bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a measure of clinicians’ self-efficacy for medical communication (SEMC)
Authors: Feldman David B. , O'Rourke Mark A. , Corn Benjamin W. , Hudson Matthew F. , Patel Naimik , Agarwal Rajiv , Fraser Valerie L. , Deininger Heidi , Fowler Lauren A. , Bakitas Marie A. , Krouse Robert A. , Subbiah Ishwaria M. 
Published: May 2022

ObjectivesStudies of clinician–patient communication have used varied, ad hoc measures for communication efficacy. We developed and validated the Self-Efficacy for Medical Communication (SEMC) scale as a standard, quantitative measure of clinician-reported skills in communicating difficult news.MethodsUsing evidence-based scale development guidelines, we created two 16-item forms of the SEMC, one assessing communication with patients and one assessing communication with families. Clinicians providing oncological care in four organisations were invited to participate and provided consent. Participant demographics, responses to the SEMC items and responses to convergent and discriminant measures (those expected to relate strongly and weakly to the SEMC) were collected online. We performed analyses to determine the convergent and discriminant validity of the SEMC as well as its reliability and factor structure.ResultsOverall, 221 oncology clinicians (including physicians, residents, fellows, medical students, nurses, nurse practitioners and physician assistants) participated. The patient and family forms both demonstrated high internal consistency reliability (alpha=0.94 and 0.96, respectively) and were strongly correlated with one another (r=0.95, p<0.001). Exploratory factor analysis demonstrated that the SEMC measures a unitary construct (eigenvalue=9.0), and its higher mean correlation with convergent (r=0.46) than discriminant (r=0.22) measures further supported its validity.ConclusionsOur findings support the SEMC’s validity and reliability as a measure of clinician-rated communication skills regarding conducting difficult conversations with patients and families. It provides a useful standard tool for future research in oncology provider–patient serious illness communication.
Hot flash clinical trial baseline measurements: how long is needed?
Authors: Childs Daniel S , Novotny Paul J , Marell Paulina S , Ruddy Kathryn J , Loprinzi Charles L 
Published: May 2022

ObjectivesClassically, hot flash studies included a baseline period of 1 week or longer. The objective of this study was to compare the accuracy of a 1-day baseline diary to a traditional 1-week diary.MethodsRaw data from 5 pilot studies and 15 phase III randomised controlled trials (RCTs), all of which used a 1-week baseline period, were obtained. Descriptive statistics were used to describe day-by-day variations in hot flash frequencies and scores, during the baseline week. Additional analyses evaluated whether the conclusions from any of the individual pilot studies would have been changed if only a 1-day baseline period had been used. For the RCTs, p values were recalculated using mixed models, adjusting for the baseline value by including it as a covariate.ResultsA total of 2573 participants were included. On average, participants had 8.5 hot flashes per day on day 1. Mean hot flash frequencies and scores on subsequent days (days 2–7) were within 6% of day 1 values. When comparing a 1-day to a 1-week baseline period, there was an absolute difference of only 0.29 hot flashes per day (SD 2.25). Reanalysis for each pilot study revealed that no individual study conclusions would have been altered by a shorter baseline. For the RCTs, a shorter baseline period changed the results of only 1 of 24 comparisons from statistically significant to not significant, or vice versa.ConclusionsA 1-day hot flash diary appears to accurately reflect the true frequency and severity of baseline symptoms in appropriately sized cohorts.
COVID-19 vaccine hesitancy and related factors among primary healthcare workers in a district of Istanbul: a cross-sectional study from Turkey
Authors: İkiışık Hatice , Sezerol Mehmet Akif , Taşçı Yusuf , Maral Işıl 
Published: May 2022

ObjectivesThis study aimed to determine the COVID-19 risk perceptions, vaccination intentions and predictive factors of family physicians and family healthcare staff working in primary care in Üsküdar.DesignA cross-sectional study was performed using an online questionnaire to determine the demographic and general characteristics of the participants and their willingness to be vaccinated.SettingAn online questionnaire was applied to family physicians and family health workers working in primary care family health centres in Üsküdar between 25 and 29 December 2020. Multivariate analysis was performed to identify independent predictors of the willingness of individuals to be vaccinated.ParticipantsOut of 323 health workers working in 44 family health centres in the district, a total of 276 health workers were reached, including 126 physicians (n=158, 79.7%) and 150 midwives/nurses (n=165, 90.9%) (response rate 85.4%).Results50.4% (n=139) of the healthcare workers were willing to have the COVID-19 vaccine, 29% (n=80) were undecided and 20.7% (n=57) refused the vaccine. The rate of acceptance to be vaccinated was higher in physicians, in men and in those who had not received a seasonal influenza vaccination regularly each year.ConclusionsHalf of the primary healthcare workers, one of the high-risk groups in the pandemic, were hesitant or refused to be vaccinated for COVID-19. Knowing the factors affecting the vaccine acceptance rates of healthcare professionals can be considered one of the most strategic moves in reaching the target of high community vaccination rates. For evidence-based planning in vaccination studies, there is a need to investigate the reasons for COVID-19 vaccine acceptance by healthcare workers at all levels.
Abnormal neural oscillations in clinical high risk for psychosis: a magnetoencephalography method study
Authors: Hu Yegang , Wu Jun , Cao YuJiao , Tang XiaoChen , Wu GuiSen , Guo Qian , Xu LiHua , Qian ZhenYing , Wei YanYan , Tang YingYing , Li ChunBo , Zhang Tianhong , Wang Jijun 
Published: May 2022

BackgroundNeural oscillations directly reflect the rhythmic changes of brain activities during the resting state or while performing specific tasks. Abnormal neural oscillations have been discovered in patients with schizophrenia. However, there is limited evidence available on abnormal spontaneous neural oscillations in clinical high risk for psychosis (CHR-P). The brain signals recorded by the magnetoencephalography (MEG) technique are not to be disrupted by the skull and scalp.MethodsIn this study, we applied the MEG technique to record the resting-state neural activities in CHR-P. This was followed by a detailed MEG analysis method including three steps: (1) preprocessing, which was band-pass filtering based on the 0.5–60 Hz frequency range, removal of 50 Hz power frequency interference, and removal of electrocardiography (ECG) and electrooculography (EOG) artefacts by independent component analysis; (2) time-frequency analysis, a multitaper time-frequency transformation based on the Hanning window, and (3) source localisation, an exact low-resolution brain electromagnetic tomography. The method was verified by comparing a participant with CHR-P with a healthy control during the MEG recordings with an eyes-closed resting state.ResultsExperimental results show that the neural oscillations in CHR-P were significantly abnormal in the theta frequency band (4–7 Hz) and the delta frequency band (1–3 Hz). Also, relevant brain regions were located in the left occipital lobe and left temporo-occipital junction for the theta band and in the right dorsolateral prefrontal lobe and near orbitofrontal gyrus for the delta band.ConclusionsAbnormal neural oscillations based on specific frequency bands and corresponding brain sources may become biomarkers for high-risk groups. Further work will validate these characteristics in CHR-P cohorts.
Endoscopic pyloromyotomy for the treatment of severe and refractory gastroparesis: a pilot, randomised, sham-controlled trial
Authors: Martinek Jan , Hustak Rastislav , Mares Jan , Vackova Zuzana , Spicak Julius , Kieslichova Eva , Buncova Marie , Pohl Daniel , Amin Sunil , Tack Jan 
Published: May 2022

ObjectiveEndoscopic pyloromyotomy (G-POEM) is a minimally invasive treatment option with promising uncontrolled outcome results in patients with gastroparesis.DesignIn this prospective randomised trial, we compared G-POEM with a sham procedure in patients with severe gastroparesis. The primary outcome was the proportion of patients with treatment success (defined as a decrease in the Gastroparesis Cardinal Symptom Index (GCSI) by at least 50%) at 6 months. Patients randomised to the sham group with persistent symptoms were offered cross-over G-POEM.ResultsThe enrolment was stopped after the interim analysis by the Data and Safety Monitoring Board prior to reaching the planned sample of 86 patients. A total of 41 patients (17 diabetic, 13 postsurgical, 11 idiopathic; 46% male) were randomised (21 G-POEM, 20-sham). Treatment success rate was 71% (95% CI 50 to 86) after G-POEM versus 22% (8–47) after sham (p=0.005). Treatment success in patients with diabetic, postsurgical and idiopathic gastroparesis was 89% (95% CI 56 to 98), 50% (18–82) and 67% (30–90) after G-POEM; the corresponding rates in the sham group were 17% (3–57), 29% (7–67) and 20% (3–67).Median gastric retention at 4 hours decreased from 22% (95% CI 17 to 31) to 12% (5–22) after G-POEM and did not change after sham: 26% (18–39) versus 24% (11–35). Twelve patients crossed over to G-POEM with 9 of them (75%) achieving treatment success.ConclusionIn severe gastroparesis, G-POEM is superior to a sham procedure for improving both symptoms and gastric emptying 6 months after the procedure. These results are not entirely conclusive in patients with idiopathic and postsurgical aetiologies.Trial registration numberNCT03356067; ClinicalTrials.gov.
Association between exercise habit changes and mortality following a cardiovascular event
Authors: Kang Dong-Seon , Sung Jung-Hoon , Kim Daehoon , Jin Moo-Nyun , Jang Eunsun , Yu Hee Tae , Kim Tae-Hoon , Pak Hui-Nam , Lee Moon-Hyoung , Lip Gregory , Yang Pil-Sung , Joung Boyoung 
Published: May 2022

ObjectiveTo investigate the associations between exercise habit changes following an incident cardiovascular event and mortality in older adults.MethodsWe analysed the relationship between exercise habit change and all-cause, cardiovascular and non-cardiovascular deaths in adults aged ≥60 years between 2003 and 2012 who underwent two consecutive health examinations within 2 years before and after diagnosis of cardiovascular disease (CVD). They were categorised into four groups according to exercise habit changes: persistent non-exercisers, exercise dropouts, new exercisers and exercise maintainers. Differences in baseline characteristics were adjusted using inverse probability of treatment weighting.ResultsOf 6076 participants, the median age was 72 (IQR 69–76) years and men accounted for 50.6%. Compared with persistent non-exercisers (incidence rate (IR) 4.8 per 100 person-years), new exercisers (IR 3.5, HR 0.73, 95% CI 0.58 to 0.91) and exercise maintainers (IR 2.9, HR 0.53, 95% CI 0.38 to 0.73) were associated with reduced risk of all-cause death. The rate of non-cardiovascular death was significantly lower in new exercisers (IR 2.3, HR 0.73, 95% CI 0.56 to 0.95) and exercise maintainers (IR 2.3, HR 0.61, 95% CI 0.42 to 0.90) than in persistent non-exercisers (IR 3.2). Also, trends towards reduced cardiovascular death in new exercisers and exercise maintainers were observed (p value for trend <0.001).ConclusionsMore virtuous exercise trajectories in older adults with CVD are associated with lower mortality rates. Our results support public health recommendations for older adults with CVD to perform physical activity.
A Qualitative study on diverse perspectives and identities of firearm owners
Authors: Thomas Arielle C. , Siry-Bove Bonnie J. , Barnard Leslie M. , Rooney Lauren , McCarthy Megan , Mustafa Ayah , Rowhani-Rahbar Ali , Rivara Frederick P. , Betz Marian E. , Knoepke Christopher 
Published: May 2022

ObjectiveResearch surrounding firearm ownership is often contextualised within the perspectives of older white men. We expand this description using the perceptions of a diverse group of firearm-owning stakeholders.MethodsWe conducted semistructured interviews from October 2020 to May 2021 with Colorado/Washington State stakeholders representing (1) firearm ranges/retailers; (2) law enforcement agencies or (3) relevant state/national firearm organisations. Data were analysed using standard qualitative techniques and included 25 participants, representing varied sociocultural groups including racial and ethnic minorities, political minorities and sexual minorities.ResultsParticipants for this analysis were of different self-identified sociocultural groups including racial and ethnic minorities (African American, Hispanic and Asian), political minorities (liberal) and sexual minorities, defined as Lesbian, Gay, Bisexual, and Transgender (LGBT). Perspectives on firearm ownership included an idea of gun culture as a component of (1) personal identity, (2) an expression of full citizenship and (3) necessary for self-protection. A strong subtheme was the intersection of minority group and firearm owner identities, creating a need for divergent social communities because of ideas on traditional gun culture. These communities are a safe place for individuals belonging to minority groups to escape negative external and internal group associations with firearms.ConclusionPerspectives on firearms and firearm ownership in the secondary analysis were heterogeneous and related to personal experiences, external and internal group pressures that influence individual behaviour. Understanding the breadth of perspectives on firearm ownership is imperative to engaging individuals for risk reduction. This study adds to the literature by expanding an understanding of the motivation for firearm ownership among diverse communities.
Treatment gaps, 1-year readmission and mortality following myocardial infarction by diabetes status, sex and socioeconomic disadvantage
Authors: Morton Jedidiah I , Ilomäki Jenni , Wood Stephen J , Bell J Simon , Huynh Quan , Magliano Dianna J , Shaw Jonathan E 
Published: May 2022

AimsWe evaluated variation in treatment for, and outcomes following, myocardial infarction (MI) by diabetes status, sex and socioeconomic disadvantage.MethodsWe included all people aged ≥30 years who were discharged alive from hospital following MI between 1 July 2012 and 30 June 2017 in Victoria, Australia (n=43 272). We assessed receipt of inpatient procedures and discharge dispensing of cardioprotective medications for each admission, as well as 1-year all-cause, cardiovascular, and MI readmission rates and 1-year all-cause mortality.ResultsRisk of all-cause (HR: 1.22 (1.19–1.26)), cardiovascular (1.29 (1.25–1.34)), MI (1.52 (1.43–1.62)) and heart failure readmission (1.62 (1.50–1.75)) and mortality (1.18 (1.11–1.26)) were higher in people with diabetes. Males and people in more disadvantaged areas were at increased risk of readmission and mortality following MI. People with diabetes (vs without) were more likely to receive coronary artery bypass grafting (CABG) but less likely to receive percutaneous coronary intervention (PCI) during, or within 30 days of, their index admission. Females were less likely to receive either (eg, 87% of males with a STEMI received PCI or CABG vs 70% of females), and people in more disadvantaged areas were less likely to receive PCI. People with diabetes, males and people in more disadvantaged areas were more likely to be dispensed cardioprotective medications at or within 90 days of discharge.ConclusionsFollowing an MI, people with diabetes and males had poorer outcomes but received more intensive cardiovascular treatments. However, socioeconomic disadvantage was associated with both less intensive inpatient treatment and poorer outcomes.
Monitoring sociodemographic inequality in COVID-19 vaccination uptake in England: a national linked data study
Authors: Dolby Ted , Finning Katie , Baker Allan , Fowler-Dowd Leigh , Khunti Kamlesh , Razieh Cameron , Yates Thomas , Nafilyan Vahe 
Published: May 2022

BackgroundThe UK began an ambitious COVID-19 vaccination programme on 8 December 2020. This study describes variation in vaccination uptake by sociodemographic characteristics between December 2020 and August 2021.MethodsUsing population-level administrative records linked to the 2011 Census, we estimated monthly first dose vaccination rates by age group and sociodemographic characteristics among adults aged 18 years or over in England. We also present a tool to display the results interactively.ResultsOur sample included 35 223 466 adults. A lower percentage of males than females were vaccinated in the young and middle age groups (18–59 years) but not in the older age groups. Vaccination rates were highest among individuals of White British and Indian ethnic backgrounds and lowest among Black Africans (aged ≥80 years) and Black Caribbeans (18–79 years). Differences by ethnic group emerged as soon as vaccination roll-out commenced and widened over time. Vaccination rates were also lower among individuals who identified as Muslim, lived in more deprived areas, reported having a disability, did not speak English as their main language, lived in rented housing, belonged to a lower socioeconomic group, and had fewer qualifications.ConclusionWe found inequalities in COVID-19 vaccination uptake rates by sex, ethnicity, religion, area deprivation, disability status, English language proficiency, socioeconomic position and educational attainment, but some of these differences varied by age group. Research is urgently needed to understand why these inequalities exist and how they can be addressed.
Camrelizumab plus famitinib for advanced or metastatic urothelial carcinoma after platinum-based therapy: data from a multicohort phase 2 study
Authors: Qu Yuan-Yuan , Sun Zhongquan , Han Weiqing , Zou Qing , Xing Nianzeng , Luo Hong , Zhang Xuepei , He Chaohong , Bian Xiao-Jie , Cai Jinling , Chen Chunxia , Wang Quanren , Ye Ding-Wei 
Published: May 2022

BackgroundDual blockade of immune checkpoint and angiogenesis is an effective strategy for multiple cancers. Camrelizumab is a monoclonal antibody against PD-1, and famitinib is a multitargeted receptor tyrosine kinase inhibitor with antiangiogenesis and antiproliferation activities against tumor cells. We conducted an open-label, multicenter phase 2 basket study of camrelizumab and famitinib in eight cohorts of genitourinary or gynecological cancers. Here, findings in cohort of advanced or metastatic urothelial carcinoma with platinum-progressive disease (cohort 2) are presented.MethodsPatients who had progressed after platinum-based chemotherapy for advanced or metastatic disease or had progressed within 12 months after completion of platinum-based (neo)adjuvant therapy were given camrelizumab (200 mg intravenously every 3 weeks) plus famitinib (20 mg orally once daily). Primary endpoint was objective response rate (ORR) per Response Evaluation Criteria in Solid Tumors version 1.1.ResultsTotally, 36 patients were recruited. With a median duration from enrollment to data cut-off of 11.9 months (range 6.1–28.5), ORR was 30.6% (95% CI 16.3% to 48.1%). Median duration of response (DoR) was 6.3 months (95% CI 2.1 to not reached). Median progression-free survival (PFS) was 4.1 months (95% CI 2.2 to 8.2), and median overall survival (OS) was 12.9 months (95% CI 8.8 to not reached). Patients with bladder cancer (n=18) had numerically better outcomes, with an ORR of 38.9% (95% CI 17.3% to 64.3%) and a median PFS of 8.3 months (95% CI 4.1 to not reached). Median DoR and OS in this subpopulation had not been reached with lower limit of 95% CI of 4.2 months for DoR and 11.3 months for OS, respectively. Of 36 patients, 22 (61.1%) had grade 3 or 4 treatment-related adverse events, mainly decreased platelet count and hypertension.ConclusionsCamrelizumab plus famitinib showed potent antitumor activity in advanced or metastatic urothelial carcinoma patients after platinum-based chemotherapy. Patients with bladder cancer seemed to have better response to this combination.Trial registration numberNCT03827837.
A2Badenosine receptor antagonists rescue lymphocyte activity in adenosine-producing patient-derived cancer models
Authors: Tay Apple Hui Min , Prieto-Díaz Rubén , Neo Shiyong , Tong Le , Chen Xinsong , Carannante Valentina , Önfelt Björn , Hartman Johan , Haglund Felix , Majellaro Maria , Azuaje Jhonny , Garcia-Mera Xerardo , Brea Jose M , Loza Maria I , Jespers Willem , Gutierrez-de-Teran Hugo , Sotelo Eddy , Lundqvist Andreas 
Published: May 2022

BackgroundAdenosine is a metabolite that suppresses antitumor immune response of T and NK cells via extracellular binding to the two subtypes of adenosine-2 receptors, A2ARs. While blockade of the A2AARs subtype effectively rescues lymphocyte activity, with four A2AAR antagonists currently in anticancer clinical trials, less is known for the therapeutic potential of the other A2BAR blockade within cancer immunotherapy. Recent studies suggest the formation of A2AAR/A2BAR dimers in tissues that coexpress the two receptor subtypes, where the A2BAR plays a dominant role, suggesting it as a promising target for cancer immunotherapy.MethodsWe report the synthesis and functional evaluation of five potent A2BAR antagonists and a dual A2AAR/A2BAR antagonist. The compounds were designed using previous pharmacological data assisted by modeling studies. Synthesis was developed using multicomponent approaches. Flow cytometry was used to evaluate the phenotype of T and NK cells on A2BAR antagonist treatment. Functional activity of T and NK cells was tested in patient-derived tumor spheroid models.ResultsWe provide data for six novel small molecules: five A2BAR selective antagonists and a dual A2AAR/A2BAR antagonist. The growth of patient-derived breast cancer spheroids is prevented when treated with A2BAR antagonists. To elucidate if this depends on increased lymphocyte activity, immune cells proliferation, and cytokine production, lymphocyte infiltration was evaluated and compared with the potent A2AAR antagonist AZD-4635. We find that A2BAR antagonists rescue T and NK cell proliferation, IFNγ and perforin production, and increase tumor infiltrating lymphocytes infiltration into tumor spheroids without altering the expression of adhesion molecules.ConclusionsOur results demonstrate that A2BAR is a promising target in immunotherapy, identifying ISAM-R56A as the most potent candidate for A2BAR blockade. Inhibition of A2BAR signaling restores T cell function and proliferation. Furthermore, A2BAR and dual A2AAR/A2BAR antagonists showed similar or better results than A2AAR antagonist AZD-4635 reinforcing the idea of dominant role of the A2BAR in the regulation of the immune system.