bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arsenic Exposure and Melanoma Among US Adults Aged 20 or Older, 2003-2016
Authors: Bedaiwi Ahmed , Wysong Ashley , Rogan Eleanor G. , Clarey Dillon , Arcari Christine M. 
Published: May 2021

Objectives Chronic exposure to arsenic has been reported as a risk factor for nonmelanoma skin cancer, notably squamous cell carcinoma. However, current knowledge is limited about the association between arsenic exposure and melanoma. Our objectives were to (1) measure the association between total urinary arsenic levels and melanoma compared with nonmelanoma skin cancer and no cancer and (2) analyze the association between water source and melanoma and nonmelanoma skin cancer. Methods We collected cross-sectional data from the 2003-2016 cycles of the National Health and Nutrition Examination Survey. We conducted univariate and multivariate logistic regressions. To evaluate the possible association of skin cancer with source of tap water, we calculated odds ratios for participants with melanoma and nonmelanoma skin cancer, compared with participants with no cancer. Results White race, higher education, higher socioeconomic status, and smoking history were associated with melanoma and nonmelanoma skin cancer in the full study population. After adjusting for age and race/ethnicity, the adjusted odds ratio of participants with >50 μg/L of total urinary arsenic for melanoma or nonmelanoma skin cancer was 1.87 (95% CI, 0.58-6.05) and 2.23 (95% CI, 1.12-4.45) times higher compared with no cancer, respectively. Participants with nonmelanoma skin cancer had 2.06 increased odds of reporting a nonmunicipal water source compared with participants without cancer. Conclusions We did not find a relationship between the incidence of melanoma and exposure to arsenic among US adults. Nonmunicipal water sources were associated with nonmelanoma skin cancer and should be further investigated.
Subacute Thyroiditis in COVID-19 Patients
Authors: Seyed Resuli Ali , Bezgal Muzaffer 
Published: May 2021

Objective: As a result of the COVID-19 pandemic that occurred in the last year, it has been revealed that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) does not only cause viral respiratory tract infection but can also affect many organs in the short or long term. In our study, we aimed to reveal that COVID-19 infection affects the endocrine system and triggers subacute thyroiditis (SAT) in the acute period. Material and Method: In our retrospective study, the ear-nose-throat examination, internal diseases consultation (investigation of COVID-19 symptoms and polymerase chain reaction [PCR] test), routine blood tests, T3, T4, thyroid-stimulating hormone, antithyroglobulin (anti-TG), antithyroid peroxidase (anti-TPO), thyroid scintigraphy, and thyroid ultrasonography results of 5 patients who applied to the otorhinolaryngology clinic due to complaints of neck pain and odynophagia between April 2020 and February 2021 were examined. Findings: All 5 patients were female patients (30.4 years) with odynophagia and pain in the front lower region of the neck. These patients had no previous history of thyroiditis. COVID-19 PCR tests of the patients diagnosed with SAT were positive, and there were no typical COVID-19 signs and symptoms except odynophagia and neck pain. Result: It comes in view that SARS-COV-2 affects thyroid functions and causes SAT and the main symptoms in patients are pain in the neck and odynophagia.
Urine Leukotriene E4: Implications as a Biomarker in Chronic Rhinosinusitis
Authors: Choby Garret , Low Christopher M. , Levy Joshua M. , Stokken Janalee K. , Pinheiro‐Neto Carlos , Bartemes Kathy , Marino Michael , Han Joseph K. , Divekar Rohit , O’Brien Erin K. , Lal Devyani 
Published: May 2021

ObjectiveTo provide a comprehensive state‐of‐the‐art review of the emerging role of urine leukotriene E4 (uLTE4) as a biomarker in the diagnosis of chronic rhinosinusitis (CRS), aspirin‐exacerbated respiratory disease (AERD), and asthma.Data SourcesOvid MEDLINE(R), Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus.Review MethodsA state‐of‐the‐art review was performed investigating the role of uLTE4 as a diagnostic biomarker, predictor of disease severity, and potential marker of selected therapeutic efficacy.ConclusionsuLTE4 has been shown to be a reliable and clinically relevant biomarker for CRS, AERD, and asthma. uLTE4 is helpful in ongoing efforts to better endotype patients with CRS and to predict disease severity.Implications for PracticeAside from being a diagnostic biomarker, uLTE4 is also able to differentiate aspirin‐tolerant patients from patients with AERD and has been associated with objective disease severity in patients with CRS with nasal polyposis. uLTE4 levels have also been shown to predict response to medical therapy, particularly leukotriene‐modifying agents.
Government human rights focal points: Lessons learned from focal points under the Convention on the Rights of Persons with Disabilities
Authors: Caughey Colin 
Published: May 2021

The exploration for tools and approaches that will make the UN human rights treaty system more impactful has been ongoing for over thirty years. The UN Convention on the Rights of Persons with Disabilities continues to represent the most innovative approach to effecting human rights implementation at the domestic level, through placing obligations on States to designate a Disability Focal Point within government and an Independent Monitoring Mechanism outside of government. This article examines the role of Disability Focal Points and considers in particular how the current drive for the establishment of National Mechanisms for Reporting and Follow-Up may have unintended consequences for their development. The article utilises the United Kingdom as a case-study to assess the potential benefits of allocating responsibility for international reporting and follow-up to a Disability Focal Point. The article finds that the role performed by Disability Focal Points at the domestic level makes them best placed to coordinate reporting and follow-up relating to the CRPD. Furthermore, the fact that Disability Focal Points are fully integrated into domestic national policy mechanisms means that they ought to be well positioned to harness the transformative potential of the treaty body examination process.
Use and Accuracy of Inpatient CGM During the COVID-19 Pandemic: An Observational Study of General Medicine and ICU Patients
Authors: Longo Rebecca Rick , Elias Heather , Khan Mehvish , Seley Jane Jefferie 
Published: May 2021

Background: Continuous glucose monitoring (CGM) is widely used in the outpatient setting for people with diabetes and has been limited to investigational use only for the inpatient population. In April 2020, the US FDA exercised enforcement discretion for the temporary use of inpatient CGM during the pandemic, thus hospitals were presented the opportunity to implement this technology. Methods: We sought to investigate the accuracy of CGM in hospitalized patients on general care floors and the intensive care unit (ICU) in attempts to decrease healthcare professional exposure to COVID-19 and ultimately improve glycemic management of patients affected by COVID-19. Point of care (POC) and laboratory (Lab) glucose values were matched with simultaneous CGM glucose values and measures of accuracy were performed to evaluate the safety and usability of CGM in this population. Our data are presented drawing a distinction between POC and Lab as reference glucose sources. Results: In 808 paired samples obtained from 28 patients (10 ICU, 18 general floor), overall mean absolute relative difference (MARD) for all patients using either POC or Lab as reference was 13.2%. When using POC as the reference glucose MARD was 13.9% and using Lab glucose as reference 10.9%. Using both POC and Lab reference glucose pairs the overall MARD for critical care patients was 12.1% and for general floor patients 14%. Conclusion: We determined, with proper protocols and safeguards in place, use of CGM in the hospitalized patient is a reasonable alternative to standard of care to achieve the goal of reducing healthcare professional exposure. Further study is necessary to validate safety, accuracy, and efficacy of this technology. Investigation and analysis are necessary for the development of protocols to utilize CGM trend arrows, alerts, and alarms.
Anxiety symptoms in working patients with major depressive disorder treated with vortioxetine: associations with clinical and treatment outcomes in the AtWoRC study
Authors: Chokka Pratap , Ge Holly , Bougie Joanna , Ettrup Anders , Clerzius Guerline 
Published: May 2021

Background: Anxiety symptoms are common in patients with major depressive disorder (MDD) and usually confer worse treatment outcomes. The long-term, open-label AtWoRC study in working patients with MDD treated with vortioxetine demonstrated a significant correlation between severity of anxiety symptoms and impaired work productivity. This analysis was undertaken to further explore clinical characteristics and treatment outcomes in patients with different levels of severity of anxiety symptoms at baseline. Methods: Post hoc analysis in 199 working patients with MDD treated with vortioxetine (10–20 mg/day), stratified by Generalized Anxiety Disorder 7-item (GAD-7) score at baseline [mild/moderate anxiety (GAD-7 ⩽14), n = 83; severe anxiety (GAD-7 ⩾15), n = 116]. Associations were examined between GAD-7 and other outcome assessment scores at baseline. Observed mean changes from baseline to week 52 were compared between groups. Results: Patients with severe anxiety had significantly worse depressive and cognitive symptoms, functioning, and work productivity at baseline than those with mild/moderate anxiety, but similar cognitive performance. Statistically significant improvements from baseline were seen for all outcomes after 52 weeks of vortioxetine treatment, with no significant differences observed between the two groups after adjustment for baseline anxiety scores. Conclusion: Treatment with vortioxetine was associated with long-term improvement in clinical symptoms and measures of work productivity in patients with MDD in a real-world setting, irrespective of severity of anxiety symptoms at the start of treatment.
Epidemiology of Clavicle Fractures Sustained at a Colorado Ski Resort
Authors: Oberle Lauren , Pierpoint Lauren , Spittler Jack , Khodaee Morteza 
Published: May 2021

Background: Although clavicle fractures are a common sports injury, there are limited studies on the incidence and causes of clavicle fractures among winter sports athletes. Purpose: To evaluate the characteristics and injury mechanisms associated with clavicle fractures among patients evaluated at a Colorado ski resort. Study Design: Descriptive epidemiology study. Methods: This was a retrospective descriptive analysis of patients with clavicle fractures at the Denver Health Winter Park Medical Center during the 2012-2013 to 2016-2017 ski seasons. Chart review was performed on the patient cohort to confirm clavicle fracture diagnosis and to evaluate factors associated with clavicle fracture. Results: A total of 393 clavicle fractures (6.2% of total clinic visits) occurred during the study period, corresponding to an overall clavicle fracture incidence of 8.4 per 100,000 participant-visits. The mean patient age was 26.4 years (range, 5-73 years). The majority were middle-third fractures (85.5%), occurring mainly in men (87.3%). More than half of the fractures were comminuted (54.5%) and occurred in snowboarders (55.0%). The most common mechanism of injury was a fall onto snow while skiing or snowboarding (92.4%). Women sustained more clavicle fractures while skiing compared with snowboarding (82.0% vs 18.0%; P < .001), while men sustained more fractures while snowboarding compared with skiing (60.3% vs 39.7%; P < .001). Conclusion: Clavicle fractures are relatively common, but there are scant incidence data for clavicle fractures in mountain sports. Consistent with prior studies, clavicle fractures were more common in younger patients and men. The most common anatomic fracture location was the midclavicle. A greater proportion of clavicle fractures among men were sustained during snowboarding and among women during skiing.
Understanding the impact of the Covid-19 pandemic through the lens of innovation
Authors: Gopalakrishnan Shanthi , Kovoor-Misra Sarah 
Published: May 2021

In this article, we explore the Covid-19 crisis through the lens of innovation. We focus on the threat and opportunity drivers of innovation, and some of their product/service and process outcomes. We contribute to crisis innovation theory and practice by suggesting that there are two categories of innovation during multi-level crises, such as a pandemic: (1) reactive, threat-driven innovations that are created to contain and respond to organizational problems and disruptions that arise from the crisis; and (2) proactive, opportunity-driven innovations that are created to capitalize on environmental needs and opportunities. We highlight the role of human, physical interdependence in organizations’ core technologies that create threats for some organizations and opportunities for others during the pandemic. JEL CLASSIFICATION: O32; O34; H12
Fashioned Mucoperichondrium Flap Technique in Caudal Septal Deviation
Authors: Nofal Ahmed Abdelfattah Bayomy 
Published: May 2021

Caudal septal dislocation is a common finding, and it could lead to functional as well as aesthetic morbidity. There are different techniques to support the anterior end of the nasal septum and stabilize it in midline position. There are technical and practical difficulties in those techniques. This study describes a newly fashioned mucoperichondrium flap technique in caudal septal dislocation. This study was done in 40 patients (29 male and 11 female) with a mean (SD) age of 25 (3.2) years who had symptomatic septal deviation with minor and moderate caudal septal dislocation. The mucoperichondium flap on the side of the columellar dislocation was fashioned to be straight and stretched by excision of the extra length. It acted as a supporting scaffold for the straightened septum to be secured and fixed in the midline without need of any stabilizing sutures. All the patients had satisfactory functional and cosmetic results with correction of the columellar dislocation.
Preoperative MRI and Intraoperative Arthroscopic Evaluation of Chondral Pathology at the Hip Chondrolabral Junction
Authors: Turner Elizabeth H.G. , Hund Samuel J. , Dooley Matthew S. , Spiker Andrea M. 
Published: May 2021

Background: Previous literature has found that hip magnetic resonance imaging (MRI) has lower accuracy and reliability in preoperative diagnosis of cartilage and labral pathology compared with knee and shoulder MRI. This is a notable limitation, as MRI findings play a significant role in the determination for surgical intervention in femoroacetabular impingement syndrome (FAIS) and aid in surgical planning, intraoperative cartilage management, and in postoperative rehabilitation expectations. Indications: Hip arthroscopy is most commonly utilized for the treatment of FAIS and associated labral tears and chondral pathology of varying grades, particularly at the chondrolabral junction. Given the difficulty in assessing chondrolabral pathology on preoperative MRI, we present our preferred method of correlating MRI to intraoperative findings at the chondrolabral junction. Technique Description: Using preoperative MRI and the Outerbridge classification system, we describe our method to assess cartilage injuries and chondrolabral junction pathology in patients who undergo hip arthroscopy for FAIS. We correlate chondral injuries with preoperative MRI to aid surgeons in interpreting the degree of chondral injury from MRI and corresponding surgical findings. Results: Given that MRI of the hip is neither as accurate nor as reliable as MRI of the knee or shoulder, an understanding of how to correlate preoperative MRI with intraoperative appearance can better prepare the surgeon for findings at the chondrolabral junction of the hip. The absence of findings on MRI does not rule out the possibility of cartilage or labral pathology. Discussion/Conclusion: Intraoperatively, hip cartilage is assessed using either the Outerbridge or Beck classification systems. These classification systems require direct visualization of the hip joint, and full assessment of the chondrolabral junction and associated pathology may not be possible until intra-articular work is complete. While MRI evaluation of the hip is difficult due to the depth of the hip joint, location of the hip relative to the MR magnet, and thinness of the acetabular cartilage, it is a useful tool for preoperative hip joint cartilage assessment, though not as accurate as knee and shoulder MRIs. Understanding the correlation between preoperative hip MRI and intraoperative chondrolabral pathology can aid the surgeon in preparation for hip arthroscopy in the treatment of FAIS.
Disentangling the aging gene expression network of termite queens
Authors: Monroy Kuhn José Manuel , Meusemann Karen , Korb Judith 
Published: May 2021

Abstract
Background
Most insects are relatively short-lived, with a maximum lifespan of a few weeks, like the aging model organism, the fruit-fly Drosophila melanogaster. By contrast, the queens of many social insects (termites, ants and some bees) can live from a few years to decades. This makes social insects promising models in aging research providing insights into how a long reproductive life can be achieved. Yet, aging studies on social insect reproductives are hampered by a lack of quantitative data on age-dependent survival and time series analyses that cover the whole lifespan of such long-lived individuals. We studied aging in queens of the drywood termite Cryptotermes secundus by determining survival probabilities over a period of 15 years and performed transcriptome analyses for queens of known age that covered their whole lifespan.

Results
The maximum lifespan of C. secundus queens was 13 years, with a median maximum longevity of 11.0 years. Time course and co-expression network analyses of gene expression patterns over time indicated a non-gradual aging pattern. It was characterized by networks of genes that became differentially expressed only late in life, namely after ten years, which associates well with the median maximum lifespan for queens. These old-age gene networks reflect processes of physiological upheaval. We detected strong signs of stress, decline, defense and repair at the transcriptional level of epigenetic control as well as at the post-transcriptional level with changes in transposable element activity and the proteostasis network. The latter depicts an upregulation of protein degradation, together with protein synthesis and protein folding, processes which are often down-regulated in old animals. The simultaneous upregulation of protein synthesis and autophagy is indicative of a stress-response mediated by the transcription factor cnc, a homolog of human nrf genes.

Conclusions
Our results show non-linear senescence with a rather sudden physiological upheaval at old-age. Most importantly, they point to a re-wiring in the proteostasis network and stress as part of the aging process of social insect queens, shortly before queens die.
Plant DNA methylation is sensitive to parent seed N content and influences the growth of rice
Authors: Fan Xiaoru , Liu Laihua , Qian Kaiyun , Chen Jingguang , Zhang Yuyue , Xie Peng , Xu Man , Hu Zhi , Yan WenKai , Wu Yufeng , Xu Guohua , Fan Xiaorong 
Published: May 2021

Abstract
Background
Nitrogen (N) is an important nutrient for plant growth, development, and agricultural production. Nitrogen stress could induce epigenetic changes in plants. In our research, overexpression of the OsNAR2.1 line was used as a testing target in rice plants with high nitrogen-use efficiency to study the changes of rice methylation and growth in respond of the endogenous and external nitrogen stress.

Results
Our results showed that external N deficiency could decrease seed N content and plant growth of the overexpression line. During the filial growth, we found that the low parent seed nitrogen (LPSN) in the overexpression line could lead to a decrease in the filial seed nitrogen content, total plant nitrogen content, yield, and OsNAR2.1 expression (28, 35, 23, and 55%, respectively) compared with high parent seed nitrogen (HPSN) in high nitrogen external supply. However, such decreases were not observed in wild type. Furthermore, methylation sequencing results showed that LPSN caused massive gene methylation changes, which enriched in over 20 GO pathways in the filial overexpression line, and the expression of OsNAR2.1 in LPSN filial overexpression plants was significantly reduced compared to HPSN filial plants in high external N, which was not shown in wild type.

Conclusions
We suggest that the parent seed nitrogen content decreased induced DNA methylation changes at the epigenetic level and significantly decreased the expression of OsNAR2.1, resulting in a heritable phenotype of N deficiency over two generations of the overexpression line.
Lessons learned implementing and managing the DIVERT-CARE trial: practice recommendations for a community-based chronic disease self-management model
Authors: Dash Darly , Schumacher Connie , Jones Aaron , Costa Andrew P. 
Published: May 2021

Abstract
Background
Chronic disease management models of care provide an opportunity to assist home care clients to manage their disease burden. However, pragmatic trial management practices and lessons learned from such models are poorly illustrated in the literature.

Methods
We describe the processes of implementing a community-based cardiorespiratory self-management model, known as DIVERT-CARE, across the home care programs of three health regions in Canada. The DIVERT-CARE model is a multi-component complex intervention that identifies home care clients at the highest risk of deterioration and provides them with resources and capacity to manage their conditions. We conducted a retrospective analysis of baseline participant characteristics, needs assessments, reviewed findings from site visits and a national workshop with study partners, and examined other study documentation.

Results
Three home care regions in Canada participated in the study. A robust and data-driven review of each site was necessary to understand the local context, home care caseloads, structure of local systems, and intensity of resources, which influenced study processes. The creation of an intervention framework highlighted the need to adapt the intervention in a way that was sensitive to the local context while maintaining intervention outcomes.

Conclusion
Our detailed review showcases the relevant activities and on-the-ground steps needed to manage and conduct a multi-site pragmatic trial in home care. This example can help other researchers in implementing multi-disciplinary and multi-component care models for practice-based research.