bluuebunny/crossref_metadata_2025_split huggingface dataset:
PD-1 inhibitor monotherapy versus combination therapy
Authors: Yang Guanli , Sun Hongfu , Zhou Chunyang , Sun Nini , Xu Lixia , Huang Wei , Li Baosheng 
Published: March 2023

Context:
Although programmed death 1 (PD-1) inhibitors are a standard second-line treatment for esophageal squamous cell carcinoma (ESCC), their efficacy when used in combination with chemotherapy or anti-angiogenesis targeted therapy is unclear.

Aim:
To compare the efficacy and safety of PD-1 inhibitor monotherapy with that of combination therapy.

Setting and Design:
A retrospective study was conducted at the Shandong Cancer Hospital.

Materials and Methods:
Based on records, patients with advanced ESCC, treated with second-line or above PD-1 inhibitor-containing regimens from August 15, 2019 to April 12, 2021 were divided into combination (PD-1 inhibitors plus chemotherapy or anti-angiogenesis targeted therapy) and monotherapy groups. The primary endpoints were progression-free survival (PFS) and overall survival (OS).

Statistical Analysis Used:
The baseline differences between subgroups were assessed using the χ2-test, Fisher's exact test, or Student's t-test. Follow-up period, PFS, OS, median survival, and 95% confidence intervals (CIs) were estimated using Kaplan[FIGURE DASH]Meier analysis. The log-rank test was used to compare subgroups.

Results:
In the 169 patients included, clinical features were well balanced between both groups. The median PFS of the combination group was better than that of the monotherapy group (8.5 months [95%CI 6.3–10.7] vs. 3.2 months [95%CI 0.0–6.5]; hazard ratio (HR) = 0.34 [95%CI 0.13–0.92]; P < 0.001). The median OS showed the same trend (18.9 months [95%CI 14.4–23.3] vs. 9.8 months [95%CI 6.3–13.2]; HR = 0.47 [95%CI 0.21–1.04]; P = 0.010).

Conclusion:
Using PD-1 inhibitors in a combination treatment may improve PFS and OS, with acceptable toxicities.
Clinical data from the real world
Authors: Qiu Zhixin , Xian Xinhong , Liu Chunrong , Yu Min , Lin Feng , Huang Meijuan , Wang Ke 
Published: March 2023

Objectives:
The real-world intracranial efficacy data of ceritinib at a dose of 450 mg quaque die (QD) are currently unavailable. Therefore, we evaluated the intracranial efficacy of ceritinib (450 mg QD) in anaplastic lymphoma kinase (ALK)-rearrangement NSCLC patients in China.

Materials and Methods:
In total, 57 ALK-rearrangement NSCLC patients with brain metastases (BM) were enrolled retrospectively in this real-world study. Of these, 53 patients experienced progression at baseline during or after prior crizotinib administration, and 24 patients received prior brain radiotherapy. Patients received ceritinib (450 mg QD) treatment. Intracranial efficacy [objective response rate (ORR) and disease control rate (DCR)] was evaluated according to the Response Assessment in Neuro-Oncology (RANO) standard; progression-free survival (PFS) and adverse events (AEs) data were obtained through follow-ups.

Results:
The intracranial ORR and DCR of ceritinib were 73.7% and 93.0%, respectively. The median intracranial PFS in patients reaching the endpoint was 8.75 months, whereas the median intracranial PFS in all patients was not reached and predicted to be not evaluable (NE) (95% CI: 12.9–NE). The estimated 12-month event-free probability (EFP) of intracranial lesions was 68.1%. A subgroup analysis revealed that the estimated 12-month EFP of intracranial lesions was relatively higher in patients with prior brain radiotherapy (93.8% vs. 47.1%, P = 0.0006).

Conclusion:
Ceritinib administered at 450 mg QD to ALK-rearrangement NSCLC patients with BM in China exhibited superior ORR and DCR, as well as PFS and event free probability. The estimated 12-month EFP for intracranial lesions improved in patients with prior brain radiotherapy.
Feasibility and efficacy of superconducting open-configuration magnetic resonance-guided microwave ablation of malignant liver tumors with real-time imaging sequences
Authors: Yuan Hui , Shen Lujun , Qi Han , Wang Xiucheng , Tan Hongtong , Cao Fei , Huang Tao , Li Da , Zhang Yan , Wang Ting , Wu Ying , Fan Weijun 
Published: March 2023

Objective:
To evaluate the safety and effectiveness of open superconducting magnetic resonance (MR)-guided microwave ablation of liver tumors and explore feasibility of real-time imaging sequence-guided needle insertion technique.

Materials and Methods:
Medical records of December 2019–May 2021 of microwave ablations of liver tumors under MR guidance in XX University Cancer Center were reviewed. Real-time imaging-guided puncture technique refers to real-time insertion and adjusting the position of a microwave applicator under a fast imaging sequence. The safety and efficacy of the procedure among the enrolled patients were assessed.

Results:
Twenty-six patients underwent 27 procedures, with 30 lesions ablated (long diameter: 1.51 ± 0.81 cm, short diameter: 1.30 ± 0.61 cm). There were 20 cases of primary liver cancer and 10 of liver metastases. All lesions were identified by MR imaging (MRI), and all procedures were successfully performed using the finger positioning method for puncture sites. Five patients underwent real-time guided needle insertion techniques. Further, the microwave applicators reached the target position at once, and the entire insertion process was completed within 3 min. The completion rate of the real-time guided needle insertion technology was 100%, and 25 (92.6%) patients had minor complications. No severe complications were observed, and the technical success rate of 30 MRI-guided lesions was 100%. Finally, the complete ablation rate of the MRI-guided ablation after the first procedure was 93.1%.

Conclusion:
Open MR-guided microwave ablation is safe and effective in treating liver tumors. Furthermore, real-time imaging sequence-guided puncture technique under MRI is feasible and efficient.
A novel irradiation stent versus conventional irradiation stent for malignant dysphagia
Authors: Zhu Guang-Yu , Lu Jian , Wang Chao , Guo Jin-He 
Published: March 2023

Aim:
To evaluate whether a novel irradiation stent (NIS) could decrease the rate of recurrent dysphagia, compared to the conventional irradiation stent (CIS) in patients with malignant dysphagia.

Materials and Methods:
We performed an open-label randomized controlled trial of participants with malignant dysphagia. A total of 94 participants were parallelly allocated into the NIS group or the NIS group between April 2019 and April 2020. The primary endpoint was the rate of recurrent dysphagia. The secondary endpoints included technical success, clinical success, overall survival, and adverse events.

Results:
The technical success rate and the clinical success rate was 100.0% (47/47) in both groups. The median follow-up period was 189 days (range 14–422 days). Recurrent dysphagia was observed in 12.8% (6/47) of patients in the NIS group and 31.9% (15/47) in the CIS group (P = 0.026). Tissue/tumor growth occurred in 4 patients (8.5%) after NIS placement and 12 (25.5%) after CIS placement (P = 0.028). Stent migration occurred in 2 patients (4.3%) after NIS placement and 3 (6.4%) after CIS placement (P = 0.646). No food obstruction was found in both groups. The median overall survival was 177 days (95% confidence interval [CI] 139–214) in the NIS group and 168 days (95% CI 153–183) in the CIS group (P = 0.932). The incidence of severe adverse events was comparable between the two groups (21.3% vs. 17.0%, P = 0.600).

Conclusions:
In patients with malignant dysphagia, compared with CIS, NIS could decrease the rate of tissue/tumor growth without increase the rate of stent migration and therefore decrease the rate of recurrent dysphagia.
Image fusion technique for target volume delineation in 125I seed implant brachytherapy for parotid gland cancers
Authors: Li Zhen-Yu , Wu Zhi-Yuan , Wu Wen-Jie , Shi Yan , Zhou Xing-Hong , Zhang Jie 
Published: March 2023

Purpose:
Variability in volume delineation is a possible error source in brachytherapy. This study assessed the interobserver variations in clinical target volume (CTV) delineation in postoperative adjuvant 125I seed implant brachytherapy after parotid gland cancer surgical resection and evaluated the image fusion technique for target volume delineation.

Material and Methods:
Five radiation oncologists delineated gross tumor volume (GTV) and CTV in 20 patients using conventional delineation and image fusion methods. The consistency in target volume delineation was determined on the basis of differences between the oncologists. Variability was determined using Kendall's W-test, the mean conformity index (CI), the mean distance to conformity (MDC), and the center of gravity distance (CGD).

Results:
There were significant variations in the delineated target volumes among radiation oncologists, but the CTV consistency was significantly enhanced using the image fusion technique, based on Kendall's W, mean CI, average MDC, and average CGD, which were 0.752, 0.41, 2.75, and 4.997, respectively, using the conventional method, and 0.987, 0.86, 0.55, and 1.27, respectively, using the image fusion method.

Conclusions:
The interobserver variation in the delineation of the postoperative parotid target volume is large, but it can be considerably decreased using image fusion technology, which resulted in a noticeable improvement in the delineation precision of the target volume for parotid gland cancer. Thus, this technology can enhance the efficacy of 125I seed implant brachytherapy and decrease any adverse effects induced by errors in target delineation.
The impact of patient sex on characteristic-adjusted bladder cancer prognosis
Authors: Zhao Chunchun , Li Kai , Zhu Mujia , Wang Fei , Zhang Ke , Fan Caibin , Wang Jianqing 
Published: March 2023

Context:
Bladder cancer is one of the most common malignancies worldwide. Some studies noted sex differences in the prognosis of bladder cancer, but results are inconsistent.

Subjects and Methods:
In this study, we assessed whether women with bladder cancer exhibit a worse prognosis, after adjustment for disease stage, age, and body mass index (BMI), using clinical data from The Cancer Genome Atlas. We used a Student's t-test to compare age and BMI in groups with different sexes.

Statistical Analysis Used:
The Kaplan–Meier method with log-rank test was used to determine clinical prognosis.

Results:
The BMI (30.15 vs. 26.68, P = 0.0035) and age (67.54 years vs. 66.01 years, P = 0.045) of female patients with muscle-invasive bladder cancer (MIBC) were higher than those of male patients. The overall survival (OS) prognosis of female patients was worse than that of male patients. After grouping by disease characteristics, the disease-free survival (DFS) and OS prognoses of female patients under 60 years of age were worse than those of male patients. In the group with BMI >24, the OS prognosis of female patients was worse than that of male patients, but no difference was found in DFS prognosis. In the group with BMI ≤24, the DFS prognosis of female patients was worse than that of male patients, but no difference was found in OS prognosis. Compared to males, female patients with Stage III disease demonstrated a worse DFS prognosis and poorer OS prognosis, women with stage T3 demonstrated a worse DFS prognosis, and women with stage N0 demonstrated a poorer OS prognosis. No difference was found in prognosis between male and female patients in all other groups.

Conclusions:
In patients with MIBC, women tended to exhibit a worse prognosis than men. More specifically, we found a correlation between prognosis and sex after grouping patients by BMI.
Dosimetry study of nasopharyngeal carcinoma based on Halcyon accelerator fixed-field intensity-modulated radiation therapy
Authors: Li Kuo , Li Chengqiang , Zhu Ting , Chen Jinhu , Cao Wentao , Yin Yong , Ma Changsheng 
Published: March 2023

Objective:
Halcyon accelerator applies the flattening filter (FF)-free mode instead of the lead gate and FF treatment mode for traditional C-type accelerators. We aimed at comparing and analyzing the quality and delivery of nasopharyngeal carcinoma (NPC) plans between Halcyon and VitalBeam (VB) accelerators in fixed-field intensity-modulated radiation therapy (IMRT).

Methods:
The IMRT plans for thirty patients with NPC who had received radiotherapy were optimized using the VB (Plan VB) and Halcyon (Plan H) accelerators. Quality assurance verification was then conducted. The dose coverage of the planning target volume (PTV) and organs at risk (OARs), monitor units (MUs), and delivery time were analyzed for each plan.

Results:
All PTV and OAR indexes of Plan H and Plan VB met the clinical requirements. In the exposure dose of bilateral optic nerves between Plan H and Plan VB, no difference was found. The maximum dose of the lens, brainstem, spinal cord were 1.13 Gy, 1.36 Gy, 1.35 Gy, 2.82 Gy lower than the plan using VB , and the mean dose of the parotid glands were 3.82 Gy, 5.56 Gy lower than the plan using VB respectively, and an insignificant difference was found in the brainstem (P > 0.05). The MU for Plan H (22.92 ± 1.58 Gy) was higher than that for Plan VB (19.69 ± 4.52 Gy), and the difference was significant (P < 0.05).

Conclusions:
The treatment plans designed by Halcyon can meet clinical requirements with better protection for OARs and show advantages over VB in the dosimetry of NPC IMRT plans.
Sleep and mental health in children and adolescents
Authors: Sahoo Surjeet , Dash Soumya Ranjan , Sahu Amiya Krushna 
Published: March 2023

Abstract
Sleep is an essential biological function of our life. The duration and pattern of sleep varies from animals to animals. We human beings sleep nearly 6 to 8 hours during night time. This consolidated night time sleep pattern normally achieved at around 4 years of age and continues thereafter. It is seen that sleep has an important role in overall growth and cognitive development of the child. Any disturbances in quality or duration of sleep in childhood may predispose the child to many physical and mental disorders in later ages. Some of the childhood sleep disorders resolve spontaneously, some resolve with age and some may persist throughout the life as a genetic burden. On the other hand many of the mental disorders of childhood and adolescent affect the sleep pattern of the individual. Substance abuse in adolescents is a challenging situation where unhealthy sleep pattern considered having a great role. This review article is meant to focus how sleep disturbances in childhood can predispose to mental illness and in turn how various mental disorders affect the normal sleep pattern of a child.
Prevalence of Type 2 Diabetes Mellitus in the General Population of Saudi Arabia, 2000–2020
Authors: Jarrar Mu'taman , Abusalah Mai Abdel Haleem , Albaker Waleed , Al-Bsheish Mohammad , Alsyouf Adi , Al-Mugheed Khalid , Issa Marwan Rasmi , Alumran Arwa 
Published: March 2023

Background:
The prevalence of type 2 diabetes mellitus (T2DM) has increased worldwide, including in Saudi Arabia.

Objective:
To systematically review the available literature and assess the pooled prevalence of T2DM in Saudi Arabia between 2000 and 2020.

Methods:
Observational studies that reported quantitative estimates of the prevalence of T2DM as their main outcome, included the general population of Saudi Arabia, and were published between 2000–2020 and in English were retrieved using three electronic databases (namely, CINAHL, Medline via PubMed, and Web of Science). Retrieved studies were screened, and relevant data were extracted. The Joanna Briggs Institute Critical Appraisal guideline was used to assess the methodological quality of included studies. A random-effects model was used to estimate the prevalence of T2DM.

Results:
Twenty-three studies were included in the systematic review, of which 19 were included in the meta-analysis (total pooled population: 258,283). The overall pooled prevalence of T2DM in Saudi Arabia was 16.4% (95% CI: 11.6–17.5). However, there was heterogeneity in the results of the studies [I2 = 99.31%, P < 0.0001] and the summary values varied from 3.18% (95% CI: 1.46–5.95) to 94.34% (95% CI: 89.53–97.38). Although the prevalence of T2DM by age varied across studies, in most studies, it was higher among the older age groups. In addition, the prevalence of diabetes widely varied across the different geographical regions of Saudi Arabia.

Conclusions:
This is the first meta-analysis that determined the pooled prevalence of T2DM in Saudi Arabia, and it revealed a high prevalence over the past two decades. However, owing to data collection inconsistencies in the identified studies, neither the modifiable (such as obesity, educational status, emotional support, etc.) nor the non-modifiable (such as gender and age) risk factors of T2DM could be determined, thereby indicating the need for a nationally collective effort in determining these factors.
Sustainable Careers under Spiritual Leadership and Workplace Spirituality: A Subordinates’ Perspective during Covid 19
Authors: Ali Huma , Shahid Tooba , Timsal Ahmad , Naseer Sohail 
Published: March 2023

When engaging in career planning every employee tends to work towards achieving meaningful career success over time. Careers have also become a focal point due to the devastations of global pandemic on organizations and general public all around the world. Where it has halted functioning of different sectors such as tourism, airline or retail industry, yet health care industry has experienced increased workload on an already saturated and overburdened health sector of Pakistan. This research is conducted to examine the relationship between spiritual leadership, workplace spirituality and maintaining sustainable careers over time in health sector of Pakistan. Spiritual leadership enhances these dimensions. Workplace spirituality works as a promoter for exhibiting spiritual leadership styles at workplace. They strengthen employees by enhancing their self-fulfillment and by nourishing different streams of their careers goals. Sustainable career consist of work experiences assumed over time while providing meaning to the individual. It is measured through indicators of health, happiness and productivity in different dimensions of time, person and context. The present study examines relationship between spiritual leadership, workplace spirituality on maintaining sustainable careers during turbulent times of pandemic. The study was conducted in health sector of Multan, Pakistan. Data is collected through interviews and qualitative analysis is performed. Verbatim method is used to report the results for analysis purpose. Our findings attest that employees were generally satisfied with a spiritual workplace and spiritual leadership but their health, happiness and productivity were affected differently when dimensions of time, person and organizational’ context were changed. This study will contribute more insights for literature of sustainable career and spirituality at workplaces.
On the results of the coordinated state policy in the field of tobacco control among young people
Authors: Sychik Sergey I. , Pronina Tatyana N. 
Published: March 2023

Introduction. Trend analysis of tobacco consumption rates is important for assessing the effectiveness of national tobacco control measures in Belarus.
Materials and methods. The study aims to monitor tobacco smoking among adolescents in Belarus by three repeat national cross sectional surveys conducted before and after introduction the regulatory act tobacco measures entered into force. Prevalence of smoking tobacco, cigarettes, electronic cigarettes and other aspects related to smoking among 13–15 years adolescents were estimated from the 2004, 2015 and 2021 Global Youth Tobacco (GYT) Surveys (n = 4523,
n = 2992, n = 3493 respectively) conducted in Belarus.
Results. The data evidenced a successful anti-tobacco policy and an improvement in the tobacco consumption and tobacco consumption by 13–15 years adolescents, expressed in reduction of many indicators. Prevalence of current cigarettes smokers significantly decreased from 26.5% in 2004 to 4.7% in 2021. Despite of current reduction of various types of tobacco smokers current GYTS data revealed that electronic cigarettes are extremely popular among adolescents – around 15%. The number of smokeless tobacco users significantly increased by 3 times.
Limitations. In order to study the tobacco consumption levels and other aspects related to smoking a survey of 11,000 adolescent students in 2004, 2015 and 2021 was conducted among schoolchildren (13–15 years old), which is a sufficient reference sample.
Conclusions. Thus, the identified positive trends in tobacco smoking (5-fold reduction in the number of cigarette smokers, decrease in susceptibility to smoking, reducing the number of tobacco products smokers and decrease the number of ever tobacco smokers and ever cigarette smokers, decreasing the number of frequent cigarette smokers) indicated the effectiveness of a complex multidisciplinary anti-tobacco measures in Belarus. New challenges and negative trends were determined. Amount of electronic cigarettes users were significantly greater than current cigarette smokers’ amount. Moreover, prevalence of users of smokeless tobacco products is getting increased. Despite of extensive legislative framework for the tobacco control there remains substantial potential to strengthen them.
Keywords: smoking; tobacco; tobacco use; cigarettes; electronic cigarettes; adolescents; smokeless tobacco; GYTS
Compliance with ethical standards: the Local ethics committee of the Republican unitary enterprise «Scientific and Practical Centre of Hygiene» of the Ministry of Health.
Patient consent. Each participant of the study (or his/her legal representative) gave informed voluntary written consent to participate in the study and publish personal medical information in an impersonal form in the journal "Gigiena i Sanitariya (Hygiene and Sanitation, Russian journal)".
The Use of WhatsApp in the Learning Process among Graduate Students in the University of Nairobi, Kenya
Authors: K. O. Evans 
Published: March 2023

Purpose: The purpose of this study is to evaluate the use of WhatsApp in the learning process among graduate students in the University of Nairobi.
Methodology: The study adopted a desktop methodology. Desk research refers to secondary data or that which can be collected without fieldwork. Desk research is basically involved in collecting data from existing resources hence it is often considered a low cost technique as compared to field research, as the main cost is involved in executive’s time, telephone charges and directories. Thus, the study relied on already published studies, reports and statistics. This secondary data was easily accessed through the online journals and library.
Findings: The findings revealed that there exists a contextual and methodological gap relating to the use of WhatsApp in the learning process among graduate students in the University of Nairobi. Preliminary empirical review reveals that there is no doubt that digital technology is of significance in education today. WhatsApp mobile technology is extremely valuable in this regard, as it is widely and extensively employed in online university education. It also provides students with more options and possibilities in the context of online learning. Almost everything in the world has gone digital.
Unique Contribution to Theory, Practice and Policy: The Social Constructivism theory and Activity theory may be used to anchor future studies on the use of WhatsApp in the learning process among graduate students in the University of Nairobi. There is need for a quantitative survey to establish the statistical significance effect of the use of WhatsApp as a method of learning for graduate school students. There is also need for a comparative study on the effectiveness of the use of WhatsApp in learning and traditional form of learning