bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and efficacy of atezolizumab plus bevacizumab in patients with unresectable hepatocellular carcinoma in early clinical practice: A multicenter analysis
Authors: Chuma Makoto , Uojima Haruki , Hattori Nobuhiro , Arase Yoshitaka , Fukushima Taito , Hirose Shunji , Kobayashi Satoshi , Ueno Makoto , Tezuka Shun , Iwasaki Shuichiro , Wada Naohisa , Kubota Kousuke , Tsuruya Kota , Shimma Yoshimasa , Hiroki Ikeda , Takuya Ehira , Tokoro Chikako , Iwase Shigeru , Miura Yuki , Moriya Satoshi , Watanabe Tsunamasa , Hidaka Hisashi , Morimoto Manabu , Numata Kazushi , Kusano Chika , Kagawa Tatehiro , Maeda Shin 
Published: November 2021

AbstractPurposeTo assess the impact of clinical factors on the safety and efficacy of atezolizumab plus bevacizumab (ATZ + BV) treatment in patients with unresectable hepatocellular carcinoma (u‐HCC).MethodNinety‐four u‐HCC patients who were treated with ATZ + BV at multiple centers were enrolled. We defined Child‐Pugh (CP)‐A patients who received ATZ + BV treatment as a first line therapy as the ‘meets the broad sense of the IMbrave150 criteria’ group (B‐IMbrave150‐in, n = 46), and patients who received ATZ + BV treatment as a later line therapy or CP‐B patients (regardless of whether ATZ + BV was a first line or later line therapy) as the B‐IMbrave150‐out group (n = 48). Patients were retrospectively analyzed for adverse events (AEs) and treatment outcomes according to their clinical characteristics, including neutrophil lymphocyte ratio (NLR) at baseline.ResultsThe overall incidence of AEs was 87.2% (82/94 patients). The frequency of interruption of ATZ + BV treatment due to fatigue was higher in CP‐B than CP‐A patients (p = 0.030). Objective response (OR) rates of the B‐IMbrave150‐in group (28.3%, 39.1%) were significantly higher than those of the B‐IMbrave150‐out group (8.3%, 18.8%; p = 0.0157, 0.0401) using Response Evaluation Criteria in Solid Tumors (RECIST) and modified RECIST, respectively. In multivariate analysis, NLR (hazard ratio (HR), 4.591; p = 0.0160) and B‐IMbrave150 criteria (HR, 4.108; p = 0.0261) were independent factors associated with the OR of ATZ + BV treatment using RECIST.ConclusionIn real‐world practice, ATZ + BV treatment might offer significant benefits in patients who meet B‐IMbrave150 criteria or have low NLR.
A cluster randomized controlled trial of a MedicineInsight Educational Quality Improvement Programme to improve the diagnosis and treatment of chronic hepatitis C in general practice (the EQUIP‐HEPC trial)
Authors: Chidwick Kendal , Myton Rimma , Rodgers Anthony , Jun Min , Dartnell Jonathan , Balcomb Annie , Dore Gregory 
Published: November 2021

AbstractThe availability of direct‐acting antivirals (DAAs) sparked efforts to eliminate hepatitis C virus (HCV) in Australia. We evaluated whether an educational intervention of a 1‐h discussion among staff using audit and feedback data from the MedicineInsight GP programme would improve DAA uptake. Of 296 eligible general practices in MedicineInsight, 11% opted out. Randomization stratified by practice caseload allocated 130 practices to the intervention arm and 129 to control. The primary outcome was the number of patients started on DAAs over 6 months using the negative binomial regression model adjusted for DAA prescription history and clustering by practice. Data for analysis were available for 78% of practices, which included 101 practices and 2469 DAA‐naive patients with confirmed/possible HCV in the intervention arm, and 100 practices and 2466 patients in the control arm. At baseline, 49.5% of practices had prescribed ≥1 DAA in the past year; 18.9% of HCV patients had already been treated with DAAs; the mean age of DAA‐naive HCV patients was 43 years old, and 57% were men. Over 6 months, 43 patients in the intervention arm and 36 in the control arm started DAAs (adjusted IRR 1.19; 95% CI 0.67–2.11, p = 0.55). In the first 3 months, 27 vs 16 patients started DAAs (adjusted IRR 1.77, 0.88–3.58; p = 0.111). Few patients were started on DAAs, and a facilitated discussion in HCV management did not lead to a significant increase. Alternative measures, such as incentivizing GP initiations or patients, are suggested to address remaining barriers to DAA uptake in Australian primary care.Australian New Zealand Clinical Trial Registry (ANZCTR) Registration Number: ACTRN12619000508178p.
Nationalism and immigration control
Authors: Ko Jiyoung , Choi Seung‐Whan 
Published: November 2021

AbstractDoes the rise of nationalism lead to immigration policy change? By focusing on elite‐led nationalism, this study offers a novel perspective: When top political leaders rely on nationalism as their legitimation strategy, they are more disposed to adopt policies aimed at strict immigration control, such as the imposition of sanctions on illegal immigrants, due to their hands being tied. We perform a battery of empirical tests using a cross‐national, time‐series data for 33 countries for the years 1980–2010. We find evidence that nationalist countries are positively associated with heightened immigration control. This finding is robust even after possible reverse causality is taken into account. The overall analysis illustrates that nationalism is a significant factor in explaining why countries are pushing for more restrictive immigration control in the contemporary world.
Left bundle branch pacing in heart failure patients with left bundle branch block: A systematic review and meta‐analysis
Authors: Cheng Yuda , Wang Zhanqi , Li Yujun , Qi Jinlei , Liu Jinyu 
Published: November 2021

AbstractBackgroundThe clinical benefit of cardiac resynchronization therapy (CRT) in heart failure patients with left bundle branch block (LBBB) has been demonstrated. However, a nonresponse rate of CRT nearly 1/3. Recent studies have reported left bundle branch pacing (LBBP) has achieved remarkable effect in CRT. This study aim to explore the efficacy and safety of LBBP in heart failure patients with LBBB.MethodsWe searched PubMed, Cochrane Library, Web of science, and CNKI databases for studies about LBBP in heart failure patients with LBBB. QRS duration (QRSd), New York Heart Association (NYHA) classification, B‐type natriuretic peptide (BNP) concentration, left ventricular ejection fraction (LVEF), left ventricular end‐diastolic diameter (LVEDD), pacing threshold and other related data were extracted and summarized.ResultsA total of 6 studies were included, and the success rate of LBBP was 93.2%. Compared with baseline, LBBP could shorten QRSd (MD = 61.23, 95% CI: 58.21–64.25, p < .01). Echocardiographic parameters including LVEF and LVEDD significantly improved (both with p < .01). Clinical outcomes including NYHA classification and BNP dramatically reduced (both with p < .01). Compared with biventricular pacing (BVP), LBBP could further improve QRSd, LVEF, LVEDD, and NYHA classification (all with p < .01). However, the pacing threshold at follow‐up was 0.06 V higher than that at baseline (p < .01), and the incidence of complications was 2.4%.ConclusionsLBBP is effective and safe in heart failure patients with LBBB, whether it is better than BVP needs to be verified by randomized controlled trials.
Establishing the national top 10 priority research questions to improve diabetes-related foot health and disease: a Delphi study of Australian stakeholders
Authors: Perrin Byron M , Raspovic Anita , Williams Cylie M , Twigg Stephen M , Golledge Jonathan , Hamilton Emma J , Crawford Anna , Hargreaves Carol , van Netten Jaap J , Purcell Nytasha , Lazzarini Peter A 
Published: November 2021

IntroductionDiabetes-related foot disease is a large cause of the global disease burden yet receives very little research funding to address this large burden. To help address this gap, it is recommended to first identify the consensus priority research questions of relevant stakeholders, yet this has not been performed for diabetes-related foot disease. The aim of this study was to determine the national top 10 priority research questions for diabetes-related foot health and disease from relevant Australian stakeholders.Research design and methodsA modified three-round Delphi online survey design was used to seek opinions from relevant Australian stakeholders including those with diabetes or diabetes-related foot disease or their carers (consumers), health professionals, researchers and industry. Participants were recruited via multiple public invitations and invited to propose three research questions of most importance to them (Round 1), prioritize their 10 most important questions from all proposed questions (Round 2), and then rank questions in order of importance (Round 3).ResultsAfter Round 1, a total of 226 unique questions were proposed by 210 participants (including 121 health professionals and 72 consumers). Of those participants, 95 completed Round 2 and 69 completed Round 3. The top 10 priority research questions covered a range of topics, including health economics, peripheral neuropathy, education, infection, technology, exercise, and nutrition. Consumers prioritized peripheral neuropathy and prevention-related questions. Health professionals prioritized management-related questions including Australia’s First Peoples foot health, health economics and infection questions.ConclusionsThese priority research questions should guide future national research agendas, funding and projects to improve diabetes-related foot disease burdens in Australia and globally. Future research should focus on consumer priority research questions to improve the burden of diabetes-related foot disease on patients and nations. Further research should also investigate reasons for different priorities between consumers and health professionals.
Potential impact of 5 years of ivermectin mass drug administration on malaria outcomes in high burden countries
Authors: Marathe Achla , Shi Ruoding , Mendez-Lopez Ana , Hu Zhihao , Lewis Bryan , Rabinovich Regina , Chaccour Carlos J , Rist Cassidy 
Published: November 2021

IntroductionThe global progress against malaria has slowed significantly since 2017. As the current malaria control tools seem insufficient to get the trend back on track, several clinical trials are investigating ivermectin mass drug administration (iMDA) as a potential additional vector control tool; however, the health impacts and cost-effectiveness of this new strategy remain unclear.MethodsWe developed an analytical tool based on a full factorial experimental design to assess the potential impact of iMDA in nine high burden sub-Saharan African countries. The simulated iMDA regimen was assumed to be delivered monthly to the targeted population for 3 months each year from 2023 to 2027. A broad set of parameters of ivermectin efficacy, uptake levels and global intervention scenarios were used to predict averted malaria cases and deaths. We then explored the potential averted treatment costs, expected implementation costs and cost-effectiveness ratios under different scenarios.ResultsIn the scenario where coverage of malaria interventions was maintained at 2018 levels, we found that iMDA in these nine countries has the potential to reverse the predicted growth of malaria burden by averting 20–50 million cases and 36 000–90 000 deaths with an assumed efficacy of 20%. If iMDA has an efficacy of 40%, we predict between 40–99 million cases and 73 000–179 000 deaths will be averted with an estimated net cost per case averted between US$2 and US$7, and net cost per death averted between US$1460 and US$4374.ConclusionThis study measures the potential of iMDA to reverse the increasing number of malaria cases for several sub-Saharan African countries. With additional efficacy information from ongoing clinical trials and country-level modifications, our analytical tool can help determine the appropriate uptake strategies of iMDA by calculating potential marginal gains and costs under different scenarios.
Predictive value of heart rate in patients with acute type A aortic dissection: a retrospective cohort study
Authors: Zhou Yong , Luo Qipeng , Guo Xiaoxiao , Wang Hongbai , Jia Yuan , Cao Liang , Wang Yang , Yan Fuxia , Yu Cuntao , Yuan Su 
Published: November 2021

ObjectiveHeart rate (HR) is a risk factor of mortality in many cardiovascular diseases but no clinical studies have focused on the association between HR and prognosis in patients with acute type A aortic dissection (ATAAD). This study aimed to evaluate the association between HR and long-term mortality and establish the criteria of HR in patients with ATAAD who underwent total aortic arch replacement combined with the frozen elephant trunk (TAR+FET).Design, setting and participantsRetrospective cohort study that studied all consecutive patients with ATAAD who underwent TAR+FET in the Fuwai Hospital between 2009 and 2015.Main outcomes and measures30-day postoperative, and estimated long-term mortality.ResultsOverall, 707 patients with ATAAD who underwent TAR+FET were followed up for a median duration of 29 months (range, 5–77 months). In multivariate logistic analysis, HR (p<0.001), age (p<0.001), renal insufficiency (p=0.033), ejection fraction (p=0.005), cardiopulmonary bypass time (p<0.001) and intraoperative blood loss (p=0.002) were significantly associated with 30-day postoperative and estimated long-term mortalities. A hinge point with a sharp increase in estimated long-term mortality was identified at 80 beats/min (bpm), and compared with HR ≤80 bpm, HR >80 bpm was associated with an almost threefold higher long-term mortality. HRs ≤60, 60–70, 70–80, 80–90, 90–100, 100–110 and >110 bpm were associated with 3.9%, 4.0%, 3.8%, 7.2%, 9.5%, 10.1% and 14.4% yearly risks of death, respectively.ConclusionsHR is a powerful predictor of long-term mortality in patients with ATAAD undergoing TAR+FET. HR >80 bpm is independently associated with elevated long-term mortality for patients with ATAAD.
Health equity audits: a systematic review of the effectiveness
Authors: van Daalen Kim Robin , Davey Fiona , Norman Claire , Ford John Alexander 
Published: November 2021

ObjectivesThe purpose of this systematic review is to explore whether health equity audits (HEAs) are effective in improving the equity of service provision and reducing health inequalities.DesignThree databases (Ovid Medline, Embase, Web of Science) and grey literature (Opengrey, Google Scholar) were systematically searched for articles published after 2000, reporting on the effectiveness of HEA. Title and abstracts were screened according to an eligibility criteria to identify studies which included a full audit cycle (eg, initial equity analysis, service changes and review). Data were extracted from studies meeting the eligibility criteria after full text review and risk of bias assessed using the ROBINS-I tool.ResultsThe search strategy identified 596 articles. Fifteen records were reviewed in full text and three records were included in final review. An additional HEA report was identified through contact with an author. Three different HEAs were included from one peer-reviewed journal article, two published reports and one unpublished report (n=4 records on n=3 HEAs). This included 102 851 participants and over 148 practices/pharmacies (information was not recorded for all records). One study reviewed health equity impacts of HEA implementation in key indicators for coronary heart disease, type 2 diabetes and chronic obstructive pulmonary disease. Two HEAs explored Stop Smoking Services on programme access and equity. All reported some degree of reduction in health inequalities compared with prior HEA implementation. However, impact of HEA implementation compared with other concurrent programmes and initiatives was unclear. All included studies were judged to have moderate to serious risk of bias.ConclusionsThere is an urgent need to identify effective interventions to address health inequalities. While HEAs are recommended, we only identified limited weak evidence to support their use. More evidence is needed to explore whether HEA implementation can reduce inequalities and which factors are influencing effectiveness.Trial registration numberThe study was registered prior to its conduction in PROSPERO (CRD 42020218642).
1-year cost-utility analysis of prostate artery embolization (PAE) versus transurethral resection of the prostate (TURP) in benign prostatic hyperplasia (BPH)
Authors: Patel Nikisha , Yung Nathan , Vigneswaran Ganesh , de Preux Laure , Maclean Drew , Harris Mark , Somani Bhaskar , Bryant Timothy , Hacking Nigel , Modi Sachin 
Published: November 2021

ObjectiveTo determine whether prostate artery embolization (PAE) is a cost-effective alternative to transurethral resection of the prostate (TURP) in the management of benign prostate hyperplasia (BPH) after 1-year follow-up.Design, setting and main outcome measuresA retrospective cost-utility analysis over a 12-month time period was conducted to compare the two interventions from a National Health Service perspective. Effectiveness was measured as quality-adjusted life years (QALYs) derived from data collected during the observational UK Register of Prostate Embolisation (UK-ROPE) Study. Costs for both PAE and TURP were derived from University Hospital Southampton, a tertiary referral centre for BPH and the largest contributor to the UK-ROPE. An incremental cost-effectiveness ratio (ICER) was derived from cost and QALY values associated with both interventions to assess the cost-effectiveness of PAE versus TURP. Further sensitivity analyses involved a decision tree model to account for the impact of patient-reported complications on the cost-effectiveness of the interventions.ResultsThe mean patient age for TURP (n=31) and PAE (n=133) was 69 and 65.6 years, respectively. In comparison to TURP, PAE was cheaper due to shorter patient stays and the lack of necessity for an operating theatre. Analysis revealed an ICER of £64 798.10 saved per QALY lost when comparing PAE to TURP after 1-year follow-up.ConclusionOur findings suggest that PAE is initially a cost-effective alternative to TURP for the management of BPH after 1-year follow-up. Due to a higher reintervention rate in the PAE group, this benefit may be lost in subsequent years.Trial registration numberNCT02434575.
Medical expenditure after marginal cut of cash benefit among public assistance recipients in Japan: natural experimental evidence
Authors: Nishioka Daisuke , Takaku Reo , Kondo Naoki 
Published: November 2021

BackgroundsIncome reduction in poor households affects healthcare demands for impoverished population. However, the impact of reduced benefits for public assistance recipients, who can use medical services for free, on healthcare costs has not been examined. We hypothesised that marginal cuts in benefits increase recipients’ medical expenditure by extra demand for medical care. We tested this hypothesis using public assistance databases of Japan.MethodsThe study population comprised households in five municipalities receiving public assistance between April 2016 and September 2018. The households have a child aged 12–60 months and receive a monthly child-support income of US$150, which reduces by US$50 when the child turns 36 months of age. Our analysis comprised an age-based sharp regression-discontinuity study.ResultsWe observed 4893 household-months (11 032 person-months). When a firstborn child reached 36 months, their frequency of outpatient visits and healthcare costs by recipients, except for the firstborn child, increased (0.45, 95% CI: 0.30 to 0.61; US$111.2, 95% CI: 20.7 to 201.7), while those of the firstborn child did not increase significantly. The monthly medical expenditure per household increased by US$248.6 (95% CI: 25.4 to 471.7). Inpatient medical costs increased significantly (US$64.3, 95% CI: 8.4 to 120.2).ConclusionsGovernment savings through income reduction were offset by increased medical expenditure. This may be due to recipients’ behavioural change and their worsening health conditions. To prevent excessive medical expenditure, policymakers should consider how income reduction affects the behaviour and health of the impoverished population.
Olfactory evaluation in hospitalised and self-isolated patients with COVID-19: a single-centre experience on 55 cases
Authors: Klarendic Maja , Zupanic Eva , Zalaznik Mateja , Georgiev Dejan , Tomazic Janez , Kojovic Maja 
Published: November 2021

AbstractBackgroundSmell loss is a common symptom of COVID-19 infection. Majority of the studies that evaluated olfactory impairment in COVID-19 used questionnaires (subjective smell evaluations) and did not compare the results with objective or semiobjective measures of smell. We performed smell testing in hospitalised and self-isolated patients with COVID-19 and control participants.MethodsFifty-five COVID-19 and 44 control participants underwent smell testing, using Burghart Sniffin’ Sticks ‘Screening 12 Test’. Participants also rated their smelling capability on the numerical scale. Differences between groups and correlation between smell loss and time from acute onset of symptoms were tested, as well as correlation between results of smell test and subjective assessment of smell.ResultsHospitalised patients with COVID-19 correctly determined 6.5/12 odorants compared with 10/12 in the self-isolated and 11/12 in the control group (p&lt;0.001). Hyposmia or anosmia were present in 87.5% of hospitalised and 29.0% of self-isolated patients (p&lt;0.001). The correlation between subjective self-assessment and results of smell testing was non-significant in both groups of patients with COVID-19, while there was a moderate positive correlation (p=0.001, Spearman's correlation coefficient=0.499) in control participants.ConclusionContrary to some previous reports suggesting that the presence of olfactory loss may predict milder course of disease, our study found that a vast majority of hospitalised patients with COVID-19 had prominent olfactory impairment. The absence of correlation between self-rated and objective smell evaluation in patients with COVID-19 indicates that subjective smell assessment is unreliable.
Evolutionary pattern of the presence and absence genes in Fragaria species
Authors: Zhong Yan , Wang Ping , Shi Qinglong , Cheng Zong-Ming 
Published: November 2021

Presence and absence polymorphisms (PAPs) exist extensively and have been investigated in different organisms. However, PAPs have rarely been detected between strawberry species at the genome level. This study identified the presence and absence genes (P/A genes) between wild strawberry species (Fragaria vesca) and octoploid cultivated species (F. × ananassa) under a relatively strict criterion. In total, 333 P/A genes present in the wild strawberry but absent in the cultivated strawberry were detected. Of the P/A genes, 91.89% (306/333) were single genes, and only 8.11% were confirmed as multi-genes. The majority of the identified P/A genes in Fragaria were generated by tandem duplications. The P/A genes were unevenly distributed on the seven chromosomes of woodland strawberry, and they clustered preferentially near the telomeric regions of the chromosomes. The P/A genes tended to encode proteins with domains closely associated with responses to varying ecological factors, such as PPR, Protein kinases (PKs), NB-ARC, F-box and EF-hand domains. This indicated that the P/A genes were associated with coping with biotic and abiotic stresses to improve the adaptability of plants to changing environments.