bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survival results according to Oncotype Dx recurrence score in patients with hormone receptor positive HER-2 negative early-stage breast cancer: first multicenter Oncotype Dx recurrence score survival data of Turkey
Authors: Ünal Çağlar , Özmen Tolga , Ordu Çetin , Pilanci Kezban Nur , İlgün Ahmet Serkan , Gökmen Erhan , Almuradova Elvina , Özdoğan Mustafa , Güler Nilüfer , Uras Cihan , Kara Halil , Demircan Orhan , Işık Selver , Alço Gül , Saip Pınar , Aydın Esra , Duymaz Tomris , Çelebi Filiz , Yararbaş Kanay , Soybir Gursel , Ozmen Vahit 
Published: June 2023

BackgroundThe Oncotype Dx recurrence score (ODx-RS) guides the adjuvant chemotherapy decision-making process for patients with early-stage hormone receptor-positive, HER-2 receptor-negative breast cancer. This study aimed to evaluate survival and its correlation with ODx-RS in pT1-2, N0-N1mic patients treated with adjuvant therapy based on tumor board decisions.Patients and methodsEstrogen-positive HER-2 negative early-stage breast cancer patients (pT1-2 N0, N1mic) with known ODx-RS, operated on between 2010 and 2014, were included in this study. The primary aim was to evaluate 5-year disease-free survival (DFS) rates according to ODX-RS.ResultsA total of 203 eligible patients were included in the study, with a median age of 48 (range 26-75) and median follow-up of 84 (range 23-138) months. ROC curve analysis for all patients revealed a recurrence cut-off age of 45 years, prompting evaluation by grouping patients as ≤45 years vs. &gt;45 years. No significant difference in five-year DFS rates was observed between the endocrine-only (ET) and chemo-endocrine (CE) groups. However, among the ET group, DFS was higher in patients over 45 years compared to those aged ≤45 years. When stratifying by ODx-RS as 0-17 and ≥18, DFS was significantly higher in the former group within the ET group. However, such differences were not seen in the CE group. In the ET group, an ODx-RS ≥18 and menopausal status were identified as independent factors affecting survival, with only an ODx-RS ≥18 impacting DFS in patients aged ≤45 years. The ROC curve analysis for this subgroup found the ODx-RS cut-off to be 18.ConclusionThis first multicenter Oncotype Dx survival analysis in Turkey demonstrates the importance of Oncotype Dx recurrence score and age in determining treatment strategies for early-stage breast cancer patients. As a different aproach to the literature, our findings suggest that the addition of chemotherapy to endocrine therapy in young patients (≤45 years) with Oncotype Dx recurrence scores of ≥18 improves DFS.
Clinical features and surgical outcomes of high grade pleomorphic xanthoastrocytomas: a single-center experience with a systematic review
Authors: Zuo Pengcheng , Li Tian , Sun Tao , Wu Wenhao , Wang Yujin , Zhang Mingxin , Wu Zhen , Zhang Junting , Zhang Liwei 
Published: June 2023

PurposeHigh grade pleomorphic xanthoastrocytomas (HGPXAs) are very rare and their management and prognostic outcomes remain unclear. To better understand the disease, we aimed to evaluate the risk factors for progression-free survival (PFS) and overall survival (OS), and propose a treatment protocol based on cases from our institute and cases from the literature.MethodsThe authors reviewed the clinical data of 26 patients with HGPXAs who underwent surgical treatment in Department of Neurosurgery of Beijing Tiantan Hospital between August 2014 and September 2021. We also searched the PubMed database using the keywords “anaplastic” combined with “pleomorphic xanthoastrocytoma(s)” between January 1997 and October 2022. Risk factors for PFS and OS were evaluated in the pooled cases.ResultsThe authors’ cohort included 11 males and 15 females with a mean age of 36.7 ± 20.3 years (range: 5.5-71 years). Gross-total resection (GTR) and non-GTR were achieved in 17 (65.4%) and 9 (34.6%) patients, respectively. Radiotherapy and chemotherapy were administered to 22 and 20 patients, respectively. After a mean follow-up of 20.5 ± 21.2 months (range: 0.5-78.1 months), 7 patients suffered tumor recurrence and 6 patients died with a mean OS time of 19.4 ± 10.8 months (range: 8-36 months). In the literature between January 1997 and October 2022, 56 cases of HGPXAs were identified in 29 males and 27 females with a mean age of 29.6 ± 19.6 years (range; 4-74 years). Among them, 24 (44.4%) patients achieved GTR. Radiotherapy and chemotherapy was administered to 31 (62%) patients and 23 (46%) patients, respectively. After a median follow-up of 31.4 ± 35.3 months (range: 0.75-144 months), the mortality and recurrence rates were 32.5% (13/40) and 70% (28/40), respectively. Multivariate Cox regression model demonstrated that non-GTR (HR 0.380, 95% CI 0.174-0.831, p=0.015), age≥30 (HR 2.620, 95% CI 1.183-5.804, p=0.018), no RT (HR 0.334,95% CI 0.150-0.744, p=0.007) and no CT (HR 0.422, 95% CI 0.184-0.967, p=0.042) were negative prognostic factors for PFS. Non-GTR (HR 0.126, 95% CI 0.037-0.422, p=0.001), secondary HGPXAs (HR 7.567, 95% CI 2.221-25.781, p=0.001), age≥30 (HR 3.568, 95% CI 1.190-10.694, p=0.023) and no RT (HR 0.223,95% CI 0.073-0.681, p=0.008) were risk factors for OS.Conclusion:High grade pleomorphic xanthoastrocytomas are very rare brain tumors. Children and younger adults have better clinical outcome than elderly patients. Secondary HGPXAs had worse OS than primary HGPXAs. Complete surgical excision plus RT and CT is recommended for this entity. The frequency of BRAF mutations in HGPXAs is 47.5% (19/40) in this study, however, we do not find the connections between BRAF mutations and clinical outcomes. Future studies with larger cohorts are necessary to verify our findings.
Cost-effectiveness and budget impact of pembrolizumab+axitinib versus sunitinib in patients with advanced clear-cell renal cell carcinoma in the Netherlands
Authors: Xander Nicolas S. H. , Fiets W. Edward , Uyl-de Groot Carin A. 
Published: June 2023

BackgroundThe phase 3 clinical trial KEYNOTE-426 suggested a higher efficacy regarding overall survival (OS) and progression-free survival (PFS) of pembrolizumab+axitinib compared to sunitinib as a first-line treatment for patients with advanced renal cell carcinoma. In this analysis, the potential cost-effectiveness of this combination treatment versus sunitinib for patients with advanced clear-cell renal cell carcinoma (accRCC) was examined from the societal perspective in the Netherlands.MethodsFor this analysis, a partitioned survival model was constructed. Clinical data were obtained from the published KEYNOTE-426 trial reports; data on costs and (dis-)utilities were derived from published literature. Costs outside of the healthcare sector included treatment-related travel, informal care and productivity loss. Next to a probabilistic scenario analysis, various scenario analyses were performed that aimed at survival extrapolation, different utility values, treatment duration and drug pricing, as well as restricting the cohort to patients with an intermediate or poor prognosis. Further, a budget impact analysis over three years was conducted, in which a sensitivity analysis concerning ranges in costs and the number of patients was applied. Moreover, a scenario concerning increasing market penetration of pembrolizumab+axitinib up to a market share of 80% in the third year was analyzed.ResultsThe incremental cost-effectiveness ratio (ICER) of pembrolizumab+axitinib was estimated at €368,396/quality-adjusted life year (QALY) gained, with an incremental QALY gain of 0.55 over sunitinib. The probability of cost-effectiveness at a willingness-to-pay threshold of €80,000/QALY was estimated at 0%, a 50% probability was estimated at €340,000/QALY. Cost-effectiveness was not achieved in any of the applied scenarios. The budget impact over three years amounted to €417.3 million upon instantaneous and full replacement of sunitinib, and to €214.9 million with increasing market penetration.ConclusionPembrolizumab+axitinib was not estimated to be cost-effective compared to sunitinib as a first-line treatment for patients with accRCC in the Netherlands from a societal perspective. In none of the analyzed scenarios, cost-effectiveness was achieved. However, price reductions and shorter treatment durations might lead to a more favorable ICER.
People's experiences living with peripheral neuropathy: a qualitative study
Authors: Alkandari Maryam , Hollywood Amelia 
Published: June 2023

IntroductionPeripheral neuropathy is a neurological disorder characterised by pain, numbness, or tingling due to nerve damage. Peripheral neuropathy is one of the main health issues in Kuwait and is a rising concern which affects a large proportion of the population, therefore the lived experience needs to be explored to identify areas for improvement in care. This qualitative study explored the experiences of people living with peripheral neuropathy in Kuwait.MethodsSemi-structured interviews were conducted with 25 participants recruited from the Neurology Outpatient Clinic of the Ibn Sina Hospital in Kuwait. The interview questions explored their experiences and understanding of pain along with the impact on their daily life. The interviews were audio recorded, transcribed and translated into English then coded using NVivo 12. Thematic analysis was conducted to identify patterns and themes in the data.ResultsThree major themes were identified including treatment beliefs (perceived effectiveness of treatment and seeking alternative treatments), the barriers to pain management (medication side effects, relationships with healthcare professionals and lack of information and access to healthcare), and the impact on quality of life (impact on work and social, physical, and psychological consequences). Self-efficacy was a key construct and over-arching theme that was discussed in all aspects, which finds reflection in the protection motivation theory.DiscussionThis paper presents the experiences of people living with peripheral neuropathy and highlights there is scope for improvement of current treatments in Kuwait. Self-management strategies are recommended alongside prescribed medication and healthcare professionals are encouraged to use a patient-centered approach. More importantly, information and support on the condition to promote coping strategies and self-efficacy should be adopted to improve quality of life. These findings can be implemented locally and globally to improve the quality of care provided to people living with peripheral neuropathy.
Dalbavancin as suppressive antibiotic therapy in patients with prosthetic infections: efficacy and safety
Authors: Ruiz-Sancho Andrés , Núñez-Núñez María , Castelo-Corral Laura , Martínez-Marcos Francisco Javier , Lois-Martínez Nagore , Abdul-Aziz Mohd Hafiz , Vinuesa-García David 
Published: June 2023

Suppressive antibiotic therapy (SAT) is a strategy to alleviate symptoms and/or to reduce the progression of an infection when other treatment options cannot be used. Dalbavancin, due to its prolonged half-life, enables (bi) weekly dosing. Here, we report our multicenter real-life clinical experience with dalbavancin used as SAT in patients with prosthetic joint or vascular infections. Medical records of all adult patients with documented vascular or orthopedic chronic prosthetic infections, who received dalbavancin as SAT between 2016 and 2018 from four Spanish hospitals were reviewed for inclusion. Descriptive analysis of demographic characteristics, Charlson Comorbidity index, Barthel index, isolated pathogens and indication, concomitant antibiotic use, adverse events, and clinical outcome of SAT were performed. Eight patients were eligible for inclusion, where six patients had prosthetic vascular infections (aortic valve) and two patients had knee prosthetic joint infections. The most common pathogens were methicillin-susceptible Staphylococcus aureus and Enterococcus faecium. All patients had a history of prior antibiotic treatment for the prosthetic infection [median duration of antibiotic days 125 days (IQR, 28–203 days)]. The median number of dalbavancin doses was 29 (IQR, 9–61) and concomitant antibiotic use (n = 5, 62.5%). Clinical success was reported in 75% (n = 6) of patients. Adverse events were reported in two patients (mild renal and hepatic impairment). The median estimated cost savings due to the avoided hospital days was €60185 (IQR, 19,916–94984) per patient. Despite the limitations of our study, this preliminary data provides valuable insight to support further evaluation of dalbavancin for SAT in patients with prosthetic infections in the outpatient setting when alternative treatments are not feasible.
An open-label, acute clinical trial in adults to assess ketone levels, gastrointestinal tolerability, and sleepiness following consumption of (R)-1,3-butanediol (Avela™)
Authors: Lowder James , Fallah Shafagh , Venditti Carolina , Musa-Veloso Kathy , Kotlov Vassili 
Published: June 2023

Introduction: A study was undertaken to determine the acute effects of a beverage made with Avela™ (R)-1,3-butanediol, on blood beta-hydroxybutyrate (BHB) levels (using the Keto-Mojo monitor), gastrointestinal (GI) tolerability (using the modified visual analogue scale GI Symptoms Tool), and sleepiness (using the Stanford Sleepiness Scale).Methods: Following a 12-h overnight fast, 26 healthy adults consumed one beverage containing 11.5 g of (R)-1,3-butanediol at each of 0, 30, and 60 min, culminating in a total intake of 34.5 g of (R)-1,3-butanediol. Blood BHB levels, GI tolerability, and sleepiness were assessed at baseline (0 min), and at 30, 60, 90, 120, 180, 240, and 300 min. At 240 min, a protein bar was consumed.Results: The mean (±SD) BHB fasting baseline level, maximal concentration, time at maximal concentration, and incremental area under the curve over 300 min were 0.23 ± 0.21 mmol/L, 2.10 ± 0.97 mmol/L, 133.85 ± 57.07 min, and 376.73 ± 156.76 mmol/L*min, respectively. BHB levels at each time point were significantly increased relative to baseline. In females, BHB Tmax was significantly greater (p = 0.046), and BHB iAUC0–300 min nearly significantly greater (p = 0.06) than in males.Discussion: The beverage formulated with Avela™ had no impact on sleepiness and was generally well-tolerated, with no or mild GI symptoms reported in most participants. Mild headaches were reported as an adverse event by five participants and judged possibly related to the study product in two of the participants.
The impact of basketball on the social adjustment of Chinese middle school students: the chain mediating role of interpersonal relationships and self-identity
Authors: Haoran Sui , Tianci Lu , Hanwen Chen , Baole Tao , Yiran Chen , Yan Jun 
Published: June 2023

BackgroundThis study examines the effects of 12 weeks of basketball on interpersonal relationships, self-identity and social adjustment of middle school students, as well as exploring the mediating role of interpersonal relationships and self-identity in basketball’s influence on social adjustment.MethodsA total of 87 students from a middle school in Jiangsu Province, China, were selected to participate in this study. A 12-week basketball intervention experiment was conducted, and questionnaires were administered to measure the study variables. Common method bias test, normality test, ANOVA and Pearson correlation analysis were used to analyze the study variables. The theoretical model of this study was also validated using the Process plug-in developed by Hayes, setting p &lt; 0.05 (two-tail) as statistically significant.ResultsAfter a 12-week basketball intervention experiment, the interpersonal relationships, self-identity and social adjustment of the middle school students in the experimental and control groups showed improvement, with the experimental group showing significantly more significant improvement than the control group. A 12-week basketball intervention can positively impact the social adjustment of middle school students, with interpersonal relationships and self-identity acting as a chain mediator in the impact process.
Is a combination of individual consultations, text message reminders and interaction with a Facebook page more effective than educational sessions for encouraging university students to increase their physical activity levels?
Authors: Alsaleh Eman 
Published: June 2023

BackgroundPhysical activity (PA) has been consistently reported as a crucial component of disease prevention and improvement of people’s health. Nevertheless, data has evidenced a decline in physical activity levels among adults in Jordan. Although previous behavioral change interventions have documented efficacy in increasing physical activity among adults, the PA levels is low among adults. A new motivational intervention that focuses on changing behavior toward performing the recommended level of physical activity is on need.ObjectiveThis two-arm single-center randomized controlled trial aimed to measure the efficacy of a multi-component behavioral intervention (including goal setting, self-monitoring, and feed-back) for increasing physical activity levels and self-efficacy for exercise and decreasing body mass index and blood pressure among students at a Jordanian University.SettingPhiladelphia University in Jordan.MethodsA behavioral intervention based on individualized consultations, text messages reminders and interaction with a Facebook page was compared with educational sessions in terms of efficacy for increasing physical activity levels among students at Philadelphia University.ResultsThe intervention and control groups were comparable at baseline. At 6 months a significant increase was seen in the moderate physical activity and walking levels of the intervention group compared with the control group. The mean change (SD) in total METs of moderate physical activity and walking was 503 (325.20) METs/week in the intervention group and 6 (271.20) METs/week in the control group. The mean change (SD) in steps/day was 3,000 (1,217) steps/day in the intervention group and 876 (1120.23) steps/day in the control group. The difference between mean change of the two groups was very significant at 2,124 (−820 to −563). Self-efficacy for exercise scale significantly increased among the intervention group compared with the control group. In addition, body mass index (BMI) declined from the baseline (Mean: 28.23, SD: 4.82) to 6 months (Mean: 25.36, SD: 5.23) for the intervention group.ConclusionBehavioral intervention through multicomponent strategies, alongside the implementation of an advanced communication strategy via phone and social media, is effective for motivating adult students to increase their physical activity levels.Clinical trial registrationISRCTN54100536.
Clonal hematopoiesis as a novel risk factor for type 2 diabetes mellitus in patients with hypercholesterolemia
Authors: Kim Min Joo , Song Han , Koh Youngil , Lee Heesun , Park Hyo Eun , Choi Sung Hee , Yoon Ji Won , Choi Su-Yeon 
Published: June 2023

IntroductionClonal hematopoiesis of indeterminate potential (CHIP) is associated with atherosclerosis and cardiovascular disease. It has been suggested that CHIP may be related to diabetes, so we investigated the association between CHIP and new-onset type 2 diabetes.MethodsThis study included 4,047 subjects aged &gt;=40 years without diabetes. To detect CHIP, targeted gene sequencing of genomic DNA from peripheral blood cells was performed. The incidence of new-onset type 2 diabetes during the follow-up period was evaluated.ResultsOf the total subjects, 635 (15.7%) had CHIP. During the median follow-up of 5.1 years, the incidence of new-onset diabetes was significantly higher in CHIP carriers than in subjects without CHIP (11.8% vs. 9.1%, p = 0.039). In a univariate analysis, CHIP significantly increased the risk of new-onset diabetes (HR 1.32, 95% CI 1.02–1.70, p = 0.034), but in a multivariate analysis, it was not significant. The CHIP-related risk of new onset diabetes differed according to LDL cholesterol level. In the hyper-LDL cholesterolemia group, CHIP significantly increased the risk of diabetes (HR 1.64, 95% CI 1.09–2.47, p = 0.018), but it did not increase the risk in the non-hyper-LDL cholesterolemia group. The subjects with CHIP and hyper-LDL-cholesterolemia had approximately twice the risk of diabetes than subjects without CHIP and with low LDL cholesterol (HR 2.05, 95% CI 1.40–3.00, p &lt; 0.001).ConclusionThe presence of CHIP was a significant risk factor for new-onset type 2 diabetes, especially in subjects with high LDL cholesterol. These results show the synergism between CHIP and high LDL cholesterol as a high-risk factor for diabetes.
Burden of falls attributable to low bone mineral density among people aged 60 years and over in China from 1990 to 2019
Authors: Fu Yali , Ba Lei , Lü Nianqing , Yang Huafeng , Hong Xin , Zhou Jinyi , Sun Zhiming 
Published: June 2023

ObjectiveFalls in older people have become a major public health, economic and societal problem. Osteoporosis predisposes older adults to high risk of falls, which were the most common outcome attributable to low bone mineral density (LBMD). In this study, we analyze the long-term trends in falls burden attributable to LBMD among people aged 60 years and over from 1990 to 2019, using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019).MethodsData from GBD 2019 were used to assess the long-term trends in mortality and disability-adjusted life-year (DALY) rates by Joinpoint regression. The age-period-cohort (APC) model was used to evaluate the effects of age, period and cohort on mortality rate of falls attributable to LBMD.ResultsThe mortality and DALYs rates of falls attributable to LBMD among people aged 60 years and over increased from 1990 to 2019, with average annual percentage changes (AAPCs) of 1.74% (95% CI: −1.47 to 2.01%) and 0.99% (95% CI: 0.80–1.19%), respectively. APC analysis revealed that the mortality rate due to LBMD significantly increased among the older people over the age of 75 years. The risk of falls mortality due to LBMD during the period of 1990–2019 initially declined but later elevated. An overall increasing risk for falls death attributable to LBMD was presented across birth cohorts, but in cohorts born after 1930, the upward trend has slowed down. The overall net drift per year attributable to LBMD was above 0. The corresponding results showed that the negative impact of period and cohort effects among males was more pronounced than those among females.ConclusionsFalls attributable to LBMD remain an ongoing health burden in the older people in China, and the mortality has been on the rise from 1990 to 2019, especially among the older people aged 80+ years group. The prevention and treatment of LBMD should be emphasized, especially among males and oldest-old people. Furthermore, there is an urgent need to strengthen the implementation of system-wide, integrated and effective public health policies and other health interventions in China.