bluuebunny/crossref_metadata_2025_split huggingface dataset:
Network Meta-analysis of First-Line Systemic Treatment for Patients With Metastatic Colorectal Cancer
Authors: Xu Shan , Sak Ali , Erol Yasin Bahadir 
Published: September 2021

Purpose To assess the relative efficacy and safety of first-line systemic therapies in patients with metastatic colorectal cancer. Experimental Design A comprehensive literature review was conducted including MEDLINE, Embase, and the Cochrane Central Registry of Controlled Trials for phase II or III randomized controlled trials (RCTs) published up to and including July 15, 2019. We included RCTs in which at least 1 intervention was either chemotherapeutic agents (such as fluorouracil, irinotecan, or oxaliplatin) or antibodies targeting angiogenesis (such as bevacizumab) or agents that act on the epidermal growth factor receptor pathway (such as cetuximab and panitumumab) or studies reported at least one of the following outcomes: overall survival (OS), progression-free survival (PFS), and/or Grade 3 + adverse events (AEs). Using a random effect model, we performed a Bayesian network meta-analysis to analyze the probability of optimal therapeutic regime obtained from direct comparisons with indirect evidences. We estimated hazard ratios for OS and PFS. Results A total of 30 RCTs comprising 12,146 mCRC patients with 25 different treatment strategies were included. The triple combination FOLFOXIRI [fluorouracil, leucovorin, oxaliplatin, and irinotecan] plus bevacizumab provided significant survival benefits with improved OS over all other treatments. The network meta-analysis also indicated a significant advantage of using FOLFOXIRI plus bevacizumab in comparison to other treatment strategies for PFS. Besides, FOLFOXIRI plus bevacizumab was associated with the well-tolerated adverse events. Conclusions Our study supported the use of FOLFOXIRI plus bevacizumab as the best first-line regimen and potentially effective and safe strategy for the management of patients with mCRC.
Gene-Specific DNA Methylation Profiles in Pediatric Medulloblastomas
Authors: Kanit Naz , Uysal Yoca Ozge , Ince Dilek , Olgun Nur , Ozer Erdener 
Published: September 2021

Introduction Medulloblastoma is the most common pediatric central nervous tumor of high malignancy that has been classified into both histological subtypes and molecular subgroups by the 2016 World Health Organization classification. However, there is a still need to understand the genomic characteristics and predict the clinical course. The aim of the study is to investigate the significance of the methylation profiles in molecular subclassification and precision medicine of the disease. Methods The study enrolled 47 pediatric medulloblastoma patients. DNA methylation levels of KLF4, SPINT2, RASSF1A, EZH2, ZIC2, and PTCH1 genes were analyzed using methylation-specific pyrosequencing. The significance of the statistical relationship between methylation profiles and clinicopathological parameters including molecular subgroups and histological subtypes, the status of metastasis, and event-free survival were analyzed. Results DNA methylation analysis demonstrated that KLF4, PTCH1, and ZIC2 hypermethylation were associated with the SHH-activated subgroup, whereas both SPINT2 and RASSF1A hypermethylation were associated with metastatic disease. EZH2 gene was not methylated in any of the samples. Conclusion We think that customized DNA methylation profiling may be a useful tool in the molecular subclassification of pediatric medulloblastoma and a potential technical approach in precision medicine.
Do patient-reported outcome measures improve after aseptic revision total hip arthroplasty?
Authors:   Cleveland Clinic OME Arthroplasty Group, Siddiqi Ahmed , Warren Jared , Anis Hiba K , Barsoum Wael K , Bloomfield Michael R , Briskin Isaac , Brooks Peter J , Higuera Carlos A , Kamath Atul F , Klika Alison , Krebs Olivia , Krebs Viktor E , Mesko Nathan W , Molloy Robert M , Mont Michael A , Murray Trevor G , Muschler George F , Patel Preetesh , Stearns Kim L , Strnad Gregory J , Suarez Juan C , Piuzzi Nicolas S 
Published: September 2021

Background: The purpose of this study was to determine patient-reported outcome measures (PROMs) changes in: (1) pain, function and global health; and (2) predictors of PROMs in patients undergoing aseptic revision total hip arthroplasty (rTHA) using a multilevel model with patients nested within surgeon. Methods: A prospective cohort of 216 patients with baseline and 1-year PROMs who underwent aseptic rTHA between January 2016 and December 2017 were analysed. The most common indication for rTHA was aseptic loosening, instability, and implant failure. The PROMs included in this study were HOOS Pain and HOOS Physical Function Short-form (PS), Veterans RAND-12 Physical Component Score (VR-12 PCS), and VR-12 Mental Component Score (MCS). Multivariable linear regression models were constructed for predicting 1-year PROMs. Results: Mean 1-year PROMs improvement for aseptic revisions were 30.4 points for HOOS Pain and 22.1 points for HOOS PS. Predictors of better pain relief were patients with higher baseline pain scores. Predictors of better 1-year function were patients with higher baseline function and patients with a posterolateral hip surgical approach during revision. Although VR-12 PCS scores had an overall improvement, nearly 50% of patients saw no improvement or had worse physical component scores. Only 30.7% of patients reported improvements in VR-12 MCS. Conclusions: Overall, patients undergoing aseptic rTHA improved in pain and function PROMs at 1 year. Although global health assessment improved overall, nearly half of aseptic rTHA patients reported no change in physical/mental health status. The associations highlighted in this study can help guide the shared decision-making process by setting expectations before aseptic revision THA.
Impact of preoperative exercise in not initially candidates to native arteriovenous fistulas
Authors: Carbayo Javier , Muñoz de Morales Alejandra , Aragoncillo Inés , Abad Soraya , Arroyo David , Vega Almudena , Goicoechea Marian 
Published: September 2021

Background: Native autologous arteriovenous fistula (AVFn) is the preferred vascular access for hemodialysis due to its long term patency and low complication rate. A challenging limitation is the anatomical inability to perform AVFn and failure of maturation. Preoperative isometric exercise (PIE) can increase vascular calibers and improve the rate of distal AVF. However, it is unknown whether PIE might enhance the performance of AVFn in patients who are not initially candidates. Methods: A retrospective observational study was conducted over a population of 45 patients evaluated in vascular access clinic, 23 were not initially candidates for radiocephalic (NRC-AVF) and 22 were not candidates for autologous fistula at all (NA-AVF). They were assigned to perform PIE with handgrip device and revaluated. Results: After 4–8 weeks of PIE, a AVFn was performed in 16 patients from NA-AVF group and a radiocephalic AVFn was performed in 21 patients from NRC-AVF group. Both groups experienced a significant and similar increase in venous caliber 0.91 ± 0.43 mm in NA-AVF versus 0.76 ± 0.47 mm in NRC-AVF ( p = 0.336) and arterial caliber 0.18 ± 0.24 mm versus 0.18 ± 0.21 mm ( p = 0.928), respectively. Nevertheless, primary failure rate was significantly higher in NA-AVF ( n = 8, 50%) than in NRC-AVF group ( n = 3, 14.3%) ( p = 0.030). After 6 months, the fistula usability for dialysis was only 50% in NA-AVF, while 86.7% were dialyzed by fistula in NRC-AVF group ( p = 0.038). Conclusions: PIE allowed the allocation of an AVFn in patients not initially candidates, but entailed a high rate of maturation failure. Patients not candidates to radiocephalic AVF benefited from PIE and preserved a long term usability of AVF for dialysis.
Impact of intravenous access site on attenuation for thoracic computed tomographic angiography: A time-matched, nested, case-control study
Authors: Winkler Michael A , Woodward Connor , Spencer Timothy R , Halicek Martin , Fu Weibo , Appiah Frank , Issa Mohamed , Raissi Driss 
Published: September 2021

Background: The objective of this study was to evaluate whether the choice of intravenous access (IVA) site affects aortic attenuation during thoracic computed tomographic angiography (T-CTA) and any associated risks with intravenous device placement. Methods: All T-CTA exams performed between 1/1/2013 and 8/14/2015 were retrospectively reviewed to identify those performed with contrast media injection via alternative (i.e. non-antecubital) IVA ( n = 1769). Using time matching, antecubital IVA exams ( n = 1769) were selected as controls. For each exam, attenuation was measured in the ascending aorta. Patient and technical data was subsequently collected from all 3538 patients included in this study. Multiple linear regression was used to determine if IVA site affected attenuation. Lastly, data related to extravasations for the entire T-CTA cohort were collected and compared. Results: Hand/wrist, arm, and central venous access device IVA were all equivalent to antecubital IVA in terms of attenuation ( P = 0.579, P = 0.599, and P = 0.522 respectively). Forearm and intraosseous IVA had significantly higher attenuation ( P = 0.010 and P = 0.002, respectively) than antecubital IVA. Right-sided IVA was associated with a small attenuation increase of 11 Hounsfield Units ( P < 0.001) compared to left-sided IVA. In terms of extravasation, antecubital IVA was equivalent to hand/wrist, forearm, and upper arm IVA ( P = 0.778, P = 0.060, and P = 0.090 respectively). Conclusions: Satisfactory aortic attenuation achieved with non-antecubital IVA is equivalent to attenuation achieved with antecubital IVA for T-CTA imaging. The risk of contrast media extravasation in peripheral IVA devices was relatively low, however, appropriate IVA site selection should be considered an important factor for successful administration of contrast media for future imaging studies. This prevents undue harm to patients through preventable device failures when using a peripheral IV device in areas of high flexion/range of movements undergoing pressure injection for contrast media.
Molecular Modeling and Bioinformatics Analysis of Drug-Receptor Interactions in the System Formed by Glargine, Its Metabolite M1, the Insulin Receptor, and the IGF1 Receptor
Authors: González-Beltrán Margarita , Gómez-Alegría Claudio 
Published: September 2021

Introduction: Insulin and insulin-like growth factor type 1 (IGF1) regulate multiple physiological functions by acting on the insulin receptor (IR) and insulin-like growth factor type 1 receptor (IGF1R). The insulin analog glargine differs from insulin in three residues (GlyA21, ArgB31, ArgB32), and it is converted to metabolite M1 (lacks residues ArgB31 and ArgB32) by in vivo processing. It is known that activation of these receptors modulates pathways related to metabolism, cell division, and growth. Though, the structures and structural basis of the glargine interaction with these receptors are not known. Aim: To generate predictive structural models, and to analyze the drug/receptor interactions in the system formed by glargine, its metabolite M1, IR, and IGF1R by using bioinformatics tools. Methods: Ligand/receptor models were built by homology modeling using SWISSMODEL, and surface interactions were analyzed using Discovery Studio® Visualizer. Target and hetero target sequences and appropriate template structures were used for modeling. Results: Our glargine/IR and metabolite M1/IR models showed an overall symmetric T-shaped conformation and full occupancy with four ligand molecules. The glargine/IR model revealed that the glargine residues ArgB31 and ArgB32 fit in a hydrophilic region formed by the α-chain C-terminal helix (αCT) and the cysteine-rich region (CR) domain of this receptor, close to the CR residues Arg270-Arg271-Gln272 and αCT residue Arg717. Regarding IGF1R, homologous ligand/receptor models were further built assuming that the receptor is in a symmetrical T-shaped conformation and is fully occupied with four ligand molecules, similar to what we described for IR. Our glargine/IGF1R model showed the interaction of the glargine residues ArgB31 and ArgB32 with Glu264 and Glu305 in the CR domain of IGF1R. Conclusion: Using bioinformatics tools and predictive modeling, our study provides a better understanding of the glargine/receptor interactions.
The link between linguistic subordination and linguistic inferiority complexes: English as a second language migrants in Australia
Authors: Tankosić Ana , Dryden Stephanie , Dovchin Sender 
Published: September 2021

Aims and objectives/purpose/research questions: This article aims to explore the link between linguistic subordination and linguistic inferiority complexes in the context of English as a second language (ESL) migrants in Australia. We address the following research questions: (a) To what extent and how do ESL migrants in Australia suffer from linguistic subordination? (b) To what extent and how is this linguistic subordination linked to linguistic inferiority complexes for ESL-migrants in Australia? (c) What are the main social implications of the link between linguistic subordination and linguistic inferiority complexes for ESL migrants? Design/methodology/approach: The study involved the participation of 150 participants who were observed using linguistic ethnography. The participants engaged in interviews and focus group discussions so that we could explore the psychological consequences of linguistic subordination that they encountered. Data and analysis: The interviews and focus group discussions were transcribed and analysed with consideration to the context, as well as the participants’ utterances and paralanguage. The study followed alternative quality criteria. Findings/conclusions: Many ESL migrants in Australia face linguistic subordination for the way they speak English. Consequently, these migrants suffer from linguistic inferiority complexes – psychological and emotional damages, which result in self-marginalisation, self-vindication, loss of sense of belonging, social withdrawal, fear, anxiety and the erosion of self-confidence. We find that there is a direct link between linguistic subordination and linguistic inferiority complexes. Originality: This article addresses a gap that exists regarding the link between linguistic subordination and the development of linguistic inferiority complexes, discusses how this has real-life consequences for ESL migrants, and explores how this may be overcome. Significance/implications: ESL migrants need support so that they can cope with their experiences of linguistic subordination, thus helping them better deal with issues related to linguistic inferiority complexes. In addition, the broader society needs greater education on how their comments and actions can affect the wellbeing of others.
Mural Painting to Collect Sensitizing Data and Encourage Research Participation Among U.S. Latinos
Authors: Martinez-Hollingsworth Adrienne , Hernández Jacqueline , Edwards Cristina , Partlow Keosha 
Published: September 2021

Purpose To describe a mural-based intervention that can be implemented in partnership with community members in Latino neighborhoods in order to improve awareness of barriers to recruitment/retention of U.S. Latinos in clinical research, while augmenting researchers’ access to sensitizing concepts critical for rigorous study design. Background Latinos in the United States suffer disproportionately from several chronic illnesses but are underrepresented as researchers and participants in National Institutes of Health–funded research. This lack of representation inhibits a nuanced awareness of the health needs of U.S. Latinos and hampers efforts to address a persistent lack of health equity among U.S. Latinos and other communities of color. Art-based interventions implemented in Latino communities are increasingly being recognized for their ability to bridge this gap and positively affect the quality and quantity of research partnerships between clinical researchers and U.S. Latinos. Method This article describes a mural-based intervention piloted in two predominantly Latino neighborhoods between 2016 and 2020. The design of this method was guided by community partnered participatory research practices and involved an Assessment–Diagnosis–Planning–Implementation–Evaluation approach. Results Mural painting addressed many of the participation challenges often associated with underrepresentation of Latinos in academic research and allowed for sensitizing interviews with key community members surrounding topics of interest to the research team. Conclusion Research methods that acknowledge traditional art forms, such as mural painting, create a space for building trust and spark interest in future research participation, while augmenting researchers’ access to sensitizing concepts that may improve the cultural competence of future studies, projects, and interventions.
Cervical cancer knowledge and screening uptake by marginalized population of women in inner-city Durban, South Africa: Insights into the need for increased health literacy
Authors: Ducray Jennifer F , Kell Colette M , Basdav Jyotika , Haffejee Firoza 
Published: September 2021

Background: Cervical cancer in South Africa accounts for 15.85% of all female cancers and 30.29% of African female cancers, resulting in over 5000 deaths annually. South Africa’s proposed move towards universal healthcare places emphasis on health promotion through education and screening, but there is little data on the baseline levels of knowledge and screening uptake regarding cervical cancer. This study explored the levels of knowledge and screening rates of cervical cancer among vulnerable women living in the inner-city of Durban, South Africa. Methods: A mixed-method study was conducted within the context of a Women’s Health outreach initiative. Data were collected from women attending the outreach ( n = 109), many of whom were from marginalized communities. A pre-intervention survey was used to collect the data. This was followed by cervical cancer education sessions and the opportunity for a free Pap smear. Results: Knowledge of cervical cancer was low (<25%) and only a third of the women had previously been screened. After the educational sessions, 64% of women ( n = 70) took advantage of the opportunity for Pap smears, with many expressing the need for wider cervical cancer education, screening centres and support groups. Only 20% of the Pap smears were normal ( n = 14). Half of the women tested positive for infections ( n = 36; 51.4%), and a small proportion ( n = 8; 11.4%) tested positive for human papilloma virus. Abnormal cervical intra-epithelial neoplasia (CIN1 and CIN 2) were also detected in this population ( n = 12; 17.1%). Conclusion: Cervical cancer knowledge and screening among vulnerable women in Durban, South Africa, is inadequate, especially considering the high levels of abnormality found in the Pap smears. Education drives, accompanied with the provision of free testing, are required. Community health outreach initiatives in collaboration with non-government organizations set in accessible locations could be a possible course of action.
Use of risk scores for predicting new atrial fibrillation after ischemic stroke or transient ischemic attack—A systematic review
Authors: Kishore Amit K , Hossain Mohammad J , Cameron Alan , Dawson Jesse , Vail Andy , Smith Craig J 
Published: September 2021

Background Newly detected atrial fibrillation (NDAF) following an ischemic stroke or transient ischemic attack is often paroxysmal in nature. While challenging to detect, extended electrocardiographic (ECG) monitoring is often used to identify NDAF which has resource implications. Prognostic risk scores have been derived which may stratify the risk of NDAF and inform patient selection for ECG monitoring approaches after ischemic stroke/transient ischemic attack. Aim The overall aim was to identify risk scores that were derived and/or validated to predict NDAF after ischemic stroke/transient ischemic attack and evaluate their performance. Summary of review A systematic literature review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, with application of the Quality Assessment of Diagnostic Accuracy-2 tool. Published studies, which derived and validated clinical risk scores in patients with ischemic stroke/transient ischemic attack, or externally validated an existing score to predict NDAF after ischemic stroke/transient ischemic attack, were considered and independently screened by two reviewers. Twenty-one studies involving 23 separate cohorts were analyzed from which 17 integer-based risk scores were identified. The overall frequency of NDAF was 9.7% (95% confidence intervals 8%–11.5%; I2 = 98%). The performance of the scores varied widely among derivation and validation cohorts (area under the receiver operating characteristic curve (AUC) 0.54–0.94); scores derived from stroke cohorts (12 scores) appeared to perform better (AUC 0.7–0.94) than those derived from non-stroke cohorts (five scores; AUC 0.53–0.79). The scores also varied considerably in their complexity, ascertainment, component variables, participant characteristics, outcome definition, and ease of application limiting their generalizability and utility. Conclusion Overall, the risk scores identified performed variably in their discriminative ability and the utility of these scores to predict NDAF in clinical practice remains uncertain. Further studies are required using larger prospective cohorts and randomized control trials to evaluate the usefulness of such scores for clinical decision making and preventative intervention.