bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Thrombectomy Protects the Internal Capsule in Patients With Proximal Middle Cerebral Artery Occlusion
Authors: Kaesmacher Johannes , Kaesmacher Mirjam , Berndt Maria , Maegerlein Christian , Mönch Sebastian , Wunderlich Silke , Meinel Thomas R. , Fischer Urs , Zimmer Claus , Boeckh-Behrens Tobias , Kleine Justus F. 
Published: April 2021

Background and Purpose:
Proximal middle cerebral artery (MCA) occlusions impede blood flow to the noncollateralized lenticulostriate artery territory. Previous work has shown that this almost inevitably leads to infarction of the dependent gray matter territories in the striate even if perfusion is restored by mechanical thrombectomy. Purpose of this analysis was to evaluate potential sparing of neighboring fiber tracts, ie, the internal capsule.

Methods:
An observational single-center study of patients with proximal MCA occlusions treated with mechanical thrombectomy and receiving postinterventional high-resolution diffusion-weighted imaging was conducted. Patients were classified according to internal capsule ischemia (IC+ versus IC−) at the postero-superior level of the MCA lenticulostriate artery territory (corticospinal tract correlate). Associations of IC+ versus IC− with baseline variables as well as its clinical impact were evaluated using multivariable logistic or linear regression analyses adjusting for potential confounders.

Results:
Of 92 included patients with proximal MCA territory infarctions, 45 (48.9%) had an IC+ pattern. Longer time from symptom-onset to groin-puncture (adjusted odds ratio, 2.12 [95% CI, 1.19–3.76] per hour), female sex and more severe strokes were associated with IC+. Patients with IC+ had lower rates of substantial neurological improvement and functional independence (adjusted odds ratio, 0.26 [95% CI, 0.09–0.81] and adjusted odds ratio, 0.25 [95% CI, 0.07–0.86]) after adjustment for confounders. These associations remained unchanged when confining analyses to patients without ischemia in the corona radiata or the motor cortex and here, IC+ was associated with higher National Institutes of Health Stroke Scale motor item scores (β, +2.8 [95% CI, 1.5 to 4.1]) without a significant increase in nonmotor items (β, +0.8 [95% CI, −0.2 to 1.9).

Conclusions:
Rapid mechanical thrombectomy with successful reperfusion of the lenticulostriate arteries often protects the internal capsule from subsequent ischemia despite early basal ganglia damage. Salvage of this eloquent white matter tract within the MCA lenticulostriate artery territory seems strongly time-dependent, which has clinical and pathophysiological implications.
Exploring the Nation: Gender, Identity and Cuisine in the UAE
Authors: Khansaheb Ayisha 
Published: April 2021

Abstract
This article examines various heritage displays and festivals that have occurred in the United Arab Emirates and analyzes, in particular, the representation of women and cuisine. Over a two-year period (August 2015 to August 2017), I interviewed senior Emirati women and collected their oral histories, focusing mainly on cooking practices in the past and how those practices evolved with time. The article compares those oral histories with the representations shown in heritage festivals and spaces and concludes that the women I interviewed are inadequately represented and that the presentation of women, along with the culinary traditions in the region, has been marginalized or oversimplified.
The Quandary of Faith and Politics of Islamization: An Incursion into Experiences and Perspectives of Pakistani Christian Minority
Authors: Azmat Sania , Bilal Muhammad , Azam Shafia 
Published: April 2021

Abstract
The state of minorities in Pakistan has been the subject of much debate and controversy since the country’s conception in 1947. Although Christians played a pivotal role in the Pakistan Movement, the state-sponsored Islamization and exploitation of Blasphemy Laws created a precarious situation for Pakistan’s religious minorities. This article explores the perceptions of the Christian minority on the Islamization of the state asking how it has been affecting their life course. Qualitative research methods involving in-depth interviews and case studies explore the lived experiences of the Christian minority in Wah Cantonment city, Pakistan. Using purposive sampling techniques, 33 Christian respondents (16 males, 17 females) and eight senior Christian High Court lawyers (four males, four females) were interviewed. Based on empirical evidence, this article demonstrates that Islamic majoritarianism and lack of pluralist vision impedes minorities’ freedom in Pakistan, creating issues of safety, legal abuse and discrimination in their own homeland.
The Qumran Pesharim and Targum Jonathan to the Prophets
Authors: Hartog Pieter B. 
Published: April 2021

Abstract
This article argues that the Qumran pesharim and TgJon originate from a common, though internally varied, elite intellectual tradition with a priestly character. This tradition developed particular interests, e.g. messianism and eschatology, and transmitted individual textual and interpretative traditions. As it appears, this tradition has pre-70 CE roots, but continued after the destruction of the temple. Both the Qumran commentaries and TgJon reflect the interests of this priestly tradition and incorporate some of its textual and exegetical traditions, though not through literary dependence.
For the Wind Is in the Palm-Trees: The 2017 Rohingya Crisis and an Emergent UK Approach to Atrocity Prevention
Authors: Ferguson Kate 
Published: April 2021

Abstract
This article explores the British government’s recent Myanmar policy, its response to the Rohingya crisis of 2017, and the extent to which increasing scrutiny from parliament and civil society in reaction to the atrocities in Rakhine prompted clearer articulation of a national approach to atrocity prevention. The article presents five key failures and argues that a goal for those wishing to preserve and strengthen the principle of the Responsibility to Protect, and advance the goal of preventing mass atrocities, must be to break it free of the United Nations sphere and integrate the pillars into state structures.
Three new species of Cloacininae (Nematoda: Strongyloidea) parasitic in Dorcopsis muelleri (Schlegel, 1866) from Papua and Salawati island, Indonesia
Authors: DEWI KARTIKA , PURWANINGSIH ENDANG 
Published: April 2021

Three new species of Cloacininae are described from Dorcopsis muelleri obtained from Salawati Island and Kaimana, Papua. Cloacina woworae sp. nov. differs from all congeners by having postero-lateral and medio-lateral rays not fused and the esophagus wider anterior to the nerve ring. Compared to its congeners, C. beveridgei sp. nov. resembles C. caballeroi Mawson, 1977, C. cretheis Beveridge, 2002, C. erigone Beveridge, 2002, and C. syphax Beveridge & Speare, 1999 in the morphology of the dorsal ray. However, C. beveridgei has distal segments of sub-median papillae longer than the proximal segments. This character differentiates it from C. caballeroi, C. cretheis, and C. erigone, which have the distal segment of the sub-median papilla shorter than the proximal. Furthermore, this new species can be distinguished with C. syphax in having a shorter vagina vera and in the shape of the anterior region of the vagina. Cervonemella kaimanaensis sp. nov. differs from Ce. reardoni, the sole species in the genus Cervonemella, in the shape and longer vagina, shorter and slender tail, shorter position of vulva from posterior end and longer spicules.
Health literacy in school-based health programmes: A case study in one Australian school
Authors: Peralta Louisa R , Cinelli Renata L , Marvell Claire L 
Published: April 2021

Objective: The ability of schools, school leaders and teachers to promote critical health literacy in teaching and learning is central to the development of health literacy in schools. However, research focusing on teachers and planning for health literacy through health programmes in school is minimal. This paper describes how one school Health and Physical Education (HPE) department planned for and implemented health literacy learning across Years 7–10 as part of the first-year delivery of the Australian Curriculum: Health and Physical Education in New South Wales, Australia. Design: Single setting case study. Setting: A Years 7–10 Catholic school for boys. The HPE department comprised five teachers and one head of department. Method: Thirty-four lessons and 61 learning activities were analysed using Nutbeam’s health literacy hierarchy and the Australian Curriculum: Health and Physical Education outcomes and content. Results: A large number of learning activities were categorised as interactive ( n = 37, 60.7%) and a smaller number of learning activities categorised as critical ( n = 16, 26.2%). The number of learning activities categorised as functional was the smallest ( n = 5, 8.1%). Conclusion: Findings suggest that school-based health programmes that lack a connection to a whole school approach may fail to provide opportunities for students to achieve the critical understandings of health literacy that will provide them with the capability to enhance the health of others.
Treatment non-adherence pattern among persons with neuropsychiatric disorders: A study from a rural community mental health centre in India
Authors: Sriramulu Sudhir Babu , Elangovan Aravind Raj , Isaac Mohan , Kalyanasundaram Janaki Raman 
Published: April 2021

Background: Treatment gap causes significant loss to individuals, families, societies and the nation. Treatment adherence enhancement is a major challenge in psychiatric disorders. Globally, the community mental health services are obligated to minimize the treatment and adherence gap. In recent years’ retrospective studies are gaining importance to measure the trend of mental health service utilization, cost effectiveness, resources allocation and similar aspects. Aim: To explore the treatment adherence pattern of persons with neuropsychiatric illness from a rural community mental health centre. Method: Five hundred and ninety-six medical records of persons with neuropsychiatric disorders who registered for outpatient treatment between 2015 and 2017 at Sakalawara Rural mental health centre of National Institute of Mental Health and Neuro Sciences, Bangalore, India, were reviewed to understand their adherence pattern Results: Out of 596 patients, 68 (11.4%) were referred to tertiary care mental health and District Mental Health Programme (DMHP) services. Out of the remaining 528 patients, 29.7% were regular to mental health services over a period of 12 months and above; majority of the patients (36.2%) dropped out of their treatment after their first contact and 34.1% discontinued their follow up visits over a period of first week to 12 months. Conclusion: Community based mental health centres too face challenges of and problems related to treatment non-adherence. Persons with neuropsychiatric disorders require continuity of care through regular home visits, out-reach services and innovative methods which will enhance treatment adherence.
Frequency of Sarcopenia, Sarcopenic Obesity, and Changes in Physical Function in Surgical Oncology Patients Referred for Prehabilitation
Authors: Ngo-Huang An , Herbert Aliea , Fontillas Rhodora C. , Parker Nathan H. , Asumbrado Roan , Garg Naveen , Dibaj Seyedeh , Liu Diane D. , Ng Amy H. , Guo Ying , Shin Ki Y. , Katz Matthew H. G. , Bruera Eduardo 
Published: April 2021

Purpose: Sarcopenia and suboptimal performance status are associated with postoperative complications and morbidity in cancer patients. Prehabilitation has emerged as an approach to improve fitness and muscle strength in patients preoperatively. We sought to describe the frequency of sarcopenia and sarcopenic obesity (SO) in a cohort of cancer patients referred for prehabilitation and the association between body composition and physical function. Methods: In this retrospective review of 99 consecutive cancer patients referred for prehabilitation prior to intended oncologic surgery, prehabilitation included physical medicine and rehabilitation (PM&R) physician evaluation of function and physical therapy for individualized home-based exercise. Sarcopenic A was defined using sex-adjusted norms of skeletal muscle (SKM), measured using the sliceOmatic software (TomoVision, 2012) on computed tomography images at baseline. Sarcopenic B was defined by abnormal SKM and physical function. SO was defined as sarcopenia with BMI ≥ 25. Six-minute walk test (6MWT), 5 times sit-to-stand (5×STS), and grip strength were obtained at consultation (baseline) and at preoperative follow-up (if available). Results: Forty-nine patients (49%) were Sarcopenic A, 28 (28%) SO, and 38 (38%) Sarcopenic B. Age was negatively correlated with SKM ( P = .0436). There were no significant associations between Sarcopenic A/B or SO with baseline or changes in physical function. Assessed by sex, Sarcopenic A females had low 5×STS ( P = .04) and Sarcopenic B females had low GS ( P = .037). Sarcopenic B males had low preoperative GS ( P = .026). 6MWT and grip strength at baseline were lower than age- and sex-related norms (both P < .001). Preoperatively, 6MWT distance and 5×STS time improved (both P < .001). Functional improvement in the sarcopenic and nonsarcopenic patients did not differ according to sex. Conclusions: In this cohort of prehabilitation surgical oncology patients, frequencies of sarcopenia and SO were high, and baseline physical function was abnormal but improved significantly regardless of body composition. These findings suggest that patients have considerable prehabilitation needs and are capable of improving with comprehensive care.
Community pharmacist prescribing of antimicrobials: A systematic review from an antimicrobial stewardship perspective
Authors: Wu Julie Hui-Chih , Khalid Fatima , Langford Bradley J. , Beahm Nathan P. , McIntyre Mark , Schwartz Kevin L. , Garber Gary , Leung Valerie 
Published: April 2021

Background: Pharmacist prescribing authority is expanding, while antimicrobial resistance is an increasing global concern. We sought to synthesize the evidence for antimicrobial prescribing by community pharmacists to identify opportunities to advance antimicrobial stewardship in this setting. Methods: We conducted a systematic review to characterize the existing literature on community pharmacist prescribing of systemic antimicrobials. We searched MEDLINE, EMBASE and International Pharmaceutical Abstracts for English-language articles published between 1999 and June 20, 2019, as well as hand-searched reference lists of included articles and incorporated expert suggestions. Results: Of 3793 articles identified, 14 met inclusion criteria. Pharmacists are most often prescribing for uncomplicated urinary tract infection (UTI), acute pharyngitis and cold sores using independent and supplementary prescribing models. This was associated with high rates of clinical improvement (4 studies), low rates of retreatment and adverse effects (3 studies) and decreased health care utilization (7 studies). Patients were highly satisfied (8 studies) and accessed care sooner or more easily (7 studies). Seven studies incorporated antimicrobial stewardship into study design, and there was overlap between study outcomes and those relevant to outpatient antimicrobial stewardship. Pharmacist intervention reduced unnecessary prescribing for acute pharyngitis (2 studies) and increased the appropriateness of prescribing for UTI (3 studies). Conclusion: There is growing evidence to support the role of community pharmacists in antimicrobial prescribing. Future research should explore additional opportunities for pharmacist antimicrobial prescribing and ways to further integrate advanced antimicrobial stewardship strategies in the community setting. Can Pharm J (Ott) 2021;154:xx-xx.
Development and external validation of a composite immune-clinical prognostic model associated with EGFR mutation in East-Asian patients with lung adenocarcinoma
Authors: Liu Chengming , Zheng Sufei , Wang Sihui , Wang Xinfeng , Feng Xiaoli , Sun Nan , He Jie 
Published: April 2021

Background: EGFR mutation is a common oncogene driver in East Asians with lung adenocarcinoma (LUAD), conferring a favorable prognosis with effective targeted therapy. However, the EGFR mutation is a weak predictor of long-term survival. Therefore, a powerful predictive tool is urgently needed to estimate disease prognosis and patient survival for East-Asian patients with LUAD. Methods: In this first systematic analysis of the relationships among EGFR mutation, immunophenotype, and prognosis in LUAD samples from East-Asian patients, we constructed a prognostic signature consisting of EGFR-associated immune-related gene pairs (EIGPs). The predictive performance for overall survival (OS) and the clinical significance of this signature were then comprehensively investigated. Results: Based on transcriptome data analysis of a training set, we proposed the EIGP index (EIGPI), represented by five EIGPs, which was significantly associated with the OS of East-Asian patients with LUAD. It was also well validated in a test set. Furthermore, the prognostic performance of the EIGPI was further verified using protein levels in an additional independent set. Stratification analysis and multivariate Cox regression analysis revealed that the EIGPI was an independent prognostic factor. When combined with stage, the composite immune-clinical prognostic model index (ICPMI) showed improved prognostic accuracy in all datasets. Conclusion: This study was the first to systematically investigate the relationships among EGFR mutation, immunophenotype, and prognosis in East Asians with LUAD and develop a composite clinical and immune model associated with EGFR mutation. This model may be a reliable and promising prognostic tool and help further personalize patient management.
KTE-X19 anti-CD19 CAR T-cell therapy in adult relapsed/refractory acute lymphoblastic leukemia: ZUMA-3 phase 1 results
Authors: Shah Bijal D. , Bishop Michael R. , Oluwole Olalekan O. , Logan Aaron C. , Baer Maria R. , Donnellan William B. , O’Dwyer Kristen M. , Holmes Houston , Arellano Martha L. , Ghobadi Armin , Pagel John M. , Lin Yi , Cassaday Ryan D. , Park Jae H. , Abedi Mehrdad , Castro Januario E. , DeAngelo Daniel J. , Malone Adriana K. , Mawad Raya , Schiller Gary J. , Rossi John M. , Bot Adrian , Shen Tong , Goyal Lovely , Jain Rajul K. , Vezan Remus , Wierda William G. 
Published: April 2021

Abstract
ZUMA-3 is a phase 1/2 study evaluating KTE-X19, an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy, in adult relapsed/refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL). We report the phase 1 results. After fludarabine-cyclophosphamide lymphodepletion, patients received a single infusion of KTE-X19 at 2 × 106, 1 × 106, or 0.5 × 106 cells per kg. The rate of dose-limiting toxicities (DLTs) within 28 days after KTE-X19 infusion was the primary end point. KTE-X19 was manufactured for 54 enrolled patients and administered to 45 (median age, 46 years; range, 18-77 years). No DLTs occurred in the DLT-evaluable cohort. Grade ≥3 cytokine release syndrome (CRS) and neurologic events (NEs) occurred in 31% and 38% of patients, respectively. To optimize the risk-benefit ratio, revised adverse event (AE) management for CRS and NEs (earlier steroid use for NEs and tocilizumab only for CRS) was evaluated at 1 × 106 cells per kg KTE-X19. In the 9 patients treated under revised AE management, 33% had grade 3 CRS and 11% had grade 3 NEs, with no grade 4 or 5 NEs. The overall complete remission rate correlated with CAR T-cell expansion and was 83% in patients treated with 1 × 106 cells per kg and 69% in all patients. Minimal residual disease was undetectable in all responding patients. At a median follow-up of 22.1 months (range, 7.1-36.1 months), the median duration of remission was 17.6 months (95% confidence interval [CI], 5.8-17.6 months) in patients treated with 1 × 106 cells per kg and 14.5 months (95% CI, 5.8-18.1 months) in all patients. KTE-X19 treatment provided a high response rate and tolerable safety in adults with R/R B-ALL. Phase 2 is ongoing at 1 × 106 cells per kg with revised AE management. This trial is registered at www.clinicaltrials.gov as #NCT02614066.
CD27 is required for protective lytic EBV antigen–specific CD8+ T-cell expansion
Authors: Deng Yun , Chatterjee Bithi , Zens Kyra , Zdimerova Hana , Müller Anne , Schuhmachers Patrick , Ligeon Laure-Anne , Bongiovanni Antonino , Capaul Riccarda , Zbinden Andrea , Holler Angelika , Stauss Hans , Hammerschmidt Wolfgang , Münz Christian 
Published: April 2021

AbstractPrimary immunodeficiencies in the costimulatory molecule CD27 and its ligand, CD70, predispose for pathologies of uncontrolled Epstein-Barr virus (EBV) infection in nearly all affected patients. We demonstrate that both depletion of CD27+ cells and antibody blocking of CD27 interaction with CD70 cause uncontrolled EBV infection in mice with reconstituted human immune system components. While overall CD8+ T-cell expansion and composition are unaltered after antibody blocking of CD27, only some EBV-specific CD8+ T-cell responses, exemplified by early lytic EBV antigen BMLF1-specific CD8+ T cells, are inhibited in their proliferation and killing of EBV-transformed B cells. This suggests that CD27 is not required for all CD8+ T-cell expansions and cytotoxicity but is required for a subset of CD8+ T-cell responses that protect us from EBV pathology.
Increased complement activation 3 to 6 h after trauma is a predictor of prolonged mechanical ventilation and multiple organ dysfunction syndrome: a prospective observational study
Authors: Rognes Ingrid Nygren , Pischke Søren Erik , Ottestad William , Røislien Jo , Berg Jens Petter , Johnson Christina , Eken Torsten , Mollnes Tom Eirik 
Published: April 2021

AbstractBackgroundComplement activation is a central mechanism in systemic inflammation and remote organ dysfunction following major trauma. Data on temporal changes of complement activation early after injury is largely missing. We aimed to describe in detail the kinetics of complement activation in individual trauma patients from admission to 10 days after injury, and the association with trauma characteristics and outcome.MethodsIn a prospective cohort of 136 trauma patients, plasma samples obtained with high time resolution (admission, 2, 4, 6, 8 h, and thereafter daily) were assessed for terminal complement complex (TCC). We studied individual TCC concentration curves and calculated a summary measure to obtain the accumulated TCC response 3 to 6 h after injury (TCC-AUC3–6). Correlation analyses and multivariable linear regression analyses were used to explore associations between individual patients’ admission TCC, TCC-AUC3–6, daily TCC during the intensive care unit stay, trauma characteristics, and predefined outcome measures.ResultsTCC concentration curves showed great variability in temporal shapes between individuals. However, the highest values were generally seen within the first 6 h after injury, before they subsided and remained elevated throughout the intensive care unit stay. Both admission TCC and TCC-AUC3–6correlated positively with New Injury Severity Score (Spearman’s rho,p-value 0.31, 0.0003 and 0.21, 0.02) and negatively with admission Base Excess (− 0.21, 0.02 and − 0.30, 0.001). Multivariable analyses confirmed that deranged physiology was an important predictor of complement activation. For patients without major head injury, admission TCC and TCC-AUC3–6were negatively associated with ventilator-free days. TCC-AUC3–6outperformed admission TCC as a predictor of Sequential Organ Failure Assessment score at day 0 and 4.ConclusionsComplement activation 3 to 6 h after injury was a better predictor of prolonged mechanical ventilation and multiple organ dysfunction syndrome than admission TCC. Our data suggest that the greatest surge of complement activation is found within the first 6 h after injury, and we argue that this time period should be in focus in the design of future experimental studies and clinical trials using complement inhibitors.