bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical predictors of survival in patients with relapsed/refractory small-cell lung cancer treated with checkpoint inhibitors: a German multicentric real-world analysis
Authors: Stratmann Jan A. , Timalsina Radha , Atmaca Akin , Rosery Vivian , Frost Nikolaj , Alt Jürgen , Waller Cornelius F. , Reinmuth Niels , Rohde Gernot , Saalfeld Felix C. , von Rose Aaron Becker , Acker Fabian , Aspacher Lukas , Möller Miriam , Sebastian Martin 
Published: June 2022

Objectives: Small-cell lung cancer (SCLC) is a lung malignancy with high relapse rates and poor survival outcomes. Treatment-resistant disease relapse occurs frequently and effective salvage therapies are urgently needed. Materials and Methods: We aimed to define efficacy and safety of checkpoint inhibitors (CPIs) in a heterogeneous population of relapsed and refractory SCLC patients in a large retrospective multicentric real-world cohort across German tertiary care centers. Results: A total of 111 patients from 11 treatment centers were included. Median age of all patients was 64 years, and 63% were male. Approximately one-third of all patients had poor performance status [Eastern Cooperative Oncology Group (ECOG) ⩾ 2], and 37% had known brain metastases. Patients were heavily pretreated with a median number of prior therapy lines of 2 (range, 1–8). Median follow-up of the entire cohort was 21.7 months. Nivolumab and Nivolumab/Ipilimumab were the most common regimens. Overall disease control rate was 27.2% in all patients and was numerically higher in CPI combination regimens compared with single-agent CPI (31.8% versus 23.8%; p = 0.16). Median overall survival (OS) was 5.8 months [95% confidence interval (CI), 1.7–9.9 months]. The 12- and 24-month survival rates were 31.8% and 12.7%, respectively. The 12-week death rate was 27.9%. Disease control and response rate were significantly lower in patients with liver metastases. Platinum sensitivity (to first-line treatment), metastatic burden, and lactate dehydrogenase (LDH) showed prognostic impact on survival in univariate analysis. Neutrophil-to-lymphocyte ratio (NLR) was a significant and independent predictor of survival in univariate ( p = 0.01) and multivariate analyses [hazard ratio (HR), 2.1; 95% CI = 1.1–4.1; p = 0.03]. Conclusion: CPI in patients with relapsed or refractory (R/R) SCLC is of limited value in an overall patient cohort; however, long-term survival, in particular with CPI combination strategies, is possible. Clinical characteristics allow a more differentiated subgroup selection, in particular patients with low NLR showed less benefit from CPI in R/R SCLC.
Health Care Professionals’ Perspectives on Use of Diabetes Technologies for Managing Visually Impaired Patients With Diabetes
Authors: Akturk Halis Kaan , Snell-Bergeon Janet , Shah Viral N. 
Published: June 2022

Background: Despite well-established safety and efficacy of diabetes technologies in management of diabetes, their utility in visually impaired patients is currently unknown. We aimed to identify providers’ preferences and challenges to prescribing diabetes technologies for visually impaired patients. Methods: A survey-based study among health care providers in the United States seeing visually impaired patients with diabetes and using diabetes technologies was conducted. The quantitative and qualitative responses were analyzed using Student t test and χ2 tests. Results: Of 79 providers, 66 completed the survey and were included in the analysis. Insulin pens and hybrid closed-loop systems were preferred insulin delivery systems for managing visually impaired patients with diabetes. Despite 96% of the providers recommending continuous glucose monitoring (CGM) for their visually impaired patients with diabetes, only 55% were aware of the voice-activation feature of Dexcom G6. Voice activation to announce glucose values and audible glucose alerts were two major incentives for selecting CGM. System initialization was seen as a prevalent challenge of using CGM in visually impaired patients with diabetes. Providers who are using CGM for visually impaired patients reported benefits for patients using the voice-activation feature for six months included HbA1c reductions of >0.5% (by 87% of providers) and less hypoglycemia (by 45% of providers). Conclusions: The CGM is the preferred glucose monitoring method for managing visually impaired patients with diabetes. Providers face many challenges of initiating CGM in these high-risk patients. Voice-activation feature of G6 CGM is underutilized and providers who used the system reported positive outcomes in visually impaired patients.
What Predicts Falls, and what are the Circumstances and Consequences of Falls in Community-Dwelling Older Adults Who Need Walking Aids or Home Help Service
Authors: Tuvemo Johnson Susanna , Anens Elisabeth , Johansson Ann-Christin , Hellström Karin 
Published: June 2022

The objective was to analyze predictive variables for falls in older community-dwelling adults who needed walking aids or home help service, to describe the circumstances and consequences of falls and fall injuries, and to describe the activities preceding falls, n = 175, mean age 83 years. Falls were self-reported monthly in a fall calendar and were followed up by a telephone interview. A logistic regression analysis was performed to investigate predictive baseline variables for falls. Injuries were reported in 82 of the 185 fall events. Previous falls and a high level of education had a significant association with falls odds ratios 1.9 (95% CI 1.3–2.7), and 2.7 (95% CI 1.4–5.3). Activities preceding the falls were classified according to the International Classification of Functioning (ICF). Falls and fall injuries were most common while moving around within the home and rising from sitting to standing.
Staff Assessment Person-Directed Care Questionnaire: Adaptation and Validation for the Portuguese Population
Authors: Barbosa Maria M. , Teixeira Laetitia , Yanguas Javier , Paul Constança , Afonso Rosa M. 
Published: June 2022

Person-centered care aims to increase and guarantee the quality of care at residential care facilities for older adults. The implementation and development of this approach requires validated assessment tools, which are still lacking in Portugal. This study aims to adapt and validate for the Portuguese population the internationally and widely used essential instrument that is the Staff Assessment Person-Directed Care (SAPDC). The adaptation of the SAPDC included its translation, back translation, and a pilot-study. For validation, staff members were recruited by distributing the study via email and on social media. Respondents included 546 native Portuguese-speaking staff members working at residential care facilities for over 6 months. The mean score of SAPDC was 165.74 (SD = 36.78). The exploratory factor analysis showed eight conceptually distinct dimensions, considered adequate by the expert team. The total scale showed a very good internal consistency (α = .96) and excellent temporal stability assessed by Intraclass Correlation Coefficient (> .90). Providing a Portuguese version of the SAPDC is useful to substantiate technical and scientific advancements and define policies with implications on evolving care approaches. This tool helps optimize the quality and dignification of gerontological practices, which is urgent at Portuguese residential care facilities.
Proliferative Diabetic Retinopathy Events in Patients With Diabetic Macular Edema: Post Hoc Analysis of VISTA and VIVID Trials
Authors: Do Diana V. , Gordon Carmelina , Suñer Ivan J. , Reed Kimberly , Moini Hadi , Gibson Andrea , Du Weiming , Shah Chirag P. 
Published: June 2022

Purpose: This work aimed to assess the incidence of proliferative diabetic retinopathy (PDR) events and improvement to mild non-PDR (NPDR) or better after intravitreal aflibercept injection (IAI) or laser treatment (control) in diabetic macular edema (DME). Methods: PDR events in the VISTA (NCT01363440) and VIVID (NCT01331681) phase 3 clinical trials were evaluated in a combined IAI-treated group (IAI 2 mg every 4 weeks or 2 mg every 8 weeks after 5 initial monthly doses; n = 475) and a macular laser control group (n = 235) through week 100 in eyes without PDR at baseline (Diabetic Retinopathy Severity Scale [DRSS] score ≤ 53). Improvement in the DRSS score to 35 or better was evaluated in those with a baseline DRSS score of 43 or greater. Results: A lower proportion of eyes in the IAI group than in the laser group developed a PDR event through week 100 (4.4% vs 11.1%; adjusted difference, −6.7%; 97.5% CI, −11.7 to −1.6; nominal P = .0008). All PDR events occurred in eyes with a baseline DRSS score of 43, 47, or 53 and not in those with a score of 35 or less. A greater proportion of eyes in the IAI group than in the control group achieved a DRSS score of 35 or less (20.0% vs 3.8%; nominal P < .0001). Conclusions: Fewer eyes with NPDR and DME treated with IAI than eyes treated with a laser had a PDR event. More eyes treated with IAI improved to mild NPDR or better (DRSS score ≤ 35) through 100 weeks.
High robustness does not always imply low uncertainty of treatment rankings: An empirical study of 60 network meta-analyses
Authors: Wu Yun-Chun , Tu Yu-Kang 
Published: June 2022

Background: Network meta-analysis computes treatment ranking to assist with clinical decision making, but it is not always clear how reliable the ranking is and how likely the accumulation of new evidence may alter the ranking. Uncertainty and robustness of ranking are two concepts related to the reliability of ranking. However, it is still unclear whether these two approaches would always yield similar conclusions on the reliability of ranking, i.e., a robust ranking is also one of low uncertainty. Purpose: This study aimed to investigate the relationship between the uncertainty and robustness of treatment ranking by using normalized entropy and quadratic weighted Cohen’s kappa, respectively. Data. We used datasets of previously published NMAs from a database maintained by Petropoulou et al. at the University of Bern. Analysis. Scatter plots and Pearson’s correlation coefficients were used to demonstrate the direction and strength of the association between uncertainty and robustness of ranking for NMA-level and treatment-level evaluation. Results: We found that when the uncertainty of ranking is very low, treatment ranking is unlikely to be altered by deleting a trial from the complete data. However, network meta-analysis with robust treatment ranking may have high uncertainty of treatment ranking. Conclusions: Therefore, although the robustness of the ranking can find the trial that has the most significant impact on the ranking, the high robustness of ranking does not mean that the ranking would not easily change when new trials are added in the future.
Care Partner Support Following a Diabetes Self-Management Education and Support Intervention
Authors: Mansfield Kelly J. , Colicchio Vanessa D. , Kauwe Tuitama Adonica I. , Tracy Eunjin Lee , Neuberger Julie D. , Litchman Michelle L. 
Published: June 2022

Purpose: The purpose of the study was to understand care partner (CP) perceptions of an interdisciplinary diabetes self-management education and support (DSMES) intervention and explore how the interdisciplinary DSMES intervention influences diabetes-specific day-to-day interactions from the CP’s perspective. Methods: A multiple-methods research design comprised of an online survey including demographics and supportive behaviors and a semistructured interview was conducted. The survey was completed by 16 CPs. Of the 16 CPs, 11 participated in semistructured interviews. Survey data were analyzed using descriptive statistics. Thematic analysis of semistructured interviews was conducted. Results: CPs provided support in 3 primary areas: (1) meal planning and preparation (87.5%), (2) participating in physical activity (56.3%), and (3) assisting with technology (43.8%). The main themes described by CPs include (1) the importance of diabetes education for caregivers, including the information they retained from the program, the acquisition of tools to support the person with diabetes, and the desire for more and ongoing education; (2) diabetes education enhances the CP’s ability to provide social support and the challenges associated with support; and (3) partners described collaborative diabetes management such as finding middle ground and making changes together. Conclusion: CPs play a significant role in patient diabetes self-management by providing social support and partnership. DSMES programs should seek to include CPs to enhance patient support.
Feasibility and Performance of Hemoglobin A1C Self-Testing During COVID-19 Among African Americans With Type 2 Diabetes
Authors: Woo Jihun , Whyne Erum Z. , Wright Jaylen I. , Lehrer H. Matthew , Alhalimi Taha A. , Wang Tianyu , Saba Victoria C. , Dubois Susan K. , Tanaka Hirofumi , Brown Sharon A. , Steinhardt Mary A. 
Published: June 2022

Purpose: The purpose of the study was to determine the feasibility of implementing A1C self-testing at home using the A1CNow® Self Check and to compare the accuracy of the A1CNow to a reference standard in African Americans with type 2 diabetes (T2D). Methods: African American adults with T2D were recruited from 13 different churches (N = 123). Phase 1, conducted during the early phase of the COVID-19 pandemic, examined the feasibility of A1C assessment using the A1CNow performed at home by untrained participants. Phase 2, conducted when in-person research resumed, compared A1C values concurrently measured using the A1CNow and the DCA Vantage™ Analyzer (reference standard) collected by research staff at church testing sites. Results: In Phase 1, 98.8% of participants successfully completed at least 1 at-home A1C test; the overall failure rate was 24.7%. In Phase 2, the failure rate of staff-performed A1CNow testing was 4.4%. The Bland-Altman plot reveals that A1CNow values were 0.68% lower than DCA values, and the mean differences (A1CNow minus DCA) ranged from −2.6% to 1.2% with a limit of agreement between −1.9% to 0.5%. Conclusions: A1C self-testing is feasible for use in community settings involving African American adults with T2D. The A1CNow Self-Check underestimated A1C values when compared with the reference standard. Ongoing improvements in point-of-care devices have the potential to expand research and clinical care, especially in underserved communities.
Impact of a Digitally Enhanced Diabetes Self-Management Program on Glycemia and Medical Costs
Authors: Chen Fang , Jasik Carolyn B. , Dall Timothy M. , Siego Cynthia Veronica 
Published: June 2022

Objective: To analyze economic savings and health impacts associated with a virtual digitally enhanced diabetes self-management education and support (DSMES) program. Research design and methods: Participants (n = 1,494) were nonpregnant adults with diagnosed type 2 diabetes and baseline body mass index (BMI) of 25 kg/m2 (23 kg/m2 if of Asian descent) or higher who enrolled in virtual DSMES between February 2019 and April 2020 for at least 4 months. Participants’ changes in glycated hemoglobin (A1C) and body weight were calculated as the difference between program start and last recorded values between months 4 and 6. Outcomes for all participants were analyzed; subanalyses were done on 628 participants with starting A1C >7% (53 mmol/mol), who could benefit most from DSMES. Markov-based microsimulation approach was used to model the potential reductions in diabetes sequalae and medical expenditures if observed improvements in A1C and BMI were maintained. Results: DSMES participants with starting A1C >7% experienced average reductions of 0.9% A1C and 2.1 kg of body weight (−1.7% of BMI) within 6 months. If these improvements were maintained, simulated outcomes include reduced 5-year onset of ischemic heart disease by 9.2%, myocardial infarction by 10.6%, stroke by 12.1%, chronic kidney disease by 16.5%, and reduced onset of other sequelae. Simulated cumulative reduction in medical expenditures is $1160 after 1 year, $4150 after 3 years, $7790 after 5 years, and $18 020 after 10 years. Conclusions: Participation in virtual DSMES improves A1C and body weight, with the potential to slow onset of diabetes sequelae and reduce medical expenditures.
Understanding Hypoglycemia in the Real World
Authors: Dickinson Jane K. , Litchman Michelle L. 
Published: June 2022

Purpose: The purpose of this study was to gain a better understanding of real-world hypoglycemia experiences from people living with diabetes. Methods: An exploratory cross-sectional study of a convenience sample of 374 English-speaking adults affected by diabetes using an online survey was conducted. Results: Participant mean age was 37 years with an average diabetes duration of 21 years. On average, participants reported feeling hypoglycemia at 64 mg/dL (3.6 mmol/L), worrying about hypoglycemia at 63 mg/dL (3.5 mmol/L), and treating hypoglycemia at 72 mg/dL (4 mmol/L). Terminology used by study participants did not match the current classifications of hypoglycemia used in clinical research. Participants who have been told they have hypoglycemia unawareness treat at a significantly lower level compared to those without hypoglycemia unawareness. Only 58% always carry hypoglycemia treatment; there was a relationship with increasing age and always carrying hypoglycemia treatment. Thirty-eight percent of participants treat hypoglycemia with the recommended 15 g of carbohydrate (CHO). Survey respondents who wore continuous glucose monitors reported using significantly less CHO to treat hypoglycemia. Conclusions: In the real world, experiences related to feeling, worrying about, and treating hypoglycemia trend higher than what is noted in the standardized hypoglycemia classifications. Study findings have implications for teaching and supporting people with diabetes who experience hypoglycemia. Consuming less CHO to treat hypoglycemia could lead to fewer episodes of rebound hyperglycemia and less weight gain. Increased support for continuous glucose monitoring is warranted.
A Brief Review of Carbon Dots–Silica Nanoparticles Synthesis and their Potential Use as Biosensing and Theragnostic Applications
Authors: Ornelas-Hernández Luis Fernando , Garduno-Robles Angeles , Zepeda-Moreno Abraham 
Published: June 2022

AbstractCarbon dots (CDs) are carbon nanoparticles with sizes below 10 nm and have attracted attention due to their relatively low toxicity, great biocompatibility, water solubility, facile synthesis, and exceptional photoluminescence properties. Accordingly, CDs have been widely exploited in different sensing and biomedical applications, for example, metal sensing, catalysis, biosensing, bioimaging, drug and gene delivery, and theragnostic applications. Similarly, the well-known properties of silica, such as facile surface functionalization, good biocompatibility, high surface area, and tunable pore volume, have allowed the loading of diverse inorganic and organic moieties and nanoparticles, creating complex hybrid nanostructures that exploit distinct properties (optical, magnetic, metallic, mesoporous, etc.) for sensing, biosensing, bioimaging, diagnosis, and gene and drug delivery. In this context, CDs have been successfully grafted into diverse silica nanostructures through various synthesis methods (e.g., solgel chemistry, inverse microemulsion, surfactant templating, and molecular imprinting technology (MIT)), imparting hybrid nanostructures with multimodal properties for distinct objectives. This review discusses the recently employed synthesis methods for CDs and silica nanoparticles and their typical applications. Then, we focus on combined synthesis techniques of CD–silica nanostructures and their promising biosensing operations. Finally, we overview the most recent potential applications of these materials as innovative smart hybrid nanocarriers and theragnostic agents for the nanomedical field.Graphical abstract
Improving Agricultural Traits While Maintaining High Resistant Starch Content in Rice
Authors: Miura Satoko , Narita Maiko , Crofts Naoko , Itoh Yuki , Hosaka Yuko , Oitome Naoko F. , Abe Misato , Takahashi Rika , Fujita Naoko 
Published: June 2022

Abstract
Background
Resistant starch (RS) is beneficial for human health. Loss of starch branching enzyme IIb (BEIIb) increases the proportion of amylopectin long chains, which greatly elevates the RS content. Although high RS content cereals are desired, an increase in RS content is often accompanied by a decrease in seed weight. To further increase the RS content, genes encoding active-type starch synthase (SS) IIa, which elongates amylopectin branches, and high expression-type granule-bound SSI (GBSSI), which synthesizes amylose, were introduced into the be2b mutant rice. This attempt increased the RS content, but further improvement of agricultural traits was required because of a mixture of indica and japonica rice phonotype, such as different grain sizes, flowering times, and seed shattering traits. In the present study, the high RS lines were backcrossed with an elite rice cultivar, and the starch properties of the resultant high-yielding RS lines were analyzed.

Results
The seed weight of high RS lines was greatly improved after backcrossing, increasing up to 190% compared with the seed weight before backcrossing. Amylopectin structure, gelatinization temperature, and RS content of high RS lines showed almost no change after backcrossing. High RS lines contained longer amylopectin branch chains than the wild type, and lines with active-type SSIIa contained a higher proportion of long amylopectin chains compared with the lines with less active-SSIIa, and thus showed higher gelatinization temperature. Although the RS content of rice varied with the cooking method, those of high RS lines remained high after backcrossing. The RS contents of cooked rice of high RS lines were high (27–35%), whereas that of the elite parental rice was considerably low (< 0.7%). The RS contents of lines with active-type SSIIa and high-level GBSSI expression in be2b or be2b ss3a background were higher than those of lines with less-active SSIIa.

Conclusions
The present study revealed that backcrossing high RS rice lines with elite rice cultivars could increase the seed weight, without compromising the RS content. It is likely that backcrossing introduced loci enhancing seed length and width as well as loci promoting early flowering for ensuring an optimum temperature during RS biosynthesis.