bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of Hospital Anxiety and Depression Scale in an Indonesian population: a scale adaptation study
Authors: Tiksnadi Badai Bhatara , Triani Nurlita , Fihaya Faris Yuflih , Turu’ Allo Iswandy Janetputra , Iskandar Shelly , Putri Diba Artsiyanti Ediyana 
Published: June 2023

ObjectiveThis study aims to adapt the English-language Hospital Anxiety and Depression Scale (HADS) to the Indonesian language and evaluate the validity and reliability of the adapted version (ie, HADS-Indonesia).DesignA cross-sectional study was conducted between June and November 2018. First, a translation and back-translation process was conducted by a committee consisting of the researchers, a psychiatrist, a methodology consultant and two translators. Face and convergent validity and test–retest reliability evaluations were conducted. Next, structural validity and internal consistency analyses were performed. An intraclass correlation coefficient (ICC) test evaluated the scale’s test–retest reliability. A Spearman’s rank correlation coefficient was calculated to evaluate the correlation between HADS-Indonesia and Zung’s Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) for convergent validity evidence. Next, a structural validity analysis using exploratory factor analysis (EFA) and an internal consistency evaluation based on Cronbach’s alpha was conducted.SettingThis study was conducted in three villages in Jatinangor subdistrict, Sumedang Regency, West Java province, Indonesia; the villages were chosen based on their profiles.ParticipantsA total of 200 participants (male: n=91, 45.50% and female: n=109, 54.50%), with a mean age of 42.41 (14.25) years, were enrolled in this study using a convenience sampling method. The inclusion criteria were age ≥18 years old with basic Indonesian language literacy.ResultsThe overall HADS-Indonesia’s ICC value was 0.98. There was a significant positive correlation between HADS-Indonesia’s anxiety subscale and Zung’s SAS (rs=0.45, p=0.030) and between the depression subscale of HADS-Indonesia and Zung’s SDS (rs=0.58, p<0.001). The Kaiser-Meyer-Olkin statistics (KMO) (KMO=0.89) and Bartlett’s test of sphericity (χ2(91, N=200)=1052.38, p<0.001)) indicated an adequate number of samples for EFA. All items’ commonality was >0.40 and the average inter-item correlation was 0.36. EFA yielded a 2-factor solution explaining 50.80% (40.40%+10.40%) of the total variance. All items from the original HADS were retained, including its original subscales. The adapted HADS-Anxiety subscale consisted of seven items (alpha=0.85), and the HADS-Depression subscale consisted of seven items (alpha=0.80).ConclusionsHADS-Indonesia is a valid and reliable instrument for use in the general population of Indonesia. However, further studies are warranted to provide more sophisticated validity and reliability evidence.
Effects of programmed intermittent thoracic paravertebral bolus of
levobupivacaine on the spread of sensory block: a randomized, controlled,
double-blind study
Authors: Hida Kumiko , Murata Hiroaki , Ichinomiya Taiga , Inoue Haruka , Sato Shuntaro , Hara Tetsuya 
Published: June 2023

Background and objectives
This randomized, controlled, double-blind trial compared the
effectiveness of levobupivacaine delivery of a programmed intermittent
paravertebral bolus with a continuous paravertebral infusion.

Methods
Thirty-two consecutively enrolled patients who underwent unilateral
video-assisted thoracic surgery were randomized to receive either a
programmed intermittent paravertebral bolus of 10 mL of 0.2%
levobupivacaine every 2 hours (Bolus group, n=16) or a continuous
paravertebral infusion of 0.2% levobupivacaine at 5 mL/hour (Infusion
group, n=16) after the operation. Postoperatively, after injection of
20 mL of 0.25% levobupivacaine through the paravertebral catheter, a
mechanical infusion pump was set depending on the assigned group. The
primary efficacy outcome was the number of anesthetized dermatomes
24 hours after the initial bolus of levobupivacaine. The secondary
efficacy outcomes included the number of anesthetized dermatomes at
other time points, pain at rest and coughing, additional analgesic use
and patient acceptance of the analgesic technique. Arterial
levobupivacaine concentration was measured to ensure safety. P<0.05
was considered statistically significant.

Results
The mean (95% CI) number of anesthetized dermatomes 24 hours after
the initial bolus of levobupivacaine was significantly larger among
subjects receiving programmed intermittent bolus (n=16) compared with
those receiving continuous infusion (n=16; 6.8 (5.7–7.9) vs 3.1
(2.0–4.2); p<0.001). The arterial levobupivacaine concentration did
not reach a toxic level.

Conclusions
The programmed intermittent paravertebral bolus of levobupivacaine
provided a wider dermatomal spread of sensory block than continuous
paravertebral infusion with an identical hourly dose of
levobupivacaine.

Trial registration number
NCT000022532.
Development, usability and acceptability of an integrated eHealth system
for spondyloarthritis in the Netherlands (SpA-Net)
Authors: Webers Casper , Beckers Esther , Boonen Annelies , van Eijk-Hustings Yvonne , Vonkeman Harald , van de Laar Mart , van Tubergen Astrid 
Published: June 2023

Objective
To develop and test the usability and acceptability of a
disease-specific integrated electronic health (eHealth) system for
spondyloarthritis (SpA) in the Netherlands (‘SpA-Net’).

Methods
SpA-Net was developed in four phases. First, content and design were
discussed with experts on SpA and patients. Second, the database,
electronic medical record (EMR) and quality management system were
developed. Third, multiple rounds of testing were performed. Fourth, the
eHealth system was implemented in practice and feasibility was tested
among patients through semistructured focus interviews (n=16 patients)
and among care providers through feedback meetings (n=11
rheumatologists/fellows and 5 nurses).

Results
After completion of the first three steps of development in 2015,
SpA-Net was implemented in 2016. All patients included have a clinical
diagnosis of SpA. Information on domains relevant to clinical
record-keeping is prospectively collected at routine outpatient
consultations and readily available to care providers, presented in a
clear dashboard. Patients complete online questionnaires prior to
outpatient visits. In February 2019, 1069 patients were enrolled (mean
[SD] age 54.9 [14.1] years, 52.4% men). Patients interviewed (n=16)
considered SpA-Net an accessible system that was beneficial to disease
insight and patient–physician communication, and had additional value to
current care. Care providers appreciated the additional information for
(preparing) consultations. Barriers were the initial time required to
adopt the EMR and the quantity of data entry.

Conclusion
SpA-Net enables monitoring of patients with SpA and real-life data
collection, and could help improve knowledge and optimise communication
between patients and care providers. Both considered SpA-Net a valuable
addition to current care.

Trial registration number
NCT6740.
Psychological outcomes of low-dose CT lung cancer screening in a
multisite demonstration screening pilot: the Lung Screen Uptake Trial
(LSUT)
Authors: Kummer Sonja , Waller Jo , Ruparel Mamta , Duffy Stephen W , Janes Samuel M , Quaife Samantha L 
Published: June 2023

Background
Previous studies of psychological burden in low-dose CT (LDCT) lung
cancer screening trials may lack generalisability due to participation
bias and control arms having elevated distress.

Methods
Current and former smokers (n=787, aged 60–75) within a real-world
screening demonstration pilot completed measures of lung cancer worry at
three time points (T0: appointment,
T1: next day, T2: 3
months) and anxiety and depression at two time points
(T0and T2). A ‘screening
unaware’ community sample (n=383) with the same age and smoking
characteristics completed these measures once (T0).
Mean scores were compared by sample type and LDCT result.

Results
Compared with the community sample (T0), mean
scores were higher in the screening sample, and statistically
significantly increased in adjusted analyses, for lung cancer worry at
T0and T2(mean (M): 9.32;
95% CI 8.96 to 9.69 vs M: 11.34; 11.09 to 11.59 and M: 11.88; 11.49 to
12.27), for anxiety at T0and
T2(M: 3.32; 2.94 to 3.70 vs M: 4.73; 4.42 to
5.04 and M: 5.78; 5.33 to 6.23) and depression at
T2(M: 3.85; 3.44 to 4.27 vs M: 4.15; 3.76 to
4.55). Scores were highest for those with indeterminate (eg,
T2anxiety M: 6.93; 5.65 to 8.21) and incidental
findings (primary care follow-up M: 5.34; 4.67 to 6.02) and those
ineligible for screening (M: 6.51; 5.25 to 7.77). Being female, younger,
not in paid employment, not married/cohabiting with a partner and lower
education predicted poorer psychological outcomes at
T0, but not T2after
adjusting for baseline scores. Mean scores remained within ‘normal’
clinical ranges.

Conclusion
Psychological distress was raised among high-risk individuals
undergoing LDCT screening in a real-world setting, but overall
differences were unlikely to be clinically meaningful. It will be
critical to monitor the psychological impact of services longitudinally
across diverse settings, including subgroups vulnerable to clinically
elevated distress.

Trial registration
The Lung Screen Uptake Trial was registered prospectively with the
International Standard Registered Clinical/soCial sTudy (ISRCTN)
(Number:NCT21774741) on 23
September 2015 and the National Institutes of Health ClinicalTrials.gov
database (NCT02558101) on 22 September 2015.
Allen Carr’s Easyway to Stop Smoking - A randomised clinical
trial
Authors: Keogan Sheila , Li Shasha , Clancy Luke 
Published: June 2023

Objective
To determine if Allen Carr’s Easyway to Stop Smoking (AC) was
superior to Quit.ie in a randomised clinical trial (RCT).

Setting
Single centre, open RCT, general population based.

Participants
300 adult smokers, 18 years plus, minimum 5 cigarettes daily, and
English speaking. AC, 151 (females 44.4%) and Quit.ie, 149 (females
45.6%), mean age 44 years. outcomes for all 300 were analysed
(intention-to-treat). Recruited through advertisement from July 2015 to
February 2016.

Intervention
Randomly assigned to AC (n=151) and Quit.ie (n=149), matched for
age, sex and education. Block randomisation, enrolment and follow-up at
1, 3, 6 and 12 months. Primary aim was to determine if AC had higher
quit rates than Quit.ie service at 3 months. Secondary aims: quit rates
at 1, 6 and 12 months and analysis of associated factors including
weight. AC consisted of a 5-hour seminar, in a group setting. Quit.ie is
an online portal for smoking cessation.

Results
AC had higher quit rates at 1, 3, 6 and 12 months. AC: 38%, (n=57),
27% (n=40), 23% (n=35), 22% (n=33) vs Quit.ie: 20% (n=30), 15% (n=22),
15% (n=23), 11% (n=17), respectively (all p values <0.05). Logistic
regression AC vs Quit.ie, OR 2.26 (95% CI 1.22 to 4.21) p value=0.01.
Weight gain 3.8 kg in AC vs 1.8 kg in Quit.ie (p value
<0.05).

Conclusions
All AC quit rates were superior to Quit.ie, outcomes were comparable
with established interventions.

Trial registration number
NCT12951013. Recruitment July 2015–February
2016.
THE ASSOCIATION BETWEEN HOUNSFIELD UNIT AND PROXIMAL JUNCTIONAL KYPHOSIS IN ADULT SPINAL DEFORMITY SURGERY: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Lin Chun-Ru , Tsai Sung Huang Laurent , Hu Yung-Hsueh , Yeh Yu-Cheng , Lin Tung-Yi , Fu Tsai-Sheng , Niu Chi-Chien 
Published: June 2023

Objective: This study investigated Hounsfield unit (HU) differences in adult spinal deformity (ASD) surgery patients with and without proximal junctional kyphosis (PJK), a common complication. Summary Background Data: Previous studies have identified osteoporosis as a PJK risk factor, and CT scanning is a valuable tool for detecting osteoporosis through HU measurements. The study aimed to determine the level of HU difference between patients diagnosed with and without PJK. Methods: We conducted a meta-analysis using a random-effects model of randomized controlled trials and cohort studies that assessed HUs for ASD surgery patients who developed PJKs. We searched in PubMed, Embase, Ovid, The Cochrane Library, and Web of Science up to October 2022 and had two authors extract data and evaluate bias. Results: Four cohort studies with 250 patients were included in this study. Measurements of HUs at upper instrumented vertebra (UIV) and UIV+1 showed significant differences between PJKs and non-PJKs. (Mean difference (MD) at UIV: −25.36, 95% CI: −39.16, −11.56, p = 0.0003; MD at UIV+1: −21.06, 95% CI: −38.25, −3.88, p = 0.02). Conclusions: The study found measuring HUs of UIV and UIV+1 can predict the occurrence of PJK in ASD surgery. Further prospective studies are warranted to validate our findings.
Efficacy and Safety of Paclitaxel and Carboplatin for Platinum-Sensitive Ovarian Cancer: A Systematic Review and Meta-Analysis
Authors: Zhou Yan , Guo Wei 
Published: June 2023

Purpose. Paclitaxel and carboplatin are novel anticancer drugs that have emerged in recent years, while there is still a lack of clinical consensus on these two drugs. The study conducted a meta-analysis and systematic review to analyze the efficacy and safety of paclitaxel and carboplatin for platinum-sensitive ovarian cancer. Methods. A systematic search was carried out in three databases of the Cochrane Library, Embase, and PubMed from the inception of each database to March 2021, and defined the progression-free survival and overall survival as the primary outcomes. Data analysis was performed using STATA 15.1. Results. Altogether, five randomized controlled trials (RCTs) were included in the meta-analysis, involving 2,740 patients, including 1317 in the CD (carboplatin doxorubicin) group and 1423 in the CP (carboplatin plus paclitaxel) group. It was found that pooled OS demonstrated no significant differences between the CD group and CP group (HR = 1.02, 95% CI = 0.89–1.18,

P

= 0.340), and the differences were not statistically significant in progression-free survival (HR = 0.84, 95% CI = 0.71–0.99,

P

= 0.140), thrombocytopenia (OR = 0.23, 95% CI = 0.09−0.58, P = 0.775), and grade II alopecia between the two groups (OR = 9.41, 95% CI = 6.57–13.47,

P

= 0.215). Conclusion. Current evidence suggests that paclitaxel and carboplatin do not produce more satisfactory results with respect to overall survival and reduction of side effects in treating platinum-sensitive ovarian cancer, and further studies are needed.
Deficiency of the Polycomb Protein RYBP and TET Methylcytosine Oxidases Promotes Extensive CpG Island Hypermethylation and Malignant Transformation
Authors: Cui Wei , Huang Zhijun , Jin Seung-Gi , Johnson Jennifer , Lau Kin H. , Hostetter Galen , Pfeifer Gerd P. 
Published: June 2023

Abstract

Hypermethylation of CpG islands (CGI) is a common feature of cancer cells and predominantly affects Polycomb-associated genomic regions. Elucidating the underlying mechanisms leading to DNA hypermethylation in human cancer could help identify chemoprevention strategies. Here, we evaluated the role of Polycomb complexes and 5-methylcytosine (5mC) oxidases in protecting CGIs from DNA methylation and observed that four genes coding for components of Polycomb repressive complex 1 (PRC1) are downregulated in tumors. Inactivation of RYBP, a key activator of variant PRC1 complexes, in combination with all three 5mC oxidases (TET proteins) in nontumorigenic bronchial epithelial cells led to widespread hypermethylation of Polycomb-marked CGIs affecting almost 4,000 target genes, which closely resembled the DNA hypermethylation landscape observed in human squamous cell lung tumors. The RYBP- and TET-deficient cells showed methylation-associated aberrant regulation of cancer-relevant pathways, including defects in the Hippo tumor suppressor network. Notably, the quadruple knockout cells acquired a transformed phenotype, including anchorage-independent growth and formation of squamous cell carcinomas in mice. This work provides a mechanism promoting hypermethylation of CGIs and shows that such hypermethylation can lead to cell transformation. The breakdown of a two-pronged protection mechanism can be a route towards genome-wide hypermethylation of CGIs in tumors.

Significance:
Dysfunction of the Polycomb component RYBP in combination with loss of 5-methylcytosine oxidases promotes widespread hypermethylation of CpG islands in bronchial cells and induces tumorigenesis, resembling changes seen in human lung tumors.
Dynamic Glycoprotein Hyposialylation Promotes Chemotherapy Evasion and Metastatic Seeding of Quiescent Circulating Tumor Cell Clusters in Breast Cancer
Authors: Dashzeveg Nurmaa K. , Jia Yuzhi , Zhang Youbin , Gerratana Lorenzo , Patel Priyam , Shajahan Asif , Dandar Tsogbadrakh , Ramos Erika K. , Almubarak Hannah F. , Adorno-Cruz Valery , Taftaf Rokana , Schuster Emma J. , Scholten David , Sokolowski Michael T. , Reduzzi Carolina , El-Shennawy Lamiaa , Hoffmann Andrew D. , Manai Maroua , Zhang Qiang , D'Amico Paolo , Azadi Parastoo , Colley Karen J. , Platanias Leonidas C. , Shah Ami N. , Gradishar William J. , Cristofanilli Massimo , Muller William A. , Cobb Brian A. , Liu Huiping 
Published: June 2023

Abstract

Most circulating tumor cells (CTC) are detected as single cells, whereas a small proportion of CTCs in multicellular clusters with stemness properties possess 20- to 100-times higher metastatic propensity than the single cells. Here we report that CTC dynamics in both singles and clusters in response to therapies predict overall survival for breast cancer. Chemotherapy-evasive CTC clusters are relatively quiescent with a specific loss of ST6GAL1-catalyzed α2,6-sialylation in glycoproteins. Dynamic hyposialylation in CTCs or deficiency of ST6GAL1 promotes cluster formation for metastatic seeding and enables cellular quiescence to evade paclitaxel treatment in breast cancer. Glycoproteomic analysis reveals newly identified protein substrates of ST6GAL1, such as adhesion or stemness markers PODXL, ICAM1, ECE1, ALCAM1, CD97, and CD44, contributing to CTC clustering (aggregation) and metastatic seeding. As a proof of concept, neutralizing antibodies against one newly identified contributor, PODXL, inhibit CTC cluster formation and lung metastasis associated with paclitaxel treatment for triple-negative breast cancer.

Significance:
This study discovers that dynamic loss of terminal sialylation in glycoproteins of CTC clusters contributes to the fate of cellular dormancy, advantageous evasion to chemotherapy, and enhanced metastatic seeding. It identifies PODXL as a glycoprotein substrate of ST6GAL1 and a candidate target to counter chemoevasion-associated metastasis of quiescent tumor cells.
This article is featured in Selected Articles from This Issue, p. 1949
Computed Tomography Perfusion Parameters Predictive of Symptomatic Intracranial Hemorrhage After Mechanical Thrombectomy in Patients With Cerebral Large Vessel Occlusion
Authors: Abe Soichiro , Inoue Manabu , Shirakawa Manabu , Uchida Kazutaka , Yamada Kiyofumi , Kuramoto Yoji , Namitome Satoshi , Shindo Seigo , Sakakibara Fumihiro , Kouno Junichi , Tatebayashi Kotaro , Kinjo Norito , Tsuji Shoichiro , Tanada Shuichi , Beppu Mikiya , Matsukawa Hidetoshi , Ihara Masafumi , Yoshimura Shinichi 
Published: June 2023

Background
Hemorrhagic transformation after recanalization is a severe complication in patients with a large ischemic core due to cerebral large vessel occlusion. Risk assessment using perfusion imaging to predict hemorrhagic infarction has not been established. Thus, we aimed to investigate the association between perfusion imaging findings and hemorrhagic transformation in patients with acute cerebral large vessel occlusion who had undergone preoperative perfusion imaging evaluation and mechanical thrombectomy.

Methods
We enrolled consecutive patients who received mechanical thrombectomy after undergoing perfusion imaging for anterior large vessel occlusion from May 2019 to March 2022. The patients in whom recanalization were not achieved and who experienced procedure‐related bleeding were excluded. We investigated the predictors of symptomatic intracranial hemorrhage (sICH) by exploring preoperative perfusion imaging parameters (relative cerebral blood flow, relative cerebral blood volume, time of maximum concentration, and hypoperfusion index ratio).

Results

Among the 167 patients (median age 79 years, 47% female) enrolled, 63 (38%) and 14 (8%) patients had any intracranial hemorrhage and sICH (sICH group), respectively. The sICH group had a shorter puncture‐recanalization time than the non‐sICH group (median [interquartile range (IQR)]; 43 [34–55] versus 61 [37–88];
P
=0.046), whereas the modified Rankin scale at 90 days showed a worse prognosis (median [IQR]; 5 [5–6] versus 3 [1–4];
P
<0.01). All perfusion imaging parameters were significantly predicting the sICH group in multiple logistic regression analysis. The value of relative cerebral blood volume was the parameter most strongly associated with sICH in receiver operating characteristic curve analysis (area under the curve=0.90, 95% CI [0.83–0.98]; cutoff 43 mL; sensitivity, 86 %; specificity, 87%).

Conclusion
Among perfusion computed tomography parameters, relative cerebral blood volume is highly associated with sICH after mechanical thrombectomy for cerebral large vessel occlusion. In patients with low relative cerebral blood volume regions, the indication of mechanical thrombectomy should be carefully considered for postoperative intracranial hemorrhage.
ARMing the Edge: Designing Edge Computing–Capable Machine Learning Algorithms to Target ARM Doppler Lidar Processing
Authors: Jackson Robert C. , Raut Bhupendra A. , Dematties Dario , Collis Scott M. , Ferrier Nicola , Beckman Pete , Sankaran Rajesh , Kim Yongho , Park Seongha , Shahkarami Sean , Newsom Rob 
Published: June 2023

Abstract
There is a need for long-term observations of cloud and precipitation fall speeds in validating and improving rainfall forecasts from climate models. To this end, the U.S. Department of Energy Atmospheric Radiation Measurement (ARM) user facility Southern Great Plains (SGP) site at Lamont, Oklahoma, hosts five ARM Doppler lidars that can measure cloud and aerosol properties. In particular, the ARM Doppler lidars record Doppler spectra that contain information about the fall speeds of cloud and precipitation particles. However, due to bandwidth and storage constraints, the Doppler spectra are not routinely stored. This calls for the automation of cloud and rain detection in ARM Doppler lidar data so that the spectral data in clouds can be selectively saved and further analyzed. During the ARMing the Edge field experiment, a Waggle node capable of performing machine learning applications in situ was deployed at the ARM SGP site for this purpose. In this paper, we develop and test four algorithms for the Waggle node to automatically classify ARM Doppler lidar data. We demonstrate that supervised learning using a ResNet50-based classifier will classify 97.6% of the clear-air images and 94.7% of cloudy images correctly, outperforming traditional peak detection methods. We also show that a convolutional autoencoder paired with k-means clustering identifies 10 clusters in the ARM Doppler lidar data. Three clusters correspond to mostly clear conditions with scattered high clouds, and seven others correspond to cloudy conditions with varying cloud-base heights.