bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the Treatment Duration of Japanese Patients With Pancreatic Cancer in a Real-World Setting Using a Large Hospital Claims Database
Authors: Ueno Hideki , Shimizu Kyoko , Fukui Ayako , Nii Masahiro , Koto Ryo , Unno Michiaki 
Published: May 2024

Objectives
To clarify the treatment reality of pancreatic cancer in Japan, focusing on treatment duration and time to death.

Materials and Methods
We retrospectively analyzed Japanese hospital claims data for patients diagnosed with pancreatic cancer between April 2009 and October 2018 to investigate treatment patterns, duration of first-line chemotherapy, and time to death.

Results
Of 81,185 eligible patients, 54.2% were male, the mean age was 71.7 years, and 23.3% (n = 18,884) received chemotherapy as primary treatment. The median treatment duration was 14.1 weeks for the 6.7% of patients who received oxaliplatin, irinotecan, fluorouracil, and leucovorin (FOLFIRINOX; recommended first-line regimen) and 16.9 weeks for the 30.2% of patients who received gemcitabine plus nab-paclitaxel (GEM + nab-PTX). Time to death for patients who received FOLFIRINOX or GEM + nab-PTX was similar (15.4 and 14.8 months, respectively). The duration of first-line chemotherapy regimens tended to increase annually for both regimens. The time to death for all first-line chemotherapy regimens also increased annually.

Conclusions
This study revealed the treatment reality of pancreatic cancer in the real-world Japanese setting. Treatment duration and time to death tended to increase over time and did not differ numerically between FOLFIRINOX and GEM + nab-PTX.
Comparison of Task-Layered Clinical Orientation to Traditional Orientation in a RN Residency Program
Authors: Cantrell Faith , Shah Jinal , Hessler Karen , Dunn Kelli , Skroch Alisa , Hochheimer Camille 
Published: May 2024

OBJECTIVE
The purpose of this study was to compare outcomes of using a task-layered clinical orientation when compared with the original patient-layering approach.

BACKGROUND
Use of task-layering to orient new graduate nurses to the clinical world of nursing has been theorized to provide a decrease in cognitive load and allow for more streamlined clinical orientation.

METHODS
The method of this study was a nonrandomized, comparative design to measure the outcomes of length of orientation, new graduate perceptions about level of confidence/comfort with professional nurse responsibilities/skills, stress, satisfaction, and perceptions about orientation.

RESULTS
Analysis revealed no statistical significance between the 2 groups. However, the task-layered clinical orientation group completed orientation earlier than the traditional patient-layered group.

CONCLUSIONS
The task-layered approach to clinical orientation provided as good of outcomes as traditional orientation strategy and may result in cost savings due to decrease in total clinical orientation days.
Exploring the Roles, Functions, and Work Experiences of Nurse Scientists in the Veterans Health Administration
Authors: Mu Qiyan , Guzman-Clark Jenice , Etchin Anna G. , Sullivan Sheila Cox , Battaglia Catherine 
Published: May 2024

OBJECTIVE
The aim of this project was to describe nurse scientists' roles, functions, and work experiences in the Veterans Health Administration (VHA).

BACKGROUND
Nurse scientists play a critical role in shaping the culture of clinical inquiry and closing the gap between knowledge and practice.

METHODS
A cross-sectional survey was used to collect information on sociodemographics, workload, research, clinical practice, education, and time/effort. Data were examined using descriptive statistics and χ2 analyses.

RESULTS
One hundred forty-four nurse scientists completed the survey. These nurse scientists serve dynamic and critical roles in conducting research, implementing evidence-based practice, and reforming policy. Research effort was limited due to workload and infrastructure constraints. Better research infrastructure was associated with higher research productivity and funding.

CONCLUSIONS
This survey highlights the needs and challenges nurse scientists experience in conducting research and advancing VHA's mission. Given the national shortage of PhD-prepared nurses, long-term strategies are needed to attract, hire, and retain nurse scientists in healthcare systems.
Examining Sex Differences in Relationships Between Subjective and Objective Measures of Upper Extremity Motor Impairment in a Sample of Stroke Survivors
Authors: Dahlby Julia , Larssen Beverley C. , Boyd Lara A. 
Published: May 2024

Background and Purpose:Rehabilitation professionals use subjective and objective outcome measures to assess stroke-related impact and impairment. Understanding if subjective and objective findings correlate among stroke survivors, especially if these associations differ between females and males, can inform care decisions.Methods:A retrospective cross-sectional design was used, with data selected from subacute to chronic stroke survivors on age, time since stroke, the hand domain from the Stroke Impact Scale version 3.0 (SIS-H), and the Fugl-Meyer Upper Extremity (FMUE) Assessment. Group differences were assessed for all outcomes based on sex and time poststroke. Separate correlations for females and males were performed between the subjective (SIS-H) and objective measures (FMUE) of upper limb function and impairment.Results:Data from 148 participants (44 females) were included in this study. SIS-H was significantly correlated with FMUE in both females and males (Ps ≤ 0.001). No significant differences were found between the groups’ mean SIS-H or FMUE scores based on sex or time poststroke.Discussion and Conclusions:Subjective and objective measures of physical functioning were correlated in both females and males. Although we found no sex differences in our primary outcomes, the sample size of females was disproportionately lower than the males. This is consistent with an ongoing problem in the stroke recovery research field, where females are often underrepresented and understudied, and where females who experience higher levels of impairment are less likely to participate in research.
Safety and Efficacy of Intensive Blood Pressure–Lowering After Successful Endovascular Therapy in AIS
Authors: Liao Zhouzan , Tian Li , Wen Ming , Wang Bing , Ding Kai , Song Qionglin 
Published: May 2024

Objectives:
Higher blood pressure has been proven to be associated with poorer functional outcomes after successful reperfusion by EVT. However, the effect of intensive blood pressure–lowering regimens in these patients remains controversial and ambiguous in clinical practice. We propose further analysis aimed at determining the effect of an intensive blood pressure–lowering regimen after EVT in AIS.

Methods:
The protocol registered in PROSPERO CRD42023360989. We performed a systematic search that was comprehensively executed in online databases for studies published up to June 2022. Eligibility criteria were established based on the PICOS model. The Cochrane risk of bias algorithm was used to evaluate the risk of bias. The effect models were applied to calculate the pooled ORs and CIs via Review Manager 5.4 software.

Results:
A total of 1582 citations were identified, 3 randomized clinical trials and 2 retrospective cohort studies were included. Data from 3211 patients were analyzed. We revealed that intensive blood pressure–lowering interventions could significantly reduce symptomatic intraparenchymal hemorrhage compared with standard blood pressure lowering. Nevertheless, favorable functional outcome, poor outcome, all-cause mortality within 3 months and intraparenchymal hemorrhage in 24 hours showed no significant differences. Subgroup analysis revealed the variability of systolic blood pressure within 24 hours after EVT was not associated with odds of poor outcome and intraparenchymal hemorrhage.

Conclusions:
Based on the current evidence, intensive blood pressure–lowering regimen was superior to standard blood pressure–lowering regimen for a reduced risk of symptomatic intraparenchymal hemorrhage in AIS patients treated with EVT, but there was no statistically significant difference found between the 2 regimens for the other outcomes.
PanIN or IPMN? Redefining Lesion Size in 3 Dimensions
Authors: Kiemen Ashley L. , Dequiedt Lucie , Shen Yu , Zhu Yutong , Matos-Romero Valentina , Forjaz André , Campbell Kurtis , Dhana Will , Cornish Toby , Braxton Alicia M. , Wu Pei-Hsun , Fishman Elliot K. , Wood Laura D. , Wirtz Denis , Hruban Ralph H. 
Published: May 2024

Pancreatic ductal adenocarcinoma (PDAC) develops from 2 known precursor lesions: a majority (∼85%) develops from pancreatic intraepithelial neoplasia (PanIN), and a minority develops from intraductal papillary mucinous neoplasms (IPMNs). Clinical classification of PanIN and IPMN relies on a combination of low-resolution, 3-dimensional (D) imaging (computed tomography, CT), and high-resolution, 2D imaging (histology). The definitions of PanIN and IPMN currently rely heavily on size. IPMNs are defined as macroscopic: generally >1.0 cm and visible in CT, and PanINs are defined as microscopic: generally <0.5 cm and not identifiable in CT. As 2D evaluation fails to take into account 3D structures, we hypothesized that this classification would fail in evaluation of high-resolution, 3D images. To characterize the size and prevalence of PanINs in 3D, 47 thick slabs of pancreas were harvested from grossly normal areas of pancreatic resections, excluding samples from individuals with a diagnosis of an IPMN. All patients but one underwent preoperative CT scans. Through construction of cellular resolution 3D maps, we identified >1400 ductal precursor lesions that met the 2D histologic size criteria of PanINs. We show that, when 3D space is considered, 25 of these lesions can be digitally sectioned to meet the 2D histologic size criterion of IPMN. Re-evaluation of the preoperative CT images of individuals found to possess these large precursor lesions showed that nearly half are visible on imaging. These findings demonstrate that the clinical classification of PanIN and IPMN fails in evaluation of high-resolution, 3D images, emphasizing the need for re-evaluation of classification guidelines that place significant weight on 2D assessment of 3D structures.
Bridging dolutegravir clinical viral response across doses and formulations using model-based exposure–response analysis in pediatrics
Authors: Chandasana Hardik , Hayes Siobhán , Buchanan Ann M. , Brothers Cynthia , Wiznia Andrew , Bartlett Mattie , Popson Stephanie , Townley Ellen , George Kathy , Vavro Cindy , Ruel Theodore , Acosta Edward P. , Singh Rajendra 
Published: May 2024

Objective:
Dolutegravir (DTG) is a once-daily HIV-1 integrase inhibitor approved for the treatment of HIV-1 infection in adults and children from 4 weeks of age. The posology of DTG in children has been driven by exposure-matching relative to the adult dose for efficacy and safety. However, higher variability in pediatric exposures raises concern that efficacy may not be reliably extrapolated from adult trials. Therefore, we evaluated the relationship between DTG exposure and virologic response in children.

Design/methods:
A population exposure–response analysis using logistic regression for virologic response was undertaken based on DTG exposure and covariate data from 146 pediatric participants with HIV-1 from age at least 4 weeks to less than 18 years treated for up to 48 weeks with DTG in IMPAACT P1093 study.

Results:
None of the DTG exposure metrics were predictive of virologic response over the range of exposures in this analysis. Of the covariates tested, viral load at least 100 000 copies/ml at enrolment was a significant predictor of virologic response showing a lower probability of achieving a virologic response of HIV-1 RNA less than 50 copies/ml compared with participants with viral load less than 100 000 copies/ml at enrolment. Baseline viral load was also a significant predictor at week 48 whereby the probability of achieving a virologic response at week 48 decreased with increasing baseline viral load.

Conclusion:
This exposure–response analysis suggests that DTG exposures in children are all above the plateau of the exposure–response relationship. These results suggest that matching pediatric pharmacokinetic exposure parameters to those in adults is a reasonable approach for dose determination of DTG-containing formulations in pediatrics.
Potential Efficacy of 68Ga-Trivehexin PET/CT and Immunohistochemical Validation of αvβ6 Integrin Expression in Patients With Head and Neck Squamous Cell Carcinoma and Pancreatic Ductal Adenocarcinoma
Authors: Das Subha Shankar , Ahlawat Sunita , Thakral Parul , Malik Dharmender , Simecek Jakub , CB Virupakshappa , Koley Mrinalini , Gupta Jatin , Sen Ishita 
Published: May 2024

Purpose
αvβ6 integrin is exclusively expressed in epithelial cells and is upregulated in many carcinomas, such as pancreatic ductal adenocarcinomas (PDACs) and head and neck squamous cell carcinomas (H&NSCCs). Trivehexin is a recently synthesized trimerized αvβ6 integrin selective nonapeptide, which can be labeled with a positron emitter like 68Ga. This is a pilot study to assess the potential role of 68Ga-Trivehexin PET/CT in patients with H&NSCC and PDAC and their correlation with αvβ6 integrin expression by the tumor tissue on immunohistochemistry (IHC).

Patients and Methods
Thirty-two patients with suspected H&NSCC (n = 20) or PDAC (n = 12) underwent whole-body 68Ga-Trivehexin PET/CT and 18F-FDG PET/CT scans on 2 separate days. All 32 patients underwent biopsy from the tumor site for histopathological diagnosis and IHC for αvβ6 integrin expression. The degree of αvβ6 integrin expression on IHC was scored using the immunoreactive score and modified 4-point immunoreactive score classification.

Results
The 68Ga-Trivehexin PET images demonstrated increased tracer uptake (mean SUVmax 5.9 ± 3.3) in the primary and metastatic lesions with good lesion delineation in 8 out of the 9 cases of PDACs. However, FDG PET showed increased tracer uptake in 7 cases (6.2 ± 2.6). Among various cases of H&NSCC, increased uptakes of 68Ga-Trivehexin (6.6 ± 4.5) and 18F-FDG (12.7 ± 6.7) were seen in 17 out of the 18 patients. The 2 cases of inflammatory changes with suspected disease recurrence showed increased tracer uptake in 18F-FDG PET (7.98 ± 3.1) and no significant uptake in 68Ga-Trivehexin PET (2.2 ± 0.34).
IHC showed higher expression of αvβ6 integrins in lesions with higher uptake of 68Ga-Trivehexin. A higher sensitivity, specificity, and accuracy of 68Ga-Trivehexin PET over 18F-FDG PET was seen for detection of primary and metastatic lesions.

Conclusions

68Ga-Trivehexin is a promising noninvasive molecular imaging agent for tumors expressing αvβ6 integrin, especially in cases where 18F-FDG PET/CT scan may be suboptimal due to its low uptake, or due to its nonspecific uptake around tumor sites.
111In-Pentetreotide–Guided Radiosurgery for Intraoperative Localization of Retroperitoneal Nodal Metastasis in a Patient With Ileal Neuroendocrine Tumor
Authors: Demeure Michael J. , Giuliano Peter , Forester Jared , Zakry Nazila , Ulaner Gary A. 
Published: May 2024

Abstract

64Cu-DOTATATE PET/CT of a 44-year-old man with an ileal neuroendocrine tumor demonstrated the primary tumor, local nodal metastases, and a pericaval nodal metastasis. Localization of the pericaval node during surgery may be difficult, thus 4.4 mCi of 111In-pentetreotide was administered before surgery to assist with localization and resection. At surgery, the pericaval nodal metastasis was readily detected by gamma probe, which could then be resected and pathologically proven to be a metastasis. This demonstrates the use of somatostatin receptor–targeted imaging for intraoperative localization of an otherwise difficult to surgically localize metastasis. Without intraoperative somatostatin receptor–targeted radiosurgery, disease may have been incompletely resected.
Development of a contrast-enhanced ultrasound guided high intensity focused ultrasound system for coagulation of liver parenchyma
Authors: Tam Alexander , Contreras Kaizer , Fall Fari , Maxwell Adam , Liu Ji-Bin , Forsberg Flemming , Vlaisavljevich Eli , Goldberg Allison , Xiao Tania Siu , Kuon Yeng E. Cristina , Eisenbrey John R. , Koenig George 
Published: May 2024

ABSTRACT

BACKGROUND
The liver is the most common organ injured in blunt abdominal trauma and makes up roughly 5% of all trauma admissions. Current treatments are invasive and resource-intensive, which may delay care. We aim to develop and validate a contrast-enhanced ultrasound (CEUS)guided noninvasive tool to treat liver lacerations at the bedside.

METHODS
Two 1.8 MHz high-intensity focused ultrasound (HIFU) elements were coupled to a C1-6 diagnostic ultrasound probe and a Logiq E10 scanner (GE HealthCare) utilizing a custom enclosure for co-registered imaging and ablation. A phantom was created from polyacrylamide gel combined with thermochromic ink whose color changes above biological ablative temperatures (60 °C). The HIFU wave was focused approximately 0.5 cm below the surface utilizing a 50% duty cycle generating 11.9 MPa for 20, 30, 40, 50, and 60s. Experiments were repeated on ex vivo chicken livers in a water bath. Finally, the livers of 4 live swine underwent up to 6 CEUS-guided treatments using parameters optimized from in vitro work.

RESULTS
Treatment of the phantom between 20-60s, produced ablation sizes from 0.016 to 0.4 cm3. The relationship between time and size was exponential (R2 = 0.992). Ablation areas were also well visualized on with ultrasound imaging. The ex vivo liver ablation size at 20s was 0.37 cm3, at 30s was 0.66 cm3, and at 100 s was 5.0 cm3. For the in-vivo swine experiments, the average ablation area measured 2.0x0.75 cm with a maximum of 3.5x1.5 cm. CEUS was utilized with the contrast agent Definity (Lantheus) for identification of lacerations as well as immediate post operative evaluation of therapy.

CONCLUSION
These experiments demonstrate the feasibility of CEUS guided transdermal HIFU ablation and the time-dependent size of ablation. This work warrants future investigations into using ultrasound to detect active bleeding and HIFU to coagulate grade III and IV liver laceration.

STUDY TYPE
Therapeutic/care management
Individual and ecological heterogeneity promote complex communication in social vertebrate group decisions
Authors: Bousquet Christophe A. H. , Sueur Cédric , King Andrew J. , O'Bryan Lisa R. 
Published: May 2024

To receive the benefits of social living, individuals must make effective group decisions that enable them to achieve behavioural coordination and maintain cohesion. However, heterogeneity in the physical and social environments surrounding group decision-making contexts can increase the level of difficulty social organisms face in making decisions. Groups that live in variable physical environments (high ecological heterogeneity) can experience barriers to information transfer and increased levels of ecological uncertainty. In addition, in groups with large phenotypic variation (high individual heterogeneity), individuals can have substantial conflicts of interest regarding the timing and nature of activities, making it difficult for them to coordinate their behaviours or reach a consensus. In such cases, active communication can increase individuals’ abilities to achieve coordination, such as by facilitating the transfer and aggregation of information about the environment or individual behavioural preferences. Here, we review the role of communication in vertebrate group decision-making and its relationship to heterogeneity in the ecological and social environment surrounding group decision-making contexts. We propose that complex communication has evolved to facilitate decision-making in specific socio-ecological contexts, and we provide a framework for studying this topic and testing related hypotheses as part of future research in this area.
This article is part of the theme issue ‘The power of sound: unravelling how acoustic communication shapes group dynamics’.
Genomic Signatures of Microgeographic Adaptation inAnopheles coluzziiAlong an Anthropogenic Gradient in Gabon
Authors: Daron Josquin , Bouafou Lemonde , Tennessen Jacob A. , Rahola Nil , Makanga Boris , Akone-Ella Ousman , Ngangue Marc F , Longo Pendy Neil M. , Paupy Christophe , Neafsey Daniel E. , Fontaine Michael C. , Ayala Diego 
Published: May 2024

AbstractSpecies distributed across heterogeneous environments often evolve locally adapted populations, but understanding how these persist in the presence of homogenizing gene flow remains puzzling. In Gabon,Anopheles coluzzii,a major African malaria mosquito is found along an ecological gradient, including a sylvatic population, away of any human presence. This study identifies into the genomic signatures of local adaptation in populations from distinct environments including the urban area of Libreville, and two proximate sites 10km apart in the La Lopé National Park (LLP), a village and its sylvatic neighborhood. Whole genome re-sequencing of 96 mosquitoes unveiled∼5.7millions high-quality single nucleotide polymorphisms. Coalescent-based demographic analyses suggest an∼8,000-year-old divergence between Libreville and La Lopé populations, followed by a secondary contact (∼4,000 ybp) resulting in asymmetric effective gene flow. The urban population displayed reduced effective size, evidence of inbreeding, and strong selection pressures for adaptation to urban settings, as suggested by the hard selective sweeps associated with genes involved in detoxification and insecticide resistance. In contrast, the two geographically proximate LLP populations showed larger effective sizes, and distinctive genomic differences in selective signals, notably soft-selective sweeps on the standing genetic variation. Although neutral loci and chromosomal inversions failed to discriminate between LLP populations, our findings support that microgeographic adaptation can swiftly emerge through selection on standing genetic variation despite high gene flow. This study contributes to the growing understanding of evolution of populations in heterogeneous environments amid ongoing gene flow and how major malaria mosquitoes adapt to human.SignificanceAnopheles coluzzii, a major African malaria vector, thrives from humid rainforests to dry savannahs and coastal areas. This ecological success is linked to its close association with domestic settings, with human playing significant roles in driving the recent urban evolution of this mosquito. Our research explores the assumption that these mosquitoes are strictly dependent on human habitats, by conducting whole-genome sequencing onAn. coluzziispecimens from urban, rural, and sylvatic sites in Gabon. We found that urban mosquitoes showde novogenetic signatures of human-driven vector control, while rural and sylvatic mosquitoes exhibit distinctive genetic evidence of local adaptations derived from standing genetic variation. Understanding adaptation mechanisms of this mosquito is therefore crucial to predict evolution of vector control strategies.