bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Phase I/IIa Trial of Yttrium-90 Radioembolization in Combination with Durvalumab for Locally Advanced Unresectable Hepatocellular Carcinoma
Authors: Lee Yun Bin , Nam Joon Yeul , Cho Eun Ju , Lee Jeong-Hoon , Yu Su Jong , Kim Hyo-Cheol , Paeng Jin Chul , Yoon Jung-Hwan , Kim Yoon Jun 
Published: July 2023

AbstractPurpose:Synergistic effect of radiotherapy and immunotherapy for the treatment of hepatocellular carcinoma (HCC) has been reported. This phase I/IIa pilot trial evaluated preliminary efficacy and safety of combination of radioembolization with yttrium-90 microspheres (Y90-radioembolization) and durvalumab in patients with locally advanced unresectable HCC.Patients and Methods:Patients with Child-Pugh score ≤ 7 and locally advanced HCC, defined as Barcelona Clinic Liver Cancer (BCLC) stage B HCC or BCLC-C disease without extrahepatic metastases, received Y90-radioembolization followed by intravenous durvalumab 1,500 mg 7 to 14 days after Y90-radioembolization and every 4 weeks thereafter. Primary endpoint was time to progression (TTP) assessed by modified RECIST (mRECIST). Secondary endpoints included overall survival (OS), progression-free survival (PFS), objective response rate (ORR) determined by mRECIST, and safety.Results:All 24 patients enrolled received Y90-radioembolization and 23 received at least one dose of durvalumab. Median follow-up duration was 19.0 months (range, 2.2–24.2). Median TTP was 15.2 months [95% confidence interval (CI), 6.1–not estimated]. Median OS was not reached and 18-month OS rate was 58.3% (95% CI, 36.4–75.0). Median PFS was 6.9 months (95% CI, 5.4–15.2). Seven (29.2%) patients had a complete response and 13 (54.2%) had a partial response; ORR was 83.3% (95% CI, 62.6–95.3). Eleven (47.8%) patients experienced any-grade treatment-related adverse events. Two (8.7%) patients had grade 3 treatment-related adverse events (neutropenia and fever). None experienced any treatment-related serious adverse events.Conclusions:In patients with locally advanced unresectable HCC, the combination of Y90-radioembolization and durvalumab demonstrated promising efficacy and safety, warranting further evaluation in large-scale controlled trials.
Historical Redlining, Socioeconomic Distress, and Risk of Heart Failure Among Medicare Beneficiaries
Authors: Mentias Amgad , Mujahid Mahasin S. , Sumarsono Andrew , Nelson Robert K. , Madron Justin M. , Powell-Wiley Tiffany M. , Essien Utibe R. , Keshvani Neil , Girotra Saket , Morris Alanna A. , Sims Mario , Capers Quinn , Yancy Clyde , Desai Milind Y. , Menon Venu , Rao Shreya , Pandey Ambarish 
Published: July 2023

BACKGROUND:
The association of historical redlining policies, a marker of structural racism, with contemporary heart failure (HF) risk among White and Black individuals is not well established.

METHODS:
We aimed to evaluate the association of redlining with the risk of HF among White and Black Medicare beneficiaries. Zip code–level redlining was determined by the proportion of historically redlined areas using the Mapping Inequality Project within each zip code. The association between higher zip code redlining proportion (quartile 4 versus quartiles 1–3) and HF risk were assessed separately among White and Black Medicare beneficiaries using generalized linear mixed models adjusted for potential confounders, including measures of the zip code–level Social Deprivation Index.

RESULTS:

A total of 2 388 955 Medicare beneficiaries (Black n=801 452; White n=1 587 503; mean age, 71 years; men, 44.6%) were included. Among Black beneficiaries, living in zip codes with higher redlining proportion (quartile 4 versus quartiles 1–3) was associated with increased risk of HF after adjusting for age, sex, and comorbidities (risk ratio, 1.08 [95% CI, 1.04–1.12];
P
<0.001). This association remained significant after further adjustment for area-level Social Deprivation Index (risk ratio, 1.04 [95% CI, 1.002–1.08];
P
=0.04). A significant interaction was observed between redlining proportion and Social Deprivation Index (
P
interaction
<0.01) such that higher redlining proportion was significantly associated with HF risk only among socioeconomically distressed regions (above the median Social Deprivation Index). Among White beneficiaries, redlining was associated with a lower risk of HF after adjustment for age, sex, and comorbidities (risk ratio, 0.94 [95% CI, 0.89–0.99];
P
=0.02).

CONCLUSIONS:
Historical redlining is associated with an increased risk of HF among Black patients. Contemporary zip code–level social determinants of health modify the relationship between redlining and HF risk, with the strongest relationship between redlining and HF observed in the most socioeconomically disadvantaged communities.
Socioeconomic Disparities and Mediators for Recurrent Atherosclerotic Cardiovascular Disease Events After a First Myocardial Infarction
Authors: Ohm Joel , Kuja-Halkola Ralf , Warnqvist Anna , Häbel Henrike , Skoglund Per H. , Sundström Johan , Hambraeus Kristina , Jernberg Tomas , Svensson Per 
Published: July 2023

BACKGROUND:
Low socioeconomic status is associated with worse secondary prevention use and prognosis after myocardial infarction (MI). Actions for health equity improvements warrant identification of risk mediators. Therefore, we assessed mediators of the association between socioeconomic status and first recurrent atherosclerotic cardiovascular disease event (rASCVD) after MI.

METHODS:
In this cohort study on 1-year survivors of first-ever MI with Swedish universal health coverage ages 18 to 76 years, individual-level data from SWEDEHEART (Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies) and linked national registries was collected from 2006 through 2020. Exposure was socioeconomic status by disposable income quintile (principal proxy), educational level, and marital status. The primary outcome was rASCVD and secondary outcomes were cardiovascular and all-cause mortality. We initially assessed the incremental attenuation of hazard ratios with 95% CIs in sequential multivariable models adding groups of potential mediators (ie, previous risk factors, acute presentation and infarct severity, initial therapies, and secondary prevention). Thereafter, the proportion of excess rASCVD associated with a low income mediated through nonparticipation in cardiac rehabilitation, suboptimal statin management, a cardiometabolic risk profile, persistent smoking, and blood pressure above target after MI were calculated using causal mediation analysis.

RESULTS:
Among 68 775 participants (73.8% men), 7064 rASCVD occurred during a mean 5.7-year follow-up. Income, adjusted for age, sex, and calendar year, was associated with rASCVD (hazard ratio, 1.63 [95% CI, 1.51–1.76] in the lowest versus highest income quintile). Risk attenuated most by adjustment for previous risk factors and by adding secondary prevention variables for a final model (hazard ratio, 1.38 [95% CI, 1.26–1.51]) in the lowest versus highest income quintile. The proportions of the excess 15-year rASCVD risk in the lowest income quintile mediated through nonparticipation in cardiac rehabilitation, cardiometabolic risk profile, persistent smoking, and poor blood pressure control were 3.3% (95% CI 2.1–4.8), 3.9% (95% CI, 2.9–5.5), 15.2% (95% 9.1–25.7), and 1.0% (95% CI 0.6–1.5), respectively. Risk mediation through optimal statin management was negligible.

CONCLUSIONS:
Nonparticipation in cardiac rehabilitation, a cardiometabolic risk profile, and persistent smoking mediate income-dependent prognosis after MI. In the absence of randomized trials, this causal inference approach may guide decisions to improve health equity.
Arrhythmia and Survival Outcomes Among Black Patients and White Patients With a Primary Prevention Defibrillator
Authors: Younis Arwa , Ali Sanah , Hsich Eileen , Goldenberg Ido , McNitt Scott , Polonsky Bronislava , Aktas Mehmet K. , Kutyifa Valentina , Wazni Oussama M. , Zareba Wojciech , Goldenberg Ilan 
Published: July 2023

BACKGROUND:
Black Americans have a higher risk of nonischemic cardiomyopathy (NICM) than White Americans. We aimed to evaluate differences in the risk of tachyarrhythmias among patients with an implantable cardioverter-defibrillator (ICD).

METHODS:
The study population comprised 3895 ICD recipients in the United States enrolled in primary prevention ICD trials. Outcome measures included ventricular tachyarrhythmia (VTA), atrial tachyarrhythmia (ATA), ICD therapies, VTA burden (using Andersen-Gill recurrent event analysis), death, and the predicted benefit of the ICD. All events were adjudicated blindly. Outcomes were compared between self-reported Black patients versus White patients with cardiomyopathy (ischemic and NICM).

RESULTS:

Black patients were more likely to be female (35% versus 22%) and younger (57±12 versus 62±12 years) with a higher frequency of comorbidities. In NICM, Black patients had a higher rate of first VTA, fast VTA, ATA, and appropriate and inappropriate ICD therapy (VTA ≥170 bpm, 32% versus 20%; VTA ≥200 bpm, 22% versus 14%; ATA, 25% versus 12%; appropriate therapy, 30% versus 20%; and inappropriate therapy, 25% versus 11%;
P
<0.001 for all). Multivariable analysis showed that Black patients with NICM experienced a higher risk of all types of arrhythmia or ICD therapy (VTA ≥170 bpm, hazard ratio [HR] 1.71; VTA ≥200 bpm, HR 1.58; ATA, HR 1.87; appropriate therapy, HR 1.62; inappropriate therapy, HR 1.86;
P
≤0.01 for all), higher burden of tachyarrhythmias or therapies (VTA, HR 1.84; appropriate therapy, HR 1.84;
P
<0.001 for both), and a higher risk of death (HR 1.92;
P
=0.014). In contrast, in ischemic cardiomyopathy, the risk of all types of tachyarrhythmia, ICD therapy, or death was similar between Black patients and White patients. Both Black patients and White patients derived a significant and similar benefit from ICD implantation.

CONCLUSIONS:
Among patients with NICM with an ICD for primary prevention, Black patients compared with White patients had a high risk and burden of VTA, ATA, and ICD therapies with a lower survival rate. Nevertheless, the overall benefit of the ICD was maintained and was similar to that of White patients.
Assessing Tropical Pacific–Induced Predictability of Southern California Precipitation Using a Novel Multi-Input Multioutput Autoencoder
Authors: Passarella Linsey S. , Mahajan Salil 
Published: July 2023

Abstract
We construct a novel multi-input multioutput autoencoder (MIMO-AE) to capture the nonlinear relationship of Southern California precipitation and tropical Pacific Ocean sea surface temperature. The MIMO-AE is trained on both monthly tropical Pacific sea surface temperature (TP-SST) and Southern California precipitation (SC-PRECIP) anomalies simultaneously. The covariability of the two fields in the MIMO-AE shared nonlinear latent space can be condensed into an index, termed the MIMO-AE index. We use a transfer learning approach to train a MIMO-AE on the combined dataset of 100 yr of output from a historical simulation with the Energy Exascale Earth Systems Model, version 1, and a segment of observational data. We further use long short-term memory networks to assess subseasonal predictability of SC-PRECIP using the MIMO-AE index. We find that the MIMO-AE index provides enhanced predictability of SC-PRECIP for a lead time of up to 4 months as compared with the Niño-3.4 index and the El Niño–Southern Oscillation longitudinal index.

Significance Statement
Traditional El Niño–Southern Oscillation indices, like the Niño-3.4 index, although well predicted themselves, fail to offer reliable subseasonal-to-seasonal predictions of western U.S. precipitation. Here, we use a machine learning approach called a multi-input, multioutput autoencoder to capture the relationship between tropical Pacific Ocean and Southern California precipitation and project it onto a new index, which we call the MIMO-AE index. Using machine learning–based time series predictions, we find that the MIMO-AE index offers enhanced predictability of Southern California precipitation up to a lead time of 4 months as compared with other ENSO indices.
Performance of Cameroonian natural rubber as a polymer matrix for ecofriendly fiberboard: Modeling of water absorption and prediction of mechanical properties
Authors: Laurence Carlos Ngoune Donkeng , Aimé Elime Bouboama , Abel Emmanuel Njom , Solange Fogue Matchum , Kunwufine Deodonne , Touraine Lidwine Wandji Nana 
Published: July 2023

This research work sheds light on the manufacture of Eco-friendly fiberboards (EFBs) based on natural rubber (NR). Modeling of water absorption and prediction of tensile properties of EFBs were then developed. Sisal fibers (SF) are used for reinforcement at 50, 60, 70 and 80% rates. The 0% compound is the vulcanised natural rubber (NRV). Sulphur vulcanisation through thermo-pressure was used to produce the EFBs. Cross-linking density, mechanical, thermal, chemical and hydrous properties were investigated. Thermogravimetric analysis (TGA) and Fourier transform infrared (FTIR) revealed that SFs altered the thermal stability of NR that goes from one to three phases of thermal degradation and increases its stiffness through the increase of the young’s modulus (from 7.53 ± 0.72 MPa for NR to 31.59 ± 6.61 MPa for the best EFB value). Predictions based on the Weibull distribution set the load with the best properties at 50% for an ultimate tensile stress of 10 MPa. An analytical modeling based on the Fick water absorption process of EFBs and NRV have been developed and the load at 60% SF is defined as the threshold by the analytical model with a diffusion coefficient of 0.073 mm2/s. NRV thus shows its high suitability in the manufacture of EFBs which can be used for various purposes in the automobile sector.
Post-COVID-19 survivors’ strategies for improving occupational balance: A qualitative study
Authors: Mahdizadeh Amin , Khankeh Hamidreza , Ghodsi Hasan , Hosseini Seyed Ali , Akbarfahimi Nazila 
Published: July 2023

Introduction: Coronavirus disease 2019 (COVID-19) has caused some major changes in occupational patterns that form part of the individual’s occupational identity. Due to debilitating symptoms, post-COVID-19 survivors with limitations in the occupational performance areas may experience occupational imbalance. The objective of this study was to investigate the methods employed by patients to engage in their daily activities for regaining occupational balance. Methods: The study used an interpretive paradigm and conventional content analysis. An in-depth semi-structured interview was conducted with 11 patients who had been hospitalized due to COVID-19 in the past 6 months or less, along with their three primary caregivers residing in Tehran. The sampling method used was purposive and continued until conceptual saturation was reached. Participants with the most tremendous possible diversity in demographic variables were included. Data were analyzed using Corbin and Strauss’s recommended Constant Comparative Analysis. Results: The findings showed that patients used different strategies which included self-treatment based on others’ recommendations, compensatory, fatigue prevention and adaptive strategies to restore occupational balance. Conclusion: As occupational therapists, we must understand post-COVID-19 survivors’ perspectives on occupations and their preferred strategies. Also, findings confirm that occupational balance is a dynamic process that the adaptive capacities of the patients help to restore occupational balance.
Caregivers’ Perspectives on the Impact of Cannabidiol (CBD) Treatment for Dravet and Lennox-Gastaut Syndromes: A Multinational Qualitative Study
Authors: Marshall Jade , Skrobanski Hanna , Moore-Ramdin Lisa , Kornalska Klaudia , Swinburn Paul , Bowditch Sally 
Published: July 2023

Objective To increase understanding of the impact of cannabidiol (CBD) on outcomes beyond seizure control among individuals with Dravet syndrome or Lennox-Gastaut syndrome. Methods Qualitative interviews were conducted with caregivers of individuals with Dravet syndrome or Lennox-Gastaut syndrome treated with plant-derived, highly purified CBD medicine (Epidiolex in the USA; Epidyolex in Europe; 100 mg/mL oral solution). Symptoms and impacts of Dravet syndrome and Lennox-Gastaut syndrome on individuals were explored, as were the effects of CBD. Data were analyzed using thematic analysis. Results Twenty-one caregivers of individuals with Dravet syndrome (n = 14) and Lennox-Gastaut syndrome (n = 7) aged 4-22 years participated. Health-related quality of life improvements associated with CBD included cognitive function, communication, behavior, mobility, and participation in daily activities. Seizure frequency reduction was commonly reported (n = 12), resulting in caregivers having greater freedom and family life being less disrupted. Adverse events were reported by 10 caregivers. Conclusion In addition to reduced seizure frequency, CBD may have a wide range of beneficial effects beyond seizure control that warrant further investigation.
Profiling and Benchmarking Central Nervous System Infections in an Infectious Diseases Intensive Care Unit
Authors: Andrade Hugo Boechat , Rocha Ferreira da Silva Ivan , Espinoza Rodolfo , da Silva Mayara Secco Torres , Theodoro Pedro Henrique Nascimento , Ferreira Marcel Treptow , Soares Jesus , Belay Ermias D. , Sejvar James J. , Bozza Fernando Augusto , Cerbino-Neto José , Japiassú André Miguel 
Published: July 2023

Background There is little information comparing the performance of community acquired central nervous system infections (CNSI) treatment by intensive care units (ICUs) specialized in infectious diseases with treatment at other ICUs. Our objective was to reduce these gaps, creating bases for benchmarking and future case-mix classification. Methods This is a retrospective observational cohort of 785 admissions with 82 cases of CNSI admitted to the ICU of an important Brazilian referral center for infectious diseases (INI) between January 2012 and January 2019. Comparisons were made to data retrospectively collected from the 303,500 intensive care admissions from the Brazilian state health care system included in the Epimed Monitor database. Clinical, epidemiologic, and performance indicators: the standardized mortality rate (SMR) and the standardized resource use rate per ICU surviving patient (SRU) were collected. Results Case-mix infections profile and SMR/SRU data. SUS Mixed medical/surgical ICUs: SMR = 1.26, SRU = 1.59; SUS Neurological ICUs: SMR = 1.17, SRU = 2.23; INI ICU: SMR = 1.1, SRU = 1.1; INI ICU CNSI patients: SMR = 0.95, SRU = 1.01. Conclusions Severe patients with CNSI can be efficiently and effectively treated in an ICU specialized in infectious diseases when compared to mixed medical/surgical and neurological ICUs from the public health system. At the same time, we provided profiling and a case-mix that can help and encourage benchmarking by other institutions and other countries.
Interval cancer after two rounds of a Swedish population-based screening program using gender-specific cut-off levels in fecal immunochemical test
Authors: Ribbing Wilén Hanna , Blom Johannes 
Published: July 2023

Objective To evaluate interval cancer (IC) after two screening rounds of the Swedish population-based screening program of Stockholm–Gotland applying gender-specific cut-off levels in the fecal immunochemical test (FIT). Methods All 60- to 69-year-olds invited to screening 2015–2019 were included. The cut-off level for a positive test was 40 µg/g in women and 80 µg/g in men. Screening-detected colorectal cancers (SD CRCs) and ICs were verified in the Swedish Colorectal Cancer Register, and the follow-up time was two years from invitation. The test sensitivity, the IC rate (ICs per 10,000 screening negatives) and the IC incidence (ICs per 100,000 person-years) relative to the background CRC incidence were assessed by gender and age. The FIT levels were compared in men and women for CRCs diagnosed within one year of the sample. Results In the second screening round, 229,187 were invited, and SD CRCs and ICs were diagnosed in 193 and 144, respectively. The IC rate was 8.9 (7.4–10.3) and test sensitivity 0.61 (0.55–0.66), and was similar in men and women. For two screening rounds, the IC rate was significantly higher in men than in women, but the IC incidence/ background CRC incidence was similar in both genders. The FIT levels in female participants with CRC were significantly lower overall, and in early-staged CRCs as compared to men, and proximal localization was more common in women. In multivariable analysis, FIT levels were significantly lower in proximal CRCs. Conclusion Over two rounds, the IC incidence relative to the background CRC incidence was similar in men and women supporting a gender-specific screening strategy. The results could be explained by lower FIT levels in women due to proximal CRC localization.
Psychotherapies for the Youth: Evolution, Progress, and On Way to Eclecticism
Authors: Pradhan Basant , Sahoo Madhusmita 
Published: July 2023

Psychotherapies for the youth have resulted from the confluence of 3 major disciplines: adult psychology and psychiatry, developmental neurology and pediatrics, and developmental psychology and ethology. Since their humble origins in the psychoanalytically oriented play therapy and the related theories in the pre-War Germany, over more than a century, they have embraced diverse theoretical views that include but not limited to the integration of developmental issues, evolution of the child guidance movement, and the various influences of institutional and social policies. Such a rich journey has eventually resulted in evidence-based practices (EBPs)—powerful interventions for children and families for complex behavioral problems. In this chapter, we attempt to trace the blooming field of youth psychotherapies in their historical contexts, provide an account of the existing gaps of knowledge, briefly narrate the modern-day developments, mostly regarding the multimodal/eclectic treatment aspects and finally, given their rapid growth, we speculate about their (positive) future. Child and adolescent therapies have progressed considerably, as reflected in the number of controlled studies, their methodological quality, and identification of evidence-based treatments. Despite the methodological difficulties in outcome studies, the field has witnessed major advances regarding the efficacy of selected treatments in child and adolescent psychotherapy and good quality meta-analyses do suggest that 75% of children and young people who attend therapy benefit from it. However, despite the comforting data related to efficacy, major challenges still remain, especially in regard to patient engagement and dropout rates, gap in knowledge about what works and why it works, cultural sensitivity, and data of cost- effectiveness—just to quote a few. Several key areas have been neglected in research, such as the mechanisms of change, the moderators of treatment outcome, and the generalizability of the research findings to the clinical practice arena—this has greatly limited what we know about treatment and partly explains the relative lack of personalized psychotherapies and scarcity in their dissemination/generalization despite the documented evidence on their efficacy. Tailoring treatment more specifically to each patient may be necessary to reduce this nonresponsiveness and dropping outs, as one treatment does not fit all. This necessitates the need for eclecticism—to combine youth psychotherapies with other modes of treatments, such as medications, neuromodulation interventions, and Yoga and mindfulness-based cognitive therapy. Future practice for treatment of mental health conditions in the youth will likely adapt to this huge need for development of eclectic modalities and also reflect cost effectiveness and cultural sensitivity to an increasingly diverse population.