bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical value of PET/CT in identifying patients with oligometastatic/oligoprogressive disease among first-line tyrosine kinase inhibitor-treated advanced EGFR-mutant non-small cell lung cancer: Implications from survival comparisons
Authors: Xu Dayu , Yu Fan , Guo Tiantian , Zhou Yue , Zhang Jinmeng , Li Yida , Jiang Shanshan , Mao Jiuang , Yang Xi , Chu Li , Chu Xiao , Wang Shengping , Ni Jianjiao , Zhu Zhengfei 
Published: May 2022

Objective:
Local therapy (LT) could potentially prolong the survival of patient with advanced epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) receiving tyrosine kinase inhibitors (TKIs) and harboring oligometastatic/oligoprogressive disease (OMD/OPD). However, the optimal imaging method for identifying patients with OMD/OPD remains controversial. The objective of this study was to investigate the clinical value of incorporating PET/CT in detecting patients with OMD/OPD.

Methods:
Consecutive cases with metastatic EGFR-mutant NSCLC undergoing first-line EGFR-TKI treatment were retrospectively screened and those receiving baseline PET/CT and brain magnetic resonance imaging (MRI) or complete conventional imaging (CIM), including brain MRI, chest computed tomography (CT), abdomen ultrasound or CT and bone scintigraphy were included. OMD/OPD was defined as metastases/progressions documented at a maximum of five lesions and three organs, otherwise was defined as multiple metastatic/progressive disease (MMD/MPD). Progression-free survival (PFS) and overall survival (OS) were analyzed.

Results:
Of the 392 patients evaluated, baseline OMD was detected in 22.7% (53/233) of patients by PET/CT and in 18.2% (29/159) of patients by CIM (p = 0.171). Among the patients evaluated with baseline PET/CT, patients with OMD had longer PFS (p = 0.016) and tendency of improved OS (p = 0.058) than those with MMD. However, this result was not observed with patients evaluated using baseline CIM. With a median follow-up of 24.2 (range, 1.1–124.6) months, 297 patients had their first disease progression (FPD), of whom 164 (55.2%) had adequate imaging scans to analyze the tumor distributions at FPD comprehensively. OPD was detected in 63.0% (34/54) and 35.0% (39/110) of patients among the PET/CT and CIM assessed group (p = 0.003), respectively. Among the PET/CT assessed group, patients with OPD had significantly longer post-progressive overall survival (OS2) than those with MPD (p = 0.011). However, no significant difference of OS2 in the CIM assessed group was found.

Conclusion:
Patients with OMD/OPD, evaluated by PET/CT but not CIM, generally had more favorable survival outcomes than those with MMD/MPD among patients with metastatic NSCLC undergoing first-line EGFR-TKI treatment.

Advances in knowledge:
PET/CT seems to affect the survival of patients under first-line EGFR-TKI treated metastatic NSCLC with OMD/OPD.
Does the autism phenotype differ when selecting groups by neurodevelopmental versus genetic diagnosis? An observational study comparing autism and sex chromosome trisomy
Authors: Wilson Alexander C , Bishop Dorothy V M 
Published: May 2022

Background: Autism is diagnosed on the basis of social and non-social behavioural features that are assumed to cluster together, and assumed to be distinct from other aspects of development, such as language ability. It is unclear, however, if these assumptions are valid. This study presents a novel approach to answering this question by investigating whether correlations between autism features are similar for groups selected on behavioural versus genetic diagnosis. Methods: The autism phenotype was assessed by diagnostic interview in young people aged 7 to 14 diagnosed with autism (N=61) or sex chromosome trisomy (SCT; N=49). Data were analysed by confirmatory factor analysis and MANOVA. Results: Autism features showed a similar factor structure and were distinct from language ability in both groups. However, the SCT group was more likely to show clinically-significant difficulties in just some aspects of autism and a lower level of non-social autism features for their social-communication disabilities. Conclusions: We suggest the group differences emerged because autism diagnostic criteria do not map exactly on the autism phenotype as it manifests “naturally”. Conventional diagnostic criteria for autism miss those with uneven profiles of difficulty and those with relatively low levels of restricted and repetitive behaviours and interests.
Case Report: Systemic lupus erythematous associated with thrombotic thrombocytopenic purpura, a diagnostic challenge
Authors: Suárez-Ale Horacio , Fabian-Aquino Elizabeth , Failoc-Rojas Virgilio E. , Benites-Zapata Vicente A , Ignacio-Cconchoy Felipe 
Published: May 2022

Thrombotic thrombocytopenic purpura (TTP) is an uncommon microangiopathic disease and sometimes is associated with systemic lupus erythematous (SLE). However, this probable causal relationship has not been completely proven. The diagnostic differentiation of both diseases is difficult in the first instance because they share similar characteristics that may overlap. We present a case of a 32-year-old woman with antecedents of epileptic seizures since she was 12 years old. The patient was admitted to the emergency room with a clinical picture of headaches, fever, paleness in the skin and mucosa, confused state, paresthesia, and transient spasticity of the extremities. The laboratory results revealed direct Coombs negative hemolytic anemia, severe thrombocytopenia, significant elevation of lactate dehydrogenase, and presence of schistocytes ++ in the peripheral film. In addition, positive antinuclear antibodies and positive anti-native DNA in titers of 1/320 and 1/160, respectively, were found. Urinalysis showed that serum creatinine was in normal range. Because of limited hospital resources, ADAMTS13 was not evaluated. However, based on clinical, hematological, and biochemical findings, we concluded that it was a case of TTP associated with SLE and indicated treatment with plasmapheresis and methylprednisolone pulses, obtaining a satisfactory response (normalization of biomarker levels, health condition) after the second session of plasmapheresis. Diagnosis of both SLE and TTP is often difficult to achieve; however, adequate correlation of clinical manifestations and laboratory tests, along with the help of partial therapeutic interventions, may lead to good clinical response.
Complicity at a distance: commemorating problematic involvement in perpetration in contemporary Central and Eastern European literatures
Authors: Prade-Weiss Juliane 
Published: May 2022

Background: In the twenty-first century, literatures from Central and Eastern Europe are marked by a boom of documentary fiction portraying complicity Nazi perpetration, Soviet terror, or other instances of 20th century mass violence and totalitarianism. Since understanding the past serves requirements of the present, the boom prompts the question: Why the interest in past complicities now? My hypothesis is that the texts address convergences between involvements in past acts of mass violence and current forms of participation in wrongdoings in neoliberalism. While these issues differ profoundly, they are related: structurally, both present the challenge of forming a nuanced notion of participation. Historically, they are related since justifications of past involvements have established the terminology, narratives, and heuristics in which terror, repression, and mass violence are subsequently discussed, thus forming the frame for negotiating current problematic involvements. Method: Critical discourse analysis is used to scrutinize the legal concept of complicity and combined it with close readings of passages from four literary texts to outline how attention to reciprocity in language can enhance our understanding of problematic involvement. Results: Literary portrayals of historical complicity are ambivalent; they can help to find models for comprehending issues of the present in cultural memory, but they can also serve to establish distance between present and past to appease the sense that all is not quite well, even after the demise of Nazi and Soviet terror. The article outlines two modes of distancing: a) spacio-temporal distancing of the commemorating point of view in ‘the West’ from the portrayed violence in ‘the East’, and b) moral distancing that casts the audience as superior to complicit characters. Conclusion: By pressing for analytic or consoling distance, both strategies of distancing amount to a complicity with the transmission of discourses that justify, excuse, or deny mass violence and totalitarian terror.
Emergence of multi-drug-resistant Mycobacterium tuberculosis in Niger: A snapshot based on whole-genome sequencing
Authors: Harouna Hamidou Zelika , Morsli Madjid , Mamadou Saidou , Drancourt Michel , Saad Jamal 
Published: May 2022

Background
Among other West African countries experiencing the high endemicity of deadly tuberculosis, the situation in Niger is poorly evidenced by microbiological investigations.

Methodology/Principal findings
The study of 42 isolates of Mycobacterium tuberculosis from Niger by whole genome sequencing using Illumina iSeq technology yielded four M. tuberculosis lineages: Indo-Oceanic L1 (n = 1) (2.3%), East-Asian (n = 1) (2.3%), East-African Indian L3 (n = 2) (4.7%) and Euro-American L4 (n = 38) (90.4%). The sub-lineage L4.1.3 comprising 18 isolates (47.3%) was predominant, followed by the L4.6.2.2 sub-lineage (Cameroon genotype, n = 13 isolates) (34.2%). Investigating drug resistance profile for 12 antibiotics found 8/42 (19%) pan-susceptible isolates and 34/42 (81%) resistant isolates; with 40/42 (95.2%) isolates being susceptible to clofazimine-bedaquiline.

Conclusions/Significance
These unprecedented data from Niger highlight the dynamics of tuberculosis transmission and drug resistance in Niger and may assist tuberculosis control in this country which continues to support a high burden of tuberculosis.
The use of a chimeric antigen for Plasmodium falciparum and P. vivax seroprevalence estimates from community surveys in Ethiopia and Costa Rica
Authors: McCaffery Jessica N. , Singh Balwan , Nace Douglas , Assefa Ashenafi , Hwang Jimee , Plucinski Mateusz , Calvo Nidia , Moreno Alberto , Udhayakumar Venkatachalam , Rogier Eric 
Published: May 2022

Background
In low-transmission settings, accurate estimates of malaria transmission are needed to inform elimination targets. Detection of antimalarial antibodies provides exposure history, but previous studies have mainly relied on species-specific antigens. The use of chimeric antigens that include epitopes from multiple species of malaria parasites in population-based serological surveys could provide data for exposure to multiple Plasmodium species circulating in an area. Here, the utility of P. vivax/P. falciparum chimeric antigen for assessing serological responses was evaluated in Ethiopia, an endemic country for all four human malarias, and Costa Rica, where P. falciparum has been eliminated with reports of sporadic P. vivax cases.

Methods
A multiplex bead-based assay was used to determine the seroprevalence of IgG antibodies against a chimeric malaria antigen (PvRMC-MSP1) from blood samples collected from household surveys in Ethiopia in 2015 (n = 7,077) and Costa Rica in 2015 (n = 851). Targets specific for P. falciparum (PfMSP1) and P. vivax (PvMSP1) were also included in the serological panel. Seroprevalence in the population and seroconversion rates were compared among the three IgG targets.

Results
Seroprevalence in Costa Rica was 3.6% for PfMSP1, 41.5% for PvMSP1 and 46.7% for PvRMC-MSP1. In Ethiopia, seroprevalence was 27.6% for PfMSP1, 21.4% for PvMSP1, and 32.6% for PvRMC-MSP1. IgG levels in seropositive individuals were consistently higher for PvRMC-MSP1 when compared to PvMSP1 in both studies. Seroconversion rates were 0.023 for PvMSP1 and 0.03 for PvRMC-MSP1 in Costa Rica. In Ethiopia, seroconversion rates were 0.050 for PfMSP1, 0.044 for PvMSP1 and 0.106 for PvRMC-MSP1.

Conclusions
Our data indicate that chimeric antigen PvRMC-MSP1 is able to capture antibodies to multiple epitopes from both prior P. falciparum and P. vivax infections, and suitable chimeric antigens can be considered for use in serosurveys with appropriate validation.
Prevalence of gambling problems, help-seeking, and relationships with trauma in veterans
Authors: Metcalf Olivia , Lawrence-Wood Ellie , Baur Jenelle , Van Hooff Miranda , Forbes David , O’Donnell Meaghan , Sadler Nicole , Hodson Stephanie , Benassi Helen , Varker Tracey , Battersby Malcolm , McFarlane Alexander C. , Cowlishaw Sean 
Published: May 2022

Background and aims
Veterans who have recently left the military (i.e., transitioned) may be vulnerable to the development of psychiatric disorders, but little is known about gambling problems in this population. This study investigated the prevalence and risk factors of gambling problems, help-seeking amongst veterans with gambling problems, and relationships with trauma and posttraumatic psychopathology.

Methods
Cross-sectional self-report survey data from 3,511 Australian Defence Force members who left the military within the past five years. Surveys included measures of gambling problems (PGSI); depressive symptoms (PHQ-9); posttraumatic stress disorder (PCL-5); help-seeking behaviours; military and non-military-related trauma.

Results
Prevalence rates for problem gambling (PGSI ≥ 5) were 4.6%, while an additional 8.8% were classified in terms of at-risk gambling (PGSI = 1–4). Time since leaving the military was not associated with gambling problems. Only 2.1% of veterans with problem gambling reported help-seeking for their gambling. While trauma exposure, depression, and Posttraumatic Stress Disorder (PTSD) were all related to gambling problems at the bivariate level, only arousal and dysphoric-related affect were uniquely associated with gambling problems when adjusting for covariates.

Discussion
Gambling problems may be under-recognised relative to other psychiatric issues. Posttraumatic mental health problems, rather than trauma exposure per se, may explain the relationship between trauma and gambling problems.

Conclusions
Some veterans are in a period of vulnerability during transition out of military service, and harms associated with gambling problems may be exacerbated during this period.
Multiple Criteria Decision Analysis (MCDA) for evaluating cancer treatments in hospital-based health technology assessment: The Paraconsistent Value Framework
Authors: Campolina Alessandro Gonçalves , Estevez-Diz Maria Del Pilar , Abe Jair Minoro , de Soárez Patrícia Coelho 
Published: May 2022

BackgroundIn recent years, the potential of multi-criteria decision analysis (MCDA) in the health field has been discussed widely. However, most MCDA methodologies have given little attention to the aggregation of different stakeholder individual perspectives.ObjectiveTo illustrate how a paraconsistent theory-based MCDA reusable framework, designed to aid hospital-based Health Technology Assessment (HTA), could be used to aggregate individual expert perspectives when valuing cancer treatments.MethodsAn MCDA methodological process was adopted based on paraconsistent theory and following ISPOR recommended steps in conducting an MCDA study. A proof-of-concept exercise focusing on identifying and assessing the global value of first-line treatments for metastatic colorectal cancer (mCRC) was conducted to foster the development of the MCDA framework.ResultsOn consultation with hospital-based HTA committee members, 11 perspectives were considered in an expert panel: medical oncology, oncologic surgery, radiotherapy, palliative care, pharmacist, health economist, epidemiologist, public health expert, health media expert, pharmaceutical industry, and patient advocate. The highest weights were assigned to the criteria “overall survival” (mean 0.22), “burden of disease” (mean 0.21) and “adverse events” (mean 0.20), and the lowest weights were given to “progression-free survival” and “cost of treatment” (mean 0.18 for both). FOLFIRI and mFlox scored the highest global value score of 0.75, followed by mFOLFOX6 with a global value score of 0.71. mIFL was ranked last with a global value score of 0.62. The paraconsistent analysis (para-analysis) of 6 first-line treatments for mCRC indicated that FOLFIRI and mFlox were the appropriate options for reimbursement in the context of this study.ConclusionThe Paraconsistent Value Framework is proposed as a step beyond the current MCDA practices, in order to improve means of dealing with individual expert perspectives in hospital-based HTA of cancer treatments.
Mothers at risk of postpartum depression in Sri Lanka: A population-based study using a validated screening tool
Authors: Røysted-Solås Therese , Hinderaker Sven Gudmund , Ubesekara Lasantha , De Silva Vijitha 
Published: May 2022

Background
Postpartum depression is an important public health concern. The prevalence of postpartum depression is estimated to be 18% worldwide. The purpose of this study was to estimate the prevalence of mothers at risk of postpartum depression in Sri Lanka and to investigate its associated risk factors.

Methods
This was a cross-sectional study conducted among 975 mothers in Galle district, Sri Lanka. The prevalence of mothers at risk of postpartum depression was assessed using the Edinburgh Postpartum Depression scale (EPDS) which has been validated for screening for mothers at risk of postpartum depression in Sri Lanka with a cut-off score 9 or more. Prevalence was estimated using a cut-off 9 or more, 10 or more, 11 or more and 12 or more to assess the difference in prevalence using unvalidated cut-offs for screening. Data from routine records on pregnancy, delivery and postnatal care was collected to investigate possible predictors of EPDS score 9 or more (risk of postpartum depression). Univariate and multivariable logistic regressions were performed to identify risk factors for EPDS score 9 or more (risk of postpartum depression).

Results
The prevalence of mothers with EPDS score 9 or more was found to be 9.4% (95%CI: 7.8–11.4); EPDS score 10 or more was 5.6% (95%CI: 4.4–7.3). EPDS score 9 or more (risk of postpartum depression) was associated with the following risk factors: Former history of mental illness (aOR 32.9, 95%CI: 7.9–136.2), high maternal age 30–39 (aOR 2.2, 95%CI: 1.3–3.8), BMI 25.0–29.9 (aOR 2.6, 95%CI: 1.5–4.5), hypertension (aOR 3.6, 95%CI: 1.2–10.9) and newborn death (aOR 28.9, 95%CI: 4.5–185.1). One in five women reported thoughts of self-harm.

Conclusion
Around one in ten mothers in Sri Lanka experience symptoms of postpartum depression, highest risk among mothers who reported former history of mental illness and newborn death. The prevalence estimates were lower with a higher cut-off for screening and this highlights the importance of using the validated cut-off for screening in future studies on postpartum depression in Sri Lanka. Mothers at increased risk should be identified in antenatal care and are important targets of referral.
Students’ figurative communication of malaria messages, belief, norms, and practices in Oromia, Ethiopia: A qualitative content analysis approach
Authors: Tareke Kasahun Girma , Hayder Abdu , Teshome Firanbon , Birhanu Zewdie , Kebede Yohannes 
Published: May 2022

Background
School engagement is an emerging strategy and proven potent vehicles for social and behavioral change communication (SBCC) intervention to prevent and control malaria. Little was known about the figurative speeches used in the malaria messages disseminated and communicated by school students. Therefore, this study evaluated the figurative speeches used in the poems to convey messages related to malarial perceptions, beliefs, norms and practices to prevent and control malaria.

Methods
A qualitative content analysis was conducted to explore the figurative speeches used in malaria messages conveyed in poems produced by primary school students. Twenty poems were purposively selected from twenty schools across rural villages in five districts of Jimma Zone. Data were analyzed using ATLAS.ti version 7.1.4 software. The figurative speeches were presented using central themes and categories supported with quotations.

Results
The predominantly used figurative speeches were simile, metaphor, personification and hyperbole. Simile was used to express the nature of anopheles mosquito, and sign and symptoms of malaria. The metaphor was used to express malaria, severity/seriousness of malaria and Insecticide-Treated Net (ITN); and also to express the relationship between persons ITN malpractice and its effect on their health. Personification was used to express the nature of anopheles mosquito and malaria. Finally, hyperbole was used to express nature of anopheles mosquito, severity of malaria and exaggerated effect of ITN and Indoor Residual Spraying (IRS).

Conclusions
The students conveyed messages related to malarial perceptions, beliefs, norms and practices of the local community to prevent and control malaria through different types of figurative speeches. Therefore, conceptualizing the local norms, beliefs, values, perception and practices, and expressing in different figurative speeches to convey messages and convince the local community might be important to bring the desired or intended behavioral change.
Assessment and determinants of acute post-caesarean section pain in a tertiary facility in Ghana
Authors: Azanu Wisdom Klutse , Osarfo Joseph , Larsen-Reindorf Roderick Emil , Agbeno Evans Kofi , Dassah Edward , Amanfo Anthony Ofori , Dah Anthony Kwame , Ampofo Gifty 
Published: May 2022

Introduction
Caesarean sections (CS) feature prominently in obstetric care and have impacted positively on maternal / neonatal outcomes globally including Ghana. However, in spite of documented increasing CS rates in the country, there are no studies assessing the adequacy of post-CS pain control. This study assessed the adequacy of post-CS pain management as well as factors influencing this outcome. Additionally, post-CS analgesia prescription and serving habits of doctors and nurses were also described to help fill existing knowledge gaps.

Methods
Pain scores of 400 randomly selected and consenting post-CS women at a tertiary facility in Ghana were assessed at 6–12 hours post-CS at rest and with movement and at 24–36 hours post-CS with movement using a validated visual analog scale (VAS) from February 1, 2015 to April 8, 2015. Participant characteristics including age, marital status and duration of CS were obtained using pretested questionnaires and patient records review. Descriptive statistics were presented as frequencies and proportions. Associations between background characteristics and the outcome variables of adequacy of pain control at 6–12 hours post-CS at rest and with movement and at 24–36 hours post-CS with movement were analysed using Chi-square and Fisher’s exact tests and logistic regression methods. Adequate pain control was defined as VAS scores ≤5.

Results
At 6–12 hours post-CS (at rest), equal proportions of participants had adequate and inadequate pain control (50.1% vrs 49.9%). Over the same time period but with movement, pain control was deemed inadequate in 93% of respondents (369/396). Women who had one previous surgery [OR 0.47 95%CI 0.27, 0.82; p = 0.008] and those whose CS lasted longer than 45 mins [OR 0.39 95% CI 0.24, 0.62; p<0.001] had lower odds of reporting adequate pain control. Women prescribed 12-hourly and 8-hourly doses of pethidine had only 23.5% (12/51) and 10.3% (3/29) served as prescribed respectively. At 24–36 hours post CS, adequate pain control was reported by 85.3% (326/382) of participants.

Conclusions
Pain management was deemed inadequate within the first 12 hours post-CS with potential implications for early mother-child interaction. Appreciable numbers of participants did not have their analgesics served as prescribed. Adjunct pain control measures should be explored and healthcare workers must be encouraged to pay more attention to patients’ pain relief needs.