bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and Prognostic Factors of Immune Checkpoint Inhibitors in the Treatment of Advanced Non-small Cell Lung Cancer
Authors: Hu Yu-xiong , Guo Li-jing , Lin Meng-qing , Lin Qing-yu 
Published: February 2023

Objective:
To discuss the efficacy and potential prognostic factors of immune checkpoint inhibitors (ICIs) in patients with advanced non-small cell lung cancer (NSCLC).

Methods:
A retrospective study was conducted to analyze the medical history of patients (n=111) confirmed with advanced NSCLC in the Affiliated Hospital of Putian University from 2018 to 2020. All enrolled patients with adenocarcinoma (n=69), squamous cell carcinoma (n=28), and other types of lung cancer (n=14) were treated with the programmed death-ligand 1 (PD-1) inhibitors. They were divided into groups of PD-1 inhibitors, PD-1 inhibitors in combination with chemotherapy, and PD-1 inhibitors in combination with chemotherapy and angiogenesis inhibitors according to the treatment regimen. General clinical data of all patients were collected, and the Kaplan-Meier analysis was applied to estimate progression-free survival (PFS) and overall survival (OS). In addition, univariate and multivariate Cox regression analyses were performed to analyze prognostic factors associated with PFS and OS after treatment.

Results:
Of 111 patients with advanced NSCLC treated with ICIs, 6 were fully responsive, 33 were partially responsive, 55 were stable, and 17 were progressive. There was no significant difference in objective response rate between the 3 groups. In the subgroup analysis according to the lines of therapy, the objective response rate of patients receiving first-line treatment was 46.7%, which was significantly higher than that of other line treatment groups (P=0.014). The results of multivariate Cox regression analysis indicated that the history of hormone use (HR=1.593; P=0.033), second-line or further lines of therapy (HR=2.871; P<0.001), and high neutrophil/lymphocyte ratio (NLR; HR=1.498; P=0.045) were independent risk factors for PFS after immunotherapy for advanced NSCLC. And the history of hormone use (HR=1.518; P=0.015) and high NLR (HR=3.053; P=0.001) were as well the independent risk factors for OS after immunotherapy for advanced NSCLC.

Conclusion:
ICIs therapy clearly had a greater survival benefit in patients who received first-line therapy, had no history of hormone use, and showed low NLR after initial treatment. ICIs can be an effective treatment for advanced NSCLC.
The LabPS score
Authors: Nieder Carsten , Haukland Ellinor C. , Mannsåker Bård , Dalhaug Astrid 
Published: February 2023

Objectives:
To provide a widely applicable, blood-biomarker-based and performance-status-based prognostic model, which predicts the survival of patients undergoing palliative non-brain radiotherapy. This model has already been examined in a cohort of patients treated for brain metastases and performed well.

Methods:
This was a retrospective single-institution analysis of 375 patients, managed with non-ablative radiotherapy to extracranial targets, such as bone, lung, or lymph nodes. Survival was stratified by LabPS score, a model including serum hemoglobin, platelets, albumin, C-reactive protein, lactate dehydrogenase, and performance status. Zero, 0.5, or 1 point was assigned and the final point sum calculated. A higher point sum indicates shorter survival.

Results:
The LabPS score predicted overall survival very well (median 0.6 to 26.5 mo, 3-month rate 0% to 100%, 1-year rate 0% to 89%), P=0.0001. However, the group with the poorest prognosis (4.5 points) was very small. Most patients with comparably short survival or radiotherapy administered in the last month of life had a lower point sum. Additional prognostic factors, such as liver metastases, opioid analgesic use, and/or corticosteroid medication, were identified.

Conclusions:
If busy clinicians prefer a general prognostic model rather than a panel of separate diagnosis-specific/target-specific scores, they may consider validating the LabPS score in their own practice. In resource-constrained settings, inexpensive standard blood tests may be preferable over imaging-derived prognostic information. Just like other available scores, the LabPS cannot identify all patients with very short survival.
Evaluating Potential Impacts of a Preferential Vaccine Recommendation for Adults 65 Years of Age and Older on US Influenza Burden
Authors: Morris Sinead E. , Grohskopf Lisa A. , Ferdinands Jill M. , Reed Carrie , Biggerstaff Matthew 
Published: February 2023

Background:
High-dose, adjuvanted, and recombinant influenza vaccines may offer improved effectiveness among older adults compared with standard-dose, unadjuvanted, inactivated vaccines. However, the Advisory Committee on Immunization Practices (ACIP) only recently recommended preferential use of these “higher-dose or adjuvanted” vaccines. One concern was that individuals might delay or decline vaccination if a preferred vaccine is not readily available.

Methods:
We mathematically model how a recommendation for preferential use of higher-dose or adjuvanted vaccines in adults ≥65 years might impact influenza burden in the United States during exemplar “high-” and “low-”severity seasons. We assume higher-dose or adjuvanted vaccines are more effective than standard vaccines and that such a recommendation would increase uptake of the former but could cause (i) delays in administration of additional higher-dose or adjuvanted vaccines relative to standard vaccines and/or (ii) reductions in overall coverage if individuals only offered standard vaccines forego vaccination.

Results:
In a best-case scenario, assuming no delay or coverage reduction, a new recommendation could decrease hospitalizations and deaths in adults ≥65 years by 0%–4% compared with current uptake. However, intermediate and worst-case scenarios, with assumed delays of 3 or 6 weeks and/or 10% or 20% reductions in coverage, included projections in which hospitalizations and deaths increased by over 7%.

Conclusions:
We estimate that increased use of higher-dose or adjuvanted vaccines could decrease influenza burden in adults ≥65 in the United States provided there is timely and adequate access to these vaccines, and that standard vaccines are administered when they are unavailable.
Psychiatric Disorders Are Predictive of Worse Pain Severity and Functional Outcomes After Fasciotomy for Chronic Exertional Compartment Syndrome of the Leg
Authors: Bi Andrew S. , Shankar Dhruv S. , Avendano John P. , Borowski Lauren E. , Jazrawi Laith M. , Cardone Dennis A. 
Published: February 2023

Objective:
To determine whether concomitant psychiatric diagnoses and medication use were associated with postfasciotomy outcomes in patients with chronic exertional compartment syndrome (CECS).

Design:
Retrospective comparative cohort study.

Setting:
Single academic medical center from 2010 to 2020.

Patients:
All patients above 18 years old who underwent fasciotomy for CECS.

Assessment of Risk Factors/Independent Variables:
Psychiatric history was recorded from electronic health records including disease diagnosis and medications.

Main Outcome Measures:
The 3 main outcome measures were postoperative pain using the Visual Analog Scale, functional outcomes using the Tegner Activity Scale, and return to sport.

Results:
Eighty one subjects (legs), 54% male, with an average age of 30 years and follow-up of 52 months were included. 24 subjects (30%) had at least one psychiatric diagnosis at the time of surgery. Regression analysis found psychiatric history to be an independent predictor of worse postoperative pain severity and postoperative Tegner scores (P < 0.05). Furthermore, subjects with psychiatric disorders not on medication had worse pain severity (P < 0.001) and Tegner scores (P < 0.01) versus controls, whereas subjects with a psychiatric disorder on medication had better pain severity (P < 0.05) versus controls.

Conclusions:
History of psychiatric disorder was predictive of worse postoperative pain and activity outcomes after fasciotomy for CECS. Use of psychiatric medication was associated with improvement in pain severity in some domains.
Image Quality and Artifact Reduction of a Cochlear Implant With Rotatable Magnets
Authors: Winchester Arianna , Kay-Rivest Emily , Bruno Mary , Hagiwara Mari , Moonis Gul , Jethanamest Daniel 
Published: February 2023

Objective
To determine if metal reduction magnetic resonance imaging sequences and changes in implant placement minimize artifact from cochlear implants and improve visualization of intracranial structures.

Study Design
Cadaveric study.

Setting
Tertiary referral center.

Patients
Five cadaveric heads.

Interventions
Specimens were implanted with Advanced Bionics HiRes Ultra3D devices at nasion-external auditory canal angles of 90, 120, and 160 degrees, and distances from the external auditory canal of 9 or 12 cm. Standard brain/internal auditory canal (IAC) sequences with metal artifact reducing technique were acquired in a 1.5T scanner.

Main Outcome Measures
The primary outcome was visibility of 14 intracranial structures graded on a 4-point scale (1, structures <50% visible; 2, >50% visible with some areas nonvisible from artifact; 3, artifact present but adequate for diagnosis; and 4, high quality). Scores were determined by experienced head and neck radiologists and compared with one-way analysis of variance.

Results
Imaging sequences included axial 5-mm whole-brain turbo spin echo (TSE) T2 with right to left and anterior to posterior encoding, fluid-attenuation inversion recovery high bandwidth, axial 5-mm whole-brain slice-encoding metal artifact correction (SEMAC), axial IAC constructive interference in steady state, and axial 3-mm T1 IAC with and without fat saturation. T1 IACs in axial and coronal planes were best for ipsilateral structures overall (mean [standard deviation {SD}], 3.8 [0.6] and 3.8 [0.5]). SEMAC (mean [SD], 3.5 [0.8]) was superior to TSE with anterior to posterior encoding (mean [SD], 3.5 [0.9) for ipsilateral cortex, cerebellopontine angle, and brainstem/cerebellum, and equivalent for the inner ear. Constructive interference in steady state and T1 with fat saturation were poor for all ipsilateral structures (mean, 2.8 [p < 0.01]; mean, 3.1 [p < 0.01]). The 120 degrees/12 cm position was overall best, although the 120 degrees/9 cm position still afforded visualization of ipsilateral structures; other angles and distances conferred slight advantages for specific structures of interest.

Conclusions
SEMAC and T2 TSE with anterior to posterior encoding sequences provide artifact suppression while retaining excellent image quality. Different placement angles did not confer improvement in visualization, although placement distances provided slight advantages for some structures.
Targeted Next-Generation Sequencing in Children With Bilateral Sensorineural Hearing Loss: Diagnostic Yield and Predictors of a Genetic Cause
Authors: Boudewyns An , van den Ende Jenneke , Peeters Nils , Van Camp Guy , Hofkens-Van den Brandt Anouk , Van Schil Kristof , Wouters Kristien , Wuyts Wim 
Published: February 2023

Objective
To investigate the diagnostic yield of targeted next-generation sequencing using hearing loss panels and to identify patient-related factors that are associated with a definite genetic cause.

Study Design
Retrospective chart review.

Setting
Tertiary referral center.

Patients
Children with congenital or late-onset, bilateral sensorineural hearing loss.

Intervention(s)
Diagnostic.

Main Outcome Measure(s)
The number of patients with a definite genetic diagnosis.

Results
We report on 238 patients with hearing loss: 130 were male and 108 were female. About 55% had congenital hearing loss. A genetic cause was identified in 94 of the patients (39.5%), with 72.3% of these showing nonsyndromic and 27.6% showing syndromic hearing loss. The diagnostic yield was highest among North African patients (66.7%). A multiple linear regression model shows that profound hearing loss, family history of hearing loss, congenital hearing loss, and North African ethnicity are significantly related to identifying a genetic cause.

Conclusions
Targeted next-generation sequencing using a panel of hearing loss genes identified a genetic diagnosis in almost 40% of children with bilateral sensorineural hearing loss. We describe the predictors of a genetic diagnosis, and this information may be used during genetic counseling.
Initial Stage of Disease Similar for White and Black Patients With Early-Onset Colorectal Cancer at a Safety-Net Hospital
Authors: Chiu Laura S. , Huang Kevin Z. , Xu Xixi , Heeren Timothy , Haque Rubiya , Schroy Paul S. 
Published: February 2023

Background:
Non-Hispanic Black (NHB) patients with early-onset colorectal cancer (EOCRC) are more likely to present with advanced-stage disease than their Non-Hispanic White (NHW) counterparts. To further elucidate whether differences in tumor biology or disparities in access to care may be responsible, we examined the association between race/ethnicity and initial stage of disease, time to diagnosis, and tumor characteristics among NHW and NHB patients with EOCRC cared for in a safety-net health care setting.

Methods:
We performed a retrospective cohort study of NHW and NHB patients diagnosed with primary EOCRC who received care at Boston Medical Center between January 2000 and May 2020. We compared demographics, risk factors, presenting signs/symptoms, time to diagnosis, health care utilization, and tumor characteristics (stage, grade, location, and mutational status).

Results:
We identified 103 patients (mean age 41.5±7.2 y, 53.4% men), including 40 NHWs and 63 NHBs, with EOCRC. NHB and NHW patients were similar with respect to demographics, presenting signs/symptoms, and risk factor distribution. There were also no significant differences between NHWs and NHBs with respect to the advanced stage of disease at presentation (45.0% vs. 42.9%, P=0.83), the median time to diagnosis [152 d (IQR, 40 to 341) vs. 160 d (IQR, 61 to 312), P=0.79] or tumor characteristics, except for a predilection for proximal disease among NHBs (30.2% vs. 15.0%).

Conclusions:
NHB patients were no more likely than NHW patients to present with advanced-stage disease, aggressive tumor histology, or experience delays in diagnosis within a safety-net health care system.
Pediatric coronavirus disease 2019 in Africa
Authors: van der Zalm Marieke M. , Dona’ Daniele , Rabie Helena 
Published: February 2023

Purpose of review
Three years into the coronavirus disease 2019 (COVID-19) pandemic, data on pediatric COVID-19 from African settings is limited. Understanding the impact of the pandemic in this setting with a high burden of communicable and noncommunicable diseases is critical to implementing effective interventions in public health programs.

Recent findings
More severe COVID-19 has been reported in African settings, with especially infants and children with underlying comorbidities at highest risk for more severe disease. Data on the role of tuberculosis and HIV remain sparse. Compared to better resourced settings more children with multisystem inflammatory disease (MISC) are younger than 5 years and there is higher morbidity in all settings and increased mortality in some settings. Several reports suggest decreasing prevalence and severity of MIS-C disease with subsequent severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variant waves. Whether this decrease continues remains to be determined. Thus far, data on long-COVID in African settings is lacking and urgently needed considering the severity of the disease seen in the African population.

Summary
Considering the differences seen in the severity of disease and short-term outcomes, there is an urgent need to establish long-term outcomes in children with COVID-19 and MIS-C in African children, including lung health assessment.
Developing Cultural Humility Through an Interprofessional Clinical Education Experience
Authors: Frie Kathryn , Timm Jennifer 
Published: February 2023

Background:
An interprofessional clinical education model operating student-led, faculty-guided clinics partnered with rural Midwest American communities lacking health care access.

Purpose:
To evaluate how an internship, guided by the Theory of Cultural Humility, during the COVID-19 pandemic supported development of cultural humility in interprofessional health profession students.

Approach:
Nursing, exercise science, public health, and social work participants completed an internship during early phases of the COVID-19 pandemic, despite many experiences being suspended. Quantitative evaluation using pre-/postadministration of Foronda's Cultural Humility Scale was completed across 3 periods measuring change in cultural humility.

Results:
Total scores of Foronda's Cultural Humility Scale increased for all 3 periods (n = 11, n = 74, and n = 44), demonstrated by aggregate data and statistical analysis. The largest change occurred in the first period.

Conclusions:
Engaging interprofessional students in experiential learning during real-life, real-time public health events creates reflection of complex practice issues while developing cultural humility.
The application of health recommender systems based on knowledge graph: a scoping review
Authors: Zhang Xu , Yi Mo , Sun Yue , Han Shuyu , Zhang Wenmin , Wang Zhiwen 
Published: February 2023

Abstract

Background:
Tailored knowledge graph-based recommender systems (KGRSs) have been demonstrated to be able to provide accurate and effective health recommendations to users, and thus significantly reduce health care costs. They are now strongly recommended to be applied in the health care field.

Objective:
This scoping review aims to identify the current application of KGRSs, their target users and performance metrics, and the potential limitations of implementing health recommender systems in clinical practice.

Methods:
A review of the studies published from inception to November 1, 2022 was conducted, using key search terms in 6 scientific databases to identify health recommender systems based on knowledge graph technology. Key information from the included studies was extracted and charted. The scoping review was reported following the PRISMA Extension for Scoping Reviews.

Result:
We included 16 studies and 5 grants totally about the health recommender systems based on knowledge graph technology. They were used in different health areas: traditional Chinese medicine, health management, disease-related decision support, diet, and nutrition recommendations. Among them, 6 studies were for the general public and 6 were for physicians. A total of 13 (81.25%) studies evaluated the KGRS using performance metrics, such as accuracy, recall, F1 score, and area under the curve. All studies pointed out the limitations of the recommender systems and provided directions for their subsequent optimization and improvement.

Conclusion:
This review describes the state-of-the-art and potential limitations of KGRS used in the health care field. This novel approach has been proven to be effective in overcoming the drawbacks of traditional algorithms, helping users filter massive amounts of data to find out the personalized information they need. Its great potential in digital health needs to be further explored.
Internet-Delivered Sexually Transmitted Infection and Teen Pregnancy Prevention Program: A Randomized Trial
Authors: Kissinger Patricia J. , Green Jakevia , Latimer Jennifer , Schmidt Norine , Ratnayake Aneeka , Madkour Aubrey Spriggs , Clum Gretchen , Wingood Gina M. , DiClemente Ralph J. , Johnson Carolyn 
Published: February 2023

Background
Black older-teenaged women have disproportionately high rates of sexually transmitted infections (STI) and unintended pregnancy (UTP). Internet-based interventions can be delivered to large groups of people in a relatively inexpensive manner. In this randomized trial, we examine the efficacy of an evidence-based STI/UTP prevention intervention adapted for older teens and for Internet delivery.

Methods
Black women aged 18–19 years who were not pregnant/seeking to become pregnant were enrolled (n = 637) and randomized to an 8-session intervention or attention control and were followed up at 6/12 months postintervention. The primary outcome was defined as uptake of reliable contraceptives. Other secondary outcomes were examined, including intention to use condoms, intention to use reliable contraception, and STI or pregnancy rates.

Results
Overall, at baseline, reliable contraception was 54.8% and dual protection was 29.4%, and the prevalence of STI was 11.1%. Participants were similar by arm for most factors considered. Participation and follow-up rates were excellent (60.9% and 80.3%). There was no statistically significant difference in uptake of reliable contraception for intervention versus controls at 6 months (1.45 [0.99–2.12]) or 12 months (1.33 [0.92–1.91]). At 6 months, several secondary outcomes were improved/trended toward improvement in intervention compared with control, but this effect waned by 12 months, except for intention to use condoms which remained improved.

Conclusion and Relevance
The intervention was efficacious for increasing some self-reported UTP and STI prevention behaviors, which waned over time, and the intervention had minimal impact on STI or pregnancy rates suggesting that this type of online intervention may need additional components.
Immediate and Ongoing Impact of COVID-19 on Chlamydia Treatment in Australia
Authors: Engstrom Teyl , Baliunas Dolly , Smith Angela , Dean Judith A. , Pole Jason D. 
Published: February 2023

Background
The COVID-19 pandemic has impacted the sexual health and well-being of individuals, directly through risk of contracting COVID-19, and indirectly through government lockdowns. Government restrictions were especially strict and long-lasting in Australia, they also varied by state, offering an interesting opportunity to study the impacts of varying restrictions. This study compares the impact of the COVID-19 pandemic and resulting restrictions on chlamydia treatment prescriptions during 2020, through to July 2021 between different states and demographic groups in Australia.

Methods
The rate of prescriptions per 100,000 population filled each month from January 2017 to July 2021 from Australia's Pharmaceutical Benefits Scheme for Azithromycin with a restricted indication to treat Chlamydia trachomatis was used to measure chlamydia treatment. The impact of COVID-19 lockdowns was modeled using an interrupted time-series Poisson regression model.

Results
The data included 520,025 prescriptions to treat chlamydia, averaging 37.5 prescriptions per month per 100,000 population. Prescriptions declined 26% in April to May 2020 when initial COVID-19 lockdowns began in Australia; prescriptions increased in the following months but remained on average 21% below prepandemic (2017–2019) levels through to July 2021. Prescriptions declined the most in 1 Australian state, Victoria, both in the initial lockdown and the following period; generally, states with more COVID-19 cases saw bigger reductions in prescriptions.

Conclusions
This is the first study to examine how treatment for chlamydia in Australia was impacted by the COVID-19 pandemic and restrictions not only in the immediate-term, but also ongoing up to July 2021, providing important information for planning for sexual health services in future pandemics.