bluuebunny/crossref_metadata_2025_split huggingface dataset:
External validation study of endometrial cancer preoperative risk stratification model (ENDORISK)
Authors: Vinklerová Petra , Ovesná Petra , Hausnerová Jitka , Pijnenborg Johanna M. A. , Lucas Peter J. F. , Reijnen Casper , Vrede Stephanie , Weinberger Vít 
Published: August 2022

IntroductionAmong industrialized countries, endometrial cancer is a common malignancy with generally an excellent outcome. To personalize medicine, we ideally compile as much information as possible concerning patient prognosis prior to effecting an appropriate treatment decision. Endometrial cancer preoperative risk stratification (ENDORISK) is a machine learning–based computational Bayesian networks model that predicts lymph node metastasis and 5-year disease-specific survival potential with percentual probability. Our objective included validating ENDORISK effectiveness in our patient cohort, assessing its application in the current use of sentinel node biopsy, and verifying its accuracy in advanced stages.MethodsThe ENDORISK model was evaluated with a retrospective cohort of 425 patients from the University Hospital Brno, Czech Republic. Two hundred ninety-nine patients were involved in our disease-specific survival analysis; 226 cases with known lymph node status were available for lymph node metastasis analysis. Patients were included undergoing either pelvic lymph node dissection (N = 84) or sentinel node biopsy (N =70) to explore the accuracy of both staging procedures.ResultsThe area under the curve was 0.84 (95% confidence interval [CI], 0.77–0.9) for lymph node metastasis analysis and 0.86 (95% CI, 0.79–0.93) for 5-year disease-specific survival evaluation, indicating quite positive concordance between prediction and reality. Calibration plots to visualize results demonstrated an outstanding predictive value for low-risk cancers (grades 1–2), whereas outcomes were underestimated among high-risk patients (grade 3), especially in disease-specific survival. This phenomenon was even more obvious when patients were subclassified according to FIGO clinical stages.ConclusionsOur data confirmed ENDORISK model’s laudable predictive ability, particularly among patients with a low risk of lymph node metastasis and expected favorable survival. For high-risk and/or advanced stages, the ENDORISK network needs to be additionally trained/improved.
Augmenting antibody response to EGF-depleting immunotherapy: Findings from a phase I trial of CIMAvax-EGF in combination with nivolumab in advanced stage NSCLC
Authors: Evans Rachel , Lee Kelvin , Wallace Paul K. , Reid Mary , Muhitch Jason , Dozier Askia , Mesa Circe , Luaces Patricia L. , Santos-Morales Orestes , Groman Adrienne , Cedeno Carlos , Cinquino Aileen , Fisher Daniel T. , Puzanov Igor , Opyrchal Mateusz , Fountzilas Christos , Dai Tong , Ernstoff Marc , Attwood Kristopher , Hutson Alan , Johnson Candace , Mazorra Zaima , Saavedra Danay , Leon Kalet , Lage Agustin , Crombet Tania , Dy Grace K. 
Published: August 2022

BackgroundCIMAvax-EGF is an epidermal growth factor (EGF)-depleting immunotherapy which has shown survival benefit as a switch maintenance treatment after platinum-based chemotherapy in advanced non-small cell lung cancer (NSCLC). The primary objective of this trial is to establish the safety and recommended phase II dose (RP2D) of CIMAvax-EGF in combination with nivolumab as second-line therapy for NSCLC.MethodsPatients with immune checkpoint inhibitor-naive metastatic NSCLC were enrolled using a “3+3” dose-escalation design. Toxicities were graded according to CTCAE V4.03. Thirteen patients (one unevaluable), the majority with PD-L1 0%, were enrolled into two dose levels of CIMAvax-EGF.FindingsThe combination was determined to be safe and tolerable. The recommended phase 2 dose of CIMAvax-EGF was 2.4 mg. Humoral response to CIMAvax-EGF was achieved earlier and in a greater number of patients with the combination compared to historical control. Four out of 12 evaluable patients had an objective response.
Factor Structures of Patient Health Questionnaire-9 Instruments in Exploring Depressive Symptoms of Suburban Population
Authors: Vu Linh Gia , Le Linh Khanh , Dam Anh Vu Trong , Nguyen Son Hoang , Vu Thuc Thi Minh , Trinh Trang Thu Hong , Do Anh Linh , Do Ngoc Minh , Le Trang Huyen , Latkin Carl , Ho Roger C. M. , Ho Cyrus S. H. 
Published: August 2022

BackgroundThis study aims to examine the psychometric properties of the nine-item Patient Health Questionnaire (PHQ-9) and assess the relationship between the PHQ-9 domain and demographics and health behaviors in Vietnamese people.Materials and MethodsThe PHQ9 was administered to 899 participants. Exploratory factor and reliability analyses were performed. Tobit regression and Ordered logistic regression were further performed to determine factors associated with the PHQ-9 score and characteristics of depression.ResultsThe 2-factor model of PHQ-9, including factor 1 “Somatic” and factor 2 “Cognitive/Affective,” showed good psychometric properties. The Cronbach’s alpha value showed high internal consistency in two factors (0.84 and 0.80, respectively). Gender, health behavior exercising, drinking, and health status had associations with both factors of the PHQ-9 model.ConclusionThe PHQ-9 scale is a valid and reliable instrument to assess depression in the Vietnam population. This scale can be a useful screening tool for depression; however, further validation studies in other populations are required.
Factors influencing hospital anxiety and depression among emergency department nurses during the COVID-19 pandemic: A multi-center cross-sectional study
Authors: Alzahrani Naif S. , Almarwani Abdulaziz Mofdy , Asiri Saeed A. , Alharbi Hanan F. , Alhowaymel Fahad M. 
Published: August 2022

IntroductionThe emergency department (ED) is a highly stressful environment, which exposes nurses to infection. ED nurses handle life-threatening conditions, endure long working hours, and deal with anxious patients and their families.AimThis study aimed to examine factors, which may influence anxiety and depression levels among ED nurses during the coronavirus disease 2019 (COVID-19) pandemic.MethodsA cross-sectional design was used with 251 participants from six hospitals in Saudi Arabia (mean age = 32.7 ± 6.59, range = 21–54 years, 70.5% females). Data were collected using the Hospital Anxiety and Depression Scale (HADS), and the analysis was conducted using structural equation modeling (SEM).ResultsBased on the HADS scores, 29.1 and 25.5% of ED nurses were identified as doubtful cases for depression and anxiety, respectively. Additionally, 34.7 and 43.3% of ED nurses were identified as definite cases for depression and anxiety, respectively. Higher anxiety levels were observed among female nurses, nurses with lower physical activity levels, and nurses who worked in urban areas. Low physical activity levels and more than 6 years of work experience correlated with a higher level of depression. None of the hypothesized paths in the anxiety and depression models were significant, except for two observed variables—namely, work location and physical exercise in the anxiety model and physical exercise in the depression model.ConclusionEmergency department nurses expressed high levels of anxiety and depression during the COVID-19 pandemic, which may negatively affect their performance and reduce care quality. Therefore, health care leaders should implement specialized mental health education programs focused on nursing occupational safety and support to improve ED nurses’ psychological well-being. Specific attention should be paid to ED female nurses who work in urban areas, especially those with more than 6 years of experience.
Seeking bridge symptoms of anxiety, depression, and sleep disturbance among the elderly during the lockdown of the COVID-19 pandemic—A network approach
Authors: Zhang Liang , Tao Yanqiang , Hou Wenxin , Niu Haiqun , Ma Zijuan , Zheng Zeqing , Wang Shujian , Zhang Shuang , Lv Yichao , Li Qiubai , Liu Xiangping 
Published: August 2022

BackgroundBesides physical changes, elderly adults are prone to have mental disorders such as anxiety, depression, and sleep disturbance, and the pandemic of COVID-19 worsened the situation. However, internal relationships and co-occurrence of psychopathologies were scarcely examined. Therefore, in the current study, through network analysis, we inspected relationships among symptoms of depression, anxiety, and sleep disturbance and identified key symptoms that espoused the disease.MethodsWe asked 1,302 elderly adults to fill in Patient Health Questionnaire-2 (depressive symptoms), the Generalized Anxiety Disorder-2 (anxiety symptoms), and the Youth Self-rating Insomnia Scale (sleep disturbance) and then constructed three networks for elderly adults, male elderly, and female elderly. Via network analysis, we accomplished four goals. First, we identified symptom with the highest centrality (i.e., strength) index for each network; then, we found the strongest correlation (i.e., edges) in each network; thirdly, we confirmed specific nodes that could bridge anxiety, depression, and sleep disturbance; the last was to compare networks based on genders. Network stability and accuracy tests were performed.ResultsNetworks of elderly adults, male elderly, and female elderly were stable, accurate, and intelligible. Among all networks, “Nervousness”- “Excessive worry” (GAD-1- GAD-2) had the strongest correlation, and “Nervousness” (GAD-1) had the highest strength and bridge strength value. When we made a comparison between female elderly's and male elderly's networks, except for the significant difference in the mean value of “Difficulty initiating sleep” (YSIS-3), the findings showed that the two networks were similar. Network stability and accuracy proved to be reliable.ConclusionsIn networks of anxiety, depression, and sleep disturbance, anxiety played a conspicuous role in comorbidity, which could be a target for practical intervention and prevention.
The impact of social media on risk perceptions during COVID-19 in Saudi Arabia
Authors: Angawi Khadijah , Albugmi Mutlaq 
Published: August 2022

BackgroundSocial media is considered a critical source for seeking health information, especially during outbreaks. During the Coronavirus disease 2019 (COVID-19) pandemic, social media played an important role in disseminating information. However, it has been a source of misinformation in many communities throughout the pandemic. Whether this disseminated information has a positive or negative impact, individuals' risk perceptions of disease are influenced. It is important to explore factors that build public behaviors and their adaptation of risk reduction measures during the COVID-19 pandemic. Therefore, the aim of this study is to determine the role of social media and its impact on the risk perceptions of the COVID-19 in Saudi Arabia.MethodsThis was a cross-sectional study, and participants were recruited using different social media outlets between August to October 2020. The survey was delivered through Qualtrics platform targeting Saudi Arabian residents over the age of 18 years old. The questionnaire was delivered in English and Arabic. A convenience sampling was used to recruit participants to the study. The survey link was posted on several social media platforms.ResultsA total of 2,680 respondents completed the online survey. The results showed that male gender, individuals earning 4,000–12,000 SAR, and employed had positive and significant relationships with risk perception compared to their counterparts (β: 0.044, p-value: 0.035 and β: 0.051, p-value: 0.041, β: 0.108 p-value: &lt; 0.001, β: 0.119 p-value: &lt; 0.001), respectively. In second block, individuals exposed to social media had higher risk perception (β: 0.096, p-value &lt; 0.001). In third block, self-efficacy was significantly but negatively associated with risk perception, indicating individuals who were self-efficient were less likely to perceive risk for the COVID-19 (β: −0.096, p-value &lt; 0.001). There was no interactive effect of social media and self-efficacy on risk perception.ConclusionThe current study results show that social media exposure to the COVID-19 information has a positive impact in shaping an individuals' risk perception. The study also suggests that there is a need for public officials and policymakers to develop effective communication strategies through risk communication campaigns targeted at women, individuals with lower socioeconomic status, and those who are single as they showed a negative relationship with risk perception.
Heterogeneity of symptoms and functions among women receiving chemotherapy for breast cancer in China: A multicentre, cross-sectional study
Authors: Cai Tingting , Zhou Tingting , Yuan Changrong , Yu Chunfang , Ni Feixia , Sheng Zhiren 
Published: August 2022

BackgroundCurrently, few studies have explored the heterogeneity of symptoms and functions in patients with breast cancer. This study aimed to identify the subgroups of symptoms and functions in women receiving chemotherapy for breast cancer and determine whether the subgroups differed in demographic and clinical characteristics.MethodsA cross-sectional multicenter survey involving five hospitals in Zhejiang, Shanghai, Shandong, and Guangxi provinces of Mainland China was implemented between August 2020 to December 2021. Participants completed questionnaires that included the PROMIS-57, PROMIS cognitive function short form, and demographic and clinical characteristics. Latent class analysis was performed, followed by chi-square test and analysis of variance. Subsequently, significant variables were included in multinomial logistic regression.ResultsA total of 1,180 patients were investigated, with an average age of 48.9 years. Three classes were identified: low symptom burdens and functions group (26.2%, Class 1), moderate symptom burdens and functions group (16.9%, Class 2), and low symptom burdens and high functions group (56.9%, Class 3). Compared with patients in Class 1 and 3, those in Class 2 consistently showed a higher tendency of having urban employee health insurance (odds ratio = 2.506, P &lt; 0.05) and rural health insurance (odds ratio = 2.207, P &lt; 0.05). Additionally, patients in Class 2 tended to be in their fourth cycle of chemotherapy. However, receiving chemotherapy and surgery increased the likelihood of belonging to Class 1.ConclusionsA high proportion of patients experienced varying degrees of symptom and function issues, suggesting that attention is warranted for women with breast cancer undergoing chemotherapy. Patients with the urban employee basic medical system, the new rural cooperative medical system and in the early stage of chemotherapy cycles were more likely to have symptom burdens. Middle-aged postmenopausal women reported varying degrees of cognitive issues. Additionally, surgery increased the presence of potential long-term effects in functional levels.
Effect of a tailored upper extremity strength training intervention combined with direct current stimulation in chronic stroke survivors: A Randomized Controlled Trial
Authors: Palimeris Stephania , Ansari Yekta , Remaud Anthony , Tremblay François , Corriveau Hélène , Boudrias Marie Hélène , Milot Marie Hélène 
Published: August 2022

Strengthening exercises are recommended for managing persisting upper limb (UL) weakness following a stroke. Yet, strengthening exercises often lead to variable gains because of their generic nature. For this randomized controlled trial (RCT), we aimed to determine whether tailoring strengthening exercises using a biomarker of corticospinal integrity, as reflected in the amplitude of motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS), could optimize training effects in the affected UL. A secondary aim was to determine whether applying anodal transcranial direct current stimulation (tDCS) could enhance exercise-induced training effects. For this multisite RCT, 90 adults at the chronic stage after stroke (&gt;6 months) were recruited. Before training, participants underwent TMS to detect the presence of MEPs in the affected hand. The MEP amplitude was used to stratify participants into three training groups: (1) low-intensity, MEP &lt;50 μV, (2) moderate-intensity, 50 μV &lt; MEP &lt; 120 μV, and (3) high-intensity, MEP&gt;120 μV. Each group trained at a specific intensity based on the one-repetition maximum (1 RM): low-intensity, 35–50% 1RM; moderate-intensity, 50–65% 1RM; high-intensity, 70–85% 1RM. The strength training targeted the affected UL and was delivered 3X/week for four consecutive weeks. In each training group, participants were randomly assigned to receive either real or sham anodal tDCS (2 mA, 20 min) over the primary motor area of the affected hemisphere. Pre-/post-intervention, participants underwent a clinical evaluation of their UL to evaluate motor impairments (Fugl-Meyer Assessment), manual dexterity (Box and Blocks test) and grip strength. Post-intervention, all groups exhibited similar gains in terms of reduced impairments, improved dexterity, and grip strength, which was confirmed by multivariate and univariate analyses. However, no effect of interaction was found for tDCS or training group, indicating that tDCS had no significant impact on outcomes post-intervention. Collectively, these results indicate that adjusting training intensity based on the size of MEPs in the affected extremity provides a useful approach to optimize responses to strengthening exercises in chronic stroke survivors. Also, the lack of add-on effects of tDCS applied to the lesioned hemisphere on exercise-induced improvements in the affected UL raises questions about the relevance of combining such interventions in stroke.Clinical trial registry numberNCT02915185.https://www.clinicaltrials.gov/ct2/show/NCT02915185.
Predictive value of modified systemic inflammation score for postoperative unplanned ICU admission in patients with NSCLC
Authors: Wang Zhulin , Zhang Hua , Huang Chunyao , Li Kaiyuan , Luo Wenqing , Zhang Guoqing , Li Xiangnan 
Published: August 2022

BackgroundThe purpose of this study was to investigate the predictive value of the modified systemic inflammation score (mSIS) in postoperative unplanned admission to the intensive care unit (ICU) in patients with non-small-cell lung cancer (NSCLC).MethodsThe clinical data of 1,321 patients with NSCLC treated with thoracic surgery in our hospital from August 2019 to June 2021 were analyzed retrospectively. The preoperative mSIS, which takes into account the serum albumin (ALB) level and lymphocyte-to-monocyte ratio (LMR), was recorded as 0, 1 or 2 and then was used to identify high-risk patients with unplanned admission to the ICU. The independent risk factors for unplanned admission to the ICU in patients with NSCLC after surgery were identified by multivariate logistic regression analysis.ResultsA total of 1,321 patients, including 549 (41.6%) males and 772 (58.4%) females, were included. The median age was 57 years (range 16–95 years). The incidence of unplanned admission to the ICU in patients with mSIS = 2 was significantly higher than that in those with mSIS = 0 and mSIS = 1. The multivariate analysis showed that an mSIS of 2 (OR = 3.728; P = 0.004; 95% CI, 1.520–9.143), an alcohol consumption history (OR = 2.791, P = 0.011; 95% CI, 1.262–6.171), intraoperative infusion volume (OR = 1.001, P = 0.021; 95% CI, 1.000–1.001) and preoperative underlying diseases (OR = 3. 57, P = 0.004; 95% CI, 1.497–8.552) were independent risk factors for unplanned admission to the ICU after lung cancer surgery. In addition, the multivariate logistic regression model showed that the C-statistic value was 0.799 (95% CI: 0.726∼0.872, P &lt; 0.001).ConclusionsThe mSIS scoring system can be used as a simplified and effective predictive tool for unplanned ICU admission in patients with NSCLC.
Non-electrocardiography- and electrocardiography-gated computed tomography angiography for the evaluation of feline coronary arteries
Authors: Kim Junyoung , Kim Dae-Hyun , Kim Kitae , Oh Dayoung , Yoon Junghee 
Published: August 2022

ObjectivesFew studies have directly compared the clinical feasibility of electrocardiography-gated and non-electrocardiography-gated multidetector computed tomography for evaluating coronary arteries in veterinary medicine. We aimed to characterize and visualize feline coronary arteries using these two imaging modalities. We hypothesed that ECG-gated MDCT is superior to or advantageous to the non-ECG gated.MethodsThis prospective, controlled, comparative pilot study examined six client-owned cats (five clinically normal and one with hypertrophic cardiomyopathy) using non-electrocardiography-gated and retrospective electrocardiography-gated scans. Optimal non-electrocardiography scan timing or electrocardiography-gated R-R reconstruction interval for coronary artery visualization was determined. The degree of opacification and sharpness of proximal coronary branches was subjectively graded; coronary dominance, left coronary artery branching types, and the diameter and length of coronary artery branches were also assessed.ResultsNon-electrocardiography-gated images provided the least information on the bilateral coronary artery ostium and proximal segments, while electrocardiography-gated images clarified the detailed course of the main coronary branches at diastole in all cats. The degree of opacification and sharpness of the coronary arteries was subjectively evaluated as good/excellent in all cats. Coronary dominance (left: four; right: two) and left coronary artery branching types (three different patterns, two additional tortuous branches) varied. Body weight and sex were not significantly associated with coronary artery length or diameter. Vertebral heart score positively correlated with the right coronary artery and negatively correlated with the left main coronary artery.Clinical significanceElectrocardiography-gated multidetector computed tomography provides images with adequate resolution to identify the anatomy of feline coronary arteries. Detailed morphological knowledge of feline coronary vessels will enable novel diagnostic and therapeutic methods in veterinary medicine.
Determinants of Voluntary Counseling and Testing Service Uptake Among Adult Sub-Saharan Africans: A Systematic Review and Meta-Analysis
Authors: Sambou Muhammed Lamin , Dai Juncheng , Zhao Xiaoyu , Hong Tongtong , Basnet Til Bahadur , Marley Gifty , Sambou Alima , Fadoua El Hafa , Naveed Muhammad 
Published: August 2022

Objective: To examine the major determinants of VCT service uptake among adults in SSA.Methods: Electronic databases were searched to identify eligible English language publications. Reporting of the study selection procedure was done according to PRISMA and the selected articles were also critically appraised.Results: We found 8 significant determinants of VCT uptake among adults in SSA, such as less physical access [OR (Odds ratio): 0.77 (95% CI (Confidence interval): 0.62–0.96), p &lt; 0.01], older age [OR: 1.36 (95% CI: 1.08–1.73), p &lt; 0.01], higher education level [OR: 1.60 (95% CI: 1.24–2.05), p &lt; 0.01], high knowledge of HIV and VCT awareness [OR: 1.40 (95% CI: 1.03–1.90), p &lt; 0.01], unprotected sexual practices [OR: 1.75 (95% CI: 1.18–2.58), p &lt; 0.01], discussion on HIV among partners and others [OR: 1.76 (95% CI: 1.10–2.81), p &lt; 0.01], other STIs [OR: 1.40 (95% CI: 1.00–1.98), p &lt; 0.01], and divorced/separated [OR: 1.39 (95% CI: 1.12–1.72), p &lt; 0.01].Conclusion: This study showed that 8 determinants were significantly associated with VCT service uptake in SSA. Thus, HIV interventions and policy initiatives should be tailored to these determinants to ensure scale-up of VCT service uptake in SSA.