bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of immune checkpoint inhibitors combined with bevacizumab in MSS/pMMR advanced colorectal cancer after first-line treatment failure
Authors: Chen Xiaoqian , Li Wenkui , Lei Xiaogai , Li Zhanhong , Guo Qijing , Ma Xinfu , Luo Yushuang , Wang Liang 
Published: August 2024

ObjectiveTo investigate the effects of a PD-1 inhibitor combined with a bevacizumab monoclonal antibody on tumor immune cells in patients with first-line treatment failure in MSS/pMMR advanced colorectal cancer.MethodsControl group consisted of 50 patients treated with the FOLFIRI combined with Bevacizumab regimen. The experimental group consisted of 60 patients treated with the Sintilimab combined with Bevacizumab regimen. By comparing the expression levels of CD8+ T lymphocytes, TAMs, and CAFs before and after treatment, short-term efficacy after treatment, and adverse drug reactions between the two groups, we comprehensively evaluated the impact of Sintilimab combined with Bevacizumab on patients with MSS/pMMR advanced colorectal cancer who failed first-line treatment.ResultsThere was a statistically significant difference in the percentage of CD8+ T lymphocytes, TAMs, and CAFs before and after treatment between the two groups (P&lt;0.05);Immunohistochemical scoring of CD8+ T lymphocytes, TAMs, and CAFs showed significant differences between the groups post-treatment (P&lt;0.05). The experimental group demonstrated statistically significant differences in immunohistochemical scoring of CD8+ T lymphocytes, TAMs, and CAFs before and after treatment (P&lt;0.05). There was a statistically significant difference in the therapeutic effect between the two groups of tumors (P&lt;0.05). The experimental group had greater PFS, mPFS, ORR, and DCR than did the control group. There was no statistically significant difference in the occurrence rate of drug-related adverse reactions after treatment between the two groups (P&gt;0.05). The results of the Cox proportional hazards model analysis indicate that age, gender, and group are independent risk factors affecting MSS/pMMR advanced colorectal cancer patients treated with second-line therapy in this study. Patients aged ≤60 years, male patients, and those in the experimental group showed better treatment responses in this study.ConclusionBy administering immune checkpoint inhibitors in combination with bevacizumab to patients with advanced colorectal cancer with MSS/pMMR disease for whom first-line treatment failed, not only did the patients’ prognosis improve, but the adverse drug reactions were also safe and controllable.
Navigating the shadows: medical professionals’ values and perspectives on end-of-life care within pediatric intensive care units in Croatia
Authors: Curkovic Marko , Rubic Filip , Jozepovic Ana , Novak Milivoj , Filipovic-Grcic Boris , Mestrovic Julije , Lah Tomulic Kristina , Peter Branimir , Spoljar Diana , Grosek Štefan , Janković Sunčana , Vukovic Jurica , Kujundžić Tiljak Mirjana , Štajduhar Andrija , Borovecki Ana 
Published: August 2024

Background and aimThis study explores healthcare professionals’ perspectives on end-of-life care in pediatric intensive care units (ICUs) in Croatia, aiming to illuminate their experiences with such practices, underlying attitudes, and major decision-making considerations. Amid the high variability, complexity, and emotional intensity of pediatric end-of-life decisions and practices, understanding these perspectives is crucial for improving care and policies.MethodsThe study utilized a cross-sectional survey intended for physicians and nurses across all pediatric ICUs in Croatia. It included healthcare professionals from six neonatal and four pediatric ICUs in total. As the data from neonatal and pediatric ICUs were examined jointly, the term pediatric ICU was used to denominate both types of ICUs. A statistical analysis was performed using Python and JASP, focusing on professional roles, professional experience, and regional differences.ResultsThe study included a total of 103 participants (with an overall response rate—in relation to the whole target population—of 48% for physicians and 29% for nurses). The survey revealed diverse attitudes toward and experiences with various aspects of end-of-life care, with a significant portion of healthcare professionals indicating infrequent involvement in life-sustaining treatment (LST) limitation discussions and decisions, as well as somewhat ambiguous attitudes regarding such practices. Notably, discrepancies emerged between different professional roles and, in particular, regions, underscoring the high variability of LST limitation-related procedures.ConclusionsThe findings highlight a pressing need for more straightforward guidelines, legal frameworks, support mechanisms, and communication strategies to navigate the complex terrain of rather burdensome end-of-life pediatric care, which is intrinsically loaded with profound ethical quandaries.
Intracranial pressure-flow relationships in traumatic brain injury patients expose gaps in the tenets of models and pressure-oriented management
Authors: Stroh J. N. , Foreman Brandon , Bennett Tellen D. , Briggs Jennifer K. , Park Soojin , Albers David J. 
Published: August 2024

Background: The protocols and therapeutic guidance established for treating traumatic brain injury (TBI) in neurointensive care focus on managing cerebral blood flow (CBF) and brain tissue oxygenation based on pressure signals. The decision support process relies on assumed relationships between cerebral perfusion pressure (CPP) and blood flow, pressure-flow relationships (PFRs), and shares this framework of assumptions with mathematical intracranial hemodynamics models. These foundational assumptions are difficult to verify, and their violation can impact clinical decision-making and model validity.Methods: A hypothesis- and model-driven method for verifying and understanding the foundational intracranial hemodynamic PFRs is developed and applied to a novel multi-modality monitoring dataset.Results: Model analysis of joint observations of CPP and CBF validates the standard PFR when autoregulatory processes are impaired as well as unmodelable cases dominated by autoregulation. However, it also identifies a dynamical regime -or behavior pattern-where the PFR assumptions are wrong in a precise, data-inferable way due to negative CPP-CBF coordination over long timescales. This regime is of both clinical and research interest: its dynamics are modelable under modified assumptions while its causal direction and mechanistic pathway remain unclear.Conclusion: Motivated by the understanding of mathematical physiology, the validity of the standard PFR can be assessed a) directly by analyzing pressure reactivity and mean flow indices (PRx and Mx) or b) indirectly through the relationship between CBF and other clinical observables. This approach could potentially help to personalize TBI care by considering intracranial pressure and CPP in relation to other data, particularly CBF. The analysis suggests a threshold using clinical indices of autoregulation jointly generalizes independently set indicators to assess CA functionality. These results support the use of increasingly data-rich environments to develop more robust hybrid physiological-machine learning models.
Model-driven engineering for digital twins: a graph model-based patient simulation application
Authors: Trevena William , Zhong Xiang , Lal Amos , Rovati Lucrezia , Cubro Edin , Dong Yue , Schulte Phillip , Gajic Ognjen 
Published: August 2024

IntroductionDigital twins of patients are virtual models that can create a digital patient replica to test clinical interventions in silico without exposing real patients to risk. With the increasing availability of electronic health records and sensor-derived patient data, digital twins offer significant potential for applications in the healthcare sector.MethodsThis article presents a scalable full-stack architecture for a patient simulation application driven by graph-based models. This patient simulation application enables medical practitioners and trainees to simulate the trajectory of critically ill patients with sepsis. Directed acyclic graphs are utilized to model the complex underlying causal pathways that focus on the physiological interactions and medication effects relevant to the first 6 h of critical illness. To realize the sepsis patient simulation at scale, we propose an application architecture with three core components, a cross-platform frontend application that clinicians and trainees use to run the simulation, a simulation engine hosted in the cloud on a serverless function that performs all of the computations, and a graph database that hosts the graph model utilized by the simulation engine to determine the progression of each simulation.ResultsA short case study is presented to demonstrate the viability of the proposed simulation architecture.DiscussionThe proposed patient simulation application could help train future generations of healthcare professionals and could be used to facilitate clinicians’ bedside decision-making.
Body position and cuff size influence lower limb arterial occlusion pressure and its predictors: implications for standardizing the pressure applied in training with blood flow restriction
Authors: de Queiros Victor S. , Rolnick Nicholas , Kamiş Okan , Formiga Magno F. , Rocha Roberto F. C. , Alves Júlio César Medeiros , Vieira João Guilherme , Vianna Jeferson Macedo , Wilk Michal , Fostiak Krzysztof , Cabral Breno Guilherme de Araújo Tinôco , Dantas Paulo Moreira Silva 
Published: August 2024

Background:Arterial occlusion pressure (AOP) is a relevant measurement for individualized prescription of exercise with blood flow restriction (BFRE). Therefore, it is important to consider factors that may influence this measure.Purpose:This study aimed to compare lower limb AOP (LL-AOP) measured with 11 cm (medium) and 18 cm (large) cuffs, in different body positions, and explore the predictors for each of the LL-AOP measurements performed. This information may be useful for future studies that seek to develop approaches to improve the standardization of pressure adopted in BFRE, including proposals for equations to estimate LL-AOP.Methods:This is a cross-sectional study. Fifty-one healthy volunteers (males,n= 25, females,n= 26; Age: 18–40 years old) underwent measurement of thigh circumference (TC), brachial blood pressure, followed by assessments of LL-AOP with medium and large cuffs in positions supine, sitting and standing positions.Results:The large cuff required less external pressure (mmHg) to elicit arterial occlusion in all three-body positions when compared to the medium cuff (p &lt; 0.001). The LL-AOP was significantly lower in the supine position, regardless of the cuff used (p &lt; 0.001). Systolic blood pressure was the main predictor of LL-AOP in the large cuff, while TC was the main predictor of LL-AOP with the medium cuff. Body position influenced strength of the LL-AOP predictors.Conclusion:Our results indicate that LL-AOP and its predictors are substantially influenced by body position and cuff width. Therefore, these variables should be considered when standardizing the pressure prescribed in BFRE.
Is it possible for people to develop a sense of empathy toward humanoid robots and establish meaningful relationships with them?
Authors: Morgante Elena , Susinna Carla , Culicetto Laura , Quartarone Angelo , Lo Buono Viviana 
Published: August 2024

IntroductionEmpathy can be described as the ability to adopt another person’s perspective and comprehend, feel, share, and respond to their emotional experiences. Empathy plays an important role in these relationships and is constructed in human–robot interaction (HRI). This systematic review focuses on studies investigating human empathy toward robots. We intend to define empathy as the cognitive capacity of humans to perceive robots as equipped with emotional and psychological states.MethodsWe conducted a systematic search of peer-reviewed articles using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched Scopus, PubMed, Web of Science, and Embase databases. All articles were reviewed based on the titles, abstracts, and full texts by two investigators (EM and CS) who independently performed data collection. The researchers read the full-text articles deemed suitable for the study, and in cases of disagreement regarding the inclusion and exclusion criteria, the final decision was made by a third researcher (VLB).ResultsThe electronic search identified 484 articles. After reading the full texts of the selected publications and applying the predefined inclusion criteria, we selected 11 articles that met our inclusion criteria. Robots that could identify and respond appropriately to the emotional states of humans seemed to evoke empathy. In addition, empathy tended to grow more when the robots exhibited anthropomorphic traits.DiscussionHumanoid robots can be programmed to understand and react to human emotions and simulate empathetic responses; however, they are not endowed with the same innate capacity for empathy as humans.
Serious leisure and successful aging among elderly air volleyball players: examining the mediating role of social support and flow experience
Authors: Wang Jingzhong , Tian Haibo 
Published: August 2024

IntroductionPrevious literature has demonstrated that engagement in serious leisure (SL) is associated with subjective well-being among older adults, while the relationship between successful aging (SA) and SL remains unexplored. This study aims to investigated the association between SL, social support (SS), flow experience (FE), and SA.MethodsA total of 435 older adults participating in air volleyball events were included in this study.ResultsThe findings revealed that: (i) SL directly and positively influences on SS, FE, and SA; (ii) SS is positively related to FE, and FE is positively associated with older adults’SA; (iii) Both SS and FE fully mediate the relationship between SL and SA, with SS partially explaining this mediation through FE.DiscussionThis study builds upon prior research in this field and highlights the significance of SL for the SA among older adults. Future studies should further explore the underlying mechanisms linking serious sport experiences to successful elderly life.
Electroconvulsive therapy modulates loudness dependence of auditory evoked potentials: a pilot MEG study
Authors: Dib Michael , Lewine Jeffrey David , Abbott Christopher C. , Deng Zhi-De 
Published: August 2024

IntroductionElectroconvulsive therapy (ECT) remains a critical intervention for treatment-resistant depression (MDD), yet its neurobiological underpinnings are not fully understood. This pilot study aims to investigate changes in loudness dependence of auditory evoked potentials (LDAEP), a proposed biomarker of serotonergic activity, in patients undergoing ECT.MethodsHigh-resolution magnetoencephalography (MEG) was utilized to measure LDAEP in nine depressed patients receiving right unilateral ECT. We hypothesized that ECT would reduce the LDAEP slope, reflecting enhanced serotonergic neurotransmission. Depression severity and cognitive performance were assessed using the 24-item Hamilton Depression Rating Scale (HDRS24) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), respectively.ResultsContrary to our hypothesis, findings indicated a significant increase in LDAEP post-ECT (t8 = 3.17, p = .013). The increase in LDAEP was not associated with changes in depression severity or cognitive performance.DiscussionThe observed increase in LDAEP suggests a more complex interaction between ECT and neurobiological systems, rather than a direct reflection of serotonergic neurotransmission. Potential mechanisms for this increase include ECT’s impact on serotonergic, dopaminergic, glutamatergic, and GABAergic receptor activity, neuroplasticity involving brain-derived neurotrophic factor (BDNF), and inflammatory modulators such as TNF-α. Our results highlight the multifaceted effects of ECT on brain function, necessitating further research to elucidate these interactions.
A mobile app-based intervention improves anthropometry, body composition and fitness, regardless of previous active-inactive status: a randomized controlled trial
Authors: Gómez-Cuesta Nerea , Mateo-Orcajada Adrián , Meroño Lourdes , Abenza-Cano Lucía , Vaquero-Cristóbal Raquel 
Published: August 2024

IntroductionThe use of mobile apps to promote physical activity in adolescents can improve health-related parameters. However, previous studies have not evaluated whether the benefits depend on the users’ prior active or inactive status. Therefore, the main objective was to analyze differences in physical activity levels, adherence to the Mediterranean diet (AMD), anthropometry, body composition, and physical fitness between active and inactive adolescents.MethodsThe study was conducted through a randomized controlled trial (RCT) with 462 adolescents, divided into experimental (EG) and control groups (CG), further categorized as active and inactive. Variables of physical activity, kinanthropometry, body composition, and physical fitness were measured before (pre-test) and after (post-test) a 10-week intervention using step-tracking apps (Strava, Pacer, MapMyWalk, and PokémonGo) at least three times per week.ResultsThe results showed that inactive EG adolescents significantly increased their physical activity levels, body mass, and muscle mass, and improved in all fitness variables except the countermovement jump (CMJ). The sum of three skinfolds also significantly decreased. Active EG adolescents increased body and muscle mass and improved in all fitness variables. Additionally, they significantly reduced fat mass and the sum of three skinfolds. All covariates, mainly gender and maturity, had significant effects on the study variables. Comparing changes between the active EG and CG groups, significant differences were found in body mass index (BMI) and CMJ in favor of the EG. However, while significant differences were observed in the study variables when analyzing each app individually, there were no differences between the changes produced by each app in these variables.ConclusionAfter a 10-week program of physical activity promoted through step-tracking apps, improvements were observed in fat variables, cardiorespiratory fitness, and curl-up performance. Furthermore, only inactive adolescents perceived an increase in their level of physical activity. The measurement protocol was registered prior to the start of the intervention at ClinicalTrials.gov (code: NCT04860128).
Impact of recruitment strategies on individual participation practices in the Canadian National Vaccine Safety Network: prospective cohort study
Authors: Soe Phyumar , Sadarangani Manish , Naus Monika , Muller Matthew P. , Vanderkooi Otto G. , Kellner James D. , Top Karina A. , Wong Hubert , Isenor Jennifer E. , Marty Kimberly , De Serres Gaston , Valiquette Louis , McGeer Allison , Bettinger Julie A. ,   for the Canadian Immunization Research Network
Published: August 2024

BackgroundThe Canadian National Vaccine Safety (CANVAS) network conducted a multi-center, prospective vaccine safety study to collect safety data after dose 1 and 2 of COVID-19 vaccines and follow up safety information 7 months after dose 1.ObjectiveThis study aimed to describe and evaluate the recruitment methods used by CANVAS and the retention of participants by each modality.MethodsCANVAS deployed a multi-pronged recruitment approach to reach a larger sample, without in-person recruitment. Three primary recruitment strategies were used: passive recruitment, technology-assisted electronic invitation through the vaccine booking system (auto-invitation), or auto-registration through the vaccine registries (auto-enrollment).ResultsBetween December 2020 and April 2022, approximately 1.3 million vaccinated adults either self-enrolled or were auto-enrolled in CANVAS, representing about 5% of the vaccinated adult Canadian population. Approximately 1 million participants were auto-enrolled, 300,000 were recruited by auto-invitation, and 5,000 via passive recruitment. Overall survey completion rates for dose 1, dose 2 and the 7-month follow-up surveys were 51.7% (681,198 of 1,318,838), 54.3% (369,552 of 681,198), and 66.4% (452,076 of 681,198), respectively. Completion rates were lower among auto-enrolled participants compared to passively recruited or auto-invited participants who self-enrolled. However, auto-enrolled samples were much larger, which offset the lower completion rates.ConclusionOur data suggest that auto-enrollment provided an opportunity to reach and retain a larger number of individuals in the study compared to other recruitment modalities.
Promising behavior change techniques for climate-friendly behavior change – a systematic review
Authors: Masciangelo Lisa , Lopez Lumbi Susanne , Rinderhagen Michel , Hornberg Claudia , Liebig-Gonglach Michaela , Mc Call Timothy 
Published: August 2024

IntroductionBesides societal and governmental actions to mitigate greenhouse gases, individual behavioral changes are also urgently needed to limit global temperature rise. However, these individual changes have proven to be difficult to achieve in the general population.MethodsWe conducted a systematic review in five electronic databases with the aim of systematically depicting the content of interventions that promote climate-friendly behavior in individuals and households in high- and upper-middle-income countries.ResultsWe included 25 studies. The analyses included identification of the used Behavior Change Techniques (BCTs) and comparison of their promise ratio. Across our three outcome categories energy consumption, water consumption, and mobility the most frequently used BCT categories are not the ones that are most promising in terms of behavior change.DiscussionBased on these results, our recommendation for climate change mitigation interventions is to include components that provide concrete instructions on how to perform the desired behavior (shaping knowledge), setting goals and commitments (goals and planning), substituting undesired behavior, and practicing desired behavior (repetition and substitution). Other reviews with similar aims use different wordings, definitions, or degrees of detail in their intervention component labelling which makes it difficult to compare the results. We recommend to use a standardized classification system, like the BCT taxonomy in combination with the promise ratio, which this study has shown to be a suitable tool to classify applied intervention techniques and give an indication of successful techniques.