bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reshape of the Bistable and Multistable Properties of Conical Structures Through Integrated Modification of Local Cross Section
Authors: Zhao Jian , Fang Qifeng , Zhang Jian , Huang Yu , Wang Hongyu , Liu Pengbo 
Published: June 2023

Abstract
Multistable structures can maintain multiple steady states without additional loads. However, the presence of geometric and material nonlinearities in multistable structures adds complexity and difficulty to their optimal design. In this paper, a novel method is proposed to achieve multistability in conical structures by local cross-section modification. A conical multistable structure with varying cross section is designed based on this method. The finite element model considering the nonlinear large deformation mechanics and rubber material’s hyperelasticity was established for analyzing the multistable properties and meanwhile verified by experiments. The influence of geometric parameters of the cross section (thickness, width, and position) on the multistabilities (number, distribution, and snapping threshold) was analyzed. The steady-state number can be effectively used to redesign the multistable properties by local reinforcement. It is also observed that the quasi-zero stiffness region of the force–displacement curve can be extended by 61.7% compared to the original conical structure. Moreover, the optimized QZS structure allows for an actively designable stepped dynamic response under forced vibration.
A New Contact Model of Sphere Asperity in the Fully Plastic Regime Considering Strain Hardening
Authors: Xu Jinli , Zhu Jiwei 
Published: June 2023

Abstract
Understanding the contact characteristics of rough surfaces is essential to explain engineering phenomenon in interface. In order to improve accuracy of contact model, a novel simplified fully plastic contact model of sphere asperity was proposed considering material properties based on fractal theory. First, based on Von Mises yield criteria, maximum contact pressure factor was derived. Second, relationships taking into consideration strain hardening effects were proposed to describe contact area based on the fully plastic contact area index and contact pressure. Then, the critical interference at inception of fully plastic deformation was derived. Lastly, validations were conducted for different materials. The results show that the present work is remarkably consistent with experimental results and has higher accuracy than other models.
Justification of a New Original Homogenized Model for Ionic Diffusion in Porous Media
Authors: Bourbatache M. K. , Millet O. , Gagneux G. 
Published: June 2023

Abstract
In this work, a new original justification of an homogenized model for ionic diffusion in porous media is proposed. The approach used enables to specify clearly the domain of validity of this homogenized model, involving a source term characterizing the electrical double layer effect at the macroscale. This homogenized model is obtained from the formal periodic homogenization of a Nernst–Planck–Poisson system at the pore scale accounting for conductivity of the solid phase which is generally neglected. The Poisson equation is defined in both fluid and solid phases and the discontinuity of fluxes at the solid–fluid interface is modeled by a jump of the electrical field, linked to the surface electrical charge of the solid interface. Numerical simulations are carried out at the scale of the unit cell to underscore the influence of the contrast on the electrical permittivity between fluid and solid phases. The comparison of the concentrations and the electrical potential given at the macroscale by the homogenized model and by a direct pore scale model reveals the accuracy of the homogenized model which is very simple to use.
Severe thrombocytopenia after trastuzumab in a patient with HER2-positive serous endometrial cancer
Authors: Kucera Celia , Chappell Nicole , Wang Stephanie 
Published: June 2023

Trastuzumab is a humanised, monoclonal antibody that interferes with the human epidermal growth factor receptor 2 (HER2)/neu receptor and binds selectively to the HERB2 protein. It has been shown to prolong survival of patients with HER2-positive advanced uterine serous carcinoma.We report the case of a woman in her 70s with HER2-positive metastatic papillary serous endometrial adenocarcinoma, who experienced severe thrombocytopenia related to trastuzumab administration. One week after the first dose of carboplatin/paclitaxel/trastuzumab combination chemotherapy, the patient was admitted to the hospital with vaginal bleeding, melena, petechiae and platelet counts of 0×109/L. The patient was suspected to have a severe trastuzumab-induced thrombocytopenia. A rapid and complete recovery was observed after multiple platelet transfusions, high-dose IV corticosteroids and immunoglobulin.Among the 13 reported cases of trastuzumab-induced thrombocytopenia, this is the first case reported in the literature occurring in a patient with a gynecologic malignancy.
Out of sight, out of mind? Evidence from cross-sectional surveys on hidden caesarean sections among women with stillbirths in Ghana, 2007 and 2017
Authors: Zethof Siem , Christou Aliki , Benova Lenka , Beyuo Titus Kofi , van Roosmalen Jos , van den Akker Thomas 
Published: June 2023

BackgroundCaesarean section (CS) rates in women experiencing stillbirth have not been studied with nationally representative data. Two Ghana Maternal Health Surveys (GMHS) have captured pregnancy and mode of birth data for all women including those with stillbirths. We compared CS rates between women with live births and stillbirths, and identified socio-economic and pregnancy-related factors associated with CS in stillbirths.MethodsA population-based cross-sectional study was conducted in a pooled sample of 17 138 women who had given birth within 5 years preceding the 2007 and 2017 GMHS. CS rates were compared between women with stillbirths and very early neonatal deaths (SBVENDs) and women with live births who survived the first day. Bivariate and multivariable logistic regressions explored variables associated with CS. Effect modification of household’s wealth and maternal educational level by birth outcome was assessed using multivariable logistic regression with interaction terms.ResultsCS rate in women with SBVEND was 19.3% compared with 9.6% in women with live births who survived the first day (rate ratio 2.2; 95% CI 1.6 to 2.9). In multivariable analysis, attaining middle school compared with no formal education (adjusted OR, aOR 2.8; 95% CI 1.1 to 7.1), having had five or more births compared with nulliparity (aOR 3.7; 95% CI 1.3 to 10.7) and reporting prolonged or obstructed labour (aOR 3.3; 95% CI 1.3 to 8.3) were associated with CS in women with SBVEND. Higher household wealth and educational levels were associated with an increased risk of CS in both study groups, with no statistically significant difference in effect.ConclusionDisaggregating CS rates by birth outcome revealed a high rate among women with SBVEND, twice the overall rate compared with live births. Exclusion of these ‘hidden’ CSs from rate calculations may lead to underestimation of (inter)national CS rates and potentially conceals CS overuse or misuse.
Relationship between morphological changes in the foveal avascular zone of the epiretinal membrane and postoperative visual function
Authors: Yoshida Hiromitsu , Terashima Hiroko , Ueda Eriko , Hasebe Hiruma , Matsuoka Naoki , Nakano Hideyuki , Fukuchi Takeo 
Published: June 2023

ObjectiveTo investigate the relationship between the preoperative morphology of the foveal avascular zone (FAZ) and postoperative visual function in patients with idiopathic epiretinal membrane (ERM).Methods and analysisThis retrospective study enrolled 36 patients who underwent a unilateral internal limiting membrane peeling with vitrectomy for idiopathic ERM. We measured the area of superficial FAZ in the eyes with ERM and in the contralateral control eyes preoperatively and at 6 months postoperatively using optical coherence tomography (OCT) angiography. The ERM stage was measured using swept-source OCT. We evaluated the FAZ area ratio (preoperative FAZ of the ERM eye/FAZ of the control eye) to indicate the degree of FAZ contraction in the ERM eyes compared with the control eyes. The correlations between the FAZ area ratio and postoperative visual function and changes in macular morphology were assessed.ResultsPreoperative mean best-corrected visual acuity (BCVA) significantly improved from the logarithm of the minimum angle of resolution 0.20±0.24 to 0.01±0.13 at 6 months postoperatively (p<0.01). The mean area of the FAZ increased significantly from 0.06±0.07 mm2preoperatively to 0.09±0.07 mm2after vitrectomy (p<0.01). FAZ area ratio showed significant negative correlations with changes in BCVA (r=−0.44, p<0.01) and the ERM stages (r=−0.56, p<0.01).ConclusionThe FAZ is reduced as ERM progresses and enlarges after vitrectomy. The FAZ area ratio based on preoperative FAZ may predict postoperative visual acuity.
Development of a web-based decision aid for initiating biological or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in axial spondyloarthritis
Authors: Beckers Esther , Boonen Annelies , van Tubergen Astrid 
Published: June 2023

ObjectivesTo develop a web-based evidence-based decision aid to support shared decision-making in patients with axial spondyloarthritis (axSpA) who face a treatment decision to initiate or switch a biological or targeted synthetic disease modifying antirheumatic drug (b/tsDMARDs).MethodsThrough an iterative process, we systematically developed a decision aid based on evidence from the literature, explorative needs assessment interviews among patients and care providers, and input from experts of the SpA working group of the Dutch Society for Rheumatology and professionals on patient information employed at the Dutch Arthritis Society. The usability, ease of use and feasibility of the pilot version were tested among stakeholders and feedback was used to adapt the decision aid. Finally, a multifaceted strategy was used to introduce the decision aid in clinical practice.ResultsThe decision aid consists of (1) consultation support instructions in the context of disease control and treatment needs, (2) an overview of available treatment options for axSpA, (3) detailed information on b/tsDMARDs and an interactive option grid that facilitates comparison of characteristics and (4) a final check supporting patients to deliberate on the decision to initiate or switch a b/tsDMARD. Rheumatologists introduced the decision aid in several Dutch rheumatology settings and the Dutch Arthritis Society posted it on their website, social media and in their monthly newsletter.ConclusionWe developed an evidence-based decision aid to support axSpA patients who face a treatment decision to initiate or switch a b/tsDMARD and introduced this in clinical practice.
Clinical pharmacist in oncology palliative medicine: drug compliance and patient adherence
Authors: Novosadova Martina , Filip Stanislav , Molnarova Veronika , Priester Peter , Svecova Dagmar 
Published: June 2023

ObjectivesMost patients in palliative oncology care are polymorbid and thus treated with multiple drugs. The therapeutic effect and safety of these drugs can be compromised by drug/drug interactions, but also by wider problems such as polypharmacy and compliance. The clinical pharmacist is, therefore, responsible for risk analysis and prevention. Our prospective open label non-randomised clinical study evaluated the importance of a clinical pharmacist in the palliative care team.MethodsA total of 250 outpatients were included in the clinical study: 126 women (50.4%) and 124 men (49.6%), with a mean age of 71 years (range 21–94 years; SD 11.9). The patients had the performance status scale 0–3(x∼=2). Clinical examinations were performed on a monthly basis (n=509 check-up visits). The clinical pharmacist prepared an educational chart for all medications used after each visit and evaluated any drug-related problems. Follow-up was 6 months.ResultsThis study found a significant association between drug related-problems and polypharmacy (p<0.001). A low risk of drug-rfelated problems was observed during the initial visit, that is, 68 female (27.2%) and 25 male (10.4%) patients. A greater clinical-pharmaceutical risk was observed among the patients taking antihypertensive drugs (p=0.003) and/or beta blockers (p=0.048).ConclusionThis study confirms the essential role of a clinical pharmacist in oncology palliative care. The feedback obtained from the patients showed a notable improvement in their quality of life. Further, this clinical study confirmed the need for a personalised approach in palliative oncology care.
Abstract 20: Clinical and Non-Clinical Determinants of Cervical Cancer Mortality: A Retrospective Cohort Study in Lagos, Nigeria
Authors: Ola Idris , Okunowo Adebola , Habeebu Muhammad , Jonasson Junmei Miao 
Published: June 2023

Abstract
Purpose: Cervical cancer (CCa) is the fourth most frequent and a common cause of cancer mortality in women, the majority of whom live in low- and middle-income countries. Data on CCa mortality and its determinants have been poorly studied in Nigeria, resulting in a paucity of information that can assist patient management and cancer control policy.
The purpose of this study was to assess the mortality rate among CCa patients in Nigeria as well as the major factors influencing CCa mortality.
Methods: Data from the medical records of 343 CCa patients seen at the Lagos University Teaching Hospital and NSIA-LUTH Cancer Center from 2015 to 2021 were used in a retrospective cohort analysis. The hazard ratios (HR) and confidence intervals (CI) associated with the exposure variables and CCa mortality were calculated using Cox proportional hazard regression.
Results: The CCa mortality rate was 30.5 per 100 women-years after 2.2 years of median follow-up. Clinical factors such as HIV/AIDS (adjusted HR [aHR]: 11.9; 95% CI: 4.6, 30.4), advanced clinical stage (aHR: 2.7; 95% CI: 1.5, 4.7), and anemia at presentation (aHR: 1.8; 95% CI: 1.1, 3.0) were associated with a higher mortality risk, as were non-clinical factors such as age at diagnosis &gt;50 years (aHR: 1.4; 95% CI: 1.0, 1.9) and family history of CCa (aHR: 3.5; 95%CI: 1.1, 11.1)
Conclusion: CCa has a high mortality rate in Nigeria. Incorporating these clinical and non-clinical factors into CCa management and control policies may improve women’s outcomes.
Citation Format: Idris Ola, Adebola Okunowo, Muhammad Habeebu, Junmei Miao Jonasson. Clinical and Non-Clinical Determinants of Cervical Cancer Mortality: A Retrospective Cohort Study in Lagos, Nigeria [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 20.
Abstract 23: Comparative Analysis of Time Between Diagnosis and First Treatment of Malignant Prostate Cancer in the Brazilian Public Health System (SUS)
Authors: Beltramo Luiza Seixas de Sá , Azambuja Fernando , Barreto Pedro Antonio Paludo Menna , Silveira Pedro Arthur Zimmer , da Silva Laura Tibola Marques , Kieling Lucas , de Andrade Rafaela , Alberti Arthur Minas , Lech Gabriele Eckerdt 
Published: June 2023

Abstract
Purpose: Prostate cancer is the most prevalent type of cancer in males in Brazil, with an increase of 29% new cases every year. Treatment may be done by surgery, radiotherapy or chemotherapy. Due to its size and diversity, the country has noticeable inequalities in the Unified Public Healthcare System (SUS). Therefore, we intend to analyze the time between malignant prostate cancer diagnosis and first treatment with possible disparities in this process in Brazil.
Methods: A cross-sectional design of data collected from the Oncology Panel of DATASUS’s Hospital Information System. The study analyzes the time between diagnosis and initial treatment for malignant prostate cancer between 2015 and 2020. There were 4 intervals: the same day, 1-30 days, 31-60 days, and above 60 days.
Results: The number of prostate treatments in Brazil, through the Public Health System (SUS), between January 2015 and December 2020, was 153.802. From those, 18.545 were performed the same day of diagnosis; 11.025 in the 1-30 days interval between diagnosis and treatment; 19.960 in the 31-60 days interval and 104.272 above 60 days. Hence, 49.530 (32,2%) treatments were performed within 60 days and 104.272 (67,8%) were performed after 60 days of diagnosis.
Conclusion: The Brazilian Law stipulates that the care must be provided within 60 days of diagnosis. However, the results of this study shows there is a significant delay in this system, which affects the morbimortality of the majority of patients subjected to postponements. As a result, it is essential to determine the extent of these consequences to improve the management and execution of malignant prostate cancer treatments.
Citation Format: Luiza Seixas de Sá Beltramo, Fernando Azambuja, Pedro Antonio Paludo Menna Barreto, Pedro Arthur Zimmer Silveira, Laura Tibola Marques da Silva, Lucas Kieling, Rafaela de Andrade, Arthur Minas Alberti, Gabriele Eckerdt Lech. Comparative Analysis of Time Between Diagnosis and First Treatment of Malignant Prostate Cancer in the Brazilian Public Health System (SUS) [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 23.
Abstract 24: Comparison Between the White Skin Color Distribution on the Brazil and Diagnoses of Nonmelanoma Skin Cancer
Authors: Alberti Arthur Minas , Kieling Lucas , Barreto Pedro Antonio Paludo Menna , Silveira Pedro Arthur Zimmer , de Andrade Rafaela , Azambuja Fernando , Beltramo Luiza Seixas de Sá , Lech Gabriele Eckerdt , da Silva Laura Tibola Marques , Pereira Maria Eduarda Corrêa 
Published: June 2023

Abstract
Purpose: According to the National Institute of Cancer (INCA), people with lighter skin tone have a higher chance of being stricken by Nonmelanoma skin cancer. Still, according to the same institute, this cancer is the most frequent tumor for both genders in Brazil. Therefore, it’s important to measure how impactful this risk factor is in Brazil.
Methods: In this analysis, the data about the diagnosis of nonmelanoma skin cancer between the years of 2013 to 2021 in the different regions of Brazil was captured using the DATASUS Oncology Panel as data source, through the TABNET system. Also the data about the resident population of each region by color and race uncovered in the last census realized by the Brazilian Institute of Geography and Statistic (IBGE) in 2010 has been collected. This information has been correlated with the statistics about the tumor, using the Pearson coefficient as the method to measure the relation between these two variables.
Results: The region that has the highest number of white people is the southeast region, with 44.152.518 people, followed by the south, with 21.456.204. The region with the lowest number of white habitants is the north region, with 3.686.144 individuals. The number of diagnoses of nonmelanoma skin cancer between the years of 2013-2021 follows a similar logic, with the highest number of cases in the southeast and south region (88.851 and 70.046 respectively). In this way, correlating both variables it has been found a determination coefficient (r2) of 0.943 and a p-value= 0.016, that demonstrate the significance of the relation.
Conclusion: It’s evident that a direct relation between the number of nonmelanoma skin cancer diagnoses and the population of white skin per location in Brazil exists, as indicated by relevant value of the determination coefficient founded (r2 = 0.943), as well as the p-value &lt; 0.05. So, the data show that, in Brazil, the lighter skin tone is an important risk factor associated with the tumor referred to, being this information important to subsidize future campaigns to prevent the disease.
Citation Format: Arthur Minas Alberti, Lucas Kieling, Pedro Antonio Paludo Menna Barreto, Pedro Arthur Zimmer Silveira, Rafaela de Andrade, Fernando Azambuja, Luiza Seixas de Sá Beltramo, Gabriele Eckerdt Lech, Laura Tibola Marques da Silva, Maria Eduarda Corrêa Pereira. Comparison Between the White Skin Color Distribution on the Brazil and Diagnoses of Nonmelanoma Skin Cancer [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 24.
Abstract 38: External Quality Assessment for Prostate Specific Antigen Test Accuracy: A Needs Assessment of Nigerian Tertiary Hospitals
Authors: Nnakenyi Ifeyinwa , Onyeka Tonia , Idemili-Aronu1 Ngozi , Onu Justus , Ezeanolue Echezona 
Published: June 2023

Abstract
Purpose: Prostate cancer is a major cause of death in African men, and the accuracy of prostate specific antigen (PSA) test results is important to ensure patients have access to accurate early diagnosis and treatment. External Quality Assessment (EQA) is an established framework to improve the quality of PSA results. We aimed to determine the need for implementing an EQA program for PSA in Nigeria.
Methods: We used mixed-method design to collect data from 6 tertiary hospitals across the six regions in Nigeria. We conducted an online survey using a structured questionnaire developed from the International Standard Organization (ISO) 15189 checklist for accreditation of diagnostic laboratories. Responses were analyzed to obtain descriptive categorical data that was analyzed on Microsoft Excel. Using an in-depth interview guide, 12 respondents (6 Urologists and 6 Chemical Pathologists) from sampled hospitals were interviewed virtually. Responses were recorded and transcribed and relevant themes were identified and generated from the transcribed data.
Results: Five of six laboratories sampled (83%) reported conducting repeat PSA testing. No sampled lab (0%) was enrolled in an EQA program for PSA. Eleven of the twelve respondents confirmed occasional disparities between PSA results and patient’s clinical status. They gave the impact of an erroneous PSA result on patient care as: extra unnecessary cost to the patient due to repeat testing; delay in decision making and initiating appropriate treatment; unnecessary invasive procedures. Training of lab staff, adoption of standard operating procedures and quality measures for EQA were considered opportunities to encourage PSA EQA practice while lack of funds for EQA programs, weak logistics for distribution of EQA samples and results, poor staff motivation and commitment were mentioned as barriers to effective practice uptake.
Conclusion: There is a clear need for the implementation of an EQA program for PSA in Nigeria. This will reduce the incidence of incongruous PSA results, thus promoting better clinician approach to disease treatment and better patient outcomes especially in resource-constrained environments.
Citation Format: Ifeyinwa Nnakenyi, Tonia Onyeka, Ngozi Idemili-Aronu1, Justus Onu, Echezona Ezeanolue. External Quality Assessment for Prostate Specific Antigen Test Accuracy: A Needs Assessment of Nigerian Tertiary Hospitals [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 38.