bluuebunny/crossref_metadata_2025_split huggingface dataset:
Supporting ColoREctal Equitable Navigation (SCREEN): a protocol for a stepped-wedge cluster randomized trial for patient navigation in primary care
Authors: Rivera Rivera Jessica N. , AuBuchon Katarina E. , Schubel Laura C. , Starling Claire , Tran Jennifer , Locke Marjorie , Grady Melanie , Mete Mihriye , Blumenthal H. Joseph , Galarraga Jessica E. , Arem Hannah 
Published: June 2024

Abstract
Background
Black individuals in the United States (US) have a higher incidence of and mortality from colorectal cancer (CRC) compared to other racial groups, and CRC is the second leading cause of death among Hispanic/Latino populations in the US. Patient navigation is an evidence-based approach to narrow inequities in cancer screening among Black and Hispanic/Latino patients. Despite this, limited healthcare systems have implemented patient navigation for screening at scale.

Methods
We are conducting a stepped-wedge cluster randomized trial of 15 primary care clinics with six steps of six-month duration to scale a patient navigation program to improve screening rates among Black and Hispanic/Latino patients. After six months of baseline data collection with no intervention we will randomize clinics, whereby three clinics will join the intervention arm every six months until all clinics cross over to intervention. During the intervention roll out we will conduct training and education for clinics, change infrastructure in the electronic health record, create stakeholder relationships, assess readiness, and deliver iterative feedback. Framed by the Practical, Robust Implementation Sustainment Model (PRISM) we will focus on effectiveness, reach, provider adoption, and implementation. We will document adaptations to both the patient navigation intervention and to implementation strategies. To address health equity, we will engage multilevel stakeholder voices through interviews and a community advisory board to plan, deliver, adapt, measure, and disseminate study progress. Provider-level feedback will include updates on disparities in screening orders and completions.

Discussion
Primary care clinics are poised to close disparity gaps in CRC screening completion but may lack an understanding of the magnitude of these gaps and how to address them. We aim to understand how to tailor a patient navigation program for CRC screening to patients and providers across diverse clinics with wide variation in baseline screening rates, payor mix, proximity to specialty care, and patient volume. Findings from this study will inform other primary care practices and health systems on effective and sustainable strategies to deliver patient navigation for CRC screening among racial and ethnic minorities.

Trial registration
NCT06401174
Detection research of insulating gloves wearing status based on improved YOLOv8s algorithm
Authors: Tao Caixia , Wang Chaoting , Li Taiguo 
Published: June 2024

AbstractThe safety hazards may be caused by power grid operators not wearing insulating gloves according to regulations for live electrical working. Additionally, existing methods for detecting the wearing status of insulating gloves suffer from low recognition accuracy, slow detection speed, and large memory occupation by weight files. To address these issues, a Mixup-CA-Small-YOLOv8s (MCS-YOLOv8s) algorithm is proposed for detecting the wearing status of insulating gloves. Firstly, the mixup data augmentation technology using image mixing is introduced, increasing the data’s diversity and improving the model’s generalization ability. Secondly, the coordinate attention (CA) module is added to the original backbone network to strengthen the channel and positional information, suppressing the secondary feature information. Finally, a small target detection structure is designed by removing the last bottom feature detection layer in the original neck network and adding a shallow feature. The ability of small targets’ feature extraction is enhanced without increasing too much computation. The experimental results indicate that the mean average precision of the MCS-YOLOv8s algorithm on the test set is 0.912, the detection speed is 87 FPS, and the model’s weight memory occupies 15.7 MB. It is verified that the model has the advantages of high detection accuracy, fast speed, and small weight memory, which has great significance in ensuring the safe and stable operation of the power grid.
“If it all goes digital, we’ll have to learn”: facilitators and barriers to uptake of digital health in British South Asians with cardiometabolic disease
Authors: Ramasawmy Mel , Sunkersing David , Persson Dan Roland , Poole Lydia , Patel Kiran , Modha Shivali , Sajid Madiha , Gill Paramjit , Stevenson Fiona , Khan Nushrat , Banerjee Amitava 
Published: June 2024

Abstract
Background
Although availability and utilisation of digital health interventions (DHIs) for management of diabetes and cardiovascular disease (“cardiometabolic disease”) have increased, they may exacerbate health inequalities. South Asians have increased cardiometabolic risk, but their experiences of DHIs are poorly investigated and characterised.

Objective
To explore facilitators and barriers to DHI uptake and use in South Asian individuals in the UK with cardiometabolic disease.

Methods
Mixed-methods approach encompassing online/face-to-face/individual interviews (n = 45) and survey (n = 100). After informed consent, transcription and coding, we conducted a thematic analysis informed by a guide for understanding inequalities in DHIs to examine perceptions at the individual, healthcare professional, societal and intervention level.

Results
Participants described an intersection of factors resulting in varied digital skills and confidence within the community, including individual characteristics, awareness, and support. COVID-19 restrictions acted as both a positive (use of online shopping and social media increasing digital confidence) and negative (lack of access to health services) drivers to DHI uptake. Participants made recommendations for improving DHI uptake in the health service and policy area, such as promotion and upskilling through culturally and language-appropriate avenues such as community organisations and outlets. Participants suggested DHI design improvements should focus on literacy, numeracy, accessibility, and cultural appropriateness.

Conclusions
DHIs have the potential to support South Asian populations in the UK to prevent and manage cardiometabolic disease. To improve their uptake, approaches to their implementation should consider community diversity to provide appropriate promotion, education, and support.
Institutional review of pediatric oncology patients participating in early phase clinical trials.
Authors: Rami Avina , Bona Kira , Shusterman Suzanne , Wright Karen D. , Place Andrew E. , Umaretiya Puja J , Bhushan Ketki , DuBois Steven G. , Campbell Kevin 
Published: June 2024

10042 Background: Phase 1 or phase 1/2 trials are a first step in pediatric cancer drug development with a primary objective of evaluating safety and dosing of new therapies or new combinations. They most commonly enroll patients with relapsed/refractory or very rare cancers and currently there is a paucity of information regarding outcomes for pediatric patients enrolled on phase 1/2 trials. Thus, we sought to describe clinical outcomes of pediatric patients enrolled in phase 1 clinical trials over a 9-year period at a single institution. Methods: We queried our clinical trials management system to generate a list of all pediatric patients who were enrolled and treated on phase 1 or phase 1/2 trials from 2011-2019. We reviewed the electronic medical record to collect baseline demographic and clinical data. We also collected key efficacy and safety endpoints post-enrollment including: time to death (if applicable); objective response to trial therapy; duration on therapy; need for dose modification; and occurrence of DLT. Overall survival was calculated using Kaplan-Meier methods. Results: A total of 224 unique patients accounted for 258 enrollments and 253 episodes of treatment on trial. The median age at trial enrollment was 11 years (range 0-27 years) and 56.2% were male. The majority of patients were white (85.7%) and non-Hispanic (88.2%). English was the primary language for 86.3% of patients and 65.8% of patients had private insurance. Solid tumors were the most common malignancy at 41.0%, followed by brain tumors (34.1%), and hematologic malignancies (24.9%). The majority of patients (60%) had metastatic disease at time of first enrollment. Among episodes of treatment, 51.4% received targeted monotherapy. Median overall survival from first enrollment for 210 patients treated with available vital status was 12.8 months. Among episodes of treatment, 25.2% of patients had an objective response to trial therapy. Stratified by disease type, objective response was documented for 52.9% of patients with hematologic malignancies, 20.5% of patients with CNS tumors, and 15.8% of patients with solid tumors. Patients on trials with cytotoxic-only treatment had the highest objective response (47.5%), while patients treated with cytotoxic plus targeted therapies combinations had the lowest rate (18.9%). The median duration of therapy was 1.5 months. Twenty-seven patients (11.0%) required dose modification and 22 patients (9.0%) had DLT. Conclusions: We present clinical outcomes for a recent cohort of pediatric patients treated on early phase clinical trials. We identified differential response rates to phase 1 therapy by disease and trial-type in a single-center cohort treated over the past decade. These data are immediately informative to discussions between providers and patients/parents regarding expected phase 1 trial outcomes.
Clinical and molecular characteristics and targeted therapy of pediatric non-infantile fibrosarcoma NTRK rearrangement–related tumors.
Authors: Huang Junting , Song Mengjia , Lu Suying , Zhang Yu , Wang Shan , Wu Yanpeng , Cai Ruiqing , Wang Juan , Zhu Jia , Sun Feifei , Zhen Zijun , Zhang Yizhuo 
Published: June 2024

10048 Background: Neurotrophic tyrosine receptor kinase (NTRK) rearrangement is rare in tumors and relevant to targeted therapy. Pediatric NTRK rearrangement-related tumors have distinct clinical and molecular features compared to adults, and previous studies on pediatric NTRK rearrangement-related tumors has focused on infantile fibrosarcoma (IFS), the most common subtype. However, the clinical behaviors and molecular profiles of other subtypes of pediatric NTRK rearrangement-related tumors are largely unknown. Methods: In this study, we evaluated the molecular features, treatment response, and prognosis of 28 pediatric patients with non-IFS NTRK rearrangement-related tumors. Next-generation sequencing was performed in 21 patients to identify the NTRK fusion types and their co-occurring alterations, and pathway enrichment analysis was performed to explore the potential mechanisms involving NTRK rearrangement and resistance to tyrosine receptor kinase (TRK) inhibitors. Results: The NTRK fusion partners were diverse and tumor-specific. Several novel NTRK fusions were identified, including SNIP1-NTRK1, AGAP1-NTRK2, CRCT1-NTRK1, ZBTB7B-NTRK1, and SLC6A15-NTRK3. RTK-RAS, NOTCH, TP53, and WNT pathways were top 4 significantly enriched in tested samples. Twelve of 17 patients (70.6%) received TRK inhibitors as salvage treatment achieved complete or partial response. Patients who did not develop DDR, NOTCH, or TP53 pathway-related gene mutations had a high objective response rate of 82%, 82%, and 83%, respectively. Conclusions: Our findings may have important implications for the diagnosis and treatment of non-IFS NTRK fusion-positive tumors in pediatric patients. We also provide potential therapeutic targets for tumors resistant to TRK inhibitors. Clinical trials with TRK inhibitors, either alone or in combination, are required to establish the optimal treatment regimen and sequence in large-cohort pediatric patients with non-IFS NTRK rearrangement-related tumors. Clinical trial information: NCT05076071 .
Comparative risk of obesity-related cancer with glucagon-like protein-1 receptor agonists vs. bariatric surgery in patients with BMI ≥ 35.
Authors: Lin Cindy (Hsin-Ti) , Liu Benjamin , Hill Hannah , Wang Jiasheng , Han Xiaonan , Remick Scot C. , Tse William , Song Gengqing 
Published: June 2024

10508 Background: Bariatric surgery is suggested to reduce the risk of obesity-related cancers, prompting us to explore whether glucagon-like peptide-1 receptor agonist (GLP-1 RA) offers a similar association. Methods: We queried TriNetX, a global healthcare database to identify patients with BMI of ≥ 35. Three pair-wise propensity score-matched (PSM) comparisons were created: 1) GLP-1 RA vs. Bariatric Surgery, 2) GLP-1 RA vs. No Intervention, 3) Bariatric Surgery vs. No Intervention. Cohorts were exclusive and no intervention was defined as an ambulatory visit. Patients required a minimum of 1 year of continuous GLP-1 RA therapy or follow-up, extended to 3 and 5 years in sensitivity analyses. Exclusions included a history of cancer or in situ neoplasms, as well as factors that significantly impact cancer risk and/or mortality including alcohol use disorder, organ transplantation, HIV, decompensated cirrhosis, peptic ulcer disease, dialysis dependency, left ventricular ejection fraction ≤ 20%, or other weight loss medication exposure. PSM utilized obesity therapy indications, Elixhauser and Charlson Comorbidity indices, prior follow-up, and demographics. Follow-up extended to 15 years, assessing 13 obesity-related cancers after intervention using Kaplan Meier (KM) and Cox-proportional Hazards Models (HR). Secondary outcomes included the risk of all-cause mortality and precancerous lesions. Results: After PSM, we identified 20,009, 3,229, and 11,104 patients in Comparison 1, 2, and 3, respectively. For Comparison 1, at 15 years, 273 (KM event rate 8.75%) patients on GLP-1 RA therapy and 397 (6.58%) with bariatric surgery developed an obesity-associated cancer, respectively (HR 0.99; 95% CI 0.87 - 1.13). Patients who received GLP-1 RA (HR 0.61; 95% CI 0.46 - 0.81) and bariatric surgery (HR 0.78; 95% CI 0.67 - 0.91) had a reduced risk of obesity-related cancer compared to no intervention. Among 20,009 patients, 40 (0.353%) and 61 (0.876%) of patients developed thyroid cancer in the GLP-1 RA and bariatric surgery groups, respectively (HR: 0.837; CI: 0.558 - 1.254). Patients lost significantly more weight after bariatric surgery as compared to GLP-1 RA at 1-2 years (BMI change -5.31 ± 6.05 vs. -1.57 ± 5.12 kg/m2; p < 0.0001). GLP-1 RA initiation was associated with lower all-cause mortality compared to control (HR 0.5; 95% CI 0.40 - 0.62) and bariatric surgery (HR 0.859; 95% CI 0.77 - 0.96). Neither GLP-1 RA nor bariatric surgery was associated with precancerous lesions compared to control. Sensitivity analyses supported the above outcomes. Conclusions: GLP-1 RA was associated with a lower risk of obesity-related cancer comparable to bariatric surgery in patients with BMI ≥ 35. GLP-1 RA has superior all-cause mortality benefits despite inferior weight loss compared to bariatric surgery.
Associations between metabolic syndrome-related diseases and colorectal cancer risk: A propensity score-matched analysis using the NIH All of Us research program.
Authors: Eun Yong , Olusoji Rahman Adesoji , Osei Noah , Omore Ibrahim , Ahluwalia Meena 
Published: June 2024

10515 Background: The risk of colorectal cancer (CRC) is known to increase in patients with metabolic disorders such as hypertension (HTN), hyperlipidemia (HLD), type 2 diabetes (T2DM), and metabolic associated fatty liver disease (MASLD). Both metabolic disorders and CRC share similar demographic, socioeconomic, geographic, and environmental risk factors. This study aims to examine the associations between metabolic syndrome-related diseases and CRC incidence, controlling for confounding risk factors. Methods: This was a propensity score matched case-control study using NIH All of UsResearch Program, Registered Tier version 7. CRC diagnoses was defined as having two or more diagnosis codes in EHR. We matched CRC patients to participants without CRC diagnosis with 1:2 ratio, aligning age, gender, race/ethnicity, income, education, region, and cigarette exposure. Income level per year ( < $25K, $25-100K, > $100K), education level (grade 12 or less, some college, college graduate), cigarettes exposure ( > 100 cigs per lifetime), region (Northeast, Midwest, South, West) were assessed using the survey. Height and weight measurement collected at the time of enrollment was used to calculate BMI and define obese (BMI ≥ 30 kg/m2 ) and underweight (BMI < 18.5 kg/m2) status. We compared the average BMI between two groups, and calculated the odds ratios for obesity, underweight status, HTN, HLD, T2DM, and MASLD to assess the likelihood of these conditions being associated with colon cancer. Results: Between the control (n = 3,528) and CRC groups (n = 1,764), there was no significant differences in matched factors. The CRC group had a similar obesity prevalence and a lower mean BMI (28.8, SD 6.9) compared to the control group (29.3, SD 6.9, p = 0.017). Underweight status was linked to a 76% increase in CRC odds (OR 1.76, CI 1.21-2.56, p = 0.003), T2DM to a 26% increase (OR 1.26, CI 1.06-1.49, p = 0.008), HTN to a 58% increase (OR 1.58, CI 1.41-1.78, p < 0.001), HLD to a 32% increase (OR 1.32, CI 1.18-1.49, p < 0.001), and MASLD to over a two-fold increase (OR 2.16, CI 1.78-2.61 p < 0.001). Conclusions: Our study reinforces the significant link between metabolic dysregulation and CRC risk. The higher prevalence of metabolic disorders in the CRC group, despite a lower obesity prevalence and average BMI, suggests that other factors, potentially treatment effects, might contribute to these findings. Further research is warranted to elucidate the causal pathways linking metabolic disorders to the pathogenesis of CRC. [Table: see text]
Trends in human papilloma virus vaccination uptake by sex and race/ethnicity among US adolescents and young adults, 2011-2020.
Authors: Nguyen Jacqueline , Hong Arthur S , Zhang Allan , Nguyen Danh 
Published: June 2024

10519 Background: High-risk strains of human papillomavirus (HPV) are associated with a variety of oral and anogenital cancers, many of which are preventable through HPV vaccination. In the US, completion of an HPV vaccination series is recommended for all individuals from age 9 through 26; however, national trends in HPV vaccination uptake across sex and racial/ethnic groups over the past decade are not well described. Methods: We analyzed data from the National Health and Nutrition Examination Survey across 4 survey cycles spanning January 2011 to March 2020. We used univariate logistic regression to evaluate temporal trends in HPV vaccination uptake across sex and racial/ethnic strata, with the midpoint of each survey cycle modeled as a continuous independent variable. Vaccination uptake was defined as self/parent-reported receipt of ≥ 1 dose of an HPV vaccine series (estimates for 2 and 3 doses were unreliable due to recall bias and missing data). All estimates incorporated appropriate survey weights to be representative of the US population. Results: We identified 10,927 participants representing 70,066,252 individuals: mean age 17.4 years, 48.8% male, 54.9% White. Between 2011-March 2020, overall HPV vaccination uptake steadily increased from 23.3% to 43.0% ( P trend < 0.001; Table). HPV vaccination rates improved from 37.7% to 49.4% among females ( P trend < 0.001) and from 7.8% to 36.4% among males ( P trend < 0.001). HPV vaccination uptake increased similarly across all racial/ethnic strata by approximately 20%, with White individuals achieving the greatest vaccination uptake (45.5%) by March 2020. Conclusions: Among US adolescents and young adults, HPV vaccination uptake rose by ~20% overall and across all racial/ethnic groups. HPV vaccination uptake accelerated the most among males but still lags behind females, perhaps because routine vaccination wasn’t recommended for males until 2011, 5 years after it had been recommended for females. [Table: see text]
Acceptability of stool-based DNA colorectal cancer (CRC) screening among Black/African American patients served by a Federally Qualified Health Center (FQHC).
Authors: Keiser Evan , Corbett A. Michelle , Chido-Amajuoyi Onyema , Antoine Allison , Stehman Carrie , Dorn Isabella , Goines David , LoConte Noelle K. 
Published: June 2024

10530 Background: CRC has an increased burden among Black/African American populations in the United States. Following the COVID-19 pandemic, home-based CRC screening options are being used more frequently. We conducted focus groups to understand the acceptability of stool-based DNA testing for CRC screening in this population. Methods: 10 Focus group sessions were conducted at 2 FQHCs in Milwaukee, WI from 06/22/2023-10/30/2023. Participants were paid $40 for participation. Groups were categorized by gender and age (younger [40-50] vs. older [over 50]). Participants were recruited by fliers and direct text from the FQHC. Eligibility was verified by FQHC staff. Each session was 90 minutes, held at the FQHC, and led by the same facilitator. Participants were given an overview of CRC screening tests and shown a video about stool DNA tests before beginning the focus groups. Thematic analysis was carried out using NVivo. Results: Across 10 groups, there were 79 participants, 32 younger (40.5%) and 47 older (59.5%), with 42 males (53.2%) and 37 (46.8%) females. In the overall study population, there was minimal knowledge of one’s risk for CRC, including the concept of average versus high-risk. Also, there was limited awareness of CRC screening options among younger patients and widespread lack of knowledge about stool-based DNA testing. None of the participants had personal experience with stool-based DNA screening. Most participants were open to the idea of stool-based DNA testing for screening. Examination of DNA was not a pervasive concern in the groups. Most preferred colonoscopy as their first-choice screening test. Reasons for colonoscopy preference included: definitive removal of polyps, direct visualization of the colon, increased confidence level in effectiveness, potential longer periods between screenings, and no need for confirmatory evaluation. Conclusions: Study findings reveal that stool-based DNA testing was acceptable among our study population, however, colonoscopy was identified as the preferred screening modality among this population of Black/African American patients served by an FQHC. Given the low awareness/knowledge of screening modalities identified in our study, educational interventions and shared decision making by primary care providers are needed to promote patient awareness of CRC screening options within the population.