bluuebunny/crossref_metadata_2025_split huggingface dataset:
Definitive radiotherapy for extracranial oligoprogressive metastatic renal cell carcinoma as a strategy to defer systemic therapy escalation
Authors: De Brian , Venkatesan Aradhana M. , Msaouel Pavlos , Ghia Amol J. , Li Jing , Yeboa Debra N. , Nguyen Quynh‐Nhu , Bishop Andrew J. , Jonasch Eric , Shah Amishi Y. , Campbell Matthew T. , Wang Jennifer , Zurita‐Saavedra Amado J. , Karam Jose A. , Wood Christopher G. , Matin Surena F. , Tannir Nizar M. , Tang Chad 
Published: July 2021

ObjectiveTo study whether delivering definitive radiotherapy (RT) to sites of oligoprogression in metastatic renal cell carcinoma (mRCC) enabled deferral of systemic therapy (ST) changes without compromising disease control or survival.Patients and MethodsWe identified patients with mRCC who received RT to three or fewer sites of extracranial progressive disease between 2014 and 2019 at a large tertiary cancer centre. Inclusion criteria were: (1) controlled disease for ≥3 months before oligoprogression, (2) all oligoprogression sites treated with a biologically effective dose of ≥100 Gy, and (3) availability of follow‐up imaging. Time‐to‐event end‐points were calculated from the start of RT.ResultsA total of 72 patients were identified (median follow‐up 22 months, 95% confidence interval [CI] 19–32 months), with oligoprogressive lesions in lung/mediastinum (n = 35), spine (n = 30), and non‐spine bone (n = 5). The most common systemic therapies before oligoprogression were none (n = 33), tyrosine kinase inhibitor (n = 23), and immunotherapy (n = 13). At 1 year, the local control rate was 96% (95% CI 87–99%); progression‐free survival (PFS), 52% (95% CI 40–63%); and overall survival, 91% (95% CI 82–96%). At oligoprogression, ST was escalated (n = 16), maintained (n = 49), or discontinued (n = 7), with corresponding median (95% CI) PFS intervals of 19.7 (8.2–27.2) months, 10.1 (6.9–13.2) months, and 9.8 (2.4–28.9) months, respectively. Of the 49 patients maintained on the same ST at oligoprogression, 21 did not subsequently have ST escalation.ConclusionPatients with oligoprogressive mRCC treated with RT had comparable PFS regardless of ST strategy, suggesting that RT may be a viable approach for delaying ST escalation. Randomised controlled trials comparing treatment of oligoprogression with RT vs ST alone are needed.
Istradefylline, an adenosine A2a receptor antagonist, ameliorates neutrophilic airway inflammation and psoriasis in mice
Authors: Tokano Mieko , Kawano Masaaki , Takagi Rie , Matsushita Sho 
Published: July 2021

AbstractObjectiveExtracellular adenosine is produced from secreted adenosine triphosphate by cluster of differentiation (CD)39 and CD73. Both are critical nucleotide metabolizing enzymes of the adenosine generating pathway and are secreted by neuronal or immune cells. Adenosine plays a role in energy processes, neurotransmission and endogenous regulation of inflammatory responses. Istradefylline is a selective adenosine A2a receptor antagonist used for the treatment of Parkinson's disease. We have reported that adenosine primes hypersecretion of interleukin (IL)‐17A through the adenosine A2a receptor. Istradefylline, as well as an inhibitor of CD39 (ARL67156) and an inhibitor of CD73 (AMP‐CP), suppressed IL‐17A production, and the administration of istradefylline to mice with experimental autoimmune encephalomyelitis led to the marked amelioration of the disease. These previous results suggest that adenosine is an endogenous modulator of neutrophilic inflammation. We investigated the effect of istradefylline, ARL67156 and AMP‐CP on other mouse models of neutrophilic inflammation.MethodsWe tested the effect of istradefylline, ARL67156 and AMP‐CP on ovalbumin‐induced neutrophilic airway inflammation or imiquimod‐induced psoriasis in mice. The two mice models received these drugs orally or percutaneously, respectively. The production of IL‐17A in the lung and ear thickness were used as an index of the effects.ResultsWe show that istradefylline, ARL67156 and AMP‐CP suppressed the ovalbumin‐induced IL‐17A production in the lung and imiquimod‐induced psoriasis.ConclusionThese results show that adenosine‐mediated IL‐17A production plays a role in neutrophilic inflammation models, and furthermore, istradefylline, ARL67156 and AMP‐CP are effective in animal models of neutrophilic inflammation. Some clinical relevancies in coronavirus disease 2019 are discussed.
Timing and localization of myasthenia gravis‐related gene expression
Authors: Vergoossen Dana L. E. , Keo Arlin , Mahfouz Ahmed , Huijbers Maartje G. 
Published: July 2021

AbstractMyasthenia gravis (MG) is an acquired autoimmune disorder caused by autoantibodies binding acetylcholine receptors (AChR), muscle‐specific kinase (MuSK), agrin or low‐density lipoprotein receptor‐related protein 4 (Lrp4). These autoantibodies inhibit neuromuscular transmission by blocking the function of these proteins and thereby cause fluctuating skeletal muscle weakness. Several reports suggest that these autoantibodies might also affect the central nervous system (CNS) in MG patients. A comprehensive overview of the timing and localization of the expression of MG‐related antigens in other organs is currently lacking. To investigate the spatio‐temporal expression of MG‐related genes outside skeletal muscle, we used in silico tools to assess public expression databases. Acetylcholine esterase, nicotinic AChR α1 subunit, agrin, collagen Q, downstream of kinase‐7, Lrp4, MuSK and rapsyn were included as MG‐related genes because of their well‐known involvement in either congenital or autoimmune MG. We investigated expression of MG‐related genes in (1) all human tissues using GTEx data, (2) specific brain regions, (3) neurodevelopmental stages, and (4) cell types using datasets from the Allen Institute for Brain Sciences. MG‐related genes show heterogenous spatio‐temporal expression patterns in the human body as well as in the CNS. For each of these genes, several (new) tissues, brain areas and cortical cell types with (relatively) high expression were identified suggesting a potential role for these genes outside skeletal muscle. The possible presence of MG‐related antigens outside skeletal muscle suggests that autoimmune MG, congenital MG or treatments targeting the same proteins may affect MG‐related protein function in other organs.
Patterns of post‐drought recovery are strongly influenced by drought duration, frequency, post‐drought wetness, and bioclimatic setting
Authors: Jiao Tong , Williams Christopher A. , De Kauwe Martin G. , Schwalm Christopher R. , Medlyn Belinda E. 
Published: July 2021

AbstractUnderstanding vegetation recovery after drought is critical for projecting vegetation dynamics in future climates. From 1997 to 2009, Australia experienced a long‐lasting drought known as the Millennium Drought (MD), which led to widespread reductions in vegetation productivity. However, vegetation recovery post‐drought and its determinants remain unclear. This study leverages remote sensing products from different sources—fraction of absorbed photosynthetically active radiation (FPAR), based on optical data, and canopy density, derived from microwave data—and random forest algorithms to assess drought recovery over Australian natural vegetation during a 20‐year period centered on the MD. Post‐drought recovery was prevalent across the continent, with 6 out of 10 drought events seeing full recovery within about 6 months. Canopy density was slower to recover than leaf area seen in FPAR. The probability of full recovery was most strongly controlled by drought return interval, post‐drought hydrological condition, and drought length. Full recovery was seldom observed when drought events occurred at intervals of 3 months or less, and moderately dry (standardized water balance anomaly [SWBA] within [−1, −0.76]) post‐drought conditions resulted in less complete recovery than wet (SWBA > 0.3) post‐drought conditions. Press droughts, which are long term but not extreme, delayed recovery more than pulse droughts (short term but extreme) and led to a higher frequency of persistent decline. Following press droughts, the frequency of persistent decline differed little among biome types but peaked in semi‐arid regions across aridity levels. Forests and savanna required the longest recovery times for press drought, while grasslands were the slowest to recover for pulse drought. This study provides quantitative thresholds that could be used to improve the modeling of ecosystem dynamics post‐drought.
Agglomeration externalities and the non‐linear performance of environmental regulation: Evidence from China
Authors: Pang Rui , Zheng Dan , Shi Minjun 
Published: July 2021

AbstractThe pollution abatement effect of environmental regulation changes periodically in terms of local economic agglomeration levels, because of agglomeration externalities could influence firms' regulatory response by changing the compliance cost. Based on a panel dataset of 30 provinces in China from 1999 to 2017, this paper engages in threshold model and mediation analysis to examine the thresholds of economic agglomeration for environmental regulation to take effect and the influencing paths of environmental regulation at different agglomeration levels. The economic agglomeration degree is measured by the economic density of the built‐up area. The threshold test recognizes two thresholds of economic density, which are 0.3 CNY billion/km2 and 1.7 CNY/km2. Only when economic density exceeds the thresholds, can environmental regulation significantly reduce industrial emission intensity and emission density, respectively. At the first threshold, environmental regulation takes effect mainly through improving local industrial structure; at the second threshold, environmental regulation takes effect mainly through downsizing the scale of polluting industries. The policy enlightenment provided by this article is to formulate differentiated environmental governance strategies according to local conditions and the characteristics of the development stage of each region.
Does experience matter? The relationship between nephrologist characteristics and end stage kidney disease patient outcomes
Authors: Reule Scott , Foley Robert , Shaughnessy Daniel , Drawz Paul , Ishani Areef , Rosenberg Mark 
Published: July 2021

AbstractBackgroundNephrology offers the unique opportunity to directly link patients to providers, allowing the study of patient outcomes at the provider level. The purpose of this analysis was to determine whether nephrologist experience, defined as years in nephrology practice, was associated with clinical outcomes.DesignPhysician data contained within the American Medical Association (AMA) Physician Masterfile was combined with patient and Medicare claims data from the United States Renal Data System (USRDS) for the calendar year 2012, with follow up extending through June 30, 2014. Associations with important healthcare outcomes including mortality in patients receiving maintenance renal replacement therapy (RRT), waitlisting for kidney transplantation, and receipt of a kidney transplant were determined with broad adjustment for both patient and provider level variables, with attention on tertile of provider time in practice.ResultsWe identified 256,324 patients on maintenance RRT cared for by 6193 nephrologists. Nephrologists with the least experience were more likely to be female, reside in a region with ≥1,000,000 people, have a Doctor of Osteopathic Medicine degree, and have a listed maintenance of certification status as “yes.” Overall, 30.2% of the cohort died at a mean follow up of 1.99 years. Compared to those with the 0–10 years of experience, receipt of care from nephrologists with more experience was associated with lower mortality (AHR 0.97 CI 0.94–0.99 for nephrologists with 11–20 years) and increased listing for kidney transplantation (AHR 1.10; CI 1.01–1.21 for nephrologists with >21 years experience). Experience level did not result in a difference in kidney transplantation rates.ConclusionsReceipt of maintenance RRT from nephrologists with greater experience was associated with decreased mortality and increased listing for kidney transplantation, an effect that remained significant after multiple adjustments for important patient and nephrologist variables.
Stuff you think you can handle as a parent and stuff you can’t’. Understanding parental health‐seeking behaviour when accessing unscheduled care: A qualitative study
Authors: Conlon Ciara , Nicholson Emma , De Brún Aoife , McDonnell Therese , McAuliffe Eilish 
Published: July 2021

AbstractBackgroundUnscheduled health care constitutes a significant proportion of health‐care utilization. Parental decision making when accessing unscheduled care for their children is multifaceted and must be better understood to inform policy and practice.DesignNineteen semi‐structured interviews and one focus group (n = 4) with parents of children younger than twelve in Ireland were conducted. Participants had accessed unscheduled care for their children in the past. Data were thematically analysed.ResultsParents accessed unscheduled care for their children after reaching capacity to manage the child's health themselves. This was informed by factors such as parental experience, perceived urgency and need for reassurance. Parents considered the necessity to access care and situated their health‐seeking behaviour within a framework of ‘appropriateness’. Where parents sought unscheduled care was largely determined by timely access, and inability to secure a general practitioner (GP) appointment often led parents to access other services. Parents expressed a need for more support in navigating unscheduled care options.ConclusionsBetter resources to educate and support parents are required, and structural issues, such as accessibility to GPs, need to be addressed to enable parents to better navigate the unscheduled health system and manage their children's health. The discourse around ‘appropriate’ and ‘inappropriate’ access to health care has permeated parental decision making when accessing unscheduled health care for their children. What constitutes appropriate access should be examined, and a shift away from this framing of health‐seeking behaviour may be warranted.Patient or Public ContributionThere was no explicit patient or public involvement. All authors hold experience as users of the health system.
Effect of CO2 nanobubbles incorporation on the viscosity reduction of fruit juice concentrate and vegetable oil
Authors: Phan Khanh , Truong Tuyen , Wang Yong , Bhandari Bhesh 
Published: July 2021

AbstractViscosity is one of key parameters to handle liquid food during processing and transport. In this work, viscosities of apple juice concentrate (APJC) and canola oil (CANO) injected with CO2 nanobubbles (NBs), having size ranged approximately from 50 to 850 nm, were investigated. A significant (P ≤ 0.05) viscosity reduction was observed by up to 18% and 10% in APJC and CANO, respectively, after the NBs injection. When being stored at ambient (23 °C) and refrigerated (4 °C) temperatures for 7 days, the reduction effect on viscosities of samples treated with NBs tended to diminish in accordance with the growth of NBs’ size and the decrease of dissolved CO2 concentration. Besides, the suspension of CO2 NBs insignificantly affected pH, total soluble solid content of APJC, as well as densities of APJC and CANO. These findings suggested that utilisation of NBs can be a feasible mean to reduce viscosity and enhance processing efficiency of food fluids.
Violation and lack of awareness of employment rights in the United Kingdom's hotel industry: Isolation, fragmentation and barriers to labour enforcement
Authors: Papadopoulos Orestis , Lopez‐Andreu Marti , Jamalian Mandi 
Published: July 2021

AbstractThe article examines the extent of labour violation in the UK hotel industry and identifies the challenges and difficulties that workers face to defend their employment rights. Drawing on interview material and documents, the article identifies the factors that weaken workers' capacities to bring forward complaints and discusses the organisational, institutional and individual factors making silence dominant in the sector. This multifaceted analysis demonstrates different layers of vulnerability that create a very unfavourable environment for the promotion of employment rights in a context of heightened levels of fear. We contribute to the existing studies by demonstrating that for precarious and insecure workers in particular, the UK model of individual employment rights has ‘no substance’. Our findings highlight that it jeopardises not only the enforcement of rights but also workers' ability to acquire comprehensive knowledge and awareness of them.
Identifying suitable benchmarks in the way toward achieving targets using data envelopment analysis
Authors: Ruiz José L. , Sirvent Inmaculada 
Published: July 2021

AbstractIt was earlier claimed by the authors that the data envelopment analysis (DEA) models commonly used only implement objectives concerned with target setting, while peer identification, which is a key issue for the benchmarking, is actually a by‐product. For this reason, they developed some bi‐objective DEA benchmarking models that pay special attention to the selection of benchmarks among peers, in addition to setting the closest targets. Following an analogous approach, we here continue that research and propose new models that provide a response to the question of whom to emulate to achieve the targets that have been set for a given organization. Thus, the proposed approach now aims to relate the setting of targets and the identification of peers, specifically identifying peers that may serve as benchmarks for improving performance in the direction established by the targets set. As a result, the models identify the so‐called leading benchmark, which is the one whose performance is most aligned with the targets. Eventually, a series of targets and peers are generated by varying the importance attached to the two objectives considered, which offer decision‐makers alternatives for the selection of a course of action when planning improvements.
Did rest breaks help with acute fatigue among nursing staff on 12‐h shifts during the COVID‐19 pandemic? A cross‐sectional study
Authors: Sagherian Knar , McNeely Clea A. , Steege Linsey M. 
Published: July 2021

AbstractAimThis study aimed to explore whether 30‐min rest breaks were as effective at lowering acute fatigue among 12‐h shift hospital nursing staff who cared for patients with COVID‐19 as among those who did not.DesignThe study was cross‐sectional in design.MethodsData from the SAFE‐CARE study collected online between May and June 2020 were used. A subsample (N = 338) comprised of nursing staff who reported working 12‐h shifts, and providing direct patient care in hospitals was used in this study. Data on socio‐demographics, work and rest breaks, and subjective measures of fatigue, psychological distress, sleep and health were used. Hierarchical multiple linear regression followed by stratified analyses was conducted to explore the relationships between rest breaks and acute fatigue among nursing staff groups with and without COVID‐19 patient care.ResultsThe sample, on average, had high acute fatigue. Around 72% reported providing care to patients with COVID‐19, and 71% reported taking rest breaks ‘sometimes’, ‘often’ or ‘always’. In the group that cared for patients with COVID‐19, there was no significant relationship between rest breaks and acute fatigue (p = .507). In the group that cared for patients hospitalized for other reasons, rest breaks were associated with lower acute fatigue (p = .010).ConclusionOur findings showed both the importance and inadequacy of rest breaks in reducing acute fatigue. The process of within‐work recovery is complex, and routine rest breaks should be facilitated by nursing management on hospital units during and after the COVID‐19 pandemic.ImpactRest breaks may present an effective strategy in lowering fatigue. Although rest breaks were not associated with less fatigue among staff caring for patients with COVID‐19, other co‐workers experienced some fatigue recovery. For frontline nursing staff, routine rest breaks are encouraged, and a systematic evaluation pertaining the sufficiency of rest breaks during high work demands in future research is needed.
Moderating effects of task interdependence on interaction behaviours and creativity for nursing students on interdisciplinary teams
Authors: Liu Hsing‐Yuan 
Published: July 2021

AbstractAimsNursing students in Taiwan often study in interdisciplinary teams that must create healthcare products. Creativity is imperative for the students’ success, but studies have not explored the relational precursors to team creativity in nursing education. Therefore, the relationship was examined between task interdependence, interaction behaviours (constructive controversy, helping behaviours and spontaneous communication) and creativity for nursing students on interdisciplinary teams in Taiwan to investigate whether high task interdependence moderates the correlations between interaction behaviours and creativity.DesignDescriptive, cross‐sectional, quantitative study.MethodsParticipants were nursing students (N = 99) attending interdisciplinary capstone courses in 2‐ or 4‐year nursing programmes at a university for science and technology in Taiwan. Self‐report questionnaires were used to collect the students’ demographics and perceptions of their teams’ task interdependence, interaction behaviours and creativity between January 2018 and January 2019. Pearson's correlation coefficient revealed variable associations. SPSS PROCESS macro displayed moderating effects.ResultsTask interdependence had significant positive correlations with all three interaction behaviours and team creativity. Each interaction behaviour also had significant positive correlations with team creativity. High task interdependence negatively moderated the relationships between team creativity and (a) constructive controversy, and (b) spontaneous communication, but not (c) helping behaviours.ConclusionThe empirically validated moderation model and study results suggest that nursing educators can foster creativity in their students by encouraging task interdependence and helping behaviours, and teaching students to build constructive controversy and spontaneous communication into their collaborative plans.ImpactIn Taiwan, nursing students must demonstrate creativity in interdisciplinary capstone courses. Their ability to do so requires them to cooperate with students in other disciplines who have unique skills or knowledge. This study provides insights into the relational factors that may improve creativity for nursing students on interdisciplinary teams.