bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protocol for a feasibility randomized trial of a social support intervention plus usual care versus usual care, targeting patients treated for cardiac disease who experience loneliness.
Authors: Blakø Mitti , Christensen Anne Vinggaard , Højskov Ida Elisabeth , Palm Pernille , Bernild Camilla , Berg Selina Kikkenborg 
Published: October 2022

Abstract
Introduction: In patients treated for cardiac disease, loneliness is known to contribute negatively to health behavior, health outcome and increase risk of cardiac and all-cause mortality. Even so, in health care research, social support interventional studies targeting patients who experience loneliness is lacking.
Aim: To determine the feasibility of an individually structured social support intervention targeting patients treated for cardiac disease who experience loneliness.
Design: A feasibility study based on randomized clinical trial design with 1:1 randomization to a 6-month social support program, plus usual care (intervention) versus usual care, (i.e., regular guidelines-based follow-up). Intervention: Patients classified as high risk lonely according to the High Risk Loneliness tool will be provided with an informal caregiver in the six months rehabilitation phase following cardiac disease treatment. The informal caregiver will be designated by the patient from the existing social network or a peer, depending on patients’ preferences. The core content of the intervention is through nurse consultations at baseline, one, three and six months, to enhance and reinforce the informal caregiver’s competences to be a social support resource. The theoretical framework of the nurse consolations will be based on Middle-range theory of self-care.
Outcome: Feasibility will be evaluated in terms of acceptability and adherence according to predefined feasibility criteria. The preliminary effect of the intervention on patient-reported outcomes, health behaviors and health outcomes will be evaluated in the intervention and the control group at baseline, one, three, six and twelfth months.
Discussion: The present study will contribute with knowledge on how to implement a feasible social support intervention targeting patients treated for cardiac disease who experience loneliness and furthermore, investigate the preliminary effect on health behavior and health outcome in the early rehabilitation period.
Trial registration: The trial is registered on clinicaltrials.gov (NCT05503810) 18.08.2022.
Co-designing and Pilot Testing an Infographic to Support Patients/Families through the REMAP-CAP Consent Process: A Mixed Methods Study Protocol
Authors: O'Grady Heather K , Bhimani Zahra , Dalziel Sandra , Dolanjski Barbara , Sandhu Gyan , Santos Marlene , Smith Kathy , Murthy Srinivas , Marshall John C. , Kho Michelle E. 
Published: October 2022

Abstract
Background: Informed consent is critical to the ethical conduct of clinical research and requires understanding of a trial including its purpose, process, potential risks and benefits, and alternatives to participation. This can be challenging for complex trials, such as platform trials, and in high stress environments, such as the Intensive Care Unit (ICU). REMAP-CAP (Randomized, Embedded, Multifactorial, Adaptive Platform Trial for Community-Acquired Pneumonia) is a platform trial which studies treatments for ICU patients with community-acquired pneumonia, including COVID-19. Patient/Family Partners (PFP) identified challenges during the REMAP-CAP consent process.
Methods: This is a patient-centred co-design study to refine and test an infographic to supplement current REMAP-CAP consent documents. Infographic prototypes were developed by patients, families, and researchers with lived experience in the ICU or with ICU research. We will apply a two-phase exploratory sequential, mixed methods research design. In phase 1 we will conduct focus groups with ICU patients, substitute decision makers (SDMs) and research coordinators (RCs). We will use inductive content analysis to inform infographic refinement, to be pilot tested in phase 2. Phase 2 is a prospective study within a trial (SWAT) at < 5 REMAP-CAP sites. We will collect self-reported data from patients/SDMs and RCs. The primary outcome is feasibility (eligible consent encounters, receipt of infographic, consent to follow-up, completion of follow-up surveys). Data will be integrated to understand if/how quantitative results build upon the qualitatively informed infographic.
Discussion: Phase one results will be used to co-design an infographic, directly informed by the perspectives of patients, families and RCs involved in ICU research consent discussions. Results from phase two will determine the feasibility of infographic implementation in REMAP-CAP consent encounters. These feasibility data will inform a larger SWAT to evaluate our consent infographic. If successful, use of a co-designed infographic to support REMAP-CAP consent documents may improve the experience of consent for RCs, patients and their families.
Trial Registration: The Northern Ireland Hub for Trials Methodology Research
SWAT Repository (SWAT #176)
High accuracy epidermal growth factor receptor mutation prediction via histopathological deep learning
Authors: Zhao Dan , Zhao Yanli , He Sen , Liu Zichen , Li Kun , Zhang Lili , Wang Shuhao , Che Nanying , Jin Mulan 
Published: October 2022

Abstract
Background: The detection of epidermal growth factor receptor (EGFR) mutations in patients with non-small cell lung cancer is critical for tyrosine kinase inhibitors therapy. EGFR detection requires tissue samples, which are difficult to obtain for some patients, losing the opportunity for further treatment. To realize EGFR mutation prediction without molecular detection, we aim to build a high accuracy deep learning model with only hematoxylin-eosin-stained slides.
Methods: A total of 326 hematoxylin-eosin-stained non-small cell lung cancer slides were collected from Beijing Chest Hospital, China. After digitalized into whole slide images, 226 slides (88 with EGFR mutation) among them were fed to a convolutional neural network for model training. The remaining 100 images (50 with EGFR mutation) were used as the test set.
Results: The sensitivity and specificity of the model were 76% and 74%, respectively, with an area under the curve of 0.82. When applying the double threshold approach, the deep learning model could screen out 40% of the patients with a sensitivity and specificity of 96% and 94%, respectively. By further involving adenocarcinoma subtype information, 37.3% of the adenocarcinoma patients could be screened out with 100% sensitivity and specificity.
Conclusions: In this research, we show rapid and inexpensive pre-screening potentials of the deep learning-based EGFR mutation prediction model. It could not only act as a high-accuracy complement to current molecular detection techniques, but also provide opportunities for non-small cell lung cancer patients with limited sample to receive further treatment.
A 14-year-old girl with early-onset inclusion body myositis, systemic lupus erythematosus, Sjögren's syndrome, and autoimmune thyroiditis: a case report and literature review
Authors: Chen JingWen , Wang Xin-Yu , Li Shu-Yao , Zhang Ming-Ying , Guan Tong , Xu Qiang 
Published: October 2022

Abstract
Background: Sporadic inclusion body myositis is predominantly affecting the elderly population. It is insidious and easily misdiagnosed as other forms of neuromuscular and inflammatory myopathy. Patients may be treated with steroids and immunosuppressants for many years, leading to severe side effects. A correct diagnosis will also help avoid using high doses of steroids and immunosuppressants.
Case Presentation: We report a case of a 14-year-old girl diagnosed with sporadic inclusion body myositis, Sjögren's syndrome, systemic lupus erythematosus, and autoimmune thyroiditis. She was treated with steroids, intravenous immunoglobulin, and rituximab, which failed to relieve the progressive muscle weakness. Considering previous published cases, this case may be classified as a rare early onset form.
Conclusions: Our patient had a family history of autoimmune thyroiditis combined with various connective tissue diseases. The persistence of thyroid autoantibodies may have predicted the onset and diagnosis of sIBM. In this case report, overlapping immune diagnoses and unusually young age may be factors in misdiagnosis of sporadic inclusion body myositis. Early and more positive treatment should be a discussion of future research. We suggest that failed treatment may be related to the patient's muscle enzyme levels.
Sintilimab Plus Apatinib and Chemotherapy as Second‑/Third-Line Treatment for Advanced Gastric or Gastroesophageal Junction Adenocarcinoma: A Prospective, Single- Arm, Phase II Trial
Authors: Zhang Le , Wang Weixue , Ge Shaohua , Li Hongli , Bai Ming , Duan Jingjing , Yang Yuchong , Ning Tao , Liu Rui , Wang Xia , Ji Zhi , Wang Feixue , Zhang Haiyang , Ba Yi , Deng Ting 
Published: October 2022

Abstract
Background:The prognosis of patients with previously treated advanced gastric or gastroesophageal junction (GEJ) cancer remains poor. Given the robust development of immunotherapy and targeted therapy during the last decades, we aimed to investigate if the combination of traditional second-line chemotherapy with sintilimab and apatinib could bring survival benefits for these patients.
Methods: In this single-center, single-arm, phase Ⅱ trial, patients with previously treated advanced gastric or GEJ adenocarcinoma received specific dose level of intravenous paclitaxel or irinotecan (investigator’s choice), 200 mg intravenous sintilimab on day 1, and 250 mg oral apatinib once daily continuously in each cycle until disease progression, intolerable toxicity, or withdrawal of consent. The primary endpoints were objective response rate and progression-free survival. The secondary endpoints were mainly overall survival and safety.
Results: From May 2019 to May 2021, 30 patients were enrolled. At the data cutoff date (March 19, 2022), the median follow-up duration was 12.3 months and 53.6% (95% CI, 33.9%–72.5%) patients achieved objective response. The median progression-free survival and overall survival were 8.5 months (95% CI, 5.4–11.5) and 12.5 months (95% CI, 3.7–21.3), respectively. Grade 3-4 adverse events included hematological toxicities, elevated alanine aminotransferase, elevated aspartate aminotransferase, elevated alkaline phosphatase, elevated gamma-glutamyl transpeptidase, hyperbilirubinemia and proteinuria. The most frequent grade 3-4 adverse event was neutropenia (13.3%).No serious treatment-related adverse events or treatment-related deaths occurred.
Conclusions:Sintilimab plus apatinib and chemotherapy demonstrates promising anti-tumor activity with manageable safety profile in patients with previously treated advanced gastric or GEJ cancer.
Trial registration: ClinicalTrials.gov: NCT05025033, 27/08/2021.
Influence of Lower Extremity Impairment and Trunk Control on Postural Control and Functional Mobility in Children with Spastic Cerebral Palsy
Authors: Ozal Cemil , Aksoy Songul , Gunel Mintaze Kerem 
Published: October 2022

Abstract
Purpose
To determine influence of lower extremity impairment and trunk control on postural control and functional mobility in children with spastic Cerebral Palsy (CP).
Methods
25 children with between the ages of 6–17 were evaluated. Gross Motor Function Measure (GMFM) E Section, Modified Timed Up and Go Test (TUG), Trunk Impairment Scale (TIS), Computerized Dynamic Posturography, Sensory Organization Test (SOT) were applied; lower limb’s range of movement (ROM) of joints were evaluated passively to all participants. Spasticity levels of lower limbs were evaluated.
Results
In children with CP, there were significant relationship between spasticity, ROM and trunk control and motor function capacity and composite balance score (p < 0,05). Impairments of the lower extremity in children with CP were related with balance responses (p < 0,05). (p < 0,05). TUG, and composite balance score tests were correlated with all sub-dimensions of TIS (p < 0,05). the results of univariate and multivariate regression analyses and TIS total were found to be independent risk factor of TUG and GMFM-E according to the univariate analyses (ß=-0.77, B:0.353 standard error: 0.061, p < 0.01; ß=0.809, B:3.806 standard error: 0.578 p < 0.045 respectively). According to the multivariate regression analyses, TIS dynamic, SOM and VEST were found predictors of mTUG, and ROM, TIS dynamic and coordination, VIS were found predictors of GMFM-E (p < 0.05).
Conclusion
Lower limb impairment and trunk control plays important role on postural control and functional mobility, therefore it is important including these parameters into the physiotherapy and rehabilitation aiming to improve functional mobility.
First insight into accumulation of characteristics and tissues distribution of PCBs, PBDEs, and other BFRs in the living Indonesian coelacanth (Latimeria menadoensis)
Authors: Falahudin Dede , Hukom Frensly Demianus , Arifin Zainal , Dirhamsyah Dirhamsyah , Peristiwady Teguh , Sudaryanto Agus , Iwata Masamitsu , Hoang Anh Quoc , Watanabe Isao , Takahashi Shin 
Published: October 2022

Abstract
Persistent organic pollutants, including polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), and other brominated flame retardants, were determined in the liver, muscle, and ovary tissue of Indonesian coelacanth (Latimeria menadoensis) incidentally caught around Gangga Island, North Sulawesi Province, Indonesia on November 5, 2014. Concentrations of total PCBs (209 congeners, 300–2600 ng g− 1 lipid weight) in all tissues showed higher than those of PBDEs (9 congeners, 3.9–6.1 ng g− 1 lw) and BTBPE (1.1–3.6 ng g− 1 lw). Tissue-specific PCBs and PBDEs profiles are likely because of differences in the lipid composition. Toxic equivalent (TEQ) values of dioxin-like PCBs in the coelacanth tissues were lower than benchmark values for early life fish. However, compared with the data reported in deep-sea fishes in the Pacific and Indian Ocean, relatively high concentrations of PCBs detected in this study raise concerns about Indonesian coelacanth's conservation and habitat condition.
Chromatin accessibility differences between alpha, beta, and delta cells identifies common and cell type-specific enhancers
Authors: Mawla Alex M. , Meulen Talitha van der , Huising Mark O. 
Published: October 2022

Abstract
Background: High throughput sequencing has enabled the interrogation of the transcriptomic landscape of glucagon-secreting alpha cells, insulin-secreting beta cells, and somatostatin-secreting delta cells. These approaches have furthered our understanding of expression patterns that define healthy or diseased islet cell types and helped explicate some of the intricacies between major islet cell crosstalk and glucose regulation. All three endocrine cell types derive from a common pancreatic progenitor, yet alpha and beta cells have partially opposing functions, and delta cells modulate and control insulin and glucagon release. While gene expression signatures that define and maintain cellular identity have been widely explored, the underlying epigenetic components are incompletely characterized and understood. However, chromatin accessibility and remodeling is a dynamic attribute that plays a critical role to determine and maintain cellular identity.
Results: Here, we compare and contrast the chromatin landscape between mouse alpha, beta, and delta cells using ATAC-Seq to evaluate the significant differences in chromatin accessibility. The similarities and differences in chromatin accessibility between these related islet endocrine cells help define their fate in support of their distinct functional roles. We identify patterns that suggest that both alpha and delta cells are poised, but repressed, from becoming beta-like. We also identify patterns in differentially enriched chromatin that have transcription factor motifs preferentially associated with different regions of the genome. Finally, we not only confirm and visualize previously discovered common endocrine- and cell specific- enhancer regions across differentially enriched chromatin, but identify novel regions as well. We compiled our chromatin accessibility data in a freely accessible database of common endocrine- and cell specific-enhancer regions that can be navigated with minimal bioinformatics expertise.
Conclusions: Both alpha and delta cells appear poised, but repressed, from becoming beta cells in murine pancreatic islets. These data broadly support earlier findings on the plasticity in identity of non-beta cells under certain circumstances. Furthermore, differential chromatin accessibility shows preferentially enriched distal-intergenic regions in beta cells, when compared to either alpha or delta cells.
Lactation stage tweaks heamatological, serum biochemical, oxidative stress marker and endocrinological profiles in crossbred cows under tropical humid island ecosystem of Andaman and Nicobar Islands
Authors: Ponraj Perumal , De AK , Bhattacharya Debasis 
Published: October 2022

Abstract
The present study was outlined to appraise the interrelation between heamatological, blood metabolic profiles and lactation stages in crossbred (CB) dairy cows in ANI. Healthy (n = 18) CB cows with age of 5–7 years were selected from cattle breeding farm, ICAR-CIARI, Port Blair, ANI. Heamatological profiles, serum biochemical profiles, oxidative stress markers and endocrinological profiles were measured at 15-day interval from day 01 to 305 of lactation and divided into first (day 01 to 90), second (day 91 to 180) and third (day 181 to 305) stage of lactation. Average milk yield (L) was not significantly differed among the stages of lactations; however, first (8.42 ± 1.18) and second (9.67 ± 0.25) stages were had higher than third (7.82 ± 0.47) stage of lactation. Hematological profiles were not-differed significantly among the stages of lactation; however, these values were within the range of bovine species. Serum biochemical profiles such as glucose, triglyceride, total cholesterol, total protein and globulin were escalated significantly (p < 0.05) as stage of lactation advanced whereas albumin and creatinine were dwindled significantly (p < 0.05) as lactation stages progressed. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), calcium, phosphorous and magnesium were non-significantly differed among the stages of lactation. Similarly, serum endocrinological profiles such as Triiodo thyronine (T3), Thyroxine (T4) were surged and prolactin and cortisol were diminished significantly (p < 0.05) as stages of lactation progressed. Total antioxidant capacity (TAC) was increased and oxidative stress marker (malondialdehyde; MDA) was decreased significantly (p < 0.05) as stage progressed. It is concluded that among different stages of lactation, first and second stages are more stressful events as contrast to third stage of lactation in crossbred cattle in humid tropical island ecosystem of ANI.
The role of sodium fluorescein in pediatric supratentorial intra-axial tumor resection: new insights from a monocentric series of 33 consecutive patients
Authors: Falco Jacopo , Broggi Morgan , Schiariti Marco , Vetrano Ignazio Gaspare , Esposito Silvia , Ferroli Paolo , Acerbi Francesco 
Published: October 2022

Abstract
Surgical resection represents the mainstay of treatment, in pediatric central nervous system (CNS) tumors, and aggressive resection correlates with prognosis for several histotypes. Sodium fluorescein (SF), a green, water-soluble dye, is used as neurosurgical fluorescent tracer thanks to its property to accumulate in cerebral regions of blood-brain barrier disruption, acting as a valid tool to improve the extent of resection in tumors enhancing at preoperative MRI. Brain neoplasms represent a heterogeneous group of tumors in the pediatric age, constituting the most common solid cancers; they typically show a varying degree of contrast enhancement on MRI. In March 2016 the authors started a prospective, observational trial to evaluate intraoperative fluorescence’s characteristics of CNS tumors, the percentage of extent of resection thanks to fluorescein aid and side effects related to fluorescein administration. This report is based on a retrospective analysis of a group of 33 consecutive pediatric patients harboring a supratentorial lesion. In 17 of 33 (51.5%) procedures fluorescence was reported as intense, in 14 of 33 (42.4%) moderate and in 2 of 33 (6.1%) slight. Intraoperative fluorescence corresponds to preoperative MRI documented contrast enhancement. In 28 of 33 (84.8%) surgical procedures SF was considered useful, in 2 of 33 (6.1%) partial useful, and in 3 of 33 (9.1%) not essential because the tumor was already recognizable. No adverse effect to SF administration was registered. Fluorescein-guided surgery with a dedicated filter on the microscope is a safe and effective technique to improve visualization and resection of different pediatric brain tumors.
Heat-light soaking treatments for high-performance CIGS solar cells on flexible substrates
Authors: Carron Romain , Nishiwaki Shiro , Yang Shih-Chi , Ochoa Mario , Sun Xiaoxiao , Feurer Thomas , Tiwari Ayodhya 
Published: October 2022

Abstract
Cu(In,Ga)Se2 (CIGS) solar cells are sensitive to heat-light soaking (HLS) treatments performed at elevated temperatures. Such treatments often result in improved open-circuit voltage at the expense of short-circuit current and/or fill factor, and may be reversible. In this contribution, we analyze the changes brought in the devices by heat and light treatments to CIGS, to deliver hints regarding the fundamental reasons behind the observed changes and to ensure the long-term stability of the performance improvement. We apply HLS treatments to improve the performance of low-temperature grown CIGS solar cells on flexible polyimide and on glass substrates. We first investigate the treatment conditions favorable for device performances. A gain in open-circuit voltage is obtained, with no clear statistical impact on short-circuit current and fill factor. The changes are stable over periods of several months. Then we combine material analysis techniques to optoelectronic and electrical characterization on samples subject to a unique HLS treatment at the optimal conditions. The voltage gain arises from a large increase in the doping density in the absorber layer, correlated with increased concentrations of alkali elements Na and Rb. This improvement is partly offset by a reduction in minority charge carrier lifetime. The microscopic origin for the observed changes is discussed. At low temperatures, we also measure device enhancement due to the front interface behavior, however with unclear impact on standard operating conditions. The HLS treatment yielded a CIGS solar cell with certified record 21.4% power conversion efficiency on a flexible substrate.
Mild Course of COVID-19 infection in a patient with Rasmussen Encephalitis
Authors: Yıldız Sibel Öz , Günbey Ceren , Bilginer Burçak , Oguz Kader Karli , Gülhan Bora , Anlar Banu , Yalnızoğlu Dilek 
Published: October 2022

Abstract
Rasmussen encephalitis (RE) is a rare disease of unknown etiology that affects one hemisphere and causes refractory epilepsy, progressive neurological and cognitive dysfunction. A 17-year-old patient with RE underwent unilateral hemispheric surgery. Her seizures started at nine years old and she underwent left temporal lobectomy at 10 years old. She had been receiving intravenous immunoglobulin and tacrolimus in addition to antiseizure medications. Three weeks after hemispheric surgery, she had COVID-19 infection with mild symptoms. We suggest that light course of COVID-19 infection maybe due to exposure to long-term immunomodulatory treatment.