bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of the radiotherapy target volume and prognostic factors on the results of treatment of patients with cervical lymph nodes metastases of squamous cell carcinoma of unknown primary
Authors: Sheiko А. V. 
Published: March 2024

Introduction: The issues of the radiotherapy target volumes in cases of cervical lymph nodes metastases of squamous cell carcinoma of unknown primary (SCCUP) remain unresolved due to the lack of clinical studies. Escalation or de-escalation of treatment may be directly related to prognostic factors. Purpose of this study was to evaluate the results of treatment using ipsilateral (only involved side of the neck) or total (bilaterally neck and pharyngeal mucosa) radiation therapy (RT) and to analyze the influence of clinical factors on overall survival (OS) and progression-free survival (PFS).Methods: A retrospective non-randomized clinical trial was conducted. Two-year OS and PFS were assessed in 26 SCCUP patients, who underwent combined treatment, including radiation therapy. Inoperable patients received either definitive RT (3.85 %) or sequential chemoradiation therapy (CRT, 11.5 %), or concurrent CRT (3.85 %). Operable patients underwent neoadjuvant RT with lymph node dissection (34.6 %) or lymph node dissection with adjuvant RT (11.5 %) or adjuvant sequential CRT (7.7 %) or adjuvant concurrent CRT (27 %); 50 % of patients received RT in a dose of more than 60 Gy, in 50 % it was less than 60 Gy. In 54 % of patients, only the ipsilateral cervical lymph nodes were included in the irradiation volume while 46 % of patients received RT to the pharyngeal mucosa and lymph nodes of the neck bilaterally (total radiation therapy group).Results: The median follow-up was 17 months. The 2‑year OS was 71.5 % (95 % CI 49.3–85.3 %), the 2‑year PFS was 72.1 % (95 % CI 44.5–87.6 %). There were no significant differences in 2‑year OS between the ipsilateral and total radiotherapy groups (HR = 1.08 [0.29–4.06], p = 0.904). Only a factor of extranodal extension (ENE) had a statistically significant impact on OS (HR = 6.05 [1.45–25.19], p = 0.0134).Conclusion: There was no statistically significant difference in 2‑year OS and PFS between the ipsilateral and total radiation therapy groups. A negative prognostic factor is the extranodal extension (ENE) of a metastatic tumor. Prospective randomized trials are needed.
Study of the pharmacokinetics, pharmacodynamics, and safety of the biosimilar pembrolizumab RPH-075 compared to Keytruda® in patients with malignant neoplasms
Authors: Samoylenko I.  V. , Pokataev I. А. , Zhukova L. G. , Stroyakovsky D.  L. , Orlova R.  V. , Mudunov А. М. , Pak М. В. , Zernova Е. V. , Sobolev А. V. , Mochalova А. S. , Alekseev B. Ya. , Sekacheva М. I. , Ledin Е. V. , Petkova А. V. , Khanonina Е. К. , Podolyakina А. I. , Razzhivina V. А. 
Published: March 2024

Introduction: Pembrolizumab is a humanized monoclonal antibody selectively blocking the interaction between the PD-1 receptor and its ligands. The drug RPH-075 is a biosimilar to the original Keytruda®.Objective: To establish the equivalence of pharmacokinetic (PK) properties, as well as pharmacodynamic (PD) parameters, safety, and immunogenicity of the drug RPH-075 compared to Keytruda® in patients with malignant tumors.Materials and Methods: This multicenter double-blind randomized study included 90 patients with melanoma and non-small cell lung cancer who were randomized into two treatment groups (RPH-075 and Keytruda ®) in 1:1 ratio. In both groups, pembrolizumab was administered as monotherapy at a dose of 200 mg intravenously every 3 weeks until progression or intolerable toxicity. The primary aim of the study was to assess PK after the first administration. The primary endpoint for PK assessment was AUC(0–504), and for safety, it was the frequency of adverse events (AE). The decision on PK equivalence was planned to be made if the two-sided 90 % confidence interval (CI) for the geometric mean ratio of AUC(0–504) after a single administration of each drug would be within 80.00–125.00 %. Secondary endpoints included Cmax after the first administration, as well as the other PK, safety, and immunogenicity parameters. This study also assessed PK and PD parameters after multiple administrations, and a pilot efficacy assessment was planned.Results: This article presents the analysis of data from the first stage of the study (after the first drug administration with a 3‑week observation period). The data analysis was blinded, and the treatment groups were coded as A and B. The 90 % CI for the geometric mean ratio of AUC(0–504) after the administration of drug A to AUC(0–504) of drug B was 93.50–121.16 %, and for the ratio of B to A, it was 82.54–106.95 %. The obtained intervals met the specified equivalence limit of 80.00–125.00 %, allowing us to conclude that RPH-075 and original Keytruda® are PK equivalent. Both drugs demonstrated comparably high saturation of PD-1 receptors on CD4+ / CD8+ lymphocytes at the end of the first cycle (day 22). Binding antibodies to pembrolizumab were detected in 2 patients (one in each group) over the analyzed period, indicating comparably low immunogenicity for both drugs. Safety profile analysis during this period revealed 7 AEs in 4 patients in group A and 4 AEs in 3 patients in group B. The frequency of AEs did not significantly differ between the groups.Conclusions: PK, PD, immunogenicity, and safety parameters of the pembrolizumab biosimilar RPH-075 were equivalent to those of the original Keytruda®.
Preliminary results of surgical treatment and neoadjuvant chemotherapy in upper rectal cancer
Authors: Lukmonov S.  N. , Belenkaya Y.  V. , Gordeev S.  S. , Sadikov A.  J. , Mamedli Z. Z. 
Published: March 2024

Introduction: There is a lack of information on the role of neoadjuvant chemotherapy in upper rectal cancer. The aim of our research was to investigate the role of neoadjuvant chemotherapy in upper rectal cancer treatment.Materials and methods: We conducted a retrospective cohort multicenter study to analyze the medical records of patients with upper rectal cancer from 2007 to 2020 obtained from the archive of Research Institute FSBI «N. N. Blokhin Cancer Research Center» of the Ministry of Health of Russia, A. N. Ryzhikh National Medical Research Centre for Coloproctology, Stavropol regional Clinical oncological Dispensary and Kaliningrad oncological Center. All patients were divided into 2 groups: group 1 included patients who underwent neoadjuvant chemotherapy with CAPOX as the first treatment step, and group 2 included patients who underwent upfront surgery. Primary endpoint was 3‑year disease-free survival (DFS) rate. We also estimated the pathological complete response (pCR) rate, treatment toxicity, postoperative morbidity rate (Clavien – Dindo), degree of tumor regression, local recurrence rate, distant metastases rate, 3‑year overall survival (OS) and the neoadjuvant chemotherapy completion rate.Results: 118 patients were included in the neoadjuvant chemotherapy group and 103 patients — in the surgery group. Study groups were well balanced and comparable for gender, the ASA status and the tumor differentiation grade. More patients in the neoadjuvant chemotherapy group had clinically positive lymph nodes (p = 0.002). Median follow-up period was 36 months. There were no significant differences in 3‑year OS and DFS. The local recurrence rate was 3.9 % in the surgery group versus 0 % in the neoadjuvant chemotherapy group (p = 0.046). There were no significant differences between study groups in the distant metastases rate (p = 0.293). Sixteen (13.6 %) patients had a pCR after neoadjuvant chemotherapy. The neoadjuvant chemotherapy completion rate was 91.5 %. The hematological toxicity grade 3–4 was observed in 3.3 % (4 patients), the non-hematological toxicity grade 3–4 in 3.3 % (4 patients).Conclusion: NACT has an acceptable toxicity profile, does not impede oncological treatment results, and can be used in a selected group of patients for early systemic control.
Case reports of BRAF V600E-mutated tumors effectively treated using the agnostic approach
Authors: Prokudina N.  V. , Kramchaninov М. М. 
Published: March 2024

A tumor-agnostic approach to cancer treatment that implies the selection of agents targeting specific genetic aberrations and signaling pathways regardless of the tumor site of origin represents a new direction in personalized oncology. Pembrolizumab is the first therapy approved for unresectable microsatellite instability-high (MSI-H) tumors of any location. In 2022, the combination of dabrafenib and trametinib was approved by the US Food and Drug Administration (FDA) for the treatment of patients with solid tumors harboring BRAF V600E mutations. Melanomas, colorectal cancers, and non-small cell lung cancers are BRAF-mutated in 60 %, 15 %, and 5–8 % of cases, respectively. BRAF-mutated glioblastoma (3 %), cholangiocarcinoma (5–7 %), pancreatic cancer (1–16 %), and Langerhans cell histiocytosis (57 %) have also been reported.We present two case reports of BRAF-mutated salivary gland and pancreatic cancers in patients with progressive disease despite standard-of-care therapy who were treated with a combination of dabrafenib and trametinib according to the agnostic approach.The presented case reports have demonstrated that the agnostic approach and treatment with BRAF / MEK inhibitors stabilize the disease in patients with BRAF-positive cancers, including those with multiple metastases, and represent an additional therapeutic option for patients with rare BRAF-mutated cancers for which very few pharmacologic options are available.
Opportunities for Integration in the Dual Medicare-Medicaid Population: North Carolina Landscape Analysis
Authors: Freed Salama S. , Frascino Nicole , Jones Kelley A. , Giri Abhigya , Stewart Lucas , Hendel Keren , Clark Amy G. , Van Houtven Courtney , Higgins Aparna , Kaufman Brystana G. 
Published: March 2024

Background NC Medicaid is amid a transformation to value-based care models. The transformation requires the consideration of models that may best serve the 1 in 5 NC Medicaid beneficiaries who are dually enrolled in Medicare. The lack of integration of Medicare and Medicaid administration, financing, and care may contribute to suboptimal health outcomes and care experiences. Integrating Medicare and Medicaid to improve care for dually enrolled individuals requires knowledge of the demographic, eligibility, and enrollment trends, as well as the medical needs of these individuals throughout North Carolina. Methods We performed a cross-sectional analysis of 2019 NC Medicaid administrative enrollment data and 2015–2020 Medicare and Medicaid public use files. Results Nearly half of North Carolina’s full-benefit dual-eligible (FBDE) population was eligible for Medicare due to disability. About one-third of the FBDE population lost full Medicaid benefits at some point during 2019; of these, 65% were under age 65. Most FBDE beneficiaries were enrolled in Medicaid fee-for-service, with 3.5% enrolled in Community Alternatives Program (CAP) waivers, 2% in Medicaid waivers for beneficiaries with behavioral health or intellectual and developmental disabilities (BH/IDD) or traumatic brain injury (TBI), and 1% in the Program of All-Inclusive Care for the Elderly (PACE). Enrollment in Medicare Duals Special Needs Plans (D-SNPs) increased from 7.3% of the FBDE population in 2015 to 32.5% in 2021. Limitations This descriptive, cross-sectional evaluation of North Carolina duals may not be generalizable to other time periods and contexts. Conclusion Medicare-Medicaid integration presents an opportunity to improve the value of care for dual-eligible beneficiaries and aligns with the goals of NC Medicaid transformation. Integration strategies that leverage the current infrastructure may minimize disruption of services for beneficiaries and mitigate the impacts of unstable enrollment, particularly among working-age adults and disabled beneficiaries. The diversity within the dual-eligible populations requires a strategy designed to improve health equity across race, disability, eligibility, geography, and health care needs.
Gambaran Sanitasi Lingkungan dan Status Gizi dengan Infeksi Kecacingan pada Siswa Madrasah Ibtidaiyah Singosari, Boyolali
Authors: Irawan Nurul Anira , Sari Yulia , Haryati Sri , Negara Khesara Sastrin Prasita 
Published: March 2024

Pendahuluan: Infeksi kecacingan disebabkan oleh kelompok cacing parasit soil transmitted helminths (STH) dan non-STH. Infeksi kecacingan dapat dipengaruhi oleh sanitasi lingkungan yang buruk serta status gizi yang tidak baik. Anak-anak usia sekolah sangat rentan terhadap infeksi kecacingan karena aktivitasnya yang erat dengan tanah, terutama yang bertempat tinggal di sekitar peternakan dan memiliki orang tua dengan tingkat pendapatan yang rendah. Penelitian ini bertujuan untuk melihat gambaran sanitasi lingkungan dan status gizi dengan infeksi kecacingan pada siswa Madrasah Ibtidaiyah (MI) Singosari, Boyolali. Metode: Penelitian ini menggunakan metode cross-sectional. Penelitian dilaksanakan di MI Singosari, Boyolali. Subjek penelitian adalah seluruh siswa MI Singosari yang berjumlah 63 siswa. Berdasarkan hasil kuesioner didapatkan data sanitasi lingkungan dan data tinggi dan berat badan siswa didapatkan dari hasil pengukuran antropometri. Pemeriksaan feses dilakukan dengan metode langsung dengan larutan NaCl 0,9% dan lugol di Laboratorium Parasitologi Fakultas Kedokteran Universitas Sebelas Maret. Data dianalisis dengan metode analisis deskriptif. Hasil: Hasil penelitian menunjukkan bahwa tidak ada siswa yang mengalami infeksi kecacingan. Data juga menunjukkan bahwa 76,2% siswa memiliki sumber air bersih yang baik, 60,3% memiliki kondisi jamban yang baik, 50,8% memiliki kondisi saluran pembuangan air limbah yang baik, 84,1% memiliki kondisi tempat sampah yang baik, 77,8% memiliki kondisi lantai yang baik, dan 69,8% memiliki status gizi yang baik. Kesimpulan: Siswa MI Singosari, Boyolali tidak ada yang mengalami infeksi kecacingan dan mayoritas siswa memiliki kondisi sanitasi lingkungan dan status gizi yang baik.
Hubungan Usia Pertama Pemberian MP-ASI dengan Stunted pada Balita Usia 12-59 Bulan di Wilayah Kerja Puskesmas Purwantoro I
Authors: Naufal Sera Musthafa  , Sari Maria Galuh Kamenyangan , Siti Munawaroh  
Published: March 2024

Pendahuluan: Stunting merupakan suatu kondisi yang menjadi perhatian kesehatan di dunia. Balita yang mengalami stunting mengalami dampak besar di kehidupan kedepannya seperti kesehatan, kecerdasan, dan tumbuh kembang anak. Makanan pendamping ASI (MP-ASI) merupakan makanan yang diberikan pada balita sejak usia 6 bulan yang berguna untuk memenuhi kebutuhan dan nutrisi balita selain ASI. Namun beberapa balita mendapatkan MP-ASI pada usia >6 bulan, sehingga balita cenderung mengalami malnutrisi dapat berakibat stunting. Oleh karena itu, penelitian ini bertujuan untuk mengetahui hubungan usia pertama pemberian MP-ASI dengan kejadian stunting pada balita.
Metode: Penelitian ini merupakan penelitian observasional analitik dengan pendekatan cross sectional. Sampel yang digunakan adalah balita yang tercatat di rekam medis Puskesmas Purwantoro I yang memenuhi kriteria inklusi dan eksklusi. Sampel pada penelitian ini diambil dengan menggunakan purposive sampling yang berjumlah 100 balita. Variabel bebas adalah usia pertama pemberian MP-ASI dan variabel terikat adalah kejadian stunting. Data analisis menggunakan uji spearman dengan aplikasi SPSS versi 25.
Hasil: Pada penelitian ini jenis kelamin laki-laki dan perempuan sama banyak, yaitu 50 balita. Sebagian besar usia pertama pemberian MP-ASI adalah 6 bulan berjumlah 75 balita, usia balita terbanyak adalah 48-59 bulan sejumlah 67 balita. Ditemukan kategori Z-score TB/U terbanyak adalah < -2 SD sejumlah 49 balita. Hasil dianalisis menggunakan uji Spearman dan didapatkan nilai signifikansi 0,297 (sig. 2 tailed > 0,05).
Kesimpulan: Tidak terdapat hubungan signifikan antara usia pertama pemberian makanan pendamping ASI dengan stunted pada balita usia 12-59 bulan di wilayah kerja Puskesmas Purwantoro I.
WITHDRAWN: Impact of SMOFlipid Emulsion Integration in Total Parenteral Nutrition on Inpatient Outcomes and Economic Burden for Preterm Neonates: A Retrospective Cohort Study
Authors: Refaay Mohamed Emad Eldin , Yassine Omaima Gaber Mohamed , Abu-Sheasha Ghada Ahmad , Sayed Prof. Dr. Adel Zaki Abdel 
Published: March 2024

Abstract
INTRODUCTION: The using of lipid emulsion in TPN for preterm infants can affect clinical outcomes.
Objective: to assess the health outcomes and potential adverse effects stemming from the exclusion of SMOFlipid emulsion in TPN, specifically focusing on the incidence of neonatal sepsis, length of stay (LOS) in the Neonatal Intensive Care Unit (NICU), and the associated economic implications from the perspective of healthcare providers in Egypt.
METHODS: A record-based retrospective cohort study was conducted in 2021. We collected data from the neonatal intensive care unit (NICU) of Alexandria University Pediatric Hospital, Egypt, who received TPN. The collected data included gestational age, birth weight, sex, diagnosis of sepsis, LOS in the NICU and type of TPN. Our sample comprised 103 newborns who received TPN with SMOFlipid and 104 newborns who received TPN without SMOFlipid. Balance of baseline characteristics of the study groups was achieved using propensity score. Odds ratios were estimated using logistic regression, and the statistical significance was set at < 0.05.
RESULTS: Compared with TPN without lipids, the use of SMOFlipid was associated with an observed reduction in the risk of sepsis (OR = 0.47, 95% CI: 0.22 - 1.03) and difference in the mean reduction in hospital stay (4.12 days, p = 0.08). Moreover, using SMOFlipid was associated with a significant mean reduction in cost by 6,396 EGP (95% CI: 1,491 - 11,546 EGP).
CONCLUSION: The integration of SMOFlipid into TPN for preterm infants is associated with decreased incidence of sepsis, reduced NICU stay, and significant cost savings, warranting consideration for standard care practices.
Using Games to Simulate Medication Adherence and Nonadherence: Laboratory Experiment in Gamified Behavioral Simulation
Authors: Taj Umar , Grimani Aikaterini , Read Daniel , Vlaev Ivo 
Published: March 2024

Abstract

Background
Medical nonadherence is a significant problem associated with worse clinical outcomes, higher downstream rehospitalization rates, and a higher use of resources. To improve medication adherence, it is vital for researchers and practitioners to have a solid theoretical understanding of what interventions are likely to work. To achieve this understanding, we propose that researchers should focus on creating small-scale laboratory analogs to the larger real-world setting and determine what interventions, such as nudges or incentives, work to change behavior in the laboratory. To do this, we took inspiration from the literature on serious games and gamification and experimental economics. We call our approach “gamified behavioral simulation.” In this paper, we modeled everyday life as the state of being engaged in a simple but addictive game, illness as being interruptions to the functionality of that game, treatment as being a series of actions that can be taken to prevent or mitigate those interruptions, and adherence as sticking to a prescribed rule for the application of those actions.

Objective
This study carries out a behavioral diagnosis of the medication adherence problem through a theoretically informed framework and then develops the gamified behavioral modeling approach to simulate medication nonadherence.

Methods
A laboratory experiment was conducted using a modified popular and addictive open-source video game called “2048,” which created an abstract model for the medication adherence behavior observed in real life. In total, 509 participants were assigned to the control and 4 intervention groups (“incentive” group, “reminder” group, “commitment device” group, and “elongated duration for symptoms” group).

Results
The results of the modeling experiment showed that having theoretically informed interventions can increase the likelihood for them to be successful. In particular, there is evidence that the use of reminders improves the medication adherence rates for patients, and the same result was found in the modeling experiment, as they improved adherence significantly by 23% (95% CI −33.97% to −11.72%; P<.001). However, providing an incentive did not improve the adherence rate. We also tested the use of commitment devices, which, in line with real-world evidence, did not improve adherence rates. The fourth treatment tested elongated duration for symptoms, which attempted to show the power of modeling experiments where we test a what-if scenario that is extremely difficult to test in a real setting. The results indicated that if symptoms last longer, people did not adhere more to their medication regimen.

Conclusions
Gamified behavioral simulation is a useful tool to explain real health behaviors and help in identifying which interventions are most likely to work in a randomized trial.
Faktor yang Berhubungan dengan Kepatuhan Penggunaan Alat Pelindung Diri pada Petugas Penanganan Prasarana dan Sarana Umum Kelurahan Cawang Tahun 2023
Authors: Astuti Galuh Putri Kusuma , Amrullah Afif Amir , Simanjorang Chandrayani , Apriningsih  
Published: March 2024

APD merupakan upaya untuk mencegah penyakit akibat kerja (PAK) maupun kecelakaan kerja akibat bahaya dan risiko pekerjaan pada Petugas Penanganan Prasarana dan Sarana Umum (PPSU) Kelurahan Cawang. Tujuan dari penelitian adalah untuk melihat faktor yang berhubungan dengan kepatuhan penggunaan APD petugas PPSU Kelurahan Cawang. Penelitian dilakukan menggunakan metode analitik kuantitatif dengan desain studi cross-sectional. Besar sampel adalah 79 responden yang ditentukan berdasarkan teknik purposive sampling. Instrumen penelitian menggunakan kuesioner dan lembar observasi. Hasil penelitian dengan uji regresi logistik didapatkan bahwa pendidikan (p-value=0,014) dan peraturan K3 (p-value=0,046) memiliki hubungan dengan kepatuhan penggunaan APD. Variabel usia, masa kerja, pengetahuan, sikap, persepsi, dan pelatihan K3 tidak berhubungan dengan kepatuhan penggunaan APD. Variabel paling dominan berdasarkan analisis multivariat adalah variabel pendidikan (POR=6,088). Dapat disimpulkan bahwa variabel yang berhubungan dengan kepatuhan penggunaan APD adalah pendidikan dan peraturan K3 dengan variabel pendidikan sebagai variabel paling dominan. Disarankan untuk membuat peraturan atau SOP jelas terkait standar APD, jenis APD sesuai pekerjaan, dan sanksi terkait APD yang mudah diakses oleh petugas PPSU serta melakukan pengawasan yang lebih ketat saat bekerja.
Kata Kunci: Alat Pelindung Diri, Kepatuhan, Petugas PPSU