bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum Biomarkers of Iron Status and Risk of Hepatocellular Carcinoma Development in Patients with Nonalcoholic Fatty Liver Disease
Authors: Yu Yi-Chuan , Luu Hung N. , Wang Renwei , Thomas Claire E. , Glynn Nancy W. , Youk Ada O. , Behari Jaideep , Yuan Jian-Min 
Published: October 2021

Abstract

Background:
Nonalcoholic fatty liver disease (NAFLD) has become a major contributor to the rising incidence of hepatocellular carcinoma (HCC) in the United States and other developed countries. Iron, an essential metal primarily stored in hepatocytes, may play a role in the development of NAFLD-related HCC. Epidemiologic data on iron overload without hemochromatosis in relation to HCC are sparse. This study aimed to examine the associations between serum biomarkers of iron and the risk of HCC in patients with NAFLD.

Methods:
We identified 18,569 patients with NAFLD using the University of Pittsburgh Medical Center electronic health records from 2004 through 2018. After an average 4.34 years of follow-up, 244 patients developed HCC. Cox proportional hazard regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) of HCC incidence associated with elevated levels of iron biomarkers with adjustment for age, sex, race, body mass index, history of diabetes, and tobacco smoking.

Results:
The HRs (95% CIs) of HCC for clinically defined elevation of serum iron and transferrin saturation were 2.91 (1.34–6.30) and 2.02 (1.22–3.32), respectively, compared with their respective normal range. No statistically significant association was observed for total iron-binding capacity or serum ferritin with HCC risk.

Conclusions:
Elevated levels of serum iron and transferrin saturation were significantly associated with increased risk of HCC among patients with NAFLD without hemochromatosis or other major underlying causes of chronic liver diseases.

Impact:
Clinical surveillance of serum iron level may be a potential strategy to identify patients with NAFLD who are at high risk for HCC.
Vulnerabilidade mental e suicídio por contágio durante a vivência acadêmica
Authors: Muniz João Paulo Chagas , Finger Kamila Binsfeld , Davi Waldman Santos , Araújo Kassya Sthepanie Sousa de , Côrtes Mayra Aparecida 
Published: October 2021

Introdução: O comportamento suicida evolui de uma etiologia multifatorial na qual ocorre um compartilhamento de fatores por indivíduos de uma mesma sociedade. O sujeito social em risco é aquele que se encontra, por meio de pensamentos e valores, em situação desesperada e alienada. O discente se enquadra nessa conjuntura de vulnerabilidade, de modo que, quando exposto a informações detalhistas, demográficas e censitárias locais sobre casos de suicídio, pode vir a admitir inconscientemente o comportamento da prática, e, então, se tornar um perfil de risco. Conhecido como “Efeito Werther”, as exposições midiáticas quantitativas e qualitativas sobre o fenômeno suicídio influenciam no aumento das taxas de suicídio em indivíduos. O grau de influência possui relação dose-efeito e depende de características variáveis para o processo de imitação, identificação e reprodução do evento. Um exemplo de influência no processo de imitação é a divulgação, feita majoritariamente em redes sociais, de técnicas de suicídio, e, para o processo de identificação, a apresentação de nomes e perfis, como, por exemplo, de celebridades ou contextos sociais de suicidas. A adequação de informações expostas e a conscientização são elementos essenciais para o sucesso dos programas de prevenção do suicídio. Objetivo: Estabelecer a relação entre a vulnerabilidade mental de estudantes do ensino superior e a sua predisposição ao suicídio por contágio. Método: Trata-se de uma revisão integrativa da literatura a partir das bases de dados SciELO, LILACS, PubMed/MedLine, RCAAP, RCIPEA e daliteratura cinzenta usando os descritores: “tentativa de suicídio”; “estudantes”; “meios de comunicação”; e “saúde mental”. Resultado: Foram encontrados 3.143 artigos nas bases de dados pesquisadas. Após leitura do título e resumo e, considerando os critérios de inclusão e exclusão, foram elegíveis para o estudo 19 artigos. Somam-se às referências mencionadas dois livros-textos importantes para a temática pesquisada e dois artigos pesquisados na literatura cinzenta. Discussão: O suicídio como notícia deve ser abordado de forma discreta e reportado cuidadosamente sem exagero em detalhes para que não haja enaltecimento do fato em diversos aspectos. A população jovem é particularmente vulnerável ao efeito contágio para ideação suicida devido a uma maior inclinação para fenômenos de identificação e imitação. O ensino superior é um estágio de possível fragilidade psicológicae deve ser visto como período de risco para distúrbios mentais e desfechos trágicos. A adequação de informações expostas e a conscientização são elementos essenciais para o sucesso dos programas de prevenção do suicídio.
Tolerance and osmotic response to food deprivation and salt loading in the herbivorous non-drinking Moroccan Spiny-tailed lizard Uromastyx nigriventris (Sauria: Agamidae)
Authors: Safaa Bendami , Mohammed Znari 
Published: October 2021

Abstract
Animals inhabiting arid environments use a variety of behavioural and physiological strategies to balance their water and salt budgets. We studied the effects of dehydration and salt loading on osmoregulatory capacities in a large herbivorous desert lizard, the Moroccan Spiny-tailed lizard Uromastyx nigriventris, the family Agamidae. These lizards select plants with a high K+ to Na+ ratio of 15 to 20, and like other herbivorous lizards, effectively eliminate the extra electrolyte load, mainly via a pair of active nasal salt glands, which exude the extra ions from blood. Here we present results of a series of laboratory experiments, which tested a five-week food and water deprivation and the excretory response of nasal salt glands, during a short period of five days, following salt loading by two separated injections of KCl or NaCl at a 5-day interval (4th and 9th days). During food-water deprivation, hypohydrated lizards lost 32% of their initial body mass with a substantial decrease of their Body Condition Index and the tail volume as an index of energy (fat and then potential metabolic water) storage. Plasma osmolality significantly increased by 20%. There were also significantly increased plasma sodium, chloride, and total protein concentrations. On the other hand, there was no significant decrease in the plasma glucose level. Most of the salt loaded lizards secreted far more K+ than Na+ via the nasal glands, even after NaCl loading. The K+/Na+ ratio decreased only after two to three repetitive NaCl injections but insufficient Na+ was eliminated. Two successive KCl injections were successfully eliminated, but daily natural average K+ administration induced progressive hyperkaliemia. These experimental data agreed with previous observations showing variations of plasma Na+ and K+ concentrations in free-living lizards. The nasal gland constitutes the main route of Cl− excretion but the Cl−/(Na+ + K+) ratio may vary according to observations in other herbivorous species.
Estimating Nearshore Waves by Assimilating Buoy Directional Spectrum Data in SWAN
Authors: Walker David T. , Brunner Kelsey 
Published: October 2021

AbstractThis paper describes a variational data assimilation algorithm based on the Simulating WAves Nearshore (SWAN) wave spectrum model. The approach allows single-point wave spectrum observations to be used to estimate the wave field for a nearshore region under stationary conditions, assuming a spatially uniform incident wave spectrum at the offshore boundary. The assimilated data are in the form of Fourier directional coefficients, the standard output from operational wave buoys, and are used directly by incorporating the relationship between directional spectrum and the Fourier coefficients into the formulation. The algorithm was tested on data from nearshore buoys deployed off the coast of North Carolina in May 2012, and the estimated wave field is compared to both the input data and independent observation data. The results compare favorably to the independent data with overall RMS errors of 10%–20% for significant wave height, about half a second for mean wave period, and as much as three to four SWAN spectral grid cells for mean direction. Overall, the results show that the algorithm can be effectively used to estimate the offshore boundary spectrum and accurately reproduce wave conditions in the domain.
Soil Moisture Influence on the Incidence of Summer Mesoscale Convective Systems in the U.S. Great Plains
Authors: Gaal Rachel , Kinter III James L. 
Published: October 2021

Abstract
Mesoscale convective systems (MCS) are known to develop under ideal conditions of temperature and humidity profiles and large-scale dynamic forcing. Recent work, however, has shown that summer MCS events can occur under weak synoptic forcing or even unfavorable large-scale environments. When baroclinic forcing is weak, convection may be triggered by anomalous conditions at the land surface. This work evaluates land surface conditions for summer MCS events forming in the U.S. Great Plains using an MCS database covering the contiguous United States east of the Rocky Mountains, in boreal summers 2004–16. After isolating MCS cases where synoptic-scale influences are not the main driver of development (i.e., only non-squall-line storms), antecedent soil moisture conditions are evaluated over two domain sizes (1.25° and 5° squares) centered on the mean position of the storm initiation. A negative correlation between soil moisture and MCS initiation is identified for the smaller domain, indicating that MCS events tend to be initiated over patches of anomalously dry soils of ∼100-km scale, but not significantly so. For the larger domain, soil moisture heterogeneity, with anomalously dry soils (anomalously wet soils) located southwest (northeast) of the initiation point, is associated with MCS initiation. This finding is similar to previous results in the Sahel and Europe that suggest that induced meso-β circulations from surface heterogeneity can drive convection initiation.
Examining Violence Against Women at a Regional Level 1 Trauma Center During the COVID-19 Pandemic
Authors: Tracy Brett M. , Whitson Amy K. , Chen JC , Weiss Brian D. , Sims Carrie A. 
Published: October 2021

Introduction There is a growing concern that certain public health restrictions imposed to prevent the spread of coronavirus disease 2019 (COVID-19) could result in more violence against women (VAW). We sought to determine if the rates and types of VAW changed during the COVID-19 pandemic at our level 1 trauma center (L1TC). Methods We performed a retrospective review of female patients who presented to our L1TC because of violence from 2019 through 2020. Patients were grouped into a pre-COVID or COVID period. The primary aim of this study was to compare rates of VAW between groups. Secondary aims sought to evaluate for any difference in traumatic mechanism between periods and to determine if a temporal relationship existed between COVID-19 and VAW rates. Results There was no difference in rates of VAW between the pre-COVID and COVID period (3.1% vs 3.6%, P = .6); however, rates of penetrating trauma were greater during the COVID period (38.2% vs 10.3%, P = .01). After controlling for patient age and race, the odds of penetrating trauma increased during the pandemic (OR 5.8, 95% CI 1.6-28.5, P < .01). From February 2020 through October 2020, there was a direct relationship between rates of COVID-19 and VAW ( r2 .78, P < .01). Conclusion Rates of VAW were unchanged between the pre-COVID and COVID periods, yet the odds of penetrating VAW were 5 times greater during the pandemic. Moving forward, trauma surgeons must remain vigilant for signs of violence and ensure that support services are available during future crises.
Adjuvant Radiation Does Not Affect Locoregional Control Following Resection of Melanoma Satellitosis or In-Transit Disease
Authors: Yaney Alexander C. , Rossfeld Kara K. , Wu Trudy C. , Agnese Doreen M. , Terando Alicia M. , Wuthrick Evan J. , Howard John H. 
Published: October 2021

Background This study evaluates the association of adjuvant radiation therapy (RT) with improved locoregional (LR) recurrence for resected melanoma satellitosis and in-transit disease (ITD). Materials and Methods Data were collected retrospectively for resected melanoma satellitosis/ITD from 1996 to 2017. Results 99 patients were identified. 20 patients (20.2%) received adjuvant RT while 79 (79.8%) did not. Mean follow-up in the RT group was 4.3 years and 4.7 years in the non-RT group. 80% of patients who underwent RT suffered a complication, most commonly dermatitis. Locoregional recurrence occurred in 9 patients (45%) treated with adjuvant RT and 30 patients (38%) in the non-RT group ( P = 0.805). Median LR-DFS was 5.8 years in the RT group and 9.5 years in the non-RT group ( P = 0.604). On multivariable analysis, having a close or positive margin was the only independent predictor of LR-DFS (HR 3.8 95% CI 1.7-8.7). In-transit disease was associated with improved overall survival when compared to satellitosis (HR 0.260, 95% CI 0.08-0.82). Discussion The use of adjuvant RT is not associated with improved locoregional control in resected melanoma satellitosis or ITD. Close or positive margin was the only treatment-related factor associated with decreased LR-DFS after surgical resection of satellitosis/ITD.
Iatrogenic Injuries in Manual and Mechanical Cardiopulmonary Resuscitation
Authors: Chun Magnus J. , Zhang Yichi , Toraih Eman A. , McGrew Patrick R. 
Published: October 2021

Purpose Mechanical chest compression has been shown to be equivalent to manual chest compression in providing survival benefits to patients experiencing cardiac arrest. There has been a growing need for a contemporary review of iatrogenic injuries caused by mechanical in comparison with manual chest compression. Our study aims to analyze the studies that document significant life-threatening iatrogenic injuries caused by mechanical and manual chest compression. Methods A systematic review of PubMed and Embase was performed according to Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. All studies published after January 1st, 2000 were reviewed using inclusion/exclusion criteria and completed by May 2020. A total of 7202 patients enrolled in 15 studies were included in our meta-analysis. Results Significant life-threatening iatrogenic injuries had higher odds of occurring when mechanical chest compression was used compared to manual chest compression, especially for hemothorax and liver lacerations. Mechanical chest compression involves consistently deeper compression depths compared to manual chest compression, potentially resulting in more injuries. In the mechanical chest compression cohort, chest wall fractures had the highest incidence rate (55.7%), followed by sternal fracture (28.3%), lung injuries (3.7%), liver (1.0%), and diaphragm (.2%) lacerations. Conclusions Mechanical chest compression was associated with more iatrogenic injuries as compared to manual chest compression. Further research is needed to define the appropriate application of mechanical in comparison with manual chest compression in different scenarios. Levels of provider training, different mechanical chest compression device types, patient demographics, and compression duration/depth may all play roles in influencing outcomes.
The Efficacy and Safety of Methylnaltrexone for the Treatment of Postoperative Ileus
Authors: Beavers Jennifer , Orton Lindsay , Atchison Leanne , Medvecz Andrew , Dennis Bradley , Guillamondegui Oscar , Smith Michael C. 
Published: October 2021

Background Postoperative ileus (POI) is a surgical complication resulting in increased morbidity and length of stay (LOS). Usual care for POI includes bowel rest and gastric decompression. It has been questioned if methylnaltrexone (MNTX), a peripheral opioid antagonist, could be used as treatment for POI. The purpose of this study was to determine if MNTX is effective and safe for POI treatment. Methods This single-center, retrospective cohort study included patients ⩾ 18 years with a POI. Patients with acute colonic pseudo-obstruction, small bowel obstruction, and gastrointestinal malignancy were excluded. The intervention was MNTX administration. The primary outcome was time to ileus resolution. Secondary outcomes included LOS, duration of nasogastric tube, total parenteral nutrition requirement, and incidence of gastrointestinal perforations. Results 110 patients were included in the analysis; 28 received MNTX. Time to ileus resolution was 9.9 days for the MNTX group and 11.4 days for the control group ( P = .38). Duration of gastric decompression was 4.6 days for the MNTX group and 4.2 days for the control group ( P = .71). Length of stay was 19.9 days for the MNTX group and 19.7 days for the control group ( P = .96). The percentage of TPN requirement was 17.9% in the MNTX group and 22.0% in the control group ( P = .65). No gastrointestinal perforations were observed in either group. Conclusion For the treatment of POI, MNTX did not significantly reduce time to resolution of ileus, LOS, duration of gastric decompression, or TPN requirements. However, no gastrointestinal perforations were seen, indicating that MNTX may be safely used in these patients.
Syndromic Surveillance as a Tool for Case-Based Varicella Reporting in Georgia, 2016-2019
Authors: Adam Carolyn M. , Borroto René , Thomas Ebony , Tuttle Jessica , Pavlick Jessica , Drenzek Cherie L. 
Published: October 2021

Objectives Syndromic surveillance can be used to enhance notifiable disease case-based surveillance. We analyzed features of varicella reported in Georgia to evaluate case detection through syndromic surveillance and to compare varicella reported through syndromic surveillance with varicella reported from all other sources. Methods Syndromic surveillance was incorporated into case-based varicella surveillance by the Georgia Department of Public Health (GDPH) in May 2016. A cross-sectional study design evaluated syndromic and nonsyndromic varicella reported to GDPH from May 1, 2016, through December 31, 2019. Varicella was reported by nonsyndromic sources including health care providers, schools, and laboratories. We identified syndromic varicella cases from urgent care and emergency department visit data with discharge diagnoses containing the terms “varicella” or “chickenpox.” Results Syndromic notifications accounted for 589 of 2665 (22.1%) suspected varicella reports investigated by GDPH. The positive predictive value was 33.1% for syndromic notifications and 31.3% for nonsyndromic notifications. Mean days from rash onset to GDPH notification was 3.2 days fewer ( P < .001) among patients identified through syndromic notification than among patients identified through nonsyndromic notification. The odds of varicella identified by syndromic notification being outbreak-associated were 0.18 (95% CI, 0.09-0.36) times those of varicella identified through nonsyndromic notification. Practice Implications Syndromic notifications were an effective, timely means for varicella case detection. Syndromic patients were significantly less likely than nonsyndromic patients to be outbreak-associated, possibly because of early detection. Syndromic surveillance enhanced case-based reporting for varicella in Georgia and was a useful tool to improve notifiable disease surveillance.
How did the Affordable Care Act Medicaid Expansion Affect Coverage and Access to Care for Low-Income Parents Who Were Eligible for Medicaid Before the Law Was Passed?
Authors: McMorrow Stacey , Kenney Genevieve M. 
Published: October 2021

We use the National Health Interview Survey from 2010 to 2017 and a difference-in-differences approach to assess the impact of the Affordable Care Cct (ACA) Medicaid expansion on coverage and access to care for a subset of low-income parents who were already eligible for Medicaid when the ACA was passed. Any gains in coverage would typically be expected to improve access to and affordability of care, but there were concerns that by increasing the total population with coverage and thereby straining provider capacity, that the ACA would reduce access to care for individuals who were already eligible for Medicaid prior to the passage of the law. We found that the expansion reduced uninsurance among previously eligible parents by 12.6 percentage points, or a 40 percent decline from their 2012–2013 uninsurance rate. Moreover, these effects grew stronger over time with a 55 percent decline in uninsurance 2 to 3 years following expansion. Though we identified very few statistically significant impacts of the expansion on affordability of care, descriptive estimates show substantial declines in unmet needs due to cost and problems paying family medical bills. Descriptively, we find no significant increases in provider access problems for previously eligible parents, and very limited evidence that the Medicaid expansion was associated with more constrained provider capacity. Though sample size constraints were likely a factor in our ability to identify impacts on access and affordability measures, our overall findings suggest that the ACA Medicaid expansion positively affected our sample of low-income parents who met pre-ACA Medicaid eligibility criteria.
Romantic and parental attachment, psychosocial risk, and personal agency in emerging adulthood
Authors: Nunes Filipa , Matos Paula Mena , Ferreira Tiago , Mota Catarina Pinheiro 
Published: October 2021

This study focuses on emerging adults’ personal agency, an individual feature associated with enhanced adaptive and resilient developmental trajectories. The two objectives were to explore the role of demographic, psychosocial risk, and relational factors in predicting personal agency and analyze whether romantic attachment mediates the connection between parental attachment and personal agency. The sample consisted of 607 Portuguese emerging adults aged between 18 and 30 years. Structural equation modeling results suggest that men are more likely to exhibit higher levels of personal agency than women. Trustful romantic relations and good paternal emotional bonds are associated with greater personal agency, while dependent romantic relations and maternal relations, characterized by inhibition of exploration, are associated with lower personal agency. Moreover, in romantic relations, trust, unlike dependence, partially mediates the association between parental attachment and personal agency. These findings are discussed based on attachment and self-determination theories, considering the importance of secure relationships for agency and autonomy in personal actions. This study provides important evidence for the influencers and mediators of personal agency, contributing to a better understanding of this individual capacity.
Experience with VariClose® vein sealing system in the Czech Republic
Authors: Balaz Peter , Rokosny Slavomir , Herman Jiri , Pirkl Miloslav , Vlachovsky Robert , Whitley Adam 
Published: October 2021

Objectives The aim of this study was to assess occlusion rates of saphenous veins treated with the VariClose vein sealing system. Methods A retrospective analysis including a total of 64 patients from four centres from the Czech Republic. Occlusion was defined as a non-compressible vein with absence of flow with exception to the first 3 cm from the saphenofemoral or saphenopopliteal junction on duplex ultrasound. Results In 64 patients a total of 79 veins were treated. Technical success of the procedure was achieved in 74 (94%) of cases. The mean follow-up was 5.5 months. The closure rates calculated by the Kaplan-Meier method at 1, 3, 6 and 12 months were 94%, 85%, 69% and 36%, respectively, and there were no significant differences between centers. The average difference in VCSS score before and after the procedure was 1.8. Conclusions The present study demonstrated surprisingly worse occlusion rates than the current literature.