bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract PO020: Approval for the proliferative marker Ki-67 as an integrated biomarker for endometrial cancer in NRG study GY011
Authors: Samuelson Megan I. , Filiaci Virginia , Carrick Kelley , KD Anand Rajan , Rodgers William H. , Thiel Kristina W. , Duska Linda R. , Leslie Kimberly K. 
Published: February 2021

Abstract
Introduction: NRG Study GY011 is a surgical window trial of medroxy-progesterone acetate (MPA) +/- entinostat (E), a histone deacetylase inhibitor hypothesized to upregulate PR levels through epigenetic modifications. The principal goal of this trial was to determine the impact of treatment on the level as well as the activity of progesterone receptors (PR) in women with endometrial cancer. However, a reliable marker for PR activity was needed, and the most promising choice was Ki-67. To be approved for inclusion in the study as an integrated biomarker, Ki-67 had to first undergo rigorous evaluation by the participating pathologists with oversight by the NIH Biomarker Review Committee. Methods: Fifty patients were enrolled on GY011, and specimen collection was planned by biopsy prior to receiving study drugs and by tissue sample at the time of the hysterectomy. There were 42 pre-drug administration specimens with tumor for analysis and 1 without and 43 hysterectomy specimens with tumor. Ki-67 immunohistochemistry performed on pre and post drug specimens was evaluated by three experienced reviewers (MS, KC and AR) using a qualitative approach, blinded to treatment arm. Pre and post-drug samples for each individual patient were compared and scored as increased, decreased, or unchanged. The Fleiss kappa statistic was chosen as the measure of concordance as it allows for more than two reviewers and more than two categories. Percent agreement and standard weighted kappa statistics were calculated for individual pairs of reviewers. Results: There was very good concordance between reviewers using the qualitative comparison of post to pre-drug Ki-67 staining with Fleiss’ Kappa of 0.91 and weighted Kappa’s ranging between 0.85 and 0.95. Reviewers 1 and 2 had the highest level of concordance. Reviewer agreement ranged from 0.92 to 0.98. The reviewer-specific (marginal) score distributions were similar. Each reviewer scored about 80% (79.5%-82.5%) of pairs as decreasing, with the remainder split similarly between no change (7.5%-10%) and increasing (10%-12.8%). Conclusion: Based upon the high concordance between reviewers, the NIH Biomarker Review Committee approved Ki-67 as an integrated biomarker for GY011, setting the stage for its use as an approved biomarker of therapeutic effectiveness in future endometrial cancer trials.
Citation Format: Megan I. Samuelson, Virginia Filiaci, Kelley Carrick, Anand Rajan KD, William H. Rodgers, Kristina W. Thiel, Linda R. Duska, Kimberly K. Leslie. Approval for the proliferative marker Ki-67 as an integrated biomarker for endometrial cancer in NRG study GY011 [abstract]. In: Proceedings of the AACR Virtual Special Conference: Endometrial Cancer: New Biology Driving Research and Treatment; 2020 Nov 9-10. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(3_Suppl):Abstract nr PO020.
Cancer-related Beliefs and Preventive Health Practices among Residents of Rural versus Urban Counties in Alabama
Authors: Aly Salma , Daniel Casey L. , Bae Sejong , Scarinci Isabel C. , Hardy Claudia M. , Fouad Mona N. , Baskin Monica L. , Hoenemeyer Teri , Acemgil Aras , Demark-Wahnefried Wendy 
Published: February 2021

Abstract
Higher prevalence of cancer-related risk factors, for example, tobacco use, obesity, poor diet, and physical inactivity, is observed in the U.S. Deep South and likely contributes to its increased cancer burden. While this region is largely rural, it is unknown whether cancer-related beliefs and lifestyle practices differ by rural–urban status or are more influenced by other factors. We contacted 5,633 Alabamians to complete a cross-sectional survey to discern cancer-related beliefs and lifestyle practices, and compared data from respondents residing in rural- versus urban-designated counties. Findings were summarized using descriptive statistics; rural–urban subgroups were compared using two-tailed, χ2 and t tests. Multivariable logistic regression models were used to explore associations by rural–urban status and other sociodemographic factors. Surveys were completed by 671 rural- and 183 urban-county respondents (15.2% response rate). Overall, the prevalence for overweight and obesity (77.8%) and sugar-sweetened beverage intake (273–364 calories/day) was higher than national levels. Most respondents (58%) endorsed raising the state tobacco tax. Respondents from rural- versus urban-designated counties were significantly more likely to be racial/ethnic minority, have lower education, employment, income, food security, and internet access, and endorse fatalistic cancer-related beliefs (&lt;0.05; although regression models suggested that cancer belief differences are more strongly associated with education than counties of residence). Lifestyle practices were similar among rural–urban subgroups. Few rural–urban differences in cancer-related beliefs and lifestyle practices were found among survey respondents, although the high overall prevalence of fatalistic health beliefs and suboptimal lifestyle behaviors suggests a need for statewide cancer prevention campaigns and policies, including increased tobacco taxation.
Prevention Relevance: Cancer incidence and mortality are higher in the U.S. Deep South, likely due to increased tobacco-use, obesity, poor diet, and physical inactivity. This study explores whether cancer-related beliefs and lifestyle practices differ by rural-urban status or other sociodemographic factors in a random sample of 855 residents across Alabama.
Artificial Intelligence–Enabled Assessment of the Heart Rate Corrected QT Interval Using a Mobile Electrocardiogram Device
Authors: Giudicessi John R. , Schram Matthew , Bos J. Martijn , Galloway Conner D. , Shreibati Jacqueline B. , Johnson Patrick W. , Carter Rickey E. , Disrud Levi W. , Kleiman Robert , Attia Zachi I. , Noseworthy Peter A. , Friedman Paul A. , Albert David E. , Ackerman Michael J. 
Published: February 2021

Background:
Heart rate–corrected QT interval (QTc) prolongation, whether secondary to drugs, genetics including congenital long QT syndrome, and/or systemic diseases including SARS-CoV-2–mediated coronavirus disease 2019 (COVID-19), can predispose to ventricular arrhythmias and sudden cardiac death. Currently, QTc assessment and monitoring relies largely on 12-lead electrocardiography. As such, we sought to train and validate an artificial intelligence (AI)–enabled 12-lead ECG algorithm to determine the QTc, and then prospectively test this algorithm on tracings acquired from a mobile ECG (mECG) device in a population enriched for repolarization abnormalities.

Methods:
Using >1.6 million 12-lead ECGs from 538 200 patients, a deep neural network (DNN) was derived (patients for training, n = 250 767; patients for testing, n = 107 920) and validated (n = 179 513 patients) to predict the QTc using cardiologist-overread QTc values as the “gold standard”. The ability of this DNN to detect clinically-relevant QTc prolongation (eg, QTc ≥500 ms) was then tested prospectively on 686 patients with genetic heart disease (50% with long QT syndrome) with QTc values obtained from both a 12-lead ECG and a prototype mECG device equivalent to the commercially-available AliveCor KardiaMobile 6L.

Results:
In the validation sample, strong agreement was observed between human over-read and DNN-predicted QTc values (−1.76±23.14 ms). Similarly, within the prospective, genetic heart disease–enriched dataset, the difference between DNN-predicted QTc values derived from mECG tracings and those annotated from 12-lead ECGs by a QT expert (−0.45±24.73 ms) and a commercial core ECG laboratory [10.52±25.64 ms] was nominal. When applied to mECG tracings, the DNN’s ability to detect a QTc value ≥500 ms yielded an area under the curve, sensitivity, and specificity of 0.97, 80.0%, and 94.4%, respectively.

Conclusions:
Using smartphone-enabled electrodes, an AI DNN can predict accurately the QTc of a standard 12-lead ECG. QTc estimation from an AI-enabled mECG device may provide a cost-effective means of screening for both acquired and congenital long QT syndrome in a variety of clinical settings where standard 12-lead electrocardiography is not accessible or cost-effective.
Satellite-Based Regionalization of Solar Irradiation in Vietnam by k-Means Clustering
Authors: Thanh Nga Pham Thi , Ha Pham Thanh , Hang Vu Thanh 
Published: February 2021

AbstractThis study presents the application of k-means clustering to satellite-based solar irradiation in different regions of Vietnam. The solar irradiation products derived from the Himawari-8 satellite, named AMATERASS by the solar radiation consortium under the Japan Science and Technology Agency (JST), are validated with observations recorded at five stations in the period from October 2017 to September 2018 before their use for clustering. High correlations among them enable the use of satellite-based daily global horizontal irradiation for spatial variability analysis and regionalization. With respect to the climate regime in Vietnam, the defined 6-cluster groups demonstrate better agreement with the conventionally classified seven climatic zones rather than the four climatic zones of the Köppen classification. The spatial distribution and seasonal variation in the regionalized solar irradiation reflect interchangeable influences of large-scale atmospheric circulation in terms of the East Asian winter monsoon and the South Asian summer monsoon as well as the effect of local topography. Higher daily averaged solar radiation and its weaker seasonal variation were found in two clusters in the southern region where the South Asian summer monsoon dominates in the rainy season. Pronounced seasonal variability in solar irradiation in four clusters in the northern region is associated with the influence of the East Asian monsoon, resulting in its clear reduction during the winter months.
The Role of Vegetation in Flash Drought Occurrence: A Sensitivity Study Using Community Earth System Model, Version 2
Authors: Chen Liang , Ford Trent W. , Yadav Priyanka 
Published: February 2021

AbstractFlash droughts are noted by their unusually rapid rate of onset or intensification, which makes it difficult to anticipate and prepare for them, thus resulting in severe impacts. Although the development of flash drought can be associated with certain atmospheric conditions, vegetation also plays a role in propagating flash drought. This study examines the climatology of warm season (March–September) flash drought occurrence in the United States between 1979 and 2014, and quantifies the possible impacts of vegetation on flash drought based on a set of sensitivity experiments using the Community Earth System Model, version 2 (CESM2). With atmospheric nudging, CESM2 well captures historical flash drought. Compared with NASA’s Modern-Era Retrospective Analysis for Research and Applications, version 2 (MERRA-2), and National Climate Assessment–Land Data Assimilation System (NCA-LDAS), CESM2 shows agreement on the high flash drought frequency in the Great Plains and southeastern United States, but overestimates flash drought occurrence in the Midwest. The vegetation sensitivity experiments suggest that vegetation greening can significantly increase the flash drought frequency in the Great Plains and the western United States during the warm seasons through enhanced evapotranspiration. However, flash drought occurrence is not significantly affected by vegetation phenology in the eastern United States and Midwest due to weak land–atmosphere coupling. In response to vegetation greening, the extent of flash drought also increases, but the duration of flash drought is not sensitive to greening. This study highlights the importance of vegetation in flash drought development, and provides insights for improving flash drought monitoring and early warning.
The Naval Research Laboratory’s Coupled Ocean–Atmosphere Mesoscale Prediction System-Tropical Cyclone Ensemble (COAMPS-TC Ensemble)
Authors: Komaromi William A. , Reinecke Patrick A. , Doyle James D. , Moskaitis Jonathan R. 
Published: February 2021

AbstractThe 11-member Coupled Ocean–Atmosphere Mesoscale Prediction System-Tropical Cyclones (COAMPS-TC) ensemble has been developed by the Naval Research Laboratory (NRL) to produce probabilistic forecasts of tropical cyclone (TC) track, intensity and structure. All members run with a storm-following inner grid at convection-permitting 4-km horizontal resolution. The COAMPS-TC ensemble is constructed via a combination of perturbations to initial and boundary conditions, the initial vortex, and model physics to account for a variety of different sources of uncertainty that affect track and intensity forecasts. Unlike global model ensembles, which do a reasonable job capturing track uncertainty but not intensity, mesoscale ensembles such as the COAMPS-TC ensemble are necessary to provide a realistic intensity forecast spectrum. The initial and boundary condition perturbations are responsible for generating the majority of track spread at all lead times, as well as the intensity spread from 36 to 120 h. The vortex and physics perturbations are necessary to produce meaningful spread in the intensity prediction from 0 to 36 h. In a large sample of forecasts from 2014 to 2017, the ensemble-mean track and intensity forecast is superior to the unperturbed control forecast at all lead times, demonstrating a clear advantage to running an ensemble versus a deterministic forecast. The spread–skill relationship of the ensemble is also examined, and is found to be very well calibrated for track, but is underdispersive for intensity. Using a mixture of lateral boundary conditions derived from different global models is found to improve upon the spread–skill score for intensity, but it is hypothesized that additional physics perturbations will be necessary to achieve realistic ensemble spread.
Mental health impact of the Covid-19 pandemic on parents in high-risk, low income communities
Authors: Alonzo Dana , Popescu Marciana , Zubaroglu Ioannides Pinar 
Published: February 2021

Background: COVID-19 has spread across the globe, resulting in significant changes in virtually every aspect of life. Mitigation efforts, like shelter-in-place orders, have taken a particular toll on parents who have had to navigate disruptions in work and/or school schedules. Research from high-income countries demonstrates increased parental anxiety, stress, depression, and burnout resulting from the pandemic. It is unclear if these outcomes are the same for parents in high-risk communities in low-income countries where pre-pandemic conditions were deleterious. This study addresses this gap and examines the mental health impact of the pandemic on parents in high-risk communities in Guatemala. Methods: A total of 330 individuals from 11 districts in Guatemala participated in the study and were assessed for sociodemographic characteristics and mental health impairment. Chi-squares were conducted for bivariate analysis. Multivariate analysis was conducted using binary logistic regression. Results: Bivariate analysis revealed differences between groups on burnout, with parents more often reporting feelings of burnout than nonparents ( p < .001). Binary regression demonstrated that non-parents were 70% less likely to endorse feelings of stress as compared to parents (OR = .285; p = .014). Conclusion: Our findings underscore the importance of identifying the unique mental health impact of the COVID 19 pandemic on parents in high-risk communities. In high-risk communities, parental stress is a pressing problem that, if unaddressed, has the potential to result in even greater psychological distress and child maltreatment. Training community healthcare providers to assess and address parental stress can lead to increased community capacity and the development of a community-based network to serve as a first line of support for parents and their children.
Ten-Year Survivorship, Patient-Reported Outcome Measures, and Patient Acceptable Symptom State After Over-the-Top Hamstring Anterior Cruciate Ligament Reconstruction With a Lateral Extra-articular Reconstruction: Analysis of 267 Consecutive Cases
Authors: Grassi Alberto , Macchiarola Luca , Lucidi Gian Andrea , Silvestri Annamaria , Dal Fabbro Giacomo , Marcacci Maurilio , Zaffagnini Stefano 
Published: February 2021

Background: Long-term patient-reported outcome measures (PROMs) and predictors of success or failure after anterior cruciate ligament (ACL) reconstruction are not fully understood, especially when combined with a lateral extra-articular reconstruction. Purpose: To assess the long-term PROMs, revision rate, and predictors of success or failure after ACL reconstructions using an over-the-top surgical technique with single-bundle hamstring tendon autografts and a lateral extra-articular reconstruction. Study Design: Case series; Level of evidence, 4. Methods: The study cohort consisted of 267 consecutive patients (mean age, 30.7 years) who underwent ACL reconstruction with an over-the-top surgical technique with single-bundle hamstring tendon autografts and a lateral extra-articular augmentation between November 2007 and May 2009. The number of subsequent ACL revisions and reoperations were recorded. Subjective clinical status was assessed with PROMs—specifically, the Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm, Tegner, and visual analog scale for pain—at a minimum follow-up of 10 years. Results: Overall, 3% of patients underwent ACL revision, with a 10-year survival rate of 96.3%. High sport activity (hazard ratio, 6.9; P = .285) and concomitant meniscal lesion (hazard ratio, 2.6; P = .0487) were predictors of ACL revision or new meniscectomy. The mean ± SD Lysholm score was 94.1 ± 10.8, while that for the visual analog scale for pain was 0.2 ± 0.9 at rest and 2.1 ± 2.6 during activity. KOOS subscale scores were as follows: 95.7 ± 8.1 for Pain, 92.5 ± 10.5 for Symptoms, 98.4 ± 7.4 for Activities of Daily Living, 90.7 ± 17.2 for Sport, and 91.2 ± 17.1 for Quality of Life; respectively, 88%, 99%, 81%, 89%, and 91% of patients achieved the Patient Acceptable Symptom State. Female sex and chondropathy with Outerbridge grade ≥2 were predictors of worse KOOS subscales. Overall, 82% of patients returned to sport, and 57% were still participating at the 10-year evaluation. Conclusion: ACL reconstruction with an over-the-top surgical technique with single-bundle hamstring autografts and a lateral extra-articular reconstruction provided satisfactory results in terms of function, symptoms, sports, and quality of life in 80% to 90% of patients after 10 years. Long-term survivorship was 96%. Sport participation declined from 82% postoperatively to 57% at long-term follow-up. A concomitant medial meniscal lesion was a predictor of higher risk of ACL failure or new meniscal lesion, while advanced chondropathy and female sex were predictors of higher pain, lower function, and poor quality of life scores.
Course and Predictors of Posttraumatic Stress Disorder in the Canadian Armed Forces: A Nationally Representative, 16-Year Follow-up Study: Cours et prédicteurs du trouble de stress post-traumatique dans les Forces armées canadiennes: une étude de suivi de 16 ans nationalement représentative
Authors: Mota Natalie , Bolton Shay-Lee , Enns Murray W. , Afifi Tracie O. , El-Gabalawy Renée , Sommer Jordana L. , Pietrzak Robert H. , Stein Murray B. , Asmundson Gordon J. G. , Sareen Jitender 
Published: February 2021

Objective: This study examined baseline risk and protective predictors and interim correlates of the persistence/recurrence, remission, and onset of posttraumatic stress disorder (PTSD) in a 16-year prospective, nationally representative sample of Canadian Forces members and veterans. Methods: The 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey is a prospective study of 2,941 regular force service members and veterans who participated in the 2002 Canadian Community Health Survey on Mental Health and Wellbeing: Canadian Forces Supplement ( n = 5,155; ages 15 to 64 years; response rate 68%). PTSD diagnoses in 2002 and 2018 were used to create 4 groups: (1) no lifetime, (2) remitted, (3) new onset, and (4) persistent/recurrent PTSD. Multinomial regressions were conducted to identify predictors of PTSD courses. Results: Female sex, being a junior noncommissioned member (vs. officer), and land (vs. air) operations in 2002 were associated with all PTSD courses relative to no lifetime PTSD (relative risk ratio [RRR] range: 1.28 to 3.65). After adjusting for sociodemographic variables, baseline predictors of all PTSD courses included lifetime mental disorder, history of mental health care utilization, all trauma type categories (deployment-associated, sexual, “other”), and the number of lifetime traumatic events (RRR range: 1.14 to 8.95). New (“since 2002”) traumas, transitioning to veteran status, and alcohol dependence were mostly associated with the new onset and persistent/recurrent PTSD courses (RRR range: 1.79 to 4.31), while mental health care utilization and greater avoidance coping were associated with all PTSD courses (RRR range: 1.10 to 17.87). Protective factors for several PTSD courses at one or both time points included social support, social network size, and problem-focused coping (RRR range: 0.71 to 0.98). Conclusions: This is the first population-based survey to examine the longitudinal course of PTSD in Canadian Forces members. Prevention and intervention programs focused on bolstering social support and active coping strategies as possible protective factors/correlates may help mitigate the development and persistence of PTSD.
Deep Medullary Vein White Matter Injury Global Severity Score Predicts Neurodevelopmental Impairment
Authors: Benninger Kristen L. , Benninger Tara L. , Moore-Clingenpeel Melissa , Ruess Lynne , Rusin Jerome A. , Maitre Nathalie L. 
Published: February 2021

Aim: To examine associations between the deep medullary vein white matter injury global severity scoring system and neurodevelopmental impairment. Methods: This is a prospective observational cohort study of infants born at ≥32 weeks, diagnosed with deep medullary vein thrombosis and infarction on neuroimaging in the first month of life. Developmental testing was performed using validated measures for early, preschool, and school-age follow-up. Results: Nineteen (37%) patients had major neurodevelopmental impairment. Global severity score was higher among patients with neurodevelopmental impairment (21.6 vs 13.4, P = .04). Overall, 78% of patients with epilepsy had neurodevelopmental impairment. A greater degree of asymmetry with right-sided injury predominance was associated with lower Bayley-III cognitive scores and presence of neurodevelopmental impairment ( P < .01). Conclusions: Results suggest a need for targeted clinical surveillance for patients with a high global severity score and/or asymmetric, predominantly right cerebral white matter injury and for those who develop epilepsy.