bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optic disc and peripapillary vessel density measured with optical coherence tomography angiography and its associations in Chinese adults: a large population-based study
Authors: Zhu Ming Ming , Choy Bonnie N K , You Qi Sheng , Chan Jonathan Cheuk Hung , Ng Alex L K , Shih Kendrick , Cheung Janice Jing Chee , Wong Jasper Ka Wai , Shum Jennifer , Ni Michael Y , Lai Jimmy Shiu-Ming , Leung Gabriel M , Wong Ian Y 
Published: May 2021

PurposeTo investigate the optic disc and peripapillary vessel density, as well as its ocular and systemic associations, in healthy eyes among adult Chinese population.MethodsA population-based cross-sectional eye survey was conducted on Chinese adults residing in Hong Kong. 1891 eyes from 1891 participants who completed 4.5×4.5 mm optical coherence tomography angiography scans were recruited. Among the 1891 eyes, 404 were excluded due to low scan quality, optic disc or retinal disorders and non-Chinese ethnicity. The vessel densities (VDs) at nerve fibre layer plexus (NFLP) at both optic disc and peripapillary were collected for analysis. Multiple linear regression analysis was performed to determine the ocular and systemic associations of NFLP VD.ResultsThe study included 1487 participants (men: 41.2%) with a mean age of 48.8±15.4 years. The mean NFLP VD of the whole en face image, inside disc and peripapillary region was 53.8%, 42.7% and 60.3%, respectively. In the multivariable model, decreased NFLP VDs were significantly associated with older age, male gender, longer axial length (AL) and lower Signal Strength Index.ConclusionsThis large population-based cross-sectional study provided quantitative data of optic disc and peripapillary NFLP VD which may serve as a normative reference for clinical use. Apart from age, gender and AL, the scan signal strength also should be taken into consideration during the assessment of NFLP VD.
A scoping review of paediatric latent tuberculosis infection care cascades: initial steps are lacking
Authors: Campbell Jeffrey I , Sandora Thomas J , Haberer Jessica E 
Published: May 2021

Background and objectivesIdentifying and treating children with latent tuberculosis infection (TB infection) is critical to prevent progression to TB disease and to eliminate TB globally. Diagnosis and treatment of TB infection requires completion of a sequence of steps, collectively termed the TB infection care cascade. There has been no systematic attempt to comprehensively summarise literature on the paediatric TB infection care cascade.MethodsWe performed a scoping review of the paediatric TB infection care cascade. We systematically searched PubMed, Cumulative Index to Nursing and Allied Health Literature, Cochrane and Embase databases. We reviewed articles and meeting abstracts that included children and adolescents ≤21 years old who were screened for or diagnosed with TB infection, and which described completion of at least one step of the cascade. We synthesised studies to identify facilitators and barriers to retention, interventions to mitigate attrition and knowledge gaps.ResultsWe identified 146 studies examining steps in the paediatric TB infection care cascade; 31 included children living in low-income and middle-income countries. Most literature described the final cascade step (treatment initiation to completion). Studies identified an array of patient and caregiver-related factors associated with completion of cascade steps. Few health systems factors were evaluated as potential predictors of completion, and few interventions to improve retention were specifically tested.ConclusionsWe identified strengths and gaps in the literature describing the paediatric TB infection care cascade. Future research should examine cascade steps upstream of treatment initiation and focus on identification and testing of at-risk paediatric patients. Additionally, future studies should focus on modifiable health systems factors associated with attrition and may benefit from use of behavioural theory and implementation science methods to improve retention.
The RATIONS (Reducing Activation of Tuberculosis by Improvement of Nutritional Status) study: a cluster randomised trial of nutritional support (food rations) to reduce TB incidence in household contacts of patients with microbiologically confirmed pulmonary tuberculosis in communities with a high prevalence of undernutrition, Jharkhand, India
Authors: Bhargava Anurag , Bhargava Madhavi , Velayutham Banurekha , Thiruvengadam Kannan , Watson Basilea , Kulkarni Bharati , Singh Manjula , Dayal Rakesh , Pathak Rajeev Ranjan , Mitra Anindya , Rade Kiran , Sachdeva KS 
Published: May 2021

IntroductionIndia has the largest burden of cases and deaths related to tuberculosis (TB). Undernutrition is the leading risk factor accounting for TB incidence, while severe undernutrition is a common risk factor for mortality in patients with TB in India. The impact of nutritional supplementation on TB incidence is unknown, while few underpowered studies have assessed its impact on TB mortality. We designed an open-label, field-based cluster randomised trial to assess the impact of nutritional supplementation (with food rations) on TB incidence in a group at higher risk of TB infection and disease, viz household contacts (HHC) of patients with microbiologically confirmed pulmonary TB (PTB) in Jharkhand, a state with a high prevalence of undernutrition.Methods and analysisWe shall enrol 2800 adult patients with PTB of the national TB programme, across 28 treatment units in 4 districts, and their approximately 11 200 eligible contacts. The sample size has 80% power to detect the primary outcome of 50% reduction in incidence of active TB in HHC over 2 years of follow-up. Patients and HHC in both the arms will undergo nutritional assessment and counselling. Patients will receive monthly food rations (supplying 1200 kcal and 52 g proteins/day) and multivitamins along with antitubercular treatment. The HHC in the intervention arm will receive food rations (supplying 750 kcal and 23 g proteins/day) and multivitamins while HHC in control arm will be on usual diet. The secondary outcomes in HHC will include effects on nutritional status, non-TB infections. Secondary outcomes in patients are effects on TB mortality, adherence, adverse effects, nutritional and performance status. Substudies will examine micronutrient status and effects on dietary intake, body composition, muscle strength and immune function.Ethics and disseminationThe institutional ethics committee of ICMR-NIRT, Chennai, approved the study (289/NIRT-IEC/2018). The results will be disseminated in publications and presentations.Trial registration numberClinical Trial Registry of India: CTRI/2019/08/020490.
Application of a risk stratification tool for familial hypercholesterolaemia in primary care: an observational cross-sectional study in an unselected urban population
Authors: Carvalho Chris , Williams Crystal , Raisi-Estabragh Zahra , Rison Stuart , Patel Riyaz S , Timmis Adam , Robson John 
Published: May 2021

ObjectiveThe Familial Hypercholesterolaemia Case Ascertainment Tool (FAMCAT) has been proposed to enhance case finding in primary care. In this study, we test application of the FAMCAT algorithm to describe risks of familial hypercholesterolaemia (FH) in a large unselected and ethnically diverse primary care cohort.MethodWe studied patients aged 18–65 years from three contiguous areas in inner London. We retrospectively applied the FAMCAT algorithm to routine primary care data and estimated the numbers of possible cases of FH and the potential service implications of subsequent investigation and management.ResultsOf the 777 128 patients studied, the FAMCAT score estimated between 11 736 and 23 798 (1.5%–3.1%) individuals were likely to have FH, depending on an assumed FH prevalence of 1 in 250 or 1 in 500, respectively. There was over-representation of individuals of South Asian ethnicity among those likely to have FH, with this cohort making up 41.9%–45.1% of the total estimated cases, a proportion which significantly exceeded their 26% representation in the study population.ConclusionsWe have demonstrated feasibility of application of the FAMCAT as an aid to case finding for FH using routinely recorded primary care data. Further research is needed on validity of the tool in different ethnic groups and more refined consideration of family history should be explored. While FAMCAT may aid case finding, implementation requires information on the cost-effectiveness of additional health services to investigate, diagnose and manage case ascertainment in those identified as likely to have FH.
Modulation of lactate-lysosome axis in dendritic cells by clotrimazole potentiates antitumor immunity
Authors: Wang Zining , Xu Feifei , Hu Jie , Zhang Hongxia , Cui Lei , Lu Wenhua , He Wenzhuo , Wang Xiaojuan , Li Mengyun , Zhang Huanling , Xiong Wenjing , Xie Chunyuan , Liu Yongxiang , Zhou Penghui , Liu Jinyun , Huang Peng , Qin Xiaofeng Frank , Xia Xiaojun 
Published: May 2021

BackgroundDendritic cells (DCs) play a critical role in antitumor immunity, but the therapeutic efficacy of DC-mediated cancer vaccine remains low, partly due to unsustainable DC function in tumor antigen presentation. Thus, identifying drugs that could enhance DC-based antitumor immunity and uncovering the underlying mechanism may provide new therapeutic options for cancer immunotherapy.MethodsIn vitro antigen presentation assay was used for DC-modulating drug screening. The function of DC and T cells was measured by flow cytometry, ELISA, or qPCR. B16, MC38, CT26 tumor models and C57BL/6, Balb/c, nude, andBatf3−/−mice were used to analyze the in vivo therapy efficacy and impact on tumor immune microenvironment by clotrimazole treatment.ResultsBy screening a group of small molecule inhibitors and the US Food and Drug Administration (FDA)-approved drugs, we identified that clotrimazole, an antifungal drug, could promote DC-mediated antigen presentation and enhance T cell response. Mechanistically, clotrimazole acted on hexokinase 2 to regulate lactate metabolic production and enhanced the lysosome pathway andChopexpression in DCs subsequently induced DC maturation and T cell activation. Importantly, in vivo clotrimazole administration induced intratumor immune infiltration and inhibited tumor growth depending on both DCs and CD8+ T cells and potentiated the antitumor efficacy of anti-PD1 antibody.ConclusionsOur findings showed that clotrimazole could trigger DC activation via the lactate-lysosome axis to promote antigen cross-presentation and could be used as a potential combination therapy approach to improving the therapeutic efficacy of anti-PD1 immunotherapy.
INfluenza Vaccine Indication During therapy with Immune checkpoint inhibitors: a multicenter prospective observational study (INVIDIa-2)
Authors: Bersanelli Melissa , Giannarelli Diana , De Giorgi Ugo , Pignata Sandro , Di Maio Massimo , Clemente Alberto , Verzoni Elena , Giusti Raffaele , Di Napoli Marilena , Aprile Giuseppe , Ermacora Paola , Catino Annamaria , Scotti Vieri , Mazzoni Francesca , Guglielmini Pamela Francesca , Veccia Antonello , Maruzzo Marco , Rossi Ernesto , Grossi Francesco , Casadei Chiara , Ficorella Corrado , Montesarchio Vincenzo , Verderame Francesco , Rizzo Mimma , Guaitoli Giorgia , Fratino Lucia , Accettura Caterina , Mencoboni Manlio , Zustovich Fable , Baldessari Cinzia , Cinieri Saverio , Camerini Andrea , Laera Letizia , Sorarù Mariella , Zucali Paolo Andrea , Guadalupi Valentina , Leonardi Francesco , Tiseo Marcello , Tognetto Michele , Di Costanzo Francesco , Pinto Carmine , Negrini Giorgia , Russo Antonio , Migliorino Maria R , Filetti Marco , Buti Sebastiano 
Published: May 2021

BackgroundUntil now, no robust data supported the efficacy, safety and recommendation for influenza vaccination in patients with cancer receiving immune checkpoint inhibitors (ICIs).MethodsThe prospective multicenter observational INfluenza Vaccine Indication During therapy with Immune checkpoint inhibitors (INVIDIa-2) study investigated the clinical effectiveness of influenza vaccination in patients with advanced cancer receiving ICIs, enrolled in 82 Italian centers from October 2019 to January 2020. The primary endpoint was the time-adjusted incidence of influenza-like illness (ILI) until April 30, 2020. Secondary endpoints regarded ILI severity and vaccine safety.ResultsThe study enrolled 1279 patients; 1188 patients were evaluable for the primary endpoint analysis. Of them, 48.9% (581) received influenza vaccination. The overall ILI incidence was 8.2% (98 patients). Vaccinated patients were significantly more frequently elderly (p<0.0001), males (p=0.004), with poor European Cooperative Oncology Group performance status (p=0.009), affected by lung cancer (p=0.01), and by other non-cancer comorbidities (p<0.0001) when compared with unvaccinated. ILI incidence was not different basing on influenza vaccination: the time-to-ILI was similar in vaccinated and unvaccinated patients (p=0.62). ILI complications were significantly less frequent for patients receiving the vaccination (11.8% vs 38.3% in unvaccinated, p=0.002). ILI-related intravenous therapies were significantly less frequent in vaccinated patients than in unvaccinated (11.8% vs 29.8%, p=0.027). ILI lethality was, respectively, 0% in vaccinated and 4.3% in unvaccinated patients. Vaccine-related adverse events were rare and mild (1.5%, grades 1–2).ConclusionThe INVIDIa-2 study results support a positive recommendation for influenza vaccination in patients with advanced cancer receiving immunotherapy.
Euthanasia in persons with advanced dementia: a dignity-enhancing care approach
Authors: Gómez-Vírseda Carlos , Gastmans Chris 
Published: May 2021

In current Western societies, increasing numbers of people express their desire to choose when to die. Allowing people to choose the moment of their death is an ethical issue that should be embedded in sound clinical and legal frameworks. In the case of persons with dementia, it raises further ethical questions such as: Does the person have the capacity to make the choice? Is the person being coerced? Who should be involved in the decision? Is the person’s suffering untreatable? The use of Advance Euthanasia Directives (AED) is suggested as a way to deal with end-of-life wishes of persons with dementia. However, in the Netherlands—the only country in which this practice is legal—the experiences of patients, doctors, and relatives have been far from satisfactory.Our paper analyses this complex ethical challenge from a Dignity-Enhancing Care approach, starting from the Dutch experiences with AED as a case. We first consider the lived experiences of the different stakeholders, seeking out a dialogical-interpretative understanding of care. We aim to promote human dignity as a normative standard for end-of-life care practices. Three concrete proposals are then presented in which this approach can be operationalised in order to deal respectfully with the end-of-life choices of persons with dementia.
Is HbA1c an ideal biomarker of well-controlled diabetes?
Authors: Kaiafa Georgia , Veneti Stavroula , Polychronopoulos George , Pilalas Dimitrios , Daios Stylianos , Kanellos Ilias , Didangelos Triantafyllos , Pagoni Stamatina , Savopoulos Christos 
Published: May 2021

ABSTRACTHbA1c is a biomarker with a central role in the diagnosis and follow-up of patients with diabetes, although not a perfect one. Common comorbidities encountered in patients with diabetes mellitus, such as renal insufficiency, high output states (iron deficiency anaemia, haemolytic anaemia, haemoglobinopathies and pregnancy) and intake of specific drugs could compromise the sensitivity and specificity of the biomarker. COVID-19 pandemic poses a pressing challenge for the diabetic population, since maintaining optimal blood glucose control is key to reduce morbidity and mortality rates. Alternative methods for diabetes management, such as fructosamine, glycosylated albumin and device-based continuous glucose monitoring, are discussed.
Validation of a machine learning approach to estimate Systemic Lupus Erythematosus Disease Activity Index score categories and application in a real-world dataset
Authors: Alves Pedro , Bandaria Jigar , Leavy Michelle B , Gliklich Benjamin , Boussios Costas , Su Zhaohui , Curhan Gary 
Published: May 2021

ObjectiveUse of the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) in routine clinical practice is inconsistent, and availability of clinician-recorded SLEDAI scores in real-world datasets is limited. This study aimed to validate a machine learning model to estimate SLEDAI score categories using clinical notes and to apply the model to a large, real-world dataset to generate estimated score categories for use in future research studies.MethodsA machine learning model was developed to estimate an individual patient’s SLEDAI score category (no activity, mild activity, moderate activity or high/very high activity) for a specific encounter date using clinical notes. A training cohort of 3504 encounters and a separate validation cohort of 1576 encounters were created from the OM1 SLE Registry. Model performance was assessed using the area under the receiver operating characteristic curve (AUC), calculated using a binarised version of the outcome that sets the positive class to be those records with clinician-recorded SLEDAI scores >5 and the negative class to be records with scores ≤5. Model performance was evaluated by categorising the scores into the four disease activity categories and by calculating the Spearman’s R value and Pearson’s R value.ResultsThe AUC for the two categories was 0.93 for the development cohort and 0.91 for the validation cohort. The model had a Spearman’s R value of 0.7 and a Pearson’s R value of 0.7 when calculated using the four disease activity categories.ConclusionThe model performs well when estimating SLEDAI score categories using unstructured clinical notes.
A mixing coupling scheme for spectra of singly heavy baryons with spin-1 diquarks in P-waves
Authors: Jia Duojie , Pan Ji-Hai , Pang Cheng-Qun 
Published: May 2021

AbstractA new scheme of state classification is proposed and applied to analyze masses of the heavy baryons $$\varOmega _{Q}$$

Ω
Q

, $$\varSigma _{Q}$$

Σ
Q

and $$\varXi _{Q}^{\prime }$$

Ξ

Q

′

in P-waves. The results confirm all excited $$\varOmega _{c}$$

Ω
c

and $$\varOmega _{b}$$

Ω
b

baryons reported recently by LHCb to be bound states of a P-wave ss-diquark and a respective charm or bottom quark, and thereby predict Regge trajectories for more excited $$\varOmega _{c}$$

Ω
c

and $$\varOmega _{b}$$

Ω
b

baryons. We suggest one excited $$J^{P}=5/2^{-}$$

J
P

=
5
/

2
-

$$\varOmega _{b}$$

Ω
b

state to be unseen by LHCb around 6352 MeV, and predict P-wave masses of all spin-partners of the odd-parity baryons $$\varSigma _{c}(2800)/\varXi _{c}^{\prime }(2942)$$

Σ
c

(
2800
)

/

Ξ

c

′

(
2942
)

and $$\varSigma _{b}(6097)$$

Σ
b

(
6097
)

/$$\varXi _{b}^{\prime }(6227)$$

Ξ

b

′

(
6227
)

. A computation is further given in a relativized potential quark models to explain matched values of spin couplings of all considered baryons, by which a scaling law for these spin couplings is discussed.
Development of Care Curves Following the Stage 1 Palliation: A Comparison of Intensive Care Among 5 Centers
Authors: Sperotto Francesca , Davidson Jesse A. , Smith‐Parrish Melissa N. , Elhoff Justin J. , Sinha Anjuli , Blinder Joshua J. , Ehrmann Daniel E. , Marino Bradley S. , Kheir John N. 
Published: May 2021

Background
Comparison of care among centers is currently limited to major end points, such as mortality, length of stay, or complication rates. Creating “care curves” and comparing individual elements of care over time may highlight modifiable differences in intensive care among centers.

Methods and Results

We performed an observational retrospective study at 5 centers in the United States to describe key elements of postoperative care following the stage 1 palliation. A consecutive sample of 502 infants undergoing stage 1 palliation between January 2009 and December 2018 were included. All electronic health record entries relating to mandatory mechanical ventilator rate, opioid administration, and fluid intake/outputs between postoperative days (POD) 0 to 28 were extracted from each institution's data warehouse. During the study period, 502 patients underwent stage 1 palliation among the 5 centers. Patients were weaned to a median mandatory mechanical ventilator rate of 10 breaths/minute by POD 4 at Center 5 but not until POD 7 to 8 at Centers 1 and 2. Opioid administration peaked on POD 2 with extreme variance (median 6.9 versus 1.6 mg/kg per day at Center 3 versus Center 2). Daily fluid balance trends were variable: on POD 3 Center 1 had a median fluid balance of −51 mL/kg per day, ranging between −34 to 19 mL/kg per day among remaining centers. Intercenter differences persist after adjusting for patient and surgical characteristics (
P
<0.001 for each end point).

Conclusions
It is possible to detail and compare individual elements of care over time that represent modifiable differences among centers, which persist even after adjusting for patient factors. Care curves may be used to guide collaborative quality improvement initiatives.
Racial and Ethnic Disparities in Management and Outcomes of Cardiac Arrest Complicating Acute Myocardial Infarction
Authors: Subramaniam Anna V. , Patlolla Sri Harsha , Cheungpasitporn Wisit , Sundaragiri Pranathi R. , Miller P. Elliott , Barsness Gregory W. , Bell Malcolm R. , Holmes David R. , Vallabhajosyula Saraschandra 
Published: May 2021

Background
The role of race and ethnicity in the outcomes of cardiac arrest (CA) complicating acute myocardial infarction (AMI) is incompletely understood.

Methods and Results

This was a retrospective cohort study of adult admissions with AMI‐CA from the National Inpatient Sample (2012–2017). Self‐reported race/ethnicity was classified as White, Black, and others (Hispanic, Asian or Pacific Islander, Native American, Other). Outcomes of interest included in‐hospital mortality, coronary angiography, percutaneous coronary intervention, palliative care consultation, do‐not‐resuscitate status use, hospitalization costs, hospital length of stay, and discharge disposition. Of the 3.5 million admissions with AMI, CA was noted in 182 750 (5.2%), with White, Black, and other races/ethnicities constituting 74.8%, 10.7%, and 14.5%, respectively. Black patients admitted with AMI‐CA were more likely to be female, with more comorbidities, higher rates of non–ST‐segment–elevation myocardial infarction, and higher neurological and renal failure. Admissions of patients of Black and other races/ethnicities underwent coronary angiography (61.9% versus 70.2% versus 73.1%) and percutaneous coronary intervention (44.6% versus 53.0% versus 58.1%) less frequently compared to patients of white race (
p
<0.001). Admissions of patients with AMI‐CA had significantly higher unadjusted mortality (47.4% and 47.4%) as compared with White patients admitted (40.9%). In adjusted analyses, Black race was associated with lower in‐hospital mortality (odds ratio [OR], 0.95; 95% CI, 0.91–0.99;
P
=0.007) whereas other races had higher in‐hospital mortality (OR, 1.11; 95% CI, 1.08–1.15;
P
<0.001) compared with White race. Admissions of Black patients with AMI‐CA had longer length of hospital stay, higher rates of palliative care consultation, less frequent do‐not‐resuscitate status use, and fewer discharges to home (all
P
<0.001).

Conclusions
Racial and ethnic minorities received less frequent guideline‐directed procedures and had higher in‐hospital mortality and worse outcomes in AMI‐CA.