bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of PD-1/PD-L1 Inhibitors versus Chemotherapy in Lung Cancer with Brain Metastases: A Systematic Review and Meta-Analysis
Authors: Yang Xiaojun , Zeng Yihong , Tan Qinquan , Huang Zhihua , Jia Jun , Jiang Guanming 
Published: May 2022

Immune checkpoint inhibitors (ICIs) are widely used to treat local or metastatic lung cancer. However, the efficacy of ICI in patients with brain metastases (BM) from lung cancer is unknown. This study aimed to evaluate the efficacy of PD-1/PD-L1 ICIs compared with chemotherapy for patients with lung cancer with BM. Electronic databases (PubMed, Embase, The Cochrane Library, and Web of Science) were searched. The meta-analysis assessed overall survival (OS) and progression-free survival (PFS) of the PD-1/PD-L1 inhibitors axis and its relationship with pathological type, drug modality, and the treatment line number in patients with BM from lung cancer. We included 694 patients with BM from lung cancer from 11 randomized controlled trials. Statistical analysis showed that compared with chemotherapy, PD-1/PD-L1 inhibitors could significantly prolong OS (

hazard

ratio

HR

=
0.75

,

95
%
confidence

interval

95
%
CI

=
0.51
–
0.99

) and PFS (

HR
=
0.65

,

95
%
CI
=
0.51
–
0.80

). In the subgroup analysis, ICIs plus chemotherapy improved PFS (

HR
=
0.60

,

95
%
CI
=
0.40
–
0.80

), but not OS (

HR
=
0.75

,

95
%
CI
=
0.30
–
1.19

). The efficacy of ICI monotherapy in patients with BM was significantly different between OS and PFS: OS pooled

HR
=
0.81

(

95
%
CI
=
0.57
–
1.05

) and

PFS
=
0.78

(

95
%
CI
=
0.62
–
0.94

). Among different pathological types, the OS pooled HR was 0.67 (9

5
%
CI
=
0.39
–
0.95

) for non-small cell lung cancer (NSCLC) and 0.94 (

95
%
CI
=
0.56
–
1.33

) for small cell lung cancer (SCLC); the PFS pooled HR was 0.58 (

95
%
CI
=
0.39
–
0.76

) for NSCLC and 0.79 (

95
%
CI
=
0.65
–
0.93

) for SCLC. Subgroups analysis of treatment line showed that no advantage for OS with ICIs as first-line or subsequent-line therapy, whereas ICIs as first-line (

HR
=
0.63

,

95
%
CI
=
0.53
–
0.74

) and second-line (

HR
=
0.62

,

95
%
CI
=
0.62
–
0.96

) benefitted PFS. This meta-analysis implied that compared with chemotherapy, PD-1/PD-L1 inhibitors significantly improved efficacy treatment of patients with BM from lung cancer. Further studies are needed to confirm the role of ICIs in different pathological types and drug treatment modalities.
Neural Tracking in Infancy Predicts Language Development in Children With and Without Family History of Autism
Authors: Menn Katharina H. , Ward Emma K. , Braukmann Ricarda , van den Boomen Carlijn , Buitelaar Jan , Hunnius Sabine , Snijders Tineke M. 
Published: May 2022

Abstract
During speech processing, neural activity in non-autistic adults and infants tracks the speech envelope. Recent research in adults indicates that this neural tracking relates to linguistic knowledge and may be reduced in autism. Such reduced tracking, if present already in infancy, could impede language development. In the current study, we focused on children with a family history of autism, who often show a delay in first language acquisition. We investigated whether differences in tracking of sung nursery rhymes during infancy relate to language development and autism symptoms in childhood. We assessed speech-brain coherence at either 10 or 14 months of age in a total of 22 infants with high likelihood of autism due to family history and 19 infants without family history of autism. We analyzed the relationship between speech-brain coherence in these infants and their vocabulary at 24 months as well as autism symptoms at 36 months. Our results showed significant speech-brain coherence in the 10- and 14-month-old infants. We found no evidence for a relationship between speech-brain coherence and later autism symptoms. Importantly, speech-brain coherence in the stressed syllable rate (1–3 Hz) predicted later vocabulary. Follow-up analyses showed evidence for a relationship between tracking and vocabulary only in 10-month-olds but not in 14-month-olds and indicated possible differences between the likelihood groups. Thus, early tracking of sung nursery rhymes is related to language development in childhood.
Knowing When to Pass: The Effect of AI Reliability in Risky Decision Contexts
Authors: Elder Hannah , Canfield Casey , Shank Daniel B. , Rieger Tobias , Hines Casey 
Published: May 2022

Objective This study manipulates the presence and reliability of AI recommendations for risky decisions to measure the effect on task performance, behavioral consequences of trust, and deviation from a probability matching collaborative decision-making model. Background Although AI decision support improves performance, people tend to underutilize AI recommendations, particularly when outcomes are uncertain. As AI reliability increases, task performance improves, largely due to higher rates of compliance (following action recommendations) and reliance (following no-action recommendations). Methods In a between-subject design, participants were assigned to a high reliability AI, low reliability AI, or a control condition. Participants decided whether to bet that their team would win in a series of basketball games tying compensation to performance. We evaluated task performance (in accuracy and signal detection terms) and the behavioral consequences of trust (via compliance and reliance). Results AI recommendations improved task performance, had limited impact on risk-taking behavior, and were under-valued by participants. Accuracy, sensitivity ( d’), and reliance increased in the high reliability AI condition, but there was no effect on response bias ( c) or compliance. Participant behavior was only consistent with a probability matching model for compliance in the low reliability condition. Conclusion In a pay-off structure that incentivized risk-taking, the primary value of the AI recommendations was in determining when to perform no action (i.e., pass on bets). Application In risky contexts, designers need to consider whether action or no-action recommendations will be more influential to design appropriate interventions.
Exploring structure/property relationships to health and environmental hazards of polymeric polyisocyanate prepolymer substances-1. Design of experiments, aquatic exposure, and acute aquatic toxicity
Authors: West Robert J , Euskirchen Lisa , Neuhahn Astrid , Seneker Steve , Spence Mark W 
Published: May 2022

Polymeric polyisocyanate prepolymer substances are reactive intermediates used in the manufacture of various polyurethane products. Knowledge of their occupational and environmental hazard properties is essential for product stewardship and industrial hygiene purposes. This work reports on the systematic design of a program to explore how structural features (i.e., types of polymeric polyol and diisocyanate reactants, functionality) and physical–chemical properties (i.e., octanol–water partition coefficient [log Kow], viscosity, molecular weight) of a group of 10 toluene diisocyanate (TDI)- and methylene diphenyl diisocyanate (MDI)-based monomer-depleted prepolymer substances can be related to their exposure and hazard potentials. The revelation of trends or thresholds in such relationships could form a basis for regulatory screening of existing or new prepolymer substances, while also informing the design of substances having reduced exposure and/or hazard profiles. As a first step, the aquatic exposure and hazard potentials of these 10 substances were investigated. The results of this investigation showed that yields of dissolved reaction products (derived from non-purgeable organic carbon measurements and carbon contents of the parent prepolymers) were inversely correlated with the calculated log Kow of the substances. For prepolymer loading rates of both 100 and 1000 mg/L in water, the average dissolved reaction product yields ranged from ≤1% to 32% and from ≤0.1% to 25%, respectively, over calculated log Kow values ranging from −4.8 to 45. For both loading rates, dissolved reaction products were not quantifiable where the calculated log Kow value was >10. Yet, none of the 10 prepolymers and tested loading rates exhibited acute adverse effects on the aquatic invertebrate, Daphnia magna, in the 48-h acute immobilization test. From a product stewardship perspective, polymeric prepolymers of TDI and MDI within the investigated domain and concentration range are not expected to be hazardous in the aquatic environment.
Improved arthroscopic high-strength suture fixation for the treatment of posterior cruciate ligament avulsion fracture
Authors: Wu Lei , Xu Honggang , Li Bo , Xu Bin 
Published: May 2022

Background: To investigate the curative effects of improved non-absorbable high-strength fixation under arthroscopy on posterior cruciate ligament (PCL) avulsion fracture. Methods: A retrospective analysis was performed on 16 cases of PCL avulsion fracture in 15 patients who underwent high-strength suture fixation under arthroscopy from December 2017 to November 2019. According to the Meyers-McKeever classification, there were 2 cases of type II and 14 cases of type III. The fracture was reduced under arthroscopy, and knotted and fixed under the anterior and medial skin of the knee joint with high-strength sutures and a button plate. Regular follow-up of the knee joint healing and stability, the range of motion and the functional recovery of affected limb was conducted. The last follow-up was completed after the button plate was taken out. The Lysholm score was used to assess the recovery situation. Results: The button plate was taken out 6–9 months (average 7.2 months) after surgery. At the last follow-up, the fractures of the 15 patients were all healed. Moreover, six patients were positive for posterior drawer test within Grade 1 and the others were negative. All patients had no knee extension limitation, and the range of knee flexion reached more than 120°, with an average of (132.4 ± 3.6)°. The average Lysholm score was (93.1 ± 4.7). There were significant differences in knee flexion angle and Lysholm score at different time points after operation, p = 0.000. Conclusion: For the treatment of PCL avulsion fracture, the optimized arthroscopic high-strength suture fixation is easy to perform and repeat, and the fixation is strong and solid. The functions of the knee joint experienced good recovery after the surgery.
Poor Sleep Quality and Other Risk Factors for Unemployment Among Patients on Opioid Agonist Treatment
Authors: Huffman Margo , Cloeren Marianne , Ware Orrin D , Frey Jodi J , Greenblatt Aaron D , Mosby Amanda , Oliver Marc , Imboden Rachel , Bazell Alicia , Clement Jean , Diaz-Abad Montserrat 
Published: May 2022

Purpose: Patients with opioid use disorder (OUD) face high rates of unemployment, putting them at higher risk of treatment nonadherence and poor outcomes, including overdose death. The objective of this study was to investigate sleep quality and its association with other biopsychosocial risk factors for unemployment in patients receiving opioid agonist treatment (OAT) for OUD. Methods: Using a cross-sectional survey design, participants from 3 OAT programs for OUD completed questionnaires to measure sleep quality (Pittsburgh Sleep Quality Index [PSQI]); pain disability; catastrophic thinking; injustice experience; quality of life; and self-assessed disability. Spearman’s rank correlation was used to test for associations between sleep quality and other study variables. Results: Thirty-eight participants completed the study, with mean age 45.6 ± 10.9 years, 27 (71.1%) males, and 16 (42.1%) reporting a high school diploma/equivalent certification as the highest level of academic attainment. Poor sleep quality (defined as PSQI > 5) was identified in 29 participants (76.3%) and was positively correlated with pain disability ( r = 0.657, P < .01), self-assessed disability ( r = 0.640, P < .001), symptom catastrophizing ( r = 0.499, P < .001), and injustice experience ( r = 0.642, P < .001), and negatively correlated with quality of life ( r = −0.623, P < .001). Conclusions: There was a high prevalence of poor sleep quality in patients with OUD on OAT and this was associated with multiple known risk factors for unemployment. These findings warrant the consideration of regular screening for sleep problems and the inclusion of sleep-related interventions to improve sleep quality, decrease the unemployment rate, and enhance the recovery process for individuals with OUD undergoing OAT.
Risk factors and outcomes associated with ventilator associated pneumonia amongst intubated trauma patients admitted to the general intensive care unit of a major trauma centre
Authors: Hirst Claire , Needham Matthew 
Published: May 2022

Background Despite the use of care bundles, ventilator associated pneumonia (VAP) remains a frequently occurring health care-associated infection, increasing costs, length of stay (LOS) and mortality. The incidence is higher amongst trauma patients, although due to variable definitions and study populations risk factors for developing VAP are disputed, with few reports from the UK. Methods This 6-year review of intubated trauma patients admitted to the general Intensive Care Unit (ICU) of a UK major trauma centre, collected data on suspected risk factors for VAP, as well as demographic information, outcomes and microbiology. Ninety-nine patients who developed VAP within the first 7 days of admission were compared with 191 patient who did not, with multivariable logistic regression used to control for confounding variables. Results Univariable analysis suggested that injury severity score (ISS) (34 v 29), head injury (66.7% v 50.8%), polytrauma (79.8% v 68.1%) and ventilator days (10 v 5) were associated with increased risk of VAP, but after adjustment only ventilator days remained significant (OR 1.04, 95% CI 1.01–1.06). Antibiotics within 24 h of admission were associated with reduced odds of developing VAP, whether this was for pulmonary prophylaxis (OR 0.43, 95% CI 0.22–0.83, p = 0.013) or non-pulmonary reasons (OR 0.27, 95% CI 0.15–0.51, p < 0.001). Conclusions Only increasing ventilator days was associated with increased odds of developing VAP. The use of early antimicrobials was associated strongly with a reduction in the odds of developing VAP; this could be explained by unmeasured confounding or a prophylactic effect against aspiration.
Predicting Response to Bolus Insulin Therapy in Patients With Type 2 Diabetes
Authors: Eby Elizabeth L. , Kelly Neal R. , Hertzberg Jeffrey K. , Blodgett Moira C. , Stubbins Callie , Patel Raja H. , Meadows Eric S , Benneyworth Brian D. , Faries Douglas E. 
Published: May 2022

Background: The aim of this study was to develop a predictive model to classify people with type 2 diabetes (T2D) into expected levels of success upon bolus insulin initiation. Methods: Machine learning methods were applied to a large nationally representative insurance claims database from the United States (dNHI database; data from 2007 to 2017). We trained boosted decision tree ensembles (XGBoost) to assign people into Class 0 (never meeting HbA1c goal), Class 1 (meeting but not maintaining HbA1c goal), or Class 2 (meeting and maintaining HbA1c goal) based on the demographic and clinical data available prior to initiating bolus insulin. The primary objective of the study was to develop a model capable of determining at an individual level, whether people with T2D are likely to achieve and maintain HbA1c goals. HbA1c goal was defined at <8.0% or reduction of baseline HbA1c by >1.0%. Results: Of 15 331 people with T2D (mean age, 53.0 years; SD, 8.7), 7800 (50.9%) people met HbA1c goal but failed to maintain that goal (Class 1), 4510 (29.4%) never attained this goal (Class 0), and 3021 (19.7%) people met and maintained this goal (Class 2). Overall, the model’s receiver operating characteristic (ROC) was 0.79 with greater performance on predicting those in Class 2 (ROC = 0.92) than those in Classes 0 and 1 (ROC = 0.71 and 0.62, respectively). The model achieved high area under the precision-recall curves for the individual classes (Class 0, 0.46; Class 1, 0.58; Class 2, 0.71). Conclusions: Predictive modeling using routine health care data reasonably accurately classified patients initiating bolus insulin who would achieve and maintain HbA1c goals, but less so for differentiation between patients who never met and who did not maintain goals. Prior HbA1c was a major contributing parameter for the predictions.
Robotic pyeloplasty in a horseshoe kidney: A case report
Authors: Bennett Grace , Zelhof Bachar 
Published: May 2022

Objective: To deliver a case report showing that robotic pyeloplasty in a patient with a horseshoe kidney is not only successful but also potentially superior to laparoscopic surgery. To the best of our knowledge, this is the first case report of its kind in the United Kingdom. Method: PubMed was used to do a literature search. We have excluded papers that were written in foreign languages, or were paediatric case studies. Results: Horseshoe kidneys are the commonest congenital abnormality of the renal and are often associated with pelvic-ureteric junction obstruction (PUJO) – in the order of 30%. Minimally invasive surgery is the gold standard for management of PUJO. With the advancement of the Da Vinci robot, this case report presents a patient undergoing pyeloplasty in a horseshoe kidney with PUJO on the left side, using a robotic technique. We performed a robotic pyeloplasty on a 32-year-old woman, with a horseshoe kidney. We felt this is a case worth discussion, giving the alteration in the surgical technique in conjunction with the anatomical abnormalities, and the lack of similar reported cases in the literature. We propose that in some cases, the robotic operative technique is superior to standard laparoscopic technique. Although there is an increased cost when using the Da Vinci robot, this may be offset by the 3D visualisation, enhanced dexterity, tremor filtering and movement scaling, increased range of motion, as well as the reduction of operative time, hospital stay, blood loss, complications, and indeed patient satisfaction. In addition to the benefits of robotic surgery itself, we demonstrate that robotic surgery in this particular case was preferable to other techniques, given the anatomical exclusivity of a horseshoe kidney. Conclusion: We propose that in some cases, the robotic operative technique is superior to other minimal access techniques in urological surgery. Level of Evidence: 4
Convergence of Service Providers and Managers’ Perspectives on Strengths, Gaps, and Priorities for Rural Health System Redesign: A Whole-Systems Qualitative Study in Washington County, Maine
Authors: West Rebecca L. , Margo Judy , Brown Jeff , Dowley Amy , Haas Susan 
Published: May 2022

Introduction: Both rural residents and state government leaders describe a need to redesign rural health care systems. Community members should be at the center of this effort. Methods: We conducted 46 in-depth interviews of direct service providers between September and November 2020 in Washington County, Maine. Data were analyzed using a thematic analysis approach. Results: Existing strengths included collaboration between government and health systems, and community-based services. Gaps included insufficient workforce, restricted scope of licensing and poor reimbursement, lack of coordination between health systems, and limited paramedicine capacity. Strategies for health system redesign included addressing maldistribution of services and resource optimization, changing federal and state legislation around insurance and scope of practice, and moving toward value-based purchasing models. Conclusions: Participants provided pragmatic recommendations based on their deep understanding of the community context. Lessons learned are likely to be salient in areas with similar profiles regarding rurality and poverty.
Biodegradation behaviors of magnesium(Mg)-based alloy nails in autologous bone grafts: In vivo study in rabbit skulls
Authors: Yanagisawa Yuta , Shimizu Yoshinaka , Mukai Toshiji , Sano Yuya , Odashima Kenji , Ikeo Naoko , Saito Haruka , Yamauchi Kensuke , Takahashi Tetsu , Kumamoto Hiroyuki 
Published: May 2022

Objective: In this study, autologous bone grafts using bone-fixing nails made of magnesium-zinc-calcium ternary alloys were performed using rabbit skulls. Material and methods: Two types of nails for bone fixation were prepared: 2.5 mm width, 3 mm length and 2.5 mm width, 2 mm length. A disk-shaped bone with a diameter of 5 mm was resected from the parietal bone and fixed with a 3 mm long nail. As a control group, a 2 mm long nail was driven into the existing bone. The rabbits were sacrificed at 1, 4, 12, and 24 weeks after surgery. The resected samples were observed with micro X-ray CT, and embedded in methyl methacrylate to prepare non-decalcified specimens. The in vivo localization of elements was examined using energy-dispersive X-ray spectroscopy (EDS). Results: Micro X-ray CT images of samples showed volume reduction due to degradation in both the bone graft and control groups. No significant difference in the amount of degradation between the two groups was observed, however characteristic degradation processes were observed in each group. The samples stained with alizarin red S showed amorphous areas around the nails, which were considered as corrosion products and contacted directly with the newly formed bones. EDS analysis showed that corrosion products were mainly composed of magnesium and oxygen at an early stage, while calcium and phosphorus were detected on the surface layer during the long-term observation. Conclusions: The degradation speed of the magnesium alloy nails varied depending on the shapes of the nails and surrounding tissue conditions. A calcium phosphate layer was formed on the surface of magnesium alloy nails, suggesting that the degradation rate of the nail was slow.