bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Association between Board Composition, Board Governance, and Charity Care Provided by Nonprofit Hospitals
Authors: Ragland Linda G. , Plante Catherine A. 
Published: January 2021

ABSTRACT
In this study, we examine the association between board composition, board governance, and charity care provided by nonprofit hospitals. Using tax return data, we first investigate whether the composition of nonprofit hospital boards is associated with governing decisions related to patients' eligibility for charity care. Then, we examine whether these decisions are associated with the amount of charity care provided. These research questions are motivated by legislators' and regulators' interest in understanding how nonprofit hospitals behave in terms of charitable missions (Kennedy, Burney, Troyer, and Stroup 2010). Overall, we find percentage of doctors on the board is associated with decisions affecting patients' eligibility for free care. Related, we find that percentage of healthcare administrators on the board is associated with decisions affecting patients' eligibility for free and discounted care. We also find that governing decisions related to patients' eligibility for free and discounted care are associated with charity care provided.
Data Availability: Data used in this study are available from the authors upon request.
Epidemiology and Molecular Biology of Colorectal Cancer
Authors: Sammour Tarik , Rodriguez-Bigas Miguel A 
Published: January 2021

Colorectal cancer (CRC) is the fourth most common cancer and the second most common cause of cancer-related death in the United States. Nonmodifiable risk factors include age, male sex, African-American ethnicity, and personal or family history of CRC or polyps (especially if these were diagnosed at a younger age), inflammatory bowel disease, or diabetes. Modifiable risk factors include poor physical activity; obesity; high consumption of red meats, processed meats, or alcohol; low total dietary intake of fiber, folate, fruits, or vegetables; and smoking tobacco. There have been several advances in diagnostic techniques, which, when combined with newly discovered genetic pathways, contribute to an expanding knowledge on which to base treatment. There are three known major molecular pathways of CRC carcinogenesis: the chromosomal instability pathway, the microsatellite instability pathway, and the serrated carcinoma pathway. Approximately 5% of all CRC cases will have a specific known genetic mutation associated with a well-characterized familial cancer syndrome with defined features. These syndromes are important to recognize distinctly as their identification facilitates surveillance and management with the aim of prevention, prophylaxis, and surgical cure.

This review contains 2 figures, 3 tables and 50 references.
Key words: colon cancer, colorectal cancer, familial, familial adenomatous polyposis, Lynch syndrome, microsatellite, polyp, polyposis, rectal cancer, serrated
Endoscopic Management of Polyps and Early Malignancy
Authors: Mahmud Nadim , Berzin Tyler 
Published: January 2021

Gastrointestinal endoscopy plays a critical role in the detection, diagnosis, and management of premalignant and malignant conditions. Because of the diversity of polypoid and nonpolypoid abnormalities that may be encountered throughout the gastrointestinal tract, the modern endoscopist must be keenly aware of the differential diagnosis of these lesions, the appropriateness of biopsy or resection, and the subsequent management based on pathology or staging information. A variety of tissue sampling and resection techniques have been developed for this purpose, including forceps biopsy, snare polypectomy, endoscopic mucosal resection, and endoscopic submucosal dissection. Depending on the lesion encountered, these techniques may be both diagnostic and therapeutic. Here we review the endoscopic management of premalignant polyps and early malignancy that may be encountered at different locations in the gastrointestinal tract.
This review contains 17 figures, 5 tables and 47 references
Key words: ablation, adenocarcinoma, adenoma, Barrett esophagus, biopsy, endoscopic mucosal resection, endoscopic submucosal dissection, forceps, polypectomy, snare
Upper Gastrointestinal Bleeding
Authors: Croft Chasen A , Moore Frederick 
Published: January 2021

Acute upper gastrointestinal bleeding (UGIB) is a common and potentially life-threatening emergency. Despite significant advances in intensive care resuscitation, medical treatment of gastric acid hypersecretion, and progress in endoscopic and surgical management, mortality from upper gastrointestinal hemorrhage has remained steady over the past four decades. One of the major challenges of managing UGIB involves identifying patients who are at high risk for rebleeding and death and who require admission to the intensive care unit. Regardless of the cause, initial evaluation of patients with UGIB is based on the degree of hemodynamic instability and the presumed rate of bleeding. Those patients with evidence of active bleeding and hemodynamic instability require aggressive resuscitation and hospitalization. Although diagnostic imaging may be useful in identifying the source of bleeding, endoscopy remains the “gold standard” diagnostic and therapeutic modality. Recent advances in transcatheter angiographic embolization have made this modality an attractive alternative to surgical intervention in patients who fail endoscopic management. However, in the hemodynamically unstable patient, surgical intervention is often necessary. In this review, we describe the most common causes of acute UGIB and detail the initial workup and management of each cause.
This review contains 6 figures, 3 tables, and 71 references.
Key words: acute upper gastrointestinal bleeding, angiographic embolization, Billroth, Dieulafoy, esophagogastroduodenoscopy, peptic ulcer disease, scintigraphy, varices
Direct Oral Anticoagulants
Authors: Codner Panna A. , Mount Michael G 
Published: January 2021

Non–vitamin K antagonist oral anticoagulants, also known as direct oral anticoagulants, are a relatively recent class of medications introduced into clinical practice. Due to their safety profiles, fixed dosing, and lack of need for frequent laboratory monitoring, they are becoming preferred to traditional anticoagulation with warfarin in many cases of nonvalvular atrial fibrillation and venous thromboembolism. Currently, four drugs are available: dabigatran, a direct thrombin inhibitor, and rivaroxaban, apixaban, and edoxaban, factor Xa inhibitors. This review covers the pharmacology, monitoring, and reversal agents currently available for these medications. The indications for their use are covered through a review of the major clinical trials that led to their US and European approvals for clinical use. Perioperative management of these medications is discussed. Tables list indications, dosing, and monitoring, as well as bleeding risks and efficacy compared with warfarin.
This review contains 1 figure, 11 tables, and 70 references.
Key words: apixaban, dabigatran, direct oral anticoagulant, edoxaban, rivaroxaban
Disorders of Potassium, Calcium, and Magnesium
Authors: Miller Emily S , Golden Katie E. 
Published: January 2021

Potassium, calcium and magnesium play important roles in physiology, particularly cardiac and neurologic function. Abnormalities in these electrolytes can cause subtle symptoms, but are common in patients with multiple medical problems and significantly increase morbidity and mortality. This review details the pathophysiology, assessment, treatment, and disposition of patients with hypokalemia, hyperkalemia, hypocalcemia, hypercalcemia, hypomagnesemia, and hypermagnesemia. Figures show approaches to identifying the causes of hypokalemia and hyperkalemia, changes in the electrocardiogram due to hypokalemia and hyperkalemia, and demonstration of Trousseau sign (carpal spasm with inflation of the blood pressure cuff) and Chvostek sign (facial muscle spasm with tapping of the facial nerve). Tables describe replenishing potassium via oral route, factors contributing to increased plasma potassium, medications that cause hyperkalemia, contraindications to succinylcholine, a summary of emergency treatment for hyperkalemia, common causes of hypocalcemia in the emergency department, and a summary of emergency treatment for hypercalcemia.
This review contains 4 highly rendered figures, 7 tables, and 39 references.
Toxic Gases
Authors: Weiss Stephanie T , Weibrecht Kathryn W 
Published: January 2021

This review looks at the potential causes, diagnoses, and possible treatments for three asphyxiant gases: carbon monoxide, hydrogen cyanide, and hydrogen sulfide, Exposure to these gases can lead to central nervous system depression, unconsciousness, and death due to tissue hypoxia. These gases are among the most common causes of fatalities related to toxic gas poisoning, with carbon monoxide responsible for 36% and hydrogen sulfide 7.7%. It is necessary to remove victims affected by poisoning immediately from the source of the toxic gas, administer oxygen, and assess their stability. As symptoms of these gases can differ widely, ranging from broad and unspecific to highly morbid, and may require different levels of care, the correct diagnosis should also rely on inferences from the patient history and the context of the admission, including evidence of fire and chemical reactions. Normobaric oxygen and hyperbaric oxygen are the two main treatments for carbon monoxide, although studies have been inconclusive in regards to the effectiveness of hyperbaric oxygen. The Cyanokit (containing hydroxocobalamin) is considered to be more effective for hydrogen cyanide when compared with the Cyanide Antidote Kit due to the former’s low toxicity and high effectiveness. Hydrogen sulfide is often used as a suicide agent, the mortality of which is close to 100%. Figures show the mechanisms by which the asphyxiant gases carry out their negative effects on the human body. Tables show the half-life of carboxyhemoglobin with oxygen therapy and a comparison between the Cyanide Antidote Kit and the Cyanokit.
This review contains 3 figures, 13 tables, and 44 references.
Keywords: Inhalation, poisoning, carbon monoxide, cyanide, methemoglobin, carboxyhemoglobin, hydrogen sulfide, smoke
Familial Polyposis Syndromes
Authors: Nissim Sahar , Lim Ramona M. 
Published: January 2021

Although sporadic polyps in the gastrointestinal tract are common with increasing age, the finding of a large number of polyps raises suspicion for a hereditary polyposis syndrome associated with a germline genetic mutation. Because many of these hereditary polyposis syndromes also confer an increased risk of gastrointestinal and extraintestincal cancers, implicated in approximately 1% of all colorectal cancers, recognition of these syndromes is critical to offer preventive screening measures. A key distinguishing feature is polyp histologic type, ranging from adenomatous, to serrated, to hamartomatous. A clinical diagnosis can be confirmed by genetic testing for a germline mutation in known cancer susceptibility genes, although in many polyposis families, a genetic etiology has not yet been identified. This review covers familial adenomatous polyposis, MUTYH-associated polyposis, polyposis associated with polymerase proofreading, juvenile polyposis syndrome, PTEN hamartoma tumor syndromes, hereditary mixed polyposis syndrome, and serrated polyposis. The figures shows the spectrum of histologic types and genetic etiologies of hereditary polyposis syndromes. Tables list polyposis syndromes, American College of Gastroenterology surveillance guidelines for hereditary polyposis syndromes, diagnostic criteria for juvenile polyposis syndrome, diagnostic criteria for PTEN hamartoma tumor syndrome, and World Health Organization diagnostic criteria for serrated polyposis syndrome.

This review contains 1 highly rendered figure, 5 tables, and 172 references
Key words: Familial adenomatous polyposis; Polyposis syndromes; Gastrointestinal polyps; Hereditary polyposis syndromes
Anemia: Production Defects Generally Associated with a Normal or Largely Normal Bone Marrow
Authors: Berliner Nancy , Gansner John M 
Published: January 2021

This review focuses on anemia resulting from production defects generally associated with a normal or largely normal bone marrow. The definition, epidemiology, etiology, pathogenesis, diagnosis, differential diagnosis, management, complications, and prognosis of the following production defects are discussed: Anemia of inflammation (AI; formerly known as anemia of chronic disease), and anemia in kidney disease, as well as anemia secondary to other conditions such as alchohol abuse and starvation. Iron deficiency anemia (IDA) is discussed elsewhere in this publication. A figure depicts peripheral smear changes in the size and shape of red blood cells seen in starvation. A table lists the differential diagnoses of hypochromic anemias.
This review contains 1 figure; 1 table; 79 references
Infections Due to Streptococcus pneumoniae
Authors: Stevens Dennis L. , Hobdey Sarah E 
Published: January 2021

Pneumococci, or Streptococcus pneumoniae, are gram-positive, lancet-shaped diplococci but may also grow in short chains. The polysaccharide polymer that forms the outer capsule of S pneumoniae is chemically and antigenically unique and is crucial to virulence. There are at least 90 distinct serotypes. The capsule allows the bacteria to resist phagocytosis by leukocytes unless the organisms have been opsonized by antibody or serum complement components. Certain pneumococcal serotypes, such as the heavily encapsulated type 3 pneumococcus, are particularly virulent. In fact, only 23 serotypes account for 80% of bacteremic pneumococcal infections in the United States; capsular polysaccharides from these 23 serotypes are incorporated into the polyvalent polysaccharide pneumococcal vaccine (PPSV23), which has been available since 1983. This review covers the epidemiology and pathogenesis of pneumococcal infections, clinical pneumococcal infections, and prevention of pneumococcal infections. Adverse outcomes in pneumococcal pneumonia, antibiotic treatment for penicillin-resistant S pneumoniae, and Centers for Disease Control and Prevention child and adolescent immunization schedules are discussed.
This review contains 1 figure, 6 tables, and 41 references.
Key words: bacterial pneumonia, PCV13, penicillin-resistant Streptococcus pneumoniae, pneumococcal pneumonia, pneumococcus, PPSV23, pneumonia vaccine, Streptococcus pneumoniae
Epigenetics In Autoimmune Disease
Authors: Jeffries Matlock A 
Published: January 2021

Autoimmunity refers to a pathologic state of immunologic dysregulation in which the human immune system turns inward, attacking healthy tissues. The key step in this process is a break of self-immune tolerance. Recent studies have implicated dysregulation of gene expression via altered epigenetic control as a key mechanism in the development and promotion of autoimmunity. Epigenetics is defined as heritable changes in gene expression as a result of modification of DNA methylation, histone side chains, and noncoding RNA. Studies examining identical twins discordant for lupus, for example, were among the first to identify alterations in DNA methylation leading to lupus. Histone side-chain changes have been studied extensively in rheumatoid arthritis (RA), and many pathogenic cell types in RA exhibit a hyperacetylation phenotype. Finally, new research in the noncoding RNA field has not only uncovered potentially targetable pathways (e.g., miR-155) but may lead to the development of new diagnostic and prognostic biomarkers, helping physicians better tailor specific treatment regimens to improve response to therapy in autoimmune disease.

This review contains 4 figures, 1 table and 47 references
Key Words: autoimmunity, big data, biomarkers, computational biology, DNA methylation, epigenetics, histone acetylation, histone methylation, microRNA, noncoding RNA
Encephalitis
Authors: Bhattacharyya Shamik , Lyons Jennifer L. 
Published: January 2021

In 2013, the International Encephalitis Consortium proposed clinical criteria for acute encephalitis consisting of 24 hours of altered level of consciousness, lethargy, or personality change and at least three additional supportive features. Although viruses are the most common cause of acute encephalitis, not all encephalitides are acute, viral, or even infectious. Chronic encephalitis can be pathologically similar to acute encephalitis, but the causative agents and clinical manifestations vary. Management of encephalitis is largely supportive; however, for many common encephalitides primary preventive approaches exist. This module reviews the epidemiology, manifestations, diagnosis, management, and prevention of various encephalitides, including herpes family encephalitis (herpes simplex virus, varicella-zoster virus, cytomegalovirus, human herpesvirus 6), arbovirus encephalitis (West Nile virus, eastern equine encephalitis virus, tick-borne encephalitis virus, Japanese encephalitis virus), other encephalitides associated with viruses (influenza virus, human immunodeficiency virus, John Cunningham virus, rabies virus), encephalitides associated with bacteria (Mycoplasma pneumonia, Listeria monocytogenes), and autoimmune encephalitis (acute disseminated encephalomyelitis, paraneoplastic and other autoimmune encephalitides, immune reconstitution inflammatory syndrome). Tables include the International Encephalitis Consortium’s supportive feature of encephalitis, differential diagnosis for magnetic resonance imaging (MRI) findings in the patient with suspected encephalitis, diagnostic considerations for triaging workup of infection-associated encephalitis, differential diagnosis of arboviral infections by location of travel or residence, and preventive strategies for select infectious encephalitis. Figures include MRIs showing patients with herpes simplex encephalitis, varicella-zoster virus, eastern equine encephalitis, HIV, Listeria monocytogenes, acute disseminated encephalomyelitis, acute hemorrhagic leukoencephalitis, and immune reconstitution inflammatory syndrome.
This review contains 8 highly rendered figures, 5 tables, and 78 references.
Introduction to Clinical Immunology: Overview of the Immune Response, Autoimmune Conditions, and Immunosuppressive Therapeutics for Rheumatic Diseases
Authors: Lundy Steven K. , Gizinski Alison , Fox David A. 
Published: January 2021

The immune system is a complex network of cells and mediators that must balance the task of protecting the host from invasive threats. From a clinical perspective, many diseases and conditions have an obvious link to improper functioning of the immune system, and insufficient immune responses can lead to uncontrolled acute and chronic infections. The immune system may also be important in tumor surveillance and control, cardiovascular disease, health complications related to obesity, neuromuscular diseases, depression, and dementia. Thus, a working knowledge of the role of immunity in disease processes is becoming increasingly important in almost all aspects of clinical practice. This review provides an overview of the immune response and discusses immune cell populations and major branches of immunity, compartmentalization and specialized immune niches, antigen recognition in innate and adaptive immunity, immune tolerance toward self antigens, inflammation and innate immune responses, adaptive immune responses and helper T (Th) cell subsets, components of the immune response that are important targets of treatment in autoimmune diseases, mechanisms of action of biologics used to treat autoimmune diseases and their approved uses, and mechanisms of other drugs commonly used in the treatment of autoimmune diseases. Figures show the development of erythrocytes, platelets, lymphocytes, and other immune system cells originating from hematopoietic stem cells that first reside in the fetal liver and later migrate to the bone marrow, antigen–major histocompatibility complex recognition by T cell receptor control of T cell survival and activation, and Th cells as central determinants of the adaptive immune response toward different stimuli. Tables list cell populations involved in innate and adaptive immunity, pattern recognition receptors with known ligands, autoantibody-mediated human diseases: examples of pathogenic mechanisms, selected Food and Drug Administration–approved autoimmune disease indications for biologics, and mechanism of action of biologics used to treat autoimmune diseases.

This review contains 3 highly rendered figures, 5 tables, and 64 references.
Pulmonary Edema in Pregnancy
Authors: Easter Sarah Rae , Smith Nicole A. 
Published: January 2021

Pulmonary edema is characterized by the movement of excess fluid into the alveoli of the lungs. Although the alterations of cardiovascular and pulmonary physiology in pregnancy may predispose patients to pulmonary edema, it is never normal and constitutes severe maternal morbidity. The etiologies of pulmonary edema are diverse, ranging from disease processes independent of pregnancy to pathophysiology unique to the gravid state. The causes of pulmonary edema can be broadly classified as either cardiogenic or noncardiogenic, which constitutes the first important branch point in the diagnosis and management of the disease. The treatment of pulmonary edema in pregnancy parallels that in the nonpregnant population with an emphasis on maintaining the physiologic alterations of pregnancy through supportive care, including mechanical ventilation if needed. In all cases of pulmonary edema, the decision to proceed with delivery to improve the maternal status should be considered within the context of the etiology and anticipated disease course, the gestational age, and the goals of care.
This review contains 3 figures, 4 tables, and 60 references.
Key Words: Pulmonary edema, respiratory alkalosis, acute respiratory distress syndrome (ARDS), cardiogenic pulmonary edema, transfusion-related acute lung injury (TRALI), transfusion-associated circulatory overload (TACO), mechanical ventilation, extra corporeal membrane oxygenation (ECMO).
Polycystic Ovary Syndrome
Authors: Alur-Gupta Snigdha , Dokras Anuja 
Published: January 2021

Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine disorder in women of reproductive age. In this review, the pathophysiology and current diagnostic criteria for PCOS are reviewed. Treatment options for symptoms commonly associated with PCOS such as hirsutism, acne, and menstrual irregularity are reviewed. Combined hormonal contraceptives are the first line of therapy in women not attempting pregnancy. The metabolic complications commonly associated with PCOS are impaired glucose tolerance and dyslipidemia. A summary of the current guidelines on screening and prevention of these complications is presented. In addition, PCOS is associated with an increased risk of depressive symptoms and anxiety disorders for which patients should be monitored.

This review contains 7 tables and 59 references.
Keywords: Polycystic ovary syndrome, PCOS