bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of school-level and area-level socio-economic factors on elementary school student COVID-19 infections: a population-based observational study
Authors: Srivastava Prachi , Lau Nathan T T , Ansari Daniel , Thampi Nisha 
Published: March 2023

ObjectivesTo estimate the variability of the cumulative incidence of SARS-CoV-2 infections among elementary school students attributable to individual schools and/or their geographic areas, and to ascertain whether socio-economic characteristics of school populations and/or geographic areas may be predictive of this variability.DesignPopulation-based observational study of SARS-CoV-2 infections among elementary school children.Setting3994 publicly funded elementary schools in 491 forward sortation areas (designated geographic unit based on first three characters of Canadian postal code), Ontario, Canada, September 2020 to April 2021.ParticipantsAll students attending publicly funded elementary schools with a positive molecular test for SARS-CoV-2 reported by the Ontario Ministry of Education.Main outcome measuresCumulative incidence of laboratory-confirmed elementary school student SARS-CoV-2 infections in Ontario, 2020–21 school year.ResultsA multilevel modelling approach was used to estimate the effects of socio-economic factors at the school and area levels on the cumulative incidence of elementary school student SARS-CoV-2 infections. At the school level (level 1), the proportion of the student body from low-income households was positively associated with cumulative incidence (β=0.083, p<0.001). At the area level (level 2), all dimensions of marginalisation were significantly related to cumulative incidence. Ethnic concentration (β=0.454, p<0.001), residential instability (β=0.356, p<0.001) and material deprivation (β=0.212, p<0.001) were positively related, while dependency (β=-0.204, p<0.001) was negatively related. Area-related marginalisation variables explained 57.6% of area variability in cumulative incidence. School-related variables explained 1.2% of school variability in cumulative incidence.ConclusionsThe socio-economic characteristics of the geographic area of schools were more important in accounting for the cumulative incidence of SARS-CoV-2 elementary school student infections than individual school characteristics. Schools in marginalised areas should be prioritised for infection prevention measures and education continuity and recovery plans.
Impact of minimally invasive surgery on surgeon health (ISSUE) study: protocol of a single-arm observational study conducted in the live surgery setting
Authors: Amirthanayagam Anumithra , Zecca Massimiliano , Barber Shaun , Singh Baljit , Moss Esther L 
Published: March 2023

IntroductionThe rapid evolution of minimally invasive surgery has had a positive impact on patient outcomes; however, it is reported to be associated with work-related musculoskeletal symptoms (WMS) in surgeons. Currently there is no objective measure to monitor the physical and psychological impact of performing a live surgical procedure on the surgeon.Methods and analysisA single-arm observational study with the aim of developing a validated assessment tool to quantify the impact of surgery (open/laparoscopic/robotic-assisted) on the surgeon. Development and validation cohorts of major surgical cases of varying levels of complexity performed by consultant gynaecological and colorectal surgeons will be recruited. Recruited surgeons wear three Xsens DOT monitors (muscle activity) and an Actiheart monitor (heart rate). Salivary cortisol levels will be taken and questionnaires (WMS and State-Trait Anxiety Inventory) completed by the participants preoperatively and postoperatively. All the measures will be incorporated to produce a single score that will be called the 'S-IMPACT' score.Ethics and disseminationEthical approval for this study has been granted by the East Midlands Leicester Central Research Ethics Committee REC ref 21/EM/0174. Results will be disseminated to the academic community through conference presentations and peer-reviewed journal publications. The S-IMPACT score developed within this study will be taken forward for use in definitive multicentre prospective randomised control trials.
Prediction of cardiovascular death and non-fatal cardiovascular events by the Kidney age–Chronological age Difference (KCD) score in men and women of different ages in a community-based cohort
Authors: Campbell Duncan J , Magliano Dianna J , Shaw Jonathan E 
Published: March 2023

ObjectiveWe examined the utility of the Kidney age–Chronological age Difference (KCD) score, an age-adapted measure of kidney function, to identify increased cardiovascular (CV) death or non-fatal CV event risk in participants of the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab), a community-based cohort aged 23–95 years.DesignCohort study.SettingCommunity.Participants11205 randomly selected participants from urban and nonurban areas across Australia.Outcome measuresMortality status and underlying and contributory causes of death obtained from the Australian National Death Index, and non-fatal CV events from adjudicated hospital records. The association of CV death or non-fatal CV event risk with KCD score was examined using penalised spline curve analysis.ResultsOf 11 180 participants with serum creatinine measurement at baseline and 5-year outcome data, there were 308 CV deaths or non-fatal CV events after 5 years. Penalised spline curve analysis showed similar progressive increase in CV death or non-fatal CV event risk with increasing KCD score in men and women, and participants aged <50 years to ≥80 years. Receiver operating characteristic curve analysis showed optimal discrimination at a KCD score ≥20 years (KCD20) for all participants. Among 148 participants aged<70 years with CV death or non-fatal CV event, KCD20 identified 24 (16%) participants, whereas estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2identified 8 (5%) participants (p=0.0001), with specificities of 95% and 99%, respectively (p<0.0001).ConclusionKCD20 predicted CV death or non-fatal CV event risk similarly in men and women of different ages in this population-based cohort. The higher sensitivity for prediction of CV death or non-fatal CV event risk in participants aged <70 years by KCD20 than by eGFR <60 mL/min/1.73 m2offers opportunity for earlier renoprotective therapy in individuals with eGFR-associated increased CV death or non-fatal CV event risk.
Use of tranexamic acid (TXA) to reduce preterm birth and other adverse obstetrical outcomes among pregnant individuals with placenta previa: a systematic review protocol
Authors: Seguin Niève , Visintini Sarah , Muldoon Katherine A , Walker Mark 
Published: March 2023

IntroductionPlacenta previa is a placental implantation pathology where the placenta overlies the internal endocervical os. Placenta previa affects approximately 4 per 1000 pregnancies and increases the risk of antepartum bleeding, emergent preterm labour and emergency caesarean sections. Currently, placenta previa is managed through expectant management. Guidelines primarily revolve around the mode and timing of delivery, in-hospital admissions and surveillance. However, the methods to prolong pregnancy have not proven to be clinically effective. Tranexamic acid (TXA), an antifibrinolytic agent, is effectively used to prevent and treat postpartum haemorrhage as well as menorrhagia, with limited adverse effect, and may prove to be an effective treatment for placenta previa. The objective of this systematic review protocol is to review and synthesise the evidence of TXA use for antepartum haemorrhage in placenta previa.Methods and analysisPreliminary searches were conducted on 12 July 2022. We will search MEDLINE, EMBASE, CINAHL, Scopus and the Cochrane Central Register of Controlled Trials. Grey literature resources such as clinical trials registries (ClinicalTrials.gov and the WHO’s International Clinical Trials Registry) and preprint servers (Europe PMC and Open Science Framework) will also be searched. The search terms will comprise of index headings and keyword searches related to TXA and the placenta or antepartum bleeding. Cohort and randomised and non-randomised trials will be considered. The target population is pregnant people, of any age, with placenta previa. The intervention is TXA given in the antepartum period. The main outcome of interest is preterm birth before 37 weeks, however, all perinatal outcomes will be collected. Title and abstract will be screened by two reviewers and any conflict will be discussed and evaluated by a third reviewer. The literature will be summarised in narrative form.Ethics and disseminationNo ethics approval is required for this protocol. Findings will be disseminated through peer-review publication, lay summaries and conference presentations.PROSPERO registration numberCRD42022363009).
Acceptability and usability of a paediatric HIV screening tool in high-volume outpatient settings in Malawi, perspectives from caregivers and healthcare workers
Authors: Katirayi Leila , Maphosa Thulani , Kudiabor Kwashie , Kayira Dumbani , Gross Jessica , Hrapcak Susan , Chamanga Rachel , Nkhoma Harrid , Puleni Paul , Maida Alice , Ahimbisibwe Allan , Woelk Godfrey 
Published: March 2023

BackgroundUsing an HIV pretest screening tool to identify children most at risk for HIV infection may be a more efficient and cost-effective approach to identify children living with HIV in resource-limited settings. These tools seek to reduce overtesting of children by increasing the positive predictive value while ensuring a high negative predictive value for those screened for HIV.MethodsThis qualitative study in Malawi evaluated acceptability and usability of a modified version of the Zimbabwe HIV screening tool to identify children aged 2–14 years most-at-risk. The tool included additional questions about previous hospitalisations due to malaria and prior documented diagnoses. Sixteen interviews were conducted with expert clients (ECs), trained peer-supporters, which administered the screening tool and 12 interviews with biological and non-biological caregivers of screened children. All interviews were audiorecorded, transcribed and translated. Transcripts were analysed manually using a short-answer analysis, compiling responses for each question by study participant group. Summary documents were generated, identifying common and outlier perspectives.ResultsThe HIV paediatric screening tool was generally accepted by caregivers and ECs, with both groups seeing the benefit of the tool and promoting its use. The ECs who were primarily responsible for implementing the tool initially struggled with acceptance of the tool but started to accept it after additional training and mentorship was provided. Overall, caregivers accepted having their children tested for HIV, although non-biological caregivers expressed hesitancy in giving consent for HIV testing. ECs reported challenges with the ability for non-biological caregivers to answer some questions.ConclusionThis study found general acceptance of paediatric screening tools in children in Malawi and identified some minor challenges that raise important considerations for tool implementation. These include the need for a thorough orientation of the tools for the healthcare workers and caregivers, appropriate space at the facility, and adequate staffing and commodities.
On modelling relative risks for longitudinal binomial responses: implications from two dueling paradigms
Authors: Lin Tuo , Zhao Rongzhe , Tu Shengjia , Wu Hao , Zhang Hui , Tu Xin M 
Published: March 2023

Although logistic regression is the most popular for modelling regression relationships with binary responses, many find relative risk (RR), or risk ratio, easier to interpret and prefer to use this measure of risk in regression analysis. Indeed, since Zou published his modified Poisson regression approach for modelling RR for cross-sectional data, his paper has been cited over 7 000 times, demonstrating the popularity of this alternative measure of risk in regression analysis involving binary responses. As longitudinal studies have become increasingly popular in clinical trials and observational studies, it is imperative to extend Zou’s approach for longitudinal data.The two most popular approaches for longitudinal data analysis are the generalised linear mixed-effects model (GLMM) and generalised estimating equations (GEE). However, the parametric GLMM cannot be used for the extension within the current context, because Zou’s approach treats the binary response as a Poisson variable, which is at odds with the Bernoulli distribution for the binary response. On the other hand, as it imposes no mathematical model on data distributions, the semiparametric GEE is coherent with Zou’s modified Poisson regression. In this paper, we develop a GEE-based longitudinal model for binary responses to provide inference about RR.
Interaction between tumor cell TNFR2 and monocyte membrane-bound TNF-α triggers tumorigenic inflammation in neuroblastoma
Authors: Tomolonis Julie A , Xu Xin , Dholakia Kshiti H , Zhang Chunchao , Guo Linjie , Courtney Amy N , Wang Siyue , Balzeau Julien , Barragán Gabriel A , Tian Gengwen , Di Pierro Erica J , Metelitsa Leonid S 
Published: March 2023

BackgroundTumor progression and resistance to therapy in children with neuroblastoma (NB), a common childhood cancer, are often associated with infiltration of monocytes and macrophages that produce inflammatory cytokines. However, the mechanism by which tumor-supportive inflammation is initiated and propagated remains unknown. Here, we describe a novel protumorigenic circuit between NB cells and monocytes that is triggered and sustained by tumor necrosis factor alpha (TNF-α).MethodsWe used NB knockouts (KOs) of TNF-α andTNFRSF1AmRNA (TNFR1)/TNFRSF1BmRNA (TNFR2) and TNF-α protease inbitor (TAPI), a drug that modulates TNF-α isoform expression, to assess the role of each component in monocyte-associated protumorigenic inflammation. Additionally, we employed NB-monocyte cocultures and treated these with clinical-grade etanercept, an Fc-TNFR2 fusion protein, to neutralize signaling by both membrane-bound (m) and soluble (s)TNF-α isoforms. Further, we treated NOD/SCID/IL2Rγ(null) mice carrying subcutaneous NB/human monocyte xenografts with etanercept and evaluated the impact on tumor growth and angiogenesis. Gene set enrichment analysis (GSEA) was used to determine whether TNF-α signaling correlates with clinical outcomes in patients with NB.ResultsWe found that NB expression of TNFR2 and monocyte membrane-bound tumor necrosis factor alpha is required for monocyte activation and interleukin (IL)-6 production, while NB TNFR1 and monocyte soluble TNF-α are required for NB nuclear factor kappa B subunit 1 (NF-κB) activation. Treatment of NB-monocyte cocultures with clinical-grade etanercept completely abrogated release of IL-6, granulocyte colony-stimulating factor (G-CSF), IL-1α, and IL-1β and eliminated monocyte-induced enhancement of NB cell proliferation in vitro. Furthermore, etanercept treatment inhibited tumor growth, ablated tumor angiogenesis, and suppressed oncogenic signaling in mice with subcutaneous NB/human monocyte xenografts. Finally, GSEA revealed significant enrichment for TNF-α signaling in patients with NB that relapsed.ConclusionsWe have described a novel mechanism of tumor-promoting inflammation in NB that is strongly associated with patient outcome and could be targeted with therapy.
Role of optical coherence tomography in pipeline embolization device for the treatment of vertebral–basilar artery dissecting aneurysms
Authors: Ma Yongjie , Ji Zhe , Yang Wanxin , Li Li , Han Liqiang , Liu Yu , Guo Yuanhao , Dmytriw Adam A , He Chuan , Li Guilin , Zhang Hongqi 
Published: March 2023

Background
Vertebral–basilar artery dissecting aneurysms (VADAs) are an uncommon phenomenon in all fields of cerebrovascular disease. The flow diverter (FD) can be used as an endoluminal reconstruction device that promotes neointima formation at the aneurysmal neck and preserves the parent artery. To date, imaging examinations such as CT angiography, MR angiography, and DSA are the main methods used to evaluate the vasculature of patients. However, none of these imaging methods can reveal the situation of neointima formation, which is of great importance in evaluating occlusion of VADAs, especially those treated with a FD.

Methods
Three patients were included in the study from August 2018 to January 2019. All patients underwent preprocedural, postprocedural, and follow-up evaluations with high resolution MRI, DSA, and optical coherence tomography (OCT), as well as the formation of intima on the surface of the scaffold at the 6 month follow-up.

Results
Preprocedural, postoperative, and follow-up high resolution MRI, DSA, and OCT of all three cases successfully evaluated occlusion of the VADAs and occurrence of in stent stenosis from different views of intravascular angiography and neointima formation.

Conclusions
OCT was feasible and useful to further evaluate VADAs treated with FD from a near pathological perspective, which may contribute toward guiding the duration of antiplatelet medication and early intervention of in stent stenosis.
Characterization of length of stay after minimally invasive endoscopic intracerebral hemorrhage evacuation
Authors: Ali Muhammad , Smith Colton , Vasan Vikram , Downes Margaret , Schuldt Braxton R , Odland Ian , Murtaza-Ali Muhammad , Dullea Jonathan , Rossitto Christina P , Schupper Alexander J , Hardigan Trevor , Asghar Nek , Liang John , Mocco J , Kellner Christopher P 
Published: March 2023

BackgroundMinimally invasive evacuation may help ameliorate outcomes after intracerebral hemorrhage (ICH). However, hospital length of stay (LOS) post-evacuation is often long and costly.ObjectiveTo examine factors associated with LOS in a large cohort of patients who underwent minimally invasive endoscopic evacuation.MethodsPatients presenting to a large health system with spontaneous supratentorial ICH qualified for minimally invasive endoscopic evacuation if they met the following inclusion criteria: age ≥18, premorbid modified Rankin Scale (mRS) score ≤3, hematoma volume ≥15 mL, and presenting National Institutes of Health Stroke Scale (NIHSS) score ≥6. Demographic, clinical, radiographic, and operative characteristics were included in a multivariate logistic regression for hospital and ICU LOS dichotomized into short and prolonged stay at 14 and 7 days, respectively.ResultsAmong 226 patients who underwent minimally invasive endoscopic evacuation, the median intensive care unit and hospital LOS were 8 (4–15) days and 16 (9–27) days, respectively. A greater extent of functional impairment on presentation (OR per NIHSS point 1.10 (95% CI 1.04 to 1.17), P=0.007), concurrent intraventricular hemorrhage (OR=2.46 (1.25 to 4.86), P=0.02), and deep origin (OR=per point 2.42 (1.21 to 4.83), P=0.01) were associated with prolonged hospital LOS. A longer delay from ictus to evacuation (OR per hour 1.02 (1.01 to 1.04), P=0.007) and longer procedure time (OR per hour 1.91 (1.26 to 2.89), P=0.002) were associated with prolonged ICU LOS. Prolonged hospital and ICU LOS were in turn longitudinally associated with a lower rate of discharge to acute rehabilitation (40% vs 70%, P<0.0001) and worse 6-month mRS outcomes (5 (4–6) vs 3 (2–4), P<0.0001).ConclusionsWe present factors associated with prolonged LOS, which in turn was associated with poor long-term outcomes. Factors associated with LOS may help to inform patient and clinician expectations of recovery, guide protocols for clinical trials, and select suitable populations for minimally invasive endoscopic evacuation.
Radiative and viscid dissipative flowing influences on heat and mass transfer in MHD Casson fluid employing Galerkin finite element style
Authors: Shankar Gollapalli , Sheri Siva Reddy , Jamshed Wasim , Ibrahim Rabha W. , Eid Mohamed R. , Guedri Kamel 
Published: March 2023

This work employs a numerical calculation to investigate the heat and mass transfer process of a hydromagnetic radiative Casson fluid flowing through a vertical plate in the presence of heat generation, viscid dissipation and chemical processes. The governing dimensional partial differential equations (PDE) for considered Casson fluid are first converted into dimensionless PDE utilizing proper variables. The obtained system is then computed using Galerkin finite element method (G-FEM). The approximated results for different parameters are shown through curves and tables. The impact of dimensionless parameters is visualized on fluid velocity, fluid temperature, fluid concentration, Nusselt number and skin friction. The heat transmission mechanism of Casson fluid is superior to that of the Newtonian liquid. In the limited scenario, the study findings are in excellent accord with the existing literature.
Why the Five Eyes? Power and Identity in the Formation of a Multilateral Intelligence Grouping
Authors: Williams Brad 
Published: March 2023

Abstract
Adopting an analytically eclectic approach that draws on theories of realist bargaining, identity, and socialization, this article investigates the early Cold War origins of the Five Eyes intelligence grouping (the United States, Canada, Great Britain, Australia, and New Zealand). An understanding of identity grounded in culture suggests a natural process of international intelligence community building, but this was not the case with the Five Eyes. The formation of the grouping was not preordained. Although Anglo-Saxonism was a necessary condition, it was not sufficient. In addition to being able to provide valuable sites for signals intelligence collection, aspiring members had to be seen as staunchly anti-Communist (and therefore politically trustworthy) by the United States in order to become full members of this exclusive community. Early postwar concerns over the political loyalties and secrecy protection regime of the Australian government prompted the British to initiate a process of socialization aimed at bolstering its affiliate's security institutions and practices and guaranteeing its own access to U.S. secrets.
Tears and Contrition in Early Modern Iberian Inquisitorial Trials (1560–1610): A Preliminary Study
Authors: Soyer François 
Published: March 2023

Abstract
The History of Emotions has been establishing itself as a field of historical research since the 1980s, but, to date, almost no attempt has been made to approach the study of the Spanish and Portuguese inquisitions through the history of emotions. Focusing on the period 1560–1610, which followed the conclusion of the Council of Trent, this essay endeavours to offer a preliminary analysis of Iberian inquisitorial trials for the history of emotions. The first section examines the case study offered by the trial of the Spanish soldier Bartolomé Domínguez, who was prosecuted in Portugal for committing sacrilege in 1589. Having lost all his money gambling, Bartolomé drew his sword and slashed at a wayside cross. This public act of sacrilege led to Bartolomé’s arrest and an investigation by the Inquisition. The surviving inquisitorial trial dossier provides an interesting insight into the role played by emotions in inquisitorial justice and social disciplining in the early modern Iberian Peninsula. The second section examines a limited sample of trials that have been edited and seeks to find references to tears and weeping in such sources. It discusses what such references reveal about the attitudes of inquisitors towards tears within the legal context of inquisitorial trials, and whether tears were always seen as evidence of genuine contrition. The third and final section focuses on investigating how the context of post-Tridentine spirituality might have played a role in the increased attention that the inquisitors paid to other physical signs of contrition beyond tears.