bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Outcomes and Risk Stratification of Early-Stage Melanoma Micrometastases From an International Multicenter Study: Implications for the Management of American Joint Committee on Cancer IIIA Disease
Authors: Moncrieff Marc D. , Lo Serigne N. , Scolyer Richard A. , Heaton Martin J. , Nobes Jenny P. , Snelling Andrew P. , Carr Michael J. , Nessim Carolyn , Wade Ryckie , Peach A. Howard , Kisyova Rumi , Mason Jennifer , Wilson Ewan D. , Nolan Grant , Pritchard Jones Rowan , Johansson Iva , Olofsson Bagge Roger , Wright Lucie J. , Patel Nakul G. , Sondak Vernon K. , Thompson John F. , Zager Jonathan S. 
Published: July 2022

PURPOSE Indications for offering adjuvant systemic therapy for patients with early-stage melanomas with low disease burden sentinel node (SN) micrometastases, namely, American Joint Committee on Cancer (AJCC; eighth edition) stage IIIA disease, are presently controversial. The current study sought to identify high-risk SN-positive AJCC stage IIIA patients who are more likely to derive benefit from adjuvant systemic therapy. METHODS Patients were recruited from an intercontinental (Australia/Europe/North America) consortium of nine high-volume cancer centers. All were adult patients with pathologic stage pT1b/pT2a primary cutaneous melanomas who underwent SN biopsy between 2005 and 2020. Patient data, primary tumor and SN characteristics, and survival outcomes were analyzed. RESULTS Three thousand six hundred seven patients were included. The median follow-up was 34 months. Pairwise disease comparison demonstrated no significant survival difference between N1a and N2a subgroups. Survival analysis identified a SN tumor deposit maximum dimension of 0.3 mm as the optimal cut point for stratifying survival. Five-year disease-specific survival rates were 80.3% and 94.1% for patients with SN metastatic tumor deposits ≥ 0.3 mm and < 0.3 mm, respectively (hazard ratio, 1.26 [1.11 to 1.44]; P < .0001). Similar findings were seen for overall disease-free and distant metastasis-free survival. There were no survival differences between the AJCC IB patients and low-risk (< 0.3 mm) AJCC IIIA patients. The newly identified high-risk (≥ 0.3 mm) subgroup comprised 271 (66.4%) of the AJCC IIIA cohort, whereas only 142 (34.8%) patients had SN tumor deposits > 1 mm in maximum dimension. CONCLUSION Patients with AJCC IIIA melanoma with SN tumor deposits ≥ 0.3 mm in maximum dimension are at higher risk of disease progression and may benefit from adjuvant systemic therapy or enrollment into a clinical trial. Patients with SN deposits < 0.3 mm in maximum dimension can be managed similar to their SN-negative, AJCC IB counterparts, thereby avoiding regular radiological surveillance and more intensive follow-up.
A global survey of healthcare professionals undertaking MRI of patients with cochlear implants: a heterogeneity of practice and opinions
Authors: Dewey Rebecca Susan , Bowtell Richard , Kitterick Padraig 
Published: July 2022

Objective: To capture practice and opinions around the current clinical use of MRI in patients with cochlear implants (CIs), and to characterise patient progression from referral to image reporting. Methods: An online survey recruited 237 healthcare professionals between 9 December 2019 and 9 September 2020. Descriptive statistics and informal thematic analyses were conducted. Results: Respondents estimated that approximately 75% of CI users referred for an MRI proceeded to image acquisition, of which ~70% of cases comprised image acquisition on the head and the remaining cases on another area. They estimated that the proportion of these images that were usable was 93 and 99%, respectively. Confidence in most processes was high, with at least two-thirds of respondents reporting to be very or somewhat confident in obtaining consent and acquiring images. Conversely, fewer than half the respondents had the same confidence when splinting and bandaging the implant and troubleshooting any issues arising. Patient safety was rated of paramount importance, with patient comfort a clear second and image quality third. Conclusion: These findings highlight the need for consistent publication of clear, succinct, and standardised operating procedures for scanning patients with CIs and the requirement for regular training of radiographic and radiological healthcare professionals to address the heterogeneity of devices available. Advances in knowledge: There is a need to improve the communication to radiography and radiology personnel regarding the nature of CIs, the heterogeneity of devices in existence, and the key differences between them. CI users risk being underserved by diagnostic medical imaging.
Prevention of venous thromboembolic events in patients with lower leg immobilization after trauma: Systematic review and network meta-analysis with meta-epsidemiological approach
Authors: Douillet D. , Chapelle C. , Ollier E. , Mismetti P. , Roy P.-M. , Laporte S. 
Published: July 2022

Background
Lower limb trauma requiring immobilization is a significant contributor to overall venous thromboembolism (VTE) burden. The clinical effectiveness of thromboprophylaxis for this indication and the optimal agent strategy are still a matter of debate. Our main objective was to assess the efficacy of pharmacological thromboprophylaxis to prevent VTE in patients with isolated temporary lower limb immobilization after trauma. We aimed to estimate and compare the clinical efficacy and the safety of the different thromboprophylactic treatments to determine the best strategy.

Methods and findings
We conducted a systematic review and a Bayesian network meta-analysis (NMA) including all available randomized trials comparing a pharmacological thromboprophylactic treatment to placebo or to no treatment in patients with leg immobilization after trauma. We searched Medline, Embase, and Web of Science until July 2021. Only RCT or observational studies with analysis of confounding factors including adult patients requiring temporary immobilization for an isolated lower limb injury treated conservatively or surgically and assessing pharmacological thromboprophylactic agents or placebo or no treatment were eligible for inclusion. The primary endpoint was the incidence of major VTE (proximal deep vein thrombosis, symptomatic VTE, and pulmonary embolism-related death). We extracted data according to Preferred Reporting Items for Systematic Reviews and Meta-analyses for NMA and appraised selected trials with the Cochrane review handbook. Fourteen studies were included (8,198 patients). Compared to the control group, rivaroxaban, fondaparinux, and low molecular weight heparins were associated with a significant risk reduction of major VTE with an odds ratio of 0.02 (95% credible interval (CrI) 0.00 to 0.19), 0.22 (95% CrI 0.06 to 0.65), and 0.32 (95% CrI 0.15 to 0.56), respectively. No increase of the major bleeding risk was observed with either treatment. Rivaroxaban has the highest likelihood of being ranked top in terms of efficacy and net clinical benefit. The main limitation is that the network had as many indirect comparisons as direct comparisons.

Conclusions
This NMA confirms the favorable benefit/risk ratio of thromboprophylaxis for patients with leg immobilization after trauma with the highest level of evidence for rivaroxaban.

Trial registration
PROSPERO CRD42021257669.
Geospatial modeling of pre-intervention nodule prevalence of Onchocerca volvulus in Ethiopia as an aid to onchocerciasis elimination
Authors: Shrestha Himal , McCulloch Karen , Hedtke Shannon M. , Grant Warwick N. 
Published: July 2022

Background
Onchocerciasis is a neglected tropical filarial disease transmitted by the bites of blackflies, causing blindness and severe skin lesions. The change in focus for onchocerciasis management from control to elimination requires thorough mapping of pre-control endemicity to identify areas requiring interventions and to monitor progress. Onchocerca volvulus nodule prevalence in sub-Saharan Africa is spatially continuous and heterogeneous, and highly endemic areas may contribute to transmission in areas of low endemicity or vice-versa. Ethiopia is one such onchocerciasis-endemic country with heterogeneous O. volvulus nodule prevalence, and many districts are still unmapped despite their potential for onchocerciasis transmission.

Methodology/Principle findings
A Bayesian geostatistical model was fitted for retrospective pre-intervention nodule prevalence data collected from 916 unique sites and 35,077 people across Ethiopia. We used multiple environmental, socio-demographic, and climate variables to estimate the pre-intervention prevalence of O. volvulus nodules across Ethiopia and to explore their relationship with prevalence. Prevalence was high in southern and northwestern Ethiopia and low in Ethiopia’s central and eastern parts. Distance to the nearest river (RR: 0.9850, 95% BCI: 0.9751–0.995), precipitation seasonality (RR: 0.9837, 95% BCI: 0.9681–0.9995), and flow accumulation (RR: 0.9586, 95% BCI: 0.9321–0.9816) were negatively associated with O. volvulus nodule prevalence, while soil moisture (RR: 1.0218, 95% BCI: 1.0135–1.0302) was positively associated. The model estimated the number of pre-intervention cases of O. volvulus nodules in Ethiopia to be around 6.48 million (95% BCI: 3.53–13.04 million).

Conclusions/Significance
Nodule prevalence distribution was correlated with habitat suitability for vector breeding and associated biting behavior. The modeled pre-intervention prevalence can be used as a guide for determining priorities for elimination mapping in regions of Ethiopia that are currently unmapped, most of which have comparatively low infection prevalence.
The spatial-temporal distribution of soil-transmitted helminth infections in Guangdong Province, China: A geostatistical analysis of data derived from the three national parasitic surveys
Authors: Huang Si-Yue , Lai Ying-Si , Fang Yue-Yi 
Published: July 2022

Background
The results of the latest national survey on important human parasitic diseases in 2015–2016 showed Guangdong Province is still a moderately endemic area, with the weighted prevalence of soil-transmitted helminths (STHs) higher than the national average. High-resolution age- and gender-specific spatial-temporal risk maps can support the prevention and control of STHs, but not yet available in Guangdong.

Methodology
Georeferenced age- and gender-specific disease data of STH infections in Guangdong Province was derived from three national surveys on important human parasitic diseases, conducted in 1988–1992, 2002–2003, and 2015–2016, respectively. Potential influencing factors (e.g., environmental and socioeconomic factors) were collected from open-access databases. Bayesian geostatistical models were developed to analyze the above data, based on which, high-resolution maps depicting the STH infection risk were produced in the three survey years in Guangdong Province.

Principal findings
There were 120, 31, 71 survey locations in the first, second, and third national survey in Guangdong, respectively. The overall population-weighted prevalence of STH infections decreased significantly over time, from 68.66% (95% Bayesian credible interval, BCI: 64.51–73.06%) in 1988–1992 to 0.97% (95% BCI: 0.69–1.49%) in 2015–2016. In 2015–2016, only low to moderate infection risk were found across Guangdong, with hookworm becoming the dominant species. Areas with relatively higher risk (>5%) were mostly distributed in the western region. Females had higher infection risk of STHs than males. The infection risk of A. lumbricoides and T. trichiura were higher in children, while middle-aged and elderly people had higher infection risk of hookworm. Precipitation, elevation, land cover, and human influence index (HII) were significantly related with STH infection risk.

Conclusions/Significance
We produced the high-resolution, age- and gender-specific risk maps of STH infections in the three national survey periods across nearly 30 years in Guangdong Province, which can provide important information assisting the control and prevention strategies.
Association of primary postpartum hemorrhage with inter-pregnancy interval in urban South Ethiopia: A matched nested case-control study
Authors: Jena Belayneh Hamdela , Biks Gashaw Andargie , Gete Yigzaw Kebede , Gelaye Kassahun Alemu 
Published: July 2022

Background
Globally, postpartum hemorrhage is the leading preventable cause of maternal mortality. To decrease postpartum hemorrhage-related maternal mortalities, identifying its risk factors is crucial to suggest interventions. In this regard, little is known about the link between primary postpartum hemorrhage and inter-pregnancy interval in Ethiopia, where more than half of pregnancies occur shortly after the preceding childbirth. Therefore, we aimed to elucidate the association of primary postpartum hemorrhage with an inter-pregnancy interval in urban South Ethiopia.

Methods
A community-based matched nested case-control study was conducted among a cohort of 2548 pregnant women. All women with primary postpartum hemorrhage during the follow-up (n = 73) were taken as cases. Women who were randomly selected from those without primary postpartum hemorrhage (n = 292) were taken as controls. Cases were individually matched with controls (1:4 ratio) for age group and location. A conditional logistic regression analysis was done using R version 4.0.5 software. Statistically, a significant association was declared using 95% CI and p-value. Attributable fraction (AF) and population attributable fraction (PAF) were used to estimate the public health impacts of the inter-pregnancy interval.

Results
This study found out that more than half (66%) of primary postpartum hemorrhage was attributed to inter-pregnancy interval <24 months (AF = 66.3%, 95% CI: 37.5, 82.5%). This could be prevented if the inter-pregnancy interval was increased to 24–60 months. Likewise, nearly half (49%) of primary postpartum hemorrhage in the study population could be prevented if the inter-pregnancy interval <24 months was prevented. Additionally, primary postpartum hemorrhage was attributed to antepartum hemorrhage, prolonged labour and multiple pregnancies.

Conclusions
Primary postpartum hemorrhage was associated with inter-pregnancy interval under 24 months, highlighting the need to improve postpartum modern contraceptive utilization in the community. Counseling couples about how long to wait until subsequent pregnancy and the risk when the inter-pregnancy interval is short need to be underlined.
Who is seeking help for psychological distress associated with the COVID-19 pandemic? Characterization of risk factors in 1269 participants accessing low-threshold psychological help
Authors: Hilbert Kevin , Boeken Ole , Asbrand Julia , Seemann Sophia , Langhammer Till , Praxl Berit , Horváth Leonore , Ertle Andrea , Lueken Ulrike 
Published: July 2022

BackgroundThe COVID-19 pandemic and accompanying restrictions are associated with substantial psychological distress. However, it is unclear how this increased strain translates into help-seeking behavior. Here, we aim to characterize those individuals who seek help for COVID-19 related psychological distress, and examine which factors are associated with their levels of distress in order to better characterize vulnerable groups.MethodsWe report data from 1269 help-seeking participants subscribing to a stepped-care program targeted at mental health problems due to the COVID-19 pandemic. Sample characteristics were compared to population data, and linear regression analyses were used to examine which risk factors and stressors were associated with current symptom levels.ResultsSeeking for help for COVID-19 related psychological distress was characterized by female gender, younger age, and better education compared to the general population. The majority reported mental health problems already before the pandemic. 74.5% of this help-seeking sample also exceeded clinical thresholds for depression, anxiety, or somatization. Higher individual symptom levels were associated with higher overall levels of pandemic stress, younger age, and pre-existing mental health problems, but were buffered by functional emotion regulation strategies.ConclusionsResults suggest a considerable increase in demand for mental-healthcare in the pandemic aftermath. Comparisons with the general population indicate diverging patterns in help-seeking behavior: while some individuals seek help themselves, others should be addressed directly. Individuals that are young, have pre-existing mental health problems and experience a high level of pandemic stress are particularly at-risk for considerable symptom load. Mental-healthcare providers should use these results to prepare for the significant increase in demand during the broader aftermath of the COVID-19 pandemic as well as allocate limited resources more effectively.
The microeconomic impact of out-of-pocket medical expenditure on the households of cardiovascular disease patients in general and specialized heart hospitals in Ibadan, Nigeria
Authors: Adeniji Folashayo Ikenna Peter , Lawanson Akanni Olayinka , Osungbade Kayode Omoniyi 
Published: July 2022

Background
Cardiovascular diseases (CVDs) present a huge threat to population health and in addition impose severe economic burden on individuals and their households. Despite this, there is no research evidence on the microeconomic impact of CVDs in Nigeria. Therefore, this study estimated the incidence and intensity of catastrophic health expenditures (CHE), poverty headcount due to out-of-pocket (OOP) medical spending and the associated factors among the households of a cohort of CVDs patients who accessed healthcare services in public and specialized heart hospitals in Ibadan, Nigeria.

Methods
This study adopts a descriptive cross-sectional study design. A standardized data collection questionnaire developed by the Initiative for Cardiovascular Health Research in Developing Countries was adapted to electronically collect data from all the 744 CVDs patients who accessed healthcare services in public and specialized heart hospitals in Ibadan between 4th November 2019 to the 31st January 2020. A sensitivity analysis, using rank-dependent thresholds of CHE which ranged from 5%-40% of household total expenditures was carried out. The international poverty line of $1.90/day recommended by the World Bank was utilized to ascertain poverty headcounts pre-and post OOP payments for healthcare services. Categorical variables like household socio-demographic and clinical characteristics, CHE and poverty headcounts, were presented using percentages and proportions. Unadjusted and adjusted logistic regression models were used to assess the factors associated with CHE and poverty. Data were analyzed using STATA version 15 and estimates were validated at 5% level of significance.

Results
Catastrophic OOP payment ranged between 3.9%-54.6% and catastrophic overshoot ranged from 1.8% to 12.6%. Health expenditures doubled poverty headcount among households, from 8.13% to 16.4%. Having tertiary education (AOR: 0.49, CI: 0.26–0.93, p = 0.03) and household size (AOR: 0.40, CI: 0.24–0.67, p = 0.001) were significantly associated with CHE. Being female (AOR: 0.41, CI: 0.18–0.92, p = 0.03), household economic status (AOR: 0.003, CI: 0.0003–0.25, p = <0.001) and having 3–4 household members (AOR: 0.30, CI: 0.15–0.61, p = 0.001) were significantly associated with household poverty status post payment for medical services.

Conclusion
OOP medical spending due to CVDs imposed enormous strain on household resources and increased the poverty rates among households. Policies and interventions that supports universal health coverage are highly recommended.
Алкогольные циклы: динамика потребления алкоголя в советской и постсоветской России, 1980–2010-е годы
Authors: Радаев Вадим Валерьевич 
Published: July 2022

Цель работы — выявление основных трендов в потреблении алкогольных напитков, включая прослеживание циклов и смены структурной модели потребления алкоголя в российском обществе с 1980 по 2020 гг. В качестве комплементарных источников эмпирических данных используется статистика Росстата и Всемирной организации здравоохранения об объемах потребления алкоголя, экспертные оценки потребления нелегального алкоголя, данные 29 волн опросов Российского мониторинга экономического положения и здоровья населения НИУ ВШЭ (RLMS-HSE) о динамике объема потребления алкоголя и доли потребителей основных алкогольных напитков.
Статистические и опросные данные демонстрируют в целом сходные тенденции, обнаруживая циклические изменения в уровне потребления легального и нелегального алкоголя. При этом циклы потребления сопровождаются относительно устойчивыми структурными сдвигами. Сформировавшаяся в 1960—1980-е годы советская модель потребления алкоголя в результате нескольких экономико-политических шоков уступает место новой модели, связанной в том числе с постепенным уходом от традиционного для советской России «северного» стиля потребления алкоголя. Устойчиво снижается доля водки и крепких напитков в целом. Пиво перегоняет водку сначала по доле потребителей, а затем и по объему потребления в литрах чистого алкоголя. Относительно стабильным остается потребление вина. Во второй половине 2000-х годов очередная повышательная волна сменяется снижением потребления алкоголя и по его объему, и по доле потребителей (преимущественно за счет роста доли абстинентов). Затем, с середины 2010-х годов, снижение потребления алкоголя останавливается. Вопрос о характере последующей волны пока остается открытым.
Благодарность. Работа выполнена в Лаборатории экономико-социологических исследований НИУ ВШЭ при поддержке Программы фундаментальных исследований НИУ ВШЭ.