bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of YouTube by academic medical centres during the COVID-19 pandemic: an observational study in Taiwan
Authors: Kuo Yen-Ling , Lin Ching-Heng , Wang Ya-Yu , Shieh Gow-Jen , Chu Wei-Min 
Published: April 2023

ObjectivesYouTube has been of immense importance in conveying essential information on COVID-19 and promoting the latest healthcare policies during the outbreak. However, there have been few studies that have focused on how healthcare organisations have used YouTube to communicate with the public and increase their awareness during the pandemic, as well as its effectiveness.DesignA nationwide observational study.SettingsWe analysed all YouTube video posts culled from the official accounts of all medical centres in Taiwan from December 2019 to August 2021.ParticipantsAll YouTube videos were categorised as either COVID-19 or non-COVID-19 related. The COVID-19-related videos were divided into five categories, and detailed metrics for each video were recorded. For comparison, we also surveyed all YouTube video posts placed by the Ministry of Health and Welfare and the Taiwan Centers for Disease Control (TCDC).ResultsWe analysed official YouTube channels from 17 academic medical centres, involving a total of 943 videos. We found a relationship between the quantity of YouTube videos uploaded by the TCDC and the trend of confirmed cases (Pearson’s correlation coefficient was 0.25, p=0.02). Data from private hospitals revealed that they posted more COVID-19 videos (103 vs 56) when compared with public hospitals. In addition, multivariate linear regression showed that more ‘likes’ (estimate 41.1, 95% CI 38.8 to 43.5) and longer lengths (estimate 10 800, 95% CI 6968.0 to 14 632.0) of COVID-19-related videos correlated significantly with an increased number of ‘views’.ConclusionsThis nationwide observational study, performed in Taiwan, demonstrates well the trend and effectiveness of academic medical centres in promoting sound healthcare advice regarding COVID-19 through YouTube due to the channel’s easy accessibility and usability.
Improving sleep and learning in rehabilitation after stroke, part 2 (INSPIRES2): study protocol for a home-based randomised control trial of digital cognitive behavioural therapy (dCBT) for insomnia
Authors: Weightman Matthew , Robinson Barbara , Fallows Ricky , Henry Alasdair L , Kyle Simon D , Garratt Emma , Pick Anton , Teal Rachel , Ajina Sara , Demeyere Nele , Espie Colin A , Seymour Ben , Johansen-Berg Heidi , Fleming Melanie K 
Published: April 2023

IntroductionConsolidation of motor skill learning, a key component of rehabilitation post-stroke, is known to be sleep dependent. However, disrupted sleep is highly prevalent after stroke and is often associated with poor motor recovery and quality of life. Previous research has shown that digital cognitive behavioural therapy (dCBT) for insomnia can be effective at improving sleep quality after stroke. Therefore, the aim of this trial is to evaluate the potential for sleep improvement using a dCBT programme, to improve rehabilitation outcomes after stroke.Methods and analysisWe will conduct a parallel-arm randomised controlled trial of dCBT (Sleepio) versus treatment as usual among individuals following stroke affecting the upper limb. Up to 100 participants will be randomly allocated (2:1) into either the intervention (6–8 week dCBT) or control (continued treatment as usual) group. The primary outcome of the study will be change in insomnia symptoms pre to post intervention compared with treatment as usual. Secondary outcomes include improvement in overnight motor memory consolidation and sleep measures between intervention groups, correlations between changes in sleep behaviour and overnight motor memory consolidation in the dCBT group and changes in symptoms of depression and fatigue between the dCBT and control groups. Analysis of covariance models and correlations will be used to analyse data from the primary and secondary outcomes.Ethics and disseminationThe study has received approval from the National Research Ethics Service (22/EM/0080), Health Research Authority (HRA) and Health and Care Research Wales (HCRW), IRAS ID: 306 291. The results of this trial will be disseminated via presentations at scientific conferences, peer-reviewed publication, public engagement events, stakeholder organisations and other forms of media where appropriate.Trial registration numberNCT05511285.
Association between the number of prehospital defibrillation attempts and a sustained return of spontaneous circulation: a retrospective, multicentre, registry-based study
Authors: Ko Byuk Sung , Kim Youn-Jung , Han Kap Su , Jo You Hwan , Shin JongHwan , Park Incheol , Kang Hyunggoo , Lim Tae Ho , Hwang SO , Kim Won Young 
Published: April 2023

BackgroundCurrently, there is no consensus on the number of defibrillation attempts that should be made before transfer to a hospital in patients with out-of-hospital cardiac arrest (OHCA). This study aimed to evaluate the association between the number of defibrillations and a sustained prehospital return of spontaneous circulation (ROSC).MethodsA retrospective analysis of a multicentre, prospectively collected, registry-based study in Republic of Korea was conducted for OHCA patients with prehospital defibrillation. The primary outcome was sustained prehospital ROSC, and the secondary outcome was a good neurological outcome at hospital discharge, defined as Cerebral Performance Category score 1 or 2. Cumulative incidence of sustained prehospital ROSC and good neurological outcome according to number of defibrillations were examined. Multivariable logistic regression analysis was used to examine whether the number of defibrillations was independently associated with the outcomes.ResultsExcluding 172 patients with missing data, a total of 1983 OHCA patients who received prehospital defibrillation were included. The median time from arrest to first defibrillation was 10 (IQR 7–15) min. The numbers of patients with sustained prehospital ROSC and good neurological outcome were 738 (37%) and 549 (28%), respectively. Sustained ROSC rates decreased as the number of defibrillation attempts increased from the first to the sixth (16%, 9%, 5%, 3%, 2% and 1%, respectively). The cumulative sustained ROSC rate, and good neurological outcome rate from initial defibrillation to sixth defibrillation were 16%, 25%, 30%, 34%, 36%, 36% and 11%, 18%, 22%, 25%, 26%, 27%, respectively. With adjustment for clinical characteristics and time to defibrillation, a higher number of defibrillations was independently associated with a lower chance of a sustained ROSC (OR 0.81, 95% CI 0.76 to 0.86) and a lower chance of good neurological outcome (OR 0.86, 95% CI 0.80 to 0.92).ConclusionsWe observed no significant increase in ROSC after five defibrillations, and no absolute increase in ROSC after seven defibrillations. These data provide a starting point for determination of the optimal defibrillation strategy prior to consideration for prehospital extracorporeal cardiopulmonary resuscitation (ECPR) or conveyance to a hospital with an ECPR capability.Trial registration numberNCT03222999
Association of Life’s Simple 7 and ideal cardiovascular health in American Indians/Alaska Natives
Authors: Rawal Smita , Johnson Blake Ryan , Young Henry Nolan , Gaye Bamba , Sattler Elisabeth Lilian Pia 
Published: April 2023

ObjectiveAmerican Indians and Alaska Natives (AI/ANs) are an understudied population at high risk for cardiovascular diseases (CVDs); little is known about contextual factors contributing to CVDs in AI/ANs. This study examined the association of Life’s Simple 7 (LS7) factors and social determinants of health (SDH) with CVD outcomes in a nationally representative sample of AI/ANs.MethodsWe conducted a cross-sectional study of 8497 AI/ANs using 2017 Behavioural Risk Factor Surveillance Survey data. Individual LS7 factors were summarised as ideal and poor levels. Coronary heart disease, myocardial infarction and stroke were defined as CVD outcomes. Healthcare access measures represented SDH. Logistic regression analyses examined associations of LS7 factors and SDH with CVD outcomes. Population attributable fractions (PAFs) quantified individual contributions of LS7 factors to CVD outcomes.ResultsN=1,297 (15%) participants with CVD outcomes were identified. Smoking, physical inactivity, diabetes, hypertension and hyperlipidaemia were LS7 factors associated with CVD outcomes. Hypertension was the largest contributor to CVD (aPAF 42%; 95% CI 37% to 51%), followed by hyperlipidaemia (aPAF 27%; 95% CI 17% to 36%) and diabetes (aPAF 18%; 95% CI 7% to 23%). Compared with individuals with poor LS7 levels, participants with ideal levels showed 80% lower odds of CVD outcomes (aOR 0.20; 95% CI 0.16 to 0.25). Access to health insurance (aOR 1.43, 95% CI 1.08 to 1.89) and a regular care provider (aOR 1.47, 95% CI 1.24 to 1.76) were associated with CVD outcomes.ConclusionsEffective interventions are needed to address SDH and attain ideal LS7 factors to improve cardiovascular health among AI/ANs.
Contralateral oblique view can prevent dural puncture in fluoroscopy-guided cervical epidural access: a prospective observational study
Authors: Kwon Hyun-Jung , Kim Chan-Sik , Kim Jinsun , Kim Sungwon , Shin Jae Young , Choi Seong-Soo , Shin Jin-Woo , Kim Doo-Hwan 
Published: April 2023

IntroductionAlthough the contralateral oblique (CLO) view at 50°±5° is clinically useful for cervical epidural access, no previous studies have confirmed its safety. This prospective observational study was conducted to assess the safety profile, including the risk of dural puncture, in fluoroscopically guided cervical epidural access using the CLO view.MethodsIn cervical epidural access using the CLO view, the incidence of dural puncture was investigated as the primary outcome. Other intraprocedural complications, including intravascular entry, subdural entry, spinal cord injury and vasovagal injury, and postprocedural complications were investigated as secondary outcomes. Procedural variables including first-pass success, final success, needling time, total number of needle passes and false loss of resistance (LOR) were evaluated.ResultsOf the 393 patients who underwent cervical interlaminar epidural access were included for analysis, no instances of dural puncture or spinal cord injury were observed. The incidence of intravascular entry, vasovagal reaction and subdural entry were 3.1%, 0.5% and 0.3%, respectively. All procedures were successfully performed, with 85.0% of first-pass success rate. The mean needling time was 133.8 (74.9) s. The false-positive and false-negative LOR rates were 8.2% and 2.0%, respectively. All needle tips were visualized clearly during the procedure.ConclusionsThe fluoroscopy-guided CLO view at 50°±5° avoided dural puncture or spinal cord injury and decreased the incidence of false LOR during cervical epidural access with a paramedian approach.Trial registration numberNCT04774458.
Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy postoperative symptomatology: palliative care impact
Authors: Sneider Abigail P , Dhiman Ankit , Morgan Ryan , Tun Sandy , Turaga Kiran K , Eng Oliver S 
Published: April 2023

ObjectivesPalliative care (PC) for patients with advanced cancer has been associated with improved symptom burden and quality of life (QoL). This study aimed to characterise postoperative symptoms of cytoreductive surgery (CRS)/hyperthermic intraperitoneal chemotherapy (HIPEC) patients and to assess PC impact by analysing symptom burden before and after PC interventions.MethodsCRS/HIPEC patients with two PC visits within 5 months postoperatively (2016–2021) at a tertiary care centre were identified from a retrospective database. For each patient, documentation of QoL-associated symptoms at the initial PC visit and changes in symptomatology at the second PC visit were recorded. Descriptive statistics were performed.Results46 patients were included in this study. Median age was 62.2 (range 31.9–84.6) years. Median peritoneal cancer index was 23.5 (range 0–39). The most common histologies were colorectal (32.6%) and appendiceal (30.4%). Symptoms most frequently reported were pain (84.8%), fatigue (54.3%) and appetite loss/change (52.2%). Following PC interventions, most symptoms were stable or improved. The mean number of symptoms per patient was 3.7, with an average of 3.5 improved/stable and 0.5 worse/new onset at follow-up (p<0.001).ConclusionCRS/HIPEC patients experienced a high QoL-associated symptom burden. Following postoperative PC interventions, significantly more symptoms were reported as improved/stable, compared with worse/new onset.
Evidence of $$A_{CP}(D^0\rightarrow \pi ^+\pi ^-)$$ implies observable CP asymmetry in the $$D^0\rightarrow \pi ^0\pi ^0$$ decay
Authors: Wang Di 
Published: April 2023

AbstractInspired by the recent measurement of CP asymmetry in the individual mode on LHCb, we study CP asymmetry of the $$D\rightarrow \pi \pi $$

D
→
π
π

system in the isospin and topological analysis. The ratio between penguin and tree amplitudes $$P/(T+C)$$

P
/
(
T
+
C
)

in the $$D\rightarrow \pi \pi $$

D
→
π
π

system is found to be greater than two in most values of the relative strong phase. And $$D^0\rightarrow \pi ^0\pi ^0$$

D
0

→

π
0

π
0

is a potential mode to reveal the CP asymmetry of the order of $$10^{-3}$$

10

-
3

, which would be observed by Belle II in the future. The large CP asymmetry in the $$D\rightarrow \pi \pi $$

D
→
π
π

system might be understood in the t-channel final-state interaction.
Dusty plasma in active galactic nuclei
Authors: Czerny Bożena , Zajaček Michal , Naddaf Mohammad-Hassan , Sniegowska Marzena , Panda Swayamtrupta , Różanska Agata , Adhikari Tek P. , Pandey Ashwani , Jaiswal Vikram Kumar , Karas Vladimír , Borkar Abhijeet , Martínez-Aldama Mary Loli , Prince Raj 
Published: April 2023

Abstract
For many years we have known that dust in the form of a dusty-molecular torus is responsible for the obscuration in active galactic nuclei (AGN) at large viewing angles and, thus, for the widely used phenomenological classification of AGN. Recently, we gained new observational and theoretical insights into the geometry of the torus region and the role of dust in the dynamics of emerging outflows and failed winds. We will briefly touch on all these aspects and provide a more detailed update of our dust-based model (FRADO—Failed Radiatively Accelerated Dusty Outflow) capable of explaining the processes of formation of Balmer lines in AGN.

Graphic abstract
New anisotropic star solutions in mimetic gravity
Authors: Nashed G. G. L. , Saridakis Emmanuel N. 
Published: April 2023

AbstractWe extract new classes of anisotropic solutions in the framework of mimetic gravity, by applying the Tolman–Finch–Skea metric and a specific anisotropy not directly depending on it, and by matching smoothly the interior anisotropic solution to the Schwarzschild exterior one. Then, in order to provide a transparent picture we use the data from the 4U 1608-52 pulsar. We study the profile of the energy density, as well as the radial and tangential pressures, and we show that they are all positive and decrease toward the center of the star. Furthermore, we investigate the anisotropy parameter and the anisotropic force that are both increasing functions of the radius, which implies that the latter is repulsive. Additionally, by examining the radial and tangential equation-of-state parameters, we show that they are monotonically increasing, not corresponding to exotic matter. Concerning the metric potentials, we find that they have no singularity, either at the center of the star or at the boundary. Furthermore, we verify that all energy conditions are satisfied, we show that the radial and tangential sound speed squares are positive and sub-luminal, and we find that the surface redshift satisfies the theoretical requirement. Finally, in order to investigate the stability we apply the Tolman–Oppenheimer–Volkoff equation, we perform the adiabatic index analysis, and we examine the static case, showing that in all cases the star is stable.
Symplectic non-convexity of toric domains
Authors: Dardennes Julien , Gutt Jean , Zhang Jun 
Published: April 2023

We investigate the convexity up to symplectomorphism (called symplectic convexity) of star-shaped toric domains in [Formula: see text]. In particular, based on the criterion from Chaidez–Edtmair in [Invent. Math. 229(1) (2022) 243–301] via Ruelle invariant and systolic ratio of the boundary of star-shaped toric domains, we provide elementary operations on domains that can kill the symplectic convexity. These operations only result in small perturbations in terms of domains’ volume. Moreover, one of the operations is a systematic way to produce examples of dynamically convex but not symplectically convex toric domains. Finally, we are able to provide concrete bounds for the constants that appear in Chaidez–Edtmair’s criterion.
FDA Approval Summary: Amivantamab for the Treatment of Patients with Non–Small Cell Lung Cancer with EGFR Exon 20 Insertion Mutations
Authors: Chon Katie , Larkins Erin , Chatterjee Somak , Mishra-Kalyani Pallavi S. , Aungst Stephanie , Wearne Emily , Subramaniam Sriram , Li Yangbing , Liu Jiang , Sun Jielin , Charlab Rosane , Zhao Hong , Saritas-Yildirim Banu , Bikkavilli Rama Kamesh , Ghosh Soma , Philip Reena , Beaver Julia A. , Singh Harpreet 
Published: April 2023

Abstract
The FDA granted accelerated approval for amivantamab-vmjw (hereafter referred to as amivantamab), a bispecific antibody directed against EGFR and mesenchymal–epithelial transition receptor, on May 21, 2021, for the treatment of adult patients with locally advanced or metastatic non–small cell lung cancer (NSCLC) with EGFR exon 20 insertion mutations whose disease has progressed on or after platinum-based chemotherapy. Approval was based on results of an ongoing, multicenter, nonrandomized, open-label, multicohort clinical trial (CHRYSALIS, NCT 02609776), demonstrating a substantial overall response rate (ORR) and durable responses, with an ORR of 40% [95% confidence interval (CI): 29–51] and a median response duration of 11.1 months (95% CI: 6.9–not evaluable). Guardant360 CDx was contemporaneously approved as a companion diagnostic for this indication to identify EGFR exon 20 insertion mutations in plasma specimens.
The most notable safety finding was the high incidence (66%) of infusion-related reactions, which is addressed in both the Dosage and Administration and Warnings and Precautions sections of the product label. Other common adverse reactions (occurring in ≥20% of patients) were rash, paronychia, musculoskeletal pain, dyspnea, nausea and vomiting, fatigue, edema, stomatitis, cough, and constipation. The approval of amivantamab was the first approval of a targeted therapy for patients with advanced NSCLC harboring EGFR exon 20 insertion mutations.
An Immune-Related Gene Expression Signature Predicts Benefit from Adding Atezolizumab to FOLFOXIRI plus Bevacizumab in Metastatic Colorectal Cancer
Authors: Antoniotti Carlotta , Boccaccino Alessandra , Seitz Robert , Giordano Mirella , Catteau Aurélie , Rossini Daniele , Pietrantonio Filippo , Salvatore Lisa , McGregor Kimberly , Bergamo Francesca , Conca Veronica , Leonetti Simone , Morano Federica , Papiani Giorgio , Tamburini Emiliano , Bensi Maria , Murgioni Sabina , Ross Douglas Teller , Passardi Alessandro , Boquet Isabelle , Nielsen Tyler J. , Galon Jérôme , Varga Matthew Gordon , Schweitzer Brock L. , Cremolini Chiara 
Published: April 2023

Abstract

Purpose:
AtezoTRIBE phase II randomized study demonstrated that adding atezolizumab to first-line FOLFOXIRI (5-fluorouracil, oxaliplatin, irinotecan) plus bevacizumab prolongs progression-free survival (PFS) of patients with metastatic colorectal cancer (mCRC), with a modest benefit among proficient mismatch repair (pMMR). DetermaIO is an immune-related 27-gene expression signature able to predict benefit from immune checkpoint inhibition in triple-negative breast cancer. In this analysis of AtezoTRIBE, we investigated the predictive impact of DetermaIO in mCRC.

Experimental Design:
Patients with mCRC unselected for MMR status were randomly assigned (1:2) to FOLFOXIRI plus bevacizumab (control arm) or the same regimen with atezolizumab (atezolizumab arm). qRT-PCR by DetermaIO was performed on RNA purified from pretreatment tumors of 132 (61%) of 218 enrolled patients. A binary result (IOpos vs. IOneg) adopting the preestablished DetermaIO cut-off point (0.09) was obtained, and an exploratory optimized cut-off point (IOOPT) was computed in the overall population and in pMMR subgroup (IOOPTpos vs. IOOPTneg).

Results:
DetermaIO was successfully determined in 122 (92%) cases, and 23 (27%) tumors were IOpos. IOpos tumors achieved higher PFS benefit from atezolizumab arm than IOneg (HR: 0.39 vs. 0.83; Pinteraction = 0.066). In pMMR tumors (N = 110), a similar trend was observed (HR: 0.47 vs. 0.93; Pinteraction = 0.139). In the overall population, with the computed IOOPT cut-off point (0.277), 16 (13%) tumors were IOOPTpos and they derived higher PFS benefit from atezolizumab than IOOPTneg (HR: 0.10 vs. 0.85, Pinteraction = 0.004). Similar results were found in the pMMR subgroup.

Conclusions:
DetermaIO may be useful to predict benefit of adding atezolizumab to first-line FOLFOXIRI plus bevacizumab in mCRC. The exploratory IOOPT cut-off point should be validated in independent mCRC cohorts.
Analysis of Donor Pancreata Defines the Transcriptomic Signature and Microenvironment of Early Neoplastic Lesions
Authors: Carpenter Eileen S. , Elhossiny Ahmed M. , Kadiyala Padma , Li Jay , McGue Jake , Griffith Brian D. , Zhang Yaqing , Edwards Jacob , Nelson Sarah , Lima Fatima , Donahue Katelyn L. , Du Wenting , Bischoff Allison C. , Alomari Danyah , Watkoske Hannah R. , Mattea Michael , The Stephanie , Espinoza Carlos E. , Barrett Meredith , Sonnenday Christopher J. , Olden Nicholas , Chen Chin-Tung , Peterson Nicole , Gunchick Valerie , Sahai Vaibhav , Rao Arvind , Bednar Filip , Shi Jiaqi , Frankel Timothy L. , Pasca di Magliano Marina 
Published: April 2023

Abstract

The adult healthy human pancreas has been poorly studied given the lack of indication to obtain tissue from the pancreas in the absence of disease and rapid postmortem degradation. We obtained pancreata from brain dead donors, thus avoiding any warm ischemia time. The 30 donors were diverse in age and race and had no known pancreas disease. Histopathologic analysis of the samples revealed pancreatic intraepithelial neoplasia (PanIN) lesions in most individuals irrespective of age. Using a combination of multiplex IHC, single-cell RNA sequencing, and spatial transcriptomics, we provide the first-ever characterization of the unique microenvironment of the adult human pancreas and of sporadic PanIN lesions. We compared healthy pancreata to pancreatic cancer and peritumoral tissue and observed distinct transcriptomic signatures in fibroblasts and, to a lesser extent, macrophages. PanIN epithelial cells from healthy pancreata were remarkably transcriptionally similar to cancer cells, suggesting that neoplastic pathways are initiated early in tumorigenesis.

Significance:
Precursor lesions to pancreatic cancer are poorly characterized. We analyzed donor pancreata and discovered that precursor lesions are detected at a much higher rate than the incidence of pancreatic cancer, setting the stage for efforts to elucidate the microenvironmental and cell-intrinsic factors that restrain or, conversely, promote malignant progression.
See related commentary by Hoffman and Dougan, p. 1288.
This article is highlighted in the In This Issue feature, p. 1275