bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is Chemotherapy Associated with Improved Overall Survival in Patients with Dedifferentiated Chondrosarcoma? A SEER Database Analysis
Authors: Cranmer Lee D. , Chau Bonny , Mantilla Jose G. , Loggers Elizabeth T. , Pollack Seth M. , Kim Teresa S. , Kim Edward Y. , Kane Gabrielle M. , Thompson Matthew J. , Harwood Jared L. , Wagner Michael J. 
Published: October 2021

Abstract

Background
Dedifferentiated chondrosarcoma is a chondrosarcoma subtype associated with high rates of recurrence and a poor prognosis. Others have proposed treatment of dedifferentiated chondrosarcoma using osteosarcoma protocols, including perioperative chemotherapy. However, the rarity of this condition poses difficulties in undertaking single- institution studies of sufficient sample size.

Question/purpose
Is perioperative chemotherapy associated with improved overall survival in patients with dedifferentiated chondrosarcoma?

Methods
We queried the Surveillance, Epidemiology, and End Results (SEER) 1973 to 2016 database for patients with a diagnosis of dedifferentiated chondrosarcoma (n = 308). As dedifferentiated chondrosarcoma was only classified as a distinct entity in SEER starting in 2000, only patients treated in 2000 and later were included. We excluded from our analyses those patients with distant disease at diagnosis, a primary site of disease other than bone or joints, and those who did not receive cancer-directed surgery. These criteria yielded 185 dedifferentiated chondrosarcoma patients for inclusion. We used Kaplan-Meier analyses and Cox proportional hazards models to assess the association of clinical, demographic, and treatment characteristics on overall survival (OS).

Results
After controlling for confounding variables, including age, sex, tumor size, stage, grade, location, and radiation treatment status, and after adjusting for missing data, no overall survival benefit was associated with receipt of chemotherapy in patients with dedifferentiated chondrosarcoma (hazard ratio 0.75 [95% confidence interval 0.49 to 1.12]; p = 0.16).

Conclusion
Chemotherapy treatment of dedifferentiated chondrosarcoma was not associated with improved OS. These results must be viewed cautiously, given the limited granularity of information on chemotherapy treatment, the concerns regarding chemotherapy misclassification in SEER data, and the small sample of patients with dedifferentiated chondrosarcoma, all of which limit the power to detect a difference. Our findings are nevertheless consistent with those of prior reports in which no benefit of chemotherapy could be detected. Lack of clear benefit from perioperative chemotherapy in dedifferentiated chondrosarcoma argues that it should be used only after careful consideration, and ideally in the context of a clinical trial.

Level of Evidence
Level III, therapeutic study.
Sebaceous Carcinomas: A Clinicopathological Comparison of Ocular and Extraocular Variants
Authors: Plaza Jose A. , Chung Catherine , Salim Sadia , Gru Alejandro , Sangueza Martin 
Published: October 2021

Abstract:
Sebaceous carcinomas (SC) are rare tumors and are currently classified into ocular and extraocular variants. Both variants of SC have very different clinical behavior and different histomorphologic appearance; however, published data are confounding as literature describes prognosis of both variants is similar or even that extraocular variants are more aggressive. In this study we evaluated the clinical and the histopathology of ocular and extraocular SC to confirm the difference between them. We performed a retrospective review of SC in which we studied the clinical and histomorphologic features of 106 cases, including 39 cases of ocular SC and 67 cases of extraocular SC. Only 2/67 cases of extraocular SC had multiple recurrences and none of them metastasized as opposed to our cases of ocular SC wherein 21/39 cases were locally aggressive with multiple recurrences and 5 cases metastasized. Histologically, both neoplasms showed major distinct morphologic features including poor differentiation in cases of ocular SC and well-differentiated tumors in the extraocular anatomic sites. To the best of our knowledge, this is the first case series of SC that compares the clinicopathologic features of ocular and extraocular variants. Awareness of such discrepancy is key to understand this disease and to possibly diagnose and manage these patients accordingly.
Emotional Activation in Simulation
Authors: O'Regan Stephanie A. , Ekelund Kim , Watterson Leonie M. 
Published: October 2021

Introduction
The degree of emotional activation required for optimal learning in either hands-on or observer roles is unclear, as is the level of stress that impedes learning. Measuring emotional activation is time-consuming, and many scales measure threat or anxiety without considering pleasurable activation. This study examined emotional activation in the observer and hands-on roles in 2 different scenario designs.

Methods
This study was a 2-cohort, parallel study of graduate nurses and doctors completing 2 different courses in managing the deteriorating patient. We examined emotional activation by role across 2 scenario designs. We measured emotional activation on 3 anchored measures scales: the State Trait Anxiety Inventory, Cognitive Appraisal Index, and the Affect Grid with data analysis using analysis of variance and repeated measures.

Results
Hands-on learners experienced higher anxiety, threat, and arousal levels and less pleasure than observers in both scenario designs. There were no differences in pre-emotional and postemotional activation in immersive scenarios for either role and increased arousal and decreased threat and anxiety in the hands-on role in the pause-and-discuss scenario design.

Conclusions
Hands-on learners were more emotionally activated than observers in both scenario designs. There was significant perceived anxiety, threat, and pleasurable arousal in both roles and both scenario designs. Pause-and-discuss scenarios demonstrated similar levels of activation as the immersive scenario design. The Affect Grid provided a quick subjective view of arousal and pleasure in simulation participants, potentially providing educators with an indication of whether emotional activation is positive (excitement) or negative (stressful) and may be helpful in educational planning and future research.
Efficacy of Computer-Based Simulation as a Modality for Learning Pediatric Disaster Triage for Pediatric Emergency Nurses
Authors: Levy Arielle R. , Khalil Elene , Chandramohan Minuoja , Whitfill Travis M. , Cicero Mark X. 
Published: October 2021

Summary Statement
Pediatric disaster triage (PDT) is challenging for healthcare personnel. Mistriage can lead to poor resource utilization. In contrast to live simulation, screen-based simulation is more reproducible and less costly. We hypothesized that the screen-based simulation “60 Seconds to Survival” (60S) to learning PDT will be associated with improved triage accuracy for pediatric emergency nursing personnel.
During this prospective observational study, 138 nurse participants at 2 tertiary care emergency departments were required to play 60S at least 5 times over 13 weeks. Efficacy was assessed by measuring the learners' triage accuracy, mistriage, and simulated patient outcomes using JumpStart.
Triage accuracy improved from a median of 61.1 [interquartile range (IQR) = 48.5–72.0] to 91.7 (IQR = 60.4–95.8, P < 0.0001), whereas mistriage decreased from 38.9 (IQR = 28.0–51.5) to 8.3 (IQR = 4.2–39.6, P < 0.0001), demonstrating a significant improvement in accuracy and decrease in mistriage. Screen-based simulation 60S is an effective modality for learning PDT by pediatric emergency nurses.
C-reactive protein as a triage tool for adults with presumptive pulmonary tuberculosis in South Africa: a prospective cohort study
Authors: Calderwood Claire J , Reeve Byron WP , Mann Tiffeney , Palmer Zaida , Nyawo Georgina , Mishra Hridesh , Abubakar Ibrahim , Noursadeghi Mahdad , Theron Grant , Gupta Rishi K 
Published: October 2021

AbstractBackgroundIdentification of an accurate, low-cost triage test for pulmonary TB among people presenting to healthcare facilities is an urgent global research priority. We assessed the diagnostic accuracy and clinical utility of C-reactive protein (CRP) for TB triage among symptomatic adult outpatients, irrespective of HIV status.MethodsWe prospectively enrolled adults reporting at least one (for people with HIV) or two (for people without HIV) symptoms of cough, fever, night sweats, or weight loss at two TB clinics in Cape Town, South Africa. Participants provided sputum for culture and Xpert MTB/RIF Ultra. We evaluated the diagnostic accuracy of CRP (measured using a laboratory-based assay) against a TB-culture reference standard as the area under the receiver operating characteristic curve (AUROC) and sensitivity and specificity at pre-specified thresholds. We assessed clinical utility using decision curve analysis, benchmarked against WHO recommendations.ResultsOf 932 included individuals, 255 (27%) had culture-confirmed TB and 389 (42%) were living with HIV. CRP demonstrated an AUROC of 0.80 (95% confidence interval 0.77–0.83), with sensitivity 93% (89–95%) and specificity 54% (50–58%) using a primary cut-off of ≥10mg/L. Performance was similar among people with HIV to those without. In decision curve analysis, CRP-based triage offered greater clinical utility than confirmatory testing for all up to a number willing to test threshold of 20 confirmatory tests per true positive TB case diagnosed.ConclusionsCRP approached the WHO-defined minimum performance for a TB triage test and showed evidence of clinical utility among symptomatic outpatients, irrespective of HIV status.
Psychiatric Manifestations and Associated Risk Factors among Hospitalized Patients with COVID-19 in Edo State, Nigeria
Authors: Okogbenin Esther O. , Seb-Akahomen Omonefe J. , Edeawe Osahogie I. , Ehimigbai Mary , Eboreime Helen , Odike Angela , Obagaye Michael O. , Aweh Benjamin E. , Erohubie Paul , Eriyo Williams O. , Inogbo Chinwe F. , Akhideno Peter , Eifediyi Gloria , Eifediyi Reuben , Asogun Danny , Okogbenin Sylvanus A. 
Published: October 2021

ABSTRACTObjectiveThe Coronavirus Disease 2019 (COVID-19) has had devastating effects globally. These effects are likely to result in mental health problems at different levels. Although studies have reported the mental health burden of the pandemic on the general population and frontline health workers, the impact of the disease on the mental health of patients in COVID-19 treatment and isolation centres have been understudied in Africa. We estimated the prevalence of depression and anxiety and associated risk factors in hospitalized persons with COVID-19.MethodsA cross-sectional survey was conducted among 489 patients with COVID-19 at the three government designated treatment and isolation centres in Edo State, Nigeria. The 9-item Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) tool were used to assess depression and anxiety respectively. Binary logistic regression was applied to determine risk factors of depression and anxiety.ResultsOf the 489 participants, 49.1% and 38.0% had depressive and anxiety symptoms respectively. The prevalence of depression, anxiety, and combination of both were 16.2%, 12.9% and 9.0% respectively. Moderate-severe symptoms of COVID-19, ≥14 days in isolation, worrying about the outcome of infection and stigma increased the risk of having depression and anxiety. Additionally, being separated/divorced increased the risk of having depression and having comorbidity increased the risk of having anxiety.ConclusionA substantial proportion of our participants experienced depression, anxiety and a combination of both especially in those who had the risk factors we identified. The findings underscore the need to address these risk factors early in the course of the disease and integrate mental health interventions into COVID-19 management guidelines.
The role of educational settings in the transmission chain of SARS-CoV-2 in 2020: a systematic review
Authors: Vardavas Constantine , Nikitara Katerina , Mathioudakis Alexander , Hilton-Boon Michele , Phalkey Revati , Leonardi-Bee Jo , Pharris Anastasia , Deogan Charlotte , Suk Jonathan E. 
Published: October 2021

AbstractBackgroundSchool closures have been used as a core Non pharmaceutical intervention during the COVID-19 pandemic, however the role of educational settings in COVID-19 transmission is still unclear.MethodsThis systematic literature review assessed studies published between December 2019 and April 1, 2021 in Medline and Embase, which included studies that assessed educational settings from approximately January 2020 to January 2021. The inclusion criteria were based on the PCC framework (P-Population, C-Concept, C-Context). The studyPopulationwas restricted to people 1-17 years old (excluding neonatal transmission), theConceptwas to assess child-to-child and child-to-adult transmission, while theContextwas to assess specifically educational setting transmission clusters.ResultsFifteen studies met inclusion criteria, ranging from daycare centers to high schools and summer camps, while eight studies assessed the re-opening of schools in the 2020-2021 school year. In principle although there is sufficient evidence that children can both be infected by and transmit SARS-CoV-2 in school settings, the SAR remain relatively low -when NPI measures are implemented in parallel. Moreover, although the evidence was limited there was an indication that younger children may have a lower SAR than adolescents.ConclusionsTransmission in educational settings in 2020 was minimal -when NPI measures were implemented in parallel. However, with an upsurge of cases related to variants of concern, continuous surveillance and assessment of the evidence is warranted to ensure the maximum protection of the health of students and the educational workforce, while also minimising the numerous negative impacts that school closures may have on children.Strengths and limitations of this studyThis study provides a rapid review of the peer-reviewed literature pertaining to SARS-CoV-2 transmission by children within educational settings.The review reflects the status quo of the previous school years (January 2020 -January 2021) due to the lag time between study implementation, peer review and publication.The included studies represent child-to-child transmission within the context of previous SARS-CoV-2 strains and are not directly applicable to newer variants.
Changes in paediatric respiratory infections at a UK teaching hospital 2016-2021; impact of the SARS-CoV-2 pandemic
Authors: Lumley Sheila F. , Richens Nicholas , Lees Emily , Cregan Jack , Kalimeris Elizabeth , Oakley Sarah , Morgan Marcus , Segal Shelley , Dawson Moya , Walker A. Sarah , Eyre David W. , Crook Derrick W. , Beer Sally , Novak Alex , Stoesser Nicole E. , Matthews Philippa C. 
Published: October 2021

ABSTRACTObjectiveTo describe the impact of the SARS-CoV-2 pandemic on the incidence of paediatric viral respiratory tract infection in Oxfordshire, UK.MethodsData on paediatric Emergency Department (ED) attendances (0-15 years inclusive), respiratory virus testing, vital signs and mortality at Oxford University Hospitals were summarised using descriptive statistics.ResultsBetween 1-March-2016 and 30-July-2021, 155,056 ED attendances occurred and 7,195 respiratory virus PCRs were performed. Detection of all pathogens was suppressed during the first national lockdown. Rhinovirus and adenovirus rates increased when schools reopened September-December 2020, then fell, before rising in March-May 2021. The usual winter RSV peak did not occur in 2020/21, with an inter-seasonal rise (32/1,000 attendances in 0-3yr olds) in July 2021. Influenza remained suppressed throughout. A higher Paediatric Early Warning Score (PEWS) was seen for attendees with adenovirus during the pandemic compared to pre-pandemic (p=0.04, Mann-Witney U test), no other differences in PEWS were seen.ConclusionsSARS-CoV-2 caused major changes in the incidence of paediatric respiratory viral infection in Oxfordshire, with implications for clinical service demand, testing strategies, timing of palivizumab RSV prophylaxis, and highlighting the need to understand which public health interventions are most effective for preventing respiratory virus infections.
A video-based behavioural intervention associated with improved HPV knowledge and intention to vaccinate
Authors: Marshall Sarah , Moore Anne , Fleming Aoife , Sahm Laura J 
Published: October 2021

AimsThe aim of this study was to design, develop and evaluate a theory and evidence-based intervention to improve human papillomavirus (HPV) and HPV vaccine knowledge, and intention to vaccinate, among parent-daughter dyads.MethodsA theory and evidence-based online behavioural intervention, “Is the HPV vaccine for me?” was developed to improve HPV and HPV vaccine knowledge, and intention to vaccinate. The impact and feasibility of the intervention was evaluated in a prospective randomised controlled feasibility trial.ResultsA total of 49 parent-daughter dyads completed baseline knowledge assessment (n=24 control, n=25 intervention), and 35 dyads completed knowledge assessment at week 2 (n=17 control, n=18 intervention). The intervention was associated with a statistically significant increase in HPV, and HPV vaccine knowledge and intention to vaccinate. All intervention participants found the video interesting, while 96% found it useful.ConclusionsThis intervention was found to be affordable, practicable, effective (cost-effective), acceptable, safe, and equitable, in this feasibility study.
Annulment of antagonism shifts properties that are beneficial to plants in two-member consortia of Bacillus velezensis
Authors: Shao Jiahui , Liu Yan , Xie Jiyu , Štefanič Polonca , Lv Yu , Fan Ben , Mandic-Mulec Ines , Zhang Ruifu , Xu Zhihui , Shen Qirong 
Published: October 2021

ABSTRACTBacillus spp. strains that are beneficial to plants are widely used in commercial biofertilizers and biocontrol agents for sustainable agriculture. Generally, functional Bacillus strains are applied as single strain communities since the principles of synthetic microbial consortia constructed with Bacillus strains remain largely unclear. Here, we demonstrated that the mutual compatibility directly affects the survival and function of two-member consortia composed of B. velezensis SQR9 and FZB42 in the rhizosphere. A mutation in the global regulator Spo0A of SQR9 markedly reduced the boundary phenotype with wild-type FZB42, and the combined use of the SQR9∆spo0A mutant and FZB42 improved biofilm formation, root colonization and the production of secondary metabolites that are beneficial to plants. We further confirmed the correlation between the swarm discrimination phenotype between the two consortia members and the effects that are beneficial to plants in a greenhouse experiment. Our results provide evidence that social interactions among bacteria could be an influencing factor in achieving a desired community-level function.IMPORTANCEBacillus velezensis is one of the most widely applied bacteria in biofertilizers in China and Europe. Additionally, the molecular mechanisms of plant growth promotion and disease suppression by representative model strains are well established, such as B. velezensis SQR9 and FZB42. However, it remains extremely challenging to design efficient consortia based on these model strains. Here, we showed that swarm discrimination phenotype is one of the major determinants affects the performance of two-member Bacillus consortia in vitro and in the rhizosphere. Deletion in global regulatory gene spo0A of SQR9 reduced the strength of boundary formation with FZB42, result in the improved plant growth promotion performance of dual consortium. This knowledge provides new insights into efficient probiotics consortia design in Bacillus.
Bacterial, phytoplankton, and viral dynamics of meromictic Lake Cadagno offer insights into the Proterozoic ocean microbial loop
Authors: Saini Jaspreet S , Hassler Christel , Cable Rachel , Fourquez Marion , Danza Francesco , Roman Samuele , Tonolla Mauro , Storelli Nicola , Jacquet Stéphan , Zdobnov Evgeny M. , Duhaime Melissa B. 
Published: October 2021

ABSTRACTLake Cadagno, a permanently stratified high-alpine lake with a persistent microbial bloom in its anoxic chemocline, has long been considered a model for the low-oxygen, high-sulfide Proterozoic ocean where early microbial life gave rise to Earth’s oxygenated atmosphere. Although the lake has been studied for over 25 years, the absence of concerted study of the bacteria, phytoplankton, and viruses, together with primary and secondary production, has hindered a comprehensive understanding of its microbial food web. Here, the identities, abundances, and productivity of microbes were evaluated in the context of Lake Cadagno biogeochemistry. Photo-synthetic pigments and chloroplast 16S rRNA gene phylogenies suggested high abundances of eukaryotic phytoplankton, primarilyChlorophyta, through the water column. Of these, a close relative ofAnkyra judayi, a high-alpine adapted chlorophyte, peaked with oxygen in the mixolimnion, whileClosteriopsis-related chlorophytes peaked in the chemocline and monimolimnion. Anoxygenic phototrophic sulfur bacteria, Chromatium, dominated the chemocline along withLentimicrobium, a newly observed genus of known fermenters. Secondary production peaked in the chemocline, suggesting anoxygenic primary producers depended on heterotrophic nutrient remineralization. Virus-to-microbe ratios spanned an order of magnitude, peaking with high phytoplankton abundances and at a minimum at the peak of Chromatium, dynamic trends that suggest viruses may play a role in the modulation of oxygenic and anoxygenic photo- and chemosynthesis in Lake Cadagno. Through the combined analysis of bacterial, eukaryotic, viral, and biogeochemical dynamics of Lake Cadagno, this study provides a new perspective on the biological and geochemical connections that comprised the food webs of the Proterozoic ocean.IMPORTANCEAs a window to the past, the study offers insights into the role of microbial guilds of Proterozoic ocean chemoclines in the production and recycling of organic matter of sulfur- and ammonia-containing ancient oceans. The new observations described here suggest that eukaryotic algae were persistent in the low oxygen upper-chemocline in association with purple and green sulfur bacteria in the lower half of the chemocline. Further, this study provides the first insights into Lake Cadagno viral ecology. High viral abundances suggested viruses may be essential components of the chemocline where their activity may result in the release and recycling of organic matter. The framework developed in this study through the integration of diverse geochemical and biological data types lays the foundation for future studies to quantitatively resolve the processes performed by discrete populations comprising the microbial loop in this early anoxic ocean analogue.