bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of automated HIV case reporting system using national electronic medical record in Thailand
Authors: Yingyong Thitipong , Aungkulanon Suchunya , Saithong Wasun , Jantaramanee Supiya , Phokhasawad Kanjanakorn , Fellows Ian , Naiwatanakul Thananda , Mobnarin Jariya , Charoen Narong , Waikayee Paiboon , Northbrook Sanny Chen 
Published: September 2022

BackgroundAn electronic medical record (EMR) has the potential to improve completeness and reporting of notifiable diseases. We developed and assessed the validity of an HIV case detection algorithm and deployed the final algorithm in a national automated HIV case reporting system in Thailand.MethodsThe HIV case detection algorithms leveraged a combination of standard laboratory codes, prescriptions and International Classification of Diseases, 10th Revision diagnostic codes to identify potential cases. The initial algorithm was applied to the national EMR from 2014 to June 2020 to identify HIV-infected subjects to build the national HIV case reporting system (Epidemiological Intelligence Information System (EIIS)). A subset of potential positives identified by the initial algorithm were then validated and reviewed by infectious disease specialists. This review identified that a proportion of the false positives were due to pre-exposure prophylaxis/postexposure prophylaxis (PrEP/PEP) antiretrovirals, and so the algorithm was refined into a ‘Final Algorithm’ to address this.ResultsPositive predictive value of identifying HIV cases was 90% overall for the initial algorithm. Individuals misclassified as HIV-positive were HIV-negative patients with incorrect diagnostic codes, prescription records for PrEP, PEP and hepatitis B treatment. Additional revision to the algorithm included triple drug regimen to avoid further misclassification. The final HIV case detection algorithm was applied to national EMR between 2014 and 2020 with 449 088 HIV-infected subjects identified from 1496 hospitals. EIIS was designed by applying the final algorithm to automated extract HIV cases from the national EMR, analysing them and then transmitting the results to the Ministry of Public Health.ConclusionsEMR data can complement traditional provider-based and laboratory-based disease reports. An automated algorithm incorporating laboratory, diagnosis codes and prescriptions have the potential to improve completeness and timeliness of HIV reporting, leading to the implementation of a national HIV case reporting system.
2 Cardiopulmonary exercise testing excludes clinically significant disease in military patients recovering from COVID-19
Authors: Chamley Rebecca , Holdsworth David , Barker-Davies Robert , Bennett Alexander , O’Sullivan Oliver , Ladlow Peter , Houston Andrew , May Samantha , Mulae Joseph , Xie Cheng , Cranley Mark , Sellon Ed , Naylor Jon , Halle Martin , Parati Gianfranco , Davos Constantinos , Nicol Ed 
Published: September 2022

BackgroundPost-COVID-19 syndrome presents a challenge when determining the occupational grading of symptomatic military personnel, and their ability to deploy. In particular, the accurate assessment of patients with post COVID-19 syndrome is complicated by health anxiety and coincident symptomatic autonomic dysfunction. We therefore sought to determine whether either symptoms or objective cardiopulmonary exercise testing could predict clinically significant findings in the UK Armed Forces.Methods113 consecutive patients were assessed in a post COVID-19 military clinical assessment pathway. This included symptom reporting, history, examination, spirometry, echocardiography and cardiopulmonary exercise testing (CPET) in all, with chest CT, dual-energy CTPA and cardiac MRI where indicated. Symptoms, CPET findings and presence/absence of significant pathology were reviewed. Data were analysed to identify diagnostic strategies that may be used to exclude significant disease.Results7/113 (6%) patients had clinically significant disease adjudicated by cardiothoracic multi-disciplinary team. These patients had reduced fitness (&Vdot;O2 26.7(±5·1) vs. 34.6(±7·0) ml/kg/min; p = 0·002) and functional capacity (peak power 200 (±36) vs. 247 (±55) Watts; p = 0·026) compared to those without significant disease. Simple CPET criteria (&Vdot;O2 <100% predicted and VE/&Vdot;CO2 slope >30.0 or VE/&Vdot;CO2 slope >35.0 in isolation) excluded significant disease with sensitivity and specificity of 86% and 83% respectively (AUC 0.89). The addition of capillary blood gases to estimate A-a gradient improved diagnostic performance to 100% sensitivity and 78% specificity (AUC 0.92). Symptoms and spirometry did not discriminate significant disease.ConclusionUK Armed Forces personnel with persistent symptoms post SARS-CoV-2 infection demonstrate reassuringly little organ pathology. CPET and functional capacity testing, but not reported symptoms, allow the exclusion of clinically significant disease.
Chronic disease care integration into primary care services in sub-Saharan Africa: a ‘best fit’ framework synthesis and new conceptual model
Authors: Harrison Simon R , Jordan Aileen M 
Published: September 2022

ObjectiveTo examine the relevance of existing chronic care models to the integration of chronic disease care into primary care services in sub-Saharan Africa and determine whether additional context-specific model elements should be considered.Design‘Best fit’ framework synthesis comprising two systematic reviews. First systematic review of existing chronic care conceptual models with construction of a priori framework. Second systematic review of literature on integrated HIV and diabetes care at a primary care level in sub-Saharan Africa, with thematic analysis carried out against the a priori framework. New conceptual model constructed from a priori themes and new themes. Risk of bias of included studies was assessed using CASP and MMAT.Eligibility criteriaConceptual models eligible for inclusion in construction of a priori framework if developed for a primary care context and described a framework for long-term management of chronic disease care. Articles eligible for inclusion in second systematic review described implementation and evaluation of an intervention or programme to integrate HIV and diabetes care into primary care services in SSA.Information sourcesPubMed, Embase, CINAHL Plus, Global Health and Global Index Medicus databases searched in April 2020 and September 2022.ResultsTwo conceptual models of chronic disease care, comprising six themes, were used to develop the a priori framework. The systematic review of primary research identified 16 articles, within which all 6 of the a priori framework themes, along with 5 new themes: Improving patient access, stigma and confidentiality, patient-provider partnerships, task-shifting, and clinical mentoring. A new conceptual model was constructed from the a priori and new themes.ConclusionThe a priori framework themes confirm a need for co-ordinated, longitudinal chronic disease care integration into primary care services in sub-Saharan Africa. Analysis of the primary research suggests integrated care for HIV and diabetes at a primary care level is feasible and new themes identified a need for a contextualised chronic disease care model for sub-Saharan Africa.
TEM8 Tri-specific Killer Engager binds both tumor and tumor stroma to specifically engage natural killer cell anti-tumor activity
Authors: Kaminski Michael F , Bendzick Laura , Hopps Rachel , Kauffman Marissa , Kodal Behiye , Soignier Yvette , Hinderlie Peter , Walker Joshua T , Lenvik Todd R , Geller Melissa A , Miller Jeffrey S , Felices Martin 
Published: September 2022

BackgroundThe tumor microenvironment contains stromal cells, including endothelial cells and fibroblasts, that aid tumor growth and impair immune cell function. Many solid tumors remain difficult to cure because of tumor-promoting stromal cells, but current therapies targeting tumor stromal cells are constrained by modest efficacy and toxicities. TEM8 is a surface antigen selectively upregulated on tumor and tumor stromal cells, endothelial cells and fibroblasts that may be targeted with specific natural killer (NK) cell engagement.MethodsA Tri-specific Killer Engager (TriKE) against TEM8—‘cam1615TEM8’—was generated using a mammalian expression system. Its function on NK cells was assessed by evaluation of degranulation, inflammatory cytokine production, and killing against tumor and stroma cell lines in standard co-culture and spheroid assays. cam1615TEM8-mediated proliferation and STAT5 phosphorylation in NK cells was tested and compared with T cells by flow cytometry. NK cell proliferation, tumor infiltration, and tumor and tumor-endothelium killing by cam1615TEM8 and interleukin-15 (IL-15) were assessed in NOD scid gamma (NSG) mice.Resultscam1615TEM8 selectively stimulates NK cell degranulation and inflammatory cytokine production against TEM8-expressing tumor and stromal cell lines. The increased activation translated to superior NK cell killing of TEM8-expressing tumor spheroids. cam1615TEM8 selectively stimulated NK cell but not T cell proliferation in vitro and enhanced NK cell proliferation, survival, and tumor infiltration in vivo. Finally, cam1615TEM8 stimulated NK cell killing of tumor and tumor endothelial cells in vivo.ConclusionsOur findings indicate that the cam1615TEM8 TriKE is a novel anti-tumor, anti-stroma, and anti-angiogenic cancer therapy for patients with solid tumors. This multifunctional molecule works by selectively targeting and activating NK cells by costimulation with IL-15, and then targeting that activity to TEM8+ tumor cells and TEM8+ tumor stroma.
New morphological parameter for intracranial aneurysms and rupture risk prediction based on artificial neural networks
Authors: Yang Hyeondong , Cho Kwang-Chun , Kim Jung-Jae , Kim Yong Bae , Oh Je Hoon 
Published: September 2022

BackgroundNumerous studies have evaluated the rupture risk of intracranial aneurysms using morphological parameters because of their good predictive capacity. However, the limitation of current morphological parameters is that they do not always allow evaluation of irregularities of intracranial aneurysms. The purpose of this study is to propose a new morphological parameter that can quantitatively describe irregularities of intracranial aneurysms and to evaluate its performance regarding rupture risk prediction.MethodsIn a retrospective study, conventional morphological parameters (aspect ratio, bottleneck ratio, height-to-width ratio, volume to ostium ratio, and size ratio) and a newly proposed morphological parameter (mass moment of inertia) were calculated for 125 intracranial aneurysms (80 unruptured and 45 ruptured aneurysms). Additionally, hemodynamic parameters (wall shear stress and strain) were calculated using computational fluid dynamics and fluid–structure interaction. Artificial neural networks trained with each parameter were used for rupture risk prediction.ResultsAll components of the mass moment of inertia (Ixx, Iyy, and Izz) were significantly higher in ruptured cases than in unruptured cases (p values for Ixx, Iyy, and Izzwere 0.032, 0.047, and 0.039, respectively). When the conventional morphological and hemodynamic parameters as well as the mass moment of inertia were considered together, the highest performance for rupture risk prediction was obtained (sensitivity 96.3%; specificity 85.7%; area under the receiver operating characteristic curve 0.921).ConclusionsThe mass moment of inertia would be a useful parameter for evaluating aneurysm irregularity and hence its risk of rupture. The new approach described here may help clinicians to predict the risk of aneurysm rupture more effectively.
Operator assessment versus core laboratory adjudication of recanalization following endovascular treatment of acute ischemic stroke: a systematic review and meta-analysis
Authors: Ibrahim Mohamed K , Shehata Mostafa A , Ghozy Sherief , Bilgin Cem , Jabal Mohamed Sobhi , Heiferman Daniel M , Kadirvel Ramanathan , Kallmes David F 
Published: September 2022

BackgroundSuccessful recanalization after endovascular thrombectomy serves as the primary endpoint in clinical trials and is a crucial predictor of long-term outcomes. Radiographic outcomes for various interventions have been shown to vary based on the type of interpreter, including the site interventionalist compared with an independent reader.ObjectiveTo compare angiographic outcomes in stroke thrombectomy procedures based on the type of reader.MethodsA systematic literature search was conducted in Medline, EMBASE, Scopus, and Web-of-Science through February 2022. We included primary studies that reported core laboratory-read and operator angiographic outcomes after mechanical thrombectomy for ischemic stroke. Furthermore, study-defined successful recanalization data were collected.ResultsEight studies were included with 4797 patients, 51.2% of whom were male. Four thousand, four hundred and thirty-one patients had core readings, and 4211 had operator readings. Study-defined successful recanalization was significantly higher for operator (84%, 3543/4211) examinations than for core laboratory-read (78.4%, 3476/4431) examinations (p<0.001; OR=1.462, 95% CI 1.175 to 1.819). The modified Thrombolysis in Cerebral Infarction (mTICI) scale score of ≥2 b was higher for operator (85%, 3341/3929) examinations than for core laboratory-read (78.6%, 3107/3952) examinations (p<0.001; OR=1.349, 95% CI 1.071 to 1.701). mTICI 3 was significantly higher for operator (54.6%, 1000/1832) examinations than for core laboratory-read (39.9%, 731/1832) examinations (p<0.001; OR=1.823, 95% CI 1.598 to 2.081).ConclusionOperator angiographic reads are statistically significantly higher than core laboratory-read readings following stroke thrombectomy, especially for complete recanalization. These differences should be considered when interpreting reports of angiographic outcomes after thrombectomy.
Susceptibility weighted imaging for ruptured basilar artery perforator aneurysms in the setting of angiographically negative subarachnoid hemorrhage
Authors: Zhu François , Liao Liang , Bracard Serge , Derelle Anne-Laure , Muszynski Patricio , Merlot Isabelle , Planel Sophie , Schmitt Emmanuelle , Braun Marc , Gory Benjamin , Anxionnat René 
Published: September 2022

BackgroundRuptured basilar artery perforator aneurysms (BAPAs), defined as microaneurysms which develop in basilar perforator arteries without direct involvement of the basilar trunk, represent a rare cause of subarachnoid hemorrhage (SAH). The diagnosis of BAPAs is difficult because of their small size, with high rates of negative angiography. The development of high-resolution MRI could increase the diagnostic performance. In this study we describe the usefulness of susceptibility weighted imaging (SWI) for the diagnosis of ruptured BAPAs.MethodsIn a case series, we retrospectively collected data of patients admitted to our institution from 2018 to 2021 for SAH with negative CT angiography who underwent MRI (including SWI) and DSA during hospitalization.ResultsEight patients with a definitive diagnosis of ruptured BAPA and five patients with a definitive diagnosis of angiogram-negative SAH were included. In all of the patients with BAPAs MRI showed a focal, thick, semi-circumferential SWI hypointensity covering the vessel wall at the level of the BAPA subsequently revealed on DSA; this phenomen is known as ‘SWI capping’. No SWI capping was observed in the five patients with a definitive diagnosis of angiogram-negative SAH.ConclusionSWI capping appears to be a reliable indirect sign for the diagnosis and localization of ruptured BAPAs, a rare form of microaneurysm easily misdiagnosed on DSA in initial angiogram-negative SAH.
Endovascular therapy for acute ischemic stroke in patients with active malignancy: a meta-analysis with trial sequential analysis
Authors: Jhou Hong-Jie , Yang Li-Yu , Chen Po-Huang , Lee Cho-Hao 
Published: September 2022

BackgroundActive malignancy has a poorer prognosis and more deaths in patients with acute ischemic stroke (AIS). The outcomes of endovascular therapy (EVT) remain controversial in patients with AIS and active malignancy.MethodsWe searched PubMed, Cochrane, and Embase for articles published up to June 1, 2022. The primary outcome was good functional outcome at 3 months and successful reperfusion between patients with cancer and AIS and control patients. The secondary and safety outcomes included mortality at 3 months, in-hospital mortality, symptomatic intracerebral hemorrhage (sICH), any ICH, and subarachnoid hemorrhage (SAH).ResultsTwelve studies involving 5944 patients with AIS secondary to EVT were included (389 patients having active malignancy). The OR of good functional outcome at 3 months was 0.53 (95% CI 0.41 to 0.67) between the two groups. The OR of successful reperfusion between the two groups was 0.90 (95% CI 0.63 to 1.30). Compared with patients without cancers, those with cancers had a higher risk of mortality at 3 months (OR 3.64; 95% CI 2.35 to 6.27) and in-hospital mortality (OR 3.46; 95% CI 1.71 to 7.01). Despite a higher point estimate regarding any ICH (OR 1.41; 95% CI 1.01 to 1.96) and SAH (OR 2.53; 95% CI 1.10 to 5.81), sICH (OR 0.85; 95% CI 0.51 to 1.42) was not significant.ConclusionAlthough a quarter of patients with active malignancy and AIS regained functional independence, physicians and patients should consider whether to apply EVT in patients with active malignancy.
Using cultivated organic soil depth to form soil conservation management zones
Authors: Deragon Raphaël , Julien Anne-Sophie , Dessureault-Rompré Jacynthe , Caron Jean 
Published: September 2022

Cultivated Organic soils in Montreal's southwest plain are the most productive soils in the province of Quebec. After their initial drainage to enable farming, Organic soils are susceptible to many forms of degradation and soil loss. In this study, we characterized the physical, chemical, and pedological properties of 114 sites from five peatlands to form soil conservation management zones. We attempted to use the maximum peat thickness (MPT) as a soil degradation proxy. The MPT can be defined as the thickness of the layer of peat until coprogenous or mineral materials are reached. The latter are undesired growing media and are not considered in MPT calculation. A series of multivariate analysis of variance indicated that MPT was moderately related to soil degradation (optimal model's Pillai's trace = 0.495). Three soil degradation groups were defined, separated by two MPT thresholds: 60 and 100 cm. When looking at 17 different depth-property combinations, shallower sites (MPT < 60 cm) showed signs of soil degradation significantly higher than sites with an MPT above 60 cm. The second threshold was proposed for practical purposes. Then, these thresholds were used to separate the study area into spatially distinct management zones. Important spatial contrasts were found. This supports the theory that precision agriculture techniques are needed to target fields to optimize soil conservation interventions. The relationship between the MPT and soil degradation should be further explored to account for other degradation factors, and to better identify degraded soils and soils at risk.
Investigating the structure of gluon fluctuations in the proton with incoherent diffraction at HERA
Authors: Kumar Arjun , Toll Tobias 
Published: September 2022

AbstractImpact parameter dependent dipole models are ideal tools for investigating the spatial structure of the proton. We investigate the incoherent ep cross section in exclusive $$J/\psi $$

J
/
ψ

photoproduction as measured by HERA, and find that as |t| increases, the models need several levels of substructure of gluon density fluctuations in order to describe the measured data well. In lieu of a perturbative description, we add this substructure by hand. This substructure is modelled as hotspots within hotspots. This enables us to describe measurements for $$|t|> 1$$

|
t
|
>
1

GeV$$^2$$

2

, which is necessary for describing any observable which integrate over the t-spectrum, such as the rapidity or $$W_{\gamma p}$$

W

γ
p

. We find that three levels of proton substructure are adequate for a good description of all available ep data up to $$|t|=30$$

|
t
|
=
30

GeV$$^2$$

2

. We note that the gluonic density fluctuation structure follows a scaling behaviour, such that the logarithms of the number of hotspots and their size fall on a line, effectively reducing the available parameter space of the model. Our findings systematically constrains and provides a benchmark for the development of a perturbative model of spatial gluon fluctuations in nucleons.
Sensitization to Ionizing Radiation by MEK Inhibition Is Dependent on SNAI2 in Fusion-Negative Rhabdomyosarcoma
Authors: Hensch Nicole R. , Bondra Kathryn , Wang Long , Sreenivas Prethish , Zhao Xiang R. , Modi Paulomi , Vaseva Angelina V. , Houghton Peter J. , Ignatius Myron S. 
Published: September 2022

Abstract
In fusion-negative rhabdomyosarcoma (FN-RMS), a pediatric malignancy with skeletal muscle characteristics, &gt;90% of high-risk patients have mutations that activate the RAS/MEK signaling pathway. We recently discovered that SNAI2, in addition to blocking myogenic differentiation downstream of MEK signaling in FN-RMS, represses proapoptotic BIM expression to protect RMS tumors from ionizing radiation (IR). As clinically relevant concentrations of the MEK inhibitor trametinib elicit poor responses in preclinical xenograft models, we investigated the utility of low-dose trametinib in combination with IR for the treatment of RAS-mutant FN-RMS. We hypothesized that trametinib would sensitize FN-RMS to IR through its downregulation of SNAI2 expression. While we observed little to no difference in myogenic differentiation or cell survival with trametinib treatment alone, robust differentiation and reduced survival were observed after IR. In addition, IR-induced apoptosis was significantly increased in FN-RMS cells treated concurrently with trametinib, as was increased BIM expression. SNAI2’s role in these processes was established using overexpression rescue experiments, where overexpression of SNAI2 prevented IR-induced myogenic differentiation and apoptosis. Moreover, combining MEK inhibitor with IR resulted in complete tumor regression and a 2- to 4-week delay in event-free survival (EFS) in preclinical xenograft and patient-derived xenograft models. Our findings demonstrate that the combination of MEK inhibition and IR results in robust differentiation and apoptosis, due to the reduction of SNAI2, which leads to extended EFS in FN-RMS. SNAI2 thus is a potential biomarker of IR insensitivity and target for future therapies to sensitize aggressive sarcomas to IR.