bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary mediastinal germ cell tumors ‐ A retrospective analysis of >30 years of experience in a single institution
Authors: Koizumi Tomonobu , Kanda Shintaro , Nihonmatu Ryo , Gomi Daisuke , Sekiguchi Nodoka , Noguchi Takuro , Fukushima Toshirou , Kobayashi Takashi , Yamamoto Hiroshi , Takeda Tetsu 
Published: January 2021

AbstractBackgroundThis study was performed to clarify the treatment outcome of patients with primary mediastinal germ cell tumors (PMGCTs), focusing on the clinical manifestations and management during definitive therapy and long‐term follow‐up.MethodsIn this study, we retrospectively reviewed the medical records of patients with PMGCTs treated at Shinshu University School of Medicine, and examined the clinical profiles and treatment outcomes of 22 patients (mean age of 29 years) with primary mediastinal GCTs treated at our hospital between 1983 and 2019.ResultsFive patients were diagnosed with pure seminoma and 17 had nonseminomatous GCT. A total of 21 patients were treated with cisplatin‐based chemotherapy and 15 patients (68.2%) underwent thoracic surgery after chemotherapy. Although all cases of nonseminomatous GCT were negative for tumor markers after cisplatin‐based chemotherapy, two cases showed variable GCT cells and two had somatic components (angiosarcoma and rhabdomyosarcoma) in resected specimens. Three relapsed soon after surgery. Growing teratoma syndrome developed during chemotherapy in four cases. Urgent thoracic surgery was performed in three patients, but one case was inoperable. The calculated 10‐year overall survival rates were 100% in mediastinal seminoma and 64.7% in NSGCT. During follow‐up, second non‐GCT malignancies developed in three patients (colon cancer, 190 months; thyroid cancer, 260 months; non‐small cell lung cancer, 250 months after the initial chemotherapy) and one patient with primary mediastinal seminoma was associated with multiple type I endocrine tumors.ConclusionsOur experiences demonstrated that long‐term survival and/or cure can be achieved with adequate chemotherapy followed by local surgical treatment even in patients with mediastinal GCTs. However, the clinical manifestations and biological behaviors during and/or after chemotherapy were complex and varied. In addition, the development of secondary malignancies should be taken into consideration for long‐term follow‐up. Clinicians should be aware of the various clinical features and secondary malignancies in primary mediastinal GCTs.
A visualisation approach for pitching research
Authors: Faff Robert W. , Kernbach Sebastian 
Published: January 2021

AbstractBased on a simple template tool, Faff’s ‘pitching’ framework provides a succinct and methodical approach to conveying a new research proposal to an academic expert. Some potential users are discouraged by a mistaken belief that it is just a ‘form‐filling’ exercise. We argue that one fruitful way to make the proposed ‘pitching’ process more inviting, support researchers' thinking process and enable a fruitful communication with others is to invoke a visualisation strategy. Accordingly, we propose a visualisation enhancement through visual templates with a particular focus on a ‘canvas’ technique – which we label the ‘Pitching Research Canvas’.
Trajectories of suicidal ideation after first‐episode psychosis: a growth mixture modeling approach
Authors: Salagre Estela , Grande Iria , Jiménez Esther , Mezquida Gisela , Cuesta Manuel J. , Llorente Cloe , Amoretti Sílvia , Lobo Antonio , González‐Pinto Ana , Carballo Juan José , Corripio Iluminada , Verdolini Norma , Castro‐Fornieles Josefina , Legido Teresa , Carvalho Andre F. , Vieta Eduard , Bernardo Miquel ,   PEPs Group
Published: January 2021

AbstractObjectiveThe period immediately after the onset of first‐episode psychosis (FEP) may present with high risk for suicidal ideation (SI) and attempts, although this risk may differ among patients. Thus, we aimed to identify trajectories of SI in a 2‐years follow‐up FEP cohort and to assess baseline predictors and clinical/functional evolution for each trajectory of SI.MethodsWe included 334 FEP participants with data on SI. Growth mixture modeling was used to identify trajectories of SI. Putative sociodemographic, clinical, and cognitive predictors of the distinct trajectories were examined using multinomial logistic regression.ResultsWe identified three distinct trajectories:Non‐SItrajectory (85.53% sample),Improving SItrajectory (9.58%), andWorsening SItrajectory (6.89%). Multinomial logistic regression model revealed that greater baseline pessimistic thoughts, anhedonia, and worse perceived family environment were associated with higher baseline SI followed by anImprovingtrajectory. Older age, longer duration of untreated psychosis, and reduced sleep predictedWorsening SItrajectory. Regarding clinical/functional evolution, individuals within theImproving SItrajectory displayed moderate depression at baseline which ameliorated during the study period, while theWorsening SIsubgroup exhibited persistent mild depressive symptoms and greater functional impairment at follow‐up assessments.ConclusionOur findings delineated three distinct trajectories of SI among participants with FEP, one experiencing no SI, another in which SI might depend on acute depressive symptomatology, and a last subset where SI might be associated with mild but persistent clinical and functional impairments. These data provide insights for the early identification and tailored treatment of suicide in this at‐risk population.
An evaluation of the variation and underuse of clozapine in the United Kingdom
Authors: Whiskey Eromona , Barnard Alex , Oloyede Ebenezer , Dzahini Olubanke , Taylor David M. , Shergill Sukhwinder S. 
Published: January 2021

AbstractBackgroundClozapine is the only licensed treatment for treatment refractory schizophrenia. Despite this, it remains grossly underused relative to the prevalence of refractory schizophrenia. The extent of underuse and the degree of regional variation in prescribing in the United Kingdom is unknown. It is also unclear, how the UK compares with other European countries in rates of clozapine prescribing.MethodsWe obtained data relating to all clozapine prescribing in the UK from the relevant clozapine registries. We examined regional variation in clozapine use across England, corrected for the known prevalence of severe mental illness (SMI). We also compared the UK rate of clozapine use per 100,000 population to that described in other European countries.FindingsThere is substantial variation in clozapine prescribing across different regions of England and only about a third of potentially eligible patients were prescribed the drug in the UK. Clozapine prescribing rate in the UK was lower than in several European countries.InterpretationThere is clear regional inequity in access to the most effective treatment in refractory schizophrenia in England. Strategies to increase clozapine use, by overcoming both real and perceived barriers, are urgently necessary to reduce treatment inequity for patients with refractory schizophrenia.
Accidental injury, self‐injury, and assault among children of women with schizophrenia: a population‐based cohort study
Authors: Taylor Clare L. , Brown Hilary K. , Saunders Natasha R. , Barker Lucy C. , Chen Simon , Cohen Eyal , Dennis Cindy‐Lee , Ray Joel G. , Vigod Simone N. 
Published: January 2021

AbstractObjectiveWe aimed to compare the risk for injury overall and by intent (accidental injury, self‐injury, and assault) among children born to women with versus without schizophrenia.MethodsUsing health administrative data from Ontario, Canada, children born from 2003 to 2017 to mothers with (n = 3769) and without (n = 1,830,054) schizophrenia diagnosed prior to their birth were compared on their risk for child injury, captured via emergency department, hospitalization, and vital statistics databases up to age 15 years. Cox proportional hazard models generated hazard ratios for time to first injury event (overall and by intent), adjusted for potential confounders (aHR). We stratified by child sex and age at follow‐up: 0–1 (infancy), 2–5 (pre‐school), 6–9 (primary school), and 10–15 (early adolescence) planning to collapse age categories as needed to obtain stable and reportable estimates.ResultsMaternal schizophrenia was associated with elevated risk for child injury overall (105.4 vs. 89.4/1000 person‐years (py), aHR 1.08, 95% CI 1.03–1.14), accidental injury (104.7 vs. 88.1/1000py, 1.08, 1.03–1.14), for self‐injury (0.4 vs. 0.2/1000py, 2.14 1.18–3.85), and assault (1.0 vs. 0.3/1000py, 2.29, 1.45–3.62). By child sex, point estimates were of similar magnitude and direction, though not all remained statistically significant. For accidental injury and self‐injury, the risk associated with maternal schizophrenia was most elevated in 10–15‐year‐olds. For assault, the risk associated with maternal schizophrenia was most elevated among children in the 0–1 and 2–5‐year‐old age groups.ConclusionThe elevated risk of child injury associated with maternal schizophrenia, especially for self‐injury and assault, suggests that targeted monitoring and preventive interventions are warranted.
Concerns regarding the use of the vulnerability concept in research on people with intellectual disability
Authors: Snipstad Øyvind Ibrahim Marøy 
Published: January 2021

Accessible Summary

People with intellectual disability are often described as “vulnerable” or a “vulnerable group.”

The paper focuses on vulnerability as part of an ethical discussion in research.

The paper says that people with intellectual disability are not necessarily more vulnerable than others in all areas of life but, like everyone else, experience many social contexts that may or may not place them in vulnerable positions.

The paper is concerned with how the negative attributes often related to the label intellectual disability and vulnerability affect the decisions and views of researchers.

AbstractBackgroundPeople with intellectual disability are often defined as a vulnerable group. The feminist philosopher Jackie Scully argues that vulnerability is often associated with qualities such as immaturity, helplessness, victimhood, passivity and so forth. As research is a social activity, the qualities associated with vulnerability affect researchers’ decisions about who to include and exclude from their research project as well as influencing their interpretations of the research participants’ answers, behaviour and actions. This may result in excluding people with intellectual disability from research or that their ways of being becomes interpreted as mere symptoms of their diagnosis rather than subjective opinions and experiences.ConclusionBy addressing these issues through the work of Norwegian philosopher Hans Skjervheim, this paper contests traditional interpretations of vulnerability and instead argues that vulnerability should be related more specifically to each individual research project and prompt questions such as: How do we protect these particular participants from harm?
Anti‐renal interstitial fibrosis effect of norcantharidin is exerted through inhibition of PP2Ac‐mediated C‐terminal phosphorylation of Smad3
Authors: Luo Han‐wen , Yin Dan‐dan , Xiao Zheng , Wen Lu , Liao Ying‐jun , Tang Cheng‐yuan , Zeng Dong , Xiao Heng‐ting , Li Ying 
Published: January 2021

AbstractNorcantharidin (NCTD), the demethylated analog of cantharidin isolated from Mylabris, is known to inhibit renal fibrosis. However, the underlying mechanism is largely unknown. The present study investigates whether NCTD exerts this effect through regulation of the protein phosphatase 2A catalytic subunit (PP2Ac)‒Smad3 pathway. HK‐2 human renal proximal tubule cells exposed to transforming growth factor (TGF)‐β1 were used as an in vitro model of renal fibrosis. The levels of total Smad3, C‐terminal‐phosphorylated Smad3 (p‐Smad3), PP2Ac, and fibronectin (Fn) were evaluated by Western blotting. A PP2Ac overexpression plasmid and the PP2Ac inhibitor okadaic acid (OA) were used for functional analyses. The subcellular localization of Smad3 was visualized by immunofluorescence labeling. The results showed that PP2Ac overexpression increased Smad3 phosphorylation and nuclear translocation in HK‐2 cells, while pharmacologic inhibition of PP2Ac with OA had the opposite effect. NCTD suppressed Fn and p‐Smad3 expression and TGF‐β1‐induced nuclear entry of Smad3, but these effects were abrogated by inhibition of PP2Ac. Thus, the anti‐renal interstitial fibrosis effect of NCTD is exerted through inhibition of PP2Ac‐mediated C‐terminal phosphorylation of Smad3. These findings highlight the therapeutic potential of NCTD for the treatment of renal interstitial fibrosis.
US farm support under a Biden administration: Plus ça change, plus c'est la même chose?
Authors: Glauber Joseph W. , Smith Vincent H. 
Published: January 2021

AbstractDuring the Trump administration, there has been an unprecedented increase in the level of domestic support provided to US agricultural producers. Direct farm supports, including price and income support payments, federal crop insurance, and supplemental assistance to compensate losses due to the trade war with China and the pandemic, have accounted for more than one‐third of net farm income. Those payments have threatened to push the United States over its World Trade Organization (WTO) domestic support obligations and increased its vulnerability to potential dispute settlement challenges in the WTO. The incoming Biden administration will likely bring a new focus to repurpose farm subsidies to provide environmental benefits, such as reduced greenhouse gas emissions, but to achieve those reforms they will need to convince a US Congress that has historically been prone to maintaining the status quo.
Role of international politics on agri‐food trade: Evidence from US–Canada bilateral relations
Authors: Afesorgbor Sylvanus Kwaku , Beaulieu Eugene 
Published: January 2021

AbstractA well‐functioning trade relationship between Canada and the United States is crucial to the economic vitality of the Canadian agri‐food industry. However, agri‐food trade is more susceptible than other sectors to political interventions. The Trump presidency has strained Canada–US relations and his trade policy actions have significantly increased trade restrictions and trade policy uncertainty and undermined the rules‐based global trading system. We examine the pattern of agri‐food trade between the two countries and find that the upward trajectory of bilateral agri‐food trade ended in 2013. Although this flatlining predates the Trump administration, we show that Trump increased trade policy uncertainty starting in 2017 and likely impacted further expansion of trade. We examine what might change under the Biden presidency and argue that the new administration is likely to restore strong relationships with allies and work to rebuild important international institutions such as the World Trade Organization (WTO). Although protectionist forces will continue to impact bilateral agri‐food trade, we expect closer political ties between a Biden administration and the Canadian Prime Minister. This should have a positive effect on the Canadian agri‐food industry by reducing trade uncertainties, thereby increasing agri‐food trade between Canada and the United States.
Retrospective long‐term clinical evaluation of implant‐prosthetic rehabilitations after head and neck cancer therapy
Authors: Pieralli Stefano , Spies Benedikt Christopher , Schweppe Felix , Preissner Saskia , Nelson Katja , Heiland Max , Nahles Susanne 
Published: January 2021

AbstractObjectiveTo assess clinical and patient‐reported outcomes of implant‐prosthetic rehabilitations in patients with a history of head–neck cancer (HNC), treated with tumor resection without (TR) or with adjuvant radiotherapy (TR/RT). A healthy cohort rehabilitated with the same reconstructive protocols served as control group (C).Materials and MethodsA total of 28 women and 29 men were considered in the present retrospective study. Participants received 322 implants, finally supporting 79 prosthetic reconstructions. Primary outcome was the assessment of implant and prosthetic survival rates. Furthermore peri‐implant soft tissue parameters (attached peri‐implant mucosa, AM; modified bleeding and plaque indices, mBI/mPI; probing depth, PD) and prosthetic technical complications were documented. Patient‐reported outcome measures (PROMs) by means of visual analog scales (VAS) and the Oral Health Impact Profile German 14 form (OHIP G14) were collected. For statistical purposes Chi‐square and Mann–Whitney‐U‐Test were adapted.ResultsAfter a mean follow‐up of 81.2 ± 50.3 months, implant survival rate was 98.1% (HNC‐TR), 98.2% (HNC‐TR/RT) and 100.0% (C), respectively (four implants failed in the HNC groups). HNC‐TR/RT showed significant higher mPI and mBI compared to C. Within HNC‐TR/RT, vestibuloplasty significantly reduced mBI and PD values. No failures occurred at the prosthetic level. Overall, higher VAS scores were reported for bar‐ compared with Locator‐retained prostheses. Furthermore, increased OHIP G14 values resulted for HNC‐TR/RT.ConclusionsHigh survival rates on implant and prosthetic level were observed. The use of soft tissue grafts resulted in stabilization of the peri‐implant mucosa in irradiated patients. In terms of retention and chewing ability, participants preferred bars over Locator attachments.
Usefulness of an artificial intelligence system for the detection of esophageal squamous cell carcinoma evaluated with videos simulating overlooking situation
Authors: Waki Kotaro , Ishihara Ryu , Kato Yusuke , Shoji Ayaka , Inoue Takahiro , Matsueda Katsunori , Miyake Muneaki , Shimamoto Yusaku , Fukuda Hiromu , Matsuura Noriko , Ono Yoichiro , Yao Kenshi , Hashimoto Satoru , Terai Shuji , Ohmori Masayasu , Tanaka Kyosuke , Kato Motohiko , Shono Takashi , Miyamoto Hideaki , Tanaka Yasuhito , Tada Tomohiro 
Published: January 2021

ObjectivesArtificial intelligence (AI) systems have shown favorable performance in the detection of esophageal squamous cell carcinoma (ESCC). However, previous studies were limited by the quality of their validation methods. In this study, we evaluated the performance of an AI system with videos simulating situations in which ESCC has been overlooked.MethodsWe used 17,336 images from 1376 superficial ESCCs and 1461 images from 196 noncancerous and normal esophagi to construct the AI system. To record validation videos, the endoscope was passed through the esophagus at a constant speed without focusing on the lesion to simulate situations in which ESCC has been missed. Validation videos were evaluated by the AI system and 21 endoscopists.ResultsWe prepared 100 video datasets, including 50 superficial ESCCs, 22 noncancerous lesions, and 28 normal esophagi. The AI system had sensitivity of 85.7% (54 of 63 ESCCs) and specificity of 40%. Initial evaluation by endoscopists conducted with plain video (without AI support) had average sensitivity of 75.0% (47.3 of 63 ESCC) and specificity of 91.4%. Subsequent evaluation by endoscopists was conducted with AI assistance, which improved their sensitivity to 77.7% (P = 0.00696) without changing their specificity (91.6%, P = 0.756).ConclusionsOur AI system had high sensitivity for the detection of ESCC. As a support tool, the system has the potential to enhance detection of ESCC without reducing specificity. (UMIN000039645)
Comparable COVID‐19 outcomes with current use of GLP‐1 receptor agonists, DPP‐4 inhibitors or SGLT‐2 inhibitors among patients with diabetes who tested positive for SARS‐CoV‐2
Authors: Israelsen Simone Bastrup , Pottegård Anton , Sandholdt Håkon , Madsbad Sten , Thomsen Reimar Wernich , Benfield Thomas 
Published: January 2021

AbstractIncretin‐based therapies, glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) and dipeptidyl peptidase‐4 inhibitors (DPP‐4i), have been hypothesized to exert beneficial effects on COVID‐19 outcomes due to anti‐inflammatory properties. In this population‐based cohort study, we retrieved data from nationwide registries on all individuals diagnosed with severe acute respiratory syndrome coronavirus 2 infection up to 1 November 2020. For individuals with diabetes, we examined the impact of use of GLP‐1 RAs (n = 370) and DPP‐4i (n = 284) compared with sodium‐glucose cotransporter‐2 inhibitors (SGLT‐2i) (n = 342) on risk of hospital admission and severe outcomes. Relative risks (RRs) were calculated after applying propensity score weighted methods to control for confounding. Current users of GLP‐1 RAs had an adjusted RR of 0.89 (95% confidence interval 0.34‐2.33), while users of DPP‐4i had an adjusted RR of 2.42 (95% confidence interval 0.99‐5.89) for 30‐day mortality compared with SGLT‐2i use. Further, use of GLP‐1 RAs or DPP‐4i compared with SGLT‐2i was not associated with decreased risk of hospital admission. Thus, use of incretin‐based therapies in individuals with diabetes and severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) was not associated with improved clinical outcomes.
Cardiovascular safety of evogliptin in patients with type 2 diabetes: A nationwide cohort study
Authors: Park So‐Hee , Jeong Han Eol , Oh In‐Sun , Hong Sang‐Mo , Yu Sung Hoon , Lee Chang Beom , Shin Ju‐Young 
Published: January 2021

AbstractAimTo assess whether the use of evogliptin, a novel dipeptidyl peptidase‐4 inhibitor (DPP‐4i), was associated with an increased risk of cardiovascular events compared with glimepiride in patients with type 2 diabetes (T2D).MethodsWe conducted a population‐based cohort study using South Korea's nationwide healthcare database from 1 January 2014 to 31 December 2018. We identified a base cohort of patients with T2D who newly initiated metformin monotherapy, from which we identified a study cohort of patients who either added or switched to glimepiride or DPP‐4is (including evogliptin). Patients were followed up from initiation of DPP‐4is or glimepiride until the earliest of either outcome occurrence or 31 December 2018. Our primary outcome was hospitalization or an emergency visit for cardiovascular events, a composite endpoint comprised of cerebrovascular events, heart failure, myocardial infarction, transient ischaemic attack, angina pectoris and revascularization procedures; secondary outcomes were the individual components of the primary outcome. A multivariable Cox proportional hazards model was used to estimate adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) for the risk of study outcomes associated with evogliptin compared with glimepiride.ResultsOur base and study cohorts had 317,307 and 128,788 patients, respectively, of which 100,038 were DPP‐4i users (2946 were evogliptin users) and 28,750 were glimepiride users within the study cohort. The median follow‐up was 195 days for evogliptin and 113 days for glimepiride users. Compared with glimepiride, evogliptin was associated with a reduced risk of the primary outcome (aHR 0.67, 95% CI 0.48–0.95) and cerebrovascular events (aHR 0.41, 95% CI 0.22–0.78) but showed non‐significant associations for myocardial infarction (aHR 0.63, 95% CI 0.27–1.46), heart failure (aHR 0.35, 95% CI 0.09–1.47), transient ischaemic attack (aHR 0.23, 95% CI 0.03–1.72) and angina pectoris (aHR 1.35, 95% CI 0.82–2.21).ConclusionsFindings from this population‐based cohort study provide novel real‐world evidence that the use of evogliptin, compared with glimepiride, did not increase the risk of cardiovascular events, including cerebrovascular events, myocardial infarction, heart failure, transient ischaemic attack and angina pectoris.