bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deceased donor kidney allocation: an economic evaluation of contemporary longevity matching practices
Authors: Senanayake Sameera , Graves Nicholas , Healy Helen , Baboolal Keshwar , Barnett Adrian , Sypek Matthew P. , Kularatna Sanjeewa 
Published: October 2020

AbstractBackgroundMatching survival of a donor kidney with that of the recipient (longevity matching), is used in some kidney allocation systems to maximize graft-life years. It is not part of the allocation algorithm for Australia. Given the growing evidence of survival benefit due to longevity matching based allocation algorithms, development of a similar kidney allocation system for Australia is currently underway. The aim of this research is to estimate the impact that changes to costs and health outcomes arising from ‘longevity matching’ on the Australian healthcare system.MethodsA decision analytic model to estimate cost-effectiveness was developed using a Markov process. Four plausible competing allocation options were compared to the current kidney allocation practice. Models were simulated in one-year cycles for a 20-year time horizon, with transitions through distinct health states relevant to the kidney recipient. Willingness to pay was considered as AUD 28000.ResultsBase case analysis indicated that allocating the worst 20% of Kidney Donor Risk Index (KDRI) donor kidneys to the worst 20% of estimated post-transplant survival (EPTS) recipients (option 2) and allocating the oldest 25% of donor kidneys to the oldest 25% of recipients are both cost saving and more effective compared to the current Australian allocation practice.Option 2, returned the lowest costs, greatest health benefits and largest gain to net monetary benefits (NMB). Allocating the best 20% of KDRI donor kidneys to the best 20% of EPTS recipients had the lowest expected incremental NMB.ConclusionOf the four longevity-based kidney allocation practices considered, transplanting the lowest quality kidneys to the worst kidney recipients (option 2), was estimated to return the best value for money for the Australian health system.
Implementation of guidelines on family involvement for persons with psychotic disorders in community mental health centres (IFIP): protocol for a cluster randomised controlled trial
Authors: Hestmark Lars , Romøren Maria , Heiervang Kristin Sverdvik , Weimand Bente , Ruud Torleif , Norvoll Reidun , Hansson Kristiane Myckland , Norheim Irene , Aas Eline , Landeweer Elisabeth Geke Marjan , Pedersen Reidar 
Published: October 2020

Abstract
Background
Family involvement for persons with psychotic disorders is under-implemented in mental health care, despite its firm scientific, economic, legal and moral basis. This appears to be the case in Norway, despite the presence of national guidelines providing both general recommendations on family involvement and support in the health- and care services, and specific guidance on family interventions for patients with psychotic disorders. The aim of this project is to improve mental health services and the psychosocial health of persons with psychotic disorders and their relatives, by implementing selected recommendations from the national guidelines in community mental health centres, and to evaluate this process.

Methods
The trial is cluster randomised, where 14 outpatient clusters from community mental health centres undergo stratified randomisation with an allocation ratio of 1:1. The seven intervention clusters will receive implementation support for 18 months, whereas the control clusters will receive the same support after this implementation period. The intervention consists of: 1. A basic level of family involvement and support. 2. Family psychoeducation in single-family groups. 3. Training and guidance of health care personnel. 4. A family coordinator and 5. Other implementation measures. Fidelity to the intervention will be measured four times in the intervention arm and two times in the control arm, and the differences in fidelity changes between the arms constitute the primary outcomes. In each arm, we aim to include 161 patients with psychotic disorders and their closest relative to fill in questionnaires at inclusion, 6 months and 12 months, measuring psychosocial health and satisfaction with services. Clinicians will contribute clinical data about patients at inclusion and 12 months. Use of health and welfare services and work participation, for both patients and relatives, will be retrieved from national registries. We will also perform qualitative interviews with patients, relatives, health care personnel and leaders. Finally, we will conduct a cost-effectiveness analysis and a political economy analysis.

Discussion
This project, with its multilevel and mixed methods approach, may contribute valuable knowledge to the fields of family involvement, mental health service research and implementation science.

Trial registration
ClinicalTrials.gov Identifier NCT03869177. Registered 11.03.19.
High glycated albumin is an independent predictor of low response to clopidogrel in ACS patients: a cross-sectional study
Authors: Zhao Xiliang , Li Quan , Tu Chenchen , Zeng Yong , Ye Yicong 
Published: October 2020

Abstract
Background
Glycated albumin (GA) is a marker of short-term glycemic control and is strongly associated with the occurrence of diabetes. Previous studies have shown an association between GA and the effect of clopidogrel therapy on ischemic stroke. However, limited information is available regarding this relationship in acute coronary syndrome (ACS) patients. In this study, we evaluated the effect of GA on platelet P2Y12 inhibition by clopidogrel in patients with ACS.

Methods
Consecutive Chinese patients with ACS who received loading or maintenance doses of clopidogrel in addition to aspirin were recruited. At least 12 h after the patient had taken the clopidogrel dose, thromboelastography (TEG) and light transmittance aggregometry (LTA) were used to calculate the quantitative platelet inhibition rate to determine clopidogrel-induced antiplatelet reactivity. A prespecified cutoff of the maximum amplitude of adenosine diphosphate (ADP)-induced platelet-fibrin clot strength > 47 mm plus an ADP-induced platelet inhibition rate < 50% assessed by TEG or ADP-induced platelet aggregation > 40% assessed by LTA to indicate low responsiveness to clopidogrel were applied for evaluation. Patients were categorized into two groups based on a GA level of 15.5%, the cutoff point indicating the development of early-phase diabetes. Multivariate linear regression analysis was used to assess the interaction of GA with clopidogrel antiplatelet therapy.

Results
A total of 1021 participants were evaluated, and 28.3% of patients (289 of 1021) had low responsiveness to clopidogrel assessed by TEG. In patients with elevated GA levels, low responsiveness to clopidogrel assessed by TEG was observed in 33.7% (139 of 412) of patients, which was a significantly higher rate than that in the lower-GA-level group (24.6%, P = 0.002). According to multivariate linear regression analysis, a GA level > 15.5% was independently associated with low responsiveness to clopidogrel after adjustment for age, sex and other conventional confounding factors. This interaction was not mediated by a history of diabetes mellitus. A GA level ≤ 15.5% was associated with a high positive value [75.4%, 95% CI 73.0–77.6%] for predicting a normal responsiveness to clopidogrel.

Conclusions
GA could be a potential biomarker to predict the effects of clopidogrel antiplatelet therapy in ACS patients and might be a clinical biomarker to guide DAPT de-escalation.
Validation of subscales of the Severe Asthma Questionnaire (SAQ) using exploratory factor analysis (EFA)
Authors: Lanario Joseph W. , Hyland Michael E. , Menzies-Gow Andrew , Mansur Adel H. , Dodd James W. , Fowler Stephen J. , Jones Rupert C. , Masoli Matthew 
Published: October 2020

Abstract
Background
The Severe Asthma Questionnaire (SAQ) is a health related quality of life (HRQoL) questionnaire validated for use in severe asthma. It is scored using the mean value of 16 items (SAQ score) in addition to a single item global rating of HRQoL (SAQ-global). The aim was to validate clinically relevant subscales using exploratory factor analysis (EFA).

Methods
The SAQ was completed, along with measures of asthma control and EQ5D-5L by patients attending six UK severe asthma centres. Clinical data were included in the analysis. EFA using principal axis factoring and oblimin rotation was used to achieve simple structure of data.

Results
460 patients with severe asthma participated, 65% women, mean age 51 (16–83) years. A three factor solution achieved best fit and showed that the SAQ items formed three distinct but inter-correlated groups of items where items were grouped in a way that was consistent with item content. The three subscales were differentially associated with clinically relevant variables (lung function and mood). Males and females interpreted the question of night disturbance in different ways.

Conclusions
This paper provides a template for best practice in the use of EFA when validating HRQoL subscales. The SAQ can be scored as three subscales with content reflecting three different constructs people with severe asthma use when making judgements about their lives. The subscale ‘My Life’ assesses the impact of severe asthma on different life activities, ‘My Mind’ assesses the perceived emotional impact and ‘My Body’ the impact of extra-pulmonary symptoms and side effects.
Scaling up population health interventions from decision to sustainability – a window of opportunity? A qualitative view from policy-makers
Authors: Lee Karen , van Nassau Femke , Grunseit Anne , Conte Kathleen , Milat Andrew , Wolfenden Luke , Bauman Adrian 
Published: October 2020

Abstract
Background
While known efficacious preventive health interventions exist, the current capacity to scale up these interventions is limited. In recent years, much attention has focussed on developing frameworks and methods for scale-up yet, in practice, the pathway for scale-up is seldom linear and may be highly dependent on contextual circumstances. Few studies have examined the process of scaling up from decision to implementation nor examined the sustainability of scaled-up interventions. This study explores decision-makers’ perceptions from real-world scaled-up case studies to examine how scale-up decisions were made and describe enablers of successful scale-up and sustainability.

Methods
This qualitative study included 29 interviews conducted with purposively sampled key Australian policy-makers, practitioners and researchers experienced in scale-up. Semi-structured interview questions obtained information regarding case studies of scaled-up interventions. The Framework Analysis method was used as the primary method of analysis of the interview data to inductively generate common and divergent themes within qualitative data across cases.

Results
A total of 31 case studies of public health interventions were described by interview respondents based on their experiences. According to the interviewees’ perceptions, decisions to scale up commonly occurred either opportunistically, when funding became available, or when a deliberate decision was made and funding allocated. The latter scenario was more common when the intervention aligned with specific political or strategic goals. Decisions to scale up were driven by a variety of key actors such as politicians, senior policy-makers and practitioners in the health system. Drivers of a successful scale-up process included good governance, clear leadership, and adequate resourcing and expertise. Establishing accountability structures and appropriate engagement mechanisms to encourage the uptake of interventions were also key enablers. Sustainability was influenced by evidence of impact as well as good acceptability among the general or target population.

Conclusions
Much like Kingdon’s Multiple Streams Theory of ‘policy windows’, there is a conceptually similar ‘window for scale-up’, driven by a complex interplay of factors such as political need, strategic context, funding and key actors. Researchers and policy-makers need to consider scalability from the outset and prepare for when the window for scale-up opens. Decision-makers need to provide longer term funding for scale-up to facilitate longer term sustainability and build on the resources already invested for the scale-up process.
Receptor-interacting protein kinase 1 is a
key mediator in TLR3 ligand and Smac mimetic-induced cell death and suppresses TLR3
ligand-promoted invasion in cholangiocarcinoma
Authors: Lomphithak Thanpisit , Choksi Swati , Mutirangura Apiwat , Tohtong Rutaiwan , Tencomnao Tewin , Usubuchi Hajime , Unno Michiaki , Sasano Hironobu , Jitkaew Siriporn 
Published: October 2020

Abstract
Background
Toll-like receptor 3 (TLR3) ligand which activates TLR3 signaling
induces both cancer cell death and activates anti-tumor immunity. However, TLR3
signaling can also harbor pro-tumorigenic consequences. Therefore, we examined
the status of TLR3 in cholangiocarcinoma (CCA) cases to better understand TLR3
signaling and explore the potential therapeutic target in CCA.

Methods
The expression of TLR3 and receptor-interacting protein kinase 1
(RIPK1) in primary CCA tissues was assayed by Immunohistochemical staining and
their associations with clinicopathological characteristics and survival data
were evaluated. The effects of TLR3 ligand, Poly(I:C) and Smac mimetic, an IAP
antagonist on CCA cell death and invasion were determined by cell death
detection methods and Transwell invasion assay, respectively. Both genetic and
pharmacological inhibition of RIPK1, RIPK3 and MLKL and inhibitors targeting
NF-κB and MAPK signaling were used to investigate the underlying
mechanisms.

Results
TLR3 was significantly higher expressed in tumor than adjacent
normal tissues. We demonstrated in a panel of CCA cell lines that TLR3 was
frequently expressed in CCA cell lines, but was not detected in a nontumor
cholangiocyte. Subsequent in vitro study demonstrated that Poly(I:C)
specifically induced CCA cell death, but only when cIAPs were removed by Smac
mimetic. Cell death was also switched from apoptosis to necroptosis when
caspases were inhibited in CCA cells-expressing RIPK3. In addition, RIPK1 was
required for Poly(I:C) and Smac mimetic-induced apoptosis and necroptosis. Of
particular interest, high TLR3 or low RIPK1 status in CCA patients was
associated with more invasiveness. In vitro invasion demonstrated that
Poly(I:C)-induced invasion through NF-κB and MAPK signaling. Furthermore, the
loss of RIPK1 enhanced Poly(I:C)-induced invasion and ERK activation in vitro.
Smac mimetic also reversed Poly(I:C)-induced invasion, partly mediated by RIPK1.
Finally, a subgroup of patients with high TLR3 and high RIPK1 had a trend toward
longer disease-free survival (p = 0.078,
28.0 months and 10.9 months).

Conclusion
RIPK1 plays a pivotal role in TLR3 ligand, Poly(I:C)-induced cell
death when cIAPs activity was inhibited and loss of RIPK1 enhanced
Poly(I:C)-induced invasion which was partially reversed by Smac mimetic. Our
results suggested that TLR3 ligand in combination with Smac mimetic could
provide therapeutic benefits to the patients with CCA.

Graphical abstract
Effective inactivation of Nipah virus in serum samples for safe processing in low-containment laboratories
Authors: Watanabe Shumpei , Fukushi Shuetsu , Harada Toshihiko , Shimojima Masayuki , Yoshikawa Tomoki , Kurosu Takeshi , Kaku Yoshihiro , Morikawa Shigeru , Saijo Masayuki 
Published: October 2020

Abstract
Background
Nipah virus (NiV) is an emerging zoonotic paramyxovirus that causes severe encephalitis and respiratory disease with a high mortality rate in humans. During large outbreaks of the viral disease, serological testing of serum samples could be a useful diagnostic tool, which could provide information on not only the diagnosis of NiV disease but also the history of an individual with previous exposure to the virus, thereby supporting disease control. Therefore, an efficient method for the inactivation of NiV in serum samples is required for serological diagnosis.

Methods
We determined the optimal conditions for the inactivation of NiV infectivity in human serum using heating and UV treatment. The inactivation method comprised UV irradiation with a cover of aluminum foil for 30 min and heating at 56 °C for 30 min.

Results
With an optimized protocol for virus inactivation, NiV infectivity in serum samples (containing 6.0 × 105 TCID50) was completely inactivated.

Conclusions
We developed a recommended protocol for the effective inactivation of NiV. This protocol would enable a regional or local laboratory to safely transport or process samples, including NiV, for serological testing in its biosafety level-2 facility.
Risk factors for adolescents’ mental health during the COVID-19 pandemic: a comparison between Wuhan and other urban areas in China
Authors: Chen Shitao , Cheng Zeyuan , Wu Jing 
Published: October 2020

Abstract
Background
The outbreak of Coronavirus Disease is causing considerable acute risk to public health and might also have an unanticipated impact on the mental health of children and adolescents in the long run. This study collected data during the national lockdown period in China and aims to understand whether there is a clinically significant difference in anxiety, depression, and parental rearing style when comparing adolescents from Wuhan and other cities in China. This study also intends to examine whether gender, grade in school, single child status, online learning participation, parents’ involvement in COVID-19 related work, and parents being quarantined or infected due to the disease would lead to clinically significant differences in anxiety and depression. Beyond that, this study explored the pathways among the different variables in order to better understand how these factors play a part in impacting adolescents’ mental health condition.

Results
Results showed that there was a statistically significant difference in anxiety symptoms between participants who were from Wuhan compared to other urban areas, but not in depressive symptoms. In addition, participants’ grade level, gender, relative being infected, and study online have direct positive predictive value for depressive and anxiety symptoms, whereas location and sibling status have indirect predictive value. Having relatives who participated in COVID-19 related work only had positive direct predictive value toward depression, but not anxiety.

Conclusions
This study discovered several risk factors for adolescents’ depression and anxiety during the pandemic. It also called for a greater awareness of Wuhan parents’ mental wellbeing and recommended a systematic approach for mental health prevention and intervention.
CT-guided hook-wire localization of malignant pulmonary nodules for video assisted thoracoscopic surgery
Authors: Zhang Huijun , Li Ying , Yimin Nadier , He Zelai , Chen Xiaofeng 
Published: October 2020

Abstract
Objectives
Video assisted thoracoscopic surgery (VATS) can currently be used to diagnose and treat pulmonary nodules. However, intraoperative location of pulmonary nodules in VATS is challenging due to their small diameter and deep location in the pulmonary parenchyma. The purpose of this study was to report the clinical safety and effectiveness of CT-guided hook-wire for preoperative localization of malignant pulmonary nodules smaller than 1 cm in diameter.

Methods
From February 2017 to January 2018, we collected the data of 80 patients with malignant pulmonary nodules less than 1 cm in diameter who underwent CT-guided hook-wire preoperative localization and VATS surgery. The effectiveness of preoperative localization was evaluated based on surgical duration, success rate of VATS surgery, and localization-related complications.

Results
The diameter of pulmonary nodules were 0.85 ± 0.17 mm with a distance to the pleural surface of 19.66 ± 14.10 mm. The length of the hook-wire in the lung parenchyma was 29.17 ± 13.14 mm and hook-wire dislodgement occurred in 2 patients. Complications included 27 cases of minor pneumothorax and 18 cases of mild parenchymal hemorrhage. A significant correlation was observed between the length of the hook-wire in the lung parenchyma and mild parenchymal hemorrhage (P = 0.044). The average time of hook-wire localization was 9.0 ± 2.6 min and the average operation time for VATS was 89.02 ± 23.35 min without conversion thoracotomy.

Conclusions
CT-guided hook-wire localization of the lesion during VATS resection is safe for malignant pulmonary nodules with diameter less than 1 cm.
Presentation and management of N-acetylglutamate synthase deficiency: a review of the literature
Authors: Kenneson Aileen , Singh Rani H. 
Published: October 2020

Abstract
Background
N-Acetylglutamate synthase (NAGS) deficiency is an extremely rare autosomal recessive metabolic disorder affecting the urea cycle, leading to episodes of hyperammonemia which can cause significant morbidity and mortality. Since its recognition in 1981, NAGS deficiency has been treated with carbamylglutamate with or without other measures (nutritional, ammonia scavengers, dialytic, etc.). We conducted a systematic literature review of NAGS deficiency to summarize current knowledge around presentation and management.

Methods
Case reports and case series were identified using the Medline database, as well as references from other articles and a general internet search. Clinical data related to presentation and management were abstracted by two reviewers.

Results
In total, 98 cases of NAGS deficiency from 79 families, in 48 articles or abstracts were identified. Of these, 1 was diagnosed prenatally, 57 were neonatal cases, 34 were post-neonatal, and 6 did not specify age at presentation or were asymptomatic at diagnosis. Twenty-one cases had relevant family history. We summarize triggers of hyperammonemic episodes, diagnosis, clinical signs and symptoms, and management strategies. DNA testing is the preferred method of diagnosis, although therapeutic trials to assess response of ammonia levels to carbamylglutamate may also be helpful. Management usually consists of treatment with carbamylglutamate, although the reported maintenance dose varied across case reports. Protein restriction was sometimes used in conjunction with carbamylglutamate. Supplementation with citrulline, arginine, and sodium benzoate also were reported.

Conclusions
Presentation of NAGS deficiency varies by age and symptoms. In addition, both diagnosis and management have evolved over time and vary across clinics. Prompt recognition and appropriate treatment of NAGS deficiency with carbamylglutamate may improve outcomes of affected individuals. Further research is needed to assess the roles of protein restriction and supplements in the treatment of NAGS deficiency, especially during times of illness or lack of access to carbamylglutamate.