bluuebunny/crossref_metadata_2025_split huggingface dataset:
ACL Injuries Aren’t Just for Girls: The Role of Age in Predicting Pediatric ACL Injury
Authors: Bloom David A. , Wolfert Adam J. , Michalowitz Andrew , Jazrawi Laith M. , Carter Cordelia W. 
Published: August 2020

Background: Female athletes have a higher rate of anterior cruciate ligament (ACL) injuries than male athletes; however, the role of age in mediating this injury risk has not been explored. The purpose of this study was to characterize the relationship between age and sex in predicting ACL injury in the pediatric population. Hypothesis: Prepubescent boys are more likely to sustain an ACL injury than prepubescent girls. Study Design: Descriptive epidemiological study. Level of Evidence: Level 4. Methods: Data were collected from the Statewide Planning and Research Cooperative System database for the state of New York from 1996 to 2016. The database was queried for patients aged ≤19 years who had been diagnosed with an ACL tear using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code 844.2 or the ICD-10 (10th Revision) codes S83.512A/S83.511A/S83.519A. Patient age and sex at time of ACL injury diagnosis were recorded. Chi-square analysis was used to compare the frequency of ACL injury between groups, with statistical significance set at P < 0.05. Results: A total of 20,128 patients aged ≤19 years were diagnosed with an ACL tear (10,830 males, 9298 females; male:female, 1.16:1). In all, 129 patients aged <12 years sustained an ACL tear (85 boys, 44 girls; male:female, 1.93:1), and 19,999 of those patients were aged 12 to 19 years (10,745 males, 9254 females; male:female, 1.16:1). Chi-square analysis demonstrated a significant relationship between sex and age group ( P < 0.006). Additional analysis revealed that female athletes were most at risk for ACL injury from ages 12 to 16 years, with 4025 male and 5095 female athletes sustaining ACL injuries in this group (male:female, 1:1.27; P < 0.0001). Conclusion: Prepubescent boys (aged <12 years) are more likely to sustain an ACL injury than same-aged female peers. Clinical Relevance: This study demonstrates that the risk of ACL injury varies with age and sex throughout childhood and adolescence, further guiding treatment and prevention for these pediatric athletes.
Cumulative Trauma Disorders
Authors: Frederick Linda J. 
Published: August 2020

Data from individual studies and worksites indicate that CTDs are a major problem in some industries. Evidence exists for an association between symptoms of CTDs and occupational risk factors such as forceful exertion, repetitiveness, and extreme postures. Although the pathogenesis of these disorders is not known, they are believed to involve physiological and mechanical responses of soft tissues to repeated or sustained biomechanical stress. The efficacy of ergonomic interventions or programs must be evaluated using the same methods as used to identify problems initially. User (worker) feedback about any job or tool redesigns is essential. Implementing ergonomic interventions likely will be an ongoing, iterative process. The ability of the occupational health nurse to carry out basic nursing functions of health promotion and prevention of injury and illness will be enhanced through the application of the ergonomic principles.
On-Site Occupational Health Nursing Services
Authors: Davidson Gestur , Widtfeldt Anne , Bey Jean 
Published: August 2020

This article has described a quantitative assessment model that was developed to provide useful information to a large corporation about the benefits and costs of an on-site occupational health nursing program. The number and complex nature of the effects of such programs both complicate this task and necessarily restrict the comprehensiveness of its assessment. The model focuses on estimating the net cost savings arising from the direct substitution of on-site for off-site occupational health nursing services. Part II of this article discussed applications of this quantitative assessment model that could be useful to management decision making; identifying assumptions, interpretations, and limitations of the model and illustrating approaches for reducing these limitations. The on-site provision of occupational health nursing services clearly continues to be an issue of interest to large corporations concerned with cost-containment, productivity, and employee relations. While the model and approaches described here are restricted to measurable, short term benefits, the careful measurement of these benefits and costs can usefully inform management decision making until more comprehensive, longer term assessment models can be empirically implemented.
Developing Health Service Staff
Authors: Wachs Joy E. 
Published: August 2020

Professional nurses frequently view continuing education and staff development narrowly, as in the form of an annual offsite seminar. Staff development is a year around, planned program, adequately funded and creatively administered. Development needs can be identified during annual performance appraisals and strategies to meet the needs written into a formal plan. These strategies might include a variety of educational and vocational opportunities within the organization and in the community. An effective development program should lead to more staff with a wider repertoire of skills and a new vision of their role and responsibility. The nurse manager should see these changes reflected in a more effective and efficient health service and in personal accolades from the organization.
Health and Safety Hazards Associated with Farming
Authors: Ehlers Janet K. , Connon Catherine , Themann Christa L. , Myers John R. , Ballard Tern 
Published: August 2020

Farming is a hazardous occupation with a unique combination of exposures and psychosocial factors that often vary with the type of operation. Some hazards are unique to farming; others are common in industry. Many who farm also work at other jobs. Even for non-agricultural companies, farm related illnesses and injuries can be costly in terms of lost work time, medical insurance, and life insurance. According to a former U.S Surgeon General, “Because of agriculture's diversity and geographic distribution, we must depend on local action to deal practically with the problem” (Novello, 1991). Occupational health nurses in both agricultural and non-agricultural industries can play an important role in local action to protect their workers, neighbors, friends, and families.
Job Stress and Occupational Health Nursing
Authors: Crawford Susan Lee 
Published: August 2020

Job stress is a condition or event in the workplace that induces strain (a physical, psychological, or behavioral response to a stressor). The outcome of unrelieved job stress can be burnout, characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment. Identification and treatment of job stress falls into four conceptual models: medical, clinical/ counseling psychology, engineering psychology, and organizational psychology. Occupational health nurses can experience job stress in the areas of intrinsic job factors, organizational structures, reward systems, human resource systems, and leadership. Because occupational health nurses promote stress reduction strategies in worker populations, modeling these behaviors is important to enhance the credibility of those promoting such strategies.
Drug Testing for Current Employees
Authors: Morris Judy A. 
Published: August 2020

Occupational health nurses who assist in the development of substance abuse testing policies for current employees should thoughtfully examine the issues of who is to be tested, when they are to be tested, which test methodology is to be used, and how the confidentiality of the individual's health status will be maintained. Will certain employees be tested routinely at the time of health examinations? Will employees be tested only for cause? Is the cause to be only when impairment becomes visible or job performance is compromised? Will employees be tested after an accident occurs? Which accidents? Which test method will be used—one that measures current impairment or one that measures lifestyle? Resolving ethical dilemmas requires that one be cognizant of personal values, use critical reflection, and apply ethical principles. One can then make appropriate decisions in the context of the legal and moral climate of society, the culture of the workplace, and the individual rights and civil liberties of employees.
The development of ruxolitinib for glucocorticoid-refractory acute graft-versus-host disease
Authors: Zeiser Robert , Socié Gérard 
Published: August 2020

AbstractAcute graft-versus-host disease (aGVHD) is a life-threatening complication after allogeneic hematopoietic cell transplantation (allo-HCT). Despite the use of prophylactic immunosuppression including calcineurin inhibitors, antimetabolites, antithymocyte globulin, or posttransplant cyclophosphamide, patients still develop severe aGVHD. In particular, patients with glucocorticoid-refractory GVHD (SR-GVHD) have a dismal prognosis with a low 1-year post–allo-HCT survival rate. Most classical drugs used to prevent or treat aGVHD target 1 specific pathway such as calcineurin inhibitors or mammalian target of rapamycin inhibitors, or they interfere with fast-dividing activated cells (eg, methotrexate, mycophenolate, and cyclophosphamide). In contrast to these drugs, inhibition-of-signaling molecules, used by multiple immune cells and critical for signal transduction of multiple proinflammatory cytokines, could be more efficacious at blocking GVHD. Ruxolitinib blocks Janus kinases 1 and 2, which are required to mediate the downstream signaling of multiple cytokine receptors. Recently, a multicenter phase 3 clinical trial showed that ruxolitinib led to significant improvements in efficacy outcomes compared to best available therapy, which will lead to a paradigm shift in the treatment of SR-GVHD.
The burden of exacerbations in mild asthma: a systematic review
Authors: FitzGerald J. Mark , Barnes Peter J. , Chipps Bradley E. , Jenkins Christine R. , O'Byrne Paul M. , Pavord Ian D. , Reddel Helen K. 
Published: August 2020

BackgroundAlthough most patients with asthma have mild disease, data on how mild asthma is defined, and how frequently exacerbations occur in this patient population are scarce, so we aimed to redress this.MethodsWe searched Medline and Medline In-Process (PubMed), and Embase in OVID for English-language publications containing “mild asthma” plus at least one relevant therapy and outcome/keyword, limited to randomised controlled trials (RCTs) and observational studies published between January 1990 and February 2019. Publications were filtered to ensure appropriate data extraction. The main outcomes were the definitions of mild asthma and exacerbations, baseline exacerbation rates and exacerbation data for placebo recipients in prospective studies. Meta-analysis of exacerbation rates was planned.FindingsOf 4064 articles identified, 64 were included in our review (49 743 subjects); 54 RCTs and 10 observational/other studies. Six main types of definitions of mild asthma were identified. While care was taken to ensure inclusion only of patients with mild asthma, marked heterogeneity was revealed in the definitions of mild asthma and hence the study populations. Reporting of exacerbations also varied widely between studies, precluding meta-analysis. Between 0–22% of patients were hospitalised for asthma or had a severe exacerbation in the previous year, according to baseline data from prospective studies. In RCTs, severe exacerbation rates in placebo recipients taking only short-acting β2-agonist therapy ranged from 0.20–2.88 per year.ConclusionsThese data provide new evidence of the burden of exacerbations in mild asthma and highlight the need for standardised definitions of mild asthma and of exacerbations to progress further research.
Sex chromosome and sex locus characterization in goldfish, Carassius auratus (Linnaeus, 1758)
Authors: Wen Ming , Feron Romain , Pan Qiaowei , Guguin Justine , Jouanno Elodie , Herpin Amaury , Klopp Christophe , Cabau Cedric , Zahm Margot , Parrinello Hugues , Journot Laurent , Burgess Shawn M. , Omori Yoshihiro , Postlethwait John H. , Schartl Manfred , Guiguen Yann 
Published: August 2020

AbstractBackgroundGoldfish is an important model for various areas of research, including neural development and behavior and a species of significant importance in aquaculture, especially as an ornamental species. It has a male heterogametic (XX/XY) sex determination system that relies on both genetic and environmental factors, with high temperatures being able to produce female-to-male sex reversal. Little, however, is currently known on the molecular basis of genetic sex determination in this important cyprinid model. Here we used sequencing approaches to better characterize sex determination and sex-chromosomes in an experimental strain of goldfish.ResultsOur results confirmed that sex determination in goldfish is a mix of environmental and genetic factors and that its sex determination system is male heterogametic (XX/XY). Using reduced representation (RAD-seq) and whole genome (pool-seq) approaches, we characterized sex-linked polymorphisms and developed male specific genetic markers. These male specific markers were used to distinguish sex-reversed XX neomales from XY males and to demonstrate that XX female-to-male sex reversal could even occur at a relatively low rearing temperature (18 °C), for which sex reversal has been previously shown to be close to zero. We also characterized a relatively large non-recombining region (~ 11.7 Mb) on goldfish linkage group 22 (LG22) that contained a high-density of male-biased genetic polymorphisms. This large LG22 region harbors 373 genes, including a single candidate as a potential master sex gene, i.e., the anti-Mullerian hormone gene (amh). However, no sex-linked polymorphisms were detected in the coding DNA sequence of the goldfishamhgene.ConclusionsThese results show that our goldfish strain has a relatively large sex locus on LG22, which is likely the Y chromosome of this experimental population. The presence of a few XX males even at low temperature also suggests that other environmental factors in addition to temperature could trigger female-to-male sex reversal. Finally, we also developed sex-linked genetic markers, which will be important tools for future research on sex determination in our experimental goldfish population. However, additional work would be needed to explore whether this sex locus is conserved in other populations of goldfish.
Joint analysis of duration of ventilation, length of intensive care, and mortality of COVID-19 patients: a multistate approach
Authors: Hazard Derek , Kaier Klaus , von Cube Maja , Grodd Marlon , Bugiera Lars , Lambert Jerome , Wolkewitz Martin 
Published: August 2020

AbstractBackgroundThe clinical progress of patients hospitalized due to COVID-19 is often associated with severe pneumonia which may require intensive care, invasive ventilation, or extracorporeal membrane oxygenation (ECMO). The length of intensive care and the duration of these supportive therapies are clinically relevant outcomes. From the statistical perspective, these quantities are challenging to estimate due to episodes being time-dependent and potentially multiple, as well as being determined by the competing, terminal events of discharge alive and death.MethodsWe used multistate models to study COVID-19 patients’ time-dependent progress and provide a statistical framework to estimate hazard rates and transition probabilities. These estimates can then be used to quantify average sojourn times of clinically important states such as intensive care and invasive ventilation. We have made two real data sets of COVID-19 patients (n = 24* andn = 53**) and the corresponding statistical code publically available.ResultsThe expected lengths of intensive care unit (ICU) stay at day 28 for the two cohorts were 15.05* and 19.62** days, while expected durations of mechanical ventilation were 7.97* and 9.85** days. Predicted mortality stood at 51%* and 15%**. Patients mechanically ventilated at the start of the example studies had a longer expected duration of ventilation (12.25*, 14.57** days) compared to patients non-ventilated (4.34*, 1.41** days) after 28 days. Furthermore, initially ventilated patients had a higher risk of death (54%* and 20%** vs. 48%* and 6%**) after 4 weeks. These results are further illustrated in stacked probability plots for the two groups from time zero, as well as for the entire cohort which depicts the predicted proportions of the patients in each state over follow-up.ConclusionsThe multistate approach gives important insights into the progress of COVID-19 patients in terms of ventilation duration, length of ICU stay, and mortality. In addition to avoiding frequent pitfalls in survival analysis, the methodology enables active cases to be analyzed by allowing for censoring. The stacked probability plots provide extensive information in a concise manner that can be easily conveyed to decision makers regarding healthcare capacities. Furthermore, clear comparisons can be made among different baseline characteristics.
Mycoplasma and Ureaplasma carriage in pregnant women: the prevalence of transmission from mother to newborn
Authors: Peretz Avi , Tameri Oran , Azrad Maya , Barak Shay , Perlitz Yuri , Dahoud Wadie Abu , Ben-Ami Moshe , Kushnir Amir 
Published: August 2020

Abstract
Background
Mycoplasma and Ureaplasma have been extensively studied for their possible impact on pregnancy, and their involvement in newborn diseases. This work examined Mycoplasma and Ureaplasma carriage among gravidas women and newborns in Israel, as well as associations between carriage and demographic characteristics, risk factors, pregnancy outcomes, and newborn morbidity rates.

Methods
A total of 214 gravidas women were examined for vaginal pathogen carriage through standard culture and polymerase chain reaction assay. Pharyngeal swabs were collected from newborns of carrier mothers. Clinical and demographic data were collected and infected newborn mortality was monitored for 6 months.

Results
Nineteen mothers were carriers, with highest prevalence among younger women. Pathogen carriage rates were 2.32% for Mycoplasma genitalium (Mg), 4.19% for Ureaplasma parvum (Up) and 2.32% for Ureaplasma urealyticum (Uu). Arab ethnicity was a statistically significant risk factor (p = 0.002). A higher prevalence was seen among women residing in cities as compared to villages. Thirteen (68%) newborns born to carrier mothers were carriers as well, with a higher prevalence among newborns of women delivering for the first time, compared to women that had delivered before. Infection rates among newborns were 20% for Mg (p = 0.238), 100% for Up (p < 0.01), and 28.5% for Uu (p = 0.058), with more male than female newborns being infected. No association was found between maternal carriage and newborn morbidity.

Conclusions
Maternal Mycoplasma or Ureaplasma carriage may be associated with ethnicity and settlement type. Further studies will be needed to identify factors underlying these associations and their implications on delivery.
Neutrophil to lymphocyte ratio, not platelet to lymphocyte or lymphocyte to monocyte ratio, is predictive of patient survival after resection of early-stage pancreatic ductal adenocarcinoma
Authors: Pointer David T. , Roife David , Powers Benjamin D. , Murimwa Gilbert , Elessawy Sameh , Thompson Zachary J. , Schell Michael J. , Hodul Pamela J. , Pimiento Jose M. , Fleming Jason B. , Malafa Mokenge P. 
Published: August 2020

Abstract
Background
NLR, PLR, and LMR have been associated with pancreatic ductal adenocarcinoma (PDAC) survival. Prognostic value and optimal cutpoints were evaluated to identify underlying significance in surgical PDAC patients.

Methods
NLR, PLR, and LMR preoperative values were available for 277 PDAC patients who underwent resection between 2007 and 2015. OS, RFS, and survival probability estimates were calculated by univariate, multivariable, and Kaplan-Meier analyses. Continuous and dichotomized ratio analysis determined best-fit cutpoints and assessed ratio components to determine primary drivers.

Results
Elevated NLR and PLR and decreased LMR represented 14%, 50%, and 50% of the cohort, respectively. OS (P = .002) and RFS (P = .003) were significantly decreased in resected PDAC patients with NLR ≥5 compared to those with NLR < 5. Optimal prognostic OS and RFS cutpoints for NLR, PLR, and LMR were 4.8, 192.6, and 1.7, respectively. Lymphocytes alone were the primary prognostic driver of NLR, demonstrating identical survival to NLR.

Conclusions
NLR is a significant predictor of OS and RFS, with lymphocytes alone as its primary driver; we identified optimal cutpoints that may direct future investigation of their prognostic value. This study contributes to the growing evidence of immune system influence on outcomes in early-stage pancreatic cancer.
Relationship between internet addiction and sleep disturbance in high school students: a cross-sectional study
Authors: Tokiya Mikiko , Itani Osamu , Otsuka Yuichiro , Kaneita Yoshitaka 
Published: August 2020

AbstractBackgroundThe increase in the number of Internet users has increased Internet dependence worldwide. In adolescents, this dependence may interfere with sleep, which is important for the development of psychophysiological capabilities. However, few large-scale surveys have described the relationship between Internet addiction (IA) and sleep disturbance using standardized questionnaires. We conducted a survey in one prefecture in Japan to determine the relationship between sleep disturbance and IA in adolescents based on the categories of the Young Diagnostic Questionnaire (YDQ).MethodsIn 2016, high school students (N = 10,405, age range: 15–16 years) in all 54 daytime high schools in the selected prefecture were surveyed using a self-administered questionnaire. Participants with scores > 5.5 points on the Japanese version of the Pittsburgh Sleep Quality Index were defined as having a sleep disturbance. IA was evaluated using the YDQ: Participants with five to eight YDQ items present were classified as having IA; those with three or four items present were classified as “at risk of IA”; and those with two or less YDQ items were classified as “non-IA”. Multiple logistic regression analysis was performed with sleep disturbance as the dependent variable, IA as the explanatory variable, and adjustments for eight other variables.ResultsHigh YDQ scores were associated with a high prevalence of sleep disturbance in boys and girls. These findings persisted after controlling for other factors in the multiple regression model.ConclusionsAmong Japanese adolescents, there was a significant independent relationship between IA and sleep disturbance.