bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cancer Demographics and Time-to-Care in Belize
Authors: Wong Wayne , Dickerson James C , Valtis Yannis K , Habet Marta , Bernard Margaret , Kelly Lorna , Lattin John , Garrity Philip , Sood Rupali , Ohanian Alec , Chege Maryanne W , Bhatt Ami S , Huang Franklin W , Yacab Ramon 
Published: March 2023

Abstract

Background
Belize is a middle-income Caribbean country with poorly described cancer epidemiology and no comprehensive cancer care capacity. In 2018, GO, Inc., a US-based NGO, partnered with the Ministry of Health and the national hospital in Belize City to create the first public oncology clinic in the country. Here, we report demographics from the clinic and describe time intervals to care milestones to allow for public health targeting of gaps.

Patients and Methods
Using paper charts and a mobile health platform, we performed a retrospective chart review at the Karl Heusner Memorial Hospital (KHMH) clinic from 2018 to 2022.

Results
During this time period, 465 patients with cancer presented to the clinic. Breast cancer (28%) and cervical cancer (12%) were most common. Most patients (68%) presented with stage 3 or 4 disease and were uninsured (78%) and unemployed (79%). Only 21% of patients ever started curative intent treatment. Median time from patient-reported symptoms to a biopsy or treatment was 130 and 189 days. For the most common cancer, breast, similar times were seen at 140 and 178 days. Time intervals at the clinic: &lt;30 days from initial visit to biopsy (if not previously performed) and &lt;30 days to starting chemotherapy.

Conclusion
This study reports the first clinic-based cancer statistics for Belize. Many patients have months between symptom onset and treatment. In this setting, the clinic has built infrastructure allowing for minimal delays in care despite an underserved population. This further affirms the need for infrastructure investment and early detection programs to improve outcomes in Belize.
Detector bandwidth and polarization switching rates: spectrophotometric observations of the Sun by the Birmingham Solar Oscillations Network
Authors: Hale S J , Chaplin W J , Davies G R , Elsworth Y P , Howe R 
Published: March 2023

Abstract
The Birmingham Solar Oscillations Network (BiSON) observes acoustic oscillations of the Sun. The dominant noise source is caused by fluctuations of Earth’s atmosphere, and BiSON seeks to mitigate this effect by combining multiple rapid observations in alternating polarization states. Current instrumentation uses bespoke Pockels-effect cells to select the polarization state. Here, we investigate an alternative off-the-shelf solution, a liquid crystal (LC) retarder, and discuss the potential impact of differences in performance. We show through electrical simulation of the photodiode-based detectors, and assessment of both types of polarization device, that although the switching rate is slower the off-the-shelf LC retarder is a viable replacement for a bespoke Pockels-effect cell. The simplifications arising from the use of off-the-shelf components allow easier and quicker instrumentation deployment.
Changing conceptualization of innovation in the European Union and its impact on universities: Critical junctures and evolving institutional demands
Authors: Cinar Ridvan , Benneworth Paul , Coenen Lars 
Published: March 2023

Abstract
This article explores underlying mechanisms triggering a change in conceptualization of innovation in the European Union (EU), the impact of this change on institutional demands upon European universities and implications for evaluation procedures. We mobilize the theoretical concept of critical junctures to explore significant periods that have affected understanding of innovation in the EU as well as institutional expectations from universities. Through an analysis of European policy corpus relating to innovation, we identify three distinct periods, 1983–6, 1995–2000, and 2008–12, entailing fairly fundamental shifts that have considerably broadened the understanding of innovation and then demonstrate the way this broadening conceptualization has affected institutional demands upon universities. Following this, we discuss the implications of the critical junctures on evaluation approaches. We conclude by arguing that different approaches towards innovation have created complex institutional environment for universities to navigate and suggest that implementing more nuanced and customized evaluation schemes aligned to the institutional demands of each critical juncture could help addressing this complexity.
Performance of the 2016 ACR-EULAR myositis response criteria in juvenile dermatomyositis therapeutic trials and consensus profiles
Authors: Kim Hanna , Saygin Didem , Douglas Christian , Wilkerson Jesse , Erman Brian , Pistorio Angela , McGrath John A , Reed Ann M , Oddis Chester V , Bracaglia Claudia , van Royen-Kerkhof Annet , Bica Blanca , Dolezalova Pavla , Ferriani Virginia P L , Flato Berit , Bernard-Medina Ana G , Herlin Troels , Miller Frederick W , Vencovsky Jiri , Ruperto Nicolino , Aggarwal Rohit , Rider Lisa G ,   for the International Myositis Assessment and Clinical Studies Group (IMACS) and Paediatric Rheumatology INternational Trials Organization (PRINTO), Pinal-Fernandez Iago , Kim Susan , Ascherman Dana , Schiffenbauer Adam 
Published: March 2023

Abstract

Objectives
The 2016 ACR-EULAR Response Criteria for JDM was developed as a composite measure with differential weights of six core set measures (CSMs) to calculate a Total Improvement Score (TIS). We assessed the contribution of each CSM, representation of muscle-related and patient-reported CSMs towards improvement, and frequency of CSM worsening across myositis response criteria (MRC) categories in validation of MRC.

Methods
Data from JDM patients in the Rituximab in Myositis trial (n = 48), PRINTO JDM trial (n = 139), and consensus patient profiles (n = 273) were included. Observed vs expected CSM contributions were compared using Sign test. Characteristics of MRC categories were compared by Wilcoxon tests with Bonferroni adjustment. Spearman correlation of changes in TIS and individual CSMs were examined. Agreement between physician-assessed change and MRC categories was evaluated by weighted Cohen’s kappa.

Results
Of 457 JDM patients with IMACS CSMs and 380 with PRINTO CSMs, 9–13% had minimal, 19–23% had moderate and 41–50% had major improvement. The number of improved and absolute percentage change of CSMs increased by MRC improvement level. Patients with minimal improvement by MRC had a median of 0–1 CSM worsened, and those with moderate/major improvement had a median of zero worsening CSMs. Of patients improved by MRC, 94–95% had improvement in muscle strength and 93–95% had improvement in ≥1 patient-reported CSM. IMACS and PRINTO CSMs performed similarly. Physician-rated change and MRC improvement categories had moderate-to-substantial agreement (Kappa 0.5–0.7).

Conclusion
The ACR-EULAR MRC perform consistently across multiple studies, supporting its further use as an efficacy end point in JDM trials.
NATURAL RADIOACTIVITY AND ASSESSMENT OF HAZARD INDICES OF THE SOIL FOUND AT SUNG VALLEY, MEGHALAYA
Authors: Ryngnga Jodie T , Jyrwa B M , Nandy Maitreyee , Saxena Atul 
Published: March 2023

Abstract
In this work, the variation of the radioactivity at different depth of the soil found at the Sung Valley in West Jaiñtia Hills District of Meghalaya in India is estimated by using the gamma-ray spectroscopy. The average activity concentration of 226Ra, 232Th and 40K for soil samples at different depths are measured to be 57, 156 and 352 Bq kg−1, respectively. The radiological hazard indices for the soil samples are calculated using standard models in order to determine the safe utility of these materials that are being used to manufacture domestic products by the locals. Values of all the radiological hazard indices are observed to be within the internationally recommended values as proposed by the European Commission and the United Nations Scientific Committee on the Effects of Atomic Radiation. The present study ensures that the soil analysed presents a negligible radiation hazard, and produced poetries and artefacts radiological incidence will stay within the allowed natural limit.
FOIL ACTIVATION TECHNIQUE—A TOOL FOR THE EVALUATION OF PHOTO-NEUTRON DOSE IN RADIOTHERAPY
Authors: Sathian Deepa , Bakshi Ashok K , Kannan Umasankari , Beck Mudit , Haneefa Abdul , Cyriac Siji 
Published: March 2023

Abstract
Treatment of cancer is carried out using photon beams from high-energy medical linear accelerators. Photo-neutrons are also produced as an unwanted by product in the process of dose delivery to the cancer patients during their radiation treatments. In the present study, photo-neutron dose equivalents (both thermal and fast components) per unit delivered gamma-photon dose were measured at different depths, as function of distances from iso-centre in patient plane, field sizes, wedge angles and at LINAC head for a 15-MV medical linear accelerator model Elekta Precise using multi-foil activation technique. The neutron dose equivalents determined for the above-mentioned parameters were found to be lower (&lt;0.05%) in comparison with the therapeutic photon dose delivered and within the prescribed limits recommended by the national regulatory authority.
Race, State Surveillance, and Policy Spillover: Do Restrictive Immigration Policies Affect Citizen Earnings?
Authors: Browne Irene , An Weihua , Auguste Daniel , Delia-Deckard Natalie 
Published: March 2023

AbstractThis paper investigates whether restrictive immigration policy affects earnings among White, African-American, and Latinx US citizens. Incorporating sociological theories of race that point to state surveillance of Black and Latinx bodies as a linchpin of racial inequality, we ask: Do immigration policies that expand the reach of law enforcement spill over to lower or to raise earnings of employed US citizens? If so, are the effects of these policies greater for Latinx and African-American citizens compared to their White counterparts? Are the effects of these policies stronger among Latinx and African-American men—who are more directly targeted by surveillance policing as a function of their gender—than for co-ethnic women? To investigate these questions, we combine two nationally representative longitudinal datasets—the 1979 National Longitudinal Survey of Youth and the 1997 National Longitudinal Survey of Youth. We find that immigration policies that expand the reach of law enforcement raise wages among native-born Whites. However, we also find that state policies enhancing immigration law enforcement decrease wages among Latinx and African-American citizens compared to Whites. We find no gender/race interactions influencing spillover effects of immigration policy on earnings.
Evolution of semiaquatic habits in hippos and their extinct relatives: insights from the ear region
Authors: Orliac Maëva J , Mourlam Mickaël J , Boisserie Jean-Renaud , Costeur Loïc , Lihoreau Fabrice 
Published: March 2023

Abstract
Since molecular data identified hippopotamids as the closest living relatives of cetaceans, a common aquatic/semiaquatic ancestor hypothesis for these modern taxa has naturally been proposed. However, recent molecular studies concluded that most molecular adaptations in extant cetaceans occurred after their split from hippopotamids. If the question of aquatic affinities of the first cetaceans has been investigated at large, it has not been the case for the forebears of hippopotamids. Sensory organs are drastically affected by underwater perception. In this work, we question the aquatic affinities of fossil hippopotamoids through an investigation of the morphology and morphometrics of the petrosal bone and cochlea of 12 extinct hippopotamoid taxa. Petrosal and bony labyrinth morphological characters constitute a source of structured phylogenetic signal, both supporting major hippopotamoid clades and bringing original relationships. The morphometric study of functional measurements of the cochlear canal shows that anthracotheres bridge the morphological gap between terrestrial artiodactyls and modern hippopotamids. The integrated functional signal of the ear region further supports convergent acquisitions of semiaquatic behaviour in hippopotamids and cetaceans and indicates that terrestrial hearing was an ancestral trait among Hippopotamoidea. We highlight multiple convergent acquisitions of semiaquatic traits in the ear region of hippopotamoids and new robust phylogenetic characters.
Molecular analysis of 12 Chinese patients with 11β‐hydroxylase deficiency and in vitro functional study of 20 CYP11B1 missense variants
Authors: Sun Bang , Lu Lin , Xie Shaowei , Zhang Wei , Zhang Xiaoxia , Tong Anli , Chen Shi , Wu Xueyan , Mao Jiangfeng , Wang Xi , Qiu Ling , Nie Min 
Published: March 2023

AbstractSteroid 11β‐hydroxylase deficiency (11β‐OHD) is a rare autosomal recessive disorder caused by pathogenic variants of CYP11B1 gene. This study aimed to perform molecular analysis of a Chinese 11β‐OHD series and in vitro functional study of twenty CYP11B1 missense variants. Twelve Chinese patients with clinical diagnosis of 11β‐OHD were included in the study to analyze their molecular etiology. Genomic DNA of patients was extracted to be sequenced all coding exons and intronic flanking sequences of CYP11B1. Fourteen missense variants found in 12 patients mentioned above along with 6 missense variants previously reported by our team were evaluated functionally. Amino acid substitutions were analyzed with computational program to determine their effects on the three‐dimensional structure of CYP11B1 protein. Clinical characteristics and hormone levels at baseline of the 18 patients carrying 18 missense variants aforementioned were recorded to perform genotype–phenotype correlation. A total of 21 rare variants including 9 novel and 12 recurrent ones were identified in 12 patients, out of which 17 were missense, 2 were nonsense, 1 was a splice site variant, and 1 was a deletion–insertion variant. Results of in vitro functional study revealed that 3 out of 20 missense mutants (p.Leu3Pro, p.Gly267Ser, and p.Ala367Ser) had partial enzyme activity and the other 17 had little enzymatic activity. The impairment degree of enzymatic activity in vitro functional study was also reflected in the severity degree of interaction change between the wild‐type/mutant‐type amino acid and its adjacent amino acids in three‐dimensional model. In conclusion, the addition of 9 novel variants expands the spectrum of CYP11B1 pathogenic variants. Our results demonstrate that twenty CYP11B1 variants lead to impaired 11β‐hydroxylase activity in vitro. Visualizing these variants in the three‐dimensional model structure of CYP11B1 protein can provide a plausible explanation for the results measured in vitro.
Availability of Specific Programs and Medications for Addiction Treatment to Vulnerable Populations: Results from the Addiction Treatment Locator, Assessment, and Standards (ATLAS) Survey
Authors: Oldfield Benjamin J. , Chen Kevin , Joudrey Paul J. , Biegacki Emma T. , Fiellin David A. 
Published: March 2023

Objectives
This study aimed to describe addiction treatment facilities by their offerings of medications for alcohol use disorder (MAUD) and/or for opioid use disorder (MOUD), and by their offering services to groups with barriers to care: uninsured and publicly insured, youth, seniors, individuals preferring to receive care in Spanish, and sexual minority individuals.

Methods
We examined addiction treatment facility survey data in 6 US states. We performed bivariate analyses comparing facilities that offered MAUD, MOUD, and both (main outcomes). We then constructed a multivariable model to identify predictors of offering MAUD, MOUD, or both, including exposures that demonstrate programming for special populations.

Results
Among 2474 facilities, 1228 (50%) responded between October 2019 and January 2020. Programs were offered for youth (30%), elderly (40%), Spanish-speaking (37%), and sexual minority populations (39%), with 58% providing MAUD, 67% providing MOUD, and 56% providing both. Among those providing MAUD, MOUD, or both, a majority (>60% for all exposures) offered programming to vulnerable populations. With Delaware as reference, Louisiana (adjusted odds ratio [aOR], 0.28; 95% confidence interval [CI], 0.12–0.67) and North Carolina (aOR, 0.33; 95% CI, 0.15–0.72) facilities had lesser odds of offering both MAUD and MOUD. All exposures identifying facilities offering treatment to vulnerable groups were associated with offerings of MAUD and/or MOUD except for offerings to youth; these facilities had less odds of offering MOUD (aOR, 0.31; 95% CI, 0.31–0.62).

Conclusions
There are facility-level disparities in providing MAUD and MOUD by state, and facilities with youth programming have lesser odds of offering MOUD than other facilities.
Outcomes of Extremely Prolonged (> 50 d) Venovenous Extracorporeal Membrane Oxygenation Support
Authors: Malas Jad , Chen Qiudong , Shen Tao , Emerson Dominic , Gunn Tyler , Megna Dominick , Catarino Pedro , Nurok Michael , Bowdish Michael , Chikwe Joanna , Cheng Susan , Ebinger Joseph , Kumaresan Abirami 
Published: March 2023

Objectives:There has been a sustained increase in the utilization of venovenous extracorporeal membrane oxygenation (ECMO) over the last decade, further exacerbated by the COVID-19 pandemic. We set out to describe our institutional experience with extremely prolonged (> 50 d) venovenous ECMO support for recovery or bridge to lung transplant candidacy in patients with acute respiratory failure.Design:Retrospective cohort study.Setting:A large tertiary urban care center.Patients:Patients 18 years or older receiving venovenous ECMO support for greater than 50 days, with initial cannulation between January 2018 and January 2022.Interventions:None.Measurements and Main Results:One hundred thirty patients were placed on venovenous ECMO during the study period. Of these, 12 received prolonged (> 50 d) venovenous ECMO support. Eleven patients (92%) suffered from adult respiratory distress syndrome (ARDS) secondary to COVID-19, while one patient with prior bilateral lung transplant suffered from ARDS secondary to bacterial pneumonia. The median age of patients was 39 years (interquartile range [IQR], 35–51 yr). The median duration of venovenous ECMO support was 94 days (IQR, 70–128 d), with a maximum of 180 days. Median time from intubation to cannulation was 5 days (IQR, 2–14 d). Nine patients (75%) were successfully mobilized while on venovenous ECMO support. Successful weaning of venovenous ECMO support occurred in eight patients (67%); 6 (50%) were bridged to lung transplantation and 2 (17%) were bridged to recovery. Of those successfully weaned, seven patients (88%) were discharged from the hospital. All seven patients discharged from the hospital were alive 6 months post-decannulation; 83% (5/6) with sufficient follow-up time were alive 1-year after decannulation.Conclusions:Our experience suggests that extremely prolonged venovenous ECMO support to allow native lung recovery or optimization for lung transplantation may be a feasible strategy in select critically ill patients, further supporting the expanded utilization of venovenous ECMO for refractory respiratory failure.
MALIGNANT TRANSFORMATION OF A CHOROIDAL NEVUS AFTER 19 YEARS OF OBSERVATION FOLLOWED BY RAPID PROGRESSION OF THE CHOROIDAL MELANOMA
Authors: Istre-Wilz Hannah M. , Di Nicola Maura , Augsburger James J. , Williams Basil K. 
Published: March 2023

Purpose:
To describe the case of a woman who developed rapid progression of a choroidal melanoma after 19 years of observation of a previously treated choroidal nevus.

Methods:
A 71-year-old woman with a 22-year history of a choroidal nevus was observed for 19 years after undergoing transpupillary thermotherapy for a localized, macula-involving, exudative, retinal detachment. Five months after her most recent stable examination, she presented for routine follow-up.

Results:
The lesion was noted to have increased thickness with the development of lipofuscin and subretinal fluid, suggestive of malignant transformation. In the 1 month between diagnosis and treatment with iodine-125 plaque brachytherapy, the lesion continued to expand, requiring a radiation dose adjustment.

Conclusion:
Choroidal nevus transformation into melanoma has been well-documented, highlighting the need for routine follow-up. Treatment within 1 month is typically sufficient for appropriate management. Occasionally, melanomas may grow substantially between diagnosis and treatment, suggesting that repeat measurement may be necessary in rare instances to ensure appropriate radiation treatment.
Characteristics of Fecal Incontinence
Authors: Hoedl Manuela , Osmancevic Selvedina , Bauer Silvia 
Published: March 2023

Objectives
The aim of conducting this study was to investigate the relations between different characteristics of fecal incontinence (FI) and incontinence-associated dermatitis (IAD), placing a focus on stool consistency.

Methods
This is a secondary data analysis of data from cross-sectional studies. We merged data from the years 2014, 2015, and 2016.

Results
Of all participating persons, 1.9% were only fecal incontinent and 8.6% lost both urine and fecal material, of which 28.8% lost liquid fecal material and 71.2% lost solid stool. The prevalence of IAD among persons with FI was 5.6%. Persons with liquid FI had a 2.786-time higher risk of developing an IAD than persons with solid stool.

Conclusion
Because of the higher risk of developing an IAD, persons with liquid FI should be analyzed in further studies by applying the definition of FI from the International Continence Society and referring to the Bristol stool chart.
Disease-specific mortality and major adverse cardiovascular events after bariatric surgery: a meta-analysis of age, sex, and BMI-matched cohort studies
Authors: Cui Beibei , Wang Guohui , Li Pengzhou , Li Weizheng , Song Zhi , Sun Xulong , Zhu Liyong , Zhu Shaihong 
Published: March 2023

Background:
Obesity is associated with a significant predisposition towards cardiovascular events and acts as an important risk factor for mortality. Herein, we conducted a comprehensive meta-analysis to estimate the protective effect of bariatric surgery on disease-specific mortality and major adverse cardiovascular events (MACEs) in patients with severe obesity.

Methods:
PubMed and Embase were searched from inception to 4 June 2022. Eligible studies were age, sex, and BMI-matched cohort studies. The protocol for this meta-analysis was registered on PROSPERO (ID: CRD42022337319).

Results:
Forty matched cohort studies were identified. Bariatric surgery was associated with a lower risk of disease-specific mortality including cancer mortality [hazard ratio with 95% confidence interval: 0.46 (0.37–0.58)], cardiovascular mortality [0.38 (0.29–0.50)], and diabetes mortality [0.25 (0.11–0.57)]. Bariatric surgery was associated with a lower incidence of MACEs [0.58 (0.51–0.66)] and its components including all-cause mortality [0.52 (0.47–0.58)], atrial fibrillation [0.79 (0.68–0.92)], heart failure [0.52 (0.42–0.65)], myocardial infarction [0.55 (0.41–0.74)], and stroke [0.75 (0.63–0.89)]. According to subgroup analysis on all-cause mortality, patients with severe obesity and type 2 diabetes benefited more from bariatric surgery than those with severe obesity only (heterogeneity between groups: P=0.001), while different surgical approaches brought similar benefits (heterogeneity between groups: P=0.87).

Conclusions:
This meta-analysis of 40 matched cohort studies supports that bariatric surgery reduces disease-specific mortality and incidence of both MACEs and its components in patients with severe obesity compared with nonsurgical subjects. Bariatric surgery deserves a more aggressive consideration in the management of severe obesity.