bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proposed prognostic subgroups and facilitated clinical decision-making for additional locoregional radiotherapy in de novo metastatic nasopharyngeal carcinoma: a retrospective study based on recursive partitioning analysis
Authors: Yao Yuyi , Sun Xuesong , Huang Huageng , Wang Zhao , Fang Xiaojie , Chen Meiting , Chen Zegeng , Weng Huawei , Guo Chengcheng , Hong Huangming , Huang He , Lin Tongyu 
Published: January 2023

Abstract
Background
The high heterogeneity of de novo metastatic nasopharyngeal carcinoma (dmNPC) makes its prognosis and treatment challenging. We aimed to accurately stage dmNPC and assess the patterns of treatment strategies for different risk groups.

Methods
The study enrolled a total of 562 patients, 264 from 2007 to 2013 in the training cohort and 298 from 2014 to 2017 in the validation cohort. Univariate and multivariate Cox regression analyses were conducted to determine the independent variables for overall survival (OS). Recursive partitioning analysis (RPA) was applied to establish a novel risk-stratifying model based on these variables.

Results
After pairwise comparisons of OS, three risk groups were generated: low-risk (involved lesions ≤ 4 without liver involvement), intermediate-risk (involved lesions ≤ 4 with liver involvement or involved lesions > 4 with Epstein–Barr virus (EBV)-DNA < 62,000 copies/ml), and high-risk (involved lesions > 4 with EBV-DNA > 62,000 copies/ml). The 3-year OS rate differed significantly between groups (80.4%, 42.0%, and 20.4%, respectively, all P < 0.05). Adding locoregional intensity-modulated radiotherapy (LRRT) followed by palliative chemotherapy (PCT) resulted in a significant OS benefit over PCT alone for the low- and intermediate-risk groups (P = 0.0032 and P = 0.0014, respectively). However, it provided no survival benefits for the high-risk group (P = 0.6). Patients did not benefit from concurrent chemotherapy during LRRT among the three subgroups (P = 0.12, P = 0.13, and P = 0.3, respectively). These results were confirmed with the validation cohort.

Conclusions
The novel RPA model revealed superior survival performance in subgroup stratification and could facilitate more effective treatment strategies for dmNPC.
The lived experience of patients with conflict associated injuries whose wounds are affected by antimicrobial resistant organisms: a qualitative study from northwest Syria
Authors: Aldbis Ahmet , Naal Hady , Kishawi Tarik , Wazni Rim , Abbara Aula 
Published: January 2023

Abstract
Introduction
For those with severe conflict-associated wounds which are affected by antimicrobial resistant (AMR) organisms, health systems during protracted conflict are often ill-equipped to respond to their needs. In this study, our aim is to explore the experiences of those with conflict-associated wounds whose wounds have been infected with AMR bacteria and who reside in northwest Syria (NWS). This is with a view to understanding the challenges they face and how the health and humanitarian system can better respond to their needs.

Methods
A qualitative research methodology where in-depth interviews were conducted with patients who are known to have AMR organisms infecting conflict-associated wounds was used. Patients were recruited from Bab Al-Hawa hospital in NWS based on pre-set inclusion criteria. They were invited to participate in remote interviews due to the ongoing COVID-19 pandemic. Interviews were conducted during January and February 2021 and transcribed in Arabic before thematic analysis was undertaken to identify key themes and subthemes.

Results
14 in-depth interviews were conducted of which 12 were with men. The age range was 20–49 years. We categorised the findings into 6 themes: i. those related to the mechanism of injury, ii, the impact of the conflict on health system accessibility, iii. experiences of immediate inpatient management, iv. the experience of outpatient and home management, v. the current impact of the injury on participants, and vi. participant perspectives around improving healthcare access for those with conflict-related wounds affected by AMR organisms. Important findings relate to the quality and capacity for both immediate and longer-term care and the psychosocial and socioeconomic impacts of the injuries which many of the participants continue to grapple with.

Conclusion
This is the first exploration through qualitative research of the experiences of those with conflict-affected wounds which are infected with AMR organisms in NWS. Emerging themes as told by participants can help stakeholders, including policy makers, humanitarian organisations and those involved with health system planning in NWS consider gaps in current and future care needs (including livelihood opportunities) for this vulnerable group.
Novel CD19-specific γ/δ TCR-T cells in relapsed or refractory diffuse large B-cell lymphoma
Authors: Li Chenggong , Zhou Fen , Wang Jing , Chang Qi , Du Mengyi , Luo Wenjing , Zhang Yinqiang , Xu Jia , Tang Lu , Jiang Huiwen , Liu Lin , Kou Haiming , Lu Cong , Liao Danying , Wu Jianghua , Wei Qiuzhe , Ke Sha , Deng Jun , Liu Cheng , Mei Heng , Hu Yu 
Published: January 2023

Abstract
Background
T cell receptor (TCR)-T cells possess similar effector function, but milder and more durable signal activation compared with chimeric antigen receptor-T cells. TCR-T cell therapy is another active field of cellular immunotherapy for cancer.

Methods
We previously developed a human anti-CD19 antibody (ET190L1) and generated novel CD19-specific γ/δ TCR-T cells, ET019003, by fusing the Fab fragment of ET190L1 with γ/δ TCR constant chain plus adding an ET190L1-scFv/CD28 co-stimulatory molecule. ET019003 cells were tested in preclinical studies followed by a phase 1 clinical trial.

Results
ET019003 cells produced less cytokines but retained comparable antitumor potency than ET190L1-CAR-T cells in vivo and in vitro. In the first-in-human trial, eight patients with relapsed or refractory DLBCL were treated. CRS of grade 1 was observed in three (37.5%) patients; ICANS of grade 3 was noted in one (12.5%) patient. Elevation of serum cytokines after ET019003 infusion was almost modest. With a median follow-up of 34 (range 6–38) months, seven (87.5%) patients attained clinical responses and six (75%) achieved complete responses (CR). OS, PFS and DOR at 3 years were 75.0%, 62.5%, and 71.4%, respectively. Notably, patient 1 with primary CNS lymphoma did not experience CRS or ICANS and got an ongoing CR for over 3 years after infusion, with detectable ET019003 cells in CSF. ET019003 showed striking in vivo expansion and persisted in 50% of patients at 12 months. Three patients received a second infusion, one for consolidation therapy after CR and two for salvage therapy after disease progression, but no response was observed. ET019003 expansion was striking in the first infusion, but poor in the second infusion.

Conclusions
CD19-specific γ/δ TCR-T cells, ET019003, had a good safety profile and could induce rapid responses and durable CR in patients with relapsed or refractory DLBCL, even primary CNS lymphoma, presenting a novel and potent therapeutic option for these patients.
Trial registration: NCT04014894.
High visceral fat-to-muscle ratio is an independent factor that predicts worse overall survival in patients with primary epithelial ovarian, fallopian tube, and peritoneal cancer
Authors: Ham Sooji , Choi Jin Hwa , Shin Soo Gui , Lee Eun-Ju 
Published: January 2023

Abstract
Background
The intra-abdominal cavity, surrounded by adipocytes, is the main metastatic site of epithelial ovarian, fallopian tube, and peritoneal cancer. Epidemiological and molecular studies have demonstrated a link between adipose tissue and ovarian cancer. However, the clinical significance of fatty tissue has not been elucidated. Thus, we investigated the clinical significance of body composition in patients with epithelial ovarian, fallopian tube, and peritoneal cancer.

Methods
Fat and skeletal muscle areas were measured using software based on pretreatment computed tomography scans at the third lumbar vertebra. Fat-to-muscle ratios were calculated using the total (visceral and subcutaneous) fat area or visceral fat area. High fat-to-muscle ratios were defined by values greater than the mean. Sarcopenia was defined as a skeletal muscle index < 38.7 cm2/m2. The clinicopathological parameters and survival of 153 patients were analyzed.

Results
High visceral fat-to-muscle ratios and sarcopenia at the time of diagnosis were observed in 43.8% and 33.3% of the patients, respectively. Multivariate analysis showed that high visceral fat-to-muscle ratio (p = 0.014), advanced Federation of Gynecology and Obstetrics stage (p = 0.008), and chemoresistance (p = 0.027) were independent factors for worse overall survival. Patients with high visceral fat-to-muscle ratios were older, had higher body mass indexes, and were more likely to have diabetes/hypertension, serous cancer subtypes, and implementation of neoadjuvant chemotherapy than those with low visceral fat-to-muscle ratios. The platelet count was significantly higher in the high visceral fat-to-muscle ratio group than in the low visceral fat-to-muscle ratio group (p = 0.011).

Conclusions
Pretreatment visceral fat area could be an independent predictive factor of overall survival in patients with epithelial ovarian, fallopian tube, and peritoneal cancer and may be significantly associated with thrombocytosis.
Relationship between nutrient intakes in the transition phase and postnatal growth of preterm infants: a systematic review
Authors: Wang Na , Zhang Jia , Wang Bo , Yu Zhangbin , Zhang Jun , Qu Linlin , Tang Bin 
Published: January 2023

AbstractNutrition practices for preterm infants include phases of parenteral nutrition, gradually interrupted parenteral nutrition (transition phase), and full enteral nutrition. However, nutrition management during the transition phase is frequently overlooked. This review examined the relationship between nutrient intake during the transition phase and preterm infant growth. PubMed, Embase, Web of Science, Cochrane, Chinese National Knowledge Infrastructure Database, Wanfang Database, and Chinese Science and Technique Journals Database were searched for studies examining the relationship between nutrient intake during the transition phase and postnatal growth of preterm infants from each database's earliest inception through February 28, 2022. The quality of the studies was assessed using the Newcastle–Ottawa scale. A total of three studies conducted in the USA, Italy and China met the inclusion criteria. The growth indicators were extrauterine growth restriction (weight < 10th percentile for post-menstrual age) or inadequate weight growth velocity (growth velocity < 15 g/kg/d) at discharge or the end of the transition phase. The transition phase was divided into two periods in two studies: the early period (parenteral energy intake > 50% of total energy intake) and the late period (enteral energy intake > 50% of the total energy intake). The cumulative protein intake in the transition phase was generally lower in preterm infants with extrauterine growth restriction or inadequate weight growth velocity, especially in the early transition phase. The deficiency of energy and protein intake during the transition phase cannot be explicitly determined due to differences in growth indicators and definitions of the transition phase. However, enteral protein intake should be closely monitored in the early transition phase to ensure a better growth rate for preterm infants. To elucidate potential associations, further well-designed research will be required.
Clinician perceptions of the impact of ICU family visiting restrictions during the COVID-19 pandemic: an international investigation
Authors: McPeake Joanne , Kentish-Barnes Nancy , Banse Emilie , Anderson Lynne , Cuzco Cecilia , Azoulay Elie , Quasim Tara , Castro Pedro , Puxty Kathryn 
Published: January 2023

AbstractPurposeTo guarantee the safety of the public, clinicians and patients during the COVID-19 pandemic, hospital visits were severely restricted internationally. There are limited data on the precise impact of these visiting restrictions on Intensive Care Unit clinicians. Our objectives therefore were to explore the impact of family visitation restrictions on clinicians and care delivery and describe innovation alongside areas for potential improvement.MethodsA qualitative approach using focus groups was employed. We recruited members of the multi-disciplinary team from Spain, France and the UK. Framework analysis was used to synthesize and interpret data.ResultsIn total, 28 staff from multiple international sites contributed to data across six focus groups: 12 from the UK, 9 from France and 7 from Spain. In relation to the key aims, we derived four themes: the emergence of new technologies, relationships and rapport establishment, communication challenges and end-of-life care provision. Across each theme, the overarching concepts of clinician emotional exhaustion and emotional distress emerged alongside the negative impact on job satisfaction.ConclusionThe impact of COVID-19 family visitation restrictions is far reaching. Future research should examine the wider impact of family presence in the ICU.
Smartphone imaging repository: a novel method for creating a CT image bank
Authors: Dula Adrienne N. , Milling Truman J. , Johnston S. Claiborne , Aydelotte Jayson , Peil Gary W. , Robinson Alec , Asif Kaiz , Pan Stephen , Parekh Sohan , Warach Steven 
Published: January 2023

Abstract

Background
Imaging repositories are commonly attached to ongoing clinical trials, but capturing, transmitting, and storing images can be complicated and labor-intensive. Typical methods include outdated technologies such as compact discs. Electronic file transfer is becoming more common, but even this requires hours of staff time on dedicated computers in the radiology department.

Methods
We describe and test an image capture method using smartphone camera video-derived images of brain computed tomography (CT) scans of traumatic intracranial hemorrhage. The deidentified videos are emailed or uploaded from the emergency department for central adjudication. We selected eight scans, mild moderate, and severe subdural and multicompartmental hematomas and mild and moderate intraparenchymal hematomas. Ten users acquired data using seven different smartphones. We measured the time in seconds it took to capture and send the files. The primary outcomes were hematoma volume measured by ABC/2, Marshall scale, midline shift measurement, image quality by a contrast-to-noise ratio (CNR), and time to capture. A radiologist and an imaging scientist applied the ABC/2 method and calculated the Marshall scale and midline shift on the data acquired on different smartphones and the PACS in a randomized order. We calculate the intraclass correlation coefficient (ICC). We measured image quality by calculating the contrast-to-noise ratio (CNR). We report summary statistics on time to capture in the smartphone group without a comparator.

Results
ICC for lesion volume, midline shift, and Marshall score were 0.973 (95% CI 0.931, 0.994), 0.998 (95% CI: 0.996, 0.999), and 0.973 (0.931, 0.994), respectively. Lesion conspicuity was not different among the image types via assessment of CNR using the Friedman test, $${\lambda }^{2}$$

λ

2

of 24.8, P =  < .001, with a small Kendall’s W effect size (0.591). Mean (standard deviation) time to capture and email the video was 60.1 (24.3) s.

Conclusions
Typical smartphones may produce video image quality high enough for use in a clinical trial imaging repository. Video capture and transfer takes only seconds, and hematoma volumes, Marshall scales, and image quality measured on the videos did not differ significantly from those calculated on the PACS.
Heterogeneous separation consistency training for adaptation of unsupervised speech separation
Authors: Han Jiangyu , Long Yanhua 
Published: January 2023

AbstractRecently, supervised speech separation has made great progress. However, limited by the nature of supervised training, most existing separation methods require ground-truth sources and are trained on synthetic datasets. This ground-truth reliance is problematic, because the ground-truth signals are usually unavailable in real conditions. Moreover, in many industry scenarios, the real acoustic characteristics deviate far from the ones in simulated datasets. Therefore, the performance usually degrades significantly when applying the supervised speech separation models to real applications. To address these problems, in this study, we propose a novel separation consistency training, termed SCT, to exploit the real-world unlabeled mixtures for improving cross-domain unsupervised speech separation in an iterative manner, by leveraging upon the complementary information obtained from heterogeneous (structurally distinct but behaviorally complementary) models. SCT follows a framework using two heterogeneous neural networks (HNNs) to produce high confidence pseudo labels of unlabeled real speech mixtures. These labels are then updated and used to refine the HNNs to produce more reliable consistent separation results for real mixture pseudo-labeling. To maximally utilize the large complementary information between different separation networks, a cross-knowledge adaptation is further proposed. Together with simulated dataset, those real mixtures with high confidence pseudo labels are then used to update the HNN separation models iteratively. In addition, we find that combing the heterogeneous separation outputs by a simple linear fusion can further slightly improve the final system performance. In this paper, we use cross-dataset to simulate the cross-domain situation in real-life. The term of “source domain” and “target domain” refer to the simulation set for model pre-training and the real unlabeled mixture for model adaptation. The proposed SCT is evaluated on both public reverberant English and anechoic Mandarin cross-domain separation tasks. Results show that, without any available ground-truth of target domain mixtures, the SCT can still significantly outperform our two strong baselines with up to 1.61 dB and 3.44 dB scale-invariant signal-to-noise ratio (SI-SNR) improvements, on the English and Mandarin cross-domain conditions, respectively.
Unintended pregnancies among HIV-positive women in sub-Saharan Africa: a scoping review protocol
Authors: Oguntade Racheal Tomilola , Ojewole Elizabeth Bolanle , Ogunrombi Modupe Olufunmilayo 
Published: January 2023

AbstractBackgroundUnintended pregnancies pose a severe threat to the well-being of HIV-positive women and their unborn children. Factors contributing to the high incidence of unintended pregnancies include contraceptive failure, low uptake of contraceptives, and misuse of contraceptives. Despite various contraceptive options, an increased incidence of unintended pregnancies is rampant among HIV-positive women in the region of sub-Saharan Africa. This study seeks to present evidence of unintended pregnancies among women living with HIV in sub-Saharan Africa, including those using contraceptives.MethodThis study entails a scoping review to survey and interrogate the literature to provide evidence for the incidence of unintended pregnancies among HIV-positive women in sub-Saharan Africa. A proposed framework by Arksey and O’Malley will guide this scoping review. Peer-reviewed articles which address the research questions will constitute the main search. Electronic databases such as EBSCOhost, Cochrane Library, World of Science, World Health Organization (WHO) library databases, Science Direct, Google Scholar PubMed, and gray literature search will be involved. Reference list from studies included will also be searched. The investigation of articles will be done employing keywords from the studies included. The inclusion and exclusion criteria will guide two separate reviewers with the screening of abstracts and full papers. To summarize the findings from this review, thematic content analysis will be done using NVivo version 11.DiscussionWe expect that this review will add to the current body of knowledge on the incidence of unintended pregnancies among HIV-positive women, identify gaps for further future research, and show evidence that may contribute to strengthening the health system’s regulations, guidelines, and policies that may help prevent unintended pregnancies among HIV-positive women.Systematic review registration10.17605/OSF.IO/EY3R5
Predicting the total Unified Parkinson’s Disease Rating Scale (UPDRS) based on ML techniques and cloud-based update
Authors: Hamzehei Sahand , Akbarzadeh Omid , Attar Hani , Rezaee Khosro , Fasihihour Nazanin , Khosravi Mohammad R. 
Published: January 2023

AbstractNowadays, smart health technologies are used in different life and environmental areas, such as smart life, healthcare, cognitive smart cities, and social systems. Intelligent, reliable, and ubiquitous healthcare systems are a part of the modern developing technology that should be more seriously considered. Data collection through different ways, such as the Internet of things (IoT)-assisted sensors, enables physicians to predict, prevent and treat diseases. Machine Learning (ML) algorithms may lead to higher accuracy in medical diagnosis/prognosis based on health data provided by the sensors to help physicians in tracking symptom significance and treatment steps. In this study, we applied four ML methods to the data on Parkinson’s disease to assess the methods’ performance and identify the essential features that may be used to predict the total Unified Parkinson’s disease Rating Scale (UPDRS). Since accessibility and high-performance decision-making are so vital for updating physicians and supporting IoT nodes (e.g., wearable sensors), all the data is stored, updated as rule-based, and protected in the cloud. Moreover, by assigning more computational equipment and memory in use, cloud computing makes it possible to reduce the time complexity of the training phase of ML algorithms in the cases we want to create a complete structure of cloud/edge architecture. In this situation, it is possible to investigate the approaches with varying iterations without concern for system configuration, temporal complexity, and real-time performance. Analyzing the coefficient of determination and Mean Square Error (MSE) reveals that the outcomes of the applied methods are mostly at an acceptable performance level. Moreover, the algorithm’s estimated weight indicates that Motor UPDRS is the most significant predictor of Total UPDRS.