bluuebunny/crossref_metadata_2025_split huggingface dataset:
The association of nodal upstaging with surgical approach and its impact on long-term survival after resection of non-small-cell lung cancer
Authors: Hennon Mark W , DeGraaff Luke H , Groman Adrienne , Demmy Todd L , Yendamuri Sai 
Published: October 2019

Abstract

OBJECTIVES
Proponents of open thoracotomy (OPEN) and robot-assisted thoracic surgery (RATS) claim its oncological superiority over video-assisted thoracic surgery (VATS) in terms of the accuracy of lymph node staging.

METHODS
The National Cancer Database was queried for patients with non-small-cell lung cancer (NSCLC) undergoing lobectomy without neoadjuvant therapy from 2010 to 2014. Nodal upstaging rates were compared using a surgical approach. Overall survival adjusted for confounding variables was examined using the Cox proportional hazards model.

RESULTS
A total of 64 676 patients fulfilled the selection criteria. The number of patients who underwent lobectomy by RATS, VATS and OPEN approaches was 5470 (8.5%), 17 545 (27.1%) and 41 661 (64.4%), respectively. The mean number of lymph nodes examined for each of these approaches was 10.9, 11.3 and 10 (P &lt; 0.01) and upstaging rates were 11.2%, 11.7% and 12.6% (P &lt; 0.01), respectively. For patients with clinical stage I disease (N = 46 826; RATS = 4338, VATS = 13 416 and OPEN = 29 072), the mean lymph nodes examined were 10.6, 10.8 and 9.4 (P &lt; 0.01), and upstaging rates were 10.8%, 11.1% and 12.1% (P &lt; 0.01), respectively. A multivariable analysis suggested an association with improved survival with RATS and VATS compared with OPEN surgery [hazard ratio (HR) = 0.89 and 0.89, respectively; P &lt; 0.01] for patients with all stages. In stage I disease, VATS but not RATS was associated with increased overall survival compared with the OPEN approach (HR = 0.81; P &lt; 0.01).

CONCLUSIONS
RATS lobectomy is not superior to VATS lobectomy with respect to lymph node yield or upstaging of NSCLC. Increased nodal upstaging by the OPEN approach does not confer a survival advantage in any stage of NSCLC and may be associated with decreased overall survival.
Judging International Judgments Anew? The Human Rights Courts before Domestic Courts
Authors: Kunz Raffaela 
Published: October 2019

Abstract
In recent times, instances of contestation against the European Court of Human Rights and the Inter-American Court of Human Rights have made headlines, and, in many of these cases, domestic courts have played a role by refusing to follow the human rights courts or even declaring their judgments to be unconstitutional. This article undertakes an in-depth analysis of these instances of judicial resistance and puts them into context. This shows that domestic courts, even though originally not having been allocated this role, have become important ‘compliance partners’ of the human rights courts and now play an important and autonomous role in the implementation of their judgments. At the same time, they act as ‘gatekeepers’ and limit their effects in the domestic order. Recent cases even suggest a turn to a less open and more national self-perception of domestic courts. While this reflects to some extent the multiple – and sometimes conflicting – roles domestic courts perform at the intersection of legal orders, the article argues that the open and flexible stance many domestic courts take when faced with international judgments is better suited to cope with the complex and plural legal reality than systematically judging anew on matters already decided by the human rights courts.
A systematic review of patient complaints about general practice
Authors: O’Dowd Emily , Lydon Sinéad , Madden Caoimhe , O’Connor Paul 
Published: October 2019

Abstract

Background
Health care complaints are an underutilized resource for quality and safety improvement. Most research on health care complaints is focused on secondary care. However, there is also a need to consider patient safety in general practice, and complaints could inform quality and safety improvement.

Objective
This review aimed to synthesize the extant research on complaints in general practice.

Methods
Five electronic databases were searched: Medline, Web of Science, CINAHL, PsycINFO and Academic Search Complete. Peer-reviewed studies describing the content, impact of and motivation for complaints were included and data extracted. Framework synthesis was conducted using the Healthcare Complaints Analysis Tool (HCAT) as an organizing framework. Methodological quality was appraised using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD).

Results
The search identified 2960 records, with 21 studies meeting inclusion criteria. Methodological quality was found to be variable. The contents of complaints were classified using the HCAT, with 126 complaints (54%) classified in the Clinical domain, 55 (23%) classified as Management and 54 (23%) classified as Relationships. Motivations identified for making complaints included quality improvement for other patients and monetary compensation. Complaints had both positive and negative impacts on individuals and systems involved.

Conclusion
This review highlighted the high proportion of clinical complaints in general practice compared to secondary care, patients’ motivations for making complaints and the positive and negative impacts that complaints can have on health care systems. Future research focused on the reliable coding of complaints and their use to improve quality and safety in general practice is required.
Early Discontinuation of Infliximab in Pregnant Women With Inflammatory Bowel Disease
Authors: Truta Brindusa , Leeds Ira L , Canner Joseph K , Efron Jonathan E , Fang Sandy H , Althumari Azah , Safar Bashar 
Published: October 2019

Abstract

Objectives
Early discontinuation of infliximab (IFX) in pregnant women with inflammatory bowel disease (IBD) decreases the intrauterine fetal exposure to the drug but may increase the risk of disease flaring leading to poor pregnancy outcomes. In this study, we assessed the impact of early IFX discontinuation on mother’s disease activity and on their at-risk babies.

Methods
In a retrospective study of the Truven Health Analytics MarketScan database from 2011 to 2015, we compared IBD patients who discontinued IFX more than 90 days (“early IFX”) with those who discontinue IFX 90 days or less (“late IFX) before delivery. We evaluated the risk of flaring, defined by new steroid prescriptions, visits to emergency room and/or hospital admissions, the pregnancy outcomes, and the at-risk babies.

Results
After IFX discontinuation, the early IFX group (68 deliveries) required significantly more steroid prescriptions than the late IFX group (318 deliveries) to control disease activity (P &lt; 001). There were more preterm babies in the early IFX group (P &lt; 049), but no difference within the 2 groups was noticed in the rate of intrauterine growth retardation, small for gestation, and stillborn babies. Similarly, there was no increase in acute respiratory infections, development delays, and congenital malformations in babies of the mothers from the late IFX vs early IFX groups.

Conclusions
Steroid-free remission IBD mothers are at risk for disease flares and preterm babies when IFX is discontinued early in pregnancy. Continuation of IFX seems to be safe at least for the first year of life.
Shifting Cost-drivers of Health Care Expenditures in Inflammatory Bowel Disease
Authors: Click Benjamin , Lopez Rocio , Arrigain Susana , Schold Jesse , Regueiro Miguel , Rizk Maged 
Published: October 2019

Abstract

Background
Inflammatory bowel diseases (IBD) are costly, chronic illnesses. Key cost-drivers of IBD health care expenditures include pharmaceuticals and unplanned care, but evolving treatment approaches have shifted these factors. We aimed to assess changes in cost of care, determine shifts in IBD cost-drivers, and examine differences by socioeconomic and insurance status over time.

Methods
The Medical Expenditure Panel Survey (MEPS), a nationally representative database that collects data on health care utilization and expenditures from a nationally representative sample since 1998, was utilized. Adult subjects with IBD were identified by ICD-9 codes. To determine changes in per-patient costs or cost-drivers unique to IBD, a control population of rheumatoid arthritis (RA) subjects was generated and matched in 1:1 case to control. Total annual health care expenditures were obtained and categorized as outpatient, inpatient, emergency, or pharmacy related. Temporal cohorts from 1998 to 2015 were created to assess change over time. Per-patient expenditures were compared by disease state and temporal cohort using weighted generalized linear models.

Results
A total of 641 IBD subjects were identified and matched to 641 RA individuals. From 1998 to 2015, median total annual health care expenditures nearly doubled (adjusted estimate 2.20; 95% CI, 1.6–3.0) and were 36% higher in IBD compared with RA. In IBD, pharmacy expenses increased 7% to become the largest cost-driver (44% total expenditures). Concurrently, inpatient spending in IBD decreased by 40%. There were no significant differences in the rate of change of cost-drivers in IBD compared with RA.

Conclusions
Per-patient health care costs for chronic inflammatory conditions have nearly doubled over the last 20 years. Increases in pharmaceutical spending in IBD may be accompanied by reduction in inpatient care. Additional studies are needed to explore patient-, disease-, system-, and industry-level cost mitigation strategies.
Becoming Chapels and Everyday Congregations: How the Repair and Maintenance of London’s Wesleyan Chapels Illustrates Their Communities’ Everyday Practices and Experiences (1851–1932)
Authors: Slatter Ruth 
Published: October 2019

Abstract
This article uses archival references to maintenance and repair to approach nineteenth- and early-twentieth-century Wesleyan chapels and their material contents as ‘becoming’ things. Reflecting on the material changes that made the maintenance or repair of Wesleyan chapels necessary, or occurred because of these processes, it considers what maintenance and repair reveal about everyday practices and experiences within these communities. This article’s approach allows it to draw conclusions about individuals’ personal and mundane engagements with Wesleyanism in London during the nineteenth and early twentieth centuries. As such, it overcomes some of the problems that historians interested in the everyday have traditionally faced as a result of the shortage of surviving personal testimonies about the everyday nature of church attendance during this period. Using Wesleyan chapels from London’s northern suburbs and East End as case studies, this article particularly focuses on the repair and maintenance of organs and chapel interiors. It uses these examples to reflect on the practicalities of everyday life in Wesleyan communities, demonstrating how considering moments of repair and maintenance highlights the (sometimes fraught) interrelationships between the spiritual, social, and practical priorities of Wesleyan communities.
Development and validation of nomograms for prediction of overall survival and cancer-specific survival of patients of colorectal cancer
Authors: Zhang Jieyun , Yang Yue , Fu Xiaojian , Guo Weijian 
Published: October 2019

Abstract

Purpose
Nomograms are intuitive tools for individualized cancer prognosis. We sought to develop a clinical nomogram for prediction of overall survival and cancer-specific survival for patients with colorectal cancer.

Methods
Patients with colorectal cancer diagnosed between 1988 and 2006 and those who underwent surgery were retrieved from the Surveillance, Epidemiology, and End Results database and randomly divided into the training (n = 119 797) and validation (n = 119 797) cohorts. Log-rank and multivariate Cox regression analyses were used in our analysis. To find out death from other cancer causes and non-cancer causes, a competing-risks model was used, based on which we integrated these significant prognostic factors into nomograms and subjected the nomograms to bootstrap internal validation and to external validation.

Results
The 1-, 3-, 5- and 10-year probabilities of overall survival in patients of colorectal cancer after surgery intervention were 83.04, 65.54, 54.79 and 38.62%, respectively. The 1-, 3-, 5- and 10-year cancer-specific survival was 87.36, 73.44, 66.22 and 59.11%, respectively. Nine independent prognostic factors for overall survival and nine independent prognostic factors for cancer specific survival were included to build the nomograms. Internal and external validation CI indexes of overall survival were 0.722 and 0.721, and those of cancer-specific survival were 0.765 and 0.766, which was satisfactory.

Conclusions
Nomograms for prediction of overall survival and cancer-specific survival of patients with colorectal cancer. Performance of the model was excellent. This practical prognostic model may help clinicians in decision-making and design of clinical studies.
Cancer in General Responders Participating in World Trade Center Health Programs, 2003–2013
Authors: Shapiro Moshe Z , Wallenstein Sylvan R , Dasaro Christopher R , Lucchini Roberto G , Sacks Henry S , Teitelbaum Susan L , Thanik Erin S , Crane Michael A , Harrison Denise J , Luft Benjamin J , Moline Jacqueline M , Udasin Iris G , Todd Andrew C 
Published: October 2019

AbstractBackgroundFollowing the September 11, 2001, attacks on the World Trade Center (WTC), thousands of workers were exposed to an array of toxins known to cause adverse health effects, including cancer. This study evaluates cancer incidence in the WTC Health Program General Responder Cohort occurring within 12 years post exposure.MethodsThe study population consisted of 28 729 members of the General Responder Cohort enrolled from cohort inception, July 2002 to December 31, 2013. Standardized incidence ratios (SIRs) were calculated with cancer case inclusion and follow-up starting post September 11, 2001 (unrestricted) and, alternatively, to account for selection bias, with case inclusion and follow-up starting 6 months after enrollment in the WTC Health Program (restricted). Case ascertainment was based on linkage with six state cancer registries. Under the restricted criterion, hazard ratios were estimated using multivariable Cox proportional hazards models for all cancer sites combined and for prostate cancer.ResultsRestricted analyses identified 1072 cancers in 999 responders, with elevations in cancer incidence for all cancer sites combined (SIR = 1.09, 95% confidence interval [CI] = 1.02 to 1.16), prostate cancer (SIR = 1.25, 95% CI = 1.11 to 1.40), thyroid cancer (SIR = 2.19, 95% CI = 1.71 to 2.75), and leukemia (SIR = 1.41, 95% CI = 1.01 to 1.92). Cancer incidence was not associated with any WTC exposure index (composite or individual) for all cancer sites combined or for prostate cancer.ConclusionOur analyses show statistically significant elevations in cancer incidence for all cancer sites combined and for prostate and thyroid cancers and leukemia. Multivariable analyses show no association with magnitude or type of exposure.
The Fungal PCR Initiative's evaluation of in-house and commercial Pneumocystis jirovecii qPCR assays: Toward a standard for a diagnostics assay
Authors: Gits-Muselli Maud , White P Lewis , Mengoli Carlo , Chen Sharon , Crowley Brendan , Dingemans Gijs , Fréalle Emilie , L Gorton Rebecca , Guiver Malcom , Hagen Ferry , Halliday Catriona , Johnson Gemma , Lagrou Katrien , Lengerova Martina , Melchers Willem J G , Novak-Frazer Lily , Rautemaa-Richardson Riina , Scherer Emeline , Steinmann Joerg , Cruciani Mario , Barnes Rosemary , Donnelly J Peter , Loeffler Juergen , Bretagne Stéphane , Alanio Alexandre 
Published: October 2019

Abstract
Quantitative real-time PCR (qPCR) is increasingly used to detect Pneumocystis jirovecii for the diagnosis of Pneumocystis pneumonia (PCP), but there are differences in the nucleic acids targeted, DNA only versus whole nucleic acid (WNA), and also the target genes for amplification. Through the Fungal PCR Initiative, a working group of the International Society for Human and Animal Mycology, a multicenter and monocenter evaluation of PCP qPCR assays was performed. For the multicenter study, 16 reference laboratories from eight different countries, performing 20 assays analyzed a panel consisting of two negative and three PCP positive samples. Aliquots were prepared by pooling residual material from 20 negative or positive- P. jirovecii bronchoalveolar lavage fluids (BALFs). The positive pool was diluted to obtain three concentrations (pure 1:1; 1:100; and 1:1000 to mimic high, medium, and low fungal loads, respectively). The monocenter study compared five in-house and five commercial qPCR assays testing 19 individual BALFs on the same amplification platform. Across both evaluations and for all fungal loads, targeting WNA and the mitochondrial small sub-unit (mtSSU) provided the earliest Cq values, compared to only targeting DNA and the mitochondrial large subunit, the major surface glycoprotein or the beta-tubulin genes. Thus, reverse transcriptase-qPCR targeting the mtSSU gene could serve as a basis for standardizing the P. jirovecii load, which is essential if qPCR is to be incorporated into clinical care pathways as the reference method, accepting that additional parameters such as amplification platforms still need evaluation.
A galaxy’s accretion history unveiled from its integrated spectrum
Authors: Boecker Alina , Leaman Ryan , van de Ven Glenn , Norris Mark A , Mackereth J Ted , Crain Robert A 
Published: October 2019

Abstract
We present a new method of quantifying a galaxy’s accretion history from its integrated spectrum alone. Using full spectral fitting and calibrated regularization techniques we show how we can accurately derive a galaxy’s mass distribution in age-metallicity space and further separate this into stellar populations from different chemical enrichment histories. By exploiting the fact that accreted lower mass galaxies will exhibit an offset to lower metallicities at fixed age compared to the in-situ stellar population, we quantify the fraction of light that comes from past merger events, that are long since mixed in phase-space and otherwise indistinguishable. Empirical age-metallicity relations (AMRs) parameterized for different galaxy masses are used to identify the accreted stellar populations and link them back to the progenitor galaxy’s stellar mass. This allows us to not only measure the host galaxy’s total ex-situ mass fraction (facc), but also quantify the relative amount of accreted material deposited by satellite galaxies of different masses, i.e. the accreted satellite mass function in analogy to the subhalo mass function. Using mock spectra of present-day, early-type galaxies with total stellar mass ∼109 − 1012 M⊙ from the EAGLE simulation suite we demonstrate that our method can recover the total accreted fraction to within $\approx 38 \%$, the stellar mass of the most massive accreted subhalo to within $\approx 56 \%$ and the slope of the accreted satellite mass function to within $\approx 17 \%$ of the true values from the EAGLE merger trees. Future application of this method to observations could potentially provide us accretion histories of hundreds of individual galaxies, for which deep integrated light spectroscopy is available.
Stellar proton event-induced surface radiation dose as a constraint on the habitability of terrestrial exoplanets
Authors: Atri Dimitra 
Published: October 2019

ABSTRACT
The discovery of terrestrial exoplanets orbiting in habitable zones around nearby stars has been one of the significant developments in modern astronomy. More than a dozen such planets, like Proxima Centauri b and TRAPPIST-1 e, are in close-in configurations and their proximity to the host star makes them highly sensitive to stellar activity. Episodic events such as flares have the potential to cause severe damage to close-in planets, adversely impacting their habitability. Flares on fast-rotating young M stars occur up to 100 times more frequently than on G-type stars, which makes their planets even more susceptible to stellar activity. Stellar energetic particles emanating from stellar proton events (SPEs) cause atmospheric damage (erosion and photochemical changes), and produce secondary particles, which in turn results in enhanced radiation dosage on planetary surfaces. We explore the role of SPEs and planetary factors in determining planetary surface radiation doses. These factors include SPE fluence and spectra, and planetary column density and magnetic field strength. Taking particle spectra from 70 major solar events (observed between 1956 and 2012) as proxy, we use the geant4 Monte Carlo model to simulate SPE interactions with exoplanetary atmospheres, and we compute surface radiation dose. We demonstrate that in addition to fluence, SPE spectrum is also a crucial factor in determining the surface radiation dose. We discuss the implications of these findings in constraining the habitability of terrestrial exoplanets.
Effect of BRCA1 missense variants on gene reversion in DNA double-strand break repair mutants and cell cycle-arrested cells of Saccharomyces cerevisiae
Authors: Lodovichi Samuele , Bellè Francesca , Cervelli Tiziana , Lorenzoni Alessandra , Maresca Luisa , Cozzani Cristina , Caligo Maria Adelaide , Galli Alvaro 
Published: October 2019

AbstractEvaluation of the functional impact of germline BRCA1 variants that are likely to be associated to breast and ovarian cancer could help to investigate the mechanism of BRCA1 tumorigenesis. Expression of pathogenic BRCA1 missense variants increased homologous recombination (HR) and gene reversion (GR) in yeast. We thought to exploit yeast genetics to shed light on BRCA1-induced genome instability and tumorigenesis. We determined the effect on GR of several neutral and pathogenic BRCA1 variants in the yeast strain RSY6wt and its isogenic DSB repair mutants, such as mre11∆, rad50∆ and rad51∆. In the RSY6wt, four out of five pathogenic and two out of six neutral variants significantly increased GR; rad51∆ strain, the pathogenic variants C61G and A1708E induced a weak but significant increase in GR. On the other hand, in rad50∆ mutant expressing the pathogenic variants localised at the BRCT domain, a further GR increase was seen. The neutral variant N132K and the VUS A1789T induced a weak GR increase in mre11∆ mutant. Thus, BRCA1 missense variants require specific genetic functions and presumably induced GR by different mechanisms. As DNA repair is regulated by cell cycle, we determined the effect on GR of BRCA1 variants in cell cycle-arrested RSYwt cells. GR is highly BRCA1-inducible in S-phase-arrested cells as compared to G1 or G2. Sequence analysis of genomic DNA from ILV1 revertant clones showed that BRCA1-induced ilv1-92 reversion by base substitution when GR is at least 6-fold over the control. Our study demonstrated that BRCA1 may interfere with yeast DNA repair functions that are active in S-phase causing high level of GR. In addition, we confirmed here that yeast could be a reliable model to investigate the mechanism and genetic requirements of BRCA1-induced genome instability. Finally, developing yeast-based assays to characterise BRCA1 missense variants could be useful to design more precise therapies.