bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adjuvant Therapy for Breast Cancer: Practice Patterns of Community Physicians
Authors: Harlan Linda C. , Abrams Jeffrey , Warren Joan L. , Clegg Lin , Stevens Jennifer , Ballard-Barbash Rachel 
Published: July 2002

PURPOSE: We evaluated the use of adjuvant therapy for breast cancer using the National Institutes of Health (NIH) Consensus Development Conference statements as guideposts for assessing how rapidly community physicians adopt recommended therapies. PATIENTS AND METHODS: Women with stage I through IIIA breast cancer diagnosed in 1987 through 1991 and in 1995 were randomly sampled from the population-based National Cancer Institute Surveillance, Epidemiology, and End-Results program. A total of 8,106 women were included in the study with younger women, ≤ 50 years, being oversampled. Their treating physicians were asked to verify whether chemotherapy, hormonal therapy, or both were given. RESULTS: After adjusting for clinical and nonclinical factors, the use of 1985 recommendations for adjuvant therapy in women with node-positive disease was already high at 80% in 1987 and increased slightly to 84% by 1995. Use of combined multidrug chemotherapy plus tamoxifen increased. In contrast, the use of 1990 recommendations for adjuvant therapy for node-negative disease was slightly less than 13% in 1987 and increased markedly to 57% by 1995. For women with node-negative tumors ≥ 1 cm in size diagnosed in 1995, 40% received tamoxifen, 16% combination chemotherapy, and 7% both, an increase from 10%, 5%, and 0.4%, respectively, in 1987. CONCLUSION: Community physicians began prescribing adjuvant chemotherapy and hormonal therapy in advance of publication of the NIH consensus statement in 1990. Adoption of recommended treatments for node-negative disease has been less complete compared with node-positive tumors, perhaps reflecting the more complex nature of the clinical trials data or the smaller anticipated benefit from adjuvant therapy for this disease subset.
Psychiatric Morbidity and Impact on Hospital Length of Stay Among Hematologic Cancer Patients Receiving Stem-Cell Transplantation
Authors: Prieto Jesús M. , Blanch Jordi , Atala Jorge , Carreras Enric , Rovira Montserrat , Cirera Esteve , Gastó Cristóbal 
Published: July 2002

PURPOSE: To determine the prevalence of psychiatric disorders during hospitalization for hematopoietic stem-cell transplantation (SCT) and to estimate their impact on hospital length of stay (LOS). PATIENTS AND METHODS: In a prospective inpatient study conducted from July 1994 to August 1997, 220 patients aged 16 to 65 years received SCT for hematologic cancer at a single institution. Patients received a psychiatric assessment at hospital admission and weekly during hospitalization until discharge or death, yielding a total of 1,062 psychiatric interviews performed. Psychiatric disorders were determined on the basis of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Univariate and multivariate linear regression analyses were used to identify variables associated with LOS. RESULTS: Overall psychiatric disorder prevalence was 44.1%; an adjustment disorder was diagnosed in 22.7% of patients, a mood disorder in 14.1%, an anxiety disorder in 8.2%, and delirium in 7.3%. After adjusting for admission and in-hospital risk factors, diagnosis of any mood, anxiety, or adjustment disorder (P = .022), chronic myelogenous leukemia (P = .003), Karnofsky performance score less than 90 at hospital admission (P = .025), and higher regimen-related toxicity (P < .001) were associated with a longer LOS. Acute lymphoblastic leukemia (P = .009), non-Hodgkin’s lymphoma (P = .04), use of peripheral-blood stem cells (P < .001), second year of study (P < .001), and third year of study (P < .001) were associated with a shorter LOS. CONCLUSION: Our data indicate high psychiatric morbidity and an association with longer LOS, underscoring the need for early recognition and effective treatment.
Phase II Study of Paclitaxel Plus Gemcitabine in Refractory Germ Cell Tumors (E9897): A Trial of the Eastern Cooperative Oncology Group
Authors: Hinton Stuart , Catalano Paul , Einhorn Lawrence H. , Loehrer Patrick J. , Kuzel Timothy , Vaughn David , Wilding George 
Published: July 2002

PURPOSE: Despite great success in the treatment of disseminated germ cell tumors, 20% of patients are incurable and become candidates for investigational therapy. Paclitaxel and gemcitabine have shown activity as single agents in refractory germ cell tumors and can be combined with manageable toxicity. PATIENTS AND METHODS: Patients with germ cell tumors believed to be incurable with chemotherapy or surgery were treated with paclitaxel 110 mg/m2 and gemcitabine 1,000 mg/m2 intravenously on days 1, 8, and 15 of a 4-week cycle for a maximum of six cycles. Patients were evaluated for response and toxicity. RESULTS: Twenty-eight of 30 enrolled patients were assessable. Toxicity was primarily hematologic but was manageable with only a single case of neutropenic fever. Six (21.4%) of 28 patients responded, including three complete responses. Two of the complete responders were continuously disease-free at 15+ and 25+ months. CONCLUSION: Paclitaxel plus gemcitabine is an active regimen in refractory germ cell tumors, with an acceptable toxicity profile. This regimen has the possibility for long-term disease-free survival in this refractory patient population.
Oncologists’ Attitudes Toward and Practices in Giving Bad News: An Exploratory Study
Authors: Baile Walter F. , Lenzi Renato , Parker Patricia A. , Buckman Robert , Cohen Lorenzo 
Published: July 2002

PURPOSE: To examine the attitudes and practices of oncologists in disclosure of unfavorable medical information to cancer patients.METHODS: A questionnaire was administered to a group of physicians who attended the 1999 Annual Meeting of the American Society of Clinical Oncology. The questionnaire assessed demographic and practice-related information and the frequency of patient encounters in which unfavorable cancer-related information was disclosed. Participants were also asked about difficulties they had when approaching stressful discussions and communication strategies used in giving unfavorable information.RESULTS: The questionnaire was completed by 167 oncologists. Sixty-four percent were medical oncologists. Thirty-eight percent practiced in North America, 26% practiced in Europe, 13% practiced in South America, and 13% practiced in Asia. Participants gave bad news to patients an average of 35 times per month. Discussing no further curative treatment and hospice was reported as most difficult. In disclosing the cancer diagnosis and prognosis, physicians from Western countries were less likely to withhold unfavorable information from the patient at the family’s request, avoid the discussion entirely, use euphemisms, and give treatments known not to be effective so as not to destroy hope than physicians from other countries. There was significant variability in opinions regarding the best time to discuss resuscitation, with 18% of respondents believing that it should be done close to the end of life.CONCLUSION: There was significant variability in how physicians approach information disclosure to cancer patients. Factors such as geographical region and cultural and family variables may be important influences in this process.
Frailty in Medicare Advantage Beneficiaries and Traditional Medicare Beneficiaries
Authors: Shi Sandra M. , Olivieri-Mui Brianne , Park Chan Mi , Sison Stephanie , McCarthy Ellen P. , Kim Dae H. 
Published: August 2024

ImportanceA growing proportion of the population is enrolling in Medicare Advantage (MA), which typically offers additional benefits compared with traditional Medicare (TM).ObjectiveTo determine whether frailty and frailty trajectories differ between MA enrollees and TM enrollees.Design, Setting, and ParticipantsThis retrospective cohort study used data from the National Health and Aging Trends Study (2015-2016). Analyses were conducted from August 2023 to March 2024. Participants were community-dwelling Medicare beneficiaries aged 65 years and older.ExposureEnrollment in MA vs TM.Main Outcomes and MeasuresFrailty was calculated by a frailty index (FI) (range, 0-1, with higher values indicating greater frailty) and the Fried Frailty Phenotype (FFP) score (range, 0-5, with higher values indicating greater frailty). Physical performance, including Short Physical Performance Battery (SPPB) score (range, 0-12, with higher values indicating better performance), and gait speed (meters per second) were measured. The primary outcome was the difference in FI and FFP scores from the 2015 baseline assessment to the 2016 follow-up assessment. Secondary outcomes include the 1-year changes in SPPB and gait speed.ResultsThe final cohort consisted of 7063 participants (2775 [23.1%] aged &amp;gt;80 years; 4040 [54.7%] female), representing a sample of the 38.8 million beneficiaries. There were 2583 (35.0%) MA enrollees (13.6 million) and 4480 (65.0%) TM enrollees (25.2 million). At baseline, the FI score was similar between MA and TM enrollees (mean [SD], 0.22 [0.15] vs 0.21 [0.14]), although MA enrollees had worse phenotypic frailty (496 participants [15.2%] vs 811 participants [13.7%] considered frail by FFP score), SPPB scores (mean [SD], 6.91 [3.34] vs 7.21 [3.27]), and gait speed (0.79 [0.24] m/s vs 0.82 [0.23] m/s) than TM enrollees. One year later, there were no differences between MA and TM enrollees in the 1-year change in FI score (mean [SD], 0.016 [0.071] vs 0.014 [0.066]; adjusted mean difference, 0.001 [95% CI, −0.004 to 0.005]), FFP score (mean [SD], 0.017 [1.004] vs 0.007 [0.958]; adjusted mean difference, −0.009 [95% CI, −0.067 to 0.049]), SPPB score (mean [SD], −0.144 [2.064] vs −0.211 [1.968]; adjusted mean difference, 0.068 [95% CI, −0.076 to 0.212]), and gait speed (mean [SD], −0.0160 [0.148] m/s vs −0.007 [0.148] m/s; adjusted mean difference, −0.010 m/s [95% CI, −0.067 to 0.049 m/s]).Conclusions and RelevanceIn this cohort study of Medicare beneficiaries from 2015, MA enrollees experienced similar declines in frailty over 1 year compared with TM enrollees. Future work should examine whether the specific types of services covered by health insurance can impact frailty and health trajectories for older adults.
Functional and radiological sinonasal outcomes of CFTR modulators for sinus disease in cystic fibrosis: A meta‐analysis
Authors: Tham Tristan , Li Felisha A. , Schneider Jacob R. , Saleem Matthew I. , Werner Michael T. , Chaskes Mark B. , Tong Charles C. L. , Fastenberg Judd H. 
Published: August 2024

AbstractBackgroundCystic fibrosis transmembrane conductance regulator (CFTR) modulators improve pulmonary outcomes in cystic fibrosis (CF) by stabilizing the CFTR protein on respiratory epithelial surfaces. To determine the efficacy of CFTR modulators on sinonasal outcomes in patients with CF, we performed a meta‐analysis of clinical trials to date that include functional and radiographic evidence of sinus disease.MethodsEnglish full‐text articles were searched in PubMed, Embase, and Scopus databases. Two reviewers screened articles and a third reviewer resolved disagreements. Articles were included if they reported functional or radiological sinonasal outcomes in patients with CF before and after CFTR modulator therapies. Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines were followed, and the risk of bias in non‐randomized studies of interventions tool was used for quality assessment. The generic inverse variance method with random effects model was used for meta‐analysis. Standardized mean difference (SMD) and mean difference (MD) were used as effect measurements.ResultsSeven prospective and two retrospective studies representing 248 patients were included in this analysis. There was a significant improvement in sinonasal outcome test‐22 scores on elexacaftor‒tezacaftor‒ivacaftor (MD = 12.80, [95% confidence interval, CI: 10.46‒15.13], p < 0.001, n = 222), with no heterogeneity detected (I2 = 0%, p = 0.820). There was also a significant improvement in Lund‒Mackay scores (SMD = 1.25, [95% CI: 0.58‒1.91], p < 0.001, n = 88), with heterogeneity detected (I2 = 67%, p = 0.030).ConclusionsCFTR modulators improve functional and radiologic sinonasal outcomes. Given the utility of CFTR modulators, the treatment paradigm for CF‐related chronic rhinosinusitis promises to evolve.
Optimized chattering‐attenuated sliding mode controller for a perturbed VTOL system
Authors: Oliva‐Leal Idael , Cervantes‐Rojas Jorge Said , Lozano Rogelio , González‐Hernández Iván 
Published: August 2024

AbstractThis study presents a novel design of an optimized chattering‐attenuated quasi‐sliding mode controller for the stabilization of a vertical take‐off and landing aircraft affected by external disturbances. We propose a methodology based on a particle swarm optimization algorithm to provide an optimal boundary layer thickness of the quasi‐sliding mode controller (QSMC) structure based on a sigmoid‐type function approximation to reduce the chattering noise in the control signal while an adequate stabilization quality is guaranteed. This represents an alternative to the common strategies based on a trial and error tuning of such boundary layer thickness of sigmoid‐type approximations. Also, the Lyapunov formalism is applied to restrict the search space of the QSMC gain to guarantee stability conditions. Some simulation tests were carried out to demonstrate the enhanced chattering attenuation capability of the proposed solution against a standard sliding mode controller and the superior stabilization performance versus other robust controllers.
Free‐Standing Carbon Materials for Lithium Metal Batteries
Authors: Kim Hongjung , Son Yeonguk , Jo Changshin 
Published: August 2024

AbstractLithium metal, with its high theoretical capacity and low redox potential, is the most promising next‐generation high‐energy‐density battery anode material. However, the formation of uneven surface layers and dead lithium, significant volume changes in the electrode, and dendrite growth lead to rapid capacity degradation, low cycling stability, and safety issues, limiting the commercialization of lithium metal batteries (LMBs). As a strategy to improve the stability of LMBs, introducinga three‐dimensional (3D) structure with a large surface area can accommodate lithium (Li) inside the structure and homogenize local current density. Also, as a current collector and host material, free‐standing carbon materials, with the advantages of lightness, low cost, electrochemical and mechanical stability, and excellent electronic conductivity, can effectively enhance energy density and cycle performance. In this review, we first discuss the chemical properties of carbon, and then summarize recent research progress related to the 3D structuring and chemical modification of carbon materials as a Li metal host. Finally, we present perspectives on future research for the practical application of free‐standing carbon materials for LMBs.
Ecotoxicological assessment of waste foundry sands and the application of different classification systems
Authors: Alias Carlotta , Cioli Flavio , Abbà Alessandro , Feretti Donatella , Sorlini Sabrina 
Published: August 2024

Abstract
The application of a battery of bioassays is widely recognized as a useful tool for assessing environmental hazard samples. However, the integration of different toxicity data is a key aspect of this assessment and remains a challenge. The evaluation of industrial waste leachates did not initially undergo any of the proposed integration procedures. This research addressed this knowledge gap. Twenty-five samples of waste foundry sands were subjected to a leaching test (UNI EN 12457-2) to evaluate waste recovery and landfill disposal. The leachates were evaluated using a battery of standardized toxicity bioassays composed of Aliivibrio fischeri (EN ISO 11348-3), Daphnia magna (UNI EN ISO 6341), and Pseudokirchneriella subcapitata (UNI EN ISO 8692), both undiluted and diluted. Daphnia magna and P. subcapitata were the most affected organisms, with significant effects caused by 68% and 64% of undiluted samples, respectively. The dilution of samples facilitates the calculation of EC50 values, which ranged from greater than the highest concentration tested to 2.5 g/L for P. subcapitata. The data on single-organism toxicity were integrated using three methods: the Toxicity Classification System, the toxicity test battery integrated index, and the EcoScore system. The three classifications were strongly similar. According to all applied systems, three samples were clearly nontoxic (from iron casting plants) and two were highly toxic (from steel casting plants). Moreover, the similar ranking between undiluted and diluted leachates suggests the possibility of using only undiluted leachates for a more cost-effective and time-efficient screening of waste materials. The findings of this study highlight the usefulness of integrating ecotoxicological waste assessment. Integr Environ Assess Manag 2024;20:2294–2311. © 2024 The Author(s). Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).
Key Points
The toxicity of waste foundry sand leachates was assessed using three ecotoxicity tests, and the results were summarized using three different synthetic indices to assess the environmental risk associated with the possible reuse of these materials. The samples of cast steel and a binder system based on sodium silicate-ester cured were very toxic and were associated with high environmental risk, whereas the samples of cast iron and different binder systems were associated with a very low level of risk. Classification systems are useful tools for responding to management and regulatory frameworks. Despite these findings, there remains a lack of development in the real-world use of these systems in the waste management industry.
Studies on Taxonomy and Grouping of Pyrus Species
Authors: Terpó András 
Published: August 2024

SummaryAuthor describes the development of sections of Pyrus species and comes forward with a suggestion for a new manner of grouping of species of the genus. Dealing with taxonomical revision of species he declares P. cordata Desv. — living in Western Europe — as a taxon on level of species. This species is not related to P. pyraster but to P. magyarica (Sect. Pashia) wich lives in Hungary.A West European group of populations of P. pyraster can be distinguished on level of subspecies (subsp. achras). The overwhelming majority of wild pear populations living on Balkan which have pubescent, narrow obovate leaves belong to species P. slaronica (Syn.: P. bulgarica) described by Kitaibel. Author arranges in groups the Pyrus species on the basis of origin as well (autochton, escaped etc.).
Über das ökologische und soziologische Verhalten von Rhamnus cathartica L. und Frangula alnus Mill. in der planaren Stufe der DDR
Authors: Scamoni Alexis 
Published: August 2024

ZusammenfassungDir ökologschen und soziologischen Bedingungen von Rhamnus cathartica L. und Frangula alnus Mill. werden untersucht. Beide Arten weisen in dieser Hinsicht viele Unterschiede auf. Nur auf wenigen Standorten wachsen sie zusammen.
Sporenkeimung und Lebensstrategie der Pilze
Authors: Kreisel Hanns 
Published: August 2024

ZusammenfassungDer Autor diskutiert die Bedingungen der Sporenkeimung bei Eumycota unter ökologischen Gesichtspunkten. Mehrere Phänomene wie Dormanz., Bedarf an exogenen Nährstoffen, Empfindlichkeit für Boden‐Fungistasis stehen in engem Zusammenhang mit der Lebensweise und den von Pugh (1980) in die Mykologie übernommenen Kategorien der Lebensstrategie. Jedoch ist das von Pugh hauptsächlich für saprophytische terrestriche Pilze entworfene zweidimensionale Schema nicht ausreichend, um die Mannigfaltigkeit pilzlicher Lebensstrategien auszudrücken.
A taxonomic study of Crataegus Ser. Kyrtostylae Pojark. ex Botschantzev in Europe
Authors: Christensen Knud Ib 
Published: August 2024

SummaryThe type species of Crataegus Ser. Kyrtostylae Pojark. ex Botschantzev — C. kyrtostyla sensu Pojark. — is revised. The correct binary name for this species is shown to be C. rosaeformis Janka. C. kyrtostyla Fingerh. is G. monogyna Jacq. (Ser. Monogynae Pojark. ex Botschantzev) × rosaeformis, i.e. a hybrid between two species of different series. It is, therefore, proposed to rename Ser. Kyrtostylae as Crataegus Ser. Rosaeformes K. I. Christ. nom. nov. C. rosaeformis is divided into two subspecies: ssp. rosaeformis (C. curvisepala Lindm.) and ssp. lindmanii (Hrab.‐Uhr.) K. I. Christ, comb. nov. (C. calycina Peterm. emend. Lindm., C. lindmanii Hrab.‐Uhr.). C. curvisepala var. aceriformis Hrab.‐Uhr. is transfered to C. × kyrtostyla Fingerh, (C. monogyna × rosaeformis) and C. domicensis Hrab.‐Uhr. is interpreted as C. monogyna × rosaeformis ssp. lindmanii (C. × kyrtostyla nothossp. domicensis (Hrab.‐Uhr.) and C. curvisepala ssp. colorata Hrab.‐Uhr. are referred to C. monogyna. C. plagiosepala Pojark. presumably represents a form of C. × kyrtostyla close to C. rosaeformis.
Vergleichende taxonomische Untersuchung von Vicia hirsuta (L.) S. F. Gray und Vicia meyeri Boiss.
Authors: Tersijski Dimitar , Delipavlov Dimitar 
Published: August 2024

ZusammenfassungEs werden die Ergebnisse von vergleichenden taxonomischen Untersuchungen von den in Bulgarien vorkommenden Arten V. hirsuta und V. meyeri mitgeteilt. V. meyeri wird zum ersten Mal in der Flora Bulgariens und der Balkanhalbinsel nachgewiesen. Ziel der Untersuchung war die Klärung der taxonomischen Beziehungen zwischen beiden Arten. Durchgeführt wurde eine vergleichende Analyse der Morphologie der Nebenblätter, Blütenstände, Blüten, des Indumenta der Hülsen und Samen. Es wurden auch scanningelektronenmikroskopisch festgestellte Merkmale der Samen und der Karyotyp herangezogen. Die Ergebnisse zeigen, daß beide Arten eng verwandt, morphologisch und biologisch jedoch gut charakterisiert sind.