bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical implications of neoadjuvant chemotherapy in advanced endometrial cancer: a multi-center retrospective cohort study
Authors: Lim Hyunji , Bang Seung Hyun , Kim Yeorae , Cho Sang Hyun , Shin Wonkyo , Kim Se Ik , Kim Tae Hun , Suh Dong Hoon , Lim Myong Cheol , Kim Jae-Weon 
Published: June 2022

Abstract
Background
The mainstay of endometrial cancer treatment is surgical resection of tumors and postoperative adjuvant treatment is recommended if necessary. However, there is no consensus on the management of unresectable metastatic endometrial cancer. This study aimed to assess the feasibility and effectiveness of neoadjuvant chemotherapy followed by interval debulking surgery (NAC-IDS) in unresectable, metastatic endometrial cancer.

Methods
From the endometrial cancer cohorts of four institutions in Korea, we identified patients with International Federation of Gynecology and Obstetrics stages IIIC–IVB endometrial cancer who received NAC-IDS between January 2008 and December 2020. Through a medical record review, we collected patients’ clinicopathological data. Progression-free survival (PFS), overall survival (OS), and the factors affecting survival outcomes were analyzed.

Results
Overall, 32 patients were included with endometrioid (n = 18), serous (n = 5), carcinosarcoma (n = 6), and other histological types (n = 3). Among them, 28 (87.5%) patients had stage IVB disease. The most common neoadjuvant chemotherapy (NAC) regimen was paclitaxel-carboplatin (n = 25, 78.1%), which was administered for a median of six cycles. While 26 (81.3%) patients showed an objective response, two (6.3%) progressed despite NAC. At the time of interval debulking surgery (IDS), 23 (71.9%) patients achieved complete cytoreduction. During 31.0 months of the median follow-up, there were 23 recurrences and 11 deaths, corresponding to a median PFS of 19.7 months and a 3-year OS rate of 69.7%. In multivariate analyses, non-endometrioid histology and residual tumor after IDS were identified as independent poor prognostic factors for PFS (adjusted hazard ratio [HR], 7.322; P < 0.001 and 5.934; P = 0.001, respectively). Multivariate analysis for OS could not be conducted because of the small number of events, although non-endometrioid histology was the only factor associated with worse OS in univariate analysis (adjusted HR, 4.523; P = 0.032).

Conclusions
NAC-IDS may be a treatment option for unresectable metastatic endometrial cancer. Tumor histology and the possibility of complete cytoreduction are the primary considerations for NAC-IDS.
PIK3R3, a regulatory subunit of PI3K, modulates ovarian cancer stem cells and ovarian cancer development and progression by integrative analysis
Authors: Sohn Eun Jung 
Published: June 2022

Abstract
Background
Ovarian cancer is the most lethal gynecologic disease and is one of the most commonly diagnosed cancers among women worldwide. The phosphatidylinositol 3-kinase (PI3K) family plays an important regulatory role in various cancer signaling pathways, including those involved in ovarian cancer development; however, its exact function remains to be fully understood. We conducted this study to understand the role of P13K in the molecular mechanisms underlying ovarian cancer development.

Methods
To determine the differential gene expression of phosphoinositide-3-kinase regulatory subunit 3 (PIK3R3), a regulatory subunit of PI3K, in normal, tumor, and metastatic ovary tissues, TNM plotter analysis was performed. The microarray dataset GSE53759 was downloaded from Gene Expression Omnibus. ROC plotter analysis was conducted to understand the potential of PIK3R3 as a predictive marker for effectiveness of therapy in ovarian cancer. muTarget was used to identify mutations that alter PIK3R3 expression in ovarian cancer. To determine the interacting partners for PIK3R3 in ovarian tissues, the interactome-atlas tool was used. The Kyoto encyclopedia of genes and genomes (KEGG) analysis was conducted to identify the pathways in which these interacting partners were primarily enriched.

Results
PIK3R3 was overexpressed in ovarian and metastatic tumors. Elevated PIK3R3 levels were observed in ovarian cancer stem cells, wherein inhibiting PIK3R3 expression significantly reduced the size of ovarian cancer spheroids. Treatment of ovarian cancer stem cells with PF-04691502 (10 μM), an inhibitor of both PI3K and mTOR kinases, also reduced the size of spheroids and the level of OCT4. PIK3R3 was highly expressed in ovarian cancer with several somatic mutations and was predicted better outcomes in patients undergoing Avastin® chemotherapy using bioinformatic tool. Protein interaction analysis showed that PIK3R3 interacts with 157 genes, including GRB2, EGFR, ERBB3, PTK2, HCK, IGF1R, YES1, and PIK3CA, in the ovary. KEGG enrichment analysis revealed that the interacting partners of PIK3R3 are involved in the ErbB signaling pathway, proteoglycans in cancer, FoxO, prolactin, chemokine, and insulin signaling pathways.

Conclusions
PIK3R3 plays a pivotal role in ovarian cancer development and is therefore a potential candidate for developing novel therapeutic approaches.
Ecological factors and childhood eating behaviours at 5 years of age: findings from the ROLO longitudinal birth cohort study
Authors: Delahunt Anna , Conway Marie C. , O’Brien Eileen C. , Geraghty Aisling A. , O’Keeffe Linda M. , O’Reilly Sharleen L. , McDonnell Ciara M. , Kearney Patricia M. , Mehegan John , McAuliffe Fionnuala M. 
Published: June 2022

Abstract
Background
Individual differences in children eating behaviours have been linked with childhood overweight and obesity. The determinants of childhood eating behaviours are influenced by a complex combination of hereditary and ecological factors. This study examines if key ecological predictors of childhood overweight; maternal socio-economic status (SES), children’s screen time, and childcare arrangements, are associated with eating behaviours in children aged 5-years-old.

Methods
This is secondary, cross-sectional analysis of the ROLO (Randomized COntrol Trial of LOw glycemic diet in pregnancy) study, using data from the 5-year follow-up (n = 306). Weight, height, and body mass index (BMI) were obtained from mothers and children at the 5-year follow-up. Children’s BMI z-scores were calculated. SES was determined using maternal education level and neighborhood deprivation score. Information on children’s screen time and childcare arrangements were collected using lifestyle questionnaires. Children’s eating behaviours were measured using the Children’s Eating Behaviour Questionnaire (CEBQ). Multiple linear regression, adjusted for potential confounders, assessed associations between maternal SES, screen time and children’s eating behaviours. One-way ANOVA, independent sample t-tests and Spearman’s correlation examined childcare exposure and children’s eating behaviour.

Results
Mothers in the lowest SES group had higher BMI and were younger than those in the highest SES group (p =  < 0.001, p = 0.03 respectively). In adjusted analysis, the lowest SES group was associated with a 0.463-point higher mean score for ‘Desire to Drink’ (95% CI = 0.054,0.870, p = 0.027) and higher ‘Slowness to Eat’ (B = 0.388, 95% CI = 0.044,0.733, p = 0.027) when compared with the highest SES group. Screen time (hours) was associated with higher ‘Food Fussiness’ (B = 0.032, 95% CI = 0.014,0.051, p = 0.001). Those who attended childcare had higher scores for ‘Desire to Drink’(p = 0.046). No relationship was observed between longer duration (years) spent in childcare and eating behaviours.

Conclusions
In this cohort, the ecological factors examined had an influence on children’s eating behaviours aged 5-years-old. Our results illustrate the complexity of the relationship between the child’s environment, eating behaviour and children’s body composition. Being aware of the ecological factors that impact the development of eating behaviours, in the pre-school years is vital to promote optimal childhood appetitive traits, thus reducing the risk of issues with excess adiposity long-term.
Challenges and recommendations to improve implementation of phototherapy among neonates in Malawian hospitals
Authors: Kinshella Mai-Lei Woo , Salimu Sangwani , Chiwaya Brandina , Chikoti Felix , Chirambo Lusungu , Mwaungulu Ephrida , Banda Mwai , Hiwa Tamanda , Vidler Marianne , Molyneux Elizabeth M. , Dube Queen , Mfutso-Bengo Joseph , Goldfarb David M. , Kawaza Kondwani , Nyondo-Mipando Alinane Linda 
Published: June 2022

Abstract
Background
Severe neonatal jaundice can result in long term morbidities and mortality when left untreated. Phototherapy is the main-stay intervention for treating moderate jaundice and for prevention of the development of severe jaundice. However, in resource-limited health care settings, phototherapy has been inconsistently used. The objective of this study is to evaluate barriers and facilitators for phototherapy to treat neonatal jaundice at Malawian hospitals.

Methods
We conducted a convergent mixed-method study comprised of a facility assessment and qualitative interviews with healthcare workers and caregivers in southern Malawi. The facility assessment was conducted at three secondary-level hospitals in rural districts. In-depth interviews following a semi-structured topic guide were conducted at a district hospital and a tertiary-level hospital. Interviews were thematically analysed in NVivo 12 software (QSR International, Melbourne, Australia).

Results
The facility assessment found critical gaps in initiating and monitoring phototherapy in all facilities. Based on a total of 31 interviews, participants identified key challenges in diagnosing neonatal jaundice, counselling caregivers, and availability of infrastructure. Participants emphasized the need for transcutaneous bilirubinometers to guide treatment decisions. Caregivers were sometimes fearful of potential harmful effects of phototherapy, which required adequate explanation to mothers and family members in non-medical language. Task shifting and engaging peer support for caregivers with concerns about phototherapy was recommended.

Conclusion
Implementation of a therapeutic intervention is limited if accurate diagnostic tests are unavailable. The scale up of therapeutic interventions, such as phototherapy for neonatal jaundice, requires careful holistic attention to infrastructural needs, supportive services such as laboratory integration as well as trained human resources.
The impact of the euthanasia assessment procedure: a qualitative interview study among adults with psychiatric conditions
Authors: Verhofstadt Monica , Chambaere Kenneth , Pardon Koen , Mortier Freddy , Liégeois Axel , Deliens Luc , Audenaert Kurt 
Published: June 2022

Abstract
Background
Assisted dying for adults with psychiatric conditions (APC) is highly controversial but legally possible in a few countries, including Belgium. Previous research has suggested that the complex euthanasia assessment procedure may cause additional suffering in APC but may also induce positive experiences. This study reports on the impact of the euthanasia assessment procedure as experienced by APC on three counts: 1) their mental state, including death ideation; 2) their treatment trajectory; 3) their social relationships.

Methods
We performed an in-depth qualitative interview study with 16 APC in Flanders, Belgium, who had voiced a euthanasia request between 2016–2020. Thematic coding was used.

Findings
We interviewed 16 APC. Euthanasia assessment procedures brought out a plethora of experiences in APC, both favourable and unfavourable. Whereas thoughts of suicide remain present to a certain extent, being in the assessment procedure allows some APC to reconsider alternatives towards life, and also to attempt new treatment options. However, many APC experience ambivalence about the supposedly inherent desirability and dignity in euthanasia. Worries also surfaced about the rationale behind and effects of involvement of APCs’ social circle, and about the impact it could have on them.

Conclusion
Further research, including other stakeholder perspectives, is recommended with a view to maximising favourable and minimising unfavourable impacts for all involved. In clinical practice attention to these impacts is paramount, and clear communication and management of expectations between physician and patient, seems appropriate to address the many ambivalent experiences that accompany APC during the euthanasia assessment procedure. Policy attention could in this regard go to clarifying certain sources of ambivalence and issues that are insufficiently addressed, such as modalities of relatives’ involvement.
Optimising mothers’ health behaviour after hypertensive disorders of pregnancy: a qualitative study of a postnatal intervention
Authors: Rossiter Chris , Henry Amanda , Roberts Lynne , Brown Mark A. , Gow Megan , Arnott Clare , Salisbury Justine , Ruhotas Annette , Hehir Angela , Denney-Wilson Elizabeth 
Published: June 2022

AbstractBackgroundHypertensive disorders of pregnancy have longer-term implications, increasing women’s lifetime cardiovascular disease risk. The Blood Pressure Postpartum study is a multi-centre randomised three-arm trial of interventions, ranging in intensity and including education and lifestyle coaching, to support women to maintain or adopt healthy eating and physical activity during the first postpartum year. This qualitative sub-study nested within the main trial aimed to investigate whether and how women adopted healthy behaviours after a pregnancy complicated by a hypertensive disorder.MethodsSemi-structured telephone interviews were recorded, transcribed and analysed thematically, following Braun and Clarke principles. They explored behaviour change among new mothers following their hypertensive pregnancy, and the intervention’s effect on their capacity and motivation to pursue healthy lifestyles.ResultsThirty-four women from all three trial arms participated at 10–12 months postpartum. The three main themes were 1) Awareness of cardiovascular risk: some did not acknowledge the health risks, whereas others embraced this information. 2) Sources of motivation: while the majority were motivated to make a concerted effort to adapt their health behaviour, motivation often centred on their baby and family rather than their own needs. 3) Sustaining behaviour change with a new baby: women in the more intensive intervention arm demonstrated increased recognition of the importance of reducing cardiovascular health risks, with greater motivation and guidance to change their health behaviour. There was minimal evidence of crossover amongst groups, with women largely accepting their randomised level of intervention and not seeking additional help when randomised to minimal intervention.ConclusionsAmong women participating in an early post-hypertensive disorders of pregnancy randomised controlled trial aimed at improving their cardiovascular disease risk profile, the majority recognised the future health risks and appeared motivated to improve their lifestyle, particularly women in the highest-intensity intervention group. This highlights the importance of structured support to assist women embrace healthy lifestyles especially during the challenges of new parenthood.Trial registrationThe Blood Pressure Postpartum study was prospectively registered as a clinical trial with the Australian New Zealand Clinical Trials Registry (anzctr.org.au) on 13 December 2018 (registration number: ACTRN12618002004246).
Development and validation of a nomogram to predict plastic bronchitis in children with refractory Mycoplasma pneumoniae pneumonia
Authors: Zhao Lihua , Zhang Tongqiang , Cui Xiaojian , Zhao Linsheng , Zheng Jiafeng , Ning Jing , Xu Yongsheng , Cai Chunquan 
Published: June 2022

Abstract
Background
Early identification of plastic bronchitis (PB) is of great importance and may aid in delivering appropriate treatment. This study aimed to develop and validate a nomogram for predicting PB in patients with refractory Mycoplasma pneumoniae pneumonia (RMPP).

Methods
A total of 547 consecutive children with RMPP who underwent fiberoptic bronchoscopy (FOB) intervention from January 2016 to June 2021 were enrolled in this study. Subsequently, 374 RMPP children (PB: 137, without PB: 237) from January 2016 to December 2019 were assigned to the development dataset to construct the nomogram to predict PB and 173 RMPP children from January 2020 to June 2021 were assigned to the validation dataset. The clinical, laboratory and radiological findings were screened using Least Absolute Shrinkage and Selection Operator (LASSO) regression and logistic regression was applied to construct a nomogram. The performance of the nomogram was evaluated by discrimination, calibration and clinical utility. Comparsion of ROC analysis and decision curve analysis (DCA) between nomogram and other models was performed to evaluate the discrimination ability and clinical utility.

Results
The development dataset included 374 patients with a mean age of 6.6 years and 185(49.5%) were men. The validation dataset included 173 patients and the mean age of the dataset was 6.7 years and 86 (49.7%) were men. From 26 potential predictors, LASSO regression identified 6 variables as significant predictive factors to construct the nomogram for predicting PB, including peak body temperature, neutrophil ratio (N%), platelet counts (PLT), interleukin-6 (IL-6), actic dehydrogenase (LDH) and pulmonary atelectasis. The nomogram showed good discrimination, calibration and clinical value. The mean AUC of the nomogram was 0.813 (95% CI 0.769–0.856) in the development dataset and 0.895 (95% CI 0.847–0.943) in the validation dataset. Through calibration plot and Hosmer–Lemeshow test, the predicted probability had a good consistency with actual probability both in the development dataset (P = 0.217) and validation dataset (P = 0.183), and DCA showed good clinical utility. ROC analysis indicated that the nomogram showed better discrimination ability compared with model of peak body temperature + pulmonary atelactsis and another model of N% + PLT + IL-6 + LDH, both in development dataset (AUC 0.813 vs 0.757 vs 0.754) and validation dataset (AUC 0.895 vs 0.789 vs 0.842).

Conclusions
In this study, a nomogram for predicting PB among RMPP patients was developed and validated. It performs well on discrimination ability, calibration ability and clinical value and may have the potential for the early identification of PB that will help physicians take timely intervention and appropriate management.
Smoking cessation by combined medication and counselling: a feasibility study in lung cancer patients
Authors: Reinhardt Christian , Harden Markus , Herrmann-Lingen Christoph , Rittmeyer Achim , Andreas Stefan 
Published: June 2022

Abstract
Purpose
Smoking cessation in patients with diagnosed lung cancer has positive effects on cancer therapy and overall prognosis. Despite this, knowledge on smoking cessation in lung cancer patients is sparse.

Methods
This is an observational single centre, 12-week, prospective, single-arm trial at a tertiary lung cancer centre. Responsive patients were enrolled following confirmed lung cancer diagnosis. Smoking cessation intervention included counselling as well as pharmacotherapy. The primary endpoint was the point prevalence abstinence rate at week 12 based on biochemical verification. Secondary endpoints were the abstinence rate at week 26, quality of life and side effects.

Results
80 patients were enrolled. Mean age was 62.6 ± 7.9 years. Most patients (63%) were treated with chemotherapy or radiochemotherapy. 39 patients used nicotine replacement therapy, 35 varenicline whereas six patients did not use pharmacotherapy. During the study period 13 patients died. Data were available in 72 patients after 12 weeks and 57 patients at week 24. Point prevalence abstinence rates were 37.5% (95% CI 26.4–49.7%) at week 12 and 32.8% (95% CI 21.8–45.4%) at week 26, respectively. Quality of life and side effects were not significantly affected by pharmacotherapy.

Conclusion
In conclusion, our results suggest that smoking cessation is feasible in patients with newly diagnosed lung cancer. The observed abstinence rate is comparable to other patient cohorts. Furthermore, pharmacotherapy in addition to cancer therapy was safe and did not show novel side effects in these seriously ill patients. Thus, smoking cessation should be an integral part of lung cancer treatment.
Trial registration The study was conducted in accordance with good clinical practice standards (GCP) and approved by the local ethics committee (16/3/14), the European PAS registry (EUPAS8748) and the German BfArM (NIS-Studien-Nr. 5508). All patients provided written informed consent before study enrollment.
Sex-specific effects of localized muscle fatigue on upper body kinematics during a repetitive pointing task
Authors: Yang Chen , Côté Julie N. 
Published: June 2022

AbstractBackgroundFemales are reported to have a higher risk of musculoskeletal disorders than males. Repetitive motions can lead to muscle fatigue, which may play a mediator role in the development of musculoskeletal disorders. However, sex differences in adaptations to localized fatigue at different joints are poorly understood. We examined the sex-specific effects of fatigue location on shoulder, elbow and spinal joint angles, and angular variabilities during a repetitive pointing task.MethodsSeven males and ten females performed a 30-s standing repetitive pointing task with their right upper limb when they were non-fatigued (NF), elbow-fatigued (EF), shoulder-fatigued (SF) and trunk-fatigued (TF), while trunk and upper body tridimensional kinematic data was recorded. Joint angles and angular variabilities of shoulder, elbow, upper thoracic spine, lower thoracic spine, and lumbar spine were calculated.ResultsResults showed that shoulder angles changed the most after EF in males, but after SF in females. The similarities between sexes were that SF increased the variabilities at upper (lateral flexion: 0.15° greater than NF, rotation: 0.26° greater than all other conditions) and lower thoracic spine (lateral flexion: 0.13° greater than NF, rotation: averagely 0.1° greater than all other condition) in both sexes. TF altered upper thoracic spine variability (0.36° smaller than SF), lower thoracic spine angle (lateral flexion: 3.00° greater than NF, rotation: 1.68° greater than SF), and lumbar angle (averagely 1.8° smaller than all other conditions) in both sexes. However, females had greater lower thoracic spine angle (lateral flexion: 8.3° greater,p = 0.005) as well as greater upper (rotation: 0.53° greater,p = 0.006) and lower thoracic spine (rotation: 0.5° greater,p = 0.007; flexion: 0.6° greater,p = 0.014) angular variabilities than males.ConclusionsResults suggest that females’ fatigue responses focused on the trunk and spine. Results highlight a few sex differences in adapting to localized muscle fatigue, which may help explain how sex differences in repetitive motion-related injuries differ between joints.