bluuebunny/crossref_metadata_2025_split huggingface dataset:
First-line Nivolumab Plus Ipilimumab for Unresectable MPM in China: a Cost-effectiveness Analysis
Authors: Yang Liu , Song Xiaobing , Zeng Wanxian , Zheng Zhiwei , Lin Wenqiang 
Published: May 2023

Abstract
What is known and objective: The regimen of nivolumab plus ipilimumab(NI) has been recommended by the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology-Malignant Pleural Mesothelioma (Version 1.2022) and Chinese Guidelines for the Clinical Diagnosis and Treatment of Malignant Pleural Mesothelioma (2021 edition) as the first-line treatment for Malignant Pleural Mesothelioma (MPM). But whether immunotherapy has a financial advantage over conventional chemotherapy (pemetrexed plus cisplatin/carboplatin, C) is uncertain.
Methods: Based on survival and safety data from the CheckMate 743 clinical trial (NCT02899299), a partitioned survival model was constructed using TreeAge Pro2022 software. The model cycle was set to 1 month and the study period was 10 years. The output indicators included total cost, quality-adjusted life year (QALY) and incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses were used to assess the robustness of the results, considering only direct medical costs.
Results and discussion: The ICER for group NI vs. Group C was $375,656/QALY in all randomized patients, $327,943/QALY in patients with epithelioid histology, and $115,495/QALY in patients with non-epithelioid histology. The ICERs of all three different populations all exceeded the willingness-to-pay threshold (three times the per capita gross domestic product of China in 2021). The results of univariate sensitivity analysis showed that the price of pemetrexed and nivolumab had great influence on the analysis results. The results of the probabilistic sensitivity analysis show that the probability of the NI scheme being more economical in all three different populations was 0.
What is new and conclusion: From the perspective of Chinese payers, in patients with unresectable MPM, NI has no economic advantage over C.
Accelerated biological aging, cardiovascular risks, and cardiometabolic multimorbidity: a cohort study
Authors: Jiang Meijie , Tian Sifan , Lin Xihong , Belsky Daniel , Guo Xinbiao , Huang Tao , Baccarelli Andrea , Gao Xu 
Published: May 2023

Abstract
Background
Cardiometabolic multimorbidity (CMM) is the coexistence of two or three cardiometabolic diseases (CMDs), including diabetes, ischemic heart disease (IHD), and stroke, which are recognized as cardiometabolic physiology changes with aging. However, whether accelerated biological aging is associated with the trajectories of CMM development remains poorly understood.
Objectives
To evaluate the association between accelerated biological aging and the trajectories of CMM.
Methods
Baseline accelerated biological aging status of 341,159 adults from UK Biobank was assessed by the Klemera-Doubal method biological age (KDM-BA), PhenoAge, and frailty status. A multi-state model was employed to evaluate their associations with CMM trajectories and corresponding prediction capacities.
Results
During a median follow-up of 8.84 years, 26,319 participants developed at least one CMD, 2,502 of which subsequently developed CMM. Robust associations were observed between three aging measures and the risk from the first CMD (FCMD) to CMM. Adjusted HRs from FCMD to CMM of PhenoAge acceleration and KDM-BA acceleration were 1.15 (95% CI: 1.12–1.19) and 1.14 (95% CI: 1.08–1.21), respectively, and the HRs of frail individuals were 1.33 (95% CI: 1.15–1.53) compared to the non-frail. Classifying the FCMD into three individual cardiovascular diseases, we observed three aging measures separately indicated risk projections to CMM from each disease. People with accelerated aging were with 10 ~ 30% higher probability of death from FCMD or CMM than from baseline. PhenoAge acceleration could predict the CMM risk the best individually (Harrell C-statistics = 0.6254). Two cardiovascular risk scores, Framingham risk score and SCORE2, yielded similar prediction power, but with much reduced risk estimates compared to aging measures.
Conclusions
Accelerated biological aging provide a reservoir for a better prediction of cardiometabolic aging to optimize the subclinical prevention of CMM, and could be targeted for may provide a novel target for early intervention.
Effects of pain neuroscience training combined with neuromuscular exercises on pain, functional disability and psychological factors related to chronic low back pain: A study protocol for a single-blind randomized controlled trial
Authors: Alvani Ehsan , Sheikhi Bahram , Letafatkar Amir , Rossettini Giacomo 
Published: May 2023

Abstract
Background: Chronic low back pain (CLBP) is considered one of the most common health conditions, significantly increasing the disease burden worldwide. Several interventions have been used to relieve CLBP. Pain Neuroscience Education (PNE) approach is used to help patients better understand their pain from a biological and physiological perspectives. Specialists also provide it to reduce pain and disability in chronic pain patients. Also, neuromuscular exercises (NMS) are targeted exercises to control impairments presented in CLBP. In this study, PNE combined with NMS is being investigated.
Objective: This Randomized Control Trial (RCT) aims to investigate whether a program of NMS combined with PNE on pain, functional disability and psychological factors related to CLBP is effective.
Methods/ Design: In this single-blind RCT, 42 patients (men and women, aged 30 to 60) diagnosed with CLBP will be randomly assigned to one of the following groups: (1) PNE plus NMS (21 people) and (2) the NMS (21 people). Outcome assessors will be blinded toward group allocation. The primary outcome will be pain intensity. The secondary outcomes will be disability, fear-avoidance beliefs during work and physical activity, self-efficacy, fear of movement, and kinesiophobia. A blinded assessor will assess all outcomes pre- and post-test. The primary and secondary outcomes will be assessed at baseline and post-intervention (8 weeks) and also at 6 months.
Discussion: Pain neuroscience education has been recognized as an effective approach to chronic low back pain management. PNE appears to be effective when combined with NME to reduce pain, improve the patient's knowledge of pain, reduce disability and reduce psychosocial factors, increase movement and minimize the use of health care. Therefore, PNE combined with NME is an effective intervention for patients with chronic low back pain.
Study registration: The registration reference is IRCT20190427043384N2. Registered on 17 March 2023.
Protocol of a multicenter, single-blind, randomized, parallel controlled trial evaluating the effect of microbiological rapid on-site evaluation (M-ROSE) guiding anti-infection treatment in patients with severe hospital-acquired pneumonia
Authors: Wang Xiuli , Wang Kaifei , Xie Fei , Han Zhihai , Liu Yuhong , Pan Lei , Zhu Guangfa , Cao Zhixin , Yan Peng , Xiao Li , Duan Zhimei , Hu Ye , Xiao Kun , Chen Xuxin , Fu Han , Shi Yinghan , Song Yuwei , Han Xiaobo , Xie Wuxiang , Xie Lixin 
Published: May 2023

Abstract
Introduction: The mortality rate of hospitalized patients with severe hospital-acquired pneumonia (SHAP) remains high. Empirical broad-spectrum antibiotic coverage and the misuse of high-grade antibiotics could lead to the emergence of multi-drug and even pandrug-resistant bacteria. In addition to metagenomic next-generation sequencing (mNGS), microbiological rapid on-site evaluation(M-ROSE) might be a useful technique to identify the pathogens in the early stage, however the effect of M-ROSE guiding anti-infection treatment on prognostic outcomes of SHAP patients is still unclear.
Methods/design: This is a multicenter, single-blind, prospective, randomized controlled trial to evaluate the effect of M-ROSE guiding anti-infection treatment in SHAP patients, which will provide new strategies for the prevention and control of clinical multi-drug resistance bacteria. A total of 166 patients with SHAP, aged 18 years and over, will be recruited from seven centers in Beijing and randomly assigned to the intervention group (M-ROSE combined with mNGS) or the control group (mNGS only) in a 1:1 ratio using the central randomization system. Patients in the intervention group will accept M-ROSE and mNGS analysis, and the control group will accept mNGS analysis. Individualized anti-infective treatment and routine treatment will be selected according to the analysis results. The primary outcome is the 28-day mortality. The safety of the intervention measures will be evaluated during the entire trial period. This trial will be the first randomized controlled trial to evaluate the effect of M-ROSE guiding treatment on mortality in patients with SHAP, and may change the prevalence of multi-drug resistant bacteria.
Ethics and dissemination: This trial adheres to the Declaration of Helsinki and guidelines of Good Clinical Practice. Signed informed consent will be obtained from all participants. The trial has been approved by the Chinese PLA General Hospital (Approval Number: 20220322001).
Trail registration number: ClinicalTrials.gov, NCT05300776. Registered on 25 March 2022.
Clinical and Pathological Features in Women with Vulvar Squamous Intraepithelial Neoplasia: A Single Center Experience from China
Authors: Xiao jingjing , chen ziren , Xiao Yinping , sui long , wang chao , cong qing 
Published: May 2023

Abstract
Objective: This study aimed to investigate the optimal depth of vulvar intraepithelial neoplasia (VIN) and involved skin appendages to provide evidence for treatment.
Methods: The study retrospectively enrolled and analyzed the clinical characteristics of all VINs in the obstetrics and gynecology department of a university hospital from January 1, 2019, to December 30, 2021. The study further explored the thickness of epithelium and skin appendages of 285 women with low-grade VIN (VIN 1) and 285 women with high-grade VIN (VIN 2/3).
Results: The study included 1,474 VINs: 1,139 (80%) VIN 1 and 335 (20%) VIN 2/3 cases. The VIN 1 and VIN 2/3 groups showed a significant difference in HPV infection (P<0.01) but not in cytology (P=0.499). The majority (89.90%, 1,325) of the cases occurred in one area of the vulva, whereas 10.11% had multifocal areas. VIN commonly occurred on the posterior fourchette (76.85%), labia majora (11.61%), and labia minora (9.92%). The VIN 2/3 groupreported a significantly higher positive rate for concurrent Cervical and Vaginal intraepithelial neoplasia (160 of 285) compared with the VIN 1 group (321 of 953) (P=0.000). The involved epithelial thicknesses in VIN 2/3 and VIN 1 were 0.69±0.44 and 0.49±0.23 mm, respectively, both greater than their noninvolved epithelial thickness (0.31±0.19 and 0.32±0.10 mm, p<0.001 and p<0.001, respectively). In circumstances of appendage involvement, VIN thickness was 1.98±0.64 mm.
Conclusions: VIN thickness was generally ≤1 mm for the superficial lesions in non-hairy areas. Lesions extending onto hairy areas were about 3 mm, destroying involved skin appendages.
Performance, Emission and Combustion Characteristics of Aloevera-diesel Emulsified Fuel in a Di Diesel Engine
Authors: Manikandan Rajendran , Raja Thimmarayan , Raja Kengaiah Vijaya , Suresh Gopi , Vezhavendhan Rajasekharan , Kumaresan Govindasamy , Ganesamoorthy Raju 
Published: May 2023

Abstract
Nowadays mankind are very particular about the usage of the energy in most effective manner by keeping the view of less adulterating the atmosphere, are the key aspects of many scientists all around the world. In this particular study, the aloevera diesel has been chosen as the primary fuel and studies have been conducted in emission pollutant characteristics, by choosing appropriate diesel engine. Further to this, stable emulsions have been produced by using aloevera and the same was mixed with diesel as the ratio of 5% and 10% as compound. Moreover, span 80 and tween 80 are used as the surfactant with HLB balance of 9.95. Similarly, the emulsions are prepared with help of mechanical stirrer for exact duration of 30 minutes. In order to carry out the experimental investigation process, single cylinder diesel engine was used with data acquisition system. The entire analyses are carried with two set of methods such as no load and full load. The performance and combustion characteristics such as heat release, combustion pressure, thermal efficiency and specific fuel consumption of brake were measured. Likewise, emission parameters such as CO, HC, NOx and CO2 are measured by using AVL Di-gas analyzer. It was noticed that, increased peak cylinder pressure and greater heat release rate on account of longer ignition delay period. Additionally, increase in engine performance and corresponding reduction in exhaust emission also have been observed upon using alovera emulsified diesel fuel.
Association between olfactory dysfunction and sleep duration in US adults: A cross-sectional study
Authors: Miao Chunyu , Jiang Hongqun 
Published: May 2023

Abstract

Olfactory is closely associated with many diseases, and sleep is the foundation of good health. While the relationship between sleep and olfactory has been reported in numerous studies, there has been relatively little research on whether sleep duration has an effect on smell, so we aimed to evaluate the relationship between sleep duration and olfactory. This study used cross-sectional data from people over 40 years old who took part in the National Health and Nutrition Examination Survey between 2011 and 2012, collecting details on their severe sleep duration, self-report olfactory changes, and several other essential variables. There were 2844 participants, with 23.7% (675/2844) discovering olfactory alterations. Compared with individuals with less than 6 hours of sleep, the adjusted OR values for sleep duration and olfactory dysfunction in 6 to 8 hours of sleep, and more than 8 hours of sleep were 0.7 (95% CI: 0.56–0.88, p = 0.003), and 0.66 (95% CI: 0.52–0.85, p = 0.001), respectively. The association between sleep duration and olfactory dysfunction is an L-shaped curve (nonlinear, p = 0.023). The OR of developing migraine was 0.89 (95% CI: 0.801–0.996, p = 0.042) in participants with sleep seven hours/day. The link between sleep duration and olfactory dysfunction in US adults is L-shaped, with an inflection point of roughly 7 hours/day.
Levels of handwashing and vaccine uptake in Kenya, Uganda, and Tanzania to prevent and control COVID-19: a systematic review and meta-analysis
Authors: Muchangi Josphat Martin , Mturi James , Mukasa Hajra , Kithuki Kioko , Kosgei Sarah Jebet , Kanyangi Lennah Muhoja , Mararo Rogers , Nankaja Mauren 
Published: May 2023

Abstract
Introduction: Coronavirus Disease 2019 (COVID-19) presents a massive challenge in Africa due to overwhelmed and underresourced health systems, as well as the existing burden of communicable and non- communicable diseases. Self-inoculation may occur when an individual touches their mucous membrane following direct contact between their hands and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-contaminated surfaces. Therefore, handwashing can be used along with COVID-19 vaccines to reduce the spread of SARS-CoV-2 and the burden of COVID-19. We were interested in investigating the levels of handwashing and vaccine uptake to control and prevent COVID-19 in Kenya, Uganda and Tanzania using a systematic review and meta-analysis.
Methods: We searched PubMed, African Index Medicus and African Journals Online for studies published since inception to 31st January 2023. We included all studies that assessed: the levels of COVID-19 vaccine acceptance and hesitance as indicators of vaccine uptake; and studies on the levels of handwashing to prevent and control COVID-19 in Kenya, Uganda and Tanzania. Study findings were synthesized by meta-analysis to get the pooled effect measure. Three studies were synthesized qualitatively due to high level of heterogeneity in effect measure precluding a quantitative meta-analysis.
Results: Our search identified 128 articles of which 17 studies with 18,305 participants and 622 vaccination sites were reviewed with 14 of them being meta-analyzed. This systematic review and meta-analysis reports high levels of COVID-19 vaccine acceptance and handwashing in Kenya, Uganda and Tanzania at 67% (95% CI: 55, 78) and 88% (95% CI: 73, 97), respectively. Vaccine hesitance among the participants was low at 31% (95% CI: 15, 49).
Conclusions: Despite their importance in the control and prevention of COVID-19, some countries do not implement handwashing and vaccination effectively. There is a need for public health strategies to raise awareness about the importance of handwashing and the uptake of the COVID-19 vaccine.
Registration: PROSPERO ID CRD42023394698; registered on 6th January 2023.
A Pressure-Sensitive Bioadhesive for Wet Tissues and Organs
Authors: Nam Kum Seok , Park Geonho , Kim Yeji , Hwang Kiwook , Kim Minyoung , Chong Jooyeun , Jeon Jooik , Yang Congqi , Lu Yung Hsiang , Paniccia Christian , Choi Jeongwon , Kim Dong Geun , Lee Haeseung , Oh Seung Won , Kim Sanha , Rhyu Jee-Wook , Kang Jiheong , Hyun Jung Keun , Karp Jeffrey , Lee Yuhan , Yuk Hyunwoo , Park Seongjun 
Published: May 2023

Abstract
Pressure-sensitive adhesives (PSAs) have been a workhorse in diverse applications from the repair of objects to heavy-duty industrial use due to their unique capability to form near-instant and robust yet repeatable adhesion to a wide range of engineering solids via physical bonding. While these characteristics of PSAs are highly favorable in various biomedical applications, commercial PSAs lack adhesion to wet tissue surfaces. Moreover, existing bioadhesives are mostly limited to single-use applications incapable of repeated adhesion and repositioning due to the irreversible nature of chemical adhesion. In this work, we introduce a pressure-sensitive bioadhesive (PSB) that synergistically combines the advantages of viscoelastic PSAs and bioadhesives. Enabled by a one-pot scalable copolymerization of a poly(glycerol sebacate)-co-poly(ethylene glycol) (PGS-co-PEG) block copolymer, the PSB provides near-instant (~ 1 s), robust, and repeatable (over 1,000 times) adhesion to wet biological tissues (i.e., skin, lung, heart) and engineering (i.e., metals, plastics) substrates without prior surface functionalization. We further demonstrate in vitro and in vivo biocompatibility and biodegradability of the PSB and its potential applications as a surgical sealant and the rapid, robust, and repositionable integration of biomedical devices with wet dynamic organs in rat and porcine models.
Iatrogenic Left Ventricle Outflow Tract Ventricular Tachycardia Following Transcatheter Aortic Valve Replacement: A Case Series
Authors: Qavi Ahmed Hassaan , Naniwadekar Aditi , Shah Neeraj N 
Published: May 2023

Abstract
Background: Focal left ventricular outflow tract ventricular tachycardia (LVOT-VT) has been rarely reported following transcatheter aortic valve replacement (TAVR).
Case Presentation: Our first case is a 70-year-old man with bicuspid aortic valve (Sievers type 0) who was found to have severe aortic valve stenosis and underwent uncomplicated transfemoral TAVR with 26-mm Edwards SAPIEN-3 Ultra valve. Five months later, he presented to emergency room with dizziness and dyspnea. ECG suggested VT of LVOT origin. Cardiac MRI revealed no fibrosis. Patient was treated with amiodarone with suppression of VT. Our second case is of an 80-year-old man who was diagnosed with symptomatic severe aortic stenosis. He also underwent transfemoral TAVR with 26-mm Edwards SAPIEN-3 Ultra valve. He had complete heart block postoperatively, necessitating a pacemaker. Twelve hours later, he suffered sustained VT of one hour duration, morphology suggestive of LVOT on ECG. Coronary angiography showed patent coronary arteries. He was also managed with amiodarone with suppression of VT.
Conclusions: LVOT-VT following TAVR may be secondary to disease process affecting the valve and adjacent area, direct mechanical pressure of valve stent against LVOT, change in LVOT geometry, periaortic scar or yet unknown mechanism from an unrelated substrate. Unexplained sudden cardiac death after TAVR may be attributable to VT; hence it is important to be aware of this rare association.
Hybrid Oxide Coatings Generate Stable Cu Catalysts for CO2 Electroreduction
Authors: Albertini Petru , Newton Mark , Wang Min , Lecina Ona Segura , Green Philippe , Stoian Dragos , Oveisi Emad , Loiudice Anna , Buonsanti Raffaella 
Published: May 2023

Abstract
Hybrid organic/inorganic materials have contributed to solve many challenges in different areas of science.1–5 One of the biggest challenges for a more sustainable society is to have active and stable catalysts which enable the transition from fossil to renewable feedstocks, reduce energy consumption, and minimize the environmental footprint. Herein, we synthesize novel hybrid materials where an amorphous oxide coating with embedded organic ligands surrounds metallic nanocrystals. We demonstrate that the hybrid coating is a powerful mean to create electrocatalysts stable against structural reconstruction during the CO2 electroreduction. These electrocatalysts consists of copper nanocrystals encapsulated in a hybrid organic/inorganic alumina shell. This shell locks a fraction of the copper surface into a reduction resistant Cu2+ state, which inhibits those redox processes responsible for the structural reconstruction of copper. The electrocatalyst activity is preserved, which would not be possible with a conventional dense alumina coating. Varying the shell thickness and the coating morphology yields fundamental insights into the stabilization mechanism and emphasizes the importance of the Lewis acidity of the shell in relation to the retention of catalyst structure. The synthetic tunability of the chemistry developed herein opens new avenues for the design of stable electrocatalysts and beyond.
Sex ratio of offspring is not statistically altered following pre-implantation genetic testing under a specific sex selection policy
Authors: Bakkensen Jennifer Bender , Speedy Sedona , Mumm Margaret , Boots Christina 
Published: May 2023

Abstract
Purpose
To determine whether the use of pre-implantation genetic testing (PGT) under a specific sex selection policy is associated with alterations in offspring sex ratio.
Methods
This was a single-center retrospective cohort study of singleton live births from January 2018-December 2020 achieved via single blastocyst non-PGT or PGT frozen embryo transfer (FET). Per institutional policy, sex may be disclosed following PGT. If both sexes are available and morphologic grade is similar, patients may select the sex of the embryo to be transferred. Demographics and cycle characteristics were compared between non-PGT vs. PGT cycles with Mann-Whitney U or 𝒳2. Poisson regression with robust variance estimates was used to model the risk of female vs. male offspring among non-PGT vs. PGT cycles, reported as risk ratio (RR) and 95% confidence interval (CI).
Results(s):
Among 541 live births, 350 (64.7%) were achieved with PGT and 191 (35.3%) without PGT. In both groups, female sex was more common, representing 59.4% of PGT-offspring and 55.0% of non-PGT offspring. After adjusting for potential confounders, the use of PGT was not significantly associated with an increased likelihood of female offspring (RR 1.04, 95% CI 0.98–1.11, p = 0.22).
Conclusion(s):
Singletons born following FET had a higher rate of female sex than male. Allowing sex selection per institutional policy did not increase this ratio. These results contrast with those of prior publications and should motivate individual centers to monitor their own sex ratios. As utilization of PGT increases, local, regional, and national monitoring will become increasingly important.