bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breast Cancer Population Attributable Risk Proportions Associated with Body Mass Index and Breast Density by Race/Ethnicity and Menopausal Status
Authors: Bissell Michael C.S. , Kerlikowske Karla , Sprague Brian L. , Tice Jeffery A. , Gard Charlotte C. , Tossas Katherine Y. , Rauscher Garth H. , Trentham-Dietz Amy , Henderson Louise M. , Onega Tracy , Keegan Theresa H.M. , Miglioretti Diana L. 
Published: July 2020

Abstract

Background:
Overweight/obesity and dense breasts are strong breast cancer risk factors whose prevalences vary by race/ethnicity. The breast cancer population attributable risk proportions (PARP) explained by these factors across racial/ethnic groups are unknown.

Methods:
We analyzed data collected from 3,786,802 mammography examinations (1,071,653 women) in the Breast Cancer Surveillance Consortium, associated with 21,253 invasive breast cancers during a median of 5.2 years follow-up. HRs for body mass index (BMI) and breast density, adjusted for age and registry were estimated using separate Cox regression models by race/ethnicity (White, Black, Hispanic, Asian) and menopausal status. HRs were combined with observed risk-factor proportions to calculate PARPs for shifting overweight/obese to normal BMI and shifting heterogeneously/extremely dense to scattered fibroglandular densities.

Results:
The prevalences and HRs for overweight/obesity and heterogeneously/extremely dense breasts varied across races/ethnicities and menopausal status. BMI PARPs were larger for postmenopausal versus premenopausal women (12.0%–28.3% vs. 1.0%–9.9%) and nearly double among postmenopausal Black women (28.3%) than other races/ethnicities (12.0%–15.4%). Breast density PARPs were larger for premenopausal versus postmenopausal women (23.9%–35.0% vs. 13.0%–16.7%) and lower among premenopausal Black women (23.9%) than other races/ethnicities (30.4%–35.0%). Postmenopausal density PARPs were similar across races/ethnicities (13.0%–16.7%).

Conclusions:
Overweight/obesity and dense breasts account for large proportions of breast cancers in White, Black, Hispanic, and Asian women despite large differences in risk-factor distributions.

Impact:
Risk prediction models should consider how race/ethnicity interacts with BMI and breast density. Efforts to reduce BMI could have a large impact on breast cancer risk reduction, particularly among postmenopausal Black women.
Head and Neck Cancer Survival Disparities by Race and Rural–Urban Context
Authors: Clarke Jacob A. , Despotis Alyssa M. , Ramirez Ricardo J. , Zevallos Jose P. , Mazul Angela L. 
Published: July 2020

Abstract

Background:
This study aims to examine the relationship between race and rural–urban context in head and neck cancer (HNC) survival and determine factors that potentially drive this disparity.

Methods:
Using the National Cancer Database from 2004 to 2015, we identified a retrospective cohort of 146,256 patients with HNC. Kaplan–Meier survival curves and the Cox proportional hazards regression were used to calculate adjusted HRs.

Results:
Median survival by patient subgroup was as follows: White urban [67 months; 95% confidence interval (CI), 66.0–67.9], White rural (59.1 months; 95% CI, 57.2–60), Black urban (43.1 months; 95% CI, 41.1–44.5), and Black rural (35.1 months; 95% CI, 31.9–39.0). The difference in 5-year survival, stratified by rural–urban context, was greater among Black patients [Δ restricted mean survival time (ΔRMST) 0.18; 95% CI, 0.10–0.27] than White patients (ΔRMST 0.08; 95% CI, 0.06–0.11). In the univariate Cox proportional hazards analysis with White urban patients as reference group, Black rural patients had the worst survival (HR, 1.45; 95% CI, 1.43–1.48; P &lt; 0.001), followed by Black urban patients (HR, 1.29; 95% CI, 1.28–1.30; P &lt; 0.001), and White rural patients (HR, 1.08; 95% CI, 1.07–1.09; P &lt; 0.001). This disparity persisted when controlling for demographic, socioeconomic, and clinical factors.

Conclusions:
Black patients with HNC, specifically those living in rural areas, have decreased survival. Survival differences by rural–urban status are greater among Black patients than White patients.

Impact:
We have shown that race and rural–urban status impact HNC survival outcomes. Our findings will help future researchers to better frame approaches to address this disparity.
Little spatial and temporal segregation between coexisting lionfishes (Pterois miles and Pterois radiata) in the Red Sea
Authors: Gavriel Tal , Belmaker Jonathan 
Published: July 2020

Abstract
Spatial and temporal niche partitioning are common strategies to reduce competition between closely related species. While spatial partitioning is widely studied, temporal partitioning, especially in marine environments, is much less documented. The lionfish Pterois miles is common in the Red Sea and have recently established populations within the Mediterranean Sea. However, to date, the sympatric and closely related Pterois radiata has yet to become established outside its native range. In this study, we focus on describing spatio-temporal patterns of activity in P. miles and P. radiata within their native range. This may help understand their coexistence mechanisms and whether the presence of one species can influence the probability of the other species to become established. We used visual surveys across day and night to assess activity patterns and the tendency of the species to co-occur. We found that while P. miles is a flexible crepuscular, P. radiata is strictly nocturnal. However, we detected only slight spatio-temporal segregation between the species. Hence, the coexistence of these two species may not be related to habitat or temporal partitioning. However, we do find a more generalist behavior of P. miles in terms of activity duration, which adds to its known broad diet and habitat use patterns, and may jointly explain its introduction success.
The Tropical Pacific ENSO–Mean State Relationship in Climate Models over the Last Millennium
Authors: Wyman D. Allie , Conroy Jessica. L. , Karamperidou Christina 
Published: July 2020

AbstractENSO and the mean zonal sea surface temperature gradient (dSST) of the tropical Pacific are important drivers of global climate and vary on decadal to centennial time scales. However, the relationship between dSST and ENSO cannot be assessed with the short instrumental record, and is uncertain in proxy data, with intervals of both stronger and weaker ENSO postulated to occur with overall strong dSST in the past. Here we assess the ENSO–dSST relationship during the last millennium using general circulation models (GCMs) participating in phase 3 of the Paleoclimate Modeling Intercomparison Project. Last millennium GCM simulations show diversity in the strength and direction of the ENSO–dSST relationship. Yet, the models that best simulate modern tropical Pacific climate frequently have a more negative ENSO–dSST correlation. Thus, last millennium tropical Pacific climate simulations support the likelihood of enhanced ENSO during decadal to centennial periods of reduced tropical Pacific dSST. However, the alternating directional ENSO–dSST relationship in all model simulations suggests that this relationship is not constant through time and is likely controlled by multiple mechanisms.
A Technique to Minimize Aerosolization During Percutaneous Tracheostomy in COVID-19 Patients
Authors: Betancourt-Ramirez Alejandro , Yelon Jay A. , Boland Paul , Amaturo Michael 
Published: July 2020

Background The SARS-CoV-2 pandemic has caused respiratory failure in many patients. With no effective treatment or vaccine, prolonged mechanical ventilation is common in survivors. Timing and performance of tracheostomy, for both patient and surgical team safety, remains a question. Here within, we report our experience with percutaneous dilatational tracheostomy with modification to minimize aerosolization. Methods A modified percutaneous dilatational tracheostomy technique is described. The technique was performed on 10 patients in the surgical intensive care unit. Results Ten patients underwent percutaneous dilatational tracheostomy. There were 7 males, and the average age for the group was 60.8 years. The average number of ventilator days before the operation was 26.3. All procedures were successful, and no patient had any procedure-related complications. Conclusions The procedure described was successful in our patient population. We believe that this approach is safe for patients with coronavirus disease 2019 and limits aerosolization during the operation. Level of evidence Level IV, case series.
Adaptations of a Tertiary Otorhinolaryngology Head and Neck Surgery Department in Singapore during the COVID-19 Outbreak
Authors: See Anna , Go Lih Khuang , Teo Constance E. H. , Teo Neville Wei Yang , Toh Song Tar 
Published: July 2020

Purpose: The novel coronavirus 2019 (COVID-19) outbreak which was first reported in Wuhan, China has been declared a pandemic by the World Health Organization on March 11, 2020. Otorhinolaryngologists deal intimately with pathologies of the head and neck region and upper respiratory tract and have been reported as a vulnerable group of healthcare workers who may be more susceptible to COVID-19 nosocomial infection. Methods: In this article, we provide a comprehensive overview of the adaptations of Singapore’s largest tertiary Otorhinolaryngology department during the COVID-19 outbreak. This was undertaken via an evidence-based approach. The relevant medical literature and evidence underlying our adaptations are highlighted. Results: A four-pronged strategy including (1) personnel segregation, (2) triaging and decantment, (3) use of personal protective equipment and (4) changes in clinical practice was employed. The strategy was bolstered by drawing upon a collective learnt experience from the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak. Conclusion: A rigorous framework which can preserve operationality while navigating the heightened risks during this outbreak is critical for every Otorhinolaryngology department. As the pandemic continues to evolve and more scientific reports of this disease are made available, approaches will need to be morphed.
Religiosity as a predictor of mental health in Egyptian teenagers in preparatory and secondary school
Authors: Abdel-Khalek Ahmed M , Korayem Adel Shokry , Lester David 
Published: July 2020

Background: There have been few studies of religiosity in adolescents and even fewer in Muslim cultures. Aims: The present study investigated the associations of religiosity with subjective well-being (WB, and mental and physical health) using samples of Egyptian children and adolescents. Method: Samples of Egyptian preparatory school children and secondary school children were administered questions concerning religiosity, mental and physical health and satisfaction with life. Results: In study 1, boys obtained significantly higher mean scores than girls did on the self-rating scales of religiosity, mental health, physical health and satisfaction with life. In study 2, boys obtained significantly higher mean scores on the Arabic Scale of Mental Health and the self-rating scales of physical health and happiness. All the Pearson correlation coefficients between religiosity, WB and health were significant and positive in both studies. Predictors of mental health differed for boys and girls, but religiosity played a significant role in the prediction of mental health for the younger boys and for the older girls. Conclusion: Religion plays an important role in the lives of the present two samples of Egyptian adolescents
Computed tomography angiography as an adjunct to computational fluid dynamics for prediction of oxygenator thrombus formation
Authors: Conway Robert G , Zhang Jiafeng , Jeudy Jean , Evans Charles , Li Tieluo , Wu Zhongjun Jon , Griffith Bartley P 
Published: July 2020

Introduction: Extracorporeal membrane oxygenation circuit performance can be compromised by oxygenator thrombosis. Stagnant blood flow in the oxygenator can increase the risk of thrombus formation. To minimize thrombogenic potential, computational fluid dynamics is frequently applied for identification of stagnant flow conditions. We investigate the use of computed tomography angiography to identify flow patterns associated with thrombus formation. Methods: A computed tomography angiography was performed on a Quadrox D oxygenator, and video densitometric parameters associated with flow stagnation were measured from the acquired videos. Computational fluid dynamics analysis of the same oxygenator was performed to establish computational fluid dynamics–based flow characteristics. Forty-one Quadrox D oxygenators were sectioned following completion of clinical use. Section images were analyzed with software to determine oxygenator clot burden. Linear regression was used to correlate clot burden to computed tomography angiography and computational fluid dynamics–based flow characteristics. Results: Clot burden from the explanted oxygenators demonstrated a well-defined pattern, with the largest clot burden at the corner opposite the blood inlet and outlet. The regression model predicted clot burden by region of interest as a function of time to first opacification on computed tomography angiography (R2 = 0.55). The explanted oxygenator clot burden map agreed well with the computed tomography angiography predicted clot burden map. The computational fluid dynamics parameter of residence time, when summed in the Z-direction, was partially predictive of clot burden (R2 = 0.35). Conclusion: In the studied oxygenator, clot burden follows a pattern consistent with clinical observations. Computed tomography angiography–based flow analysis provides a useful adjunct to computational fluid dynamics–based flow analysis in understanding oxygenator thrombus formation.
Factors associated with long-term survival in patients with stroke after coronary artery bypass grafting
Authors: Wagner Brandie D. , Grunwald Gary K. , Hossein Almassi G. , Li Xinli , Grover Frederick L. , Shroyer A. Laurie W. 
Published: July 2020

Objective Occurrence of a stroke within 30 days following coronary artery bypass grafting (CABG) is an uncommon, but often devastating, complication. This study aimed to identify factors associated with long-term survival (beyond 30 days) in patients with stroke after CABG. Methods De-identified patients’ records from the Veterans Affairs Surgical Quality Improvement Program database were used to identify risk factors and perioperative complications associated with survival for up to 20 years in patients with post-CABG stroke. The multivariable Cox proportional hazards model was used for analyzing survival. Results The median survival time for patients with stroke (n = 1422) was 6.7 years. The mortality rate for these patients was highest in the first year post-CABG and was significantly elevated compared with non-stroke patients. Survival rates at 1, 5, and 10 years for stroke versus non-stroke patients were 79% vs. 96%, 58% vs. 83%, and 36% vs. 63%, respectively. High preoperative serum creatinine levels, postoperative occurrence of renal failure, prolonged ventilation, coma, and reoperation for bleeding were important predictors of 1-year mortality of patients with post-CABG stroke. Conclusions Veterans with post-CABG stroke have a considerably higher risk for mortality during the first year compared with patients without stroke.
Vitamin D levels in patients with non-Hodgkin lymphoma/diffuse large B-cell lymphoma, chronic lymphocytic leukemia and multiple myeloma
Authors: Graklanov Vasko , Popov Veselin 
Published: July 2020

Purpose To investigate serum vitamin D levels in patients newly diagnosed with non-Hodgkin lymphoma/diffuse large B-cell lymphoma (NHL-DLBCL), multiple myeloma (MM) and chronic lymphocytic leukemia (CLL). Patients and methods We measured serum levels of vitamin D by ELISA in 103 patients prior to initiation of treatment, of whom 37 were diagnosed with MM, 32 with CLL and 34 with NHL-DLBCL. Results Suboptimal serum vitamin D levels (<30 ng/mL) were observed in all 103 patients. In 14 patients, serum vitamin D levels were between 20 and 30 ng/mL, while all other patients had vitamin D deficiency (<20 ng/mL). Severe vitamin D deficiency (<10 ng/mL) was observed in 32.3% of NHL-DLBCL patients, 28.1% of CLL patients and 81% of MM patients. Conclusion We observed low serum vitamin D levels in the majority of patients newly diagnosed with NHL-DLBCL, CLL and MM.
Non-invasive vagus nerve stimulation for primary headache: A clinical update
Authors: Silberstein Stephen D , Yuan Hsiangkuo , Najib Umer , Ailani Jessica , Morais Andreia Lopes de , Mathew Paul G , Liebler Eric , Tassorelli Cristina , Diener Hans-Christoph 
Published: July 2020

Background Non-invasive vagus nerve stimulation (nVNS) is a proven treatment for cluster headache and migraine. Several possible mechanisms of action by which nVNS mitigates headache have been identified. Methods We conducted a narrative review of recent scientific and clinical research into nVNS for headache, including findings from mechanistic studies and their possible relationships to the clinical effects of nVNS. Results Findings from animal and human studies have provided possible mechanistic explanations for nVNS efficacy in headache involving four core areas: Autonomic nervous system functions; cortical spreading depression inhibition; neurotransmitter regulation; and nociceptive modulation. We discuss how overlap and interplay among these areas may underlie the utility of nVNS in the context of clinical evidence supporting its safety and efficacy as acute and preventive therapy for both cluster headache and migraine. Possible future nVNS applications are also discussed. Conclusion Significant progress over the past several years has yielded valuable mechanistic and clinical evidence that, combined with the excellent safety and tolerability profile of nVNS, suggests that it should be considered a first-line treatment for both acute and preventive treatment of cluster headache, an effective option for acute treatment of migraine, and a highly relevant, practical option for migraine prevention.
Googling migraine: A study of Google as an information resource of migraine management
Authors: Bojazar Rachid , Do Thien Phu , Hansen Jakob Møller , Dodick David W , Ashina Messoud 
Published: July 2020

Introduction Health information is one of the most frequently searched topics on the internet. In this observational cross-sectional study, we evaluated the content of the highest indexed Google search results related to migraine management. Methods We identified the five most used search terms related to migraine management via Google Trends in the time period 1 January 2004 to 2 October 2019. We entered each search term into Google’s search engine and retrieved the search results from the first three pages from each search query. We stratified the recommended treatment options and evaluated the websites using the DISCERN tool. Results In total, 73 unique websites recommended a total of 77 different migraine treatment options, consisting of 35 (45%) acute and 42 (55%) preventive treatments. For acute treatments, pharmacological options were more frequently recommended (88% of websites), whereas non-pharmacological options were more frequent among preventive treatments (67%). Evaluation of the consumer health information using the DISCERN tool showed that non-governmental organizations had the highest mean total score with 3.8 (±0.19). Conclusions Googling when looking for migraine treatments reveals a multitude of management proposals of varying quality. Non-governmental organizations provide the overall highest quality of written consumer health information on migraine treatments among search results. We encourage stakeholders to optimize and distribute high-quality and peer-reviewed information on migraine management.
Evaluation of a Pharmacy Service to Lower BMI Prior to Total Joint Arthroplasty
Authors: Chaplin Michelle DeGeeter , Boland Cassie L. , Custer Buzz , Gillette Chris 
Published: July 2020

Background: Total joint arthroplasty (TJA) postsurgical complications are increased in patients with a body mass index (BMI) greater than 30 kg/m2. Reducing BMI prior to surgery can be complicated and it is important to find effective methods to achieve weight loss goals prior to surgery. Pharmacy services have proven to be effective models for weight loss in prior studies and may be an avenue for achieving BMI reduction prior to TJA surgeries. Objective: The purpose of this study was to examine the benefit of pharmacist-driven interventions in an ambulatory care setting to achieve weight loss goals prior to TJA orthopedic surgeries. Methods: A retrospective chart review was conducted on patients referred from an orthopedic surgeon’s office to a clinical pharmacist service providing chronic disease state management. Patients were referred based on need to decrease BMI prior to TJA orthopedic surgeries. Visits included evaluations of medications, education on weight loss management techniques, including therapeutic lifestyle changes, and recommendations for weight loss medications. Results: There was a statistically significant difference in post-BMI when compared with pre-BMI ( P = .007). Of 16 subjects who had complete pre- and post-BMI measurements, 4 (25%) subjects met their BMI goal. There was a statistically significant relationship between the number of appointments and difference in BMI (ρ = −0.71, P = .002). Conclusion: Pharmacists may be utilized in a collaborative health care model in the ambulatory care setting to assist patients with lifestyle or medication management to achieve weight loss prior to orthopedic surgeries.
Data Linkage: Cleft Live-Birth Prevalence and Hospitalizations in Western Australia: 1980 to 2016
Authors: Nicholls Wendy , Harper Craig , Robinson Suzanne 
Published: July 2020

Objective: To provide information on live-birth prevalence and hospitalizations, including anxiety and depression, for cleft lip and/or palate (CL/P) in Western Australia (WA), using live-birth data 1980 to 2015. Design: Retrospective data linkage. Setting: Tertiary hospital. Patients: Cleft cohort consisted of people live-born with CL/P in WA between 1980 and 2015, and a gender and age-matched control group. Measures: Live-birth prevalence for CL/P by year. Hospital event counts, event ages, and length of stay (LOS) days by 18 diagnosis groups and 4 birth year categories between the cleft cohort and control group, and between cleft types. Count of events per alive persons per calendar year, and relative risk for proportions of persons in the cleft cohort and control group by diagnosis group. Results: Live-birth prevalence for CL/P was 19.7 per 10 000 (1 in 522). The cleft cohort had significantly higher event counts, lower event ages, and higher LOS days than the control group. Cleft lip and palate had significantly higher event counts, lower event ages, and higher LOS days than cleft lip or cleft palate only. There were 2 significant differences for anxiety or depression between the cleft cohort and control group, lower event ages, and higher LOS days in 1990s birth year category. Conclusions: This study provides a cleft data reference for WA. Live-birth prevalence for all clefts and by cleft type offers an appropriate method for estimating service utilization and provision. Patients with cleft accessed hospital services more frequently, at an earlier age, with higher LOS days than the control group.