bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enrichment of Circulating Tumor Cells of Lung Cancer and Correlation With Serum Leukomonocyte and Tumor Biomarkers: A Retrospective Study
Authors: Mei Zhou-Fang , Yan Jing , Qian Ling , He Yan-Chao , Feng Jing-Jing , Wang Jie , Jie Zhi-Jun , Zou Hua 
Published: April 2023

Study design Circulating tumor cells is important in the clinical diagnosis of cancer and there are a number of circulating tumor cell detection systems associated with different isolation strategies being validated. There is a novel platform, the CytoBot 2000, which utilizes a combination of physical and immunological technologies to isolate and capture circulating tumor cells. Methods In this retrospective study, 39 lung cancer patients and 11 normal healthy individuals were enrolled and performed circulating tumor cell tests and immunofluorescence staining with CytoBot 2000. The performance of this device was assessed by receiver operating characteristic curve. The clinical relevance of circulating tumor cells was assessed by Chi-square. The correlations between circulating tumor cell number and blood lymphocytes and tumor biomarkers were analyzed by Pearson correlation coefficient. Results The number of circulating tumor cell is significantly increased in lung cancer patients (3.74 > 0.45, P < .0001). The CytoBot 2000 presented a 100% (39/39) circulating tumor cell detection rate in lung cancer patients and 36% (4/11) in healthy individual blood samples, the sensitivity and specificity were 89.7% and 90.9%, respectively, and with the area under curve of 0.966. Further, there was a positive correlation between circulating tumor cell count and carcinoembryonic antigen 211 (R2 = 0.125, P = .027), but not blood lymphocytes ( P = .089). Conclusions This automatic platform showed excellent performance of circulating tumor cell detection by clinical sample. The tumor biomarkers increased with the number of circulating tumor cell in the lung cancer patients.
Accumulated Dose Deviation of Rotational and Residual Setup Errors on Nasopharyngeal Carcinoma Using MIM Treated by Helical Tomotherapy
Authors: Yao Wenyan , Hu Jiang , Xu Peixun , He Mengxue , Fang Yongwen , Liu Mingzhi , Li Zongtai , He Huilang , Liu Hui , Sun Wenzhao , Xu Senkui 
Published: April 2023

Background To analyze the relationship between the rotational and residual setup errors and the dose deviation on nasopharyngeal carcinoma (NPC) treated by helical tomotherapy (HT). Methods From 25 July 2017 to 20 August 2019, 16 treated NPC patients were enrolled in the study. These patients were scanned with full target range megavoltage computed tomography (MVCT) every other day. Adaptive radiotherapy function application software MIM7.1.3 were used to accumulate the actual dose. The dose deviation with the initial plan dose of the patients’ target and organs at risk (OAR) were compared, and the correlation between the dose change and the setup errors (rotational setup errors and neck residual setup error) was analyzed. Results Translational setup errors increased farther away from the head. Statistically significant difference among 3 groups was achieved in the directions of left-right ( P < .001) and anteroposterior ( P < .001) by analysis of variance test. Compared with the initial plan dose, the actual accumulated dose of the target area decreased with the actual exposure dose of the OAR increased. However, most of the dosimetric parameters differed by less than 5%. No correlation was found between dose deviation values and the translational setup errors of target. However, sagittal rotational setup errors (pitch) had a positive relationship ( P < .05) with the avearge dose of PTVnd (L) ( r = 0.885), PTVnd(R) ( r = 0.547) PTV1( r = 0.633) and PTV2( r = 0.584). Transverse rotational setup errors (roll) had a positive relationship ( P < .05) with the avearge dose of PTVnd(R) ( r = 0.593), PTV1( r = 0.505) and PTV2( r = 0.662). Conclusions Dose deviation between the actual accumulated and initial plan is not negligible, but most indicators difference is less than 5%, NPC patients treated by HT with MVCT correction setup errors every other day did not need adaptive radiotherapy model unless got rapid tumor shrinkage or weight loss. Moreover, to minimize the dose deviation, more attention should be paid to the reduction of pitch, roll, and residual error of cervical vertebrae during body positioning.
Dose Delays, Dose Reductions, and Relative Total Dose Intensity in Patients With Advanced Cancer Who Exercised During Neoadjuvant Chemotherapy Treatment
Authors: Wonders Karen Y. , Schmitz Kathryn , Harness Jay 
Published: April 2023

Background: When it comes to chemotherapy, maintaining the dose and schedule of treatment are of vital importance, as clinical evidence suggests that dose intensity is associated with optimal treatment outcomes for various tumors. Yet, reduced dose intensity is a common method of mitigating the chemotherapy-induced side effects. Exercise has been shown to attenuate chemotherapy-related symptoms that frequently cluster together. Understanding this, we conducted a retrospective analysis in patients with advanced disease treated with adjuvant or neoadjuvant chemotherapy regimens and who completed exercise training during treatment. Methods: Data were collected retrospectively in a chart review of 184 patients, aged 18 years or older and treated for Stage IIIA-IV cancer. Data collection included baseline patient demographics and clinical characteristics, including age at diagnosis, cancer stage at initial diagnosis, chemotherapy regimen, and planned dose and schedule. Cancer types included brain (6.5%), breast (35.9%), colorectal (8.7%), non-Hodgkin’s lymphoma (7.6%), Hodgkin’s lymphoma (11.4%), non-small cell lung (16.8%), ovarian (10.9%), and pancreatic (2.2%). All patients completed at least 12 weeks of prescribed, individualized exercise. Each program included cardiovascular, resistance training, and flexibility components, under the supervision of a certified exercise oncology trainer once a week. Results: RDI was measured for each myelosuppressive agent in a regimen over the entire chemotherapy course and then averaged across the myelosuppressive agents in a regimen. An RDI of less than 85% was designated as the clinically meaningful threshold for reduction in RDI based on previously published studies. Conclusions: A considerable proportion of patients across regimens had dose delays (18.3%-74.3%) and dose reductions (18.1%-84.6%). Between 12% and 83.9% of patients missed at least 1 dose of a myelosuppressive agent that was part of their standard regimen. Overall, 50.8% of patients received less than 85% of the RDI. In short, patients with advanced cancer and an exercise adherence above 84.3% saw fewer chemotherapy dose delays and dose reductions. These delays and reductions occurred significantly less frequently compared to the published norms in the sedentary population ( P < .05).
Babao Dan Alleviates Cancer Cachexia in Mice Via Inhibiting IL-6/STAT3 Signaling Pathway
Authors: Qiu Zhengliang , Wo Da , Zhong Xiaomei , Chen Jinxiao , Ma En , He Jia , Peng Jun , Zhu Weidong , Ren Dan-ni 
Published: April 2023

Background: Cancer cachexia is a common but severe condition that causes muscle wasting, body weight loss, and progressive functional impairment, affecting over 50% of cancer patients. Currently, there are no effective treatments that can alleviate cachexia, and hence the discovery of new therapeutics that can effectively prevent or even reverse cancer cachexia is crucial. Babao Dan (BBD) is a Traditional Chinese Medicine (TCM) formula that has been used clinically in combating various cancers, however, its therapeutic potential in alleviating cancer cachexia remains unexplored. Our current study aims to determine the anti-cachectic effects of BBD treatment in alleviating cancer cachexia, as well as determining the underlying mechanisms involved. Methods: Mouse models of cancer cachexia were induced via implantation of CT26 colon adenocarcinoma cells, and the anti-cachectic effects and mechanisms of BBD were determined via examinations of body weight and muscle mass, as well as serum and muscle markers of cachexia and muscle atrophy. Results: CT26 tumor implantation reduced in the rapid occurrence of cancer cachexia characterized by marked reductions in body weight and muscle mass, functional decrease in muscle function and accelerated deaths. BBD administration not only demonstrated robust anti-cachectic ability via preventing decreases in body weight, muscle mass, and muscle atrophy, but also markedly prolonged survival. The effects of BBD in alleviating cancer cachexia and its associated adverse effects were due to its ability in preventing the activation of IL-6/STAT3 signaling post-CT26 tumor implantation. Conclusion: Our findings demonstrated the robust ability of BBD in preventing cancer cachexia and alleviating the main cachexia-induced symptoms as well as prolonging survival via inhibiting activation of IL-6/STAT3 signaling pathway. Therefore, our study demonstrating the strong anti-cachectic effects of BBD in mice may provide a theoretical basis for the use of BBD as a safe and effective drug in the treatment of cancer cachexia.
In Pursuit of the Most Cost-Effective Laparoscopic Appendicectomy: A Review of the Literature
Authors: Curwen Oliver , Gaber Mohannad , Gerogiannis Ioannis 
Published: April 2023

Purpose To review the literature and identify the most economical techniques for laparoscopic appendicectomy (LA) that do not compromise on patient care. Methods We performed a search of the Cochrane Library, PubMed, EMBASE and Google Scholar for papers published between January 2001 and January 2021. The outcomes of the included studies were then grouped by theme of cost analysis, with the main areas of focus being the use of disposable equipment, appendiceal stump closure, and retrieval of the appendix. Results After screening a total of 254 search results, 40 studies were included, representing 13 285 patient outcomes, having two main areas of focus: the use of reusable or disposable equipment and the different methods of appendiceal stump closure. Use of disposable instruments has been cost effective in LA in 2 studies. However, use of reusable trocars has reduced cost of procedure by €250 in another study. Appendiceal stump closure using ligature, endoloops or Endoclips had been cost-effective compared to Endostaplers in 25 studies. This can save up to €350. Endoscopic specimen bags are single use and represent further disposable equipment costs. The use of a sterile glove to replace this piece of kit can further provide cost benefit as shown in 2 studies. Conclusion Laparoscopic appendicectomy can be performed in a variety of ways with equivocal patient safety. We present the use of extracorporeal ligature of the appendiceal base, combined with the use of a surgical glove retrieval system as the most economic technique in laparoscopic appendicectomy.
Perceptions of mindfulness practices as a support for individuals managing caregiving responsibilities and chronic disease: A qualitative study
Authors: West Nathan T. , Harmon Brook E. , Rawlett Kristen E , Short Sarah J. , Spanier Adam J. , Mathews Shifali , Kimble Katrina , McGehee Chad , Ratliff Macy L. , Puett Robin C. 
Published: April 2023

Objectives Explore the lived experience of individuals managing and/or caregiving for someone with a chronic disease and their perceptions of developing a mindfulness program for stress reduction. Methods Sixteen participants with chronic disease and/or caregivers participated. Participants completed eligibility screening, demographic questionnaires, and semi-structured interviews (30–60 min each) online or by phone. Interviews ( n = 16) were audio recorded, transcribed, and analyzed using thematic analysis and NVivo® 12. Survey data were analyzed using SPSS® 28. Results Four themes emerged: (a) Chronic disease management and stress—perspectives on life's stressors; (b) Stress reduction techniques/perceptions of mindfulness—knowledge and implementation of stress reduction practices and familiarity with mindfulness; (c) Mindfulness program acceptability, barriers, and facilitators—interest, barriers, and facilitators to attending; (d) Mindfulness program structure—logistics to increase access and appeal to diverse audiences. Discussion Mindfulness has the potential for addressing the complexities of stress associated with disease management. Targeting mindfulness programs for populations with chronic disease management and caregiving responsibilities should include: Consideration of group formats with participation limited to this population, structuring programs to overcome barriers (i.e., culturally appropriate location), and equipping members of the community being served as instructors to ensure culturally relevant instruction.
EF-24, a Curcumin Analogue, Could Inhibit HSP90 and Induce Apoptosis-Mediated by Autophagy/Inflammation/Oxidative Stress in Papillary Thyroid Cancer Cell Lines
Authors: Zhou Guangying , Zhang Yanting , Akbari Abolfazl , Wang Xin , Wei Jing 
Published: April 2023

Objective Papillary thyroid cancer (PTC) is one of the most common thyroid cancers and its prevalence has increased in recent years. Studies have shown that autophagy, angiogenesis, inflammation, oxidative damage, apoptosis, and some signaling pathways such as PI3K/AKT/mTOR play an important role in cancer progression. Moreover, most of their signaling molecules are the clients of heat shock protein 90 (HSP90), and its inhibition attenuates tumorigenesis. Diphenyl difluoroketone (EF-24), a curcumin analog, has antioxidative, anti-inflammatory, and anticancer properties and, unlike curcumin, has high efficacy, and may treat PTC. Therefore, the antioxidant, anti-inflammatory, angiogenic, apoptotic, and anticancer effects of EF-24 on PTC cell lines (BCPAP and TPC-1) were investigated in this study. Methods In this study, the effect of different concentrations of EF-24 and cisplatin on cell viability, apoptosis, inflammation, autophagy, oxidative status, and angiogenesis, along with HSP90 expression was evaluated in BCPAP and TPC-1 cell lines. Results The results showed that treatment with different EF-24 concentrations could significantly decrease cell viability by inducing apoptosis. EF-24 (40 µg/mL) also significantly downregulated HSP90 and the gene and protein involved in oxidative damage, angiogenesis, inflammation, and autophagy. Conclusions In conclusion, EF-24 could decrease cell viability by inducing apoptosis mediated by autophagy, oxidative stress, angiogenesis, inflammation, and the PI3K/AKT/mTOR pathway. It is possible that a decrease in HSP90 may mediate these effects. These results indicate that EF-24 is a viable option for the prevention and treatment of PTC.
Importance of preemptive analgesia and pain assessment as perceived by intensive care unit nurses
Authors: Abdalrahim Maysoon S , Hamdan Khaldoun M , Shaheen Abeer M 
Published: April 2023

Background The importance and efficacy of Preemptive analgesia in reducing pain for patients undergoing painful procedures still debatable and seldom investigated. The aim of this study was to describe intensive care nurses’ perception of the importance of pain assessment and Preemptive analgesia prior painful procedures in critical care settings in Jordan. Method A cross-sectional descriptive design was used. The sample consisted of 300 registered nurses recruited from 22 intensive care units in Jordan. The data was gathered using a self-administered questionnaire. Results The results showed that nurses considered pain assessment moderately and extremely important for surgical ( n = 263, 87.7%), burn ( n = 261, 87%), and trauma patients ( n = 256, 85.3%). The majority of nurses rated pain assessment as moderately to extremely important for invasive line placement 80.3%, wound care 78.3%, and drain removal 69%. Nurses assessed the need for Preemptive analgesia more frequently before wound care 70.7%, and before invasive line placement 69.7%. Nurses perceived pain assessment for Preemptive analgesia as less priority for unconscious patients. Conclusion Effective assessment and management of pain for critically ill patients is mandatory. Thus, it is important to improve nurses’ knowledge regarding the Preemptive analgesia and its effects in relieving post-procedural pain in critically ill patient. It is recommended to ensure proper clinical training on how to assess critically ill patients and auditing system.
Older adults with complex care needs’ experiences within a hospital-to-home transition patient navigator program: A qualitative descriptive study
Authors: Kokorelias Kristina M , Singh Hardeep , Knoepfli Amanda , Das Gupta Tracey , Ziegler Naomi , Hitzig Sander L 
Published: April 2023

Introduction Older adults living with complex care needs are often hospitalized due to poor community support. Recommendations for improving patient and family experiences include having a patient navigator to support patients and caregivers in hospital and community settings. This study aimed to report on older adults’ and caregivers’ experiences of receiving services from a hospital-to-home patient navigation program. Methods A qualitative descriptive study was conducted. Telephone interviews were conducted with 14 older adults with complex care needs or their family caregivers in Toronto, Ontario from 2020 to 2021. Data were analyzed using inductive thematic analysis. Results Four themes were identified: (1) Initial Hesitancy; (2) Meeting Evolving Needs; (3) Unexpected Benefits of Patient Navigation; and (4) The Value of Patient Navigation in Sustaining Aging-in-Place. Participants viewed all their interactions with the navigator as positive, and perceived navigators improved their quality of care. Discussion These study findings suggest that patient navigators may be well-positioned to address gaps in services around psychosocial support and care coordination while also encouraging self-management in older adults with complex care needs.
Considerations for at-home upper-limb rehabilitation technology following stroke: Perspectives of stroke survivors and therapists
Authors: Forbrigger Shane , Liblong Madeleine , Davies TC , DePaul Vincent , Morin Evelyn , Hashtrudi-Zaad Keyvan 
Published: April 2023

Introduction This study investigated the needs of stroke survivors and therapists, and how they may contrast, for the design of robots for at-home post stroke rehabilitation therapy, in the Ontario, Canada, context. Methods Individual interviews were conducted with stroke survivors ( n = 10) and therapists ( n = 6). The transcripts were coded using thematic analysis inspired by the WHO International Classification of Functioning, Disability, and Health. Results Design recommendations, potential features, and barriers were identified from the interviews. Stroke survivors and therapists agreed on many of the needs for at-home robotic rehabilitation; however, stroke survivors had more insights into their home environment, barriers, and needs relating to technology, while therapists had more insights into therapy methodology and patient safety and interaction. Both groups felt a one-size-fits-all approach to rehabilitation robot design is inappropriate. Designs could address a broader range of impairments by incorporating household items and breaking activities down into their component motions. Designs should incorporate hand and wrist supports and activities. Designs should monitor trunk and shoulder motion and consider incorporating group activities. Conclusion While therapists can provide insight in the early stages of design of rehabilitation technology, stroke survivors’ perspectives are crucial to designing for the home environment.
Researching Forms of Shadow Education: Methodological Challenges and Complexities of Private Supplementary Tutoring in Myanmar
Authors: Suante Peter Kamtungtuang , Bray Mark 
Published: April 2023

Purpose The growing literature on private supplementary tutoring, widely known as shadow education, addresses multiple dimensions and roles. However, many studies inadequately capture the diversity and implications of different forms of tutoring. This paper examines these matters in Myanmar, highlighting complexities and ambiguities in descriptors and in the nature of provision. Design/Approach/Methods Using a mixed-methods design, this study was conducted in Mandalay Region and Chin State. The data were obtained from interviews with 110 Grade 11 students, 34 high school teachers, 30 parents, 29 private tutoring providers, and two private school owners. Findings The article categorizes tutoring forms based on their styles and orientations, particularly lecture-type teaching and homework supervision by guides, class sizes, durations of fee-charging (e.g., annually), the number of subjects taught per tutor, and tutoring locations. The study brings the topic out of the shadows for clearer analysis of the phenomenon and thus for assessment of its implications. Originality/Value The study makes a methodological contribution to the wider picture by demonstrating the need for greater clarity and precision in the national and international comparative literatures. It also underscores shortcomings of predetermined categories in questionnaires and the value of qualitative interviews.
On the Trail of Self-Directed Online Learners
Authors: Bonk Curtis J. , Zhu (朱美娜) Meina 
Published: April 2023

Purpose We describe a series of more than a dozen studies on self-directed online learning spanning over a decade. Design/Approach/Methods We incorporated surveys, interviews, focus groups, and content analyses into these research studies, which initially targeted the goals, motivations, and challenges of learners using open educational resources and OpenCourseWare and then focused on learning from massive open online courses (MOOCs). This research accelerated after creating a database of over 3,000 MOOC instructors, through which we explored cultural sensitivity and personalization practices in MOOCs as well as instructional design considerations and challenges, MOOC instructor professional development and career development, instructor motivation and engagement, and student and instructor perceptions of self-directed learning. Findings This study reveals that self-directed online learners (SDOLs) seek learning environments offering freedom, choice, control, and a sense of autonomy and that both learners and instructors have intrinsic motivation for engaging in open online learning environments. Originality/Value Based on this research with both MOOC instructors and MOOC learners, we offer instructional design guidelines to address SDOLs’ needs and assist in efforts to foster a new generation of SDOLs.