bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experiences and Satisfaction With Telehealth During the COVID-19 Pandemic: The Perspectives of Patients With Cancer in Australia
Authors: Nanda Arnav , Lam Lyn Ley , Lynch Jodi , Soudy Hussein 
Published: August 2024

PURPOSE There has been a significant rise in telehealth consultations across Australia since COVID-19 was declared a worldwide pandemic. We aimed to obtain patient feedback on telehealth, identify key strengths and weaknesses, and assess the feasibility of telehealth beyond the pandemic. METHODS A survey was developed to obtain patient feedback on telehealth. Patients attending medical oncology clinics at St George Hospital and Sutherland Hospital from April 1, 2020, to May 31, 2020, were identified. Patients who were reviewed via phone or videoconference were included in this study. Eligible patients were texted or emailed a survey link within a week of their telehealth consultation. Surveys were anonymous and completion of the survey implied informed consent. Patients who did not have a mobile number or e-mail were excluded from this study. RESULTS One thousand fifty-nine patients were reviewed during the study period, of whom 644 (60%) were reviewed via telehealth. The survey response rate was 36.3% (230 patients responded of 634 surveys sent). Ten telehealth patients did not have a mobile number or email and were excluded. Sixty-seven percent of telehealth consults were for active surveillance, 31% for prechemotherapy/treatment reviews, 1.6% for best supportive care, and 0.5% for new consults. Seventy percent of patients were satisfied that their medical needs were met via telehealth. Ninety percent wanted another telehealth consult, and 73% wanted telehealth to continue post resolution of the pandemic. Minimizing risk of exposure to COVID-19 and patient convenience were identified as key strengths of telehealth while absence of physical examination was the main disadvantage. CONCLUSION Majority of the patients surveyed were satisfied that telehealth safely met their medical needs. There is a considerable demand for telehealth to continue beyond the pandemic.
Devimistat (CPI-613) With Modified Fluorouarcil, Oxaliplatin, Irinotecan, and Leucovorin (FFX) Versus FFX for Patients With Metastatic Adenocarcinoma of the Pancreas: The Phase III AVENGER 500 Study
Authors: Philip Philip A. , Sahai Vaibhav , Bahary Nathan , Mahipal Amit , Kasi Anup , Rocha Lima Caio Max S. , Alistar Angela T. , Oberstein Paul E. , Golan Talia , Metges Jean-Philippe , Lacy Jill , Fountzilas Christos , Lopez Charles D. , Ducreux Michel , Hammel Pascal , Salem Mohamed , Bajor David , Benson Al B. , Luther Sanjeev , Pardee Timothy , Van Cutsem Eric 
Published: August 2024

PURPOSE
Metastatic pancreatic adenocarcinoma (mPC) remains a difficult-to-treat disease. Fluorouarcil, oxaliplatin, irinotecan, and leucovorin (FFX) is a standard first-line therapy for mPC for patients with a favorable performance status and good organ function. In a phase I study, devimistat (CPI-613) in combination with modified FFX (mFFX) was deemed safe and exhibited promising efficacy in mPC.

METHODS

The AVENGER 500 trial (ClinicalTrials.gov identifier:
NCT03504423
) is a global, randomized phase III trial conducted at 74 sites across six countries to investigate the efficacy and safety of devimistat in combination with mFFX (experimental arm) compared with standard-dose FFX (control arm) in treatment-naïve patients with mPC. Treatment, administered in once-every-2-weeks cycles until disease progression or intolerable toxicity, included intravenous devimistat at 500 mg/m
2
total per day on days 1 and 3 in the experimental arm. The primary end point of the study was overall survival (OS).

RESULTS

Five hundred and twenty-eight patients were randomly assigned (266 in the experimental arm and 262 in the control arm). The median OS was 11.10 months for devimistat plus mFFX versus 11.73 months for FFX (hazard ratio [HR], 0.95 [95% CI, 0.77 to 1.18];
P
= .655) and median progression-free survival was 7.8 months versus 8.0 months, respectively (HR, 0.99 [95% CI, 0.76 to 1.29];
P
= .94). Grade ≥3 treatment-emergent adverse events with >10% frequency in the devimistat plus mFFX arm versus the FFX arm were neutropenia (29.0%
v
34.5%), diarrhea (11.2%
v
19.6%), hypokalemia (13.1%
v
14.9%), anemia (13.9%
v
13.6%), thrombocytopenia (11.6%
v
13.6%), and fatigue (10.8%
v
11.5%), respectively.

CONCLUSION
Devimistat in combination with mFFX did not improve long- and short-term mPC patient outcomes compared with standard FFX. There were no new toxicity signals with the addition of devimistat.
An Advanced Twin-Screw Granulation Technology: The use of Non-Volatile Solvents with High Solubilizing Capacity
Authors: Kolipaka Siva Satyanarayana , Junqueira Laura Andrade , Ross Steven , Garg Vivek , Mithu Md Sadeque Hossein , Bhatt Saumil , Douroumis Dennis 
Published: August 2024

Abstract
Purpose
Twin-screw wet granulation (TSWG) is a manufacturing process that offers several advantages for the processing of water-insoluble active pharmaceutical ingredients (APIs) and has been used for increasing the solubility and dissolution rates. Here we introduce a novel TSWG approach with reduced downstream processing steps by using non-volatile solvents as granulating binders.

Methods
Herein, TSWG was carried out using Transcutol a non-volatile protic solvent as a granulating binder and dissolution enhancer of ibuprofen (IBU) blends with cellulose polymer grades (Pharmacoat® 603, Affinisol™, and AQOAT®).

Results
The physicochemical characterisation of the produced granules showed excellent powder flow and the complete transformation of IBU into the amorphous state. Dissolution studies presented immediate release rates for all IBU formulations due to the high drug-polymer miscibility and the Transcutol solubilising capacity.

Conclusions
Overall, the study demonstrated an innovative approach for the development of extruded granules by processing water-insoluble APIs with non-volatile solvents for enhanced dissolution rates at high drug loadings.

Graphical Abstract
Changes in the Bile Acid Pool and Timing of Female Puberty: Potential Novel Role of Hypothalamic TGR5
Authors: Vanden Brink Heidi , Vandeputte Doris , Brito Ilana L , Ronnekleiv Oline K , Roberson Mark S , Lomniczi Alejandro 
Published: August 2024

Abstract

Context
The regulation of pubertal timing and reproductive axis maturation is influenced by a myriad of physiologic and environmental inputs yet remains incompletely understood.

Objective
To contrast differences in bile acid isoform profiles across defined stages of reproductive maturity in humans and a rat model of puberty and to characterize the role of bile acid signaling via hypothalamic expression of bile acid receptor populations in the rodent model.

Methods
Secondary analysis and pilot studies of clinical cohorts, rodent models, ex vivo analyses of rodent hypothalamic tissues. Bile acid concentrations is the main outcome measure.

Results
Lower circulatory conjugated:deconjugated bile acid concentrations and higher total secondary bile acids were observed in postmenarcheal vs pre–/early pubertal adolescents, with similar shifts observed in infantile (postnatal day [PN]14) vs early juvenile (PN21) rats alongside increased tgr5 receptor mRNA expression within the mediobasal hypothalamus of female rats. 16S rRNA gene sequencing of the rodent gut microbiome across postnatal life revealed changes in the gut microbial composition predicted to have bile salt hydrolase activity, which was observed in parallel with the increased deconjugated and increased concentrations of secondary bile acids. We show that TGR5-stimulated GnRH release from hypothalamic explants is mediated through kisspeptin receptors and that early overexpression of human-TGR5 within the arcuate nucleus accelerates pubertal onset in female rats.

Conclusion
Bile acid isoform shifts along stages of reproductive maturation are conserved across rodents and humans, with preclinical models providing mechanistic insight for the neuroendocrine-hepatic-gut microbiome axis as a potential moderator of pubertal timing in females.
Οι πολιτικές ανταμοιβής των Εκπαιδευτικών με βάση την επίδοση των μαθητών/τριών τους (erformance-based pay).
Authors: ΚΑΡΑΤΖΑΣ ΦΙΛΙΠΠΟΣ 
Published: August 2024

Μέσα από την βελτίωση της ποιότητας του εκπαιδευτικού συστήματος κάθε κράτος επιδιώκει τη βελτίωση των επιδόσεων των μαθητών με απώτερο σκοπό να αξιοποιηθούν στο έπακρο τα ταλέντα και οι ικανότητες τους ώστε να βοηθήσουν στην ανάπτυξη και την ευημερία της κοινωνίας. Οι εκπαιδευτικοί αποτελούν την καρδιά των σχολείων και επομένως βρίσκονται στο επίκεντρο κάθε προγράμματος σχολικής βελτίωσης. Για το λόγο αυτό τα τελευταία χρόνια οι εκπαιδευτικές πολιτικές δίνουν μεγάλη σημασία στην βελτίωση της ποιότητας των εκπαιδευτικών που διδάσκουν. Αυτό επιτυγχάνεται με την χορήγηση κίνητρων για συνεχή βελτίωση τα οποία εκτός από εσωτερικά είναι και εξωτερικά. Τα τελευταία χρόνια η ανταμοιβή των εκπαιδευτικών βασισμένη στην απόδοση των μαθητών σε τυποποιημένες δοκιμασίες αποτελεί κυρίαρχο θέμα για την αξιολόγηση και την επιβράβευση των καλύτερων εκπαιδευτικών, δημιουργώντας και εγείροντας αντιρρήσεις για την ορθότητά της. Η ανασκόπηση της βιβλιογραφίας δείχνει ότι η επιστημονική κοινότητα είναι διχασμένη από τη χρήση των μαθητικών επιδόσεων για την εξαγωγή συμπερασμάτων που αφορούν την ποιότητα των εκπαιδευτικών και παρόλο που η πρακτική αυτή θα παραμείνει δεν μπορεί να δώσει έγκυρα αποτελέσματα για την σχέση ποιότητας των εκπαιδευτικών και των επιδόσεων που πραγματοποιούν οι μαθητές.
Optimization of E-commerce Product Recommendation Algorithm Based on User Behavior
Authors: Ji Yifan , Chen Lan , Xiong Rui 
Published: August 2024

In order to implement personalized recommendation algorithms for e-commerce, the author proposes a genetic fuzzy algorithm based on user behavior to improve the sales, personalized recommendation, user satisfaction, and purchase matching performance of e-commerce. Collect data based on e-commerce personalized preference recommendation information, extract the associated feature quantities of personalized data for clustering processing, and then combine fuzzy B-means clustering method to achieve e-commerce personalized recommendation. According to the individual preferences of e-commerce, the collected data samples are fitted with differences and restructured, and a genetic evolution method is adopted for global optimization. The experimental results show that the optimized genetic fuzzy algorithm used in this method has improved stability and accuracy compared to the PSO method, with an accuracy increase of 4%. This proves that the algorithm can provide the services needed by users more quickly and is an effective means.
Epidural analgesia in labour and the risk of emergency caesarean: a retrospective observational study
Authors: Salfarlie Nadia 
Published: August 2024

Background/Aims A Cochrane review reported that epidural analgesia had no effect on the risk of emergency caesarean section; there was a discrepancy between these findings and the author's clinical observations, prompting the author to evaluate labour outcomes for women with and without epidural analgesia. The aim was to establish whether the author's clinical observations were supported by data. Methods A retrospective review of the outcomes of 200 labours with and without epidural analgesia was carried out, limited to women the author had personally cared for. A subsequent trust-wide analysis of labours was conducted to explore wider trends in analgesia and emergency caesarean section. Results In the personal review, epidural analgesia was associated with a more than two-fold increase in risk of emergency caesarean section, regardless of the underlying obstetric risk factors (from 14.7% to 36.4%). A similar trend was found across the trust. Conclusions Epidural analgesia in labour is associated with increased risk of an emergency caesarean section. Potential reasons for the discrepancy with the Cochrane review findings include differences in anaesthetic practice, timing and dilation at the time of receiving epidural analgesia, and evidence that women taking part in a randomised controlled trial experience better outcomes than those receiving routine care.
Breastfeeding knowledge assessment tools among nursing and midwifery students: a systematic review
Authors: Hamdoune Meryem , Jounaidi Khaoula 
Published: August 2024

Background/Aims Training nursing and midwifery students is essential to support breastfeeding reinforcement plans. Various scales have been developed to assess knowledge acquired during training. This study was conducted to explore these instruments. Methods A systematic review of online databases (Scopus, Web of Science, Science-Direct, Cochrane Library and PubMed) was performed. Studies published in English from 2013 were included. Results Five studies that used validated instruments were included in the review. An additional scale, the breastfeeding knowledge assessment form, was identified but had only been tested once. Most tools were designed to assess mothers' knowledge, and no instruments were developed for nursing and midwifery students. Factors that influenced knowledge and its acquisition among nursing and midwifery students included the lack of training courses on breastfeeding for undergraduate students. Conclusions There is a lack of such instruments specifically designed for nursing and midwifery students. A comprehensive training module should be included in undergraduate curricula based on WHO and the UNICEF educational requirements.
Radiological predictors of outcomes in hip arthroscopy for femoroacetabular impingement
Authors: Wagner Moritz , Schaller Luca , Endstrasser Franz , Vavron Petr , Braito Matthias , Schmaranzer Ehrenfried , Schmaranzer Florian , Brunner Alexander 
Published: August 2024

AimsHip arthroscopy has gained prominence as a primary surgical intervention for symptomatic femoroacetabular impingement (FAI). This study aimed to identify radiological features, and their combinations, that predict the outcome of hip arthroscopy for FAI.MethodsA prognostic cross-sectional cohort study was conducted involving patients from a single centre who underwent hip arthroscopy between January 2013 and April 2021. Radiological metrics measured on conventional radiographs and magnetic resonance arthrography were systematically assessed. The study analyzed the relationship between these metrics and complication rates, revision rates, and patient-reported outcomes.ResultsOut of 810 identified hip arthroscopies, 359 hips were included in the study. Radiological risk factors associated with unsatisfactory outcomes after cam resection included a dysplastic posterior wall, Tönnis grade 2 or higher, and over-correction of the α angle. The presence of acetabular retroversion and dysplasia were also significant predictors for worse surgical outcomes. Notably, over-correction of both cam and pincer deformities resulted in poorer outcomes than under-correction.ConclusionWe recommend caution in performing hip arthroscopy in patients who have three positive acetabular retroversion signs. Acetabular dysplasia with a lateral centre-edge angle of less than 20° should not be treated with isolated hip arthroscopy. Acetabular rim-trimming should be avoided in patients with borderline dysplasia, and care should be taken to avoid over-correction of a cam deformity and/or pincer deformity.Cite this article: Bone Joint J 2024;106-B(8):775–782.
Five-year outcomes for patients sustaining severe fractures of the lower limb from the Wound Healing in Surgery for Trauma (WHIST) trial
Authors: Costa Matthew L. , Achten Juul , Knight Ruth , Campolier Marta , Massa M. S. 
Published: August 2024

AimsThe aims of this study were to report the outcomes of patients with a complex fracture of the lower limb in the five years after they took part in the Wound Healing in Surgery for Trauma (WHIST) trial.MethodsThe WHIST trial compared negative pressure wound therapy (NPWT) dressings with standard dressings applied at the end of the first operation for patients undergoing internal fixation of a complex fracture of the lower limb. Complex fractures included periarticular fractures and open fractures when the wound could be closed primarily at the end of the first debridement. A total of 1,548 patients aged ≥ 16 years completed the initial follow-up, six months after injury. In this study we report the pre-planned analysis of outcome data up to five years. Patients reported their Disability Rating Index (DRI) (0 to 100, in which 100 = total disability), and health-related quality of life, chronic pain scores and neuropathic pain scores annually, using a self-reported questionnaire. Complications, including further surgery related to the fracture, were also recorded.ResultsA total of 1,015 of the original patients (66%) provided at least one set of outcome data during the five years of follow-up. There was no evidence of a difference in patient-reported disability between the two groups at five years (NPWT group mean DRI 30.0 (SD 26.5), standard dressing group mean DRI 31.5 (SD 28.8), adjusted difference -0.86 (95% CI -4.14 to 2.40; p = 0.609). There was also no evidence of a difference in the complication rates at this time.ConclusionWe found no evidence of a difference in disability ratings between NPWT compared with standard wound dressings in the five years following the surgical treatment of a complex fracture of the lower limb. Patients in both groups reported high levels of persistent disability and reduced quality of life, with little evidence of improvement during this time.Cite this article: Bone Joint J 2024;106-B(8):858–864.
Serum albumin-to-globulin ratio and CRP-to-albumin ratio did not outperform serum CRP in diagnosing periprosthetic joint infections
Authors: Luger Markus , Böhler Christoph , Puchner Stephan E. , Apprich Sebastian , Staats Kevin , Windhager Reinhard , Sigmund Irene K. 
Published: August 2024

AimsSerum inflammatory parameters are widely used to aid in diagnosing a periprosthetic joint infection (PJI). Due to their limited performances in the literature, novel and more accurate biomarkers are needed. Serum albumin-to-globulin ratio (AGR) and serum CRP-to-albumin ratio (CAR) have previously been proposed as potential new parameters, but results were mixed. The aim of this study was to assess the diagnostic accuracy of AGR and CAR in diagnosing PJI and to compare them to the established and widely used marker CRP.MethodsFrom 2015 to 2022, a consecutive series of 275 cases of revision total hip (n = 129) and knee arthroplasty (n = 146) were included in this retrospective cohort study. Based on the 2021 European Bone and Joint Infection Society (EBJIS) definition, 144 arthroplasties were classified as septic. Using receiver operating characteristic curve (ROC) analysis, the ideal thresholds and diagnostic performances were calculated. The areas under the curve (AUCs) were compared using the z-test.ResultsAGR, CAR, and CRP were associated with PJI (p < 0.001). Sensitivities were 62.5% (95% CI 54.3 to 70.0), 73.6% (95% CI 65.8 to 80.1), and 71.5% (95% CI 63.6 to 78.3), respectively. Specificities were calculated with 84.7% (95% CI 77.5 to 89.9), 86.3% (95% CI 79.2 to 91.2), and 87.8% (95% CI 80.9 to 92.4), respectively. The AUC of CRP (0.797 (95% CI 0.750 to 0.843)) was significantly higher than the AUC of AGR (0.736 (95% CI 0.686 to 0.786), p < 0.001), and similar to AUC of CAR (0.799 (95% CI 0.753 to 0.846), p = 0.832). Decreased sensitivities were observed in PJIs caused by low-virulence organisms (AGR: 60%, CAR: 78%) compared to high-virulence pathogens (AGR: 80%, p = 0.042; CAR: 88%, p = 0.158). Higher sensitivities were seen in acute haematogenous (AGR: 83%, CAR: 96%) compared to chronic PJIs (AGR: 54%, p = 0.001; CAR: 65%, p < 0.001).ConclusionSerum AGR and CAR showed limited diagnostic accuracy (especially in low-grade and chronic infections) and did not outperform the established marker CRP in our study. Hence, neither parameter can be recommended as an additional tool for diagnosing PJI.Cite this article: Bone Joint Res 2024;13(8):372–382.
High red blood cell distribution width attenuates the effectiveness of Immune checkpoint inhibitor therapy: An exploratory study using a clinical data warehouse
Authors: Matsumoto Hiromi , Fukushima Taichi , Kobayashi Nobuaki , Higashino Yuuki , Muraoka Suguru , Ohtsu Yukiko , Hirata Momo , Somekawa Kohei , Kaneko Ayami , Nagasawa Ryo , Kubo Sousuke , Tanaka Katsushi , Murohashi Kota , Fujii Hiroaki , Watanabe Keisuke , Horita Nobuyuki , Hara Yu , Kaneko Takeshi 
Published: August 2024

Background
Immune checkpoint inhibitors (ICIs) have improved outcomes in cancer treatment but are also associated with adverse events and financial burdens. Identifying accurate biomarkers is crucial for determining which patients are likely to benefit from ICIs. Current markers, such as PD-L1 expression and tumor mutation burden, exhibit limited predictive accuracy. This study utilizes a Clinical Data Warehouse (CDW) to explore the prognostic significance of novel blood-based factors, such as the neutrophil-to-lymphocyte ratio and red cell distribution width (RDW), to enhance the prediction of ICI therapy benefit.

Methods
This retrospective study utilized an exploratory cohort from the CDW that included a variety of cancers to explore factors associated with pembrolizumab treatment duration, validated in a non-small cell lung cancer (NSCLC) patient cohort from electronic medical records (EMR) and CDW. The CDW contained anonymized data on demographics, diagnoses, medications, and tests for cancer patients treated with ICIs between 2017–2022. Logistic regression identified factors predicting ≤2 or ≥5 pembrolizumab doses as proxies for progression-free survival (PFS), and Receiver Operating Characteristic analysis was used to examine their predictive ability. These factors were validated by correlating doses with PFS in the EMR cohort and re-testing their significance in the CDW cohort with other ICIs. This dual approach utilized the CDW for discovery and EMR/CDW cohorts for validating prognostic biomarkers before ICI treatment.

Results
A total of 609 cases (428 in the exploratory cohort and 181 in the validation cohort) from CDW and 44 cases from EMR were selected for study. CDW analysis revealed that elevated red cell distribution width (RDW) correlated with receiving ≤2 pembrolizumab doses (p = 0.0008), with an AUC of 0.60 for predicting treatment duration. RDW’s correlation with PFS (r = 0.80, p<0.0001) and its weak association with RDW (r = -0.30, p = 0.049) were confirmed in the EMR cohort. RDW also remained significant in predicting short treatment duration across various ICIs (p = 0.0081). This dual methodology verified pretreatment RDW elevation as a prognostic biomarker for shortened ICI therapy.

Conclusion
This study suggests the utility of CDWs in identifying prognostic biomarkers for ICI therapy in cancer treatment. Elevated RDW before treatment initiation emerged as a potential biomarker of shorter therapy duration.