bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of neoadjuvant PD-1 inhibitors or PD-L1 inhibitors for muscle invasive bladder cancer: a systematic review and meta-analysis
Authors: Huang Shibo , Huang Yanping , Li Chunyan , Liang Yiwen , Huang Miaoyan , Luo Raoshan , Liang Weiming 
Published: January 2024

IntroductionThis meta-analysis aims to evaluate the efficacy and safety of neoadjuvant PD-1 inhibitors or PD-L1 inhibitors [PD-(L)1 inhibitors] for muscle-invasive bladder carcinoma (MIBC).Materials and methodsFour databases (Medline, Embase, Web of Science, and 21 CENTRAL) were searched for articles studying neoadjuvant PD-(L)1 inhibitors for MIBC. The search time period was from the establishment of each database to 21 July 2023. Meta-analyses of pCR, pPR, Grade≥ 3 irAEs rate, RFS, and OS were performed.ResultsIn total, 22 studies were included for meta-analysis. The overall pooled pCR of neoadjuvant PD-(L)1 inhibitors was 0.36 (95%CI=0.30–0.42, p=0.00). In subgroup meta-analysis, the pooled PCR of PD-(L)1 inhibitors alone, PD-(L)1 inhibitors plus other ICI, and PD-(L)1 inhibitors plus chemotherapy was 0.27 (95%CI=0.19–0.35, p=0.1), 0.41 (95%CI=0.21–0.62, p=0.01), 0.43 (95%CI=0.35–0.50, p=0.06), respectively. The overall pooled pPR of neoadjuvant PD-(L)1 inhibitors was 0.53 (95%CI=0.46–0.60, p=0.00). In subgroup meta-analysis, the pooled pPR of PD-(L)1 inhibitors alone, PD-(L)1 inhibitors plus other ICI, and PD-(L)1 inhibitors plus chemotherapy was 0.36 (95%CI=0.22–0.51, p=0.01), 0.51 (95%CI=0.39–0.62, p=0.43), and 0.61 (95%CI=0.53–0.69, p=0.01), respectively. Kaplan–Meier curves for OS and RFS were reconstructed, but there was no significant difference among three groups in terms of OS or RFS. The pooled result of Grade≥ 3 irAEs rate for neoadjuvant PD-(L)1 inhibitors was 0.15 (95%CI=0.09–0.22, p=0.00%). In subgroup analysis, the pooled result of Grade≥ 3 irAEs rate for PD-(L)1 inhibitors alone, PD-(L)1 inhibitors plus other ICI, and PD-(L)1 inhibitors plus chemotherapy was 0.07 (95%CI=0.04–0.11, p=0.84), 0.31 (95%CI=0.16–0.47, p=0.06), and 0.17 (95%CI=0.06–0.31, I2 = 71.27%, p=0.01), respectively.ConclusionNeoadjuvant PD-(L)1 inhibitors were feasible and safe for muscle invasive bladder cancer. Compared with PD-(L)1 inhibitors alone, PD-(L)1 inhibitors plus other ICI and PD-(L)1 inhibitors plus chemotherapy were associated with higher pCR and pPR, but higher Grade≥3 irAEs. Kaplan–Meier curves for OS and RFS indicated that neoadjuvant PD-(L)1 inhibitors had an acceptable long-term prognostic, but it was not possible to discern statistical differences between the three neoadjuvant subgroups.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023452437, identifier PROSPERO (CRD42023452437).
Rescue subthalamic stimulation after unsatisfactory outcome of pallidal stimulation in Parkinson's disease: a case series and review
Authors: Zeng Zhitong , Huang Peng , Lin Zhengyu , Pan Yixin , Wan Xiaonan , Zhang Chencheng , Sun Bomin , Li Dianyou 
Published: January 2024

BackgroundSubthalamic nucleus (STN) and globus pallidus interna (GPi) are two main structures primarily targeted by deep brain stimulation (DBS) to treat advanced Parkinson's disease (PD). A subset of cases with unsatisfactory outcomes may benefit from rescue DBS surgery targeting another structure, while these patients' characteristics have not been well described and this phenomenon has not been well reviewed.MethodsThis monocentric retrospective study included patients with PD, who underwent rescue STN DBS following an unsatisfactory outcome of the initial bilateral GPi DBS in a retrospective manner. A short review of the current literature was conducted to report the clinical outcome of rescue DBS surgeries.ResultsEight patients were identified, and six of them were included in this study. The rescue STN DBS was performed 19.8 months after the initial GPi DBS. After 8.8 months from the rescue STN DBS, patients showed a significant off-medication improvement by 29.2% in motor symptoms compared to initial GPi DBS. Non-motor symptoms and the health-related quality of life were also significantly improved.ConclusionOur findings suggest that the rescue STN DBS may improve off-medication motor and non-motor symptoms and quality of life in patients with failure of initial GPi DBS. The short review of the current literature showed that the target switching from GPi to STN was mainly due to poor initial outcomes and was performed by target substitution, whereas the switching from STN to GPi was mainly due to a gradual waning of benefits, long-term axial symptoms, dyskinesia, and dystonia and was performed by target addition.
The efficacy and safety of third-generation antiseizure medications and non-invasive brain stimulation to treat refractory epilepsy: a systematic review and network meta-analysis study
Authors: Yang Yang , Shangguan Yafei , Wang Xiaoming , Liu Ruihong , Shen Ziyi , Tang Ming , Jiang Guohui 
Published: January 2024

BackgroundThe new antiseizure medications (ASMs) and non-invasive brain stimulation (NIBS) are controversial in controlling seizures. So, this network meta-analysis aimed to evaluate the efficacy and safety of five third-generation ASMs and two NIBS therapies for the treatment of refractory epilepsy.MethodsWe searched PubMed, EMBASE, Cochrane Library and Web of Science databases. Brivaracetam (BRV), cenobamate (CNB), eslicarbazepine acetate (ESL), lacosamide (LCM), perampanel (PER), repetitive transcranial magnetic stimulation (rTMS), and transcranial direct current stimulation (tDCS) were selected as additional treatments for refractory epilepsy in randomized controlled studies and other cohort studies. Randomized, double-blind, placebo-controlled, add-on studies that evaluated the efficacy or safety of medication and non-invasive brain stimulation and included patients with seizures were uncontrolled by one or more concomitant ASMs were identified. A random effects model was used to incorporate possible heterogeneity. The primary outcome was the change in seizure frequency from baseline, and secondary outcomes included the proportion of patients with ≥50% reduction in seizure frequency, and the rate of treatment-emergent adverse events.ResultsForty-five studies were analyzed. The five ASMs and two NIBS decreased seizure frequency from baseline compared with placebo. The 50% responder rates of the five antiseizure drugs were significantly higher than that of placebo, and the ASMs were associated with fewer adverse events than placebo (p &lt; 0.05). The surface under the cumulative ranking analysis revealed that ESL was most effective in decreasing the seizure frequency from baseline, whereas CNB provided the best 50% responder rate. BRV was the best tolerated. No significant publication bias was identified for each outcome index.ConclusionThe five third-generation ASMs were more effective in controlling seizures than placebo, among which CNB, ESL, and LCM were most effective, and BRV exhibited better safety. Although rTMS and tDCS did not reduce seizure frequency as effectively as the five drugs, their safety was confirmed.Systematic review registrationPROSPERO, https://www.crd.york.ac.uk/prospero/ (CRD42023441097).
Molecular epidemiology study of programmed death ligand 1 and ligand 2 protein expression assessed by immunohistochemistry in extensive-stage small-cell lung cancer
Authors: Steiniche Torben , Georgsen Jeanette Baehr , Meldgaard Peter , Deitz Anne C. , Ayers Mark , Pietanza M. Catherine , Zu Ke 
Published: January 2024

ObjectivesPrevalence of tumor PD-L1 expression in extensive-stage small-cell lung cancer (ES-SCLC) is variable, and data on PD-L2 expression are limited. The prognostic values of these biomarkers are not well understood. The current study was conducted to address these data gaps.MethodsA retrospective cohort study of Danish patients with histologically confirmed ES-SCLC and evaluable tumor samples who were receiving usual care before the introduction of immunotherapy was conducted. Protein expression of PD-L1 and PD-L2 was determined by immunohistochemistry (IHC) using the PD-L1 IHC 22C3 pharmDx assay and a PD-L2 IHC assay using a propriety mouse monoclonal antibody. A combined positive score (CPS) of ≥1 was used to define biomarker positivity. Kaplan-Meier plots and Cox proportional hazard models were employed to assess the relationship between PD-L1 and PD-L2 protein expression and OS.ResultsAmong 80 patients, 31% (n=25) and 36% (n=29) had disease positive for PD-L1 and PD-L2, respectively. Overall, 85% (n=68) of patients had concordant PD-L1/PD-L2 status; 26% (n=21) had double positive disease (both PD-L1 and PD-L2 CPS ≥1) and 59% (n=47) had double negative disease (both PD-L1 and PD-L2 CPS &lt;1). PD-L1 and PD-L2 positivity were each associated with longer OS (unadjusted hazard ratios [HRs], 0.35 [95% CI, 0.21−0.61] and 0.50 [95% CI, 0.31−0.82]); the associations persisted after adjustment for several known prognostic factors (HRs, 0.41 [95% CI, 0.22–0.75] and 0.44 [95% CI, 0.25–0.79] for PD-L1 and PD-L2 positivity, respectively). When evaluating OS in patients with double positive disease, unadjusted and adjusted HRs for double positive compared with double negative were similar to those with only PD-L1 or PD-L2 positivity (unadjusted HR, 0.36 [95% CI, 0.20–0.64]; adjusted HR, 0.36 [0.18−0.73]).ConclusionPD-L1 and PD-L2 positivity were observed in approximately one-third of assessed ES-SCLC tumor samples and were highly congruent. Patients with PD-L1 and PD-L2 positivity, alone or combined, were associated with longer OS, independent of other prognostic factors.
Application value of PET/CT in monophasic primary sacral synovial sarcoma: a case report and review of literature
Authors: Shao Mingyan , Xu Rong , Qi Wanling , Luo Zhehuang , Liao Fengxiang , Fan Sisi 
Published: January 2024

BackgroundSynovial sarcoma is a malignant tumor of mesenchymal origin with a high degree of malignancy and easy metastasis. It mostly occurs in distal extremities or adjacent joints, and it is most common in deep knee joint. Primary sacral synovial sarcoma (PSSS) is extremely rare. The PET/CT imaging findings of a case of monophasic PSSS were reported. The clinical, imaging, and pathological data were summarized, and the literature was reviewed.Case descriptionA 67-year-old female patient presented with sacrococcygeal pain without obvious causes on 16 September 2022, with occasional pain at night, as well as aggravated pain during hip flexion and long-distance walking, which could be slightly relieved with rest, without special treatment. For further treatment before 1 month to Jiangxi Provincial People’s Hospital, after admission, laboratory tests were negative. Non-contrast CT scan showed expansive bone destruction in the S1-3 vertebrae with soft tissue density of about 58 mm × 46 mm × 52 mm. The boundary was clear, necrosis was visible within the vertebrae, and the boundary between the mass and the anterior sacral blood vessels and rectum was unclear. Non-contrast MRI scan showed mixed signals in lumbosacral masses, with equal signals in T1 and uneven and slightly higher signals in T2. Cystic degeneration and necrosis were visible, with multiple compartments in the lumbosacral masses. MRI enhancement showed uneven enhancement of lumbosacral mass with multiple compartments and no enhanced cystic lesion. The left sacral alar bone is destroyed, as shown by large flaky uneven strengthening. PET/CT showed that S1-3 vertebral body and left sacral alar bone were destroyed and soft tissue shadow formed, invading the sacral canal and the left foramina of S1-3. FDG metabolism was significantly increased, and malignant tumor was diagnosed by PET/CT. Pathological examination: The pathological diagnosis was monophasic PSSS. After systemic chemotherapy and local radiotherapy, no significant signs of recurrence and metastasis were found on CT so far. Follow-up treatment was continued.ConclusionThe incidence of PSSS is very low, its clinical and imaging manifestations lack characteristics, and the final diagnosis still needs pathology. PET/CT imaging has a certain value in the diagnosis of PSSS and has great application value in the preoperative staging, postoperative efficacy evaluation, and follow-up.
Cost-effectiveness of rezvilutamide versus bicalutamide and androgen-deprivation therapy in patients with highvolume, metastatic, hormone-sensitive prostate cancer
Authors: Wu Huina , Sun Lei , Feng Rui , Zhang Huiyue , Tang Ke , Wang Shuo , Nie Jing 
Published: January 2024

Background: Rezvilutamide, a novel androgen-receptor inhibitor with limited blood-brain barrier penetration, exhibits significant antitumour activity against highvolume, metastatic, hormone-sensitive prostate cancer (mHSPC). In this study, we aimed to compare the cost-effectiveness of rezvilutamide and bicalutamide as first-line treatments for untreated prostate cancer among Chinese patients, in order to evaluate the efficacy of rezvilutamide.Methods: In this study, we utilized partition survival model to assess the cost-effectiveness of rezvilutamide and bicalutamide treatments for highvolume mHSPC. The model was developed using TreeAge Pro 2022 software and relied on clinical data obtained from the CHART trial. Transition probabilities were estimated from the reported survival probabilities in trials using parametric survival modeling. From the perspective of the Chinese healthcare system, we calculated quality-adjusted life years (QALYs), incremental cost-effectiveness ratio (ICER), and lifetime cost. A lifetime horizon and an annual discount rate of 5% were employed. To address modeling uncertainties, we conducted one-way sensitivity analysis and probabilistic sensitivity analysis.Results: The cost of rezvilutamide versus bicalutamide were $62700 and $13200. Rezvilutamide had an ICER of $41900 per additional QALYs gained compared with bicalutamide. Research indicated that rezvilutamide achieved at least an 28.20% probability of cost-effectiveness at the threshold of $38223.34/QALY. One-way sensitivity analysis revealed that the results were sensitive to utility of PD. Scenario analysis showed that rezvilutamide was cost-effectiveness if its price was reduced by more than 10%.Conclusion: Based on the analysis at the current price, rezvilutamide was found to be less cost-effective for patients with highvolume mHSPC compared to bicalutamide in China.
Chinese parents’ school-readiness beliefs and parenting styles: patterns and associated factors
Authors: Cui Shujing , Greger David 
Published: January 2024

IntroductionA smooth transition to primary school is positively related to children’s later school experience. Certain parental school-readiness beliefs and parenting styles, among other factors, contribute to the smoothness of this transition.MethodsTherefore, this study adopted a latent profile analysis to examine the patterns of Chinese parents’ school-readiness beliefs and their parenting styles and investigated socioeconomic status (SES) differentials in both. Two-stage probability sampling method is adopted in this study and a total of 1,204 Chinese parents of 5- to 6 years-old children were investigated with school-readiness beliefs scale, Parenting Styles and Dimensions Questionnaire, as well as scale of attitudes regarding roles in school readiness All data analyses were processed in Mplus 8.6.Results and discussionThree profiles were identified: (1) supportive parenting with a very strong emphasis on school readiness; (2) partially supportive parenting with a reflection of school readiness; (3) weakly supportive parenting with no emphasis on school readiness. Higher SES was found to be more likely to be associated with membership in Profile 1 rather than Profile 2. The present study shows quantitative support for Anette Lareau’s work and has implications for the development of more targeted parental intervention programs.
Validation of the Amharic version of Internet Addiction Test-20: a cross-sectional study
Authors: Feleke Nekatbeb , Mihretu Awoke , Habtamu Kassahun , Amare Beakal , Teferra Solomon 
Published: January 2024

BackgroundInternet Addiction is defined as excessive internet use or poorly controlled preoccupations, impulses, or behaviors related to computer use and internet access that cause impairment or suffering. It had devastating effect on people lives, families, productivity, academic performance and rarely engaging in criminal acts like alcohol use, drug addiction, or compulsive gambling. This study aimed to investigate the psychometric properties of the Amharic version of Internet Addiction Test-20 among Addis Ababa University, College of Health Sciences medical students, Addis Ababa, Ethiopia.MethodsA cross sectional study was carried out among 410 medical students using a convenience sampling method after stratifying them based on their year level. SPSS Version 23 was used to do Pearson’s correlation coefficient to determine the convergent validity of Amharic version of IAT. We computed correlation coefficient between the aggregate scores of IAT-20 and the scores for depressive symptoms, problematic substance use, and other characteristics of participants which was assessed using Patient health questionnaire-9 (PHQ-9), Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and questionnaire developed to assess demographic and internet use related characteristics, respectively. AMOS 23 software was used to conduct confirmatory factor analysis (CFA) to evaluate the construct validity of Amharic version of IAT. Test–retest reliability was also determined with 2 weeks interval (n = 51).ResultsThe data confirmed a two-factor structure. Normed Fit Index (NFI) = 0.89, Tucker Lewis Index (TLI) = 0.91 and Comparative Fit Index (CFI) = 0.92, Root Mean Square Error Approximation (RMSEA) = 0.07, and Standardized Root Mean Residual (SRMR) =0.05 indicated a good fit model structure. There was moderate positive correlation between the aggregate scores of IAT-20 and PHQ-9 scores (r = 0.55, p &lt; 0.00), but weak positive correlation between IAT-20 and ASSIST scores (r = 0.14, p &lt; 0.00). IAT-20 was also found to have good internal consistency (Cronbach’s alpha = 0.89 for each factor). The test–retest reliability was also good for all items (Intra Class Correlation Coefficient (ICC) &gt; 0.30) except item 16.ConclusionWe found that the IAT-20 is psychometrically sound and a simple screening test for Internet Addiction. However, it is important to acknowledge that further studies are necessary to replicate these findings on diverse population.
Potentially inappropriate prescriptions of antibiotics in geriatric psychiatry—a retrospective cohort study
Authors: Pfister Tabea , Schröder Sebastian , Heck Johannes , Bleich Stefan , Krüger Tillmann H. C. , Wedegärtner Felix , Groh Adrian , Schulze Westhoff Martin 
Published: January 2024

IntroductionOlder patients are frequently affected by infectious diseases and adverse drug reactions (ADRs) of consecutively prescribed antibiotics. Particularly within geriatric psychiatry, high rates of potentially inappropriate prescriptions (PIPs) have been described, significantly complicating pharmacological treatment. Therefore, this study aimed to investigate the frequency and characteristics of antibiotic PIPs in geriatric psychiatry.MethodsMedication charts of 139 patient cases (mean age 78.8 years; 69.8% female) receiving antibiotic treatment on a geriatric psychiatric ward were analyzed. Utilizing previously published definitions of antibiotic PIPs, adequacy of the antibiotic prescriptions was subsequently assessed.Results16.3% of all screened patient cases (139/851) received an antibiotic treatment during their inpatient stay. 59.5% of antibiotic prescriptions were due to urinary tract infections, followed by pulmonary (13.3%) and skin and soft tissue infections (11.3%). 46.7% of all antibiotic prescriptions fulfilled at least one PIP criterium, with the prescription of an antibiotic course for more than seven days as the most common PIP (15.3%).DiscussionAntibiotic PIPs can be considered as a frequent phenomenon in geriatric psychiatry. Especially the use of fluoroquinolones and cephalosporins should be discussed critically due to their extensive side effect profiles. Due to the special characteristics of geriatric psychiatric patients, international guidelines on the use of antibiotics should consider frailty and psychotropic polypharmacy of this patient population more closely.
Women’s status, empowerment, and utilization of skilled delivery services in Papua New Guinea: an empirical analysis based on structural equation modeling
Authors: Shen Hao , Zhao Hang , Wang Baoqin , Jiang Yi 
Published: January 2024

BackgroundSkilled birth attendants (SBA) facilitate identifying and overcoming labor problems and saving lives. With one of the highest maternal death rates in the Asia-Pacific area, SBA utilization during childbirth among Papua New Guinea (PNG) women remains low. Women’s status and empowerment are important factors in maternal and child health services and critical to maternal and child health development. This study is intended to apply structural equation modeling based on data from the Demographic and Health Survey (DHS) to evaluate the causal relationship between women’s status, empowerment, and SBA utilization in PNG and the mechanisms of their influence.MethodsThis study employed data from the 2016–2018 Papua New Guinea Demographic Health Survey (PNG DHS), which recruited 18,175 women aged 15–49 years. A multi-stage sample and a structured questionnaire were used to collect information on maternal health, women’s empowerment, and related topics. STATA 17.0 was used to describe the data, while MPLUS 8.2 was employed for structural equation modeling and pathway analysis.ResultsThe two empowerment dimensions of household decision-making (standardized path coefficient, β = 0.049, p &lt; 0.05) and access to health services (β = 0.069, p &lt; 0.01) were positively associated with SBA utilization, while the association between attitudes toward partner violence and SBA utilization was not statistically significant. In addition, mediation analysis revealed that education indirectly influenced SBA utilization through access to health services (β = 0.011, 95% CI: 0.002, 0.022).ConclusionThe findings confirmed the direct and indirect effects of women’s status and empowerment on SBA utilization in PNG. Therefore, a call for further evidence-based interventions in PNG and possibly Pacific Small Island Developing States (PSIDS) is needed to improve women’s educational attainment, household decision-making, and access to health services to enhance maternal and newborn health and well-being.
ANALISIS RELASI PERSAHABATAN DITINJAU DARI INTERAKSI SOSIAL DAN ORIENTASI INDIVIDU
Authors: Varlina Vivi , Dewi Safira Angelia , Raiha Yasmin Mutia 
Published: January 2024

Kehidupan manusia tidak terlepas dari relasi dengan lingkungannya. Adanya kebutuhan untuk berelasi mengharuskan terciptanya kesepahaman dalam setiap perilaku tertentu. Namun, ternyata tidak mudah dalam menciptakan kesepahaman antar individu. Kebutuhan hidup manusia yang semakin kompleks menjadi salah satu penghambat terjalinnya komunikasi interpersonal sehingga sulit mencapai relasi yang baik. Oleh sebab itu, mengharuskan individu untuk meninjau lawan bicaranya atau berorientasi setelah melakukan interaksi sosial. Penelitian ini berfokus pada pengaruh interaksi sosial dan orientasi individu yang ditinjau dari segi inklusi, kontrol, dan afeksi dengan menggunakan Teori Fundamental Interpersonal Relations Orientation (FIRO). Berdasarkan penelitian dan menggali hubungan antar variabel, peneliti melibatkan 51 orang responden yang memiliki kualifikasi sebagai generasi Z dengan rentan usia 18-25 tahun dan berasal dari berbagai wilayah di Indonesia. Analisis menyebutkan bahwa terdapat korelasi dari pengaruh interaksi sosial dan orientasi individu terhadap relasi persahabatan yang dijalin oleh generasi Z saat ini.