bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vertebral fracture risk in glucocorticoid-induced osteoporosis: the role of hypogonadism and corticosteroid boluses
Authors: Florez Helena , Hernández-Rodríguez Jose , Carrasco Josep Lluis , Prieto-González Sergio , Muxi Africa , Filella Xavier , Ruiz-Gaspà Silvia , Gómez-Puerta José A , Cid Maria , Espinosa Gerard , Monegal Ana , Guañabens Núria , Peris Pilar 
Published: September 2020

ObjectiveThe aim of this study was to identify the risk factors associated with fragility fracture (FF) development in glucocorticoid (GC)-treated patients.Methods127 patients (aged 62±18 years, 63% women) on GC-treatment (mean dose 14.5±14.1 mg/day and duration 47.7±69 months) were included. The clinical data collected included bone metabolism study (including gonadal axis), GC-treatment, disease activity, dual-energy X-ray absorptiometry analysis (evaluating densitometric osteoporosis (OP) and trabecular bone score (TBS) degraded microarchitecture values (DMA)), X-ray (assessing vertebral fractures (VF)), FRAX risk (GC-adjusted) and previous FF.Results17% of the patients had VF, 28% FF (VF and/or non-VF), 29% OP and 52% DMA. Patients with VF received more GC boluses (57.1% vs 29.5%, p=0.03), were older (68±13 vs 60±19 years, p=0.02), postmenopausal (100% vs 67%, p=0.02), had low testosterone levels (57% vs 11%, p=0.02), lower TBS values (1.119±0.03 vs 1.237±0.013, p<0.001) and higher FRAX risk (17.2±16 vs 9.3±7.6, p=0.003). Patients with FF showed higher accumulated GC doses (16.6±18.4 vs 11.1±12.9 g, p=0.046). On multivariate analysis, hypogonadism (OR 12.38; 95% CI 1.85 to >100, p=0.01) and having received GC boluses (OR 3.45; 95% CI 1.04 to 12.15, p=0.01) were the main factors related to VF. Hypogonadism (OR 7.03; 95% CI 1.47 to 38.37, p=0.01) and FRAX >20 (OR 7.08; 95% CI 1.28 to 53.71, p=0.02) were factors related to FF.ConclusionHypogonadism is the principal risk factor for developing fractures in GC-treated men and women, whereas receiving GC boluses is a major factor for VF. These results indicate the importance of evaluating the gonadal axis in these patients.
SARS-CoV-2 seroprevalence and asymptomatic viral carriage in healthcare workers: a cross-sectional study
Authors: Shields Adrian , Faustini Sian E , Perez-Toledo Marisol , Jossi Sian , Aldera Erin , Allen Joel D , Al-Taei Saly , Backhouse Claire , Bosworth Andrew , Dunbar Lyndsey A , Ebanks Daniel , Emmanuel Beena , Garvey Mark , Gray Joanna , Kidd I Michael , McGinnell Golaleh , McLoughlin Dee E , Morley Gabriella , O'Neill Joanna , Papakonstantinou Danai , Pickles Oliver , Poxon Charlotte , Richter Megan , Walker Eloise M , Wanigasooriya Kasun , Watanabe Yasunori , Whalley Celina , Zielinska Agnieszka E , Crispin Max , Wraith David C , Beggs Andrew D , Cunningham Adam F , Drayson Mark T , Richter Alex G 
Published: September 2020

ObjectiveTo determine the rates of asymptomatic viral carriage and seroprevalence of SARS-CoV-2 antibodies in healthcare workers.DesignA cross-sectional study of asymptomatic healthcare workers undertaken on 24/25 April 2020.SettingUniversity Hospitals Birmingham NHS Foundation Trust (UHBFT), UK.Participants545 asymptomatic healthcare workers were recruited while at work. Participants were invited to participate via the UHBFT social media. Exclusion criteria included current symptoms consistent with COVID-19. No potential participants were excluded.InterventionParticipants volunteered a nasopharyngeal swab and a venous blood sample that were tested for SARS-CoV-2 RNA and anti-SARS-CoV-2 spike glycoprotein antibodies, respectively. Results were interpreted in the context of prior illnesses and the hospital departments in which participants worked.Main outcome measureProportion of participants demonstrating infection and positive SARS-CoV-2 serology.ResultsThe point prevalence of SARS-CoV-2 viral carriage was 2.4% (n=13/545). The overall seroprevalence of SARS-CoV-2 antibodies was 24.4% (n=126/516). Participants who reported prior symptomatic illness had higher seroprevalence (37.5% vs 17.1%, χ2=21.1034, p<0.0001) and quantitatively greater antibody responses than those who had remained asymptomatic. Seroprevalence was greatest among those working in housekeeping (34.5%), acute medicine (33.3%) and general internal medicine (30.3%), with lower rates observed in participants working in intensive care (14.8%). BAME (Black, Asian and minority ethnic) ethnicity was associated with a significantly increased risk of seropositivity (OR: 1.92, 95% CI 1.14 to 3.23, p=0.01). Working on the intensive care unit was associated with a significantly lower risk of seropositivity compared with working in other areas of the hospital (OR: 0.28, 95% CI 0.09 to 0.78, p=0.02).Conclusions and relevanceWe identify differences in the occupational risk of exposure to SARS-CoV-2 between hospital departments and confirm asymptomatic seroconversion occurs in healthcare workers. Further investigation of these observations is required to inform future infection control and occupational health practices.
Progressive visual loss and severe retinal degeneration in a captive Kodiak bear (Ursus arctos mittendorfi)
Authors: Caruso Kelly A , Koch Seth , Reynolds Benjamin David , McCarthy Paul Massimo Giannoni , Whittaker Cameron J 
Published: September 2020

SUMMARYA 27‐year‐old female Kodiak bear displayed signs of progressive visual loss over an 18‐year period. The bear was examined under general anaesthesia, where fixed mydriatic pupils, a diffusely hyper‐reflective retina with vascular attenuation was observed. An electroretinogram was performed bilaterally, revealing no electrical activity associated with either retina and confirming a diagnosis of severe bilateral retinal degeneration. The bear was euthanased eight months later due to a diagnosis of a metastasised hepatic neoplasm. Histopathology of the bear's eyes revealed marked outer layer retinal degeneration. The aetiology of this retinal degeneration could not be confirmed.
Laparoscopic iliopubic tract repair for pediatric inguinal hernia has very low recurrence: an Indian experience
Authors: Nayak Sunil Kumar , Parthasarathi Ramakrishnan , G H V Raghavendra Gupta , Rajapandian Subbaiah , Palanisamy Nalankilli Vaiyapurigoundar , Palanivelu Chinnusamy 
Published: September 2020

BackgroundThe aim of this study is to document results of laparoscopic iliopubic tract (IPT) repair for inguinal hernia in the pediatric age group.MethodsHospital records of 190 children who underwent IPT repair between January 2015 and January 2020 were analyzed retrospectively for demographic details, variations between clinical, radiological and laparoscopic diagnosis, associated pathologies, operative time, hospital stay, postoperative complications and follow-up. The internal ring was narrowed by approximating IPT to conjoint tendon using 3-0 polypropylene continuous or interrupted suture.ResultsIn total, 238 IPT repairs were done under general anesthesia in 190 children aged between 1 and 17 years. 7.9% of children had phimosis, and three children had hydrocele. Three patients had undescended testis and another three IPT repairs were done in cases who presented with appendicitis. Contralateral patent processus vaginalis (CPPV) was detected at the time of laparoscopy in 18.3% of cases. Thus far, 166 children had been followed, and no recurrence was observed in any of these 96 of whom have completed more than 3 years after their surgery. However, two patients developed hernia on the contralateral side.ConclusionsLaparoscopy is beneficial to pick up CPPV. Laparoscopic IPT repair for pediatric inguinal hernia is reproducible and safe with the least recurrence reported thus far. However, further follow-up is needed. Moreover, development of contralateral hernia needs to be investigated.
Potent Activity of an Anti-ICAM1 Antibody–Drug Conjugate against Multiple Myeloma
Authors: Sherbenou Daniel W. , Su Yang , Behrens Christopher R. , Aftab Blake T. , Perez de Acha Olivia , Murnane Megan , Bearrows Shelby C. , Hann Byron C. , Wolf Jeffery L. , Martin Thomas G. , Liu Bin 
Published: September 2020

Abstract

Purpose:
New therapies have changed the outlook for patients with multiple myeloma, but novel agents are needed for patients who are refractory or relapsed on currently approved drug classes. Novel targets other than CD38 and BCMA are needed for new immunotherapy development, as resistance to daratumumab and emerging anti-BCMA approaches appears inevitable. One potential target of interest in myeloma is ICAM1. Naked anti-ICAM1 antibodies were active in preclinical models of myeloma and safe in patients, but showed limited clinical efficacy. Here, we sought to achieve improved targeting of multiple myeloma with an anti-ICAM1 antibody–drug conjugate (ADC).

Experimental Design:
Our anti-ICAM1 human mAb was conjugated to an auristatin derivative, and tested against multiple myeloma cell lines in vitro, orthotopic xenografts in vivo, and patient samples ex vivo. The expression of ICAM1 was also measured by quantitative flow cytometry in patients spanning from diagnosis to the daratumumab-refractory state.

Results:
The anti-ICAM1 ADC displayed potent anti-myeloma cytotoxicity in vitro and in vivo. In addition, we have verified that ICAM1 is highly expressed on myeloma cells and shown that its expression is further accentuated by the presence of bone marrow microenvironmental factors. In primary samples, ICAM1 is differentially overexpressed on multiple myeloma cells compared with normal cells, including daratumumab-refractory patients with decreased CD38. In addition, ICAM1-ADC showed selective cytotoxicity in multiple myeloma primary samples.

Conclusions:
We propose that anti-ICAM1 ADC should be further studied for toxicity, and if safe, tested for clinical efficacy in patients with relapsed or refractory multiple myeloma.
Health Insurance Coverage Mandates: Colorectal Cancer Screening in the Post-ACA Era
Authors: Preston Michael A. , Ross Levi , Chukmaitov Askar , Smith Sharla A. , Odlum Michelle L. , Dahman Bassam , Sheppard Vanessa B. 
Published: September 2020

Abstract

Building a culture of precision public health requires research that includes health delivery model with innovative systems, health policies, and programs that support this vision. Health insurance mandates are effective mechanisms that many state policymakers use to increase the utilization of preventive health services, such as colorectal cancer screening. This study estimated the effects of health insurance mandate variations on colorectal cancer screening post Affordable Care Act (ACA) era. The study analyzed secondary data from the Behavioral Risk Factor Surveillance System (BRFSS) and the NCI State Cancer Legislative Database (SCLD) from 1997 to 2014. BRFSS data were merged with SCLD data by state ID. The target population was U.S. adults, age 50 to 74, who lived in states where health insurance was mandated or nonmandated before and after the implementation of ACA. Using a difference-in-differences (DD) approach with a time-series analysis, we evaluated the effects of health insurance mandates on colorectal cancer screening status based on U.S. Preventive Services Task Force guidelines. The adjusted average marginal effects from the DD model indicate that health insurance mandates increased the probability of up-to-date screenings versus noncompliance by 2.8% points, suggesting that an estimated 2.37 million additional age-eligible persons would receive a screening with such health insurance mandates. Compliant participants' mean age was 65 years and 57% were women (n = 32,569). Our findings are robust for various model specifications. Health insurance mandates that lower out-of-pocket expenses constitute an effective approach to increase colorectal cancer screenings for the population, as a whole.

Prevention Relevance:
The value added includes future health care reforms that increase access to preventive services, such as CRC screening, are likely with lower out-of-pocket costs and will increase the number of people who are considered “up-to-date”. Such policies have been used historically to improve health outcomes, and they are currently being used as public health strategies to increase access to preventive health services in an effort to improve the nation's health.
Lactate-Modulated Immunosuppression of Myeloid-Derived Suppressor Cells Contributes to the Radioresistance of Pancreatic Cancer
Authors: Yang Xuguang , Lu Yun , Hang Junjie , Zhang Junfeng , Zhang Tiening , Huo Yanmiao , Liu Jun , Lai Songtao , Luo Dawei , Wang Liwei , Hua Rong , Lin Yuli 
Published: September 2020

Abstract
The mechanisms responsible for radioresistance in pancreatic cancer have yet to be elucidated, and the suppressive tumor immune microenvironment must be considered. We investigated whether the radiotherapy-augmented Warburg effect helped myeloid cells acquire an immunosuppressive phenotype, resulting in limited treatment efficacy of pancreatic ductal adenocarcinoma (PDAC). Radiotherapy enhanced the tumor-promoting activity of myeloid-derived suppressor cells (MDSC) in pancreatic cancer. Sustained increase in lactate secretion, resulting from the radiation-augmented Warburg effect, was responsible for the enhanced immunosuppressive phenotype of MDSCs after radiotherapy. Hypoxia-inducible factor-1α (HIF-1α) was essential for tumor cell metabolism and lactate-regulated activation of MDSCs via the G protein-coupled receptor 81 (GPR81)/mTOR/HIF-1α/STAT3 pathway. Blocking lactate production in tumor cells or deleting Hif-1α in MDSCs reverted antitumor T-cell responses and effectively inhibited tumor progression after radiotherapy in pancreatic cancer. Our investigation highlighted the importance of radiation-induced lactate in regulating the inhibitory immune microenvironment of PDAC. Targeting lactate derived from tumor cells and the HIF-1α signaling in MDSCs may hold distinct promise for clinical therapies to alleviate radioresistance in PDAC.
Registro em prontuário: reflexões sobre a qualidade documental na terapia ocupacional
Authors: Bombarda Tatiana Barbieri , Joaquim Regina Helena Vitale Torkomian 
Published: September 2020

Os registros de Terapia Ocupacional têm por finalidade descrever o processo terapêutico tornando explícito o pensamento crítico, o raciocínio profissional e a tomada de decisões do terapeuta ocupacional. Contudo, a importância do prontuário vai além do âmbito assistencial, visto essas anotações também ser utilizadas nocontexto administrativo, educacional e científico. Mas o desempenho deste procedimento é realizado com qualidade pelos terapeutas ocupacionais? Visando discorrer sobre o tema, serão apresentados pelos autores apontamentos sobre a qualidade dos registros, a partir de uma análise reflexiva norteada pelas diretrizes da profissão sobre documentação. Como principais apontamentos, pode-se afirmar que a prática documental dos terapeutas ocupacionais ocorre de modo inconsistente, fator vinculado ao desconhecimento das diretrizes da profissão, à dificuldades com a linguagem técnica e ao processo de formação inicial e continuada. Recomenda-se a ampliação e aprofundamento de pesquisas sobre o tema para obtenção de estratégias educacionais mais eficazes e sistematizações de modelos de registros melhor gerenciáveis.
Outcomes of Acute Aortic Dissection Surgery in Octogenarians
Authors: Hsu Ming‐En , Chou An‐Hsun , Cheng Yu‐Ting , Lee Hsiu‐An , Liu Kuo‐Sheng , Chen Dong‐Yi , Wu Victor Chien‐Chia , Chu Pao‐Hsien , Chen Tien‐Hsing , Chen Shao‐Wei 
Published: September 2020

Background
Octogenarians (≥80 years old) are high‐risk patients for acute aortic dissection (AAD) surgery. However, no population‐based study has investigated the late outcomes of AAD surgery in octogenarians. This study aimed to investigate the late outcomes of AAD surgery in octogenarians.

Methods and Results
A total of 3998 patients who received AAD surgery from 2005 to 2013 were identified from the Taiwan National Health Insurance Research Database. In‐hospital complications and late outcomes including all‐cause mortality, major adverse cardiac and cerebrovascular event, respiratory failure, and redo aortic surgery were evaluated. The risks of late outcomes between octogenarians and nonoctogenarians were compared using the multivariable Cox proportional hazard model or Fine and Gray competing model. The numbers of the octogenarians who underwent type A and B AAD surgeries were 206 (6%; 206/3423) and 79 (13.7%; 79/575), respectively. Compared with the nonoctogenarians, the type A octogenarians had higher risks of in‐hospital mortality and several in‐hospital complications, whereas the type B octogenarians did not. Furthermore, compared with the nonoctogenarians, the type A octogenarians had a higher risk of all‐cause mortality (61.7% vs 32.5%; hazard ratio [HR], 2.35; 95% CI, 1.95–2.84) and a higher cumulative incidence of major adverse cardiac and cerebrovascular event and respiratory failure, and the type B octogenarians demonstrated a higher risk of all‐cause mortality (44.3% vs 30.4%; HR, 1.74; 95% CI, 1.18–2.55). The octogenarians receiving AAD surgeries had higher mortality rates than the normal octogenarian population.

Conclusions
Octogenarians receiving AAD surgeries exhibit worse late outcomes than nonoctogenarian counterparts.
Gunshot Injuries in American Trauma Centers: Analysis of the Lethality of Multiple Gunshot Wounds
Authors: Zeineddin Ahmad , Williams Mallory , Nonez Harry , Nizam Wasay , Olufajo Olubode A. , Ortega Gezzer , Haider Adil , Cornwell Edward E. 
Published: September 2020

Introduction Trauma center care and survival have been improving over the past several years. However, yearly firearm-related deaths have remained near constant at 33 000. One challenge to decreasing gunshot mortality is patients presenting with complex injury patterns from multiple gunshot wounds (GSWs) made possible by high-caliber automated weapons. Our study analyzes outcomes of trauma patients of firearms using the National Trauma Databank (NTDB). Methods We conducted a retrospective review of the NTDB from the years 2003-2015 for patients with penetrating injuries. We separated patients into groups based on stab wounds, single GSW, and multiple GSW. We performed multivariate logistic regression analyses in which we adjusted for demographics and injury severity. Results Overall, 382 376 patients presenting with penetrating injuries were analyzed. Of those 167 671 had stab, 106 538 single GSW, and 57 819 multiple GSW injuries. Crude mortality was 1.97% for stab wounds, 13.26% for single GSW, and 18.84% for multiple GSW. Adjusted odds ratio (OR) compared with 2003 demonstrates a trend toward decreased mortality for stab wounds (OR range of 0.48-0.69, P < .05 for years 2010-2015). A similar trend was demonstrated in single GSW injuries (OR 0.31-0.83, P < .01 for years 2005-2015). Conversely, multiple GSW injuries did not follow this trend (OR 0.91-1.36 with P > 0.05 for each year). Conclusion In contrast to significant improvement in survival in patients with a single GSW injury since 2003, multiple GSW injuries still pose a challenge to trauma care. This warrants further investigation into the efficacy of legislature, and the lack thereof, as well as future preventative measures to this type of injury.
Oncologic Outcomes of Robotic Left Pancreatectomy for Pancreatic Adenocarcinoma: A Single-Center Comparison to Laparoscopic Resection
Authors: Baimas-George Maria , Watson Michael , Salibi Patrick , Tschuor Christoph , Murphy Keith J. , Iannitti David , Baker Erin , Ocuin Lee , Vrochides Dionisios , Martinie John B. 
Published: September 2020

Background Feasibility and safety of robotic surgery for pancreatic disease has been well demonstrated; however, there is scarce literature on long-term oncologic outcomes. We compared perioperative and oncologic outcomes between robotic left pancreatectomy (RLP) and laparoscopic left pancreatectomy (LLP) for pancreatic adenocarcinoma. Methods A retrospective review evaluated left pancreatectomies performed for pancreatic adenocarcinoma from 2009 to 2019 in a tertiary institution. Baseline characteristics, operative and oncologic outcomes were compared between RLP and LLP. Results There were 75 minimally invasive left pancreatectomy cases for pancreatic adenocarcinoma identified of which 33 cases were done robotically and 42 laparoscopically. Baseline characteristics demonstrated no difference in gender, age, BMI, T stage, N stage, neoadjuvant, or adjuvant chemotherapy. An analysis of operative variables demonstrated no difference in blood loss, increased duration, and higher lymph node yield with RLP (20 vs 12; P = .0029). Postoperatively, both cohorts had 30% pancreatic fistulas and no difference in complications. There were no differences in length of stay (LOS), 30- or 90-day readmission rates, or 90-day mortality. The analysis of oncologic outcomes demonstrated similar R0 resections (RLP: 72% vs OLP: 67%), recurrence rates (RLP: 36% vs OLP: 41%), and time to recurrence (RLP: 324 vs OLP 218 days). There was increased survival in the RLP cohort that was not significant (32 vs 19 months). Conclusion This analysis demonstrates RLP is at least equivalent to LLP in perioperative and oncologic outcomes. The significantly higher lymph node yield and trend toward an improved survival suggests oncologic advantage. Randomized controlled studies are needed to clarify benefit.
Genesis of a Social Space: Think Tanks in Belarus 1992–1995
Authors: Bigday Maria 
Published: September 2020

This article belongs to the special cluster, “Think Tanks in Central and Eastern Europe”, guest-edited by Katarzyna Jezierska and Serena Giusti. The article looks at think tanks through the prism of a specific social space whose emergence is ascribable to both transnational processes and local social structures. Four processes are identified as shaping the institutionalization of the first think tanks in Belarus, founded as a tool for the “desovietization” of science and “democratization” of politics in the early 1990s: (1) the destabilization of relations between science and politics spurred by the Soviet perestroika beginning in 1986; (2) the autonomization of national elites and a political field in Belarus following the collapse of the Soviet Union; (3) the transformation of the labor market, including the crisis of state-supported research and academia, which ejected a large number of well-educated professionals; and (4) the intensification of transnational exchanges and the legitimization of references to Western practices. To systematically analyze these processes, a model consisting of the following four dimensions is proposed: configuration of relations between science and politics, position of the think tank space in the field of power, professional logics of career or competition, and transnational diffusion of resources and their local appropriation.