bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health systems, population and patient challenges for achieving universal health coverage for hypertension in Ghana
Authors: Koduah Augustina , Nonvignon Justice , Colson Abigail , Kurdi Amanj , Morton Alec , van der Meer Robert , Aryeetey Genevieve , Megiddo Itamar 
Published: July 2021

Abstract
Ghana has signed on to the United Nations Sustainable Development Goal to achieve universal health coverage (UHC), ensuring that all individuals receive the health care they require without financial hardship. Achieving that goal is a difficult task in any setting. The challenges are further exacerbated by a changing disease landscape, as the burden of non-communicable diseases (NCDs) is increasing and creating a dual burden along with infectious diseases. This study explores the existing health system for delivering hypertension care and the challenges of delivering UHC for hypertension in Ghana. Document analysis of national health reports, policies and legislations along with a review of research articles was conducted to explore the challenges of delivering UHC for NCDs in Ghana, and hypertension in particular. The main themes and indicators related to the challenges of delivering UHC for hypertension were mapped and analysed. The main challenges to delivering UHC for hypertension can be grouped into population and patient, on the one hand, and health system factors, on the other. Population and patient factors include (1) unhealthy lifestyles overburdening the health system, (2) poor health-seeking behaviour and (3) poor adherence to medication, which has led to uncontrolled cases and poor clinical outcomes even among treated patients with hypertension. Health system factors include (1) inadequate health system capacity for early diagnosis due to an increasing number of patients, (2) inequitable distribution of health care facilities affecting access, (3) financial sustainability of the National Health Insurance Scheme and delays in reimbursement of claims to facilities that affect the health system’s ability to provide timely management of hypertension and (4) health care facilities and practitioners’ use of non-standardized and uncalibrated blood pressure measuring equipment. Ghana therefore will need to make important decisions to overcome operational and financial challenges on its path to UHC.
Towards healthy One Planet cities and communities: planetary health promotion at the local level
Authors: Hancock Trevor ,   the IUHPE’s Global Working Group on Waiora Planetary Health
Published: July 2021

Abstract
Health promotion has paid a lot of attention to the social determinants of health and to health equity but much less attention to the ecological determinants. Yet the most fundamental determinants of health are the natural systems that make the Earth liveable and are the source of our air, water, food, fuels and materials. Yet they are threatened by the very economic and social development that we have created to meet the social determinants of health. Moreover, the benefits and burdens of that development are inequitably distributed, resulting in both ecological and social injustice. In the past few years the new field of planetary health—‘the health of human civilization and the state of the natural systems on which it depends’—has emerged, while WHO has confirmed that ‘the source of human health [is] nature’. So arguably the most important task facing health promotion in the 21st century is to turn its attention to planetary health: health promotion workers must become planetary health promoters. Local health promotion in the 21st century needs to incorporate the concept of planetary health promotion and its application in the creation of healthy ‘One Planet’ communities and must become part of the emerging network of community organizations and individuals working to create sustainable, just and healthy communities.
Visceral Adipose Tissue Volumetrics Inform Odds of Treatment Response and Risk of Subsequent Surgery in IBD Patients Starting Antitumor Necrosis Factor Therapy
Authors: Gu Phillip , Chhabra Avneesh , Chittajallu Punya , Chang Christopher , Mendez Denisse , Gilman Andrew , Fudman David I , Xi Yin , Feagins Linda A 
Published: July 2021

Abstract

Background
Data describing the effect of obesity on antitumor necrosis factor (anti-TNF) treatment response are inconsistent. Visceral adipose tissue (VAT) is a superior marker of adiposity to body mass index. However, its effect on treatment response is unclear. We aimed to evaluate the effect of VAT on anti-TNF treatment response.

Methods
Inflammatory bowel disease (IBD) patients starting anti-TNF agents between January 1, 2009, and July 31, 2019, were included. 3-dimensional measurements of VAT volume and visceral fat index (visceral:subcutaneous adipose tissue ratio; VFI) were obtained from computed tomography (CT) scans. Subjects were categorized by predefined volume cutoffs (&lt;1500cm3, 1500–2999cm3, ≥3000cm3) and VFI (&lt;0.33, 0.33–0.66, ≥0.67). Primary outcomes included a composite treatment response end point at 6 and 12 months. Secondary outcomes were surgery at 6 and 12 months. Multivariable logistic regression was used to calculate adjusted odds ratio (aOR) and 95% confidence interval (CI).

Results
The final cohort included 176 patients. No significant differences in treatment response at 6 months was observed. At 12 months, compared with volume &lt;1500cm3, patients with volume 1500–2999cm3 had higher odds of response (aOR, 3.52; 95% CI, 1.16–10.71; P = .023), whereas volume ≥3000cm3 did not. Compared with VFI&lt;0.33, VFI ≥0.67 had higher odds of surgery at 6 (aOR, 48.22; 95% CI, 4.73–491.57; P = .023) and 12 months (aOR, 20.94; 95% CI, 3.14–139.67; P = .004). Post hoc analysis suggested VAT may affect drug pharmacokinetics.

Conclusions
We found VAT volume is associated with anti-TNF treatment response in a nondose dependent manner, and VFI may inform risk of surgery after anti-TNF initiation. If confirmed by prospective studies, VAT volumetrics are potentially useful biomarkers to inform IBD treatment decisions.
Diversity of lymphatic flow in patients with lung cancer revealed by computed tomography lymphography
Authors: Kawakami Yukikiyo , Takizawa Hiromitsu , Toba Hiroaki , Kawakita Naoya , Yoshida Mitsuteru , Kondo Kazuya , Tangoku Akira 
Published: July 2021

Abstract

OBJECTIVES
This study was conducted to verify the optimal extent of lymph node dissection or sampling during lung cancer surgery based on the sentinel node (SN) map created by computed tomography (CT) lymphography.

METHODS
From April 2010 to January 2015, patients with clinical stage I non-small-cell lung cancer, who were candidates for lobectomy or segmentectomy with standard hilar and mediastinal lymph node dissection, and in whom bronchus reached the tumour, were enrolled. An ultrathin bronchoscope was inserted to the target bronchus under the guidance of virtual bronchoscopic navigation images. CT images of the chest were obtained 30 s after 2.5 ml of iopamidol was injected. SNs were identified when the maximum CT attenuation value of the lymph nodes on postcontrast CT images increased by 30 Hounsfield units or more compared with the precontrast images. Patients underwent lobectomy with standard lymph node dissection.

RESULTS
SNs were identified in 36 (87.8%) of the 41 patients. The average number of SNs was 1.6 (range, 1–4). There was 1 false negative case; therefore, the accuracy of SN identification was 97.2% (35/36). In 5 (13.9%) of 36 patients, SNs were outside the lobe-specific lymph node station range (#11i from right S1, #7 from right S1, #4R from right S8, #12u from right S8, #7 and #12l from left S1 + 2).

CONCLUSIONS
CT lymphography demonstrated the diversity of lymphatic spreading patterns and there were cases in which lymph flows are found outside the lymph node dissection range.
Marginal Benefits of the Core Securities Laws
Authors: Haeberle Kevin S 
Published: July 2021

ABSTRACT
To every thing there is a season. In the area of securities regulation in the United States, it is the season for expansion. This article shows why such expansion should not involve use of the core issuer disclosure, fraud, and insider trading laws to reduce information asymmetry in the stock market in the name of investor protection. I argue that any expansion of these laws focused on this secondary market should therefore be justified by distinct concerns (namely, efficiency ones). Moreover, any push to better serve and protect investors should be focused on other areas of securities law (such as those relating to the structure of securities markets) or other markets (such as the market for investment management).
Hate Crimes Against Minorities in India
Authors: Viswanath Raghavi 
Published: July 2021

Abstract
Violence against Muslims and Dalits in India has drastically increased since the incumbent political party, the Bharatiya Janata Party (BJP), came to power in 2014. Around 85% of perpetrators are alleged to have been associated either with the BJP or its sister Hindu organizations. In at least some cases, law enforcement agencies have been either indifferent or hostile to the victims. Such crimes may be considered as hate crimes, yet an understanding of this concept — as a tool which accounts for the criminality of individual acts while appreciating the systemic prejudices that motivate them — is lacking in Indian law. This warrants consideration of international criminal law, as a discourse which may complement and support domestic reform, since hate crimes constitute an inhumane affront to the values of dignity and liberty which underlie international core crimes. In this context, this article examines whether the elements of crimes against humanity, particular those of murder and persecution, may be applied to the recent events in India.
Determining PD-L1 Status in Patients With Triple-Negative Breast Cancer: Lessons Learned From IMpassion130
Authors: Badve Sunil S , Penault-Llorca Frédérique , Reis-Filho Jorge S , Deurloo Regula , Siziopikou Kalliopi P , D’Arrigo Corrado , Viale Giuseppe 
Published: July 2021

AbstractTriple-negative breast cancer (TNBC) accounts for approximately 12% to 17% of all breast cancers and has an aggressive clinical behavior. Increased tumor-infiltrating lymphocyte counts are prognostic for survival in TNBC, making this disease a potential target for cancer immunotherapy. Research on immunophenotyping of tumor-infiltrating lymphocytes is revealing molecular and structural organization in the tumor microenvironment that may predict patient prognosis. The anti–programmed death-ligand 1 (PD-L1) antibody atezolizumab plus nab-paclitaxel was the first cancer immunotherapy combination to demonstrate progression-free survival benefit and clinically meaningful overall survival benefit in the first-line treatment of metastatic TNBC (mTNBC) in patients with PD-L1–expressing tumor-infiltrating immune cells in 1% or more of the tumor area. This led to its United States and European Union approval for mTNBC and US approval of the VENTANA PD-L1 (SP142) assay as a companion diagnostic immunohistochemistry assay. Subsequently, the anti–programmed death-1 (PD-1 ) antibody pembrolizumab plus chemotherapy was approved by the US Food and Drug Administration for mTNBC based on progression-free survival benefit in patients with a combined positive score of at least 10 by its concurrently approved 22C3 companion diagnostic assay. Treatment guidelines now recommend PD-L1 testing for patients with mTNBC, and the testing landscape will likely become increasingly complex as new anti–PD-L1 and anti–PD-1 agents and diagnostics are approved for TNBC. Integrating PD-L1 testing into current diagnostic workflows for mTNBC may provide more treatment options for these patients. Therefore, it is critical for medical oncologists and pathologists to understand the available assays and their relevance to therapeutic options to develop an appropriate workflow for immunohistochemistry testing.
Lean Principles to Improve Quality in High-Throughput COVID-19 Testing Using SwabSeq: A Barcoded Sequencing-Based Testing Platform
Authors: Jones Janae , Saul Rosita , Sathe Laila , Xie Joanna , Marquette Dawn , Arboleda Valerie A 
Published: July 2021

Abstract

Objective
To describe and quantify the effect of quality control (QC) metrics to increase testing efficiency in a high-complexity, Clinical Laboratory Improvement Amendments–certified laboratory that uses amplicon-based, next generation sequencing for the clinical detection of SARS-CoV-2. To enable rapid scalability to several thousands of specimens per day without fully automated platforms, we developed internal QC methods to ensure high-accuracy testing.

Methods
We implemented procedures to increase efficiency by applying the Lean Six Sigma model into our sequencing-based COVID-19 detection.

Results
The application of the Lean Six Sigma model increased laboratory efficiency by reducing errors, allowing for a higher testing volume to be met with minimal staffing. Furthermore, these improvements resulted in an improved turnaround time.

Conclusion
Lean Six Sigma model execution has increased laboratory efficiency by decreasing critical testing errors and has prepared the laboratory for future scaling up to 50,000 tests per day.
Plasma microlensing dynamic spectrum probing fine structures in the ionized interstellar medium
Authors: Shi Xun , Xu Zhu 
Published: July 2021

ABSTRACT
Gravitational microlensing has become a mature technique for discovering small gravitational lenses in the Universe that are otherwise beyond our detection limits. Similarly, plasma microlensing can help us explore cosmic plasma lenses. Both pulsar scintillation and extreme scattering events of compact radio sources suggest the existence of ∼au-scale plasma lenses in the ionized interstellar medium (IISM), whose astrophysical correspondence remains a mystery. We demonstrate that plasma microlensing events by these plasma lenses recorded in the form of wide-band dynamic spectra are a powerful probe of their nature. Using the recently developed Picard–Lefschetz integrator for the Kirchhoff–Fresnel integral, we simulate such dynamic spectra for a well-motivated family of single-variable plasma lenses. We demonstrate that the size, strength, and shape of the plasma lens can be measured from the location of the cusp point and the shape of spectral caustics, respectively, with a combination of distances and the effective velocity known a priori or measured from the widths of the interference pattern. Future wide-band observations of pulsars, whose plasma microlensing events may be predictable from parabolic arc monitoring, are the most promising ground to apply our results for a deeper insight into the fine structures in the IISM.
AI-assisted superresolution cosmological simulations – II. Halo substructures, velocities, and higher order statistics
Authors: Ni Yueying , Li Yin , Lachance Patrick , Croft Rupert A C , Di Matteo Tiziana , Bird Simeon , Feng Yu 
Published: July 2021

ABSTRACT
In this work, we expand and test the capabilities of our recently developed superresolution (SR) model to generate high-resolution (HR) realizations of the full phase-space matter distribution, including both displacement and velocity, from computationally cheap low-resolution (LR) cosmological N-body simulations. The SR model enhances the simulation resolution by generating 512 times more tracer particles, extending into the deeply nonlinear regime where complex structure formation processes take place. We validate the SR model by deploying the model in 10 test simulations of box size 100 h−1 Mpc, and examine the matter power spectra, bispectra, and two-dimensional power spectra in redshift space. We find the generated SR field matches the true HR result at per cent level down to scales of k ∼ 10 h  Mpc−1. We also identify and inspect dark matter haloes and their substructures. Our SR model generates visually authentic small-scale structures that cannot be resolved by the LR input, and are in good statistical agreement with the real HR results. The SR model performs satisfactorily on the halo occupation distribution, halo correlations in both real and redshift space, and the pairwise velocity distribution, matching the HR results with comparable scatter, thus demonstrating its potential in making mock halo catalogues. The SR technique can be a powerful and promising tool for modelling small-scale galaxy formation physics in large cosmological volumes.
X-ray observations of two candidate symbiotic binaries in the galactic bulge
Authors: Wetuski Joshua , Hynes R I , Maccarone T J , Heinke C , Torres M A P , Jonker P G , Britt Christopher T , Steeghs D , Nelemans G 
Published: July 2021

ABSTRACT
This paper analyses X-ray observations by the Chandra X-ray Observatory of CXOGBS J174614.3−321949 (CXB3) and CXOGBS J173620.2−293338 (CX332), two symbiotic binary star candidates identified by the Galactic Bulge Survey. Using new Chandra observations, we improved their X-ray positional uncertainties to 0.24 and 0.92 arcsec, respectively, confidently associating them with single optical counterparts. In particular, new observations of symbiotic X-ray candidate CX332 further solidify confidence in its coincidence with a carbon star. We demonstrate X-ray variability in both targets with a more recent observation of CX332 showing a decrease in brightness by a factor of 30, while CXB3 observations show it usually in a quiescent state with a factor-of-6 flare-like event in the final observations. In a combined spectral fit for CXB3, we find an NH value of $\sim (2\!-\! 3) \times 10^{22}\, \rm {cm}^{-2}$ with a Γ value of $1.5^{+0.2}_{-0.2}$ for a power-law fit and kT$10.6_{-2.9}^{+5.7}$ keV for an apec fit and an estimated luminosity of ∼8.4 × 1032 erg s−1. Spectra of CXB3 would be consistent with thermal emission as seen in white dwarf symbiotic systems, but the high X-ray luminosity in the light curve is more typically seen in symbiotic X-ray binary systems. Optical spectra of both objects taken with Gemini GMOS indicate CXB3 as containing an M-type star and CX332 having a carbon star counterpart. Both targets show at most marginal evidence of H α emission favouring a symbiotic X-ray binary interpretation for both sources, though we cannot rule out a white dwarf for either case.
Selective blood-brain barrier permeabilization of brain metastases by a type 1 receptor-selective tumor necrosis factor mutein
Authors: Munoz Pinto Mario F , Campbell Sandra J , Simoglou Karali Christina , Johanssen Vanessa A , Bristow Claire , Cheng Vinton W T , Zarghami Niloufar , Larkin James R , Pannell Maria , Hearn Arron , Chui Cherry , Brinquis Nunez Barbara , Bokma Evert , Holgate Robert , Anthony Daniel C , Sibson Nicola R 
Published: July 2021

AbstractBackgroundMetastasis to the brain is a major challenge with poor prognosis. The blood-brain barrier (BBB) is a significant impediment to effective treatment, being intact during the early stages of tumor development and heterogeneously permeable at later stages. Intravenous injection of tumor necrosis factor (TNF) selectively induces BBB permeabilization at sites of brain micrometastasis, in a TNF type 1 receptor (TNFR1)-dependent manner. Here, to enable clinical translation, we have developed a TNFR1-selective agonist variant of human TNF that induces BBB permeabilization, while minimizing potential toxicity.MethodsA library of human TNF muteins (mutTNF) was generated and assessed for binding specificity to mouse and human TNFR1/2, endothelial permeabilizing activity in vitro, potential immunogenicity, and circulatory half-life. The permeabilizing ability of the most promising variant was assessed in vivo in a model of brain metastasis.ResultsThe primary mutTNF variant showed similar affinity for human TNFR1 than wild-type human TNF, similar affinity for mouse TNFR1 as wild-type mouse TNF, undetectable binding to human/mouse TNFR2, low potential immunogenicity, and permeabilization of an endothelial monolayer. Circulatory half-life was similar to mouse/human TNF and BBB permeabilization was induced selectively at sites of micrometastases in vivo, with a time window of ≥24 hours and enabling delivery of agents within a therapeutically relevant range (0.5-150 kDa), including the clinically approved therapy, trastuzumab.ConclusionsWe have developed a clinically translatable mutTNF that selectively opens the BBB at micrometastatic sites, while leaving the rest of the cerebrovasculature intact. This approach will open a window for brain metastasis treatment that currently does not exist.
Impaired Timing of Speech-Related Neurons in the Subthalamic Nucleus of Parkinson Disease Patients Suffering Speech Disorders
Authors: Tankus Ariel , Lustig Yael , Fried Itzhak , Strauss Ido 
Published: July 2021

AbstractBACKGROUNDOur previous study found degradation to subthalamic neuronal encoding of speech features in Parkinson disease (PD) patients suffering from speech disorders.OBJECTIVETo find how timing of speech-related neuronal firing changes in PD patients with speech disorders compared to PD patients without speech disorders.METHODSDuring the implantation of deep brain stimulator (DBS), we recorded the activity of single neurons in the subthalamic nucleus (STN) of 18 neurosurgical patients with PD while they articulated, listened to, or imagined articulation of 5 vowel sounds, each following a beep. We compared subthalamic activity of PD patients with (n = 10) vs without speech disorders.RESULTSIn this comparison, patients with speech disorders had longer reaction times and shorter lengths of articulation. Their speech-related neuronal activity preceding speech onset (planning) was delayed relative to the beep, but the time between this activity and the emission of speech sound was similar. Notwithstanding, speech-related neuronal activity following the onset of speech (feedback) was delayed when computed relative to the onset. Only in these patients was the time lag of planning neurons significantly correlated with the reaction time. Neuronal activity in patients with speech disorders was delayed during imagined articulation of vowel sounds but earlier during speech perception.CONCLUSIONOur findings indicate that longer reaction times in patients with speech disorders are due to STN or earlier activity of the speech control network. This is a first step in locating the source(s) of PD delays within this network and is therefore of utmost importance for future treatment of speech disorders.
Complete resolution of a giant multilocular prostatic cystadenoma following androgen deprivation therapy: an illustrative case report
Authors: Sushentsev Nikita , Rimmer Yvonne , Barrett Tristan 
Published: July 2021

ABSTRACT
Giant multilocular prostatic cystadenoma (GMPC) is a rare benign pelvic mass for which complete surgical resection is an accepted treatment of choice. This report presents the first case of complete resolution of GMPC following a 3-year course of luteinising hormone-releasing hormone agonist alongside external beam radiotherapy for the concurrent treatment of unfavorable intermediate-risk prostate cancer. In addition to illustrating the imaging features of the effect of androgen deprivation therapy (ADT) and radiotherapy on GMPC regression, this case provides evidence for considering ADT as an alternative, noninvasive GMPC treatment option in patients in whom surgical treatment is either contraindicated or can be made less invasive by reducing the size of GMPC prior to its removal.