bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment-related adverse events of immune checkpoint inhibitors in clinical trials: a systematic review and meta-analysis
Authors: Shen Xin , Yang Jun , Qian Geng , Sheng Mingyu , Wang Yu , Li Guohui , Yan Jiaqing 
Published: May 2024

AimThis study comprehensively assesses the incidence and profiles of treatment-related adverse events (trAEs) of immune checkpoint inhibitor (ICI)-based therapies across cancer at various sites.MethodsWe systematically searched the PubMed, Embase, and Cochrane databases for trials investigating ICI-based therapies published between their inception and August 2023.ResultsIn total, 147 studies involving 45,855 patients met the inclusion criteria. Among them, patients treated with ICIs reported 39.8% and 14.9% of all-grade and grade ≥3 immune-related adverse events (irAEs), respectively. The most common all-grade irAEs were dermatological and gastrointestinal issues, diarrhea, and pruritus, whereas patients who received ICIs showed most common grade ≥3 irAEs, including gastrointestinal events, diarrhea, increased aspartate aminotransferase and alanine transaminase levels, and hepatic and dermatological events. The overall trAE incidence in patients treated with ICIs was 83.2% for all-grade trAEs and 38.2% for grade ≥3 trAEs. TrAE incidence was highest for patients treated with cytotoxic T lymphocyte antigen-4 inhibitors for all-grade and grade ≥3 trAEs, with incidences of 86.4% and 39.2%, respectively. ICIs combined with targeted therapy showed the highest all-grade and grade ≥3 trAEs, with incidences of 96.3% and 59.4%, respectively. The most common all-grade trAEs were anemia, decrease in white blood cell count, decrease in neutrophil count, nausea, fatigue, diarrhea, and alopecia; patients who received ICIs presented relatively high incidences of grade ≥3 trAEs.ConclusionThis study provided comprehensive data regarding irAEs and trAEs in patients receiving ICIs. These results should be applied in clinical practice to provide an essential reference for safety profiles of ICIs.Systematic review registrationINPLASY platform, identifier INPLASY202380119.
GDF-15 is a potential candidate biomarker for an elevated risk of cardiotoxicity in breast cancer patients receiving neoadjuvant dual anti-HER2 therapy
Authors: Tian Chunyu , Zhang Hongxu , Liu Jianping , Xu Mengze , Ma Lihui 
Published: May 2024

ObjectiveGrowth differentiation factor 15 (GDF-15) is a stress-responsive cytokine that regulates myocardial injury, cardiac overloading pressure, and inflammation and is related to the risk of cardiovascular diseases and events. The current study aimed to investigate the correlation of GDF-15 levels with clinical features, biochemical indices, and especially the risk of cardiotoxicity in breast cancer patients receiving neoadjuvant dual anti-HER2 therapy.MethodsA total of 103 HER2-positive breast cancer patients who underwent neoadjuvant dual anti-HER2 therapy (trastuzumab and pertuzumab plus chemotherapy) were included. Serum GDF-15 levels before neoadjuvant treatment were detected by enzyme-linked immunosorbent assay. Cardiotoxicity was evaluated during neoadjuvant therapy by referring to a decline of ≥10 percentage points in the left ventricular ejection fraction from baseline to an absolute level less than 50%.ResultsGDF-15 exhibited a skewed distribution, with a median level of 714 (range: 207–1805) pg/mL. GDF-15 was positively correlated with age (p = 0.037), diabetes (p = 0.036), and the N-terminal pro-brain natriuretic peptide level (p = 0.013) and positively correlated with the total cholesterol level (p = 0.086) and troponin T level (p = 0.082), but these correlations were not statistically significant. A total of 6.8% of patients experienced cardiotoxicity during neoadjuvant therapy. By comparison, the GDF-15 level was greater in patients who experienced cardiotoxicity than in those who did not (p = 0.008). A subsequent receiver operating characteristic curve revealed that GDF-15 predicted cardiotoxicity risk, with an area under the curve of 0.803 (95% CI: 0.664–0.939). After multivariate adjustment, GDF-15 independently predicted a greater risk of cardiotoxicity (p = 0.020).ConclusionGDF-15 is a candidate biomarker for increased risk of cardiotoxicity in breast cancer patients receiving neoadjuvant dual anti-HER2 therapy.
What information did the DSM-5 Cultural Formulation Interviews provide when used with Swedish-speaking patients in a psychiatric setting in Stockholm?
Authors: Wallin Malin Idar , DeMarinis Valerie , Nevonen Lauri , Bäärnhielm Sofie 
Published: May 2024

IntroductionCultural and contextual factors affect communication and how psychiatric symptoms are presented, therefore psychiatric assessments need to include awareness of the patients’ culture and context. The Cultural Formulation Interview (CFI) in DSM-5 is a person-centred tool developed to support the exploration of cultural and contextual factors in an individualized and non-stereotypic way.MethodsThe aim of this qualitative study was to find out what information the DSM-5 CFI revealed when used with native Swedish-speaking patients as part of routine clinical psychiatric assessment at an outpatient clinic. An additional aim was to enhance understanding of what kind of information the questions about background and identity yielded. The CFI was added to the psychiatric assessment of 62 native Swedish-speaking patients at an outpatient psychiatric clinic in Stockholm.ResultsFrom the thematic analysis of the documented CFI answers, six central themes were found; Descriptions of distress and dysfunction, Managing problems and distress, Current life conditions affecting the person, Perceived failure in meeting social expectations, Making sense of the problem, and Experiences of, and wishes for, help. The CFI questions about identity yielded much information, mainly related to social position and feelings of social failure.DiscussionFor further refinement of the CFI, we see a need for re-framing the questions about cultural identity and its impact on health so that they are better understood. This is needed for majority population patients as direct questions about culture may be difficult to understand when cultural norms are implicit and often unexamined. For clinical implications, our findings suggest that for cultural majority patients the DSM-5 CFI can be a useful person-centred tool for exploring cultural and, in particular, social factors and patients’ perception and understanding of distress.
Spatial distribution and geographical heterogeneity factors associated with households' enrollment level in community-based health insurance
Authors: Demsash Addisalem Workie 
Published: May 2024

BackgroundHealthcare service utilization is unequal among different subpopulations in low-income countries. For healthcare access and utilization of healthcare services with partial or full support, households are recommended to be enrolled in a community-based health insurance system (CBHIS). However, many households in low-income countries incur catastrophic health expenditure. This study aimed to assess the spatial distribution and factors associated with households' enrollment level in CBHIS in Ethiopia.MethodsA cross-sectional study design with two-stage sampling techniques was used. The 2019 Ethiopian Mini Demographic and Health Survey (EMDHS) data were used. STATA 15 software and Microsoft Office Excel were used for data management. ArcMap 10.7 and SaTScan 9.5 software were used for geographically weighted regression analysis and mapping the results. A multilevel fixed-effect regression was used to assess the association of variables. A variable with a p &lt; 0.05 was considered significant with a 95% confidence interval.ResultsNearly three out of 10 (28.6%) households were enrolled in a CBHIS. The spatial distribution of households' enrollment in the health insurance system was not random, and households in the Amhara and Tigray regions had good enrollment in community-based health insurance. A total of 126 significant clusters were detected, and households in the primary clusters were more likely to be enrolled in CBHIS. Primary education (AOR: 1.21, 95% CI: 1.05, 1.31), age of the head of the household &gt;35 years (AOR: 2.47, 95% CI: 2.04, 3.02), poor wealth status (AOR: 0.31, 95% CI: 0.21, 1.31), media exposure (AOR: 1.35, 95% CI: 1.02, 2.27), and residing in Afar (AOR: 0.01, 95% CI: 0.003, 0.03), Gambela (AOR: 0.03, 95% CI: 0.01, 0.08), Harari (AOR: 0.06, 95% CI: 0.02, 0.18), and Dire Dawa (AOR: 0.02, 95% CI: 0.01, 0.06) regions were significant factors for households' enrollment in CBHIS. The secondary education status of household heads, poor wealth status, and media exposure had stationary significant positive and negative effects on the enrollment of households in CBHIS across the geographical areas of the country.ConclusionThe majority of households did not enroll in the CBHIS. Effective CBHIS frameworks and packages are required to improve the households' enrollment level. Financial support and subsidizing the premiums are also critical to enhancing households' enrollment in CBHIS.
Depressive symptoms and associated factors among older patients with arthritis: evidence from a community-based study in eastern China
Authors: Wang Xinyi , Zhang Tao , Gu Xue , Xu Le , Li Fudong , Zhai Yujia , Wu Mengna , Lin Junfen 
Published: May 2024

IntroductionDepressive symptoms are often experienced by patients with arthritis and are correlated with poor health outcomes. However, the association between depressive symptoms and multidimensional factors (sociodemographic characteristics, health conditions, health behaviors, and social support) among older patients with arthritis in China remains poorly understood. This study aimed to explore the prevalence of depressive symptoms in older patients with arthritis in eastern China and identify the associated factors.MethodsWe analyzed data of 1,081 older patients with arthritis using secondary data from 2014 to 2020 from a community-based ongoing study initiated in 2014 in eastern China. The prevalence of depressive symptoms was calculated, and univariate and multilevel logistic regression analyses were used to identify the associated factors.ResultsThe mean age of older patients with arthritis was 69.16 ± 7.13 years; 42.92% were men and 57.08% were women. The prevalence of depressive symptoms in older patients with arthritis was 14.99% (95% confidence interval: 12.91–17.26%), about 1.8 times higher than that in older adults without arthritis (8.49%, p &lt; 0.001). Multilevel logistic regression identified perception of poor economic status (odds ratio [OR] = 5.52, p &lt; 0.001), multimorbidity (OR = 1.96, p = 0.001), limitations in activities of daily living (OR = 2.36, p = 0.004), and living alone (OR = 3.13, p = 0.026) as factors positively associated with depressive symptoms. Patients diagnosed with arthritis at an older age had lower odds of experiencing depressive symptoms (OR = 0.67, p = 0.046).ConclusionScreening for depressive symptoms is essential among older patients with arthritis, especially those who perceive themselves as having a poor economic status, are diagnosed at an earlier age, have multimorbidity, have limitations in activities of daily living, and live alone. The associations of age at arthritis diagnosis and dietary behaviors with depressive symptoms require further research.
Bayesian inference for the onset time and epidemiological characteristics of emerging infectious diseases
Authors: Shi Benyun , Yang Sanguo , Tan Qi , Zhou Lian , Liu Yang , Zhou Xiaohong , Liu Jiming 
Published: May 2024

BackgroundEmerging infectious diseases pose a significant threat to global public health. Timely detection and response are crucial in mitigating the spread of such epidemics. Inferring the onset time and epidemiological characteristics is vital for accelerating early interventions, but accurately predicting these parameters in the early stages remains challenging.MethodsWe introduce a Bayesian inference method to fit epidemic models to time series data based on state-space modeling, employing a stochastic Susceptible-Exposed-Infectious-Removed (SEIR) model for transmission dynamics analysis. Our approach uses the particle Markov chain Monte Carlo (PMCMC) method to estimate key epidemiological parameters, including the onset time, the transmission rate, and the recovery rate. The PMCMC algorithm integrates the advantageous aspects of both MCMC and particle filtering methodologies to yield a computationally feasible and effective means of approximating the likelihood function, especially when it is computationally intractable.ResultsTo validate the proposed method, we conduct case studies on COVID-19 outbreaks in Wuhan, Shanghai and Nanjing, China, respectively. Using early-stage case reports, the PMCMC algorithm accurately predicted the onset time, key epidemiological parameters, and the basic reproduction number. These findings are consistent with empirical studies and the literature.ConclusionThis study presents a robust Bayesian inference method for the timely investigation of emerging infectious diseases. By accurately estimating the onset time and essential epidemiological parameters, our approach is versatile and efficient, extending its utility beyond COVID-19.
Deteksi Serangan DDoS SYN Flood Pada Jaringan Internet of Things (IoT) Menggunakan Metode Deep Neural Network (DNN)
Authors: Syifa Munawarah Syifa Munawarah , Kurniabudi  , Eko Arip Winanto  
Published: May 2024

Sistem dan aplikasi Internet of Thing (IoT) mulai banyak diimplementasikan kedalam berbagai bidang, hal ini membuat IoT menjadi sasaran menarik untuk kejahata cyber, terutama serangan DDoS seperti SYN Flood, dimana serangan ini membuat ketersediaan layanan terganggu dan membanjiri server sehingga server kehilangan sumber daya. Salah satu cara untuk mendeteksi serangan DDoS dapat menggunakan Intrusion Detection System (IDS) dimana teknik baru dalam penerapan IDS adalah Deep Learning yaitu metode Deep Neural Network (DNN) yang mampu menemukan manipulasi matematis yang tepat untuk mengubah input menjadi output, maka pada penelitian ini mengusulkan penggunaan metode DNN dalam mendeteksi serangan DDoS SYN Flood pada jaringan IoT. Hasil pengujian pada penelitian yang menggunakan dataset CICIoT2023 dengan 14 file yang berisi dua label yaitu DDoS-SYN_Flood dan BenignTraffic memberikan hasil yang memuaskan. Pangujian menggunakan epoch dengan nilai 10, 50, dan 100, menunjukkan bahwa epoch 100 memberikan hasil performa tertinggi, dapat dilihat dari nilai rata-rata accuracy sebesar 99,36%, nilai precision sebesar 99,44%, nilai recall sebesar 99,75% dan nilai f1-score sebesar 99,59%.
Bagaimanakah Kualitas Layanan Dokumen Kependudukan Di Kota Jambi..?
Authors: Yaldi Effiyaldi , Pasaribu Johni Paul Karolus , Suratno Eddy , Yossinomita  
Published: May 2024

Tujuan penelitian ini adalah untuk mengetahui transparansi organisasi terhadap pengaruh kualiyas layanan dalam pengurusan dokumen kependudukan di kota Jambi. Menggunakan metode Structural Equation Model. Sampel yang digunakan sebanyak 320 orang. Bahwa terdapat pengaruh signifikan transparansi organisasi terhadap kualitas pelayanan dalam pelayanan dokumen kependudukan di kota Jambi. Saran untuk penelitian selanjutnya adalah perlu diteliti lagi dengan mengangkat variabel kepuasan kerja, kemampuan kerja, fasilitas kerja dan kerjasama pada kualitas layanan dan denan implikasi pada kepercayaan publik.
Pelayanan Prima dalam Meningkatkan Kepuasan Mahasiswa terhadap Layanan Pembelajaran di Universitas Mandiri
Authors: Siti Maryam Neneng 
Published: May 2024

Untuk meningkatkan kepuasan mahasiswa dalam layanan pembelajaran, lingkungan perguruan tinggi baik negeri maupun swasta dituntut dapat memberikan pelayanan prima. Tujuan dari penelitian ini adalah untuk mengetahui bagaimana pelaksanaan pelayanan prima yang diberikan oleh Universitas Mandiri dalam layanan pembelajaran sehingga dapat meningkatkan kepuasan mahasiswa. Penelitian ini menggunakan metode deskriptif kualitatif dengan pendekatan penelitian lapangan. Adapun yang menjadi informan terdiri dari 1 orang ketua prodi, 3 orang dosen, 6 orang mahasiswa, dan 1 orang staf akademik. Hasil penelitian menunjukkan bahwa pelayanan prima yang diberikan Universitas Mandiri kepada mahasiswa dalam layanan pembelajaran belum optimal karena adanya unsur pelayanan prima yang tidak terpenuhi yaitu kurangnya sarana dan prasarana dalam mendukung proses pembelajarana. Kesimpulan dari hasil penelitian bahwa ketersediaan sarana yaitu internet, AC dan infocus, prasarana yaitu ruang kelas merupakan faktor yang mendukung kepuasan mahasiswa dalam pembelajaran.
An ultrasonic transducer focusing ultrasound into a thin waveguide by two elliptical reflectors
Authors: Ieiri Shoki , Yamada Kyohei , Sasamura Tatsuki , Itoh Shinsuke , Kasashima Takashi , Morita Takeshi 
Published: May 2024

Abstract
A high-power ultrasonic transducer for minimally invasive treatments is proposed, capable of treating areas inaccessible by high-intensity focused ultrasound treatments. This transducer employs two elliptical reflectors that efficiently focus ultrasound waves into a thin waveguide by utilizing mode conversion. Additionally, a slit structure is introduced to suppress wave diffraction, further enhancing the focusing capabilities of the transducer. Finite element analysis demonstrates that the proposed transducer achieves an impressive energy density magnification factor of 325, with an energy efficiency of 24.2

%
.

This efficiency is 3.4 times higher than that of a conventional transducer, Double Parabolic refLector wave-guided Ultrasonic transducer.
A imprescindível participação do Ministério Público na aplicação e efetividade da Lei 14.228/2021
Authors: Gil Ariana Anari 
Published: May 2024

O presente artigo irá abordar a importância da Lei 14.228/2021 no território nacional como forma de assegurar a saúde única brasileira e contribuir para evitar pandemias como a covid-19, que ceifa prematuramente vidas. A preservação das espécies humana, animal e ambiental depende da implementação de políticas públicas eficazes e transparentes que garantam o direito à saúde de todos. Contudo, só elaboração de leis não basta; é preciso aplicação e efetividade para que vivamos em equilíbrio social, vez que toda sociedade deve viver à mercê do princípio da legalidade, inclusive a Administração Pública, nos termos do artigo 5º, inciso II c.c. artigo 37 ambos da Constituição Federal, na omissão poderá o Ministério Público intervir para garantir direito fundamental e o estado de conformidade.
Clinical manifestations, diagnosis and long-term prognosis of adult autoimmune enteropathy: Experience from Peking Union Medical College Hospital
Authors: Li Mu-Han , Ruan Ge-Chong , Zhou Wei-Xun , Li Xiao-Qing , Zhang Sheng-Yu , Chen Yang , Bai Xiao-Yin , Yang Hong , Zhang Yu-Jie , Zhao Peng-Yu , Li Ji , Li Jing-Nan 
Published: May 2024

BACKGROUND
Autoimmune enteropathy (AIE) is a rare disease whose diagnosis and long-term prognosis remain challenging, especially for adult AIE patients.
AIM
To improve overall understanding of this disease’s diagnosis and prognosis.
METHODS
We retrospectively analyzed the clinical, endoscopic and histopathological characteristics and prognoses of 16 adult AIE patients in our tertiary medical center between 2011 and 2023, whose diagnosis was based on the 2007 diagnostic criteria.
RESULTS
Diarrhea in AIE patients was characterized by secretory diarrhea. The common endoscopic manifestations were edema, villous blunting and mucosal hyperemia in the duodenum and ileum. Villous blunting (100%), deep crypt lymphocytic infiltration (67%), apoptotic bodies (50%), and mild intraepithelial lymphocytosis (69%) were observed in the duodenal biopsies. Moreover, there were other remarkable abnormalities, including reduced or absent goblet cells (duodenum 94%, ileum 62%), reduced or absent Paneth cells (duodenum 94%, ileum 69%) and neutrophil infiltration (duodenum 100%, ileum 69%). Our patients also fulfilled the 2018 diagnostic criteria but did not match the 2022 diagnostic criteria due to undetectable anti-enterocyte antibodies. All patients received glucocorticoid therapy as the initial medication, of which 14/16 patients achieved a clinical response in 5 (IQR: 3-20) days. Immunosuppressants were administered to 9 patients with indications of steroid dependence (6/9), steroid refractory status (2/9), or intensified maintenance medication (1/9). During the median of 20.5 months of follow-up, 2 patients died from multiple organ failure, and 1 was diagnosed with non-Hodgkin’s lymphoma. The cumulative relapse-free survival rates were 62.5%, 55.6% and 37.0% at 6 months, 12 months and 48 months, respectively.
CONCLUSION
Certain histopathological findings, including a decrease or disappearance of goblet and Paneth cells in intestinal biopsies, might be potential diagnostic criteria for adult AIE. The long-term prognosis is still unsatisfactory despite corticosteroid and immunosuppressant medications, which highlights the need for early diagnosis and novel medications.
Feasibility of High-resolution Transmission Spectroscopy for Low-velocity Exoplanets
Authors: Cheverall Connor J. , Madhusudhan Nikku 
Published: May 2024

Abstract
In recent years, high-resolution transmission spectroscopy in the near-infrared has led to detections of prominent molecules in several giant exoplanets on close-in orbits. This approach has traditionally relied on the large Doppler shifts of the planetary spectral lines induced by the high velocities of close-in planets, which were considered necessary for separating them from the quasi-static stellar and telluric lines. In this work, we demonstrate the feasibility of high-resolution transmission spectroscopy for chemical detections in atmospheres of temperate low-mass exoplanets around M dwarfs with low radial velocity variation during transit. We pursue this goal using model injection and recovery tests with H- and K-band high-resolution spectroscopy of the temperate sub-Neptune TOI-732 c, observed using the IGRINS spectrograph on Gemini South. We show that planetary signals in transit may be recovered when the change in the planet’s radial velocity is very small, down to subpixel velocities. This is possible due to the presence of the planetary signal in only a subset of the observed spectra. A sufficient number of out-of-transit spectra can create enough contrast between the planet signal and telluric/stellar contaminants that the planet signal does not constitute a principal component of the time-series spectra and can therefore be isolated using principal-component-analysis-based detrending without relying on a significant Doppler shift. We additionally explore novel metrics for finding such signals, and investigate trends in their detectability. Our work extends the scope of high-resolution transmission spectroscopy and creates a pathway toward the characterization of habitable sub-Neptune worlds with ground-based facilities.