bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic resection of Barrett's adenocarcinoma: Intramucosal and low‐risk tumours are not associated with lymph node metastases
Authors: Benech Nicolas , O'Brien Jean Marc , Barret Maximilien , Jacques Jéremie , Rahmi Gabriel , Perrod Guillaume , Hervieu Valérie , Jaouen Alexandre , Charissoux Aurélie , Guillaud Olivier , Legros Romain , Walter Thomas , Saurin Jean‐Christophe , Rivory Jérôme , Prat Fréderic , Lépilliez Vincent , Ponchon Thierry , Pioche Mathieu 
Published: September 2020

AbstractBackgroundSuperficial oesophageal adenocarcinoma can be resected endoscopically, but data to define a curative endoscopic resection are scarce.ObjectiveOur study aimed to assess the risk of lymph node metastasis depending on the depth of invasion and histological features of oesophageal adenocarcinoma.MethodsWe retrospectively included all patients undergoing an endoscopic resection for T1 oesophageal adenocarcinoma among seven expert centres in France in 2004–2016. Mural invasion was defined as either intramucosal or submucosal tumours; the latter were further divided into superficial submucosal (<1000 mm) and deep submucosal (>1000 mm). Absence or presence of lymphovascular invasion and/or poorly differentiated cancer (G3) defined a low‐risk or a high‐risk tumour, respectively. For submucosal tumours, invasion depth and histological features were systematically confirmed after a second dedicated histological assessment (new 2‐mm thick slices) performed by a second pathologist. Occurrence of lymph node metastasis was recorded during the follow‐up from histological or PET CT reports when an invasive procedure was not possible.ResultsIn total, 188 superficial oesophageal adenocarcinomas were included with a median follow‐up of 34 months. No lymph node metastases occurred for intramucosal oesophageal adenocarcinomas (n = 135) even with high‐risk histological features. Among submucosal oesophageal adenocarcinomas, only tumours with lymphovascular invasion or poorly differentiated cancer or with a depth of invasion >1000 μm developed lymph node metastasis tumours (n = 10/53%; 18.9%; hazard ratio 12.04). No metastatic evolution occurred under a 1000‐mm threshold for all low‐risk tumours (0/25), nor under 1200 mm (0/1) and three over this threshold (3/13%, 23.1%).ConclusionIntramucosal and low‐risk tumours with shallow submucosal invasion up to 1200 mm were not associated with lymph node metastasis during follow‐up. In case of high‐risk features and/or deep submucosal invasion, endoscopic resections are not sufficient to eliminate the risk of lymph node metastasis, and surgical oesophagectomy should be carried out. These results must be confirmed by larger prospective series.
An Interprofessional Approach in Caring for a Patient on Maintenance Hemodialysis with COVID-19 in Toronto, Canada: An Educational Case Report
Authors: Hendren Elizabeth M. , Matthews Nicola , Oliver Mathew , Rice Julie , Tobe Sheldon W. , Auguste Bourne L. 
Published: September 2020

Rationale: Hemodialysis patients are at significant risk from COVID-19 due to their frequent interaction with the health care system and medical comorbidities. We followed up the trajectory of the first COVID-19–positive maintenance hemodialysis patient at Sunnybrook Health Sciences Centre in Toronto. We present the lessons learned and changes in practices that occurred to prevent an outbreak in our center. Presenting concerns of the patient: The patient, a 66-year-old woman on in-center hemodialysis, initially presented with a 2-day history of a productive cough. She subsequently developed a fever, was placed on contact and droplet isolation, and admitted to hospital. Diagnoses: On March 13, 2020, the patient tested positive for COVID-19. Within the next 48 hours, she developed hypoxia and acute respiratory distress syndrome as a complication of her illness requiring an extended critical care stay. This extended critical care stay resulted in critical illness–associated secondary sclerosing cholangitis. Interventions: An interprofessional team was established, performing rapid Plan-Do-Study-Act quality improvement cycles to improve screening practices and promote the safety of patients and staff in the hemodialysis unit. Outcomes: We present here the lessons learned, the changes to our screening protocols, and the clinical course of our first in-center hemodialysis patient with SARS-CoV-2. Teaching points: Regular review of the infection screening processes is paramount in preventing outbreaks of COVID-19, particularly in hemodialysis units. Hospital admission should be arranged if a patient exhibits any clinical signs of hemodynamic compromise or hypoxia. Early education for health care practitioners caring for patients with COVID-19 and refresher information regarding personal protective equipment helped promote the safety of staff and prevent health care–associated outbreaks.
Refining the influence of family involvement in management on firm performance: The mediating role of technological innovation efficiency
Authors: Martínez-Alonso Rubén , Martínez-Romero María J. , Rojo-Ramírez Alfonso A. 
Published: September 2020

Determining what factors influence firm performance constitutes an essential issue in both the management and the family firm research fields. This article, building on the resource-based view perspective, develops a mediation model that involves a unique intervening mechanism, namely, technological innovation efficiency (TI efficiency), with the potential to explain the inconsistencies found in prior work on the ways through which family involvement in management affects performance outcomes. Regression analyses utilizing a longitudinal sample of 1,118 Spanish private firms largely support the hypothesized mediating relationship, revealing that TI efficiency leads to richer firm performance in family firms with active family involvement in management. Overall, our findings help elucidate the black box of performance outcomes within family firms and make several contributions to theory and practice.JEL CLASSIFICATION L25; M12; O32
A psychiatrist's perspective from a COVID-19 epicentre: a personal account
Authors: Pacchiarotti Isabella , Anmella Gerard , Fico Giovanna , Verdolini Norma , Vieta Eduard 
Published: September 2020

Background
The COVID-19 pandemic has and will have a huge impact on mental health, especially in countries that have been significantly affected, such as Spain.

Aims
Here we aim to provide the perspectives of a group of psychiatrists from Barcelona, one of the epicentres of the pandemic so far, to highlight the potential fatality of a virus that caught us unaware and unprepared, and hopefully this article will be of aid to countries about to face the pandemic.

Results
The unprecedented situations that we have been faced with so far have included reconfiguring hospitals and the redeployment of healthcare professionals, with flexibility and adaptability key to managing the overload in demand. This has led to healthcare professionals being exposed to extremely stressful situations and they have had impossible decisions to make that may have mental health consequences, some of which may be severe and long lasting.

Conclusions
A rebound effect on mental health problems is to be expected in the medium and long term, especially for healthcare professionals and psychiatric patients, necessitating a strengthening of preventive approaches and policies for mental health along with a prompt reopening of mental health services. Ways to provide psychiatric healthcare in the immediate future need to be re-evaluated, and the development of telepsychiatry services is probably to be expected.
Young Adult Experience in an Outpatient Interdisciplinary Palliative Care Cancer Clinic
Authors: Avery Jonathan , Mosher Pamela J. , Kassam Alisha , Srikanthan Amirrtha , D’Agostino Norma , Zimmermann Camilla , Castaldo Yan , Aubrey Rachel , Rodrigues Caroline M. , Thavaratnam Adrian , Samadi Mahsa , Al-Awamer Ahmed , Gupta Abha 
Published: September 2020

PURPOSE: Young adults (YAs; defined as 18-39 years of age) with advanced cancer are a group for whom standardized age-appropriate palliative care has not been established. The purpose of this study was to explore the YA experience and perceptions of palliative care in an outpatient interdisciplinary palliative care clinic for this population. PATIENTS AND METHODS: Using an interpretive descriptive design, semistructured interviews were conducted with 12 YAs with advanced cancer who were being seen jointly by a palliative care physician and psychiatrist in an ambulatory palliative care clinic. Interviews explored participants’ understanding and experiences of receiving palliative care. Six family members were also interviewed to build on the YA experience. Data collection and analysis occurred concurrently, drawing on the constructivist grounded theory method to analyze the data. RESULTS: Participants described being referred to and seen in the interdisciplinary palliative care clinic as a conflicting and at times difficult experience because of the feeling of being categorized as palliative as YAs. Even so, there were key aspects associated with the specific palliative care approach that allowed YAs to cope with this new label, leading to a beneficial experience, specifically: provided YAs with time and space to explore the experience of having cancer at a younger age, created repeat opportunities to talk openly with people who “got it,” and highlighted the importance of including family support in the care of YAs. CONCLUSION: YAs who were referred to the interdisciplinary palliative care clinic struggled with the category of palliative care but also found the care they received beneficial. Findings provide an approach to palliative care tailored to YAs with advanced cancer.
Clinical Utilization, Utility, and Reimbursement for Expanded Genomic Panel Testing in Adult Oncology
Authors: Hsiao Susan J. , Sireci Anthony N. , Pendrick Danielle , Freeman Christopher , Fernandes Helen , Schwartz Gary K. , Henick Brian S. , Mansukhani Mahesh M. , Roth Kevin A. , Carvajal Richard D. , Oberg Jennifer A. 
Published: September 2020

PURPOSE The routine use of large next-generation sequencing (NGS) pan-cancer panels is required to identify the increasing number of, but often uncommon, actionable alterations to guide therapy. Inconsistent coverage and variable payment is hindering NGS adoption into clinical practice. A review of test utilization, clinical utility, coverage, and reimbursement was conducted in a cohort of patients diagnosed with high-risk cancer who received pan-cancer panel testing as part of their clinical care. MATERIALS AND METHODS The Columbia Combined Cancer Panel (CCCP), a 467-gene panel designed to detect DNA variations in solid and liquid tumors, was performed in the Laboratory of Personalized Genomic Medicine at Columbia University Irving Medical Center. Utilization was characterized at test order. Results were reviewed by a molecular pathologist, followed by a multidisciplinary molecular tumor board where clinical utility was classified by consensus. Reimbursement was reviewed after payers provided final coverage decisions. RESULTS NGS was performed on 359 high-risk tumors from 349 patients. Reimbursement data were available for 246 cases. The most common reason providers ordered CCCP testing was for patients diagnosed with a treatment-resistant or recurrent tumor (n = 214; 61%). Findings were clinically impactful for 229 cases (64%). Molecular alterations that may inform future therapy in the event of progression or relapse were found in 42% of cases, and a targeted therapy was initiated in 23 cases (6.6%). The majority of tests were denied coverage by payers (n = 190; 77%). On average, insurers reimbursed 10.75% of the total NGS service charge. CONCLUSION CCCP testing identified clinically impactful alterations in 64% of cases. Limited coverage and low reimbursement remain barriers, and broader reimbursement policies are needed to adopt pan-cancer NGS testing that benefits patients into clinical practice.
Regenerative Injectable Therapies: Current Evidence
Authors: West William H. , Beutler Anthony I. , Gordon Christopher R. 
Published: September 2020

Abstract
Regenerative medicine is a growing field of musculoskeletal treatments that focuses on amplifying the body's natural healing properties to improve function and pain after injury. Regenerative treatments are applied locally at the site of injury and work though different mechanisms, some of which are unexplained at this time. Current evidence demonstrates benefit for certain regenerative treatments, but further standardization of treatments and additional studies are required to provide additional data to support specific regenerative treatments. This review seeks to explore the evidence and discuss appropriate use of the most common regenerative treatments including platelet-rich plasma, prolotherapy, autologous mesenchymal stem cells, human-derived allograft products, and saline.
Concussions in Ice Hockey — Moving Toward Objective Diagnoses and Point-of-care Treatment: A Review
Authors: Pender Sara C. , Smith Aynsley M. , Finnoff Jonathan T. , Huston John , Stuart Michael J. 
Published: September 2020

AbstractThe incidence of sport-related concussion coupled with a doubling of the participation rate in youth hockey over the past two decades provides impetus for the review of the most promising concussion treatment options. This narrative review summarizes the future treatment options for sport-related concussions in ice hockey, while acknowledging their generalizability to concussion in all sports. Symptom assessment, sign observation, as well as cognitive and balance testing, have historically been used to diagnose a concussion. These methods continue to improve, but the need for effective treatments is clear. Pharmacologic, transcranial light, and nutritional supplement treatment options for concussion warranting further investigation have been identified. Dimethyl fumarate is an immunomodulatory compound thought to trigger antioxidant gene expression. Memantine reduces apoptosis and astrogliosis by inhibiting the calcium influx into cells normally caused by glutamate's activation ofN-methyl-d-aspartate receptors. Thioredoxin-mimetic peptides and transcranial photobiomodulation temper the effects of the energy crisis by acting as free radical scavengers. In addition, seven neuroprotective nutritional supplements have been identified: berberine, creatine, curcumin, melatonin, omega-3 fatty acids, resveratrol, and vitamins. An estimated US $1.1 billion has been spent on unsuccessful traumatic brain injury clinical trials. As our ability to accurately diagnose concussion improves, dimethyl fumarate, memantine, thioredoxin-mimetic peptides, transcranial photobiomodulation, and nutritional supplements (berberine, creatine, curcumin, melatonin, omega-3 fatty acids, resveratrol, and vitamins) warrant further preclinical and clinical examination in advancing the treatment of sport-related concussions.
Inflammation Mediates Exercise Effects on Fatigue in Patients with Breast Cancer
Authors: HIENSCH ANOUK E. , MIJWEL SARA , BARGIELA DAVID , WENGSTRÖM YVONNE , MAY ANNE M. , RUNDQVIST HELENE 
Published: September 2020

ABSTRACT

Purpose
The randomized controlled OptiTrain trial showed beneficial effects on fatigue after a 16-wk exercise intervention in patients with breast cancer undergoing adjuvant chemotherapy. We hypothesize that exercise alters systemic inflammation and that this partially mediates the beneficial effects of exercise on fatigue.

Methods
Two hundred and forty women scheduled for chemotherapy were randomized to 16 wk of resistance and high-intensity interval training (RT-HIIT), moderate-intensity aerobic and high-intensity interval training (AT-HIIT), or usual care (UC). In the current mechanistic analyses, we included all participants with >60% attendance and a random selection of controls (RT-HIIT = 30, AT-HIIT = 27, UC = 29). Fatigue (Piper Fatigue Scale) and 92 markers (e.g., interleukin-6 [IL-6] and tumor necrosis factor α [TNF-α]) were assessed at baseline and postintervention. Mediation analyses were conducted to explore whether changes in inflammation markers mediated the effect of exercise on fatigue.

Results
Overall, chemotherapy led to an increase in inflammation. The increases in IL-6 (pleiotropic cytokine) and CD8a (T-cell surface glycoprotein) were however significantly less pronounced after RT-HIIT compared with UC (−0.47, 95% confidence interval = −0.87 to −0.07, and −0.28, 95% confidence interval = −0.57 to 0.004, respectively). Changes in IL-6 and CD8a significantly mediated the exercise effects on both general and physical fatigue by 32.0% and 27.7%, and 31.2% and 26.4%, respectively. No significant between-group differences in inflammatory markers at 16 wk were found between AT-HIIT and UC.

Conclusions
This study is the first showing that supervised RT-HIIT partially counteracted the increase in inflammation during chemotherapy, i.e., IL-6 and soluble CD8a, which resulted in lower fatigue levels postintervention. Exercise, including both resistance and high-intensity aerobic training, might be put forward as an effective treatment to reduce chemotherapy-induced inflammation and subsequent fatigue.
Attenuated Rapid-Onset Vasodilation to Forearm Muscle Contraction in Black Men
Authors: KAUR JASDEEP , BARBOSA THALES C. , NANDADEVA DAMSARA , YOUNG BENJAMIN E. , STEPHENS BRANDI Y. , BROTHERS R. MATTHEW , FADEL PAUL J. 
Published: September 2020

ABSTRACT

Purpose
Non-Hispanic Black individuals have a blunted ability to vasodilate at rest compared with other racial groups. Limited studies have investigated blood flow responses to exercise in Black individuals. Recently, our laboratory demonstrated that Black men exhibit attenuated increases in forearm vascular conductance (FVC) during steady-state rhythmic handgrip. The mechanisms for this remain unknown. Herein, we used single muscle contractions, a modality that allows for assessment of rapid-onset vasodilation (ROV) independent of major elevations in shear stress, tissue metabolism, and systemic hemodynamics.

Methods
Ten young, healthy Black and White men performed single forearm contractions at 20%, 40%, and 60% maximal voluntary contraction (MVC). In addition, cuff inflations were performed on the forearm to examine the contribution of mechanical compression to ROV. Forearm blood flow (FBF; duplex Doppler ultrasound), heart rate (ECG), and mean arterial pressure (Finometer) were continuously measured. FVC was calculated as FBF/mean arterial pressure.

Results
Baseline FVC (White men vs Black men, 0.75 ± 0.11 vs 0.80 ± 0.09 mL·min−1·mm Hg−1; P = 0.73), FBF, and MVCs (White men vs Black men, 54 ± 2 vs 54 ± 2 kg; P = 0.95) were similar between the groups. After single contractions, both groups exhibited intensity-dependent FVC and FBF increases during ROV; however, these responses were attenuated in the Black group at all intensities (e.g., 60%MVC FVC: White men vs Black men, +371% ± 37% vs +220% ± 23% baseline; P = 0.001). FVC and FBF responses to cuff inflation alone were also attenuated in Black individuals (P < 0.001).

Conclusions
Collectively, these data indicate that Black men have an overall blunted ability to rapidly vasodilate compared with young White men.
Improving the image quality of DWI in breast cancer: comparison of multi-shot DWI using multiplexed sensitivity encoding to conventional single-shot echo-planar imaging DWI
Authors: Baxter Gabrielle C , Patterson Andrew J , Woitek Ramona , Allajbeu Iris , Graves Martin J , Gilbert Fiona 
Published: September 2020

Objective:
To compare diffusion-weighted images (DWI) acquired using single-shot echo-planar imaging (ss-EPI) and multiplexed sensitivity encoding (MUSE) in breast cancer.

Methods
20 females with pathologically confirmed breast cancer (age 51 ± 12 years) were imaged with ss-EPI-DWI and MUSE-DWI. ADC, normalised ADC (nADC), blur and distortion metrics and qualitative image quality scores were compared. The Crété-Roffet and Mattes mutual information metrics were used to evaluate blurring and distortion, respectively. In a breast phantom, six permutations of MUSE-DWI with varying parallel acceleration factor and number of shots were compared. Differences in ADC and nADC were compared using the coefficient of variation in the phantom and a paired t-test in patients. Differences in blur, distortion and qualitative metrics were analysed using a Wilcoxon signed-rank test.

Results:
There was a low coefficient of variation (&lt;2%) in ADC between ss-EPI-DWI and all MUSE-DWI permutations acquired using the phantom. 22 malignant and three benign lesions were identified in 20 patients. ADC values measured using MUSE were significantly lower compared to ss-EPI for malignant but not benign lesions (p &lt; 0.001, p = 0.21). nADC values were not significantly different (p = 0.62, p = 0.28). Blurring and distortion improved with number of shots and acceleration factor, and significantly improved with MUSE in patients (p &lt; 0.001, p = 0.002). Qualitatively, image quality improved using MUSE.

Conclusion:
MUSE improves the image quality of breast DWI compared to ss-EPI.

Advances in knowledge:
MUSE-DWI has superior image quality and reduced blurring and distortion compared to ss-EPI-DWI in breast cancer.
Νεολαία, αριστερή ψήφος και ριζοσπαστισμός τη δεύτερη δεκαετία του 2000
Authors: Παντελίδου-Μαλούτα Μάρω , Ζηργάνου-Καζολέα Λίνα 
Published: September 2020

Το άρθρο αυτό έχει ως στόχο να απαντήσει στο ερώτημα αν η σύγχρονη νεολαία στην Ελλάδα, μετά την ή/και λόγω της κρίσης, μπορεί να χαρακτηριστεί ως ριζοσπαστική, βάσει του είδους της πολιτικής κοσμοαντίληψης και συμπεριφοράς που εκδηλώθηκαν από σημαντικό κομμάτι της. Κι εάν, συνεπώς, θα μπορούσε να προσληφθεί ως δυνητική κινητήρια δύναμη κοινωνικών κατά το πρότυπο της νεολαίας της Μεταπολίτευσης. Από μια άποψη αποτελεί συνέχεια προηγούμενου άρθρου (Παντελίδου Μαλούτα, 2015), όπου έγινε προσπάθεια να καταδειχθεί τάση «επιστροφής» της νεολαίας στην πολιτική ήδη από το 2008, τάση η οποία εντάθηκε και διευρύνθηκε στην κρίση. Επεκτείνοντας την προβληματική εκείνη, και θεωρώντας ως δεδομένα τα στοιχεία που καταδεικνύουν τη στροφή των νέων προς την Αριστερά, και την «επιστροφή» τους στην πολιτική αρχικά μέσω δυναμικών μορφών συμμετοχής, θα επιδιωχθεί εδώ να προσεγγιστεί με τη βοήθεια δεδομένων ποιοτικής έρευνας, το αρχικό ερώτημα: Αποτελεί o ριζοσπαστισμός σήμερα καθοριστικό ιδεολογικό και συμπεριφορικό χαρακτηριστικό της νεολαίας; Λέξεις κλειδιά: Νεολαία, πολιτική δράση, ριζοσπαστισμός, Aριστερά, ψήφος των νέων AbstractThis article aims at answering whether today’s youth in Greece could be defined as radical, based on the kind of political behavior and worldview manifested by a significant part of young people. And, hence, whether it could be perceived as a potential driving force of social change, according to the example of the youth of “Metapolitefsi”. In a way, this article draws from and further continues a previous article (Παντελίδου-Μαλούτα, 2015), which sought to illustrate Greek youth’s tendency to “return” to politics; a development already evident since 2008 that intensified during the crisis. Delving deeper into this rationale and taking into account data which attest to the youth’s turn towards the Left and return to politics, initially through dynamic modes of participation, here, we will employ qualitative research data in an attempt to approach the original question: Does radicalism constitute a defining ideological and behavioral characteristic of today’s youth? Key wordsYouth politics, voting behavior, radicalism, political attitudes, the Left