bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survival Analysis of 159 Patients With Advanced Non-Small-Cell Lung Cancer Resistant to First-Generation Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitor
Authors: Hu Aimin , Li Kun , Zheng Hua , Rao Haitao , Zhang Tongmei , Li Baolan 
Published: June 2023

Background: Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) have limited or no response in some certain patients of non-small-cell lung cancer (NSCLC). However, real-world survival analyses comparing clinical data and EGFR-plasma mutation are still lacking. Methods: In total, 159 patients with advanced NSCLC resistant to first-generation EGFR-TKIs were included for consecutive blood sampling in this study. Super-amplification refractory mutation system (Super-ARMS) was used to detect EGFR-plasma mutations and correlations between survival and circulating tumor DNA (ctDNA) were analyzed. Results: Among 159 eligible patients, the T790M mutation was detected in 27.0% (43/159) of patients. The median progression-free survival (mPFS) was 10.7 months in all patients. Survival analysis revealed that patients with the T790M mutation had shorter progression-free survival (PFS) than those with the T790M wild-type (10.6 months vs 10.8 months, P = .038). Patients who cleared EGFR-plasma mutation had prolonged PFS compared with those with nonclearing EGFR-plasma mutation (11.6 months vs 9.0 months, P = .001). Cox multivariate analysis showed that the nonclearance of EGFR-plasma mutations was an independent risk factor for PFS (RR = 1.745, 95% CI: [1.184, 2.571], P = .005). The T790M mutation was associated with nonclearance of the EGFR-plasma mutation ( χ2 = 10.407, P = .001). Conclusion: Patients with advanced NSCLC who were resistant to the first-generation EGFR-TKI had a prolonged PFS with clearance of EGFR-plasma mutation. Those nonclearers were more likely to harbor T790M mutations in plasma.
“Survival classes for a neurotypical world”: What French autistic adults want and need after receiving an autism diagnosis
Authors: Bureau Raven , Clément Céline 
Published: June 2023

Research on how adults react to receiving an autism diagnosis is focused on the United States or the United Kingdom context even though cultural differences might have an impact on these experiences. Few interventions for autistic adults exist, and when they do, they are often described as inappropriate. Our study aimed to explore the experiences of French adults diagnosed with autism and the needs they identified following this diagnosis as well as to ask them directly what type of interventions they would have wanted. We conducted semi-structured interviews with 12 adults and identified three recurring themes: (1) reactions to the diagnosis, (2) relations with others and society, and (3) wants and needs. Results indicated that some experiences were congruent with existing Anglophone literature, while others were heavily influenced by the specific cultural context. Our participants also highlighted a number of unmet needs and offered suggestions for adequate interventions. Lay abstract Adults receiving an autism diagnosis might not react the same depending on their countries or cultures. We also know that autistic people are rarely asked what they think would be best for them following this diagnosis. In this study, we asked 12 French autistic adults about their experiences of receiving an autism diagnosis as well as what they thought might be useful afterwards. Overall, we found that some experiences were similar to experiences related by English or American participants, but some were specific to the French culture, suggesting that such research should expand into new territories and cultures, especially non-European ones. Our participants also had quite a few ideas as to what would be useful for people in the same situation. Some of the suggestions can be put into action by peers and professionals alike, while others are wishes relating to how our participants would like society to behave toward them and people like them, for example. This article allows for a better comprehension of how cultural differences can impact the experience of receiving an autism diagnosis as an adult and provides some insight into what these adults want and desire following such a diagnosis.
Bilingualism but not bidialectalism influences cognitive control among young adult Chinese–English bilinguals
Authors: Xie Zhilong , Zhong Qianyun 
Published: June 2023

Aims and objectives/purpose/research questions: This study investigates whether bilingualism and bidialectalism influence cognitive control, and whether the two variables interact. Design/methodology/approach: The study compared two matched groups differing in second language (L2) proficiency through the Flanker and Wisconsin Card Sorting Test (WCST). The two groups were further divided into four groups differing in dialect proficiency, so that the effects of L2 proficiency and dialect proficiency and the interactive effect were examined. Data and analysis: A mixed analysis of variance (ANOVA) was applied to the Flanker task data, with the task condition as the within-subject variable and the participant group as the between-subject variable. Independent t-test and ANOVA analyses were used to compare the performance differences between groups on the WCST. Findings/conclusion: The high L2 proficiency group performed better than the low L2 proficiency group both in the Flanker task and the WCST, reflecting better monitoring and shifting ability. L2 proficiency effect on cognitive control was significant. However, no dialect effect was observed, and no interaction effect was found. Further multiple regression results confirmed the role of L2 proficiency but not dialect proficiency. Originality: This is one of the first bilingual studies to incorporate both bilingualism and bidialectalism simultaneously. Significance/implications: The current research provides robust evidence that bilingualism is related to the enhancement of cognitive control, but questions the effect of bidialectalism.
mHealth in sub-Saharan Africa and Europe: A systematic review comparing the use and availability of mHealth approaches in sub-Saharan Africa and Europe
Authors: Aboye Genet Tadese , Vande Walle Martijn , Simegn Gizeaddis Lamesgin , Aerts Jean-Marie 
Published: June 2023

Background mHealth can help with healthcare service delivery for various health issues, but there's a significant gap in the availability and use of mHealth systems between sub-Saharan Africa and Europe, despite the ongoing digitalization of the global healthcare system. Objective This work aims to compare and investigate the use and availability of mHealth systems in sub-Saharan Africa and Europe, and identify gaps in current mHealth development and implementation in both regions. Methods The study adhered to the PRISMA 2020 guidelines for article search and selection to ensure an unbiased comparison between sub-Saharan Africa and Europe. Four databases (Scopus, Web of Science, IEEE Xplore, and PubMed) were used, and articles were evaluated based on predetermined criteria. Details on the mHealth system type, goal, patient type, health concern, and development stage were collected and recorded in a Microsoft Excel worksheet. Results The search query produced 1020 articles for sub-Saharan Africa and 2477 articles for Europe. After screening for eligibility, 86 articles for sub-Saharan Africa and 297 articles for Europe were included. To minimize bias, two reviewers conducted the article screening and data retrieval. Sub-Saharan Africa used SMS and call-based mHealth methods for consultation and diagnosis, mainly for young patients such as children and mothers, and for issues such as HIV, pregnancy, childbirth, and child care. Europe relied more on apps, sensors, and wearables for monitoring, with the elderly as the most common patient group, and the most common health issues being cardiovascular disease and heart failure. Conclusion Wearable technology and external sensors are heavily used in Europe, whereas they are seldom used in sub-Saharan Africa. More efforts should be made to use the mHealth system to improve health outcomes in both regions, incorporating more cutting-edge technologies like wearables internal and external sensors. Undertaking context-based studies, identifying determinants of mHealth systems use, and considering these determinants during mHealth system design could enhance mHealth availability and utilization.
Examining the Schenck KD I Classification in Patients With Documented Tibiofemoral Knee Dislocations: A Multicenter Retrospective Case Series
Authors: Green Joshua S. , Yalcin Sercan , Moran Jay , Vasavada Kinjal , Kahan Joseph B. , Li Zachary I. , Alaia Michael J. , Medvecky Michael J. 
Published: June 2023

Background: Acute tibiofemoral knee dislocations (KDs) with a single cruciate ligament remaining intact are rare and can be classified as Schenck KD I. The inclusion of multiligament knee injuries (MLKIs) has contributed to a recent surge in Schenck KD I prevalence and has convoluted the original definition of the classification. Purpose: To (1) report on a series of true Schenck KD I injuries with radiologically confirmed tibiofemoral dislocation and (2) introduce suffix modifications to further subclassify these injuries based on the reported cases. Study Design: Case series; Level of evidence, 4. Methods: A retrospective chart review identified all Schenck KD I MLKIs at 2 separate institutions between January 2001 and June 2022. Single-cruciate tears were included if a concomitant complete disruption of a collateral injury was present or injuries to the posterolateral corner, posteromedial corner, or extensor mechanism. All knee radiographs and magnetic resonance imaging scans were retrospectively reviewed by 2 board-certified orthopaedic sports medicine fellowship-trained surgeons. Only documented cases consistent with a complete tibiofemoral dislocation were included. Results: Of the 227 MLKIs, 63 (27.8%) were classified as KD I, and 12 (19.0%) of the 63 KD I injuries had a radiologically confirmed tibiofemoral dislocation. These 12 injuries were subclassified based on the following proposed suffix modifications: KD I-DA (anterior cruciate ligament [ACL] only; n = 3), KD I-DAM (ACL + medial collateral ligament [MCL]; n = 3), KD I-DPM (posterior cruciate ligament [PCL] + MCL; n = 2), KD I-DAL (ACL + lateral collateral ligament [LCL]; n = 1), and KD I-DPL (PCL + LCL; n = 3). Conclusion: The Schenck classification system should only be used to describe dislocations with bicruciate injuries or with single-cruciate injuries that have clinical and/or radiological evidence of tibiofemoral dislocation. Based on the presented cases, the authors recommend the suffix modifications for subclassifying Schenck KD I injuries with the goal of improving communication, surgical management, and the design of future outcome studies.
Dual Bracing for Ulnar Collateral Ligament Injuries Restores Native Valgus Laxity and Native Medial Joint Gapping of the Elbow
Authors: Otto Alexander , Muench Lukas N. , Mehl Julian , Baldino Joshua B. , Murphy Matthew , Obopilwe Elifho , Cote Mark P. , Scheiderer Bastian , Imhoff Andreas B. , Mazzocca Augustus D. , Siebenlist Sebastian 
Published: June 2023

Background: Despite growing evidence on the role of the posterior ulnar collateral ligament (pUCL) in elbow stability, current ligament bracing techniques are mainly focused on the anterior ulnar collateral ligament (aUCL). A dual-bracing technique combines the repair of the pUCL and aUCL with a suture augmentation of both bundles. Purpose: To biomechanically assess a dual-bracing approach addressing aUCL and pUCL for humeral-sided complete UCL lesions to restore medial elbow laxity without overconstraining. Study Design: Controlled laboratory study. Methods: A total of 21 unpaired human elbows (11 right, 10 left; 57.19 ± 11.7 years) were randomized into 3 groups to compare dual bracing with aUCL suture augmentation and aUCL graft reconstruction. Laxity testing was performed with 25 N applied 12 cm distal to the elbow joint for 30 seconds at randomized flexion angles (0°, 30°, 60°, 90°, and 120°) for the native condition and then for each surgical technique. A calibrated motion capture system was used for assessment, allowing the 3-dimensional displacement during the complete valgus stress cycle between the optical trackers to be quantified as joint gap and laxity. The repaired constructs were then cyclically tested through a materials testing machine starting with 20 N for 200 cycles at a rate of 0.5 Hz. The load was increased stepwise by 10 N for 200 cycles until displacement reached 5.0 mm or complete failure occurred. Results: Dual bracing and aUCL bracing resulted in significantly ( P = .045) less joint gapping at 120° of flexion compared with aUCL reconstruction. No significant differences in valgus laxity were found among the surgical techniques. Within each technique, there were no significant differences between the native and the postoperative state in valgus laxity and joint gapping. No significant differences between the techniques were observed in cycles to failure and failure load. Conclusion: Dual bracing restored native valgus joint laxity and medial joint gapping without overconstraining and provided similar primary stability regarding failure outcomes as established techniques. Furthermore, it was able to restore joint gapping in 120° of flexion significantly better than aUCL reconstruction. Clinical Relevance: This study provides biomechanical data on the dual-bracing approach that may help surgeons to consider this new method of addressing acute humeral UCL lesions.
Impact of vessel tortuosity and radiological thrombus characteristics on the choice of first-line thrombectomy strategy: Results from the ESCAPE-NA1 trial
Authors: Bala Fouzi , Cimflova Petra , Singh Nishita , Zhang Jianhai , Kappelhof Manon , Kim Beom Joon , Najm Mohamed , Golan Rotem , Elebute Ibukun , Benali Faysal , Terreros Nerea Arrarte , Marquering Henk , Majoie Charles , Almekhlafi Mohammed , Goyal Mayank , Hill Michael D , Qiu Wu , Menon Bijoy K 
Published: June 2023

Introduction: Despite improvements in device technology, only one-third of stroke patients undergoing endovascular thrombectomy (EVT) achieve first-pass effect (FPE). We investigated the effect of arterial tortuosity and thrombus characteristics on the relationship between first-line EVT strategy and angiographic outcomes. Patients and methods: Patients with thin-slice baseline CT-angiography from the ESCAPE-NA1 trial (Efficacy and safety of nerinetide for the treatment of acute ischemic stroke) were included. Tortuosity was estimated using the tortuosity index extracted from catheter pathway, and radiological thrombus characteristics were length, non-contrast density, perviousness and hyperdense artery sign. We assessed the association of first-line EVT strategy (stent-retriever [SR] versus contact aspiration [CA] versus combined SR+CA) with FPE (eTICI score 2c/3 after one pass), final eTICI 2b/3, number of passes and procedure duration using multivariable regression. Interaction of tortuosity and thrombus characteristics with first-line technique were assessed using interaction terms. Results: Among 520 included patients, SR as a first-line modality was used in 165 (31.7%) patients, CA in 132 (25.4%), and combined SR+CA in 223 (42.9%). FPE was observed in 166 patients (31.9%). First-line strategy was not associated with FPE. Tortuosity had a significant effect on FPE only in the CA group (aOR = 0.90 [95% CI 0.83–0.98]) compared with stent-retrievers and combined first-line approach (p interaction = 0.03). There was an interaction between thrombus length and first-line strategy for number of passes (p interaction = 0.04). Longer thrombi were associated with higher number of passes only in the CA group (acOR 1.03 [95% CI 1.00–1.06]). Conclusion: Our study suggests that vessel tortuosity and longer thrombi may negatively affect the performance of first-line contact aspiration catheters in acute stroke patients undergoing EVT.
A Review of the History of Sonography and its Effect on the Center for Medical Ultrasound at Wake Forest University
Authors: Bullins Adelia Thal 
Published: June 2023

A tremendous need for sonographers and vascular technologists exists, however it would be informative to look back at a time when a similar demand occurred. A review of the history of sonography is provided and how it impacted the Center for Medical Ultrasound at Wake Forest University. This historical review also marks the rise of early sonography education and how it evolved into a range of options such as a 4-year Bachelor of Science degree, a 2-year Associate Science degree, or a multiweek certificate program. No matter the length of the program, or the style in which it is delivered, the following basic key ingredients are considered requisite:  • Access to newer model ultrasound equipment systems  • Dynamic classroom lectures (online, live, or a combination of both)  • Active clinical experiences under the guidance of an experienced and enthusiastic sonography expert, specific to a sonographic specialty (OB, cardiac, abdominal, etc.). Without all these key ingredients, the educational program will not be effective and sustainable. Sonography is a visual science and vital to display images, for the interpreting physician. The sonographer and physicians must work closely as a unified team. An effective working team (physician and sonographer) allows for trading ideas and suggesting possible answers to the diagnostically difficult patient cases.
Cognitive behavioural therapy combined with physical activity behavioural modification strategies during pulmonary rehabilitation in patients with COPD
Authors: Armstrong Matthew , Hume Emily , McNeillie Laura , Chambers Francesca , Wakenshaw Lynsey , Burns Graham , Heslop Marshall Karen , Vogiatzis Ioannis 
Published: June 2023

IntroductionPatients with COPD who exhibit elevated levels of anxiety and/or depression are typically less able to improve symptoms and physical activity levels following a programme of pulmonary rehabilitation (PR). The objective of the present study was to provide proof of concept that offering an intervention comprising cognitive behavioural therapy (CBT) alongside physical activity behavioural modification strategies (BPA) during PR is more effective in improving physical activity outcomes compared to PR and CBT alone.Methods32 patients with COPD (mean±sdforced expiratory volume in 1 s 42±14% predicted) were assigned 1:1 to receive PR+CBT+BPA or PR+CBT. BPA comprised motivational interviews, step-count monitoring, feedback using a pedometer and goal setting. Assessments included accelerometer-derived steps per day, movement intensity, 6-min walk distance (6MWD) and Hospital Anxiety and Depression Scale (HADS) scores.ResultsThe magnitude of improvement across physical activity outcomes was greater for the PR+CBT+BPA compared to the PR+CBT intervention (by 829 steps per day (p=0.029) and by 80±39 vector magnitude units (p=0.042), respectively). Compared to PR and CBT alone, the PR+CBT+BPA intervention induced greater clinically meaningful improvements in HADS anxiety scores (by −2 units, 95% CI −4–1 units) and 6MWD (by 33±20 m).ConclusionsProviding anxious and/or depressed patients with COPD with a combined intervention of CBT and BPA during PR presents more favourable improvements in physical activity outcome measures compared to CBT alone during PR.
A pilot, prospective trial of IntuBrite® versus Macintosh direct laryngoscopy for paramedic endotracheal intubation in out of hospital cardiac arrest
Authors: Kluj Przemysław , Fedorczak Michał , Gaszyński Tomasz , Ratajczyk Paweł 
Published: June 2023

Abstract
Background
Intubation in the case of out-of-hospital cardiac arrest (OHCA) is one of the most difficult procedures for Emergency Medical Services (EMS). The use of a laryngoscope with a dual light source is an interesting alternative to classic laryngoscopes. However, there are as yet no prospective data concerning the use of double light direct laryngoscopy (DL) by paramedics in traditional ground ambulance agencies in OHCA.

Methods
We performed a non-blinded trial in a single EMS in Poland within ambulances crews, comparing time and first pass success (FPS) for endotracheal intubation (ETI) in DL using the IntuBrite® (INT) and Macintosh laryngoscope (MCL) during cardiopulmonary resuscitation (CPR). We collected both patient and provider demographic information along with intubation details. The time and success rates were compared using an intention-to-treat analysis.

Results
Over a period of 40 months, a total of 86 intubations were performed using 42 INT and 44 MCL based on an intention-to-treat analysis. The FPS time of the ETI attempt (13.49 vs. 15.55 s) using an INT which was shorter than MCL was used (p < 0.05). First attempt success (34/42, 80.9% vs. 29/44, 64.4%) was comparable for INT and MCL with no statistical significance.

Conclusions
We found a statistically significant difference in intubation attempt time when the INT laryngoscope was used. Intubation first attempt success rates with INT and MCL were comparable with no statistical significance during CPR performed by paramedics.

Trial Registration
Trial was registered in Clinical Trials: NCT05607836 (10/28/2022)
Risk factors for recurrent wheezing after bronchiolitis
Authors: Fan YH , Zhang PL , Huang YJ , Xie C , Ai T 
Published: June 2023

Abstract
Background
This study aimed to determine whether there was an association between certain factors in patients with bronchiolitis and recurrent wheezing in childhood.

Method
In 2021 we tracked children hospitalized for bronchiolitis at Chengdu Women’s and Children’s Central Hospital in 2017. The patients were classified into recurrent wheezing group (RWG) and non-recurrent wheezing group (NRWG). Possible risk factors including maternal age, school-age siblings, allergic history, atopic dermatitis, allergic rhinitis, atopic family history, severity of the condition, duration of hospitalization, nasopharyngeal secretions culture, blood eosinophil counts, FeNO and skin prick test were compared between the two groups. Continuous variables were analyzed by independent sample t-test for normal distribution and Mann-Whitney U-test for non-normal distribution. Categorical variables were tested using chi-square tests. Multifactor analysis was conducted by stepwise logistics regression analysis.

Results
In total 167 participants were included, of which 26 and 141 were in RWG and NRWG respectively. In RWG children represented higher maternal age (P = 0.02) and greater probability of allergic history, atopic dermatitis, allergic rhinitis, atopic family history (odds ratio [OR] = 4.0,3.7, 7.8, 10.9 respectively, P < 0.01). However, school-age siblings, severity of the condition, duration of hospitalization, blood eosinophil counts, fractional exhaled nitric oxide and skin prick test results seemed unrelated to recurrent wheezing. In the subgroup analysis of nasopharyngeal secretion culture, there were more Moraxella catarrhalis-positive in RWG(P = 0.043). Atopic dermatitis, allergic rhinitis and atopic family history were identified as independent risk factors for recurrent wheezing.

Conclusion
Some children with bronchiolitis will develop recurrent wheezing, and the risk factors are allergic history, Moraxella catarrhalis infection or colonization, atopic dermatitis, allergic rhinitis and atopic family history; the latter three are independent risk factors.