bluuebunny/crossref_metadata_2025_split huggingface dataset:
Weekly variation in quality of care for acute ST-segment elevation myocardial infarction by day and time of admission: a retrospective observational study
Authors: Wang Chao , Li Xi , Sun Wantong , Li Jingkun , Wang Yupeng , Bao Xiaoqiang , Liu Meina , Zhang Qiuju 
Published: July 2020

BackgroundThe admission time of patients with ST-segment elevation myocardial infarction (STEMI) may affect the quality of care they receive. This study aimed to explore the pattern and magnitude of variation in quality of care for patients with STEMI in both the process and outcome domains.MethodsWe performed a retrospective study based on STEMI data from China. We estimated the adjusted ORs of six process indicators and one outcome indicator of STEMI care quality by fitting multilevel multivariable regression models across 42 4hour time periods per week.ResultsThe study cohort comprised 98 628 patients with STEMI. Care quality varied by time of arrival to the emergency department. We identified three main patterns of variation, which were consistent across days of the week. In the first pattern, which applied to electrocardiographic examination within 10 min of arrival and to aspirin or clopidogrel use within 10 min of arrival, quality was lowest for arrivals between 08:00 and 12:00, rose through the day and peaked for arrivals between 24:00 and 04:00. Percutaneous transluminal coronary intervention treatment within 90 min showed the same pattern but with maximal performance for those arriving 20:00–24:00. In the third pattern, applying to lipid function evaluation within 24 hours and beta blocker use within 24 hours, quality was best for arrivals between 04:00–08:00 and 16:00–19:00 and worst for arrivals between 24:00–04:00 and 12:00–16:00.ConclusionsThe quality of care for STEMI shows three patterns of diurnal variation. Detecting the times at which quality is relatively low may lead to quality improvement in healthcare. Quality improvement should focus on reducing the weekend effect and off-hour effect and the diurnal temporal variation.
Gastrointestinal perforations in patients with rheumatoid arthritis treated with biological disease-modifying antirheumatic drugs in Sweden: a nationwide cohort study
Authors: Barbulescu Andrei , Delcoigne Bénédicte , Askling Johan , Frisell Thomas 
Published: July 2020

ObjectivesTo compare incidence rates of gastrointestinal (GI) perforations between patients with RA and the general population, and between patients treated with tumour necrosis factor inhibitors (TNFi) and non-TNFi biologics.MethodsIn this nationwide cohort study, a total of 63 532 patients with RA, with 26 050 biological treatment episodes (TNFi, rituximab, abatacept or tocilizumab) and 76 304 general population controls, were followed between 2009 and 2017 until the first outcome event. The main outcome was hospitalisation or death due to lower GI perforations, identified according to a prespecified list of ICD-10 (International Classification of Diseases, 10th revision) codes. Inverse probability of treatment weighting was used for adjustment.ResultsThe sex-standardised and age-standardised incidence rates of lower GI perforations were 1.1 (95% CI 1.0 to 1.3) events per 1000 person-years among general population controls, 1.6 (1.5–1.7) among bionaïve patients and ranged from 1.8 (1.4–3.6) (TNFi) to 4.5 (2.7–10.4) (tocilizumab) among biologics-treated patients. After adjustment for glucocorticoid use, the risk in bionaïve, TNFi-treated, abatacept-treated or rituximab-treated patients with RA was no longer different from the general population, while for tocilizumab it remained significantly higher. Comparing tocilizumab to TNFi, the adjusted HR for lower GI perforations was 2.2 (1.3–3.8), corresponding to one additional GI perforation per 451 patient-years treated with tocilizumab instead of TNFi.ConclusionTocilizumab was associated with a higher risk of lower GI perforations compared with alternative biologics. In absolute numbers, the risk remained low on all biologics commonly used to treat RA, but the accumulated evidence across settings and outcome definitions supports that this risk should be considered in treatment guidelines for RA.
Integrated thematic geological mapping of the Atlantic Margin of Iberia
Authors: Terrinha Pedro , Medialdea Teresa , Batista Luis , Somoza Luis , Magalhães Vitor , González Francisco Javier , Noiva João , Lobato Ana , Rosa Marcos , Marino Egidio , Brito Pedro , Neres Marta , Ribeiro Carlos 
Published: July 2020

Abstract
This paper synthesizes the geology of the Atlantic Margin off the coast of Iberia and surrounding Abyssal Plains using published thematic mapping freely downloadable from EMODNET-Geology portal at different scales. Selected information was chosen in order to highlight mineral occurrences and natural hazards overlaid on geological and morphological maps. Altogether, this information is published and interpreted here for the first time; nevertheless this exercise can be carried out by anyone interested and allows different visualizations of geological objects. Cross-correlations of geological objects and processes can easily arise. Because all of the information (each piece of data and metadata) in the EMODNET-Geology portal has bibliographic references associated, readers are able to find the original source of information. It is shown that clicking in and out of layers of information (that cannot be found all together in a single scientific paper) allows quick cross-correlation using the EMODNET Geology thematic portal. This allows a free, versatile and quick way of cross-correlating geological objects and processes in vast marine areas and their comparison with onshore geology.
A Novel Mechanism to Induce BRCAness in Cancer Cells
Authors: Cai Changmeng 
Published: July 2020

Abstract
Cancer cells with germline deleterious mutations of BRCA1 or BRCA2 are deficient in homologous recombination repair and therefore sensitive to PARP inhibitor treatment. However, wild-type BRCA1/2-expressing cells with defects in other DNA damage repair pathway components may also exhibit “BRCAness,” which in combination with PARP inhibition can similarly induce synthetic lethality. In this issue of Cancer Research, Luo and colleagues report a novel mechanism by which BRCA1 protein degradation in response to DNA double-strand breaks is regulated by prolyl isomerase Pin1. Inactivation of Pin1 can establish BRCAness in cancer cells and thus sensitize cells to PARP inhibitor treatment.
See related articles by Luo et al., p. 3033
A Phase I/II Study of Veliparib (ABT-888) in Combination with 5-Fluorouracil and Oxaliplatin in Patients with Metastatic Pancreatic Cancer
Authors: Pishvaian Michael J. , Wang Hongkun , He Aiwu Ruth , Hwang Jimmy J. , Smaglo Brandon G. , Kim Sunnie S. , Weinberg Benjamin A. , Weiner Louis M. , Marshall John L. , Brody Jonathan R. 
Published: July 2020

AbstractPurpose:Up to 17% of patients with pancreatic ductal adenocarcinoma (PDAC) harbor pathogenic (germline or somatic) mutations in a homologous recombination, DNA damage response and repair (HR-DDR) gene, such as BRCA1/2, or PALB2. Platinum-based chemotherapy, or treatment with PARP inhibitors are of particular benefit in these patients. However, there may be even greater benefit when platinums and PARP inhibitors are combined.Patients and Methods:We performed a single-arm, open-label, phase I/II study of the PARP inhibitor, veliparib, with 5-fluorouracil (no 5FU bolus) and oxaliplatin (FOLFOX) for patients with metastatic PDAC. Thirty-one patients were enrolled in a phase I dose escalation of veliparib (40 mg to 250 mg twice a day, days 1–7 of each 14-day cycle), to identify the recommended phase II dose (RP2D) of veliparib for the combination. Another 33 patients were enrolled in two parallel phase II trials to assess the objective response rate (ORR) in untreated or in previously treated patients. If available, germline or somatic testing was collected to identify pathogenic HR-DDR mutations.Results:The combination of veliparib and FOLFOX was tolerable at a RP2D of veliparib of 200 mg twice a day. The primary endpoint for both phase II cohorts was met, and the ORR overall was 26%. There was greater activity in platinum-naïve patients, and those who harbored a pathogenic HR-DDR mutation. Specifically, the ORR of HR-DDR mutated, platinum-naïve patients was 57%.Conclusions:The combination of veliparib and FOLFOX was safe for patients with metastatic PDAC and showed promising activity particularly in patients with platinum-naïve disease that harbors a pathogenic HR-DDR mutation.
Molecular Mechanism for Breast Cancer Incidence in the Women's Health Initiative
Authors: Jordan V. Craig 
Published: July 2020

AbstractThe Women's Health Initiative (WHI) was designed to evaluate the benefits of hormone replacement therapy. The primary goal was to establish the value of synthetic progestin and estrogen or estrogen alone to reduce the risk of coronary heart disease (CHD). The estrogen/synthetic progestin trial was stopped at 5.2 years and the estrogen trial was stopped after 6.8 years. Although the estrogen/synthetic progestin trial was stopped for the anticipated rise in the risk of breast cancer, the estrogen trial was stopped for elevation of strokes. Women taking estrogen/synthetic progestin or estrogen alone had no benefit from a reduction in CHD. Paradoxically, there was a decrease in breast cancer incidence in the estrogen trial. The decrease in breast cancer was sustained. The elevation of breast cancer in the estrogen/synthetic progestin trial was also sustained a decade after stopping treatment. Evidence is presented to explain the paradoxical sustained decrease in breast cancer with estrogen and the mechanism for the reversal of breast cancer incidence and mortality with the mixed synthetic progestin/glucocorticoid actions of the synthetic progestin used with estrogen in women with an intact uterus. The fact that the WHI study had an estrogen deprivation gap of at least 5 years, introduced an experimental biological dimension not observed in medical practice using progestin/estrogen hormone replacement. The evidence presented confirms the known human cancer biology of estrogen action.
Implementation of anti-collision train prototype based on arduino microcontroller
Authors: Ibrahim Ahmed R. , Abood Ziad M. 
Published: July 2020

<p><span>Because the electrical train become a popular mode and Eco-Friendly of transport in largest cities in the world in our day life and due to increase in the train accidents. In this paper a train collision avoidance system is designed and implemented using Arduino NANO and an ultrasonic sensor. A prototype is used to explain the system function using; two train samples on single track. The ultrasonic sensor is connected to the Arduino NANO to transmit the measured distance to the microcontroller and make the decision to stop the train. The ultrasonic sensor on both trains from the front end and continually measures the distance between them and when they reach the decided distance a signal to the trains engines will slow down or stop both trains to avoid a collision while when the ultrasonic sensors from the rear-end continually measure the distance between them and when it reaches the decided distance a signal to the train engine will slow down and stop the first train to avoid a collision.</span></p>
Intervenção motora precoce em bebês prematuros
Authors: Rosa Maria Izabel Zaniratti da , Oliveira Renata Pianezzola de , Gerzson Laís Rodrigues , Sbruzzi Graciele , Almeida Carla Skilhan de 
Published: July 2020

O desenvolvimento motor busca independência funcional através de mudanças nos sistemas corporais, possui caráter cumulativo e é influenciado por diferentes fatores, entre eles a prematuridade. Portanto, quando um bebê nasce prematuro ele necessita realizar intervenção precoce para minimizar os efeitos da prematuridade. Objetivo: Revisar sistematicamente os efeitos da intervenção motora precoce comparada ao tratamento convencional ou comparada à condição de controle sobre o desenvolvimento motor de prematuros. Método: A busca foi realizada nas bases Pubmed, PEDro, Lilacs e Cochrane, do início até julho de 2015. Utilizamos os descritores “premature”, “early intervention”, e seus sinônimos, além do filtro para ensaios clínicos randomizados. Foram incluídos ensaios clínicos randomizados com bebês prematuros que realizaram intervenção precoce comparado com tratamento convencional, grupo controle ou outro tipo de intervenção precoce, e que avaliaram o desenvolvimento motor. Resultados: Dos 970 estudos identificados, 13 foram incluídos. Seis estudos apresentaram resultados favoráveis no desenvolvimento motor no grupo intervenção, enquanto sete não apresentaram resultados significativos apesar de apresentarem melhoras no desenvolvimento motor. Conclusão: Os estudos apresentaram uma alta variabilidade metodológica, o que dificultou uma comparação entre os mesmos, visto que haviam diferentes métodos de avaliação, intervenção e frequências de tratamento. Por esse motivo, estudos como maior rigor metodológico ainda devem ser realizados para que possa haver um melhor entendimento do efeito da intervenção precoce em prematuros.
Current Historians of the World, De-Nationalhistoricize Ourselves! Reading the Writing the Nation Series in a Globalized Age
Authors: Odanaka Naoki 
Published: July 2020

Abstract
This article aims to analyze and evaluate the arguments presented in the Writing the Nation series (8 vols., ed. Stefan Berger, Christoph Conrad, and Guy Marchal [Basingstoke: Palgrave Macmillan, 2008–2015]). The main question to answer here is: In a globalized world, do we historians still need to talk about national history, that is, the practice of writing the history of nations, or should we instead seek to produce historical works suitable for the globalized world, including global histories?
Patient Factors Lead to Extensive Variation in Outcomes and Cost From Cholecystectomy
Authors: Baimas-George Maria , Kirks Russell C. , Cochran Allyson , Baker Erin H. , Lauren Paton B. , Schiffern Lynnette M. , Matthews Brent D. , Martinie John B. , Vrochides Dionisios , Iannitti David A. 
Published: July 2020

Background Cholecystectomy is a common procedure with significantly varied outcomes. We analyzed differences in comorbidities, outcomes, and cost of cholecystectomy by acute care surgery (ACS) versus hepatopancreaticobiliary (HPB) surgery. Study design Patients were retrospectively identified between 2008 and 2015. Exclusion criteria included the following: (1) part of another procedure; (2) abdominal trauma; (3) ICU admission; vasopressors. Results One hundred and twenty-six ACS and 122 HPB patients were analyzed. The HPB subset had higher burden of comorbid disease and significantly lower projected 10-year survival (87.4% ACS vs 68.5% HPB, P < .0001). Median lengths of stay were longer in HPB patients (2 vs 5 days, P < .0001) as were readmission rates (30-day 5.6% vs 13.1%, P = .040; 90-day 7.9% vs 20.5%, P = .005). Median cost was higher including operative supply cost ($969.42 vs $1920.66, P < .0001) and total cost of care ($7340.66 vs $19 338.05, P < .0001). A predictive scoring system for difficult gallbladders was constructed and a phone application was created. Conclusion Cholecystectomy in a complicated patient can be difficult with longer hospital stays and higher costs. The utilization of procedure codes to explain disparities is not sufficient. Incorporation of comorbidities needs to be addressed for planning and reimbursement.
Perceived barriers to access care, anticipated discrimination and structural vulnerability among African Americans with substance use disorders
Authors: Jegede Oluwole , Muvvala Srinivas , Katehis Emmanuel , Paul Saad , Soipe Ayorinde , Jolayemi Ayodeji 
Published: July 2020

Background: The application of the structural vulnerability construct in medicine addresses social structures as the source of health inequities. Evidence demonstrates structural vulnerability as the meta-problem that underlie health disparities faced by underrepresented minorities who are less likely to access care and face stigma for substance use disorders (SUDs). Objective: The objective of this study is to assess perceived vulnerability at the structural and interpersonal levels depicted by barriers to care, treatment-related stigma and anticipated discrimination among African Americans with SUDs. Methods: Participants were 58 consecutive African American patients receiving treatment at an acute inpatient substance use service of a teaching hospital from September to November 2019. Structural vulnerability, barriers to care and anticipated discrimination were assessed using the structural vulnerability assessment tool, Barriers to Access Care Evaluation (BACE) and the Questionnaire on Anticipated Discrimination (QUAD) surveys, respectively. Results: The total mean scores for the BACE-3, BACE-3 stigma subscale and QUAD were 1.0, 1.15 and 1.51, respectively. No statistically significant differences are found in the stigma subscale based on gender and psychiatric diagnosis ( p > .05). Furthermore, there were also no gender, age or differences based on psychiatric diagnosis across both the BACE and QUAD scales. Conclusion: Structural and interpersonal factors remain sources of vulnerability, stigma and anticipated discrimination for African Americans with SUDs and comorbid mental illness.
Vitamin D levels in children and adolescents with autism
Authors: Şengenç Esma , Kıykım Ertuğrul , Saltik Sema 
Published: July 2020

Objective This study aimed to investigate the relationship between autism spectrum disorder (ASD) and vitamin D levels in children and adolescents. Methods We measured serum 25-hydroxyvitamin D (25-OHD) levels in 1529 patients with ASD aged 3 to 18 years, without any additional chronic diseases. Levels of 25-OHD were compared according to sex, age (<11 or ≥11 years), and birth season. Additionally, laboratory parameters (calcium, phosphorus, alkaline phosphatase, and 25-OHD) of 100 selected patients with ASD were compared with those of the healthy control group. Results Vitamin D deficiency or insufficiency was found in approximately 95% of all patients. Levels of 25-OHD in adolescent patients with ASD aged 11 to 18 years were significantly lower than those in patients aged younger than 11 years. In the 100 selected patients with ASD, mean serum 25-OHD levels were significantly lower and alkaline phosphatase levels were higher compared with those in healthy children. Conclusion Our study suggests a relationship between vitamin D and ASD in children. Monitoring vitamin D levels is crucial in autistic children, especially adolescents, to take protective measures and treat this condition early.
Acute Surgical Repair of Complete, Nonavulsion Proximal Semimembranosus Injuries in Professional Athletes
Authors: Ayuob Atif , Kayani Babar , Haddad Fares S. 
Published: July 2020

Background: Nonoperative management of proximal semimembranosus injuries is associated with prolonged periods of convalescence and high risk of recurrence. To our knowledge, the outcomes of acute surgical repair for complete, nonavulsion proximal semimembranosus injuries have not been previously reported. Hypothesis: Acute surgical repair of complete, nonavulsion proximal semimembranosus injuries enables early return to sporting activity with low risk of recurrence. Study Design: Case series: Level of evidence, 4. Methods: This prospective single-surgeon study included 20 professional athletes undergoing acute primary surgical repair of complete, nonavulsion proximal semimembranosus injuries confirmed on preoperative magnetic resonance imaging. All study patients underwent a standardized postoperative rehabilitation program. Predefined outcomes were recorded at regular intervals after surgery. Mean follow-up time was 27.6 months (range, 24.0-34.6 months) from date of surgery. Results: Of the 20 patients, 19 (95%) returned to their preinjury level of sporting activity. Mean ± SD time from surgical repair to full sporting activity was 11.9 ± 5.7 weeks. No patients had recurrence of the primary injury. At 3 months after surgery, patients had improved mean passive straight leg raise (71.5° ± 5.9° vs 31.1° ± 7.2°; P < .001); increased mean isometric hamstring muscle strength at 0° (83.8% ± 5.9% vs 48.4% ± 8.3%; P < .001), 15° (77.6% ± 6.0% vs 52.3% ± 14.7%; P < .001), and 45° (88.6% ± 5.4% vs 66.7% ± 13.1%; P < .001); higher mean lower extremity functional scores (64.8 ± 4.6 vs 34.4 ± 5.1; P < .001); and improved Marx activity rating scores (10.7 ± 1.6 vs 5.5 ± 2.0; P < .001) as compared with preoperative values. High patient satisfaction and functional outcome scores were maintained at 1 and 2 years after surgery. Conclusion: Acute surgical repair of complete, nonavulsion proximal semimembranosus injuries is associated with high patient satisfaction, increased muscle strength, improved functional outcome scores, and high return to preinjury level of sporting activity with low risk of recurrence at short-term follow-up.
Impact of Pulmonary Embolism Response Team on Anticoagulation Prescribing Patterns in Patients With Acute Pulmonary Embolism
Authors: Kuhrau Shannon , Masic Dalila , Mancl Erin , Brailovsky Yevgeniy , Porcaro Katerina , Morris Stephen , Haines Jeremiah , Charo Kim , Fareed Jawed , Darki Amir 
Published: July 2020

Introduction: Anticoagulation remains the mainstay pharmacotherapy for acute pulmonary embolism (PE), but multiple treatment options exist. The Pulmonary Embolism Response Team (PERT) is a multidisciplinary group that evaluates patients, formulates evidence-based treatment plans, and mobilizes resources. The objective of this study was to characterize the anticoagulation prescribing patterns made by PERT and to determine the clinical impact of anticoagulant selection. Materials and Methods: This was a retrospective analysis of patients evaluated by PERT from 2016 to 2018. Multivariable linear regression was conducted to determine predictors of length of stay (LOS). Results: A total of 209 patients were evaluated by PERT and received anticoagulation on discharge. Of those, 47% received a non-vitamin K oral anticoagulant (NOAC), 29% received warfarin, and 23% received low-molecular-weight heparin. Patient preferences and comorbidities were the most common reasons for NOAC omission. Patients who received NOACs had a shorter median LOS than warfarin (6.1 [4.6-7.6] days vs 10.9 [8.4-13.4] days; P < .05). Selection of NOAC upon discharge was the only factor independently associated with reduced LOS (β coefficient: −0.6; 95% CI: −1.01 to −0.18; P < .01). Conclusion: The most common recommendation made by PERT was to initiate a NOAC upon discharge, resulting in shorter hospital LOS compared to patients who received warfarin.