bluuebunny/crossref_metadata_2025_split huggingface dataset:
How are patients with rare diseases and their carers in the UK impacted by the way care is coordinated? An exploratory qualitative interview study
Authors: Simpson Amy , Bloom Lara , Fulop Naomi J. , Hudson Emma , Leeson-Beevers Kerry , Morris Stephen , Ramsay Angus I. G. , Sutcliffe Alastair G. , Walton Holly , Hunter Amy 
Published: February 2021

Abstract
Background
Care coordination is considered important for patients with rare conditions, yet research addressing the impact of care coordination is limited. This study aimed to explore how care coordination (or lack of) impacts on patients and carers. Semi-structured interviews were conducted with 15 patients and carers/parents in the UK, representing a range of rare conditions (including undiagnosed conditions). Transcripts were analysed thematically in an iterative process.

Results
Participants described a range of experiences and views in relation to care coordination. Reports of uncoordinated care emerged: appointments were uncoordinated, communication between key stakeholders was ineffective, patients and carers were required to coordinate their own care, and care was not coordinated to meet the changing needs of patients in different scenarios. As a result, participants experienced an additional burden and barriers/delays to accessing care. The impacts described by patients and carers, either attributed to or exacerbated by uncoordinated care, included: impact on physical health (including fatigue), financial impact (including loss of earnings and travel costs), and psychosocial impact (including disruption to school, work and emotional burden). Overall data highlight the importance of flexible care, which meets individual needs throughout patients’/carers’ journeys. Specifically, study participants suggested that the impacts may be addressed by: having support from a professional to coordinate care, changing the approach of clinics and appointments (where they take place, which professionals/services are available and how they are scheduled), and improving communication through the use of technology, care plans, accessible points of contact and multi-disciplinary team working.

Conclusion
This study provides further evidence of impacts of uncoordinated care; these may be complex and influenced by a number of factors. Approaches to coordination which improve access to care and lessen the time and burden placed on patients and carers may be particularly beneficial. Findings should influence future service developments (and the evaluation of such developments). This will be achieved, in the first instance, by informing the CONCORD Study in the UK.
The effect of the ongoing civil strife on key immunisation outcomes in the North West and South West regions of Cameroon
Authors: Saidu Yauba , Vouking Marius , Njoh Andreas Ateke , Bachire Hassan Ben , Tonga Calvin , Mofor Roberts , Bayiha Christain , Ewane Leonard , Cornelius Chebo , Mbida Ndi Daniel Daddy , Abizou Messang Blandine , Njie Victor Mbome , Nzuobontane Divine 
Published: February 2021

Abstract
Background
Civil strife has long been recognized as a significant barrier in the fight against vaccine preventable diseases in several parts of the world. However, little is known about the impact of the ongoing civil strife on the immunisation system in the Northwest (NW) and Southwest (SW) regions of Cameroon, which erupted in late 2016. In this paper, we assessed the effect of the conflict on key immunisation outcomes in the North West and South West regions of Cameroon.

Methods
Data were obtained from the standard EPI data reporting tool, the District Vaccine and Data Management Tool (DVDMT), from all the districts in the two regions. Completed forms were then reviewed for accuracy prior to data entry at central level. Summary statistics were used to estimate the variables of interest for each region for the years 2016 (pre-conflict) and 2019 (during conflict).

Results
In the two regions, the security situation has deteriorated in almost all districts, which in turn has disrupted basic healthcare delivery in those areas. A total of 26 facilities were destroyed and 11 healthcare workers killed in both regions. Reported immunisation coverage rates for key antigens including, BCG, DPT-3 and MR, witnessed a dramatic decline between 2016 and 2019, ranging from 22% points decline for BCG in the NW and to 42% points decline for DPT-3 in the SW. Similarly, the proportion of districts with DPT-3 coverage of at least 80% dropped from 75% in 2016 to 11% in 2019 in the NW. In the SW this proportion dropped from 16% in 2016 to 0 % in 2019.

Conclusion
Our data demonstrates the marked negative impact of the ongoing civil strife on key immunisation outcomes in the two regions and the country at large. This decline could amplify the risk of vaccine preventable diseases vaccine preventable diseases outbreaks in the two regions. Besides the ongoing actions to contain the crises, effective strategies for reaching children in the conflict zones as well as the internally displaced population are needed. There is also the need to rebuild destroyed facilities as well as to protect health facilities and staff from targeted violence.
High activity and low toxicity of a novel CD71-targeting nanotherapeutic named The-0504 on preclinical models of several human aggressive tumors
Authors: Falvo Elisabetta , Damiani Verena , Conti Giamaica , Boschi Federico , Messana Katia , Giacomini Patrizio , Milella Michele , De Laurenzi Vincenzo , Morea Veronica , Sala Gianluca , Fracasso Giulio , Ceci Pierpaolo 
Published: February 2021

Abstract
Background
Ferritin receptor (CD71) is an example of a very attractive cancer target, since it is highly expressed in virtually all tumor types, including metastatic loci. However, this target can be considered to be inaccessible to conventional target therapies, due to its presence in many healthy tissues. Here, we describe the preclinical evaluation of a tumor proteases-activatable human ferritin (HFt)-based drug carrier (The-0504) that is able to selectively deliver the wide-spectrum topoisomerase I inhibitor Genz-644282 to CD71-expressing tumors, preventing the limiting toxic effects associated with CD71-targeting therapies.

Methods
CD71 expression was evaluated using flow cytometry and immunohistochemistry techniques. The-0504 antiproliferative activity towards several cancer cell lines was assessed in vitro. The-0504 antitumor efficacy and survival benefit were evaluated in different human tumors, which had been grown either as xenografts or patient-derived xenografts in mice. The-0504 toxicology profile was investigated in multiple-cycle repeat-dose study in rodents.

Results
In vitro studies indicate that The-0504 is highly specific for CD71 expressing cells, and that there is a relationship between CD71 levels and The-0504 anticancer activity. In vivo treatments with The-0504 showed a remarkable efficacy, eradicating several human tumors of very diverse and aggressive histotypes, such as pancreas, liver and colorectal carcinomas, and triple-negative breast cancer.

Conclusions
Durable disease-free survival, persistent antitumor responses after discontinuation of treatment and favorable toxicology profile make The-0504 an ideal candidate for clinical development as a novel, CD71-targeted, low-toxicity alternative to chemotherapy.
Klebsiella pneumoniae infection causes mitochondrial damage and dysfunction in bovine mammary epithelial cells
Authors: Cheng Jia , Zhang Jv , Yang Jingyue , Yi Bing , Liu Gang , Zhou Man , Kastelic John P. , Han Bo , Gao Jian 
Published: February 2021

AbstractKlebsiella pneumoniae, an important cause of bovine mastitis worldwide, is strongly pathogenic to bovine mammary epithelial cells (bMECs). Our objective was to determine the role of mitochondrial damage in the pathogenicity of K. pneumoniae on bMECs, by assessing several classical indicators of mitochondrial dysfunction, as well as differentially expressed genes (DEGs). Two K. pneumoniae strains (HLJ-D2 and HB-AF5), isolated from cows with clinical mastitis (CM), were used to infect bMECs (MAC-T line) cultured in vitro. In whole-transcriptome analysis of bMECs at 6 h post-infection (hpi), there were 3453 up-regulated and 3470 down-regulated genes for HLJ-D2, whereas for HB-AF5, there were 2891 up-regulated and 3278 down-regulated genes (P < 0.05). Based on GO term enrichment of differentially expressed genes (DEGs), relative to the controls, the primary categories altered in K. pneumoniae-infected bMECs included cellular macromolecule metabolism, metabolic process, binding, molecular function, etc. Infections increased (P < 0.05) malondialdehyde concentrations and formation of reactive oxygen species in bMECs. Additionally, both bacterial strains decreased (P < 0.05) total antioxidant capacity in bMECs at 6 and 12 hpi. Furthermore, infections decreased (P < 0.05) mitochondrial membrane potential and increased (P < 0.01) mitochondrial calcium concentrations. Finally, severe mitochondrial swelling and vacuolation, as well as mitochondrial rupture and cristae degeneration, were detected in infected bMECs. In conclusion, K. pneumoniae infections induced profound mitochondrial damage and dysfunction in bMECs; we inferred that this caused cellular damage and contributes to the pathogenesis of K. pneumoniae-induced CM in dairy cows.
An integrated MVDR beamformer for speech enhancement using a local microphone array and external microphones
Authors: Ali Randall , van Waterschoot Toon , Moonen Marc 
Published: February 2021

AbstractAn integrated version of the minimum variance distortionless response (MVDR) beamformer for speech enhancement using a microphone array has been recently developed, which merges the benefits of imposing constraints defined from both a relative transfer function (RTF) vector based on a priori knowledge and an RTF vector based on a data-dependent estimate. In this paper, the integrated MVDR beamformer is extended for use with a microphone configuration where a microphone array, local to a speech processing device, has access to the signals from multiple external microphones (XMs) randomly located in the acoustic environment. The integrated MVDR beamformer is reformulated as a quadratically constrained quadratic program (QCQP) with two constraints, one of which is related to the maximum tolerable speech distortion for the imposition of the a priori RTF vector and the other related to the maximum tolerable speech distortion for the imposition of the data-dependent RTF vector. An analysis of how these maximum tolerable speech distortions affect the behaviour of the QCQP is presented, followed by the discussion of a general tuning framework. The integrated MVDR beamformer is then evaluated with audio recordings from behind-the-ear hearing aid microphones and three XMs for a single desired speech source in a noisy environment. In comparison to relying solely on an a priori RTF vector or a data-dependent RTF vector, the results demonstrate that the integrated MVDR beamformer can be tuned to yield different enhanced speech signals, which may be more suitable for improving speech intelligibility despite changes in the desired speech source position and imperfectly estimated spatial correlation matrices.
Monotone iterative solutions for a coupled system of p-Laplacian differential equations involving the Riemann–Liouville fractional derivative
Authors: Bi Bo , He Ying 
Published: February 2021

AbstractApplying the monotone iterative technique and the method of upper and lower solutions, we investigate the existence of extremal solutions for a nonlinear system of p-Laplacian differential equations with nonlocal coupled integral boundary conditions. We present a numerical example to illustrate the main result.
Ischemic small bowel perforation caused by cholesterol crystal embolism following transcatheter arterial chemoembolization for recurrent hepatocellular carcinoma: a case report
Authors: Hamura Ryoga , Haruki Koichiro , Iwase Ryota , Furukawa Kenei , Shirai Yoshihiro , Onda Shinji , Gocho Takeshi , Ikegami Toru 
Published: February 2021

AbstractBackgroundCholesterol crystal embolism (CCE) following transcatheter arterial chemoembolization (TACE) is rare.Case presentationA 71-year-old man underwent TACE for recurrence of hepatocellular carcinoma (HCC). On postoperative day (POD) 5, he developed abdominal pain and fever. Computed tomography revealed intraperitoneal free air. The patient was diagnosed with gastrointestinal perforation with peritonitis, for which partial intestinal resection and covering ileostomy were performed. Histological examination revealed perforation of the small intestine caused by CCE. The patient made a satisfactory recovery and was discharged on POD 30. The patient showed no recurrence of cholesterol crystal embolism or HCC for 2 years after surgery.ConclusionWe reported a successfully treated case of ischemic small bowel perforation due to cholesterol crystal embolism following transcatheter arterial chemoembolization for recurrent HCC.
Could SARS-CoV-2 herald a surge of multiple sclerosis?
Authors: Shalaby Nevin Mohieldin , Shehata Hatem Samir 
Published: February 2021

AbstractDuring the current COVID-19 pandemic, many queries are raised regarding its nature, outcome, and sequelae. This letter raises the concern of potential impact on increasing the incidence of multiple sclerosis whose pathology involves a possible viral etiology. Besides, the potential neurotropism of the acute respiratory distress syndrome corona virus-2 (SARS-CoV-2), which is still not established, may raise concerns about the use of certain disease modifying therapies namely natalizumab.
Shallow tunnel detection using converted surface waves
Authors: Peterie Shelby L. , Ivanov Julian , Knippel Erik , Miller Richard D. , Sloan Steven D. 
Published: February 2021

Seismic surface waves that were likely converted from incident body waves were used to detect a 3 m deep tunnel using two novel processing methods. In data acquired at a tunnel test site, a unique forward-propagating wave (traveling away from the tunnel and seismic source) was identified as an early-arriving surface wave converted at the tunnel from an incident body wave. To our knowledge, our research represents the first time converted surface waves have been observed originating from a tunnel. We have developed two novel processing methods targeting this unique wavefield component for detecting tunnels, cavities, or other shallow anomalies. The first is a time-domain imaging method that takes advantage of the unique kinematic characteristics of converted surface waves to produce a cross section with a coherent, high-amplitude signature originating from the horizontal location of the tunnel. The second method uses frequency-domain analysis of surface-wave amplitudes, which reveals increased amplitudes (primarily from converted surface waves) at locations expected for the tunnel. These proposed approaches for analysis of converted surface waves were successfully used to detect the tunnel and accurately interpret its horizontal location in real-world data. These novel methods could be the key for detecting shallow tunnels or other subsurface anomalies and complement existing seismic detection methods.
Care Experience, by Site of Care, for Adolescents and Young Adults With Cancer
Authors: Jacobsen Rebecca L. , Macpherson Catherine Fiona , Pflugeisen Bethann Mangel , Johnson Rebecca H. 
Published: February 2021

PURPOSE: Most of the 77,000 adolescents and young adults (AYAs) 15-39 years of age diagnosed with cancer annually in the United States are treated at community rather than academic centers. Little is known about their healthcare experience. METHODS: A cross-sectional, anonymous, online survey was conducted with a convenience sample of AYAs treated for cancer at US academic (n = 112) or community centers (n = 64). RESULTS: Clinical trials were offered more frequently to respondents treated at academic centers (26.8% v 7.8%; P = .005). Eighty percent of all those offered a clinical trial chose to enroll. Over three-fourths reported awareness of community-based or online AYA oncology support services; however, significantly more respondents from academic centers reported awareness of services provided by the institution itself (40.2% v 7.8%; P < .001). Significantly more respondents from academic centers reported receiving information relevant to their age group (41.1% v 15.6%; P < .001). Respondents treated at academic centers were significantly more satisfied with support, communication, and overall treatment. Odds of respondents treated at an academic center reporting that their healthcare team knew enough about AYAs were 3.12-fold higher than those treated at community centers (95% CI, 1.6 to 6.4; P = .002). Odds of overall satisfaction were significantly higher for respondents who reported that their healthcare team “knew enough about AYAs” (aOR, 9.7, 95% CI, 2.4 to 53.9; P = .003). CONCLUSION: Cancer treatment for AYAs at both academic and community centers can be optimized by improving healthcare providers' understanding of the key issues facing AYAs with cancer and by increasing AYA-specific institutional resources and support services.
Cortical Bone Mass is Low in Boys with Klinefelter Syndrome and Improves with Oxandrolone
Authors: Vogiatzi Maria G , Davis Shanlee M , Ross Judith L 
Published: February 2021

Abstract

Context
Klinefelter syndrome (KS) is the most common sex aneuploidy in men. Affected males have hypogonadism, and, as a result, face an increased risk for osteoporosis and fractures. Androgen therapy is standard in adolescents and adults with KS but has not been used earlier in childhood.

Objective
To determine the effects of androgen treatment on bone mass in children with KS.

Methods
Randomized, double-blind, placebo-controlled clinical trial of oxandrolone (OX; 0.06 mg/kg daily; n = 38) versus placebo (PL; n = 40) for 2 years in boys with KS (ages 4-12 years). Changes in bone mass were examined by digital x-ray radiogrammetry, which determines the Bone Health Index (BHI) and standard deviation score (SDS).

Results
BHI SDS was similar between groups at baseline (–0.46 ± 1.1 vs –0.34 ± 1.0 OX vs PL, P &gt; .05) and higher in the OX group at 2 years (–0.1 ± 1.3 vs –0.53 ± 0.9, OX vs PL, P &lt; .01). At baseline, BHI SDS values of all subjects were not normally distributed with 25.7% of subjects plotted below –1 SDS (P &lt; .001), suggesting a deficit in bone mass. In total, 13.5% of subjects had sustained a fracture and their BHI SDS was lower than those with no fractures (–1.6 ± 1.3 vs –0.3 ± 1.0, P = .004).

Conclusion
Bone mass using BHI SDS is reduced in some children with KS and improves with OX. Since these individuals are at risk for osteoporosis, age-appropriate androgen replacement and future studies on bone health in children with KS should be further explored.
“Reexamining the Influence of Conditional Cash Transfers on Migration From a Gendered Lens”: Comment
Authors: Stark Oded 
Published: February 2021

Abstract
In a recent article, “Reexamining the Influence of Conditional Cash Transfers on Migration From a Gendered Lens,” Hughes (2019) claimed that conditional cash transfers, CCT, limit the likelihood of migration by women, compensating them for giving up an attractive migration option. I question the analysis that lies behind this claim. I argue that in seeking to understand the likelihood of women migrating if they participate in a CCT program, issues of selectivity, endogeneity, and optimization cannot be set aside. In particular, it is not that receiving CCT curtails a migration option; it is that not contemplating migration encourages women to accept CCT. And if a household perspective is brought to bear, then a household's free choices weaken the appeal of migration to women. This reduction in appeal does not arise from an exogenously imposed curb but rather from endogenously determined preferences.
Visual stimulus-specific habituation of innate defensive behaviour in mice
Authors: Tafreshiha Azadeh , van der Burg Sven A. , Smits Kato , Blömer Laila A. , Heimel J. Alexander 
Published: February 2021

ABSTRACT
Innate defensive responses such as freezing or escape are essential for animal survival. Mice show defensive behaviour to stimuli sweeping overhead, like a bird cruising the sky. Here, we tested this in young male mice and found that mice reduced their defensive freezing after sessions with a stimulus passing overhead repeatedly. This habituation is stimulus specific, as mice freeze again to a novel shape. Habituation occurs regardless of the visual field location of the repeated stimulus. The mice generalized over a range of sizes and shapes, but distinguished objects when they differed in both size and shape. Innate visual defensive responses are thus strongly influenced by previous experience as mice learn to ignore specific stimuli.
The frugivorous bat Carollia perspicillata dynamically changes echolocation parameters in response to acoustic playback
Authors: Beetz M. Jerome , Kössl Manfred , Hechavarría Julio C. 
Published: February 2021

ABSTRACT
Animals extract behaviorally relevant signals from ‘noisy’ environments. Echolocation behavior provides a rich system testbed for investigating signal extraction. When echolocating in acoustically enriched environments, bats show many adaptations that are believed to facilitate signal extraction. Most studies to date focused on describing adaptations in insectivorous bats while frugivorous bats have rarely been tested. Here, we characterize how the frugivorous bat Carollia perspicillata adapts its echolocation behavior in response to acoustic playback. Since bats not only adapt their echolocation calls in response to acoustic interference but also with respect to target distances, we swung bats on a pendulum to control for distance-dependent call changes. Forward swings evoked consistent echolocation behavior similar to approach flights. By comparing the echolocation behavior recorded in the presence and absence of acoustic playback, we could precisely define the influence of the acoustic context on the bats' vocal behavior. Our results show that C. perspicillata decrease the terminal peak frequencies of their calls when echolocating in the presence of acoustic playback. When considering the results at an individual level, it became clear that each bat dynamically adjusts different echolocation parameters across and even within experimental days. Utilizing such dynamics, bats create unique echolocation streams that could facilitate signal extraction in noisy environments.