bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of nivolumab in comparison to chemotherapy and gefitinib for advanced NSCLC
Authors: Esha Ahmad 
Published: April 2024

Background: Lung cancer is one of the major causes of cancer related death worldwide, while non-small cell lung cancer (NSCLC) consists of 85% of all lung cancer cases. Despite adequate treatment, most of the NSCLC patients progress to advance stages. Single or doublet-chemotherapy are considered as standard care for advance NSCLC patients. Gefitinib is considered as standard therapy for EGFR mutant advanced NSCLC. Recently, a human monoclonal antibody called Nivolumab has shown encouraging efficacy for advanced NSCLC patients. The aim of this systematic review is to show the efficacy of nivolumab in comparison to single or doublet chemotherapy and gefitinib.
Method: A systematic search was performed in PubMed, Google Scholar and Cochrane Library to identify primary research, published in English language between 2000 and 2018, involving Nivolumab, chemotherapy and gefitinib for advanced NSCLC patients. The primary outcome of interest was median overall survival (mOS). The secondary outcome of interest were progression free survival, objective response rate and grade-3 and treatment related adverse effects.
Results: After screening 600 full-text articles, 17 clinical studies involving 9284 patients of advanced NSCLC were included. All treatment regimen seemed to be feasible. The mOS for nivolumab was ranging between 9.2 months and 16.2 months; for chemotherapy between 6 months and 18.8 months; and for gefitinib between 7.6 months and 30.5 months.
Conclusion: Nivolumab is more effective and safe for EGFR non-mutant advanced NSCLC patients than either chemotherapy or gefitinib. However, gefitinib is more effective than nivolumab for EGFR-mutant NSCLC patients.
J Bangladesh Coll Phys Surg 2024; 42: 176-188
GENDER AND SEXUALITY AS MODI OF LONELINESS IN CHRISTOPHER ISHERWOOD’S “THE WORLD IN THE EVENING”
Authors: Drannikov Anton 
Published: April 2024

The paper offers an insight into the functioning of the phenomenon of loneliness in Christopher Isherwood’s “The World in the Evening”. Despite the text being dismissed as a failure by the writer himself, some scholars note its innovative treatment of gender and sexuality. The fact that psychological and sociological research often lists sex, gender, and sexual orientation as most frequent causes for loneliness, as well as the author’s peculiar interest in the depiction of the marginalised and alienated allow for a reading of the novel through the lens of identity studies.
The paper’s focus is on understanding of gender as a social construct and a performative category. The protagonist’s self is developed, transformed, and readjusted under the influence of female characters, and this situation contrasts with the androcentric homodiegetic narration. With his very masculinity questioned, under the pressure of societal expectations to perform a certain gendered role, the protagonist experiences an identity crisis and feels lonely in all of his relationships. He avoids taking responsibility for his own life, constantly seeking some sort of validation or guidance from the women around him and becoming childish and deliberately cruel towards others when he gets none.
The sexual aspect of identity is analysed within the framework of queer theory. The protagonist’s bisexuality is treated by Isherwood as a somewhat neurotic condition arising from the clash between heteronormativity and ‘perverse’ homosexual desire. It is opposed to another part of the queer sexuality spectrum represented by two gay male characters successfully building a harmonious relationship. This image of the homosexual not as a deviation but rather an integral part of society is further reinforced by the alternative models of masculinity, those of gay men not only accepting their sexuality but willing to fight both for their country in the Second World War and their right to existence in the heteronormative world.
Oxidative balance score: a potential tool for reducing the risk of colorectal cancer and its subsites incidences
Authors: Chang Yu , Li Fan , Wang Zhi , Zhao Qi , Wang Zhaodi , Han Xiaoping , Xu Zifeng , Yu Chanjiao , Liu Yue , Chang Shiyu , Li Hongyan , Hu Sileng , Li Yuqin , Tang Tongyu 
Published: April 2024

BackgroundThe Oxidative Balance Score (OBS) is commonly used to assess oxidative stress and provides a comprehensive evaluation of dietary and lifestyle-related exposures. However, there is limited research on the association between OBS and colorectal cancer (CRC), its subsites, and complications. The objective of this study was to assess the relationship between OBS and the risk of CRC, its subsites, and common complications in a large prospective cohort study.MethodsWe included data from 175,808 participants in the UK Biobank data sample repository from 2006 to 2010. We evaluated OBS using a scoring system based on 22 dietary and lifestyle factors. Multiple adjustments, including multivariate Cox proportional hazard regression, gender stratification, subgroup analysis, and sensitivity analysis, were performed to fully explore the relationship between OBS and CRC, its subsites, and complications. The mediation analysis was conducted to investigate whether serum albumin, uric acid, and neutrophil levels mediate the relationship between OBS and CRC.ResultsAfter adjusting for potential confounding factors, a significant negative correlation was found between OBS and the risk of CRC and its subsites (proximal colon cancer, distal colon cancer, and rectal cancer). This correlation was particularly pronounced in male CRC patients. Serum albumin, uric acid, and neutrophil count, which are biomarkers, were found to have a significant mediating effect between OBS and CRC.ConclusionOur study suggests that higher exposure to antioxidants assessed through OBS (diet and lifestyle rich in antioxidants) may decrease the occurrence of CRC and its subsites.
Gas6/TAM system as potential biomarker for multiple sclerosis prognosis
Authors: D’Onghia Davide , Colangelo Donato , Bellan Mattia , Tonello Stelvio , Puricelli Chiara , Virgilio Eleonora , Apostolo Daria , Minisini Rosalba , Ferreira Luciana L. , Sozzi Leonardo , Vincenzi Federica , Cantello Roberto , Comi Cristoforo , Pirisi Mario , Vecchio Domizia , Sainaghi Pier Paolo 
Published: April 2024

IntroductionThe protein growth arrest-specific 6 (Gas6) and its tyrosine kinase receptors Tyro-3, Axl, and Mer (TAM) are ubiquitous proteins involved in regulating inflammation and apoptotic body clearance. Multiple sclerosis (MS) is the most common inflammatory demyelinating disease of the central nervous system leading to progressive and irreversible disability if not diagnosed and treated promptly. Gas6 and TAM receptors have been associated with neuronal remyelination and stimulation of oligodendrocyte survival. However, few data are available regarding clinical correlation in MS patients. We aimed to evaluate soluble levels of these molecules in the cerebrospinal fluid (CSF) and serum at MS diagnosis and correlate them with short-term disease severity.MethodsIn a prospective cohort study, we enrolled 64 patients with a diagnosis of clinical isolated syndrome (CIS), radiological isolated syndrome (RIS) and relapsing–remitting (RR) MS according to the McDonald 2017 Criteria. Before any treatment initiation, we sampled the serum and CSF, and collected clinical data: disease course, presence of gadolinium-enhancing lesions, and expanded disability status score (EDSS). At the last clinical follow-up, we assessed EDSS and calculated MS severity score (MSSS) and age-related MS severity (ARMSS). Gas6 and TAM receptors were determined using an ELISA kit (R&amp;D Systems) and compared to neurofilament (NFLs) levels evaluated with SimplePlex™ fluorescence-based immunoassay.ResultsAt diagnosis, serum sAxl was higher in patients receiving none or low-efficacy disease-modifying treatments (DMTs) versus patients with high-efficacy DMTs (p = 0.04). Higher CSF Gas6 and serum sAXL were associated with an EDSS &lt;3 at diagnosis (p = 0.04; p = 0.037). Serum Gas6 correlates to a lower MSSS (r2 = −0.32, p = 0.01). Serum and CSF NFLs were confirmed as disability biomarkers in our cohort according to EDSS (p = 0.005; p = 0.002) and MSSS (r2 = 0.27, p = 0.03; r2 = 0.39, p = 0.001). Results were corroborated using multivariate analysis.ConclusionsOur data suggest a protective role of Gas6 and its receptors in patients with MS and suitable severity disease biomarkers.
The prevalence and characteristics of frailty in cirrhosis patients: a meta-analysis and systematic review
Authors: Xie Ruiyu , Jing Xiaotong , Yang Chuanjie 
Published: April 2024

ObjectivesThis study aimed to assess the prevalence of frailty in cirrhosis patients and the distribution of age, sex, and body mass index (BMI) in cirrhotic patients with frailty.MethodsWe performed a thorough literature search using PubMed, Embase, Web of Science, and the Cochrane Library from inception to 29 February 2024. The estimated prevalence with a 95% confidence interval (CI) was calculated with a random effect model. Subgroup analysis and sensitivity analysis were performed to assess the heterogeneity and characterize the distribution of age, sex, and body mass index (BMI) in cirrhotic patients. Publication bias was assessed by the funnel plot, Begg's test, and Egger's test.ResultsThe 16 included studies, which were all observational, reported a prevalence of frailty in 8,406 cirrhosis patients ranging from 9 to 65%, and the overall estimated prevalence was 27% (95% CI: 21–33%; I2 = 97.7%, P &lt; 0.001). This meta-analysis indicated that the estimated prevalence of frailty in cirrhosis patients was high, and compared to the non-frail cohort, the frail cohort tended to have a higher mean age, with a mean age of 63.3 (95% CI: 59.9, 66.7; Z = 36.48; P &lt; 0.001), and a larger proportion of male patients with worse liver function, with a mean of 73.5% (95% CI: 71.4, 75.5%; Z = 7.65; P &lt; 0.001), ND in the frail cohort, 54.8% (95% CI: 43.1, 66.5%; P &lt; 0.001) and 23.4% (95% CI: 13.2, 33.7%; P &lt; 0.001) were classified into Child-Pugh B and C, respectively. Meanwhile, the patients in the non-frail cohort are more likely to have a higher BMI, with a mean of 28.4 (95% CI: 24.1, 32.7; Z = 13.07; P &lt; 0.001).ConclusionThe current study suggests that cirrhosis patients have a high prevalence of frailty. Compared with the non-frail cohort, the frail patients tend to be male, older, and have a lower BMI with worse liver function.
Hypo-connectivity of the primary somatosensory cortex in Parkinson’s disease: a resting-state functional MRI study
Authors: Wang Yinghua , Gong Tao , Tao Na , Zeng Ying , Ma Haotian , Yuan Wu , Luo Wenmin , Zhou Fuqing 
Published: April 2024

BackgroundParkinson’s disease (PD) is characterized by a range of motor symptoms as well as documented sensory dysfunction. This sensory dysfunction can present itself either as a “pure” sensory disturbance or as a consequence of sensory-motor integration within the central nervous system. This study aims to investigate changes in the functional connectivity of the primary somatosensory cortex (S1) and its clinical significance in Parkinson’s disease (PD), an area that has received limited attention in previous neuroimaging studies.MethodsThis study included thirty-three patients with PD and thirty-four healthy controls (HCs). Clinical evaluations were conducted to assess the clinical manifestations, severity, and functional capacity of all the patients. Resting-state functional MRI (fMRI) was employed to evaluate the functional connectivity of six paired S1 subregions in the participants. Seed-based correlation (SBC) analysis was utilized to construct the correlation matrix among the subregions and to generate connectivity maps between the subregions and the remaining brain voxels. Finally, the study employed partial least-squares (PLS) correlation analysis to investigate the association between modified functional connectivity and clinical characteristics in PD patients.ResultsIn the correlation matrix, patients with PD demonstrated a notable decrease in functional connectivity across various S1 subregions in comparison to HCs (p &lt; 0.001, corrected using network-based methods). In connectivity maps, hypo-connectivity was primarily observed in the sensorimotor network as common patterns (p &lt; 0.001, corrected for false discovery rate) and in the default mode network (DMN) as distinct patterns. Moreover, this study identified a negative association between the correlation matrix within S1 subregions and the scores for axial symptoms and postural instability/gait difficulty (PIGD) in PD patients. Nevertheless, a direct relationship between the connectivity maps of S1 subregions and clinical assessment scales was not established.ConclusionThis study offers novel insights into the neurobiological mechanisms that contribute to S1 dysfunction in PD, highlighting the significant involvement of S1 hypo-connectivity in the motor disturbances observed in PD patients.
Altered asymmetry of functional connectome gradients in major depressive disorder
Authors: Yang Yaqian , Zhen Yi , Wang Xin , Liu Longzhao , Zheng Yi , Zheng Zhiming , Zheng Hongwei , Tang Shaoting 
Published: April 2024

IntroductionMajor depressive disorder (MDD) is a debilitating disease involving sensory and higher-order cognitive dysfunction. Previous work has shown altered asymmetry in MDD, including abnormal lateralized activation and disrupted hemispheric connectivity. However, it remains unclear whether and how MDD affects functional asymmetries in the context of intrinsic hierarchical organization.MethodsHere, we evaluate intra- and inter-hemispheric asymmetries of the first three functional gradients, characterizing unimodal-transmodal, visual-somatosensory, and somatomotor/default mode-multiple demand hierarchies, to study MDD-related alterations in overarching system-level architecture.ResultsWe find that, relative to the healthy controls, MDD patients exhibit alterations in both primary sensory regions (e.g., visual areas) and transmodal association regions (e.g., default mode areas). We further find these abnormalities are woven in heterogeneous alterations along multiple functional gradients, associated with cognitive terms involving mind, memory, and visual processing. Moreover, through an elastic net model, we observe that both intra- and inter-asymmetric features are predictive of depressive traits measured by BDI-II scores.DiscussionAltogether, these findings highlight a broad and mixed effect of MDD on functional gradient asymmetry, contributing to a richer understanding of the neurobiological underpinnings in MDD.
The introduction of virtual reality in forensic mental healthcare – an interview study on the first impressions of patients and healthcare providers regarding VR in treatment
Authors: Kouijzer M. T. E. , Kip H. , Kelders S. M. , Bouman Y. H. A. 
Published: April 2024

BackgroundRecognizing the potential of Virtual Reality (VR) as a powerful technology to support behavior change, the careful introduction of this technology into treatment settings is essential. This is especially important in vulnerable populations like forensic psychiatric patients. This study aims to gain insight from the impressions of both patients and healthcare providers concerning the integration of VR in practice. The study aims to contribute valuable information that guides the introduction of VR technology, ensuring its optimal use in the complex context of forensic mental healthcare.MethodsSemi-structured interviews were conducted with healthcare providers (n = 10) working at forensic outpatient clinics and forensic psychiatric patients (n = 8). All participants experienced VR before the interview. Inductive thematic analysis was employed for analyzing the interview data.ResultsPatients valued the unique opportunity to simulate personal experiences in VR scenarios and reflect on them with healthcare providers. In addition to positive first impressions, areas for improvement were identified, including the wish for enhanced realism and reduced physical discomfort while immersed in VR. Finally, important factors contributing to the successful introduction of VR were identified. For example, taking into account psychological distress experienced by patients or supporting healthcare providers with implementation resources.ConclusionThe integration of VR into forensic mental healthcare holds great potential for behavior change. However, its immersive characteristics also increase the chance of amplifying psychological distress. This emphasizes the need for caution when using VR– especially when a vulnerable patient group is subjected to triggering scenarios. This study advocates for a gradual introduction of the technology and provides valuable insights into essential elements for this introduction in clinical practice. It highlights that even the initial step of integrating VR into practice – the introduction phase – demands careful planning and a personalized approach. This underscores the need for ongoing refinement and a systematic approach to the overall implementation of VR. These efforts are crucial to fully realize its potential in clinical practice.
Progressive muscle relaxation alleviates anxiety and improves sleep quality among healthcare practitioners in a mobile cabin hospital: a pre-post comparative study in China
Authors: Luo Yuding , Du Juan , Wang Junqiu , Liu Pingchuan , Shi Zhongli , He Yu , Che Guangyao , Huang Ke , Wang Jian 
Published: April 2024

ObjectiveTo investigate the anxiety levels, sleep quality and potential risk factors of healthcare practitioners involved in the management of COVID-19 patients in a mobile cabin hospital, and further to assess the impact of progressive muscle relaxation (PMR) on their anxiety levels and sleep quality.MethodsWe conducted a pre-post self-controlled trial. Healthcare practitioners meeting the inclusion criteria underwent daily 30-min PMR sessions for seven consecutive days. The Pittsburgh Sleep Quality Index (PSQI) and Hamilton Anxiety Scale (HAMA) were used to assess the anxiety and sleep quality of subjects pre- and post-intervention. Statistical analysis was performed using the Wilcoxon test, Mann–Whitney U test, Kruskal-Wallis H test, and Spearman rank correlation.ResultsA total of 94 participants completed the study. No statistically significant differences in HAMA or PSQI total scores were observed between groups categorized based on demographic variables such as age, sex, and years of education (p &gt; 0.05). The PSQI total score and its components (excluding sleep medication usage) exhibited a positive correlation with the HAMA total score and its psychological anxiety component (p &lt; 0.05), and a correlation was observed between somatic anxiety manifestations and several components of the PSQI. The PSQI total scores before and after intervention were 10.0 (8.0, 13.0) and 8.0 (6.0, 9.0) respectively (p &lt; 0.001); the HAMA total scores were 8.0 (5.0, 13.0) and 6.0 (4.0, 9.5) respectively (p &lt; 0.001). The detection rates of poor sleep and anxiety states, along with their severity, significantly decreased post-intervention (p &lt; 0.001).ConclusionHealthcare practitioners experience prominent anxiety and sleep issues in the mobile cabin hospital. PMR can be an effective intervention for improving the anxiety and sleep quality of healthcare professionals during support periods in the mobile cabin hospital. However, trials with larger samples are necessitated to further affirm these preliminary findings.
Validation of the Barthel Index in Chinese nursing home residents: an item response theory analysis
Authors: Liang Minyu , Yin Mei , Guo Bing , Pan Yichao , Zhong Tong , Wu Jieyi , Ye Zengjie 
Published: April 2024

BackgroundThe Barthel Index (BI) is used to standardize the grading of assessments for clinical needs, insurance support, and long-term care resource allocation in China. However, its psychometric properties among nursing home residents remain unclear. Therefore, this study aims to assess and modify the psychometric properties of BI in nursing home residents.MethodsA total of 1,402 individuals undergoing evaluation in a nursing home facility in China were included in this study from November 2021 to November 2022. Correlations between items were examined to identify the potential multicollinearity concerns. The unidimensional item response theory (IRT) was used to validate and modify the single structure of BI. Furthermore, the logistic regression/IRT hybrid DIF detection method was conducted to assess differential item functioning (DIF) between the dementia group and the normal group.ResultsThe pairing of items 5 (“bowl control”) and 6 (“bladder control”) revealed a local dependence issue, leading to their consolidation. Items 56 (bowel and bladder control) and 9 (mobility) both displayed poor fit indices and underwent category collapsing. Through the application of the generalized partial credit model, the adjusted scale displayed better fit indices, demonstrating a robust discriminative power (DC &gt;1.5) and orderly thresholds. Furthermore, non-uniform DIF was identified in item 2 (bathing) between the dementia group and the normal group.ConclusionThe modified BI demonstrated favorable psychometric properties and proved to be suitable for evaluating nursing home residents experiencing moderate functional impairment, which may provide a precise evaluation for long-term care resource allocation. Future studies could explore integrating supplementary measurements, such as objective indices, to assess a broader spectrum of functional statuses to potentially enhance the limited precision width observed in BI.