bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multiple sclerosis subgroups: Data-driven clusters based on patient-reported outcomes and a large clinical sample
Authors: De Nadai Alessandro S , Zamora Ryan J , Finch Alyse , Miller Deborah M , Ontaneda Daniel , Gunzler Douglas D , Briggs Farren S 
Published: October 2024

Background: While standard clinical assessments provide great value for people with multiple sclerosis (PwMS), they are limited in their ability to characterize patient perspectives and individual-level symptom heterogeneity. Objectives: To identify PwMS subgroups based on patient-reported outcomes (PROs) of physical, cognitive, and emotional symptoms. We also sought to connect PRO-based subgroups with demographic variables, functional impairment, hypertension and smoking status, traditional qualitative multiple sclerosis (MS) symptom groupings, and neuroperformance measurements. Methods: Using a cross-sectional design, we applied latent profile analysis (LPA) to a large database of PROs; analytic sample N = 6619). Results: We identified nine distinct MS subtypes based on PRO patterns. The subtypes were primarily categorized into low, moderate, and high mobility impairment clusters. Approximately 70% of participants were classified in a low mobility impairment group, 10% in a moderate mobility impairment group, and 20% in a high mobility impairment group. Within these subgroups, several unexpected patterns were observed, such as high mobility impairment clusters reporting low non-mobility impairment. Conclusions: The present study highlights an opportunity to advance precision medicine approaches in MS. Combining PROs with data-driven methodology allows for a cost-effective and personalized characterization of symptom presentations. that can inform clinical practice and future research designs.
Trajectories and management of vascular risk following the diagnosis of multiple sclerosis: A population-based matched cohort study between 1987 and 2018 in England
Authors: Palladino Raffaele , Chataway Jeremy , Mathew Mekha , Majeed Azeem , Marrie Ruth Ann 
Published: October 2024

Background: People with multiple sclerosis (PwMS) have an increased cardiovascular and cerebrovascular disease burden, but this could be mitigated by vascular risk factor management. Objectives: We compared the trajectories of vascular risk factors, vascular comorbidities and clinical management in PwMS against the general population post-MS diagnosis while controlling for frailty. Methods: Retrospective longitudinal analysis using English data from the Clinical Practice Research Datalink between 1987 and 2018 comprising PwMS matched with up to six controls without MS by age, sex and general practice. Results: We compared 12,251 PwMS with 72,572 matched controls; 3.8% of PwMS had mild–moderate frailty, 1.2% more than matched controls. Compared to controls, PwMS had an elevated incidence of Type 2 diabetes (HR 1.18, 95% CI (1.04, 1.34)), and starting antihypertensive medications (HR 1.40, 95% CI (1.33, 1.47)). Among those with hypertension at baseline, blood pressure trajectories did not differ between PwMS and controls. PwMS had increased rates of meeting targets for hypertension management (HR 1.25, 95% CI (1.12, 1.41)). Conclusion: The observation that PwMS with hypertension are more likely to meet treatment targets than matched controls is encouraging, but the elevated rates of vascular comorbidities suggest that tighter vascular management may be needed in this population.
‘Just knowing it’s there gives me comfort’: Exploring the benefits and challenges of autism alert cards
Authors: Edwards Chris , Love Abigail MA , Flower Rebecca L , Ying Cai Ru , Gibbs Vicki 
Published: October 2024

This study explores the experiences and outcomes associated with the use of an autism alert card, developed to assist with the complexities of autism disclosure. A mixed-methods approach was employed, surveying 272 Australian participants, including 136 Autistic adults, 128 parents or caregivers of Autistic children and eight Autistic children. Our research aimed to understand who is using the alert card, in what contexts and the differences in perceptions of the card between Autistic individuals and their parents. Findings indicate that about half of the participants used the card, primarily in public settings such as transport (17%), healthcare (16%) and retail (16%). The card was seen as a valuable tool for facilitating communication, reducing the need for verbal explanations and providing a sense of security. However, challenges were reported, including societal disbelief, patronising attitudes and internalised stigma, highlighting the need for greater public education on autism. Despite these challenges, majority of participants (76.2%) would recommend the card. This research underscores the dual nature of autism alert cards as both beneficial and limited by societal attitudes, emphasising the need for comprehensive training and awareness programmes to maximise their effectiveness. Lay abstract This study looks at how people use and feel about autism alert cards, which help Autistic people communicate their diagnosis/identity. We surveyed 272 Australian people, including 136 Autistic adults, 128 parents of Autistic children and eight Autistic children. About half of the participants used the card after ordering it, mostly in public places such as public transport, healthcare settings and in retail settings. People found the card helpful because it made it easier to explain their needs without having to speak and provided them a sense of security. However, some people treated Autistic people poorly after being shown the card due to a lack of understanding about autism. Many participants felt that more education about autism is needed to improve how people react to the alert card. Despite these challenges, most participants (76.2%) would recommend the alert card to others. This research shows that while autism alert cards can be very helpful, their effectiveness depends on how well other people understand and accept autism. To make these cards work better, we need more training and awareness programmes for the general public and professionals such as doctors or police officers who may interact with Autistic people.
Social workers’ support of the status quo: Results from a national survey
Authors: Hudson Kimberly D , Godfrey Erin B 
Published: October 2024

Summary Social work has an intimate and complex relationship with the systems that shape the social, political, economic, and environmental fabric of the United States. System justification theory helps explain why people are motivated to accept the status quo of systems and unequal social arrangements. This study examined the system-justifying beliefs of a national sample ( N = 516) of master’s-level social workers to better understand how beliefs about the status quo may shape job outcomes (e.g., burnout and satisfaction) and practice outcomes (e.g., goals, motivations, perceptions of clients, and endorsement of practice behaviors). Findings Ordinary least squares regression analyses adjusting for demographic characteristics indicated significant relationships with both practice outcomes and job outcomes. Higher system-justifying beliefs were associated with less social justice motivation, more practical motivation, less transformative practice goals, and less understanding of clients’ needs as symptoms of structural failures. However, higher system-justifying beliefs were also associated with more compassion satisfaction, less secondary trauma, and less emotional exhaustion. Applications Key interventions into the structural conditions of social work practice so that social workers rely less on system-justifying beliefs to cope with burnout and increase satisfaction are discussed. Examples include investments in support resources, workplace empowerment, increased discretion, and workload reduction. Cognitive and psychological interventions, specifically the development of critical consciousness and critical thinking, are also suggested.
Foster care breakdown in adolescence: A retrospective view of young individuals on their experiences
Authors: Ben-Shlomo Shirley , Meir Yifat 
Published: October 2024

Summary Placement with a foster family is one of the care arrangements available for children who cannot live at home. Many of those in foster care are teenagers. The complexity of the development during adolescence poses major challenges and may ultimately lead to what is known in the literature as “foster breakdown.” Most of the research in this area focuses on the point of view of social workers or foster parents. The current study examines this experience through a retrospective view of those who were teenagers at the time of foster care breakdown. To this end, semi-structured interviews were conducted with 14 Israeli young individuals (16–30 years old) who had experienced foster breakdown at various stages of adolescence. Findings The findings paint a complex and multidimensional picture of breakdown. While most of the interviewees described it as a sudden, unexpected event, closer examination revealed a dynamic process of collapse. This process comprised various factors, including those associated with the welfare system, the foster family, and characteristics related to the developmental stage of adolescence of the research participants. The combination of these factors led to the premature termination of the foster arrangement. Applications This study opens a window to the complex experience of foster breakdown in adolescence, an issue that has received very little research attention thus far. Understanding the dynamics of foster breakdown from the perspective of young individuals can improve professional foster care practices and policy and can benefit social workers in their work with foster families.
Social workers and generative practices for the inclusion of people with intellectual disabilities
Authors: Knevel Jeroen , Wilken Jean Pierre , Schippers Alice 
Published: October 2024

Summary Incited by the United Nations adoption and ratification of the UN Convention on the Rights of Persons with Disabilities, social workers are prompted to increasingly pursue an inclusion-focused approach. Our research was carried out in the Netherlands and sought to identify social work practices conducive to fostering social inclusion, in this case with respect to adults with mild intellectual disabilities. For 2½ years, a responsive methodology was employed in a combined action and social design research. Sixteen social workers and five people with intellectual disabilities were involved. The study was conducted in three different settings across the Netherlands, both rural and urban. Findings Three social work practices were captured that generate social inclusion: agency, advocacy, and intrapreneurship. Applications Identification of generative practices provides guidance to social workers in shaping the promotion of social inclusion. It provides guidance in reflecting on past and current inclusion-focused social work performance, it may encourage social workers to adopt inclusion-focused pathways inspired by agency, advocacy and intrapreneurship, and knowledge of generative practices toward social inclusion can help to specify social workers’ competencies.
The Use of Short Dilator Tip in Endovascular Branched Arch Repair: A Case Series
Authors: Becker D. , Stana J. , Prendes C. , Ali A. , Pichlmaier M. , Peterss S. , Tsilimparis N. 
Published: October 2024

Objectives: The aim of the study was to investigate the safety and feasibility of branched endovascular arch repair (b-TEVAR) with a custom-made double or triple inner branched arch endograft using a short dilator tip (35 mm) in patients with aortic arch pathologies. Methods: Retrospective analysis of all consecutive patients undergoing b-TEVAR with a short dilator tip for the treatment of aortic arch pathologies in a high-volume tertiary center between January 2019 and July 2023. The combined primary endpoint was technical success and perioperative complications caused by the endograft, including tip-induced cardiac injury and trackability issues. Secondary endpoints were major adverse events (MAE), including morbidity, mortality, and reinterventions within 30 days. Results: During a 4-year period, 22 patients (median age 72 years, 16 males) were treated with a custom-made double or triple inner-branched TEVAR for different aortic arch pathologies using a short dilator tip (35 mm). After initial exclusive treatment of patients with previous valve replacement, the use of a short dilator tip became standard. Eighteen patients received a triple- and 4 patients received a double-branched endograft. Seventeen patients (77.3%) underwent elective treatment, while 5 patients underwent urgent repair due to contained rupture or symptomatic aneurysms. The technical success was 100%. No tip-induced cardiac mortality and morbidity occurred perioperatively. The trackability of the device was in no case affected by the short tip. Within 30 days, the MAE rate was 45%, including one death. No re-intervention had to be performed. Conclusion: Endovascular aortic arch repair with inner-branched arch endografts using a short dilator tip (35 mm) appears to be safe and technically feasible and could potentially reduce the risk of fatal myocardial injuries. Clinical impact Due to safe and stable maneuverability and deployment of endograft in zone 0 the use of short dilator tip might have the potential to become standard in endovascular branched arch repair. This is one of the first reports on the use of short dilator tip and associated complications in endovascular branched arch repair.
Intravascular Lithotripsy for Peripheral Artery Calcification: 30-Day Outcomes From the Disrupt PAD III Observational Study
Authors: Armstrong Ehrin J. , Adams George , Soukas Peter A. , Mangalmurti Sarang S. , Shammas Nicolas W. , Mehrle Anderson , Bertolet Barry , Gray William A. , Tepe Gunnar , Woo Edward Y. , McKinsey James F. , Holden Andrew , Parikh Sahil A. 
Published: October 2024

Purpose:Intravascular lithotripsy (IVL) has shown promising safety and effectiveness in calcified peripheral artery disease (PAD) in large trials and small real-world experiences. Real-world evidence from a larger cohort is lacking, so we aimed to evaluate the real-world acute performance of IVL in the treatment of calcified PAD.Materials and Methods:The Disrupt PAD III Observational Study (OS) is a prospective, multicenter, single-arm study. Patients with claudication or critical limb-threatening ischemia (CLTI) and at least moderate calcification were eligible. Independent predictors of procedural outcomes were assessed by multivariable analysis.Results:Between November 2017 and June 2021 across 30 global sites, 1373 patients with 1677 lesions (1531, 91.3% core lab evaluable) were enrolled. Diameter stenosis and lesion length was 80.6±17.6% and 93.5±74.3 mm, respectively. Target vessels included femoropopliteal (61%), iliac (15.8%), common femoral (10.7%), and infrapopliteal arteries (12.8%). Lesion characteristics included 31.1% chronic total occlusions (CTOs) and 19.3% long lesions (≥15 cm). At final assessment, residual stenosis was 23.8±11.3%, with 0.9% serious angiographic complications, no abrupt closures, distal embolization, no flow, or thrombotic events. Independent predictors of ≤30% residual stenosis were lesion length ≥15 cm (odds ratio [OR]=0.384), female sex (OR=1.850), age ≤75 years (OR=1.625), IVL balloon to artery ratio ≥1.0 (OR=1.538), and CTO lesions (OR=0.638). Lesion length ≥15 cm (OR=16.076) was an independent predictor of procedural complications.Conclusions:The Disrupt PAD III OS represents the largest assessment of IVL periprocedural outcomes in calcified PAD. It confirmed excellent procedural safety and effectiveness in complex lesions across multiple peripheral vascular beds.Clinical ImpactThis final analysis of the PAD III OS represents the largest report of peripheral IVL utilization in daily clinical practice. The outcomes of this study indicate that previously reported procedural results in clinical trial settings can be translated to a broader patient population. Treatment with peripheral IVL in severely calcified stenotic lower limb lesions demonstrated consistent acute safety and stenosis reduction, even in complex patients across multiple vessel beds. In addition, the importance of proper IVL balloon sizing to achieve excellent acute stenosis reduction was confirmed by multivariate analysis.
Topkan's CARWL Index Efficiently Predicts the Radiation-Induced Tooth Loss Rates in Radically Treated Locally Advanced Nasopharyngeal Cancer Patients
Authors: Somay Efsun , Topkan Erkan , Bascil Sibel , Ozturk Duriye , Senyurek Sukran , Durankus Nilufer Kilic , Selek Ugur 
Published: October 2024

Purpose To assess the usefulness of the novel CARWL index in predicting radiation-induced tooth loss (RITL) rates in locally advanced nasopharyngeal cancer (LA-NPC) patients undergoing concurrent chemoradiotherapy (C-CRT). Methods The study retrospectively examined data from 323 LA-NPC patients. The patients were divided into two groups based on cutoff values for CAR and weight loss (WL). The ideal cutoff for RITL was 3.0 g/dL [AUC: 83.0%, sensitivity: 83.6%, specificity: 81.4%, J-index: 0.650]. CARWL index was created by combining pretreatment CAR and WL status (WL ≤ 5.0% vs > 5.0%, resulting in four groups: Group 1: CAR < 3.0 and WL ≤ 5.0%, Group 2: CAR < 3.0 and WL > 5.0%, Group 3: CAR ≥ 3.0 and WL ≤ 5.0%, and Group 4: CAR > 3.0 and WL > 5.0%. Results RITL was diagnosed in 67.2% of patients. Since the RITL rates of Groups 2 and 3 were statistically indistinguishable, we combined them and created the three-tiered CARWL score groups: CARWL-0: CAR < 3.0 and WL ≤ 5.0%; CARWL-1: CAR < 3.0 and WL > 5.0%, or CAR ≥ 3.0 and WL ≤ 5.0%; and CARWL-2: CAR > 3.0 and WL > 5.0%. Comparative analysis revealed that the RITL rates gradually and significantly increased from CARWL-0 to CARWL-2 score groups (49.4% vs 64.7% vs 83.0%; P <0.001) despite similar baseline disease and patient characteristics. Results of the multivariate analysis showed that higher CARWL score groups were independent and significant predictors of increased RITL rates (p < 0.001). Conclusion Present results suggest that the novel CARWL index is a reliable biomarker for predicting RITL incidence in LA-NPC patients.
Proof-of-Concept of an Integrated Yoga and Psychological Intervention in Mitigating Distress Among Diverse Women With Gynecologic, Gastrointestinal, and Thoracic Cancers
Authors: Hanvey Grace Ann , Kacel Elizabeth L. , Bacharz Kelsey C. , Wilborn Adaixa Padrón , Mesa Sonia , McCracken Halle , Estores Irene M. , Markham Merry-Jennifer , Kaye Frederic J. , Jones Dennie , George Thomas J. , Pereira Deidre B. 
Published: October 2024

Background: Fear of cancer recurrence (FCR), cancer-distress, depression, and anxiety are prevalent concerns among women with gynecologic and other understudied cancers, especially among women of color and lower socioeconomic status (SES). Evidence indicates that mind-body interventions are effective in reducing such distress. This study evaluates (1) proof-of-concept of an integrated group yoga and psychological intervention in alleviating distress among women with gynecologic, gastrointestinal, and thoracic cancers and (2) differences in efficacy across social and economic factors. Methods: One hundred twenty-five participants were enrolled in a 10-week, single-arm, integrated group intervention utilizing mindfulness meditation, psychotherapy skills, and yoga. They completed measures of FCR, cancer-distress, depression, and anxiety at baseline and following intervention. Mixed-linear models evaluated change in outcomes across the intervention and moderating effects of age, minority status, and SES among 51 participants with available data. Results: Reductions in total ( b = −2.06, P = .012) and somatic depressive symptoms ( b = −1.79, P = .002) and state anxiety ( b = −6.21, P = .005) were observed across the sample. Higher SES was associated with greater reductions in psychosocial distress related to FCR ( b = −0.74, P = .050), and in total (b = −1.06, P = .049) and affective depressive symptoms ( b = −0.76, P = .006). Women of color experienced greater declines in somatic symptoms compared to non-Hispanic White women ( b = −2.71, P = .031), with women of color experiencing lower SES exhibiting greatest reduction in these symptoms ( b = 1.73, P = .026). Conclusions: This study demonstrates proof-of-concept that an integrated psychological and yoga intervention may reduce depressive symptoms and state anxiety among women with gynecologic, gastrointestinal, and thoracic cancers, with racial and/or ethnic minority status and SES moderating some of these effects. Future research should examine intervention feasibility and acceptability among diverse women with cancer and evaluate efficacy using a randomized controlled trial design. Trial registration: ClinicalTrials.gov NCT03385577
Real-world clinical efficacy of bevacizumab biosimilar in patients with advanced non-small-cell lung cancer
Authors: Ou Wei-Fan , Hsu Kuo-Hsuan , Tseng Jeng-Sen , Lee Po-Hsin , Chen Kun-Chieh , Huang Yen-Hsiang , Chang Gee-Chen , Yang Tsung-Ying 
Published: October 2024

Background: Bevacizumab is extensively used in the treatment of advanced non-small-cell lung cancer (NSCLC). Numerous clinical trials have proven the clinical efficacies of bevacizumab biosimilars (BB). Objective: Our study aimed to compare the clinical outcomes between bevacizumab reference product (RP) and BB among advanced NSCLC patients in a real-world setting. Design: We retrospectively analyzed stage IV metastatic NSCLC patients who were treated with bevacizumab as part of a combination therapy. Patients were categorized into chemotherapy (CT) and epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) groups. We compared the patients’ characteristics, treatment efficacy, and adverse events between RP and BB in the two treatment groups. Methods: From January 2020 to July 2022, a total of 171 patients who underwent combination therapy with bevacizumab were screened. Seventy-nine of these patients met the study’s inclusion criteria and were enrolled in the final analysis. We utilized the Kaplan–Meier method to estimate progression-free survival (PFS) and the log-rank test to compare PFS between groups. The Cox proportional hazards model was used to identify predictors of PFS. Results: Within the CT cohort, 34 patients were treated with RP in combination with platinum and pemetrexed, and 25 patients received a combination regimen with BB. The median PFS was 6.9 months in the RP group and 8.9 months in the BB group ( p = 0.255). Within the EGFR-TKI cohort, 20 patients with EGFR-mutant NSCLC received first-line treatment with EGFR-TKI plus bevacizumab. Of these patients, 9 were treated with a combination regimen that included RP, and 11 patients received EGFR-TKI in combination with BB. The median PFS was 18.4 months for the RP group and 13.6 months for the BB group ( p = 0.363). Conclusion: In our advanced NSCLC patients, we found no difference in clinical outcomes when receiving treatment with RP or BB. Given a combination regimen, BB was as effective as RP together with either CT or EGFR-TKIs.