bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigating Concussion Knowledge in US Born Versus Internationally Born Collegiate Student-Athletes in the United States
Authors: Hoersten Tricia , Gray Ashley , Payne Ellen K. , Gear William , Hageman Jason 
Published: September 2020

Objective:
To compare concussion knowledge between US born and internationally born collegiate student-athletes. Furthermore, to investigate whether length of time in the United States impacted concussion knowledge.

Design:
Survey.

Setting:
Preparticipation physicals at a midwestern NAIA college.

Participants:
Three hundred one collegiate student-athletes.

Interventions:
Demographic questionnaire and the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS).

Main Outcome Measures:

t test was used to determine whether a difference in Concussion Knowledge Index (CKI) scores exists between US born and internationally born student-athletes. A one-way analysis of variance was used to determine significance for length of time in the United States.

Results:
A statistically significant difference was found for CKI scores between US born (19.22 ± 2.38) and internationally born student-athletes (18.01 ± 2.57) (t = 3.895, P = 0.000). Analysis of variance demonstrated statistically significant difference for CKI scores (F
2,300 = 13.883, P = 0.001). Post hoc analysis found significant differences in CKI scores between US born (19.22 ± 2.38) and internationally born student-athletes in the United States less than 2 years (17.31 ± 2.52) (P = 0.000), and between internationally born student-athletes in the United States 2 or more years (19.15 ± 2.25) and internationally born student-athletes in the United States less than 2 years (17.31 ± 2.52) (P = 0.002).

Conclusion:
Among this sample, being born in the United States and length of time in the United States contribute to student-athletes' concussion knowledge.

Clinical Relevance:
Standardized guidelines are needed to assist health care professionals in properly educating student-athletes about concussions as the recognition and management of concussions can be affected by a student-athlete's knowledge.
Healthy dietary patterns to reduce obesity-related metabolic disease: polyphenol-microbiome interactions unifying health effects across geography
Authors: Diotallevi Camilla , Fava Francesca , Gobbetti Marco , Tuohy Kieran 
Published: September 2020

Purpose of review
The spread of the Western lifestyle across the globe has led to a pandemic in obesity-related metabolic disease. The Mediterranean diet (MedDiet), Okinawa diet (OkD) and Nordic diet, derived from very different regions of the world and culinary traditions, have a large whole plant food component and are associated with reduced disease risk. This review focuses on polyphenol : microbiome interactions as one possible common mechanistic driver linking the protective effects whole plant foods against metabolic disease across healthy dietary patterns irrespective of geography.

Recent findings
Although mechanistic evidence in humans is still scarce, animal studies suggest that polyphenol or polyphenol rich foods induce changes within the gut microbiota and its metabolic output of trimethylamine N-oxide, short-chain fatty acids, bile acids and small phenolic acids. These cross-kingdom signaling molecules regulate mammalian lipid and glucose homeostasis, inflammation and energy storage or thermogenesis, physiological processes determining obesity-related metabolic and cardiovascular disease risk. However, it appears that where in the intestine metabolites are produced, the microbiota communities involved, and interactions between the metabolites themselves, can all influence physiological responses, highlighting the need for a greater understanding of the kinetics and site of production of microbial metabolites within the gut.

Summary
Interactions between polyphenols and metabolites produced by the gut microbiota are emerging as a possible unifying protective mechanism underpinning diverse healthy dietary patterns signaling across culinary traditions, across geography and across domains of life.
Changes in Symptoms of Midday Fogging with a Novel Scleral Contact Lens Filling Solution
Authors: Fogt Jennifer Swingle , Karres Matthew , Barr Joseph T. 
Published: September 2020

SIGNIFICANCE
Midday fogging of scleral contact lenses requires frequent lens removal and reapplication for a large portion of lens wearers. Using a lens filling solution that mimics the composition of tears is hypothesized to have an impact on the production of material trapped under a scleral lens.

PURPOSE
The purposes of this open-label study were to assess the safety of a scleral lens filling solution, which closely approximates the ionic concentration and pH of human tears, and to assess signs and symptoms of midday fogging with this formulation and with subjects' habitual sodium chloride solutions.

METHODS
Existing scleral lens wearers with midday fogging (N = 22) were examined and completed surveys of symptoms. Subjects filled the concavity of their current lenses with test solution and were assessed immediately and approximately 4 hours later for safety monitoring. Test solution was dispensed and used for 5 to 9 days when subjects were reexamined and repeated the surveys. Biomicroscopy and anterior optical coherence tomography images were used to assess midday fogging objectively.

RESULTS
The median (interquartile range) Ocular Surface Disease Index score decreased from 27.1 (21.7) U when using habitual filling solution to 9.1 (20.1) U when using the test solution (P = .006). Current Symptoms Survey findings with the test solution compared with habitual solution resulted in statistically significant decreases in burning/stinging (P = .04), grittiness/foreign body sensation (P = .01), dryness (P = .002), blurry/fluctuating vision (P = .002), and overall pain/discomfort (P = .006). Objective assessment of corneal staining and fogging revealed decreases that were not statistically significant in this small sample size.

CONCLUSIONS
This study establishes the safety and subject tolerance of a scleral lens filling solution that mimics the ionic composition of human tears. Significant improvements in subjective ratings, although likely biased in this unmasked trial, suggest that further studies of the effectiveness of this solution in reducing midday fogging are warranted.
Optical Quality and Visual Performance for One Year in a Sample of Scleral Lens Wearers
Authors: Macedo-de-Araújo Rute J. , Faria-Ribeiro Miguel , McAlinden Colm , van der Worp Eef , González-Méijome José M. 
Published: September 2020

ABSTRACT

SIGNIFICANCE
This study shows the optical and visual quality behavior of modern scleral lenses (SLs) in the medium and long term in patients with irregular cornea (IC) and regular cornea (RC).

PURPOSE
The purpose of this study was to evaluate the 12-month optical quality outcomes with SL in patients with IC and RC.

METHODS
Sixty-nine patients completed the 12 months of follow-up (99 eyes with IC and 27 with RC). LogMAR high- and low-contrast visual acuity, whole eye aberrometry, and the size (Light Disturbance Index, %) and shape (BFCIrregSD, mm) of night vision disturbances were measured at baseline with habitual correction (HC), best spectacle correction (BSC), and SL at all the follow-up visits (1, 3, 6, and 12 months). Subjective visual quality was measured with the Quality of Vision (QoV) questionnaire.

RESULTS
After SL fitting, high-contrast visual acuity improved significantly compared with HC and BSC in the IC group (average improvement of +0.35 ± 0.32 and +0.29 ± 0.26 to +0.08 ± 0.14, P < .001) and RC group (+0.17 ± 0.23 and +0.12 ± 0.23 to +0.10 ± 0.23, P < .05). Light Disturbance Index decreased significantly with SL compared with HC and BSC from 13.85 ± 13.99% and 15.89 ± 13.38% to 5.75 ± 4.51% in the IC group (P < .001) and 6.16 ± 5.38 and 5.98 ± 5.39 to 3.99 ± 3.05 in the RC group (P < .05). BFCIrregSD also decreased significantly, namely, in the IC group (−51%). All subscales of the QoV questionnaire had a statistically significant decrease (improvement) with SL (P < .05).

CONCLUSIONS
Scleral lenses promote a better subjective and objective visual quality, mainly in patients with IC. Additional measurements such as night vision disturbances, aberrometry, and subjective perceptions should be considered to characterize the visual enhancement promoted by SL in RC and IC patients.
Clinical Outcomes of Scleral Lens Fitting with a Data-driven, Quadrant-specific Design: Multicenter Review
Authors: Barnett Melissa , Carrasquillo Karen G. , Schornack Muriel M. 
Published: September 2020

SIGNIFICANCE
Alignment of the scleral lens haptic with the anterior ocular surface is of critical importance when fitting scleral lenses. The concept of leveraging big-data analysis to drive lens design is explored in this study. This retrospective study evaluated fitting outcomes of a data-driven, quadrant-specific scleral lens design and found that most patients (76%) were successfully fit with this design.

PURPOSE
The purpose of this study was to evaluate clinical outcomes with a data-driven, quadrant-specific scleral lens design compared with traditional lens designs.

METHODS
For this multicenter retrospective observational study, A REDCap (Research Electronic Data Capture) survey was distributed to scleral lens practitioners who participated in β testing of a data-driven, quadrant-specific scleral lens design (study lens) between June 1, 2016, and January 31, 2017. Descriptive data were collected, and patient-reported outcomes, visual acuity, and lens design outcomes achieved with the study lens were described.

RESULTS
Seventy-five patients (85 eyes) were fit with the study lens design between June 2016 and January 2017. Mean patient age was 47 years (range, 17 to 77 years). Forty-six were male, and 29 were female. Seventy-six eyes (89%) were fit for corneal irregularity, whereas nine eyes (11%) were fit for management of ocular surface disease. Compared with habitual correction, 22% more eyes achieved 20/20 or better, and 21% more eyes achieved 20/40 or better. There was also a 60% decrease in the need for midday removal with the study lens. An average of two lenses were manufactured per eye to complete the fitting process.

CONCLUSIONS
Using a data-driven, quadrant-specific scleral lens resulted in visual improvement, a reduced need for midday removal, and an average of two lenses needed to complete the fitting process. Longer-term clinical outcomes and the use of big-data analysis to inform scleral lens design should be further explored.
Use of Opioids and Nonopioid Analgesics to Treat Pediatric Postoperative Pain in the Emergency Department
Authors: Stake Christine E. , Manworren Renee C. B. , Rizeq Yazan K. , Minhas Sana , Quan Hehui , Barsness Katherine A. 
Published: September 2020

Objectives
The incidence, demographic characteristics, and treatment approaches for pediatric patients who present to the ED with a primary complaint of postoperative pain have not been well described. The purpose of this study was to describe opioid and nonopioid prescribing patterns for pediatric patients evaluated for postoperative pain in the Emergency Department (ED).

Methods
Pediatric Health Information System is an administrative database of encounter-level data from 48 children's hospitals. Emergency department visits for postoperative pain from January 2014 to September 2017 were analyzed. Visits were matched by the Pediatric Health Information System identifier to associate corresponding same site surgery encounters directly preceding ED visits.

Results
There were 7365 ED visits for acute postoperative pain, for which 4044 could be linked to corresponding surgical procedure. Eight-one percent of ED visits were within 7 days of surgery. Opioids were given at 1979 (49%) of visits, and nonopioids at 678 (17%) of visits. The most common surgeries preceding a postoperative pain ED visit were for tonsils and adenoids (48.5%). Age, sex, length of stay for both procedure and ED visits, procedure specialty, and the number of days between procedure discharge and admission to ED were associated with opioid administration during ED visits (P < 0.05).

Conclusions
Pediatric patients treated in the ED for postoperative pain were often treated with opioid and nonopioid analgesics, with wide prescriber variability. Further research is warranted to help balance optimal pain management and safe prescribing practices.
Prognostic and Predictive Factors in Metastatic Renal Cell Carcinoma
Authors: Gan Chun Loo , Dudani Shaan , Heng Daniel Y. C. 
Published: September 2020

Abstract
Metastatic renal cell carcinoma (mRCC) comprises a highly heterogeneous group of diseases with varied clinical outcomes. As a result, models to estimate prognosis were developed in an attempt to aid patient counseling, treatment selection, and clinical trial design. Contemporary prognostic models have been mostly generated based on clinical factors because of their ease of use. Recent advances in molecular techniques have allowed unprecedented molecular profiling of RCC and the discovery of genomic and proteotranscriptomic factors that may contribute to disease trajectory. With the advent of multiple systemic therapies in mRCC in recent years, predictive biomarkers have become increasingly relevant in treatment selection. In this review, we discuss the existing staging systems and prognostic models in mRCC. We also highlight various promising molecular biomarkers according to the subtypes of RCC and explore their integration into the traditional prognostic models. In addition, we discuss emerging predictive biomarkers in the era of immuno-oncology. Lastly, we explore future directions with a focus on liquid biopsies and composite biomarkers.
Comprehensive Analysis of Multiple Primary Cancers in Patients With Esophageal Squamous Cell Carcinoma Undergoing Esophagectomy
Authors: Yoshida Naoya , Eto Kojiro , Kurashige Junji , Izumi Daisuke , Sawayama Hiroshi , Horinouchi Tomo , Iwatsuki Masaaki , Baba Yoshifumi , Miyamoto Yuji , Baba Hideo 
Published: September 2020

Objective:
The aim of this study was to elucidate the latest epidemiology and risk factors for multiple primary cancers (MPCs), and the association between neoadjuvant chemotherapy (NAC) and postoperative metachronous cancer (PMC) in patients with esophageal squamous cell carcinoma (ESCC) who underwent esophagectomy.

Summary of Background Data:
Background data to derive appropriate screening strategies are insufficient.

Methods:
This study consisted of 3 retrospective investigations. A total of 766 consecutive patients with ESCC who underwent esophagectomy between April 2005 and December 2019 were eligible for epidemiological analysis. Of these, 688 patients without missing data were analyzed for the risk of MPCs. In total, 364 patients who underwent NAC (115) and no preoperative treatments (249) were investigated for the association between NAC and PMC.

Results:
Of 766 patients, 288 (38%) patients experienced 357 MPCs in their life. PMCs identified after the completion of 5-year postoperative follow-up were significantly more advanced (P = 0.019). Male sex [hazard ratio (HR) = 3.04, P = 0.038], older age (HR = 2.39, P < 0.001), and diabetes mellitus (HR = 1.76, P = 0.034) were risk factors for preoperative metachronous cancers. Heavy smoking (HR = 1.70, P = 0.014) and drinking (HR = 1.61, P = 0.029) were risk factors for synchronous cancers. NAC significantly reduced PMC incidence (P = 0.043). NAC showed a trend to contribute to improved survival via reduced deaths from PMCs, although this did not reach significance (P = 0.082).

Conclusions:
ESCC is associated with a high risk of MPCs. Continuing follow-up for PMCs after the completion of 5-year postoperative follow-up is important. NAC may reduce PMCs, representing a novel mechanism for improving survival in patients with locally advanced ESCC.
A Prospective, Single-arm, Multicenter Trial of Diverting Stoma Followed by Neoadjuvant Chemotherapy Using mFOLFOX6 for Obstructive Colon Cancer
Authors: Ishibe Atsushi , Watanabe Jun , Suwa Yusuke , Nakagawa Kazuya , Suwa Hirokazu , Misumi Toshihiro , Ota Mitsuyoshi , Endo Itaru 
Published: September 2020

Objective:
We conducted the first prospective clinical trial of neoadjuvant chemotherapy for patients with obstructive colon cancer.

Background:
Obstructive colorectal cancer is locally advanced colorectal cancer with a poor prognosis. The effect of neoadjuvant chemotherapy for obstructive colon cancer is unclear.

Methods:
We conducted a single arm, multicenter trial involving patients from the Yokohama Clinical Oncology Group with obstructive colon cancer. All eligible patients underwent diverting stoma formation before neoadjuvant chemotherapy. Patient received 6 cycles of mFOLFOX6 followed by primary tumor surgery and then 6 cycles of adjuvant chemotherapy. The primary endpoint was the objective response rate of all intended neoadjuvant therapy. The study was registered with the Japanese Clinical Trials Registry as UMIN000013198.

Results:
Between April 2014, and July 2016, 50 patients were registered, and 46 received neoadjuvant chemotherapy. The objective response rate as the primary endpoint was 67.4%. The most common grade >3 adverse event associated with neoadjuvant chemotherapy was neutropenia (28.3%). Forty-five patients underwent surgical resection of the primary lesion (R0 resection in all cases). Grade >2 surgery-related complications occurred in 7 patients (15.6%). The downstaging rate was 48.9%, and the moderate or greater regression rate was 52.2%; no cases showed pathological complete response. Adjuvant chemotherapy with mFOLFOX6 was performed in 34 patients (75.6%). The 3-year relapse-free and overall survival rates were 76.5% and 95.4%, respectively.

Conclusion:
Neoadjuvant chemotherapy using mFOLFOX6 was feasible and might be a treatment option for patients with obstructive colon cancer. Further large-scale studies are warranted to confirm the present findings.
The Role of Race and Gender in the Career Experiences of Black/African American Academic Surgeons
Authors: Crown Angelena , Berry Cherisse , Khabele Dineo , Fayanju Oluwadamilola M. , Cobb Adrienne , Backhus Leah , Smith Randi N. , Sweeting Raeshell , Hasson Rian M. , Johnson-Mann Crystal , Oseni Tawakalitu , Newman Erika A. , Turner Patricia , Karpeh Martin , Pugh Carla , Jordan Andrea Hayes , Henry-Tillman Ronda , Joseph Kathie-Ann 
Published: September 2020

Objective:
To determine the role of race and gender in the career experience of Black/AA academic surgeons and to quantify the prevalence of experience with racial and gender bias stratified by gender.

Summary of Background Data:
Compared to their male counterparts, Black/African American women remain significantly underrepresented among senior surgical faculty and department leadership. The impact of racial and gender bias on the academic and professional trajectory of Black/AA women surgeons has not been well-studied.

Methods:
A cross-sectional survey regarding demographics, employment, and perceived barriers to career advancement was distributed via email to faculty surgeon members of the Society of Black American Surgeons (SBAS) in September 2019.

Results:
Of 181 faculty members, 53 responded (29%), including 31 women (58%) and 22 men (42%). Academic positions as a first job were common (men 95% vs women 77%, P = 0.06). Men were more likely to attain the rank of full professor (men 41% vs women 7%, P = 0.01). Reports of racial bias in the workplace were similar (women 84% vs men 86%, not significant); however, reports of gender bias (women 97% vs men 27%, P < 0.001) and perception of salary inequities (women 89% vs 63%, P = 0.02) were more common among women.

Conclusions and Relevance:
Despite efforts to increase diversity, high rates of racial bias persist in the workplace. Black/AA women also report experiencing a high rate of gender bias and challenges in academic promotion.
Arduino-based lab equipment: building a multipurpose pressure transducer device
Authors: Di Domenico Stefano 
Published: September 2020

AbstractBackgroundLab equipments could be expensive and their cost can be unsustainable for scientist with limited financial resources. In order to overcome these impediments and to improve our experimental studies on liver resection in rat, a multipurpose pressure measurement device was project and realized using low cost components.Materials and MethodsThe device is based on an Arduino board, an easy-to-use and open-source microcontroller, that receives analog inputs from an instrumental amplifier connected to a disposable pressure traducer. The analogic inputs are converted to digital values and an LCD can visualize the pressure values calculated from the digital inputs. Programs has been written using C++ within the Arduino IDE, while the pressure data has been recorded on PC using data-logging freeware. Calibration has been performed using a water column as standard. Measure agreement was studied by comparing this device with a water column and with a standard clinical monitoring system.ResultsThe final device it is handy and portable, it costs less the 20 euros and both the hardware and the software are easy modifiable. Calibration procedures resulted in reliable measurements as showed by the Bland-Altman measure agreement analysis.Discussion and conclusionThe final device meets the goals of the original project and offers pressure measurements that are enough accurate for our studies on liver regeneration.In a wider contest the present article shows the potentiality of the open-source-hardware movement to increase the opportunities for scientists and educators.
BRD4-mediated repression of p53 is a target for combination therapy in AML
Authors: Latif Anne-Louise , Newcombe Ashley , Li Sha , Gilroy Kathryn , Robertson Neil , Lei Xue , Stewart Helen , Cole John , Terradas Maria Terradas , Rishi Loveena , McGarry Lynn , McKeeve Claire , Reid Claire , Clark William , Campos Joana , Kirschner Kristina , Davis Andrew , Lopez Jonathan , Sakamaki Jun-Ichi , Morton Jennifer , Ryan Kevin M. , Tait Stephen , Abraham Sheela , Holyoake Tessa , Higgins Brian , Huang Xu , Blyth Karen , Copland Mhairi , Chevassut Tim , Keeshan Karen , Adams Peter D. 
Published: September 2020

SummaryAcute Myeloid Leukemia (AML) is a typically-lethal molecularly heterogeneous disease, with few broad-spectrum therapeutic targets. Unusually, most AML retain wild-typeTP53, encoding the pro-apoptotic tumor suppressor p53. MDM2 inhibitors (MDM2i), which activate wild-type p53, and BET inhibitors (BETi), targeting the BET-family co-activator BRD4, both show encouraging pre-clinical activity, but limited clinical activity as single agents. Here, we report synergistic toxicity of combined MDM2i and BETi towards AML cell lines, primary human blasts and mouse models, resulting from BETi’s ability to evict an unexpected repressive form of BRD4 from p53 target genes, and hence potentiate MDM2i-induced p53 activation. These results indicate that wild-typeTP53and a transcriptional repressor function of BRD4 together represent a potential broad-spectrum synthetic therapeutic vulnerability for AML.