bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smoking cessation interventions for people living in rural and remote areas: a systematic review protocol
Authors: Lum Alistair , Skelton Eliza , McCarter Kristen Louise , Handley Tonelle , Judd Lucy , Bonevski Billie 
Published: November 2020

IntroductionSmoking rates among people living in rural and remote areas are higher and quit rates are lower over the past 10 years compared with people living in suburban and urban areas. Higher smoking rates contribute to greater tobacco-related disease and morbidity in rural and remote areas. Physical and social isolation, greater exposure to pro-tobacco marketing, pro-tobacco social norms, and lower socioeconomic and educational levels are contributing to these higher smoking rates and lower quit rates. Smoking cessation interventions for people in rural and remote areas have been conducted, however little is known about their effectiveness or their mechanisms of action as well as the quality of such research. Behaviour change techniques (BCTs) are mechanisms of action derived from behaviour change theory, such as goal setting and reward. Improved understanding of the contribution of BCTs for smoking cessation in the rural and remote population will support future intervention development. We aim to review the literature on smoking cessation interventions for people living in rural and remote areas to inform evidence about intervention effectiveness and mechanisms of action.Methods and analysisWe will conduct a systematic review using seven scientific databases (EMBASE, MedLine, PsycINFO, CINAHL, Cochrane, Informit Health and Scopus). We will include peer-reviewed journal articles published in English that examine a smoking cessation intervention delivered to people living in rural and remote areas in the USA, Canada and Australia. We will examine outcome data relating to intervention effectiveness (eg, point prevalence abstinence or continuous abstinence), as well as the BCTs used in included interventions and their relationship with intervention outcomes. We will also assess the feasibility, acceptability and quality of research interventions of included articles, and provide graded recommendations based on the review outcomes. Data will be synthesised using narrative approaches and interpreted using content analysis.Ethics and disseminationEthics was not required for this systematic review. The results will be disseminated through peer-reviewed publication and at conferences by presentations.PROSPERO registration number177398.
Examining the effect of non-specialised clinical rotations upon medical students’ Thanatophobia and Self-efficacy in Palliative Care: a prospective observational study in two medical schools
Authors: Gryschek Guilherme , Cecilio-Fernandes Dario , Barros Guilherme Antonio Moreira de , Mason Stephen , de Carvalho-Filho Marco Antonio 
Published: November 2020

IntroductionIncluding palliative care (PC) in overloaded medical curricula is a challenge, especially where there is a lack of PC specialists. We hypothesised that non-specialised rotations could provide meaningful PC learning when there are enough clinical experiences, with adequate feedback.ObjectiveObserve the effects of including PC topics in non-specialised placements for undergraduate medical students in two different medical schools.DesignObservational prospective study.SettingMedical schools in Brazil.Participants134 sixth-year medical students of two medical schools.MethodsThis was a longitudinal study that observed the development of Self-efficacy in Palliative Care (SEPC) and Thanatophobia (TS) in sixth-year medical students in different non-specialised clinical rotations in two Brazilian medical schools (MS1 and MS2). We enrolled 78 students in MS1 during the Emergency and Critical Care rotation and 56 students in MS2 during the rotation in Anaesthesiology. Both schools provide PC discussions with different learning environment and approaches.Primary outcomesSEPC and TS Scales were used to assess students at the beginning and the end of the rotations.ResultsIn both schools’ students had an increase in SEPC and a decrease in TS scores.ConclusionNon-specialised rotations that consider PC competencies as core aspects of being a doctor can be effective to develop SEPC and decrease TS levels.
FN3K expression in COPD: a potential comorbidity factor for cardiovascular disease
Authors: Alderawi Amr , Caramori Gaetano , Baker Emma H , Hitchings Andrew William , Rahman Irfan , Rossios Christos , Adcock Ian , Casolari Paolo , Papi Alberto , Ortega Victor E , Curtis Jeffrey L , Dunmore Simon , Kirkham Paul 
Published: November 2020

IntroductionCigarette smoking and oxidative stress are common risk factors for the multi-morbidities associated with chronic obstructive pulmonary disease (COPD). Elevated levels of advanced glycation endproducts (AGE) increase the risk of cardiovascular disease (CVD) comorbidity and mortality. The enzyme fructosamine-3-kinase (FN3K) reduces this risk by lowering AGE levels.MethodsThe distribution and expression of FN3K protein in lung tissues from stable COPD and control subjects, as well as an animal model of COPD, was assessed by immunohistochemistry. Serum FN3K protein and AGE levels were assessed by ELISA in patients with COPD exacerbations receiving metformin. Genetic variants within the FN3K and FN3K-RP genes were evaluated for associations with cardiorespiratory function in the Subpopulations and Intermediate Outcome Measures in COPD Study cohort.ResultsThis pilot study demonstrates that FN3K expression in the blood and human lung epithelium is distributed at either high or low levels irrespective of disease status. The percentage of lung epithelial cells expressing FN3K was higher in control smokers with normal lung function, but this induction was not observed in COPD patients nor in a smoking model of COPD. The top five nominal FN3K polymorphisms with possible association to decreased cardiorespiratory function (p<0.008–0.02), all failed to reach the threshold (p<0.0028) to be considered highly significant following multi-comparison analysis. Metformin enhanced systemic levels of FN3K in COPD subjects independent of their high-expression or low-expression status.DiscussionThe data highlight that low and high FN3K expressors exist within our study cohort and metformin induces FN3K levels, highlighting a potential mechanism to reduce the risk of CVD comorbidity and mortality.
Quality versus risk of bias assessment of palliative care trials: comparison of two tools
Authors: Isenberg Sarina R , Kavalieratos Dio , Chow Ronald , Le Lisa , Wegier Pete , Zimmermann Camilla 
Published: November 2020

BackgroundRandomised controlled trials (RCTs) of palliative care interventions are challenging to conduct and evaluate. Tools used to judge the quality of RCTs do not account for the complexities of conducting research in seriously ill populations and may artificially downgrade confidence in palliative care research.ObjectiveTo compare assessments from the Palliative Care Trial Assessment Tool (PCTAT) and Cochrane Risk of Bias (RoB) tool.DesignReviewers assessed 43 RCTs using PCTAT and RoB. We compared assessments of each trial, assessed overall agreement (weighted kappa (Kw)) and examined (dis)agreement for comparable items. We assessed quality of life at 1–3 months among trials grouped according to RoB or PCTAT score (using meta-analysis) and whether RoB or quality improved over time (Cochran-Armitage trend test).ResultsOf 43 trials, those rated low RoB had a mean PCTAT score of 73 (SD 10); those rated high RoB had a mean PCTAT score of 56 (SD 14). Overall Kwwas 0.33 (95% CI 0.19 to 0.42). Total agreement between comparable items was observed for 56% of trials (24/43) and total disagreement for 21% (8/43). The standardised mean difference in quality of life was statistically significant among RCTs with low RoB and high PCTAT, but not for those with medium/low PCTAT or high/unclear RoB. Quality of reporting improved over time, whereas RoB did not.ConclusionAlthough there was fair agreement between tools, areas of disagreement/non-comparability suggest the tools capture different aspects of bias/quality. A specific tool to evaluate quality of palliative care trials may be warranted.
Errors in prostate core biopsy diagnosis in an era of specialisation and double reporting
Authors: Szecsei Cornelia Margaret , Oxley Jon D 
Published: November 2020

AimTo examine the effects of specialist reporting on error rates in prostate core biopsy diagnosis.MethodBiopsies were reported by eight specialist uropathologists over 3 years. New cancer diagnoses were double-reported and all biopsies were reviewed for the multidisciplinary team (MDT) meeting. Diagnostic alterations were recorded in supplementary reports and error rates were compared with a decade previously.Results2600 biopsies were reported. 64.1% contained adenocarcinoma, a 19.7% increase. The false-positive error rate had reduced from 0.4% to 0.06%. The false-negative error rate had increased from 1.5% to 1.8%, but represented fewer absolute errors due to increased cancer incidence.ConclusionsSpecialisation and double-reporting have reduced false-positive errors. MDT review of negative cores continues to identify a very low number of false-negative errors. Our data represents a ‘gold standard’ for prostate biopsy diagnostic error rates. Increased use of MRI-targeted biopsies may alter error rates and their future clinical significance.
A complex DICER1 syndrome phenotype associated with a germline pathogenic variant affecting the RNase IIIa domain of DICER1
Authors: Pontén Emeli , Frisk Sofia , Taylan Fulya , Vaz Raquel , Wessman Sandra , de Kock Leanne , Pal Niklas , Foulkes William D , Lagerstedt-Robinson Kristina , Nordgren Ann 
Published: November 2020

BackgroundGermline pathogenic variants in DICER1 cause DICER1 syndrome, an autosomal dominant, pleiotropic tumour predisposition syndrome with variable expressivity and reduced penetrance for specific dysplastic and neoplastic lesions. Recently, a syndrome with the acronym GLOW (Global developmental delay, Lung cysts, Overgrowth, Wilms tumour) was described in two children with mosaic missense mutations in hotspot residues of the DICER1 RNase IIIb domain.MethodsWhole genome sequencing, exome sequencing, Sanger sequencing, digital PCR and a review of Wilms tumours with DICER1 RNase III domain mutations were performed.ResultsA de novo heterozygous c.4031C>T (p.S1344L) variant in the sequence encoding the RNase IIIa domain of DICER1 was detected. Clinical investigations revealed a phenotype that resembles the GLOW subphenotype of DICER1 syndrome.ConclusionThe phenotypic overlap between patients with p.S1344L mutation and GLOW syndrome provide clinical support for recent discoveries that RNase IIIa-Ser1344 site mutations impede miRNA-5p biogenesis analogous to DICER1 hotspot mutations in the RNase IIIb domain. We show that an individual with a heterozygous germline p.S1344L mutation has a severe form of DICER1 syndrome (‘DICER1 syndrome plus’), with notable features of intellectual disability, macrocephaly, physical abnormalities, Wilms tumour and a well-differentiated fetal adenocarcinoma of the lung.
Cerebral microhaemorrhage in COVID-19: a critical illness related phenomenon?
Authors: Dixon Luke , McNamara Cillian , Gaur Pritika , Mallon Dermot , Coughlan Charles , Tona Francesca , Jan Wajanat , Wilson Mark , Jones Brynmor 
Published: November 2020

BackgroundCerebral microhaemorrhages are increasingly being recognised as a complication of COVID-19. This observational retrospective study aims to further investigate the potential pathophysiology through assessing the pattern of microhaemorrhage and clinical characteristics of patients with COVID-19 and microhaemorrhage. By comparing with similar patterns of microhaemorrhage in other non-COVID-19 disease, this study aims to propose possible common pathogenic mechanisms.MethodsA retrospective observational case series was performed identifying all patients with COVID-19 complicated by cerebral microhaemorrhage on MRI. The distribution and number of microhaemorrhages were recorded using the microbleed anatomical scale, and patients’ baseline characteristics and salient test results were also recorded.ResultsCerebral microhaemorrhages were noted to have a predilection for the corpus callosum, the juxtacortical white matter and brainstem. All patients had a preceding period of critical illness with respiratory failure and severe hypoxia necessitating intubation and mechanical ventilation.DiscussionThis study demonstrates a pattern of cerebral microhaemorrhage that is similar to the pattern reported in patients with non-COVID-19 related critical illness and other causes of severe hypoxia. This raises questions regarding whether microhaemorrhage occurs from endothelial dysfunction due the direct effect of SARS-CoV-2 infection or from the secondary effects of critical illness and hypoxia.
Using Machine Learning Algorithms to Predict Immunotherapy Response in Patients with Advanced Melanoma
Authors: Johannet Paul , Coudray Nicolas , Donnelly Douglas M. , Jour George , Illa-Bochaca Irineu , Xia Yuhe , Johnson Douglas B. , Wheless Lee , Patrinely James R. , Nomikou Sofia , Rimm David L. , Pavlick Anna C. , Weber Jeffrey S. , Zhong Judy , Tsirigos Aristotelis , Osman Iman 
Published: November 2020

Abstract

Purpose:
Several biomarkers of response to immune checkpoint inhibitors (ICI) show potential but are not yet scalable to the clinic. We developed a pipeline that integrates deep learning on histology specimens with clinical data to predict ICI response in advanced melanoma.

Experimental Design:
We used a training cohort from New York University (New York, NY) and a validation cohort from Vanderbilt University (Nashville, TN). We built a multivariable classifier that integrates neural network predictions with clinical data. A ROC curve was generated and the optimal threshold was used to stratify patients as high versus low risk for progression. Kaplan–Meier curves compared progression-free survival (PFS) between the groups. The classifier was validated on two slide scanners (Aperio AT2 and Leica SCN400).

Results:
The multivariable classifier predicted response with AUC 0.800 on images from the Aperio AT2 and AUC 0.805 on images from the Leica SCN400. The classifier accurately stratified patients into high versus low risk for disease progression. Vanderbilt patients classified as high risk for progression had significantly worse PFS than those classified as low risk (P = 0.02 for the Aperio AT2; P = 0.03 for the Leica SCN400).

Conclusions:
Histology slides and patients' clinicodemographic characteristics are readily available through standard of care and have the potential to predict ICI treatment outcomes. With prospective validation, we believe our approach has potential for integration into clinical practice.
Youtubers indígenas no Brasil: abordagens políticas e comunicativas
Authors: Souza Rose Mara Vidal de , Kaseker Mônica Panis 
Published: November 2020

Os povos indígenas passaram a utilizar os meios de comunicação digitais como ferramentas de afirmação de suas identidades, de resistência e de posicionamento político. Este artigo apresenta uma discussão sobre o ativismo indígena no YouTube. Do ponto de vista metodológico, o estudo tem por base a pesquisa bibliográfica e exploratória. O referencial teórico perpassa por Hall, Bauman e Eagleton sobre a questão das identidades culturais e Araújo, Di Felice e Braighi sobre os conceitos de ciberativismo, net-ativismo e midiativismo. Foram realizados um mapeamento da presença indígena no You Tube e uma análise dos canais dos youtubers indígenas Ysani Kalapalo e Cristian Wariu. Com posicionamentos políticos e abordagens comunicativas totalmente diversas, os dois youtubers surgem como importantes influenciadores digitais no Brasil contemporâneo
Fungal biocontrol reduces the populations of the lesion nematode, Pratylenchus brachyurus, in soybean and corn
Authors: Pacheco Paulo V.M. , Monteiro Thalita S.A. , Coutinho Raul R. , Balbino Huarlen M. , de Freitas Leandro G. 
Published: November 2020

Summary
Pratylenchus brachyurus is considered one of the most important plant pathogens of soybean and corn in Brazil, mainly found in areas where no-tillage is practised. Nematophagous fungi are used as an alternative for chemical nematicides in the management of nematodes that affect these crops in Brazil. This study evaluated the fungi Pochonia chlamydosporia, Trichoderma sp. and Duddingtonia flagrans for the biocontrol of P. brachyurus in soybean and corn. The first and second experiments were carried out using soybean, and five isolates of P. chlamydosporia (Pc-3, Pc-4, Pc-10, Pc-35 and Pc-49), one of Trichoderma sp. (T-10), an isolate of D. flagrans (AC001) and a mix (MIX) of all the isolates. In the third experiment using corn, three isolates of P. chlamydosporia (Pc-3, Pc-10 and Pc-35) and one isolate of Trichoderma sp. (T-10) were compared. In the first experiment, the isolates Pc-3, Pc-10, Pc-35 and T-10 reduced the total population of P. brachyurus up to 43.7% when compared with the control treatment. In the second experiment, the isolates Pc-10, T-10 and the MIX reduced the total population of P. brachyurus up to 58.7% when compared with the control. In the third experiment, the isolates reduced the total population of P. brachyurus in corn when compared with the control treatment, except for D. flagrans, which was not able to control P. brachyurus in any experiment. The P. chlamydosporia (Pc-3, Pc-10, Pc-35) and Trichoderma sp. (T-10) isolates were shown to be promising for the control of P. brachyurus in soybean and corn.
‘Concerned with the Health and Welfare of Mankind …’ The un Drug Conventions – A Suitable Legal Framework for the 21st Century?
Authors: Geiß Robin , Wisehart Daniel 
Published: November 2020

The contribution analyses whether the un Drug Conventions still serve their original purpose, namely the furtherance of the health and welfare of mankind in the 21st century. To this end the contribution begins with an outline of how the un Drug Conventions aim to protect mankind’s health and welfare. On this basis it is inquired whether un Drug Conventions are somehow irreversibly imbued with a zero-tolerance approach that undermines the health and welfare of vulnerable groups on both ends of the supply chain respectively. Thus, with respect to the supply side the question is pursued whether the un Drug Conventions provisions on crop cultivation imperil the livelihoods of rural communities. With regard to the demand side it is examined whether the un Drug Conventions forestall the adoption of more liberal, i.e. non-punitive and health-oriented approaches towards illicit drug users. In a next step, the analysis turns to a long-standing and currently particularly prevalent criticism according to which the international drug control regime puts disproportionate pressure on so-called drug producing and drug transit States, while turning a blind eye on the so-called drug consuming States. In concluding, the contribution turns to the question how the international drug control system could be enhanced to better meet its proper goals of protecting mankind’s health and welfare.
The Role of Curvature in Modifying Frontal Instabilities. Part II: Application of the Criterion to Curved Density Fronts at Low Richardson Numbers
Authors: Buckingham Christian E. , Gula Jonathan , Carton Xavier 
Published: November 2020

AbstractWe continue our study of the role of curvature in modifying frontal stability. In Part I, we obtained an instability criterion valid for curved fronts and vortices in gradient wind balance (GWB): Φ′ = L′q′ < 0, where L′ and q′ are the nondimensional absolute angular momentum and Ertel potential vorticity (PV), respectively. In Part II, we investigate this criterion in a parameter space representative of low-Richardson-number fronts and vortices in GWB. An interesting outcome is that, for Richardson numbers near 1, anticyclonic flows increase in q′, while cyclonic flows decrease in q′, tending to stabilize anticyclonic and destabilize cyclonic flow. Although stability is marginal or weak for anticyclonic flow (owing to multiplication by L′), the destabilization of cyclonic flow is pronounced, and may help to explain an observed asymmetry in the distribution of small-scale, coherent vortices in the ocean interior. We are referring to midlatitude submesoscale and polar mesoscale vortices that are generated by friction and/or buoyancy forcing within boundary layers but that are often documented outside these layers. A comparison is made between several documented vortices and predicted stability maps, providing support for the proposed mechanism. A simple expression, which is a root of the stability discriminant Φ′, explains the observed asymmetry in the distribution of vorticity. In conclusion, the generalized criterion is consistent with theory, observations, and recent modeling studies and demonstrates that curvature in low-stratified environments can destabilize cyclonic and stabilize anticyclonic fronts and vortices to symmetric instability. The results may have implications for Earth system models.
A retrospective analysis of CO2 derived goal-directed perfusion variables under normothermic conditions: do we need to re-evaluate threshold values?
Authors: Overdevest Eddy , van den Heuvel Evi , van Hoeven Marloes 
Published: November 2020

This study investigated if current predictive values for increased lactate formation: VCO2i > 60 ml min−1 m−2, respiratory quotient (RQ) > 0.90, and DO2/VCO2 < 5.0, are valid under normothermic conditions. CO2 derived parameters were analyzed in 91 patients undergoing normothermic CABG and related to increase of blood lactate concentrations during bypass. In this study population, 85 patients (93%) had a median VCO2i above 60 ml min−1 m−2 and 53 patients (58%) had a DO2/VCO2 ⩽ 5.0. Eighteen patients (20%) had a median RQ ⩾ 0.90, but RQ remained with a maximum value of 0.94 below the biological threshold of 1.0. Increase of lactate concentrations remained without clinical significance and showed weak correlations with VCO2i (rs = 0.277, p = 0.008) and RQ (rs = 0.346, p = 0.001). The cohort was separated for the different CO2 variables by their median value to compare increase in lactate concentration. Patients with a high VCO2i (⩾70 ml min−1 m−2) and a high RQ (⩾0.82) showed significant higher increase in lactate concentration compared to patients with VCO2i < 70 ml min−1 m−2 (p = 0.004), and a RQ < 0.82 (p = 0.012). Groups separated by a median DO2/VCO2 of 4.8 did not show a difference in increase of lactate concentration in blood. In summary, specific CO2 derived threshold values for the prediction of lactate formation, which have been reported in other studies, cannot be confirmed with our findings. However, a CO2 production ⩾70 ml min−1 m−2 and a RQ ⩾ 0.82 in this study population were correlated with increased lactate formation. Because CO2 production during bypass depends on patient temperature, a different cutoff value, that may take into account the influence of demographic variables, should be determined during normothermic CPB.