,491 patients had bypassed a high-volume hospital. Of the remaining 757 patients who did not bypass a high-volume hospital, half of the individuals would have needed to travel less than an additional hour to reach a high-volume center. Nearly two-thirds of patients undergoing an esophagectomy for cancer received care at a low-volume center; 85% of patients either bypassed a high-volume hospital or would have needed to travel less than an additional hour to reach a high-volume center.
Associations between the supply and utilization of primary care and newborn, children and maternal health in rural counties of Guangdong Province, China
Authors: Ke Naiqi , Ma Yuanzhu , Luo Zhuojun , Xu Shuyi , Kuang Li 
Published: February 2020

Abstract

Background
The Chinese government is ambitious regarding strengthening the primary care system for women and children. Primary care contributes to better health outcomes among neonates, infants, children and pregnant women, especially for vulnerable groups. However, few published studies have examined this issue in China.

Objective
This study examined whether greater supply and utilization of primary care was associated with improved health outcomes among targeted populations in the total and interprovincial migrant populations in the rural counties of Guangdong Province, China.

Methods
This ecological study analysed annual panel data from all 63 rural counties in Guangdong Province from 2014 to 2016 (n = 189). A linear random-effects panel data model was applied.

Results
Higher proportions of primary care visits were significantly associated with reduced incidences of low birth weight (P &lt; 0.05) and preterm birth rates (P &lt; 0.05) for the total population, and were significantly associated with reduced infant (P &lt; 0.1) and under-five (P &lt; 0.01) mortality rates for migrants. Greater primary care physician supply was significantly associated with reduced maternal mortality (P &lt; 0.1) rates among migrants. However, primary care indicators were insignificant for both the total and migrant populations regarding neonatal mortality rates, as well as the infant and under-five mortality rates in the total population (P &gt; 0.1).

Conclusions
These findings support existing evidence regarding associations between primary care and improved health outcomes among newborns, children and pregnant women, especially for disadvantaged populations. However, associations were not significant for all studied health outcomes, implying the need for further study.
A Study of Faster-Z Evolution in the Great Tit (Parus major)
Authors: Hayes Kai , Barton Henry J , Zeng Kai 
Published: February 2020

AbstractSex chromosomes contribute substantially to key evolutionary processes such as speciation and adaptation. Several theories suggest that evolution could occur more rapidly on sex chromosomes, but currently our understanding of whether and how this occurs is limited. Here, we present an analysis of the great tit (Parus major) genome, aiming to detect signals of faster-Z evolution. We find mixed evidence of faster divergence on the Z chromosome than autosomes, with significantly higher divergence being found in ancestral repeats, but not at 4- or 0-fold degenerate sites. Interestingly, some 4-fold sites appear to be selectively constrained, which may mislead analyses that use these sites as the neutral reference (e.g., dN/dS). Consistent with other studies in birds, the mutation rate is significantly higher in males than females, and the long-term Z-to-autosome effective population size ratio is only 0.5, significantly lower than the expected value of 0.75. These are indicative of male-driven evolution and high variance in male reproductive success, respectively. We find no evidence for an increased efficacy of positive selection on the Z chromosome. In contrast, the Z chromosome in great tits appears to be affected by increased genetic drift, which has led to detectable signals of weakened intensity of purifying selection. These results provide further evidence that the Z chromosome often has a low effective population size, and that this has important consequences for its evolution. They also highlight the importance of considering multiple factors that can affect the rate of evolution and effective population sizes of sex chromosomes.
Under the Roof of Rebels: Civilian Targeting After Territorial Takeover in Sierra Leone
Authors: Oswald Christian , Sauter Melanie , Weber Sigrid , Williams Rob 
Published: February 2020

Abstract
Do rebels target civilians as part of the process of establishing control in their territories? This research note shows that transition periods after rebels gain territorial control are remarkably violent for civilians. Speaking to the civilian victimization and rebel governance literature, we investigate the immediate time period after rebels successfully capture and hold territory. We argue that rebels use violence to gain compliance in newly captured territories until they are able to build up local capacities and institutions for peaceful governance. To test this argument, we draw on methodological advances in integrating event data and combine multiple datasets to study patterns of violence perpetrated by the Revolutionary United Front in Sierra Leone from 1997 to 2001. The findings of our spatiotemporal analysis show that civilian targeting increases in the period after rebels capture territory from the government compared to areas without territorial takeover, suggesting that life under the roof of rebels is initially more dangerous for civilians.
Real-life management of drug–drug interactions between antiretrovirals and statins
Authors: Courlet Perrine , Livio Françoise , Alves Saldanha Susana , Scherrer Alexandra , Battegay Manuel , Cavassini Matthias , Stoeckle Marcel , Decosterd Laurent Arthur , Marzolini Catia ,   the Swiss HIV Cohort Study, Aebi-Popp K , Anagnostopoulos A , Battegay M , Bernasconi E , Böni J , Braun D L , Bucher H C , Calmy A , Cavassini M , Ciuffi A , Dollenmaier G , Egger M , Elzi L , Fehr J , Fellay J , Furrer H , Fux C A , Günthard H F , Haerry D , Hasse B , Hirsch H H , Hoffmann M , Hösli I , Huber M , Kahlert C R , Kaiser L , Keiser O , Klimkait T , Kouyos R D , Kovari H , Ledergerber B , Martinetti G , Martinez de Tejada B , Marzolini C , Metzner K J , Müller N , Nicca D , Paioni P , Pantaleo G , Perreau M , Rauch A , Rudin C , Scherrer A U , Schmid P , Speck R , Stöckle M , Tarr P , Trkola A , Vernazza P , Wandeler G , Weber R , Yerly S 
Published: February 2020

Abstract

Background
PIs cause drug–drug interactions (DDIs) with most statins due to inhibition of drug-metabolizing enzymes and/or the hepatic uptake transporter OATP1B1, which may alter the pharmacodynamic (PD) effect of statins.

Objectives
To assess the management of DDIs between antiretrovirals (ARVs) and statins in people living with HIV (PLWH) considering statin plasma concentrations, compliance with dosing recommendations and achievement of lipid targets.

Methods
PLWH of the Swiss HIV Cohort Study were eligible if they received a statin concomitantly with ARVs. HDL, total cholesterol (TC) and statin plasma concentration were measured during follow-up visits. Individual non-HDL and TC target values were set using the Framingham score and the 2018 European AIDS Clinical Society recommendations.

Results
Data were analysed for rosuvastatin (n = 99), atorvastatin (n = 92), pravastatin (n = 46) and pitavastatin (n = 21). Rosuvastatin and atorvastatin underdosing frequently led to suboptimal PD response. Insufficient lipid control was observed with PIs despite high atorvastatin concentrations, likely explained by inhibition of OATP1B1 resulting in less statin uptake in the liver. Target lipid values were more often achieved with unboosted integrase inhibitors due to both their favourable DDI profiles and neutral effect on lipids. Insufficient lipid control was common with pravastatin and pitavastatin regardless of co-administered ARVs and despite using maximal recommended statin doses. The latter suggests lower efficacy compared with rosuvastatin or atorvastatin.

Conclusions
Suboptimal management of DDIs with statin underdosing was observed in 29% of prescriptions. Integrase inhibitor-based regimens and/or treatment with rosuvastatin or atorvastatin should be favoured in patients with refractory dyslipidaemia.
Editorial Assessment and Processing
Authors: Fontanarosa Phil , Christiansen Stacy , Flanagin Annette 
Published: February 2020

Abstract
The Editorial Assessment and Processing chapter of the 11th edition of the AMA Manual of Style describes the procedures that some scientific journals use to evaluate and then process articles for publication. For the evaluation process of peer review, not only the selection of reviewers but also criteria for manuscript assessment, masked (“blind”) or unmasked review, revisions, and appeals are described. The steps an accepted manuscript then undergoes as it moves toward publication (manuscript editing, composition and page makeup, and proofreading), as well as issue makeup (including advertising placement and final review) are outlined. Finally, postpublication review and corrections are emphasized as important parts of the process.
Plurals
Authors: Gregoline Brenda 
Published: February 2020

Abstract
The Plurals chapter of the 11th edition of the AMA Manual of Style describes how plurals are formed, parenthetical plurals, when not to use plurals, and plurals of symbols, letters, numbers, and years. Also considered are collective nouns, Latin and Greek vs English plurals, plurals of microorganisms and abbreviations, and false singulars.
Non-English Words, Phrases, and Accent Marks
Authors: Gregoline Brenda 
Published: February 2020

Abstract
The Non-English Words, Phrases, and Accent Marks chapter of the 11th edition of the AMA Manual of Style includes guidelines on the use of italics, translation of titles, capitalization and punctuation, and accent marks (diacritics). A table showing examples of accent marks and usage concludes the chapter.
Units of Measure
Authors: Fischer Lauren , Frank Paul 
Published: February 2020

Abstract
The Units of Measure chapter of the 11th edition of the AMA Manual of Style begins with guidance on the International System of Units (SI) and includes an updated SI conversion table (laboratory reference ranges are no longer included because of differences among laboratories worldwide). Conventions related to format, style, and punctuation of units (eg, exponents, plurals, subject-verb agreement, spelling out units of measure, abbreviations, punctuation, hyphens, and spacing) and capitalization and expression of products and quotients of unit symbols are addressed. A detailed description of use of numerals with units is included, as are specific discussions of units of length, area, volume, and mass; temperature; time; visual acuity; pressure; pH; solutions and concentrations; energy; drug doses; laboratory values; and radiation. The list of international currencies and symbols has been updated and expanded. A change in policy to include a space after the number and before degrees Celsius and degrees Fahrenheit follows SI standards.
Study Design and Statistics
Authors: Livingston Edward H. 
Published: February 2020

Abstract
The Study Design and Statistics chapter of the 11th edition of the AMA Manual of Style begins with a description of the parts of a scientific manuscript and the role of each part: Abstract, Introduction, Methods, Results, and Discussion. The features unique to different study types are outlined: randomized clinical trials, parallel-design double-blind trials, crossover trials, equivalence and noninferiority trials, cluster trials, observational studies, cohort studies, case-control studies, case series, comparative effectiveness research, meta-analyses, cost-effectiveness/cost-benefit analyses, quality improvement studies, and survey studies. Because correct treatment depends on accurate diagnosis, attention is given to various types of diagnostic tests. A large glossary of statistical terms indicates the appropriate applications of commonly used statistical techniques, providing definitions, presentation, and tips and guidelines for correct usage. Many new terms have been added to this glossary since the previous edition.
Racial differences in patient consent policy preferences for electronic health information exchange
Authors: Turvey Carolyn L , Klein Dawn M , Nazi Kim M , Haidary Susan T , Bouhaddou Omar , Hsing Nelson , Donahue Margaret 
Published: February 2020

Abstract

Objective
This study aimed to explore the association between demographic variables, such as race and gender, and patient consent policy preferences for health information exchange as well as self-report by VHA enrollees of information continuity between Veterans Health Administration (VHA) and community non-VHA heath care providers.

Materials and Methods
Data were collected between March 25, 2016 and August 22, 2016 in an online survey of 19 567 veterans. Three questions from the 2016 Commonwealth Fund International Health Policy Survey, which addressed care continuity, were included. The survey also included questions about consent policy preference regarding opt-out, opt-in, and “break the glass” consent policies.

Results
VHA enrollees had comparable proportions of unnecessary laboratory testing and conflicting information from providers when compared with the United States sample in the Commonwealth Survey. However, they endorsed medical record information being unavailable between organizations more highly. Demographic variables were associated with gaps in care continuity as well as consent policy preferences, with 56.8% of Whites preferring an opt-out policy as compared with 40.3% of Blacks, 44.9% of Hispanic Latinos, 48.3% of Asian/Pacific Islanders, and 38.3% of Native Americans (P &lt; .001).

Discussion
Observed large differences by race and ethnicity in privacy preferences for electronic health information exchange should inform implementation of these programs to ensure cultural sensitivity. Veterans experienced care continuity comparable to a general United States sample, except for less effective exchange of health records between heath care organizations. VHA followed an opt-in consent policy at the time of this survey which may underlie this gap.
A2 THE BOWEL CLEANSING NATIONAL INITIATIVE (BCLEAN): PREDICTORS OF INADEQUATE BOWEL PREPARATION
Authors: Barkun A N , Martel M , Epstein I L , Hallé P , Hilsden R J , James P , Rostom A , Sey M , Singh H , Sultanian R , Telford J J , Von Renteln D 
Published: February 2020

Abstract

Background
Adequate bowel cleansing before colonoscopy is, in theory, a simple concept but the high rate of inadequate or incomplete bowel cleanliness and its consequences have been the subject of many studies, guidelines, and meta- analyses. The complexity resides in all the pre-endoscopic factors surrounding preparation intake that may? influence quality of the bowel preparation.

Aims
To identify preendoscopic variables associated with inadequate bowel preparation

Methods
In this randomized trial conducted in adult outpatients in 10 Canadian hospitals, all early morning (AM) colonoscopies were scheduled between 7h30AM and 10h30AM and patients were randomized to PEG low volume or high- volume split-dose or high- volume day before. Later colonoscopies (PM) were scheduled between 10h30AM and 16h30PM and patients were randomized to PEG low-volume or high- volume split-dose or low- volume same day. A secondary random allocation assigned patients to a clear fluid or low residue diet. Inadequate bowel preparation was identified on the Boston Bowel Preparation Scale with a total score &lt;6 with any of the 3 colonic segments subscores &lt;2). All preendoscopic variables such as patients related factors, diet and type of bowel preparation were evaluated between groups with chi-square, Fisher’s exact or t-test where appropriate. All variables found to be significantly associated with a clean preparation on univariable analysis at the P=0.15 level were used to construct a multivariable model. Because of stratified randomization by time with possible resulting differing confounders, AM and PM patients were analysed separately.

Results
Over 29 months, 1726 patients were stratified in the AM group and 1750 patients in the PM group. 16.9% had inadequate bowel preparation in the AM group and 9.8% in the PM group. Pre-endoscopic variables associated with an inadequate bowel cleanliness in AM colonoscopy were a non screening indication (OR 1.36, 95%CI 1.04–1.78), a Charlson score&gt;0 (OR 1.36, 95% 1.03–1.80) and a low residue diet (OR 1.53, 95%CI 1.17–2.01). Amongst PM colonoscopies, variables associated with an inadequate bowel cleanliness were increased age (OR 1.03, 95% 1.01–1.04), a non screening indication (OR 1.90 95%CI 1.35–2.70); a Charlson score&gt;0 (OR 1.63, 95%CI 1.15–2.32), and a low residue diet (OR 1.41, 95%CI 1.01; 1.98).

Conclusions
In this large randomized trial, amongst patients undergoing an AM colonoscopy, pre- endoscopic factors associated with an inadequate bowel preparation were a non screening indication, comorbidities and a low residue diet. Amongst PM colonoscopy patients, in addition to these variables, an increased age was also associated with an inadequate bowel preparation.

Funding Agencies
received arm-length funding from Pendopharm Inc.
A3 TREATMENT IN DISPROPORTIONATELY MINORITY HOSPITALS IS ASSOCIATED WITH AN INCREASED MORTALITY IN END STAGE LIVER DISEASE
Authors: Alotaibi A S , Brahmania M , Mooney O , Rush B 
Published: February 2020

Abstract

Background
Racial and ethnic disparities continue to remain a barrier in delivery of health care across the United States. Care for minority patients tends to be clustered into a small number of providers at minority hospitals, which has been associated with worse clinical outcomes in several conditions. However, the outcomes of treatment in end stage liver disease (ESLD) patients at predominately minority hospitals is unknown.

Aims
To evaluate in-hospital mortality rate among ESLD patients treated in minority hospitals compared to non-minority hospitals.

Methods
We utilized the Nationwide Inpatient Sample (NIS) to conduct a retrospective nationwide cohort analysis. All patients &gt;18 years of age admitted with ESLD were included in the analysis. A multivariate logistic regression model was used to study the mortality rate among ESLD patients treated at minority hospitals compared to ESLD patients treated at non-minority hospitals.

Results
A total of 53,281,467 hospitalizations from the 2008–2014 NIS sample were analyzed. There were 163,470 patients with ESLD that met inclusion criteria. There were 10,178 (6.2%) and 31,226 (19.1%) ESLD patients treated at Black and Hispanic minority hospitals, respectively. In hospital mortality rate for all races were 8.0% and 8.1% in Black and Hispanic minority hospitals, respectively, compared to 7.3% in non-minority hospitals (p&lt;0.01). On multivariate analysis, treatment of ESLD in Black and Hispanic minority hospitals were associated with a 11% (OR: 1.11; 95% CI: 1.03–1.20; p&lt;0.01) and 22% (OR: 1.22; 95% CI: 1.09–1.37; p&lt;0.01) increased odds of death, respectively, compared to treatment in a non-minority hospital regardless of patient race.

Conclusions
ESLD patient treated at minority hospital are faced with an increased mortality rate regardless of a patients race. The current study highlights a quality gap that needs improvement to effect overall survival among ESLD patients.

Funding Agencies
None
A7 DEVELOPING NEW TOOLS TO IDENTIFY NOVELS TARGETS TO OVERCOME TREATMENT RESISTANCE IN ESOPHAGEAL CANCER
Authors: Douchin J , Lemaire N , Kérignard E , Giroux V 
Published: February 2020

Abstract

Background
In Canada, patients with esophageal cancer have the 2nd worst 5-year survival rate (14%). Esophageal squamous cell carcinoma (ESCC) is the most common esophageal cancer type worldwide. Its high mortality rate is partly due to the treatment resistance acquired by patients, which has mostly been attributed to the presence of cancer stem cells (CSCs). Therefore, targeting CSCs is a promising strategy to improve treatment and survival of ESCC patients. CSCs are a subpopulation of tumor cells presenting high self-renewal and multipotent capacities, and therefore largely contribute to tumor heterogeneity in addition to treatment resistance.

Aims
In this study, we aim to establish human ESCC cell lines resistant to radiotherapy (TE15RR), chemotherapy (TE15CR) and both (TE15RCR), and study the relationship between resistance acquisition and CSC properties;

Methods
To do so, we exposed human ESCC cell line TE15 to chronic doses of radiotherapy (2 Gy/week for a total dose of 60 Gy) and/or increasing doses of chemotherapy (5-FU (1, 2, 5, 10 and 15mM)). We harvested samples at different time points to fully investigate resistance acquisition process. Then, we further validated resistance and properties of the resistant TE15 cell lines.

Results
We confirmed that TE15RR cells are less susceptible to radiation than control cells and showed that they are more proliferative at baseline using MTT assays. Moreover, we demonstrated that TE15RR cells comprise a higher proportion of CD24high/CD44high CSC population using flow cytometry. We also found that they express higher levels of ALDH1, another well-known CSC marker, by qPCR and Western Blot. Our preliminary observations also suggest a higher invasive phenotype in TE15RR cells in limited dilution spheroid assay than in control cells supporting that TE15RR cells display CSC-like properties. TE15CR and TE15RCR cell lines were validated using similar approaches. Finally, mass spectrometry was performed to compare the proteomic profile of the resistant cell lines to the control cell line in order to identify key players in treatment resistance acquisition.

Conclusions
Brief, we developed radioresistant, chemoresistant and radiochemoresistant human ESCC cell lines and demonstrated that resistance acquisition correlates with CSC enrichment. Mass spectrophotometry revealed significant proteomic differences between resistant and control cell lines, which should lead to the identification of novel targets to overcome resistance in ESCC patients.

Funding Agencies
Canada research chair TIER 2