bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bowel‐Associated‐Dermatosis‐Arthritis Syndrome (BADAS) as early presentation of ulcerative colitis in an adolescent girl
Authors: Johns Hannah Russell , Shetty Nayha , Cash Joshua , Patel Tejesh , Pourciau Crystal 
Published: February 2022

AbstractA 14‐year‐old girl presented with fevers, joint pain, leukocytosis, and painful, fluctuant skin lesions, preceded by a 2‐week history of abdominal cramping and diarrhea. Workup revealed bowel‐associated‐dermatosis‐arthritis syndrome (BADAS) in the setting of ulcerative colitis, a rare finding in the pediatric population.
Impact of review narrativity on sales in a competitive environment
Authors: Mukhopadhyay Soumya , Kumar V , Sharma Amalesh , Chung Tuck Siong 
Published: February 2022

Online user‐generated reviews have received significant importance in the literature as they help consumers make consumption decisions. However, despite significant developments in this domain in the past decade, little attention has been paid to how narrative aspects of reviews affect consumers’ consumption decisions and, consequently, influence sales. A narrative can be defined as a sequentially structured discourse that provides an understanding of the events that unfold around the narrator. Relying on the literature on narrative transportation, we examine the role of review narrativity in determining firm sales, the contingency effect of the competitive environment, and review polarity. Specifically, we propose that review narrativity has an asymmetric U‐shaped (or, J‐shaped) relationship with sales; the impact of review narrativity on sales would have significant positive interaction with the polarity of the review text; and that under high (low) competitive agglomeration, review narrativity would have a significant (insignificant) positive impact on sales. Operationalizing review narrativity using three different measures from a unique and rich dataset collected from OpenTable and using a Bayesian framework, consistent with our hypotheses, we find that the narrativity of textual reviews exerts a significant nonlinear impact on sales contingent on their polarity. Enriching the relatively nascent empirical literature on the effects of competitive context on eWOM, the current paper further offers clear empirical evidence that the impact of review narrativity on sales is significantly higher (lower) under a high (low) competitive agglomeration. The paper makes a methodological contribution by developing a flexible framework to identify the proposed relationships better while accounting for heterogeneity, endogeneity, and temporal patterns in the context of dynamic panels.
Language and learning in ethnically mixed communities
Authors: Kumar Hemanshu , Somanathan Rohini , Vasishth Mahima 
Published: February 2022

AbstractMany school children in ethnically diverse countries live in multilingual environments where the medium of instruction in school differs from their mother tongue. We conduct a field experiment in a multiethnic village in northern India to study the relative importance of linguistic distance and neighborhood isolation in the acquisition of language and mathematics skills in elementary school. The village has two sizable ethnic groups speaking languages very different from the medium of school instruction. Students attempt a set of mazes and take tests in reading and mathematics. We find that performance in language‐dependent tasks relative to mazes is lower for children whose mother tongue is different from the medium of instruction only if their ethnic group is also residentially segregated. Language policy in most countries has traditionally favored either mother‐tongue instruction or assimilation into mainstream language and culture. Our results suggest that there may be value in a more nuanced approach that flexibly combines some instructional support in a mother tongue for those who need it, with policies that encourage contact with speakers of dominant languages to benefit from peers and social networks.
Is national identity in crisis? An assessment of national imaginations in the early 2020s
Authors: Aguirresarobe Asier H. 
Published: February 2022

AbstractThe current context of a worldwide pandemic has once again sparked debate about the bleak future of nationalism. For those who support this view, the fact that long‐lasting national identities are being decisively contested represents a major symptom of the crisis of nationalism, which the challenges associated with the coronavirus outbreak can only accentuate. In this paper, it is my objective to prove this belief incorrect and to demonstrate that nationalism remains almost hegemonic as a form of political and communal identification. My method for achieving this goal comprises two interlinked endeavours: first, a theoretical analysis of the concepts of crisis and national identity; second, an overview of current global conflicts and political debates to determine the extent to which they fit with a nationalist worldview. The results of this research suggest that national perspectives – from which national identities arise – are not experiencing any meaningful challenge in contemporary societies. Even in those cases where deep‐seated national discourses are threatened, such opposition remains constrained by the assumptions of the nationalist worldview. Consequently, and albeit the COVID‐19 pandemic may ultimately result in the triumph of globalism, it is more likely that international cooperation will develop in a world constructed of national imaginations rather than one from which these have disappeared.
Key factors influencing the effectiveness of hospital quality management tools: using the quality control circle as an example–a cross-sectional study
Authors: Zhang Dan , Yan Yue , Liu Ting-Fang 
Published: February 2022

ObjectiveTo identify the key factors influencing the effectiveness of hospital quality management tools and analyse the mechanisms needed for long-term scientific hospital management.MethodsIn this cross-sectional study, a large number of participants in quality control circle (QCC) activities were investigated on site. Data were collected by the questionnaire during the sixth National Hospital Quality Control Circle Competition in Shandong, China, in October 2018. A total of 1500 participants were randomly selected, in which 1316 questionnaires were completed, yielding an overall response rate of 87.73%, and 1181 questionnaires were valid. We performed a stepwise regression analysis to identify the independent variables with explanatory ability. Then the total mean score of the organisational, group, and individual factors were introduced layer by layer, and a regression model with four levels was established.ResultsThe application effectiveness of QCC activities can be divided into three dimensions: individual factors, group factors and organisational factors. Utility perception was the most important individual factor. Inappropriate incentives and rewards had a negative effect on both organisational effectiveness and individual effectiveness. The attitude and ability of the circle monitor and counsellors, the specificity of the goals were the key group factors. Of the organisational factors, activity orientation had the greatest impact. Among the three dimensions, individual factors had the most significant influence on the effectiveness of QCCs, followed by group factors, then by organisational factors.ConclusionThese results suggest that addressing the concerns of the leaders and implementing a safeguard system that protects the QCC tool from neglect or failure, that strengthening team building and using team rewards or non-material incentives to enhance enthusiasm, and that mobilising the enthusiasm of the circle members and even the whole hospital for using quality management tools are essential.
Effect and neural mechanisms of the transcutaneous vagus nerve stimulation for relapse prevention in patients with remitted major depressive disorder: protocol for a longitudinal study
Authors: Zhang Zhu-Qing , Guo Zhi-Peng , Lv Xue-Yu , Sörös Peter , Wang Xiao-Xu , Wang Lihong , Liu Chun-Hong 
Published: February 2022

IntroductionAfter the first episode, patients with remitted major depressive disorder (MDD) have a 60% chance of experiencing a second episode. There are currently no accepted, effective methods to prevent the recurrence of MDD in remission. Transcutaneous vagus nerve stimulation (taVNS) is a non-invasive, safe and economical approach based on the efficacy of VNS in improving clinical depression symptoms. This clinical trial will study the efficacy of taVNS in preventing MDD relapse and investigate the underlying mechanisms of this.Methods and analysisWe will conduct a multicentre, randomised, patient-blinded and evaluators double-blinded trial. We will randomise 90 eligible participants with recurrent MDD in remission in a 1:1 ratio into a real or sham taVNS group. All participants will be given six biopsychosocial assessments: proinflammatory cytokines, serum monoamine neurotransmitters, cognition, affective neuropsychology, multimodal neuroimaging and endocrinology. After the baseline measurements, all participants will be given corresponding interference for 6 months and then complete a 1-year follow-up. The assessments will be performed three times: at baseline, post-treatment and at the end of 1-year follow-up (except for multimodal MRI scanning, which will be conducted at the first two assessments only). Change in 17-item Hamilton Depression Rating Scale scores for MDD is the primary outcome parameter.Ethics and disseminationThe study protocol was approved by the Medical Ethical Committee of Beijing Hospital of Traditional Chinese Medicine on 18 January 2019 (2018BL-076). The trial results will be published in peer-reviewed journals and at conferences.Trial registration numberChiCTR1900022618.
Investigating the optimal handling of uncertain pregnancy episodes in the CPRD GOLD Pregnancy Register: a methodological study using UK primary care data
Authors: Campbell Jennifer , Bhaskaran Krishnan , Thomas Sara , Williams Rachael , McDonald Helen I , Minassian Caroline 
Published: February 2022

ObjectivesTo investigate why episodes of pregnancy identified from electronic health records may be incomplete or conflicting (overlapping), and provide guidance on how to handle them.SettingPregnancy Register generated from the Clinical Practice Research Datalink (CPRD) GOLD UK primary care database.ParticipantsFemale patients with at least one pregnancy episode in the Register (01 January 1937−31 December 2017) which had no recorded outcome or conflicted with another episode.DesignWe identified multiple scenarios potentially explaining why uncertain episodes occur. Criteria were established and systematically applied to determine whether episodes had evidence of each scenario. Linked Hospital Episode Statistics were used to identify pregnancy events not captured in primary care.ResultsOf 5.8 million pregnancy episodes in the Register, 932 604 (16%) had no recorded outcome, and 478 341 (8.5%) conflicted with another episode (251 026 distinct conflicting pairs of episodes among 210 593 women). 826 146 (89%) of the episodes without outcome recorded in primary care and 215 577 (86%) of the conflicting pairs were consistent with one or more of our proposed scenarios. For 689 737 (74%) episodes with recorded outcome missing and 215 544 (86%) of the conflicting pairs (at least one episode), supportive evidence (eg, antenatal records, linked hospital records) suggested they were true and current pregnancies. Furthermore, 516 818 (55 %) and 160 936 (64%), respectively, were during research quality follow-up time. For a sizeable proportion of uncertain episode, there is evidence to suggest that historical outcomes being recorded by the general practitioner during an ongoing pregnancy may offer explanation (73 208 (29.2%) and 349 874 (37.5%)).ConclusionsThis work provides insight to users of the CPRD Pregnancy Register on why uncertain pregnancy episodes exist and indicates that most of these episodes are likely to be real pregnancies. Guidance is given to help researchers consider whether to include/exclude uncertain pregnancies from their studies, and how to tailor approaches to minimise underestimation and bias.
Toripalimab plus axitinib in patients with metastatic mucosal melanoma: 3-year survival update and biomarker analysis
Authors: Li Siming , Wu Xiaowen , Yan Xieqiao , Zhou Li , Chi Zhihong , Si Lu , Cui Chuanliang , Tang Bixia , Mao Lili , Lian Bin , Wang Xuan , Bai Xue , Dai Jie , Kong Yan , Tang Xiongwen , Feng Hui , Yao Sheng , Flaherty Keith T , Guo Jun , Sheng Xinan 
Published: February 2022

BackgroundMucosal melanoma is an aggressive melanoma subtype with poor response to antiprogrammed cell death-1 (PD-1) monotherapy. Axitinib in combination with toripalimab, a humanized IgG4 mAb against PD-1, showed a promising response rate in patients with metastatic mucosal melanoma (MM) in a phase Ib study. Here, we report the updated overall survival (OS), duration of response (DoR), and biomarker analysis results.MethodsPatients with advanced MM received toripalimab 1 or 3 mg/kg intravenously every 2 weeks combined with axitinib 5 mg orally two times per day until disease progression or unacceptable toxicity. Tumor programmed cell death ligand-1 (PD-L1) expression, tumor mutational burden (TMB), and gene expression profile (GEP) by messenger RNA sequencing were evaluated for correlation with survival.ResultsAs of April 2, 2021, the median follow-up was 42.5 months. Among 29 chemotherapy-naïve patients with metastatic MM, the median OS was 20.7 months (95% CI 9.7 to 32.7 months); the median progression-free survival (PFS) was 7.5 months (95% CI 3.8 to 14.8 months); and the median DoR was 13.4 months (95% CI 5.5 to 20.6 months). The OS rates of 1, 2, and 3 years were 62.1%, 44.8%, and 31.0%, respectively. Biomarker analysis found that PD-L1 expression and TMB level were not associated with survival benefits. In contrast, a 12-GEP signature correlated with improved PFS (17.7 vs 5.7 months, p=0.0083) and OS (35.6 vs 17.6 months, p=0.039).ConclusionsThe 3-year survival update confirmed the antitumor activity and long-term survival benefit of the toripalimab plus axitinib combination in patients with advanced MM. The 12-gene GEP is of value in predicting the outcomes of vascular endothelial growth factor receptor-tyrosine kinase inhibitor and PD-1 blockade combination therapy, but requires further validation.Trial registration numbersNCT03086174.
Immune response to SARS-CoV-2 vaccination in relation to peripheral immune cell profiles among patients with multiple sclerosis receiving ocrelizumab
Authors: Räuber Saskia , Korsen Melanie , Huntemann Niklas , Rolfes Leoni , Müntefering Thomas , Dobelmann Vera , Hermann Alexander M , Kölsche Tristan , von Wnuck Lipinski Karin , Schroeter Christina B , Nelke Christopher , Regner-Nelke Liesa , Ingwersen Jens , Pawlitzki Marc , Teegen Bianca , Barnett Michael Harry , Hartung Hans-Peter , Aktas Orhan , Albrecht Philipp , Levkau Bodo , Melzer Nico , Ruck Tobias , Meuth Sven G , Kremer David 
Published: February 2022

BackgroundVaccination has proven to be effective in preventing SARS-CoV-2 transmission and severe disease courses. However, immunocompromised patients have not been included in clinical trials and real-world clinical data point to an attenuated immune response to SARS-CoV-2 vaccines among patients with multiple sclerosis (MS) receiving immunomodulatory therapies.MethodsWe performed a retrospective study including 59 ocrelizumab (OCR)-treated patients with MS who received SARS-CoV-2 vaccination. Anti-SARS-CoV-2-antibody titres, routine blood parameters and peripheral immune cell profiles were measured prior to the first (baseline) and at a median of 4 weeks after the second vaccine dose (follow-up). Moreover, the SARS-CoV-2-specific T cell response and peripheral B cell subsets were analysed at follow-up. Finally, vaccination-related adverse events were assessed.ResultsAfter vaccination, we found anti-SARS-CoV-2(S) antibodies in 27.1% and a SARS-CoV-2-specific T cell response in 92.7% of MS cases. T cell-mediated interferon (IFN)-γ release was more pronounced in patients without anti-SARS-CoV-2(S) antibodies. Antibody titres positively correlated with peripheral B cell counts, time since last infusion and total IgM levels. They negatively correlated with the number of previous infusion cycles. Peripheral plasma cells were increased in antibody-positive patients. A positive correlation between T cell response and peripheral lymphocyte counts was observed. Moreover, IFN-γ release was negatively correlated with the time since the last infusion.ConclusionIn OCR-treated patients with MS, the humoral immune response to SARS-CoV-2 vaccination is attenuated while the T cell response is preserved. However, it is still unclear whether T or B cell-mediated immunity is required for effective clinical protection. Nonetheless, given the long-lasting clinical effects of OCR, monitoring of peripheral B cell counts could facilitate individualised treatment regimens and might be used to identify the optimal time to vaccinate.
Depressive Symptoms and Incident Heart Failure in the Jackson Heart Study: Differential Risk Among Black Men and Women
Authors: Gaffey Allison E. , Cavanagh Casey E. , Rosman Lindsey , Wang Kaicheng , Deng Yanhong , Sims Mario , O’Brien Emily C. , Chamberlain Alanna M. , Mentz Robert J. , Glover LáShauntá M. , Burg Matthew M. 
Published: February 2022

Background
Associations between depression, incident heart failure (HF), and mortality are well documented in predominately White samples. Yet, there are sparse data from racial minorities, including those who are women, and depression is underrecognized and undertreated in the Black population. Thus, we examined associations between baseline depressive symptoms, incident HF, and all‐cause mortality across 10 years.

Methods and Results

We included Jackson Heart Study (JHS) participants with no history of HF at baseline (n=2651; 63.9% women; median age, 53 years). Cox proportional hazards models tested if the risk of incident HF or mortality differed by clinically significant depressive symptoms at baseline (Center for Epidemiological Studies–Depression scores ≥16 versus <16). Models were conducted in the full sample and by sex, with hierarchical adjustment for demographics, HF risk factors, and lifestyle factors. Overall, 538 adults (20.3%) reported high depressive symptoms (71.0% were women), and there were 181 cases of HF (cumulative incidence, 0.06%). In the unadjusted model, individuals with high depressive symptoms had a 43% greater risk of HF (
P
=0.035). The association remained with demographic and HF risk factors but was attenuated by lifestyle factors. All‐cause mortality was similar regardless of depressive symptoms. By sex, the unadjusted association between depressive symptoms and HF remained for women only (
P
=0.039). The fully adjusted model showed a 53% greater risk of HF for women with high depressive symptoms (
P
=0.043).

Conclusions
Among Black adults, there were sex‐specific associations between depressive symptoms and incident HF, with greater risk among women. Sex‐specific management of depression may be needed to improve cardiovascular outcomes.
Accelerometer‐Derived Daily Life Movement Classified by Machine Learning and Incidence of Cardiovascular Disease in Older Women: The OPACH Study
Authors: Nguyen Steve , Bellettiere John , Wang Guangxing , Di Chongzhi , Natarajan Loki , LaMonte Michael J. , LaCroix Andrea Z. 
Published: February 2022

Background
Current physical activity guidelines focus on volume and intensity for CVD prevention rather than common behaviors responsible for movement, including those for daily living activities. We examined the associations of a machine‐learned, accelerometer‐measured behavior termed daily life movement (DLM) with incident CVD.

Methods and Results
Older women (n=5416; mean age, 79±7 years; 33% Black, 17% Hispanic) in the Women’s Health Initiative OPACH (Objective Physical Activity and Cardiovascular Health) study without prior CVD wore ActiGraph GT3X+ accelerometers for up to 7 days from May 2012 to April 2014 and were followed for physician‐adjudicated incident CVD through February 28th, 2020 (n=616 events). DLM was defined as standing and moving in a confined space such as performing housework or gardening. Cox models estimated hazard ratios (HR) and 95% CI, adjusting for age, race and ethnicity, education, alcohol use, smoking, multimorbidity, self‐rated health, and physical function. Restricted cubic splines examined the linearity of the DLM‐CVD dose‐response association. We examined effect modification by age, body mass index, Reynolds Risk Score, and race and ethnicity. Adjusted HR (95% CIs) across DLM quartiles were: 1.00 (reference), 0.68 (0.55–0.84), 0.70 (0.56–0.87), and 0.57 (0.45–0.74); p‐trend<0.001. The HR (95% CI) for each 1‐hour increment in DLM was 0.86 (0.80–0.92) with evidence of a linear dose‐response association (p non‐linear>0.09). There was no evidence of effect modification by age, body mass index, Reynolds Risk Score, or race and ethnicity.

Conclusions
Higher DLM was independently associated with a lower risk of CVD in older women. Describing the beneficial associations of physical activity in terms of common behaviors could help older adults accumulate physical activity.
Long‐Term Cardiovascular Health After Pregnancy in Danish Women With Congenital Heart Disease. A Register‐Based Cohort Study Between 1993 and 2016
Authors: Kloster Stine , Tolstrup Janne S. , Nielsen Dorte Guldbrand , Søndergaard Lars , Johnsen Søren Paaske , Ersbøll Annette Kjær 
Published: February 2022

Background
Little is known about the impact of pregnancy on long‐term cardiovascular health in individuals with congenital heart disease (CHD). We aimed to determine if giving birth in patients with CHD is associated with higher risk of long‐term cardiovascular morbidity.

Methods and Results
We studied a cohort of 1262 individuals with CHD giving birth (live or still) from 1993 to 2015 using Danish nationwide registers. We randomly sampled a comparison cohort matched on age of women with CHD who had not given birth at the time. We balanced the 2 cohorts on baseline demographic (eg, education) and clinical variables (eg, CHD severity) using inverse probability of treatment weighting. Individuals were followed for critical (eg, heart failure), other cardiovascular morbidity (eg, arrhythmia), and cardiac surgery/interventions after pregnancy. Individuals were followed for median 6.0 years (interquartile range 3.2–9.2). Among individuals giving birth the incidence rate per 1000 person‐years was 1.6, 10.0, and 6.0 for critical and other cardiovascular morbidity and cardiac surgery, respectively. There was no overall difference in risk of neither critical and other cardiovascular morbidity nor cardiac surgery among individuals who gave birth and individuals who did not; adjusted hazard ratios (aHR) were 0.74 (95% CI, 0.37–1.48), 0.88 (95% CI, 0.65–1.19), and 0.78 (95% C,I 0.54–1.12), respectively. However, individuals with obstetric complications had a higher long‐term risk of other cardiovascular morbidity (aHR, 1.85; 95% CI, 1.07–3.20).

Conclusions
Giving birth seemed not to be associated with a higher risk of long‐term cardiovascular morbidity among women with CHD. However, individuals having obstetric complications had a higher risk of other cardiovascular morbidity in the long term.