bluuebunny/crossref_metadata_2025_split huggingface dataset:
Design Trade-Offs Under Power Asymmetry: COPs and Flexibility Clauses
Authors: Morin Jean-Frédéric , Tremblay-Auger Benjamin , Peacock Claire 
Published: July 2021

Abstract
Negotiating parties to an environmental agreement can manage uncertainty by including flexibility clauses, such as escape and withdrawal clauses. This article investigates a type of uncertainty so far overlooked by the literature: the uncertainty generated by the creation of a Conference of the Parties (COP) in a context of sharp power asymmetry. When negotiating an agreement, it is difficult for powerful states to make a credible commitment to weaker states, whereby they will not abuse their power to influence future COP decision-making. Flexibility clauses provide a solution to this credibility issue. They act as an insurance mechanism in case a powerful state hijacks the COP. Thus we expect that the creation of a collective body interacts with the degree of power asymmetry to make flexibility clauses more likely in environmental agreements. To test this argument, we draw on an original data set of several specific clauses in 2,090 environmental agreements, signed between 1945 and 2018. The results support our hypothesis and suggest that flexibility clauses are an important design feature of adaptive environmental agreements.
Global compound floods from precipitation and storm surge: Hazards and the roles of cyclones
Authors: Lai Yangchen , Li Jianfeng , Gu Xihui , Liu Cancan , Chen Yongqin David 
Published: July 2021

AbstractDuring simultaneous or successive occurrences of precipitation and storm surges, the interplay of the two types of extremes can exacerbate the impact to a greater extent than either of them in isolation. The compound flood hazards from precipitation and storm surges vary across regions of the world because of the various weather conditions. By analyzing in-situ observations of precipitation and storm surges across the globe, we found that the return periods of compound floods with marginal values exceeding the 98.5th percentile (i.e., equivalent to a joint return period of 12 years if the marginal variables are independent) are < 2 years in most areas, while those in northern Europe are > 8 years due to weaker dependence. Our quantitative assessment shows that cyclones (i.e., tropical cyclones (TCs) and extratropical cyclones (ETCs)) are the major triggers of compound floods. More than 80% of compound floods in East Asia and > 50% of those in the Gulf of Mexico and northern Australia are associated with TCs, while in northern Europe and the higher latitude coast of North America, ETCs contribute to the majority of compound floods (i.e., 80%). Weather patterns characterized by deep low pressure, cyclonic wind, and abundant precipitable water content are conducive to the occurrence of compound floods. Extreme precipitation and extreme storm surges over Europe tend to occur in different months, which explains the relatively lower probability of compound floods in Europe. The comprehensive hazard assessment of global compound floods in this study serves as an important reference for flood risk management in coastal regions across the globe.
Surgical Treatment for Intrahepatic, Peri-Hilar, and Distal Cholangiocarcinoma: 20-Single Institutional Year Experience
Authors: Istanbouli Ayah , Patel Shreya , Almerey Tariq , Li Zhuo , Stauffer John A. 
Published: July 2021

Background Surgical resection is the curative treatment for all subtypes of cholangiocarcinoma (CCA), including intrahepatic, hilar/peri-hilar, and distal. This study evaluates patients with CCA who underwent surgery and determines factors that impact their survival. Methods A retrospective cohort study was performed for patients who underwent surgical resection for CCA at our institution from 1995 to 2016. Demographics, operative variables between CCA tumors, and postoperative complications were analyzed. Predictors of overall and recurrence-free survival were determined via statistical analysis. Results A total of 170 patients with a mean age of 61 years old underwent surgical resection of intrahepatic (n = 64, 37.6%), hilar/peri-hilar (n = 75, 44.1%), and distal (n = 31, 18.2%) CCA. Operations performed included liver resections (n = 83, 48.8%), liver transplants (n = 56, 32.9%), and pancreaticoduodenectomies (n = 31, 18.2%). The overall survival rate at 1, 5, and 10 years was 81.1%, 32.4%, and 17.2%, respectively. Low pathological stage and negative resection margins were associated with lower recurrence and higher survival rates. Tumor location and the type of operation performed were not predictive of recurrence or OS in this cohort. Discussion This study shows that definitive surgical resection with negative margins can result in long-term survival even at 10 years. Small tumor size and low pathological stage are predictive of higher survival rates post-surgery, emphasizing the importance of early diagnosis and appropriate surgical treatment in achieving positive outcomes.
Comparison of Narrowband Imaging and White‐Light Endoscopy for Diagnosis and Screening of Nasopharyngeal Cancer
Authors: Kim Do Hyun , Lee Min Hyeong , Lee Seulah , Kim Sung Won , Hwang Se Hwan 
Published: July 2021

ObjectivesWe compared the diagnostic accuracies of narrowband imaging and white‐light endoscopy in the detection of nasopharyngeal cancer.Data SourcesSix databases (PubMed, Cochrane Database, Embase, Web of Science, SCOPUS, and Google Scholar).Review MethodsThe 6 databases were thoroughly reviewed by 2 authors (working independently) from their dates of inception to December 2019. Nasopharyngeal mucosal or vascular changes detected by narrowband imaging were compared to those detected by white‐light endoscopy. The authors extracted true‐positive, true‐negative, false‐positive, and false‐negative parameters for each study. Methodological quality was evaluated using the Quality Assessment of Diagnostic Accuracy Studies version 2 tool. The extent of interrater agreement was assessed.ResultsEighteen prospective or retrospective studies were included. The diagnostic odds ratio of narrowband imaging was 77.560 (95% confidence interval [CI], 37.424‐160.739). The area under the summary receiver operating characteristic curve was 0.926. The sensitivity, specificity, and negative predictive value were 0.871 (95% CI, 0.808‐0.915), 0.905 (95% CI, 0.816‐0.953), and 0.955 (95% CI, 0.906‐0.979), respectively. The correlation between sensitivity and the false‐positive rate was 0.284, indicating that heterogeneity was absent. Narrowband imaging exhibited moderate interrater reliability (0.7037; 95% CI, 0.6558‐0.746). Subgroup analysis showed that vascular patterns revealed by endoscopy in a screened subgroup were significantly more diagnostically accurate than mucosal patterns used for surveillance of a recurrent cancer subgroup.ConclusionsNarrowband imaging exhibits high diagnostic accuracy and should be used in the diagnostic workup of nasopharyngeal cancer. However, further studies are necessary to confirm our results.
National Analysis of Oropharyngeal Salivary Gland Malignancies Treated With Transoral Robotic Surgery
Authors: Bollig Craig A. , Wang Kevin , Llerena Pablo , Puram Sidharth V. , Pipkorn Patrik J. , Jackson Ryan S. , Stubbs Vanessa C. 
Published: July 2021

Objectives(1) To compare perioperative outcomes and overall survival of patients with oropharyngeal salivary gland malignancies (OPSGMs) treated with transoral robotic surgery (TORS) versus other approaches. (2) To identify clinical factors associated with a robotic surgical approach.Study DesignRetrospective analysis of the National Cancer Database (NCDB).SettingNCDB.MethodsData obtained from the NCDB were analyzed between 2010 and 2017 for patients with T1‐T4a OPSGMs without distant metastases treated surgically. Patients were stratified by surgical approach (TORS vs nonrobotic), and clinicopathologic factors were compared with the t test or chi‐square test for continuous or categorical variables, respectively. Overall survival was analyzed by patient demographics and clinical factors according to Kaplan‐Meier and Cox proportional hazards models. Factors associated with TORS were assessed with logistic regression.ResultsA total of 785 patients were analyzed. A non–soft palate primary site (odds ratio, 12.9; 95% CI, 6.6‐25.2) and treatment at an academic facility (odds ratio, 2.0; 95% CI, 1.2‐3.5) were independently associated with TORS. There were no significant differences in the positive margin rate, 30‐day mortality, or overall survival between the groups. The 30‐day unplanned readmission rate was higher in patients treated with TORS versus nonrobotic resections (5.8% vs 1.7%, P =. 0004). When stratified by tumor subsite, there was a significant decrease in hospital length of stay in patients with tongue base tumors undergoing TORS versus nonrobotic resections (P =. 029).ConclusionThis study suggests that TORS may be a viable treatment modality for appropriately selected patients with OPSGM.
Glutathione S-transferase Omega 2 DD genotype is associated with an increased risk of sporadic amyotrophic lateral sclerosis in Chinese men
Authors: Fan Zhiliang , Jiang Hong , Song Xueqin , Guo Yansu , Tian Xinying 
Published: July 2021

Objective To investigate whether GSTA1, GSTO2, and GSTZ1 are relevant to an increased risk of amyotrophic lateral sclerosis (ALS) in a Chinese population. Methods In this study, 143 sporadic ALS (sALS) patients (83 men, 60 women) and 210 age- and sex-matched healthy subjects were enrolled. Blood samples were collected by venipuncture. Genomic DNA was isolated by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) according to the manufacturer’s instructions. The potential associations between ALS and GSTA1, GSTO2, and GSTZ1 polymorphisms were estimated using chi-squared analysis and unconditional logistic regression. Results The D allele and genotype frequencies of GSTO2 were increased in sALS patients compared with healthy subjects, indicating that the GSTO2 DD genotype was associated with an increased risk of sALS (odds ratio [OR] = 3.294, 95% confidence interval [CI] = 1.039–10.448). However, a significant association between the DD genotype and the risk of sALS was evident in men only (OR = 7.167, 95% CI = 1.381–37.202). Conclusion This study revealed that the D allele and genotype frequencies of GSTO2 were increased in sALS patients. The GSTO2 DD genotype was associated with an increased risk of sALS in men in a Chinese population.
Diagnosis and treatment of sexually transmitted infections in male partners of pregnant women in Brazil
Authors: Yeganeh Nava , Kreitchmann Regis , Leng Mei , Nielsen-Saines Karin , Gorbach Pamina M , Klausner Jeffrey D 
Published: July 2021

Sexually transmitted infections (STIs) can adversely affect a woman’s pregnancy and the health of the developing fetus. The source of these infections may be the male sexual partner who remains under-diagnosed and un-treated due to a combination of lack of symptoms, decreased access to health care, and poor health-seeking behaviors. From September 2018 to November 2019, we offered a cohort of pregnant women (gestational age range: 4.6–41 weeks) clinic-based STI testing for HIV and syphilis (via lateral flow assay rapid tests) and for Neisseria (N.) gonorrhoeae, Chlamydia (C.) trachomatis, and Trichomonas (T.) vaginalis (via PCR-based testing) at Santa Casa Hospital and 10 affiliated prenatal clinics in Porto Alegre, Brazil. 400 women between the ages of 18 and 46 years (mean age: 27 years) enrolled and 24% were diagnosed with an STI. Each woman enrolled agreed to invite their male partners to clinic for the same panel of STI testing, and 255 men (64%) between the ages of 18 and 64 years (mean age: 29 years) attended clinic and all accepted full intervention. In these male partners, 40 (16%) were diagnosed with an STI including 22 (8.7%) testing positive for C. trachomatis, 15 (6%) for treponemal antibody (syphilis), 7 (2.8%) for T. vaginalis, 3 (1.2%) for N. gonorrhoeae, and 1 (0.4%) for HIV antibody. In our multivariate analysis, having symptoms of an STI (AOR 4.5, 95% CI 1.3–15.2) and arguing about jealousy (AOR 3.1, 95% CI 1.2–8.2) remained significantly associated with male diagnosis of an STI. Sexually transmitted infections are common in sexual partners of pregnant women in Brazil and should be addressed to prevent reinfection of pregnant women.
Does hydroxychloroquine improve patient reported outcomes in patients with lupus?
Authors: Jolly Meenakshi , Sehgal Vinay , Arora Shilpa , Azizoddin Desiree , Pinto Benzeeta , Sharma Aman , Devilliers Herve , Inoue Mitsuyo , Toloza Sergio , Bertoli Ana , Blazevic Ivana , Vilá Luis M , Moldovan Ioana , Torralba Karina D , Mazzoni Davide , Cicognani Elvira , Hasni Sarfaraz , Goker Berna , Haznedaroglu Seminur , Bourre-Tessier Josiane , Navarra Sandra V , Clarke Ann , Weisman Michael , Wallace Daniel , Mok Chi Chiu 
Published: July 2021

Background Hydroxychloroquine (HCQ) use is associated with less disease activity, flares, damage and improved survival in Systemic Lupus Erythematosus (SLE). However, its effect on patient reported health outcomes (PROs) such as quality of life (QOL) is not known. Methods International data from Study on Outcomes of Lupus (SOUL) from 2,161 SLE patients were compared by HCQ use. Disease activity and damage were assessed using SELENA-SLEDAI and SLICC-ACR/SDI. QOL was evaluated using LupusPRO and Lupus Impact Tracker (LIT). Linear regression analyses were performed with LupusPRO summary scores health related HRQOL, non-health related NHRQOL and LIT as dependent and HCQ use as independent variable. Analyses were undertaken to test mediation of effects of HCQ use on QOL through disease activity. Results Mean age was 40.5 ± 12.8 years, 93% were women. Sixty-three (1363/2161) percent were on HCQ. On univariate analysis, HCQ use was associated with (a) better QOL (LupusPRO-HRQOL: β 6.19, 95% CI 4.15, 8.24, P ≤ 0.001, LupusPRO NHRQOL: β 5.83, 95% CI 4.02, 7.64, P ≤ 0.001) and less impact on daily life (LIT: β −9.37, 95% CI −12.24, −6.50, P ≤ 0.001). On multivariate and mediational analyses, the effects of HCQ on QOL were indirectly and completely mediated through disease activity. Conclusions HCQ use in SLE is associated with better patient reported health outcomes (LupusPRO-HRQOL and NHRQOL and impact on daily life), and the effects are mediated through disease activity. This information can facilitate patients and physician’s communication with decision-making regarding the use of HCQ for SLE management.
What Proportion of Foster Care Children Do Not Have Child Protective Services Reports? A Preliminary Look
Authors: Drake Brett , Fluke John D. , Kim Hyunil , Orsi Rebecca , Stubblefield Jessica L. 
Published: July 2021

It is perhaps surprising that we lack complete national information about why children enter foster care. While the annual Adoption and Foster Care Analysis Reporting System (AFCARS) report is informative, it leaves many questions unanswered, particularly “how many children enter foster care by means other than Child Protective Services (CPS) reports?” Drawing from a unique new integrated dataset, we examined foster care data (AFCARS) and CPS report data (National Child Abuse and Neglect Data System Child File). The linked dataset included 210,062 children with foster care placements in 2017 and no placements in the prior 5 years. We categorized each placed child along two dimensions of four levels each: Time since prior CPS report (if any) and stated AFCARS placement reason, ranging from clearly maltreated to clearly not maltreated. We also tracked the siblings of placed children, to see if non-maltreated children entered care because of maltreated siblings. We find that between 8–35% of children enter foster care for reasons other than maltreatment, depending how thresholds are set. These numbers decline somewhat when siblings are considered. A meaningfully large number of children are placed in foster care for reasons other than maltreatment investigated by CPS. Further research into these children is warranted to better inform foster care policy.
Impact of radioiodine treatment on acute phase proteins in hyperthyroid cats
Authors: Glück Katharina , Mohrs Sabrina , Hazuchova Katarina , Bauer Natali , Neiger Reto 
Published: July 2021

Objectives The aim of this study was to investigate the impact of radioiodine treatment (RIT) on the acute phase proteins (APPs) serum amyloid A (SAA), alpha-1-acid glycoprotein (AGP) and haptoglobin (Hp) in hyperthyroid cats. Methods Between June 2013 and November 2014, 33 hyperthyroid cats without clinical or laboratory signs of inflammatory or neoplastic disease and a body weight >2.5 kg were enrolled. Immediately before, and 12, 36, 72 h and 6 days after RIT, serum samples were obtained for determination of APP concentrations. Results Both SAA and AGP concentrations changed significantly after RIT. The concentration of AGP increased gradually after treatment with a maximum concentration at the end of the study period (median baseline 398 μg/ml; median 6 days post-RIT 562 μg/ml [ P = 0.001]). A relevant >two-fold increase in AGP was seen in 8/33 (24%) cats. SAA concentration increased significantly within 12 h (baseline 9.2 μg/ml; 12 h post-RIT 22.5 μg/ml [ P = 0.012]). In 7/33 (21%) cats, a clinically relevant >10-fold increase in SAA was observed. Hp concentration showed no significant change ( P = 0.12). Conclusions and relevance RIT induced a mild, mainly not clinically relevant acute phase reaction (APR). AGP and SAA were useful APPs to determine RIT-induced APR.
Choroidal structural changes and choroidal vascularity index in patients with systemic hypertension
Authors: Aşıkgarip Nazife , Temel Emine , Kıvrak Ahmet , Örnek Kemal 
Published: July 2021

Purpose: To assess the impact of systemic hypertension on the choroidal structure and choroidal vascularity index (CVI). Methods: This prospective cross-sectional study comprised 50 eyes of 50 treatment-naive hypertensive patients and 50 eyes of 50 healthy subjects. Choroidal thickness (CT) was measured in the subfoveal region, 1500 µm nasal to the fovea, and 1500 µm temporal to the fovea. Binarization of the enhanced depth-optical coherence tomography images was performed with Image-J software. The CT, choroidal area (CA), luminal area (LA), and CVI were compared statistically. Results: The mean subfoveal, nasal, and temporal CT were decreased in the patient group (p 0.003, 0.026, and 0.001, respectively). The mean CA, LA, and CVI were decreased in the patient group in comparison to controls ( p = 0.047, 0.009, and 0.016 respectively). The correlation between the subfoveal CT and systolic blood pressure was significant ( r = −0.450, p < 0.001). There was a significant correlation between the systolic blood pressure and CVI ( r = −0.401, p < 0.001). Conclusion: The significant decrease in the structural parameters and CVI show that choroid is affected in patients with treatment-naive hypertension.
Isolated medial rectus muscle laceration after bird strike
Authors: Duranoğlu Yaşar , Beğendi Diğdem 
Published: July 2021

Introduction: A 66 year-old male suffered globe trauma due to A bird, a German Desert Hawk, strike. At the first examination in the emergency ünit a few hours after the injury, the patient reported persistent horizontal diplopia. Case report: He had right conjunctival laceration, mild proptosis, subconjunctival hematoma, exotropia with no adduction. Magnetic Resonance Imaging (MRI) revealed that it was suggestive of laceration of the right medial rectus muscle, at about the junction of it’s anterior and middle thirds. During surgery; initially, the lacerated proximal end of the distal segment was isolated. The proximal segment of the medial rectus muscle was then carefully dissected. The two lacerated ends were then joined with 6-0 polyglactin sutures. Conclusion: The day after surgery, there was no deviation and diplopia in all diagnostic gaze positions.
Impact of femtosecond laser-assisted in situ keratomileusis on retinal ganglion cell function
Authors: Lauzirika Gorka , Arranz-Marquez Esther , Garcia-Gonzalez Montserrat , Hernández-Verdejo José Luis , Teus Miguel A. 
Published: July 2021

Purpose: To analyse the effect of femtosecond laser-assisted in situ keratomileusis (FS-LASIK) on the electrical response of retinal ganglion cells using pattern electroretinography (pERG). Methods: This was a longitudinal, prospective, observational pilot study. We included consecutive myopic patients who underwent FS-LASIK to correct up to 6 dioptres of myopia and up to 2 dioptres of astigmatism. Patients with excessive blinking or tearing and those with Snellen uncorrected visual acuity less than 0.9 dec on postop day 1 were excluded. Diopsys NOVA® (Diopsys Inc., NJ) pERG records, using high- and low-contrast patterns, were obtained 16 h and 1 month after FS-LASIK was performed. Magnitude (μV), Magnitude D (μV), Magnitude D/Magnitude ratio and signal-to-noise ratio (dB) were analysed. Wilcoxon test for nonparametric paired data was employed. Results: pERG data from 24 eyes were analysed from 24 patients who underwent FS-LASIK. Mean age was 35.79 ± 9.86 years. Mean preoperative refraction was −2.69 ± 7.6 D (spherical) and −0.38 ± 0.40 D (cylinder). Mean surgical time was 56.88 ± 7.6 s. No statistically significant differences were obtained for any of the studied parameters when comparing 16 h with 1 month after FS-LASIK, with the exception of Magnitude with low contrast, which increased from 1.21 ± 0.2 to 1.39 ± 0.29 µV at 16 h and 1 month postoperatively, respectively ( p = 0.03). Conclusions: FS-LASIK seems to induce a mild and transitory defect in retinal ganglion cell function. Only a mild decrease was detected in the magnitude value for low-contrast stimuli when pERG was performed 16 h postoperatively, and it returned to normal 1 month after surgery.
The safe zones for endoscopic proximal hamstring repair: a cadaveric assessment of standard portal placement and their relationship to major neurovascular structures
Authors: Su Charles A , LaBelle Mark W , Ina Jason G , Sivasundaram Lakshmanan , Nho Shane , Mather Richard C , Salata Michael J 
Published: July 2021

Purpose: To define the anatomical relationship of the major neurovascular structures to the standard endoscopic portals used in endoscopic hamstring repair. A secondary outcome was to determine the safest angle of insertion from each standard portal. Methods: Endoscopic portals were established in the 3 standard locations (lateral, medial, and inferior) and Steinmann pins inserted at various angles. Each hip was dissected and the distance between the pins and the pertinent anatomy measured. Results: The lateral portal placed the sciatic and posterior femoral cutaneous (PFC) nerves at greatest risk: direct injury to the sciatic nerve was seen in 11/30 (37%) of the lateral portals sited. A lateral portal with an approach at 60° was the most dangerous orientation with a mean distance of 0.36 ± 0.49 mm and 4.30 ± 2.69 mm from the sciatic and PFC nerves, respectively ( p < 0.001). The 60° medial portal was the safest of all portals measured, at a mean distance of 67.37 ± 11.06mm (range, 47–78 mm) from the sciatic nerve and 58.90 ± 10.57 mm (range 40–70 mm) from the PFC nerve. Conclusions: While currently described techniques recommend establishing the standard lateral portal first, this study shows that it carries the highest risk of injury if used blind. We recommend that the standard medial endoscopic portal is established first to identify the neurovascular structures and minimise iatrogenic neurovascular injury. The inferior and lateral portals can then be established created under direct vision. The lateral portal should be inserted in a more horizontal orientation to decrease the risk of nerve injury.