bluuebunny/crossref_metadata_2025_split huggingface dataset:
J-shaped associations of pan-immune-inflammation value and systemic inflammation response index with stroke among American adults with hypertension: evidence from NHANES 1999–2020
Authors: Chen Junchen , Luo Cheng , Tan Dianhui , Li Yong 
Published: July 2024

IntroductionStroke, a leading cause of death and disability worldwide, is primarily ischemic and linked to hypertension. Hypertension, characterized by systemic chronic inflammation, significantly increases stroke risk. This study explores the association of novel systemic inflammatory markers (SII, PIV, SIRI) with stroke prevalence in hypertensive U.S. adults using NHANES data.MethodsWe analyzed data from hypertensive participants in the NHANES 1999–2020 survey, excluding those under 20, pregnant, or with missing data, resulting in 18,360 subjects. Systemic inflammatory markers (SII, PIV, SIRI) were calculated from blood counts. Hypertension and stroke status were determined by self-report and clinical measurements. Covariates included sociodemographic, lifestyle, and medical history factors. Weighted statistical analyses and multivariate logistic regression models were used to explore associations, with adjustments for various covariates. Ethical approval was obtained from the NCHS Ethics Review Board.ResultsIn a cohort of 18,360 hypertensive individuals (mean age 56.652 years), 7.25% had a stroke. Stroke patients were older, had lower PIR, and were more likely to be female, single, less educated, smokers, non-drinkers, physically inactive, and have diabetes and CHD. Multivariate logistic regression showed that SII was not significantly associated with stroke. However, PIV and SIRI were positively associated with stroke prevalence. Each unit increase in lnPIV increased stroke odds by 14% (OR = 1.140, p = 0.0022), and lnSIRI by 20.6% (OR = 1.206, p = 0.0144). RCS analyses confirmed J-shaped associations for lnPIV and lnSIRI with stroke. Stratified analyses identified gender and smoking as significant effect modifiers. Smoking was significantly associated with elevated PIV, SIRI, and SII levels, especially in current smokers.ConclusionElevated PIV and SIRI levels significantly increase stroke prevalence in hypertensive individuals, notably among males and smokers. A predictive model with PIV, SIRI, and sociodemographic factors offers strong clinical utility.
Physiotherapy-assisted overground exoskeleton use: mixed methods feasibility study protocol quantifying the user experience, as well as functional, neural, and muscular outcomes in children with mobility impairments
Authors: Bradley Stefanie S. , de Holanda Ledycnarf Januario , Chau Tom , Wright F. Virginia 
Published: July 2024

BackgroundEarly phase research suggests that physiotherapy paired with use of robotic walking aids provides a novel opportunity for children with severe mobility challenges to experience active walking. The Trexo Plus is a pediatric lower limb exoskeleton mounted on a wheeled walker frame, and is adjustable to fit a child’s positional and gait requirements. It guides and powers the child’s leg movements in a way that is individualized to their movement potential and upright support needs, and can provide progressive challenges for walking within a physiotherapy-based motor learning treatment paradigm.MethodsThis protocol outlines a single group mixed-methods study that assesses the feasibility of physiotherapy-assisted overground Trexo use in school and outpatient settings during a 6-week physiotherapy block. Children ages 3–6 years (n= 10; cerebral palsy or related disorder, Gross Motor Function Classification System level IV) will be recruited by circle of care invitations to participate. Study indicators/outcomes will focus on evaluation of: (i) clinical feasibility, safety, and acceptability of intervention; (ii) pre-post intervention motor/functional outcomes; (iii) pre-post intervention brain structure characterization and resting state brain connectivity; (iv) muscle activity characterization during Trexo-assisted gait and natural assisted gait; (v) heart rate during Trexo-assisted gait and natural assisted gait; and (vi) user experience and perceptions of physiotherapists, children, and parents.DiscussionThis will be the first study to investigate feasibility indicators, outcomes, and experiences of Trexo-based physiotherapy in a school and outpatient context with children who have mobility challenges. It will explore the possibility of experience-dependent neuroplasticity in the context of gait rehabilitation, as well as associated functional and muscular outcomes. Finally, the study will address important questions about clinical utility and future adoption of the device from the physiotherapists’ perspective, comfort and engagement from the children’s perspective, and the impressions of parents about the value of introducing this technology as an early intervention.Clinical trial registrationhttps://clinicaltrials.gov, identifier NCT05463211
Phase II study of nab-paclitaxel with gemcitabine for relapsed/refractory small cell lung cancer
Authors: Byrne Margaret M. , Sutamtewagul Grerk , Zeitler William , Mott Sarah L. , Zamba Gideon K.D. , Kojadinovic Arsenije , Zhang Jun , Abu-Hejleh Taher , Clamon Gerald , Furqan Muhammad 
Published: July 2024

BackgroundPatients with small cell lung cancer (SCLC) often respond to first-line chemoimmunotherapy. However, relapse is inevitable and is associated with a poor prognosis. Treatments for relapsed SCLC, such as lurbinectedin and topotecan, are limited by modest efficacy and significant hematologic adverse events, leaving a need for newer therapeutic agents or regimens. The combination of gemcitabine and nab-paclitaxel is active and safe in other types of malignancies, such as pancreatic cancer.Patients and methodsWe conducted a phase II trial evaluating the efficacy and safety of gemcitabine and nab-paclitaxel in patients with relapsed/refractory SCLC. The primary endpoint was objective response rate (ORR), defined as the proportion of patients with confirmed complete or partial response. Secondary endpoints included time to progression (TTP), progression-free survival (PFS), overall survival (OS), and safety.ResultsBetween October 2016 and May 2021, 32 patients were enrolled. Patients were followed for a median of 9.3 months (range 1.8–65.2). Median age was 65 years (range 48–81). Fifty percent of patients were female. Fifty-three percent of patients had platinum-resistant/refractory relapsed SCLC. The ORR was 28.1% (95% confidence interval [CI] 15.5–100%). Median PFS was 2.9 months (95% CI 2.4–3.6), and median OS was 9.3 months (95% CI 5.2–12.4). Seven patients (21.9%) developed grade 3 or 4 neutropenia.ConclusionOur study showed that the combination of gemcitabine and nab-paclitaxel led to encouraging outcomes in relapsed/refractory SCLC. Further studies are needed to compare this combination with other treatments used for relapsed SCLC, including lurbinectedin, temozolomide, and topotecan.Clinical trial registrationhttps://clinicaltrials.gov/study/NCT02769832?cond=NCT02769832&amp;rank=1, identifier NCT02769832.
Challenges in overcoming advanced-stage or relapsed refractory extranodal NK/T-cell lymphoma: meta-analysis of individual patient data
Authors: Kim Tong Yoon , Kim Tae Jung , Han Eun Ji , Min Gi June , Jeon Youngwoo , Cho Seok-Goo 
Published: July 2024

IntroductionExtranodal NK/T-cell lymphoma (ENKTCL), a non-Hodgkin lymphoma, is known for its destructive local impact on nasal structures and systemic induction of inflammatory cytokines. Concurrent treatment with radiation and nonanthracycline- based chemotherapy has improved survival rates in patients with localized disease stages. However, survival outcomes vary significantly in advanced-stage and relapsed or refractory (R/R) cases.MethodsTherefore, we conducted a meta-analysis using random effects models to assess prognostic factors in advanced or R/R ENKTCL, employing a digital extractor on Kaplan–Meier graphs owing to the scarcity of published prospective trials for these patients.ResultsWe observed that patients with advanced ENKTCL treated with Lasparaginase had a median progression-free survival (PFS) of 14.3 months and an overall survival (OS) of 19 months. In R/R ENKTCL, PFS and OS were 11.7 and 15.6 months, respectively. Additionally, OS outcomes in advanced-stage ENKTCL were better in the asparaginase group than that in the non-asparaginase group, with PEG-asparaginase showing superior results compared with that using Lasparaginase. Epstein–Barr Virus (EBV)-DNA positivity in the bloodstream prior to treatment was associated with poor outcomes in advanced-stage ENKTCL, and similar trends were observed in patients with R/R ENKTCL and post-treatment EBV viremia.DiscussionCollectively, these findings suggest that chemotherapy with Lasparaginase or PEG-asparaginase can enhance survival in advanced or R/R ENKTCL. However, future strategies must be developed to effectively suppress EBV viremia and achieve a deep response toward tumor eradication.
Association of extreme hyperoxemic events and mortality in pediatric critical care: an observational cohort study
Authors: Bachman Thomas E. , Newth Christopher J. L. , Ross Patrick A. , Patel Nimesh , Bhalla Anoopindar 
Published: July 2024

ObjectiveOur aim was to confirm whether extreme hyperoxemic events had been associated with excess mortality in our diverse critical care population.MethodsRetrospective analysis of 9 years of data collected in the pediatric and cardiothoracic ICUs in Children's Hospital Los Angeles was performed. The analysis was limited to those mechanically ventilated for at least 24 h, with at least 1 arterial blood gas measurement. An extreme hyperoxemic event was defined as a PaO2 of ≥300 torr. Multivariable logistic regression was used to assess the association of extreme hyperoxemia events and mortality, adjusting for confounding variables. Selected a-priori, these were Pediatric Risk of Mortality III predicted mortality, general or cardiothoracic ICU, number of blood gas measurements, as well as an abnormal blood gas measurements (pH &lt; 7.25, pH &gt; 7.45, and PaO2 &lt; 50 torr).ResultsThere were 4,003 admissions included with a predicted mortality of 7.1% and an actual mortality of 9.7%. Their care was associated with 75,129 blood gas measurements, in which abnormal measurements were common. With adjustments for these covariates, any hyperoxemic event was associated with excess mortality (p &lt; 0.001). Excess mortality increased with multiple hyperoxemic events (p &lt; 0.046). Additionally, treatment resulting in SpO2 &gt; 98% markedly increased the risk of a hyperoxemic event.ConclusionRetrospective analysis of critical care admissions showed that extreme hyperoxemic events were associated with higher mortality. Supplemental oxygen levels resulting in SpO2 &gt; 98% should be avoided.
Synergistic antitumor activity of baicalein combined with almonertinib in almonertinib-resistant non-small cell lung cancer cells through the reactive oxygen species-mediated PI3K/Akt pathway
Authors: Chen Teng , Zhang Pei , Cong Xiao-Fan , Wang Yuan-Yuan , Li Shuo , Wang Hao , Zhao Su-Rong , Sun Xiao-Jin 
Published: July 2024

IntroductionAlmonertinib is an important third-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) exhibiting high selectivity to EGFR-sensitizing and T790M-resistant mutations. Almonertinib resistance is a major obstacle in clinical use. Baicalein possesses antitumor properties, but its mechanism of antitumor action against almonertinib-resistant non-small cell lung cancer (NSCLC) remains unelucidated.MethodsCCK-8 assay was used to examine the survival rate of H1975/AR and HCC827/AR cells following treatment for 24 h with different concentrations of baicalein, almonertinib or their combination. The changes in colony formation ability, apoptosis, and intracellular reactive oxygen species (ROS) levels of the treated cells were analyzed using colony formation assay and flow cytometry. Western blotting was performed to detect the changes in protein expressions in the cells. The effects of pre-treatment with NAC on proliferation, apoptosis, and PI3K/Akt signaling pathway were observed in baicalein- and/or almonertinib-treated cells. A nude mouse model bearing subcutaneous HCC827/AR cell xenograft were treated with baicalein (20 mg/kg) or almonertinib (15 mg/kg), and the tumor volume and body mass changes was measured.ResultsBoth baicalein and almonertinib represses the viability of HCC827/AR and H1975/AR cells in a concentration-dependent manner. Compared with baicalein or almonertinib alone, the combined application of the two drugs dramatically attenuates cell proliferation; triggers apoptosis; causes cleavage of Caspase-3, PARP, and Caspase-9; downregulates the protein expressions of p-PI3K and p-Akt; and significantly inhibits tumor growth in nude mice. Furthermore, baicalein combined with almonertinib results in massive accumulation of reactive oxygen species (ROS) and preincubation with N-acetyl-L-cysteine (ROS remover) prevents proliferation as well as inhibits apoptosis induction, with partial recovery of the decline of p-PI3K and p-Akt.DiscussionThe combination of baicalein and almonertinib can improve the antitumor activity in almonertinib-resistant NSCLC through the ROS-mediated PI3K/Akt pathway.
Efficacy and safety of HAIC combined with tyrosine kinase inhibitors versus HAIC monotherapy for advanced hepatocellular carcinoma: a multicenter propensity score matching analysis
Authors: Yang Miaomiao , Jiang Xiongying , Liu Huan , Zhang Qingyu , Li Jing , Shao Li , Zhao Lei 
Published: July 2024

PurposeThis study aimed to assess the clinical efficacy and safety of the combined approach involving hepatic arterial infusion chemotherapy (HAIC) and tyrosine kinase inhibitors (TKIs) for the treatment of advanced hepatocellular carcinoma (HCC).Patients and methodsIn this multicenter retrospective study conducted from January 2020 to December 2023, we reviewed advanced HCC patients who were treated either with HAIC alone or with a combination of HAIC and TKIs. To address initial disparities between the two groups, we employed propensity score matching (PSM). Tumor response evaluation was performed following RECIST 1.1 criteria. We compared survival outcomes, including overall survival (OS), progression-free survival (PFS), and objective response rate (ORR), between the two treatment groups. Safety assessments were conducted for all patients.ResultsFollowing the eligibility review, 138 patients underwent combined treatment with HAIC and TKIs (HT group), while 198 patients received HAIC monotherapy (HA group) and met the inclusion criteria for enrollment in this study. After PSM, 107 patients were assigned to each group. The HT group exhibited a longer median OS (18.0 versus 8.8 months; hazard ratio [HR], 0.52, p &lt; 0.001) compared to the HA group. Median PFS was also longer in the HT group, although without statistical significance (6.0 versus 4.7 months; HR, 0.85, p = 0.265). The HT group demonstrated a higher ORR (41.1% versus 25.2%; p = 0.020). No significant differences were observed between the two groups in the incidence of all adverse events (AEs) or grade 3/4 AEs (any grade: 81.2% for HT versus 78.8% for HA, p = 0.68; grade 3/4: 18.1% for HT versus 13.6% for HA, p = 0.29). Importantly, all AEs were manageable and acceptable. Notably, no grade 5 AEs occurred in either group.ConclusionCombination therapy involving HAIC and TKIs effectively prolonged survival in advanced HCC patients. It represented a preferable alternative to HAIC monotherapy, with manageable safety.
How the perfectionistic climate of a sports team predicts the athletic performance of elite athletes: a case study of the CUBAL women’s basketball team
Authors: Meng Meng , Su Rong-Hai , Kogiso Kohei , Zheng Rong-Rong , Chen Lin , Wei Wei , Li Wei , Hsu Mao-Chou 
Published: July 2024

ObjectiveIn competitive sports, understanding how the perfectionistic climate within teams influences the performance of elite female athletes can provide valuable insights for enhancing coaching practice and athletic achievement. Based on the cognitive appraisal theory of stress, this study constructs a dual-path model using stressors and coping strategies as mediators, referred to as the Perfectionistic Climate on Athletic Performance model (PCPM). The study explores the predictive role of the perfectionistic climate within sports teams on the athletic performance of elite female basketball players.MethodsThe empirical study the relationships among the variables in the model using a sample of 125 core players from the top-level women’s basketball teams in the 24th CUBAL24 tournament in 2022. A Structural Equation Modeling (SEM) analysis was conducted using AMOS 20.0, primarily employing the bias-corrected Bootstrap method to test the dual-path model.ResultsThe findings reveal double-edged paths towards a perfectionistic climate on athletic performance. In the positive pathway, a perfectionistic climate can positively predict athletic performance through challenge-related sources of stress and positive coping strategies. In the negative pathway, a perfectionistic climate can negatively predict athletic performance through threat-related sources of stress and negative coping strategies.ConclusionCoaches need to pay attention to athletes’ cognitive evaluations of the perfectionistic climate as a source of pressure. By setting challenging goals, coaches can guide athletes to view the perfectionistic climate of the sports team as a source of challenging pressure, thus unleashing their potential. Coaches should actively guide athletes in coping with the pressure brought about by the perfectionistic climate, enhancing their ability to handle stress. This will enable athletes to better adapt to the team’s perfectionistic climate and further improve individual and team athletic performance.
Assessing inoculation’s effectiveness in motivating resistance to conspiracy propaganda in Finnish and United States samples
Authors: Bessarabova Elena , Banas John A. , Reinikainen Hanna , Talbert Neil , Luoma-aho Vilma , Tsetsura Katerina 
Published: July 2024

IntroductionThis study tested the motivational power of inoculation to foster resistance to conspiracy propaganda (9/11 Truth Movement), comparing inoculation effects across United States and Finnish study participants.MethodWe used a 2 inoculation (treatment vs. control)  ×  2 national culture (American vs. Finnish) independent groups design (N = 319), while examining the effects of motivational threat and thinking modes—analytic vs. intuitive—on the inoculation process. To test the effectiveness of the inoculation strategy, we used an excerpt from a conspiracy film Loose Change as a counterattitudinal attack message.ResultsOur results indicated that inoculation was effective at motivating resistance regardless of national culture. Inoculation effects emerged mostly as a direct effect on resistance and two indirect effects wherein motivational threat mediated the relationship between inoculation and resistance as well as inoculation and analytic mode of message processing. Although we found that an increase in analytic mode of processing facilitated resistance and intuitive processing increased conspiracy-theory endorsement, the indirect effects between inoculation and resistance via message processing modes were not significant. Finally, the data revealed national culture differences in analytic mode and cultural-context differences mostly pertaining to the relationships between thinking styles, media literacy, and modes of thinking.DiscussionThese results offer important theoretical implications for inoculation scholarship and suggest viable practical solutions for efforts to mitigate misinformation and conspiratorial beliefs.
HGSHS-5:G—First results with the short version of the test for the Harvard Group Scale of Hypnotic Susceptibility and a comparison with the full version
Authors: Zech Nina , Riegel Bjoern , Rasch Bjoern , Peter Burkhard , Hansen Ernil 
Published: July 2024

IntroductionThe HGSHS:A is one of the most commonly used measures of hypnotic suggestibility. However, this test suffers from low feasibility due to a time requirement exceeding 1 h, and from a questionable representation of the normal population. Recently, a short version of HGSHS-5:G was developed and published, and now the first results are available. The scope of this investigation was to verify the assumption of equally positioned and normally distributed scores, resulting in equally sized suggestibility groups in a number of different studies with full or short versions of HGSHS, and to compare the results of the 11-item score with the 5-item score, the latter being calculated from either the full version or the short version test.MethodsData from 21 studies with testing for HGSHS were analyzed, 15 using the HGSHS:A full version and six using the HGSHS-5:G short version, for a total of 2,529 data sets. Position and distribution of both the 11-item score and the 5-item score were tested. Linear regression analysis was used to compare the two scores, as well as cross-table and weighted Cohen’s kappa to determine the match of grouping into low and high suggestibility. To evaluate contributing factors to the observed differences in the study results, a multifactorial analysis of variance was performed.ResultsIn the different studies, position and distribution of scores, as well as group sizes for low and high suggestibles, varied. All score distributions were found to be non-normal and shifted to the right from the middle score; the shift was more extensive with the 11-item score. The correlation between both scores calculated from full version tests was moderate (R2 = 0.69), as was the match of suggestibility grouping (κ = 0.58). Studies using the short version involving less student-dominated populations showed sufficient agreement with the full version, but lower scores were caused by an increase in the zero score.ConclusionA normal population is not represented in most applications of HGSHS, and grouping into low and high suggestibles varies, mainly due to different positions of score distributions. A direct comparison of full and short versions of HGSHS tested in the same subjects is still missing.