bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tofacitinib for treatment in immune-mediated myocarditis: The first reported cases
Authors: Liu Yun , Jiang Lindi 
Published: August 2020

Introduction Immune checkpoint inhibitors (ICI) has demonstrated significant clinical benefit in advanced cancer. Despite favorable benefits, the use of ICI is accompanied by various side effects, which are inflammatory side effects potentially affecting any organ. Among which myocarditis is the most severe and has a relatively high mortality. However, there is no effective treatments, and many patients respond poorly to glucocorticoids and immunosuppressants. Therefore, it is urgent to explore effective treatments. Cases report Here we describe two patients with metastatic cancer who developed immune-mediated myocarditis after receiving anti-programmed cell death protein (PD)-1 antibody. The main clinical manifestations are dyspnea. All patients had an elevation of cardiac enzyme, a variety of atypical electrocardiographic (ECG) abnormalities and preserved left ventricular ejection fraction (LVEF). All our patients underwent cardiac MRI (CMRI) and suggested typical features of myocarditis, including myocardial oedema and delayed enhancement. Management and outcome: All patients were treated promptly with glucocorticoids, followed by other immunosuppressive treatments include plasma exchange and intravenous immunoglobulin (IVIG). However, no significant improvement was observed and we then administered tofacitinib 5 mg twice daily to treat the refractory myocarditis and the elevated levels of pro-inflammatory cytokines. All patients recovered and were discharged. No major adverse reaction was reported during tofacitinib therapy. Discussion To our knowledge, this is the first report in the world of patients with ICI-associated myocarditis treated with oral tofacitinib. Our results can at least provide a new option for clinical treatment of refractory myocarditis or other immune-related adverse events.
Breastfeeding in a patient with chronic myeloid leukemia during tyrosine kinase inhibitor therapy
Authors: Terao Ryuta , Nii Mitsumaro , Asai Hiroko , Nohara Fumikatsu , Okamoto Toshio , Nagaya Ken , Azuma Hiroshi 
Published: August 2020

Introduction Although imatinib is the first-line of therapy for Philadelphia chromosome (Ph)-positive chronic myeloid leukemia (CML), in Japan, it is recommended by the manufacturer that lactating women treated with imatinib mesylate for CML should discontinue breastfeeding their infants. Case A 32-year-old pregnant patient was diagnosed with Ph-positive CML at 13 weeks of gestation. She received imatinib (400 mg/day) after 28 weeks of gestation. A female infant was delivered at a gestational age of 35 weeks and 3/7 days after preterm premature rupture of membranes. It was decided to feed only colostrum to the infant and formula feeding was done subsequently because of the risk of the transfer of imatinib to breast milk. The milk/plasma (M/P) ratio and the relative infant dose (RID) for imatinib were calculated to be 0.35 and 1.4%, respectively at 5 days of life. Moreover, the serum level of imatinib in the child of age 5 days was 27 ng/mL, which was much lower than the target trough value for CML (1000 ng/mL). Conclusion The M/P ratio and RID values for maternally administered imatinib were within the safe range for breastfeeding, as reported in previous studies. In addition, it was found that the serum concentration of imatinib in the child was relatively low during short-term breastfeeding.
Developmental Trajectories of Tobacco/Nicotine and Cannabis Use and Patterns of Product Co-use in Young Adulthood
Authors: Dunbar Michael S , Davis Jordan P , Tucker Joan S , Seelam Rachana , Shih Regina A , D’Amico Elizabeth J 
Published: August 2020

Introduction: Concurrent co-use of tobacco/nicotine and cannabis (T/C) products is common among young people and may increase risks for negative health and psychosocial outcomes, but little is known about developmental patterns of T/C co-use. This study aimed to identify distinct trajectory classes of concurrent T/C co-use from ages 16 to 21 and compare groups on T/C co-use behaviors in young adulthood. Methods: Participants (n = 2497) reported T/C use on annual online surveys from 2015 to 2019 (ages 16-22). We used parallel process growth mixture models to model simultaneous trajectories of past-month cigarette, e-cigarette, smokeless tobacco, and cannabis use and identify latent classes of T/C trajectories. Classes were then compared on types and number of T/C products used and types of T/C co-use in young adulthood. Results: Models revealed 4 T/C classes: Low/No T/C Use, Early Concurrent T/C Co-use, Late Concurrent T/C Co-use, and Tobacco Quitters/Cannabis Maintainers. Compared to other classes, the Early Concurrent T/C Co-use group—individuals with rapid progression to concurrent T/C co-use during adolescence—were more likely to report poly-tobacco use, poly-cannabis use, same-occasion sequential T/C co-use and T/C co-administration (ie, mixing T/C) of both combustible and vaping products in young adulthood. Conclusion: Early progression to concurrent T/C co-use in adolescence is prospectively linked to poly-product use and co-use of T/C products in young adulthood. Prevention efforts targeting co-use of T/C products in adolescence may help to reduce riskier patterns of T/C use and co-use in young adulthood.
Experience of Information Provision at the Stroke Unit From the Perspective of Relatives to Stroke Survivors
Authors: Kristensson Linda , Björkdahl Ann 
Published: August 2020

Introduction: Stroke not only affects the stroke survivor, it also significantly affects their families. Given the important supportive role that relatives of stroke survivor have, they should receive information that helps them plan and cope with the new situation. The objective of the study was to explore how relatives to stroke survivors perceived the information provided by the stroke unit. Methods: This qualitative study was based on extensive semi-structured interviews with an inductive approach. A heterogeneous convenience sample of relatives to stroke survivor (n=14) was selected. Qualitative content analysis served to analyze the transcribed interview texts. Results: The content analysis yielded four categories, each with 2–3 subcategories. The overall theme was “to be acknowledged or not”: it encompassed the underlying meaning and the relationships between the categories. The four categories were as follows: shifting information needs; striving for information; lacking of continuity and structure; and taking part and being acknowledged. Conclusions: The study highlighted that the relatives of stroke survivors have a strong need for information and showed that the relatives experienced that they did not always feel satisfactorily informed and supported by the healthcare professionals in the stroke unit. A challenge for the healthcare professionals was to be able to give the right information at the right time and in the appropriate way. The study also showed that when the relatives were acknowledged and invited to participate in the rehabilitation process, they were less anxious of the discharge.
Overcoming non-take-up of rights: A realist evaluation of Integrated Rights-Practices
Authors: Boost Didier , Raeymaeckers Peter , Hermans Koen , Elloukmani Sara 
Published: August 2020

Summary In contemporary welfare states, the non-take-up of rights is a pervasive and considerable problem. Yet, our empirical and theoretical understanding of this phenomenon is still rather limited. In this context, the historical role of social work practice in bridging between citizens and the welfare state cannot be overlooked. To adequately tackle non-take-up, there is an urgency for usable knowledge that is oriented towards practice. In this article, we address this issue by studying Integrated Rights-Practices that focus on overcoming non-take-up through proactive, outreaching, generalist and relation-based interventions. We conducted a qualitative realist evaluation (n = 18) with the intention to explain how and why these interventions provide an answer to the determinants of non-take-up. Findings We argue that the aforementioned guidelines – referring to the ‘who’, ‘where’, ‘what’ and ‘how’ of social interventions – are not to be considered separate strategies, but should rather be understood as synergistic, jointly activating 10 generative mechanisms that overcome the information, process and social costs associated to non-take-up. Applications This article makes both a methodological and theoretical contribution. First, the potential of realist evaluation has convincingly been advocated for by different authors in social work academia, but empirical examples have been lacking hitherto. Second, the identified mechanisms and interventions can provide inspiration to develop similar practices to tackle non-take-up in other welfare regimes and contexts.
Challenges for a Cancer Center in the Novel Coronavirus Pneumonia Epidemic
Authors: Wang Xiao Shan , Zeng Ming 
Published: August 2020

Introduction: The novel Coronavirus disease 2019 pandemic is sweeping through China, posing the greatest ever threat to its public health and economy. As a tertiary cancer center in Southwest China, we formulated and implemented an anti-infection protocol to prevent the spread of Coronavirus disease 2019 in our department. Methods: The anti-infection protocol divided patients into 3 categories, namely outpatients, inpatients, and patients receiving radiation therapy at our cancer center, and each category had a distinct anti-infection protocol to minimize the risk of Coronavirus disease 2019 transmission. In each category, the patients were classified into high-, intermediate-, and low-risk groups. Each risk group was managed differently. A survey of patient volume changes prior to and during the Coronavirus disease 2019 outbreak was performed. Results: We carried out the anti-infection protocol at our cancer center during the Coronavirus disease 2019 outbreak. We found that the total volume of both outpatient visits and inpatient treatment declined significantly depending on the conditions of each group. Radiation therapy and palliative service had the lowest and highest volume reductions at 58.3% and 100%, respectively. The decline in outpatient volumes was higher than the decline in inpatient treatment services (78.8% vs 71.8%). There was no Coronavirus disease 2019 cross-infection at our center, or Coronavirus disease 2019–related injury or death. The anti-infection protocol measures continue to be taken at the hospital even today but they have been modified depending on the prevalent local conditions. Conclusions: Challenges from the Coronavirus disease 2019 pandemic remain in our community. The anti-infection protocol implemented at our cancer center has been effective in preventing cross-infection. Whether our anti-infection protocol experience can be applied to curb the spread of the infection in other parts of the world remains to be tested.
Prognostic Factors in Patients With Osteosarcoma With the Surveillance, Epidemiology, and End Results Database
Authors: Fu Peng , Shi Yu , Chen Gang , Fan Yaohua , Gu Yanhong , Gao Zhenzhen 
Published: August 2020

Background: Osteosarcoma is a rare type of bone tumor, and this study aimed to assess the clinicopathologic features and prognoses of osteosarcoma patients. Methods: Clinicopathologic and survival data of 1025 patients between 2010 and 2016, 230 between 2008 and 2009 were downloaded and analyzed from the SEER database. Patients’ survival was analyzed using the Kaplan-Meier analysis; prognostic factors were assessed using the Cox regression hazards model. The 1-, 3-, and 5-year survival rates were estimated with nomogram. Competitive risk models were used to identify prognostic risk factors related to endpoint events of osteosarcoma patients. Results: Overall, 722 samples were obtained from the extremities, 134 from the axial bones, and 119 from the cranial and mandible in SEER (2010-2016 cohort). After the preliminary diagnosis, the median survival time of patients with osteosarcoma was 39 months, and the 1-, 3-, and 5-year survival rates were 87.3%, 67.2%, and 58.0%, respectively (P < 0.001). The competitive risk model revealed no competitive risks of the endpoint event. Conclusion: Our study found out the prognostic factors in patients with Osteosarcoma by Cox regression hazards model, after that, nomogram was established to predict the 1-, 3-, and 5-year survival rates, which may help oncologists to understand the highly malignant tumor.
Chinese Herbal Medicine Is Helpful for Survival Improvement in Patients With Multiple Myeloma in Taiwan: A Nationwide Retrospective Matched-Cohort Study
Authors: Huang Chia-Yu , Wu Mei-Yao , Kuo Yu-Hung , Tou Sio-Ian , Yen Hung-Rong 
Published: August 2020

Aim of the Study: The purpose of this study is to demonstrate that Chinese herbal medicine is beneficial for survival improvement in patients with multiple myeloma. Materials and Methods: We performed a 1:1 propensity score–matched cohort study to analyze patients with multiple myeloma diagnosed between January 1, 2002, and December 31, 2012, through the Taiwanese National Health Insurance Research Database. Patients who received Chinese herbal medicine therapy from the initial date of diagnosis of multiple myeloma to December 31, 2012, were included in the Chinese herbal medicine group. Patients who were not treated with Chinese herbal medicine during the same interval were categorized in the non-Chinese herbal medicine group. A Cox regression model was used to adjust for sex, age, comorbidities, and drug use. Hazard ratios were also compared between the 2 groups. Results: A total of 312 patients were identified after 1:1 propensity score matching. The patients had similar basic characteristics. A better survival status was found in the Chinese herbal medicine cohort (log-rank test, P < .0001). Finally, 49 patients in the Chinese herbal medicine cohort and 96 patients in the non-Chinese herbal medicine cohort died (adjusted hazard ratio = 0.35, 95% confidence interval = 0.24-0.51). The effect of survival improvement from Chinese herbal medicine in patients with multiple myeloma could be observed when prescriptions had the duration of ≥30 days. Conclusions: Our results showed that patients with multiple myeloma could benefit from Chinese herbal medicine treatment, which could improve the survival rate in Taiwan. The findings offer important ideas for further study.
Alternative splicing of leptin receptor overlapping transcript in osteosarcoma
Authors: Rothzerg Emel , Ho Xuan D , Xu Jiake , Wood David , Märtson Aare , Maasalu Katre , Kõks Sulev 
Published: August 2020

Alternative splicing of RNA is an essential mechanism that increases proteomic diversity in eukaryotic cells. Aberrant alternative splicing is often associated with various human diseases, including cancer. We conducted whole-transcriptome analysis of 18 osteosarcoma bone samples (paired normal—tumor biopsies). Using RNA-seq, we identified statistically significant (FDR <0.05) 26 differentially expressed transcript variants of leptin receptor overlapping transcript ( LEPROT) gene. Some of the transcripts were overexpressed in normal cells, whereas others were overexpressed in tumor cells. The function of LEPROT is not completely understood. Herein, we highlight a possible association between OS and aberrant alternative splicing events and its interaction with the expression of LEPROT. We also discuss the role of LEPROT in regulating growth hormone and its receptor, and the relationship with initiation and progression of OS. This research study may help to understand the association of alternative splicing mechanism in OS and in tumorigenesis more generally. Further, LEPROT gene can also be considered as a potential biomarker of osteosarcoma.Impact statementOsteosarcoma (OS, also known as osteogenic sarcoma) is the most common primary malignancy of bone in children and adolescents. The molecular mechanisms of OS are extremely complicated and its molecular mediators remain to be elucidated. We sequenced total RNA from 18 OS bone samples (paired normal—tumor biopsies). We found statistically significant (FDR <0.05) 26 differentially expressed transcript variants of LEPROT gene with different expressions in normal and tumor samples. These findings contribute to the understanding of molecular mechanisms of OS development and provide encouragement to pursue further research.
Measuring Differential Volume Using the Subtraction Tool for Three-Dimensional Breast Volumetry: A Proof of Concept Study
Authors: Jeon Faith Hyun Kyung , Griffin Michelle , Almadori Aurora , Varghese Jajini , Bogan Stephanie , Younis Ibby , Mosahebi Ash , Butler Peter E. 
Published: August 2020

Background. Three-dimensional (3D) photography provides a promising means of breast volumetry. Sources of error using a single-captured surface to calculate breast volume include inaccurate designation of breast boundaries and prediction of the invisible chest wall generated by computer software. An alternative approach is to measure differential volume using subtraction of 2 captured surfaces. Objectives. To explore 3D breast volumetry using the subtraction of superimposed images to calculate differential volume. To assess optimal patient positioning for accurate volumetric assessment. Methods. Known volumes of breast enhancers simulated volumetric changes to the breast (n = 12). 3D photographs were taken (3dMDtorso) with the subject positioned upright at 90° and posteriorly inclined at 30°. Patient position, breathing, distance and camera calibration were standardised. Volumetric analysis was performed using 3dMDvultus software. Results. A statistically significant difference was found between actual volume and measured volumes with subjects positioned at 90° ( P < .05). No statistical difference was found at 30° ( P = .078), but subsequent Bland–Altman analysis showed evidence of proportional bias ( P < .05). There was good correlation between measured and actual volumes in both positions (r = .77 and r = .85, respectively). Univariate analyses showed breast enhancer volumes of 195 mL and 295 mL to incur bias. The coefficient of variation was 5.76% for single observer analysis. Conclusion. Positioning the subject at a 30° posterior incline provides more accurate results from better exposure of the inferior breast. The subtraction tool is a novel method of measuring differential volume. Future studies should explore methodology for application into the clinical setting.
The Radial Stapler Facilitates Lung-Conserving Wedge Resections
Authors: Makey Ian A. , El-Sayed Ahmed Magdy M. , Jacob Samuel 
Published: August 2020

Objective To test whether use of the radial stapler facilitates lung-conserving wedge resections compared to the linear stapler. Methods A video-assisted thoracoscopic simulation lab was established to compare wedge resections performed only with linear staplers to wedge resections performed with the option of a radial stapler. Preserved sheep lungs were used. The target was a 0.5 cm mark on an ovoid surface of the lung equidistant from all edges. Seven fully trained cardiothoracic surgeons participated. They were instructed to obtain at least a 1 cm margin in all directions from the mark. The surgeons were allowed to work from only 2 preassigned ports. Each resected specimen was weighed. The resection margin was the shortest distance measured from the edge of the mark to the staple line. The mass-to-margin ratio was defined as the mass of the specimen divided by the length of the margin. The results were analyzed using a t-test for 2 independent means. Results The 17 radial resections demonstrated a significantly better mass-to-margin ratio (3.31 [SD = 1.19]) compared to the 11 linear resections (4.75 [SD = 1.32], t[26] = 3, P = 0.006). Conclusions In a thoracoscopic simulation, the option of a radial stapler allowed for a better mass-to-margin resection of a small target from a broad surface of the lung than a linear stapler-only option.
Prevalence of leisure participation in older adults with and without pain: A secondary data analysis of the 2014 Health and Retirement Study
Authors: Feller Haley , Baker Nancy 
Published: August 2020

Objectives The purpose of this study is to describe the prevalence of leisure activities in adults ages 50 and over and to examine if pain changes that prevalence. Methods We completed a secondary analysis using data from the 2014 Health and Retirement Study Leave-Behind Questionnaire (n = 7,541) to analyze frequency and 95% confidence intervals of leisure participation and its relationship to pain. Results The majority of respondents reported regular participation in half of the 10 leisure activities analyzed. Watching television (98.0%) and using the computer (64.5%) had the highest reported regular participation, while volunteering and attending a club or meeting warranted less than 10% regular participation. Of the 7,541 respondents, 39.1% reported pain. For those with pain, regular participation was significantly lower than those without pain in five leisure activities, with exercise having the greatest difference. Discussion The results of our secondary data analysis indicate that older adults may not be regularly participating in different types of leisure activities and that they more regularly participate in passive activities, such as watching television. Older adults with pain have significantly lower reported rates of participation in leisure activities than those without pain, especially in relation to exercise.
Prior mood disorder diagnoses do not relate to current mood disorder symptoms or patient-reported disease severity in rotator cuff patients
Authors: Gibson Eric , LeBlanc Justin , Sabo Marlis T 
Published: August 2020

Background Surgery for rotator cuff syndrome does not always produce symptom improvement. Biological factors may explain some symptoms, but mood disorder symptoms may also contribute. The purpose of this study is to examine the interaction between disease severity, prevalence of mood disorder diagnoses, and current mood disorder symptoms in preoperative rotator cuff patients. Methods A prospective cohort of patients aged 35–75 years with unilateral rotator cuff disease awaiting surgery participated. Demographics, psychiatric history, the Hospital Anxiety & Depression Scale, and the Western Ontario Rotator Cuff index were collected. Descriptive and univariate statistical testing was performed. Results Of 140 participants (75M:65W) aged 55 ± 8 years, 34 reported a prior diagnosis of a mood disorder. There was a moderate positive relationship between disease severity and current depression and anxiety scores. Women were more likely to carry a diagnosis of a mood disorder, but there were no differences in current symptom levels between genders. No differences were found in patient-reported outcome measure scores between patients with and without a mood disorder diagnosis. Discussion Current mood disorder symptoms were associated with greater disease severity, whereas the presence of a past mood disorder diagnosis was not. Awareness of this relationship may reduce bias about past mood disorder diagnoses during decision-making.