bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increasing age and atrial arrhythmias are associated with increased thromboembolic events in a young cohort of adults with repaired tetralogy of Fallot
Authors: Tsui Clara , Wan Darryl , Grewal Jasmine , Kiess Marla , Barlow Amanda , Human Derek , Chakrabarti Santabhanu 
Published: September 2021

AbstractBackgroundAdults with repaired Tetralogy of Fallot (rTOF) comprise one of the largest cohorts among adults with congenital heart disease (ACHD). These patients have a higher burden of atrial arrhythmias (AA), leading to increased adverse events, including stroke and transient ischemic attack (TIA). However, the data on factors associated with stroke/TIA in rTOF are limited, and classic risk factors may not apply. We studied event rates and associated factors for thromboembolism in a rTOF cohort.MethodsRetrospective cohort study of all adult patients age >18 years with rTOF followed at a single ACHD tertiary care center. AA of interest were atrial fibrillation (AF) and atrial flutter (AFL).ResultsData from 260 patients were identified, mean age 37.6 SD 13.3 years, followed over 5108 patient‐years (mean 16.6 SD 8.2 years). 43 patients had AF and/or AFL, and 30 patients had thromboembolic events, of which 19 patients had stroke/TIA. The event rate for any thromboembolism was 3.39 per 100 patient‐years follow‐up in patients with AA, compared to 1.80 in patients without (P = .07). In univariate analysis, older age and diabetes were associated with thromboembolic events. In multivariate analysis, only older age was associated with thromboembolic events.ConclusionsIn our relatively young cohort of adults with rTOF, there was a high prevalence of AA, associated with nearly double the rate of thromboembolic events compared to patients without AA. Older age alone is independently associated with thromboembolic events. Further studies into assessment of silent AA are required, and routine assessments should be considered at an earlier age.
Prognostic and predictive value of mismatch repair deficiency in gastric and gastroesophageal junction adenocarcinoma patients receiving neoadjuvant or adjuvant chemotherapy
Authors: Li Ziyu , Wang Yinkui , Ying Xiangji , Zhang Li , Gao Xiangyu , Jia Yongning , Zhang Lianhai , Wu Aiwen , Su Xiangqian , Ji Jiafu 
Published: September 2021

AbstractBackground and objectivesEvidence is inconclusive regarding the prognostic significance of deficient DNA mismatch repair (dMMR) in gastric and gastroesophageal junction (GEJ) adenocarcinoma patients receiving chemotherapy. We aim to explore such associations with a large cohort.MethodsWe retrospectively identified a consecutive cohort of patients who had histology proven gastric or GEJ adenocarcinoma and received neoadjuvant chemotherapy plus surgery or upfront surgery plus adjuvant chemotherapy. MMR status was assessed by immunohistochemistry staining on surgical specimen. The association of MMR status with tumor regression grade (TRG), overall survival (OS), and disease‐free survival (DFS) were analyzed.ResultsIn total, 1568 patients received neoadjuvant or adjuvant chemotherapy, of which 128 (8.2%) had dMMR tumors. No significant difference was found in the frequencies of TRG categories between proficient MMR (pMMR) and dMMR tumors (p = .62). Among patients receiving neoadjuvant chemotherapy, dMMR status was associated with better OS (log‐rank p = .044) and DFS (log‐rank p = .022) in the univariate analysis; this association became nonsignificant after adjusting for pathologic stages and other prognostic factors. Similar results were found for patients receiving adjuvant chemotherapy.ConclusionsdMMR status was not significantly associated with OS and DFS among gastric and GEJ adenocarcinoma patients with neoadjuvant and adjuvant platinum and fluorouracil‐based chemotherapy.
The Visualized Urethral Mobility Profile in Stress Urinary Incontinence Described by Four‐Dimensional Transperineal Ultrasound
Authors: Zhao Baihua , Wen Lieming , Liu Dan , Huang Shanya 
Published: September 2021

ObjectivesTo describe the urethral mobility during urine leaking in stress urinary incontinence (SUI) by transperineal ultrasound (TPUS) with urethral mobility profile (UMP) analysis.MethodsThis was a prospective study of 380 women who had a cough stress test (CST) with TPUS. UMP software automatically placed six equidistant points from the bladder neck (Point 1) to the external urethral meatus (Point 6) and determined their x and y coordinates relative to the symphysis pubis. Urethral mobility vector of Points 1–6 (Vectors 1–6) and the distance between the six points and the symphysis (Dist. 1–6) were calculated and compared between the two groups. The visualized UMP was created by reproducing the positions of the six points at rest and on Valsalva.ResultsValid data of 188 women with SUI and 174 continent women were analyzed. The mean age of all 362 women was 49.3 years. Mean body mass index in the SUI group was significantly increased (23.8 vs 22.2 kg/m2, P < .001). During CST, Vectors 1–6 and Dist. 2–6 were significantly increased (all P < .005) in the SUI group. The UMP showed the mid‐urethral rotated down around the symphysis pubis. The upper urethral profile in the two groups was similar. But the gap between the mid‐urethra and the symphysis was wider in the SUI group.ConclusionsThe visualized UMP illustrated the mid‐urethral hypermobility in SUI by showing a wider gap due to the unstable connection between the mid‐urethra and the symphysis pubis.
Impact of the COVID‐19 Pandemic on the 2021 Otolaryngology Residency Match: Analysis of the Texas STAR Database
Authors: Lenze Nicholas R. , Mihalic Angela P. , Kovatch Kevin J. , Thorne Marc C. , Kupfer Robbi A. 
Published: September 2021

Objectives/HypothesisTo estimate the impact of the coronavirus disease 2019 (COVID‐19) pandemic on the 2021 otolaryngology match with regard to geographic clustering, interview distribution, applicant‐reported costs, and matched applicant characteristics.Study DesignRetrospective cohort study.MethodsSurvey data from applicants to otolaryngology residency programs were obtained from the Texas Seeking Transparency in Applications to Residency database. Applicant differences between the 2021 match year and prior match years (2018, 2019, and 2020) were analyzed using two‐sided t‐tests, Chi‐square tests, and Fisher's exact tests.ResultsA total of 442 otolaryngology residency applicants responded to the survey, including 329 from the match years 2018 to 2020 and 113 from match year 2021. In 2021, 30.7% of responding applicants reported matching at a program where they had a geographic connection, compared to 40.0% in prior years (P = .139). Matched applicants in 2021 reported attending less interviews than applicants in prior years (mean 12.2 vs. 13.3, P = .040), and 26.1% of responding applicants reported matching at a program where they sent a preference signal. Applicants in the 2021 match reported significantly lower total costs than applicants in prior years (mean difference −$5,496, 95% confidence interval −$6,234 to −$4,759; P < .001). Compared to prior match years, matched applicants in 2021 had no meaningful differences in characteristics such as United States Medical Licensing Exam board scores, clerkship grades, honors society memberships, research output, volunteer experiences, or leadership experiences.ConclusionBased on this sample, there was no evidence of significant interview hoarding or increased geographic clustering in the 2021 otolaryngology match, and the COVID‐19 pandemic did not appear to result in significantly different matched applicant characteristics.Level of Evidence4 Laryngoscope, 132:1177–1183, 2022
CO‐CREATION LEADERSHIP
Authors: Jackson Terry 
Published: September 2021

AbstractThe author discusses co‐creation leadership; describing Co‐creation as “the collaboration among interested parties to create something better than either could have created on its own.” In today's increasingly complex world, where problems reach global levels of concern, “solving for the needs of one stakeholder must take into account the needs of all stakeholders, lest creating solutions that solve one problem only contribute to creating another.” It ends with what he calls a “Recipe,” in his words: R‐Revolutionary Results E‐Execution C‐Culture I‐Intention P‐Purpose E‐Evolution. There are many practical benefits, including that “when all people are more educated and prosperous, society as a whole becomes more educated and prosperous.” Business examples are drawn from companies like the Lego Corporation and the South Korean cosmetics retailer Missha. In Public health he discusses the unprecedented cooperation leading to COVID‐19 vaccines. In society and government, he uses historic examples from the United States Senate; and the International Space Station (ISS0, within Science. In how to co‐create, he notes that “organizations that do not value their employees’ contributions will lose the best of them to those that do. Those who remain will become more disengaged, and more problematic.”
Flexible and Highly Conductive AgNWs/PEDOT:PSS Functionalized Aramid Nonwoven Fabric for High‐Performance Electromagnetic Interference Shielding and Joule Heating
Authors: Li Lele , Sun Baojie , Li Wenyue , Jiang Liang , Zhou Yanfen , Ma Jianwei , Chen Shaojuan , Ning Xin , Zhou Feng‐Lei 
Published: September 2021

AbstractHigh‐performance multifunctional textiles are highly demanded for human health‐related applications. In this work, a highly conductive nonwoven fabric is fabricated by coating silver nanowires (AgNWs)/poly(3,4‐ethyl enedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) on a poly(m‐phenylene isophthalamide) (PMIA) nonwoven fabric through a multistep dip coating process. The as‐prepared PMIA/AgNWs/PEDOT:PSS composite nonwoven fabric shows an electrical resistance as low as 0.92 ± 0.06 Ω sq−1 with good flexibility. The incorporation of the PEDOT:PSS coating layer improves the adhesion between AgNWs and PMIA nonwoven fabric, and also enhances the thermal stability of the composite nonwoven fabric. Electromagnetic interference (EMI) shielding and Joule heating performances of the PMIA/AgNWs/PEDOT:PSS composite nonwoven fabric are also investigated. The results show that the average EMI shielding effectiveness (SE) of the single‐layer nonwoven fabric in X‐band is as high as 56.6 dB and retains a satisfactory level of SE after being washed, bended, and treated with acid/alkali solution and various organic solvents. The composite nonwoven fabric also exhibits low voltage‐driven Joule heating performance with reliable heating stability and repeatability. It can be envisaged that the multifunctional PMIA/AgNWs/PEDOT:PSS nonwoven fabric with reliable stability and chemical robustness can be used in EMI shielding devices and personal thermal management products.
Deep analysis of the LRTOMTc.242G>A variant in non‐syndromic hearing loss North African patients and the Berber population: Implications for genetic diagnosis and genealogical studies
Authors: Mosrati Mohamed Ali , Fadhlaoui‐Zid Karima , Benammar‐Elgaaied Amel , Gibriel Abdullah Ahmed , Ben Said Mariem , Masmoudi Saber 
Published: September 2021

AbstractAutosomal recessive non‐syndromic hearing loss (ARNSHL) is the most common inherited sensory impairment. It is particularly frequent in North African populations who have a high rate of consanguineous marriage. The c.242G>A homozygous variant in LRTOMT gene was previously established as pathogenic and is associated with NSHL in both humans and mice. The aim of this study is to determine the carrier frequency for the LRTOMT c.242G>A variant and also to estimate its age in addition to evaluating its diagnostic potential as a deafness biomarker among various populations and ethnicities in Northern African countries. A total of 179 Tunisian and 34 Libyan unrelated deafness patients were screened for this variant. The homozygous c.242G>A variant was found in 5.02% and 2.94% in Tunisian and Libyan families, respectively. Subsequent screening for this variant in 263 healthy controls of various ethnicities (136 Tunisian Berbers, 32 Andalusian and 95 Tunisian from undefined ethnic origin) revealed higher frequency for the heterozygous state among Tunisians of Berber origin only (19.11%). Genotyping 7 microsatellite markers nearby the variant location in ARNSHL patients who had the homozygous variant revealed the same haplotype suggesting a common founder origin for this variant. The age of this variant was estimated to be between 2025 and 3425 years (this corresponds to 3400 years when the variant rate was set at 10−3 or 2600 years when the variant rate is set at 10−2), spreading along with the Berber population who migrated to North Africa. In conclusion, the LRTOMT c.242G>A homozygous variant could be used as a useful deafness biomarker for North African ARNSHL patients meanwhile the heterozygous variant could be utilized in genealogical studies for tracing those of the Berber ethnic group.
The changing pattern of acute spinal referrals during primary and secondary waves of the COVID‐19 pandemic
Authors: Naskar Rajib , Baryeh Kwaku W. , Pavuluri Sindhu , Rajagopal Trichy 
Published: September 2021

AbstractIntroductionThe COVID‐19 pandemic has had a devastating effect on health systems globally. This led to changes in patient access to healthcare particularly spinal services. This study investigates the impact of the pandemic on the volume of patients being referred to and accessing spinal services during both the first and second waves.MethodsAll emergency spinal referrals and related hospital attendances to the emergency department in a busy district general hospital were analysed. The data were evaluated at three time points each covering a 3‐month period. Data collected included patient demographics, duration and nature of symptoms, reason for referral, clinical and MRI findings, length of stay in hospital, any interventions performed and the follow‐up plan.ResultsThere were a total of 316 emergency referrals across the three time periods. The number of referrals fell by 15% between the pre‐COVID‐19 period and the first wave. Comparing the first and second waves, the number of referrals was increased by 58%. Comparing the second wave to the pre‐COVID‐19 period, referrals were 34% greater in the second wave (p < 0.005).ConclusionWe highlight an increase in referrals to our spinal service during the secondary wave, having fallen during the first wave. We hypothesise that the increase in referrals, despite similar restrictions to the first wave, is a result of changing patterns of behaviour due to the fear of contracting COVID during the first wave and difficulty in accessing primary care services in the second wave.
Neurological safety and efficacy of darifenacin and mirabegron for the treatment of overactive bladder in patients with history of cerebrovascular accident: A prospective study
Authors: Vasudeva Pawan , Kumar Amitabh , Yadav Siddharth , Kumar Niraj , Chaudhry Neera , Prasad Vishnu , Nagendra Rao Swatantra , Yadav Prashant , Patel Samarth 
Published: September 2021

AbstractObjectivesTo evaluate the neurological safety and clinical efficacy of darifenacin and mirabegron in patients with a history of cerebrovascular accident (CVA) who had overactive bladder (OAB) symptoms.MethodsThis prospective randomized study, approved by the institute's ethics committee, was carried out at a tertiary care center from December 2018 to June 2020. Treatment naïve adult patients with a past history of CVA with stable neurological status for atleast past 3 months with symptoms of OAB for 3 or more months were included. Eligible patients received either darifenacin or mirabegron for a period of 3 months and various parameters on the 3‐day International Consultation on Incontinence Questionnaire (ICIQ) bladder diary, the Montreal Cognitive Assessment—Basic score (MoCA‐B), and the adverse events at 3 months posttreatment were compared to that at the baseline.ResultsA total of 60 patients were included, 30 in each arm. After 3 months of treatment with darifenacin or mirabegron, the majority of the ICIQ bladder diary parameters improved and there was no deterioration in the cognitive function as noted on the MoCA‐B score in either of the arms. On intergroup comparison, the mean change in bladder diary parameters and the MoCA‐B scores was similar between the two groups.ConclusionDarifenacin and mirabegron, in the short term, do not adversely affect the cognitive function in patients with a history of CVA with OAB symptoms. Both are safe and effective treatment options in patients with OAB post‐CVA.
Patient-Reported Outcomes with Selpercatinib Treatment Among Patients with RET-Mutant Medullary Thyroid Cancer in the Phase I/II LIBRETTO-001 Trial
Authors: Wirth Lori J , Robinson Bruce , Boni Valentina , Tan Daniel S W , McCoach Caroline , Massarelli Erminia , Hess Lisa M , Jen Min-Hua , Kherani Jennifer , Olek Elizabeth , Subbiah Vivek 
Published: September 2021

Abstract

Background
Medullary thyroid cancer (MTC) standard of care includes multikinase inhibitors (MKIs), which can exacerbate disease-related diarrhea, primarily because of non-RET kinase inhibition. We report diarrhea and other patient-reported outcomes (PROs) with selpercatinib, a highly selective RET inhibitor, among patients with RET-mutant MTC in the ongoing, phase I/II LIBRETTO-001 trial.

Materials and Methods
Instrument completion time points were baseline (cycle 1, day 1) and approximately every other 28-day cycle until cycle 13 (every 12 weeks thereafter) for the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, and baseline, weekly during cycle 1, and day 1 of every cycle for the modified Systemic Therapy–Induced Diarrhea Assessment Tool (mSTIDAT). A ≥10-point change from baseline in domain score was considered clinically meaningful. PROs were summarized through cycle 13 in all patients and by subgroups with or without prior exposure to MKIs vandetanib and/or cabozantinib (V/C).

Results
Among the overall MTC population (n = 226), 88 (39%) and 124 (55%) patients comprised the V/C-naïve and previous V/C subgroups, respectively. Compliance was &gt;85% for both instruments at each time point. Most patients maintained/improved in all health-related quality of life (HRQoL) subscales throughout treatment. Improvements in diarrhea were clinically meaningful in 43.5% of patients overall and in 36.8% and 51.3% of V/C-naïve and previous V/C subgroups, respectively. At baseline, 80.4% of all patients reported diarrhea on mSTIDAT. The percentage of patients who reported diarrhea was reduced to less than half of all patients (range: 33.3%–48.3%) after cycle 2.

Conclusion
These interim results demonstrate that patients with RET-mutant MTC improved/remained stable on all domains of HRQoL during treatment with selpercatinib. Future analyses will be conducted as the data mature.
Assessment of PD-L1 Expression on Circulating Tumor Cells for Predicting Clinical Outcomes in Patients with Cancer Receiving PD-1/PD-L1 Blockade Therapies
Authors: Tan Zhaoli , Yue Chunyan , Ji Shoujian , Zhao Chuanhua , Jia Ru , Zhang Yun , Liu Rongrui , Li Da , Yu Qian , Li Ping , Hu Zhiyuan , Yang Yanlian , Xu Jianming 
Published: September 2021

Abstract

Background
Programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) blockade immunotherapies have changed the landscape of cancer therapy. However, the main limitation of these therapies is the lack of definitively predictive biomarkers to predict treatment response. Whether PD-L1 expression on circulating tumor cells (CTCs) is associated with the clinical outcomes of immunotherapy remains to be extensively investigated.

Materials and Methods
One hundred fifty-five patients with different advanced cancers were enrolled in this study and treated with anti-PD-1/PD-L1 monoclonal antibodies. Using the Pep@MNPs method, CTCs were isolated and enumerated. The PD-L1 expression levels were analyzed by an immunofluorescence assay for semiquantitative assessment with four categories (negative, low, medium, and high).

Results
Prior to immunotherapy, 81.93% (127/155) of patients had PD-L1-positive CTCs, and 71.61% (111/155) had at least one PD-L1-high CTC. The group with PD-L1-positive CTCs had a higher disease control rate (DCR) (71.56%, 91/127), with a DCR of only 39.29% (11/28) for the remaining individuals (p = .001). The objective response rate and DCR in PD-L1-high patients were higher than those in the other patients (32.44% vs. 13.64%, p = .018 and 75.68% vs. 40.91%, p &lt; .0001, respectively). The reduction in the counts and ratios of PD-L1-positive CTCs and PD-L1-high CTCs reflected a beneficial response to PD-1/PD-L1 inhibitors. Furthermore, patients with PD-L1-high CTCs had significantly longer progression-free survival (4.9 vs. 2.2 months, p &lt; .0001) and overall survival (16.1 vs. 9.0 months, p = .0235) than those without PD-L1-high CTCs.

Conclusion
The PD-L1 level on CTCs may serve as a clinically actionable biomarker for immunotherapy, and its dynamic changes could predict the therapeutic response.

Implications for Practice
This study was designed to investigate the role of programmed death-ligand 1 (PD-L1) expression on circulating tumor cells in predicting and monitoring response to programmed death-1 (PD-1)/PD-L1 blockade immunotherapies in patients with advanced cancer. The results of the study showed that PD-L1-high-expression circulating tumor cells (CTCs) were both a predictive biomarker and a prognostic factor in patients with advanced cancer treated with anti-PD-1/PD-L1 monoclonal antibodies. These observations suggest that PD-L1 level on CTCs is a potential clinical biomarker for immunotherapy.
Self‐reported cognitive impairment in cervical cancer survivors: A cross‐sectional study
Authors: Areklett Elisabeth Wang , Fagereng Elisabeth , Bruheim Kjersti , Andersson Stein , Lindemann Kristina 
Published: September 2021

AbstractObjectiveCancer‐related cognitive impairment (CRCI) is a major obstacle for cervical cancer survivors, preventing the return to their social life. This study assessed the prevalence of CRCI in cervical cancer survivors and studied the association of self‐reported cognitive impairment with treatment regimen and the quality of life (QoL) domains depression, anxiety, and fatigue.MethodsSix hundred twenty one cervical cancer survivors, treated with combined chemo‐radiotherapy (CCRT) (n = 458) or surgery only (n = 163) were invited in this cross‐sectional study. Self‐reported cognitive function was assessed using the Functional Assessment of Cancer Therapy‐Cognitive Function (FACT‐Cog). Fatigue and psychological distress were assessed using EORTC‐QLQ C30 and Hospital Anxiety and Depression Scale (HADS).ResultsData of 254 women (40.9%) was available for the analysis. Of those, 204 (80.3%) women had received CCRT and 50 (19.7%) surgery only. In the whole cohort, 42.5% reported significant cognitive impairment. In both treatment groups cognitive complaints were significantly associated with anxiety, depression, and fatigue (all p < 0.001). CCRT was strongly associated with increased risk of CRCI (OR = 4.02, 95% CI = 1.57–10.25). Anxiety, depression, and fatigue increased the risk of CRCI by 13% (OR: 1.13, 95% CI 1.03–1.23), 16% (OR 1.16, 95% CI 1.04–1.28) and 2% (OR 1.02, 95% CI 1.00–1.03), respectively.ConclusionAlmost half of the cervical cancer survivors after CCRT report significant cognitive impairment. CRCI is associated with other indicators of poor QoL, such as depression, anxiety and fatigue. An increased understanding of the specific cognitive domains affected and of the associated late effects like fatigue is crucial to customize successful interventions.