bluuebunny/crossref_metadata_2025_split huggingface dataset:
Women in neurosurgery and interventional neuroradiology in Brazil and other countries: can lightning strike the same place twice?
Authors: Maranha Gatto Luana Antunes , Galdino Chaves Jennyfer Paula 
Published: July 2021

Background Neurosurgery is historically a specialty with a wide male predominance. Interventional neuroradiology, considered in many countries to be a subspecialty of neurosurgery (but also radiology and neurology), has never been the setting for this discussion, but the even greater gender inequality of professionals working in this area is well known. Aims The initial objective of this research was to describe the personal and professional profile of the few women in Brazil who practise neurosurgery and interventional neuroradiology, and the difficulties they encountered throughout their careers just because they are women. However, the shocking stories they experienced led the team to expand searches around the world, obtaining data from some other countries, mainly in South America. Machismo, harassment, misogyny, discrimination and wage inequality go beyond borders. Discussion Current times do not allow these situations anymore, but which, according to the narrative descriptions of 28 interventional neuroradiology women interviewed, still occur very frequently. A more inclusive vision must be sought by interventional neuroradiology societies, and it is up to the leaders to take care of those who need more attention (which does not mean they are more fragile).
Digital work engagement among Italian neurologists
Authors: Brigo Francesco , Ponzano Marta , Sormani Maria Pia , Clerico Marinella , Abbadessa Gianmarco , Cossu Giovanni , Trojsi Francesca , Colucci Fabiana , Tortorella Carla , Miele Giuseppina , Spina Emanuele , Artusi Carlo Alberto , Carmisciano Luca , Servillo Giovanna , Bozzali Marco , Sparaco Maddalena , Leocani Letizia , Lanzillo Roberta , Tedeschi Gioacchino , Bonavita Simona , Lavorgna Luigi 
Published: July 2021

Background: Digital health, including telemedicine, is increasingly recommended for the management of chronic neurological disorders, and it has changed the roles of patients and clinicians. Methods: In this cross-sectional study we aimed to investigate the digital work engagement of Italian neurologists through a survey collected between September 2020 and January 2021. Questionnaires were anonymous and collected demographic characteristics, attitudes towards digital devices and social media, and details about the clinician–patient relationship. We used logistic-regression models to identify characteristics associated with the propensity to communicate with patients using social media. Results: Among the 553 neurologists who participated to the study, smartphones and computers were widely preferred compared with tablets; wearable devices were not common, although some neurologists desired them. A total of 48% of participants reported communicating with patients using social media but only a few were in favor of social friendship with patients; WhatsApp was the social media most popular for professional (86%) and personal (98%) purposes. Propensity to communicate with social media was significantly higher among those who were older ( p < 0.001) and lived in regions outside northern Italy (center: p = 0.006; south and the islands: p < 0.001). For 58% of responders, social media improved their relationship with patients, but 72% usually warned patients about unreliable websites. Conclusions: The preferred social media were those which were rapid and which safeguard privacy more effectively; neurologists made many efforts to disprove fake news circulating online, providing help to patients in various ways. This analysis can help direct future interventions for the management of chronic neurological disorders.
A Systematic Review of Workplace-Based Employee Health Interventions and Their Impact on Sleep Duration Among Shift Workers
Authors: Robbins Rebecca , Underwood Phoenix , Jackson Chandra L. , Jean-Louis Giradin , Madhavaram Shreya , Kuriakose Shiana , Vieira Dorice , Buxton Orfeu M. 
Published: July 2021

Background: Shift work is associated with long-term health risks. Workplace-based health interventions hold promise for improving or maintaining the health of shift workers; yet, the impact of workplace-based interventions on shift worker sleep duration has not been assessed. We conducted a systematic review of workplace interventions on shift worker sleep. Methods: We conducted searches in PubMed, Web of Knowledge, EMBASE, Scopus, and PsycINFO ( n = 6,868 records) of all studies published through May 15, 2019. Eligibility criteria included the following: (a) individuals aged ≥18 years; (b) a workplace-based employee intervention; (c) an employee population comprised predominantly of shift workers (>50%); and (d) sleep duration as a study outcome. Findings: Twenty workplace interventions met eligibility criteria. Mean intervention duration was 125 ( SD = 187) days and mean sample size was 116 employees ( SD = 256) with a mean age of 36.4 years ( SD = 6.5). Interventions most commonly focused on light exposure (25%) or shift timing (25%), followed by sleep hygiene (20%). Most interventions were conducted in the health care and social assistance sector (60%). Study quality on average was 64% ( SD = 7%). A majority of the studies found that a workplace-based health intervention was associated with a desirable increase in 24-hour total sleep duration (55%). The overall average increase in daily employee sleep duration achieved by interventions ranged for RCT studies from 0.34 to 0.99 hours and for non-RCT studies from 0.02 to 1.15 hours. Conclusions/Applications to Practice: More than half of the employee health interventions, especially yoga or mindfulness interventions, resulted in a desirable increase in sleep duration. Workplaces hold promise as an avenue? for delivering programs and policies that aim to improve sleep duration among shift workers.
Direct Cost of Illness for Spinal Cord Injury: A Systematic Review
Authors: Malekzadeh Hamid , Golpayegani Mahdi , Ghodsi Zahra , Sadeghi-Naini Mohsen , Asgardoon Mohammadhossein , Baigi Vali , Vaccaro Alexander R. , Rahimi-Movaghar Vafa 
Published: July 2021

Study Design: Systematic review. Objective: Providing a comprehensive review of spinal cord injury cost of illness studies to assist health-service planning. Methods: We conducted a systematic review of the literature published from Jan. 1990 to Nov. 2020 via Pubmed, EMBASE, and NHS Economic Evaluation Database. Our primary outcomes were overall direct health care costs of SCI during acute care, inpatient rehabilitation, within the first year post-injury, and in the ensuing years. Results: Through a 2-phase screening process by independent reviewers, 30 articles out of 6177 identified citations were included. Cost of care varied widely with the mean cost of acute care ranging from $290 to $612,590; inpatient rehabilitation from $19,360 to $443,040; the first year after injury from $32,240 to $1,156,400; and the ensuing years from $4,490 to $251,450. Variations in reported costs were primarily due to neurological level of injury, study location, methodological heterogeneities, cost definitions, study populations, and timeframes. A cervical level of the injury, ASIA grade A and B, concomitant injuries, and in-hospital complications were associated with the greatest incremental effect in cost burden. Conclusion: The economic burden of SCI is generally high and cost figures are broadly higher for developed countries. As studies were only available in few countries, the generalizability of the cost estimates to a regional or global level is only limited to countries with similar economic status and health systems. Further investigations with standardized methodologies are required to fill the knowledge gaps in the healthcare economics of SCI.
Factors Affecting Prolonged Postoperative Pain and Analgesic Use After Arthroscopic Full-Thickness Rotator Cuff Repair
Authors: Misir Abdulhamit , Uzun Erdal , Kizkapan Turan Bilge , Ozcamdalli Mustafa , Sekban Hazim , Guney Ahmet 
Published: July 2021

Background: Postoperative pain and analgesic use after arthroscopic rotator cuff repair remain important issues that affect rehabilitation and overall outcomes. Purpose: To evaluate the pre- and intraoperative factors that may cause prolonged duration of postoperative pain and analgesic use. Study Design: Case-control study; Level of evidence, 3. Methods: We included 443 patients who underwent arthroscopic rotator cuff repair and subacromial decompression. Visual analog scale (VAS) scores for pain were obtained preoperatively and at 30 and 90 days postoperatively. Patients were divided into a group who had prolonged postoperative pain (duration ≥1 and <3 months; n = 86 patients) and a group with nonprolonged pain (duration <1 month; n = 357 patients). The following factors were compared between groups: age, sex, body mass index, repair technique, tear size, retraction amount, repair tension, tendon degeneration, preoperative pseudoparesis, symptom duration, application of microfracture to the rotator cuff footprint for marrow stimulation, smoking, degree of fatty degeneration, preoperative narcotic analgesic use, diabetes, acromioclavicular joint degeneration, and preoperative Douleur Neuropathique 4 (DN4) and American Shoulder and Elbow Society (ASES) scores. Results: Significant differences were seen between the prolonged and nonprolonged groups regarding the median duration of pain (54 vs 27 days, respectively; P < .001) and analgesic use (42 vs 28 days, respectively; P < .001). Significant differences were noted between the groups for symptom duration ( P = .007), smoking status ( P = .001), degree of fatty degeneration ( P = .009), preoperative narcotic analgesic use ( P < .001), preoperative DN4 and ASES scores, 30-day VAS score ( P < .001), duration of opioid and nonopioid analgesic use ( P < .001), tear size ( P = .026), and retraction stage ( P = .032). Tear size ( P = .009), retraction amount ( P = .005), preoperative narcotic analgesic use ( P < .001), degree of fatty degeneration ( P < .001), and preoperative DN4 score ( P = .024) were factors independently associated with prolonged postoperative pain and analgesic use. Conclusion: Patients with larger size tears, retracted tendons, preoperative use of narcotic analgesics, higher tensioned tendon after repair, and Goutallier grade 3 or 4 fatty degeneration faced an increased risk of prolonged postoperative pain and analgesic use after arthroscopic rotator cuff repair. These factors might be mitigated by psychosocial support; gentle, controlled, and individualized postoperative rehabilitation approaches; detailed preoperative evaluation; and closer follow-up of patients who are treated operatively.
Counter-Clockwise Rotation of Maxillomandibular Complex and Customized Joint Reconstruction as a Single Stage Management for Facial Deformity in Temporomandibular Joint Ankylosis: A 2 Year Follow-Up
Authors: Mehrotra Divya , Yadav Pradeep K , Katrolia Ravi , Khan Haaris 
Published: July 2021

Study Design: A case report with 2 year follow up. Objective: The aim of this paper is to present a case of bilateral TMJ ankylosis with coexisting dentofacial deformity and occlusal cant, and 2 years follow-up evaluation for changes and relapse in the facial skeletal and airway. Methods: The patient was planned preoperatively by computer simulation for bilateral interposition arthroplasty and surgical jigs, coronoidectomy, detachment of masseter and medial pterygoid muscles from ramus, LeFort 1 osteotomy, temporary maxillomandibular fixation, counter-clockwise rotation of the maxillomandibular complex, maxillary fixation and iliac crest graft, reconstruction of bilateral TMJ with custom-made total joint prosthesis, dermal fat interposition in the joint, reattachment of muscles, maxillomandibular fixation, and active physiotherapy. Results: Average ramal length improved by 28.35 mm (81%) in the immediate postoperative and 25.6 mm (73.45%) at 2 years, showing 2.75 mm (4.4%) vertical bone resorption at the angle region. Point A advanced by 1.3 mm, but showed 4.5% horizontal relapse; Point B advanced by 10.2 mm, but showed 9.5% relapse at 2 years. Pogonion advanced by 26.3 mm (70%) but presented 7 mm (10.9%) horizontal relapse; and menton by 28.6 mm (89%) with 5.4 mm (8.9%) relapse at 2 years. The mean mandibular plane angle decreased by 33.5° (42%) after surgery and by 32° (40%) at 2 years. Pharyngeal airway increased by 49% after surgery and by 75.6% at 2 years follow-up. Conclusion: This computer simulated approach for the management of bilateral TMJ ankylosis with facial deformity and occlusal cant improves aesthetics, function and airway in a single surgery, thereby reducing the management cost and time, and deliver precise results.
Siglec-6 is a novel target for CAR T-cell therapy in acute myeloid leukemia
Authors: Jetani Hardikkumar , Navarro-Bailón Almudena , Maucher Marius , Frenz Silke , Verbruggen Christina , Yeguas Ana , Vidriales María Belén , González Marcos , Rial Saborido Judit , Kraus Sabrina , Mestermann Katrin , Thomas Simone , Bonig Halvard , Luu Maik , Monjezi Razieh , Mougiakakos Dimitrios , Sauer Markus , Einsele Hermann , Hudecek Michael 
Published: July 2021

AbstractAcute myeloid leukemia (AML) is an attractive entity for the development of chimeric antigen receptor (CAR) T-cell immunotherapy because AML blasts are susceptible to T-cell–mediated elimination. Here, we introduce sialic acid–binding immunoglobulin-like lectin 6 (Siglec-6) as a novel target for CAR T cells in AML. We designed a Siglec-6–specific CAR with a targeting domain derived from the human monoclonal antibody JML-1. We found that Siglec-6 is commonly expressed on AML cell lines and primary AML blasts, including the subpopulation of AML stem cells. Treatment with Siglec-6 CAR T cells confers specific antileukemia reactivity that correlates with Siglec-6 expression in preclinical models, including induction of complete remission in a xenograft AML model in immunodeficient mice (NSG/U937). In addition, we confirmed Siglec-6 expression on transformed B cells in chronic lymphocytic leukemia (CLL), and specific anti-CLL reactivity of Siglec-6 CAR T cells in vitro. Of particular interest, we found that Siglec-6 is not detectable on normal hematopoietic stem and progenitor cells (HSPCs) and that treatment with Siglec-6 CAR T cells does not affect their viability and lineage differentiation in colony-formation assays. These data suggest that Siglec-6 CAR T-cell therapy may be used to effectively treat AML without the need for subsequent allogeneic hematopoietic stem cell transplantation. In mature normal hematopoietic cells, we detected Siglec-6 in a proportion of memory (and naïve) B cells and basophilic granulocytes, suggesting the potential for limited on-target/off-tumor reactivity. The lack of expression of Siglec-6 on normal HSPCs is a key to differentiating it from other Siglec family members (eg, Siglec-3 [CD33]) and other CAR target antigens (eg, CD123) that are under investigation in AML, and it warrants the clinical investigation of Siglec-6 CAR T-cell therapy.
Phase 1 study of ibrutinib and the CXCR4 antagonist ulocuplumab in CXCR4-mutated Waldenström macroglobulinemia
Authors: Treon Steven P. , Meid Kirsten , Hunter Zachary R. , Flynn Catherine A. , Sarosiek Shayna R. , Leventoff Carly R. , White Timothy P. , Cao Yang , Roccaro Aldo M. , Sacco Antonio , Demos Maria G. , Guerrera Maria Luisa , Kofides Amanda , Liu Xia , Xu Lian , Patterson Christopher J. , Munshi Manit , Tsakmaklis Nicholas , Yang Guang , Ghobrial Irene M. , Branagan Andrew R. , Castillo Jorge J. 
Published: July 2021

Abstract
MYD88 and CXCR4 mutations are common in Waldenström macroglobulinemia (WM). Mutated CXCR4 (CXCR4Mut) impacts BTK-inhibitor response. We conducted a phase 1 trial of the CXCR4-antagonist ulocuplumab with ibrutinib in this first-ever study to target CXCR4Mut in WM. Ibrutinib was initiated at 420 mg/d with cycle 1 and continued until intolerance or progression; ulocuplumab was given cycles 1 to 6, with a 3 + 3 dose-escalation design. Each cycle was 4 weeks. Thirteen symptomatic patients, of whom 9 were treatment-naive patients were enrolled. Twelve were evaluable for response. At best response, their median serum immunoglobulin M declined from 5574 to 1114 mg/dL; bone marrow disease decreased from 65% to 10%, and hemoglobin increased from 10.1 to 14.2 g/dL (P &lt; .001). The major and VGPR response rates were 100% and 33%, respectively, with VGPRs observed at lower ulocuplumab dose cohorts. Median times to minor and major responses were 0.9 and 1.2 months, respectively. With a median follow-up of 22.4 months, the estimated 2-year progression-free survival was 90%. The most frequent recurring grade ≥2 adverse events included reversible thrombocytopenia, rash, and skin infections. Ulocuplumab dose-escalation did not impact adverse events. The study demonstrates the feasibility of combining a CXCR4-antagonist with ibrutinib and provides support for the development of CXCR4-antagonists for CXCR4Mut WM. This trial was registered at www.clinicaltrials.gov as #NCT03225716.
Structured headache services as the solution to the ill-health burden of headache: 1. Rationale and description
Authors: Steiner Timothy J. , Jensen Rigmor , Katsarava Zaza , Stovner Lars Jacob , Uluduz Derya , Adarmouch Latifa , Al Jumah Mohammed , Al Khathaami Ali M. , Ashina Messoud , Braschinsky Mark , Broner Susan , Eliasson Jon H. , Gil-Gouveia Raquel , Gómez-Galván Juan B. , Gudmundsson Larus S. , Herekar Akbar A. , Kawatu Nfwama , Kissani Najib , Kulkarni Girish Baburao , Lebedeva Elena R. , Leonardi Matilde , Linde Mattias , Luvsannorov Otgonbayar , Maiga Youssoufa , Milanov Ivan , Mitsikostas Dimos D. , Musayev Teymur , Olesen Jes , Osipova Vera , Paemeleire Koen , Peres Mario F. P. , Quispe Guiovanna , Rao Girish N. , Risal Ajay , de la Torre Elena Ruiz , Saylor Deanna , Togha Mansoureh , Yu Sheng-Yuan , Zebenigus Mehila , Zewde Yared Zenebe , Zidverc-Trajković Jasna , Tinelli Michela ,   on behalf of Lifting The Burden: the Global Campaign against Headache
Published: July 2021

AbstractIn countries where headache services exist at all, their focus is usually on specialist (tertiary) care. This is clinically and economically inappropriate: most headache disorders can effectively and more efficiently (and at lower cost) be treated in educationally supported primary care. At the same time, compartmentalizing divisions between primary, secondary and tertiary care in many health-care systems create multiple inefficiencies, confronting patients attempting to navigate these levels (the “patient journey”) with perplexing obstacles.High demand for headache care, estimated here in a needs-assessment exercise, is the biggest of the challenges to reform. It is also the principal reason why reform is necessary.The structured headache services model presented here by experts from all world regions on behalf of the Global Campaign against Headache is the suggested health-care solution to headache. It develops and refines previous proposals, responding to the challenge of high demand by basing headache services in primary care, with two supporting arguments. First, only primary care can deliver headache services equitably to the large numbers of people needing it. Second, with educational supports, they can do so effectively to most of these people. The model calls for vertical integration between care levels (primary, secondary and tertiary), and protection of the more advanced levels for the minority of patients who need them. At the same time, it is amenable to horizontal integration with other care services. It is adaptable according to the broader national or regional health services in which headache services should be embedded.It is, according to evidence and argument presented, an efficient and cost-effective model, but these are claims to be tested in formal economic analyses.
Eculizumab in gemcitabine-induced thrombotic microangiopathy: experience of the French thrombotic microangiopathies reference centre
Authors: Grall Maximilien , Daviet Florence , Chiche Noémie Jourde , Provot François , Presne Claire , Coindre Jean-Philippe , Pouteil-Noble Claire , Karras Alexandre , Guerrot Dominique , François Arnaud , Benhamou Ygal , Veyradier Agnès , Frémeaux-Bacchi Véronique , Coppo Paul , Grangé Steven 
Published: July 2021

Abstract
Background
Gemcitabine is a broadly prescribed chemotherapy, the use of which can be limited by renal adverse events, including thrombotic microangiopathy (TMA).

Methods
This study evaluated the efficacy of eculizumab, a monoclonal antibody targeting the terminal complement pathway, in patients with gemcitabine-induced TMA (G-TMA). We conducted an observational, retrospective, multicenter study in 5 French centres, between 2011 and 2016.

Results
Twelve patients with a G-TMA treated by eculizumab were included. The main characteristics were acute renal failure (100%), including stage 3 acute kidney injury (AKI, 58%) and renal replacement therapy (17%), hypertension (92%) and diffuse oedema (83%). Eculizumab was started after a median of 15 days (range 4–44) following TMA diagnosis. A median of 4 injections of eculizumab was performed (range 2–22). Complete hematological remission was achieved in 10 patients (83%) and blood transfusion significantly decreased after only one injection of eculizumab (median of 3 packed red blood cells (range 0–10) before treatment vs 0 (range 0–1) after one injection, P < 0.001). Two patients recovered completely renal function (17%), and 8 achieved a partial remission (67%). Compared to a control group of G-TMA without use of eculizumab, renal outcome was more favourable. At the end of the follow up, median eGFR was 45 vs 33 ml/min/1.73m2 respectively in the eculizumab group and in the control group.

Conclusions
These results suggest that eculizumab is efficient on haemolysis and reduces transfusion requirement in G-TMA. Moreover, eculizumab may improve renal function recovery.
An integrated primary care workforce planning toolkit at the regional level (part 2): quantitative tools compiled for decision-makers in Toronto, Canada
Authors: Simkin Sarah , Chamberland-Rowe Caroline , Bourgeault Ivy Lynn 
Published: July 2021

Abstract
Background
Health workforce planning capability at a regional level is increasingly necessary to ensure that the healthcare needs of defined local populations can be met by the health workforce. In 2016, a regional health authority in Toronto, Canada, identified a need for more robust health workforce planning infrastructure and processes. The goal of this project was to develop an evidence-informed toolkit for integrated, multi-professional, needs-based primary care workforce planning for the region. This article presents the quantitative component of the workforce planning toolkit and describes the process followed to develop this tool.

Methods
We conducted an environmental scan to identify datasets addressing population health need and profession-specific health workforce supply that could contribute to quantitative health workforce modelling. We assessed these sources of data for comprehensiveness, quality, and availability. We also developed a quantitative health workforce planning model to assess the alignment of regional service requirements with the service capacity of the workforce.

Results
The quantitative model developed as part of the toolkit includes components relating to both population health need and health workforce supply. Different modules were developed to capture the information and address local issues impacting delivery and planning of primary care health services in Toronto.

Conclusions
A quantitative health workforce planning model is a necessary component of any health workforce planning toolkit. In combination with qualitative tools, it supports integrated, multi-professional, needs-based primary care workforce planning. This type of planning presents an opportunity to address inequities in access and outcome for regional populations.