bluuebunny/crossref_metadata_2025_split huggingface dataset:
Real-world risk of brain metastases in stage III non-small cell lung cancer in the era of PET and MRI staging
Authors: Alhusaini Saud , Lanman Tyler A. , Ko Ryan B. , Therkelsen Kate E. , Eyben Rie Von , Diehn Maximilian , Soltys Scott G. , Pollom Erqi L. , Chin Alexander , Vitzthum Lucas , Wakelee Heather A. , Padda Sukhmani K. , Ramchandran Kavitha , Loo Billy W. , Neal Joel W. , Nagpal Seema 
Published: March 2023

ObjectiveThe 2-year incidence of brain metastases (BrMs) in stage III non-small lung cell cancer (NSCLC) has been estimated to be around 30%. However, recent clinical trials have demonstrated considerably lower BrMs rates in this patient population. In this study, we aimed to review the real-world incidence, surveillance, and treatment patterns of BrMs in stage III NSCLC.Materials and methodsUsing a retrospective single-center study design, we identified patients with stage III NSCLC who received radiation with curative intent over a 10-year period. Outcome variables included BrMs incidence, overall survival (OS), and survival from date of BrMs. Additionally, we assessed patterns of BrMs surveillance in stage III NSCLC and treatment.ResultsWe identified a total of 279 stage III NSCLC patients, of which 160 with adequate records were included in the final analyses [adenocarcinoma (n = 96), squamous cell carcinoma (n = 53), other histology subtype (n = 11)]. The median OS for the entire cohort was 41 months (95% CI, 28-53), while the median time from BrMs to death was 19 months (95% CI, 9-21). Twenty-three patients (14.4%) received planned surveillance brain MRIs at 6, 12, and 24 months after completion of treatment. The remaining 137 patients (85.6%) received brain MRIs at systemic recurrence (restaging) or when neurologically symptomatic. A total of 37 patients (23%) developed BrMs, with a 2-year cumulative BrMs incidence of 17% (95% CI, 11-23). A higher incidence of BrMs was identified in patients with adenocarcinoma relative to those with squamous cell carcinoma (p &lt; 0.01). Similarly, a higher 2-year BrMs incidence was observed in patients who received planned surveillance brain MRI relative to those who did not, although statistical significance was not reached. Stereotactic radiosurgery (SRS) treated 29 of BrMs patients (78.4%) and was preferred over WBRT, which treated only 3 patients (8.1%).ConclusionsAt our center, BrMs incidence in stage III NSCLC patients was lower than historically reported but notably higher than the incidence described in recent clinical trials. Routine BrMs surveillance potentially allows earlier detection of asymptomatic BrMs. However, asymptomatic BrMs were mostly detected on restaging MRI at the time of recurrence.
Sex differences in heart rate and heart rate variability in rats: Implications for translational research
Authors: Carnevali Luca , Barbetti Margherita , Statello Rosario , Williams DeWayne P. , Thayer Julian F. , Sgoifo Andrea 
Published: March 2023

The present study aimed to investigate sex differences in measures of cardiac chronotropy and heart rate variability (HRV) in 132 young adult wild-type Groningen rats (n = 45 females). Electrocardiographic signals were recorded for 48 h in freely moving rats to quantify heart rate (HR) and inter-beat interval (IBI) as measures of cardiac chronotropy, and time- and frequency-domain HRV parameters as physiological readouts of cardiac vagal modulation. Females showed greater vagally-mediated HRV despite having higher HR and shorter IBI than males during undisturbed conditions. Such differences were evident i) at any given level of HRV, and ii) both during the 12-h light/inactive and 12-h dark/active phase of the daily cycle. These findings replicate the paradoxical cardiac chronotropic control reported by human meta-analytic findings, since one would expect greater vagally-mediated HRV to be associated with lower HR and longer IBI. Lastly, the association between some HRV measures and HR was stronger in female than male rats. Overall, the current study in young adult rats provides data illustrating a sex-dependent association between vagally-mediated HRV and indexes of cardiac chronotropy. The current results i) are in line with human findings, ii) suggest to always consider biological sex in the analysis and interpretation of HRV data in rats, and iii) warrant the use of rats for investigating the neuro-hormonal basis and temporal evolution of the impact of sex on the association between vagally-mediated HRV and cardiac chronotropy, which could inform the human condition.
Evidence of internal structure of the transactional eHealth literacy among Vietnamese youth: An instrument validation study
Authors: Nguyen Thao Phuong Thi , Do Anh Linh , Do Ha Ngoc , Vu Thuc Minh Thi , van Kessel Robin , Wong Brian Li Han , Boyer Laurent , Fond Guillaume , Auquier Pascal , Nguyen Tham Thi , Latkin Carl A. , Ho Cyrus S. H. , Ho Roger C. M. 
Published: March 2023

BackgroundThe progression into the Digital Age has brought an array of novel skill requirements. Unlike traditional literacy, there are currently few measures that can reliably measure eHealth literacy. The Transactional Model of eHealth Literacy and subsequent Transactional eHealth Literacy Instrument may provide a feasible option for measuring eHealth literacy.ObjectiveThis instrument has yet to be validated, which is the aim of this study. In particular, this article was conducted to validate the TeHLI to see which components of the tool (how many and which components included) would be the best fit statistically and whether the tool applies to groups of different characteristics.MethodsWe conducted an online cross-sectional study among 236 Vietnamese young people. A exploratory factor analysis was used to identify the best fit model of the Transactional eHealth Literacy Instrument. A confirmatory factor analysis tested measurement invariance at four levels: configural, metric, scalar, and strict invariance. Only metric invariance was partially invariant, while the rest tested fully invariant. Even with partial metric invariance, there is reason to assume that functional, communicative, critical, and translational eHealth literacy (the four levels according to the transactional model) are consistently measured when deploying the Transactional eHealth Literacy Instrument across groups.ResultsThe study findings substantiate that the most optimal composition of the TeHLI consists of four factors: functional, communicative, critical, and translational eHealth literacy, with RMSEA = 0.116; CFI = 0.907, and the highest internal consistency (Cronbach's α = 0.91, 0.92, 0.88, and 0.92 for each factor respectively). After using measurement invariance, that gender, education, marital status, age, location, and household economy do not influence the way participants to respond to the TeHLI to the point that would introduce measurement bias. In other word, using TeHLI across population groups should not produce error margins that substantially differ from each other.ConclusionsThis study suggests the instrument can be used for comparisons across groups and has the potential to generate high-quality data usable for informing change agents as to whether a particular population is proficient enough to adopt novel eHealth innovations.
Spatial disparity and factors associated with dementia mortality: A cross-sectional study in Zhejiang Province, China
Authors: Heng Xiaotian , Liu Xiaoting , Li Na , Lin Jie , Zhou Xiaoyan 
Published: March 2023

ObjectiveEvidence of spatial disparity in dementia mortality in China has been found to have higher dementia mortality in eastern and rural China. Regional factors of physical and social features may be influencing this spatial disparity. However, the extent of spatial difference in dementia mortality across small regional localities is unclear. This study aims to investigate the geographic variations in mortality and risk of all dementia subtypes and identify the effect of the associated environmental risk factors.MethodsWe used surveillance data on death reports from Alzheimer’s disease and other forms of dementia in Zhejiang province from 2015 to 2019. We estimated the relative risk of dementia mortality using a Bayesian spatial model. We mapped predicted relative risk to visualize the risk of death from different types of dementia and to identify risk factors associated with dementia.ResultsThirty thousand three hundred and ninety-eight deaths attributable to dementia as the underlying or related cause (multiple causes) were reported during 2015–2019. Counties and districts in the southeast and west of Zhejiang province had significantly higher standardized mortality ratios than others. Counties and districts with a smaller proportion of residents aged 60 years or older, poorer economic status, insufficient health resources, and worse pollution had a higher risk of deaths due to dementia.ConclusionHigher risks of dementia mortality were found in counties and districts with poorer economic status, insufficient health resources, and worse pollution in Zhejiang. Our study adds new evidence on the association between socioeconomic and environmental factors and the mortality risk due to dementia.
Economic evaluation of toripalimab combined with chemotherapy in the treatment of non-small cell lung cancer
Authors: Wang Hao , Long Yunchun , Xu Yuan , Liao Li , Zhou Yujie 
Published: March 2023

Background and objectiveThe CHOICE-01 trial showed that toripalimab plus chemotherapy achieved satisfactory outcomes compared with chemotherapy in patients with advanced non-small cell lung cancer (NSCLC) who were negative for driver genes, but the economics of this regimen is unclear. Therefore, this study aimed to evaluate the cost-effectiveness of toripalimab in combination with chemotherapy in advanced NSCLC with negative driver genes from the perspective of the Chinese healthcare system.Materials and methodsA three-state partitioned survival model was developed to simulate the costs and outcomes associated with adding toripalimab to first-line chemotherapy. The clinical data in the model came from the CHOICE-01 trial, only direct medical costs were included, and utility values were referred to the literature. Four models were applied to explore the differences in the results of fitting and extrapolating K-M curves from different models, and cost-effectiveness subgroup analysis was performed. The incremental cost-effectiveness ratio (ICER) was used as the main outcome measure. Sensitivity analysis was performed to assess the impact of parameter uncertainty on the model.ResultsThe baseline analysis showed that toripalimab coupled with chemotherapy cost $21,052 more than chemotherapy ($43,197 vs. $22,145) and also gained 0.71 QALYs more (1.75 QALYs vs. 1.03 QALYs), with an ICER of $29,478/QALYs. At the current willingness-to-pay threshold ($35,108/QALY), the extra cost was well worth it. The results of fitting and extrapolating the survival curves using other models were consistent with the results of the standard parametric model. Subgroup analysis demonstrated that the addition of toripalimab to chemotherapy was economical. Sensitivity analysis showed that the utility values of PD and PFS stages had the greatest impact on the model.ConclusionFrom the viewpoint of the Chinese healthcare system, toripalimab combined with chemotherapy in the treatment of advanced NSCLC with negative driver genes was likely to be cost-effective compared with chemotherapy.
Determinants of COVID-19 vaccine acceptance and access among people experiencing homelessness in Germany: A qualitative interview study
Authors: Grune Julianna , Savelsberg Darius , Kobus Marta , Lindner Andreas K. , Herrmann Wolfram J. , Schuster Angela 
Published: March 2023

IntroductionPeople experiencing homelessness face lower life expectancy, higher prevalence of somatic and mental diseases and a more difficult access to healthcare compared to people in secure living. During the COVID-19 pandemic transmission rates were higher among people experiencing homelessness and preventive public health measures were not properly adapted to the specific needs of people experiencing homelessness. Thus, goal of our study was understanding the determinants of acceptability and access of the COVID-19 vaccine.Materials and methodsWe conducted a qualitative interview study with twenty guideline interviews with adult people currently experiencing homelessness in Berlin, Germany (August 2021 – April 2022). Participants were approached in a purposive sampling strategy. The interviews were analyzed with qualitative content analysis according to Mayring.ResultsAcceptance and attitude toward the COVID-19 vaccine is influenced by confidence in the vaccine as well as in the political and healthcare system, the individual COVID-19 risk perception and sense of collective responsibility. Overall, the acceptance of the vaccine was high among our participants. Facilities offering low threshold COVID-19 vaccines for people experiencing homelessness were perceived as helpful. Language barriers and the need for identity documents were major barriers to access the COVID 19 vaccine.DiscussionPeople experiencing homelessness are a marginalized and vulnerable group often underrepresented in the public and scientific discourse. During the COVID-19 pandemic, preventive public health measures, including the COVID-19 vaccine, failed to consider specific needs of people experiencing homelessness. Multidimensional strategy to enhance inclusive healthcare are needed to improve access and to reduce discrimination and stigmatization.
Vaginal microbiota of adolescents and their mothers: A preliminary study of vertical transmission and persistence
Authors: Bassis Christine M. , Bullock Kaylie A. , Sack Daniel E. , Saund Katie , Pirani Ali , Snitkin Evan S. , Alaniz Veronica I. , Quint Elisabeth H. , Bell Jason D. , Young Vincent B. 
Published: March 2023

IntroductionFactors that influence vaginal microbiota composition, including its source, are not well understood.MethodsTo determine if vaginal microbiota transmission from mother to daughter at birth could possibly influence the human vaginal microbiota composition in adolescence, we conducted a preliminary study to investigate the relationship between the vaginal microbiota of 13 adolescents (ages 15-21) and their mothers and the daughter’s birth mode.Results and discussionBased on analysis of bacterial 16S rRNA gene sequences, the vaginal microbiotas of mother/daughter pairs were more similar to each other if the daughter was born by vaginal delivery rather than by C-section. Specifically, within pair β-diversity, measured by the Yue and Clayton θ (θYC) distance metric, was significantly lower if the daughter was born by vaginal delivery. Additionally, genome sequences from an important member of the vaginal microbiota, Lactobacillus crispatus, isolated from one mother/daughter pair in which the daughter was born by vaginal delivery, were highly similar based on recombination-filtered single nucleotide polymorphisms (SNPs). Both community-level analysis and isolate genome sequence analysis are consistent with birth-mode dependent transmission and persistence of at least some members of the vaginal microbiota.
Applying interpretable machine learning algorithms to predict risk factors for permanent stoma in patients after TME
Authors: Liu Yuan , Zhao Songyun , Du Wenyi , Tian Zhiqiang , Chi Hao , Chao Cheng , Shen Wei 
Published: March 2023

ObjectiveThe purpose of this study was to develop a machine learning model to identify preoperative and intraoperative high-risk factors and to predict the occurrence of permanent stoma in patients after total mesorectal excision (TME).MethodsA total of 1,163 patients with rectal cancer were included in the study, including 142 patients with permanent stoma. We collected 24 characteristic variables, including patient demographic characteristics, basic medical history, preoperative examination characteristics, type of surgery, and intraoperative information. Four machine learning algorithms including extreme gradient boosting (XGBoost), random forest (RF), support vector machine (SVM) and k-nearest neighbor algorithm (KNN) were applied to construct the model and evaluate the model using k-fold cross validation method, ROC curve, calibration curve, decision curve analysis (DCA) and external validation.ResultsThe XGBoost algorithm showed the best performance among the four prediction models. The ROC curve results showed that XGBoost had a high predictive accuracy with an AUC value of 0.987 in the training set and 0.963 in the validation set. The k-fold cross-validation method was used for internal validation, and the XGBoost model was stable. The calibration curves showed high predictive power of the XGBoost model. DCA curves showed higher benefit rates for patients who received interventional treatment under the XGBoost model. The AUC value for the external validation set was 0.89, indicating that the XGBoost prediction model has good extrapolation.ConclusionThe prediction model for permanent stoma in patients with rectal cancer derived from the XGBoost machine learning algorithm in this study has high prediction accuracy and clinical utility.
Exoscope and operative microscope for training in microneurosurgery: A laboratory investigation on a model of cranial approach
Authors: Calloni Tommaso , Antolini Laura , Roumy Louis-Georges , Nicolosi Federico , Carrabba Giorgio G. , Di Cristofori Andrea , Fontanella Marco M. , Giussani Carlo G. 
Published: March 2023

ObjectiveTo evaluate the viability of exoscopes in the context of neurosurgical education and compare the use of a 4k3D exoscope to a traditional operative microscope in the execution of a task of anatomic structure identification on a model of cranial approach.Material and methodsA cohort of volunteer residents performed a task of anatomical structure identification with both devices three times across an experimental period of 2 months. We timed the residents’ performances, and the times achieved were analyzed. The volunteers answered two questionnaires concerning their opinions of the two devices.ResultsAcross tries, execution speed improved for the whole cohort. When using the exoscopes, residents were quicker to identify a single anatomical structure starting from outside the surgical field when deep structures were included in the pool. In all other settings, the two devices did not differ in a statistically significant manner. The volunteers described the exoscope as superior to the microscope in all the aspects the questionnaires inquired about, besides the depth of field perception, which was felt to be better with the microscope. Volunteers furthermore showed overwhelming support for training on different devices and with models of surgical approaches.ConclusionThe exoscope appeared to be non-inferior to the microscope in the execution of a task of timed identification of anatomical structures on a model of cranial approach carried out by our cohort of residents. In the questionnaires, the residents reported the exoscope to be superior to the microscope in eight of nine investigated domains. Further studies are needed to investigate the use of the exoscope in learning of microsurgical skills.
Selected biomarkers of oxidative stress in healthy Beagle dogs: A preliminary study
Authors: Porato Mathilde , Noël Stéphanie , Pincemail Joël , Albert Adelin , Cheramy-Bien Jean-Paul , Le Goff Caroline , Hamaide Annick 
Published: March 2023

IntroductionWhile oxidative stress has been studied in pathologic conditions in dogs, data in presumably healthy dogs and standardized protocols are lacking. This work purposed to bridge the gap by presenting provisional physiological ranges for oxidative stress biomarkers in a group of Beagle dogs.MethodsBased on our long-standing clinical expertise in the field of oxidative stress, nine plasma biomarkers of oxidative stress were evaluated for their concentrations (mean ± SD) in 14 healthy adult Beagle dogs.ResultsSelected biomarkers were: vitamins C (7.90 ± 1.36 μg/mL) and E (34.1 ± 6.63 μg/mL), zinc (0.80 ± 0.17 mg/L), copper (0.54 ± 0.048 mg/L), selenium (256 ± 25.7 μg/L), total and oxidized glutathione (822 ± 108 μM and 3.56 ± 1.76 μM), myeloperoxidase (67.4 ± 56.2 ng/mL), and isoprostanes (340 ± 95.3 ng/mL). Glutathione peroxidase activity and superoxide anion production in whole blood were also measured. Glutathione peroxidase activity was 473 ± 34.0 IU/g of hemoglobin and superoxide anion production in whole blood was 18,930 ± 12,742 counts per 30 min. Reduced glutathione/oxidized glutathione and copper/zinc ratios were, respectively, 280 ± 139 and 0.70 ± 0.15. Sex-related differences were recorded for zinc (p = 0.0081), copper/zinc ratio (p = 0.0036) and plasma isoprostanes (p = 0.0045).ConclusionProvisional physiological norms covering 95% of our group were proposed for each biomarker and should be of interest for future studies of canine oxidative stress.
Relationship Between Educational Level and Attitudes Towards Alcohol Conversations in Healthcare: A Cross-Sectional Survey Conducted in Four European Countries
Authors: Karlsson Nadine , Skagerström Janna , O'Donnell Amy , Abidi Latifa , Thomas Kristin , Nilsen Per , Lid Torgeir Gilje 
Published: March 2023

Objectives: To examine the association between educational level and attitudes towards alcohol conversations in healthcare using population-based surveys of adults in England, the Netherlands, Norway, and Sweden; and to compare attitudes towards alcohol conversations in healthcare between these four countries.Methods: Cross-sectional surveys were conducted amongst adults in the general population in England (n = 3,499), the Netherlands (n = 2,173), Norway (n = 1,208), and Sweden (n = 3,000). Logistic regression analysis was used to examine associations between attitudes towards alcohol conversations in healthcare and educational level, key demographic variables, alcohol consumption, and country of residence.Results: In all four countries, low educational level (p &lt; 0.001) and male gender (p &lt; 0.001) were associated with holding negative attitudes towards discussing alcohol in healthcare. Risky drinkers had more negative attitudes than low risky drinkers towards discussing alcohol in healthcare (p &lt; 0.001) in all countries except England (p = 0.48), and also reported low levels of perceived honesty and confidence in healthcare (p &lt; 0.001).Conclusion: These findings highlight the importance of considering patients’ socio-economic status when developing and implementing alcohol prevention interventions in healthcare.