bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fundamental Rights in European Union Policy-making: The Effects and Advantages of Institutional Diversity
Authors: Dawson Mark 
Published: January 2020

ABSTRACT
This article investigates how the European Union’s political process affects the level of rights protection afforded by European Union (EU) law. It does so in two steps, firstly by analysing how institutional politics plays an important role in the evolution of the EU fundamental rights framework and secondly by demonstrating empirically how legislative interaction affects the level of protection provided by three important EU legislative acts. As the article will demonstrate, this interaction tends to result in the overall level of rights protection being increased. Analysing this finding, the article uses institutionalist theory to argue that the EU’s political process carries certain positive effects: the diversity of the legislative process (both within and between institutions) makes the explicit overlooking of rights-based concerns difficult. These findings carry implications for the increasing tendency to channel EU law and policy outside of the ‘ordinary’ legislative process.
Recent Trends in the Incidence and Survival of Stage 1A Pancreatic Cancer: A Surveillance, Epidemiology, and End Results Analysis
Authors: Blackford Amanda L , Canto Marcia Irene , Klein Alison P , Hruban Ralph H , Goggins Michael 
Published: January 2020

Abstract

Background
Rapid access to pancreatic imaging and regular pancreatic surveillance may help identify stage I pancreatic cancer. We investigated recent trends in the stage of newly diagnosed pancreatic ductal adenocarcinoma (PDACs), age at diagnosis, and survival.

Methods
Trends in age-adjusted incidence of stage IA PDAC between 2004 and 2016 were determined from the National Cancer Institute’s Surveillance, Epidemiology and End Results database. All tests were two-sided.

Results
The incidence of stage IA PDAC cases diagnosed increased statistically significantly from 2004 to 2016 (annual percent change = 14.5, 95% confidence interval [CI] = 11.4 to 17.7; P &lt; .001). During the study period, average age at diagnosis for stage IA and IB casesAQ3 declined by 3.5 years (95% CI = 1.2 to 5.9; P = .004) and 5.5 years (95% CI = 3.4 to 7.6; P &lt; .001), whereas average age increased for higher-stage cases (by 0.6 to 1.4 years). Among stage IA cases, the proportion of blacks was smaller (10.2% vs 12.5%), and the proportion of other non-Caucasians was higher compared with higher-stage cases (11.9% vs 8.4%; P &lt; .001). Stage IA cases were more likely to carry insurance (vs Medicaid or none) than higher-stage cases (cases aged younger than 65 years; odds ratio = 2.45, 95% CI = 1.96 to 3.06; P &lt; .001). The 5-year overall survival for stage IA PDAC improved from 44.7% (95% CI = 31.4 to 63.7) in 2004 to 83.7% (95% CI = 78.6% to 89.2%) in 2012; 10-year survival improved from 36.7% (95% CI = 24.1 to 55.8) in 2004 to 49.0% (95% CI = 37.2% to 64.6%) in 2007.

Conclusions
In recent years, the proportion of patients diagnosed with stage IA PDAC has increased, their average age at diagnosis has decreased, and their overall survival has improved. These trends may be the result of improved early diagnosis and early detection.
International Trends in the Incidence of Cancer Among Adolescents and Young Adults
Authors: Gupta Sumit , Harper Andrew , Ruan Yibing , Barr Ronald , Frazier A Lindsay , Ferlay Jacques , Steliarova-Foucher Eva , Fidler-Benaoudia Miranda M 
Published: January 2020

Abstract

Background
Although adolescent and young adult (AYA) cancers represent a unique spectrum of malignancies, epidemiological studies of cancer incidence often group AYAs together with younger or older populations, obscuring patterns specific to this population.

Methods
We examined AYA cancer incidence trends in 41 countries over a 15-year period using the CI5plus database. Truncated age-standardized incidence rates were calculated and the annual percentage change was assessed, with statistical significance corresponding to a 95% confidence interval that does not include zero.

Results
From 1998 to 2012, the 41 included countries contributed a total of 1 846 588 cancer cases and 3.1 billion person-years among AYAs. Although statistically significant increases in the overall cancer burden were observed in 23 countries, the magnitude varied considerably, with the greatest increase in incidence observed in South Korea (annual percentage change2002–2012 = 8.5%, 95% confidence interval = 7.6% to 9.4%) due to thyroid cancer. Notable trends included sharp increases in the incidence of obesity-related malignancies among AYAs; indeed, statistically significant increases were observed among AYAs for 10 of 11 and 9 of 11 obesity-related cancer sites in the US and UK, respectively, with at least five obesity-related cancers statistically significantly increasing in Canada, Japan, South Korea, Australia, and the Netherlands. Other striking trends were noted for thyroid and testicular cancer, with statistically significantly increasing rates observed in 33 and 22 countries, respectively, whereas statistically significant declines in incidence were observed for smoking-related cancers, cervical cancer, and Kaposi sarcoma in many countries.

Conclusions
Our results highlight the future health-care needs related to treatment as well as the urgency for public health initiatives that can mitigate the increasing burden of cancer in AYAs.
Dynamics of strand slippage in DNA hairpins formed by CAG repeats: roles of sequence parity and trinucleotide interrupts
Authors: Xu Pengning , Pan Feng , Roland Christopher , Sagui Celeste , Weninger Keith 
Published: January 2020

AbstractDNA trinucleotide repeats (TRs) can exhibit dynamic expansions by integer numbers of trinucleotides that lead to neurodegenerative disorders. Strand slipped hairpins during DNA replication, repair and/or recombination may contribute to TR expansion. Here, we combine single-molecule FRET experiments and molecular dynamics studies to elucidate slipping dynamics and conformations of (CAG)n TR hairpins. We directly resolve slipping by predominantly two CAG units. The slipping kinetics depends on the even/odd repeat parity. The populated states suggest greater stability for 5′-AGCA-3′ tetraloops, compared with alternative 5′-CAG-3′ triloops. To accommodate the tetraloop, even(odd)-numbered repeats have an even(odd) number of hanging bases in the hairpin stem. In particular, a paired-end tetraloop (no hanging TR) is stable in (CAG)n = even, but such situation cannot occur in (CAG)n = odd, where the hairpin is “frustrated’’ and slips back and forth between states with one TR hanging at the 5′ or 3′ end. Trinucleotide interrupts in the repeating CAG pattern associated with altered disease phenotypes select for specific conformers with favorable loop sequences. Molecular dynamics provide atomic-level insight into the loop configurations. Reducing strand slipping in TR hairpins by sequence interruptions at the loop suggests disease-associated variations impact expansion mechanisms at the level of slipped hairpins.
Mothers and Fathers in Parliament: MP Parental Status and Family Gaps from a Global Perspective
Authors: Joshi Devin K , Goehrung Ryan 
Published: January 2020

AbstractStudies of Western parliaments find women experience greater difficulty than men in combining parenting with a career in parliament. Is it the same worldwide? Addressing this issue, we compared the marital and parental status of legislators in 25 diverse parliaments around the world while theoretically exploring whether parliamentary family gaps are due to individual, family, institutional, societal or global-level conditions. Through a fuzzy-set qualitative comparative analysis, we find institutional- and societal-level factors matter. Namely, family gaps between men and women members of parliament (MPs) were narrower under conditions of higher female employment, women in parliamentary leadership and lower rates of child mortality. Thus, motherhood penalties for women MPs are likely to diminish with increases in women’s paid employment, better social welfare provisions and more women in parliamentary leadership positions. Our findings also point to the importance of public policies, parliamentary rules and critical actors in reducing time demands on parents who are MPs.
The Political Economy of Debt and Entitlements
Authors: Bouton Laurent , Lizzeri Alessandro , Persico Nicola 
Published: January 2020

Abstract
This article presents a dynamic political-economic model of total government obligations. Its focus is on the interplay between debt and entitlements. In our model, both are tools by which temporarily powerful groups can extract resources from groups that will be powerful in the future: debt transfers resources across periods; entitlements directly target the future allocation of resources. We prove the following results. First, the presence of endogenous entitlements dampens the incentives of politically powerful groups to accumulate debt, but it leads to an increase in total government obligations. Second, fiscal rules can have perverse effects: if entitlements are unconstrained, and there are capital market frictions, debt limits lead to an increase in total government obligations and to worse outcomes for all groups. Analogous results hold for entitlement limits. Third, our model sheds some lights on the influence of capital market frictions on the incentives of governments to adopt fiscal rules, and implement entitlement programs. Finally, we identify preference polarization as a possible explanation for the joint growth of debt and entitlements.
Post‐ERCP Pancreatitis in Pediatric Patients
Authors: Iqbal Corey W , Baron Todd H , Moir Christopher R , Ishitani Michael B 
Published: January 2020

ABSTRACTObjectives:Pancreatitis is a known complication of endoscopic retrograde cholangiopancreatography (ERCP). Our aim was to assess the prevalence and severity of ERCP‐associated pancreatitis using established criteria.Materials and Methods:Retrospective review of patients younger than 18 years undergoing ERCP complicated by post‐ERCP pancreatitis defined by the 1991 consensus statement. Patients with chronic pancreatitis were studied separately using modified criteria. Risk factors for post‐ERCP pancreatitis were analyzed.Results:Three hundred forty‐three ERCPs were performed in 224 patients. Two hundred seventy‐six ERCPs were performed in patients without chronic pancreatitis, 7 of which were complicated by post‐ERCP pancreatitis (prevalence 2.5%). Patients undergoing diagnostic‐only ERCP were less likely to develop post‐ERCP pancreatitis (P < 0.01). Sixty‐seven procedures were performed on patients with chronic pancreatitis; 10 developed postprocedure pain requiring or prolonging hospitalization (prevalence 14.9%). Pancreatic duct stenting was a risk factor for post‐ERCP pain in this subset of patients (P = 0.02).Conclusions:The prevalence of post‐ERCP pancreatitis is low—2.5% excluding patients with chronic pancreatitis and 4.96% overall. Therapeutic procedures and the presence of chronic pancreatitis are risk factors for post‐ERCP pancreatitis.
Late Treatment of Displaced Intra-Articular Calcaneus Fractures: Successful Management With Anatomic Reduction
Authors: Swords Michael , Shank John , Fraticelli Nicole , Benirschke Stephen 
Published: January 2020

Introduction:
The aim of this study was to evaluate the results of displaced intra-articular calcaneus fractures treated more than 25 days after injury by open reduction and internal fixation (ORIF) using a lateral extensile surgical approach.

Methods:
Twenty patients identified by retrospective review of our trauma database were treated with ORIF for a displaced intra-articular calcaneus fracture more than 25 days after injury. OTA/AO 82-B and 82-C fracture patterns were included. All had ORIF by a lateral extensile approach. Bohler's angle was measured on injury radiographs, after operative fixation and the final follow-up and compared with the Bohler's angle of the contralateral uninjured extremity. Patients completed a Musculoskeletal Function Assessment (MFA) to evaluate the functional outcome.

Results:
The mean number of days from injury to fixation was 33.4 days (range, 26–58 days). A total of 18/20 patients were available for follow-up (mean 26.1 months; range 12.5–100 months). Eleven injuries were joint depression (82-C), and 7 injuries were tongue type (82-B) fracture patterns. The reason for delayed presentation was delayed transfer to our institution (11 patients), hemodynamic instability from polytrauma (2 patients), excessive fracture blisters (2 patients), and sepsis (1 patient). Bohler's angle at the time of injury was a mean of 10.9 degrees, which corrected to a mean of 33.3 after operative fixation but decreased to a mean of 28.1 at the time of the final follow-up. The mean Bohler angle was 32.3 on the contralateral uninjured side. The mean MFA score was 16.5 (range, 1–34). There were no wound infections or subtalar arthrodesis procedures performed.

Conclusions:
ORIF by a lateral extensile approach is a safe and viable option for patients presenting in a delayed fashion with a displaced intraarticular calcaneus fracture. Marked improvement in the Bohler angle, acceptable functional outcome, and low complication rates can be expected when surgery is performed by an experienced surgeon.

Level of Evidence:
Level IV. See Instructions for Authors for a complete description of levels of evidence.
Current Global Bioethical Dilemmas in Corneal Transplantation
Authors: Córdoba Andrea , Mejía Luis F. , Mannis Mark J. , Navas Alejandro , Madrigal-Bustamante José A. , Graue-Hernandez Enrique O. 
Published: January 2020

Purpose:
To analyze some of the bioethical dilemmas that may arise during the process required for corneal transplantation.

Methods:
We conducted a narrative review based on the available literature and the experience of cornea specialists from 3 different countries.

Results:
Bioethical dilemmas related to informed consent for organ and tissue donation, allocation of corneal tissues, transplant tourism, corneal tissue exportation and importation, and for-profit eye banking were analyzed and discussed.

Conclusions:
Around the world, the number of required corneal transplants exceeds the number of donated corneas that are available and suitable for transplantation. This shortage of corneal tissue has led to the emergence of practices that may put the 4 basic principles of bioethics at risk: autonomy, beneficence, nonmaleficence, and justice. Therefore, it has been necessary to create ethical guidelines such as the Barcelona Principles and the World Health Organization Principles of Transplantation that attempt to regulate these practices.
Retrospective Multicenter Matched Controlled Comparison of Endoscopic Retrograde Cholangiopancreatography in Pediatric Patients
Authors: Shah Rushikesh , Cohen Reuven Zev , Mekaroonkamol Parit , Taylor Alexis , Freeman Alvin Jay , Fritzen Christopher , Sauer Cary , Chawla Saurabh , Keilin Steven , Cai Qiang , Nieto Jose , Willingham Field F. 
Published: January 2020

ABSTRACTIntroduction:This study was designed to evaluate outcomes in pediatric patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) as compared with an American Society of Gastrointestinal Endoscopy (ASGE) complexity grade‐matched adult cohort.Method:In this retrospective case‐control study, ERCPs performed in pediatric patients from January 2008 to December 2018 in 2 tertiary referral hospitals were compared with a complexity‐matched adult control group with similar procedural indications. Primary outcomes included the clinical success rate, technical success rate, and complication rate. Secondary outcomes included postprocedural admission rates, mode of sedation, procedure time, fluoroscopy time, hospitalization length, and the number of repeat procedures.Results:Two hundred thirty‐two ERCPs performed in 110 pediatric patients (average age 13.3) and 318 ERCPs performed in 160 ASGE grade‐matched adult controls (average age 47.2 years) were analyzed. All procedures were therapeutic. There was no difference in the technical success rate (P = 0.2), clinical success rate (P = 0.5), complication rates (P = 0.1), and fluoroscopy time (P = 0.4), between the pediatric and adult cohorts. General anesthesia use and length of stay were significantly higher in the pediatric group (P = 0.0001). In subgroup analysis, technical (P = 0.2) and clinical success (P = 0.2) as well as complication rates (P = 0.6) were comparable between patients 10 years or less and patients 11 to 18 years within pediatric cohort.Conclusions:ERCP in pediatric cohorts appears to be safe and effective with equivalent outcomes relative to an ASGE complexity‐matched adult cohort. Pediatric patients are more likely to require general anesthesia and have a longer average length of stay relative to adult controls.
Low Radiation Dose and High Image Quality of 320-Row Coronary Computed Tomography Angiography Using a Small Dose of Contrast Medium and Refined Scan Timing Prediction
Authors: Shirasaka Takashi , Nagao Michinobu , Yamasaki Yuzo , Kojima Tsukasa , Kondo Masatoshi , Hamasaki Hiroshi , Kamitani Takeshi , Kato Toyoyuki , Asayama Yoshiki 
Published: January 2020

Objective
The aim of the study was to investigate the feasibility of coronary computed tomography (CT) angiography with a low kilovoltage peak scan and a refined scan timing prediction using a small contrast medium (CM) dose.

Methods
In protocol A, 120-kVp scanning and a standard CM dose were used. The scan timing was fixed. In protocol B, 80 kVp and a 60% CM dose were used. The scan timing was determined according to the interval from the CM arrival to the peak time in the ascending aorta. We measured the CT number and recorded the radiation dose.

Results
Higher CT numbers were observed in the left circumflex (proximal, P = 0.0235; middle, P = 0.0007; distal, P < 0.0001) in protocol B compared with protocol A. The radiation dose in protocol B was significantly lower than in protocol A (2.2 ± 0.9 vs 4.3 ± 1.7 mSv).

Conclusions
Low-contrast, low–radiation dose, high–image quality coronary CT angiography can be performed with low kilovoltage peak scanning and a refined scan timing prediction.
Postnatal Intracranial Findings Following Fetal Repair of Spinal Dysraphisms
Authors: Calle Susana , Bonfante Eliana , Simmons Garrett , Rogers Jason , Sitton Clark , Hughes Katrina , Papanna Ramesh M. , Riascos Roy , Patel Rajan 
Published: January 2020

Objective
Our objective is to document the imaging appearance in the intracranial compartment at the time of the infants' first postnatal brain MR imaging after fetal repair for spinal dysraphisms.

Methods
Twenty-nine patients were evaluated on fetal and postnatal magnetic resonance imaging for a series of features of Chiari II malformation.

Results
Of the 29 infants, 55% had resolution of tonsillar ectopia, and 62% showed a dorsal outpouching of the near the foramen magnum on postnatal magnetic resonance imaging. The majority had persistence of Chiari II features including: prominent massa intermedia (93%), tectal beaking (93%), towering cerebellum (55%), flattening of the fourth ventricle (90%), hypoplastic tentorium (97%), and tonsillar hypoplasia (59%).

Conclusions
Normally positioned or minimally descended, oftentimes hypoplastic tonsils in the presence of a posterior fossa configuration typical of Chiari II, was the most common presentation. An additional documented feature was an outpouching of the dorsal thecal sac between the opisthion and the posterior arch of C1.
Computed Tomography Angiography Combined With Knowledge-Based Iterative Algorithm for Transcatheter Aortic Valve Implantation Planning: Image Quality and Radiation Dose Exposure With Low-kV and Low-Contrast-Medium Protocol
Authors: Ippolito Davide , Riva Luca , Talei Franzesi Cammillo , De Vito Andrea , Cangiotti Cecilia , Crespi Andrea , Corso Rocco , Sironi Sandro 
Published: January 2020

Objective
To evaluate image quality and radiation dose exposure of low-kV setting and low-volume contrast medium (CM) computed tomography angiography (CTA) protocol for transcatheter aortic valve implantation (TAVI) planning in comparison with standard CTA protocol.

Methods
Sixty-patients were examined with 256-row MDCT for TAVI planning: 32 patients (study group) were evaluated using 80-kV electrocardiogram-gated protocol with 60 mL of CM and IMR reconstruction; 28 patients underwent a standard electrocardiogram-gated CTA study (100 kV; 80 mL of CM; iDose4 reconstruction). Subjective and objective image quality was evaluated in each patient at different aortic levels. Finally, we collected radiation dose exposure data (CT dose index and dose-length product) of both groups.

Results
In study protocol, significant higher mean attenuation values were achieved in all measurements compared with the standard protocol. There were no significant differences in the subjective image quality evaluation in both groups. Mean dose-length product of study group was 56% lower than in the control one (P < 0.0001).

Conclusion
Low-kV and low-CM volume CTA, combined with IMR, allows to correctly performing TAVI planning with high-quality images and significant radiation dose reduction compared with standard CTA protocol.
In Vitro, In Vivo, and In Silico Methods for Assessment of Muscle Size and Muscle Growth Regulation
Authors: Rupert Joseph E. , Jengelley Daenique H. A. , Zimmers Teresa A. 
Published: January 2020

ABSTRACT
Trauma, burn injury, sepsis, and ischemia lead to acute and chronic loss of skeletal muscle mass and function. Healthy muscle is essential for eating, posture, respiration, reproduction, and mobility, as well as for appropriate function of the senses including taste, vision, and hearing. Beyond providing support and contraction, skeletal muscle also exerts essential roles in temperature regulation, metabolism, and overall health. As the primary reservoir for amino acids, skeletal muscle regulates whole-body protein and glucose metabolism by providing substrate for protein synthesis and supporting hepatic gluconeogenesis during illness and starvation. Overall, greater muscle mass is linked to greater insulin sensitivity and glucose disposal, strength, power, and longevity. In contrast, low muscle mass correlates with dysmetabolism, dysmobility, and poor survival. Muscle mass is highly plastic, appropriate to its role as reservoir, and subject to striking genetic control. Defining mechanisms of muscle growth regulation holds significant promise to find interventions that promote health and diminish morbidity and mortality after trauma, sepsis, inflammation, and other systemic insults. In this invited review, we summarize techniques and methods to assess and manipulate muscle size and muscle mass in experimental systems, including cell culture and rodent models. These approaches have utility for studies of myopenia, sarcopenia, cachexia, and acute muscle growth or atrophy in the setting of health or injury.