bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility Study of Computed Tomographic Radiomics Model for the Prediction of Early and Intermediate Stage Hepatocellular Carcinoma Using BCLC Staging
Authors: Dong Han , Yang Lu , Shaofeng Duan , Lili Guo 
Published: April 2024

Background Hepatocellular carcinoma (HCC) is a serious health concern because of its high morbidity and mortality. The prognosis of HCC largely depends on the disease stage at diagnosis. Computed tomography (CT) image textural analysis is an image analysis technique that has emerged in recent years. Objective To probe the feasibility of a CT radiomic model for predicting early (stages 0, A) and intermediate (stage B) HCC using Barcelona Clinic Liver Cancer (BCLC) staging. Methods A total of 190 patients with stages 0, A, or B HCC according to CT-enhanced arterial and portal vein phase images were retrospectively assessed. The lesions were delineated manually to construct a region of interest (ROI) consisting of the entire tumor mass. Consequently, the textural profiles of the ROIs were extracted by specific software. Least absolute shrinkage and selection operator dimensionality reduction was used to screen the textural profiles and obtain the area under the receiver operating characteristic curve values. Results Within the test cohort, the area under the curve (AUC) values associated with arterial-phase images and BCLC stages 0, A, and B disease were 0.99, 0.98, and 0.99, respectively. The overall accuracy rate was 92.7%. The AUC values associated with portal vein phase images and BCLC stages 0, A, and B disease were 0.98, 0.95, and 0.99, respectively, with an overall accuracy of 90.9%. Conclusion The CT radiomic model can be used to predict the BCLC stage of early-stage and intermediate-stage HCC.
Evaluation of Patient Education Materials From Large-Language Artificial Intelligence Models on Carpal Tunnel Release
Authors: Croen Brett J. , Abdullah Mohammed S. , Berns Ellis , Rapaport Sarah , Hahn Alexander K. , Barrett Caitlin C. , Sobel Andrew D. 
Published: April 2024

Background: ChatGPT, an artificial intelligence technology, has the potential to be a useful patient aid, though the accuracy and appropriateness of its responses and recommendations on common hand surgical pathologies and procedures must be understood. Comparing the sources referenced and characteristics of responses from ChatGPT and an established search engine (Google) on carpal tunnel surgery will allow for an understanding of the utility of ChatGPT for patient education. Methods: A Google search of “carpal tunnel release surgery” was performed and “frequently asked questions (FAQs)” were recorded with their answer and source. ChatGPT was then asked to provide answers to the Google FAQs. The FAQs were compared, and answer content was compared using word count, readability analyses, and content source. Results: There was 40% concordance among questions asked by the programs. Google answered each question with one source per answer, whereas ChatGPT’s answers were created from two sources per answer. ChatGPT’s answers were significantly longer than Google’s and multiple readability analysis algorithms found ChatGPT responses to be statistically significantly more difficult to read and at a higher grade level than Google’s. ChatGPT always recommended “contacting your surgeon.” Conclusion: A comparison of ChatGPT’s responses to Google’s FAQ responses revealed that ChatGPT’s answers were more in-depth, from multiple sources, and from a higher proportion of academic Web sites. However, ChatGPT answers were found to be more difficult to understand. Further study is needed to understand if the differences in the responses between programs correlate to a difference in patient comprehension.
Improving olaparib exposure to optimize adverse effects management
Authors: Sterlé Marylise , Puszkiel Alicja , Burlot Chloé , Pereira Eva , Bellesoeur Audrey , De Percin Sixtine , Beinse Guillaume , Fumet Jean-David , Favier Laure , Niogret Julie , Blanchet Benoit , Royer Bernard , Bengrine-Lefevre Leïla , Schmitt Antonin 
Published: April 2024

Background: Olaparib is an inhibitor of the human poly-(ADP-ribose)-polymerase enzymes (PARP1/2) needed to repair single-strand DNA breaks. It is used in breast, ovarian, prostate and pancreatic cancer. Objectives: This work aimed to describe the pharmacokinetics/pharmacodynamics (PK/PD) relationship between olaparib plasma concentrations and common adverse effects (i.e. anaemia and hypercreatininaemia), in a real-life setting, to propose a target concentration for therapeutic drug monitoring. Methods: Two PK/PD models describing the evolution of haemoglobinaemia and creatininaemia as a function of time were developed, based on data from, respectively, 38 and 37 patients receiving olaparib. The final model estimates were used to calculate the incidence of anaemia and creatinine increase according to plasma trough concentrations for 1000 virtual subjects to define target exposure. Results: The final models correctly described the temporal evolution of haemoglobinaemia and creatininaemia for all patients. The haemoglobinaemia PK/PD model is inspired by Friberg’s model, and the creatininaemia PK/PD model is an indirect response model. Model parameters were in agreement with physiological values and close to literature values for similar models. The mean (population) plasma haemoglobin concentration at treatment initiation, as estimated by the model, was 11.62 g/dL, while creatinine concentration was 71.91 µmol/L. Using simulations, we have identified a target trough concentration of 3500–4000 ng/mL, above which more than 20% of patients would report grade ≥3 anaemia. Conclusion: Based on real-world data, we were able to properly describe the time course of haemoglobinaemia and plasma creatininaemia during olaparib treatment.
Automated osteoporosis classification and T-score prediction using hip radiographs via deep learning algorithm
Authors: Chen Yu-Pin , Chan Wing P. , Zhang Han-Wei , Tsai Zhi-Ren , Peng Hsiao-Ching , Huang Shu-Wei , Jang Yeu-Chai , Kuo Yi-Jie 
Published: April 2024

Background: Despite being the gold standard for diagnosing osteoporosis, dual-energy X-ray absorptiometry (DXA) is an underutilized screening tool for osteoporosis. Objectives: This study proposed and validated a controllable feature layer of a convolutional neural network (CNN) model with a preprocessing image algorithm to classify osteoporosis and predict T-score on the proximal hip region via simple hip radiographs. Design: This was a single-center, retrospective study. Methods: An image dataset of 3460 unilateral hip images from 1730 patients (age ⩾50 years) was retrospectively collected with matched DXA assessment for T-score for the targeted proximal hip regions to train (2473 unilateral hip images from 1430 patients) and test (497 unilateral hip images from 300 patients) the proposed CNN model. All images were processed with a fully automated CNN model, X1AI-Osteo. Results: The proposed screening tool illustrated a better performance (sensitivity: 97.2%; specificity: 95.6%; positive predictive value: 95.7%; negative predictive value: 97.1%; area under the curve: 0.96) than the open-sourced CNN models in predicting osteoporosis. Moreover, when combining variables, including age, body mass index, and sex as features in the training metric, there was high consistency in the T-score on the targeted hip regions between the proposed CNN model and the DXA ( r = 0.996, p < 0.001). Conclusion: The proposed CNN model may identify osteoporosis and predict T-scores on the targeted hip regions from simple hip radiographs with high accuracy, highlighting the future application for population-based opportunistic osteoporosis screening with low cost and high adaptability for a broader population at risk. Trial registration: TMU-JIRB N201909036.
Understanding the role and impact of electronic health records in labor and delivery nursing practice: A scoping review protocol
Authors: Bignell Crystal A , Petrovskaya Olga 
Published: April 2024

Background Electronic health records have a significant impact on nursing practice, particularly in specializations such as labor and delivery, or acute care maternity nursing practice. Although primary studies on the use of electronic health records in labor and delivery have been done, no reviews on this topic exist. Moreover, the topic of labor and delivery nurses’ organizing work in the electronic health record-enabled context has not been addressed. Objective To (a) synthesize research on electronic health record use in labor and delivery nursing and (b) map how labor and delivery nursing organizing work is transformed by the electronic health record (as described in the reviewed studies). Methods The scoping review will be guided by a modified methodology based on selected recommendations from the Joanna Briggs Institute and the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews. A comprehensive search will be conducted in the following databases: CINAHL Complete, MEDLINE, Academic Search Complete, Web of Science, Scopus and Dissertations and Theses Abstracts and Indexes. Included sources will be primary research, dissertations, or theses that address the use of electronic health records in labor and delivery nursing practice in countries with high levels of electronic health record adoption. Data extracted from included sources will be analyzed thematically. Further analysis will theorize labor and delivery nurses’ organizing work in the context of electronic health record use by utilizing concepts from Davina Allen's Translational Mobilization Theory. Findings will be presented in tabular and descriptive formats. Conclusion The findings of this review will help understand transformations of nursing practice in the electronic health record-enabled labor and delivery context and identify areas of future research. We will propose an extension of the Translational Mobilization Theory and theorize nurses’ organizing work involving the use of the electronic health record.
Comparison of Alabama Nurse Experiences Between Practice Areas During the Early COVID-19 Pandemic
Authors: Montgomery Aoyjai P. , Sullivan Courtney , Dick Tracey , Roberson Charlene , Harris Lindsey M. , Patrician Patricia A. 
Published: April 2024

Background: According to the Total Worker Health® framework, safety culture including a reasonable workload among healthcare workers is essential to the security and well-being of patients, staff, and healthcare organizations. Evaluating the impact of the pandemic on the nursing workforce in different practice areas is critical for addressing workforce health and sustainability. The purpose of this study was to compare work and selfcare experiences among Alabama nurses between practice areas and the early pandemic years (2020 vs. 2021). Methods: A secondary analysis of cross-sectional Alabama State Nurses Association (ASNA) survey data was conducted. Kruskal–Wallis analysis of variance, Wilcoxon rank, and false discovery rates were examined. Results: There were 1,369 and 2,458 nurse survey responses in 2020 and 2021, respectively. By 2021, nurses reported worsening staff shortages, a greater need for retired and new graduate nurses to help with the workload burden, and perceptions of heavier emergency department workloads. Lower proportions of nurses reported the ability to engage in self-care activities and satisfaction with state and federal crisis management. Intensive care nurses were more likely to report staffing shortages while also reporting the lowest ability to engage in self-care. Conclusions: Overall, the Alabama nursing workforce perceived worsening work conditions in 2021 compared to when the pandemic began. Practice areas varied greatly in their responses, with acute and intensive care areas perceiving more difficult work conditions. Total Worker Health® programs should be designed to promote and support nurses’ well-being based on their experience and the needs of specific practice areas.
An Exploration of Student Perception Toward Interprofessional High-Fidelity Clinical Simulation
Authors: Hannides Michael , Tariq Rameez , Holland Mark , Nomikos Polykarpos Angelos , McKelvin Rory , Powell Michelle 
Published: April 2024

OBJECTIVES Interprofessional education is recognized for its potential for collaboration and teamwork, reflecting clinical practice; however, existing literature for simulation-based interprofessional education does not include Physician Associate (PA) students. This initiative aimed to explore the students’ perception of interprofessional clinical simulation for PA students and allied health professional (AHP) students as part of our program development. METHODS A high-fidelity simulation session was designed and conducted for volunteering students from the PA, paramedic science, and physiotherapy courses. We used a mixed-method electronic questionnaire consisting of 15 statements rated on a numerical rating scale (0-5) and four open-ended questions with unlimited free-text responses to explore student perceptions. Inductive thematic analysis was used for qualitative analysis. The session design was underpinned by Allport's (intergroup) contact hypothesis with an emphasis on mutual intergroup differentiation. RESULTS Forty-six students participated in the simulation teaching, with 48% (n = 22) providing feedback. Overall student perception was mainly positive toward the interprofessional simulation; however, some barriers to learning were recognized. Based on the evaluation of our initiative and existing literature, we propose 5 top tips to promote an effective learning experience for students. (1) Understand the importance of interprofessional collaboration. (2) Establish clear roles. (3) Plan the scenarios in advance. (4) Maintain equal status between groups. (5) Provide clear instructions and expectations. CONCLUSION To our knowledge, this is the first study of high-fidelity interprofessional simulation involving PA and AHP students. We successfully explored student perception which highlighted aspects that can impact learning. This pilot study demonstrated that interprofessional simulation is a feasible and acceptable form of learning for our students and highlighted how to improve future interprofessional simulation teaching sessions.
The PIVOT App: A User Guide
Authors: Dadoo Sahil , Miller Liane , Fatora Gabrielle , Tisherman Robert , Musahl Volker 
Published: April 2024

Background: While the pivot shift examination is often regarded as the gold standard test for diagnosis of anterior cruciate ligament (ACL) injury, one of the pitfalls of the pivot shift test is that it lacks standardization among physicians. The PIVOT App is a validated application to quantify the amount of tibial translation during the pivot shift maneuver and improve standardization of clinical measurement. Indications: The PIVOT App can be used in both clinic and operating room settings for patients who sustained injury to the ACL. The PIVOT App may assist in identifying the amount of rotatory knee laxity in patients with ACL deficiency or following ACL reconstruction. Technique Description: The PIVOT App works by quantifying the amount of translation in the lateral tibia relative to a marker on the lateral femoral epicondyle. To use the PIVOT App, 3 yellow circle stickers are placed on the bony prominences of the lateral knee: the lateral epicondyle, Gerdy’s tubercle, and the “pivot point” 3 cm posterior to Gerdy’s tubercle parallel to the joint line. Once placed, the pivot shift flexion maneuver can be recorded in the PIVOT App and analyzed to identify both the distance of spontaneous tibial reduction during the pivot shift maneuver and the time of reduction in seconds. The most common problems encountered while using the application include (1) improper marker placement, (2) interference of marker tracking with yellow color in the background, (3) interference of marker tracking with overhead lighting, and (4) extraneous data collection before and after pivot shift flexion. Results: Previous studies have validated the PIVOT App to accurately distinguish normal, low-grade, and high-grade pivot shifts with resultant increasing tibial translation in the lateral compartment of the knee. The PIVOT App has been used at institutions worldwide to quantify and standardize measurement of the pivot shift. Conclusion: The PIVOT App is a validated application to quantify the amount of lateral tibial translation and reduction during the pivot shift maneuver. Proper use and avoidance of complications while using the application can aid clinicians in accurate diagnosis of rotatory knee laxity in patients following ACL injury. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
“Don't keep me waiting”: estimating the impact of reduced vein-to-vein time on lifetime US 3L+ LBCL patient outcomes
Authors: Vadgama Sachin , Pasquini Marcelo C. , Maziarz Richard T. , Hu Zhen-Huan , Ray Markqayne , Smith Harry , Bullement Ash , Edmondson-Jones Mark , Sullivan Will , Cartron Guillaume 
Published: April 2024

Abstract
Chimeric antigen receptor T-cell therapy (CAR T) has revolutionized the treatment of hematological cancers. Its production requires a complex logistical process, and the time from leukapheresis to patient infusion (known as the vein-to-vein time [V2VT]) can be long during which a patients clinical condition may deteriorate. This study was designed to estimate the benefits of reduced V2VT for third-line or later (3L+) relapsed/refractory large B-cell lymphoma (R/R LBCL) patients treated with CAR T. A mathematical model was developed to estimate the lifetime outcomes of a hypothetical cohort of patients who had either a long or short V2VT. Life-years (LYs), quality-adjusted LYs (QALYs), and costs were estimated. Scenario analyses were performed to assess the robustness of results to key assumptions. The results of the model show that reducing V2VT from 54 days (tisa-cel median V2VT; JULIET) to 24 days (axi-cel median V2VT; ZUMA-1) led to a 3.2-year gain in life expectancy (4.2 vs 7.7 LYs), and 2.4 additional QALYs (3.2 vs 5.6) per patient. Furthermore, a shorter V2VT was shown to be cost-effective under conventional willingness-to-pay thresholds in the United States. Results are driven by a higher infusion rate and a better efficacy of CAR T for those infused. Scenario analyses using a smaller difference in V2VT (24 vs 36 days) produced consistent results. Our study is the first to quantify lifetime V2VT-related outcomes for 3L+ R/R LBCL patients treated with CAR T utilizing currently available evidence. Shorter V2VTs led to improved outcomes, demonstrating the importance of timely infusion achievable by faster manufacturing times and optimization of hospital delivery.
Brensocatib in non-cystic fibrosis bronchiectasis: ASPEN protocol and baseline characteristics
Authors: Chalmers James D. , Burgel Pierre-Régis , Daley Charles L. , De Soyza Anthony , Haworth Charles S. , Mauger David , Mange Kevin , Teper Ariel , Fernandez Carlos , Conroy Dan , Metersky Mark 
Published: April 2024

IntroductionBrensocatib is an investigational, oral, reversible inhibitor of dipeptidyl peptidase-1 shown to prolong time to first exacerbation in adults with bronchiectasis. Outlined here are the clinical trial design, and baseline characteristics and treatment patterns of adult patients enrolled in the phase 3 ASPEN trial (NCT04594369).MethodsThe ASPEN trial is a global study enrolling patients with a clinical history consistent with bronchiectasis (cough, chronic sputum production and/or recurrent respiratory infections), diagnosis confirmed radiologically and ≥2 exacerbations in the prior 12 months. It was designed to evaluate the impact of two brensocatib doses (10 mg and 25 mg) on exacerbation rate over a 52-week treatment periodversusplacebo. Comprehensive clinical data, including demographics, disease severity, lung function,Pseudomonas aeruginosastatus and quality of life, were collected at baseline.Results1682 adults from 35 countries were randomised from December 2020 to March 2023. Mean age was 61.3 years and 64.7% were female. ∼70% had moderate-to-severe Bronchiectasis Severity Index (BSI) scores, 29.3% had ≥3 exacerbations in the prior 12 months and 35.7% were positive forP. aeruginosa. Mean BSI scores were highest in Australia/New Zealand (8.3) and lowest in Latin America (5.9). Overall, the most common aetiology was idiopathic (58.4%). InP. aeruginosa-positiveversus P. aeruginosa-negative patients, lung function was lower, with greater long-term macrolide (21.5%versus14.0%) and inhaled corticosteroid use (63.5%versus53.9%). There was wide regional variation in long-term antibiotic use in patients with bronchiectasis andP. aeruginosa.DiscussionASPEN baseline characteristics and treatment profiles were representative of a global bronchiectasis population.
Randomised, phase 1/2a trial of ION-827359, an antisense oligonucleotide inhibitor of ENaC
Authors: Sutharsan Sivagurunathan , Fischer Rainald , Gleiber Wolfgang , Horsley Alex , Crosby Jeff , Guo Shuling , Xia Shuting , Yu Rosie , Newman Kenneth B. , Elborn J. Stuart 
Published: April 2024

BackgroundHyperactivity of epithelial sodium channel (ENaC) with increased sodium absorption is a feature of cystic fibrosis (CF). ION-827359 is a 2.5-generation antisense oligonucleotide targeted to reduce ENaC protein. This study evaluated ION-827359 safety, pharmacokinetics and pharmacodynamics.MethodsIn this three-part phase 1/2a, double-blind, randomised study, healthy volunteers received single doses of placebo or ION-827359 (3, 10, 37.5 or 100 mg; Part 1) or multiple doses of placebo or ION-827359 (5×10 mg, 5×37.5 mg, 5×75 mg or 10×37.5 mg; Part 2). People with CF (pwCF) received multiple doses of placebo or ION-827359 (5×10 mg, 5×37.5 mg, 5×75 mg and 5×100 mg; Part 3). Treatments were administeredviaPari eFlow©mesh nebuliser. The primary outcome was safety; pharmacokinetic and pharmacodynamic parameters were also assessed.Results64 healthy volunteers and 34 pwCF were enrolled. ION-827359 was well tolerated with an acceptable safety profile. There were no clinically relevant changes in laboratory values, ECG or vital signs. Systemic drug exposure was low (plasma half-life ∼2 weeks). Multiple doses of ION-827359 were associated with dose-dependent reductions in ENaC mRNA in bronchial epithelium. After multiple dosing, forced expiratory volume in 1 s was slightly higher in pwCF receiving ION-827359 (+2.9% with ION-827359 100 mgversusplacebo; p=0.27).ConclusionsThe tolerability and safety of ION-827359 appear favourable at this stage of investigation. Reduction in ENaC mRNA supports mechanistic efficacy at the doses and regimens tested, and supports further investigation of ION-827359 in pwCF.