bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biomarker Analyses Investigating Disease Biology and Associations with Outcomes in the JAVELIN Merkel 200 Trial of Avelumab in Metastatic Merkel Cell Carcinoma
Authors: D’Angelo Sandra P. , Lebbé Céleste , Nghiem Paul , Brohl Andrew S. , Mrowiec Thomas , Leslie Trent , Georges Sara , Güzel Gülseren , Shah Parantu 
Published: July 2024

Abstract

Purpose:
Avelumab (anti–PD-L1) became the first approved treatment for metastatic Merkel cell carcinoma (mMCC) based on results from the phase II JAVELIN Merkel 200 trial. In this study, we report exploratory biomarker analyses from the trial.

Patients and Methods:
Patients with mMCC (n = 88) with or without prior first-line chemotherapy received avelumab 10 mg/kg every 2 weeks. We conducted analyses on somatic mutations, mutational signatures, and tumor mutational burden using paired whole-exome sequencing. Additionally, we examined gene and gene set expression, immune content from RNA sequencing profiles, as well as tumor PD-L1 and CD8 statuses from IHC and CD8 status from digital pathology.

Results:
Tumors positive for Merkel cell polyomavirus (MCPyV) were characterized by an absence of driver mutations and a low tumor mutational burden, consistent with previous studies. A novel MCPyV-specific host gene expression signature was identified. MCPyV+ tumors had increased levels of immunosuppressive M2 macrophages in the tumor microenvironment, which seemed to correlate with PD-L1 expression; high CD8+ T-cell density in these tumors did not predict response to avelumab. Conversely, in patients with MCPyV− tumors, higher CD8+ T-cell density seemed to be associated with response to avelumab. Mutations in several genes were associated with treatment outcomes. Compared with tumors sampled before chemotherapy, tumors sampled after chemotherapy had downregulated gene signatures for immune responses, including reduced expression of IFNγ-related pathways. Levels of activated dendritic cells in responding patients were higher in patients assessed after versus before chemotherapy.

Conclusions:
Exploratory analyses provide insights into mMCC biology and potential associations with response to avelumab. Chemotherapy seems to negatively modulate the immune microenvironment.
Morphological, physiological and anatomical traits in durum wheat (Triticum durum Desf.) as affected by semi-arid conditions
Authors: Ali Arous , Zemour Kamel , Mehdeb Djamila , Labdelli Amina , Zemour Hafidh , Chouhim Kada Mohamed Amine , Adda Ahmed , Belkhoudja Moulay 
Published: July 2024

Durum wheat (Triticum durum Desf.) is one of Algeria's primary cereal crops. Although the areas reserved for this species are estimated at approximately 40%, the production remains low to meet national grain requirements. This shortfall is primarily due to the impact of biotic and abiotic stresses, particularly drought, which significantly limit wheat yields. For that, this study assessed the behavior of five genotypes of durum wheat (Waha, Acsad1361, Vitron, Oued Zenati and Langlois) under water stress conditions. The experiment was carried out in Tiaret (Western Algeria). The studied parameters are morpho-physiological and anatomical of the flag leaf. The obtained results showed that the water deficit greatly affected the dimensions of the plant and triggered a decrease in the water content. Structural modifications due to cellular resizing of the structural constituents of the last leaf, reflected by variations in the rate of the outer epidermal wall thickness and reductions of leaf mesophiles. These modifications remain effective in maintaining the hydration of the aerial part by limiting water loss and increasing the hydraulic resistance of the leaves. According to this study, it seems that an inter-varietal difference has been highlighted. However, a genetic cross is recommended to combine the maximum number of resistant genes into a single variety. This strategy is considered as an effective solution for mitigating the effects of abiotic stresses, especially in semi-arid regions.
Association of Medication Adherence and Health Status in Heart Failure With Reduced Ejection Fraction: Insights From the CHAMP-HF Registry
Authors: El-Zein Rayan S. , Mohammed Moghniuddin , Nguyen Daniel D. , Hill C. Larry , Thomas Laine , Nassif Michael , DeVore Adam D. , Albert Nancy M. , Butler Javed , Patterson J. Herbert , Williams Fredonia B. , Hernandez Adrian , Fonarow Gregg C. , Spertus John A. 
Published: July 2024

BACKGROUND:
The foundation for managing heart failure with reduced ejection fraction (HFrEF) is adherence to guideline-directed medical therapy. Finding an association between medication adherence and patients’ health status (their symptoms, function, and quality of life) can be used to underscore its importance to patients.

METHODS:
The association of self-reported medication adherence in US outpatients with HFrEF enrolled in the Change the Management of Patients with Heart Failure registry from 2015 to 2017 was compared with their health status at baseline and 12 months later. A secondary analysis of changes in adherence between baseline and 6 months with 6-month health status was also performed. Medication adherence was assessed with the self-reported 4-item Morisky-Green-Levine Medication Adherence Scale, with scores ≥1 classified as nonadherent. The primary health status outcome was the disease-specific 12-item Kansas City Cardiomyopathy Questionnaire Overall Summary Score (KCCQ-OS; range, 0–100; higher is better). Robust linear regression models adjusted for confounders were used.

RESULTS:

After excluding those who died (n=316) or did not provide 12-month KCCQ (n=1285), 3495 outpatients with HFrEF were included, of whom 1108 (31.7%) reported being nonadherent. Nonadherent participants were younger, had significantly worse baseline health status (−5.83-point difference;
P
<0.001), and showed less improvement at 12 months (−1.7-point difference in mean change;
P
=0.017) than adherent participants. Among nonadherent patients at baseline, those whose adherence improved trended toward greater 6-month health status improvements than those remaining nonadherent (fully adjusted difference of 2.52 points;
P
=0.054).

CONCLUSIONS:
In HFrEF, medication nonadherence was associated with worse health status and less improvement over the following year. Improvements in adherence were associated with better health status than remaining nonadherent, underscoring the importance of supporting adherence with guideline-directed medical therapy in patients with HFrEF.
Cross-cultural adaptation and validation of the Arabic convergence insufficiency symptom survey (Arab-CISS) in Saudi Arabia
Authors: Aljohani Saeed , Alnawmasi Mohammed M 
Published: July 2024

Background: Convergence insufficiency (CI) is a common binocular vision disorder characterized by difficulty maintaining close visual focus. The Convergence Insufficiency Symptom Survey (CISS) is widely used to assess the presence and severity of CI symptoms, yet its applicability across different linguistic and cultural groups requires validation. This study aimed to translate, validate, and culturally adapt the CISS for Arabic-speaking populations, focusing on a sample from Saudi Arabia. Methods: Following established guidelines for questionnaire adaptation, the CISS was translated into Arabic and back-translated to ensure accuracy. The Arab-CISS underwent rigorous validation processes, including expert review and pre-testing. A sample of 104 participants from Qassim University, aged 18–40 years, was recruited with a Best-Corrected Visual Acuity (BCVA) of 0.1 (20/25) or better in both eyes. Internal consistency was evaluated using Cronbach’s alpha, and test–retest reliability was assessed through the Intraclass Correlation Coefficient (ICC). Results: The Arab-CISS demonstrated excellent internal consistency (Cronbach’s alpha = 0.88) and test–retest reliability (ICC = 0.93, 95% confidence interval (CI): 0.69–0.97). The Bland–Altman analysis supported these findings, showing minimal mean difference between test and retest scores (−0.1 ± 1.51), indicating stable and consistent responses over time without significant bias. Conclusion: The Arab-CISS is a reliable and valid instrument for assessing CI symptoms among Arabic-speaking individuals. Its introduction is a significant step toward improving the diagnosis and management of CI in Arabic-speaking populations.
Exploring the impact of early-stage dementia on everyday activities
Authors: Edwards Bethan M , Busse Monica , Clouston Teena J , Hannigan Ben 
Published: July 2024

Introduction: This paper explores the impact that early-stage dementia has on everyday activities from the perspective of people living with dementia, their supporters and occupational therapy practitioners. Method: People living with dementia and their supporters ( n = 10), and occupational therapy practitioners ( n = 21) took part in semi-structured interviews, with transcripts analysed thematically. Findings: Six primary themes were identified across participants, namely: (1) ‘Everybody seems to be different, [but] they are similar’; (2) An awareness of change: ‘Something’s not quite right’; (3) ‘ Changes’ and ‘ difficulties’ associated with complex and unfamiliar activities; (4) Social withdrawal and exclusion: ‘I’ve felt like I was a leper’; (5) Post-diagnostic mental health: ‘. . . a dark place’; and (6) A process of adaptation: ‘I’m still who I am, I can still do things. . .’ Conclusion: Findings indicate that occupational therapy intervention programmes for people living with early-stage dementia should target difficulties associated with a broad range of activity types, and include components that target mental health and motivational needs. The study adds to existing knowledge about the need to personally tailor interventions to ensure that they meet individual needs, experiences, and circumstances. Findings will inform the development of an occupational therapy intervention programme theory (theory of change) for early-stage dementia.
Gemcitabine and synthesized silver nanoparticles impact on chemically induced hepatocellular carcinoma in male rats
Authors: Mohamed Mohamed R , Osman Soheir A , Hassan Asmaa A , Raafat Amany I , Refaat Mahmoud M , Fathy Shadia A 
Published: July 2024

Objective: Gemcitabine (GEM) is a deoxycytidine analog chemotherapeutic drug widely used to treat many cancers. Silver nanoparticles (AgNPs) are important nanomaterials used to treat many diseases. Using gamma radiation in nanoparticle preparation is a new eco-friendly method. This study aims to evaluate the efficiency of co-treating gemcitabine and silver nanoparticles in treating hepatocellular carcinoma. Method: The AgNPs were characterized using UV-visible spectroscopy, XRD, TEM, and EDX. The MTT cytotoxicity in vitro assay of gemcitabine, doxorubicin, and cyclophosphamide was assessed against Wi38 normal fibroblast and HepG2 HCC cell lines. After HCC development, rats received (10 µg/g b.wt.) of AgNPs three times a week for 4 weeks and/or GEM (5 mg/kg b.wt.) twice weekly for 4 weeks. Liver function enzymes were investigated. Cytochrome P450 and miR-21 genes were studied. Apoptosis was determined by using flow cytometry, and apoptotic modifications in signaling pathways were evaluated via Bcl-2, Bax, Caspase-9, and SMAD-4. Results: The co-treatment of GEM and AgNPs increased apoptosis by upregulating Bax and caspase 9 while diminishing Bcl2 and SMAD4. It also improved cytochrome P450 m-RNA relative expression. The results also proved the cooperation between GEM and AgNPs in deactivating miR21. The impact of AgNPs as an adjuvant treatment with GEM was recognized. Conclusions: The study showed that co-treating AgNPs and GEM can improve the efficiency of GEM alone in treating HCC. This is achieved by enhancing intrinsic and extrinsic apoptotic pathways while diminishing some drawbacks of using GEM alone.
Dementia Specialty Care Clinicians’ Perspectives on Their Role in the Dementia Diagnostic Process and Diagnostic Disclosure
Authors: Sideman Alissa B. , Harrison Krista L. , Garrett Sarah B. , Paladino Joanna , Naasan Georges , Ritchie Christine S. 
Published: July 2024

Background Delivering a diagnosis of Alzheimer’s disease and related dementias (ADRD) can be challenging not just for patients and families, but also for clinicians. Our objective was to understand dementia specialty care clinicians’ perspectives on their role in diagnosis and diagnostic disclosure in dementia. Methods Qualitative interviews with clinicians from a specialty tertiary dementia care center focused on practices, challenges, and opportunities addressing patient and caregiver needs in dementia. Data was analyzed by an interdisciplinary team using thematic analysis. Results The 16 participants included behavioral neurologists, social workers, neuropsychologists, and nurses. Themes included the value of providing an accurate diagnosis, the timing and challenges of delivering a diagnosis, the central focus on diagnosis alongside the need for more education on care management, and the role of the interdisciplinary team. Discussion We identified areas for improvement and strengths that can be built upon or adapted to other settings, including providing clinicians in specialty and primary care settings more guidance and support when diagnostic challenges arise, strengthening interdisciplinary teamwork, and making dementia diagnosis and care more accessible.
Measuring Consumer-Reported Quality of Life Among Recipients of Publicly Funded Home- and Community-Based Services: Implications for Health Equity
Authors: Shippee Tetyana P. , Duan Yinfei , Baker Zachary G. , Parikh Romil , Bucy Taylor , Jutkowitz Eric 
Published: July 2024

Objectives Despite an increased policy focused on home- and community-based services (HCBS), little is known about their quality of life (QoL)—a key measure of person-centered care. This paper addresses this gap by measuring consumers’ self-reported QoL and identifying factors associated with disparities in QoL. Methods We analyzed the 2015–2016 National Core Indicators–Aging and Disability survey for 3426 respondents in Minnesota, using factor analyses to identify latent QoL domains. Multivariable regression models identified predictors of QoL domains. Results Factor analyses identified three valid and reliable latent QoL domains: security, self-determination, and care experiences. Younger consumers with disabilities (versus consumers ≥65 years of age), minoritized racial/ethnic groups, consumers with hearing loss, without a spouse/domestic partner, and not living in consumer’s own/family home reported significantly lower QoL in various domains ( p < .001). Discussion Disparities in HCBS consumer-reported QoL exist, necessitating equitable reforms to improve HCBS quality for its increasingly diversified consumer base.
Rollet’s mixed chancre in an adult woman diagnosed in the state of Amazonas, Brazil: A case report
Authors: Maciel Marcel G , Andefiki Ubandoma , Fasogbon Ilemobayo V , Awache Ibrahim , Yakubu Michael N 
Published: July 2024

Rollet’s Mixed Chancre is a clinical presentation of sexually transmitted infections (STI), involving the coexistence of Haemophilus ducreyi and Treponema pallidum at the same site of infection. Here, we report a case of Rollet’s Mixed Chancre in a 32-year-old Brazilian woman. On physical examination she presented with a unilateral bubo measuring approximately 5 × 3 centimeters in diameter, in association with an ulcerated lesion that evolved for 10 days at the inguinal region. She was successfully treated at a health unit with antibiotics. Rollet’s Mixed Chancre, though uncommon, poses diagnostic challenges. This case highlights the importance of considering rare STI manifestations. Moreover, comprehensive STI screening and adherence to treatment guidelines are essential for effective management and prevention of further transmission.
Forced to Choose Silence: Social Gaming with Disabilities
Authors: Baltzar Pauliina , Hassan Lobna , Turunen Markku 
Published: July 2024

Background Socialization during gaming is an important aspect of gaming for people with and without disabilities. However, we know little about how gamers with disabilities play with others. Aim This study investigated the social gaming experiences of individuals with disabilities focusing on research questions 1) Who do people with disabilities play with?, and 2) How do people with disabilities communicate while gaming? Method We conducted a survey study which focused on experiences of gaming with disabilities. In total 92 responses were analyzed. Results The results suggest that gamers with disabilities play digital multiplayer games locally and online with friends, family, strangers, and people they know. The most used communication methods were speech, text, and built-in features. However, some were not communicating at all due to a lack of suitable communication methods. Furthermore, communication varied depending on if the gaming was happening online or locally, and depending on the gaming companions. Discussion The results align with previous research indicating that people with disabilities engage in gaming with friends, family, and strangers similar to any other gamer. However, there is a lack of studies on how people generally communicate in games, nonetheless, as speech and text communication methods are most commonly seen in games, we can assume that they are the most used communication methods for all gamers. Limitations and Future Research This study has limitations both related to the survey questions and the survey participants. We cannot be sure if all understood the questions in the same way, furthermore, most of the participants were experienced Finnish gamers with physical disabilities which could have skewed the results. Further research is necessary to address these limitations and broaden the scope of the study's findings. Conclusions Based on the results, we argue that games should provide multiple means of communication to make social gaming more accessible.
Efficient vibration analysis system using empirical mode decomposition residual signal and multi-axis data
Authors: Ninawe Swapnil , Deshmukh Raghavendra 
Published: July 2024

The empirical mode decomposition (EMD) method is a technique that recursively decomposes an input signal into intrinsic mode functions (IMFs) by residual signals, primarily for identifying desirable features. The suggested algorithm observes the residual signal instead of the IMF, which lowers the computing load. The study introduces a new method for detecting bearing faults by enhancing signal extraction from sensor data using EMD and multi-axis feature extraction. This method streamlines the process by filtering out high-frequency noise and correlating residual signal information with analysis. The approach also enhances the signal-to-noise ratio (SNR) and feature signature identification using digital signal processing (DSP) techniques. The algorithm for vibration data analysis is tested for bearing failures, identifying shaft frequency and inner race bearing faults, which can be implemented in parallel. For the inner race fault bearing analysis, two-level EMD with a residual signal generates output similar to five-iteration EMD, saving 60% of computations. The use of spectral multiplication to multi-axis data processing produced a rise in the SNR of 18.32 dB to 20.92 dB for Y-axis and X-axis input, respectively. When compared to the single-axis IMF data computation, 20% fewer iterations are needed overall. A single-level EMD is adequate for calculating the rotational frequency of a healthy bearing. For the Y- and X-axis input, multi-axis analysis increases SNR by 10.68 dB and 13.14 dB, accordingly. This comprehensive strategy reduces computational complexity, improves fault detection accuracy, and minimizes noise impact, making it a promising solution for bearing fault detection.
The Association Between Proneness to Smartphone Addiction and Social Anxiety Among School Students and the Mediating Role of Social Support: A Call to Advance Jordanian Adolescents’ Mental Health
Authors: Abu Khait Abdallah , Menger Austin , Al-Atiyyat Nijmeh , Hamaideh Shaher H. , Al-Modallal Hanan , Rayapureddy Harshita 
Published: July 2024

Background: Social anxiety is an emerging public health issue associated with significant impairment of social functioning during adolescence. Among many determinants of social anxiety, proneness to smartphone addiction may significantly contribute to the development of social anxiety. To cope with the consequential development of social anxiety, adolescent school students may rely on various forms of social support. Particularly in the Middle East, including Jordan, the relationship between proneness to smartphone addiction and adolescent social anxiety is understudied. Aim: To examine the mediating role of social support in the relationship between proneness to smartphone addiction and social anxiety in a sample of adolescent school students. Methods: In this cross-sectional study, 432 adolescents were recruited via a random cluster sample from public schools across three provinces in Jordan. The data were collected face-to-face using the Social Anxiety Scale for Adolescents, the Smartphone Addiction Proneness Scale, and the Multidimensional Scale of Perceived Social Support. Results: Significantly higher levels of social anxiety were associated with females of lower economic status who reported more gaming hours and higher levels of proneness to smartphone addiction. Familial social support significantly mediated the relationship between proneness to smartphone addiction and social anxiety, controlling for the other covariates in the social anxiety model. Conclusions: Familial social support reduced the impact of proneness to smartphone addiction on social anxiety. Nurses may supplement treatment for reducing social anxiety in adolescents suffering from proneness to smartphone addiction by fostering sources of familial social support.
How are nature-based interventions defined in mild cognitive impairment and dementia studies? A conceptual systematic review and novel taxonomy
Authors: Jiang Harmony , Eaglestone Gill , McCrone Paul , Carr Catherine , Stoner Charlotte 
Published: July 2024

Objectives To systematically review research testing nature-based interventions for people living with mild cognitive impairment or dementia, and to report how authors have defined their interventions by presenting a taxonomy of the nature-based interventions. Methods A conceptual systematic review of research published between 2008 and 2024 investigating nature-based interventions for people living with mild cognitive impairment or dementia was conducted. Three reviewers contributed independently. Exclusion criteria: not specifying if participants had mild cognitive impairment or dementia, only recruiting caregivers, no primary data, study protocols, abstracts, reviews, not peer-reviewed journal articles and any other grey literature. Intervention descriptions within the papers were thematically analysed. Results Fifty-two articles reporting fifty-one studies were included. The most common interventions were nature virtual reality (VR technology) and gardening. From the definition data, we produced a taxonomy with overarching domains of: (a) Other terms used; (b) Characteristics; (c) Activities. Subdomains included: development or approach, modes of action, location, physical features, and activities. Some interventions could be grouped. Structure and standardisation of the interventions varied, with a lack of clear reporting. Conclusion This taxonomy provides conceptualisations of nature-based interventions that can be used by future researchers to guide the development, evaluation and reporting of robust interventions in this area.