bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of paediatric injuries in Nepal: evidence from emergency department injury surveillance
Authors: Magnus Dan , Bhatta Santosh , Mytton Julie , Joshi Elisha , Bhatta Sumiksha , Manandhar Sunil , Joshi Sunil 
Published: August 2021

BackgroundGlobally, injuries cause >5 million deaths annually and children and young people are particularly vulnerable. Injuries are the leading cause of death in people aged 5–24 years and a leading cause of disability. In most low-income and middle-income countries where the majority of global child injury burden occurs, systems for routinely collecting injury data are limited.MethodsA new model of injury surveillance for use in emergency departments in Nepal was designed and piloted. Data from patients presenting with injuries were collected prospectively over 12 months and used to describe the epidemiology of paediatric injury presentations.ResultsThe total number of children <18 years of age presenting with injury was 2696, representing 27% of all patients presenting with injuries enrolled. Most injuries in children presenting to the emergency departments in this study were unintentional and over half of children were <10 years of age. Falls, animal bites/stings and road traffic injuries accounted for nearly 75% of all injuries with poisonings, burns and drownings presenting proportionately less often. Over half of injuries were cuts, bites and open wounds. In-hospital child mortality from injury was 1%.ConclusionInjuries affecting children in Nepal represent a significant burden. The data on injuries observed from falls, road traffic injuries and injuries related to animals suggest potential areas for injury prevention. This is the biggest prospective injury surveillance study in Nepal in recent years and supports the case for using injury surveillance to monitor child morbidity and mortality through improved data.
Identifying the top research priorities in postmastectomy breast cancer reconstruction: a James Lind Alliance priority setting partnership
Authors: Zhong Toni , Mahajan Anisha , Cowan Katherine , Temple-Oberle Claire , Porter Geoff , LeBlanc Martin , Metcalfe Kelly 
Published: August 2021

BackgroundMajor improvements in breast cancer treatment in the last decade include advancements in postmastectomy breast reconstruction (PMBR). Unfortunately, the studies in PMBR are primarily researcher or industry led with minimal input from patients and caregivers. The aim of this study is to use the James Lind Alliance (JLA) approach to bring together the patients, caregivers and clinicians in a priority setting partnership to identify the most important unanswered research questions in PMBR.MethodsThe JLA priority setting methodology involved four key stages: gathering research questions on PMBR from patients, caregivers and clinicians; checking these research questions against existing evidence; interim prioritisation and a final consensus meeting to determine the top 10 unanswered research questions using the modified nominal group methodology.ResultsIn stage 1, 3168 research questions were submitted from 713 respondents across Canada, of which 73% of the participants were patients or caregivers. Stage 2 confirmed that there were a total of 48 unique unanswered questions. In stage three, 488 individuals completed the interim prioritisation survey and the top 25 questions were taken to a final consensus meeting. In the final stage, the top 10 unanswered research questions were determined. They cover a breadth of topics including personalised surgical treatment, safety of implants and newer techniques, access to PMBR, breast cancer recurrence and rehabilitation.InterpretationIdentification of the top 10 unanswered research questions is an important first step to generating relevant and impactful research that will ultimately improve the PMBR experience for patients with breast cancer.
Pulmonary thromboembolism in hospitalised patients with COVID-19: a retrospective national study of patients managed in critical care and ward environments in Scotland
Authors: McGettrick Michael , MacLellan Alexander , McCaughey Paul , Bagot Catherine , Brewis Melanie J , Lang Ninian N , Johnson M K , Church Alistair Colin 
Published: August 2021

ObjectivesTo assess for increase in pulmonary thromboembolism (PTE) in hospitalised patients with COVID-19, in both critical care and ward environments.SettingWe reviewed all CT pulmonary angiograms (CTPA) performed in Scotland between 23 March 2020 and 31 May 2020 and identified those with COVID-19 using either classical radiological appearances or positive COVID-19 PCR swab.ParticipantsAll hospitalised patients in Scotland with COVID-19 between 23 March 2020 and 31 May 2020 who underwent a CTPA.Primary outcome measureTo assess if the rate of PTE was increased in those with COVID-19 compared with previously published figures of hospitalised patients.Secondary outcome measuresTo assess the effect of right heart strain or requirement for critical care on mortality.Results3401 CTPAs were reviewed. 192 were positive for PTE in patients with evidence of COVID-19 either real-time PCR swab positive for SARS-CoV-2 (n=104) or having radiological changes consistent with COVID-19 (n=88). The total number of hospital admissions in Scotland between 23rd March 2020 and 31st May 2020 with COVID-19 was 5195. The incidence of PTE during this time was 3.7% in all patients admitted to all hospitals in Scotland with COVID-19 during this period. 475 hospitalised patients were managed in critical care (both level 2 and level 3 care), in whom the incidence of PTE was 6% (n=29). 4720 patients did not require admission to critical care, in whom the incidence of PTE was 3.5% (n=163). There was increased risk of death with right heart strain (25/52 vs 128/140 (p<0.01)) and in critical care (15/29 vs 146/163 (p<0.01)).ConclusionsWe have demonstrated an increased risk of PTE in critical care and ward-based environments. Further studies are required to establish effective prophylactic anticoagulation in this group.
Development of a patient decision aid on subacromial decompression surgery and rotator cuff repair surgery: an international mixed-methods study
Authors: Zadro Joshua , Jones Caitlin , Harris Ian , Buchbinder Rachelle , O'Connor Denise A , McCaffery Kirsten , Thompson Rachel , Karunaratne Sascha , Teng Min Jiat , Maher Christopher , Hoffmann Tammy 
Published: August 2021

ObjectiveTo develop and user test a patient decision aid for people with subacromial pain syndrome that presents evidence-based information on the benefits and harms of subacromial decompression surgery and rotator cuff repair surgery.DesignMixed-methods study outlining the development of a patient decision aid.SettingWe assembled a multidisciplinary steering group, and used existing decision aids and decision science to draft the decision aid. Participants were recruited through social media (not restricted by country nor setting), local hospitals and the authors’ collaboration network.ParticipantsPeople with shoulder pain and health professionals who manage people with shoulder pain.Primary and secondary outcomesWe interviewed participants to gather feedback on the decision aid, assessed useability and acceptability (using qualitative and quantitative methods) and performed iterative cycles of redrafting the decision aid and reinterviewing participants as necessary. Interview data were analysed using thematic analysis. Quantitative data were summarised descriptively.ResultsWe interviewed 26 health professionals (11 physiotherapists, 7 orthopaedic surgeons, 4 general practitioners, 3 chiropractors and 1 osteopath) and 14 people with shoulder pain. Most health professionals and people with shoulder pain rated all aspects of decision aid acceptability as adequate-to-excellent (eg, length, presentation, comprehensibility). Interviews highlighted agreement among health professionals and people with shoulder pain on most aspects of the decision aid (eg, treatment options, summary of benefits, harms and practical issues, questions to ask a health professional, graphics, formatting). However, some aspects of the decision aid elicited divergent views among health professionals (eg, causes and symptoms of shoulder pain, evidence on benefits and harms).ConclusionThis decision aid could be an acceptable and valuable tool for helping people with subacromial pain syndrome make informed treatment choices. A randomised controlled trial evaluating whether this decision aid reduces people’s intentions to undergo shoulder surgery and facilitates informed treatment choices is underway.Trial registration numberACTRN12621000992808
CXCR6 is required for antitumor efficacy of intratumoral CD8+T cell
Authors: Wang Binglin , Wang Yi , Sun Xiaofan , Deng Guoliang , Huang Wei , Wu Xingxin , Gu Yanghong , Tian Zhigang , Fan Zhimin , Xu Qiang , Chen Hongqi , Sun Yang 
Published: August 2021

BackgroundIncreasing infiltration of CD8+T cells within tumor tissue predicts a better prognosis and is essential for response to checkpoint blocking therapy. Furthermore, current clinical protocols use unfractioned T cell populations as the starting point for transduction of chimeric antigen receptors (CARs)-modified T cells, but the optimal T cell subtype of CAR-modified T cells remains unclear. Thus, accurately identifying a group of cytotoxic T lymphocytes with high antitumor efficacy is imperative. Inspired by the theory of yin and yang, we explored a subset of CD8+T cell in cancer with the same phenotypic characteristics as highly activated inflammatory T cells in autoimmune diseases.MethodsCombination of single-cell RNA sequencing, general transcriptome sequencing data and multiparametric cytometric techniques allowed us to map CXCR6 expression on specific cell type and tissue. We appliedCxcr6−/−mice, immune checkpoint therapies and bone marrow chimeras to identify the function of CXCR6+CD8+T cells. TransgenicCxcr6−/−OT-I mice were employed to explore the functional role of CXCR6 in antigen-specific antitumor response.ResultsWe identified that CXCR6 was exclusively expressed on intratumoral CD8+T cell. CXCR6+CD8+T cells were more immunocompetent, and chimeras with specific deficiency on CD8+T cells showed weaker antitumor activity. In addition,Cxcr6−/−mice could not respond to anti-PD-1 treatment effectively. High tumor expression of CXCR6 was not mainly caused by ligand-receptor chemotaxis of CXCL16/CXCR6 but induced by tumor tissue self. Induced CXCR6+CD8+T cells possessed tumor antigen specificity and could enhance the effect of anti-PD-1 blockade to retard tumor progression.ConclusionsThis study may contribute to the rational design of combined immunotherapy. Alternatively, CXCR6 may be used as a biomarker for effective CD8+T cell state before adoptive cell therapy, providing a basis for tumor immunotherapy.
Neural Crest-Like Stem Cell Transcriptome Analysis Identifies LPAR1 in Melanoma Progression and Therapy Resistance
Authors: Liu Jianglan , Rebecca Vito W. , Kossenkov Andrew V. , Connelly Thomas , Liu Qin , Gutierrez Alexis , Xiao Min , Li Ling , Zhang Gao , Samarkina Anastasia , Zayasbazan Delaine , Zhang Jie , Cheng Chaoran , Wei Zhi , Alicea Gretchen M. , Fukunaga-Kalabis Mizuho , Krepler Clemens , Aza-Blanc Pedro , Yang Chih-Cheng , Delvadia Bela , Tong Cynthia , Huang Ye , Delvadia Maya , Morias Alice S. , Sproesser Katrin , Brafford Patricia , Wang Joshua X. , Beqiri Marilda , Somasundaram Rajasekharan , Vultur Adina , Hristova Denitsa M. , Wu Lawrence W. , Lu Yiling , Mills Gordon B. , Xu Wei , Karakousis Giorgos C. , Xu Xiaowei , Schuchter Lynn M. , Mitchell Tara C. , Amaravadi Ravi K. , Kwong Lawrence N. , Frederick Dennie T. , Boland Genevieve M. , Salvino Joseph M. , Speicher David W. , Flaherty Keith T. , Ronai Ze'ev A. , Herlyn Meenhard 
Published: August 2021

AbstractMetastatic melanoma is challenging to clinically address. Although standard-of-care targeted therapy has high response rates in patients with BRAF-mutant melanoma, therapy relapse occurs in most cases. Intrinsically resistant melanoma cells drive therapy resistance and display molecular and biologic properties akin to neural crest-like stem cells (NCLSC) including high invasiveness, plasticity, and self-renewal capacity. The shared transcriptional programs and vulnerabilities between NCLSCs and cancer cells remains poorly understood. Here, we identify a developmental LPAR1-axis critical for NCLSC viability and melanoma cell survival. LPAR1 activity increased during progression and following acquisition of therapeutic resistance. Notably, genetic inhibition of LPAR1 potentiated BRAFi ± MEKi efficacy and ablated melanoma migration and invasion. Our data define LPAR1 as a new therapeutic target in melanoma and highlights the promise of dissecting stem cell–like pathways hijacked by tumor cells.Significance:This study identifies an LPAR1-axis critical for melanoma invasion and intrinsic/acquired therapy resistance.
Informational Determinants of Large-Area Hurricane Evacuations
Authors: Dormady Noah , Fasano Anthony , Roa-Henriquez Alfredo , Flanagan Drew , Welch William , Wood Dylan 
Published: August 2021

Abstract
This study reports on two experiments to investigate the informational determinants of hurricane evacuation decisions (temporal and spatial). Whereas most observational and experimental studies in this domain address the public’s response to forecast information, this study addresses emergency management decisions. Using a subject sample of emergency managers and other public safety leaders, contrasted with a more typical university subject pool, this study presents an experimental design that overcomes the counterfactual problem present in all prior published experiments, by relying on an actual storm (Hurricane Rita) with a known outcome. Several methodological advancements are presented, including the use of an established numeracy instrument, integration of advanced hydrodynamic forecasts, and use of a loss aversion frame to improve generalizability. Results indicate that the availability of additional forecast information (e.g., wind speed, forecast tracks) significantly increases the probability and improves the timing of early voluntary evacuation. However, we observe that more numerate subjects are less likely to avoid relying upon forecast information that is characterized by probability (e.g., the uncertainty in the forecast track, sometimes referred to as the “cone of uncertainty”). Consequently, more numerate emergency managers are almost twice as likely as less numerate ones to provide additional evacuation time to their coastal communities, and they do so by longer than a typical workday (8.8 h). Results also indicate that subjects knowingly overevacuate large populations when making spatial mandatory evacuation orders. However, results indicate that numeracy mitigates this effect by more than half in terms of the population subject to mandatory evacuation.
Risk Factors for Hepatocellular Carcinoma After Splenectomy in Liver Cirrhotic Patients
Authors: Honmyo Naruhiko , Kobayashi Tsuyoshi , Kuroda Shintaro , Ide Kentaro , Ohira Masahiro , Tahara Hiroyuki , Morimoto Hiroshi , Tanimine Naoki , Hamaoka Michinori , Yamaguchi Megumi , Yamamoto Masateru , Takei Daisuke , Aikata Hiroshi , Chayama Kazuaki , Ohdan Hideki 
Published: August 2021

Background Splenectomy is sometimes indicated for portal hypertension caused by cirrhosis, which is a risk for hepatic carcinogenesis. This study aimed to identify risk factors for hepatocellular carcinoma (HCC) development after splenectomy. Methods This retrospective study included 65 patients who underwent splenectomy for portal hypertension between 2009 and 2017. Cox regression analyses were performed to identify factors related to HCC development after splenectomy. The predictive index for HCC development was constructed from the results of multivariate analysis, and 3 risk-dependent groups were defined. Discrimination among the groups was estimated using Kaplan-Meier curves and the log-rank test. Results Post-splenectomy, 36.9% of patients developed HCC. In the univariate analysis, the etiology of cirrhosis (hepatitis C virus antibody, P = .005, and hepatitis B surface antigen, P = .008, referring to non-B and non-C patients, respectively), presence of HCC history ( P < .001), and preoperative hemoglobin level ( P = .007) were related to HCC development, and the presence of HCC history ( P = .002) and preoperative hemoglobin level ( P = .022) were independent risk factors. The predictive index classified three groups at risk; the hazards in each group were significantly different (low vs middle risk, P = .035, and middle vs high risk, P = .011). Discussion The etiology of cirrhosis, presence of HCC history, and hemoglobin level were associated with HCC development after splenectomy. The predictive model may aid in HCC surveillance after splenectomy for patients with portal hypertension.
The Cycle of Dependency 50 Years Later
Authors: Katz Claudio 
Published: August 2021

Dependency theory faces a new scenario in Latin America, with cycles and crises impacting a weakened industry and fragmented consumption. The primacy of agricultural and mining exports contributes to imbalances in all models, while, in contrast to the South Korean case, the exploitation of the workforce has been more decisive than the commercial opening. The relationship with China recreates patterns of subordination, and there is no state income management such as is seen in other countries. Geopolitical action has contradictory effects on development, and ruling classes, bureaucracies, and governments act under severe conditioning. A general reconsideration of Marxist dependency theory points to a way in which it can be revived and expanded. La teoría de la dependencia afronta otro escenario en América Latina. Los ciclos y crisis impactan sobre una industria debilitada y un consumo fragmentado. La primacía de la exportación agro-minera potencia los desequilibrios en todos los modelos.La explotación de la fuerza de trabajo ha sido más determinante que la apertura comercial en el contraste con Corea del Sur. La relación con China recrea subordinaciones y no existe el manejo estatal de la renta que se observa en otros países. La acción geopolítica tiene efectos contradictorios sobre el desarrollo. Clases dominantes, burocracias y gobiernos actúan bajo severos condicionamientos. Una reconsideración general indica cómo renovar y ampliar el dependentismo marxista.
Clinicopathological analysis of primary carcinoid tumour of the ovary arising in mature cystic teratomas
Authors: Yan Fengcai , Zhou Quan , Lin Yulin , Yu Chunkai , Chang Hong , Li Yan 
Published: August 2021

Objective To investigate the clinicopathological features, diagnosis and differential diagnosis of patients with primary ovarian carcinoid tumours arising in mature cystic teratomas. Methods This retrospective case series analysed the data from patients with primary ovarian carcinoid tumours arising in mature cystic teratomas. Results The study enrolled four patients. Histopathological analysis of the tumours identified the following subtypes: insular ( n = 1), trabecular ( n = 1) and strumal ( n = 2). All four primary ovarian carcinoid tumours originated from a mature teratoma. The morphology of the primary ovarian carcinoids was similar to other neuroendocrine tumours. Strumal carcinoids were composed of different proportions of thyroid tissue intimately admixed with carcinoid tumour. Tumour tissue was arranged in insular and/or trabecular patterns. The nucleus of tumour cells displayed exquisite chromatin without obvious mitotic figures. Tumour tissues were positively stained for neuroendocrine markers chromogranin A, synaptophysin and CD56 to varying degrees. Strumal carcinoid tumours were cytokeratin 19 positive and thyroid transcription factor 1 negative. No recurrence or metastasis occurred during follow-up (12–71 months). Conclusion Primary ovarian carcinoid tumours arising in mature cystic teratomas are rare. Diagnosis and differential diagnosis should be confirmed by clinical features, histopathological characteristics and specific immunophenotyping.
Comparative assessment of health-related quality of life with and without anticonvulsant therapy in patients with childhood epilepsy with centrotemporal spikes
Authors: An Olga , Nagae Lidia Mayumi , Aringazina Altyn , Winesett Steven Parrish 
Published: August 2021

Objective To estimate anti-seizure medication (ASM) treatment burden and its effects on health-related quality of life (HRQOL) in new-onset childhood epilepsy with centrotemporal spikes (CECTS) using different treatment approaches in Kazakhstan. Methods Forty-three patients were followed prospectively during 2015 to 2020 for at least 2 years. Patients were divided into three groups: (1) history of ≤3 seizures (n = 32); (2) ≥4 seizures (n = 6); (3) cerebral palsy coexisting with CECTS (n = 5). The first group was subdivided into treated (n = 8) and observed (n = 24) subgroups. The shortened Quality of Life in Childhood Epilepsy Questionnaire (QOLCE-55) was completed by parents after 6 months of follow-up. Results At the end of the study, all children had a sustained remission from seizures for at least 2 years. Differences were identified in emotional, social, and physical subscales between patients in the low seizure frequency group. Signs of low self-esteem, anxiety, depression, limited social interaction owing to pharmacotherapy, painful medical procedures, and stigma were reasons for decreased HRQOL in the treated subgroup. Overall HRQOL in treated (89.2 ± 5.2) patients was significantly decreased compared with observed children with low seizure frequency (98.0 ± 3.0). Conclusion ASM therapy does not necessarily improve and may decrease HRQOL in children with low seizure frequency CECTS.
Quality of Life in Patients With Velopharyngeal Insufficiency in West China
Authors: Lu Lidan , Yakupu Aipiziguli , Wu Yanhui , Li Xiangnan , Zhang Pengxin , Aihaiti Guliziba , Xu Hui 
Published: August 2021

Objective This study aimed to investigate the quality of life (QOL) of patients with cleft lip and palate and velopharyngeal insufficiency (VPI) in relation to sex, age, age at initial cleft lip surgery, and age at initial cleft palate surgery. Design This is a cross-sectional study. Setting The study was conducted in a tertiary medical center. Participants The participants were caregivers of 72 patients with cleft lip and palate and VPI aged 4 to 20 years. Main Outcome Measure(s) Participants completed the Chinese version of the caregiver report of the VPI Effects on Life Outcomes (VELO) questionnaire. The Mann–Whitney U test was used to evaluate the patients’ sex, age, age at initial cleft lip repair, and age at initial cleft palate repair in relation to VELO total score and domains. Spearman correlation analysis was completed including all study variables. Associations between the study variables and the VELO total score were tested using a generalized linear mixed model. Results In the univariate analysis, patients’ age and age at initial cleft palate surgery influenced the QOL of patients with VPI. There were no differences in the VELO total score or domains based on sex or age at first cleft lip surgery. In the generalized linear mixed model, patients older than 8 years had higher VELO total scores. Conclusions By caregiver report, the QOL of patients under age 8 years with VPI was lower than older patients. In addition, the caregiver impact domain was higher for parents of children who had their initial cleft palate surgery at age 2 years or younger.