bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ibrutinib With Rituximab in First-Line Treatment of Older Patients With Mantle Cell Lymphoma
Authors: Jain Preetesh , Zhao Shuangtao , Lee Hun Ju , Hill Holly A. , Ok Chi Young , Kanagal-Shamanna Rashmi , Hagemeister Fredrick B. , Fowler Nathan , Fayad Luis , Yao Yixin , Liu Yang , Moghrabi Omar B. , Navsaria Lucy , Feng Lei , Nogueras Gonzalez Graciela M. , Xu Guofan , Thirumurthi Selvi , Santos David , Iliescu Cezar , Tang Guilin , Medeiros L. Jeffrey , Vega Francisco , Avellaneda Michelle , Badillo Maria , Flowers Christopher R. , Wang Linghua , Wang Michael L. 
Published: November 2021

PURPOSE Most patients with mantle cell lymphoma (MCL) are older. In this study, we investigated the efficacy and safety of a chemotherapy-free combination with ibrutinib and rituximab (IR) in previously untreated older patients with MCL (age ≥ 65 years). METHODS We enrolled 50 patients with MCL in this single-institution, single-arm, phase II clinical trial ( NCT01880567 ). Patients with Ki-67% ≥ 50% and blastoid morphology were excluded. Ibrutinib was administered with rituximab up to 2 years with continuation of ibrutinib alone. The primary objective was to assess the overall response rate and safety of IR. In evaluable samples, whole-exome sequencing and bulk RNA sequencing from baseline tissue samples were performed. RESULTS The median age was 71 years (interquartile range 69-76 years). Sixteen percent of patients had high-risk simplified MCL international prognostic index. The Ki-67% was low (< 30%) in 38 (76%) and moderately high (≥ 30%-50%) in 12 (24%) patients. The best overall response rate was 96% (71% complete response). After a median follow-up of 45 months (interquartile range 24-56 months), 28 (56%) patients came off study for various reasons (including four progression, 21 toxicities, and three miscellaneous reasons). The median progression-free survival and overall survival were not reached, and 3-year survival was 87% and 94%, respectively. None of the patients died on study therapy. Notably, 11 (22%) patients had grade 3 atrial fibrillation. Grade 3-4 myelosuppression was seen in < 5% of patients. Differential overexpression of CCND1, BIRC3, BANK1, SETBP1, AXIN2, and IL2RA was noted in partial responders compared with patients with complete response. CONCLUSION IR combination is effective in older patients with MCL. Baseline evaluation for cardiovascular risks is highly recommended. Randomized trial is needed for definitive conclusions.
Spectrum of High Resolution Computed tomography chest findings in PCR positive COVID-19 patients according to duration of infection and CT severity score assessment
Authors: Irshad Nadia , Hanif Nadia 
Published: November 2021

Objective: To evaluate the spectrum of HRCT findings of COVID-19 in RT-PCR positive patients according to duration of infection and severity of disease.
Methods: This retrospective study was conducted at Radiology department of Lahore General Hospital, Lahore from May to July 2020. Total 40 COVID-19 patients were reviewed for clinical features, HRCT chest findings based on time from symptom onset and CT conduction. Chi-square and fissure exact test were used for measuring association with severity of COVID-19, p value ≤0.05 was reported significant. Mean CT scores were calculated. ROC curve analysis showed threshold values of CT-SS for severe disease.
Results: Of total 40 patients with age ranged from 22-83 years, 22(55%) were males and 18(45%) females. The hallmark of COVID-19 was combined GGO and consolidation, GGO alone and consolidation alone in bilateral, sub pleural and posterior distribution. Early stage had normal CT or GGO alone, intermediate and late stage had both GGO and consolidation. Septal lines/bands and crazy paving pattern were prevalent in late stage. Clinically, 24 (60%) were in severe group and 16(40%) in mild group. Severity of COVID-19 was associated with GGO alone (p=0.05), GGO and consolidation (p=0.01), crazy paving (p=0.01) and lung scores (p≤0.05). The threshold values of CT-SS for identifying severe disease by two radiologists were 18.50 and 20.50.
Conclusion: HRCT manifestations along with CT-SS aids in predicting disease severity. Staging according to duration of infection is effective in understanding variation in pattern of chest findings in coronavirus disease.
doi: https://doi.org/10.12669/pjms.38.1.4204
How to cite this:Irshad N, Hanif N. Spectrum of High Resolution Computed tomography chest findings in PCR positive COVID-19 patients according to duration of infection and CT severity score assessment. Pak J Med Sci. 2022;38(1):106-112. doi: https://doi.org/10.12669/pjms.38.1.4204
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Comparison of Chest X-rays findings in COVID-19 suspected and confirmed cases at a university teaching hospital: A retrospective comparative study
Authors: Durrani Misbah , Shahid Afshan , Tahir Umme Kalsoom , Haq Inam-ul- , Yousaf Anum , Naveed Saqib 
Published: November 2021

Objectives: To compare Chest X-rays findings in COVID-19 suspected and confirmed patients on RT-PCR, presented at corona filtration center, Benazir Bhutto hospital Rawalpindi.
Methods: In this study, Chest radiographs of 100 COVID-19 RT-PCR positive confirmed patients were compared with 100 RT-PCR negative suspected COVID-19 patients screened at corona filtration center, Benazir Bhutto Hospital Rawalpindi from November 2020 to December 2020. Data on demographics, presenting complaints, co-morbid, lesion characteristic, distribution and attenuation, lobar involvement, pleural effusion and lymphadenopathy were collected. Associations between imaging characteristics and COVID-19 pneumonia were analyzed with univariate and multivariate logistic regression modals.
Results: Chest X-rays findings revealed bilateral lung consolidation with peripheral and diffuse distribution, involving middle and lower lobe to be statistically significant (p<0.05) between RT-PCR positives and negative patients. Peripheral distribution was associated with an 11.08-fold risk in COVID-19 positive patients than diffuse distribution. Middle lobe involvement had four folds risk and lower lobe involvement had 11.04 folds risk in COVID-19 cases as compared to upper lobe involvement. Consolidation had 2.6 folds risk in COVID-19 positive cases.
Conclusions: Bilateral, peripheral distribution of middle and lower lobes ground glass haze or consolidation with no pleural effusion is significantly related to COVID-19 pneumonia. Overlapping imaging features of the infectious and non-infectious COVID mimickers can be further excluded by detailed clinical evaluation and further radiological workup.
doi: https://doi.org/10.12669/pjms.38.1.4624
How to cite this:Durrani M, Shahid A, Kalsoom U, Inam-ul-Haq, Yousaf A, Naveed S. Comparison of Chest X-rays findings in COVID-19 suspected and confirmed cases at a university teaching hospital: A retrospective comparative study. Pak J Med Sci. 2022;38(1):76-83. doi: https://doi.org/10.12669/pjms.38.1.4624
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Technical Note—A Permutation-Dependent Separability Approach for Capacitated Two-Echelon Inventory Systems
Authors: Shen Xiaobei , Yu Yimin , Huh Woonghee Tim 
Published: November 2021

Analyzing Capacitated Two-Echelon Systems with Permutation-Dependent Separability Capacitated multiechelon systems are common in practice due to the escalating costs of labor and advanced manufacturing technology. However, identifying the optimal replenishment policies for such systems is a largely open area of research due to the intrinsic complexity, especially when there is an upstream bottleneck. In “A Permutation-Dependent Separability Approach for Capacitated Two-Echelon Inventory Systems”, Shen, Yu, and Huh propose a new approach, that is, permutation-dependent separability, to tackle a capacitated two-echelon system in which the capacity of upstream stage can be the bottleneck. They show that the value function for the capacitated two-echelon system in each period is permutation-dependent separable, and that for each echelon, a permutation-dependent echelon base stock policy is optimal. The authors also develop efficient solution procedures on how to obtain the optimal policy.
Radiological changes, infections and neurological complications after reverse shoulder arthroplasty related to different design types and their rates: Part II
Authors: Nabergoj Marko , Denard Patrick J. , Collin Philippe , Trebše Rihard , Lädermann Alexandre 
Published: November 2021

Early reported complication rates with the Grammont-type reverse shoulder arthroplasty (RSA) were very high, up to 24%. A ‘problem’ is defined as an intraoperative or postoperative event that is not likely to affect the patient’s final outcome, such as intraoperative cement extravasation and radiographic changes. A ‘complication’ is defined as an intraoperative or postoperative event that is likely to affect the patient’s final outcome, including infection, neurologic injury and intrathoracic central glenoid screw placement. Radiographic changes around the glenoid or humeral components of the RSA are very frequently observed and described in the literature. High complication rates related to the Grammont RSA design led to development of non-Grammont designs which led to a dramatic fall in the majority of complications. The percentage of radiological changes after RSA is not negligible and remains unsolved, despite a decrease in its occurrence in the last decade. However, such changes should be now considered as simple problems because they rarely have a negative influence on the patient’s final outcome, and their prevalence has dramatically decreased. With further changes in indications and designs for RSA, it is crucial to accurately track the rates and types of complications to justify its new designs and increased indications. Cite this article: EFORT Open Rev 2021;6:1109-1121. DOI: 10.1302/2058-5241.6.210040
Chemical Concentration and Spatial Uniformity of a Premixing In-Line Injection System Attached to a Variable-Rate Orchard Sprayer
Authors: Zhang Zhihong , Zhu Heping , Wei Zhiming , Salcedo Ramon 
Published: November 2021

HighlightsA newly developed premixing in-line injection system attached to a variable-rate orchard sprayer was evaluated.Tests were conducted to verify the in-line injection system performance using a vertical spray patternator.Concentration accuracy and spatial distribution uniformity were determined with a fluorescent tracer.Uniform spray mixtures were obtained for different spray viscosities and duty cycle combinations.Abstract. Pesticide spray application efficiency is highly dependent on the chemical concentration accuracy and spatial distribution uniformity. In this study, the performance of a newly developed premixing in-line injection system was evaluated when it was attached to a laser-guided, pulse width modulated (PWM), variable-rate orchard sprayer. The chemical concentration accuracy was determined with respect to spray deposition with a fluorescent tracer, and the spatial distribution uniformity was determined with spray deposits at different heights on a vertical spray patternator. Outdoor tests were conducted with 27 combinations of target chemical concentration (1.0%, 1.5%, and 2.0%), viscosity of the simulated pesticide (1.0, 12.0, and 24.0 mPa·s), and various spray outputs manipulated with PWM duty cycles. For each injection loop, the amounts of the chemical concentrate and water discharged into the mixing line were measured separately in response to preset target concentrations. The results showed that the measured concentrations were consistent across the patternator heights, spray viscosities, and duty cycle combinations. For all treatments, the mean absolute percentage error (MAPE) of the measured concentration was 6.96%, indicating that the concentration accuracy of the system was acceptable. The mean coefficient of variation was 3.35%, indicating that the spatial distribution uniformity of the system was in the desirable range. In addition, there was little variation in chemical concentration for spray mixtures collected at different heights on the patternator. Thus, the premixing in-line injection system could adequately dispense chemical concentrate and water to produce accurate concentrations and uniform spray mixtures for variable-rate nozzles to discharge to targets. Keywords: Environment protection, Precision pesticide application, Laser-guided sprayer, Tank mixture disposal, Specialty crop.
Impact of 12-week exercise program on biomarkers of gut barrier integrity in patients with coronary artery disease
Authors: Feng Vivian , Bawa Kritleen K. , Marzolini Susan , Kiss Alex , Oh Paul , Herrmann Nathan , Lanctôt Krista L. , Gallagher Damien 
Published: November 2021

Introduction
Breakdown of gut barrier integrity has been associated with inflammatory activation and is implicated in the etiology of several chronic medical conditions. Acute exercise is known to increase gut barrier permeability but the impact of chronic exercise is not clear. Most studies to date have examined how acute exercise impacts gut barrier integrity in healthy adults, while few studies have examined the impact of chronic exercise in older adults with comorbidities. We aim to investigate the impact of a 12-week program of aerobic and resistance training on biomarkers of gut barrier integrity in a sample of older adults with coronary artery disease.

Methods
Participants were adults with coronary artery disease undergoing a moderate-intensity 12-week cardiac rehabilitation exercise program. Fasting blood samples were taken at baseline and study termination. Serum levels of biomarkers of gut barrier integrity (zonulin and fatty acid-binding protein 2 (FABP2)) were measured by ELISA. Cardiorespiratory fitness was assessed by peak oxygen uptake (VO2peak) at study start & completion. Data analyses were performed using SPSS software version 24.0.

Results
Among study participants (n = 41, 70% male, age = 62.7± 9.35) we found a significant negative association between baseline FABP2 levels and baseline VO2peak in a multiple linear regression model adjusting for covariates (B = -0.3, p = 0.009). Over the course of the exercise program an increase in VO2peak (≥ 5 mL/kg/min) was independently associated with a relative decrease in FABP2 (B = -0.45, p = 0.018) after controlling for medical covariates.

Conclusion
Our findings indicate that an increase in cardiorespiratory fitness during a 12-week exercise program resulted in a relative improvement in a biomarker of gut barrier integrity. This indicates a potential mechanism by which longer term exercise may improve gut barrier integrity.
Quality of Care Program Reduces Unplanned Health Care Utilization in Patients With Inflammatory Bowel Disease
Authors: Melmed Gil Y. , Oliver Brant , Hou Jason K. , Lum Donald , Singh Siddharth , Crate Damara , Almario Christopher , Bray Harry , Bresee Catherine , Gerich Mark , Gerner Donna , Heagy Erica , Holthoff Megan , Hudesman David , McCutcheon Adams Kelly , Mattar Mark C. , Metwally Mark , Nelson Eugene , Ostrov Arthur , Rubin David T. , Scott Frank , Samir Shah , van Deen Welmoed , Younes Ziad , Oberai Ridhima , Weaver Alandra , Siegel Corey A. ,   on behalf of IBD Qorus
Published: November 2021

INTRODUCTION:
There is significant variation in processes and outcomes of care for patients with inflammatory bowel disease (IBD), suggesting opportunities to improve quality of care. We aimed to determine whether a structured quality of care program can improve IBD outcomes, including the need for unplanned health care utilization.

METHODS:
We used a structured approach to improve adult IBD care in 27 community-based gastroenterology practices and academic medical centers. Patient-reported outcomes (PRO) and health care utilization were collected at clinical visits. Outcomes were monitored monthly using statistical process control charts; improvement was defined by special cause (nonrandom) variation over time. Multivariable logistic regression was applied to patient-level data. Nineteen process changes were offered to improve unplanned health care utilization. Ten outcomes were assessed, including disease activity, remission status, urgent care need, recent emergency department use, hospitalizations, computed tomography scans, health confidence, corticosteroid or opioid use, and clinic phone calls.

RESULTS:
We collected data prospectively from 20,382 discrete IBD visits. During the 15-month project period, improvement was noted across multiple measures, including need for urgent care, hospitalization, steroid use, and opioid utilization. Adjusted multivariable modeling showed significant improvements over time across multiple outcomes including urgent care need, health confidence, emergency department utilization, hospitalization, corticosteroid use, and opioid use. Attendance at monthly coached webinars was associated with improvement.

DISCUSSION:
Outcomes of IBD care were improved using a structured quality improvement program that facilitates small process changes, sharing of best practices, and ongoing feedback. Spread of these interventions may facilitate broad improvement in IBD care when applied to a large population.
Increasing Incidence of Cirrhosis Over the Past 2 Decades Among Children in Ontario, Canada
Authors: Kehar Mohit , Griffiths Rebecca , Flemming Jennifer A. 
Published: November 2021

INTRODUCTION:
We describe the incidence of cirrhosis in the general pediatric population.

METHODS:
This is a population-based study using health-care data from Ontario, Canada, between 1997 and 2017. Age-adjusted and sex-adjusted standardized incidence rates were described, and age-period-cohort modeling approach was used to estimate the independent effect of birth cohort.

RESULTS:
In total, 2,966 new diagnoses of cirrhosis among children were identified at a median age of 9 years. The incidence rate increased almost 4-fold over the study period (2.7/100,000 person-years in 1997 vs 10.6/100,000 person-years in 2017) with the highest increase seen in children younger than 1 year.

DISCUSSION:
In this first population-based study in children, the incidence of cirrhosis has increased dramatically over the past 2 decades.
Humoral Immunogenicity of mRNA COVID-19 Vaccines Among Patients With Inflammatory Bowel Disease and Healthy Controls
Authors: Caldera Freddy , Knutson Keith L. , Saha Sumona , Wald Arnold , Phan Hiep S. , Chun Kelly , Grimes Ian , Lutz Megan , Hayney Mary S. , Farraye Francis A. 
Published: November 2021

INTRODUCTION:
Patients with inflammatory bowel disease (IBD) on immune-modifying therapies may have a lower vaccine response to certain vaccines. The aim of our study was to evaluate humoral immunogenicity of mRNA coronavirus disease 2019 (COVID-19) vaccines among patients with IBD and healthy controls (HCs).

METHODS:
We performed a prospective study to evaluate humoral immunogenicity among patients with IBD and HCs after completion of mRNA COVID-19 vaccines.

RESULTS:
One hundred twenty-two patients with IBD and 60 HCs were enrolled. All HCs and 97% of patients with IBD developed antibodies. Antibody concentrations were lower in patients with IBD compared with those in HCs (median 31 vs 118 μg/mL; P < 0.001). Those who received the mRNA-1273 (Moderna) COVID-19 (median 38; interquartile range [IQR] 24–75 vs μg/mL) had higher antibody concentrations compared with those who received the Pfizer-BNT vaccine series (median 22; IQR 11–42 μg/mL; P < 0.001). Patients on immune-modifying therapy (median 26; IQR 13–50 μg/mL) had lower antibody concentrations compared with those who were on no treatment, aminosalicylates, or vedolizumab (median 59; IQR 31–75 μg/mL; P = 0.003).

DISCUSSION:
Almost all patients with IBD in our study mounted an antibody response. Future studies are needed in evaluating sustained humoral immunity and the impact of booster dosing in patients with IBD.
Multiple Myeloma Presenting as Chronic Diarrhea
Authors: Bajwa Arouj , Trieu Judy , Mirza Kamran , Ding Xianzhong , Liem Brian 
Published: November 2021

ABSTRACT
Extramedullary gastrointestinal tract involvement in plasma cell dyscrasias is rare and represents a diagnostic challenge. We present a 66-year-old man with an unusual presentation of multiple myeloma. He presented with chronic diarrhea, and extensive biopsies in the jejunum allowed for the presumptive diagnosis of multiple myeloma to be made and the weighted decision to treat without a definitive diagnosis. Plasma cell dyscrasias can have highly varied presentations, unclear differentiation, and require a multidisciplinary approach for diagnosis and management. Adequate tissue sampling of the small bowel is critical in assessing patients with chronic diarrhea.
Development and psychometric evaluation of the motivation for nursing student scale (MNSS): a cross sectional validation study
Authors: Bulfone Giampiera , Badolamenti Sondra , Biagioli Valentina , Maurici Massimo , Macale Loreana , Sili Alessandro , Vellone Ercole , Alvaro Rosaria 
Published: November 2021

Abstract

Objectives
To develop a self-report scale to measure academic motivation among nursing students and to test its psychometric properties.

Methods
a cross-sectional validation study with a convenience sample of nursing students (n=1,635) was performed. The Motivation Nursing Students Scale was developed; content, face, construct validity, hypothesis testing and reliability were evaluated.

Results
The validity structure revealed a four-factor solution and the model reached a satisfactory fit (χ2=622.835 df=160, p<0.01, CFI=0.90, TLT=0.83, RMSEA=0.060 (90% [CI] 0.055–0.064, p=0.001, SRMR=0.067). The hypothesis testing was confirmed with a positive correlation of the academic self-efficacy with Introjected, Intrinsic motivation and a negative correlation with Amotivation.

Conclusions
We verified a link between academic self-efficacy and motivation. Both motivation and self-efficacy may increase academic achievement and the possibility for HEIs to degrees a number of students in line with demands.
Anti-sway method for reducing vibrations on a tower crane structure
Authors: Caporali Roberto P. L. 
Published: November 2021

Abstract
We develop a solution to the problem of the behavior of a tower crane considered as a deformable system, and therefore subject to vibrations, whereas the controlled movement of a payload is implemented. The motion of the payload is calculated taking into account the normal vibration modes of the tower crane and the swaying of the payload. A “command smoothing” method relative to an open-loop system is used for reducing the sway of the payload, through smoothing the original command by the crane operator. This leads, as a consequence, to a reduction in the vibrations of the crane structure. An iterative calculation of the sway angle and the corresponding applied velocity profiles as input to the crane motors is applied. The tower crane is considered as a high nonlinear underactuated system; it is modeled considering the possible deformation of the structure. The results relating to the normal deformations of the crane are obtained, highlighting how these vibrations are strongly attenuated when an anti-sway system for the payload is implemented. Therefore, it is shown how this control leads to the best results in terms of performance for both the payload movement (shortest possible profile for the rotation movement and damping of the load oscillation) and the structure of the tower crane. Applying the method described in this paper, the structure of the tower crane does not undergo the strong horizontal and vertical oscillations that occur when the elastic structure is not considered in the crane model.