bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical efficacy of combination therapy of an immune checkpoint inhibitor with taxane plus platinum versus an immune checkpoint inhibitor with fluorouracil plus platinum in the first-line treatment of patients with locally advanced, metastatic, or recurrent esophageal squamous cell carcinoma
Authors: Li Ying , Ji Yanyan , Shen Lin , Yin Xudong , Huang Tianyu , Deng Bin , Guo Hong , Wu Yunjiang , Chen Yong 
Published: December 2022

BackgroundChemotherapy combined with immune checkpoints inhibitors (ICIs) has been established as a standard treatment for locally advanced, metastatic, or recurrent esophageal squamous cell cancer (ESCC). However, the optimal chemotherapy regimen in combination therapy is still unclear.PurposeTo investigate the efficacy and adverse events of the fluorouracil plus platinum (FP) and taxane plus platinum (TP) regimens in ESCC patients receiving chemo-immunotherapy, we conducted this systematic review and meta-analysis.MethodsPotentially eligible studies were searched from Medline, Embase, Web of Science, and the Cochrane Library. Pooled rates of overall response rate (ORR), disease control rate (DCR), overall survival (OS), progression-free survival (PFS), and adverse events were compared between ICIs+TP and ICIs+FP groups in ESCC patients receiving first-line chemo-immunotherapy.ResultsA total of 10 clinical trials were included, of which 5 were randomized controlled trials. Compared with chemotherapy alone, chemo-immunotherapy significantly improved the OS of ESCC patients (pooled HR=0.69; 95% CI, 0.63–0.76; p&lt;0.01). Pooled analysis revealed that ESCC patients receiving ICIs+TP had significantly higher ORR, DCR, PFS, and OS rates than those receiving ICIs+FP. No statistically significant difference in the pooled incidence rate of treatment-related death was found (2.3% vs 0.9%, P=0.08). ICIs+TP had significantly higher rates of hematologic toxicity but lower rates of gastrointestinal toxicity than ICIs+FP.ConclusionsBased on the current data, the first-line treatment using ICIs+TP may be a better option than ICIs+FP in advanced, metastatic, or recurrent ESCC.
Multiple colorectal adenomas in Lynch syndrome
Authors: Jain Ayushi , Alimirah Maryam , Hampel Heather , Pearlman Rachel , Ma Jianing , Peng Jing , Kalady Matthew F. , Stanich Peter P. 
Published: December 2022

BackgroundLynch syndrome has not traditionally been considered to have a high colorectal adenoma burden. However, with increasing adenoma detection rates in the general population, the incidence of adenoma detection in Lynch syndrome may also be increasing and leading to higher cumulative adenoma counts.AimTo clarify the prevalence and clinical impact of multiple colorectal adenomas (MCRA) in Lynch syndrome.MethodsA retrospective review of patients with Lynch syndrome at our institution was performed to assess for MCRA (defined as ≥10 cumulative adenomas).ResultsThere were 222 patients with Lynch syndrome among whom 14 (6.3%) met MCRA criteria. These patients had increased incidence of advanced neoplasia (OR 10, 95% CI: 2.7-66.7).ConclusionsMCRA is not unusual in Lynch syndrome and is associated with a significantly increased likelihood of advanced colon neoplasia. Consideration should be given to differentiating colonoscopy intervals based on the presence of polyposis in Lynch syndrome.
Serum soluble DR5 predicts mortality risk in patients with HBV-related hepatocellular carcinoma
Authors: Liang Jiaqi , Feng Ying , Liu Yao , Shi Ke , Zhou Guiqin , Liu Long , Liu Yaxin , Qiao Kexin , Liu Wen , Wang Xianbo 
Published: December 2022

IntroductionDeath receptor 5 (DR5) is significantly upregulated in various human tumor tissues; however, the relationship between serum levels of soluble DR5 (sDR5) and the mortality risk of hepatocellular carcinoma (HCC) is not understood. Our aim is to investigate the prognostic value of serum sDR5 in HCC patients.MethodsA total of 170 patients with HBV-HCC were recruited, with 82 and 88 patients as derivation and validation cohorts, respectively. sDR5 levels were analyzed using ELISA. The predictive factors for mortality were selected using LASSO regression analysis. Cox regression analysis was used to analyze the independent factors affecting mortality in 2 years. A nomogram based on the interquartile range of the sDR5 values predicted mortality rates.ResultsSerum sDR5 level was identified as an independent risk factor for mortality in patients with HBV-HCC. The 2-year cumulative mortality rates of HBV-HCC were 10, 28.57, 38.10, and 95% across the sDR5 quartiles, respectively (p &lt; 0.001). The sDR5 had an AUROC of 0.851 (95% CI: 0.755–0.920) in the derivation cohort. When the cut-off value was 30.06pg/mL, the AUROC of sDR5 was 0.778 (95% CI 0.677–0.860) in the validation cohort. The calibration curves fit well, and the decision curves showed that sDR5 had a high standardized net benefit. sDR5 predicted the prognosis of HBV-HCC patients most accurately. Further, serum sDR5 level was significantly positively associated with BCLC stage and the presence or absence of ascites.ConclusionsDR5 showed high predictive accuracy in patients with HBV-HCC; thus, it is considered a new serological biomarker.
Symptomatic bone marrow metastases in breast cancer: A retrospective cohort study
Authors: Yang Ruohan , Jia Lin , Lu Guanyu , Lv Zheng , Cui Jiuwei 
Published: December 2022

ObjectiveBreast cancer symptomatic bone marrow metastasis (BMM) is rare and has a poor prognosis. Chemotherapy is usually the primary treatment, but it has limited efficacy, resulting in dose reduction and a decrease in quality of life due to the adverse effects of the agent. Other than chemotherapy, there are no other treatment studies for BMM. This study aimed to explore the clinicopathological characteristics of BMM patients with breast cancer, the prognosis using different treatment modalities, and the risk factors that affect the prognosis.MethodsThis retrospective study included patients diagnosed with breast cancer BMM from January 2018 to January 2022 in the Cancer Center of the First Hospital of Jilin University. The analysis focused on the characteristics of the patients, the treatment regimen, and the prognosis.ResultsOf 733 patients with advanced breast cancer, 33 patients were identified with BMM. All patients showed a hemoglobin decrease, and 25 (75.75%) presented with a fever of unknown origin. As for the metastasis breast cancer subtype, 25 (75.75%) were hormone receptor (HR) positive/human epidermal growth factor receptor 2 (HER2) negative, three (9.09%) had HER2 overexpression, and five (15.15%) were triple negative. The BMM patients had a median progression-free survival (PFS) of 7 months (1–21 months) and a median overall survival (OS) of 18 months (2–108 months). Among 25 HR+/HER2− BMM patients treated with different modalities, the median OS of the endocrine therapy (ET) group was 23 months, compared with 5 months in the chemotherapy group. Cox proportional hazards models suggested that higher Eastern Cooperative Oncology Group (ECOG) scores and old age were associated with shorter survival.ConclusionWhen breast cancer patients present with anemia and fever of unknown origin, BMM should be considered. For HR+/HER2− patients with good physical status and can receive active treatment, CDK4/6 inhibitors combined with ET can be used to control disease progression, improve quality of life, and prolong survival.
Identification of cervical epidural space: A comparison study between contrast spread and loss of resistance techniques
Authors: Perper Yakov 
Published: December 2022

Background and objectivesEarly epidural space identification is critical to the efficacy and safety of cervical epidural steroid injections (CESI). Currently, the accepted method for epidural space recognition is the loss of resistance technique (LORT). I hypothesized that the contrast spread technique might recognize epidural space concurrently with or sooner than LORT and that smaller needles might be employed with the fluoroscopy only method but not with LORT. To test my hypotheses, I conducted a comparison study.MethodsThe study participants were patients from my practice with a clinical diagnosis of cervical radiculitis divided into two groups of 20 each, who underwent CESI with either an 18 G or a 25 G Tuohy needle. All CESIs were performed utilizing the fluoroscopy only method. Then, LOR was tested using an Epidrum device that was observed for 30 s; if the Epidrum deflated, the result was positive.ResultsLOR was positive in 12 out of 20 patients in the 18 G group and 2 out of 20 in the 25 G group. The 95% confidence interval test for proportion revealed a statistically significantly lower rate for epidural space detection by LORT in both groups: [0.385, 0.815] in the 18 G and [-0.031, 0.231] in the 25 G group. Statistical significance of the difference between groups in LOR accuracy rate (60% vs. 10%) was confirmed by z-test for independent proportions: z = 3.31 (p &lt; 0.001), Cohen's h = 1.13.ConclusionFluoroscopy only method might be a safer alternative to LORT as it employs a different concept, might recognize epidural space sooner, and favors smaller needles.Clinical trial registrationNCT05260294.
UGT1A1*6 mutation associated with the occurrence and severity in infants with prolonged jaundice
Authors: Yang Zhe , Lin Fen , Xu Jia-Xin , Yang Hui , Wu Yong-Hao , Chen Zi-Kai , Xie He , Huang Bin , Lin Wei-Hao , Wu Jian-Peng , Ma Yu-Bin , Li Jian-Dong , Yang Li-Ye 
Published: December 2022

BackgroundThis study aimed to investigate the influence of a variant of the UGT1A1 gene on the occurrence and severity of prolonged jaundice in Chinese infants at term.Methods175 infants with prolonged jaundice and 149 controls were used in this retrospective case-control study. The infants with prolonged jaundice were subdivided into the mild-medium and severe jaundice groups (TSB ≥ 342 µmol/L). The frequency and genotype distribution of the UGT1A1 and G6PD genes, and clinical parameters including sex, birth weight, delivery mode, gestational age, and feeding mode, were analyzed, and the differences in the parameters between the two groups were compared.ResultsThe allele frequency of UGT1A1*6 in the prolonged jaundice group was higher than that in the control group. Similarly, it was also higher in the severe jaundice group than in the mild-medium jaundice group. Homozygous and heterozygous UGT1A1*6 were also found more frequently in the prolonged jaundice group than in the control group. Exclusive breastfeeding, homozygous and heterozygous forms of UGT1A1*6 were significant risk indicators for prolonged jaundice. Moreover, UGT1A1*6 was the best predictor of prolonged severe jaundice.ConclusionUGT1A1*6 appears to be a risk factor for prolonged jaundice with hyperbilirubinemia in term infants of Chinese ancestry who are exclusively breastfed.
A study of factors influencing Chinese college students’ intention of using metaverse technology for basketball learning: Extending the technology acceptance model
Authors: Ren Longfei , Yang Fangfang , Gu Chao , Sun Jie , Liu Yunfeng 
Published: December 2022

IntroductionBased on the expansion of flow constructs based on the TAM model, this study assesses the impact of metaverse technology in college basketball courses.MethodsWe surveyed 849 effective samples using an online questionnaire survey, verified our analysis using structural equation modeling, and examined the moderating effect of gender on the path relationship.ResultsThe perceived ease of use, the flow experience, and the perceived usefulness of the product are important predictors of behavioral intention. According to the study, perceived usefulness, and flow experience influence attitudes significantly. A moderating effect of gender is observed on perceived ease of use on the path to behavioral intention, and the results extend the theoretical research on the use of metaverse technology for basketball instruction and TAM.DiscussionA metaverse-based learning experience can enhance the flow experience of basketball learning, thus increasing the willingness to use and the effectiveness of learning.
Psychometric properties, factor structure, and German population norms of the multidimensional fatigue inventory (MFI-20)
Authors: Westenberger Adrian , Nöhre Mariel , Brähler Elmar , Morfeld Matthias , de Zwaan Martina 
Published: December 2022

ObjectiveThe Multidimensional Fatigue Inventory (MFI-20) is commonly used, but its factor structure remains unclear. The MFI-20 consists of five subscales (general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue). This study investigates the psychometric properties, including the factor structure, of a general German population sample and tests group hypotheses on gender and age. Another objective is to provide normative data by gender and age groups.MethodsUsing data from a representative German sample (n=2,509), reliability and convergent validity measures, group hypothesis testing, and confirmatory/exploratory factor analyses were conducted.ResultsThe MFI-20 demonstrated satisfactory internal consistency and showed adequate convergent validity with the SF-36. All subscales of the MFI-20 were significantly correlated (0.71–0.85). Physical fatigue exhibited the highest (0.42) and mental fatigue had the lowest (0.19) correlation with age. Fatigue scores were significantly higher for women and significantly increased with age. A five-factor structure showed poor model fit; using an exploratory factor analysis, a two-factor structure emerged (a general factor and a mental/motivational factor).ConclusionThe MFI-20 is a reliable and valid instrument for measuring fatigue in the general population, but the five-factor structure is not supported. The subscale general fatigue or the MFI-20 total score might measure fatigue sufficiently. The provided norms can be used for further research and individual assessment.
The relationship between Hikikomori risk factors and social withdrawal tendencies among emerging adults—An exploratory study of Hikikomori in Singapore
Authors: Lin Patrick K. F. , Andrew  , Koh Alethea H. Q. , Liew Kongmeng 
Published: December 2022

IntroductionOnce a localized Japanese phenomenon, Hikikomori-type social withdrawal has since been observed globally in increasing numbers. However, there is a lack of research about Hikikomori in Singapore. Consequently, local variations of Hikikomori may differ from past research in Japan. Drawing on associations found in international and Japanese Hikikomori research, we explored some variables relevant and generalizable to the Singaporean context. Specifically, we examined the relationships between (1) Hikikomori risk factors, (2) social withdrawal tendencies, (3) depression and anxiety, (4) connections with family and friends, and (5) employment status.MethodsIn a cross-sectional survey study (N = 416; Mage = 24.90, SDage = 4.79; females = 236, males = 177, undisclosed = 3), participants were provided a Qualtrics link and asked to complete a questionnaire comprising the NHR scale, LSNS-6, DASS-21, ERQ, and HQ-25.ResultsWe found that (a) Hikikomori risk factors positively correlated with social withdrawal tendencies and depression and anxiety but negatively correlated with support from family and friends, (b) high Hikikomori risk factors predicted high social withdrawal tendencies, (c) support from friends (one of the psychosocial factors) predicted social withdrawal tendencies together with the Hikikomori risk factors, and (d) social withdrawal tendencies moderated the relationship between Hikikomori risk factors and depression among the emerging adults in Singapore.ConclusionThe current research findings serve as a basis for future Hikikomori research in Singapore.
A survey of systemic lupus erythematosus patients' attitudes toward influenza and pneumococcal vaccination in Southwest China
Authors: Chen Yanling , Chen Bo , Shen Xiaolin , Zhou Aiping , Liang Yan , Wang Ying , Chen Hong 
Published: December 2022

IntroductionVaccination is the most effective measure for prevention against infectious diseases in patients with systemic lupus erythematosus (SLE). Therefore, it is important to know SLE patients' attitudes toward influenza and pneumococcal vaccination. This study aimed to investigate the attitude toward influenza and pneumococcal vaccination among SLE patients in Southwest China and its influencing factors.MethodsA web-based questionnaire was conducted to collect data regarding SLE patients' demographics, history of infections, medications, comorbidities, attitudes toward infection and vaccination, rates of influenza and pneumococcal vaccination, and role of health professionals in promoting vaccination. Univariate and multivariate logistic regression analyses were conducted to assess the vaccination willingness-associated factors.ResultsA total of 251 patients participated in the survey and 240 questionnaires were completed and statistically analyzed. The influenza and pneumococcal vaccination rates were 8.3 and 1.7%, respectively. The top three reasons for non-vaccination were worrying about the SLE exacerbation or flare resulting from the vaccine or its adjuvants, being concerned about adverse events, and the lack of awareness of vaccine availability. More than half of the participants were willing to be vaccinated against influenza (56.2%) and pneumococcus (52.9%). Factors associated to the willingness to receive the influenza vaccine and pneumococcal vaccine were being afraid of infection, believing in the efficacy of influenza vaccination, lower family income, less perceived care from family members, perceived susceptibility to pneumococcal infection, and perceiving influenza and pneumococcal vaccination as beneficial for health.ConclusionsThe influenza and pneumococcal vaccination rates are low among SLE patients in Southwest China. The positive perspective of vaccination on health represented the most impacting factor on their willingness to undergo influenza and pneumococcal vaccination. Non-vaccinated patients were mainly concerned about exacerbation of the disease or adverse events caused by vaccines. It is important to improve the compliance with the guideline-recommended roles of health professionals and to promote the collaboration between rheumatology and primary care teams.
Utility estimations of different health states of patients with type I, II, and III spinal muscular atrophy in China: A mixed approach study with patient and proxy-reported data
Authors: Hu Jiahao , Zhu Lin , Bao Han , Liu Yuhan , Xing Huanping , Kang Qi , Jin Chunlin 
Published: December 2022

IntroductionSpinal muscular atrophy (SMA) is a rare autosomal-recessive neuromuscular disease. Health state utility values (HSUV) are used in health economic evaluation regarding the desirability of health outcomes such as a certain health state or change in health states over time. There is no utility data of Chinese patients with SMA.Materials and methodsVignettes were developed for 10 pediatric neurologists to value the utility of Chinese patients with Type I SMA. A mixed patient/proxy derived approach using EQ-5D-Y-3L, EQ-5D-3L, and CHU9D was adopted to estimate the HSUV data of patients with Type II and III SMA, including 112 patients and 301 caregivers.ResultThe utility of Type I SMA patients ranged from 0.19 to 0.72 with the health state improved from “permanent ventilation” to “walking”. The utility of children patients with Type II and III SMA derived from EQ-5D-Y-3L ranged from 0.33 to 0.82 while that derived from CHU9D ranged from 0.46 to 0.75. The utility of adult patients with Type II and III SMA measured by EQ-5D-3L ranged from 0.30 to 0.83.ConclusionThe better health states the patients with SMA were in, the higher were the HSUV. The utilities derived from population with different age and disease subtypes were not statistically different when patients with SMA were in the same health states. We recommend further studies on the Chinese specific value set for EQ-5D-Y-3L and other PBMs for children to derive more robust utility data.
Ergonomic risk factors and work-related musculoskeletal disorders in clinical physiotherapy
Authors: Fan L. J. , Liu S. , Jin T. , Gan J. G. , Wang F. Y. , Wang H. T. , Lin T. 
Published: December 2022

ObjectivesThe purpose of this study was to objectively quantify and evaluate the ergonomic risk of clinical physiotherapy practices and evaluate physiotherapists for work-related musculoskeletal disorders and pain.MethodsTwenty-nine physiotherapists in the rehabilitation department of a large-scale tertiary hospital were recruited in this study. The sampling period lasted for 2 weeks for each physiotherapist and interval sampling was adopted to avoid duplication of cases. Therapist posture during physiotherapy was captured, tracked and analyzed in real time using structured light sensors with an automated assessment program. The quantification of ergonomic risk was based on REBA (Rapid Entire Body Assessment) and the RPE (perceived physical exertion) scores of the therapists were recorded before and after treatment, respectively.ResultsTwo hundred and twenty-four clinical physiotherapy cases were recorded, of which 49.6% were high risk and 33% were very high risk, with none of the cases presenting negligible risk. The positioning (p &lt; 0.001) of physiotherapist had a considerable impact on ergonomic risk and pediatric physiotherapy presented a higher risk to physiotherapists than adults (p &lt; 0.001). The RPE score of physiotherapist after performing physiotherapy was greater than before physiotherapy and was positively correlated with the REBA distribution.ConclusionOur study creates an automatic tool to assess the ergonomic risk of physiotherapy practices and demonstrates unacceptable ergonomic risk in common practices. The high prevalence of musculoskeletal disorders and pains recommends that rehabilitation assistance devices should be optimized and standard ergonomic courses should be included in physiotherapists' training plans.
Adsorption of Fluoride onto Acid-Modified Low-Cost Pyrolusite Ore: Adsorption Characteristics and Efficiencies
Authors: Induvesa Phacharapol , Rattanakom Radamanee , Sriboonnak Sornsiri , Pumas Chayakorn , Duangjan Kritsana , Rakruam Pharkphum , Nitayavardhana Saoharit , Sittisom Prattakorn , Wongrueng Aunnop 
Published: December 2022

Fluoride concentrations in the groundwater continue to be a major cause for concern in Thailand, particularly in the country’s north and west. The process of removing fluoride through adsorption has captured the attention of the abundance of ore in the mining industry. For the purpose of this investigation, the utilization of the adsorbent pyrolusite, which is a manganese mineral largely composed of MnO2, was a major component. Lab-scale experiments were conducted to investigate the efficacy of original pyrolusite ore (PA-1) and acid-modification PA (PA-2) created as low-cost adsorption materials for fluoride removal. The results of the adsorption rate in both PAs showed a fast rate of adsorption within 60 min of reaching equilibrium. According to the results of the adsorption capacity (qe) tests, PA that had been treated with an acid solution (PA-2) had the capacity to contain more fluoride (qe = 0.58 mg/g) than the PA that had been used initially (PA-1) (qe = 0.11 mg/g). According to the findings of an isotherm, primary adsorption behavior is determined by the effect that surface components and chemical composition have on porous materials. This is the first current study that provides a comparison between pyrolusite from Thailand’s mining industry and basic modified pyrolusite regarding their ability to remove a fluoride contaminant in synthetic groundwater by an adsorption process. Such an approach will be able to be used in the future to protect the community from excessive fluoride concentrations in household and drinking water treatment technology.