bluuebunny/crossref_metadata_2025_split huggingface dataset:
Normofractionated and moderately hypofractionated proton therapy: comparison of acute toxicity and early quality of life outcomes
Authors: Pelak Maciej J. , Flechl Birgit , Hug Eugen , Galalae Razvan , Konrath Lisa , Góra Joanna , Fossati Piero , Lütgendorf-Caucig Carola , Tubin Slavisa , Konstantinovic Rastko , Mock Ulrike , Fussl Christoph , Georg Petra 
Published: August 2022

AimData on the safety of moderately hypofractionated proton beam therapy (PBT) are limited. The aim of this study is to compare the acute toxicity and early quality of life (QoL) outcomes of normofractionated (nPBT) and hypofractionated PBT (hPBT).Material and methodsWe prospectively compared acute toxicity and QoL between patients treated with nPBT (dose per fraction 1.8–2.3 Gy, n = 90) and hPBT (dose per fraction 2.5–3.1 Gy, n = 49) in following locations: head and neck (H&amp;N, n = 85), abdomen and pelvis (A&amp;P, n = 43), and other soft tissue (ST, n = 11). The toxicities were grouped into categories—mucosal, skin, and other sites—and evaluated according to the Common Terminology Criteria for Adverse Events (CTCAE) version 4.03 at baseline, treatment completion, and 3 months after PBT completion. QoL was evaluated with the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30 scale for all locations and additionally with EORTC QLQ-HN35 for H&amp;N patients.ResultsOverall, the highest toxicity grades of G0, G1, G2, and G3 were observed in 7 (5%), 40 (28.8%), 78 (56.1%), and 15 (10.8%) patients, respectively. According to organ and site, no statistically significant differences were detected in the majority of toxicity comparisons (66.7%). For A&amp;P, hPBT showed a more favorable toxicity profile as compared to nPBT with a higher frequency of G0 and G1 and a lower frequency of G2 and G3 events (p = 0.04), more patients with improvement (95.7% vs 70%, p = 0.023), and full resolution of toxicities (87% vs 50%, p = 0.008). Skin toxicity was unanimously milder for hPBT compared to nPBT in A&amp;P and ST locations (p = 0.018 and p = 0.025, respectively). No significant differences in QoL were observed in 97% of comparisons for QLQ-C30 scale except for loss of appetite in H&amp;N patients (+33.3 for nPBT and 0 for hPBT, p = 0.02) and role functioning for A&amp;P patients (0 for nPBT vs +16.7 hPBT, p = 0.003). For QLQ-HN35, 97.9% of comparisons did not reveal significant differences, with pain as the only scale varying between the groups (−8.33 vs −25, p = 0.016).ConclusionHypofractionated proton therapy offers non-inferior early safety and QoL as compared to normofractionated irradiation and warrants further clinical investigation.
Successful conversion surgery for locally advanced gallbladder cancer after gemcitabine and nab-paclitaxel chemotherapy
Authors: Yang Ziyi , Wu Ziyou , Xiong Yichen , Liu Shilei , Cai Chen , Shao Ziyu , Zhu Yidi , Song Xiaoling , Shen Wei , Wang Xuefeng , Wu Xiangsong , Gong Wei 
Published: August 2022

ObjectiveGallbladder cancer (GBC) is highly malignant and is often diagnosed at the advanced stage. Lack of opportunity to surgery results in an unsatisfactory outcome. This pilot study employed gemcitabine combined with nab-paclitaxel (AG) as a conversion therapeutic measure for locally advanced GBC and successfully achieved conversion surgery in three initially unresectable GBC patients. We will introduce our experience on improving the outcome of this dismal disease.MethodsRadiology and nuclear medicine imaging were performed in each patient, and resectability was evaluated by joint consultation of our multi-disciplinary team (MDT). Patients evaluated as unresectable were treated with the AG regimen and re-evaluated for treatment response. When complete or partial response is achieved, MDT opinion would be required to assess the possibility of performing conversion surgery with R0 resection.ResultsThree GBC patients who were initially evaluated as unresectable successfully underwent R0 resection after conversion therapy with the AG regimen. The first case was a recurrent GBC patient evaluated as locally advanced and eventually achieved pathological complete response. The second case was a GBC patient who underwent R1 resection with residual lesions in the gallbladder bed and isolated No. 16 lymph node metastasis and who had a pathologically complete response after treatment. The third case had multiple but resectable liver metastases; both objective response and partial pathologic response were achieved. None of the patients experienced serious treatment-related adverse events. All cases revealed no evidence of recurrence or metastasis after a median follow-up of 12 months.ConclusionsConversion therapy shows a favorable efficacy in those unresectable GBC patients. Gemcitabine plus nab-paclitaxel has the potential to be used as a preoperative treatment option for GBC patients at the advanced stage. To further explore the efficacy of AG on conversion therapy for GBC patients, a prospective clinical trial has been registered (ChiCTR2200055698).
Total extract of Abelmoschus manihot L. alleviates uric acid-induced renal tubular epithelial injury via inhibition of caspase-8/caspase-3/NLRP3/GSDME signaling
Authors: Ding Zhihui , Zhao Jing , Wang Xufang , Li Wei , Chen Chong , Yong Chen , Zhu Yiye , Tian Fang , Liu Li , Yu Manshu , Zhou Enchao , Gu Liubao , Yao Chunlei , Gao Kun 
Published: August 2022

Purpose: The incidence of uric acid (UA)-induced kidney injury is increasing owing to the high incidence of hyperuricemia in recent years. The flower of Abelmoschus manihot (Linneus) Medik is a traditional Chinese medicinal herb widely used in the treatment of some kidney diseases. In our previous study, we reported that the total extract of A. manihot L. flower (TEA) attenuated adriamycin-induced renal tubular cell injury. In this study, we aimed to evaluate the role of TEA in UA-induced tubular cell injury.Methods: Normal rat proximal epithelial NRK-52E cells were incubated with UA to mimic hyperuricemia conditions. The role of TEA in the renal tubular cells was also assessed. The cellular morphology was observed using phase-contrast microscopy, and cell viability was analyzed using the Cell Counting kit-8. Living and dead cells were stained using a Calcein-AM/PI double stain kit. The release of lactate dehydrogenase (LDH) was analyzed by LDH cytotoxicity Assay Kit. The expression of target proteins was analyzed using western blot analysis.Results: UA triggered NRK-52E cell injury, as evidenced by morphological changes, detachment of cells from the bottom, cell swelling, large bubbles blowing from cell membrane and loss of cell viability. UA increased release of LDH. UA induced the expression of p-ERK1/2 and the subsequent activation of caspase-8, caspase-3, and NLRP3 inflammasomes. Pyroptosis was elicited by UA after gasdermin E N-terminal (GSDME-NT) was cleaved from gasdermin E (GSDME). Z-DEVD-FMK, a caspase-3 inhibitor, suppressed the expression of both NLRP3 and GSDME-NT, but not that of caspase-8. INF39, an NLRP3 inhibitor, altered the expression of GSDME-NT expression, but not that caspase-3 and caspase-8. TEA alleviated UA-induced cell injury by suppressing ERK1/2/caspase-8/caspase-3/NLRP3/GSDME signaling.Conclusion: GSDME-mediated pyroptosis was involved in UA-induced renal tubular cell injury. This is the first study to report that TEA protects renal tubular epithelial cells against UA by inhibiting the ERK/1/2/caspase-8/caspase-3/NLRP3/GSDME pathway.
Successful wayfinding in age: A scoping review on spatial navigation training in healthy older adults
Authors: Fricke Madeleine , Morawietz Christina , Wunderlich Anna , Muehlbauer Thomas , Jansen Carl-Philipp , Gramann Klaus , Wollesen Bettina 
Published: August 2022

IntroductionSpatial navigation is a complex cognitive function that declines in older age. Finding one’s way around in familiar and new environments is crucial to live and function independently. However, the current literature illustrates the efficacy of spatial navigation interventions in rehabilitative contexts such as pathological aging and traumatic injury, but an overview of existing training studies for healthy older adults is missing. This scoping review aims to identify current evidence on existing spatial navigation interventions in healthy older adults and analyze their efficacy.MethodsTo identify spatial navigation interventions and assessments and investigate their effectiveness, four electronic databases were searched (Pubmed, Web of Science, CINAHL and EMBASE). Two independent reviewers conducted a screening of title, abstract and full-texts and performed a quality assessment. Studies were eligible if (1) published in English, (2) the full text was accessible, (3) at least one group of healthy older adults was included with (4) mean age of 65 years or older, (5) three or more spatial navigation-related training sessions were conducted and (6) at least one spatial ability outcome was reported.ResultsTen studies were included (N = 1,003, age-range 20–95 years, 51.5% female), only healthy older adults (n = 368, mean age ≥ 65) were assessed further. Studies differed in sample size (n = 22–401), type of training, total intervention duration (100 min–50 h), and intervention period (1–16 weeks).ConclusionThe spatial navigation abilities addressed and the measures applied to elicit intervention effects varied in quantity and methodology. Significant improvements were found for at least one spatial ability-related outcome in six of 10 interventions. Two interventions achieved a non-significant positive trend, another revealed no measurable post-training improvement, and one study did not report pre-post-differences. The results indicate that different types of spatial navigation interventions improve components of spatial abilities in healthy older adults. The existing body of research does not allow conclusions on transferability of the trained components on everyday life spatial navigation performance. Future research should focus on reproducing and extending the promising approaches of available evidence. From this, valuable insights on healthy aging could emerge.Trial RegistrationThis scoping review was preregistered at Open Science Framework (https://osf.io/m9ab6).
Development of the Everyday Life Rehabilitation model for persons with long-term and complex mental health needs: Preliminary process findings on usefulness and implementation aspects in sheltered and supported housing facilities
Authors: Lindström Maria 
Published: August 2022

This paper describes the initial phases of the design and development of the Everyday Life Rehabilitation (ELR) intervention, and it presents preliminary findings on usefulness and implementation aspects derived from an ongoing larger trial exploring the effect, cost-effectiveness, and usefulness of ELR. ELR is a model designed to meet the absence of meaningful activities and challenges with integrated, activity- and recovery-oriented rehabilitation in sheltered and supported housing facilities for persons with extensive psychiatric disabilities. The aim of the present study was to examine early experiences of implementing the ELR model from the perspectives of managers, housing staff, and occupational therapists. The paper will sum up preliminary findings based on process data included in an internal pilot prior to a full-scale pragmatic clustered RCT. Four Swedish municipalities with 19 housing facility units were involved and provided process data for the study. Thematic analysis were applied. The informants perceived the methodology to be well suited to the target group and context and to contribute to positive changes in participants' lives. The web-based training was also experienced as relevant and easily accessible to staff, as well as elements of collegial learning and feedback. However, they reported that their municipalities lacked basic conditions for making the whole concept work in such a short time. The ELR is overall perceived as useful, but experiences also make complex difficulties visible regarding integrated, coordinated rehabilitation and organizational readiness. Based on findings, a recommendation on basic prerequisites will be added to the ELR guidance for leadership and management.Clinical trial registration[ClinicalTrials.gov, 24 September 2021], identifier [NCT05056415].
Cross-sector decision landscape in response to COVID-19: A qualitative network mapping analysis of North Carolina decision-makers
Authors: Biddell Caitlin B. , Johnson Karl T. , Patel Mehul D. , Smith Raymond L. , Hecht Hillary K. , Swann Julie L. , Mayorga Maria E. , Hassmiller Lich Kristen 
Published: August 2022

IntroductionThe COVID-19 pandemic response has demonstrated the interconnectedness of individuals, organizations, and other entities jointly contributing to the production of community health. This response has involved stakeholders from numerous sectors who have been faced with new decisions, objectives, and constraints. We examined the cross-sector organizational decision landscape that formed in response to the COVID-19 pandemic in North Carolina.MethodsWe conducted virtual semi-structured interviews with 44 organizational decision-makers representing nine sectors in North Carolina between October 2020 and January 2021 to understand the decision-making landscape within the first year of the COVID-19 pandemic. In line with a complexity/systems thinking lens, we defined the decision landscape as including decision-maker roles, key decisions, and interrelationships involved in producing community health. We used network mapping and conventional content analysis to analyze transcribed interviews, identifying relationships between stakeholders and synthesizing key themes.ResultsDecision-maker roles were characterized by underlying tensions between balancing organizational mission with employee/community health and navigating organizational vs. individual responsibility for reducing transmission. Decision-makers' roles informed their perspectives and goals, which influenced decision outcomes. Key decisions fell into several broad categories, including how to translate public health guidance into practice; when to institute, and subsequently loosen, public health restrictions; and how to address downstream social and economic impacts of public health restrictions. Lastly, given limited and changing information, as well as limited resources and expertise, the COVID-19 response required cross-sector collaboration, which was commonly coordinated by local health departments who had the most connections of all organization types in the resulting network map.ConclusionsBy documenting the local, cross-sector decision landscape that formed in response to COVID-19, we illuminate the impacts different organizations may have on information/misinformation, prevention behaviors, and, ultimately, health. Public health researchers and practitioners must understand, and work within, this complex decision landscape when responding to COVID-19 and future community health challenges.
Educational disparities in adult health across U.S. states: Larger disparities reflect economic factors
Authors: Montez Jennifer Karas , Cheng Kent Jason 
Published: August 2022

IntroductionEducation level is positively associated with adult health in the United States. However, new research shows that the association is stronger in some U.S. states than others, and that states with stronger associations also tend to have poorer overall levels of health. Understanding why educational disparities in health are larger in some states than others can advance knowledge of the major drivers of these disparities, between individuals and states. To that end, this study examined how key mechanisms (economic conditions, health behaviors, family, healthcare) help explain the education-health association in each state and whether they do so systematically.MethodsUsing data on over 1.7 million adults ages 25–64 in the 2011–2018 Behavioral Risk Factor Surveillance System, we estimated the association between education level and self-rated health in each state, net of age, sex, race/ethnicity, and calendar year. We then estimated the contribution of economic, behavioral, family, and healthcare mechanisms to the association in each state.ResultsThe strength of the education-health association differed markedly across states and was strongest in the Midwest and South. Collectively, the mechanisms accounted for most of the association in all states, from 55% of it in North Dakota to 73% in Oklahoma. Economic (employment, income) and behavioral (smoking, obesity) mechanisms were key, but their contribution to the association differed systematically across states. In states with stronger education-health associations, economic conditions were the dominant mechanism linking education to health, but in states with weaker associations, the contribution of economic mechanisms waned and that of behavioral mechanisms rose.DiscussionMeaningful reductions in educational disparities in health, and overall improvements in health, may come from prioritizing access to employment and livable income among adults without a 4-year college degree, particularly in Southern and Midwestern states.
The C-reactive protein/albumin ratio predicts postoperative delirium in patients older than 60 years following total knee arthroplasty
Authors: Zhang Lin , Li Baoquan , Bai Yujiang , Liu Xiaoshuang , Chai Xin 
Published: August 2022

PurposeThis study aimed to investigate the relationship between serum C-reactive protein (CRP)/Albumin ratio (CAR) and postoperative delirium (POD) in patients older than 60 years following total knee arthroplasty (TKA).MethodsFrom January 2019 to January 2021, 268 patients were recruited in this prospective observational investigation. Patients with serum CRP, Alb, CAR, delirious status and delirious score were assessed. The effect of CRP, Alb, CAR on predicting delirium was assessed with the area under the receiver operating characteristic (ROC) curve (AUC).ResultsThe study found that higher CRP level (P &lt; 0.001), low Alb level (P &lt; 0.001), and higher CAR (P &lt; 0.001) were independently associated with POD. The AUC of CAR for POD was 0.782, with the cut-off value of 0.117, a sensitivity of 83.3% and a specificity of 65.9% respectively (P &lt; 0.001), suggesting that CAR had moderate efficacy on predicting POD occurrence than CRP (AUC: 0.761) and Alb (AUC: 0.300). The results also showed that age, ASA and the operation time was an independent predictor for patients with POD.ConclusionsOur findings demonstrated CAR may be an effective biomarker to predict postoperative delirium in patients over 60 years of age with TKA, which provides potential recommendations for early intervention in delirium care.
Carcass Proximate Composition and Amino acid Profiles of Hybrid Catfish fed Supplementary Cockroach Meal
Authors: Adamu Kabir Mohammed , David Diana Bmazazhin , Muhammad Hafsat , Djadjiti Namla , Mohammad Hafsat 
Published: August 2022

The high demand for fish as a protein source in fishmeal with the increasing production pressure on aquaculture has led to the research on the use of insects as an alternative source of protein for fish production. Studies have been reported on nutritional potentials of some insect’s protein on growth indices with little attention on the fish carcass's proximate composition and amino acid analyses; thus, this study was conducted to investigate the carcass proximate and amino acid analyses of hybrid catfish fed supplemented cockroach meal. Four experimental diets were formulated with varying inclusion levels of the insect (Diet A (100% fishmeal), Diet B (100% cockroach meal), Diet C (50% fishmeal and 50% cockroach meal), and Diet D (Commercial diet)). The hybrid catfish were fed twice daily with formulated/commercial diets for 12 weeks. After, the 12-week periods, pool samples of whole fish, were sacrificed for proximate analyses and amino acid analyses. The test fish carcass revealed the highest moisture content (9.22±0.01%) and crude protein (66.23±0.02%) values in Diet A and B respectively. Similarly, the highest crude fiber, ash, and carbohydrate content of 0.73±0.03%, 13.96±0.10%, and 12.55±0.13% were recorded in fish-fed diet B. The amino acid profiles of fish carcass fed diet B recorded the highest values of lysine, phenylalanine, methionine, proline, arginine, cysteine, alanine, and glutamic acid; glycine, threonine, and serine. Whilst other amino acids monitored in fish fed Diet B were moderate amongst others. The fish fed Diet C, also recorded positive (p<0.05) proximate compositions and amino acid profiles compared to the control carcass. The observed carcass proximate compositions and amino acid profiles in fish-fed Diets B and C may be attributed to the presence of cockroach meal in the diets. Hence, the inclusion of cockroaches in the diets of hybrid catfish could be employed as a potential source of protein for catfish fingerlings as revealed by the hybrid catfish carcass proximate composition and amino acid analyses. this makes a potential source of protein for human consumption
Evaluation of Adults’ Acumen with Quantified Anthropometric Indices
Authors: Islam Md. Hasibul , Tara Kusum , Mohonta Shadhon Chandra , Sayem Abu Sadat Md , Sarkar Ajay Krisna , Anower Md. Shamim 
Published: August 2022

<p> This work considers adults’ acumen to be assessed with four quantified indices like cell membrane capacitance (CM), total body fat (TBF), total body water (TBW), and total body impedance (TBI) that reflect subjects’ cerebral stress handling competence in the face of intense cognitive task. Primarily, an electrical model of the epithelial tissue structure (ETS) has been represented and anatomized in the light of hormonal change happens inside human body to propose a number of preambles. An intelligence quotient (IQ) test designed to agitate mind has been conducted right before measuring body composition parameters. Finally, comprehend data operations and juxtaposed investigations to vindicate model-implied preambles along with quantified indices were made by comparing them to IQ test outcomes. Effectively innervated nervous system with homeostasis endocrine human anatomy has been reported to have CM, TBF, TBW, and TBI in the range of 1.0-2.1nF, 7.9-20%, 56.8-80%, and 470-550 Ω respectively for the subjects whose acumen is classified as “Class-A”, while “Class-B” is also presented with distinct quantified indices. These indices are expected to be paradigm of non-invasive neurological disorder detection, additionally, it can also be applied in categorizing youngsters before deploying them to highly productive tasks suitable for them. </p>