bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do no harm: the impact of implementing cancer prevention strategies on other preventive health measures
Authors: Emmons Karen M. , Pelton-Cairns Leslie , Gundersen Daniel A. , Cruz Jennifer L. , Mascioli Lynette , Kruse Gina R. ,   For the ISCCCE Partnership
Published: May 2024

Abstract
Background
Translational efforts to increase uptake of evidence-based practices typically look at those outcomes in isolation of their impact on other aspects of care delivery. If we are in fact to “do no harm”, we must consider the possible negative impact of improving use of one practice on other quality measures. Alternatively, a focus on one practice could lead to spread of effective strategies to other practices, which would be highly beneficial. We studied the impact of a colorectal cancer (CRC) screening initiative on delivery of other preventive care measures.

Methods
We used an interrupted time series design with implementation year as the interruption point. The initiative was conducted between 2015 and 2020, with three staggered cohorts. Main outcomes were quality measures for colorectal cancer screening, cervical cancer screening, hypertension management, diabetes management, weight screening and follow-up, tobacco use screening and cessation treatment, and depression screening and follow-up.

Results
The initiative was associated with an increase in CRC screening (OR = 1.67, p ≤ 0.01; average marginal effect = 12.2% points), and did not reduce performance on other quality measures in the year of CRC program implementation or a change in their respective secular trends.

Conclusions
The initiative led to a clinically meaningful increase in CRC screening and was not associated with reductions in delivery of six other preventive services. Quality improvement (QI) initiatives typically approach implementation with an eye towards reducing unintended impact and leveraging existing staff and resources. Implementation research studies may benefit from considering how QI initiatives factor in the local context in implementation efforts.
Upper limb muscle strength and exercise endurance as predictors of successful extubation in mechanically ventilated patients
Authors: de Beer-Brandon Caroline R. , van Rooijen Agatha J. , Becker Piet J. , Paruk Fathima 
Published: May 2024

Abstract
Background
Failed extubation increases the intensive care unit (ICU) length of stay, hospital length of stay, and financial costs and it reduces the patient’s functional ability. Avoiding failed extubation is of utmost importance, therefore predictors for successful extubation are paramount.

Objective
To determine if successful extubation in mechanically ventilated patients can be predicted by physiotherapists using upper limb muscle strength and exercise endurance.

Methods
Fifty-seven patients from the medical and trauma ICUs of a large academic hospital were eligible for testing. Muscle strength was evaluated using the Oxford grading scale, Medical Research Council score (MRC score), handgrip dynamometer, and maximum inspiratory pressure (MIP). Exercise endurance was tested while the patient was actively riding the MOTOmed® letto2 cycle ergometer for six minutes with the upper limbs.

Results
Exercise endurance (time the patient rode actively) (P = 0.005), MRC-score (P = 0.007), and number of days ventilated (P = 0.005) were associated with successful extubation. The handgrip strength (P = 0.061), MIP (P = 0.095), and muscle strength of the sternocleidomastoid (P = 0.053) and trapezius muscles (P = 0.075) were marginally associated with successful extubation. Due to multicollinearity when developing the prediction equation, the final multivariable logistic regression prediction model included only exercise endurance and the number of days ventilated. The newly developed prediction equation conferred a sensitivity of 81.82% and a specificity of 77.14% to predict successful extubation.

Conclusion
Successful extubation of mechanically ventilated patients can be predicted by physiotherapists using the newly developed prediction equation consisting of exercise endurance and number of days ventilated.
Phase I and Randomized Phase II Study of Ruxolitinib With Frontline Neoadjuvant Therapy in Advanced Ovarian Cancer: An NRG Oncology Group Study
Authors: Landen Charles N. , Buckanovich Ronald J. , Sill Michael W. , Mannel Robert S. , Walker Joan L. , DiSilvestro Paul A. , Mathews Cara A. , Mutch David G. , Hernandez Marcia L. , Martin Lainie P. , Bishop Erin , Gill Sarah E. , Gordinier Mary E. , Burger Robert A. , Aghajanian Carol , Liu Joyce F. , Moore Kathleen N. , Bookman Michael A. 
Published: May 2024

PURPOSE The interleukin-6/Janus kinase (JAK)/signal transducers and activators of transcription 3 axis is a reported driver of chemotherapy resistance. We hypothesized that adding the JAK1/2 inhibitor ruxolitinib to standard chemotherapy would be tolerable and improve progression-free survival (PFS) in patients with ovarian cancer in the upfront setting. MATERIALS AND METHODS Patients with ovarian/fallopian tube/primary peritoneal carcinoma recommended for neoadjuvant chemotherapy were eligible. In phase I, treatment was initiated with dose-dense paclitaxel (P) 70 mg/m2 once daily on days 1, 8, and 15; carboplatin AUC 5 intravenously day 1; and ruxolitinib 15 mg orally (PO) twice a day, every 21 days (dose level 1). Interval debulking surgery (IDS) was required after cycle 3. Patients then received three additional cycles of chemotherapy/ruxolitinib, followed by maintenance ruxolitinib. In the randomized phase II, patients were randomly assigned to paclitaxel/carboplatin with or without ruxolitinib at 15 mg PO twice a day for three cycles, IDS, followed by another three cycles of chemotherapy/ruxolitinib, without further maintenance ruxolitinib. The primary phase II end point was PFS. RESULTS Seventeen patients were enrolled in phase I. The maximum tolerated dose and recommended phase II dose were established to be dose level 1. One hundred thirty patients were enrolled in phase II with a median follow-up of 24 months. The regimen was well tolerated, with a trend toward higher grade 3 to 4 anemia (64% v 27%), grade 3 to 4 neutropenia (53% v 37%), and thromboembolic events (12.6% v 2.4%) in the experimental arm. In the randomized phase II, the median PFS in the reference arm was 11.6 versus 14.6 in the experimental, hazard ratio (HR) for PFS was 0.702 (log-rank P = .059). The overall survival HR was 0.785 ( P = .24). CONCLUSION Ruxolitinib 15 mg PO twice a day was well tolerated with acceptable toxicity in combination with paclitaxel/carboplatin chemotherapy. The primary end point of prolongation of PFS was achieved in the experimental arm, warranting further investigation.
Phase I/II Study of a Vascular Endothelial Growth Factor Receptor Vaccine in Patients With NF2-Related Schwannomatosis
Authors: Tamura Ryota , Yamanobe Yoshiharu , Fujioka Masato , Morimoto Yukina , Fukumura Mariko , Nakaya Masato , Oishi Yumiko , Sato Mizuto , Ueda Ryo , Fujiwara Hirokazu , Hikichi Tetsuro , Noji Shinobu , Oishi Naoki , Ozawa Hiroyuki , Ogawa Kaoru , Kawakami Yutaka , Ohira Takayuki , Yoshida Kazunari , Toda Masahiro 
Published: May 2024

PURPOSE The humanized antivascular endothelial growth factor (VEGF) antibody bevacizumab (Bev) is efficacious for the treatment of NF2-related schwannomatosis (NF2), previously known as neurofibromatosis type 2. This study evaluated the safety and efficacy of a VEGF receptor (VEGFR) vaccine containing VEGFR1 and VEGFR2 peptides in patients with NF2 with progressive schwannomas (jRCTs031180184). MATERIALS AND METHODS VEGFR1 and VEGFR2 peptides were injected subcutaneously into infra-axillary and inguinal regions, once a week for 4 weeks and then once a month for 4 months. The primary end point was safety. Secondary end points included tolerability, hearing response, imaging response, and immunologic response. RESULTS Sixteen patients with NF2 with progressive schwannomas completed treatment and were assessed. No severe vaccine-related adverse events occurred. Among the 13 patients with assessable hearing, word recognition score improved in five patients at 6 months and two at 12 months. Progression of average hearing level of pure tone was 0.168 dB/mo during the year of treatment period, whereas long-term progression was 0.364 dB/mo. Among all 16 patients, a partial response was observed in more than one schwannoma in four (including one in which Bev had not been effective), minor response in 5, and stable disease in 4. Both VEGFR1-specific and VEGFR2-specific cytotoxic T lymphocytes (CTLs) were induced in 11 patients. Two years after vaccination, a radiologic response was achieved in nine of 20 assessable schwannomas. CONCLUSION This study demonstrated the safety and preliminary efficacy of VEGFR peptide vaccination in patients with NF2. Memory-induced CTLs after VEGFR vaccination may persistently suppress tumor progression.
Multi-Institutional Study of Referral Patterns for Gynecologic Oncology Consultation
Authors: DeMari Joseph A. , Madeka Isheeta , Evans Joni K. , Bailey Courtney , Bartucci Kristen , Bottsford-Miller Justin , Bradford Leslie , Burnett Brian , Kelly Rebeca , Rowland Michelle , Wallbillich John J. , Shalowitz David I. 
Published: May 2024

PURPOSE Evaluation by a gynecologic oncologist (GO) is associated with improved clinical outcomes for patients with gynecologic cancers, yet little is known about health care factors that influence patients' referrals to GO. METHODS Medical records of 50 consecutive new patients seen in GO clinics at each of six referral centers across the United States were reviewed. Patient and disease characteristics were collected along with referral indication, evaluation and referral dates, diagnostic procedures, provider specialties, and zone improvement plan (ZIP) code of up to three referring providers per patient. The primary outcome was interval between first evaluation and referral. Univariate associations were evaluated with Chi-square and Wilcoxon rank-sum tests and multivariable associations with negative binomial regression models. Secondary outcome was prolonged time to GO referral, defined as greater than the 75th percentile. Logistic regression was used for multivariable modeling. RESULTS Three hundred patient records were analyzed. The median time from first health care encounter to referral was 15 days (IQR, 5-43). The mean distance from residence to GO was 39.8 miles (standard deviation, 53.8). Seventy-one percent of GO referrals were initiated by obstetrician-gynecologists, 9% by family physicians, and 6% internists. Presentation-to-referral interval was 76% shorter for patients evaluated by an emergency medicine clinician (exp(Beta), 0.24; 95% CI, 0.11 to 0.53; P < .001). Public insurance was associated with 1.47 times longer time to referral compared with private insurance (exp(Beta), 1.47; 95% CI, 1.05 to 2.04; P = .001). Residents of nonmetropolitan ZIP codes were less likely to have prolonged time to referral (odds ratio [OR], 0.288; P = .017). Distance from residence to GO (per 10 miles) increased the likelihood of prolonged time to referral (OR, 1.10; P = .010). CONCLUSION Interventions are needed to improve recognition and referral of patients for gynecologic oncology evaluation. Community outreach and engagement with obstetrician-gynecologists should be prioritized to improve times to referral.
The p-type modulation of
by Ca and Cd doping
Authors: Cui Huiqin , Zheng Shijiao , Zhang Zhiyi , Chen Bo , Zhang Yongjia , Li Jie , Wang Juanfen , Xue Lin , Zhang Longlong 
Published: May 2024

Abstract
Two-dimensional (2D) Bi2O2Se has been widely used as optoelectronic detector due to its excellent carrier mobility and environmental stability. However, the synthesis of the p-type Bi2O2Se remains challenging which hinders its further applications. In this paper, we have investigated the electronic properties of the native point defects and the Ca/Cd-doping effects on Bi2O2Se using first-principles calculations. The results indicate that Se vacancy (V
Se
) and O vacancy (V
O
) are shallow donors, which lead to the n-type Bi2O2Se semiconductor. Ca substituting Bi (Ca
Bi
) and Cd substituting Bi (Cd
Bi
) are acceptors and can compensate the n-type behavior of shallow donors. The compensation effect of Cd
Bi
is weaker than that of Ca
Bi
due to its higher formation energies. Additionally, the calculation results of the Fermi level, defect and carrier concentrations indicate that Ca
Bi
shifts the Fermi level towards the valence band maximum (VBM), however, it is not sufficient to convert Bi2O2Se into the p-type.
Timing of a First Romantic Union Among Sexual Minority Young Adults
Authors: Mernitz Sara , Hsu Jaime , Pollitt Amanda 
Published: May 2024

Abstract
Cohabitation and marriage are critical milestones during the transition to adulthood; however, there is limited research on the timing of young adults’ first same-sex unions. There is some evidence that same-sex unions may be delayed, particularly for men. Further, formation of both same- and different-sex dating relationships, common among sexual minority young adults, may also extend to cohabitation and marriage. We used the National Longitudinal Study of Adolescent to Adult Health to predict the timing of a first romantic union, defined as a cohabitation or marriage, among sexual minority young adults. We then distinguished between women and men and the timing of a different-sex versus a same-sex union. Compared with heterosexual young adults, lesbian and gay young adults entered a union at later ages (driven by men), whereas bisexual young adults entered a union at younger ages (driven by women). Lesbian and gay young adults who entered a first union with a same-sex partner did so at later ages than those who entered a first union with a different-sex partner. Results suggest that patterns of sexual minority dating relationship formation might extend to unions.
Clear Cell Renal Cell Carcinoma with Neovascularization and Ureteral Extension in a 63-Year-Old Female Unravelled by Pelvicalyceal Penetration
Authors: Zafar Nauman , Nusrat Nadeem , Bajwa Sarmad Imtiaz , Imtiaz Saira 
Published: May 2024

Approximately 3% to 4% of all newly diagnosed cancers are kidney tumours, which can develop from either the renal parenchymal tissue or the renal pelvis. Kidney cancer is one of the 13 most prevalent kinds of malignancy worldwide. 85% of all malignant kidney neoplasms are renal cell carcinomas (RCC). We present a rare instance of an RCC that had a thrombus in the ureter and had directly extended into the renal pelvicalyceal system.
A thorough diagnostic workup was required because the patient had a number of symptoms, including flank pain, hematuria, and weight loss. Imaging tests identified a renal parenchymal-derived infiltrative tumour with remarkable pelvicalyceal penetration. Neovascularization was found within the tumour as a result of additional search. The discovery of ureteral extension, a peculiar characteristic, raised questions regarding both local and distant metastases. R.E.N.A.L nephrometry score was 11 with high complexity. Multidisciplinary management of the intricate clinical problem was employed. After removing the tumour mass, the ureteral involvement was treated with surgical resection, adjuvant therapy, and CT monitoring over the three-month high-risk follow-up period. With surgery, targeted treatment was employed to stop the cancer from growing.
Conclusion: The importance of identifying unusual RCC presentations and employing a comprehensive diagnostic and treatment strategy is emphasised by this study. The complex interaction of ureteral extension, neovascularization, and pelvicalyceal penetration highlights the aggressiveness of advanced RCC. Since we are not aware of any literature documented instances including this combination, there are few studies explaining pelvicalyceal system invasion that defies commonly recognised diagnostic and treatment paradigms for renal cell carcinoma.
doi: https://doi.org/10.12669/pjms.40.6.8715
How to cite this: Zafar N, Nadeem Bin Nusrat, Bajwa SI, Imtiaz S. Clear Cell Renal Cell Carcinoma with Neovascularization and Ureteral Extension in a 63-Year-Old Female Unravelled by Pelvicalyceal Penetration. Pak J Med Sci. 2024;40(6):1300-1302. doi: https://doi.org/10.12669/pjms.40.6.8715
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Design and application of high-precision calibration blackbody for space optical remote sensing sensor
Authors: Yang Ming , Gao Chao , Luo Shi Kui , Wang Lei , Xia Chenhui 
Published: May 2024

Radiation calibration is a crucial step in producing high-quality images for spaceborne infrared cameras. Blackbody radiation sources, as the standard equipment for infrared thermometers, play an increasingly important role in radiation calibration. But as the camera aperture increases, blackbody faces challenges such as poor temperature uniformity, slow heating and cooling rates, large mass, and large volume. This article proposes a design scheme for spaceborne calibration blackbody based on a combination of rope pull fixation and limit block positioning. The temperature uniformity, temperature stability, temperature rise and fall rate, thermal stress characteristics, and anti-emission vibration characteristics of the blackbody under this scheme are analyzed and optimized in detail. The analysis results show that the conduction thermal resistance between the blackbody and the environment is nearly two orders of magnitude higher than that of the conventional scheme. The blackbody has excellent temperature uniformity, temperature stability, wide calibration temperature range, light weight, small volume, and fast temperature rise and fall speed. The blackbody scheme with a thickness of only 1.5 mm was implemented and applied on orbit.
Method for LAMOST cofocus maintenance based on an Eddy current edge sensor
Authors: Yin Jing , Zhu Shuyu , Ni Jijun , Chen Xiaoting , Feng Zhihua 
Published: May 2024

The current cofocus maintenance strategy of the primary mirror of the
Large Sky Area Multi-Object Spectroscopic Telescope (Mb) using
Shack–Hartmann Wavefront Sensor (SHWFS) interrupts the observation
mission. This study proposed an Eddy current edge sensor with high
precision and accuracy to achieve closed-loop cofocus control. Through
structural design, interaction matrix deduction, installation
parameter analysis, and performance calibration, the edge sensor was
validated for use in detecting segment attitudes. The minimum cofocus
maintenance system comprising three segments was separated from Mb and
established to validate the effectiveness of the closed-loop cofocus
control with the novel edge sensor. The closed-loop control system was
effective within less than 1.5°C environmental temperature changes
after 13 h, which is considerably longer than the maintenance
time with the SHWFS. Moreover, continuous observation without
interruption is possible during one observation night.
The beneficial effect of fluoxetine on behavioral and cognitive changes in chronic experimental Chagas disease unveils the role of serotonin fueling astrocyte infection by Trypanosoma cruzi
Authors: Vilar-Pereira Glaucia , Gibaldi Daniel , Castaño-Barrios Leda , da Silva Andrea Alice , Resende Pereira Isabela , Cruz Moreira Otacílio , Britto Constança , Mata dos Santos Hílton Antônio , de Oliveira Lopes Raquel , Wanderley Tinoco Luzineide , Oliveira Wilson , Lannes-Vieira Joseli 
Published: May 2024

Background
In Chagas disease (CD), a neglected tropical disease caused by the parasite Trypanosoma cruzi, the development of mental disorders such as anxiety, depression, and memory loss may be underpinned by social, psychological, and biological stressors. Here, we investigated biological factors underlying behavioral changes in a preclinical model of CD.

Methodology/Principal Findings
In T. cruzi-infected C57BL/6 mice, a kinetic study (5 to 150 days postinfection, dpi) using standardized methods revealed a sequential onset of behavioral changes: reduced innate compulsive behavior, followed by anxiety and depressive-like behavior, ending with progressive memory impairments. Hence, T. cruzi-infected mice were treated (120 to 150 dpi) with 10 mg/Kg/day of the selective serotonin reuptake inhibitor fluoxetine (Fx), an antidepressant that favors neuroplasticity. Fx therapy reversed the innate compulsive behavior loss, anxiety, and depressive-like behavior while preventing or reversing memory deficits. Biochemical, histological, and parasitological analyses of the brain tissue showed increased levels of the neurotransmitters GABA/glutamate and lipid peroxidation products and decreased expression of brain-derived neurotrophic factor in the absence of neuroinflammation at 150 dpi. Fx therapy ameliorated the neurochemical changes and reduced parasite load in the brain tissue. Next, using the human U-87 MG astroglioma cell line, we found no direct effect of Fx on parasite load. Crucially, serotonin/5-HT (Ser/5-HT) promoted parasite uptake, an effect increased by prior stimulation with IFNγ and TNF but abrogated by Fx. Also, Fx blocked the cytokine-driven Ser/5-HT-promoted increase of nitric oxide and glutamate levels in infected cells.

Conclusion/Significance
We bring the first evidence of a sequential onset of behavioral changes in T. cruzi-infected mice. Fx therapy improves behavioral and biological changes and parasite control in the brain tissue. Moreover, in the central nervous system, cytokine-driven Ser/5-HT consumption may favor parasite persistence, disrupting neurotransmitter balance and promoting a neurotoxic environment likely contributing to behavioral and cognitive disorders.
Electrophysiological grading scale for polyneuropathy severity
Authors: Abraham Alon , Bril Vera 
Published: May 2024

Objective
To establish a simple electrophysiological scale for patients with distal symmetric axonal polyneuropathy, in order to promote standardized and informative electrodiagnostic reporting, and understand the complex relationship between electrophysiological and clinical polyneuropathy severity.

Methods
We included 76 patients with distal symmetric axonal polyneuropathy, from a cohort of 151 patients with polyneuropathy prospectively recruited from November 2016 to May 2017. Patients underwent nerve conduction studies (NCS), were evaluated by the Toronto Clinical Neuropathy Score (TCNS), and additional tests. The number of abnormal NCS parameters was determined, within the range of 0–4, considering low amplitude or conduction velocity in the sural and peroneal nerve.

Results
Higher number of NCS abnormalities was associated with higher TCNS, indicating more severe polyneuropathy. Polyneuropathy severity per the TCNS was most frequently (63%-70%) mild in patients with a low (0–1) number of NCS abnormalities, and most frequently (57%-67%) severe in patients with a high number (3–4) of NCS abnormalities, while patients with an intermediate (2) number of NCS abnormalities showed mainly mild and moderate severity with equal distribution (40%).

Conclusions
A simple NCS classification system can objectively grade polyneuropathy severity, although significant overlap exists especially at the intermediate range, underscoring the importance of clinical based scoring.