bluuebunny/crossref_metadata_2025_split huggingface dataset:
Meta-Analysis and Systematic Review of the Genomics of Mucosal Melanoma
Authors: Broit Natasa , Johansson Peter A. , Rodgers Chloe B. , Walpole Sebastian T. , Newell Felicity , Hayward Nicholas K. , Pritchard Antonia L. 
Published: March 2021

AbstractMucosal melanoma is a rare subtype of melanoma. To date, there has been no comprehensive systematic collation and statistical analysis of the aberrations and aggregated frequency of driver events across multiple studies. Published studies using whole genome, whole exome, targeted gene panel, or individual gene sequencing were identified. Datasets from these studies were collated to summarize mutations, structural variants, and regions of copy-number alteration. Studies using next-generation sequencing were divided into the “main” cohort (n = 173; fresh-frozen samples), “validation” cohort (n = 48; formalin-fixed, paraffin-embedded samples) and a second “validation” cohort comprised 104 tumors sequenced using a targeted panel. Studies assessing mutations in BRAF, KIT, and NRAS were summarized to assess hotspot mutations. Statistical analysis of the main cohort variant data revealed KIT, NF1, BRAF, NRAS, SF3B1, and SPRED1 as significantly mutated genes. ATRX and SF3B1 mutations occurred more commonly in lower anatomy melanomas and CTNNB1 in the upper anatomy. NF1, PTEN, CDKN2A, SPRED1, ATM, CHEK2, and ARID1B were commonly affected by chromosomal copy loss, while TERT, KIT, BRAF, YAP1, CDK4, CCND1, GAB2, MDM2, SKP2, and MITF were commonly amplified. Further notable genomic alterations occurring at lower frequencies indicated commonality of signaling networks in tumorigenesis, including MAPK, PI3K, Notch, Wnt/β-catenin, cell cycle, DNA repair, and telomere maintenance pathways. This analysis identified genomic aberrations that provide some insight to the way in which specific pathways may be disrupted.Implications:Our analysis has shown that mucosal melanomas have a diverse range of genomic alterations in several biological pathways.
Abstract P61: Pulsatility Index Outperforms Conventional Imaging Markers in the Association With Cognition in Community Subjects
Authors: Lam Maggie L , Mok Vincent C , Lam Bonnie Y 
Published: March 2021

Increase in pulsatility index (PI), measured by the transcranial Doppler (TCD), correlates with cognitive impairment and is associated with progression of non-demented patients into Alzheimer’s disease (AD) with dementia, suggesting that increase in small vessel resistance is a critical marker of cognitive decline. No study compared PI and MRI markers for small vessel disease or AD that have been shown to be associated with worse cognitive functions. The objectives of this study include: (i) compare PI against conventional MRI markers in its association with cognition, and (ii) investigate the association of PI and cognition in the presence of vascular risk factors.
We measured clinical data and PI in the middle cerebral artery in 331 stroke- and dementia-free community subjects. General cognition was assessed using Hong Kong-Montreal Cognitive Assessment. Conventional imaging markers (including lacunes, white matter hyperintensities (WMH), brain parenchymal fraction (BPF), cerebral microbleeds, Alzheimer’s Disease Resemblance Atrophy Index (ADRAI)) were assessed by MRI. Linear regression models were used to compare the sensitivity of PI against conventional MRI markers (including WMH, BPF, ADRAI, lacune and cerebral microbleeds count), with age and years of education entered as covariates.
PI was negatively associated with cognition (standardised b=-0.122, p=0.01). PI outperformed (standardised b=-0.118, p=0.012) other imaging markers and contributes to 1.1% change in the variance. PI was associated with higher systolic blood pressure (standardised b=0.122, p=0.028), and level of triglyceride (standardised b = 0.126, p = 0.021).
To conclude, PI is associated with cognition, higher levels of blood pressure and triglycerides, suggesting a vascular component in cognitive decline. PI outperforms conventional MRI markers in the association with cognition in community subjects without dementia. As TCD is non-invasive, portable with a lower cost than MRI, PI may serve as a simple marker in monitoring cerebral small vessel resistance and cognition in older people.
Terms of Address: A Contrastive Investigation of Ongoing Changes in British, American and Indian English and in German
Authors: Bruns Hanna , Kranich Svenja 
Published: March 2021

Abstract
Address terms are closely related to the conceptualisation of hierarchical relations in a speech community, so, since – at least in Western societies – tendencies towards a flattening of hierarchies have been noted (cf. Mair, 2006), we expect changes in this domain. Some evidence has been produced for German, American and British English, but empirical insights on address choice in Indian English are lacking to date. As it tends to be a conservative variety (cf. e.g. Collins, 2012), we might expect resistance to change.
The study makes a novel use of discourse completion tasks to investigate ongoing change using an ‘apparent-time’ approach. Our findings support the view of Indian English as conservative and of American English as changing most clearly towards informalisation, visible in the increasing use of informal attention getters (hey!). However, evidence of recent change is otherwise not as pronounced as expected and actually absent regarding pronoun choice in German.
Memory Unbound, Unfounded Memory? On Medicine, the Holocaust, and Bioethical Reflection
Authors: Schütz Mathias 
Published: March 2021

Abstract
The article deals with the notion that medical theories and practices played a significant role in the advent and execution of the Holocaust, and that bioethical lessons need to be drawn from this relation. Three underlying premises of this notion are critically assessed: First, that the importance of medicine for the Holocaust has been neglected by Holocaust scholarship; secondly, that there is a considerable empirical connection between Nazi medical crimes and the Holocaust; and thirdly, that this empirical connection represents a paradigmatic epistemological significance of medicine for the Holocaust. The article stresses that the Nazi medical crimes and the participation of physicians in inhumane research practices and mass murder were a significant aspect of Nazi history, but did not play a constitutive role in the extermination of European Jewry. For reasons of historical accuracy, as well as ethical specificity, they should, therefore, not simply be subsumed under the term Holocaust.
Advances in Land Surface Models and Indicators for Drought Monitoring and Prediction
Authors: Peters-Lidard Christa D. , Mocko David M. , Su Lu , Lettenmaier Dennis P. , Gentine Pierre , Barlage Michael 
Published: March 2021

AbstractMillions of people across the globe are affected by droughts every year, and recent droughts have highlighted the considerable agricultural impacts and economic costs of these events. Monitoring the state of droughts depends on integrating multiple indicators that each capture particular aspects of hydrologic impact and various types and phases of drought. As the capabilities of land surface models and remote sensing have improved, important physical processes such as dynamic, interactive vegetation phenology, groundwater, and snowpack evolution now support a range of drought indicators that better reflect coupled water, energy, and carbon cycle processes. In this work, we discuss these advances, including newer classes of indicators that can be applied to improve the characterization of drought onset, severity, and duration. We utilize a new model-based drought reconstruction to illustrate the role of dynamic phenology and groundwater in drought assessment. Further, through case studies on flash droughts, snow droughts, and drought recovery, we illustrate the potential advantages of advanced model physics and observational capabilities, especially from remote sensing, in characterizing droughts.
Effects of MJO Vertically Tilted Structure on Its Phase Speed from the Moisture Mode Theory Perspective
Authors: Hu Feng , Li Tim 
Published: March 2021

AbstractThe effect of vertically tilted structure (VTS) of the MJO on its phase propagation speed was investigated through the diagnosis of ERA-Interim reanalysis data during 1979–2012. A total of 84 eastward propagating MJO events were selected. It was found that all MJO events averaged throughout their life cycles exhibited a clear VTS, and the tilting strength was significantly positively correlated to the phase speed. The physical mechanism through which the VTS influenced the phase speed was investigated. On the one hand, a stronger VTS led to a stronger vertical overturning circulation and a stronger descent in the front, which caused a greater positive moist static energy (MSE) tendency in situ through enhanced vertical MSE advection. The stronger MSE tendency gradient led to a faster eastward phase speed. On the other hand, the enhanced overturning circulation in front of MJO convection led to a stronger easterly/low pressure anomaly at the top of the boundary layer, which induced a stronger boundary layer convergence and stronger ascent in the lower troposphere. This strengthened the boundary layer moisture asymmetry and favored a faster eastward propagation speed.
Evaluation of Patterns in Access to Breast Cancer Care and Breast Cancer Presentation in a Safety Net Patient Population
Authors: Choe Erica , Park Hayoung , Hembrick Ma’at , Dauphine Christine , Ozao-Choy Junko 
Published: March 2021

Background While prior studies have shown the apparent health disparities in breast cancer diagnosis and treatment, there is a gap in knowledge with respect to access to breast cancer care among minority women. Methods We performed a retrospective analysis of patients with newly diagnosed breast cancer from 2014 to 2016 to evaluate how patients presented and accessed cancer care services in our urban safety net hospital. Patient demographics, cancer stage, history of breast cancer screening, and process of referral to cancer care were collected and analyzed. Results Of the 202 patients identified, 61 (30%) patients were younger than the age of 50 and 75 (63%) were of racial minority background. Only 39% of patients with a new breast cancer were diagnosed on screening mammogram. Women younger than the age of 50 ( P < .001) and minority women ( P < .001) were significantly less likely to have had any prior screening mammograms. Furthermore, in patients who met the screening guideline age, more than half did not have prior screening mammograms. Discussion Future research should explore how to improve breast cancer screening rates within our county patient population and the potential need for revision of screening guidelines for minority patients.
Maternal Worry About Infant Weight and its Influence on Artificial Milk Supplementation and Breastfeeding Cessation
Authors: DiTomasso Diane , Wambach Karen Ann , Roberts Mary B. , Erickson-Owens Debra A. , Quigley Aimee , Newbury Jessica M. 
Published: March 2021

Background Maternal worry about infant weight has inconsistently been reported as a breastfeeding barrier. Weight monitoring is a critical tool to assess adequacy of infant feeding. Yet, little is known about the intensity of maternal worry about infant weight or associated breastfeeding outcomes. Research aims To examine (1) the frequency and intensity of maternal worry about infant weight; (2) the relationship between worry about weight and use of artificial milk; and 3) the relationship between worry about weight and breastfeeding cessation. Methods A prospective cross-sectional design was used. A questionnaire was completed by women in the United States ( N = 287) from 12 web-based maternal support groups. Results Sixty-three percent of women ( n = 182) had some worry about infant weight. Participants breastfeeding for the first time had more worry ( p = .035). Participants still breastfeeding had less worry about weight compared to those who had stopped (67%, n = 147 vs. 41%, n = 28). Exclusive breastfeeding participants had less worry ( p < .001) compared to those who supplemented with artificial milk. Increased worry was associated with the use of artificial milk within 1 week of birth ( p < .001) and early breastfeeding cessation ( p < .001). Conclusions Worry about weight is a significant breastfeeding barrier. It is associated with first time breastfeeding, less exclusive breastfeeding, use of artificial milk, and earlier breastfeeding cessation. Lactating mothers need anticipatory guidance about expected neonatal weight changes and interventions to help relieve worry about infant weight.
Quantitative Analysis of Deltoid Ligament Degradation in Patients With Chronic Ankle Instability Using Computed Tomographic Images
Authors: Ikuta Yasunari , Nakasa Tomoyuki , Sumii Junichi , Nekomoto Akinori , Adachi Nobuo 
Published: March 2021

Background: Rotational ankle instability (RAI) is associated with the faster onset of severe ankle osteoarthritis via dysfunction of the anterior talofibular ligament, calcaneofibular ligament, and deltoid ligament. No specific clinical examination is available for RAI, and diagnostic imaging has limitations in evaluating ligament degradation. This study investigated the deltoid ligament degeneration using Hounsfield unit (HU) values on computed tomography (CT) images. Methods: Patients were enrolled in this retrospective analysis if they had undergone magnetic resonance imaging (MRI) and CT scans of the ankle. The chronic ankle instability (CAI) group comprised 20 ankles with CAI (9 men, 11 women; mean age, 28.7 years) and the control group comprised 28 ankles (16 men, 12 women, mean age, 41.3 years). The average HU values of the deep posterior tibiotalar ligament (dPTL) that constitutes the deltoid ligament were measured on coronal CT images, and MRI results were used as a reference. All patients were subdivided based on the MRI findings of dPTL injury such as fascicular disruption, irregularity, and the loss of striation. Results: A strong negative correlation was identified between age and HU values for all patients (Spearman ρ = −0.63; P < .001). The mean HU values of the dPTL for participants aged <60 years were 81.0 HU for the control group (21 ankles) and 69.5 HU for the CAI group ( P = .0075). No significant differences in the HU values were observed for the dPTL among the MRI subgroups. Conclusion: In addition to the conventional imaging examination such as stress radiographs and MRI, HU measurements of CT images could be useful for quantitatively and noninvasively evaluating degenerative changes in the deltoid ligament for CAI patients to assist the diagnosis of RAI. Level of Evidence: Level III. case-control study.
Public perceptions of how alcohol consumption is dealt with in Swedish and Norwegian health care
Authors: Karlsson Nadine , Skagerström Janna , O’Donnell Amy , Abidi Latifa , Thomas Kristin , Nilsen Per , Lid Torgeir Gilje 
Published: March 2021

Aims: The aims of this study were to evaluate and compare popular beliefs and attitudes regarding alcohol conversations in healthcare in Sweden and Norway; and to explore which factors were associated with different levels of support for alcohol-prevention work in the two countries. Methods: Population-based cross-sectional surveys were conducted in Sweden ( n = 3000) and Norway ( n = 1208). Logistic regression was used to identify the characteristics of participants who were supportive of routine alcohol screening and brief intervention delivery. Results: A higher proportion of Swedish respondents agreed to a large extent that healthcare professionals should routinely ask about alcohol consumption. In addition, a higher proportion of Swedish respondents compared to respondents from Norway agreed that healthcare providers should only ask about patient’s alcohol consumption if this was related to specific symptoms. There were similar correlates of being supportive of routine alcohol screening and brief intervention delivery in both countries. Support was lower in both countries amongst moderate and risky drinkers, and among single adults or those on parental leave, but higher amongst older individuals. Having had an alcohol conversation in healthcare increased the level of support for alcohol prevention in routine healthcare among risky drinkers. Conclusions: There is a high level of support for preventative alcohol conversations in routine healthcare in Norway and Sweden, although there was a lower proportion of respondents who were positive to alcohol prevention in routine healthcare in Norway compared to Sweden. Experiencing alcohol conversation may positively affect risky drinkers’ attitudes towards and support for alcohol prevention. Thus, more frequent alcohol conversations in routine healthcare may also result in increased level of support for alcohol prevention among risky drinkers.
Treatment Outcomes in Aspirin-Exacerbated Respiratory Disease Based on the 12-Item Short Form Survey
Authors: Locke Tran B. , Sweis Auddie M. , Douglas Jennifer E. , Ig-Izevbekhai Kevin I. , Stevens Elizabeth M. , Civantos Alyssa M. , McCarty Elizabeth B. , Kumar Ankur , Kohanski Michael A. , Kennedy David W. , Palmer James N. , Bosso John V. , Adappa Nithin D. 
Published: March 2021

Background Aspirin-exacerbated respiratory disease (AERD) is optimally managed by endoscopic sinus surgery (ESS) followed by aspirin therapy after desensitization (ATAD). Most AERD quality of life (QOL) studies use the 22-item Sinonasal Outcomes Test (SNOT-22), which focuses predominantly on sinonasal outcomes. Objective This study seeks to assess QOL outcomes in AERD patients after ESS and ATAD via the 12-item Short Form Survey (SF-12), a well-validated QOL measure for general health status of chronic conditions. Methods Retrospective review of 112 AERD patients who underwent ESS followed by ATAD at our institution between 2016 and 2019. SF-12 was collected preoperatively, postoperatively/pre-AD, and serially post-AD (1–3, 4–6, 7–12, and >12 months). Optum® PRO CoRE software was used to compare data to national norms. ANOVA was performed comparing physical component summary (PCS), mental component summary (MCS) and eight health domains (physical functioning, role physical, general health, bodily pain, vitality, social functioning, role emotional, and mental health). Results AERD patients showed improvement in PCS scores across all timepoints after ESS and ATAD (p = 0.004). When stratified by gender, women demonstrated an improvement in PCS scores (p = 0.004). Within the domains, there were significant improvements in social functioning (SF), role physical (RP), and bodily pain (BP) at all timepoints (SF: p = 0.006; RP: p = 0.005; BP: p < 0.001). Conclusions AERD patients undergoing ESS and ATAD show improvement in physical QOL and 3 of the 8 health domains as measured by the SF-12. Future studies can use the SF-12 to study the impact of AERD treatment versus other chronic diseases and health demographics.
Retrospective cross sectional analysis of demographic disparities in outcomes of CPR performed by EMS providers in the United States
Authors: Hill Tess , Weber Thomas , Roberts Marshall , Garzon Hernando , Fraga Alvaro , Wetterer Craig , Puglisi Jose 
Published: March 2021

Objective To investigate demographic disparities in prehospital cardiopulmonary resuscitation (CPR) initiation and successful outcomes of patients with out-of-hospital cardiac arrest (OHCA) treated by emergency medical services (EMS) providers. Methods We analyzed the National Emergency Medical Service Information Systems (NEMSIS) 2017 database, analyzing patient gender, age and race against CPR initiation and Return of Spontaneous Circulation (ROSC). The analysis was performed for a subset of patients who received bystander interventions (n = 3,362), then repeated for the whole cohort of patients (n = 5,833). Results Within the subgroup of patients that received CPR or AED application prior to the arrival of the paramedics, a logistic regression for CPR initiation rates as a function of race, gender and age reported the following adjusted odds ratios: African American (AA) to White 0.570 (95%CI [0.419, 0.775]), Hispanic to White 0.735 (95%CI [0.470, 1.150]); female to male 0.768 (95%CI [0.598, 0.986]); senior to adult 0.708 (95%CI [0.545, 0.920). Similarly, a logistic regression of ROSC as a function of race, gender and age reported the following adjusted odds ratios: AA to White 0.652 (95%CI [0.533, 0.797]) Hispanic to White 1.018 (95%CI [0.783, 1.323]); female to male 0.887 (95%CI [0.767, 1.025]); senior to adult 0.817 (95%CI [0.709, 0.940]). Similar trends existed in the entire cohort of patients. Conclusions These results suggest that there are discrepancies in patient care during cardiopulmonary arrest performed by EMS for OHCA, inviting further exploration of healthcare differences in the prehospital EMS approach to OHCA.
Tibial Tunnel Placement in ACL Reconstruction Using a Novel Grid and Biplanar Stereoradiographic Imaging
Authors: Montreuil Julien , Saleh Joseph , Cresson Thierry , De Guise Jacques A. , Lavoie Frédéric 
Published: March 2021

Background: Nonanatomic graft placement is a frequent cause of anterior cruciate ligament reconstruction (ACLR) failure, and it can be attributed to either tibial or femoral tunnel malposition. To describe tibial tunnel placement in ACLR, we used EOS, a low-dose biplanar stereoradiographic imaging modality, to create a comprehensive grid that combines anteroposterior (AP) and mediolateral (ML) coordinates. Purpose: To (1) validate the automated grid generated from EOS imaging and (2) compare the results with optimal tibial tunnel placement. Study Design: Descriptive laboratory study. Methods: Using EOS, 3-dimensional models were created of the knees of 37 patients who had undergone ACLR. From the most medial, lateral, anterior, and posterior points on the tibial plateau of the EOS 3-dimensional model for each patient, an automated and personalized grid was generated from 2 independent observers’ series of reconstructions. To validate this grid, each observer also manually measured the ML and AP distances, the medial proximal tibial angle (MPTA), and the tibial slope for each patient. The ideal tibial tunnel placement, as described in the literature, was compared with the actual tibial tunnel grid coordinates of each patient. Results: The automated grid metrics for observer 1 gave a mean (95% CI) AP depth of 54.7 mm (53.4-55.9), ML width of 75.0 mm (73.3-76.6), MPTA of 84.9° (83.7-86.0), and slope of 7.2° (5.4-9.0). The differences with corresponding manual measurements were means (95% CIs) of 2.4 mm (1.4-3.4 mm), 0.5 mm (–1.3 to 2.2 mm), 1.2° (–0.4° to 2.9°), and –0.4° (–2.1° to 1.2°), respectively. The correlation between automated and manual measurements was r = 0.78 for the AP depth, r = 0.68 for the ML width, r = 0.18 for the MPTA, and r = 0.44 for the slope. The center of the actual tibial aperture on the plateau was a mean of 5.5 mm (95% CI, 4.8-6.1 mm) away from the referenced anatomic position, with a tendency toward more medial placement. Conclusion: The automated grid created using biplanar stereoradiographic imaging provided a novel, precise, and reproducible description of the tibial tunnel placement in ACLR. Clinical Relevance: This technique can be used during preoperative planning, intraoperative guidance, and postoperative evaluation of tibial tunnel placement in ACLR.