bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case of malignant glomus tumor (glomangiosarcoma) of the nasal cavity
Authors: Alhroub Omar A , Mahameed Shimaa A , Abdelhafez Mohammad O , Alhroub Asil , Hour Hani , Hasasna Nabil , Kamal Nazmi 
Published: December 2021

Abstract
Glomus tumors are rare and usually benign. The malignant form (glomangiosarcoma) comprises &lt;1% of all glomus tumors. There are limited reports that describe glomus tumors in the nasal cavity. However, to the best of our knowledge, glomangiosarcoma of the nasal cavity was never reported in humans. We report on the first case of nasal cavity glomangiosarcoma in a 59-year-old male who presented with a bleeding mass in his right nostril. We completely excised the lesion with a 0.7-mm free margin, and the histopathologic examination was consistent with glomangiosarcoma. A 6-month follow-up illustrated no evidence of recurrence or distant metastasis. Although it is rare, glomus tumors should be in the differential diagnosis of nasal cavity tumors. Histopathologic examination is essential for glomangiosarcoma diagnosis. Treatment requires complete excision with free margin, alongside careful clinical and radiological follow-up.
Challenges With Engaging Military Stakeholders for Clinical Research at the Point of Care in the U.S. Military Health System
Authors: Rhon Daniel I , Oh Robert C , Teyhen Deydre S 
Published: December 2021

ABSTRACT
The DoD has a specific mission that creates unique challenges for the conduct of clinical research. These unique challenges include (1) the fact that medical readiness is the number one priority, (2) understanding the role of military culture, and (3) understanding the highly transient flow of operations. Appropriate engagement with key stakeholders at the point of care, where research activities are executed, can mean the difference between success and failure. These key stakeholders include the beneficiaries of the study intervention (patients), clinicians delivering the care, and the military and clinic leadership of both. Challenges to recruitment into research studies include military training, temporary duty, and deployments that can disrupt availability for participation. Seeking medical care is still stigmatized in some military settings. Uniformed personnel, including clinicians, patients, and leaders, are constantly changing, often relocating every 2-4 years, limiting their ability to support clinical trials in this setting which often take 5-7 years to plan and execute. When relevant stakeholders are constantly changing, keeping them engaged becomes an enduring priority. Military leaders are driven by the ability to meet the demands of the assigned mission (readiness). Command endorsement and support are critical for service members to participate in stakeholder engagement panels or clinical trials offering novel treatments. To translate science into relevant practice within the Military Health System, early engagement with key stakeholders at the point of care and addressing mission-relevant factors is critical for success.
Special-Science Counterfactuals
Authors: List Christian 
Published: December 2021

AbstractOn the standard analysis, a counterfactual conditional such as “If P had been the case, then Q would have been the case” is true in the actual world if, in all nearest possible worlds in which its antecedent (P) is true, its consequent (Q) is also true. Despite its elegance, this analysis faces a difficulty if the laws of nature are deterministic. Then the antecedent could not have been true, given prior conditions. So, it is unclear what the relevant “nearest possible worlds” are. David Lewis suggested that they are ones in which a local breach of the laws occurred: a “small miracle.” Others have suggested that they are ones in which the initial conditions were different (“backtracking”). I propose another response. It builds on the idea that the special sciences, where counterfactual reasoning is most common, operate at a higher level of description from fundamental physics, and that the world may behave indeterministically at higher levels even if it behaves deterministically at the fundamental physical one. The challenge from determinism can then be bypassed for many special-science counterfactuals.
Dual IGF1R/IR inhibitors in combination with GD2-CAR T-cells display a potent anti-tumor activity in diffuse midline glioma H3K27M-mutant
Authors: de Billy Emmanuel , Pellegrino Marsha , Orlando Domenico , Pericoli Giulia , Ferretti Roberta , Businaro Pietro , Ajmone-Cat Maria Antonietta , Rossi Sabrina , Petrilli Lucia Lisa , Maestro Nicola , Diomedi-Camassei Francesca , Pezzullo Marco , De Stefanis Cristiano , Bencivenga Paola , Palma Alessia , Rota Rossella , Del Bufalo Francesca , Massimi Luca , Weber Gerrit , Jones Chris , Carai Andrea , Caruso Simona , De Angelis Biagio , Caruana Ignazio , Quintarelli Concetta , Mastronuzzi Angela , Locatelli Franco , Vinci Maria 
Published: December 2021

AbstractBackgroundDiffuse midline gliomas (DMG) H3K27M-mutant, including diffuse intrinsic pontine glioma (DIPG), are pediatric brain tumors associated with grim prognosis. Although GD2-CAR T-cells demonstrated significant anti-tumor activity against DMG H3K27M-mutant in vivo, a multimodal approach may be needed to more effectively treat patients. We investigated GD2 expression in DMG/DIPG and other pediatric high-grade gliomas (pHGG) and sought to identify chemical compounds that would enhance GD2-CAR T-cell anti-tumor efficacy.MethodsImmunohistochemistry in tumor tissue samples and immunofluorescence in primary patient-derived cell lines were performed to study GD2 expression. We developed a high-throughput cell-based assay to screen 42 kinase inhibitors in combination with GD2-CAR T-cells. Cell viability, western blots, flow-cytometry, real time PCR experiments, DIPG 3D culture models, and orthotopic xenograft model were applied to investigate the effect of selected compounds on DIPG cell death and CAR T-cell function.ResultsGD2 was heterogeneously, but widely, expressed in the tissue tested, while its expression was homogeneous and restricted to DMG/DIPG H3K27M-mutant cell lines. We identified dual IGF1R/IR antagonists, BMS-754807 and linsitinib, able to inhibit tumor cell viability at concentrations that do not affect CAR T-cells. Linsitinib, but not BMS-754807, decreases activation/exhaustion of GD2-CAR T-cells and increases their central memory profile. The enhanced anti-tumor activity of linsitinib/GD2-CAR T-cell combination was confirmed in DIPG models in vitro, ex vivo, and in vivo.ConclusionOur study supports the development of IGF1R/IR inhibitors to be used in combination with GD2-CAR T-cells for treating patients affected by DMG/DIPG and, potentially, by pHGG.
Bilateral renal infarction with COVID-19 pneumonia: a case report
Authors: Jana Kundan , Janga Kalyana C , Greenberg Sheldon , Kumar Kamlesh 
Published: December 2021

ABSTRACT
Acute renal infarction is a rare and often underdiagnosed condition with estimated incidence of 0.5–1.5%. Coronavirus disease 2019 (COVID-19) has been shown to cause a hypercoagulable state in patients leading to arterial and venous thromboembolism. Renal infarction as a consequence of COVID-associated coagulopathy has been reported, sometimes resulting in acute kidney injury. Most of the patients so far reported had other existing comorbidities and risk factors that compounded the risk of precipitating an infarction. Here, we present a 37-year-old, the youngest patient reported so far, with no pre-existing comorbidities or risk factors, who developed bilateral renal infarction with COVID-19 pneumonia. The patient was treated with anticoagulation for renal infarction and discharged on apixaban. Anticoagulation is an important part of current treatment strategies for COVID-19 pneumonia and should extend beyond the acute phase of the disease to prevent long-term sequelae, especially in young patients.
Bureaucracy and the Imaginal Realm: Max Weber, Rationality and the Substantive Basis of Public Administration
Authors: Langer Julie 
Published: December 2021

AbstractMax Weber is an important figure in Public Administration. Nearly all foundational texts in the field include his theory of bureaucracy. Yet, although the field teaches the core tenets of an efficient bureaucracy, namely, formalization, division of labor, impersonality, and hierarchy, his view of the formally rational thought systems undergirding it and the role of values in shaping bureaucratic action are largely overlooked. An attempt here is made to reexamine Weber’s conceptualization of bureaucracy and review his propositions regarding both the promise and peril it holds for social progress. In order to evaluate the degree to which Weber’s darker propositions have come to fruition and the forces at play acting as bulwarks against them, the relationship between formal and substantive rationality is considered against the backdrop of changing administrative models in the United States. Based on this analysis, a substantive path for the future of Public Administration in the United States is laid out.
Average stride length and stride rate of Thoroughbreds and Quarter Horses during racing
Authors: Vergara-Hernandez Fernando B , Nielsen Brian D , Robison Cara I , Fabus Taylor A , Kompare Jasmin L , LeCompte Lazić Rebecca Ashley , Colbath Aimee C 
Published: December 2021

Abstract
The main factors influencing speed in athletes are stride length (SL) and stride rate (SR). However, conflict remains whether SL or SR is the key determinant of higher speeds. Quarter Horses (QH) generally reach higher speeds in their races than do Thoroughbreds (TB). However, the influence of SL and SR on this greater speed is unclear. Therefore, the main objective of this study was to compare SL and SR in QH and TB raced in short (sprint) and long (classic) distances. We hypothesized that QH have a higher SR in comparison to TB, and SR decreases as distance increases. Two race distances were analyzed for each breed: QH races of 100.6 and 402.3 m, and TB races of 1,207.0 and 2,011.7 m. Data from 20 horses were obtained, consisting of five horses from each race distance (10 QH and 10 TB). Five individuals watched recordings of each race three times counting the number of strides taken by each winning horse. The SR was calculated using the average number of strides over a given race duration, and SL was determined by calculating the total number of strides over the distance covered. Speed was calculated by dividing the distance by the time of the winning horse. The PROC Mixed Procedure was used to identify statistical differences between breeds, and between distances within the same breed. Results showed that although the SL of the TB was longer in comparison with the QH (P &lt; 0.001), the average SR in QH was higher than in TB (2.88 vs. 2.34 + 0.03 strides/s; P &lt; 0.001). Furthermore, QH classic distance demonstrated a faster speed than TB at either distance (P &lt; 0.001). In conclusion, QH achieve a higher SR in comparison to TB (between 14% and 20% more than TB), confirming the importance of SR in achieving high racing speeds.
A Rare Case of Cytomegalovirus and Herpes Simplex Virus Coinfection Gastritis and Colitis in a Person Living With HIV/AIDS
Authors: Huang Jingwen , Qamar Zahra , Gancher Elizabeth 
Published: December 2021

Abstract
Herpes simplex virus (HSV) colitis and gastritis is a very rare gastrointestinal manifestation in immunocompromised patients. We report the case of a 46-year-old man with a medical history of poorly controlled HIV/AIDS who presented with 2 months of progressively worsening nonbloody diarrhea. Esophagogastroduodenoscopy showed gastritis and sigmoidoscopy revealed severe colitis. Biopsy immunostaining revealed cytomegalovirus and HSV viral inclusions in the stomach, appendix, and rectum. The patient's symptoms largely improved with ganciclovir. To our knowledge, this is the first case demonstrating cytomegalovirus and HSV coinfection gastritis and colitis in a patient with HIV/AIDS.
Long-Acting Lipoglycopeptide Antibiotics (Dalbavancin and Oritavancin) for the Treatment of Endotipsitis in a Patient With Cirrhosis
Authors: Winbush Angelina , Alpizar-Rivas Rodolfo , Gupta Purba , Zanoria Catherine , Chuang Sally , Prasad Paritosh , Louie Ted 
Published: December 2021

Abstract
Endovascular Staphylococcal infections involving prosthetic material typically require long courses of intravenous antibiotics, which are often completed at home or in a rehabilitation facility with outpatient parenteral antibiotic therapy. An alternative to outpatient parenteral antibiotic therapy is the use of long-acting lipoglycopeptides (LaLGPs). Dalbavancin and oritavancin are LaLGPs that have been used for the treatment of catheter-related blood-stream infections and endocarditis. However, their use in patients with liver dysfunction is not well documented in the literature. Herein, we describe a case of LaLGPs used to successfully treat endotipsitis, an infection of the transjugular intrahepatic portosystemic shunt system, in a patient with cirrhosis.
Disparities of Access, Use, and Barriers to Seeking Health Care Services in Arizona
Authors: Gallaway Michael Shayne , Aseret-Manygoats Teresa , Tormala Wayne 
Published: December 2021

Background:
Access to health care (HC) services is important for promoting and maintaining health, preventing and managing disease, reducing unnecessary disability and premature death, and achieving health equity for all persons.

Objectives:
We assess social indicators among people living in Arizona that are associated with access, use, and barriers to seeking HC services.

Research Design:
We analyzed data (n=8073) from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) to describe demographic and health characteristics among persons by HC access and use, and for whom costs were a barrier to seeking care.

Results:
Among Arizona adults, 13.5% reported lacking HC coverage, 28.7% reported lacking a personal doctor, and medical costs were a barrier to seeking care for 14.1%. Arizonans aged 18–34 years or with a high school education or less more often reported lacking HC coverage, a personal doctor, or not visiting a doctor because of costs. Past year medical and dental checkups were less common among less educated (≤high school) and never married persons. Hispanic persons more often reported lacking HC coverage or not visiting a doctor because of costs, and less often reported past year dental checkups.

Conclusions:
BRFSS can be analyzed to identify and quantify unique HC disparities, and the findings can serve as the basis for improving HC in communities. Expansion of HC services and providers may be achieved, in part, through incentives for providers to work in designated health professional shortage areas and/or leveraging telehealth/telemedicine in rural and urban underserved communities.
Differential Effects by Mental Health Status of Filling the Medicare Part D Coverage Gap
Authors: Liu Judith , Zhang Yuting , Kaplan Cameron M. 
Published: December 2021

Objective:
The objective of this study was to study how changes in insurance benefit design affect medication use of older adults with mental disorders.

Data Sources:
US Medicare claims data from 2007 to 2018.

Study Design:
Exploiting the gradual elimination of the Medicare prescription drug coverage gap beginning in 2011, we examine the effects on medication use and out-of-pocket spending by drug type with a difference-in-differences approach. We identify subpopulations by mental disorder and compare the estimates across mental health groups and to the general Medicare population.

Principal Findings:
Closing the gap substantially reduced individuals’ out-of-pocket spending, and the reduction was larger for those with more severe mental disorders. The policy led to a statistically significant increase in branded drugs used for the Medicare population (0.91; P<0.01; 12.12% increase), beneficiaries with severe mental disorders (2.71; P<0.01; 11.13% increase), and common mental disorders (2.63; P<0.01; 11.62% increase), whereas such effect for beneficiaries with Alzheimer disease and dementia (AD) is substantially smaller (0.44; P<0.01; 1.83% increase). In contrast, the policy decreased generic drugs used by about 3%–5% for all groups. Overall, beneficiaries without mental health illness have a statistically significant increase in total medication use (2.05%) following the coverage gap closure, while all 3 mental health groups have either no statistically significant changes or a small reduction in total mediation use (AD, −1.26%).

Conclusions:
Patients’ responses to price changes vary across mental disorders and by drug type. The impact on branded drug utilization among those with AD is particularly small. Our findings suggest that lowering medication costs has differential impacts across diseases and may not be sufficient to improve adherence for all conditions, in particular those with severe mental health disorders such as AD.
Monitoring Preventable Adverse Events and Near Misses: Number and Type Identified Differ Depending on Method Used
Authors: Isaksson Stina , Schwarz Anneli , Rusner Marie , Nordström Sophia , Källman Ulrika 
Published: December 2021

Objectives
This study aimed to investigate how many preventable adverse events (PAEs) and near misses are identified through the methods structured record review, Web-based incident reporting (IR), and daily safety briefings, and to distinguish the type of events identified by each method.

Methods
One year of retrospective data from 2017 were collected from one patient cohort in a 422-bed acute care hospital. Preventable adverse events and near misses were collected from the hospital’s existing resources and presented descriptively as number per 1000 patient-days.

Results
The structured record review identified 19.9 PAEs; the IR system, 3.4 PAEs; and daily safety briefings, 5.4 PAEs per 1000 patient-days. The most common PAEs identified by the record review method were drug-related PAEs, pressure ulcers, and hospital-acquired infections. The most common PAEs identified by the IR system and daily safety briefings were fall injury and pressure ulcers, followed by skin/superficial vessel injuries for the IR system and hospital-acquired infections for the daily safety briefings. Incident reporting and daily safety briefings identified 7.8 and 31.9 near misses per 1000 patient-days, respectively. The most common near misses were related to how care is organized.

Conclusions
The different methods identified different amounts and types of PAEs and near misses. The study supports that health care organizations should adopt multiple methods to get a comprehensive review of the number and type of events occurring in their setting. Daily safety briefings seem to be a particularly suitable method for assessing an organization’s inherent security and may foster a nonpunitive culture.
Frequency and Nature of Communication and Handoff Failures in Medical Malpractice Claims
Authors: Humphrey Kate E. , Sundberg Melissa , Milliren Carly E. , Graham Dionne A. , Landrigan Christopher P. 
Published: December 2021

Background
The Joint Commission has identified miscommunication as a leading cause of sentinel events, the most serious adverse events, but it is unclear what role miscommunications play in malpractice claims. We sought to determine the proportion of medical malpractice claims involving communication failure and describe their nature, including providers involved, locations, miscommunications types, costs, and the potential for handoff tools to avert risk and associated costs.

Methods
We retrospectively reviewed a random sample of malpractice claims from 2001 to 2011, collected in CRICO Strategies’ Comparative Benchmarking System, a national claims database. Two researchers reviewed cases to determine if a claim involved communication failure, its type, and potential preventability using a communication tool. Interrater reliability was assessed by dual review of 50 cases (81% agreement, κ = 0.62 for evidence of miscommunication). Claimant demographics, case characteristics, and financial data were analyzed.

Results
Communication failures were identified in 49% of claims. Claims with communication failures were significantly less likely to be dropped, denied, or dismissed than claims without (54% versus 67%, P = 0.015). Fifty-three percent of claims with communication failures involved provider-patient miscommunication, and 47% involved provider-provider miscommunication. The information types most frequently miscommunicated were contingency plans, diagnosis, and illness severity. Forty percent of communication failures involved a failed handoff; the majority could potentially have been averted by using a handoff tool (77%). Mean total costs for cases involving communication failures were higher ($237,600 versus $154,100, P = 0.005).

Conclusions
Communication failures are a significant contributing cause of malpractice claims and impose a substantial financial burden on the healthcare system. Interventions to improve transmission of critical patient information have the potential to substantially reduce malpractice expenditures.
Capturing Parents’ Perspectives of Child Wellness to Support Identification of Acutely Unwell Children in the Emergency Department
Authors: Albutt Abigail , Roland Damian , Lawton Rebecca , Conner Mark , O’Hara Jane 
Published: December 2021

Objective
Early signs of serious illness can be difficult to recognize in children and a delayed response can result in poor outcomes. Drawing on the unique knowledge of parents and carers may improve identification of the deteriorating child. However, there is a lack of evidence exploring parental perspectives as part of track and trigger systems. This study examines the utility of capturing parent-reported child wellness, using the Patient Wellness Questionnaire for Pediatrics, to support identification of acutely unwell children presenting to the Emergency Department.

Methods
Parent-reported child wellness was recorded alongside the Pediatric Observation Priority Score (POPS), a multidimensional scoring system akin to a Pediatric Early Warning Score, used as part of routine care. Multiple linear regression assessed the independent effects of 3 variables (parent-reported child wellness, nurse concern, and child age) on POPS and hospital admission.

Results
Data were collected for 407 children. All 3 variables explained a statistically significant proportion of variance in POPS (F(3, 403) = 7.525, P < 0.001, R
2 = 0.053), with parent-reported child wellness (B = 0.223, SE = 0.054, β = 0.202, P < 0.001) having the strongest effect. Approximately 10% of the children with no physiological derangement were rated as “very poorly” by their parents.

Conclusions
The findings suggest that parents have insight in to the wellness of their children that is reflected in the physiological assessment. Some parents’ perceptions about their child’s wellness were not consistent with the score captured in the same assessment. More work is needed to understand how to use and address parental perspectives and concerns to support clinical decision making and the management of acute illness.