bluuebunny/crossref_metadata_2025_split huggingface dataset:
Asian Ethnic Subgroup Disparities in Delays of Surgical Treatment for Breast Cancer
Authors: Navarro Stephanie , Yang Yifei , Ochoa Carol Y , Mejia Aaron , Kim Sue E , Liu Lihua , Lerman Caryn , Farias Albert J 
Published: December 2021

Abstract

Background
As Asian American breast cancer incidence rises, it is necessary to investigate the origins of differential breast cancer outcomes among Asian ethnic subgroups. This study aimed to examine disparities in delays of breast cancer surgery among Asian ethnic subgroups.

Methods
We obtained California Cancer Registry data on female breast cancer diagnoses and treatment from 2012 to 2017. Our main independent variable was patient race and ethnicity, including 6 Asian ethnic subgroups. Dependent variables included time to surgical treatment for breast cancer and receipt of surgical treatment within 30 and 90 days of diagnosis. We conducted multivariable logistic regression to determine the odds of receiving surgery within 30 and 90 days of diagnosis and multivariable Cox proportional hazards regression to determine the risk of prolonged time to surgery.

Results
In our cohort of 93 168 breast cancer patients, Hispanic (odds ratio [OR] = 0.86, 95% confidence interval [CI] = 0.82 to 0.89) and non-Hispanic Black (OR = 0.83, 95% CI = 0.78 to 0.88) patients were statistically significantly less likely than non-Hispanic White patients to receive surgery within 30 days of breast cancer diagnosis, whereas Asian Indian or Pakistani (OR = 1.23, 95% CI = 1.09 to 1.40) and Chinese (OR = 1.30, 95% CI = 1.20 to 1.40) patients were statistically significantly more likely to receive surgery within 30 days of diagnosis.

Conclusions
This large, population-based retrospective cohort study of female breast cancer patients is the first, to our knowledge, to demonstrate that time to surgical treatment is not equal for all Asians. Distinct differences among Asian ethnic subgroups suggest the necessity of further investigating breast cancer treatment patterns to fully understand and target disparities in breast cancer treatment.
Why Are Counterfactual Assessment Methods Not Widespread in Outcome-Based Contracts? A Formal Model Approach
Authors: Lazzarini Sergio G , Cabral Sandro , Firpo Sergio , Teodorovicz Thomaz 
Published: December 2021

Abstract
Counterfactual assessment techniques involving treated and control groups, such as randomized control trials, might be used in outcome-based contracts to avoid rewarding or sanctioning service providers for social outcomes that they did not cause. However, few outcome-based contracts adopt payment rules based on counterfactual assessment techniques. Potential explanations are that these techniques are complex and involve substantial transaction costs. In this paper, we develop a theoretical formal model that integrates the literatures of incentives and policy evaluation to propose the following alternative explanation: counterfactual techniques may lead to counterproductive incentive effects if they reduce the likelihood of payment even if project managers exert sufficient effort to promote the expected interventions. Our model shows that counterfactual assessment may undermine effort when the number of treated subjects is small and there is limited investment per treated subject. Our formal model also suggests that the increased experience of the contract sponsors may inhibit the adoption of counterfactual assessment. Simulations and descriptive evidence from a unique database of 350 outcome-based contracts designed or initiated throughout the world and from linear probability models are aligned with our predictions. By offering additional explanations on why counterfactual assessment methods are not widespread in outcome-based contracts and by identifying the boundary conditions under which these methods are used in incentive contracts, this work informs the literature on cross-sector outcome-based contracts and illustrates the use of formal models to develop novel theories in public administration.
Levels in Biological Organisms: Hierarchy of Production Mechanisms, Heterarchy of Control Mechanisms
Authors: Bechtel William 
Published: December 2021

Abstract
Among the notions of levels invoked in accounts of biological phenomena, I focus on two: levels of production mechanisms and levels of control mechanisms. I argue that these two notions of level exhibit different characteristics: production mechanisms are organized hierarchically while control mechanisms are often organized heterarchically. I illustrate the differences in these modes of organization by examining production and control mechanisms involved in cell division in Escherichia coli and in circulation of blood in mammals. I conclude by exploring how these two notions of levels can be integrated by adopting a perspective in which organisms are autonomous systems maintaining themselves far from equilibrium.
Interactions between species change the uptake of ammonium and nitrate inAbies faxonianaandPicea asperata
Authors: Hu Xuefeng , Li Wanting , Liu Qinghua , Yin Chunying 
Published: December 2021

AbstractPlant nitrogen (N) uptake is affected by plant–plant interactions, but the mechanisms remain unknown. A 15N-labeled technique was used in a pot experiment to analyze the uptake rate of ammonium (NH4+) and nitrate (NO3−) by Abies faxoniana Rehd. et Wils and Picea asperata Mast. in single-plant mode, intraspecific and interspecific interactions. The results indicated that the effects of plant–plant interactions on N uptake rate depended on plant species and N forms. Picea asperata had a higher N uptake rate of both N forms than A. faxoniana, and both species preferred NO3−. Compared with single-plant mode, intraspecific interaction increased NH4+ uptake for A. faxoniana but reduced that for P. asperata, while it did not change NO3− uptake for the two species. The interspecific interaction enhanced N uptake of both N forms for A. faxoniana but did not affect the P. asperata compared with single-plant mode. NH4+ and NO3− uptake rates for the two species were regulated by root N concentration, root nitrate reductase activity, root vigor, soil pH and soil N availability under plant–plant interactions. Decreased NH4+ uptake rate for P. asperata under intraspecific interaction was induced by lower root N concentration and nitrate reductase activity. The positive effects of interspecific interaction on N uptake for A. faxoniana could be determined mainly by positive rhizosphere effects, such as high soil pH. From the perspective of root–soil interactions, our study provides insight into how plant–plant interactions affect N uptake, which can help to understand species coexistence and biodiversity maintenance in forest ecosystems.
Study of the Factors that Influence Low-Level Viremias in Human Immunodeficiency Virus Patients in a Tertiary Hospital
Authors: Pinilla Rello Andrea , Navarro Aznárez Herminia , Magallón Martínez Arantxa , Cazorla Poderoso Lucía , Pérez Moreno María , Martínez-Sapiña Ana , Abad Sazatornil María Reyes 
Published: December 2021

Background
Low-level viremias (LLVs) can be associated with age, suboptimal adherence, antiretroviral therapy (ART), and local epidemiology. The objective of the study was to analyze the influence of adherence and ART on the LLVs of human immunodeficiency virus patients in a tertiary hospital.

Methods
A descriptive, multidisciplinary, observational, and retrospective study of human immunodeficiency virus–naive patients who started ART between 2013 and 2018, who have not undergone changes in their ART, and who have been on treatment for at least 1 year was conducted. The following are the variables of the study: age, sex, ART, treatment start date, degree of adherence, and existence of LLVs.

Results
The sample included 153 patients (83.7% men) with a median age of 40 years (12–82 years). Of the patients who started with a nonnucleotide analog reverse-transcriptase inhibitor as the third drug, 26.8% (n = 56) presented with LLVs, 62.5% (n = 16) with an enhanced protease inhibitor (PI), and 42.7% (n = 75) with an integrase inhibitor. Fifty-seven patients (37.3%) presented with LLVs, with 48 (84.2%) having high adherence (≥90%). Statistically significant differences were observed in the presence of LLVs in patients who started with nonnucleotide analog reverse-transcriptase inhibitor as the third drug (P = 0.025) and in those patients with PI as the third drug (P = 0.047). In patients with LLVs, statistically significant differences were observed in the adherence of patients with PI (P = 0.041).

Conclusions
A relationship was observed between low adherence, PI as the third drug, and LLVs. In patients with possible poor adherence to ART, a third drug with a high genetic barrier was used, but this did not prevent the presence of LLVs, making it necessary to use other strategies and closely monitor these patients.
Quantifying the Employer Burden of Persistent Musculoskeletal Pain at a Large Employer in the United Kingdom
Authors: Roomes David , Abraham Lucy , Russell Rachel , Beck Craig , Halsby Kate , Wood Robert , O’Brien Megan , Massey Lucy , Burton Kim 
Published: December 2021

Objective:
To quantify the burden of work-relevant persistent musculoskeletal (MSK) pain to a large UK employer.

Methods:
A retrospective, longitudinal, analytical cohort study using linked Rolls-Royce data systems. Cases were employees with a MSK-related referral to occupational health; controls were age-, sex-, and job role-matched employees without such a referral. Outcomes were compared during 12 months’ follow-up.

Results:
Overall, 2382 matched case–control pairs were identified (mean age: 46 y; 82% male). Cases took 39,200 MSK-related sickness absence days in total (equating to £50 million in sickness absence costs). Cases took significantly more all-cause sickness absence days than controls (82,341 [£106 million] versus 19,628 [£26 million]; P < 0.0001).

Conclusions:
Despite access to extensive occupational health services, the burden of work-relevant persistent MSK pain remains high in Rolls-Royce. There is a clear need to better understand how to effectively reduce this burden.
Magnesium valproate adjuvant therapy on patients with dementia
Authors: Zhang Chen qi , Zheng ke xin , Sun Ling qi , Sun Hongbin 
Published: December 2021

Abstract

Background:
With the aging population, the prevalence and incidence of dementia disease will continue to rise, and the associated economic burden is increasing as well. However, the available anti-dementia therapeutic arsenal is limited. Meanwhile, magnesium valproate (VPM) as an adjuvant therapy had a general positive effect on the cognitive function and psychiatric symptoms of patient with dementia (PwD). At present, there is lack of meta-analysis focusing on cognitive improvement and disease-modifying about VPM-assisted therapy in the present peer-reviewed literature. Thus, we aimed to likely analyze the efficacy and safety of VPM adjuvant therapy of PwD.

Methods:
We will research MEDLINE via PubMed, Cochrane Library, EBSCO, Embase, China National Knowledge (CNKI) and Wan fang databases to gather relevant data on VPM assistant therapy on the PwD. Meta-analysis will be performed using Stata16.0 software.

Results:
We aim to evaluate the efficacy and safety of VPM in the adjuvant treatment of PwD.

Conclusion:
VPM maybe plays an active role in the treatment of dementia patients and this research will provide reliable evidence for clinicians in therapy of PwD.

INPLASY registration number:
INPLASY2021110038 (DOI: 10.37766/inplasy2021.11.0038).
Histopathologic discrepancies between endoscopic forceps biopsy and endoscopic resection specimens in nonampullary duodenal epithelial tumors
Authors: Kim Da Mi , Kim Gwang Ha , Lee Bong Eun , Kim Kyungbin , Choi Kyung Un , Hong Seung Min , Lee Moon Won , Song Geun Am 
Published: December 2021

Abstract
For patients with nonampullary duodenal epithelial tumors (NADETs), endoscopic forceps biopsy results that reflect the final histopathologic results of the entire lesion are indispensable for accurate diagnosis and appropriate treatment modality selection. This study aimed to investigate the histopathologic discrepancies between endoscopic forceps biopsy and endoscopic resection specimens in NADETs and to elucidate the factors contributing to such discrepancies.
This retrospective observational study included 105 patients (105 lesions) who underwent endoscopic resection for NADETs at the Pusan National University Hospital between May 2006 and October 2019. NADETs were classified as low-grade intraepithelial neoplasms (LGINs), high-grade intraepithelial neoplasms (HGINs), or adenocarcinomas. Following slide reviews, the histopathologic concordance between endoscopic forceps biopsy and endoscopic resection specimens was assessed for each case.
The histopathologic discrepancy rate between endoscopic forceps biopsy and endoscopic resection specimens was 19.0% (20/105 lesions). Among the 20 diagnostically discordant lesions, up- and downgrade of the histopathologic diagnosis occurred in 17 and 3 lesions, respectively. The predominant discrepancies involved upgrades from LGIN to HGIN (n = 14) and upgrades from LGIN to adenocarcinomas (n = 2). The 3 downgraded cases included 2 from LGIN to inflammation and 1 from HGIN to LGIN. In the multivariate analyses, the old age (>67 years) was the only factor significantly associated with histopathologic upgrade (odds ratio 4.553, 95% confidence interval 1.291–15.939; P = .018).
Considerable histopathologic discrepancies were observed between endoscopic forceps biopsy and endoscopic resection specimens in NADETs. Older age was significantly associated with these discrepancies.
Misplaced emphasis, misunderstood risk: a cultural history of Public Health Service infectious disease guidelines
Authors: Hendele James B. , Limaye Ajit P. , Sibulesky Lena 
Published: December 2021

Purpose of review
To review and summarize the evolution of the Public Health Service (PHS) guidelines and Organ Procurement and Transplantation Network (OPTN) regulations for the prevention of blood borne virus transmission in solid organ transplant through the lens of popular culture, scientific evolution, patient and practitioner bias and outcomes research.

Recent findings
The most recent set of guidelines and regulations were released in 2020 and represent a culmination of decades of opinion, research and debate within the scientific and lay communities.

Summary
The guidelines were created to address public concern, and the risk of undiagnosed disease transmission in the context of the novel public health crisis of AIDS. We reviewed milestone publications from the scientific and lay press from the first description of AIDS in 1981 to the present to help illustrate the context in which the guidelines were created, the way they changed with subsequent editions, and offer critical consideration of issues with the current set of guidelines and a potential way forward. Further consideration should be given to the way in which the current guidelines identify donors with risk criteria for infectious disease transmission and mandate explanation of donor-specific risk factors to potential recipients, in our era of universal donor screening and recipient surveillance.
Comparison of Same and Different Level Height Falls on Subsequent Midline Shift in Pediatric Traumatic Brain Injury
Authors: Sullivan Brittany G. , Grigorian Areg , Lekawa Michael , Dolich Matthew O. , Schubl Sebastian D. , Barrios Cristobal , Joe Victor C. , Borazjani Boris , Nahmias Jeffry 
Published: December 2021

Objectives
Up to 44% of pediatric traumatic brain injury occurs as a result of a fall. We hypothesized that a fall from height is associated with higher risk for subsequent midline shift in pediatric traumatic brain injury compared with a fall from same level.

Methods
The Pediatric Trauma Quality Improvement Program 2016 was queried for kids younger than 16 years with an injury in the abbreviated injury scale for the head after a fall. Patients with midline shift were identified. A logistic regression model was used for analysis.

Results
The risk of a midline shift was lower in those with a fall from a height (odds ratio, 0.64; 95% confidence interval, 0.46–0.91, P = 0.01). In kids older than 4 years, there was no association between the level of height of the fall and subsequent midline shift (P = 0.62). The risk for midline shift in kids younger than 4 years after a fall from same level was lower (odds ratio, 0.40; 95% confidence interval, 0.24–0.67; P = 0.001).

Conclusions
In kids with traumatic brain injury, trauma activations due to falls from the same level are associated with a 2.5-fold higher risk of subsequent midline shift, compared with falling from height.
Computed Tomography Scans in Children With Hemophilia After Minor Head Trauma
Authors: Gardner Alison , McLean Thomas W. , Winslow James E. 
Published: December 2021

Objectives
Children with hemophilia have the usual childhood risk of falls and head trauma. Head computed tomographies (HCTs) are fast, detailed, and readily available, but increased radiation exposure in the pediatric population is now recognized as causing increased brain malignancy. By examining the incidence of intracranial cerebral hemorrhage in this population, we will be able to weigh risks and benefits of HCT use more accurately.

Methods
Using a retrospective chart review, we examined past medical records of pediatric patients, aged 0 to 15 years, with hemophilia presenting to 1 academic medical center. Primary outcomes included number of head CTs ordered, total and per patient over the years studied, and the incidence of positive findings, as defined by presence of blood products as documented by radiologist final read/interpretation.

Results
The mean number of head CTs per child was 2.5 (range, 1–10). None of the HCT scans were read as intracranial cerebral hemorrhage, and none of the patients had findings that lead to neurosurgical intervention. In a sensitivity analysis, applying Pediatric Emergency Care Applied Research Network head injury criteria, 11 HCT scans would be ordered for a reduction of 80 HCTs, or a decrease of 2 HCT scans per child. No incidence of intracranial cerebral hemorrhage would have been missed.

Conclusions
Our findings suggest that in the child with hemophilia and a history of minor head trauma, exposure to the radiation of a HCT based on the diagnosis of hemophilia alone may not be necessary but that imaging decisions need to be made in conjunction with clinical examination findings and neurologic status.
Emergency Department Utilization and Serious Bacterial Infection Rates in Children With Renal Transplants
Authors: King Jason , Kannikeswaran Nirupama , Jain Amrish , Farooqi Ahmad , Sethuraman Usha 
Published: December 2021

Objectives
Emergency department (ED) visits by children with solid organ transplants have increased significantly. Our objectives were to describe the common complaints, diagnosis, types, and rates of serious bacterial infection (SBI) in children with renal transplant (RT) who present to the hospital.

Methods
We conducted a retrospective study from 2012 to 2016 of RT children up to 18 years who presented to the ED or were directly admitted. We excluded patients who presented for a procedure. We collected demographics, transplant type, immunosuppressive data, chief complaints, diagnostic testing with results, interventions performed, and final diagnosis.

Results
We analyzed 131 visits in 29 patients during the study period. Most common chief complaints were infectious (34.4%) and gastrointestinal (26%). Infection was proven in 42.0% of visits with only 3.1% being organ rejection. Serious bacterial infection was diagnosed in 34 visits (26.0%) with urinary tract infection (UTI) being the most common (20.6%). Of the 33 visits for fever, SBI occurred in 16 (48.5%) patients with the most common SBI being UTI 10 (30.3%). Bacteremia occurred in 1 patient and hypotension in 4 patients. Antibiotic administration was the most common intervention performed (78; 59.5%). Significant interventions were uncommon (2 patients). Logistic regression revealed no factors to be associated with SBI.

Conclusions
Our cohort of children with RT presented most commonly with infections to the hospital with UTI being the most common SBI. Bacteremia and significant interventions were rare. Future studies are needed to identify subgroups of low-risk pediatric RT patients who can possibly be safely discharged home from the ED.
An Insidious Cause of Abdominal Pain in a Preschooler Girl
Authors: Raffaldi Irene , Guidi Carla , Di Gianni Valeria Rita , Cosentino Valentina , Personnettaz Eraldo , Brach del Prever Adalberto 
Published: December 2021

Abstract
The ovarian torsion (OT) represents one of the most misleading and challenging diagnoses for the pediatrician. Symptoms are often nonspecific, including sudden, piercing localized lower abdominal pain and tenderness associated with a palpable mass and peritoneal signs. Although the adnexal torsion is most frequently unilateral, cases of bilateral synchronous or asynchronous have been recorded; in the latter, the OT involved both ovaries at different settings. We reported the case of a 6-year-old girl who presented an asynchronous bilateral OT.
The Toddler's Fracture
Authors: Wang Yiqiao , Doyle Meagan , Smit Kevin , Varshney Terry , Carsen Sasha 
Published: December 2021

Objective
The tibial toddler's fracture is an important diagnosis in both emergency and urgent care, presenting as acute onset lower extremity pain or limping in a young child. Diagnosis and management may be challenging because of an extensive differential diagnosis. The objectives of this study were to provide an overview of the toddler's fracture and to guide clinicians by summarizing up to date literature for both diagnosis and management this common condition.

Methods
This study analyzed literature from the PubMed database from the years of 1964 to 2018. The main focus was on the diagnosis and management of the toddler's fracture.

Results
This review demonstrates that diagnosis is primarily made through history and physical examination, as radiographs are often negative at initial presentation. Treatment involves a short period of immobilization, which can be facilitated through the use of a cast, a splint, or no external support. Successful healing and a full return to normal activities and development are near universal.

Conclusions
Although a stable fracture with an excellent prognosis, opportunities exist to improve toddler's fractures diagnosis and treatment protocols, to optimize clinical management.