bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract PO-229: Rural disparities in surgical care from gynecologic oncologists among Midwestern ovarian cancer patients
Authors: Weeks Kristin S. , Lynch Charles F. , West Michele , Carnahan Ryan , O'Rorke Michael , Oleson Jacob , McDonald Megan , Stewart Sherri L. ,   Ovarian Cancer Treatment Study Group, Charlton Mary 
Published: December 2020

Abstract
Objective Up to one-third of women with ovarian cancer in the United States do not receive surgical care from a gynecologic oncology specialist despite guideline recommendations. There is a critical need to investigate the contributing barriers.
We aim to investigate the impact of rurality on receiving surgical care from a specialist, referral to a specialist, and specialist surgery after referral, and the consequences of specialist care. Methods We utilized a retrospective cohort created through extension of standard state cancer surveillance in three Midwestern states. Multivariable adjusted logistic regression was utilized to assess gynecologic oncologist treatment of women 18-89 years old, who were diagnosed with primary, histologically confirmed, malignant ovarian cancer in 2010-2012 in Kansas, Missouri and Iowa by rurality. As well, factors associated with surgical care were assessed among women living in urban and rural residences at the time of cancer diagnosis.
Results Rural women were significantly less likely to receive surgical care from a gynecologic oncologist specialist (adjusted odds ratio (OR) 0.37, 95% confidence interval (CI) 0.24-0.58) and referral to a specialist (OR 0.37, 95% CI 0.23-0.59) compared to urban women. There was no significant difference in specialist surgery after a referral (OR 0.56, 95% CI 0.26-1.20). Rural women treated surgically by a gynecologic oncologist versus non-specialist were more likely to receive cytoreduction and more complete tumor removal to ≤ 1cm, but experienced a greater time from diagnosis-to-surgery (mean: 19 days versus 9 days, p value 0.022). Conclusion There is a large urban-rural difference in receipt of ovarian cancer surgery from a gynecologic oncologist specialist (versus a non-specialist). Disparities in referral rates contribute to the urban-rural difference. Further research is needed into the causes of referral disparities, as well as promising strategies to address them.
Citation Format: Kristin S. Weeks, Charles F. Lynch, Michele West, Ryan Carnahan, Michael O'Rorke, Jacob Oleson, Megan McDonald, Sherri L. Stewart, Ovarian Cancer Treatment Study Group, Mary Charlton. Rural disparities in surgical care from gynecologic oncologists among Midwestern ovarian cancer patients [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-229.
Abstract PO-267: Does primary care providers' implicit and explicit bias impact cervical cancer screening recommendations for lesbian women?
Authors: Aleshire Mollie E. , Fallin-Bennett Amanda , Rayens Mary Kay , Fallin-Bennett Keisa , Hatcher Jennifer 
Published: December 2020

Abstract
Background: Lesbian women are 25% less likely to receive cervical cancer screening than other women which contributes to lesbian women’s higher risk for cervical cancer. The purposes of this study were to measure primary care providers' (PCPs) bias toward lesbian women and to assess the association of PCPs’ implicit and explicit bias toward lesbian women with PCPs’ recommendations for cervical cancer screening in this population. Methods: In this cross-sectional study, 182 PCPs in Kentucky completed a web-based survey that included a clinical vignette, an Implicit Association Test (IAT), and explicit bias measures. PCP’s bias was analyzed descriptively. Two-sample t-tests compared bias scores between PCPs who recommended and did not recommend cervical cancer screening for a lesbian woman. Multiple linear regression determined demographic predictors of implicit and explicit bias. Results: The PCP participants average IAT score (possible score range -2.00 to +2.00) was 0.34 with positive scores indicating preferences for heterosexual women and negative scores indicating preferences for lesbian women. There was no association between IAT scores and PCPs’ cervical cancer screening recommendations for lesbian women (p = .15). PCPs who supported same sex marriage (p &lt; .001) and same-sex partners’ adoption of children (p &lt; .02) and those who were less religious (p &lt; 0.1) had significantly lower IAT scores. Characteristics such as type of PCP, age, and years in practice were not significantly associated with PCPs’ implicit and explicit bias. Conclusions: PCPs’ implicit and explicit bias was not associated with their cervical cancer screening recommendations for lesbian women in this study; however, the PCPs’ had implicit bias toward lesbian women. While not uncommon, this finding supports the need for identification of implicit bias and for implicit bias training to mitigate of PCPs’ bias toward lesbian women to prevent the potential negative effects of PCPs’ implicit bias on cervical cancer screening and other health outcomes for lesbian women.
Citation Format: Mollie E. Aleshire, Amanda Fallin-Bennett, Mary Kay Rayens, Keisa Fallin-Bennett, Jennifer Hatcher. Does primary care providers' implicit and explicit bias impact cervical cancer screening recommendations for lesbian women? [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-267.
Differential Effects of Clinically Relevant N- versus C-Terminal Truncating CDKN1A Mutations on Cisplatin Sensitivity in Bladder Cancer
Authors: Sikder Rahmat K. , Ellithi Moataz , Uzzo Robert N. , Weader David J. , Metz Alexander L. , Behbahani Ali , McKenzie Erica R. , El-Deiry Wafik S. , Abbosh Philip H. 
Published: December 2020

Abstract

Muscle-invasive bladder cancer (MIBC) frequently harbors mutations in the CDKN1A gene, which encodes the tumor suppressor protein p21, with the majority of alterations truncating the peptide. The effect of these mutations is poorly understood. We hypothesized that after DNA-damaging events, cells deficient in p21 would be unable to halt the cell cycle and efficiently repair DNA damage, thus proceeding down the apoptotic pathway. We used synthetic CRISPR guide RNAs to ablate the whole peptide (sg12, targeting the 12th amino acid) or the C-terminal proliferating cell nuclear antigen (PCNA)-binding domain (sg109) to mimic different p21-truncating mutations compared with a negative control (sgGFP) in bladder cancer cell lines. Loss of detectable p21 and a stable truncated p21 peptide were identified in sg12 and sg109 single-cell clones, respectively. We found that p21-deficient cells (sg12) were sensitized to cisplatin, while cells harboring distally truncated p21 (sg12 clones) demonstrated enhanced cisplatin resistance. p21-deficient sg12 clones demonstrated less repair of DNA-platinum adducts and increased γ-H2AX foci after cisplatin exposure, suggesting there was persistent DNA damage after p21 loss. p21-deficient sg12 clones were also unable to prevent the activation of CDK1 after DNA damage, and therefore, continued through the cell cycle, resulting in replication fork collapse, potentially explaining the observed cisplatin sensitization. sg109 clones were neither unable to sequester PCNA nor localize p21 to the nucleus after DNA damage, potentially explaining the chemoresistant phenotype. Our findings suggest that different CDKN1A truncations have different and perhaps disparate biology, and that there may be a duality of effect on cisplatin sensitivity depending on mutation context.

Implications:
Some truncating CDKN1A mutations generate a retained peptide that may have neomorphic functions and affect cisplatin sensitivity in patients with bladder cancer.
Endothelial Rap1 (Ras-Association Proximate 1) Restricts Inflammatory Signaling to Protect From the Progression of Atherosclerosis
Authors: Singh Bandana , Kosuru Ramoji , Lakshmikanthan Sribalaji , Sorci-Thomas Mary G. , Zhang David X. , Sparapani Rodney , Vasquez-Vivar Jeannette , Chrzanowska Magdalena 
Published: December 2020

Objective:
Small GTPase Rap1 (Ras-association proximate 1) is a novel, positive regulator of NO release and endothelial function with a potentially key role in mechanosensing of atheroprotective, laminar flow. Our objective was to delineate the role of Rap1 in the progression of atherosclerosis and its specific functions in the presence and absence of laminar flow, to better define its role in endothelial mechanisms contributing to plaque formation and atherogenesis.

Approach and Results:

In a mouse atherosclerosis model, endothelial Rap1B deletion exacerbates atherosclerotic plaque formation. In the thoracic aorta, where laminar shear stress–induced NO is otherwise atheroprotective, plaque area is increased in Athero-Rap1B
iΔEC
(atherogenic endothelial cell–specific, tamoxifen-inducible Rap1A+Rap1B knockout) mice. Endothelial Rap1 deficiency also leads to increased plaque size, leukocyte accumulation, and increased CAM (cell adhesion molecule) expression in atheroprone areas, whereas vascular permeability is unchanged. In endothelial cells, in the absence of protective laminar flow, Rap1 deficiency leads to an increased proinflammatory TNF-α (tumor necrosis factor alpha) signaling and increased NF-κB (nuclear factor kappa-light-chain-enhancer of activated B cells) activation and elevated inflammatory receptor expression. Interestingly, this increased signaling to NF-κB activation is corrected by AKTVIII—an inhibitor of Akt (protein kinase B) translocation to the membrane. Together, these data implicate Rap1 in restricting Akt-dependent signaling, preventing excessive cytokine receptor signaling and proinflammatory NF-κB activation.

Conclusions:
Via 2 distinct mechanisms, endothelial Rap1 protects from the atherosclerosis progression in the presence and absence of laminar flow; Rap1-stimulated NO release predominates in laminar flow, and restriction of proinflammatory signaling predominates in the absence of laminar flow. Our studies provide novel insights into the mechanisms underlying endothelial homeostasis and reveal the importance of Rap1 signaling in cardiovascular disease.
Experiences and Beliefs of Low‐Income Patients With Hypertension in Louisiana and Mississippi During the COVID‐19 Pandemic
Authors: Mills Katherine T. , Peacock Erin , Chen Jing , Zimmerman Amanda , He Hua , Cyprian Alecia , Davis Gerrelda , Fuqua Sonja R. , Gilliam Darie S. , Greer Angelique , Gray‐Winfrey Lea , Williams Shondra , Wiltz Gary M. , Winfrey Keith L. , Whelton Paul K. , Krousel‐Wood Marie , He Jiang 
Published: December 2020

Background
The coronavirus disease 2019 (COVID‐19) pandemic disproportionately affects individuals with hypertension and health disparities.

Methods and Results
We assessed the experiences and beliefs of low‐income and minority patients with hypertension during the COVID‐19 pandemic. Participants (N=587) from the IMPACTS‐BP (Implementation of Multifaceted Patient‐Centered Treatment Strategies for Intensive Blood Pressure Control) study completed a telephone survey in May and June of 2020. Participants were 65.1% Black and 59.7% female, and 57.7% reported an income below the federal poverty level. Overall, 2.7% tested positive and 15.3% had lost a family member or friend to COVID‐19. These experiences were significantly more common in Black (3.9% and 19.4%, respectively) than in non‐Black participants (0.5% and 7.8%, respectively). In addition, 14.5% lost a job and 15.9% reported food shortages during the pandemic. Most participants complied with stay‐at‐home orders (98.3%), social distancing (97.8%), and always wearing a mask outside their home (74.6%). Participants also reported high access to needed health care (94.7%) and prescription medications (97.6%). Furthermore, 95.7% of respondents reported that they continued to take their regular dosage of antihypertensive medications. Among the 44.5% of participants receiving a healthcare appointment by telehealth, 96.6% got the help they needed, and 80.8% reported that the appointment quality was as good as or better than in‐person visits. Finally, 88.9% were willing to return to their primary care clinic.

Conclusions
These data suggest that low‐income patients, especially Black patients, were negatively impacted by COVID‐19. However, most patients were able to access needed healthcare services and were willing to return to their primary care clinic for hypertension management.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03483662.
Genetic diversity and gene flow decline with elevation in the Near Eastern fire salamander (Salamandra infraimmaculata) at Mount Hermon, Golan Heights
Authors: Preißler Kathleen , Küpfer Eliane , Löffler Fabian , Hinckley Arlo , Blaustein Leon , Steinfartz Sebastian 
Published: December 2020

Abstract
The Near Eastern fire salamander (Salamandra infraimmaculata) reaches its southern distribution range in Israel. Although the population structure has been analysed in central Israel and at the southern distribution limit, we lack knowledge on populations in the northern area, such as along Mount Hermon. S. infraimmaculata occurs at Mt. Hermon along an altitudinal gradient and appears to be fragmented by urban and agricultural landscape. We studied the genetic structure of four populations based on microsatellite loci and the mitochondrial D-loop to determine the genetic diversity and connectivity between populations. We observed moderate gene flow at lower parts, i.e. from Tel Dan and Nimrod Castle to Banias indicating extant but limited connectivity. Genetic diversity and gene flow declined along the altitudinal gradient at Mt. Hermon, reaching rock-bottom levels in the highest located population of Nimrod Pool. The observed isolation-by-elevation gradient might induce a higher extinction risk for the highland populations of S. infraimmaculata.
The Authority of “Precedent” in International Adjudication: the Contentious Case of the WTO Appellate Body’s Practice
Authors: Sacerdoti Giorgio 
Published: December 2020

Abstract
One of the reasons adduced by the U.S. for paralyzing the WTO Appellate Body (AB) through the non-replacement of its outgoing members has been that the AB has developed a doctrine of binding precedent based on its previous decisions, thus allegedly departing from what had been agreed in the original negotiations. This article, based also on the author’s past experience as a member of the AB, intends to show that this criticism is groundless. The AB has not followed such a doctrine but has developed a consistent interpretation of the multilateral trade agreements in accordance with the WTO objectives of promoting stability and predictability of the system. The AB statement that past interpretation of the WTO agreements provisions should be followed by Panels “absent cogent reasons” is in line with the practice of other international courts and tribunals.
The Stellenbosch Consensus on Legal National Responses to Public Health Risks
Authors: Habibi Roojin , Hoffman Steven J. , Burci Gian Luca , de Campos Thana Cristina , Chirwa Danwood , Cinà Margherita , Dagron Stéphanie , Eccleston-Turner Mark , Forman Lisa , Gostin Lawrence O. , Meier Benjamin Mason , Negri Stefania , Ooms Gorik , Sekalala Sharifah , Taylor Allyn , Yamin Alicia Ely 
Published: December 2020

Abstract
The International Health Regulations (ihr), of which the World Health Organization is custodian, govern how countries collectively promote global health security, including prevention, detection, and response to global health emergencies such as the ongoing covid-19 pandemic. Countries are permitted to exercise their sovereignty in taking additional health measures to respond to such emergencies if these measures adhere to Article 43 of this legally binding instrument. Overbroad measures taken during recent public health emergencies of international concern, however, reveal that the provision remains inadequately understood. A shared understanding of the measures legally permitted by Article 43 is a necessary step in ensuring the fulfillment of obligations, and fostering global solidarity and resilience in the face of future pandemics. In this consensus statement, public international law scholars specializing in global health consider the legal meaning of Article 43 using the interpretive framework of the Vienna Convention on the Law of Treaties.
An Evaluation of the Performance of the Twentieth Century Reanalysis Version 3
Authors: Slivinski L. C. , Compo G. P. , Sardeshmukh P. D. , Whitaker J. S. , McColl C. , Allan R. J. , Brohan P. , Yin X. , Smith C. A. , Spencer L. J. , Vose R. S. , Rohrer M. , Conroy R. P. , Schuster D. C. , Kennedy J. J. , Ashcroft L. , Brönnimann S. , Brunet M. , Camuffo D. , Cornes R. , Cram T. A. , Domínguez-Castro F. , Freeman J. E. , Gergis J. , Hawkins E. , Jones P. D. , Kubota H. , Lee T. C. , Lorrey A. M. , Luterbacher J. , Mock C. J. , Przybylak R. K. , Pudmenzky C. , Slonosky V. C. , Tinz B. , Trewin B. , Wang X. L. , Wilkinson C. , Wood K. , Wyszyński P. 
Published: December 2020

AbstractThe performance of a new historical reanalysis, the NOAA–CIRES–DOE Twentieth Century Reanalysis version 3 (20CRv3), is evaluated via comparisons with other reanalyses and independent observations. This dataset provides global, 3-hourly estimates of the atmosphere from 1806 to 2015 by assimilating only surface pressure observations and prescribing sea surface temperature, sea ice concentration, and radiative forcings. Comparisons with independent observations, other reanalyses, and satellite products suggest that 20CRv3 can reliably produce atmospheric estimates on scales ranging from weather events to long-term climatic trends. Not only does 20CRv3 recreate a “best estimate” of the weather, including extreme events, it also provides an estimate of its confidence through the use of an ensemble. Surface pressure statistics suggest that these confidence estimates are reliable. Comparisons with independent upper-air observations in the Northern Hemisphere demonstrate that 20CRv3 has skill throughout the twentieth century. Upper-air fields from 20CRv3 in the late twentieth century and early twenty-first century correlate well with full-input reanalyses, and the correlation is predicted by the confidence fields from 20CRv3. The skill of analyzed 500-hPa geopotential heights from 20CRv3 for 1979–2015 is comparable to that of modern operational 3–4-day forecasts. Finally, 20CRv3 performs well on climate time scales. Long time series and multidecadal averages of mass, circulation, and precipitation fields agree well with modern reanalyses and station- and satellite-based products. 20CRv3 is also able to capture trends in tropospheric-layer temperatures that correlate well with independent products in the twentieth century, placing recent trends in a longer historical context.
Characteristics and Outcomes in Head and Neck Sarcomatoid Squamous Cell Carcinoma: The Cleveland Clinic Experience
Authors: Mingo Katie M. , Derakhshan Adeeb , Abdullah Neelab , Chute Deborah J. , Koyfman Shlomo A. , Lamarre Eric D. , Burkey Brian B. 
Published: December 2020

Objectives: To analyze characteristics, treatment outcomes, and prognostic factors of sarcomatoid squamous cell carcinoma of the head and neck. Study Design: Retrospective chart review. Setting: Tertiary care center. Subjects and Methods: Fifty-five patients were treated for sarcomatoid squamous cell carcinoma of the head and neck between 1996 and 2018. Data collection included clinical history, tumor characteristics, pathology, treatment modality, and outcomes. Mean follow up was 17.1 months. Cox univariate analysis was used to evaluate for associations with locoregional recurrence, distant metastasis, and overall survival. Results: Most patients were white males with a smoking history and median age 66 years (range 41-92) at diagnosis. Twenty-two percent had prior head and neck radiation. Tumor site was most frequently oral cavity (41.8%), followed by larynx (29.1%), and oropharynx (16.4%). Half presented with early T stage disease (15.5% T0, 12.7% T1, 30.9% T2) and the remainder with late stage disease (16.4% T3, 34.5% T4). Locoregional recurrence rate was 60.0%, metastatic recurrence was rate 21.8%, with median time to recurrence of 4 months and mean overall survival of 20 months. Presence of lymphovascular space invasion was statistically associated with locoregional recurrence ( P = .018, HR 3.55 [95% CI 1.24, 10.14]) and poorer overall survival ( P = .015, HR 2.92 [95% CI 1.23, 4.80]). Treatment with multimodality therapy was associated with decreased locoregional recurrence ( P = .039, HR 0.39 [95% CI 0.16, 0.95]) but did not impact overall survival. Conclusion: Sarcomatoid squamous cell carcinoma remains a rare and aggressive disease variant with high recurrence rates and high mortality. High risk features such as lymphovascular space may indicate the need for more aggressive therapy.
How citizens’ dissatisfaction with street-level bureaucrats’ exercise of discretion leads to the alternative supply of public services: the case of Israeli marriage registrars
Authors: Golan-Nadir Niva , Cohen Nissim , Rubin Aviad 
Published: December 2020

Can street-level bureaucrats’ exercise of discretion lead to clients’ dissatisfaction with policy implementation? If so, under what conditions could such disaffection lead to the alternative supply of public services? Building on Albert Hirschman’s model of exit, voice, and loyalty, this article contributes to the literature by pointing to street-level bureaucrats’ exercise of discretion as influencing citizens’ dissatisfaction with policy implementation. We identify three main elements—personal, organizational, and environmental—influencing discretion informally, causing clients’ dissatisfaction. We also point to a combination of three conditions triggering the creation of an alternative supply of services: (1) citizens’ dissatisfaction with policy implementation; (2) street-level bureaucrats’ monopoly over policy implementation because only one supplier exists; and (3) clients’ perceptions of participation channels as blocked. Using a qualitative case study approach, we test our claims by analyzing the case of Israeli marriage registrars. We demonstrate how Israeli citizens’ dissatisfaction with how government bureaucrats implement marriage regulations led to the creation of the Tzohar non-governmental organization that provides alternative marriage services. Points for practitioners In situations in which street-level bureaucrats have a monopoly over policy implementation and citizens feel they cannot exercise their voice about that implementation, their dissatisfaction with how street-level bureaucrats use their discretion in implementing the policy may eventually lead to the creation of alternative sources of public services.