bluuebunny/crossref_metadata_2025_split huggingface dataset:
Upfront Surgery Versus Upfront Concurrent Chemoradiotherapy as Primary Modality in Hypopharyngeal Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis
Authors: Tsai Tsung-You , Yap Wing-Keen , Wang Ting-Hao , Lu Yi-An , See Anna , Hu Yu-Feng , Huang Yenlin , Kao Huang-Kai , Chang Kai-Ping 
Published: October 2024

Importance The management of hypopharyngeal squamous cell carcinoma (HPSCC) continues to be one of the most formidable challenges in the realm of head and neck oncology. Objectives The aim of this meta-analysis was to evaluate the disparity in survival outcomes between upfront surgery and upfront concurrent chemoradiotherapy as the primary treatment modality in patients with HPSCC. Design Systemic review with meta-analysis. Setting The meta-analysis was conducted in strict accordance with the PRISMA guideline. A literature search through PubMed, EMBASE, and the Cochrane Library were conducted until January 2023. The adjusted hazard ratio (aHR) with 95% confidence intervals (CIs) of different survival outcomes were extracted and pooled. Participants Studies that incorporated HPSCC patients without receiving induction chemotherapy. Interventions Upfront surgery versus upfront concurrent chemoradiotherapy. Main Outcome Measures Overall survival (OS) and disease-free survival (DFS). Results Eight studies published between 2015 and 2023, with a pooled patient population of 1619, were included in this meta-analysis. The outcomes reveal that upfront surgery was notably linked with improved OS (aHR 0.66, 95% CI 0.57-0.78) and DFS (aHR 0.75, 95% CI 0.63-0.90). Subgroup analyses were conducted to investigate the impact of the overall stage of the tumor and the extent of surgery on OS. In patients with advanced HPSCC (stages III and IV), upfront surgery remained associated with better OS (aHR 0.65, 95% CI 0.56-0.77). Concerning the extent of surgery, both subgroups exhibited a superior OS outcome associated with upfront surgery (exclusive total laryngopharyngectomy group: aHR 0.54, 95% CI 0.39-0.75; total/partial laryngopharyngectomy group: aHR 0.71, 95% CI 0.59-0.84). Conclusions and Relevance The results demonstrated that upfront surgery showed better OS and DFS than concurrent chemoradiation and remind the clinicians of the potential reduction in survival outcomes when choosing concurrent chemoradiotherapy as primary treatment.
Use of the Oral Sialogogue “Oriza Tablet” in Reducing Drug-Induced Xerostomia in Patients with Overactive Bladder or Neurogenic Bladder: Randomized Clinical Study
Authors: Piyawannarat Surawach , Sirisreetreelux Pokket , Rattapornsompong Wattanachai , Tancharoen Salunya , Viseshsindh Wit 
Published: October 2024

Purpose Evaluate the clinical efficacy of “Oriza tablet” (OT) for patients with neurologic bladder or overactive bladder affected by xerostomia due to receiving antimuscarinic drugs. Material and methods This was a randomized clinical trial. Twenty-eight patients (median age = 64 years) with xerostomia were divided into two groups: OT (intervention group) and placebo (control) group. Both groups comprised 14 patients each. Objective We assessed severity using a questionnaire for the subjective evaluation of xerostomia. Objective evaluation was undertaken for the stimulated salivary flow rate (SSFR). Xerostomia evaluation took place before treatment (baseline) as well as 2 weeks and 4 weeks after treatment. Results The xerostomia score decreased significantly ( p < 0.05) in the OT group compared to the placebo group, with scores of 2.75 versus 4.4 at 2 weeks and 2.19 versus 4.13 at 4 weeks, respectively. The SSFR increased significantly ( p < 0.05) in the OT group compared to the placebo group, with SSFR of 2 versus 1.2 at 2 weeks and 1.85 versus 1.1 at 4 weeks, respectively. Throughout the trial, no patient discontinued taking antimuscarinic medications. There were no adverse effects noted. Conclusion Continuous daily use of OT for 4 weeks reduced xerostomia symptoms and increased saliva production in patients suffering from neurologic bladder or overactive bladder who received antimuscarinic medications. Clinical trial registration The study was registered with The Thai Clinical Trials Registry (TCTR). ID: TCTR20240715015.
Current practice of screening and antimicrobial prophylaxis to prevent Gram-negative bacterial infection in high-risk haematology patients: results from a pan-European survey
Authors: Stemler Jannik , Gavriilaki Eleni , Hlukhareva Oksana , Khanna Nina , Neofytos Dionysios , Akova Murat , Pagano Livio , Cisneros José-Miguel , Cornely Oliver A. , Salmanton-García Jon 
Published: October 2024

Background: Bacterial infections frequently occur in haematological patients, especially during prolonged neutropenia after intensive chemotherapy, often leading to bloodstream infections and pneumonia. Objective: Routine antimicrobial prophylaxis (AMP) for high-risk haematology patients is still debated while prevalence of multi-drug resistant (MDR) Gram-negative bacteria (GNB) is rising globally. We aimed to assess the current practice of AMP in this population. Design: Cross-sectional observational survey study. Methods: Haematologists and infectious diseases physicians Europewide were invited to an online survey including questions on routine screening for GNB, incidence of MDR-GNB colonization, antimicrobial prophylaxis practices, rates of bloodstream infections (BSI), ICU admission and mortality differentiated by infections due to GNB versus MDR-GNB. Results: 120 haematology centres from 28 countries participated. Screening for MDR-GNB is performed in 86.7% of centres, mostly via rectal swabs (58.3%). In 39.2% of routine AMP is used, mostly with fluoroquinolones. Estimates of GNB-BSI yielded higher rates in patients not receiving anti-GNB prophylaxis than in those who do for E. coli (10% vs 7%) Klebsiella spp. (10% vs 5%), and Pseudomonas spp. (5% vs 4%). Rates for MDR-GNB infection were estimated lower in centres that administer AMP for MDR E. coli (5% vs 3%) Klebsiella spp. (5% vs 3%), and Pseudomonas spp. (2% vs 1%). In an exploratory analysis, Southern and Eastern European countries expected higher rates of MDR-GNB infections with lower ICU admission and mortality rates which may be subject to estimation bias. Conclusion: Screening for MDR-GNB is frequently performed. AMP against GNB infections is still often implemented. Estimated BSI rates are rather low, while the rate of MDR-GNB infections rises. Tailored prophylaxis including antimicrobial stewardship becomes more important.
Feasibility, acceptability, and preliminary effectiveness of implementing a 12-week home-based aerobic and resistance exercise program for breast cancer patients receiving endocrine treatment in Indonesia: A mixed methods study
Authors: Astari Yufi Kartika , Hutajulu Susanna Hilda , Prabandari Yayi Suryo , Bintoro Bagas Suryo , Wibowo Rakhmat Ari , Hardianti Mardiah Suci , Hartopo Anggoro Budi , Sebastiano Katie M Di , Allsop Matthew John , Burke Shaunna 
Published: October 2024

Objectives: To assess the feasibility, acceptability, and preliminary effectiveness of implementing a home-based aerobic and resistance exercise for patients with breast cancer receiving endocrine treatment in Indonesia. Methods: This is a mixed methods study with concurrent design consisting of quantitative single-arm pre-post intervention and qualitative study. We recruited patients with breast cancer ( N = 36) receiving endocrine treatment and assigned 12 weeks of home-based pedometer-driven walking and resistance exercises using therapeutic bands. Descriptive statistics were used to assess the feasibility (recruitment, retention, and adherence) and safety. The modified Bruce treadmill test was used to measure predicted aerobic capacity (V̇O2 peak). Quality of life and fatigue were assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and fatigue severity scale. Measurements were performed at baseline and post-intervention and analyzed with the paired t-test or Wilcoxon test. Semi-structured interviews and thematic analysis were conducted post-intervention to explore patients’ acceptability. Results: The results showed a recruitment rate of 75%, retention rate of 89%, and adherence rates were 53% for aerobic and 78% for resistance exercise. No severe adverse events were reported. Post-intervention interviews identified positive attitudes toward the intervention, with low burden and high perceived benefit. Exercise duration and predicted V̇O2 peak increased significantly (+1.1 min, p = 0.001 and +2.3 ml/kg/min, p = 0.043), but no significant change was detected for Quality of Life ( p > 0.050) or fatigue severity ( p = 0.299). Conclusions: A home-based aerobic and resistance exercise was feasible when implemented in the context of routine care in our study population, improving predicted aerobic capacity. Further research is required to understand limited changes to Quality of Life and fatigue and adaptations to support implementation in additional sites in Indonesia.
Data sharing considerations and practice among health researchers in Africa: A scoping review
Authors: Obiora Oluchukwu Loveth , Shead Dorothy Agnes , Olivier Benita 
Published: October 2024

Objective To examine the way African health researchers share data. It summarized the types of data collected, the data sharing platforms, and how the geographical distribution of the African-based health researchers influenced data sharing practices. Ethical, legal, and social aspects were considered. Institutional and government matters such as research support and funding were identified. Methods PubMed, Web of Science, LILAC, African Journal Archive, and Scopus databases were searched. Full-text screening was conducted, and data was extracted using the data extraction tool published in an a priori Joanna Briggs Institute-published protocol. Discrepancies were resolved by consensus. Data were illustrated using a Preferred Reporting Items for Systematic Reviews and Meta-analyses flow diagram, figures, tables, and a narrative text. Results Of the 3869 studies that were identified, 32 studies were included in the final study. There was a spike in the number of published studies from 2015 to 2019 ( n =  24, 75.0%), while a decline followed in the number of publications from 2020 to April 2023 ( n =  6, 18.8%). Ten of the studies included were from South Africa, five were from Kenya, three each were from Nigeria and Tanzania, two were from Ghana and Sierra Leone respectively, while one each was from Malawi, Ethiopia, Cameroon, Mali, Gambia, Senegal, and Burkina Faso. Negative factors impacting data sharing practices of health researchers in Africa included barriers to individual research capacity, governmental bureaucracy and corruption, legal obstacles, technological problems, prohibitive costs of publication, lack of funding, institutional delays, and ethical issues. Conclusion This review identified how African health researchers undertook data sharing in their countries. It pinpointed how geographical location and the resultant challenges to data distribution both individually and institutionally influenced health researchers’ ability to achieve data sharing and publication of their research. It was clear that many parts of Africa are still not participating in research due to the many factors that negatively impact health data sharing in Africa.
Citizen science to approach machine learning to society: Detecting loneliness in older adults
Authors: Castillo-Hornero Andrea , Belmonte-Fernández Óscar , Gascó-Compte Arturo , Caballer-Miedes Antonio , López Agustín , Afxentiou Afxentis 
Published: October 2024

Background Even if we are not aware of it, machine learning techniques are part of our daily lives. It is of the utmost interest that citizens become familiar with the use of these techniques and discover their potential to solve everyday problems. Objective and Methods In this article, we describe the methodology and results of a highly replicable citizen science project that allows citizens to get closer to the scientific process and understand the potential of machine learning to solve a social problem of interest to them. For this purpose, we have chosen a problem of social relevance in contemporary societies, namely the detection of loneliness in older adults. Citizens are challenged to apply machine learning techniques to identify levels of loneliness from natural language. Results The results of this project suggest that citizens are willing to engage in science when the challenges posed are of social interest to them. A total of 1517 citizens actively engaged in the project. A database containing 1112 texts about loneliness expressions was collected. An accuracy of 83.12% using the logistic regression algorithm and 62.23% accuracy when using the Naïve Bayes algorithm was reached in detecting loneliness from texts. Conclusions Detecting loneliness using machine learning techniques is an attractive and relevant topic that allows citizens to be involved in science and introduces them to machine learning practices. The methodology of this project can be replicated in other places around the world.
Are ICD codes reliable for observational studies? Assessing coding consistency for data quality
Authors: Nelson Stuart J. , Yin Ying , Trujillo Rivera Eduardo A. , Shao Yijun , Ma Phillip , Tuttle Mark S. , Garvin Jennifer , Zeng-Treitler Qing 
Published: October 2024

Objective International Classification of Diseases (ICD) codes recorded in electronic health records (EHRs) are frequently used to create patient cohorts or define phenotypes. Inconsistent assignment of codes may reduce the utility of such cohorts. We assessed the reliability across time and location of the assignment of ICD codes in a US health system at the time of the transition from ICD-9-CM (ICD, 9th Revision, Clinical Modification) to ICD-10-CM (ICD, 10th Revision, Clinical Modification). Materials and methods Using clusters of equivalent codes derived from the US Centers for Disease Control and Prevention General Equivalence Mapping (GEM) tables, ICD assignments occurring during the ICD-9-CM to ICD-10-CM transition were investigated in EHR data from the US Veterans Administration Central Data Warehouse using deep learning and statistical models. These models were then used to detect abrupt changes across the transition; additionally, changes at each VA station were examined. Results Many of the 687 most-used code clusters had ICD-10-CM assignments differing greatly from that predicted from the codes used in ICD-9-CM. Manual reviews of a random sample found that 66% of the clusters showed problematic changes, with 37% having no apparent explanations. Notably, the observed pattern of changes varied widely across care locations. Discussion and conclusion The observed coding variability across time and across location suggests that ICD codes in EHRs are insufficient to establish a semantically reliable cohort or phenotype. While some variations might be expected with a changing in coding structure, the inconsistency across locations suggests other difficulties. Researchers should consider carefully how cohorts and phenotypes of interest are selected and defined.
Evaluating the Predictors of Persistent Long COVID Symptoms and Their Severity in COVID-19 Survivors 1 Year After Infection
Authors: Aldhawyan Adam F. , BuSaad Mohammed A. , Alamri Bothayna A. , Alsaihati Mohammed I. , Alanazi Bader S. , alanazi Rawan A. , Bahamdan Ahmed S. 
Published: October 2024

Introduction/objective: As the coronavirus disease 2019 (COVID-19) pandemic progressed, the virus was found to cause long-term health complications known as long COVID (LC). This study aimed to investigate LC symptom severity and the factors associated with the likelihood of persistence beyond 1 year among COVID-19 survivors in Saudi Arabia. Methods: This descriptive, cross-sectional, questionnaire-based study was conducted via convenience sampling between December 1, 2023, and March 1, 2024. In-person interviews were performed, and 845 individuals with persistent symptoms after acute COVID-19 were included. Results: Hair loss and memory impairment were the most reported symptoms. In predicting LC persistence beyond 12 months, women were found to have higher odds of being symptomatic than men, and individuals from moderate-to-high-income households were more likely to report persistent symptoms than those from low-income households. Each additional acute COVID-19 symptom increased the likelihood of persistent symptoms by 1.14 times. Reporting more symptoms in the first 6 months post-infection significantly reduced the odds of long-term symptoms by approximately 30%. Conclusion: LC symptom severity varies among patients, and sociodemographic and clinical factors influence the likelihood of experiencing symptoms beyond 1 year. Understanding these factors can provide insights and help optimize management, leading to improved patient outcomes.
Mapping changes in the utilization of childhood immunization over 5 years in a south Indian tertiary care hospital
Authors: Mathew Merrin , Sanathan Savitha Rajapur , Sebastian Juny , Ravi Mandyam Dhati , Joy Taniya , Theempalangad Rovin Mathew , Gowda Panchaksharappa 
Published: October 2024

Background: Altered vaccine demands and uneven utilization patterns in childhood immunization are evident nationwide. These variabilities may stem from a range of internal and external factors influencing parental preferences. Regular checks and balances are necessary to ensure equal accessibility for all sections of society. Aim: To assess the usage trends of childhood vaccines for 5 years (2018–2022) and to monitor instances of delayed/incomplete immunization status within the community. Methodology: This study recorded the utilization trends of all recommended childhood vaccines over a 5-year period using an ambispective design. The immunization details from 3 years (2018, 2019 and 2020) were retrieved retrospectively, while those from 2 years (2021–2022) were collected prospectively through the immunization registry. Trends in childhood vaccine utilization were recorded across different years, and delays and incomplete vaccine utilization among children, along with factors resulting in deviated immunization timelines, were analysed and compared. The association of factors with deviated immunization utilization was determined using the chi-square test, and a two-way ANOVA analysed utilization variabilities over 5 years. Result: Overall, the study profiled 32,085 children’s (who utilized 87,782 vaccine doses) vaccine utilization pattern for 5 years. Optional vaccines were less utilized (18.12% doses by 25.14% children) compared to mandatory vaccines (81.88% doses utilized by 74.86%). The most utilized mandatory vaccine was oral polio (17.48%) and for optional vaccines, it was measles mumps rubella (MMR; 28.31%). Boys had the highest utilization (55.97%) with a significant male preponderance in optional vaccine utilization ( p value <0.05). Overall, there was a 26.12% decline (percent change) in vaccine utilization in 2022 compared to 2018. Among children with delayed immunization timelines (6.02%), 3.38% were on catch-up, and 2.45% were not. The most commonly delayed vaccines were diphtheria + tetanus + pertussis boosters (30.90%), Tdap (26.19%) and MMR vaccines (20.65%). Influenza vaccines (28.08%) were the most partially utilized optional vaccine, followed by varicella vaccines (20.92%). Factors such as gender (female), age over 1 year, rural residence and low- to middle-income families were significant predictors of deviated immunization status in children. Conclusion: The study mapped the utilization trends of immunizations at a tertiary care hospital in south India over the past 5 years, including the COVID-19 years. Gender inequality in the utilization of optional vaccines is a concern that warrants further research and redressal. Timely administration of childhood vaccinations is crucial for reducing susceptibility to vaccine-preventable diseases and promoting overall well-being.
Divergent modulation of activated protein C pleiotropic functions by antibodies that differ by a single amino acid
Authors: Sim Derek S. , Shukla Meenal , Mallari Cornell R. , Fernández José A. , Xu Xiao , Schneider Doug , Bauzon Maxine , Hermiston Terry W. , Mosnier Laurent O. 
Published: October 2024

Abstract
Activated protein C (APC) is a pleiotropic plasma protease with diverse functions derived from its anticoagulant, anti-inflammatory, and cytoprotective activities. The selective uncoupling and/or modulation of these APC activities by antibodies may have therapeutic benefit in diseases such as traumatic bleeding, hemophilia, sepsis, and ischemia. TPP-26870 is an antibody that targets a nonactive site of APC for the selective modulation of APC activities. To optimize the potency of TPP-26870, variants with single amino acid mutation in the complementarity-determining regions (CDRs) were screened, and 21 variants with improved affinity constant were identified. Interestingly, the affinity maturation of TPP-26870 did not merely generate a panel of variants with higher potency in functional assays. Functional data demonstrated that the pleiotropic functions of APC were very sensitive to epitope-CDR interactions. Single amino acid mutations within the CDRs of TPP-26870 were sufficient to elicit divergent antagonistic and agonistic effects on the various APC functional activities. These include prolonged in vitro APC plasma half-life, increased inhibition of anticoagulant activity, and agonistic enhancement of histone H3 cleavage, while having less impact on protease-activated receptor 1 cleavage, compared with TPP-26870. This study illustrates that APC is highly sensitive to non–active site targeting that can lead to unpredictable changes in its activity profile of this pleiotropic enzyme. Furthermore, this study demonstrates the ability to modify APC functions to advance the potential development of APC-targeted antibodies as therapeutics for the treatment of diseases including trauma bleeding, hemophilia, ischemia, and sepsis.