bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contemporary management of patients with advanced melanoma: Utility of an online interactive decision support tool to assess concordance of healthcare professional treatment patterns with expert recommendations.
Authors: Becker Marie N. , Rosenthal Kristen M. , Betof Warner Allison , Daud Adil , Lipson Evan J. , Tarhini Ahmad A. , Tawbi Hussein A. 
Published: May 2024

e13548 Background: The treatment landscape for patients with melanoma continues to evolve with approvals of novel therapeutic agents for advanced disease and new indications for therapy in earlier-stage disease. Using an online decision support tool, we compared practice patterns and treatment recommendations between community healthcare professionals (HCPs) and key opinion leaders (KOLs). Methods: The online decision support tool was developed with input from 5 KOLs who provided treatment recommendations for 151 hypothetical patients. Case scenarios covered a spectrum of stages (III, IV), central nervous system (CNS) metastases, BRAF mutation status, and treatment histories. HCPs entered specific patient criteria into the tool to define a case and their intended therapy choice and the tool then showed 5 KOL recommendations for that patient case. An analysis of KOL recommendations and HCP-selected therapy was performed. Results: Between August 2023 and January 2024, 156 patient cases were entered by 100 HCPs. HCP and KOL recommendations were concordant in 51% (80/156) of cases. The highest level of discord among HCPs and KOLs was 72% for patients with completely resected stage IIIA melanoma and no positive lymph nodes having a metastatic focus ≥1mm (n = 25) (Table). A lower level of discordance (31%, n = 35) was observed in therapy selection for patients with stage IIIA melanoma and ≥1 positive lymph node. For first-line therapy in patients with unresectable stage III or IV BRAF wild-type melanoma (n = 16), discordance was 50% between HCPs and KOLs. The level of discordance was higher for first-line therapy for patients with BRAF-mutant melanoma (68%, n = 19). For the management of patients with CNS metastases, 40% of HCP therapy selections were not aligned with KOLs (n = 40). More than one half (56%) of HCPs noted that the tool confirmed their treatment plan, and 21% intend to change practice to align with KOLs. Conclusions: This analysis identified areas of discordance in clinical practice between HCPs and KOLs for advanced melanoma that can guide further education and enhance communication of evolving evidence to HCPs. Our data suggest that use of the decision tool can confirm best practices with KOL recommendations and improve alignment of treatment choices with KOLs. [Table: see text]
Clinical decision making by ChatGPT vs medical oncologists: A retrospective concordance study.
Authors: Rushanyan Marine , Aghabekyan Tigran , Tamamyan Gevorg , Zohrabyan Davit , Safaryan Liana , Bedirian Karen , Sargsyan Karine , Mkrtchyan Gohar 
Published: May 2024

e13634 Background: This research explores the application of AI language models in clinical decision-making within the context of oncology, focusing on the concordance between AI-generated recommendations and actual treatment decisions made by physicians. Leveraging ChatGPT version 4.0, a large language model, we conducted a concordance study using retrospective patient cases from Yeolyan Hematology and Oncology Center. The hypothesis, centered on the alignment of AI chatbots with human decisions, spurred an in-depth exploration of concordance rates. Methods: A total of 228 adult solid malignancy cases from Yeolyan Hematology and Oncology Center (Jan 2020 - Sep 2021) were analyzed, focusing on primary cancers and data from multidisciplinary tumor board meetings. We scored concordance and analyzed the response times as well. Results: The study unveiled an overall 62.3% concordance rate, with varying rates among different cancer types: lung (50%), breast (50%), gastrointestinal (66%), and gynecological (81.8%) cancers. Despite promising results, challenges emerged, including variability in ChatGPT-4 responses and concerns about reliability and reproducibility. The study acknowledges the influence of prior assessments from other healthcare facilities, financial disparities impacting treatment decisions, and potential oversimplification of chemotherapy regimens. Conclusions: AI-based language models like ChatGPT present intriguing possibilities for healthcare, yet further research, controlled trials, and prospective studies are imperative to comprehensively understand and enhance their applicability in personalized patient care. This research sheds light on the complexities and considerations associated with integrating AI into oncological decision-making, offering valuable insights for future advancements in this evolving field.
Patient experience and pain outcomes among Black women with early-stage breast cancer after mastectomy.
Authors: Smith-Graziani Demetria Joy , Cao Yichun , Switchenko Jeffrey M. , Acheson Meghan , McHenry Jessica , Rimawi Mothaffar F. , Kalinsky Kevin , Brewster Abenaa M. 
Published: May 2024

e13751 Background: Racial pain disparities in breast cancer (BC) are well-described and persist despite prior trials to improve disparate pain outcomes. We previously found Black women (BW) reported more pain severity (PS) and interference with life (PI) after breast surgery compared to White women. Pain expression is multifactorial, and structural factors affect the ability to report and control pain. Perceived discrimination is associated with mistrust of medical providers, which affects clinical outcomes. Their impact on pain is understudied. We evaluated the association between discrimination, trust, and pain among BW with early-stage BC after mastectomy. Methods: BW with stage 0-III BC who had mastectomy ≤2 years of enrollment at academic and safety net hospitals in Houston, TX and Atlanta, GA, completed a demographic survey, Brief Pain Inventory (BPI), Discrimination in Medical Settings Scale (DMS), and Trust in Physician Scale (TPS). In BPI, worst, least, and average PS were reported from 0-10. PI from 0-10, pain treatments, and % relief were reported. DMS and TPS questions were on a 5-point Likert scale. We performed chart review to obtain baseline clinical data related to BC diagnosis, treatment and comorbidities. PI and DMS were scored as a mean of the total items of each survey. Mean Trust and Mistrust scores used means of TPS questions related to each category. Higher scores mean more PS, PI, discrimination, trust, or mistrust. We used ANOVA to examine associations between categorical variables and Pearson correlation coefficient for continuous variables. We performed univariate linear regression and multi-linear regression between specific variables and outcomes, accounting for collinearity. Results: Of the 77 BW surveyed, 66.2% received chemotherapy. 47.2% had a household income < $25,000, and 40.3% had private health insurance. PS, PI, DMS, and trust scores are shown (Table). Univariate analysis showed an association between DMS and mistrust (p=0.01), lower income and higher PS (p=0.01) and PI (p=0.04), and insurance status and PS (p=0.02) and PI (p=0.02). Associations between mistrust or DMS and pain were not statistically significant. A multivariate analysis with DMS as outcome showed an association with mistrust (p=0.04). Multivariate analysis also showed receipt of chemotherapy was associated with higher PS (p=0.02) and PI (p=0.03). Conclusions: BW have moderate pain up to 2 years following mastectomy. Participants reported low levels of discrimination and high trust. More discrimination was associated with more physician mistrust, but not PS or PI. Lower income and lack of private health insurance were associated with higher PS and PI. Future studies should address discrimination and trust in clinical settings and financial barriers to pain control. [Table: see text]
Patient’s perception of cancer treatment outcomes in geriatric age groups: A retrospective analysis from a tertiary care centre in India.
Authors: Choudhary Jatin , Noronha Vanita , Menon Nandini Sharrel , Shah Minit Jalan , Pillai Anupa , Kumar Anita , Rao Abhijith Rajaram , Pawar Akash , Dhekale Ratan , Prabhash Kumar 
Published: May 2024

e13774 Background: Geriatric population forms a significant part of the total cancer patients in any given country and their expectations, their needs and challenges are different from younger patients. Patients may perceive their “chances” differently from what is expected with cancer treatment. In our analysis we aimed to look at such perceived intent of therapy in geriatric patients and factors that might influence these perceptions. Methods: We retrospectively looked at data of comprehensive geriatric assessment (CGA) which is maintained by the geriatric clinic at our institute. Patients are referred to our geriatric clinic after their joint clinic meetings and after their meetings with their primary oncologists. We identified 2962 patients who underwent CGA and collected data of age, gender, social support, marital status, education level, actual intent of therapy, patients’ perception of intent, their desire of disclosure of disease status. We also collected objective scores of GDS, GAD 7, TUG and ECOG performance status. Descriptive statistics were performed to find out the factors significantly affecting patient’s perception of intent of therapy. Results: The median age of our cohort was 68 years (Interquartile range- 64-72 years). Results are shown (Table). 70.6% wanted full disclosure of disease. Out of 1404 patients who were in palliative setting, 40.2 percent patient had misperception of treatment. Conclusions: Our data highlights the significant impact of patient’s general wellbeing both physical and mental on the perception of their treatment goals. It brings forth the need to address these issues along with cancer therapy in an already vulnerable geriatric population. Our data also highlights the desire to know about the disease status in majority which may empower terminal patients to spend their time and energy on things they value. A nearly 41% misperception in palliative patients is indicative of an urgent need for better communication practices to help patients be more aware of outcomes and thus may be able to put more quality in the limited time they have. [Table: see text]
A window-of-opportunity (WOO) trial of giredestrant +/- LHRHa vs anastrozole+LHRHa in premenopausal women with ER+/HER2- early breast cancer (EBC; IBCSG 67-22; PREcoopERA).
Authors: Munzone Elisabetta , Shi Ruichao , Loi Sherene , Colleoni Marco , Viale Giuseppe , Bjelic-Radisic Vesna , Perello Antonia , Karlsson Per , Madaras Balazs , Connolly Roisin M. , Ribeiro Joana M. , Roschitzki-Voser Heidi , Kammler Roswitha , Ruepp Barbara , Regan Meredith M. , Dubsky Peter Christian ,   PREcoopERA Collaborators
Published: May 2024

TPS628 Background: Adjuvant endocrine therapy (ET) for premenopausal women with ER+/HER2- EBC often includes ovarian function suppression (OFS) via a GnRH or LHRH agonist (LHRHa) plus an aromatase inhibitor (AI) or tamoxifen. Younger age is associated with lower rates of ET adherence indicating side effects are less acceptable to these women. The development of drug regimens without OFS are clearly an unmet medical need in this setting. New oral selective ER degraders (SERDs) are emerging as potentially useful ETs in the (neo)adjuvant settings. Giredestrant is an efficient and potent SERD and a full antagonist, which translates into better anti-proliferation activity than known SERDs. PREcoopERA is a WOO trial aiming to determine, among premenopausal women with ER+/HER2- EBC: if giredestrant+LHRHa provides greater anti-proliferative activity than anastrozole+LHRHa; and if giredestrant without LHRHa provides similar (non-inferior) anti-proliferative activity to giredestrant+LHRHa. Results would provide rationale for subsequent (neo)adjuvant clinical trials. Methods: PREcoopERA (NCT05896566) is a randomized, open-label, 3-arm, WOO trial evaluating the anti-proliferative activity and safety of the oral SERD giredestrant +/- LHRHa triptorelin, as compared to the AI anastrozole + triptorelin. Eligible are premenopausal women with untreated ER+/HER2- operable stage I-III (excl. T4) EBC, with Ki-67 ≥10%. 220 women will be randomized in 2:2:1 ratio to giredestrant (30 mg/d po for 4 weeks until rebiopsy) + triptorelin (3.75 mg IM on D1); giredestrant alone; or anastrozole (1 mg/d po) + triptorelin. Rebiopsy is planned for D29, either during primary surgery or standalone procedures. The primary endpoint is change in Ki-67 labeling index between pre-treatment diagnostic tumor biopsy and post-treatment rebiopsy, as assessed by the IBCSG Pathology Office. Sample size of 80:80:40 randomized women are planned to test superiority of 4 weeks giredestrant+triptorelin vs anastrozole+triptorelin to reduce Ki-67 (hypothesized percentage changes -80% vs -65%) and to test non-inferiority of 4 weeks giredestrant vs giredesrant+triptorelin (within 10% as non-inferiority margin). The trial was activated on 9 October 2023. The first woman was enrolled on 25 January 2024. Clinical trial information: NCT05896566 .
Optimal placement of a dissimilar node for chaos suppression in networks
Authors: Chawla Komal , Sinha Sudeshna 
Published: May 2024

Abstract
We demonstrate that the presence of a single dissimilar chaotic system suppresses chaos in networks of chaotic oscillators, in a diverse set of network topologies, for sufficiently strong coupling. The key property is determined to be the sum of the path lengths between the dissimilar node and all the other nodes (or its maximum, if coupled to unconnected networks), and there exists a linear relation between this quantity and the critical coupling strength for the onset of a spatiotemporal fixed point. This holds true for a chain with the dissimilar node at different locations, a ring and complete network with one embedded dissimilar node, as well as star networks with a dissimilar hub or dissimilar peripheral node. Furthermore, we show that networks with high average degree and high clustering coefficient are more resilient to the influence of an external dissimilar system. These findings will potentially aid in the design of optimally placed dissimilar nodes for controlling chaos in complex networks.
Review of Raynaud’s phenomenon: pathomechanisms, diagnosis and treatment
Authors: Marczyk Aleksandra , Makowska Karolina , Billewicz Marta , Lis Laura , Turek Aleksandra , Popiołek Adam , Pietrzykowska Julia , Zatorska Oksana 
Published: May 2024

Introduction: Raynaud’s phenomenon (RP) is a quite common but often unrecognised vasospastic condition of the peripheral vessels. This may happen after exposure to the cold, stress, vibrations or a wide range of medical conditions. It causes episodic colour changes of the digits, firstly there is a pallor, followed by cyanosis and/or redness, usually with pain. Raynaud’s phenomenon can be primary (i.e. Raynaud’s disease) or secondary (i.e. Raynaud’s syndrome) to underlying disease.
Aim of the study: The aim of the study was to discuss the complex and incompletely understood pathophysiology of Raynaud’s phenomenon and to evaluate treatment approaches of both ‘uncomplicated’ - mostly primary and ‘complicated’ - mostly secondary Raynaud’s phenomenon.
State of knowledge: Raynaud’s phenomenon is a common disorder with an unclear pathophysiology. Although many treatment approaches have been reported, there is still no cure or gold standard therapy. Further investigations into treatment are required.
Conclusions: Future research is needed to understand the complex pathogenesis of RP and to develop optimised approaches to management.
Electric tuning of plasmonic resonances in ultrathin gold nanoribbon arrays
Authors: Wang Zhenxin , Krasavin Alexey V. , Pan Chenxinyu , Zheng Junsheng , Li Zhiyong , Guo Xin , Zayats Anatoly V. , Tong Limin , Wang Pan 
Published: May 2024

Ultrathin plasmonic nanostructures offer an unparalleled opportunity for the study of light–matter interactions at the nanoscale and realization of compact nanophotonic devices. In this study, we introduce an ultrathin gold nanoribbon array and demonstrate an electric approach to actively tuning its plasmonic resonance, which leveraging the extreme light confinement capability in the ultrathin plasmonic nanostructure and a robust nanoscale electro-optical effect in indium tin oxide. Optimizing the design (to a total thickness as small as 12 nm for a 2-nm-thick gold nanoribbon array), we numerically demonstrate a spectral shift in the plasmonic resonance up to 36 nm along with an approximately 16% change in the transmission at a gate voltage below 1.7 V at the wavelength of 1.47 μm. This work presents progress towards electric tuning of plasmonic resonances in ultrathin metallic nanostructures for various applications including surface-enhanced spectroscopy, spontaneous emission enhancement, and optical modulation.
Comparison of the intrageneric neutralization scope of monospecific, bispecific/monogeneric and polyspecific/monogeneric antisera raised in horses immunized with sub-Saharan African snake venoms
Authors: Sánchez Andrés , Durán Gina , Segura Álvaro , Herrera María , Vargas Mariángela , Villalta Mauren , Arguedas Mauricio , Moscoso Edwin , Umaña Deibid , Gómez Aarón , Gutiérrez José María , León Guillermo 
Published: May 2024

Background
Snakebite envenomation inflicts a high burden of mortality and morbidity in sub-Saharan Africa. Antivenoms are the mainstay in the therapy of envenomation, and there is an urgent need to develop antivenoms of broad neutralizing efficacy for this region. The venoms used as immunogens to manufacture snake antivenoms are normally selected considering their medical importance and availability. Additionally, their ability to induce antibody responses with high neutralizing capability should be considered, an issue that involves the immunization scheme and the animal species being immunized.

Methodology/Principal findings
Using the lethality neutralization assay in mice, we compared the intrageneric neutralization scope of antisera generated by immunization of horses with monospecific, bispecific/monogeneric, and polyspecific/monogeneric immunogens formulated with venoms of Bitis spp., Echis spp., Dendroaspis spp., spitting Naja spp. or non-spitting Naja spp. It was found that the antisera raised by all the immunogens were able to neutralize the homologous venoms and, with a single exception, the heterologous congeneric venoms (considering spitting and non-spitting Naja separately). In general, the polyspecific antisera of Bitis spp, Echis spp, and Dendroaspis spp gave the best neutralization profile against venoms of these genera. For spitting Naja venoms, there were no significant differences in the neutralizing ability between monospecific, bispecific and polyspecific antisera. A similar result was obtained in the case of non-spitting Naja venoms, except that polyspecific antiserum was more effective against the venoms of N. melanoleuca and N. nivea as compared to the monospecific antiserum.

Conclusions/Significance
The use of polyspecific immunogens is the best alternative to produce monogeneric antivenoms with wide neutralizing coverage against venoms of sub-Saharan African snakes of the Bitis, Echis, Naja (non-spitting) and Dendroaspis genera. On the other hand, a monospecific immunogen composed of venom of Naja nigricollis is suitable to produce a monogeneric antivenom with wide neutralizing coverage against venoms of spitting Naja spp. These findings can be used in the design of antivenoms of wide neutralizing scope for sub-Saharan Africa.
Incidence and predictors of mortality among road traffic accident victims admitted to hospitals at Hawassa city, Ethiopia
Authors: Afacho Amanuel Ayele , Belayneh Teshale , Markos Terefe , Geleta Dereje 
Published: May 2024

Background
Globally, road traffic accidents are the eighth-leading cause of death for all age groups. The estimated number of road traffic deaths in low income countries was more than three times as high as in high-income countries. Africa had the highest rate of fatalities attributed to road traffic accidents. Ethiopia has the highest number of road traffic fatalities among Sub-Saharan African countries. The main objective of this study was to determine the incidence and predictors of mortality among road traffic victims admitted to hospitals in Hawassa City.

Methods
A facility-based retrospective cohort study was conducted using secondary data from hospital records. A total of 398 road traffic accident victims admitted to selected hospitals in Hawassa city from January 2019 to December 2021 participated in the study. Data were analyzed using STATA version 14.1. The Cox regression model was used to determine the predictors of mortality. A hazard ratio with a 95% confidence interval and a cut-off value of P<0.05 was used to declare the risk and statistical significance, respectively.

Result
The incidence rate of mortality for road traffic accident victims was 7.34 per 10,000 person-hours. The predictors of mortality were the value of GCS at admission <8 (aHR = 5.86; 95% CI: 2.00–17.19), GCS at admission 9–12 (aHR = 3.27; 95% CI: 1.28–8.40), the value of SBP at admission ≤89mmHg (aHR = 4.41; 95% CI: 2.22–8.77), admission to the ICU (aHR = 3.89; 95% CI: 1.83–8.28) and complications (aHR = 5.48; 95% CI: 2.74–10.01).

Conclusion
The incidence of mortality among road traffic victims admitted to hospitals in Hawassa city was high. Thus, thorough follow-up and intensive management should be given to victims with critical health conditions.