bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary Care Quality of Primary Healthcare Institutions in China: Current Status and Influencing Factors
Authors: Zhan Kexin , Wan Chuchuan , Wang Ennan , Huang Yuankai 
Published: October 2024

Abstract

Objective
This study aims to assess the current state of primary care quality within Primary Healthcare Institutions (PHIs) in China and analyze potential factors that may influence the quality of primary care provided.
Methods
Employing convenience sampling, this research utilized the Chinese Primary Care Assessment Tool (PCAT-C) to gather cross-sectional data on patients' experiences with primary care during visits to PHIs across the country. A multivariate linear regression model was established to discuss the effects of various factors on the quality of primary care at PHIs.
Results
The study encompassed 2,063 valid cases, with an overall PCAT score of 71.31 (SD = 11). Among the different dimensions, the average score for the Comprehensiveness dimension was the highest at 77.78 ± 15.83, followed by Continuity (75.81 ± 10.68), Family-centered (75.67 ± 17.69), First Contact (69.46 ± 10.36), Coordination (69.39 ± 16.84), and the Community-orientation dimension with the lowest average score at 59.75 ± 16.93. The regression analysis (R2 = 0.0437, p < 0.000) indicated that the patient's area(Eastern, Middle or Western) (p < 0.001), region(Urban or Rural)(p = 0.026), presence of adult children (p = 0.008), working status (p = 0.003), family annual income (p = 0.007), participation in commercial medical insurance (p = 0.001), seeking medical attention for illness was sought (p = 0.014), the number of hospital beds per 10,000 population (p = 0.007), and per capita health expenditure as a percentage of GDP per capita (p = 0.021) significantly impact the quality of primary care at PHIs.
Conclusion
The quality of primary care for PHIs in China is still low and is affected by both micro and macro factors. The quality of primary care at PHIs in China is still relatively low, particularly in the Community-orientation dimension. Apart from being influenced by microscopic factors, the quality of primary care at PHIs is also affected by macro factors such as overall health expenditure and economic status. It is recommended that efforts be made to enhance the equity of the medical and health resource allocation mechanism, thereby promoting balanced regional development.
Correlation between the expression of BCMA/soluble BCMA and the efficacy of BCMA CAR-T cell therapy in relapsed/refractory multiple myeloma
Authors: Fu Mingwei , Li Zheng , Mu Juan , Gao Shuquan , Yuan Ting , An Gang , Cui Rui , Deng Qi 
Published: October 2024

Abstract

Anti-B cell maturation antigen (anti-BCMA) CAR T cell therapy has led to prolonged survival and response rates of 64-85% in patients with relapsed/refractory multiple myeloma (R/R MM). In a study of 29 R/R MM patients receiving anti-BCMA CAR T cell therapy, we aimed to identify predictors of pre-treatment efficacy and side effects. We observed multiple myeloma (MM) cells in bone marrow (BM), BCMA expression in MM cells, and soluble BCMA (sBCMA) levels in BM before and after therapy. Clinical response, CAR-T cell proportions, cytokine levels, and adverse events (AEs) were monitored during therapy. Twenty patients (68.97%) experienced an objective response rate (ORR) to the therapy. Before CAR-T cell therapy, there were no differences in the proportions of MM cells or BCMA expression between the ORR group and the MR+SD group, but sBCMA levels were higher in the MR+SD group compared to the ORR group. After therapy, BCMA and sBCMA expressions were lower in the ORR group than in the MR+SD group. In patients who achieved ORR, the peak levels of CAR-T cells correlated with the proportion of MM cells. IL-6 levels were correlated with the proportion of MM cells and sBCMA expressions. There were no differences in the proportion of MM cells, BCMA expressions, or sBCMA expressions between the grade 0-1 cytokine release syndrome (CRS) group and the grade 2-4 CRS group. The proportion of MM cells and BCMA expressions were lower in the grade 0 immune effector cell-associated neurotoxic syndrome (ICANS) group compared to the grade 1-3 ICANS group. There was no correlation between BCMA expression in MM cells and sBCMA levels in BM. Interestingly, high sBCMA levels in BM impacted efficacy, while the proportions of MM cells in BM and BCMA expression in MM cells did not. Therefore, we suggest that sBCMA levels in BM could be used as a predictor of the efficacy of anti-BCMA CAR T cell therapy, but further clinical verification is needed (ChiCTR2000033925).
Online peer support for families taking care of patients with an eating disorder: A randomized controlled trial
Authors: Hotta Mari Suzuki , Nishizono Aya Maher , Ohara Chisato , Sekiguchi Atsushi , Morino Yuriko , Sugawara Ayako , Kawakami Junko , Miyajima Eri 
Published: October 2024

Abstract

Background: Family caregivers of patients with eating disorders experience high levels of caregiving difficulties accompanied by poor mental health and have a strong need for peer support. This study aimed to devise a training program of peer supporter and assess the effects of subsequent consultation meetings on mental status and perceived care burden among family caregivers of patients with eating disorders.
Methods: We devised a training program and trained family peer supporters. We then performed a randomized controlled trial comparing consultations with family peer supporters (intervention group) with waiting before a meeting (control group). Outcome measures were negative mood as evaluated by Total Mood Disturbance (TMD) on the Profile of Mood States 2nd Edition (POMS 2), and perceived care burden assessed by the short version of the Japanese version of the Zarit Burden Interview (J-ZBI_8). We sent questionnaires to consultees three times (on entry and before and after consultation) for the control group and twice (before and after the consultation) for the intervention group. We were able to analyze 36 members of the intervention group and 32 members of the control group.
Results: One-time, one-on-one, online, and 40-minute consultations with peer supporters went smoothly without any adverse events. We found no significant difference in changes in POMS2 TMD scores or J-ZBI_8 between the intervention and control groups. Multiple regression analysis using data from before and after the consultations from both groups showed that the changes in consultees’ POMS2 TMD scores as an improvement in negative mood were predicted by the high POMS2 TMD score before the consultation, the severity of the current body mass index of the patient, and the high score of the General Self-Efficacy Scale. Most consultees reported being relieved and obtaining knowledge from peer supporters about how to manage problems associated with eating disorders.
Conclusions: Peer supporters trained by our program had consultation meetings with consultees without any adverse events. We found no significant effect of peer support interventions on negative mood or caregiver burden. We instead identified factors predicting the effectiveness of peer support. These findings suggest the need for some improvements before reexamining this theme.
Genetic assessment of subspecies composition in bean goose (Anser fabalis) harvest in Sweden, Finland and Estonia
Authors: Honka Johanna , de Jong Adriaan , Jumppanen Erika , Alhainen Mikko , Piironen Antti 
Published: October 2024

Abstract

Bean goose (Anser fabalis) harvest in Europe consists of two subspecies, whose conservation statuses are different. However, the proportions of each subspecies in hunting bags are unknown. We studied the subspecies composition among harvested bean geese in Sweden, Finland and Estonia as a case study by sequencing a short mitochondrial DNA (mtDNA) region (210 bp) for subspecies identification. The proportion of taiga bean geese (A. f. fabalis) over two hunting seasons was 94% in Sweden, but only 5.8% and 11% in Estonia and southeastern Finland, respectively. Majority of harvested bean geese in Estonia and southeastern Finland were tundra bean geese (A. f. rossicus), and hence the results show that the Finnish spatio-temporal harvest regulations have successfully managed to focus the harvest mostly to the abundant tundra bean goose. We also detected mitochondrial heteroplasmy, i.e. multiple mtDNA variants within some of the individuals. In addition, we discovered a few exceptional individuals with an mtDNA haplotype belonging to eastern taiga bean goose (A. f. middendorffii) or greater white-fronted goose (A. albifrons), which could be hybrids between bean goose subspecies or interspecific hybrids due to untypical morphology. Our method is more cost-efficient than previously used molecular methods, and could be used to monitor bean goose hunting bag in the future.
Determinants of Puerperal Sepsis Among Postpartum Women at Public Hospital in Gedeo Zone, Southern Ethiopia, 2023: Unmatched Case-Control Study
Authors: Shate Mulugeta Edao , Sinba Edao , Lencha Bikila , Teshome Birhanu 
Published: October 2024

Abstract

Introduction: The World Health Organization records 295,000 maternal deaths during childbirth each year, of which 15% are due to postpartum sepsis. In Ethiopia, it is the third cause of maternal death after hemorrhage and hypertension. However, data on the determinants of puerperal sepsis in the study area is scarce.
Objective: This study aimed to identify determinants of puerperal sepsis among postpartum women at a public hospital in Gedeo Zone, southern Ethiopia, in 2023.
Methods: A hospital-based, unmatched case-control study was conducted among 475 postpartum women (119 cases and 356 controls with a ratio of 1:3) at public hospitals in the Gedeo Zone from July 1 to September 20, 2023. All cases were included, and Systematic random sampling was employed to select controls. A pretested and structured face-to-face interview questionnaire was conducted. Data were entered cleared and edited using EPI-data software 4.6and then exported to Statistical Package for Social Science version 26 for analysis. Binary logistic analysis was executed, and all variables with a p-value of <0.25 were entered into multivariable logistic regression. Finally, multivariable logistic regression analysis was employed to identify independent determinants of puerperal sepsis. A P-value of >0.05 at the 95% CI was considered the cut-off point to declare a statistically significant association.
Result: Four hundred seventy-five (119 cases and 356 controls) were included in this study with a 98.96% response rate.Variables identified as significantly associated with puerperal sepsis were no ANC follow-up (AOR = 4.19, 95% CI (2.32, 7.58), cesarean section (AOR = 2.74, 95% CI (1.19, 6.31), postpartum hemorrhage (AOR=2.57, 95% CI (1.39, 4.74), duration of rupture of membrane  ≥ 24 hours (AOR=3.31, 95% CI(1.89, 5.83), duration labor  ≥ 24 hours (AOR=3.15 95% CI(1.09, 8.43), and anemia (AOR=2.46, 95% CI (1.39, 4.32).
Conclusion: In this study, variables significantly associated with puerperal sepsis were the absence of antenatal care, cesarean section, postpartum hemorrhage, prolonged PROM, duration of labor ≥ 24 hours, and anemia. Puerperal sepsis caused by these factors should be minimized by following labor management protocol and emphasizing information on dietary diversification.
Novel Surveillance Protocol for Gastric Cancer Based on CEA: A high-volume multi-center study
Authors: Zhang Ruopeng , Chen Xiaojiang , Chen Guoming , Zhao Zhoukai , Zhang Feiyang , Chen Zewei , Wei Chengzhi , Lin Jun , Liu Zhimin , Liang Yao , Liang Chengcai , Feng chenyang , Chen Shi , Nie Runcong , Chen Yingbo 
Published: October 2024

Abstract

Tumor markers are commonly used in gastric cancer patients, but their effectiveness in monitoring recurrences is not optimal. This study aims to evaluate the recurrence predictive performance of carcinoembryonic antigen (CEA) across different baseline groups and establish a new surveillance protocol. We analyzed data from 1708 patients at Sun Yat-Sen University Cancer Center with stage I-III gastric adenocarcinoma. The research findings were subjected to longitudinal validation (expanded dataset comprising 6422 follow-up records of patients) and external validation (109 patients from the Sixth Affiliated Hospital, Sun Yat-Sen University)
The 5-year disease-free survival (DFS) rates were 61.1% (95% CI: 57.4%-65.0%) for the normal baseline group and 42.1% (95% CI: 36.4%-48.6%) for the elevated baseline group. Notably, the normalization group showed a remarkably favorable DFS similar to the persistently normal group (p=0.117). Regarding the efficacy of predicting recurrence, the elevated baseline group demonstrated significantly higher sensitivity than the normal baseline group (0.73 versus 0.32, p=0.001), while the normal baseline group exhibited superior specificity (0.87 versus 0.59, p=0.031). These consistent results were further confirmed through longitudinal validation and external validation cohorts.
Different monitoring strategy should be used for different CEA baseline patients. Incorporating CEA monitoring into gastric cancer surveillance protocols with the above method may be included in the surveillance protocols of NCCN gastric cancer guideline.
Exploring the Role of Inflammatory Cytokines in Cervical cancer Pathogenesis: Evidence from Mendelian Randomization Analysis
Authors: Zhang Yuqiang , luo Danfen , Chen Juan , Zheng Chaoqun , Sun Xiaohai , Zhong Zhaomei 
Published: October 2024

Abstract

Background: Cervical cancer (CC) is a prevalent malignancy worldwide, which seriously threatens women's quality of life and health. Although CC etiology remains uncertain, mounting evidence suggests that inflammatory cytokines (CKs) contribute to CC pathogenesis. Nonetheless, more research is required to determine if there is a causal connection between them. Therefore, our study performed a Mendelian randomized (MR) study to investigate the causal link between inflammatory CKs and CC. Methods: The inflammatory CK data are derived from two European population databases: one containing 41 inflammatory CKs and the other containing 91 inflammatory CKs. The CC data came from the UK Biobank (n ≤ 408961), including 1659 cases of CC and 381902 controls of European ancestry. Our study employed the inverse variance weighted, MR-Egger, weighted median, and weighted mode to analyze the causal relation between inflammatory CKs and CC. Additionally, multiple sensitivity analyses, including MRE intercept test, MR-PRESSO and Leave One Out, were deployed to further validate the robustness of the results. Eventually, a reverse MR analysis was carried out. RESULTS: The MR results showed that the increase of the Monokine triggered by gamma interferon )INF-γ( level was negatively correlated with CC (odds ratio (OR) = 0.84, 95% confidence interval (95% CI): 0.72–0.99, P = 0.044). Elevated cystatin D (CysD), Interleukin-8 (IL-8), Leukemia Inhibitory Factor (LIF), and Monocyte chemoattractant protein 2 (MCP-2) levels were positively correlated with CC occurrence (OR = 1.18, 95% CI:1.02–1.36, P = 0.025; OR = 1.41, 95% CI:1.02–1.95, P = 0.035; OR = 1.39, 95% CI:1.00–1.94, P = 0.044; OR = 1.76, 95% CI:1.25–2.47, P = 9×10–4), which aligned with sensitivity analyses results. Reverse MR Results showed that CC had no effect on 132 inflammatory CKs. Conclusion: Herein, the MR analysis demonstrated a potential causal connection between INF-γ, CysD, IL-8, LIF, and MCP-2 levels and CC risk. The role of inflammatory CKs in CC occurrence and development needs further investigation.
FDG-PET/CT and multimodal machine learning model prediction of pathological complete response to neoadjuvant chemotherapy in triple-negative breast cancer
Authors: Groheux David , Ferrer Loïc , Vargas Jennifer , Martineau Antoine , Borgel Adrien , Teixeira Luis , Menu Philippe , Bertheau Philippe , Gallinato Olivier , Colin Thierry , Lehmann-Che Jacqueline 
Published: October 2024

Abstract

Background:
Triple-negative breast cancer (TNBC) is a biologically and clinically heterogeneous disease, associated with poorer outcomes when compared with other subtypes of breast cancer. Neoadjuvant chemotherapy (NAC) is often given before surgery and achieving pathological complete response (pCR) has been associated with patient outcomes. There is thus high clinical interest in the ability to predict pCR status using baseline data accurately.
Methods:
A cohort of 57 TNBC patients who had FDG-PET/CT before NAC was analyzed to develop a machine learning (ML) algorithm predictive of pCR. A total of 241 predictors were collected for each patient: 11 clinical features, 11 histo-pathological features, 13 genomic features, and 206 PET features, including 195 radiomics features. The optimization criterion was the Area Under the ROC Curve (AUC). Event-free survival (EFS) was estimated using the Kaplan-Meier method.
Results:
The best ML algorithm reaching an AUC of 0.82. The features with the highest weight in the algorithm were a mix of PET (including radiomics), histo-pathological, genomics, and clinical features, highlighting the importance of truly multimodal analysis. Patients with predicted pCR tended to have better EFS than patients with predicted non-pCR, even though this difference was not significant probably due to small sample size and few events observed (P=0.09).
Conclusion:
The study suggests that ML applied to baseline multimodal data can help predict pCR status after NAC for TNBC patients and seem correlated to long-term outcomes. Patients that would be predicted as non-pCR could benefit from concomitant treatment with immunotherapy or dose intensification.
Concurrent-validity of Treadmill 30-15 Intermittent Fitness Test and Treadmill Continuous 30-15 Intermittent Fitness Test to assess the cardiorespiratory fitness
Authors: Ghazzagh Abdolrahman , Agha-Alinejad Hamid , Shahrbanian Shahnaz , Clemente Fillip Manuel 
Published: October 2024

Abstract

Purpose
The 30 − 15 intermittent fitness test (30-15IFT) is a valid test to evaluate cardiorespiratory fitness (CRF). Liner and continuous form of 30-15IFT were developed previously. The aim of this study is to assess the concurrent-validity of novel versions of the 30-15IFT on a treadmill: the treadmill 30 − 15 Intermittent Fitness Test (30-15IFT-T) and the treadmill continuous 30 − 15 Intermittent Fitness Test (30-15IFT-TC).
Methods
Fifteen recreationally endurance-trained males (age = 32 ± 5 y, height = 1.79 ± 0.06 m, weight = 71 ± 8 kg) performed the 30-15IFT, 30-15IFT-T, and 30-15IFT-TC in different sessions. The VIFT, blood lactate concentration difference (ΔBLC), and rating of perceived exertion (RPE) were assessed. Furthermore, heart rate was obtained during test and recovery period.
Results
we found significant validity between VIFT in both 30-15IFT-T (r = 0.81, ICC = 0.73, P < 0.05) and 30-15IFT-TC (r = 0.85, ICC = 0.74, P < 0.05) with 30-15IFT, respectively. The VIFT of 30-15IFT (18.90 ± 1.13 km.h− 1) was significantly lower than 30-15IFT-T (19.96 ± 1.82 km.h− 1) and higher than 30-15IFT-TC (17.93 ± 1.96 km.h− 1) (P < 0.05). Moreover, ΔBLC was lower in 30-15IFT (6.69 ± 1.27 mmol.L− 1) than 30-15IFT-T (7.92 ± 1.02 mmol.L− 1) and 30-15IFT-TC (8.17 ± 1.18 mmol.L− 1) (P < 0.05).
Conclusion
Both the 30-15IFT-T and the 30-15IFT-TC are valid comparisons to the 30-15IFT when assessing the CRF. However, the participants achieved higher and lower VIFT in the 30-15IFT-T and 30-15IFT-TC, respectively, in comparison to the 30-15IFT. Additionally, the ΔBLC was higher in the 30-15IFT-T and 30-15IFT-TC, respectively, in comparison to the 30-15IFT.
Unveiling Biomarkers: A Study on Mitocytosis-Related Genes Across Multiple Cancers
Authors: Xiang Jiayu , Liu Chang , yang pei , Wen Minni , Yu Tingjie , Xiao Ningping , Zhou Yonghong , Jin Yi 
Published: October 2024

Abstract

Mitochondria are crucial organelles in eukaryotic cells that maintain cellular homeostasis through various quality control mechanisms. One such mechanism, mitocytosis, is newly identified, yet its biological significance in cancer remains unclear. This study investigates the role of mitocytosis-related genes (MYO19, KIF5B, DNM1L, DYNLL2, TSPAN4, TSPAN9) in pan-cancer. We performed an extensive analysis of expression profiles and clinical data derived from samples in The Cancer Genome Atlas (TCGA) database. This study entailed a comparison of gene expression between malignant and normal tissues, an investigation into the correlation between gene expression and clinical prognosis through Kaplan-Meier and Cox regression analyses, and a functional enrichment analysis to elucidate the potential signaling pathways involved. We employed TIMER2.0 to assess the correlations between gene expression and immune infiltration levels in various cancers.Additionally, a nomogram predicted three- and five-year overall survival rates. The study also examined the influence of CTLA-4 and PD-1 statuses on Immunoscore (IPS) in KIRC patients, revealing that these genes are overexpressed in renal clear cell carcinoma and significantly associated with Clinical prognosis and drug response.
A Phase 2 study of Savolitinib in Patients with MET Amplified Metastatic Colorectal Cancer
Authors: Jia Jingquan , Moyer Ashley , Lowe Melissa , Bolch Emily , Kortmansky Jeremy , Cho May , Lenz Heinz-Josef , Kalyan Aparna , Niedzwiecki Donna , Strickler John 
Published: October 2024

Abstract

Purpose: MET amplification (amp) is a driver of acquired resistance to epidermal growth factor receptor (EGFR) antibodies in patients with RAS wild-type (WT) metastatic colorectal cancer (mCRC). Savolitinib is an oral small molecule tyrosine kinase inhibitor that has demonstrated anti-tumor activity in MET-driven advanced solid tumors. We report the results of a phase 2 study of savolitinib in patients with mCRC with MET amp detected by circulating cell free (cf)DNA.
Methods: Patients with chemotherapy refractory mCRC and MET amp detected by cfDNA were treated with savolitinib until unacceptable toxicity or disease progression. The primary endpoint was objective response rate. Secondary endpoints were clinical activity and safety.
Results: Five patients were enrolled and treated. Best overall response was stable disease (SD) in two patients, progressive disease (PD) in two patients, and one patient unevaluable for response. The majority of treatment-related AEs were grade 1 or 2. The only grade ³3 treatment related AEs were increased ALT and AST.
Conclusion: Savolitinib was well tolerated, however in this small group of biomarker-selected patients we observed no evidence of anti-tumor activity.
Trial Registration: www.clinicaltrials.gov NCT03592641. Registered on July 17th, 2018