bluuebunny/crossref_metadata_2025_split huggingface dataset:
769 Racial, Ethnic, and Socioeconomic Disparities in Burn Care Access
Authors: Tomtschik Julia , Sweitzer Keith , Cook Caitlin , O'Shea Aidan , Bell Derek 
Published: May 2023

Abstract

Introduction
While racial, ethnic, and socioeconomic disparities in burn care have been identified, there is a paucity of research into specific means by which these disparities manifest. Here, we consider time to initial burn surgery consult.

Methods
Through a retrospective review of electronic health records, we reviewed all patients evaluated by the burn surgery service at a single regional burn center from Jun 2020 to Apr 2022. We excluded patients without data for time of onset of burn injury. We analyzed differences in time to burn consult, rate of surgical management, and average length of stay (LOS), stratifying by patient race (Caucasian, Black, Asian, Native American, Other), ethnicity (Latino, non-Latino, Other), and insurance payor (Medicaid, Private, Medicare, Other, None). Time to burn consult was defined as time from onset of burn injury to time of burn consult.

Results
365 patients met the inclusion criteria. Average age was 33.3 years; 65.8% were male. Average (standard deviation) time to burn consult was 17h7m (1d23h21m). No significant differences in time to burn consult existed when the study group was stratified by race, ethnicity, or insurance payor. Rate of surgical management (Chi-squared p=0.05) and LOS (ANOVA p&lt; 0.0001) differed by insurance payor, but not race or ethnicity. Medicare patients had higher rates of surgical intervention and longer average LOS; patients with no insurance had lower rates of surgical intervention and shorter average LOS.

Conclusions
Our results indicate that time to burn consult is unlikely to contribute meaningfully to racial, ethnic, and socioeconomic disparities in burn care. Further studies are needed to better understand other aspects of care that may contribute to these disparities.

Applicability of Research to Practice
Time to burn consult is unlikely to contribute to disparities in burn care. Burn care providers should be mindful of other ways that disparities may manifest.
770 Outcome Results of the Prospective CEA Registry
Authors: Homsombath Bounthavy , Sood Rajiv , Hartman Brett , Fagan Shawn , Griswold John 
Published: May 2023

Abstract

Introduction
Cultured epidermal autograft (CEA) is a permanent skin replacement indicated for use in adult and pediatric patients with deep dermal or full thickness burns comprising a total body surface area (TBSA) ≥ 30%. CEA may be used in conjunction with split-thickness autografts or alone, in patients for whom split-thickness autografts may not be an option due to the severity and extent of their burns. CEA was approved for use in adults in the United States in 2007 as a Humanitarian Use Device (HUD) under a Humanitarian Device Exemption (HDE) and was approved for pediatric use in 2016.

Methods
The objective of the CEA Registry is to allow prospective collection and analysis of demographic, treatment, and outcome data for the real-world use of CEA. Prior to initiation of the Registry, a central Institutional Review Board reviewed and approved written procedures and informed consent from each participating burn center. As of the date of this analysis, 5 centers were enrolling patients in the Registry. The data are collected and stored in a 21 Code of Federal Regulations (CFR) Part 11 and Health Insurance Portability and Accountability Act (HIPAA) compliant environment. First patient enrollment in the Registry was 13 June 2019 and data cutoff for this analysis was 28 July 2022.

Results
Sixtyeight patients (50 adults and 18 children) had completed data in the registry, up through hospital discharge, for this analysis. Except for age and revised Baux score, demographics and burn characteristics were similar between the adult and pediatric populations. The majority of patients were male in both the adult (76%) and pediatric (67%) groups, with burn caused by flame the most common etiology (86% and 78%, respectively). The total body surface area (TBSA) of burn was 58% in adults and 56% in pediatric patients (range 30% to 96%), and almost half had inhalation injury in each group. Approximately 74% of adults and 67% of pediatric patients had TBSA ≥50%. Median age in the adult group was 42 years, and in the pediatric group was 15 years. Since age is a component of the calculation of Baux score, pediatric patients had lower mean revised Baux scores (75) compared to adults (107.5). Overall, 59 of the 68 patients (87%) survived until hospital discharge. The mean % graft take (engraftment) in both adult (81%) and pediatric (84%) groups is notable when compared to mean final graft take in 453 Epiceltreated patients reported in the HDE database (67% in adults and 70% in pediatric). By age group, adults had 84% survival rate and pediatric patients had 94% survival.

Conclusions
Outcomes from this prospective collection of data in severely burned patients treated with CEA demonstrate favorable engraftment and survival rates and are in general agreement with recent literature.

Applicability of Research to Practice
Reported outcomes from the CEA Registry can be used as a benchmark by centers using CEA for treatment of burns.
775 Increased Reimbursement by Decreasing the Mortality Index Using GLIM in the Elderly for Malnutrition
Authors: Hollowell Jamie , Cruz Aryn , Marsh Molly , King Booker , Williams Felicia , Maxwell Eli 
Published: May 2023

Abstract

Introduction
One of the primary factors for burn wound healing is adequate nutrition. Many burn patients require supplemental nutrition during their burn care, however, their pre-existing nutritional status is also a factor in their morbidity and mortality. Malnutrition on admission or during their hospital stay has a significant impact on outcomes including wound healing, infection, and length of stay, along with effects on reimbursement and mortality outcomes predictors. American Society for Parenteral and Enteral Nutrition (ASPEN) criteria have long been used to assess malnutrition in burn patients in our institution though this may not be the ideal assessment tool, especially in patients over 65 years of age. In January 2016, the Global Leadership Initiative on Malnutrition (GLIM) working group created an updated assessment for malnutrition that takes additional factors into account. We aimed to compare ASPEN to GLIM criteria to determine if there is a difference in the number of patients meeting the criteria for malnutrition in the elderly.

Methods
All patients admitted between July 2013 to June 2021, 65 years or older, burn or skin disorder of at least 20% total body surface area, designated as Normal or underweight based upon body mass index, with registered dietitian assessments and lengths of stay of at least 2 days were included. Patients were identified using the Institutional Burn Center registry, and linked to the clinical and administrative data. Primary outcome was whether or not those patients triggered malnutrition diagnosis based upon ASPEN or GLIM criteria.

Results
Three hundred sixty-five patients were included in the study. Twenty-five patients had burns over 20%, and 14 met the criteria for nutritional assessment. Using ASPEN criteria, 2 out of 14 patients met criteria for malnutrition. Of those same patients, 8 out of 14 patients met criteria for malnutrition using GLIM assessment.

Conclusions
While this study is not powered for statistical analysis, the results demonstrate that GLIM may be a valuable adjunct to ASPEN to assess malnutrition in burn patients, especially in those patients over 65 years of age. Further study is needed to examine whether GLIM would be a superior tool or at least a worthy addition to our nutritional analysis. Burn patients have a unique need for adequate nutrition to support healing, and accurate evaluation of their requirements warrants a precise tool.

Applicability of Research to Practice
This study may demonstrate the need for additional evaluation of GLIM as a replacement or adjunct tool for malnutrition in the burn population. This study may also suggest the need for further assessment of other tools to evaluate nutrition on in this population. This study may also suggest impact on mortality index and length of stay that affect reimbursement and rankings.
Triage and Evaluation of Blast-Injured Patients in Wenling Liquefied Petroleum Gas Tanker Explosion
Authors: Shao Jiaming , Zhu Zhikang , Xu Bin , Wang Shuangshuang , Jin Ronghua , Yang Min , Zhang Wei , Han Chunmao , Wang Xingang 
Published: May 2023

Abstract
On June 13, 2020, a liquefied petroleum gas tanker exploded in Wenling. Here, the authors describe the mass casualty emergency response to the explosion. The authors collected the medical records of 176 inpatients at 8 hospitals in Taizhou and Hangzhou. The 176 inpatients with blast injuries comprised 70 females and 106 males, with an average age of 45.48 ± 19.96 years, and more than half of the patients were farmers. They were transported to six hospitals distributed around the explosion site in Taizhou in the initial rescue period and were grouped according to their new injury severity score as having mild, moderate, severe, or extremely severe injuries. Most patients with severe and extremely severe injuries were admitted to a superior hospital for postsecondary triage. Forty-four patients experienced primary blast injuries, 137 experienced secondary blast injuries, 37 experienced tertiary blast injuries, and 40 patients experienced quaternary blast injuries. Multiple blast injuries were suffered by 62 patients. Most patients (95.45%) suffered external injuries, with the chest, extremities, and face as the main affected areas. Burns were diagnosed in 26 adults, of whom 15.38%, 19.23%, 7.70%, and 57.69% suffered mild, moderate, severe, and extremely severe cases. Sixteen burn patients suffered from burn-blast injuries. Upper limbs and the head/face/neck area, as exposed areas, were more likely to experience a burn injury. Inhalation was the main accompanying injury. Of the eight patients who died in the prehospital session, seven had burn injuries. This report on the accident and injury characteristics of an open-air LPG-related explosion will facilitate responses to subsequent catastrophes.
Ten-year update: NRG Oncology/National Surgical Adjuvant Breast and Bowel Project B-42 randomized trial: extended letrozole therapy in early-stage breast cancer
Authors: Mamounas Eleftherios P , Bandos Hanna , Rastogi Priya , Lembersky Barry C , Jeong Jong-Hyeon , Geyer Charles E , Fehrenbacher Louis , Chia Stephen K , Brufsky Adam M , Walshe Janice M , Soori Gamini S , Dakhil Shaker R , Wade James L , McCarron Edward C , Swain Sandra M , Wolmark Norman 
Published: May 2023

AbstractBackgroundThe National Surgical Adjuvant Breast and Bowel Project B-42 trial evaluated extended letrozole therapy (ELT) in postmenopausal breast cancer patients who were disease free after 5 years of aromatase inhibitor (AI)–based therapy. Seven-year results demonstrated a nonstatistically significant trend in disease-free survival (DFS) in favor of ELT. We present 10-year outcome results.MethodsIn this double-blind, phase III trial, patients with stage I-IIIA hormone receptor–positive breast cancer, disease free after 5 years of an AI or tamoxifen followed by an AI, were randomly assigned to 5 years of letrozole or placebo. Primary endpoint was DFS, defined as time from random assignment to breast cancer recurrence, second primary malignancy, or death. All statistical tests are 2-sided.ResultsBetween September 2006 and January 2010, 3966 patients were randomly assigned (letrozole: 1983; placebo: 1983). Median follow-up time for 3923 patients included in efficacy analyses was 10.3 years. There was statistically significant improvement in DFS in favor of letrozole compared with placebo (hazard ratio [HR] = 0.85, 95% confidence interval [CI] = 0.74 to 0.96; P  = .01; 10-year DFS: placebo = 72.6%, letrozole = 75.9%, absolute difference = 3.3%). There was no difference in the effect of letrozole on overall survival (HR = 0.97, 95% CI = 0.82 to 1.15; P  = .74). Letrozole statistically significantly reduced breast cancer–free interval events (HR = 0.75, 95% CI = 0.62 to 0.91; P = .003; absolute difference in cumulative incidence = 2.7%) and distant recurrences (HR = 0.72, 95% CI = 0.55 to 0.92; P = .01; absolute difference = 1.8%). The rates of osteoporotic fractures and arterial thrombotic events did not differ between treatment groups.ConclusionsThe beneficial effect of ELT on DFS persisted at 10 years. Letrozole also improved breast cancer–free interval and distant recurrences without improving overall survival. Careful assessment of potential risks and benefits is necessary for selecting appropriate candidates for ELT.
Introduction to the suite: The Child as Reader, Philosopher, and Social Critic: Evaluating the Vision of Gareth B. Matthews
Authors: Gregory Maughn Rollins , Laverty Megan Jane 
Published: May 2023

Abstract
Gareth B. Matthews (1929–2011) was a specialist in ancient and medieval philosophy whose conversations with young children led him to discover their penchant for philosophical thinking, which often enriched his own. Those conversations became the impetus for a substantial component of Matthews’ scholarship, from which our book, Gareth B. Matthews, The Child’s Philosopher, features essays spanning the length of his career. Contemporary contributors to the book critically evaluate Matthews’ scholarship in three fields he helped to initiate: philosophy in children’s literature, philosophy for children, and philosophy of childhood. They assess where he broke new ground and identify developments and debates in those fields. In the reviews that follow, Harry Brighouse, David Bakhurst, and Sheron Fraser-Burgess respond to Matthews’ original essays and those of the contemporary scholars. While recognizing Matthews’ significant contribution to advancing philosophy in the lives of children, all three reviewers indicate ways to push his agenda forward. We read Brighouse as calling for engagement with philosophy in media (including television and film) beyond classical and contemporary children’s literature. Bakhurst explicitly calls for further empirical study of children’s philosophical thinking to support more realistic conceptions of childhood and philosophy—including when philosophy might not be appropriate for children. Fraser-Burgess calls for an accounting of the ways that philosophy for children may reinscribe unjust hierarchies of race, gender, and culture, and of the ways it can be used to confront and combat them.
A model where the least trimmed squares estimator is maximum likelihood
Authors: Berenguer-Rico Vanessa , Johansen Søren , Nielsen Bent 
Published: May 2023

Abstract
The least trimmed squares (LTS) estimator is a popular robust regression estimator. It finds a subsample of h ‘good’ observations among n observations and applies least squares on that subsample. We formulate a model in which this estimator is maximum likelihood. The model has ‘outliers’ of a new type, where the outlying observations are drawn from a distribution with values outside the realized range of h ‘good’, normal observations. The LTS estimator is found to be h1/2 consistent and asymptotically standard normal in the location-scale case. Consistent estimation of h is discussed. The model differs from the commonly used ϵ-contamination models and opens the door for statistical discussion on contamination schemes, new methodological developments on tests for contamination as well as inferences based on the estimated good data.
A Selective Bottleneck During Host Entry Drives the Evolution of New Legume Symbionts
Authors: Doin de Moura Ginaini Grazielli , Mouffok Saida , Gaudu Nil , Cazalé Anne-Claire , Milhes Marine , Bulach Tabatha , Valière Sophie , Roche David , Ferdy Jean-Baptiste , Masson-Boivin Catherine , Capela Delphine , Remigi Philippe 
Published: May 2023

Abstract
During the emergence of new host–microbe symbioses, microbial fitness results from the ability to complete the different steps of symbiotic life cycles, where each step imposes specific selective pressures. However, the relative contribution of these different selective pressures to the adaptive trajectories of microbial symbionts is still poorly known. Here, we characterized the dynamics of phenotypic adaptation to a simplified symbiotic life cycle during the experimental evolution of a plant pathogenic bacterium into a legume symbiont. We observed that fast adaptation was predominantly explained by improved competitiveness for host entry, which outweighed adaptation to within-host proliferation. Whole-population sequencing of bacteria at regular time intervals along this evolution experiment revealed the continuous accumulation of new mutations (fuelled by a transient hypermutagenesis phase occurring at each cycle before host entry, a phenomenon described in previous work) and sequential sweeps of cohorts of mutations with similar temporal trajectories. The identification of adaptive mutations within the fixed mutational cohorts showed that several adaptive mutations can co-occur in the same cohort. Moreover, all adaptive mutations improved competitiveness for host entry, while only a subset of those also improved within-host proliferation. Computer simulations predict that this effect emerges from the presence of a strong selective bottleneck at host entry occurring before within-host proliferation and just after the hypermutagenesis phase in the rhizosphere. Together, these results show how selective bottlenecks can alter the relative influence of selective pressures acting during bacterial adaptation to multistep infection processes.
Factors determining family and social support among pulmonary tuberculosis patients in East Khasi Hills, Meghalaya: a cross-sectional study
Authors: Nadon Herman , Dmello Mackwin K , Shetty Shraddha 
Published: May 2023

Abstract

Introduction
Family support plays a vital role in the outcome of individuals with tuberculosis (TB).

Objectives
To determine the family and social support among individuals with pulmonary TB during treatment.

Methods
A cross-sectional survey was conducted among 237 pulmonary TB patients currently in the continuous phase of treatment. Bivariate and multivariate analyses were conducted to determine the association and predictors for family and social support. P-value &lt; 0.05 was considered statistically significant.

Results
The mean age of the respondents was 31.97 ± 12.51 years, and a majority (58.2%) of the respondents with TB disease were 18 to 38 years old, and 59.9% were males. Around 49.7% of the pulmonary TB patients received a high level of family support, whereas 73% received a high level of social support. The determinants like age, average monthly income, the educational level of the head of the family and the occupational level of both the patients and the head of the family are associated with family support.

Conclusion
This study recommends a coordinated strategy to treat TB that involves not only professional services but also the vital social support network of family and community that is required throughout therapy.
ESG-Linked Compensation, CEO Skills, and Shareholder Welfare
Authors: Homroy Swarnodeep , Mavruk Taylan , Nguyen Van Diem 
Published: May 2023

Abstract
Executive compensation is increasingly being linked to ESG outcomes. This paper examines whether ESG targets are consistent with shareholder welfare. Using granular information on compensation contracts of Swedish CEOs, we show that ESG and financial targets are competing. ESG-linked compensation is 5 percentage points more common in well-governed firms and 6.3 percentage points more likely for CEOs with broader skill sets (generalist CEOs). ESG scores of well-governed firms improve when generalist CEOs have ESG-linked pay, but there is no effect on profitability. These results suggest that boards set ESG contracts because shareholders derive utility from ESG in addition to wealth, and ESG may not be produced without these incentives. (JEL M14, G14, D21, L21)
Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Combining multimodal magnetic resonance brain imaging and machine learning to unravel neurocognitive function in non-neuropsychiatric systemic lupus erythematosus
Authors: Tay Sen Hee , Stephenson Mary Charlotte , Allameen Nur Azizah , Ngo Raymond Yeow Seng , Ismail Nadiah Afiqah Binte , Wang Victor Chun Chieh , Totman John James , Cheong Dennis Lai-Hong , Narayanan Sriram , Lee Bernett Teck Kwong , Mak Anselm 
Published: May 2023

Abstract

Objective
To study whether multimodal brain MRI comprising permeability and perfusion measures coupled with machine learning can predict neurocognitive function in young patients with SLE without neuropsychiatric manifestations.

Methods
SLE patients and healthy controls (HCs) (≤40 years of age) underwent multimodal structural brain MRI that comprised voxel-based morphometry (VBM), magnetization transfer ratio (MTR) and dynamic contrast-enhanced (DCE) MRI in this cross-sectional study. Neurocognitive function assessed by Automated Neuropsychological Assessment Metrics was reported as the total throughput score (TTS). Olfactory function was assessed. A machine learning–based model (i.e. glmnet) was constructed to predict TTS.

Results
Thirty SLE patients and 10 HCs were studied. Both groups had comparable VBM, MTR, olfactory bulb volume (OBV), olfactory function and TTS. While after correction for multiple comparisons the uncorrected increase in the blood–brain barrier (BBB) permeability parameters compared with HCs did not remain evident in SLE patients, DCE-MRI perfusion parameters, notably an increase in right amygdala perfusion, was positively correlated with TTS in SLE patients (r = 0.636, false discovery rate P &lt; 0.05). A machine learning–trained multimodal MRI model comprising alterations of VBM, MTR, OBV and DCE-MRI parameters mainly in the limbic system regions predicted TTS in SLE patients (r = 0.644, P &lt; 0.0005).

Conclusion
Multimodal brain MRI demonstrated increased right amygdala perfusion that was associated with better neurocognitive performance in young SLE patients without statistically significant BBB leakage and microstructural abnormalities. A machine learning–constructed multimodal model comprising microstructural, perfusion and permeability parameters accurately predicted neurocognitive performance in SLE patients.
Three-Dimensional Spheroid Culture of Human Mesenchymal Stem Cells: Offering Therapeutic Advantages and In Vitro Glimpses of the In Vivo State
Authors: Yen B Linju , Hsieh Chen-Chan , Hsu Pei-Ju , Chang Chia-Chi , Wang Li-Tzu , Yen Men-Luh 
Published: May 2023

Abstract
As invaluable as the standard 2-dimensional (2D) monolayer in vitro cell culture system has been, there is increasing evidence that 3-dimensional (3D) non-adherent conditions are more relevant to the in vivo condition. While one of the criteria for human mesenchymal stem cells (MSCs) has been in vitro plastic adherence, such 2D culture conditions are not representative of in vivo cell-cell and cell-extracellular matrix (ECM) interactions, which may be especially important for this progenitor/stem cell of skeletal and connective tissues. The 3D spheroid, a multicellular aggregate formed under non-adherent 3D in vitro conditions, may be particularly suited as an in vitro method to better understand MSC physiological processes, since expression of ECM and other adhesion proteins are upregulated in such a cell culture system. First used in embryonic stem cell in vitro culture to recapitulate in vivo developmental processes, 3D spheroid culture has grown in popularity as an in vitro method to mimic the 3-dimensionality of the native niche for MSCs within tissues/organs. In this review, we discuss the relevance of the 3D spheroid culture for understanding MSC biology, summarize the biological outcomes reported in the literature based on such this culture condition, as well as contemplate limitations and future considerations in this rapidly evolving and exciting area.