bluuebunny/crossref_metadata_2025_split huggingface dataset:
Specimen oriented intraoperative margin assessment in oral cavity and oropharyngeal squamous cell carcinoma
Authors: Horwich P. , MacKay C. , Bullock M. , Taylor S. M. , Hart R. , Trites J. , Geldenhuys L. , Williams B. , Rigby M. H. 
Published: June 2021

Objective Evaluate the oncologic outcomes and cost analysis of transitioning to a specimen oriented intraoperative margin assessment protocol from a tumour bed sampling protocol in oral cavity (OCSCC) and oropharyngeal squamous cell carcinoma (OPSCC). Study design Retrospective case series and subsequent prospective cohort study Setting Tertiary care academic teaching hospital Subjects and methods Retrospective case series of all institutional T1-T2 OCSCC or OPSCC treated with primary surgery between January 1st 2009 – December 31st 2014. Kaplan-Meier survival estimates with log rank tests were used to compare patients based on final margin status. Cost analysis was performed for escalation of therapy due to positive final margins. Following introduction of a specimen derived margin protocol, successive prospective cohort study of T1-T4 OCSCC or OPSCC treated with primary surgery from January 1st 2017 – December 31st 2018. Analysis and comparison of both protocols included review of intraoperative margins, final pathology and treatment cost. Results Analysis of our intra-operative tumour bed frozen section protocol revealed 15 of 116 (12.9%) patients had positive final pathology margins, resulting in post-operative escalation of therapy for 14/15 patients in the form of re-resection (7/14), radiation therapy (6/14) and chemoradiotherapy (1/14). One other patient with positive final margins received escalated therapy for additional negative prognostic factors. Recurrence free survival at 3 years was 88.4 and 50.7% for negative and positive final margins respectively ( p = 0.048). Implementation of a specimen oriented frozen section protocol resulted in 1 of 111 patients (0.9%) having positive final pathology margins, a statistically significant decrease ( p < 0.001). Utilizing our specimen oriented protocol, there was an absolute risk reduction for having a final positive margin of 12.0% and relative risk reduction of 93.0%. Estimated cost avoidance applying the specimen oriented protocol to our previous cohort was $412,052.812017 CAD. Conclusion Implementation of a specimen oriented intraoperative margin protocol provides a statistically significant decrease in final positive margins. This change in protocol leads to decreased patient morbidity by avoiding therapy escalation attributable only to positive margins, and avoids the economic costs of these treatments. Graphical abstract
How does immigration affect anti-immigrant sentiment, and who is affected most? A longitudinal analysis of the UK and Japan cases
Authors: Igarashi Akira , Laurence James 
Published: June 2021

AbstractDoes increasing immigration affect natives’ attitudes towards immigrants? A significant volume of research has been conducted in Western contexts to explore this question. However, we know little about whether findings observed in Western societies translate to non-Western contexts. At the same time, there is a paucity of research into whether increasing immigration exerts differential-effects among different groups of individuals. Using Japanese and British longitudinal data, this study firstly compares and contrasts how immigrant-share in an environment affects anti-immigrant sentiment in Japan and Great Britain. Secondly, it explores two potential drivers of heterogeneity in the impact of immigration across individuals: (a) perceived financial situation, and (b) views towards the role government should play in issues of support for the vulnerable. Applying fixed-effects panel data modelling, the results show increasing immigration harms attitudes towards immigrants. Furthermore, these negative effects are stronger for those who perceive their financial situation is worse, and among those who lean further to the left on the role of government. Interestingly, these results are highly similar in Japan and the UK. Thus, these findings support similar mechanisms of the group-threat theory operating among natives in two distinct contexts.
A new classification of cardio-oncology syndromes
Authors: de Boer Rudolf A. , Aboumsallem Joseph Pierre , Bracun Valentina , Leedy Douglas , Cheng Richard , Patel Sahishnu , Rayan David , Zaharova Svetlana , Rymer Jennifer , Kwan Jennifer M. , Levenson Joshua , Ronco Claudio , Thavendiranathan Paaladinesh , Brown Sherry-Ann 
Published: June 2021

AbstractIncreasing evidence suggests a multifaceted relationship exists between cancer and cardiovascular disease (CVD). Here, we introduce a 5-tier classification system to categorize cardio-oncology syndromes (COS) that represent the aspects of the relationship between cancer and CVD. COS Type I is characterized by mechanisms whereby the abrupt onset or progression of cancer can lead to cardiovascular dysfunction. COS Type II includes the mechanisms by which cancer therapies can result in acute or chronic CVD. COS Type III is characterized by the pro-oncogenic environment created by the release of cardiokines and high oxidative stress in patients with cardiovascular dysfunction. COS Type IV is comprised of CVD therapies and diagnostic procedures which have been associated with promoting or unmasking cancer. COS Type V is characterized by factors causing systemic and genetic predisposition to both CVD and cancer. The development of this framework may allow for an increased facilitation of cancer care while optimizing cardiovascular health through focused treatment targeting the COS type.
Moving from North to North: how are the students’ university flows?
Authors: Rizzi Laura , Grassetti Luca , Attanasio Massimo 
Published: June 2021

AbstractStudent mobility has been much commented upon and much studied. Student mobility has social, economic, and political consequences. This form of mobility is relevant, in Italy, in terms of south-north flows, while the mobility of northern students toward the South and Centre of Italy is negligible. To the best of our knowledge, a proper focus on the dynamics among northern regions has not yet been carried out. This study focuses on the interregional mobility of northern first-year students. To this end, we use a longitudinal dataset with students’ individual histories from 2008 to 2017, obtained from the cohort-based datasets collected using the Italian Ministry of University’s administrative databases. Descriptive and model-based analyses are employed for assessing the association between the propensity to move and individual characteristics, as well as some territorial variables. A longitudinal study is also considered. Here, we see an increase in the population entering the university system and mobility flows across northern regions. The results show that students’ educational experiences influence the propensity to move. However, the most relevant driver of the phenomenon is the attractiveness of areas with a higher supply of university courses and a better economic context.
Inpatients with severe-enduring anorexia nervosa: Understanding the “enduringness” specifier
Authors: Marzola Enrica , Martini Matteo , Brustolin Annalisa , Abbate-Daga Giovanni 
Published: June 2021

Abstract

Background
Despite the need for a common definition of severe and enduring anorexia nervosa (SE-AN) with the overarching goal to optimize treatments, this definition still is being debated. Therefore, in this study we conducted an in-depth investigation of the history of AN and its clinical outcomes on inpatients with AN to ascertain the eventual “profiles” for individuals with varying durations of the illness (DOI).

Methods
We recruited 169 inpatients with AN, grouping them according to DOI: <3 years (short duration, SD-AN); 3–6.99 years (medium duration, MD-AN); and ≥7 years (long duration, LD-AN). We then performed a self-report and interview-based investigation of AN history, clinical data, eating, and general psychopathology, including personality, premorbid traits, stage of change, and quality of life. We measured the clinical outcomes for hospitalization as well.

Results
The majority of the measures did not differ across groups. Those with LD-AN were older and diagnosed mostly with the binge-purging AN subtype, failed more previous AN-related treatments, reported a lower lifetime body mass index, and trended toward a younger age at onset when compared to the other groups. All patients responded equally well to hospitalization, but patients with SD-AN improved less in drive for thinness and body-related concerns.

Conclusions
We did not find the “enduringness” of AN to be a specifier of severity. Hospitalization was effective for those with LD-AN and MD-AN, while interventions for the core cognitive aspects of over-evaluation of body shape should be offered to patients with SD-AN.
Associations Between Preoperative Biomarkers and Cardiac Surgery–Associated Acute Kidney Injury in Elderly Patients: A Cohort Study
Authors: Verwijmeren Lisa , Bosma Madeleen , Vernooij Lisette M. , Linde Esther M. , Dijkstra Ineke M. , Daeter Edgar J. , Van Dongen Eric P. A. , Van Klei Wilton A. , Noordzij Peter G. 
Published: June 2021

BACKGROUND:
Acute kidney injury (AKI) is associated with mortality after cardiac surgery. Novel risk factors may improve identification of patients at risk for renal injury. The authors evaluated the association between preoperative biomarkers that reflect cardiac, inflammatory, renal, and metabolic disorders and cardiac surgery–associated AKI (CSA-AKI) in elderly patients.

METHODS:
This was a secondary analysis of the 2-center prospective cohort study “Anesthesia Geriatric Evaluation.” Twelve biomarkers were determined preoperatively in 539 patients. Primary outcome was CSA-AKI. The association between biomarkers and CSA-AKI was investigated with multivariable logistic regression analysis. Secondary outcomes were 1-year mortality and patient-reported disability and were assessed with relative risks (RR) between patients with and without CSA-AKI.

RESULTS:
CSA-AKI occurred in 88 (16.3%) patients and was associated with increased risk of mortality (RR, 6.70 [95% confidence interval {CI}, 3.38–13.30]) and disability (RR, 2.13 [95% CI, 1.53–2.95]). Preoperative concentrations of N-terminal pro B-type natriuretic peptide (NT-proBNP), high-sensitive C-reactive protein (hs-CRP), hemoglobin, and magnesium had the strongest association with CSA-AKI. Identification of patients with CSA-AKI improved when a biomarker panel was used (area under the curve [AUC] 0.75 [95% CI, 0.69–0.80]) compared to when only clinical risk factors were used (European System for Cardiac Operative Risk Evaluation [EuroSCORE II] AUC 0.67 [95% CI, 0.62–0.73]).

CONCLUSIONS:
Preoperative cardiac, inflammatory, renal, and metabolic biomarkers are associated with CSA-AKI and may improve identification of patients at risk.
Intrathecal 2-Chloroprocaine 3% Versus Hyperbaric Bupivacaine 0.75% for Cervical Cerclage: A Double-Blind Randomized Controlled Trial
Authors: Lee Allison , Shatil Ben , Landau Ruth , Menon Prahlad , Smiley Richard 
Published: June 2021

BACKGROUND:
Cervical cerclage is a short ambulatory procedure. For spinal anesthesia, local anesthetic agents with rapid postoperative resolution are desired. We hypothesized that in combination with fentanyl, intrathecal 2-chloroprocaine would produce earlier resolution of motor block, resulting in shorter time to meet recovery room discharge criteria than hyperbaric bupivacaine.

METHODS:
Women undergoing cervical cerclage with spinal anesthesia were randomized to receive intrathecal 2-chloroprocaine 3% 50 mg or hyperbaric bupivacaine 0.75% 9 mg, both with fentanyl 15 µg. Doses were empirically selected. The onset and resolution of sensory and motor blockade and time to achieve recovery room discharge criteria were monitored. On postoperative day 1, patients rated their satisfaction with the anesthetic and reported on transient neurologic symptoms (TNS), back pain, or headache. The primary outcome was time from spinal injection to motor block resolution. The main secondary outcomes included times from spinal injection to (i) T12 dermatomal level, (ii) sensory block resolution, and (iii) ability to ambulate and void.

RESULTS:
Forty-three women were enrolled and randomized to either the chloroprocaine (N = 23) or bupivacaine group (N = 20). The mean (standard deviation [SD]) duration of surgery was 35.3 (11.4) minutes. There was no difference between groups for time to motor block resolution—the median [interquartile range] time for the bupivacaine group (N = 17) was 112 [97–143] minutes versus 109 [88–148] minutes in the chloroprocaine group (N = 22), P = .66, but there was a significant difference in median time to sensory block resolution: 143 [116–162] minutes in the chloroprocaine group versus 198 [152–263] minutes in the bupivacaine group, P = .002. The recovery room discharge criteria, which at our institution include the ability to ambulate unassisted and void urine, were met 76 (95% CI, 33–145) minutes earlier in the chloroprocaine group, P < .0005. One complete block failure occurred with hyperbaric bupivacaine and 2 subjects in each group received treatment for intraoperative discomfort. No patients reported TNS.

CONCLUSIONS:
Intrathecal 2-chloropocaine 3% provided similarly effective surgical anesthesia for cerclage placement. Although no difference in time to motor block resolution between groups was observed, the time to sensory block resolution and time to meet recovery room discharge criteria were both significantly shorter among patients who received chloroprocaine than patients who received bupivacaine. Future studies are needed to identify and compare equipotent doses of chloroprocaine and bupivacaine to confirm the superiority of chloroprocaine for this ambulatory obstetric procedure.
Intertestualità dantesche: Un’allusione a Ennio?
Authors: Aresu Francesco Marco 
Published: June 2021

Abstract
This article hypothesizes an intertextual relationship between the literary transfiguration of Occitan troubadour Bertran de Born in Inferno 28 and a fragment of Latin poetry preserved by late antique scholars (and disputedly attributed to Roman poet Ennius). The evidence presented in support of this hypothesis include lexical, prosodical, and rhetorical elements. The hypothesis is also examined with reference to the material and textual transmission of the fragment.
Mapping the Knowledge of Dante Commentaries in the Digital Context: A Web Ontology Approach
Authors: Meghini Carlo , Tavoni Mirko , Zaccarello Michelangelo 
Published: June 2021

AbstractWith digital repositories and databases available since the 1990s, Dante scholarship has always been at the forefront of the digital humanities and the digitization of medieval texts and manuscripts. However, the amount of information available about such aspects is imposing, and its location subject to the extreme dispersion of traditional scholarly publications: commentaries first but also academic journals, miscellanies, and so forth. Rather than being based on traditional word searches, a true advancement of knowledge needs to overcome the rigidity of text-based queries (and in-line markup embedded in text). Such paramount evolution is now made possible by the Semantic Web, an extension of the current web by description standards that help machines to understand and connect the information already available on the web. To achieve this, the latter is mapped using formal description and classification patterns, called ontologies. Ontologies are a key factor in managing meaningful search/data extraction, publishing relevant results on the web, search existing web resources, and offering answers to more sophisticated queries. Due to its vastness and complexity, Dante scholarship has calls for an ontology-based mapping, and specific tools have been designed to express the most difficult and articulate aspects of Dante’s literary production, such as its use of biblical, classical, and medieval sources. This paper aims to introduce the aims and scope of a new digital library of Dante commentaries, built according to the aforementioned standards and aiming to refine and extend the ontologies developed for Dante’s minor works to the more complex world of the Commedia.
Identifying Gender Barriers for Colorectal Cancer Screening and Assessing the Need for a Multigender Endoscopy Team: A Prospective Multicenter Study
Authors: Khara Harshit S. , Suthar Darshan , Bergenstock Marika , Berger Andrea , McKee Jessica L. , Stewart Dana , Theis Samuel R. , Komar Michael , Johal Amitpal S. , Valencia Chavez Diego R. , Hale William B. , Mangla Rakhee 
Published: June 2021

INTRODUCTION:
Gender preferences have been reported as a barrier to colorectal cancer screening, particularly among women. We aim to identify the role of patients' gender preferences for endoscopists and endoscopy team members, with the effect of age-related and regional differences.

METHODS:
We conducted an anonymous, voluntary survey of all adult outpatients presenting at our endoscopy centers before their procedures.

RESULTS:
We received 2,138 (1,207 women, 905 men, and 26 undisclosed; 50% urban and 50% rural) completed surveys. The majority of the patients (89%) did not have an endoscopist gender preference, while 8% preferred a same-gender endoscopist, and 2% preferred an opposite gender endoscopist. Among patients who expressed a gender preference, men more commonly preferred a same-gender endoscopist than women (91% vs 67%, P < 0.05). More patients preferred a same-gender endoscopy team member than a same-gender endoscopist (17% vs 8%, P < 0.05), and women more commonly preferred a same-gender endoscopy team member than men (26% vs 6%, P < 0.05). Most patients who expressed same-gender endoscopist preference were between the ages of 50–69 years as compared to other age groups (P < 0.05). Of the urban patients, 9% expressed a same-gender endoscopist preference and 3% expressed an opposite gender preference, compared with 7% and 2% of rural patients (P < 0.05). Among patients with any endoscopist gender preference, rural patients were more willing to wait longer (41% vs 21%, P < 0.05), whereas urban patients were willing to pay more (64% vs 14%, P < 0.05) to have their preferences met.

DISCUSSION:
Contrary to previous studies, most patients did not have an endoscopist gender preference. Interestingly, men had more same-gender endoscopist preference, whereas women had more same-gender endoscopy team member preference. Age-related and regional differences exist among patients' gender preferences for their endoscopist and endoscopy team member, and addressing these preferences while creating an environment of a multigender endoscopy team may be beneficial in improving colorectal cancer screening.
Tribonacci numbers with two blocks of repdigits
Authors: Bravo Eric F. , Bravo Jhon J. 
Published: June 2021

AbstractThe Tribonacci sequence is a generalization of the Fibonacci sequence which starts with 0,0,1 and each term afterwards is the sum of the three preceding terms. Here, we show that the only Tribonacci numbers that are concatenations of two repdigits are 13,24,44,81. This paper continues a previous work that searched for Fibonacci numbers which are concatenations of two repdigits.
Block Hessenberg matrices and spectral transformations for matrix orthogonal polynomials on the unit circle
Authors: Fuentes Edinson , Garza Luis E. 
Published: June 2021

Abstract
In this contribution, we study properties of block Hessenberg matrices associated with matrix orthonormal polynomials on the unit circle. We also consider the Uvarov and Christoffel spectral matrix transformations of the orthogonality measure, and obtain some relations between the associated Hessenberg matrices.
Properties of implication in effect algebras
Authors: Chajda Ivan , Länger Helmut 
Published: June 2021

Abstract
Effect algebras form a formal algebraic description of the structure of the so-called effects in a Hilbert space which serve as an event-state space for effects in quantum mechanics. This is why effect algebras are considered as logics of quantum mechanics, more precisely as an algebraic semantics of these logics. Because every productive logic is equipped with implication, we introduce here such a concept and demonstrate its properties. In particular, we show that this implication is connected with conjunction via a certain “unsharp” residuation which is formulated on the basis of a strict unsharp residuated poset. Though this structure is rather complicated, it can be converted back into an effect algebra and hence it is sound. Further, we study the Modus Ponens rule for this implication by means of so-called deductive systems and finally we study the contraposition law.
Reappraisal of Renal Arteritis in ANCA-associated Vasculitis: Clinical Characteristics, Pathology, and Outcome
Authors: Boudhabhay Idris , Delestre Florence , Coutance Guillaume , Gnemmi Viviane , Quemeneur Thomas , Vandenbussche Cyrille , Lazareth Helene , Canaud Guillaume , Tricot Leila , Gosset Clément , Hummel Aurélie , Terrier Benjamin , Rabant Marion , van Daalen Emma E. , Wester Trejo Maria A.C. , Bajema Ingeborg M. , Karras Alexandre , Duong Van Huyen Jean-Paul 
Published: June 2021

Significance Statement
The clinical significance of arteritis of the small kidney arteries has not been evaluated in detail in antineutrophil cytoplasmic antibody–associated vasculitis (AAV). A large multicenter cohort of 251 patients diagnosed with AAV and renal involvement, including 34 (13.5%) patients with arteritis, found patients with arteritis were older and had a more severe inflammatory syndrome compared with patients who did not have arteritis. The presence of arteritis on kidney biopsy was associated with poorer renal prognosis, independent of current risk stratification predictive models. The addition of the arteritis status significantly improved risk stratification of ESKD in patients classified as having low or moderate risk according to the ANCA renal risk score. The incidence and phenotype of this AAV subtype were confirmed in two external validation cohorts.

Background
Renal involvement in ANCA–associated vasculitis (AAV) is associated with poor outcomes. The clinical significance of arteritis of the small kidney arteries has not been evaluated in detail.

Methods
In a multicenter cohort of patients with AAV and renal involvement, we sought to describe the clinicopathologic characteristics of patients with AAV who had renal arteritis at diagnosis, and to retrospectively analyze their prognostic value.

Results
We included 251 patients diagnosed with AAV and renal involvement between 2000 and 2019, including 34 patients (13.5%) with arteritis. Patients with AAV-associated arteritis were older, and had a more pronounced inflammatory syndrome compared with patients without arteritis; they also had significantly lower renal survival (P=0.01). In multivariable analysis, the ANCA renal risk score, age at diagnosis, history of diabetes mellitus, and arteritis on index kidney biopsy were independently associated with ESKD. The addition of the arteritis status significantly improved the discrimination of the ANCA renal risk score, with a concordance index (C-index) of 0.77 for the ANCA renal risk score alone, versus a C-index of 0.80 for the ANCA renal risk score plus arteritis status (P=0.008); ESKD-free survival was significantly worse for patients with an arteritis involving small arteries who were classified as having low or moderate risk, according to the ANCA renal risk score. In two external validation cohorts, we confirmed the incidence and phenotype of this AAV subtype.

Conclusions
Our findings suggest AAV with renal arteritis represents a different subtype of AAV with specific clinical and histologic characteristics. The prognostic contribution of the arteritis status remains to be prospectively confirmed.