bluuebunny/crossref_metadata_2025_split huggingface dataset:
The prognostic value of TMB in early-stage non-small cell lung cancer: a systematic review and meta-analysis
Authors: Wankhede Durgesh , Grover Sandeep , Hofman Paul 
Published: August 2023

Background: Tumor mutation burden (TMB) has been validated as a predictive biomarker for immunotherapy response and survival in numerous cancer types. Limited data is available on the inherent prognostic role of TMB in early-stage tumors. Objective: To evaluate the prognostic role of TMB in early-stage, resected non-small cell lung cancer (NSCLC). Design: Systematic review and meta-analysis of pertinent prospective and retrospective studies. Data sources and methods: Publication search was performed in PubMed, Embase, Cochrane Library, and Web of Science databases. Based on the level of heterogeneity, a random- or fixed-effects model was used to calculate pooled effects of hazard ratio (HR) for overall survival (OS) and disease-free survival (DFS). The source of heterogeneity was investigated using sensitivity analysis, subgroup analysis, and publication bias assessment. Results: Ten studies comprising 2520 patients were included in this analysis. There was no statistically significant difference in OS (HR, 1.18, 95% CI, 0.70, 1.33; p 0.53, I2 = 80%; phet < 0.0001) and DFS (HR, 1.18, 95% CI, 0.91, 1.52; p = 0.53, I2 = 75%; phet = 0.0001) between the high-TMB and low-TMB group. Subgroup analyses indicated that East Asian ethnicity, and TMB detected using whole exome sequencing, and studies with <100 patients had poor DFS in the high-TMB group. Conclusion: The inherent prognostic role of TMB is limited in early-stage NSCLC. Ethnic differences in mutation burden must be considered while designing future trials on neoadjuvant immunotherapy. Further research in the harmonization and standardization of panel-based TMB is essential for its widespread clinical utility. Registration: CRD42023392846.
High-normal free thyroxine level is related with decreased bone mineral density in nonobese male patients with type 2 diabetes over 50 years old
Authors: Zhao Hanxin , Shi Dike , Wang Guoxing , Ruan Yu , Feng Xiaocheng , Jia ChengFang , Wang Qingqing , Dong Xuehong 
Published: August 2023

Background: The prevalence of ‘low bone mineral density (BMD)’ in Type 2 diabetes (T2DM), especially stratified by body mass index, is seldom reported. The relation of the euthyroid range and low BMD in T2DM remains to be further elucidated. Objectives: We aim to investigate the thyroid hormones’ impact on BMD among euthyroid patients with T2DM. Design and methods: A total of 1452 hospitalized T2DM patients with normal thyroid function (43.6% males aged over 50 and 56.4% postmenopausal females) were enrolled in this cross-sectional study. BMD was measured at lumbar spine by GE lunar dual-energy X-ray absorptiometry system, and ‘low BMD’ was defined as T-score <−1.0 SD. The prevalence of ‘low BMD’ was compared between obese and nonobese (body mass index < 25 kg/m2) groups for both sexes, and the relation of low BMD and free T4 quartiles was explored by multiple logistic regression. Results: The general prevalence of ‘low BMD’ was 12.3% for male patients aged over 50 (15.5% in the nonobese group and 8.0% in the obese group) and 49.8% for postmenopausal females (56.7% in the nonobese group and 48.9% in the obese group). After adjustment in multiple linear regression, free T4 level remained significantly related to decreased BMD in nonobese male subgroup. Multiple logistic regression revealed that BMD of the highest free T4 quartile (1.12–1.48 ng/dL) decreased significantly than other three quartiles after adjusting for confounding factors including age, body mass index, serum calcium and creatinine level, fasting glucose, alkaline phosphatase, glycosylated hemoglobin, total cholesterol, and smoking history (OR = 2.724, 95% CI = 1.085–6.840, p = 0.033). No significant relation was found in obese male or postmenopausal female groups. Conclusion: High-normal free T4 is a potential independent risk factor for ‘low BMD’ in nonobese male T2DM patients aged over 50. Close attention should be paid to thyroid function profile, even within normal range, in nonobese men with underlying higher fracture risks on diabetes status.
Preparation, characterization and swelling studies of bio-waste-derived absorbent hydrogels
Authors: Chapi Sharanappa 
Published: August 2023

A class of polymeric materials known as “hydrogel products” have a hydrophobic structure that enables them to hold significant volumes of water in their three-dimensional networks. It is thought that it is of utmost importance that they can be used extensively in a variety of industrial, biomedical and environmental applications. In this view, I have synthesized a uniuqe hydrogel made from cellulose extracted from banana pseudostem (BPC). This hydrogel exhibits superabsorbent properties. The synthesis was achieved by free-radical graft copolymerization of poly 2-(acryloyloxy) ethyl trimethylammonium chloride copolymer N,N-dimethylacrylamide (AETAC- co-DMA) onto a BPC backbone using ammonium persulfate as the initiator and methylene bisacrylamide as the cross-linking agent. The graft copolymer was studied using FT-IR spectroscopy to confirm its structure. It was further characterized by field-emission scanning electron microscopy (FESEM) and thermogravimetric analysis (TGA) to determine its morphological and thermal properties, respectively. The Effect of various parameters of free-radical graft copolymerization on the swelling behavior of the hydrogel was studied and the optimized copolymer was used to conduct pH and salt sensitivity tests on the hydrogel. The maximum water uptake of the hydrogel was found to be 427 g/g under optimum conditions of initiator, monomer and cross-linker concentrations of 0.0657 mol/L, 1.6 mol and 0.0972 mol/L correspondingly. The hydrogel was found to be pH and salt-sensitive and the salt uptake followed the order KCl>NaCl>CaCl>FeCl3. The excellent water absorbency, pH and salt responsiveness of the prepared hydrogel suggest its applicability not only in agriculture and wastewater treatment, but also in biomedicine for the controlled release of drugs.
Serum Adiponectin Levels as an Independent Marker of Severity of Psoriasis: A Cross-Sectional Analysis
Authors: Kaushik Aarushi , Chopra Dimple , Kaur Karamjot , Gupta Sharang , Chopra Preeyati 
Published: August 2023

Background Adiponectin is an adipokine, having anti-inflammatory properties, the levels of which are reduced in metabolic syndrome. In psoriasis, it plays a preventive role by inhibiting the differentiation and proliferation of keratinocytes and decreasing the levels of the signature cytokine, IL-17. Aims and objectives To find a correlation between serum adiponectin levels and the severity of psoriasis and to compare these levels amongst patients with parameters of metabolic syndrome vs those without it. Materials and methods This was a cross-sectional observational study consisting of 60 cases of chronic plaque type psoriasis and 20 controls. Mild, moderate and severe disease was defined based on Psoriasis Area Severity Index (PASI). Serum samples were analyzed for fasting serum adiponectin levels. Results The mean serum adiponectin level among cases (16.07 ± 8.55 μg/ml) was significantly lower than controls (21.65 ± 8.07 μg/ml, P = .012). It was not only lower among cases with MetS (14.28 ± 7.95 μg/ml), but also in patients without MetS (17.35 ± 8.83 μg/ml). Serum adiponectin levels were negatively correlated to age, Body Mass Index (BMI), PASI, disease duration and Erythrocyte Sedimentation Rate(ESR). However, only the negative correlation with PASI ( P = .000), duration ( P = .005) and ESR ( P = .010), was statistically significant. Conclusion Serum adiponectin is decreased in psoriasis, independent of metabolic syndrome and is negatively correlated with disease severity and duration. Limitations Analysis on a larger sample size and response to treatment could not be assessed.
Latino advanced cancer patients’ prognostic awareness and familial cultural influences on advance care planning engagement: a qualitative study
Authors: Torres Blasco Normarie , Rosario Lianel , Shen Megan J. 
Published: August 2023

Background: Advanced cancer patients need an accurate understanding of their prognoses in order to engage in informed end-of-life care treatment decision-making. Latino cancer patients experience disparities around prognostic understanding, in part due to a lack of culturally competent communication around prognosis and advance care planning (ACP). Objective: The objective of the present study of Latino patients with advanced, terminally ill cancer is to examine their understanding of prognosis, and how cultural factors may influence this understanding and engagement in ACP. Methods: A mixed methods study was conducted, which consisted of surveys and semi-structured interviews. Descriptive statistics were used for sociodemographic information and self-reported prognostic understanding. Interviews around prognostic understanding and cultural influences on this understanding and engagement in ACP were recorded, transcribed, and then coded and analyzed using thematic content analysis. Findings: Latino patients with advanced cancer ( n = 20) completed a self-reported survey and participated in a semi-structured interview. Results indicate that among terminally ill patients, 50% of the patients inaccurately believed they had early-stage cancer, 85% did not believe their cancer was terminal, and 70% believed their cancer was curable. Moreover, interviews yielded two main themes: varying levels of awareness of the incurability of their cancer and diverse end-of-life care decision-making and treatment preferences based on prognostic understanding. Within these themes, patients expressed denial or acceptance of their prognosis through communication with the oncologist, the importance of family, and incorporating their pre-existing beliefs. Conclusion: Findings indicate the importance of communication, family involvement, and incorporation of beliefs for promoting an accurate prognostic understanding among Latino patients. It is imperative to address disparities in Latino advanced cancer patients’ prognostic understanding so they can engage in informed treatment decision-making around end-of-life care.
Crucial roles of red blood cells and platelets in whole blood thrombin generation
Authors: Sun Siyu , Campello Elena , Zou Jinmi , Konings Joke , Huskens Dana , Wan Jun , Fernández Delia I. , Reutelingsperger Chris P. M. , ten Cate Hugo , Toffanin Serena , Bulato Cristiana , de Groot Philip G. , de Laat Bas , Simioni Paolo , Heemskerk Johan W. M. , Roest Mark 
Published: August 2023

Abstract
Red blood cells (RBCs) and platelets contribute to the coagulation capacity in bleeding and thrombotic disorders. The thrombin generation (TG) process is considered to reflect the interactions between plasma coagulation and the various blood cells. Using a new high-throughput method capturing the complete TG curve, we were able to compare TG in whole blood and autologous platelet-rich and platelet-poor plasma to redefine the blood cell contributions to the clotting process. We report a faster and initially higher generation of thrombin and shorter coagulation time in whole blood than in platelet-rich plasma upon low concentrations of coagulant triggers, including tissue factor, Russell viper venom factor X, factor Xa, factor XIa, and thrombin. The TG was accelerated with increased hematocrit and delayed after prior treatment of RBC with phosphatidylserine-blocking annexin A5. RBC treatment with ionomycin increased phosphatidylserine exposure, confirmed by flow cytometry, and increased the TG process. In reconstituted blood samples, the prior selective blockage of phosphatidylserine on RBC with annexin A5 enhanced glycoprotein VI–induced platelet procoagulant activity. For patients with anemia or erythrocytosis, cluster analysis revealed high or low whole-blood TG profiles in specific cases of anemia. The TG profiles lowered upon annexin A5 addition in the presence of RBCs and thus were determined by the extent of phosphatidylserine exposure of blood cells. Profiles for patients with polycythemia vera undergoing treatment were similar to that of control subjects. We concluded that RBC and platelets, in a phosphatidylserine-dependent way, contribute to the TG process. Determination of the whole-blood hypo- or hyper-coagulant activity may help to characterize a bleeding or thrombosis risk.
CD38 antibody re-treatment in daratumumab-refractory multiple myeloma after time on other therapies
Authors: Perez de Acha Olivia , Reiman Lauren , Jayabalan David S. , Walker Zachary J. , Bosma Grace , Keller Alana L. , Parzych Sarah E. , Abbott Diana , Idler Beau M. , Ribadeneyra Drew , Niesvizky Ruben , Forsberg Peter A. , Mark Tomer M. , Sherbenou Daniel W. 
Published: August 2023

Abstract
Monoclonal antibodies targeting CD38 are important for treatment of both newly diagnosed and relapsed multiple myeloma (MM). Daratumumab and isatuximab are anti-CD38 antibodies with the US Food and Drugs Administration approval in multiple different combinations. Despite good initial efficacy, patients inevitably develop drug resistance. Whether patients can be effectively re-treated with these antibodies in subsequent lines of therapy is unclear. Thus far, studies have mostly been limited to clinical retrospectives with short washout periods. To answer whether patients regain sensitivity after longer washouts, we used ex vivo sensitivity testing to isolate the anti-CD38 antibody-specific cytotoxicity in samples obtained from patients who had been exposed to and then off daratumumab for up to 53 months. MM cells from patients who had been off daratumumab for &gt;1 year showed greater sensitivity than those with &lt;1 year, although they still were less sensitive than those who were daratumumab naïve. CD38 expression on MM cells gradually recovered, although, again, not to the level of anti-CD38 antibody–naïve patients. Interestingly, low MM CD38 explained only 45% of cases identified to have daratumumab resistance. With clinical follow-up, we found ex vivo sensitivity predicted subsequent clinical response but CD38 overexpression did not. Patients clinically re-treated with anti-CD38 antibodies had &lt;6 months of clinical benefit, but 1 patient who was daratumumab exposed but not refractory achieved complete response lasting 13 months. We conclude that transient efficacy can be achieved by waiting 1 year before CD38 antibody rechallenge, but this approach may be best used as a bridge to, or after, chimeric antigen receptor T-cell therapy.
Real-world effectiveness of airway clearance techniques in children with cystic fibrosis
Authors: Filipow Nicole , Stanojevic Sanja , Raywood Emma , Shannon Harriet , Tanriver Gizem , Kapoor Kunal , Douglas Helen , Davies Gwyneth , O'Connor Rachel , Murray Nicky , Main Eleanor 
Published: August 2023

BackgroundCystic fibrosis (CF) is commonly characterised by thick respiratory mucus. From diagnosis, people with CF are prescribed daily physiotherapy, including airway clearance techniques (ACTs). ACTs consume a large proportion of treatment time, yet the efficacy and effectiveness of ACTs are poorly understood. This study aimed to evaluate associations between the quality and quantity of ACTs and lung function in children and young people with CF.MethodsProject Fizzyo, a longitudinal observational cohort study in the UK, used remote monitoring with electronic pressure sensors attached to four different commercial ACT devices to record real-time, breath-by-breath pressure data during usual ACTs undertaken at home over 16 months in 145 children. ACTs were categorised either as conformant or not with current ACT recommendations based on breath pressure and length measurements, or as missed treatments if not recorded. Daily, weekly and monthly associations between ACT category and lung function were investigated using linear mixed effects regression models adjusting for clinical confounders.ResultsAfter exclusions, 45 224 ACT treatments (135 individuals) and 21 069 days without treatments (141 individuals) were analysed. The mean±sdage of participants was 10.2±2.9 years. Conformant ACTs (21%) had significantly higher forced expiratory volume in 1 s (FEV1) (mean effect size 0.23 (95% CI 0.19–0.27) FEV1% pred per treatment) than non-conformant (79%) or missed treatments. There was no benefit from non-conformant or missed treatments and no significant difference in FEV1between them (mean effect size 0.02 (95% CI −0.01–0.05) FEV1% pred per treatment).ConclusionsACTs are beneficial when performed as recommended, but most people use techniques that do not improve lung function. Work is needed to monitor and improve ACT quality and to increase the proportion of people doing effective airway clearance at home.
Role of bronchoscopy for respiratory involvement in granulomatosis with polyangiitis and microscopic polyangiitis
Authors: Villeneuve Thomas , Prévot Grégoire , Pugnet Grégory , Plat Gavin , Héluain Valentin , Faguer Stanislas , Guibert Nicolas 
Published: August 2023

ObjectivesThis study describes data from bronchoscopy performed at the diagnosis of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).MethodsWe conducted a retrospective study between 2004 and 2019 in patients aged >18 years with a diagnosis of microscopic polyangiitis (MPA) or granulomatosis with polyangiitis (GPA) who underwent bronchoscopy at onset of the disease. We collected bronchoalveolar lavage (BAL) and histological findings obtained during bronchoscopy.Results274 patients with AAV were identified. Among 92 bronchoscopies, 62 were performed at diagnosis, and 58 procedures were finally analysed. Cough was more frequent in patients with MPA than GPA (p=0.02). The presence of endobronchial lesions (24.1%) was found to be significantly associated with GPA (p<0.0001) and proteinase 3-ANCA (p=0.01). The most frequent endobronchial lesions were inflammation and hyperaemia of the bronchial mucosa (50%), followed by stenoses (28%), ulcerations (21%) and mass-like granulomatosis (7%). The diagnostic yield of bronchial biopsies was useful for visible lesions (66.6%versus0%; p=0.006). On BAL, diffuse alveolar haemorrhage (DAH) was detected in 31 (53.4%) patients and was more frequent in MPA patients (70.4%versus38.7%; p=0.016). In 16.1% of DAH cases, BAL confirmed the diagnosis despite the absence of clinical or biological arguments. The incidence of microbial infections on BAL (38%) was similar between MPA and GPA (p=0.54).ConclusionBronchoscopy is an informative procedure at the onset of AAV disease in patients with respiratory manifestations. Endobronchial lesions are more frequently found in GPA and should be biopsied. BAL can be used to confirm DAH or diagnose superadded infection.
Positive airway pressure treatment affects respiratory symptoms and gastro-oesophageal reflux: the Icelandic Sleep Apnea Cohort Study
Authors: Emilsson Össur Ingi , Aspelund Thor , Janson Christer , Benediktsdottir Bryndis , Juliusson Sigurdur , Maislin Greg , Pack Allan I. , Keenan Brendan T. , Gislason Thorarinn 
Published: August 2023

AimTo study the effect of positive airway pressure (PAP) treatment on nocturnal gastro-oesophageal reflux (nGOR) and respiratory symptoms among clinical obstructive sleep apnoea (OSA) patients.Methods822 patients newly diagnosed with OSA referred for PAP treatment were recruited. 732 patients had a 2-year follow-up visit with continuous PAP compliance data (366 full PAP users, 366 partial/non-PAP users). They answered questionnaires, including reporting of nGOR, sleep and respiratory symptoms and general health. Patients with nGOR symptoms once a week or more were defined as “with nGOR”. Those without nGOR symptoms and nGOR medication were defined as “no nGOR”. Others were defined as “possible nGOR”.ResultsAt 2-year follow-up, PAP treatment among full users resulted in decreased nGOR (adjusted OR 0.58, 95% CI 0.40–0.86) and wheezing (adjusted OR 0.56, 95% CI 0.35–0.88) compared with partial/non-PAP users. Decreased nGOR, among both full and partial/non-users of PAP treatment, was associated with a decrease in productive morning cough (adjusted OR 4.70, 95% CI 2.22–9.99) and a decrease in chronic bronchitis (adjusted OR 3.86, 95% CI 1.74–8.58), but not decreased wheezing (adjusted OR 0.90, 95% CI 0.39–2.08). A mediation analysis found that PAP treatment directly led to a decrease in wheezing, not mediated through nGOR. Conversely, PAP treatment decreased productive cough mediated through a decrease in nGOR.ConclusionIn an unselected group of OSA patients, PAP treatment for 2 years was associated with a decrease in nGOR and respiratory symptoms. The PAP treatment itself was associated with less wheezing. A decrease in nGOR through PAP treatment was associated with a decrease in productive cough.
The hospital-to-home care transition experience of home care clients: an exploratory study using patient journey mapping
Authors: Saragosa Marianne , Nizzer Sonia , McKay Sandra , Kuluski Kerry 
Published: August 2023

Abstract
Background
Care transitions have a significant impact on patient health outcomes and care experience. However, there is limited research on how clients receiving care in the home care sector experience the hospital-to-home transition. An essential strategy for improving client care and experience is through client engagement efforts. The study's aim was to provide insight into the care transition experiences and perspectives of home care clients and caregivers of those receiving home care who experienced a hospital admission and returned to home care services by thematically and illustratively mapping their collective journey.

Methods
This study applied a qualitative descriptive exploratory design using a patient journey mapping approach. Home care clients and their caregivers with a recent experience of a hospital discharge back to the community were recruited. A conventional inductive approach to analysis enabled the identification of categories and a collective patient journey map. Follow-up interviews supported the validation of the map.

Results
Seven participants (five clients and two caregivers) participated in 11 interviews. Participants contributed to the production of a collective journey map and the following four categories and themes: (1) Touchpoints as interactions with the health system; Life is changing; (2) Pain points as barriers in the health system: Sensing nobody is listening and Trying to find a good fit; (3) Facilitators to positive care transitions: Developing relationships and gaining some continuity and Trying to advocate, and (4) Emotional impact: Having only so much emotional capacity.

Conclusions
The patient journey map enabled a collective illustration of the care transition depicted in touchpoints, pain points, enablers, and feelings experienced by home care recipients and their caregivers. Patient journey mapping offers an opportunity to acknowledge home care clients and their caregivers as critical to quality care delivery across the continuum.