bluuebunny/crossref_metadata_2025_split huggingface dataset:
What is the risk of recurrent concussion in children and adolescents aged 5–18 years? A systematic review and meta-analysis
Authors: van Ierssel Jacqueline , Osmond Martin , Hamid Jemila , Sampson Margaret , Zemek Roger 
Published: October 2020

Objective
We aimed to examine the risk of concussion in children with a previous history of concussion.

Design
Systematic review and meta-analysis. The primary outcome was number of children with and without a previous lifetime history of concussion who sustained a diagnosed concussion within each study period. Risk of bias was assessed using the Newcastle-Ottawa Scale. A random effects model was used to estimate a pooled risk ratio (RR) with corresponding 95% CIs; results were summarised in forest plots.

Data sources
Four electronic databases (MEDLINE, Embase, CINAHL, SPORTDiscus) and selected reference lists were searched (PROSPERO registration No CRD42019135462).

Eligibility criteria
Original English language peer-reviewed publications that compared concussion risk in children aged 5–18 years with and without a previous concussion history in which risk estimates were reported or able to be calculated.

Results

Of 732 identified studies, 7 studies representing 23 411 children (risk of bias range, 7–9; maximum possible score=9) were included for meta-analysis. Pooled risk of sustaining a concussion was more than three times greater in children with a previous concussion compared with those with no previous concussion (RR=3.64; 95% CI: 2.68 to 4.96; p<0.0001;
I
2
=90.55%). Unreported sex-stratified data precluded direct comparison of concussion risk in male versus female athletes.

Conclusion
Previously concussed children have four times the risk of sustaining a concussion compared with those with no previous concussion history. This should be a consideration for clinicians in return to sport decision-making. Future studies examining subsequent recurrent concussion in youth sports must consider sex differences.
Comparison of neurofilament light chain results between two independent facilities
Authors: Sejbaek Tobias , Mendoza Jason P , Penner Natasha , Madsen Jonna Skov , Olsen Dorte Aalund , Illes Zsolt 
Published: October 2020

ObjectivesTo examine levels of neurofilament light chain (NFL) in identical cerebrospinal fluid (CSF) and blood samples at two different facilities, and how differences affect interpretation of levels within and above the normal range.MethodsCSF and plasma from patients with multiple sclerosis (MS) and healthy controls (HCs) were analysed by Simoa (Quanterix) for levels of NFL providing a total of 165 CSF samples (119 from MS) and 225 plasma samples (180 from MS).ResultsCSF and plasma concentrations highly correlated between NFL laboratory facilities (R: 0.92 and 0.84, <0.0001, respectively), and there were no differences between facilities. A bias between the two sites for plasma was −0.95 pg/mL and for CSF −73.53 pg/mL. The cut-offs for CSF were 807.5 and 571.0 pg/mL at site 1 and site 2, respectively; the cut-offs for plasma were 13.0 and 11.8 pg/mL, respectively. Seven out of 180 plasma samples (3.9%) and 3 out of 119 CSF samples (2.5%) from MS patients could be reclassified as normal/abnormal, that is, below/above cut-off, when measured at different facilities.ConclusionOur study demonstrates that results of NFL in CSF and blood measured with SIMOA are comparable between facilities. Nevertheless, healthcare practitioners should consider reference values at different laboratories, since different sensitivity/specificity can affect interpretation when low values are adjacent to cut-offs.
First trimester screening for pre-eclampsia and intrauterine growth restriction using three-dimensional Doppler angiography (SPIRIT): protocol for a multicentre prospective study in nulliparous pregnant women
Authors: Bertholdt Charline , Hossu Gabriela , Banasiak Claire , Beaumont Marine , Morel Olivier 
Published: October 2020

IntroductionPre-eclampsia (PE) and intrauterine growth restriction (IUGR) are two major pregnancy complications, related to chronic uteroplacental hypoperfusion. Nowadays, there is no screening or diagnostic test for uteroplacental vascularisation deficiency in pregnant women. Since 2004, 3 three-imensional power Doppler (3DPD) angiography has been used for the evaluation of uteroplacental vascularisation and three vascular indices are usually calculated: Vascularisation Index (VI), Flow Index (FI) and vascularisation-FI (VFI). A high intraobserver and interobserver reproducibility and a potential interest for placental function study were reported by our team and others.The main objective of our study is to determine differences in 3DPD indices at first trimester between pregnancies defined at their outcome as uncomplicated pregnancy, PE (mild and severe) and IUGR in nulliparous women.Methods and analysisThis is a national multicentre prospective cohort study conducted in four French maternity units. We expect to include 2200 women in a period of 36 months. The nulliparous pregnant women will be recruited during their first trimester consultation (11–13+6 gestation week (GW)).The 3DPD and uterine artery Doppler acquisition will be included in the current routine 11–13+6 GW ultrasound. Also, additional blood samples will be taken for biomarker analysis (PAPP-A and P1GF) and biological collection. Uteroplacental VIs (FI and VFI) will be measured. For each subgroup (uncomplicated pregnancy, PE and IUGR), mean values in 3DPD indices will be computed and compared using a pairwise t test with a Bonferroni correction p value adjustment.Ethics and disseminationThe study was approved by the French Ethics Committee, the Comité de Protection des Personnes SUD MEDITERRANEE IV on 13 February 2018 with reference number 17 12 03. The results of this study will be published in a peer-reviewed journal and will be presented at relevant conferences.Trial registration numberNCT03342014; Pre-results. PHRCN-16-0567.
Assault-related severe ocular chemical injury at a London ophthalmic referral hospital: a 3-year retrospective observational study
Authors: Hoffman Jeremy John , Casswell Edward Joshua , Shortt Alex John 
Published: October 2020

ObjectivesTo understand the incidence, causes, management and outcomes of intentional (assault) and unintentional severe ocular chemical injuries (SOCI) at an urban tertiary referral centre in the UK.DesignRetrospective observational study.SettingA London tertiary referral ophthalmic centre, Moorfields Eye Hospital.ParticipantsAll cases of SOCI presenting between 1 September 2011 and 31 August 2014 were identified. The definition of SOCI was grade 3 or 4 on the Hughes-Roper-Hall classification system. We identified 25 cases (6 in 2011–2012, 8 in 2012–2013, 11 in 2013–2014). Median age was 31.1 years. 23 cases (92%) were male.Primary and secondary outcome measuresThe primary outcome was the proportion of cases of SOCI caused by assault, per year. Secondary outcome measures included the number of cases of SOCI, injury characteristics and mechanism, initial and long-term management, visual outcome and the need for surgical intervention.ResultsBetween 2011 and 2012, 3/6 cases were due to assault (50%); between 2012 and 2013, 7/8 were due to assault (87.5%); and between 2013 and 2014, 6/11 were due to assault (54.4%). Assault was responsible for 16/25 (64%) cases overall, while 8/25 (32%) cases were work related. The causative agent was known to be alkali in 16/25 (64%), while 10/25 (40%) did not complete the follow-up. The mean number of clock hours of limbal ischaemia was 5.24 (SD 2.97). 17/25 (68%) were Hughes-Roper-Hall grade 3. Surgical intervention occurred in 1/25. The final best-corrected visual acuity was 6/12 or worse in 11/25 (44%) and was counting fingers or worse in 4/25 (16%).ConclusionsPrevious studies found that SOCI had a low incidence and that work-related injuries were the most common cause. Our study demonstrates an increasing incidence of SOCI, which may be accounted for by a rise in assault using corrosive substances. A high number of patients did not attend regularly for follow-up and visual outcomes from these injuries are poor.
Association between neutrophil-to-albumin ratio and mortality in patients with cardiogenic shock: a retrospective cohort study
Authors: Peng Yangpei , Xue Yangjing , Wang Jinsheng , Xiang Huaqiang , Ji Kangting , Wang Jie , Lin Cong 
Published: October 2020

ObjectivesTo investigate the prognostic value of neutrophil-to-albumin ratio (NAR) in critically ill patients with cardiogenic shock (CS).DesignA retrospective cohort study.SettingA single centre in Boston, USA.Participants475 patients with CS were included, among which 272 (57.3%) were men and 328 (69.1%) were white.Primary and secondary outcome measuresThe primary outcome was 90-day mortality and the secondary outcomes were 30-day and 365-day mortality.ResultsA significant positive correlation between NAR levels and 90-day, 30-day or 365-day mortality was observed. For 90-day mortality, the adjusted HR (95% CI) values given NAR levels 23.54–27.86 and >27.86 were 1.71 (1.14 to 2.55) and 1.93 (1.27 to 2.93) compared with the reference (NAR<23.47). Receiver operator characteristic curve analysis showed that NAR had a certain prognostic value in predicting 90-day mortality of CS, which was more sensitive than the neutrophil percentage or the serum albumin level alone (0.651 vs 0.509, 0.584). For the secondary outcomes, the upward trend remained statistically significant.ConclusionsNAR level was associated with the mortality of CS patients. The prognostic value of NAR was more sensitive than the neutrophil percentage or the serum albumin level alone, but not as good as Sequential Organ Failure Assessment or Simplified Acute Physiology Score.
Patient and caregiver experiences with advanced cancer care: a qualitative study informing the development of an early palliative care pathway
Authors: Ahmed Sadia , Naqvi Syeda Farwa , Sinnarajah Aynharan , McGhan Gwen , Simon Jessica , Santana Maria 
Published: October 2020

BackgroundPalliative care is an approach that improves the quality of life of patients and families facing challenges associated with life-threatening illness. In order to effectively deliver palliative care, patient and caregiver priorities need to be incorporated in advanced cancer care.AimThis study identified experiences of patients living with advanced colorectal cancer and their caregivers to inform the development of an early palliative care pathway.DesignQualitative patient-oriented study.Settings/participantsPatients receiving care at two cancer centres were interviewed using semistructured telephone interviews to explore their experiences with cancer care services received prior to a new developed pathway. Interviews were transcribed verbatim, and the data were thematically analysed.ResultsFrom our study, we identified gaps in advanced cancer care that would benefit from an early palliative approach to care. 15 patients and 7 caregivers from Edmonton and Calgary were interviewed over the phone. Participants identified the following gaps in advanced cancer care: poor communication of diagnosis, lack of communication between healthcare providers, role and involvement of the family physician, lack of understanding of palliative care and advance care planning.ConclusionsEarly palliative approaches to care should consider consistent and routine delivery of palliative care information, collaborations among different disciplines such as oncology, primary care and palliative care, and engagement of patients and family caregivers in the development of care pathways.
COVID-19 risk management at the workplace, fear of infection and fear of transmission of infection among frontline employees
Authors: Nabe-Nielsen Kirsten , Nilsson Charlotte Juul , Juul-Madsen Maria , Bredal Charlotte , Hansen Lars Ole Preisler , Hansen Åse Marie 
Published: October 2020

ObjectivesWe compared COVID-19 risk management, fear of infection and fear of transmission of infection among frontline employees working within eldercare, hospital/rehabilitation, psychiatry, childcare and ambulance service and explored if group differences in fear of infection and transmission could be explained by differences in risk management. We also investigated the association of risk management with fear of infection and fear of transmission of infection among eldercare personnel.MethodsWe used cross-sectional questionnaire data collected by the Danish labour union, FOA . Data were collected 5½ weeks after the first case of COVID-19 was registered in Denmark. Data for the first aim included 2623 participants. Data for the second aim included 1680 participants. All independent variables were mutually adjusted and also adjusted for sex, age, job title and region.ResultsFear of infection (49%) and fear of transmitting infection from work to the private sphere (68%) was most frequent in ambulance service. Fear of transmitting infection during work was most frequent in the eldercare (55%). Not all differences in fear of infection and transmission between the five areas of work were explained by differences in risk management. Among eldercare personnel, self-reported exposure to infection and lack of access to test was most consistently associated with fear of infection and fear of transmission, whereas lack of access to personal protective equipment was solely associated with fear of transmission.ConclusionWe have illustrated differences and similarities in COVID-19 risk management within five areas of work and provide new insights into factors associated with eldercare workers’ fear of infection and fear of transmission of infection.
Pregnancy in a healthy population: dynamics of NTproBNP and hs-cTroponin T
Authors: Furenäs Eva , Eriksson Peter , Wennerholm Ulla-Britt , Dellborg Mikael 
Published: October 2020

ObjectiveTo describe the intraindividual changes of heart biomarker levels during and after pregnancy and to evaluate existing cut-off levels for heart failure or myocardial ischaemia in pregnant women.MethodA total of 196 healthy pregnant women were recruited from maternal outpatient clinics and included in the study. Blood samples were obtained on four occasions: at 10–12 gestational weeks (gw), 20–25 gw, after delivery and 6 months postpartum and analysed for N-terminal pro-brain natriuretic peptide (NTproBNP) and high sensitive cardiac troponin T (hs-cTNT). Echocardiography ruled out existing cardiac disease. Estimated glomerular filtration rate (eGFR) was calculated.ResultsThere were significant changes in NTproBNP between the measurements with the highest NTproBNP at 10–12 gw and the lowest value being at 20–25 gw, (with eGFR being the highest). Hs-cTNT was significantly higher at the peripartum measurement compared with the other measurements (p<0.05). Regardless, the 95th percentile for both biomarkers was below cut-off levels of 300 ng/L for NTproBNP and 14 ng/L for hs-cTNT. There was an association between NTproBNP above the upper limit of normal of 125 ng/L and eGFR (p=0.04) and between hs-cTNT >5.0 ng/L and time from delivery to blood sample (p=0.001) at the peripartum measurement. Both were associated with the use of oxytocin.ConclusionExisting cut-off values for ruling out heart failure (NTproBNP <300 ng/L) and myocardial ischaemia (hs-cTNT <14 ng/L) are applicable during pregnancy and after delivery. Elevated levels mandate further attention on cardiac symptoms and renal function.
Impact of LHC vector boson production in heavy ion collisions on strange PDFs
Authors: Kusina A. , Ježo T. , Clark D. B. , Duwentäster P. , Godat E. , Hobbs T. J. , Kent J. , Klasen M. , Kovařík K. , Lyonnet F. , Muzakka K. F. , Olness F. I. , Schienbein I. , Yu J. Y. 
Published: October 2020

AbstractThe extraction of the strange quark parton distribution function (PDF) poses a long-standing puzzle. Measurements from neutrino-nucleus deep inelastic scattering (DIS) experiments suggest the strange quark is suppressed compared to the light sea quarks, while recent studies of $$W^\pm /Z$$

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boson production at the LHC imply a larger strange component at small x values. As the parton flavor determination in the proton depends on nuclear corrections, e.g. from heavy-target DIS, LHC heavy ion measurements can provide a distinct perspective to help clarify this situation. In this investigation we extend the nCTEQ15 nPDFs to study the impact of the LHC proton-lead $$W^\pm /Z$$

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production data on both the flavor differentiation and nuclear corrections. This complementary data set provides new insights on both the LHC $$W^\pm /Z$$

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proton analyses and the neutrino-nucleus DIS data. We identify these new nPDFs as nCTEQ15WZ. Our calculations are performed using a new implementation of the nCTEQ code (nCTEQ++) based on C++ which enables us to easily interface to external programs such as HOPPET, APPLgrid and MCFM. Our results indicate that, as suggested by the proton data, the small x nuclear strange sea appears larger than previously expected, even when the normalization of the $$W^{\pm }/Z$$

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data is accommodated in the fit. Extending the nCTEQ15 analysis to include LHC $$W^\pm /Z$$

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data represents an important step as we advance toward the next generation of nPDFs.
Intrinsic resonant enhancement of light by nonlinear vacuum
Authors: Shibata Kazunori 
Published: October 2020

Abstract
In nonlinear electromagnetism in vacuum, a classical electromagnetic wave itself can generate another wave. A classical field can become a source for a nonlinear correction via the polarization and magnetization of vacuum. We elucidate that a resonant generation is intrinsic to the theoretical structure of nonlinear electromagnetism. The resonance can take place when the phases, or the cycles of the source and the nonlinear correction match. We demonstrate two specific systems as examples. For a plane wave and constant fields, nonlinear corrective electromagnetic fields are resonantly enhanced with distance. It is shown in a stationary special solution. For more realistic system, we have considered the case of a standing wave in a cavity with an appropriate initial and boundary conditions. As a result, the corrections are resonantly enhanced with time. The resonance effect in the cavity is shown to be observed more effectively by combining a static magnetic flux density. We have evaluated the resonant effect using concrete parameters of current experiments. The demonstrated resonance can be combined with existing proposals to enable experimental detection of nonlinear optical effects of vacuum easier.

Graphical abstract
Nanoengineered Disruption of Heat Shock Protein 90 Targets Drug-Induced Resistance and Relieves Natural Killer Cell Suppression in Breast Cancer
Authors: Smalley Munisha , Natarajan Siva Kumar , Mondal Jayanta , Best Douglas , Goldman David , Shanthappa Basavaraja , Pellowe Moriah , Dash Chinmayee , Saha Tanmoy , Khiste Sachin , Ramadurai Nithya , Eton Elliot O. , Smalley Joshua L. , Brown Andrew , Thayakumar Allen , Rahman Mamunur , Arai Kazuya , Kohandel Mohammad , Sengupta Shiladitya , Goldman Aaron 
Published: October 2020

Abstract

Drug-induced resistance, or tolerance, is an emerging yet poorly understood failure of anticancer therapy. The interplay between drug-tolerant cancer cells and innate immunity within the tumor, the consequence on tumor growth, and therapeutic strategies to address these challenges remain undescribed. Here, we elucidate the role of taxane-induced resistance on natural killer (NK) cell tumor immunity in triple-negative breast cancer (TNBC) and the design of spatiotemporally controlled nanomedicines, which boost therapeutic efficacy and invigorate “disabled” NK cells. Drug tolerance limited NK cell immune surveillance via drug-induced depletion of the NK-activating ligand receptor axis, NK group 2 member D, and MHC class I polypeptide-related sequence A, B. Systems biology supported by empirical evidence revealed the heat shock protein 90 (Hsp90) simultaneously controls immune surveillance and persistence of drug-treated tumor cells. On the basis of this evidence, we engineered a “chimeric” nanotherapeutic tool comprising taxanes and a cholesterol-tethered Hsp90 inhibitor, radicicol, which targets the tumor, reduces tolerance, and optimally reprimes NK cells via prolonged induction of NK-activating ligand receptors via temporal control of drug release in vitro and in vivo. A human ex vivo TNBC model confirmed the importance of NK cells in drug-induced death under pressure of clinically approved agents. These findings highlight a convergence between drug-induced resistance, the tumor immune contexture, and engineered approaches that consider the tumor and microenvironment to improve the success of combinatorial therapy.

Significance:
This study uncovers a molecular mechanism linking drug-induced resistance and tumor immunity and provides novel engineered solutions that target these mechanisms in the tumor and improve immunity, thus mitigating off-target effects.
Estratégias comerciais e operacionais das grandes companhias de saneamento
Authors: De Oliveira Alberto 
Published: October 2020

O final do século XX testemunhou a ascensão de modelos de política pública baseados em soluções de mercado, o que estimulou a privatização e o surgimento de parcerias público-privadas no setor de saneamento básico. O objetivo deste trabalho é avaliar as estratégias comerciais e operacionais adotadas pela Companhia de Saneamento Básico do Estado de São Paulo (Sabesp), tendo em vista as transformações em curso no mercado internacional, a fim de juntar elementos que contribuam para o debate das políticas de saneamento no Brasil. A metodologia do trabalho buscou identificar convergências e divergências entre os interesses dos investidores e dos usuários, a partir da análise das informações econômicas e operacionais disponíveis nos relatórios dos acionistas, com destaque para os seguintes aspectos: recursos humanos, investimentos, tarifas, eficiência operacional e lucratividade. A investigação concluiu que a Sabesp vem seguindo estratégias semelhantes às observadas nas companhias que atuam no mercado internacional, embora tenha divergido em alguns aspectos, possivelmente em razão das características da infraestruturade saneamento presentes em São Paulo. Finalmente, em oposição à harmonia preconizada nos textos que defendem as soluções de mercado, esta pesquisa apontou nas estratégias da Sabesp os conflitos entre os interesses de investidores e usuários.