bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with carer psychological and physical health during end-of-life caregiving: an observational analysis of a population-based post-bereavement survey of carers of people with cancer
Authors: Grande Gunn , Rowland Christine , Cotterill Sarah , Batistatou Evridiki , Hanratty Barbara 
Published: October 2021

ObjectiveFamily caregivers play an essential role in end-of-life care but suffer considerable impact on their own health. A better understanding of main factors related to carers’ health is important to inform interventions. The purpose of the study was to test for the first time the potential impact of a comprehensive set of observable variables on carer health during end-of-life caregiving within a population-based carer sample.DesignNational retrospective, cross-sectional, 4-month post-bereavement postal census survey of family carers of people who died from cancer.Setting and participantsRelatives who registered a death from cancer during a 2-week period in England were identified from death certificates by the Office of National Statistics; response rate was 1504/5271 (28.5%).Outcome measuresCarers’ mental health was measured through General Health Questionnaire (GHQ)-12; general health was measured through EuroQoL EQ-Visual Analogue Scale (EQ-5D VAS).MethodsSurvey questions to measure potential variables associated with carer health were based on past research and covered patients’ symptoms and functioning; caregiving activities and hours; informal and formal help received; work hours, other caregiving, volunteering; changes to work, income and expenditure; sleep and relaxation; and demographic variables. Bivariate analyses and ordinary least square regression were performed to investigate these variables’ relationship with outcomes.ResultsPatients’ psychological symptoms and functioning, caregiving hours, female gender and self-sought formal help related to worse mental health. General practitioner and social care input and relaxation related to better mental health. Patients’ psychological symptoms, caregiving hours and female gender were associated with worse general health, and older age, employment and relaxation were associated with better general health.ConclusionsImprovements in carers’ health overall may be made by focusing on potential impacts of patients’ psychological symptoms on carers, facilitating respite and relaxation, and paying particular attention to factors affecting female carers.
Combined use of two rapid tests for the conclusive diagnosis of Chagas disease: a systematic scoping review
Authors: Ortega-Arroyo Arturo , Flores-Chavez María Delmans , Puente-Alcaraz Jesús 
Published: October 2021

ObjectiveThe goal of this systematic scoping review is to collect and summarise scientific evidence regarding the validity of two simultaneous immunochromatographic tests for the conclusive diagnosis of Chagas disease. The research was informed by the following review questions: Will the use of two rapid tests be a valid method for the definitive diagnosis of Chagas disease when compared with conventional serological tests? In what type of population has the operation of two rapid tests been tried for the diagnosis of Chagas disease? What are the biomedical and public health advantages of the diagnostic method resulting from the combination of two rapid tests over the conventional serological method? Will it be a cost–benefit strategy for the diagnosis of Chagas with respect to conventional serological tests?DesignSystematic scoping review.SettingA search of the published and unpublished literature in five databases was carried out, in order to identify, screen and select the studies included in this review.Results468 studies were identified, of which 46 were screened with a full-text reading, and finally, three articles were included in the review. All studies were in endemic countries with adult and paediatric populations (n=1133) and, together, they evaluated four different rapid tests. The rapid tests showed good sensitivity (97.4%–100%) and specificity (96.1%–100%) for the diagnosis of Chagas when used in combination and compared with the reference tests.ConclusionsThe simultaneous use of at least two immunochromatographic rapid tests is a valid option for the definitive diagnosis of chronic Chagas in endemic rural areas, as long as there are studies that previously evaluate their performance on the areas of implementation. Therefore, this could be an alternative to the current diagnostic standard. However, additional studies are still needed in more countries in order to provide further evidence and to investigate the cost–benefit.
Survival after surgery for spinal metastatic disease: a nationwide multiregistry cohort study
Authors: Carrwik Christian , Olerud Claes , Robinson Yohan 
Published: November 2021

ObjectivesTo evaluate survival after surgery and indications for surgery due to spinal metastatic disease.DesignA retrospective longitudinal multiregistry nationwide cohort study.Setting19 public hospitals in Sweden with spine surgery service, where 6 university hospitals account for over 90% of the cases.Participants1820 patients 18 years or older undergoing surgery due to spinal metastatic disease 2006–2018 and registered in Swespine, the Swedish national spine surgery registry.InterventionsDecompressive and/or stabilising spine surgery due to spinal metastatic disease.Primary outcomeSurvival (median and mean) after surgery.Secondary outcomesIndications for surgery, types of surgery and causes of death.ResultsThe median estimated survival after surgery was 6.2 months (95% CI: 5.6 to 6.8) and the mean estimated survival time was 12.2 months (95% CI: 11.4 to 13.1). Neurologic deficit was the most common indication for surgery and posterior stabilisation was performed in 70.5% of the cases. A neoplasm was stated as the main cause of death for 97% of the patients.ConclusionBoth median and mean survival times were well above the generally accepted thresholds for surgical treatment for spinal metastases, suggesting that patient selection for surgical treatment on a national level is adequate. Further research on quality of life after surgery and prognostication is needed.
Abortion decision-making trajectories and factors influencing such trajectories in low- and middle-income countries: a protocol for mixed-methods systematic review
Authors: Lokubal Paul , Frischer Sandrena Ruth , Corcuera Ines , Balil Jessica Macias , Nalwadda Kayemba Christine , Kurinczuk Jennifer J , Nair Manisha 
Published: November 2021

IntroductionGlobally, about half of all pregnancies are unintended and/or unwanted and three-fifths of these end in induced abortion. When faced with a choice to terminate pregnancy, women’s abortion decision-making processes are often complex and multiphasic and maybe amplified in low- and middle-income countries (LMICs) which bear the major burden of abortion-related morbidity and mortality. Our review aims to (1) describe abortion decision-making trajectories for women in LMICs and (2) investigate factors influencing the choice of abortion decision-making trajectories in LMICs.Methods and analysisWe will search and retrieve published and unpublished qualitative, quantitative and mixed-methods, community and/or hospital-based studies conducted in LMICs from 1 January 2000 up to 16 February 2021. We will search Ovid Medline, Ovid EMBASE, Ovid PsycInfo, Ovid Global Health, Web of Science (including Social Science Citation Index), Scopus, IBSS, CINAHL via EBSCO, WHO Global Index Medicus, the Cochrane Library, WHO website, ProQuest and Google Scholar. We will search reference lists of eligible studies and contact experts for additional data/information, if required. We will extract all relevant data to answer our research questions and assess study quality using the appropriate appraisal tools. Depending on the extracted data, our analysis will use sequential or convergent synthesis methods proposed by Honget al. For qualitative studies, we will synthesise evidence using thematic synthesis, meta-ethnography or ‘best-fit’ framework synthesis; and for quantitative findings, we will provide a narrative synthesis and/or meta-analysis. We will do sensitivity analyses and assess confidence in our findings using Grades of Recommendation, Assessment, and Evaluation –Confidence in Evidence from Reviews of Qualitative Research (GRADE-CERQUal) for qualitative findings and Grades of Recommednation, Assessment, and Evaluation (GRADE) for quantitative findings.Ethics and disseminationWe did not require ethics approval for this systematic review. We will publish our findings in an open-access peer-reviewed journal with global and maternal health readership. We will also present our findings at national and international scientific conferences.
Awareness and readiness to use telemonitoring to support diabetes care among care providers at teaching hospitals in Ethiopia: an institution-based cross-sectional study
Authors: Seboka Binyam Tariku , Yilma Tesfahun Melese , Birhanu Abraham Yeneneh 
Published: October 2021

ObjectivesThis survey aimed to assess the awareness and readiness of healthcare providers to use telemonitoring (TM) technologies for managing diabetes patients as well as to identify associated factors in Ethiopia.DesignAn institution-based cross-sectional quantitative survey was conducted by using a pretested self-administered questionnaire from February to March 2020. Data analysis used a binary logistic regression and partial proportional odds model for factor identification.ParticipantsRandomly selected 423 study physicians and nurses.SettingThis study was conducted at the University of Gondar and Tibebe Ghion specialised teaching referral hospitals.Outcome measuresAwareness and readiness towards TM in diabetes care.ResultOut of 406 healthcare providers (69.7%, n=283 nurses and 30.3%, n=123 physicians) who completed the survey, 345 (38.7%) heard about TM, when it came to readiness, 321 (25.1%) and 121 (65.5%) of respondents had average and low readiness towards TM, respectively. The result of regression analysis shows that awareness towards TM was higher among respondents who had access to a computer (adjusted OR (AOR): 2.8 (95% CI 1.1 to 7.1)), computer-related training (AOR: 4.6 (95% CI 1.63 to 12.95)) and those who had the experience of supporting patients through digital tools (AOR: 1.7 (95% CI 1.0 to 2.8)). Self-perceived innovators and those who had access to a computer, computer-related training and favourable attitude towards TM had significantly higher readiness to use TM.ConclusionThe findings of this survey revealed low awareness and readiness of participant’s towards TM. However, this study suggests the need of improving participant’s attitudes, access to smartphones and computers and technical skills to fill this gap.
Willingness, preferred ways and potential barriers to use pre-exposure prophylaxis for HIV prevention among men who have sex with men in China
Authors: Yu Simin , Cross Wendy , Lam Louisa Lok Yi , Zhang Kaili , Banik Biswajit , Li Xianhong , Wang Honghong 
Published: October 2021

ObjectiveTo explore willingness and preferred ways to use HIV pre-exposure prophylaxis (PrEP), factors associated with willingness, and potential barriers to PrEP use among men who have sex with men (MSM) in Changsha, China.DesignA cross-sectional survey was conducted from 25 June to 31 August 2019. Two hundred and fifty-five MSM were recruited from three community-based organisations (CBOs) in Changsha City. Willingness and potential barriers to use PrEP were examined using researcher-created scales. Univariate and multivariate logistic regression was used to analyse the factors associated with willingness to use PrEP. P values <0.05 were considered significant.SettingThree MSM inclusive CBOs in Changsha, Hunan Province, China.Participants255 HIV-negative MSM were recruited through their CBOs with snowball sampling.ResultsLess than half of the participants (43.1%) had heard of PrEP and 15.3% were willing to use PrEP. The participants reported higher willingness to use event-driven PrEP (3.70±0.07) than daily PrEP (2.65±0.07). Higher self-rated risk and fear of contracting HIV (OR: 14.47, 95% CI 2.19 to 95.53), awareness of PrEP (OR: 4.20, 95% CI 1.64 to 10.73), sharing one’s own sexual orientation with parents or siblings (OR: 2.52, 95% CI 1.54 to 7.20) and having a university education or above (OR:0.29, 95% CI 0.12 to 0.72) were associated with willingness to use PrEP. Only 12.2% of the sample was concerned about potential barriers to PrEP use.ConclusionEfforts to improve awareness and knowledge of PrEP, teach self-evaluation of HIV infection risk and provide social and emotional support for MSM are needed to scale up PrEP implementation in China.
Defining collective capability in Australian evaluations that are conducted by, for and with Indigenous peoples for health programmes, policies and services: a concept analysis protocol
Authors: Maher Bobby Lee , Guthrie Jillian , Sturgiss Elizabeth Ann , Cargo Margaret , Lovett Raymond 
Published: October 2021

IntroductionIndigenist evaluation is emergent in Australia; the premise of which is that evaluations are undertaken for Indigenous, by Indigenous and with Indigenous people. This provides opportunities to develop new models and approaches. Exploring a collective capability approach could be one way to inform an Indigenist evaluation methodology. Collective capability suggests that a base of skills and knowledges exist, and when these assets come together, empowerment and agency emerge. However, collective capability requires defining as it is not common terminology in population health or evaluation. Our aim is to define the concept of collective capability in Indigenist evaluation in Australia from an Australian Indigenous standpoint.Methods and analysisA modified Rodgers’ evolutionary concept analysis will be used to define collective capability in an Australian Indigenous evaluation context, and to systematically review and synthesise the literature. Approximately 20 qualitative interviews with Aboriginal and Torres Strait Islander knowledge holders will clarify the meaning of collective capability and inform appropriate search strategy terms with a consensus process then used to code the literature. We will then systematically collate, synthesise and analyse the literature to identify exemplars or models of collective capability from the literature.Ethics and disseminationThe protocol has approval from the Australian Institute of Aboriginal and Torres Strait Islander Studies Ethics Committee, approval no. EO239-20210114. All knowledge holders will provide written consent to participate in the research. This protocol provides a process to developing a concept, and will form the basis of a new framework and assessment tool for Indigenist evaluation practice. The concept analysis will establish definitions, characteristics and attributes of collective capability. Findings will be disseminated through a peer-reviewed journal, conference presentations, the project advisory group, the Thiitu Tharrmay reference group and Aboriginal and Torres Strait Islander community partners supporting the project.
Spatiotemporal depletion of tumor-associated immune checkpoint PD-L1 with near-infrared photoimmunotherapy promotes antitumor immunity
Authors: Taki Shunichi , Matsuoka Kohei , Nishinaga Yuko , Takahashi Kazuomi , Yasui Hirotoshi , Koike Chiaki , Shimizu Misae , Sato Mitsuo , Sato Kazuhide 
Published: November 2021

BackgroundNear-infrared photoimmunotherapy (NIR-PIT) is a new modality for treating cancer, which uses antibody-photoabsorber (IRDye700DX) conjugates that specifically bind to target tumor cells. This conjugate is then photoactivated by NIR light, inducing rapid necrotic cell death. NIR-PIT needs a highly expressed targeting antigen on the cells because of its reliance on antibodies. However, using antibodies limits this useful technology to only those patients whose tumors express high levels of a specific antigen. Thus, to propose an alternative strategy, we modified this phototechnology to augment the anticancer immune system by targeting the almost low-expressed immune checkpoint molecules on tumor cells.MethodsWe used programmed death-ligand 1 (PD-L1), an immune checkpoint molecule, as the target for NIR-PIT. Although the expression of PD-L1 on tumor cells is usually low, PD-L1 is almost expressed on tumor cells. Intratumoral depletion with PD-L1-targeted NIR-PIT was tested in mouse syngeneic tumor models.ResultsAlthough PD-L1-targeted NIR-PIT showed limited effect on tumor cells in vitro, the therapy induced sufficient antitumor effects in vivo, which were thought to be mediated by the ‘photoimmuno’ effect and antitumor immunity augmentation. Moreover, PD-L1-targeted NIR-PIT induced antitumor effect on non-NIR light-irradiated tumors.ConclusionsLocal PD-L1-targeted NIR-PIT enhanced the antitumor immune reaction through a direct photonecrotic effect, thereby providing an alternative approach to targeted cancer immunotherapy and expanding the scope of cancer therapeutics.
Microarray testing in patients with systemic lupus erythematosus identifies a high prevalence of CpG DNA-binding antibodies
Authors: Brunekreef Tammo , Limper Maarten , Melchers Rowena , Mathsson-Alm Linda , Dias Jorge , Hoefer Imo , Haitjema Saskia , van Laar Jacob M , Otten Henny 
Published: November 2021

ObjectiveMany autoantibodies are known to be associated with SLE, although their role in clinical practice is limited because of low sensitivity and weak associations with clinical manifestations. There has been great interest in the discovery of new autoantibodies to use in clinical practice. In this study, we investigated 57 new and known antibodies and their potential for diagnostics or risk stratification.MethodsBetween 2014 and 2017, residual sera of all anti-dsDNA tests in the UMC Utrecht were stored in a biobank. This included sera of patients with SLE, patients with a diagnosis of another immune-mediated inflammatory disease (IMID), patients with low (non-IMID) or medium levels of clinical suspicion of SLE but no IMID diagnosis (Rest), and self-reported healthy blood bank donors. Diagnosis and (presence of) symptoms at each blood draw were retrospectively assessed in the patient records with the Utrecht Patient-Oriented Database using a newly developed text mining algorithm. Sera of patients were analysed for the presence of 57 autoantibodies with a custom-made immunofluorescent microarray. Signal intensity cut-offs for all antigens on the microarray were set to the 95th percentile of the non-IMID control group. Differences in prevalence of autoantibodies between patients with SLE and control groups were assessed.ResultsAutoantibody profiles of 483 patients with SLE were compared with autoantibody profiles of 1397 patients from 4 different control groups. Anti-dsDNA was the most distinguishing feature between patients with SLE and other patients, followed by antibodies against Cytosine-phosphate-Guanine (anti-CpG) DNA motifs (p<0.0001). Antibodies against CMV (cytomegalovirus) and ASCA (anti-Saccharomyces cerevisiaeantibodies) were more prevalent in patients with SLE with (a history of) lupus nephritis than patients with SLE without nephritis.ConclusionAntibodies against CpG DNA motifs are prevalent in patients with SLE. Anti-CMV antibodies are associated with lupus nephritis.
Contrasting role of NLRP12 in autoinflammation: evidence from a case report and mouse models
Authors: Lévy Dan , Mariotte Alexandre , DeCauwer Aurore , Macquin Cecile , Pichot Angélique , Molitor Anne , Maurier Francois , Meyer Alain , Carapito Raphael , Georgel Philippe 
Published: November 2021

ObjectiveTo explore at the molecular level the phenotype of a patient suffering an autoinflammatory syndrome which was diagnosed as familial cold autoinflammatory syndrome type 2 (FCAS-2). To explore the functions of Nlrp12 in inflammation using mouse models.MethodsWhole exome sequencing and Nlrp12 targeted resequencing were performed on DNA isolated from the patient and her family members. In vivo and ex vivo models of inflammation (urate crystals-dependent acute joint inflammation and urate crystals-induced peritonitis) were analysed in Nlrp12-deficient and Nlrp12-competent mice.ResultsA rare missense NLRP12 variant (c.857C>T, p.P286L) was identified in the patient and her healthy relatives. Nlrp12-deficient mice exhibit reduced systemic inflammation and neutrophilic infiltration.ConclusionNlrp12 mediates proinflammatory functions in mice. In humans, the identification of Nlrp12 variants must be cautiously interpreted depending on clinical and paraclinical data to diagnose FCAS-2.
Immunomodulatory therapies for the treatment of SARS-CoV-2 infection: an update of the systematic literature review to inform EULAR points to consider
Authors: Alunno Alessia , Najm Aurélie , Mariette Xavier , De Marco Gabriele , Emmel Jenny , Mason Laura , McGonagle Dennis G , Machado Pedro M 
Published: November 2021

ObjectiveTo update the EULAR 2020 systematic literature review (SLR) on efficacy and safety of immunomodulatory agents in SARS-CoV-2 infection.MethodsAs part of a EULAR taskforce, a systematic literature search update was conducted from 11 December 2020 to 14 July 2021. Two reviewers independently identified eligible studies and extracted data on efficacy and safety of immunomodulatory agents used therapeutically in SARS-CoV-2 infection at any stage of disease. The risk of bias (RoB) was assessed with validated tools.ResultsOf the 26 959 records, 520 articles were eligible for inclusion. Studies were mainly at high or unclear RoB. New randomised controlled trials (RCTs) on tocilizumab clarified its benefit in patients with severe and critical COVID-19, mainly if associated with glucocorticoids. There are emergent data on the usefulness of baricitinib and tofacitinib in severe COVID-19. Other therapeutic strategies such as the use of convalescent plasma and anti-SARS-CoV-2 monoclonal antibodies showed efficacy in subjects not mounting normal anti-SARS-CoV-2 antibody responses.ConclusionThis new SLR confirms that some immunomodulators (tocilizumab and JAK inhibitors) have a role for treating severe and critical COVID-19. Although better evidence is available compared with the previous SLR, the need of RCT with combination therapy (glucocorticoids+anti-cytokines) versus monotherapy with glucocorticoids still remains alongside the need for standardisation of inclusion criteria and outcomes to ultimately improve the care and prognosis of affected people. This SLR informed the 2021 update of the EULAR points to consider on the use of immunomodulatory therapies in COVID-19.