bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systemic treatment in patients with malignant pleural mesothelioma – real life experience
Authors: Ziółkowska Barbara , Cybulska-Stopa Bożena , Papantoniou Dimitrios , Suwiński Rafał 
Published: April 2022

Abstract
Background
Malignant pleural mesothelioma (MPM) is a rare, aggressive malignancy of the pleural cavity linked to asbestos exposure. The combination of pemetrexed and platinum is a standard first-line therapy for malignant pleural mesothelioma. Despite some progress, almost all MPM patients experience progression after first-line therapy. The second-line treatment is still being under discussion and there are very limited data available on the second-line and subsequent treatments.

Methods
The retrospective analysis included 57 patients (16 females and 41 males) from two Polish oncological institutions treated for advanced mesothelioma between 2013 and 2019. We analysed the efficacy of first-line and second-line therapy: progression-free survival (PFS), overall survival (OS), overall response rate (ORR).

Results
In the first-line treatment, 55 patients received pemetrexed-based chemotherapy (PBC) and two cisplatin in monotherapy. Patients’ characteristics at baseline: median age was 64.2 years, ECOG PS ≤ 1 (86.2%), epithelial histology (85.7%). Median PFS and OS were 7.6 months and 14 months, respectively. Patients with ECOG PS ≤ 1 vs > 1 had a longer median OS (14.8 months vs 9.7 months, p = 0.057). One-year OS and PFS were 60.9% and 32.0%, respectively. Disease control rate (DCR) was 82.5%. Response to first-line therapy: PFS ≥ 6 months and PFS ≥ 12 months had a significant impact on median OS. Twelve patients received second-line therapy (seven PBC and five other cytotoxic single agents: navelbine, gemcitabine, or adriamycin/vincristine/methotrexate triplet). Median PFS and OS were 3.7 months and 7.2 months, respectively. DCR was 83%. One-year OS and PFS were 37% and 16.7%, respectively.
In the group receiving PBC, OS was prolonged by 4.5 months compared to the non-PBC group (6.0 months vs 10.5 months, p = 0.47).

Conclusion
Patients who benefited from first-line therapy and had prolonged PFS at first-line and achieve PFS longer than 6 months at first-line should be offered second-line treatment. Consideration of retreatment with the same cytotoxic agent could to be a viable option when no other treatment are available.
Altered voxel-level whole-brain functional connectivity in multiple system atrophy patients with depression symptoms
Authors: Yang Hua Guang , Liu Weiyin Vivian , Wen Zhi , Hu Lan Hua , Fan Guo Guang , Zha Yun Fei 
Published: April 2022

Abstract
Background
It is yet unknown if the whole-brain resting-state network is altered in multiple system atrophy with symptoms of depression. This study aimed to investigate if and how depression symptoms in multiple system atrophy are associated with resting-state network dysfunction.

Methods
We assessed the resting-state functional network matric using Degree centrality (DC) coupling with a second ROI-wise functional connectivity (FC) algorithm in a multimodal imaging case-control study that enrolled 32 multiple system atrophy patients with depression symptoms (MSA-D), 30 multiple system atrophy patients without depression symptoms (MSA-ND), and 34 healthy controls (HC).

Results
Compared to HC, MSA-D showed more extensive DC hub dysfunction in the left precentral and right middle frontal cortex than MSA-ND. A direct comparison between MSA-D and MSA-ND detected increased DC in the right anterior cingulum cortex, but decreased DC in the left cerebellum lobule IV and lobule V, left middle pole temporal cortex, and right superior frontal cortex. Only right anterior cingulum cortex mean DC values showed a positive correlation with depression severity, and used ACC as seed, a second ROI-wise functional connectivity further revealed MSA-D patients showed decreased connectivity between the ACC and right thalamus and right middle temporal gyrus (MTG).

Conclusions
These findings revealed that dysfunction of rACC, right middle temporal lobe and right thalamus involved in depressed MSA. Our study might help to the understanding of the neuropathological mechanism of depression in MSA.
Enablers and barriers to effective parenting within the first 1000 days: an exploratory study of South African parents and primary caregivers in low socio-economic communities
Authors: Adebiyi Babatope O. , Goldschmidt Tessa , Benjamin Fatiema , Sonn Inge K. , Rich Edna , Roman Nicolette V. 
Published: April 2022

Abstract
Background
The first 1000 days is the period between conception and a child’s second birthday. Globally, research on parenting is in an advanced stage, but parenting research focusing specifically on parenting in this developmental phase is limited in South Africa. Therefore, this study explores the enablers and barriers to effective parenting within the first 1000 days through the lens of parents and caregivers in low socio-economic communities.

Methods
This study was conducted in communities in South Africa considered low socio-economic communities in the Western Cape Province of South Africa. An exploratory qualitative research design explored the enablers and barriers to effective parenting within the first 1000 days of life. Thirty participants were purposively selected and interviewed in this study. A semi-structured interview schedule was used for all interviews. The data were analysed using inductive thematic analysis.

Results
Two main categories emerged (effective parenting enablers and effective parenting barriers) during the data analysis. The main enablers of effective parenting within the first 1000 days of life include a support system, healthy behaviours/environment, unemployment/job opportunities, religion, information/knowledge, and professional assistance. On the other hand, the main barriers to effective parenting were low socio-economic circumstances, environmental circumstances, lack of partner’s support, the negative impact of technology, and lack of access to services.

Conclusion
Enablers that need to be promoted for effective parenting range from support systems to professional assistance for parents. Also, barriers that need to be removed for effective parenting range from low socio-economic circumstances to a lack of partner’s support for parents. This is because effective parenting is vital in improving developmental outcomes for children within the first 1000 days of life. Therefore, there is a need to develop policies and interventions to promote effective parenting within the first 1000 days in the communities.
Hip stability parameters with dual mobility, modular dual mobility and fixed bearing in total hip arthroplasty: an analytical evaluation
Authors: Tigani Domenico , Banci Lorenzo , Valtorta Riccardo , Amendola Luca 
Published: April 2022

Abstract
Background
Use of dual mobility (DM) in total hip arthroplasty has gained popularity due to the ability to reduce dislocation through increased jumping distance and impingement-free arc of movement. Recently, modular dual mobility (modDM) systems were introduced to give the possibility to use DM with standard metal-backed shells, however few has been studied to date regarding how jumping distance and the center of rotation change with modDM. The objective of this study was to evaluate, through analytical simulation, how jumping distance, center of rotation and arc of movement change between DM and standard cups with modDM or fixed bearings (FB).

Methods
3D-models of DM and standard press-fit cups with modDM or FB liners were used to simulate DM, modDM and FB implant configurations, matched for same cup size, according to same cup position and different femoral head diameters. Jumping distance was calculated and center of rotation lateralization and oscillation angles were measured for each size of these three implant configurations.

Results
Jumping distance with modDM was reduced by -3.9 mm to -8.6 mm in comparison with DM, from 48 to 64 mm size, but resulted comparable to polyethylene 36 mm FB and increased by + 1.1 mm and + 1.4 mm than ceramic 36 and 40 mm FBs for sizes > 54 mm. ModDM lateralized the center of rotation up to + 2.5 mm and + 4.0 mm in comparison with DM and FBs, respectively. Oscillation angle with modDM resulted higher than + 16°, + 23°, + 17° and + 14° in comparison to DM, 28 mm, 32 mm and 36 mm FB cups, respectively, for 56 mm cup size.

Conclusions
According to its specific design, modDM might change hip stability parameters in comparison to DM, worsening jumping distance and center of rotation position, but increasing arc of movement. As not restoring stability parameters in the same fashion, modDM implants should be properly used when DM cups are not feasible.
Correlation between the accumulation of skin glycosylation end products and the development of type 2 diabetic peripheral neuropathy
Authors: Zhao Xing-Wang , Yue Wan-Xu , Zhang Sen-Wei , Chen Qiu 
Published: April 2022

AbstractBackgroundThe accumulation of advanced glycation end products (AGEs) occurring in skin tissues can be measured by AGE Reader. Here, we assessed the correlation between AGEs values and the development of type 2 diabetic peripheral neuropathy (DPN).MethodsThe basic clinical information of 560 patients with T2DM was collected through an electronic system. AGEs and diabetic complication risk score was measured by AGE Reader, a non-invasive optical signal detector. All of the participants were classified into 4 groups based on Dyck criteria: grade 0 (non-DPN group), grade 1 (early stage group), grade 2 (middle stage group) and grade 3 (advanced group). Pearson correlation analysis and Spearman correlation analysis were used to evaluate the correlation between AGEs and other indexes. The sensitivity and specificity of glycosylated products were evaluated by ROC curve.ResultsWith the increase of DPN severity, the accumulative AGEs showed an increasing trend. Significant differences (P = 0.000) of AGEs were found among grades 0, 1, 2, and 3 of DPN, and significant differences (P = 0.000) of AGEs were found between grades 1 and 3. There were significant differences in DPN risk score between grades 0, 1, 2, and 3, between grades 1, 2, and 3, and between grades 2 and 3 (P < 0.01 orP < 0.05). AGEs were positively correlated with age, blood uric acid, disease course, systolic blood pressure, the risk scores of the four major complications of diabetes, renal function indicators (serum creatinine, Cystatin C, homocysteine, the ratio of urinary albumin and creatinine, urinary microalbumin, α-microglobulin, urinary transferrin, urinary immunoglobulin), inflammatory indicators (white blood cell count, neutrophil count, neutrophil-to-lymphocyte ratio, C-reactive protein), and TCSS score. However, it was negatively correlated with BMI,fasting insulin, insulin 1–3 h postprandial, lymphocyte count, HOMA insulin resistance index and estimated glomerular filtration rate. The area under the AGEs cumulant and neuropathy risk score curve was 0.769 and 0.743, respectively. The confidence intervals were (71.2–82.6%) and (68.8–79.9%), respectively. The maximum Youden’s index of AGEs cumulant was 0.440, and the corresponding AGEs cumulant value was 77.65. The corresponding sensitivity and specificity were 0.731 and 0.709, respectively. Furthermore, the maximum Youden’s index of neuropathy risk score was 0.385, and the corresponding neuropathy risk score was 66.25. The corresponding sensitivity and the specificity were 0.676 and 0.709, respectively.ConclusionThe cumulative amount of skin AGEs can be used as the diagnostic index and the prediction and evaluation index of DPN severity. Moreover, the diabetic peripheral neuropathy risk score can predict the risk of DPN in patients with T2DM.
Post graduate remediation programs in medicine: a scoping review
Authors: Cheong Clarissa Wei Shuen , Quah Elaine Li Ying , Chua Keith Zi Yuan , Lim Wei Qiang , Toh Rachelle Qi En , Chiang Christine Li Ling , Ng Caleb Wei Hao , Lim Elijah Gin , Teo Yao Hao , Kow Cheryl Shumin , Vijayprasanth Raveendran , Liang Zhen Jonathan , Tan Yih Kiat Isac , Tan Javier Rui Ming , Chiam Min , Lee Alexia Sze Inn , Ong Yun Ting , Chin Annelissa Mien Chew , Wijaya Limin , Fong Warren , Mason Stephen , Krishna Lalit Kumar Radha 
Published: April 2022

AbstractBackgroundRecognizing that physicians may struggle to achieve knowledge, skills, attitudes and or conduct at one or more stages during their training has highlighted the importance of the ‘deliberate practice of improving performance through practising beyond one’s comfort level under guidance’. However, variations in physician, program, contextual and healthcare and educational systems complicate efforts to create a consistent approach to remediation.Balancing the inevitable disparities in approaches and settings with the need for continuity and effective oversight of the remediation process, as well as the context and population specific nature of remediation, this review will scrutinise the remediation of physicians in training to better guide the design, structuring and oversight of new remediation programs.MethodsKrishna’s Systematic Evidence Based Approach is adopted to guide this Systematic Scoping Review (SSR in SEBA) to enhance the transparency and reproducibility of this review. A structured search for articles on remediation programs for licenced physicians who have completed their pre-registration postings and who are in training positions published between 1st January 1990 and 31st December 2021 in PubMed, Scopus, ERIC, Google Scholar, PsycINFO, ASSIA, HMIC, DARE and Web of Science databases was carried out. The included articles were concurrently thematically and content analysed using SEBA’s Split Approach. Similarities in the identified themes and categories were combined in the Jigsaw Perspective and compared with the tabulated summaries of included articles in the Funnelling Process to create the domains that will guide discussions.ResultsThe research team retrieved 5512 abstracts, reviewed 304 full-text articles and included 101 articles. The domains identified were characteristics, indications, frameworks, domains, enablers and barriers and unique features of remediation in licenced physicians in training programs.ConclusionBuilding upon our findings and guided by Hauer et al. approach to remediation and Taylor and Hamdy’s Multi-theories Model, we proffer a theoretically grounded 7-stage evidence-based remediation framework to enhance understanding of remediation in licenced physicians in training programs. We believe this framework can guide program design and reframe remediation’s role as an integral part of training programs and a source of support and professional, academic, research, interprofessional and personal development.
Cross-sectional study on COVID-19 vaccine hesitancy and determinants in healthcare students: interdisciplinary trainings on vaccination are needed
Authors: Gautier Sylvain , Luyt Domitille , Davido Benjamin , Herr Marie , Cardot Thomas , Rousseau Anne , Annane Djillali , Delarocque-Astagneau Elisabeth , Josseran Loïc 
Published: April 2022

Abstract
Background
To ensure the success of COVID-19 vaccination, public authorities need to have the support of the entire population and build vaccine confidence. Identifying and understanding the determinants of vaccine acceptance is essential for conducting vaccine strategy. The aim was to estimate vaccine hesitancy among healthcare students in France and to investigate the associated factors.

Methods
A web-based cross-sectional study was conducted in a large French University in greater Paris area, among 4927 healthcare students from the different training courses such as medicine studies, midwifery studies, physiotherapy studies, nurse studies and others health studies. The study was conducted between January 21 and February 8, 2021 based on a questionnaire including 25 single or multiple-choice questions, made using the free software Limesurvey. The link of the questionnaire was distributed to the students by the teachers and the student associations. The SAGE group definition of vaccine hesitancy was used. All estimates were weighted using the gender and training courses category of all healthcare students registered for the 2020–2021 year. Crude and adjusted weighted odds ratio (wOR) and 95% confidence interval (95%CI) were estimated using logistic regression.

Results
A total of 1465 healthcare students answered. A proportion of 44.5% (95%CI = [41.7–47.3]) of them were considered as hesitant. Women were more hesitant (50.9, 95%CI = [48.0–53.9]) than men (21.6, 95%CI = [15.2–28.0]). Vaccine hesitancy was significantly associated with gender (wOR = 0.27, 95%CI = [0.18–0.39]) and training courses: medical students were less likely to be hesitant than students in the common and first year of several health studies (wOR = 0.48, 95%CI = [0.33–0.70]) while nursing students were more than 5 times more likely to be hesitant (wOR = 5.20, 95%CI = [3.71–7.28]). Students who did an internship during the epidemic (wOR = 0.53, 95%CI = [0.41–0.69]) and who downloaded the mobile contact-tracing mobile app “TousAntiCovid” (wOR = 0.34, 95%CI = [0.26–0.44]) were significantly less likely to be hesitant.

Conclusions
Overall vaccine hesitancy among healthcare students was high, substantial differences were found between training courses. To reduce these disparities, interdisciplinary lectures on vaccines for all healthcare students may be implemented and evaluated.
A systematic review on the usability of robotic and virtual reality devices in neuromotor rehabilitation: patients’ and healthcare professionals’ perspective
Authors: Zanatta Francesco , Giardini Anna , Pierobon Antonia , D’Addario Marco , Steca Patrizia 
Published: April 2022

AbstractBackgroundThe application of virtual reality (VR) and robotic devices in neuromotor rehabilitation has provided promising evidence in terms of efficacy, so far. Usability evaluations of these technologies have been conducted extensively, but no overviews on this topic have been reported yet.MethodsA systematic review of the studies on patients' and healthcare professionals' perspective through searching of PubMed, Medline, Scopus, Web of Science, CINAHL, and PsychINFO (2000 to 2021) was conducted. Descriptive data regarding the study design, participants, technological devices, interventions, and quantitative and qualitative usability evaluations were extracted and meta-synthetized.ResultsSixty-eight studies were included. VR devices were perceived as having good usability and as a tool promoting patients' engagement and motivation during the treatment, as well as providing strong potential for customized rehabilitation sessions. By contrast, they suffered from the effect of learnability and were judged as potentially requiring more mental effort. Robotics implementation received positive feedback along with high satisfaction and perceived safety throughout the treatment. Robot-assisted rehabilitation was considered useful as it supported increased treatment intensity and contributed to improved patients' physical independence and psychosocial well-being. Technical and design-related issues may limit the applicability making the treatment difficult and physically straining. Moreover, cognitive and communication deficits were remarked as potential barriers.ConclusionsOverall, VR and robotic devices have been perceived usable so far, reflecting good acceptance in neuromotor rehabilitation programs. The limitations raised by the participants should be considered to further improve devices applicability and maximise technological rehabilitation effectiveness.Trial registrationPROSPERO registration ref.CRD42021224141.
The association of neurodevelopmental abnormalities, congenital heart and renal defects in a tuberous sclerosis complex patient cohort
Authors: Robinson Jessica , Uzun Orhan , Loh Ne Ron , Harris Isabelle Rose , Woolley Thomas E. , Harwood Adrian J. , Gardner Jennifer Frances , Syed Yasir Ahmed 
Published: April 2022

Abstract
Background
Tuberous sclerosis complex (TSC) is a rare multi-system genetic disorder characterised by the presence of benign tumours throughout multiple organs including the brain, kidneys, heart, liver, eyes, lungs and skin, in addition to neurological and neuropsychiatric complications. Intracardiac tumour (rhabdomyoma), neurodevelopmental disorders (NDDs) and kidney disorders (KD) are common manifestations of TSC and have been linked with TSC1 and TSC2 loss-of-function mutations independently, but the dynamic relationship between these organ manifestations remains unexplored. Therefore, this study aims to characterise the nature of the relationship specifically between these three organs’ manifestations in TSC1 and TSC2 mutation patients.

Methods
Clinical data gathered from TSC patients across South Wales registered with Cardiff and Vale University Health Board (CAV UHB) between 1990 and 2020 were analysed retrospectively to evaluate abnormalities in the heart, brain and kidney development. TSC-related abnormalities such as tumour prevalence, location and size were analysed for each organ in addition to neuropsychiatric involvement and were compared between TSC1 and TSC2 mutant genotypes. Lastly, statistical co-occurrence between organ manifestations co-morbidity was quantified, and trajectories of disease progression throughout organs were modelled.

Results
This study found a significantly greater mutational frequency at the TSC2 locus in the cohort in comparison to TSC1. An equal proportion of male and female patients were observed in this group and by meta-analysis of previous studies. No significant difference in characterisation of heart involvement was observed between TSC1 and TSC2 patients. Brain involvement was seen with increased severity in TSC2 patients, characterised by a greater prevalence of cortical tubers and communication disorders. Renal pathology was further enhanced in TSC2 patients, marked by increased bilateral angiomyolipoma prevalence. Furthermore, co-occurrence of NDDs and KDs was the most positively correlated out of investigated manifestations, regardless of genotype. Analysis of disease trajectories revealed a more diverse clinical outcome for TSC2 patients: however, a chronological association of rhabdomyoma, NDD and KD was most frequently observed for TSC1 patients.

Conclusions
This study marks the first empirical investigation of the co-morbidity between congenital heart defects (CHD), NDDs, and KDs in TSC1 and TSC2 patients. This remains a unique first step towards the characterisation of the dynamic role between genetics, heart function, brain function and kidney function during the early development in the context of TSC.
Delivery of triptolide: a combination of traditional Chinese medicine and nanomedicine
Authors: Sun Rui , Dai Jingyue , Ling Mingjian , Yu Ling , Yu Zhiqiang , Tang Longguang 
Published: April 2022

AbstractAs a natural product with various biological activities, triptolide (TP) has been reported in anti-inflammatory, anti-tumor and anti-autoimmune studies. However, the narrow therapeutic window, poor water solubility, and fast metabolism limit its wide clinical application. To reduce its adverse effects and enhance its efficacy, research and design of targeted drug delivery systems (TDDS) based on nanomaterials is one of the most viable strategies at present. This review summarizes the reports and studies of TDDS combined with TP in recent years, including passive and active targeting of drug delivery systems, and specific delivery system strategies such as polymeric micelles, solid lipid nanoparticles, liposomes, and stimulus-responsive polymer nanoparticles. The reviewed literature presented herein indicates that TDDS is a multifunctional and efficient method for the delivery of TP. In addition, the advantages and disadvantages of TDDS are sorted out, aiming to provide reference for the combination of traditional Chinese medicine and advanced nano drug delivery systems (NDDS) in the future.
Graphical Abstract