bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors affecting vaccination demand in Indonesia: a secondary analysis and multimethods national assessment
Authors: Jusril Hafizah , Rachmi Cut Novianti , Amin Mohammad Ruhul , Dynes Michelle , Sitohang Vensya , Untung Andi Sari Bunga , Damayanti Rita , Ariawan Iwan , Pronyk Paul M 
Published: August 2022

ObjectivesVaccine hesitancy remains a major barrier to immunisation coverage worldwide. We explored influence of hesitancy on coverage and factors contributing to vaccine uptake during a national measles–rubella (MR) campaign in Indonesia.DesignSecondary analyses of qualitative and quantitative data sets from existing cross-sectional studies conducted during and around the campaign.MethodsQuantitative data used in this assessment included daily coverage reports generated by health workers, district risk profiles that indicate precampaign immunisation programme performance, and reports of campaign cessation due to vaccine hesitancy. We used t-test and χ2 tests for associations. The qualitative assessment employed three parallel national and regional studies. Deductive thematic analysis examined factors for acceptance among caregivers, health providers and programme managers.ResultsCoverage data were reported from 6462 health facilities across 395 districts from 1 August to 31 December 2018. The average district coverage was 73%, with wide variation between districts (2%–100%). One-third of districts fell below 70% coverage thresholds. Sixty-two of 395 (16%) districts paused the campaign due to hesitancy. Coverage among districts that never paused campaign activities due to hesitancy was significantly higher than rates for districts ever-pausing the campaign (81% vs 42%; p<0.001). Precampaign adequacy of district immunisation programmes did not explain coverage gaps (p=0.210). Qualitative analysis identified acceptance enablers including using digital health monitoring and feedback systems, increasing caregiver knowledge and awareness, making immunisation social norm, effective cross-sectoral collaboration, conducive service environment and positive experiences for mothers and children. Barriers included misinformation diffusion on social media, halal–haram issues, lack of healthcare provider knowledge, negative family influences and traditions, previous poor experiences and misinformation on adverse events.ConclusionBarriers to vaccine uptake contributed to coverage gaps during national MR campaign in Indonesia. A range of supply-related and demand-related strategies were identified to address hesitancy contributors. Advancing a portfolio of tailored multilevel interventions will be critical to enhance vaccine acceptance.
Developing an evidence-informed model of long-term life care at home for older adults with medical, functional and/or social care needs in Ontario, Canada: a mixed methods study protocol
Authors: Giosa Justine L , Saari Margaret , Holyoke Paul , Hirdes John P , Heckman George A 
Published: August 2022

IntroductionThe COVID-19 pandemic exacerbated existing challenges within the Canadian healthcare system and reinforced the need for long-term care (LTC) reform to prioritise building an integrated continuum of services to meet the needs of older adults. Almost all Canadians want to live, age and receive care at home, yet funding for home and community-based care and support services is limited and integration with primary care and specialised geriatric services is sparse. Optimisation of existing home and community care services would equip the healthcare system to proactively meet the needs of older Canadians and enhance capacity within the hospital and residential care sectors to facilitate access and reduce wait times for those whose needs are best served in these settings. The aim of this study is to design a model of long-term ‘life care’ at home (LTlifeC model) to sustainably meet the needs of a greater number of community-dwelling older adults.Methods and analysisAn explanatory sequential mixed methods design will be applied across three phases. In the quantitative phase, secondary data analysis will be applied to historical Ontario Home Care data to develop unique groupings of patient needs according to known predictors of residential LTC home admission, and to define unique patient vignettes using dominant care needs. In the qualitative phase, a modified eDelphi process and focus groups will engage community-based clinicians, older adults and family caregivers in the development of needs-based home care packages. The third phase involves triangulation to determine initial model feasibility.Ethics and disseminationThis study has received ethics clearance from the University of Waterloo Research Ethics Board (ORE #42182). Results of this study will be disseminated through peer-reviewed publications and local, national and international conferences. Other forms of knowledge mobilisation will include webinars, policy briefs and lay summaries to elicit support for implementation and pilot testing phases.
Global monitoring of public interest in preventive measures against COVID-19 via analysis of Google Trends: an infodemiology and infoveillance study
Authors: Ito Tomoo 
Published: August 2022

ObjectivesThe COVID-19 pandemic has influenced people’s concerns regarding infectious diseases and their preventive measures. However, the magnitude of the impact and the difference between countries are unclear. This study aimed to assess the magnitude of the impact of COVID-19 on public interest and people’s behaviours globally in preventing infectious diseases while comparing international trends and sustainability.DesignAn infodemiology and infoveillance study.SettingThe study employed a web-based data collection to delineate public interest regarding COVID-19 preventive measures using Google Trends.Primary and secondary outcome measuresA relative search volume was assigned to a keyword, standardising it from 0 to 100, with 100 representing the highest share of the term searches. The search terms “coronavirus”, “wash hand”, “social distancing”, “hand sanitizer” and “mask” were investigated across 196 different countries and regions from July 2018 to October 2021 and weekly reports of the relative search volume were obtained. Persistence of interest was assessed by comparing the first 20 weeks with the last 20 weeks of the study period.ResultsAlthough the relative search volume of “coronavirus” increased and was sustained at a significantly higher level (p<0.05) than before the pandemic declaration, globally, the trends and sustainability of the interest in preventable measures against COVID-19 varied between countries and regions.ConclusionsSustained interest in preventive measures differed globally, with regional differences noted among Asia, Europe, Africa and the Americas. The global differences should be considered for implementing effective interventions against COVID-19. The increased interest in preventive behaviours against COVID-19 may be related to overall infectious disease prevention.
No-biopsy strategy for coeliac disease is applicable in adult patients: a ‘real-world’ Scottish experience
Authors: Hoyle Aoisha , Gillett Peter , Gillett Helen R , Borg Reuben , Nottley Steven , Farrow Samantha , Elgoweini Maha , Elhassan Mohamed , Fletcher Jonathan , Whannel Gemma , Gracie Edel , Morgan Sarah , Jafferbhoy Hasnain , Dunbar Laura , Reid Gordon , Metcalfe Emma L , Smith Graeme , Harris Sarah , Robertson Calum , Thomas Moira , Younger Hazel , Furrie Elizabeth 
Published: August 2022

ObjectiveEmergency interim guidance from the British Society for Gastroenterology (BSG) states that a no-biopsy strategy is possible to diagnose coeliac disease (CD) in adults with elevated transglutaminase IgA antibody (TGA-IgA) levels. We aimed to determine if the suggested TGA-IgA ≥10× ULN is safe and robust in making the diagnosis in adult patients in Scotland. We also aimed to establish if any important co-diagnoses would be missed if no biopsy was performed.MethodAll positive coeliac serology results for patients aged >15 years in Scotland in 2016 (Grampian 2019) were accessed. Data were collected on demographics, TGA-IgA titres, D1 sampling, histology and macroscopic findings at upper and lower gastrointestinal (GI) endoscopy.Results1037/1429 patients with positive serology proceeded to biopsy, of which 796/1037 (76.8%) were diagnosed as CD. A total of 320/322 (99.37%) patients with TGA-IgA ≥10× ULN were diagnosed as CD giving the cut-off a positive predictive value of 99.38%. No significant co-pathology was found at endoscopy in these patients.ConclusionOur results show that a no-biopsy strategy using a cut-off of TGA-IgA ≥10× ULN is safe to diagnose CD and that no important pathology would be missed. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition 2020 and BSG COVID-19 interim guidelines are applicable to adult patients in Scotland.
Femtosecond Laser Combined with Double-Flange Polypropylene Suture Capsular Tension Ring Suspension for the Treatment of Subluxation of Lens in Marfan Syndrome
Authors: Zhou Li , Wu Shangcao , Guo Huafang 
Published: August 2022

Purpose. To evaluate the use of femtosecond laser combined with double-flange polypropylene suture capsular tension ring (CTR) suspension to treat subluxation of lens in Marfan syndrome. The objective is to provide safer and more effective surgical procedures for patients. Setting. Eye Hospital, Aier Eye Hospital of Wuhan University, Wuhan, China Methods. In this retrospective study, we observed sixteen patients (16 eyes) with Marfan syndrome who had undergone this operation. Femtosecond laser incision was performed on the anterior capsule with the lens as the center. The suspending CTR was clipped to anterior capsule to support it, which was secured to the sclera with a double-flange polypropylene suture. Uncorrected visual acuity (UCVA), intraocular pressure (IOP), tilt, and decentration of the intraocular lens (IOL) and postoperative complications were evaluated. Results. All 16 patients were successfully implanted with suspended CTR and IOL after femtosecond laser assisted surgery. Visual acuity improved significantly after surgery (

p
<
0.01

). At 1 month, 3 months and 6 months postoperatively, the tilt of the IOL was

2.70
±
0.934
,
2.65
±
0.897
,
and

2.66
±
0.781

, and the decentration of the IOL was

0.30
±
0.770
,
0.30
±
0.682
,
and

0.29
±
0.737

; both had no statistically significant difference between the three groups. After the operation, 4 patients had hyphema and 2 patients experienced a temporary postoperative IOP increase. Only one flange was exposed one month after operation and recovered right after secondary adjustment. Conclusion. Femtosecond laser combined with double-flange polypropylene suture CTR suspension was effective in fixing the lens capsule to the scleral wall in cases of subluxation of lens seen in Marfan syndrome during our short-term observation. The long-term efficacy of this operation needs further observation and follow-up.
The Wnt Pathway Inhibitor RXC004 Blocks Tumor Growth and Reverses Immune Evasion in Wnt Ligand–dependent Cancer Models
Authors: Phillips Caroline , Bhamra Inder , Eagle Catherine , Flanagan Eimear , Armer Richard , Jones Clifford D. , Bingham Matilda , Calcraft Peter , Edmenson Cook Alicia , Thompson Ben , Woodcock Simon A. 
Published: August 2022

Wnt signaling is implicated in the etiology of gastrointestinal tract cancers. Targeting Wnt signaling is challenging due to on-target toxicity concerns and lack of druggable pathway components. We describe the discovery and characterization of RXC004, a potent and selective inhibitor of the membrane-bound o-acyl transferase Porcupine, essential for Wnt ligand secretion. Absorption, distribution, metabolism, and excretion and safety pharmacology studies were conducted with RXC004 in vitro, and pharmacokinetic exposure assessed in vivo. RXC004 effects on proliferation and tumor metabolism were explored in genetically defined colorectal and pancreatic cancer models in vitro and in vivo. RXC004 effects on immune evasion were assessed in B16F10 immune “cold” and CT26 immune “hot” murine syngeneic models, and in human cell cocultures. RXC004 showed a promising pharmacokinetic profile, inhibited Wnt ligand palmitoylation, secretion, and pathway activation, and demonstrated potent antiproliferative effects in Wnt ligand–dependent (RNF43-mutant or RSPO3-fusion) colorectal and pancreatic cell lines. Reduced tumor growth and increased cancer cell differentiation were observed in SNU-1411 (RSPO3-fusion), AsPC1 and HPAF-II (both RNF43-mutant) xenograft models, with a therapeutic window versus Wnt homeostatic functions. Additional effects of RXC004 on tumor cell metabolism were confirmed in vitro and in vivo by glucose uptake and 18fluorodeoxyglucose-PET, respectively. RXC004 stimulated host tumor immunity; reducing resident myeloid-derived suppressor cells within B16F10 tumors and synergizing with anti-programmed cell death protein-1 (PD-1) to increase CD8+/regulatory T cell ratios within CT26 tumors. Moreover, RXC004 reversed the immunosuppressive effects of HPAF-II cells cocultured with human peripheral blood mononuclear cells, confirming the multiple anticancer mechanisms of this compound, which has progressed into phase II clinical trials.Significance:Wnt pathway dysregulation drives many gastrointestinal cancers; however, there are no approved therapies that target the pathway. RXC004 has demonstrated the potential to block both tumor growth and tumor immune evasion in a genetically defined, clinically actionable subpopulation of Wnt ligand–dependent gastrointestinal cancers. The clinical utility of RXC004, and other Porcupine inhibitors, in such Wnt ligand–dependent cancers is currently being assessed in patient trials.
The Road to the EU’s Accession to the ECHR
Authors: Deftou Maria-Louiza 
Published: August 2022

Abstract
The dual European judicial protection of fundamental rights with the two Courts, namely the Court of Justice of the European Union (CJEU) and the European Court of Human Rights (ECtHR), represents a multi-layered, yet dialectic, model of protection with no formal hierarchy between its components. In the aftermath of Opinion 2/13 and faced with uncontrolled ‘unwanted migration’ flows, the EU judicature defended the principle of mutual trust at any cost and appeared to prioritise the protection of the Dublin regime (the EU responsibility allocation mechanism for examining asylum applications) instead of addressing the novel human rights challenges facing the Common European Asylum System (CEAS). Yet, their interplay has entered a new era since the renegotiation of the EU’s accession to the ECHR launched. By analysing the case law of the two Courts, this article thinks anew their relationship to ascertain whether the evolution of the accession project, throughout the latest decade, has affected the protection offered to ‘unwanted migrants’ in Europe.
The International Settlement of Disputes Under the (Draft) CAI
Authors: Ascensio Hervé 
Published: August 2022

Abstract
The EU-China Comprehensive Agreement on Investment (CAI) establishes a sophisticated inter-State dispute settlement mechanism, directly inspired by the World Trade Organization (WTO) and adapted to a bilateral context, as is also found in recent preferential trade agreements. The novelty here lies in its extension to the field of investment entry and investment facilitation. Some variations in detail are also important. Because of partial material overlap, it is necessary to consider how choice of forum is organized between CAI procedures and those under WTO or other agreements, and to clarify the possible interplay with bilateral investment treaties previously concluded by China with EU Member States. The attention given in CAI to specific procedures for sustainable development and subsidies is also notable. In sum, the solutions adopted show a willingness on the part of the two powers to exert a certain influence on developments in international investment law, without upsetting the methods of dispute resolution.
Soy, China’s Food Security, and the Brazilian Supply
Authors: Romano Schutte Giorgio , Campos Reinaldo 
Published: August 2022

Soy production in Brazil has become a key part of food security policies and has contributed to China's development and social stability since the early 2000s. On the Chinese side, there is a sectoral policy that is part of a broader development strategy, while for Brazil there is a pragmatic response that aims to take advantage of an opportunity that has opened up. The relationship between the two countries, rather than being one of complementarity and reciprocal benefits, is one of asymmetrical interdependence. A produção de soja no Brasil tornou-se parte fundamental das políticas de segurança alimentar e contribuiu para o desenvolvimento e a estabilidade social da China desde o início dos anos 2000. Do lado chinês, há uma política setorial que faz parte de uma estratégia de desenvolvimento mais ampla, enquanto para o Brasil há uma resposta pragmática que visa aproveitar uma oportunidade que se abriu. A relação entre os dois países, mais do que de complementaridade e benefícios recíprocos, é de interdependência assimétrica.
Does the journal impact factor predict individual article citation rate in otolaryngology journals?
Authors: Hussain Salman , Almansouri Abdullah , Allanqawi Lojaine , Philteos Justine , Wu Vincent , Chan Yvonne 
Published: August 2022

ObjectiveCitation skew is a phenomenon that refers to the unequal citation distribution of articles in a journal. The objective of this study was to establish whether citation skew exists in Otolaryngology—Head and Neck Surgery (OHNS) journals and to elucidate whether journal impact factor (JIF) was an accurate indicator of citation rate of individual articles.MethodsJournals in the field of OHNS were identified using Journal Citation Reports. After extraction of the number of citations in 2020 for all primary research articles and review articles published in 2018 and 2019, a detailed citation analysis was performed to determine citation distribution. The main outcome of this study was to establish whether citation skew exists within OHNS literature and whether JIF was an accurate prediction of individual article citation rate.ResultsThirty-one OHNS journals were identified. Citation skew was prevalent across OHNS literature with 65% of publications achieving citation rates below the JIF. Furthermore, 48% of publications gathered either zero or one citation. The mean and median citations for review articles, 3.66 and 2, respectively, were higher than the mean and median number of citations for primary research articles, 1 and 2.35, respectively ( P < .001). A statistically significant correlation was found between citation rate and JIF ( r = 0.394, P = 0.028).ConclusionsThe current results demonstrate a citation skew among OHNS journals, which is in keeping with findings from other surgical subspecialties. The majority of publications did not achieve citation rates equal to the JIF. Thus, the JIF should not be used to measure the quality of individual articles. Otolaryngologists should assess the quality of research through the use of other metrics, such as the evaluation of sound scientific methodology, and the relevance of the articles.
Sources of variability in metro train-induced vibration
Authors: Qu Xiangyu , Thompson David , Ma Meng , Li Minghang , Ntotsios Evangelos 
Published: August 2022

In previous in-situ measurements of metro trains it has been found that the velocity level on the track or tunnel wall may vary significantly between different train passages, even though the measuring section, the type of trains and the track and tunnel conditions are identical. An investigation is carried out into the sources of this variability, using a 3D train-track numerical model. This is built using the software SIMPACK and ABAQUS, and is connected through one-way coupling to a finite element model of the tunnel and soil. These models are used to study the influence of various train parameters, including the wheel and rail unevenness, train speed and degree of train loading. For comparison, in-situ measurements were made of the dynamic response of the rail and tunnel wall. The rail roughness at the site as well as the wheel unevenness of all 48 wheels for one train were measured. The results from the model indicate that the wheel unevenness affects the rail velocity level in the frequency region between 25 and 250 Hz and tunnel wall vibration above 5 Hz. The rail velocity level can vary by up to 20 dB due to wheel unevenness, with the largest variations occurring in the frequency bands 50–63 Hz. Variations in passenger loading affect the train-induced vibration by up to 4.5 dB, mainly in the low frequency region. When the train speed varies within a range of ±20% relative to the nominal speed 60 km/h, the frequencies of the peaks are shifted and the level in some frequency bands can change by as much as 10 dB. However, the largest influence is that of the wheel unevenness. It is concluded that the variation in these parameters, especially the wheel and rail unevenness, should be considered to achieve reliable predictions of train-induced vibration.
Tissue-Based Thrombolysis for Wake-Up Stroke With Basilar Artery Occlusion: A Case Report
Authors: Janocko Nicholas J. , Seitz Alison , Tsiouris A. J. , Lappin Richard I. , Navi Babak B. 
Published: August 2022

Stroke from basilar artery occlusion is associated with a poor natural history with high rates of death and disability. Intravenous thrombolysis administered within 4.5 hours of last known well time improves the odds of a good neurological outcome after ischemic stroke, including in patients with basilar artery occlusion. Thrombectomy for basilar artery occlusion has had mixed outcomes. The WAKE-UP randomized clinical trial demonstrated that administration of intravenous thrombolysis can benefit select patients with wake-up strokes whose brain MRI shows restricted diffusion but no accompanying T2 FLAIR change. We report a case of a wake-up acute ischemic stroke presenting with acute vertigo followed by progressive brainstem dysfunction from a basilar artery occlusion. The patient was successfully treated with intravenous thrombolysis beyond 4.5 hours of last known well and symptom discovery time according to an MRI tissue-based approach resulting in partial recanalization of her basilar artery and recovery to near normal. This case suggests that hyperacute MRI can serve as a tissue clock to select patients with wake-up stroke for acute reperfusion therapy even if they do not meet standard trial inclusion criteria, including patients with basilar artery occlusion.