bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of Risk of Metastatic Recurrence for Female Breast Cancer Patients in the Presence of Competing Causes of Death
Authors: Mariotto Angela B. , Botta Laura , Bernasconi Alice , Zou Zhaohui , Gatta Gemma , Capocaccia Riccardo 
Published: September 2023

Abstract

Background:
To estimate risk of recurrence for women diagnosed with nonmetastatic breast cancer considering the risks of other causes mortality.

Methods:
We extend a method based on the diagnosis–metastasis–death pathway to include risks of other causes mortality. We estimate three probabilities as cumulative incidence of: (i) being alive and recurrence-free, (ii) death for other causes before a recurrence, and (iii) recurrence. We apply the method to female breast cancer relative survival from the Surveillance, Epidemiology, and End Results Program registries (2000–2018) data.

Results:
The cumulative incidence of recurrence shows a higher increase with more advanced cancer stage and is less influenced by age at diagnosis. At 5 years from diagnosis, the cumulative incidence of recurrence is less than 3% for those diagnosed with stage I, 10% to 13% for those diagnosed with stage II, and 37% to 47% for those diagnosed with stage III breast cancer. The estimates of recurrence considering versus ignoring the risks of dying from other causes were generally consistent, except for older women with more advanced stage, and longer time since diagnosis. In these groups, the net probability of recurrence, excluding the risks of dying from other causes, were overestimated.

Conclusions:
For patients with cancer who are older or long-term survivors, it is important to include the risks of other cause mortality as the crude cumulative incidence of recurrence is a more appropriate measure.

Impact:
These estimates are important in clinical decision making, as higher competing mortality may preclude the benefits of aggressive treatments.
Early Immune Changes Support Signet Ring Cell Dormancy in CDH1-Driven Hereditary Diffuse Gastric Carcinogenesis
Authors: Green Benjamin L. , Gamble Lauren A. , Diggs Laurence P. , Nousome Darryl , Patterson Jesse C. , Joughin Brian A. , Gasmi Billel , Lux Stephanie C. , Samaranayake Sarah G. , Miettinen Markku , Quezado Martha , Hernandez Jonathan M. , Yaffe Michael B. , Davis Jeremy L. 
Published: September 2023

Abstract

Stage IA gastric adenocarcinoma, characterized by foci of intramucosal signet ring cells (SRC), is found in nearly all asymptomatic patients with germline pathogenic CDH1 variants and hereditary diffuse gastric cancer syndrome (HDGC). The molecular steps involved in initiating malignant transformation and promoting SRC dormancy in HDGC are unknown. Here, whole-exome bulk RNA sequencing (RNA-seq) of SRCs and adjacent non-SRC epithelium (NEP) was performed on laser-capture microdissected (LCM) regions of interest found in risk-reducing total gastrectomy specimens from patients with HDGC (Clinicaltrials.gov ID: NCT03030404). In total, 20 patients (6 male, 14 female) with confirmed HDGC were identified. Analysis of differentially expressed genes (DEG) demonstrated upregulation of certain individual EMT and proliferation genes. However, no oncogenic pathways were found to be upregulated in SRCs. Rather, SRC regions had significant enrichment in pathways involved in T-cell signaling. CIBERSORTx predicted significant increases in the presence of regulatory T cells (Treg) specific to SRC regions. IHC confirmed an increase in FOXP3+ cells in SRC foci, as well as elevations in CD4+ T cells and HLA-DR staining. In summary, the tumor immune microenvironment is microscopically inseparable from stage IA gastric SRCs using a granular isolation technique. An elevation in CD4+ T cells within SRC regions correlates with clinically observed SRC dormancy, while Treg upregulation represents a potential immune escape mechanism.

Implications:
Characterization of the tumor–immune microenvironment in HDGC underscores the potential for the immune system to shape the transcriptional profile of the earliest tumors, which suggests immune-directed therapy as a potential cancer interception strategy in diffuse-type gastric cancer.
Treatment and Control of Hypertension Among Adults With Chronic Kidney Disease, 2011 to 2019
Authors: Martinez Joshua D. , Thomas I-Chun , Montez-Rath Maria E. , Pao Alan C. , Fung Enrica , Charu Vivek , Sim John J. , An Jaejin , Odden Michelle C. , Kurella Tamura Manjula 
Published: September 2023

BACKGROUND:
Hypertension frequently accompanies chronic kidney disease (CKD) as etiology and sequela. We examined contemporary trends in hypertension treatment and control in a national sample of adults with CKD.

METHODS:

We evaluated 5% cross-sectional samples of adults with CKD between 2011 and 2019 in the Veterans Health Administration. We defined CKD as a sustained estimated glomerular filtration rate value <60 mL/min per 1.73 m
2
or a urine albumin-to-creatinine ratio ≥30 mg/g. The main outcomes were blood pressure (BP) control, defined as a systolic BP <140 mm Hg and a diastolic BP <90 mm Hg based on the mean of monthly BP measurements, and prescriptions for antihypertensive medications.

RESULTS:

The annual samples ranged between n=22 110 and n=33 039 individuals, with a mean age of 72 years, 96% of whom were men. Between 2011 and 2014, the age-adjusted proportion of adults with controlled BP declined from 78.0% to 72.2% (
P
value for linear trend, <0.001), reached a nadir of 71.0% in 2015, and then increased to 72.9% by 2019 (
P
value for linear trend, <0.001). Among adults with BP above goal, the age-adjusted proportion who did not receive antihypertensive treatment increased throughout the decade from 18.8% to 21.6%, and the age-adjusted proportion who received ≥3 antihypertensive medications decreased from 41.8% to 36.3%. Prescriptions for first-line antihypertensive agents also decreased.

CONCLUSIONS:
Among adults with CKD treated in the Veterans Health Administration, the proportion with controlled BP declined between 2011 and 2015 followed by a modest increase, coinciding with fewer prescriptions for antihypertensive medications.
Long‐Term Stability of Patients Undergoing Endovascular Parent Artery Occlusion of Their Intracranial Artery
Authors: Koizumi Satoshi , Shojima Masaaki, , Ota Takahiro , Dofuku Shogo , Miyawaki Satoru , Kiyofuji Satoshi , Maeda Keiichiro , Ochi Takashi , Ito Akihiro , Hidaka Yukihiro , Oya Soichi , Saito Akira , Yoshikawa Gakushi , Yanai Kei , Inoue Tomohiro , Tsunoda Sho , Hoya Katsumi , Saito Nobuhito 
Published: September 2023

Background
Although endovascular parent artery occlusion (PAO) of the intracranial artery is a well‐established treatment option, the long‐term stability of cerebral blood flow remains a concern. This study aimed to evaluate the long‐term clinical and radiological outcomes of patients who underwent PAO.

Methods
The patients who underwent endovascular PAO of their internal carotid or vertebral artery (VA) between April 2011 and March 2022 were included in this observational study. Information about patient characteristics, details of the endovascular treatment, and clinical and radiological follow‐up were collected.

Results
The study included a total of 104 cases (average age, 52.9±12.6 years old; men, 73 [70.2%] cases; 95 [91.3%] VA PAO cases) from 8 centers. Most cases were performed in an emergency condition, such as ruptured VA dissecting aneurysm (73 cases [70.2%]). PAO was successful in all cases. Early stroke (within 30 days) occurred in 33 (31.7%) cases (31 cases in VA PAO and 2 cases in internal carotid PAO) with ischemic stroke (29 cases) comprising the largest group. Clinical follow‐up over 1 month was available in 85 cases. During an average follow‐up period of 45.8±25.8 months, 1 case of VA PAO experienced a stroke without functional deterioration. Imaging follow‐up was performed in 75 cases. Recanalization of the occluded VA was observed in 2 cases. The remaining image change was contralateral VA stenosis after VA PAO. The incidence of clinical and radiological events was 1.2% and 1.1% per patient‐year, respectively.

Conclusion

Once the patients surpass the acute phase after PAO, their mid‐ to long‐term course was stable. The risk of late stroke or de novo aneurysm formation was lower than expected in the literature, and the direct comparison to novel reconstructive techniques is warranted in future studies. Clinical Trial Registration information:
https://www.umin.ac.jp/ctr/index.html
, trial ID: UMIN000045160.
The Abolition and Retention of Life Without Parole in Europe: A Comparative and Historical Perspective
Authors: Jouet Mugambi 
Published: September 2023

Abstract
Life without parole is increasingly recognised as another death penalty in dooming prisoners to die behind bars. On the tenth anniversary of the ECtHR’s landmark Vinter decision, abolitionism and retentionism characterise its state in Europe. In abolishing irreducible life sentences, Vinter crystallised a long-term evolution in prisoners’ rights since the Enlightenment. Meanwhile, enduring animosity towards prisoners has led to their rights repeatedly becoming the stage for wider debates concerning the legitimacy of European institutions. The United Kingdom’s threats to leave the ECtHR notably enabled it to exempt itself from Vinter. Still, the European project retains numerous supporters, which helps explain why the abolition of life without parole is making progress in continental Europe, as compared to the United States, Canada, Australia, and New Zealand. Ultimately, the article demonstrates that prisoners’ rights are both a microcosm of broader questions regarding European integration and a benchmark of human dignity’s historical evolution.
The pandemic as portal: Terror, transition and transformation
Authors: von Sommaruga Howard Teresa 
Published: September 2023

This paper was written as the keynote address for the Annual Study Day of the Irish Group Analytic Society in November 2021. Writing it gave me an opportunity to gather my thoughts about not only the deep fear and constraint I had lived with personally over the previous 18 months, but also challenged me to rethink the social consequences of the inequalities that are built into our world. I start from a position that assumes that the political and economic context in which we live influences not only our thinking and emotional life, but also our practice. As Foulkes explained many times, and he had life experiences to confirm this theory, ‘the individual is social to the core’ (1948). This means that I see a dialectical association between the external world in which I live and my internal sense-making psychic world. I notice that this link often gets missed. I suggest that what we might be taking through the portal of the pandemic will depend on our economic system, its connection to political structures, and how these contextual often ‘out-of-sight’ forces impact our lives concretely and psychically while framing our capacity to think about the situation we find ourselves in. Even though it is difficult to know what the long-term effects might be, I have found exploring these dilemmas in the social context of an on-going Larger Group gives me a form of comfort that enables me to expand my thinking and remain conscious in the face of unrelenting and frightening socio-political change. I understand the Larger Group as a place where it is possible to witness these social and political forces as they manifest themselves in the group and to explore how they connect to those that arise from my family recognizing that it is not a large Small Group but, from de Maré’s perspective, operates as an as-if society that generates different meanings. As de Maré often said,‘It is important to talk’. I have learned that talking with others in these settings, helps me to break through into new language to escribe my experience.
mHealth Apps Use and Their Associations With Healthcare Decision-Making and Health Communication Among Informal Caregivers: Evidence From the National Cancer Institute’s Health Information National Trends Survey
Authors: Mahmood Asos , Kim Hyunmin , Chang Cyril F. , Kedia Satish , Arshad Hassan , Dillon Patrick J. 
Published: September 2023

Purpose The current study investigates associations between mHealth apps and healthcare decision-making and health communication among informal caregivers in the US. Design Cross-sectional study employing secondary data. Setting The Health Information National Trends Survey (HINTS5, Cycles 2 through 4, 2018 – 2020). Sample Self-identified informal caregivers (n = 1386; had mHealth apps = 61.3%, female = 63.2%, some college or more in education = 80.3%) who reported owning at least a smartphone or a tablet computer (i.e., ownership of a “smart device”). Measures Sociodemographic characteristics, reports of having mHealth apps, smart device utilization in healthcare decision-making and health communication. Analysis Accounting for the complex design features of the HINTS data, we constructed multiple hierarchical logistic regressions to compute adjusted odds ratios (aOR) and their 95% confidence intervals (CI). Results Compared to caregivers without mHealth apps, those with the apps had higher odds of utilizing their smart devices to make a health-related decision, such as how to treat a disease or a medical condition (aOR = 1.65; 95% CI: 1.13-2.39, P < .01), or engage in health-related discussions with a healthcare provider (aOR = 2.36; 95% CI: 1.54-3.61, P < .001). Conclusion Having mHealth apps was associated with a higher likelihood of using smart devices in healthcare decision-making and health communication by informal caregivers. Empowering caregivers to make informed health-related decisions and communicate effectively with healthcare providers are both crucial to health promotion and well-being. Future studies should investigate facilitators as well as barriers to using mHealth apps and smart devices in health-promoting strategies involving informal caregivers.
Presentation and outcome of pediatric lupus nephritis from a large single centre contemporary cohort in Eastern India
Authors: Biswas Debopoma , Dasgupta Deblina , Pal Priyankar , Sinha Rajiv 
Published: September 2023

Background We present clinical, biochemical, and histopathological characteristics and treatment outcomes of biopsy proven childhood lupus nephritis (LN) from a low/middle income setting treated in the current era of increased use of Mycophenolate Mofetil (MMF) and biologics. Methods Retrospective observational study of children (1–18 years) with biopsy proven LN treated from 01.01.2010 to 31.01.2020. Results 60 children met our inclusion criteria (80%, n = 48 were females). The median age at diagnosis was 11 (IQR: 9–12) years. The most common extra-renal manifestation was mucocutaneous ( n = 54, 90%) and the most common kidney manifestation was edema ( n = 50, 83.3%). The median 24-h urinary protein excretion was 1117.8 (IQR: 795.4–1941.7) mg/m2/day with 67% ( n = 40) having nephrotic range proteinuria (>1000 mg/m2/day). 75% ( n = 45) children had eGFR <90 mL/min/1.73 m2 (median eGFR = 71; IQR: 56–90 mL/min/1.73 m2). Anti-Nuclear Antibody was positive in all, both complement three and four were low in 82% ( n = 49) and anti-double stranded DNA antibodies were positive in 63% ( n = 38). 85% ( n = 51) had proliferative LN with majority being class IV (57%, n = 34). All children received steroids for induction therapy. MMF was given as the sole induction agent in 48% ( n = 29) and cyclophosphamide in 27% ( n = 16). Rituximab was added in 17% ( n = 10) as a rescue agent. Median follow up duration was 50 (IQR: 28–82) months. Six children (10%) died as a result of serious infections and none of them had shown complete response (CR). Out of the 52 children who had a follow up duration of at least 2 years, CR was achieved in 46 children (88%) and partial response (PR) or no response (NR) in three children (6%) each. Although children who were in CR/PR at last follow up had lower proteinuria, higher eGFR, and lower histopathology activity index at onset; low numbers in the NR group precluded us from subjecting them to any statistical correlation tests. 36% ( n = 22) of children developed 36 episodes of renal flares with overall incidence of 0.14/person-year. Conclusion Our study on a contemporary cohort of childhood LN highlights the importance of achieving CR and its feasibility.
Improvements in networking processes for hip or knee revision arthroplasty: a silver lining of the COVID-19 pandemic
Authors: Chatterji Urjit , Puttock Darren , Kheiran Amin , Sandean Darren , Mundy Gary , Menon Dipen , Brown Andrew 
Published: September 2023

Background: Improvements in outcomes following hip and knee revision arthroplasties have been demonstrated following the introduction of specialised orthopaedic services in the form of ‘hub and spoke’ networking models. In light of the COVID-19 pandemic, these networks have undergone some inevitable adaptations. We investigated the impact of recent adaptations on the performance of our regional revision arthroplasty network. Methods: A retrospective review of all referrals that were discussed at our regional revision arthroplasty meeting, over 2 separate phases, was undertaken. Phase 1 included data between March 2018 and April 2019, representing an interval prior to COVID-19 pandemic. Phase-2 included data between September 2020 and March 2021 (during COVID-19 pandemic). Data were collected from East Midland South Orthopaedic Network (EMSSON) database and included data relating to indication and time to revision surgery, surgeon’s proposal plan, network proposal plan, and executed definitive plan. We compared and analysed network performance between 2 phases. Results: In phase 1, 99 cases were discussed in EMSSON meetings, equating to 35.7% of the region’s revision arthroplasty volume, according to the National Joint Registry (NJR) records. Plan alterations were recommended in 48/99 cases (48.5%), of which 41/48 (85.4%) were adhered to. Phase 2 included 98 discussed cases, equating to 81.6% of the region’s revision arthroplasty volume. Plan alterations were recommended in 20/98 cases (20.4%), all of which were adhered to (100%). Adherence to recommended adaptations showed significant improvement ( p < 0.03). Conclusions: Based upon our observations, a greater volume and proportion of revision arthroplasty cases are now being discussed. Adherence to MDT recommendations has significantly improved following the described adaptations. The number of recommended adaptations to management plans have decreased, indicating an educational value of the network. Overall, these findings demonstrate a trend towards NHS England’s target of 100% of revision arthroplasty cases undergoing MDT discussion.
Examining the antecedents and outcomes of satisfaction in film festival context: Further evidence of validity of the eudaimonic feelings construct
Authors: Medeiros Sandro Alves de , Campos Ana Cláudia , Sthapit Erose , Freitas Lara Brunelle Almeida , Mondo Tiago Savi 
Published: September 2023

Within festivals and events, film festivals are among the fastest growing cultural events in the world and are recognised as bringing environmental, sociocultural and economic benefits to host tourism destinations including enhanced well-being. These festivals are an important marketing strategy for developing destination image and attracting interest towards a destination. However, there are limited studies on the film festival experience exploring the antecedents of participants’ satisfaction. This study examines the relationship between eudaimonic feelings, novelty, local culture, nostalgia, perceived quality, satisfaction, and behavioural intentions. Data were gathered during the last 3 days of the Penedo Film in the City of Penedo, Northeast Brazil using a questionnaire. A total of 97 valid questionnaires were collected from the festival attendees. Findings show that only eudaimonic feelings and perceived quality are predictors of satisfaction. To the best of authors knowledge, this study is the first to examine the perceived experience of participants in a film festival context from a positive psychology perspective and providing further empirical support for construct validity of eudaimonic feelings. The findings contribute to the existing tourism literature on film festivals by identifying key antecedents (eudaimonic feelings and perceived quality) and outcomes (behavioural intentions) of satisfaction with film festival. One of the main managerial implications includes engaging film festival participants in co-creation processes and in promoting group discussions about a specific movie with an appealing and social relevant theme.
A Survey of Retention and Support for Anterior Bounded Saddles of Removable Partial Dentures
Authors: Faigenblum Maurice J. 
Published: September 2023

The treatment for the anterior bounded saddle because of missing teeth presents several challenges, primarily that of aesthetics. The choice of treatment depends on the position of the saddle, its size, the amount of available alveolar bone support, the health of the abutment teeth, and the patient’s wishes. With regard to the use of a removable partial denture (RPD), while acknowledging the significant importance of aesthetics, unless the presence of adequate retention of the prosthesis is ensured, the appearance of the teeth alone will not guarantee its acceptability. This article highlights techniques that are available to provide adequate retention which will, in turn, give a patient confidence with the use of their denture. The techniques described are dependent on laboratory technical knowledge and skills, and on the ability of the patient to manipulate the appliance.
Aesthetic Management of Tooth Size Discrepancies
Authors: Aulakh Raman , Weinstein Tommaso 
Published: September 2023

The aesthetic management of tooth size discrepancies is an essential component when dealing with simple and complex dental rehabilitation. Tooth size and shape is a crucial factor that strongly influences both the smile and the face in the treatment outcome. From an orthodontic perspective, evaluation of the ideal mesiodistal widths relating to both maxillary and mandibular arches is required to plan the correct occlusal, aesthetic, and functional result. The aim of this paper is to propose a safe and repeatable method to evaluate and correct tooth size discrepancy through the presentation of two case reports. Both cases were managed using a combination of clear aligner therapy and minimally invasive restorative procedures, as well as the use of digital tools.