bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is Autologous Stem Cell Transplantation a Safe and Effective Alternative to Whole Brain Radiation as Consolidation Therapy in Patients With Primary Central Nervous System Lymphoma?
Authors: Gritsch David , Mrugala Maciej M. , Marks Lisa A. , Mangipudi Kartik , Neal Matthew , Wingerchuk Dean M. , O’Carroll Cumara B. 
Published: June 2021

Background:
High-dose chemotherapy followed by autologous stem cell transplantation (HD-ASCT) is a promising alternative to whole brain radiation therapy (WBRT) in the treatment of primary central nervous system lymphoma (PCNSL). The objective of this study was to critically assess current evidence supporting the use of HD-ASCT as first-line consolidative therapy in PCNSL.

Methods:
The objective was addressed through the development of a critically appraised topic that included a clinical scenario, structured question, literature search strategy, critical appraisal, assessment of results, evidence summary, commentary, and bottom-line conclusions. Participants included consultant and resident neurologists, a medical librarian, clinical epidemiologists, and a content expert in the field of neuro-oncology.

Results:
A recent, open-label, noncomparative randomized phase II trial was selected for critical appraisal. This trial evaluated the efficacy and toxicity of consolidative therapy with HD-ASCT and WBRT in PCNSL in 2 separate treatment arms. A total of 140 patients with newly diagnosed PCNSL between the ages of 18 and 60 years were included. The primary endpoint of 2-year progression-free survival was met in 63% of patients in the WBRT arm and 87% in the HD-ASCT arm. Notably, an overall improvement in neurocognitive scores was observed following HD-ASCT, while WBRT was associated with worsened cognitive outcomes.

Conclusions:
In young patients with newly diagnosed PCNSL, consolidative therapy with HD-ASCT appears to be associated with less neurocognitive toxicity and may be more effective than WBRT at preventing relapses, however, at the cost of a higher treatment-related mortality.
‘Falsehood flies, and the truth comes limping after it’: social media and public health
Authors: Moore Justin B. , Harris Jenine K. , Hutti Ellen T. 
Published: June 2021

Purpose of review
To highlight the various uses of social media by public health practitioners and organizations, with special emphasis on how social media has been successfully applied and where applications have struggled to achieve the desired effects.

Recent findings
Social media has been used effectively in improving the timeliness and accuracy of public health surveillance. Social media has also been used to communicate information between public health organizations and reinforce consistent messaging about enduring threats to public health. It has been applied with some success to coordinate of disaster response and for keeping the public informed during other emergency situations. However, social media has also been weaponized against the public health community to spread disinformation and misinformation, and the public health community has yet to devise a successful strategy to mitigate this destructive use of social media.

Summary
Social media can be an effective tool for public health practitioners and organizations who seek to disseminate information on a daily basis, rapidly convey information in emergent situations, and battle misinformation. Social media has been uniquely valuable and distinctly destructive when it comes to protecting and improving public health.
Enhancing Parental Knowledge of Child Safety: An Interventional Educational Campaign
Authors: Temsah Mohamad-Hani , Aljamaan Fadi , Alhaboob Ali , Almosned Badr , Alsebail Raghad , Temsah Reem , Senjab Abdulrahman , Alarfaj Abdulrahman , Aljudi Talal , Esmaeil Samia , Jamal Amr , Habash Alia , Alsohime Fahad , Alhasan Khalid , Al-Eyadhy Ayman 
Published: June 2021

AbstractBackgroundSafeguarding children from unintentional injuries is a significant concern for parents and caregivers. With children staying more at home during the COVID-19 pandemic, more educational tools and valid educational programs are warranted to improve parental knowledge and awareness about children’s safety. This study aims to explore the effectiveness of child safety campaigns on parents’ knowledge and attitude towards preventable childhood injuries.MethodsThis was a pre-post experimental study, in which the pre-designed assessments were used as an evaluation tool before and after attending a Child Safety Campaign. The Pre – Post assessment question included questions to evaluate the socio-demographic status, followed by knowledge questions in line with the current child safety campaign. The outcomes of interest were assessed before and after attending the campaign’s stations.ResultsThree hundred and eight parents volunteered to participate in this study. Their knowledge score improved from 36.2 (SD 17.7) to 79.3 (SD 15.6) after attending the Child Safety Campaign (t-value= 34.6, p<0.001). Both, perceptions on the preventability of accidents and the parents’ perceived usefulness of educational campaigns showed improvements, with (t-value =6.3, p<0.001) and (t-value= 3.097, p<0.001), respectively.ConclusionThe educational child safety campaign for caregivers in Saudi Arabia resulted in a significant increase in the overall knowledge and attitudes towards children’s safety. As children are currently staying at home more, additional educational tools and programs are warranted to promote childhood safe practices among parents and caregivers.
How does the local area deprivation influence life chances for children in poverty in Wales: A record linkage cohort study
Authors: Bandyopadhyay Amrita , Whiffen Tony , Fry Richard , Brophy Sinead 
Published: June 2021

ABSTRACTBackgroundChildren growing up in poverty are less likely to achieve in school and more likely to experience mental health problems. This study examined factors in the local area that can help a child overcome the negative impact of poverty.MethodThis retrospective cohort study included 159,131 children who lived in Wales and completed their age 16 exams (Key Stage 4 (KS4)) between 2009 and 2016. Free School Meal (FSM) provision was used an indicator of household level deprivation. Area level deprivation was measured by the Welsh Index of Multiple Deprivation 2011. An encrypted unique Anonymous Linking Field was used to link the children with their health and educational records. The outcome variable of ‘Overall doing well’ was comprised of achieved at KS4, no mental health condition, no substance, and alcohol abuse records. Bidirectional logistic regression models were used to investigate the association between local areas deprivation and child’s outcome.Results22% of children on FSM were overall doing well compared to 54.9% of non-FSM children. FSM Children who lived in the least deprived areas are significantly more likely to do well (adjusted odds ratio (aOR) -2.20 (1.93-2.51)) than children lived in the most deprived areas. FSM children, living in areas with higher community safety, higher relative income, higher access to services, are more likely to do well than their peers.ConclusionThis study highlights that investing in community development (e.g., safety, back to work schemes, connectivity) helps in child’s education attainment, mental health and reduce risk-taking behaviours.What is already known on this subject?In Wales, 29.3% of children are living in povertyWelsh Index of Multiple Deprivation (WIMD) 2019 from Welsh Government highlighted the areas in Wales which remained as the topmost deprived areas for more than last 15 years and indicated a lack of social mobility in most of these areas.Growing up in a disadvantaged area increases the risk of adverse health and social outcomes in children’s life.What this study adds?Children from disadvantaged households are significantly more likely to do well if they are living in least deprived areas than the children from most deprived areas.The findings suggest that investing in community development and local area improvements such as promoting community safety, improving the access to public services and return to work schemes, can also help local children to do well in terms of education, mental health and reducing risk-taking behaviours (alcohol/drug use).
The accuracy of saliva versus nasopharyngeal and/or oropharyngeal samples for the detection of SARS-CoV-2 in children – A rapid systematic review and meta-analysis
Authors: Dhillon Sharonjit K. , Schelstraete Petra , Cornelissen Laura , Lafort Yves , Bonde Jesper , Arbyn M. 
Published: June 2021

AbstractBackgroundThe comparative performance of saliva and nasopharyngeal samples for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by reverse transcriptase polymerase chain reaction (RT-PCR) in children remains unclear. As schools reopen around the world, there is an interest in the use of saliva samples for the detection of SARS-CoV-2 in children to circumvent barriers with nasopharyngeal sampling. We systematically reviewed the literature to understand the performance of saliva sampling using RT-PCR on naso- and/or oropharyngeal swabs as the reference standard.MethodsArticles from PubMed/MEDLINE and Living Evidence were accessed until 28th April 2021. A search method without restriction to children population was applied and during the review phase, if a study included patients <18 years old, authors were contacted to provide additional information on the subset of children. Studies were eligible if they reported on matched saliva and naso- and/or oropharyngeal samples, taken from the same patient on the same day. Studies using other respiratory samples such as sputum samples were excluded. Each paired patient sample had to be tested on the same RT-PCR platform.ResultsTen studies were included, comprising 1486 matched saliva and on naso- and/or oropharyngeal pairs from children aged 0 to 18 years old. The pooled absolute sensitivity and specificity of saliva sampling using RT-PCR on nasopharyngeal samples as the reference standard was 84.5% (95% CI; 78.0%-90.3%) and 99.5% (95% CI; 98.2%-100.0%). Comparable performance of saliva to nasopharyngeal samples was shown in both symptomatic and asymptomatic children. Stratified analyses of various covariates showed no significant differences.DiscussionOur pooled accuracy estimates of RT-PCR SARS-CoV-2 testing on saliva in children did not seem to be different from meta-analyses of studies that enrolled mainly adults. Saliva could potentially be considered an alternative sampling method for screening in children and to pick up those with high viral load.
Altered cellular and humoral immune responses following SARS-CoV-2 mRNA vaccination in patients with multiple sclerosis on anti-CD20 therapy
Authors: Apostolidis Sokratis A. , Kakara Mihir , Painter Mark M. , Goel Rishi R. , Mathew Divij , Lenzi Kerry , Rezk Ayman , Patterson Kristina R. , Espinoza Diego A. , Kadri Jessy C. , Markowitz Daniel M. , Markowitz Clyde , Mexhitaj Ina , Jacobs Dina , Babb Allison , Betts Michael R. , Prak Eline T. Luning , Weiskopf Daniela , Grifoni Alba , Lundgreen Kendall A. , Gouma Sigrid , Sette Alessandro , Bates Paul , Hensley Scott E. , Greenplate Allison R. , Wherry E. John , Li Rui , Bar-Or Amit 
Published: June 2021

AbstractSARS-CoV-2 mRNA vaccination in healthy individuals generates effective immune protection against COVID-19. Little is known, however, about the SARS-CoV-2 mRNA vaccine-induced responses in immunosuppressed patients. We investigated induction of antigen-specific antibody, B cell and T cell responses in patients with multiple sclerosis on anti-CD20 (MS-aCD20) monotherapy following SARS-CoV-2 mRNA vaccination. Treatment with aCD20 significantly reduced Spike and RBD specific antibody and memory B cell responses in most patients, an effect that was ameliorated with longer duration from last aCD20 treatment and extent of B cell reconstitution. In contrast, all MS-aCD20 patients generated antigen-specific CD4 and CD8 T-cell responses following vaccination. However, treatment with aCD20 skewed these responses compromising circulating Tfh responses and augmenting CD8 T cell induction, while largely preserving Th1 priming. These data also revealed underlying features of coordinated immune responses following mRNA vaccination. Specifically, the MS-aCD20 patients who failed to generate anti-RBD IgG had the most severe defect in cTfh cell responses and more robust CD8 T cell responses compared to those who generated anti-RBD IgG, whose T cell responses were more similar to healthy controls. These data define the nature of SARS-CoV-2 vaccine-induced immune landscape in aCD20-treated patients, and provide insights into coordinated mRNA vaccine-induced immune responses in humans. Our findings have implications for clinical decision-making, patient education and public health policy for patients treated with aCD20 and other immunosuppressed patients.
On multifactorial drivers for malaria rebound in Brazil: a spatio-temporal analysis
Authors: Ayala Mario J.C. , Bastos Leonardo S , Villela Daniel A.M. 
Published: June 2021

AbstractBackgroundMalaria incidence in Brazil reversed its decreasing trend when cases from recent years, as recent as 2015, exhibited an increase in the Brazilian Amazon basin, the area with highest transmission of Plasmodium vivax and Plasmodium falciparum. In fact, an increase of more than 20% in the years 2016 and 2017 revealed possible vulnerabilities in the national malaria-control program.MethodsWe studied factors that are potentially associated with this reversal, including migration, economical activities, and deforestation, and weakening of investment in control programs. We analyze past incidences of malaria cases due to Plasmodium vivax and Plasmodium falciparum with a spatio-temporal Bayesian model using more than 5 million individual records of malaria cases from January of 2003 to December of 2018 in the Brazilian Amazon to establish the municipalities with unexpected increases in cases.ResultsWe observe an increase in imported cases from border countries in Roraima state and found small effects due to deforestation and change of occupations. Also, an overall funding reduction from 2013 to 2016 happened before an increase in malaria cases in five regions in Amazon basin, markedly for P. vivax incidence and especially, in Pará and Roraima States.ConclusionUrban developments, discontinued funding for control programs, migration from border areas, deforestation activities, and different economic activities such as mining and agriculture appear linked to the rebound on malaria incidence. These multifactorial drivers show that malaria control programs require permanent attention towards elimination.
A proteomic survival predictor for COVID-19 patients in intensive care
Authors: Demichev Vadim , Tober-Lau Pinkus , Nazarenko Tatiana , Aulakh Simran Kaur , Whitwell Harry , Lemke Oliver , Röhl Annika , Freiwald Anja , Mittermaier Mirja , Szyrwiel Lukasz , Ludwig Daniela , Correia-Melo Clara , Lippert Lena J. , Helbig Elisa T. , Stubbemann Paula , Olk Nadine , Thibeault Charlotte , Grüning Nana-Maria , Blyuss Oleg , Vernardis Spyros , White Matthew , Messner Christoph B. , Joannidis Michael , Sonnweber Thomas , Klein Sebastian J. , Pizzini Alex , Wohlfarter Yvonne , Sahanic Sabina , Hilbe Richard , Schaefer Benedikt , Wagner Sonja , Machleidt Felix , Garcia Carmen , Ruwwe-Glösenkamp Christoph , Lingscheid Tilman , de Jarcy Laure Bosquillon , Stegemann Miriam S. , Pfeiffer Moritz , Jürgens Linda , Denker Sophy , Zickler Daniel , Spies Claudia , Edel Andreas , Müller Nils B. , Enghard Philipp , Zelezniak Aleksej , Bellmann-Weiler Rosa , Weiss Günter , Campbell Archie , Hayward Caroline , Porteous David J. , Marioni Riccardo E. , Uhrig Alexander , Zoller Heinz , Löffler-Ragg Judith , Keller Markus A. , Tancevski Ivan , Timms John F. , Zaikin Alexey , Hippenstiel Stefan , Ramharter Michael , Müller-Redetzky Holger , Witzenrath Martin , Suttorp Norbert , Lilley Kathryn , Mülleder Michael , Sander Leif Erik ,   PA-COVID-19 Study group, Kurth Florian , Ralser Markus 
Published: June 2021

AbstractGlobal healthcare systems are challenged by the COVID-19 pandemic. There is a need to optimize allocation of treatment and resources in intensive care, as clinically established risk assessments such as SOFA and APACHE II scores show only limited performance for predicting the survival of severely ill COVID-19 patients. Comprehensively capturing the host physiology, we speculated that proteomics in combination with new data-driven analysis strategies could produce a new generation of prognostic discriminators. We studied two independent cohorts of patients with severe COVID-19 who required intensive care and invasive mechanical ventilation. SOFA score, Charlson comorbidity index and APACHE II score were poor predictors of survival. Plasma proteomics instead identified 14 proteins that showed concentration trajectories different between survivors and non-survivors. A proteomic predictor trained on single samples obtained at the first time point at maximum treatment level (i.e. WHO grade 7) and weeks before the outcome, achieved accurate classification of survivors in an exploratory (AUROC 0.81) as well as in the independent validation cohort (AUROC of 1.0). The majority of proteins with high relevance in the prediction model belong to the coagulation system and complement cascade. Our study demonstrates that predictors derived from plasma protein levels have the potential to substantially outperform current prognostic markers in intensive care.Trial registrationGerman Clinical Trials Register DRKS00021688
NeoScore integrates characteristics of the neoantigen:MHC class I interaction and expression to accurately prioritize immunogenic neoantigens
Authors: Borden Elizabeth S. , Buetow Kenneth H. , LaFleur Bonnie J. , Wilson Melissa A. , Hastings Karen Taraszka 
Published: June 2021

AbstractAccurate prioritization of immunogenic neoantigens is key to developing personalized cancer vaccines and distinguishing those patients likely to respond to immune checkpoint inhibition. However, there is no consensus regarding which characteristics best predict neoantigen immunogenicity, and no model to date has both high sensitivity and specificity and a significant association with survival in response to immunotherapy. We address these challenges in the prioritization of immunogenic neoantigens by 1) identifying which neoantigen characteristics best predict immunogenicity, 2) integrating these characteristics into an immunogenicity score, NeoScore, and 3) demonstrating an improved association of the NeoScore with response to immune checkpoint inhibition compared to mutational burden. One thousand random and evenly split combinations of immunogenic and non-immunogenic neoantigens from a validated dataset were analyzed using a regularized regression model for characteristic selection. The selected characteristics, the dissociation constant and binding stability of the neoantigen:MHC class I complex and expression of the mutated gene in the tumor, were integrated into the NeoScore. A web application is provided for calculation of the NeoScore. The NeoScore results in improved, or equivalent, performance in four test datasets as measured by sensitivity, specificity, and area under the receiver operator characteristics curve compared to previous models. Among cutaneous melanoma patients treated with immune checkpoint inhibition, a high NeoScore had a greater association with improved survival compared to mutational burden. Overall, the NeoScore has the potential to improve neoantigen prioritization for the development of personalized vaccines and contribute to the determination of which patients are likely to respond to immunotherapy.
Opinion of Health Care Providers on Birth Companions in Obstetrics Department of a Tertiary Care Hospital in North India
Authors: Sarwal Tanvi , Sarwal Yamini , Tyagi Shakun , Sarwal Rakesh 
Published: June 2021

ABSTRACTBackgroundDespite impressive improvements in institutional births and a fall in maternal mortality, satisfaction of women with birthing experience in public health institutions is low (68%). Birth Companion is an important part of the Labour room Quality Improvement (LaQshya) programme introduced by the Government of India in 2017. Despite mandates, implementation of the concept has been unsatisfactory (9%), even though the importance of Birth Companion has increased due to enhanced risk posed by COVID-19. Little is known about awareness among health care providers on Birth Companions, perceived barriers or their suggestions.MethodsWe canvassed a 15-question instrument using ordinal scales on 151 health care providers comprising consultants, post graduates, residents, and nurses (response rate 69%) in the department of Obstetrics & Gynecology, Lok Nayak Hospital, Delhi, India to gauge their awareness and opinions about Birth Companions.ResultsMost health care providers across all categories were aware of the concept (93%), World Health Organization’s recommendation (83%) and Government’s instructions for its hospitals (68%) that every woman should be accompanied by a Birth Companion of her choice during labour. Birth Companions of choice suggested by them were the mother (70%), husband (69%). sister (46%) or nurse (43%). Most health care providers agreed that a Birth Companion should wear clean clothes (95%), be free from any communicable disease (91%), stay with the pregnant woman throughout the process of labour (74%) and should have herself gone though labour (42%). Almost all providers (95%) agreed that the presence of a Birth Companion during labour will be beneficial, as they would provide emotional support (99%), boost the woman’s confidence (98%), provide comfort measures like massage (95%), early initiation of breastfeeding (93%), reduce post-partum depression (91%), humanize labour (83%), reduce need for analgesia (70%) and increase spontaneous vaginal births (69%). Yet support for its introduction in their hospital was low (59%). Staff nurses had reservations (62%) with only 40% of those who believed Birth Companion to be beneficial approving of its introduction in their hospital. Over-crowding in labour room and privacy concerns for other women were identified as key barriers.ConclusionEven though most health care providers were aware of and convinced of multiple benefits of Birth Companion during labour, lack of adequate infrastructure in the labour room prevented them from supporting its introduction. Government should provide adequate funding to upgrade labour rooms in a way that provides privacy to the delivering women and frame guidelines and train Birth Companions to perform their role appropriately.