bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of Metastatic Endometrial Cancer: Physicians’ Choices Beyond the First Line. A MITO Survey
Authors: Giannone Gaia , Castaldo Daniele , Tuninetti Valentina , Scotto Giulia , Turinetto Margherita , Valsecchi Anna Amela , Bartoletti Michele , Mammoliti Serafina , Artioli Grazia , Mangili Giorgia , Salutari Vanda , Lorusso Domenica , Cormio Gennaro , Zamagni Claudio , Savarese Antonella , Di Maio Massimo , Ronzino Graziana , Pisano Carmela , Pignata Sandro , Valabrega Giorgio 
Published: May 2022

BackgroundEndometrial cancer (EC) therapeutic and diagnostic approaches have been changed by the development of a new prognostic molecular classification, the introduction of dostarlimab in microsatellite instability (MSI) high pre-treated advanced EC patients with further expected innovation deriving from lenvatinib plus pembrolizumab regardless MSI status. How this is and will be translated and embedded in the clinical setting in Italy is not known; this is why we developed Multicentre Italian Trials in Ovarian cancer and gynaecologic malignancies (MITO) survey on the current practice and expected future changes in EC.MethodsWe designed a self-administered, multiple-choice online questionnaire available only for MITO members for one month, starting in April 2021.Results75.6% of the respondents were oncologists with a specific focus on gynaecologic malignancies and 73.3% of the respondents declared the availability of clinical trials in second line treatment for advanced EC. The therapeutic algorithm in second line was heterogeneous, being the most frequent choice administering anthracyclines followed by endocrine therapy or enrolling in clinical trials. While more than half of the clinicians declared that they performed the molecular classification, only six/45 respondents (13.3%) ran all the tests needed for it. On the other hand, 80% of them declared regular assessment of MSI status with IHC as recommended. The therapeutic approach in MSI high advanced EC patients has changed since dostarlimab approval. Indeed the most frequent choice in second line has been chemotherapy (53.3%) before its availability, while dostarlimab has been preferred in more than three-fourths of the cases (75.6%) after its approval. As for MSS patients, 77.8% of clinicians would choose lenvatinib plus pembrolizumab for them in second line once approved.ConclusionsDespite the selected sample of respondents from Italian MITO centres showing good knowledge of diagnostic and therapeutic innovations in EC, these are not fully implemented in everyday clinics, except for MSI status assessment.
Clinical Outcomes and Prognostic Analysis of 101 Patients of Central Neurocytoma: A 10-Year Treatment Experience at a Single Institution
Authors: Xie Qiongxuan , Xie Bin , Ou Ludi , Wang Min , Tang Ziqing , He Yuxiang , Yang Xiaoyu , Hong Jidong , Lyu Zhiping , Wei Rui 
Published: May 2022

ObjectiveCentral neurocytoma (CN) is a rare type of tumor that currently lacks an optimal treatment protocol. This study aimed to explore the clinical outcomes of CN in a cohort of 101 patients and identify prognostic factors associated with multiple treatment modalities.MethodsThis monocentric study retrospectively analyzed the clinical data of 101 CN patients who underwent surgical resection. The patients were followed up, and their overall survival (OS) and progression-free survival (PFS) were calculated.ResultsFor the entire cohort, the 5- and 10-year OS rates were 88.7% and 82.8%, respectively, and the 5- and 10-year PFS rates were 86.5% and 64.9%, respectively. Of the 82 (81.19%) patients with CN who underwent gross total resection (GTR), 28 (28/82, 34.1%) also received radiotherapy (RT). Of the 19 (18.81%) patients with CN who underwent subtotal resection (STR), 11 (11/19, 57.9%) also received RT or stereotactic radiosurgery (SRS). Compared to STR, GTR significantly improved the 5-year OS (92.4% vs. 72.4%, P=0.011) and PFS (92.4% vs. 60.4%, P=0.009) rates. Radiotherapy did not affect OS in the GTR group (p=0.602), but it had a statistically significant effect on OS in the STR group (P&lt;0.001). However, the OS (P=0.842) and PFS (P=0.915) in the STR plus radiotherapy group were comparable to those in the GTR alone group. Compared to STR alone, STR plus radiotherapy improved the 5-year PFS rate from 25% to 75% in patients with atypical CN (P=0.004). Cox regression models and a competing risk model showed that the removal degree and radiotherapy were independent prognostic factors for survival. With improvements in modern radiotherapy techniques, severe radiotherapy toxicity was not observed.ConclusionOur findings support the use of GTR whenever possible. Radiotherapy can improve the prognosis of patients who undergo STR, especially in atypical CNs having a higher tendency to relapse. Close imaging follow-up is necessary. Our findings will help clinicians to select optimal, individualized treatment strategies to improve OS and PFS for patients with CN.
Cancer and Associated Therapies Impact the Skeletal Muscle Proteome
Authors: E. L. Dillon , T. J. Wright , A. R. Filley , A. B. Pulliam , K. M. Randolph , C. P. Danesi , C. R. Gilkison , J. E. Wiktorowicz , K. V. Soman , R. J. Urban , M Sheffield-Moore 
Published: May 2022

Introduction: Both cancer and cancer associated therapies (CAT; including chemotherapy or concurrent chemoradiation) disrupt cellular metabolism throughout the body, including the regulation of skeletal muscle mass and function. Adjunct testosterone therapy during standard of care chemotherapy and chemoradiation modulates CAT-induced dysregulation of skeletal muscle metabolism and protects lean body mass during CAT. However, the extent to which the skeletal muscle proteome is altered under these therapeutic conditions is unknown.Objective: We probed the skeletal muscle proteome of cancer patients as an ancillary analysis following a randomized, double-blind, placebo-controlled phase II trial investigating the effect of adjunct testosterone on body composition in men and women with advanced cancers undergoing CAT.Methods: Men and women diagnosed with late stage (≥IIB) or recurrent head and neck or cervical cancer who were scheduled to receive standard of care CAT were administered an adjunct 7 weeks treatment of weekly intramuscular injections of either 100 mg testosterone (CAT+T, n = 7; 2M/5F) or placebo/saline (CAT+P, n = 6; 4M/2F). Biopsies were performed on the vastus lateralis before (PRE) and after (POST) the 7 weeks treatment. Extracted proteins were separated with 2-dimensional gel electrophoresis (2DE), and subjected to analyses of total protein abundance, phosphorylation and S-nitrosylation. Proteoforms showing significant 1.5 fold differences (t-test p ≤ 0.05) between PRE and POST timepoints were identified by mass spectroscopy (MS), and lists of altered proteins were subjected to Gene Set Enrichment Analysis (GSEA) to identify affected pathways.Results: A total of 756 distinct protein spots were identified. Of those spots, 102 were found to be altered in terms of abundance, phosphorylation, or S-nitrosylation, and identified by mass spectroscopy analysis to represent 58 unique proteins. Among the biological processes and pathways identified, CAT+P predominantly impacted metabolic processes, cell assembly, oxygen transport, and apoptotic signaling, while CAT+T impacted transcription regulation, muscle differentiation, muscle development, and contraction.Conclusion: Cancer and CAT significantly altered the skeletal muscle proteome in a manner suggestive of loss of structural integrity, reduced contractile function, and disrupted metabolism. Proteomic analysis suggests that the addition of adjunct testosterone minimized the structural and contractile influence of cancer and its associated therapies.
Association Between History of Gestational Diabetes Mellitus and the Risk of Arthritis in Women
Authors: Mao Yuanyuan , Hu Wenbin , Xia Bin , Liu Li , Liu Qin 
Published: May 2022

ObjectiveThe association between gestational diabetes mellitus (GDM) and the risk of arthritis has not been reported. GDM increases the risk of long-term complications including diabetes and metabolic syndrome that are positively associated with the risk of arthritis. This study aimed to explore the association between GDM and the risk of arthritis.MethodsWomen (age ≥ 20 years) who had delivered at least one live birth were included from the 2007 to 2018 National Health and Nutrition Examination Survey cohort (N = 11,997). Patients who had a history of GDM and arthritis were identified by in-home interview. Subgroup analyses were conducted by arthritis types and status of obesity, current diabetes, metabolic syndrome, smoking, alcohol drinking, and physical activity.ResultsGDM was associated with increased odds of arthritis [multivariable-adjusted odds ratio (95% confidence interval): 1.31 (1.06–1.62)], and the result was similar in sensitivity analysis with further adjustment for metabolic syndrome [1.30 (1.05–1.60)]. In subgroup analyses, GDM was associated with increased odds of osteoarthritis [1.47 (1.05–2.06)], while no association was observed with rheumatoid arthritis [1.04 (0.69–1.57)] and other types [1.26 (0.94–1.68)]. GDM was associated with increased odds of arthritis in women without metabolic syndrome [1.34 (1.00–1.78)] and diabetes [1.35 (1.03–1.76)], in obese individuals [1.64 (1.24–2.16)], current/former smokers [1.43 (1.05–1.95)], and current drinkers [1.76 (1.00–3.14)], and in individuals engaging in higher levels of physical activity [1.53 (1.06–2.20)].ConclusionsGDM was associated with increased odds of arthritis, and the association was independent of type 2 diabetes and metabolic syndrome.
Optimally Temperature Compensated FBG-Based Sensor Dedicated to Non-Intrusive Pipe Internal Pressure Monitoring
Authors: Maurin Laurent , Roussel Nicolas , Laffont Guillaume 
Published: May 2022

Pipe internal pressure measurement is of utmost importance in the oil &amp; gas industry to monitor the extraction process, and thus to prevent hydrate-plugs formation which may occur in specific temperature and pressure conditions. Traditional solutions usually rely on pressure sensors in direct contact with the fluid to monitor, therefore requiring one hole per sensor, but they also weaken the pipe structure, which may prematurely lead to significant leaks. Attempts to develop non-intrusive pressure sensors relying, for instance, on acoustic waves detection or even strain measurements (the pipe wall acting, in some way, like the membrane of a traditional intrusive sensor), are up to now not fully satisfying, mainly due to poor temperature cross-sensitivity compensation. Thus, 1 °C temperature compensation error typically leads for Fiber Bragg Grating (FBG) transducers to pressure measurement biases greater than 26% at 100 bar (e.g.: Ø 4” NPS Sch. 160 steel pipe). Consequently, if such non-intrusive, but biased, solutions could possibly have been considered to monitor, for instance, a Nuclear Power Plant (NPP) primary coolant circuit, it was with the risk of dramatic consequences since the fluid can reach temperatures up to 320 °C. On the other hand, the solution detailed here truly achieves to cancel the temperature cross-sensitivity, and potentially any additional effect on pressure measurement, provided that each effect has the same influence on all transducers. It first relies on a better understanding of the pipe behavior under hydrostatic pressure, supported by a dedicated model developed on purpose, which demonstrates that the internal pressure and the surface temperature variations of a closed pipe can be recovered with at least two direction-sensitive transducers, the temperature dependence of the pressure measurement being simply removed by a straightforward compensation process. This paper explains the underlying principle, thanks to a formal model established with only few hypotheses, but extended to more complex field conditions. It ends with a lab-test validation involving FBG transducers attached to a pressure circuit submitted to temperature variations greater than several tens of °C, and concludes about the advantages and limitations of this novel approach for non-intrusive sensing, and its potential extensions to other measurement techniques.
Case Report: 3D-Printed Prosthesis for Limb Salvage and Joint Preservation After Tibial Sarcoma Resection
Authors: Guo Zehao , Zhang Ran , Que Yukang , Hu Bo , Xu Shenglin , Hu Yong 
Published: May 2022

IntroductionReconstruction of massive tibial defects in ankle joint-preserving surgery remains challenging though biological and prosthetic methods have been attempted. We surgically treated a patient with only 18-mm distal tibia remaining and reconstructed with a unique three-dimensional printed prosthesis.Case Presentation, Intervention, and OutcomesA 36-year-old male presented to our clinic with complaints of gradually swelling left calf and palpable painless mass for five months. Imageological exam indicated a lesion spanning the entire length of the tibia and surrounding the vascular plexus. Diagnosis of chondrosarcoma was confirmed by biopsy. Amputation was initially recommended but rejected, thus a novel one-step limb-salvage procedure was performed. After en-bloc tumor resection and blood supply rebuilding, a customized, three-dimensional printed prosthesis with porous interface was fixed that connected the tumor knee prosthesis and distal ultra-small bone segment. During a 16-month follow-up, no soft tissue or prosthesis-related complications occurred. The patient was alive with no sign of recurrence or metastasis. Walking ability and full tibiotalar range of motion were preserved.ConclusionsCustom-made, three-dimensional printed prosthesis manifested excellent mechanical stability during the follow-up in this joint-preserving surgery. Further investigation of the durability and rate of long-term complications is needed to introduce to routine clinical practice.
The Prevalence of Several Risky Driving Behaviors and Associated Crash Risk in Adolescent: A Population-Based Study of Tuscany Region
Authors: Lastrucci Vieri , Innocenti Francesco , Lorini Chiara , Berti Alice , Silvestri Caterina , Lazzeretti Marco , Voller Fabio , Bonaccorsi Guglielmo 
Published: May 2022

Objectives: To evaluate the prevalence of numerous risky driving behaviors (RDBs) and the associated risk of road traffic accidents (RTA) in a population-based sample of adolescent drivers (14–19 years) of Tuscany, Italy.Methods: The frequency of participation -by age and sex- often RDBs were investigated: Multivariable analyses were performed to evaluate the association between RDBs and the risk of RTA and severe RTA.Results: 2,737 adolescents were included in the study. Talking to passenger(s), listening to loud music, speeding, and texting showed the highest weekly participation rates. For all the considered RDBs, the frequency of participation significantly increased with age. Males reported a significantly higher participation in speeding, DUI of alcohol or drugs; while females reported listening to loud music and talking to passenger(s) more frequently. All the considered RDBs were significantly associated with the risk of RTA and severe RTA.Conclusion: The prevalence of RDBs and the associated risk of RTA largely varied in adolescents. Findings provide evidence for tailoring prevention interventions and suggest the need to include common- but traditionally overlooked- RDBs in road safety campaigns.
Adventure sports and nature-based tourism: Assessment of canyoning spots in the North Region of Portugal
Authors: Correia Alexandra I. , Silva Goretti , Rachão Susana 
Published: May 2022

The growing demand for natural areas and outdoor activities in the last decade, even more noticeable in the COVID-19 worldwide pandemic situation, has led to the intensification and diversification of nature-based tourism supply in many regions, including the provision of adventure recreation activities, such as canyoning. However, and despite the increasing interest of companies, destinations, and academia in this specific type of activity, there is limited information on resources, practice conditions, and assessments based on specific, objective criteria. This information is critical for a more competitive development and positioning of regions for this activity, and to meet tourists’ increasingly demanding expectations. Therefore, this paper aims at building upon the identified research gap, by characterizing and evaluating the existing conditions for canyoning activity in the North Region of Portugal, This evaluation of twenty-seven canyoning spots. was done based on an assessment matrix, comprised of specific criteria, grounded on the literature review and semi-structured interviews with companies’ owners/managers and experts. The study concludes that the activity is evolving in the region and there is still potential for development, due to morphological, favourable conditions. Moreover, the region offers different spots, often inserted in protected areas, with unique landscapes and natural diversity, which is attractive for tourism. The presentation of an assessment matrix (that allows the characterization and evaluation of canyoning spots on a systematic approach in different geographic contexts) makes this study a contribution to the literature on nature-based, adventure tourism and recreation activities.
Winery Word of Mouth: the Role of Brand Prestige, Brand Credibility and Wine Experience
Authors: Santos Sara , Caldas Fábio , Espírito Santo Pedro , Augusto Luísa , Oliveira Adriana 
Published: May 2022

Although tourism has been heavily affected by the COVID-19 pandemic crisis, its potential as an economic activity that enables the economic and social development of the regions is recognized. As a result of concerns caused by the COVID-19 pandemic, tourist agents seek to diversify their offers. In this situation, whether because of the knowledge and interest of tourists in the wine sector or because of the credibility and prestige of some brands with greater notoriety in the sector, wine tourism can be an essential stimulus for the attractiveness of tourists and international investors.
Wine is a product of a highly differentiated experience, and tourists who visit wineries that produce wine seek to know the wine production process and have a unique experience with wine brands. These tourists who visit wine cellars seek information through specialized websites, blogs or magazines and highlight the role of word-of-mouth recommendations.
Thus, this study aimed to investigate the influence of brand prestige, brand credibility, and brand experience on wine and wineries' word of mouth (WOM). It was carried out a cross-sectional study using a quantitative methodology. Data collected from a sample of 207 individuals were analyzed using PLS structural equation modeling using SMART PLS software. The main results obtained confirm that the credibility and prestige of the brands have a crucial role in the word of mouth of wine cellars.
Learning by doing:
Authors: Vasconcelos Sandra , Melo Carla , Melo António , Liberato Dália 
Published: May 2022

Having a strong affinity and interdependence with a wide range of sectors and industries, tourism is, by nature, an interdisciplinary field. However, despite this realization, there are still different barriers to the development of interdisciplinary research and active collaborative projects within Tourism Higher Education. In addition to these barriers, there is also a disarticulation between tourism curricula and what practitioners perceive as being key skills within the industry. Hence, as the context in which the tourist activity takes place becomes more competitive, resulting in a pressing need for skilled and multifaceted professionals, educational institutions and tourism educators are increasingly being challenged to overcome these barriers and come up with creative projects that can help bridge the gap between academia and the labour market.
Aiming to describe an interdisciplinary project focusing on soft skills within different tourism subsectors, this paper will draw on a literature review, project outputs and two questionnaires, as to describe its implementation and overall results. Mostly based on students’ perceptions and determining whether they are aligned with the industry’s current demands and expectations, in addition to a general description, it will crosscut different perspectives, analysing the importance attributed to soft skills by students and prospective employers. Deriving from this analysis and the project’s scope, the authors will also put forward a reflection regarding the impact of the project on not only student’s perceptions regarding soft skills, but also on the affordances of the project to develop transversal competences, making a case for other innovative initiatives. As a result, the final section of the paper will include references to lessons learnt and future research directions.
Question of Sustainability
Authors: Brett Michael 
Published: May 2022

The Kruger National Park is the largest protected area in South Africa. The park was opened to tourists in 1927 at a time when private automobiles were becoming a feature of South African cities. Since 1927 there has been a 67,879-fold increase in tourists until 2019. The current number of tourists is 1.8 million exceeds that of any other savannah, wildlife-based national park in Africa by at least four-fold and poses the danger of overtourism. The total number of tourists that can be accommodated by accommodation within the Kruger National Park is 7400, which is high for an African national park. The paper examines historic tourist trends and the regional concentration of tourist facilities within the park. Due to its accessibility, the southern region, which comprises 21.9% of the park, receives 73.9% of tourists and has 32.9% of the 2,562-kilometre road network and 49.8% of tourist beds. A survey of members of a social media group found that 90.9% believe the southern region is overdeveloped. Open Safari Vehicles (OSVs) could be part of an Alternative Transportation Programme (ATP) as they transport an average of 5.9 tourists, compared to an average of 2.4 tourists per private automobile. A survey was conducted on the same social media site to ascertain attitudes towards OSVs, which now account for 16.7% of the park’s tourists. A total of 1,320 responses were recorded and 29.24% believed that OSV drivers have no regard for other park users, while others regarded these vehicles as an important contribution to park conservation and management.