bluuebunny/crossref_metadata_2025_split huggingface dataset:
A phase I open-label study of the safety and efficacy of apatinib (rivoceranib) administered to patients with advanced malignancies to improve sensitivity to pembrolizumab in the second- or later-line setting (APPEASE)
Authors: Gumbleton Matthew , Allan Stephanie , Conway Hannah , Boucher Kenneth , Marvin James , Hawks Josiah , Burnett William , Van Brocklin Matthew , Whisenant Jonathan , Gilcrease Glynn , Gupta Sumati 
Published: February 2023

Abstract
Objective
APPEASE is a phase I study to assess the safety, dosing, and efficacy of rivoceranib (a selective, small-molecule inhibitor of VEGFR2) in combination with pembrolizumab. We aimed to treat patients with metastatic malignancies who have progressed through at least first-line therapy, with pembrolizumab 200 mg every 3 weeks, as well as escalating doses of rivoceranib until disease progression or unacceptable toxicity.

Results
Five patients were enrolled on the starting dose of rivoceranib 300 mg once daily. There were no dose-limiting toxicities observed in combination with pembrolizumab. The dose of rivoceranib was not escalated due to study closure. We note a treatment related grade 3 adverse event (AE) rate of 40%, predominantly in urothelial cancer patients, with no deaths related to treatment related AEs. The disease control rate was 75% (3 of 4) and the median progression free survival (PFS) was 3.6 months. Tumor shrinkage was noted in patients who were previously progressing on pembrolizumab alone. Apatinib 300 mg is safe and demonstrates anti-tumor activity in advanced solid tumors in combination with pembrolizumab. Further dose escalation and efficacy need to be investigated in larger disease-specific patient populations.
Trial registration number: Clinical trial registration number: NCT03407976. Date of registration: January 17, 2018.
Accidental intrathecal injection of tranexamic acid: a case report
Authors: Harby Salama A. , Kohaf Neveen A. 
Published: February 2023

Abstract
Background
Tranexamic acid is a well-known antifibrinolytic medication frequently prescribed to individuals with bleeding disorders. Following accidental intrathecal injection of tranexamic acid, major morbidities and fatalities have been documented. The aim of this case report is to present a novel method for management of intrathecal injection of tranexamic acid.

Case presentation
In this case report, a 400 mg intrathecal injection of tranexamic acid resulted in significant back and gluteal pain, myoclonus of the lower limbs, agitation, and widespread convulsions in a 31-year-old Egyptian male with history of left arm and right leg fracture. Immediate intravenous sedation with midazolam (5 mg) and fentanyl (50 μg) was delivered with no response in seizure termination. A 1000 mg phenytoin intravenous infusion and subsequently, induction of general anesthesia was performed by thiopental sodium (250 mg) and atracurium (50 mg) infusion, and the trachea of the patient was intubated. Maintenance of anesthesia was achieved by isoflurane 1.2 minimum alveolar concentration and atracurium 10 mg every 20 minutes, and subsequent doses of thiopental sodium (100 mg) to control seizures. The patient developed focal seizures in the hand and leg, so cerebrospinal fluid lavage was done by inserting two spinal 22-gauge Quincke tip needles, one on level L2–L3 (drainage) and the other on L4–L5. Intrathecal normal saline infusion (150 ml) was done over an hour by passive flow. After cerebrospinal fluid lavage and the patient’s stabilization was obtained, he was transferred to the intensive care unit.

Conclusions
Early and continuous intrathecal lavage with normal saline, with the airway, breathing, and circulation protocol is highly recommended to decrease morbidity and mortality. The selection of the inhalational drug as a sedative and for brain protection in the intensive care unit provided possible benefits in management of this event with medication errors.
Broadband beamforming of multiplet line arrays using subband optimal beamformers eliminating port/starboard ambiguity
Authors: Simakov Sergey , Lourey Simon 
Published: February 2023

AbstractDevelopment of beamforming methods for towed sonar multiplet line arrays is stimulated by their increased use in undersea surveillance. Such methods employ various forms of narrowband optimal beamforming to resolve port/starboard ambiguity present when the array is conventionally beamformed. In this paper, we depart from the purely narrowband approach and discuss methods for port/starboard ambiguity rejection (PSAR) using a broadband formulation. The proposed methodology relies on subband beamforming for which we use non-adaptive variants of beamspace Minimum Variance Distortionless Response (MVDR) and the Linear Constraint Minimum Variance (LCMV) beamformers. We provide detailed description and comparison of both subband methods and establish a connection between them. The paper provides assessment of PSAR properties of the developed broadband beamformers using outputs of signal processing of both simulated and experimental sonar data. Experimental data for this work were obtained through the participation in the Littoral Continuous Active Sonar (LCAS) trials.
The effects of exceeding low-risk drinking thresholds on self-rated health and all-cause mortality in older adults: the Tromsø study 1994–2020
Authors: Stelander Line Tegner , Lorem Geir Fagerjord , Høye Anne , Bramness Jørgen G. , Wynn Rolf , Grønli Ole Kristian 
Published: February 2023

Abstract
Background
Based on findings of increasing alcohol consumption in older adults, it is important to clarify the health consequences. Using data from the Tromsø study, we aimed to investigate the relationship between different levels of alcohol consumption in old adulthood and self-rated health trajectories and all-cause mortality.

Methods
This is an epidemiological study utilizing repeated measures from the Tromsø study cohort. It allows follow-up of participants from 1994 to 2020. A total of 24,590 observations of alcohol consumption were made in older adults aged 60–99 (53% women). Primary outcome measures: Self-rated health (SRH) and all-cause mortality. SRH was reported when attending the Tromsø study. Time of death was retrieved from the Norwegian Cause of Death Registry. The follow-up time extended from the age of study entry to the age of death or end of follow-up on November 25, 2020. Predictor: Average weekly alcohol consumption (non-drinker, < 100 g/week, ≥100 g/week). We fitted two-level logistic random effects models to examine how alcohol consumption was related to SRH, and Cox proportional hazards models to examine its relation to all-cause mortality. Both models were stratified by sex and adjusted for sociodemographic factors, pathology, biometrics, smoking and physical activity. In addition, all the confounders were examined for whether they moderate the relationship between alcohol and the health-related outcomes through interaction analyses.

Results
We found that women who consumed ≥100 g/week had better SRH than those who consumed < 100 g/week; OR 1.85 (1.46–2.34). This pattern was not found in men OR 1.18 (0.99–1.42). We identified an equal mortality risk in both women and men who exceeded 100 g/week compared with those who consumed less than 100 g/week; HR 0.95 (0.73–1.22) and HR 0.89 (0.77–1.03), respectively.

Conclusions
There was no clear evidence of an independent negative effect on either self-rated health trajectories or all-cause mortality for exceeding an average of 100 g/week compared to lower drinking levels in this study with up to 25 years follow-up. However, some sex-specific risk factors in combination with the highest level of alcohol consumption led to adverse effects on self-rated health. In men it was the use of sleeping pills or tranquilisers and ≥ 20 years of smoking, in women it was physical illness and older age.
Assessing the impact of COVID-19 interventions on influenza-like illness in Beijing and Hong Kong: an observational and modeling study
Authors: Zhang Xingxing , Du Jing , Li Gang , Chen Teng , Yang Jin , Yang Jiao , Zhang Ting , Wang Qing , Yang Liuyang , Lai Shengjie , Feng Luzhao , Yang Weizhong 
Published: February 2023

Abstract
Background
The impact of coronavirus diseases 2019 (COVID-19) related non-pharmaceutical interventions (NPIs) on influenza activity in the presence of other known seasonal driving factors is unclear, especially at the municipal scale. This study aimed to assess the impact of NPIs on outpatient influenza-like illness (ILI) consultations in Beijing and the Hong Kong Special Administrative Region (SAR) of China.

Methods
We descriptively analyzed the temporal characteristics of the weekly ILI counts, nine NPI indicators, mean temperature, relative humidity, and absolute humidity from 2011 to 2021. Generalized additive models (GAM) using data in 2011–2019 were established to predict the weekly ILI counts under a counterfactual scenario of no COVID-19 interventions in Beijing and the Hong Kong SAR in 2020–2021, respectively. GAM models were further built to evaluate the potential impact of each individual or combined NPIs on weekly ILI counts in the presence of other seasonal driving factors in the above settings in 2020–2021.

Results
The weekly ILI counts in Beijing and the Hong Kong SAR fluctuated across years and months in 2011–2019, with an obvious winter-spring seasonality in Beijing. During the 2020–2021 season, the observed weekly ILI counts in both Beijing and the Hong Kong SAR were much lower than those of the past 9 flu seasons, with a 47.5% [95% confidence interval (CI): 42.3%, 52.2%) and 60.0% (95% CI: 58.6%, 61.1%) reduction, respectively. The observed numbers for these two cities also accounted for only 40.2% (95% CI: 35.4%, 45.3%) and 58.0% (95% CI: 54.1%, 61.5%) of the GAM model estimates in the absence of COVID-19 NPIs, respectively. Our study revealed that, “Cancelling public events” and “Restrictions on internal travel” measures played an important role in the reduction of ILI in Beijing, while the “restrictions on international travel” was statistically most associated with ILI reductions in the Hong Kong SAR.

Conclusions
Our study suggests that COVID-19 NPIs had been reducing outpatient ILI consultations in the presence of other seasonal driving factors in Beijing and the Hong Kong SAR from 2020 to 2021. In cities with varying local circumstances, some NPIs with appropriate stringency may be tailored to reduce the burden of ILI caused by severe influenza strains or other respiratory infections in future.

Graphical Abstract
A method for evaluating population and infrastructure exposed to natural hazards: tests and results for two recent Tonga tsunamis
Authors: Thomas Bruce Enki Oscar , Roger Jean , Gunnell Yanni , Ashraf Salman 
Published: February 2023

Abstract
Background
Coastal communities are highly exposed to ocean- and -related hazards but often lack an accurate population and infrastructure database. On January 15, 2022 and for many days thereafter, the Kingdom of Tonga was cut off from the rest of the world by a destructive tsunami associated with the Hunga Tonga Hunga Ha’apai volcanic eruption. This situation was made worse by COVID-19-related lockdowns and no precise idea of the magnitude and pattern of destruction incurred, confirming Tonga’s position as second out of 172 countries ranked by the World Risk Index 2018. The occurrence of such events in remote island communities highlights the need for (1) precisely knowing the distribution of buildings, and (2) evaluating what proportion of those would be vulnerable to a tsunami.

Methods and Results
A GIS-based dasymetric mapping method, previously tested in New Caledonia for assessing and calibrating population distribution at high resolution, is improved and implemented in less than a day to jointly map population clusters and critical elevation contours based on runup scenarios, and is tested against destruction patterns independently recorded in Tonga after the two recent tsunamis of 2009 and 2022. Results show that ~ 62% of the population of Tonga lives in well-defined clusters between sea level and the 15 m elevation contour. The patterns of vulnerability thus obtained for each island of the archipelago allow exposure and potential for cumulative damage to be ranked as a function of tsunami magnitude and source area.

Conclusions
By relying on low-cost tools and incomplete datasets for rapid implementation in the context of natural disasters, this approach works for all types of natural hazards, is easily transferable to other insular settings, can assist in guiding emergency rescue targets, and can help to elaborate future land-use planning priorities for disaster risk reduction purposes.
The effects of royal jelly supplementation on oxidative stress, inflammatory mediators, mental health, cognitive function, quality of life, and clinical outcomes of patients with ischemic stroke: study protocol for a randomized controlled trial
Authors: Karimi Elham , Khorvash Fariborz , Arab Arman , Sepidarkish Mahdi , Saadatnia Mohammad , Amani Reza 
Published: February 2023

Abstract
Background
Stroke is a debilitating disease that affects over 15 million people worldwide each year, resulting in the death of one-third of those people and severe disability in two-thirds of survivors. Previous studies reported various health benefits of Royal jelly in the context of its anti-inflammatory properties. We will aim to investigate the effects of royal jelly supplementation on oxidative stress, inflammatory mediators, mental health, cognitive function, quality of life, and clinical outcomes of patients with ischemic stroke.

Methods
The present study will be a triple-blind randomized placebo trial. Patients who meet our eligibility criteria will be assigned to the intervention or the control groups to receive allocated intervention for 12 weeks. Individuals of the intervention group will consume 1000 mg of Royal jelly dragee daily after breakfast. Subjects of the control group will receive a placebo dragee identical to the Royal jelly dragee. The severity of the stroke, cognitive function, mental health, quality of life, clinical outcomes, and biochemical measures will be assessed at baseline and post-intervention.

Discussion
The current study is designed to investigate the effectiveness and safety of royal jelly supplementation in a randomized, parallel, two-arms, single-center, triple-blind, placebo-controlled manner. This study will provide evidence as a phase III clinical trial.

Trial registration
IRCT20180818040827N4, registered on 16 October 2021. https://www.irct.ir/trial/59275.
Sono-elastography findings of supraspinatus tendon in supraspinatus tendinopathy and tear: comparison study with magnetic resonance imaging
Authors: Gadalla Amr A. Elfattah Hassan , Hassanein Gehad Ramadan , El Azizy Hatem Mohammed Saeed , Mohammed Walid Reda , Elliethy Neiven Ezzat Mohammed 
Published: February 2023

AbstractBackgroundRotator cuff disorders are the main causes of chronic shoulder instability and pain. Diagnostic imaging is important to guide treatment decisions with magnetic resonance imaging, which is considered the reference standard for rotator cuff evaluation. Sono-elastography is a noninvasive and reliable ultrasound technique that provides qualitative as well as quantitative assessment of tendon quality through alteration in the tissue composition before alteration in tendon echogenicity or thickness on the conventional US.PurposeTo assess the role of shear wave sonoelastography in the evaluation of supraspinatus tendon abnormalities.To assess the association between SWE and grades of tendon abnormalities on MRI (the standard imaging in the evaluation of rotator cuff abnormalities).ResultsThe shear wave velocity (SWV) was notably low (reduced tendon stiffness) in patients with supraspinatus tendinopathy and tear (mean SWV for the supraspinatus tendon in cases of tendinopathy/tear was 3.91 m/s with a standard deviation of 0.67, while the mean SWV for normal supraspinatus tendons was 6.93 m/s with a standard deviation 0.57), and a significant difference was found in SWV values between cases and controls (P < 0.001).Also, there were significant differences between the patients with different grades of tendon abnormalities (P < 0.001), with a highly significant inverse correlation observed between the measured SWV and grades of tendon abnormalities on MRI (P < 0.001).ConclusionsSonoelastography showed tendon softening in supraspinatus tendinopathy and tear with a good correlation to the MRI, making it a reproducible and low-cost imaging modality that can be a complementary tool to the US in the evaluation of shoulder disorders, especially when MRI is not allowed.
Dynamic multi-frame multi-spreading factor scheduling algorithm for LoRaWAN
Authors: Shayo Eva I. , Abdalla Abdi T. , Mwambela Alfred J. 
Published: February 2023

AbstractLong-Range Wide Area Network (LoRaWAN), as Low Power Wide Area Network that connects battery-powered devices, has gained much attention lately. The LoRaWAN technology uses ALOHA as the medium access control where the End Devices (EDs) transmit data randomly and re-transmit up to eight times if collisions occur, which is not feasible in large networks. Several techniques, including synchronization and scheduling schemes, to address the challenge have been reported. However, the existing synchronization and scheduling algorithms transmit synchronization messages randomly using one super frame with fixed time slots that accommodate devices using different Spreading Factors (SFs). This phenomenon can result in collisions, idle slots, and inefficient energy use, hence limiting the LoRaWAN network scalability. To alleviate the aforementioned problems, this work proposes a dynamic Multi-Frame Multi-Spreading Factor (MFMSF) scheduling algorithm with slotted synchronization approach. In the proposed algorithm, the time slots are assigned dynamically to EDs on first to synchronize first to be assigned basis. It was revealed that the proposed dynamic MFMSF TDMA algorithm is more energy-efficient than the existing algorithm in a denser network with devices arranged in a circular disk with different radii. The packet delivery rate for the dynamic MFMSF TDMA is about 99% signifying reduced collisions during data transmission. This implies that the use of the proposed dynamic MFMSF scheduling algorithm in LoRaWAN allows large number of EDs to communicate with reduced collisions and enhanced energy efficiency of the battery-powered devices.
The sensitivity of median versus ulnar palmar mixed nerve study in the early diagnosis of carpal tunnel syndrome
Authors: El-Hady Aliaa Omar 
Published: February 2023

Abstract
Background
Electrodiagnostic tests (EDX) are the most frequent and applicable studies in early diagnosis of carpal tunnel syndrome (CTS), but the definitive sensitive and specific tests are still under study. We aimed to evaluate the role of the median versus ulnar palmar mixed nerve study (Mix M-U), and its sensitivity in comparison to other provocative comparison studies, in supporting the early diagnosis of CTS. This cross-sectional study included 142 idiopathic early CTS hands from 100 patients and 71 hands from 50 healthy subjects as a control group. We did routine median motor and sensory studies and 4 comparative tests namely median versus radial sensory study (MVR), Mix M-U, median versus ulnar sensory study (MVU), and median versus ulnar lumbrical-interossei motor study (LU-IN).

Results
The routine median motor and sensory latency and amplitude showed a statistically significant difference between CTS and control groups as (p< 0.05) and a highly statistically significant difference between the 2 groups as regards the 4 comparative tests as (p< 0.0001). The specificities of all the 4 comparative tests were higher than 90%. MVR test had the highest sensitivity (92.2%) and followed by Mix M-U study (82.2%) and MVU (78.7%), and the least sensitive test was the LM-IN (66.9%).

Conclusions
Although the patients’ results fall within the normal range according to the reference range in the literature, it showed a statistically significant difference when compared to controls. A high percentage of those symptomatic patients showed results of typical CTS when tested with the comparative studies so there is a need to use these sensitive tests to diagnose cases with early CTS. According to sensitivity studies, the selection of which tests to do in order is a challenging choice. For the diagnosis of cases with early CTS with a normal ordinary motor and sensory studies, MVR comparative technique appeared as the best sensitive and specific provocative electrophysiological test followed by the Mix M-U test. We recommend the use of a combination of both tests first in the diagnosis of early CTS and if one of them was negative we can use the other comparative studies MVU and then LM-IN studies.
Retrospective cohort study of thromboembolic events in systemic lupus erythematosus with or without secondary antiphospholipid syndrome and their correlation to lupus activity and dyslipidemia
Authors: Ibrahim Ahmed A. G. , Shadi Hesham W. E. , Elamin Awab A. Y. , Draz Hoda E. 
Published: February 2023

Abstract
Background
Antiphospholipid syndrome (APS) is one of the most frequent forms of acquired thrombophilia and is associated with an increased risk of stroke, heart attack, pulmonary embolism, and miscarriage in young women. Thirty to 40% of systemic lupus erythematosus (SLE) patients have associated APS. Patients with SLE often have abnormal plasma lipid concentrations. The study aimed to assess the prevalence of thromboembolic insults in SLE patients, with or without APS, and its correlation with disease activity and dyslipidemia. This study included one hundred three patients, seventy-five of whom had SLE without associated APS and twenty-eight had SLE associated with APS.

Results
Vascular affection, neurological affection, and abortion were significantly higher in SLE patients associated with APS than SLE patients without APS (39.3% vs 6.7%, 46.4% vs 14.7%, 28.6% vs 5.3%, respectively; P < 0.001). Thromboembolic insults were present in 20% of SLE patients without APS, and those patients with thromboembolism demonstrated significantly higher SLEDAI (median = 15 vs 10, P < 0.001) and TG (median = 27.5 vs 18.2, P = 0.007), respectively, than other patients of the same group. The SLEDAI score was significantly higher in SLE patients associated with APS than in SLE patients without APS (P < 0.001). Serum cholesterol and low-density lipoprotein (LDL) were significantly higher in SLE patients associated with APS (93.8 ± 25.3 mg/dl) than in SLE patients without APS (82.3 ± 19.6 mg/dl, P = 0.018; 50 ± 15.9 mg/dl, P = 0.048, respectively).

Conclusions
SLE patients are at significantly high risk for accelerated atherosclerosis, thromboembolism, and pregnancy loss which is multifactorial. Active disease should be well controlled. Lupus patients should be screened for aPL antibodies, and positive cases must be treated according to international guidelines. All patients with SLE should undergo lipid profile screening, and any abnormalities should be managed promptly.
Multiscale structure of the gravitational wave signal from GW150914 based on the nonextensivity q-triplet
Authors: da Silva C. V. , Nepomuceno M. M. F. , de Freitas Daniel Brito 
Published: February 2023

Abstract
We study the ﬁrst gravitational wave, GW150914, detected by advanced LIGO and constructed from the data of measurement of strain relative deformation of the fabric of spacetime.