bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilization of an Electronic Patient-Reported Outcome Platform to Evaluate the Psychosocial and Quality-of-Life Experience Among a Community Sample of Ovarian Cancer Survivors
Authors: Hlubocky Fay J. , Daugherty Christopher K. , Peppercorn Jeffery , Young Karen , Wroblewski Kristen E. , Yamada Seiko Diane , Lee Nita K. 
Published: August 2022

PURPOSE Novel distress screening approaches using electronic patient-reported outcome (ePRO) measurements are critical for the provision of comprehensive quality community cancer care. Using an ePRO platform, the prevalence of psychosocial factors (distress, post-traumatic growth, resilience, and financial stress) affecting quality of life in ovarian cancer survivors (OCSs) was examined. METHODS A cross-sectional OCS sample from the National Ovarian Cancer Coalition-Illinois Chapter completed web-based clinical, sociodemographic, and psychosocial assessment using well-validated measures: Hospital Anxiety/Depression Scale-anxiety/depression, Post-traumatic Growth Inventory, Brief Resilience Scale, comprehensive score for financial toxicity, and Functional Assessment of Cancer Therapy-Ovarian (FACT-O/health-related quality of life [HRQOL]). Correlational analyses between variables were conducted. RESULTS Fifty-eight percent (174 of 300) of OCS completed virtual assessment: median age 59 (range 32-83) years, 94.2% White, 60.3% married/in domestic partnership, 59.6% stage III-IV, 48.8% employed full-time/part-time, 55.2% had college/postgraduate education, 71.9% completed primary treatment, and median disease duration 6 (range < 1-34) years. On average, OCS endorsed normal levels of anxiety (mean ± standard deviation = 6.9 ± 3.8), depression (4.1 ± 3.6), mild total distress (10.9 ± 8.9), high post-traumatic growth (72.6 ± 21.5), normal resilience (3.7 ± 0.72), good FACT-O-HRQOL (112.6 ± 22.8), and mild financial stress (26 ± 10). Poor FACT-O emotional well-being was associated with greater participant distress ( P < .001). Partial correlational analyses revealed negative correlations between FACT-O-HRQOL and anxiety ( r = –0.65, P < .001), depression ( r = –0.76, P < .001), and total distress ( r = –0.92, P < .001). Yet, high FACT-O-HRQOL was positively correlated with post-traumatic coping ( r = 0.27; P = .006) and resilience ( r = 0.63; P < .001). CONCLUSION ePRO assessment is feasible for identification of unique psychosocial factors, for example, financial toxicity and resilience, affecting HRQOL for OCS. Future investigation should explore large-scale, longitudinal ePRO assessment of the OCS psychosocial experience using innovative measures and community-based advocacy populations.
EphrinB2 Inhibition and Pembrolizumab in Metastatic Urothelial Carcinoma
Authors: Sadeghi Sarmad , Quinn David , Dorff Tanya , Pal Sumanta , Groshen Susan , Tsao-Wei Denice , Parikh Rahul , Devitt Michael , Parikh Mamta , Jackovich Alexandra , Ruel Nora , Vogelzang Nicholas , Burgess Earle , Siddiqi Imran , Gill Inderbir S. , Lara Primo N. , Dreicer Robert , Gill Parkash S. 
Published: August 2022

PURPOSE Patients with metastatic urothelial carcinoma have poor prognosis after failure of standard first-line chemotherapy. Immune check point programmed death 1-programmed death ligand 1 antibodies have low response rates and thus there exists a major unmet need. MATERIALS AND METHODS In this phase II trial, patients with metastatic urothelial carcinoma that recurred or progressed after platinum-based chemotherapy received soluble EphB4-human serum albumin (sEphB4-HSA) in combination with pembrolizumab. The primary end points were tolerability and overall survival (OS). The secondary end points were progression-free survival (PFS), objective response rate (ORR), duration of response, and toxicity. The expression of sEphB4-HSA target EphrinB2 was correlated with outcomes. RESULTS Seventy patients were enrolled. The median follow up was 22.9 months (range, 1.3-54.7). The regimen had acceptable toxicity. In the intent-to-treat analysis (N = 70), the median OS was 14.6 months (95% CI, 9.2 to 21.5). Twenty-six (37%) patients had an objective response (95% CI, 26 to 48). The median PFS was 4.1 (95% CI, 1.5 to 5.7) months. Forty-six (66%) patients expressed EphrinB2, and among them, the median OS was 21.5 months (95% CI, 12.4 to not reached), the ORR was 52% (95% CI, 37 to 67), including a complete response rate of 24% (11 of 46; 95% CI, 12 to 36). The median PFS was 5.7 (95% CI, 2.7 to 27.9) months. Response was maintained at 6, 12, and 24 months in 88%, 74%, and 69% of the patients, respectively. CONCLUSION The combination of sEphB4-HSA and pembrolizumab appears synergistic with improved OS and ORR compared with historical data for programmed death 1/programmed death ligand 1 monotherapy.
Mutation patterns of resistance genes for macrolides, aminoglycosides, and rifampicin in nontuberculous mycobacteria isolates from Kenya
Authors: Mwangi Zakayo , Naeku Grace , Mureithi Marianne , Onyambu Frank , Bulimo Wallace 
Published: August 2022

Background: Nontuberculous mycobacteria (NTM) treatment constitutes a macrolide-based antibiotic regimen in combination with aminoglycosides for Rapid-Growing mycobacteria (RGM), and rifampicin for Slow-Growing mycobacteria (SGM). Mutations in the anti-NTM drug target regions promote NTM evolution to mutant strains that are insusceptible to NTM drugs leading to treatment failure. We, therefore, described the mutation patterns of anti-NTM drug target genes including rrl, rrs, and rpoB in NTM isolates from Kenya. Methods: We carried out a cross-sectional study that included 122 NTM obtained from the sputum of symptomatic tuberculosis-negative patients in Kenya. All the 122 NTM underwent targeted sequencing of the rrl gene. The 54 RGM were also sequenced for rrs, and the 68 SGM were sequenced for rpoB genes using ABI 3730XL analyzer. The obtained sequences were aligned to their wild-type reference sequences for each gene using Geneious then mutations were identified. Pearson chi-square at 95% confidence interval tested the association of NTM to mutation patterns for each gene. Results: Twenty-eight (23%) of the NTM were resistant to at least one of the antibiotics used in the macrolide-based treatment. Twelve (10.4%) of NTM were macrolide resistant, with 7(58.3%) of RGM and 5(41.7%) of SGM having mutations in the rrl gene. For ten (83.3%) NTM, mutations were found at position 2058, while for two (16.6%) NTM, mutations were found at position 2059. Six (11.1%) of the 54 RGM exhibited mutations in the aminoglycoside target gene rrs at location 1408. Ten (14.7%) of the 68 SGM were resistant to rifampicin, with 40 percent having mutations at codon 531 in the rpoB gene. Conclusion: We demonstrated a significant level of drug resistance for macrolides, aminoglycosides and rifampicin in NTM isolated from symptomatic TB negative patients in Kenya.
Comparison of carbon fibre and titanium intramedullary nails in orthopaedic oncology
Authors: Yeung Caleb M. , Bhashyam Abhiram R. , Groot Olivier Q. , Merchan Nelson , Newman Erik T. , Raskin Kevin A. , Lozano-Calderón Santiago A. 
Published: August 2022

Aims Due to their radiolucency and favourable mechanical properties, carbon fibre nails may be a preferable alternative to titanium nails for oncology patients. We aim to compare the surgical characteristics and short-term results of patients who underwent intramedullary fixation with either a titanium or carbon fibre nail for pathological long-bone fracture. Methods This single tertiary-institutional, retrospectively matched case-control study included 72 patients who underwent prophylactic or therapeutic fixation for pathological fracture of the humerus, femur, or tibia with either a titanium (control group, n = 36) or carbon fibre (case group, n = 36) intramedullary nail between 2016 to 2020. Patients were excluded if intramedullary fixation was combined with any other surgical procedure/fixation method. Outcomes included operating time, blood loss, fluoroscopic time, and complications. Fisher’s exact test and Mann-Whitney U test were used for categorical and continuous outcomes, respectively. Results Patients receiving carbon nails as compared to those receiving titanium nails had higher blood loss (median 150 ml (interquartile range (IQR) 100 to 250) vs 100 ml (IQR 50 to 150); p = 0.042) and longer fluoroscopic time (median 150 seconds (IQR 114 to 182) vs 94 seconds (IQR 58 to 124); p = 0.001). Implant complications occurred in seven patients (19%) in the titanium group versus one patient (3%) in the carbon fibre group (p = 0.055). There were no notable differences between groups with regard to operating time, surgical wound infection, or survival. Conclusion This pilot study demonstrates a non-inferior surgical and short-term clinical profile supporting further consideration of carbon fibre nails for pathological fracture fixation in orthopaedic oncology patients. Given enhanced accommodation of imaging methods important for oncological surveillance and radiation therapy planning, as well as high tolerances to fatigue stress, carbon fibre implants possess important oncological advantages over titanium implants that merit further prospective investigation. Level of evidence: III, Retrospective study Cite this article: Bone Jt Open 2022;3(8):648–655.
Functional activity limitation of leprosy cases in an endemic area in Indonesia and recommendations for integrated participation program in society
Authors: Menaldi Sri Linuwih , Harini Melinda , Nelfidayani Nelfidayani , Irawati Yunia , Setiono Steven , Wahyuni Luh Karunia , Rahayu Tri , Andayani Gitalisa , Friska Dewi , Nugraha Boya 
Published: August 2022

Background
Leprosy continues to be a health problem in Indonesia, with incidence reaching over 10,000 new cases by 2021. Leprosy-related disabilities cause limitation of patients’ activity and participation in social activities. To date, no studies have been conducted in Indonesia which investigates disability in terms of bodily function, structure impairment, limitations in performing daily activities, and restrictions in participation in social activities in leprosy patients. This study is aimed to determine the demographic and clinical characteristics that might affect functional activity limitations of leprosy patients in endemic areas in Indonesia.

Methods and findings
A cross-sectional study was conducted on 267 retrospectively-diagnosed cases of leprosy. The Screening of Activity Limitation and Safety Awareness (SALSA) scale was used to measure functional activity limitation, which comprises five domains: vision, mobility, self-care, work with hands, and dexterity. Differences among variables were evaluated using Kruskal-Wallis and Mann-Whitney test. The mean age of participants was 51.89±13.66 years, the majority of which were men (62.5%), uneducated (48.3%), and classified as type 2 in the World Health Organization (WHO) disability grading for hands and feet (66.3% and 68.2%, respectively). Assessment using the SALSA Scale showed 28.5% of subjects were without limitation, 43.8% with mild limitation, 13.5% with moderate limitation, 9.4% with severe limitation, and 4.9% with extreme limitation. Significant differences in the total SALSA Scale were found between age groups (p = 0.014), educational level (p = 0.005), occupation (p<0.001), and WHO disability grades (p<0.001). Multivariate analysis showed that the most significant factor influencing the total score of SALSA was disability grading for feet (score = 0.31, p <0.001) followed by occupational status, disability grading for eyes, and age. Limitation of functional activity was significantly correlated to becoming unemployed with the odds 2.59.

Conclusion
People affected by leprosy are prone to have functional activity limitation, especially the elderly, uneducated, unemployed and those with multiple disabilities. If they can overcome their barriers in functional activities, they will have better occupational opportunities.
Assessing the impact of Ascariasis and Trichuriasis on weight gain using a porcine model
Authors: Whitehead Bradley , Thamsborg Stig M. , Denwood Matthew J. , Nejsum Peter 
Published: August 2022

Background
Infections with Ascaris lumbricoides and Trichuris trichiura remain significant contributors to the global burden of neglected tropical diseases. Infection may in particular affect child development as they are more likely to be infected with T. trichiura and/or A. lumbricoides and to carry higher worm burdens than adults. Whilst the impact of heavy infections are clear, the effects of moderate infection intensities on the growth and development of children remain elusive. Field studies are confounded by a lack of knowledge of infection history, nutritional status, presence of co-infections and levels of exposure to infective eggs. Therefore, animal models are required. Given the physiological similarities between humans and pigs but also between the helminths that infect them; A. suum and T. suis, growing pigs provide an excellent model to investigate the direct effects of Ascaris spp. and Trichuris spp. on weight gain.

Methods and results
We employed a trickle infection protocol to mimic natural co-infection to assess the effect of infection intensity, determined by worm count (A. suum) or eggs per gram of faeces (A. suum and T. suis), on weight gain in a large pig population (n = 195) with variable genetic susceptibility. Pig body weights were assessed over 14 weeks. Using a post-hoc statistical approach, we found a negative association between weight gain and T. suis infection. For A. suum, this association was not significant after adjusting for other covariates in a multivariable analysis. Estimates from generalized linear mixed effects models indicated that a 1 kg increase in weight gain was associated with 4.4% (p = 0.00217) decrease in T. suis EPG and a 2.8% (p = 0.02297) or 2.2% (p = 0.0488) decrease in A. suum EPG or burden, respectively.

Conclusions
Overall this study has demonstrated a negative association between STH and weight gain in growing pigs but also that T. suis infection may be more detrimental that A. suum on growth.
Genetically predicted cortisol levels and risk of venous thromboembolism
Authors: Allara Elias , Lee Wei-Hsuan , Burgess Stephen ,   the INVENT consortium, Larsson Susanna C. 
Published: August 2022

Introduction
In observational studies, venous thromboembolism (VTE) has been associated with Cushing’s syndrome and with persistent mental stress, two conditions associated with higher cortisol levels. However, it remains unknown whether high cortisol levels within the usual range are causally associated with VTE risk. We aimed to assess the association between plasma cortisol levels and VTE risk using Mendelian randomization.

Methods
Three genetic variants in the SERPINA1/SERPINA6 locus (rs12589136, rs11621961 and rs2749527) were used to proxy plasma cortisol. The associations of the cortisol-associated genetic variants with VTE were acquired from the INVENT (28 907 cases and 157 243 non-cases) and FinnGen (6913 cases and 169 986 non-cases) consortia. Corresponding data for VTE subtypes were available from the FinnGen consortium and UK Biobank. Two-sample Mendelian randomization analyses (inverse-variance weighted method) were performed.

Results
Genetic predisposition to higher plasma cortisol levels was associated with a reduced risk of VTE (odds ratio [OR] per one standard deviation increment 0.73, 95% confidence interval [CI] 0.62–0.87, p<0.001). The association was stronger for deep vein thrombosis (OR 0.69, 95% CI 0.55–0.88, p = 0.003) than for pulmonary embolism which did not achieve statistical significance (OR 0.83, 95% CI 0.63–1.09, p = 0.184). Adjusting for genetically predicted systolic blood pressure inverted the direction of the point estimate for VTE, although the resulting CI was wide (OR 1.06, 95% CI 0.70–1.61, p = 0.780).

Conclusions
This study provides evidence that genetically predicted plasma cortisol levels in the high end of the normal range are associated with a decreased risk of VTE and that this association may be mediated by blood pressure. This study has implications for the planning of observational studies of cortisol and VTE, suggesting that blood pressure traits should be measured and accounted for.
Development and validation of a risk score for predicting clinical success after endobiliary stenting for malignant biliary obstruction
Authors: Pausawasdi Nonthalee , Termsinsuk Panotpol , Charatcharoenwitthaya Phunchai , Limsrivilai Julajak , Kaosombatwattana Uayporn 
Published: August 2022

Background
Endoscopic drainage is the primary treatment for unresectable malignant biliary obstruction (MBO). This study developed and validated a pre-endoscopic predictive score for clinical success after stent placement.

Methods
Patients with unresectable MBO undergoing ERCP-guided endobiliary stent placement between 2007 and 2017 were randomly divided into derivation (n = 383) and validation (n = 128) cohorts. To develop the risk score, clinical parameters were built by logistic regression to predict (1) ≥ 50% total bilirubin (TB) resolution within 2 weeks and (2) bilirubin normalization (TB level <1.2 mg/dL) within 6 weeks following stenting. The scoring scheme was applied to the validation cohort to test its performance.

Results
A ≥ 50% TB resolution within 2 weeks was shown in 70.5% of cases. The risk scoring scheme had areas under the receiver operating characteristic curve (AUROC) of 0.70 (95% CI, 0.64–0.76) and 0.67 (95% CI, 0.57–0.77) in the derivation and validation cohorts, respectively. Thirty-one percent had TB normalization within 6 weeks after stenting. Significant predictors for TB normalization were extrahepatic biliary obstruction (odds ratio [OR] = 2.35), pre-endoscopic TB level (OR = 0.88), and stent type (OR = 0.42). The AUROC of a risk score for predicting TB normalization within 6 weeks was 0.78 (95% CI, 0.72–0.83) and 0.76 (95% CI, 0.67–0.86) in the derivation and validation cohorts, respectively. A score > 1.30 yielded a specificity of 98% and a positive predictive value of 84% for predicting TB normalization. A score of < -4.18 provided a sensitivity of 80%–90% and a negative predictive value of 90%–93% for predicting the absence of TB normalization.

Conclusions
The pre-endoscopic scoring system comprising biliary obstruction level, liver biochemistry, and type of stent provides prediction indices for TB normalization within 6 weeks after stenting. This scheme may help endoscopists identify patients with unresectable MBO suited for palliative stenting.
Students and examiners perception on virtual medical graduation exam during the COVID-19 quarantine period: A cross-sectional study
Authors: Alkhateeb Nazdar Ezzaddin , Ahmed Baderkhan Saeed , Al-Tawil Namir Ghanim , Al-Dabbagh Ali A. 
Published: August 2022

BackgroundWith the emergence of the COVID-19 pandemic and lockdown approach that was adopted all over the world, conducting assessments while maintaining integrity became a big challenge. This article aims at sharing the experience of conducting an online assessment with the academic community and to assess its effectiveness from both examiners’ and students’ perspectives.MethodsAn online assessment was carried out for the final year medical students of Hawler Medical University/Iraq during the lockdown period of the COVID-19 pandemic, June 2020. Then, an online questionnaire was sent to a sample of 61 examiners and 108 students who have been involved in evaluating the mentioned assessment process. Mann-Whitney and Kruskal-Wallis tests were used to compare the mean ranks of the overall satisfaction scores between categories of the students and examiners. Categorical data were summarized and presented as frequencies and percentages.ResultsThe response rates among examiners and students were 69.4% and 88.5% respectively. The majority of the examiners were generally satisfied with the online examination process compared to only around a third of the students. However, both examiners and students agreed that online examination was not suitable for assessing the physical examination skills.ConclusionThe online assessment can be considered a good alternative and acceptable method for medical students’ assessment in unpredicted emergencies, yet it was not applicable in testing physical examination skills.
Meaning-making in the European semiosphere
Authors: Bal Mieke 
Published: August 2022

Abstract
The aim of the paper is to examine how to bring together the general, large area of “semiosphere” (Lotman), the detailed (“close”) analysis of cultural objects, and the point of the flexible methodology we call interdisciplinary. The semiosphere I address is the (uncertain) one we call “Europe”. The starting point is the semiotic status of the exclamation mark as I have used it to connect two preoccupations in the title of a film I made in 2020. The heart of the analysis is ambiguity, in language as well as in other domains. This serves to enhance the uncertainties that always accompany semiotic analysis, which in my view is for the better. After the comments triggered by my film, I turn to visual art as the apparent “other” of language, but through a reflection on colour, I reject that binary in favour of the more flexible concept of the figural (Lyotard). Throughout the article I also undermine the opposition between still and moving images.
Laws of imitation and intermedia narrative – on imitation of word narrative by image narrative
Authors: Long Diyong 
Published: August 2022

Abstract
Image narrative was long regarded as imitation of a story already told in word narrative rather than as direct imitation of real life. In the connection between imitation and medium, there are the phenomena of the medium’s own position and “Anders-streben.” The former emphasizes the medium following its own nature, and the latter means not only following its own nature but transcending itself to pursue another aesthetic effect. “Inter” in intermedia narrative goes beyond the nature or strengths of an artistic work and its medium, resulting in a narrative form that showcases the characteristics of other literary works or media rather than giving full play to its own strengths. Of course, the so-called “laws of imitation” outlined by French sociologist Tarde must be followed: (i) imitation from within to without and (ii) imitation of the superior by the inferior. Whether in the former or the latter, word is a more advantageous medium, since it serves more easily as the model for images or other media to imitate in lyric expression or narrative activities. The laws of imitation are the underlying cause why image, as a spatial narrative medium, manages to achieve the corresponding temporal effect by imitating word narrative.
The German Local Population Database (GPOP), 1871 to 2019
Authors: Roesel Felix 
Published: August 2022

Abstract
I present the first database of historical local population figures for all Germany. The German Local Population Database (GPOP) includes total population in 1871, 1910, 1939, 1946, 1961, 1987, 1996, 2011, and 2019 for the universe of all German municipalities, counties, and states at consistent contemporary boundaries (31 December 2019). The database was hand-collected and assembled from more than 50 sources. The data reflect 150 years of regional development and disparities in Germany. For example, East and West Germany are heavily diverging in population since 1945; and the divide was not reversed but even doubled after reunification.