bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of relapsed and refractory nodular lymphocyte‐predominant Hodgkin lymphoma: a North American analysis
Authors: Strati Paolo , Cheng Phoebe T. M. , Steiner Raphael E. , Alcedo Andrade Pedro E. , Feng Lei , Sano Dahlia , Rao Veeramaneni A. , Singh Prachee , Miranda Roberto , Gunther Jillian R. , Pinnix Chelsea C. , Dabaja Bouthaina S. , Cuglievan Branko , Xing Katharine , Villa Diego , Skinnider Brian , Sehn Laurie H. , Connors Joseph M , Nieto Yago , Ahmed Sairah , Lee Hun J. , Savage Kerry J. 
Published: January 2021

SummaryNodular lymphocyte‐predominant Hodgkin lymphoma (NLPHL) is a rare entity, with limited data on the outcome in the relapsed/refractory setting. We evaluated the outcome of all patients diagnosed between 04/1979 and 01/2019 with relapsed or progressive NLPHL after initial active therapy at two institutions, refractory disease being defined as lack of response to treatment and/or relapse within three months of treatment. NLPHL patients with histological evidence of transformation at time of first relapse or progression were excluded. In total, 69 patients with recurrent NLPHL were included in the study. After a median follow‐up after initial diagnosis of 14 years (range, 0·5–46 years), median progression‐free survival after front‐line treatment (PFS‐1) was four years. Second‐line therapy included chemotherapy in 28 (41%) patients, biological therapy (rituximab, lenalidomide or brentuximab vedotin) in 14 (20%), high‐dose chemotherapy followed by autologous stem cell transplant in 14 (20%) and radiation therapy (RT) alone in 10 (15%). The five‐year PFS after second‐line therapy (PFS‐2) was 68% [95% confidence interval (CI), 54–79%] but the five‐year overall survival (OS) after second‐line therapy (OS‐2) remained excellent, at 94% (95% CI, 85–99%). Due to excellent outcome in case of recurrence, studies aimed at characterizing its biology to guide therapy de‐escalation are needed.
Zooming across cultures: Can a telecollaborative video exchange between language learning partners further the development of intercultural competences?
Authors: Freiermuth Mark R. , Huang Hsin‐chou 
Published: January 2021

AbstractIn the context of learning a second language, the passing on of cultural information as a means to further the development of intercultural competences is primarily viewed as being unidirectional—the “native‐speaking culture” passing on information to the language learning student. However, in EFL (English as a foreign language) environments, the most relatable cultural norms available to the learners tend to be those associated with their homeland—the place they presently reside. As such, teaching language learning students using a unidirectional cultural frame ignores the wealth of cultural knowledge that such language learners possess. Offering cultural exchanges between groups of different language learners is one way to facilitate cultural learning in a bidirectional manner. In this study, 11 university students, six Japanese and five Taiwanese, took part in a cultural exchange project using the videoconferencing application Zoom. Findings from the data suggest that such telecollaborative video activities are mutually beneficial for exchanging local cultural information. We conclude that such exchanges develop intercultural competences via increased verbosity, the application of polite language, and of the utmost importance, by building interpersonal relationships. For language teachers who ascribe to a belief in the value of intercultural exchanges, applications like Zoom open up avenues for student interactions that are real, meaningful, and culturally rich.
Talking about breast symmetry in the breast cancer clinic: What can we learn from an examination of clinical interaction?
Authors: Mace Stephanie , Collins Sarah , Speer Susan 
Published: January 2021

AbstractBackgroundBreast asymmetry is a common post‐operative outcome for women with breast cancer. Quality of cosmetic result is viewed clinically as a critical endpoint of surgery. However, research suggests that aesthetic standards governing breast reconstruction can be unrealistic and may problematically enforce feminine appearance norms. The aim of reconstructive procedures is to help women live well with and beyond breast cancer. Therefore, understanding how patients and clinicians talk about surgical outcomes is important. However, we lack evidence about such discussions.ObjectiveTo examine clinical communication about breast symmetry in real‐time consultations in a breast cancer clinic.DesignSeventy‐three consultations between 16 clinicians and 47 patients were video‐recorded, transcribed and analysed using conversation analysis.ResultsIn most cases, patients do considerable interactional work to persuade clinicians of the validity of their concerns regarding breast asymmetry, and clinicians legitimize these concerns, aligning with patients. In a significant minority of cases, patients appear more accepting of their treatment outcome, but clinicians prioritize symmetry or treat symmetry with the presence of breast tissue as normative, generating misalignment between clinician and patient.ConclusionCurrent clinical communication guidelines and practices may inadvertently reinforce culturally normative assumptions regarding the desirability of full, symmetrical breasts that are not held by all women. Clinicians and medical educators may benefit from detailed engagement with recordings of clinical communication like those analysed here, to reflect on which communicative practices may work best to attend to a patient's individual stance on breast symmetry, and optimize doctor‐patient alignment.
Decision aids to prepare patients for shared decision making: Two randomized controlled experiments on the impact of awareness of preference‐sensitivity and personal motives
Authors: Korger Simone , Eggeling Marie , Cress Ulrike , Kimmerle Joachim , Bientzle Martina 
Published: January 2021

AbstractObjectiveTo participate in shared decision making (SDM), patients need to understand their options and develop trust in their own decision‐making abilities. Two experiments investigated the potential of decision aids (DAs) in preparing patients for SDM by raising awareness of preference‐sensitivity (Study 1) and showing possible personal motives for decision making (Study 2) in addition to providing information about the treatment options.MethodsParticipants (Study 1: N = 117; Study 2: N = 217) were put into two scenarios (Study 1: cruciate ligament rupture; Study 2: contraception), watched a consultation video and were randomized into one of three groups where they received additional information in the form of (a) narrative patient testimonials; (b) non‐narrative decision strategies; and (c) an unrelated text (control group).ResultsParticipants who viewed the patient testimonials or decision strategies felt better prepared for a decision (Study 1:P < .001, = 0.43; Study 2:P < .001, = 0.57) and evaluated the decision‐making process more positively (Study 2:P < .001, = 0.13) than participants in the control condition. Decision certainty (Study 1:P < .001, = 0.05) and satisfaction (Study 1:P < .001, = 0.11; Study 2:P = .003,d = 0.29) were higher across all conditions after watching the consultation video, and certainty and satisfaction were lower in the control condition (Study 2:P < .001, = 0.05).DiscussionDecision aids that explain preference‐sensitivity and personal motives can be beneficial for improving people's feelings of being prepared and their perception of the decision‐making process. To reach decision certainty and satisfaction, being well informed of one's options is particularly relevant. We discuss the implications of our findings for future research and the design of DAs.
PRICE COMPARISON WEBSITES
Authors: Ronayne David 
Published: January 2021

AbstractThe large and growing industry of price comparison websites (PCWs) or “web aggregators” is poised to benefit consumers by increasing competitive pricing pressure on firms by acquainting shoppers with more prices. However, these sites also charge firms for sales, which feeds back to raise prices. I find that introducing any number of PCWs to a market increases prices for all consumers, both those who use the sites and those who do not. I then use my framework to identify ways in which a more competitive environment could be achieved.
Experiences of intergenerational co‐parenting during the postpartum period in modern China: A qualitative exploratory study
Authors: Xiao Xiao , Loke Alice Yuen 
Published: January 2021

AbstractMost studies conducted in the West on the role played by intergenerational families in co‐parenting have focused mostly on families with a single mother or those in difficult circumstances, while little is known about the experiences of members of intergenerational intact families during the early postpartum period. This study aimed to explore the intergenerational co‐parenting experiences of young parents and grandmothers in China, focusing on how they shared the responsibility of caring for the new mother and infant during the postpartum period. A total of 16 eligible intergenerational intact families, including 16 mothers, 15 fathers and 12 grandmothers, were interviewed. The data set was analysed using the approach of directed content analysis guided by Feinberg's Ecological Model of Co‐parenting. The data were categorized into four themes: ‘division of labour’, ‘postpartum and infant care agreement’, ‘support‐undermining’ and ‘joint family management’. An additional theme, ‘expressed a need for family support’, emerged from the data on these intergenerational families. The findings emphasize the importance of intergenerational co‐parenting relationships in families where two generations co‐parent the newborn together.
Differential protein metabolism and regeneration in hypertrophic diaphragm and atrophic gastrocnemius muscles in hibernating Daurian ground squirrels
Authors: Yan Xia , Gao Xuli , Niu Qiaohua , Peng Xin , Zhang Jie , Ma Xiufeng , Wei Yanhong , Wang Huiping , Gao Yunfang , Chang Hui 
Published: January 2021

New Findings

What is the central question of this study?
The aim was to investigate whether diaphragm hypertrophy and gastrocnemius atrophy during hibernation of Daurian ground squirrels involve differential regulation of protein metabolism and regeneration.

What is the main finding and its importance?
We clarified the differences in protein metabolism and muscle regenerative potential in the diaphragm and gastrocnemius of hibernating ground squirrels, reflecting the different adaptability of muscles.

AbstractAre differences in the regulation of protein metabolism and regeneration involved in the different phenotypic adaptation mechanisms of muscle hypertrophy and atrophy in hibernators? Two fast‐type muscles (diaphragm and gastrocnemius) in summer active and hibernating Daurian ground squirrels were selected to detect changes in cross‐sectional area (CSA) and protein expression indicative of protein synthesis metabolism (protein expression of P‐Akt, P‐mTORC1, P‐S6K1 and P‐4E‐BP1), protein degradation metabolism (MuRF1, atrogin‐1, calpain‐1, calpain‐2, calpastatin, desmin, troponin T, Beclin1 and LC3‐II) and muscle regeneration (MyoD, myogenin and myostatin). In the hibernation group compared with the summer active group, the CSA of the diaphragm muscle increased significantly by 26.1%, whereas the CSA of the gastrocnemius muscle decreased significantly by 20.4%. Our study also indicated that increased protein synthesis, decreased protein degradation and increased muscle regenerative potential contributed to diaphragm muscle hypertrophy, whereas decreased protein synthesis, increased protein degradation and decreased muscle regenerative potential contributed to gastrocnemius muscle atrophy. In conclusion, the differences in muscle regeneration and regulatory pattern of protein metabolism might contribute to the different adaptive changes observed in the diaphragm and gastrocnemius muscles of ground squirrels.
Prescribing pattern of antipsychotic medication for first-episode psychosis: a retrospective cohort study
Authors: Keating Dolores , McWilliams Stephen , Boland Fiona , Doyle Roisin , Behan Caragh , Strawbridge Judith , Clarke Mary 
Published: January 2021

ObjectiveGuidelines for antipsychotic use in first-episode psychosis (FEP) recommend that medication be chosen initially on the basis of side effect profile with doses at the lower end of the range. Our objective was to describe the pattern of antipsychotic use in FEP over a period of 21 years in the context of changing clinical guidelines and the development of specialist early intervention in psychosis (EIP) services.SettingA community-based mental health service in South County Dublin (population 187 000) and a large private hospital.ParticipantsParticipants included 465 patients with FEP (146 from an epidemiological study (1995–1999) and 319 from a specialist EIP service (2005–2016)). Treatment with antipsychotic medication did not exceed 30 days at study entry.Outcome measuresThis is a descriptive study of prescribing practices in the context of service development and changing guidelines.ResultsFirst-generation antipsychotics were prescribed for 65% of the early cohort compared with 4.3% of the EIP cohort. Olanzapine was initially prescribed for 79.7% of EIP patients. Initial doses of medication were frequently low (≤50% British National Formulary (BNF) maximum) in both cohorts (71% and 78.6%). The demographic and clinical factors investigated did not influence the initial choice of antipsychotic medication significantly. Univariate logistic regression analysis suggested inpatient treatment setting was associated with a higher initial dose (>50% BNF maximum) of antipsychotic medication. Increasing dose requirements over the first month of engagement with an EIP service was associated with poorer global functioning at baseline, greater positive symptoms at baseline and the inpatient treatment setting. However, these associations were not seen in the multivariable model.ConclusionsSecond-generation antipsychotic prescribing predominates, but guidelines are often overlooked when choosing olanzapine notwithstanding lower initial dosages. EIP services should include proactive support for optimising medicines in line with evidence-based guidelines.
Managing cancer in context of pandemic: a qualitative study to explore the emotional and behavioural responses of patients with cancer and their caregivers to COVID-19
Authors: Chia Jace Ming Xuan , Goh Zack Zhong Sheng , Chua Zi Yang , Ng Kennedy Yao Yi , Ishak Diana , Fung Si Ming , Ngeow Joanne Yuen Yie , Griva Konstadina 
Published: January 2021

ObjectivesHaving to access life-sustaining treatment during the emerging COVID-19 outbreak has placed patients with cancer at an especially vulnerable position notwithstanding their immunocompromised condition. The present study aimed to elucidate cancer patients’ and their caregivers’ experiences during this outbreak.DesignFace-to-face semistructured interviews were conducted.SettingA tertiary cancer care facility.Participants16 patients with cancer and 14 caregivers. Inclusions criteria were: (A) diagnosed with cancer, (B) receiving active treatment or follow-ups, (C) aged 21 years and above and (D) fluent in English or Mandarin.ResultsThematic analysis was conducted. Five themes were identified: heightened sense of threat, impact on healthcare experience, responsibility falls on oneself, striving for normalcy and sense of safety and trust. Heightened threat of COVID-19 was more pronounced in patients and linked to vulnerability and fear, uncertainty and actions of socially irresponsible others. Dominant in their healthcare experience was prioritising cancer and treatment amidst heightened threat and anticipatory worry about treatment disruptions. Both noted on the importance of taking responsibility for one’s health, with caregivers reporting a reinforced sense of duty towards patients. They strived to maintain normalcy by viewing COVID-19 as beyond personal control, downplaying and living life as usual. Their resolve was supported by a sense of safety from the actions of authorities, hospitals and trust towards healthcare providers.ConclusionsCancer intensifies threat and the emotional impact of COVID-19 and may trigger specific concerns related to treatment. Psychoeducation interventions led by healthcare providers over digital platforms could help address cancer-specific concerns and support patients and caregivers during the pandemic.
Real-world, single-centre prospective data of age at breast cancer onset: focus on survival and reproductive history
Authors: Karihtala Peeter , Jääskeläinen Anniina , Roininen Nelli , Jukkola Arja 
Published: January 2021

ObjectivesBeing either young or old at the time of breast cancer diagnosis has been suggested as an indicator of a poor prognosis. We studied the effect of age at breast cancer onset in relation to survival, focusing in particular on biological subtypes and reproductive anamnesis.Design, setting and participantsPatients with early breast cancer (n=594) treated in a Finnish University Hospital during 2003–2013 were prospectively collected and followed in median 102 months.ResultsPatients with luminal A-like breast cancer were older than the patients with luminal B-like (HER2-positive) (p=0.045) or patients with the HER2-positive (non-luminal) subtype (p=0.029). Patients ≥70 years received substantially less adjuvant chemotherapy (p=1.5×10−9) and radiotherapy (p=5.9×10−7) than younger women. Nevertheless, the estimated 10-year breast cancer-specific rates of survival were 84.2%, 92.9% and 87.0% in age groups <41 years, 41–69 years and ≥70 years, respectively, with no statistical difference (p=0.115). Survival rates were also comparable between the three age groups when assessed separately in different biological subtypes, and for patients with metastatic breast cancer there was similarly no difference between the age groups. Later menarche (p=5.7×10−8) and high parity (p=0.000078) correlated with increased age at breast cancer diagnosis, but, according to the patients’ oestrogen receptor (ER) status, only among ER-positive patients.ConclusionsDespite the suggested undertreatment of older patients, we report excellent long-term outcomes in all age groups in this prospective cohort. Later endogenous endocrine exposure may cause delay in breast cancer onset, but the exact biology behind this phenomenon is so far unclear.
Optimised anthropometric indices as predictive screening tools for metabolic syndrome in adults: a cross-sectional study
Authors: Wu Yating , Li Hongyu , Tao Xiujuan , Fan Yanna , Gao Qinghan , Yang Jianjun 
Published: January 2021

ObjectivesWe aimed to evaluate the association between metabolic syndrome (MetS) and two latest optimised indices, waist divided by height0.5(WHT.5R) and body mass index (BMI) multiply by the square root of BMI and waist circumference (BMI√WC), and to comprehensively compare the ability of 10 anthropometric indices to identify MetS, including BMI√WC, WHT.5R, abdominal volume index (AVI), waist-to-height ratio (WHtR), Body Roundness Index (BRI).DesignCross-sectional study.SettingNingxia, China.ParticipantsA total of 3860 adults aged 18–88 years from Ningxia, China were recruited by a single stratified cluster random sampling method.MethodsORs and 95% CIs for associations between indices and MetS were calculated using binary logistic regression, and areas under the receiver operating characteristic (ROC) curves (AUCs) were performed to compare their predictive capacity for MetS. All results for men and women were analysed and presented separately.ResultsThe highest adjusted ORs for MetS were observed for the following indices: AVI (OR 15.22, 95% CI 10.88 to 21.30), WHT.5R (OR 13.83, 95% CI 9.89 to 19.35) and BMI√WC (OR 12.14, 95% CI 8.79 to 16.76) in men, whereas BRI, WHtR (both OR 14.91, 95% CI 10.39 to 21.4), WHT.5R (OR 14.22, 95% CI 9.96 to 20.29) and AVI (OR 14.03, 95% CI 9.91 to 19.87) in women. In ROC analysis, AVI (AUC: 0.767 for men and 0.749 for women) and WHT.5R (AUC: 0.761 for men and 0.747 for women) showed the highest predictive ability for MetS.ConclusionsBMI√WC and WHT.5R were significantly positively associated with MetS, and AVI and WHT.5R could be useful screening tools for identifying MetS in both sexes.
Prognostic role of tumour-infiltrating lymphocytes assessed by H&E-stained section in gastric cancer: a systematic review and meta-analysis
Authors: Tian Chunfang , Jing Haiyan , Wang Caixia , Wang Weibo , Cui Yangang , Chen Jianpeng , Sha Dan 
Published: January 2021

ObjectivesSome studies have identified tumour-infiltrating lymphocytes (TILs) in H&E-stained sections of gastric cancer, but the prognostic and clinicopathological significance of this remains unclear. The objective of this study is to evaluate the associations between H&E-based TIL density and prognosis and clinicopathological characteristics of patients with gastric cancer.DesignSystematic review and meta-analysis.Data sourcesCochrane Library, PubMed and Embase databases were searched through 25 February 2020.Eligibility criteriaStudies evaluating the correlations between TILs assessed by H&E-stained sections and prognosis and clinicopathological characteristics of gastric cancer were included.Data extraction and synthesisRelevant data were extracted and risks of bias were assessed independently by two reviewers. HR and relative risk (RR) with 95% CI were pooled by random-effect models to estimate the associations between TIL density and overall survival (OS) and clinicopathological characteristics, respectively.ResultsWe enrolled nine studies including 2835 cases for the present meta-analysis. High TILs were associated with superior OS (HR=0.68, 95% CI 0.52 to 0.87, p=0.003) compared with low TILs. High TILs were significantly associated with lower depth of invasion (T3–T4 vs T1–T2) (RR=0.58, 95% CI 0.50 to 0.66, p<0.001), less lymph node involvement (presence vs absence) (RR=0.68, 95% CI 0.56 to 0.81, p<0.001) and earlier TNM (tumour, node, metastasis) stage (III–IV vs I–II) (RR=0.68, 95% CI 0.55 to 0.83, p<0.001). TIL density was not associated with age, gender, Lauren classification or histological grade. The methodology for evaluating TIL and its cut-off value varied across different studies, which might affect the results of our meta-analysis.ConclusionsOur meta-analysis suggests that H&E-based TIL density is a reliable biomarker to predict the clinical outcomes of patients with gastric cancer. Multicentre, prospective studies are needed to further confirm our findings.PROSPERO registration numberCRD42020169877.