bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variant-Specific IgA Protects Against Omicron Infection
Authors: Goh Yun Shan , Fong Siew-Wai , Hor Pei Xiang , Loh Chiew Yee , Wang Bei , Salleh Siti Nazihah Mohd , Ngoh Eve Zi Xian , Lee Raphael Tze Chuen , Poh Xuan Ying , Rao Suma , Chia Po Ying , Ong Sean W X , Lee Tau Hong , Lim Clarissa , Teo Jefanie , Pada Surinder , Sun Louisa Jin , Ong Desmond Luan Seng , Somani Jyoti , Lee Eng Sing , Maurer-Stroh Sebastian , Wang Cheng-I , Leo Yee-Sin , Lye David C , Young Barnaby Edward , Ng Lisa F P , Renia Laurent ,   NCID Study Group, Yu Jocelyn Jin , Soh Zheng Kuang , Chin Yi Qing , Lim Jonathan Jordon , Ongko Juwinda , Libau Eshele Anak , Theo Celine , Abdullah Mohammed Ridzwan Bin , Diong Shiau Hui , Yeo He Ping ,   COVID-19 Cohort Study Group, Rouers Angeline , Wei Chang Zi , Tay Matthew Zirui , Torres-Ruesta Anthony , Wong Nathan , Huang Yuling , Ong Alice Soh Meoy , Chua Adeline Chiew Yen , Nguee Samantha , Tan Yong Jie , Neo Vanessa , Kam Isaac Kai Jie , Yadunandan Ajayanandan , Selvam Sooriya Kannan , Goh Jarvis , Ying Ng Kah , Yi Sim Xin , Lun Wong Wei , Loo Anna Xinyi , Loo Liang Hui 
Published: November 2023

Abstract

Background
The emergence of rapidly evolving severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, coupled with waning vaccine-induced immunity, has contributed to the rise of vaccine breakthrough infections. It is crucial to understand how vaccine-induced protection is mediated.

Methods
We examined 2 prospective cohorts of mRNA vaccinated and boosted individuals during the Omicron wave of infection in Singapore.

Results
We found that individuals who remain uninfected over the follow-up period had a higher variant-specific IgA, but not IgG, antibody response at 1 month after booster vaccination, compared with individuals who became infected.

Conclusions
We conclude that IgA may have a potential contributory role in protection against Omicron infection.
Clinical Trials Registration . NCT05142319.
A new PK/PD target for assessing efficacy of micafungin against Candida parapsilosis
Authors: Beredaki Maria-Ioanna , Pournaras Spyros , Meletiadis Joseph 
Published: November 2023

Abstract

Background
Pharmacokinetic/pharmacodynamic (PK/PD) targets of echinocandins failed to support current clinical breakpoints of Candida parapsilosis as the PTA is low for susceptible isolates despite the good clinical efficacy of echinocandins against these infections. We therefore investigated the effect of micafungin against C. parapsilosis using an in vitro PK/PD in the presence of 10% human serum.

Methods
Three susceptible (MIC = 0.5–2 mg/L) and one resistant (MIC &gt; 8 mg/L) C. parapsilosis sensu stricto isolates were tested at two different inocula (104 and 103 cfu/mL) simulating micafungin human exposures in RPMI and in RPMI + 10% pooled human serum. The exposure–effect relationship tAUC0–24/MIC was described and different PK/PD targets were determined in order to calculate the PTA for the standard 100 mg IV q24h dose.

Results
A maximal effect was found at fCmax ≥ 4 mg/L in RPMI and tCmax ≥ 64 mg/L (fCmax = 0.08 mg/L) in the presence of serum for which in vitro PK/PD targets were 50 times lower. Stasis in the presence of serum was found at 272–240 tAUC0–24/MIC, close to the clinical PK/PD target (285 tAUC/MIC), validating the in vitro model. However, the PTA was low for susceptible isolates with EUCAST/CLSI MICs ≤ 2 mg/L. Among the different PK/PD targets investigated, the PK/PD target 28 tAUC/MIC associated with 10% of maximal effect with the low inoculum resulted in PTAs ≥ 95% for susceptible isolates with EUCAST/CLSI MICs ≤ 2 mg/L.

Conclusions
A new PK/PD target was found for micafungin and C. parapsilosis that supports the current clinical breakpoint. This target could be used for assessing echinocandin efficacy against C. parapsilosis.
Long-term outcomes of stimulated salivary flow and xerostomia after definitive intensity-modulated radiation therapy for patients with head and neck cancer
Authors: Hiraoka Shinya , Yoshimura Michio , Nakajima Aya , Nakashima Ryota , Mizowaki Takashi 
Published: November 2023

Abstract
This retrospective study aimed to evaluate the time to recovery from xerostomia and analyze its predictors, along with long-term outcomes of stimulated salivary flow after intensity-modulated radiation therapy (IMRT) for head and neck cancer (HNC). We evaluated patients with HNC who had received IMRT with curative intent between 2012 and 2018 at our institution. The salivary recovery ratio (SRR) was defined as ‘(the stimulated salivary flow)/(pre-treatment salivary flow)’. The cutoff value of SRR in salivary recovery was estimated via the relationship between SRR and xerostomia grades. The salivary recovery time was defined as the time for SRR to exceed cutoff values from the end of radiotherapy. Fifty-seven patients were analyzed, with a 48-month median follow-up period of stimulated salivary flow. The cutoff value for SRR was 44.8%, and patients with a higher grade of xerostomia had a lower SRR (P &lt; 0.001). The median salivary recovery time was 12 months. The cumulative incidence rates of salivary recovery at two and four years were 84 (95% confidence interval [CI]: 53–79) and 92% (95% CI: 82–97), respectively, and these were significantly lower in patients with a higher mean parotid gland dose, mean oral cavity dose and stimulated salivary flow per parotid gland volume. Stimulated salivary flow and xerostomia recover over a long period after radiotherapy.
Module 1: Setting Goals for Therapy
Authors: Jaywant Abhishek , Oberlin Lauren E. , Cherestal Stephanie , Bueno Castellano Christina , Wilkins Victoria M. , Kanellopoulos Dora 
Published: November 2023

Abstract
This chapter covers approaches the therapist can use to facilitate goal setting and enhance motivation in treatment. Goal setting is one of the most effective ways to foster motivation and achieve behavioral change, since setting goals improves the likelihood of successful behavioral change. The chapter includes strategies from Motivational Interviewing, a collaborative, evidence-based approach designed to foster internal motivation. While the facilitation needs only one session, a second session can be helpful to clarify goals for clients having difficulty articulating their goals or suboptimal motivation. At the end of the goal-setting session, therapists should emphasize to the client the importance of home practice during treatment.
Module 8: Confronting Feared and Avoided Situations
Authors: Jaywant Abhishek , Oberlin Lauren E. , Cherestal Stephanie , Bueno Castellano Christina , Wilkins Victoria M. , Kanellopoulos Dora 
Published: November 2023

Abstract
This chapter discusses how clients can evaluate the function of avoidance in their life. The therapist should aim to identify any existing maladaptive avoidance behaviors and patterns and should encourage clients to practice engaging in avoided situations to reduce anxiety and improve functioning. The fight-or-flight response may occur even if the situation is not inherently dangerous, which then motivates avoidance and escape. This module does not provide an exhaustive protocol for exposure therapy, but clients with psychiatric disorders that warrant exposure-based treatment may benefit from dedicated exposure protocols. The chapter discusses the differences between false alarms and true alarms and explains that people recovering from COVID-19 experience interoceptive and somatic sensations and then avoid activities that might trigger similar symptoms.
Module 10: Fatigue and Sleep
Authors: Jaywant Abhishek , Oberlin Lauren E. , Cherestal Stephanie , Bueno Castellano Christina , Wilkins Victoria M. , Kanellopoulos Dora 
Published: November 2023

Abstract
This chapter discusses fatigue and sleep disturbances that can occur as sequelae of COVID-19. Being aware of these issues may help clients to implement behavioral strategies to better manage fatigue and improve sleep. Using cognitive behavioral therapy techniques can help clients to better manage fatigue, learn to develop healthier activity patterns to reframe thoughts, and use mindfulness techniques to decrease overfocus on their symptoms. The chapter covers unhelpful thoughts that clients may have in the context of fatigue and behavioral strategies. It highlights the importance of home practice of the strategies and skills so they will be available when needed.
Module 11: Participating In Medical Treatment
Authors: Jaywant Abhishek , Oberlin Lauren E. , Cherestal Stephanie , Bueno Castellano Christina , Wilkins Victoria M. , Kanellopoulos Dora 
Published: November 2023

Abstract
This chapter highlights the importance of medical adherence in the context of well-being and recovery after COVID-19. It explores strategies to enhance clients’ motivation and improve their adherence to medical recommendations, and addresses common barriers to treatment engagement. Adherence to medical and rehabilitation recommendations can improve clients’ daily functioning, reduce disability, and help them return to a more independent and satisfying life. The chapter considers the barriers to adherence, which include mood and anxiety issues, low motivation, ambivalence, practical barriers, cognitive difficulties, treatment dissatisfaction, and misconceptions about COVID-19. Other topics discussed are how to prepare for medical appointments and telehealth visits. Home practice of the strategies is encouraged to implement skills and experience change in anxiety and depression symptoms.
Loss and Grief
Authors: Jaywant Abhishek , Oberlin Lauren E. , Cherestal Stephanie , Bueno Castellano Christina , Wilkins Victoria M. , Kanellopoulos Dora 
Published: November 2023

Abstract
This chapter explores the various ways that experiences of loss and grief affected individuals with COVID-19. Grief is a normal human response to loss, but other mental health challenges may co-exist or develop. The COVID-19 pandemic resulted in many forms of loss—not only death but also changes in functioning, socialization, religious practices, and social roles. Therapists also have personal experiences with the pandemic and can utilize self-care and mindfulness to attend to their emotional responses. Moreover, empathy stemming from the pandemic experience can help inform their responses to clients while maintaining a connected professional stance. The chapter also highlights the role of acceptance in grief.
StarkML: application of machine learning to overcome lack of data on electron-impact broadening parameters
Authors: Zakuskin Aleksandr S , Labutin Timur A 
Published: November 2023

ABSTRACTParameters of electron-impact (Stark) broadening and shift of spectral lines are of key importance in various studies of plasma spectroscopy and astrophysics. To overcome the lack of accurately known Stark parameters, we developed a machine learning approach for predicting Stark parameters of neutral atoms’ lines. By implementing a data pre-processing routine and explicitly testing models’ predictive ability and generalizability, we achieve a high level of accuracy in parameters prediction as well as physically meaningful temperature dependence. The applicability of the results is demonstrated by the case of low-temperature plasma diagnostics. The developed model is readily accessible for predicting desired Stark parameters.
Magnetic-reconnection-heated corona model: implication of hybrid electrons for hard X-ray emission of luminous active galactic nuclei
Authors: Liu Jie-Ying , Mao Jirong , Liu B F 
Published: November 2023

ABSTRACT
It is widely accepted that X-ray emission in luminous active galactic nuclei (AGNs) originates from hot corona. To prevent the corona from overcooling by strong X-ray emission, steady heating to the corona is essential, for which the most promising mechanisms is the magnetic reconnection. Detailed studies of the coupled disc and corona, in the frame of magnetic field transferring accretion-released energy from the disc to the corona, reveal that the thermal electrons can only produce X-ray spectrum with $\Gamma _{\rm 2-10\, keV}\gt 2.1$, which is an inevitable consequence of the radiative coupling of the thermal corona and disc. In this work, we develop the magnetic-reconnection-heated corona model by taking into account the potential non-thermal electrons accelerated in the magnetic reconnection process, in addition to the thermal electrons. We show that the features of the structure and spectrum of the coupled disc and corona can be affected by the fraction of magnetic energy allocated to thermal electrons. Furthermore, we investigate the effects of the power-law index and energy range of non-thermal electrons and the magnetic field on the spectrum. It is found that the X-ray spectrum from the Comptonization of the hybrid electrons can be flatter than that from thermal electrons only, in agreement with observations. By comparing with the observed hard X-ray data, we suggest that a large fraction ($\gt 40~{{\ \rm per\ cent}}$) of the magnetic energy be allocated to the non-thermal electrons in the luminous and flat X-ray spectrum AGNs.
CRP Predicts the Need to Escalate Care After Initial Debridement for Musculoskeletal Infection
Authors: Moore-Lotridge Stephanie N. , Daryoush Joshua R. , Wollenman Colby C. , Gibian Joseph T. , Johnson Samuel R. , Thomsen Isaac P. , Schoenecker Jonathan G. 
Published: November 2023

Background:
Musculoskeletal infections (MSKIs) are a major cause of morbidity in the pediatric population and account for nearly 1 in every 10 consultations with a pediatric orthopaedic provider at a tertiary care center. To prevent or deescalate the risk of adverse medical and musculoskeletal outcomes, timely medical intervention in the form of antibiotics and potential surgical debridement is required. While there have been numerous studies indicating the value of laboratory testing during the initial workup of a child with MSKI, few studies to date have examined the utility of longitudinal assessment of laboratory measures in the acute setting to monitor the efficacy of antibiotic therapy and/or surgical intervention. The purpose of this investigation was to retrospectively determine whether measuring changes in the inflammatory response could indicate the need for escalated care. Specifically, this study examined the hypothesis that serial measurements of C-reactive protein (CRP), immediately preoperatively and 2 days after surgical debridement, could predict the need for medical (change in antibiotics) or surgical (additional debridement) escalation.

Methods:
Retrospective review of pediatric patients undergoing operative debridement for the treatment of MSKI between September 2009 and December 2015 from whom laboratory data (CRP) was obtained preoperatively and at postoperative day (POD) 2. Patient demographics, the need for escalated care, and patient outcomes were evaluated.

Results:
Across 135 pediatric patients, preoperative CRP values >90 mg/L and a positive change in CRP at POD2 effectively predicted the need for escalation of care after initial surgical debridement (Area under the Receiver Operator Curve: 0.883). For each 10-unit increase in preoperative CRP or postoperative change in CRP, there was a 21% or 22% increased risk of needing escalated care, respectively. Stratification by preoperative CRP >90 mg/L and change in CRP postoperatively likewise correlated with increased rates of disseminated disease, percent tissue culture positivity, length of stay, and rate of adverse outcomes.

Conclusions:
This study demonstrates the utility of serial CRP to assess the need for escalated care in patients being treated for MSKI. As serial CRP measurements become standard of practice in the acute setting, future prospective studies are needed to optimize the timing of CRP reassessment during inpatient hospitalization to prognosticate patient outcomes, weighing both improvements of patient care and clinical burden.

Level of Evidence:
Level III—retrospective comparative study.
A re-usable, locally manufactured, half-face respirator provides better protection than fitted disposable N95 masks
Authors: Mbadjeu Hondjeu Arnaud Romeo , Ng William C.K. , Anwari Vahid , Kazlovich Kate , Xiao Maggie Z.X. , Rozenberg Dmitry , Zalewski Alan , Afenu Edem , Hiansen Joshua Qua , Mashari Azad 
Published: November 2023

BACKGROUND
The coronavirus disease 2019 pandemic has led to persistent shortages of respiratory protective equipment in many jurisdictions. Re-usable industrial respirators have been proposed and deployed as an alternative, but also face severe supply limitations. Numerous respirator designs have been proposed since the start of the current pandemic, but few have been systematically tested on healthcare workers (HCWs).

OBJECTIVE
In this paper, we describe a locally manufactured respirator named ‘Duo’ that includes separate, valved, inspiratory and expiratory pathways and accommodates up to two filters. Duo was compared with the disposable commercial N95 in a cohort of 41 HCWs using standardised quantitative fit-testing.

DESIGN
A prospective observational cross-sectional study.

SETTING
Conducted between May and June 2020 among HCWs at Toronto General Hospital.

PARTICIPANTS
Forty-one HCWs of both sexes working at Toronto General Hospital.

MAIN OUTCOME MEASURES
Quantitative fit-testing involving seven tests as prescribed by Canadian standard CSA Z94.4-18. We measured the median overall fit-factors; the individual manoeuvre fit-factors and pass rate.

RESULTS
The median [IQR] overall fit-factors were 2947 [2228 to 4405] and 77.2 [51.9 to 152.1] for the Duo and disposable N95 respirators respectively (P < 0.0001). The overall pass rate of quantitative fit-testing fitted disposable N95 was 58.5% (24/41), and 100% for the Duo.

CONCLUSIONS
A re-usable, locally manufactured, half-face respirator performs better than fitted disposable N95 masks as assessed by quantitative fit-testing. This can help address the global supply disruption for a better response to future pandemics. The device requires further modification and testing to optimise exhalation flow resistance, and full conformance with technical standards is required for regulatory approval.
The real-world study of the clinical characteristics, diagnosis, and treatment of advanced pancreatic cancer in China
Authors: Cui Jiujie , Fu Qihan , Chen Xiaobing , Wang Yanling , Li Qi , Wang Feng , Li Zhihua , Dai Guanghai , Wang Yusheng , Zhang Hongmei , Liang Houjie , Zhou Jun , Yang Liu , Wang Fenghua , Zheng Leizhen , Chen Xiaofeng , Gong Ping , Liu Jiang , Yuan Ying , Wang Lin , Cheng Yuejuan , Zhang Jun , Zhou Yuhong , Guo Weijian , Zhan Xianbao , Zou Zhengyun , Li Da , Zeng Shan , Li Enxiao , Li Zhiwei , Teng Zan , Cao Dan , Kan Jie , Xiong Jianping , Quan Ming , Yao Jiayu , Yang Haiyan , Wang Liwei 
Published: November 2023

Objective:Real-world diagnostic and treatment data for pancreatic cancer in China are lacking. As such, the present study investigated the clinical characteristics, diagnosis, and treatment of advanced pancreatic cancer (including locally advanced and metastatic disease) in the Hospital-based Advanced Pancreatic Cancer Cohort in China of the China Pancreas Data Center database.Methods:A total of 5349 Chinese patients with advanced pancreatic cancer were identified from a database. The entire course of real-world pancreatic cancer management was analyzed.Results:The proportion of patients with advanced pancreatic cancer was higher among males than females (62.4% vs 37.6%, respectively). Patients typically had a history of hypertension (30.8%), diabetes (21.6%), and cholangitis (20.2%). Abdominal pain (51.6%), abdominal distension (27.1%), jaundice (20.1%), and weight loss (16.3%) were the main symptoms observed in patients with advanced pancreatic cancer in this cohort. Serum carbohydrate antigen (CA)19-9 is one of the most common tumor markers. In the present study, 2562 patients underwent first-line therapy. The median progression-free survival (PFS) for patients undergoing first-line therapy was 4.1 months. The major options for first-line therapy included gemcitabine (GEM) plus S-1 (GS/X) (23.4%), nab-paclitaxel plus GEM (AG) (18.1%), oxaliplatin, irinotecan, and leucovorin-modulated fluorouracil (FOLFIRINOX; 11.9%), nab-paclitaxel plus S-1 (AS) (8.9%), and GEM combined with oxaliplatin/cisplatin (GEMOX/GP) (7.6%). The AS and GS/X regimens were associated with the highest PFS rates.Conclusion:This is the first study to report multicenter, real-world data regarding advanced pancreatic cancer in China. Results revealed that real-world treatment options differed from guideline recommendations, and PFS was shorter than that in previously reported data. Improving intelligent follow-up systems and standardizing diagnosis and treatment of pancreatic cancer is recommended.
Impact of urinary diversion type on urethral recurrence following radical cystectomy for bladder cancer: Propensity score matched and weighted analyses of retrospective cohort
Authors: Yu Jiwoong , Lee Chung Un , Chung Jae Hoon , Song Wan , Kang Minyong , Jeon Hwang Gyun , Jeong Byong Chang , Seo Seong Il , Jeon Seong Soo , Sung Hyun Hwan 
Published: November 2023

Background:
The absence of randomized controlled trials and the presence of inherent selection bias in existing studies have led to ongoing uncertainty regarding the impact of urinary diversion (UD) type (orthotopic UD or non-orthotopic UD) on urethral recurrence (UR) following radical cystectomy (RC) for bladder cancer. This study aimed to assess the impact of the UD types on UR after RC and to identify predictive factors associated with UR.

Materials and Methods:
This retrospective analysis encompassed 612 male patients who underwent RC for urothelial carcinoma of the bladder. Among them, 341 patients received non-orthotopic UD (ileal conduit [IC] or ureterocutaneostomy [UC]), whereas 271 received orthotopic neobladder (NB) between January 2012 and October 2022. To mitigate potential biases, we employed 1:1 propensity score matching (PSM) and stabilized inverse probability treatment weighting (IPTW). Kaplan–Meier analysis and log-rank tests were employed to assess UR-free survival between the IC/UC and NB groups, while multivariable Cox regression analysis was conducted to determine predictive factors for UR.

Results:
Among the 612 patients included, 33 (5.4%) experienced UR. PSM yielded matched cohort comprising 412 patients, evenly distributed with 206 patients in each group (IC/UC and NB). Clinicopathological data demonstrated similarity between the two groups. Patients who underwent NB exhibited significantly superior UR-free survival in both PSM (log-rank P=0.033) and IPTW cohorts (log-rank P=0.009). NB reconstruction (vs. IC/UC) emerged as a substantial protective factor against UR (hazard ratio [HR] 0.283; 95% confidence interval [CI] 0.088–0.916; P=0.035), whereas prostatic urethral involvement was identified as a significant risk factor (HR 5.328; 95% CI 1.298–21.868; P=0.020) in the PSM cohort. Additionally, in the IPTW cohort, NB reconstruction (vs. IC/UC) maintained its significance as a protective factor against UR (HR 0.336; 95% CI 0.131–0.858; P=0.023) along with neoadjuvant chemotherapy (HR 0.335; 95% CI 0.116–0.969; P=0.044), whereas prostatic urethral involvement remained a significant risk factor (HR 3.752; 95% CI 1.484–9.488; P=0.005).

Conclusions:
Even after mitigating selection bias, NB reconstruction holds a protective effect against UR in male patients undergoing RC for bladder cancer.