bluuebunny/crossref_metadata_2025_split huggingface dataset:
Randomized, Double-Blind, Placebo-Controlled Phase III Study of Paclitaxel ± Napabucasin in Pretreated Advanced Gastric or Gastroesophageal Junction Adenocarcinoma
Authors: Shah Manish A. , Shitara Kohei , Lordick Florian , Bang Yung-Jue , Tebbutt Niall C. , Metges Jean-Phillippe , Muro Kei , Lee Keun-Wook , Shen Lin , Tjulandin Sergei , Hays John L. , Starling Naureen , Xu Rui-Hua , Sturtz Keren , Fontaine Marilyn , Oh Cindy , Brooks Emily M. , Xu Bo , Li Wei , Li Chiang J. , Borodyansky Laura , Van Cutsem Eric 
Published: May 2022

AbstractPurpose:To compare napabucasin (generator of reactive oxygen species) plus paclitaxel with paclitaxel only in patients with second-line advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma.Patients and Methods:In the double-blind, phase III BRIGHTER study (NCT02178956), patients were randomized (1:1) to napabucasin (480 mg orally twice daily) plus paclitaxel (80 mg/m2 i.v. weekly for 3 of 4 weeks) or placebo plus paclitaxel. The primary endpoint was overall survival (OS). Secondary endpoints included progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and safety.Results:Overall, 714 patients were randomized (napabucasin plus paclitaxel, n = 357; placebo plus paclitaxel, n = 357). 72.1% were male, 74.6% had gastric adenocarcinoma, and 46.2% had peritoneal metastases. The study was unblinded following an interim analysis at 380 deaths. The final efficacy analysis was performed on 565 deaths (median follow-up, 6.8 months). No significant differences were observed between napabucasin plus paclitaxel and placebo plus paclitaxel for OS (6.93 vs. 7.36 months), PFS (3.55 vs. 3.68 months), ORR (16% vs. 18%), or DCR (55% vs. 58%). Grade ≥3 adverse events occurred in 69.5% and 59.7% of patients administered napabucasin plus paclitaxel and placebo plus paclitaxel, respectively, with grade ≥3 diarrhea reported in 16.2% and 1.4%, respectively.Conclusions:Adding napabucasin to paclitaxel did not improve survival in patients with pretreated advanced gastric or GEJ adenocarcinoma. Consistent with previous reports, the safety profile of napabucasin was driven by manageable gastrointestinal events; grade ≥3 diarrhea occurred at a higher frequency with napabucasin plus paclitaxel versus placebo plus paclitaxel.
Nectar robbing by sunbirds on the flowers of Morinda pubescens J.E. Smith (Rubiaceae)
Authors: A.J. Solomon Raju  , S. Sravan Kumar  , G. Nagaraju  , C. Venkateswara Reddy  , Tebese Peter Raliengoane  , L. Kala Grace  , K. Punny  , K. Prathyusha  , P. Srikanth  
Published: May 2022

Morinda pubescens is a dry season blooming tree species. The flowers are hermaphroditic distylous, fragrant and nectariferous. Thrips use floral buds for breeding and flowers for food. Sunbirds, Nectarinia asiatica and N. zeylonica pick up thrips from the flowers by probing the flowers legitimately and collect nectar illegitimately by making a puncture/slit at the base of the corolla tube from outside. The illegitimate nectar robbing by sunbirds on the flowers of M. pubescens relates to primary robbing. The study indicates that M. pubescens flowers are an important source of thrips as insect food and nectar as instant drink for sunbirds during dry season in the deciduous forest ecosystem.
Assessment and comparison of image quality between two real-time sequences for dynamic MRI of distal joints at 3.0 Tesla
Authors: Garetier Marc , Rousset Jean , Makki Karim , Brochard Sylvain , Rousseau François , Ben Salem Douraïed , Borotikar Bhushan 
Published: May 2022

Background Real-time sequences allow functional evaluation of various joint structures during a continuous motion and help understand the pathomechanics of underlying musculoskeletal diseases. Purpose To assess and compare the image quality of the two most frequently used real-time sequences for joint dynamic magnetic resonance imaging (MRI), acquired during finger and ankle joint motion. Material and Methods A real-time dynamic acquisition protocol, including radiofrequency (RF)-spoiled and balanced steady-state free precession (bSSFP) sequences, optimized for temporal resolution with similar spatial resolution, was performed using a 3.0-T MRI scanner on 10 fingers and 12 ankles from healthy individuals during active motion. Image quality criteria were evaluated on each time frame and compared between these two sequences. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were determined and compared from regions of interest placed on cortical bone, tendon, fat, and muscle. Visualization of anatomical structures and overall image quality appreciation were rated by two radiologists using a 0–10 grading scale. Results Mean CNR was significantly higher with bSSFP sequence compared to RF-spoiled sequence. The grading score was in the range of 5–9.3 and was significantly higher with RF-spoiled sequence for bone and joint evaluation and overall image appreciation on the two joints. The standard deviation for SNR, CNR, and grading score during motion was smaller with RF-spoiled sequence for both the joints. The inter-reader reliability was excellent (>0.75) for evaluating anatomical structures in both sequences. Conclusion A RF-spoiled real-time sequence is recommended for the in vivo clinical evaluation of distal joints on a 3.0-T MRI scanner.
Daily dynamics of grandiose narcissism: distribution, stability, and trait relations of admiration and rivalry states and state contingencies
Authors: Mota S , Mielke I , Kroencke L , Geukes K , Nestler S , Back MD 
Published: May 2022

On the basis of the Narcissistic Admiration and Rivalry Concept and recent theories on narcissistic pursuit of status, we provide a differentiated analysis of individual differences in the within-person dynamics of grandiose narcissism. In two daily diary studies (Sample 1: 56 days; Sample 2: 82 days; total participants: N = 198; total observations: N = 12,404), we investigated the degree, stability, and trait correlates of individual differences in average narcissism-relevant states (perceived status success, perceived admiration and rejection, positive and negative affect, and assertive and hostile behavior) as well as individual differences in within-person contingencies between these states. The results indicated substantial and stable between-person differences in averaged states that were related to their corresponding narcissism trait self-reports. State contingencies showed substantial strength, significant interindividual differences, and stability across the 56 and 82 days, respectively. We only found weak support for associations between state contingencies and trait narcissism self-reports. These findings support a differentiated approach to the conceptualization and assessment of grandiose state narcissism and call for even more comprehensive and fine-grained investigations.
Plasma Kynurenine: A Promising Marker for the Assessment of Renal Functions
Authors: Brekdar Fatimah , Khayat Muhammed Imad , Zrieki Afraa 
Published: May 2022

Background: Chronic kidney disease (CKD) is a worldwide issue due to the high prevalence and the serious complications, including death. Kidney functions are routinely evaluated by measuring creatinine levels, which are influenced by many factors (age, sex, diet, race, and body mass). Kynurenine is the first stable metabolite in the kynurenine pathway, which is activated in the course of CKD. Kynurenine levels in plasma can be correlated to kidney functions in CKD patients. We investigated the relationship between kynurenine levels and kidney functions indicators, and the influence of some variables (sex, age, and preexisting hypertension or diabetes) on its levels in CKD patients. Material And Methods: The study included 66 CKD patients in stages 3 to 5 seen at Tishreen University Hospital, and 22 subjects served as control. Kynurenine levels were measured by using a kynurenine ELISA kit (IDK® immundiagnostik). Results: Kynurenine levels were significantly increased with the increase in CKD stage ( P < .001), and were correlated with eGFR ( r = −.631, P < .001), creatinine levels ( r = −.464, P < .001), and urea levels ( r = .528, P < .001). Kynurenine plasma levels were not influenced by age, sex, diabetes, and hypertension in CKD patients. Conclusion: Kynurenine is a promising marker for estimating kidney functions, and its relation with kidney functions is not affected by age, sex, and presence of hypertension or diabetes in CKD patients.
Efficacy of bortezomib in reduction of systemic lupus erythematosus disease activity index score: A meta-analysis
Authors: He Huan , Luo Man , Xiong Jin-He 
Published: May 2022

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterised by the production of auto-antibodies against nuclear and cytoplasmic antigens, which can affect multiple organs. To date, no meta-analysis has reported the efficacy of bortezomib in SLE. We performed a meta-analysis to investigate the efficacy of bortezomib in patients with SLE. Methods: We searched the PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Chinese BioMedical databases for articles published before 18 August 2021 to identify all studies relevant to SLE. The following were our inclusion criteria: (1) written in all languages, (2) bortezomib administration in patients with SLE and, (3) a clear description of SLE Disease Activity Index (SLEDAI) scores. Following were the exclusion criteria: (1) duplicate publications (the most recent article was included for analysis)and, (2) animal experiments, case reports, meeting reports, and reviews. The pooled data were analysed using a fixed- or random-effects model, depending on heterogeneity (determined using the I2 index). Results: Three articles that described 29 patients were included in this study. The forest plot showed a positive association between bortezomib therapy and SLE based on analysis of SLEDAI scores, with an odds ratio of 11.30 (95% confidence interval 7.03–15.56, p < .00001). Conclusion: Bortezomib treatment can reduce the SLEDAI scores in patients with SLE, which suggests the usefulness of this therapeutic approach for SLE.
Accuracy and reliability of a wireless vital signs monitor for hospitalized patients in a low-resource setting
Authors: Nantume Assumpta , Kiwanuka Noah , Muyinda Asad , Cauvel Teresa , Shah Sona 
Published: May 2022

Objective The purpose of this study was to evaluate the accuracy and reliability of neoGuard in comparison to a conventional bedside monitor on patients in a low-resource clinical setting. Design This was a single-arm methods comparison study involving the use of a wearable vital signs monitor (neoGuardTM) versus a conventional bedside monitor (Edan iM8). Setting The study was conducted at Jinja Regional Referral Hospital, a tertiary care hospital situated in Eastern Uganda. Participants Thirty patients (10 male, 20 female) were enrolled from the adult recovery ward at JRRH. Participants were eligible for the study if they were at least 18 years of age, had 2 sets of normal vital sign measurements obtained 1 h apart, and were able and willing to provide informed consent. Main Outcome and Measures The primary outcome measures were (i) bias (mean deviation) and (ii) limits of agreement [95% CI]. Bland-Altman plots were generated to illustrate the level of agreement between the neoGuardTM technology and the Edan iM8 monitor. Results Bland-Altman analysis was performed for 24 participants; datasets from six participants were excluded due to missing or invalid measurements. Findings showed a moderate level of agreement for measurement of SpO2, PR, and RR, with >80% of subject means falling within the predefined acceptability limits. However, there was also notable variation in accuracy between subjects, with large standard deviations observed for measurement of all four parameters. While the level of agreement for measurement of temperature was low, this is partly explained by limitations in the comparison method.
Prediction of Survival Prognosis for Spinal Metastasis From Cancer of Unknown Primary: Derivation and Validation of a Nomogram Model
Authors: Yang Minglei , Ma Xiaoyu , Wang Pengru , Yang Jiaxiang , Zhong Nanzhe , Liu Yujie , Shen Jun , Wan Wei , Jiao Jian , Xu Wei , Xiao Jianru 
Published: May 2022

Study Design Retrospective and prospective cohort study. Objectives Survival estimation is necessary in the decision-making process for treatment in patients with spinal metastasis from cancer of unknown primary (SMCUP). We aimed to develop a novel survival prediction system and compare its accuracy with that of existing survival models. Methods A retrospective derivation cohort of 268 patients and a prospective validation cohort of 105 patients with SMCUP were performed. Univariate and multivariable survival analysis were used to generate independently prognostic variables. A nomogram model for survival prediction was established by integrating these independent predictors based on the size of the significant variables’ β regression coefficient. Then, the model was subjected to bootstrap validation with calibration curves and concordance index (C-index). Finally, predictive accuracy was compared with Tomita, revised Tokuhashi and SORG score by the receiver-operating characteristic (ROC) curve. Results The survival prediction model included six independent prognostic factors, including pathology ( P < .001), visceral metastases ( P < .001), Frankel score ( P < .001), weight loss ( P = .005), hemoglobin ( P = .001) and serum tumor markers ( P < .001). Calibration curve of the model showed good agreement between predicted and actual mortality risk in 6-, 12-, and 24-month estimation in derivation and validation cohorts. The C-index was .775 in the derivation cohort and .771 in the validation cohort. ROC curve analysis showed that the current model had the best accuracy for SMCUP survival estimation amongst 4 models. Conclusions The novel nomogram system can be applied in survival prediction for SMCUP patients, and furtherly be used to give individualized therapeutic suggestions based on patients’ prognosis.
A real-world study of combined modality therapy for early-stage Hodgkin lymphoma: too little treatment impacts outcome
Authors: Chohan Karan L. , Young Jason R. , Lester Scott , Alhaj Moustafa Muhamad , Rosenthal Allison , Tun Han W. , Hoppe Bradford S. , Johnston Patrick B. , Micallef Ivana N. , Habermann Thomas M. , Ansell Stephen M. 
Published: May 2022

Abstract
Multiple clinical trials have assessed de-escalation strategies from combined modality therapy (CMT) to chemotherapy-alone for the treatment of early-stage classical Hodgkin lymphoma (cHL), confirming similar outcomes. The application of these data to the real-world is limited, however. We conducted a retrospective, multicenter cohort study comparing CMT vs chemotherapy-alone in patients with early-stage cHL (stage IA-IIB) treated between January 2010 and December 2020. Positron emission tomography (PET) scans after chemotherapy cycle 2 (PET2) were independently reviewed by a nuclear radiologist (Deauville score ≥4, positive; ≤3, negative). Patient outcomes were compared by using an intention-to-treat analysis. Among 125 patients (CMT, n = 63; chemotherapy-alone, n = 62) with a median follow-up of 59.8 months (95% CI, 48.6-71.0), no differences in overall survival were observed (5-year overall survival, CMT 98.0% vs chemotherapy-alone 95.1%; log-rank test, P = .38). However, there was reduced progression-free survival (PFS) with chemotherapy-alone among all patients (2-year PFS, CMT 95.1% vs chemotherapy-alone 75.3%; log-rank test, P = .005) and in those with bulky (n = 43; log-rank test, P &lt; .001), unfavorable (n = 81; log-rank test, P = .002), or PET2-positive (n = 15; log-rank test, P = .02) disease. No significant differences in PFS were seen for patients with non-bulky (log-rank test, P = .35), favorable (log-rank test, P = .62), or PET2-negative (log-rank test, P = .19) disease. Based on our real-world experience, CMT seems beneficial for patients with early-stage cHL, especially those with PET2-positive and unfavorable disease. Chemotherapy-alone regimens can lead to comparable outcomes for patients with favorable, non-bulky, or PET2-negative disease. We conclude that although results seen in clinical trials are replicated in certain patient subgroups, other subgroups not fitting trial criteria do poorly when radiotherapy is excluded.
Real-life omalizumab exposure and discontinuation in a large nationwide population-based study of paediatric and adult asthma patients
Authors: Humbert Marc , Bourdin Arnaud , Taillé Camille , Kamar Driss , Thonnelier Céline , Lajoinie Audrey , Rigault Alexandre , Deschildre Antoine , Molimard Mathieu 
Published: May 2022

BackgroundThis real-life study aimed to assess omalizumab treatment patterns in adult and paediatric asthma patients, and to describe asthma control and healthcare resource use (HCRU) at omalizumab initiation and discontinuation.MethodsThe French healthcare database system (Système National des Données de Santé (SNDS)) was used to identify asthma patients aged ≥6 years who initiated omalizumab for at least 16 weeks from 2009 to 2019. We examined omalizumab treatment patterns using dispensation records.ResultsWe identified 16 750 adults and 2453 children initiating omalizumab. Median treatment persistence before discontinuation (TSTOP) was 51.2 (95% CI 49.3–53.4) months in adults and 53.7 (95% CI 50.6–56.4) months in children. At 2 years of omalizumab exposure, rate of hospitalisation for asthma decreased by 75% and use of oral corticosteroids (OCS) by 30%, in adults and children. Among adults who discontinued omalizumab while asthma was controlled, 70%, 39% and 24% remained controlled and did not resume omalizumab at 1, 2 and 3 years after discontinuation, respectively. These proportions were higher in children (76%, 44% and 33%, respectively). Over 2 years of follow-up after discontinuation, HCRU remained stable in adults and children, notably rate of hospitalisations for asthma (none before TSTOP, 1.3% and 0.6% at 2 years) and use of OCS (in adults and children, respectively: 20.0% and 20.2% before TSTOP, 33.3% and 24.6% at 2 years).ConclusionThis is the first large-scale study describing omalizumab real-life exposure patterns in adult and paediatric asthma patients in France with >10 years of follow-up. We showed the long-term maintenance of low HCRU in adults and children who discontinued omalizumab while asthma was controlled, notably for OCS use and hospitalisations for asthma.
Clinical and electrocardiogram presentations of patients with high serum potassium concentrations within emergency settings: a prospective study
Authors: Raffee Liqaa A. , Alawneh Khaled Z. , Ababneh Muhannad J. , Hijazi Heba H. , Al abdi Rabah M. , Aboozour Mahmoud M. , Alghzawi Fadi A. , Al-Mistarehi Abdel-Hameed 
Published: May 2022

Abstract
Background
Elevated potassium level is a common and reversible peri-arrest condition. Diagnosis and management of hyperkalemia in a short time is critical, where electrocardiogram (ECG) alterations might be helpful. We aimed to investigate the role of clinical features and ECGs in early diagnosing and treating hyperkalemia.

Methods
Prospectively, adult patients who presented to the emergency department (ED) from July 2019 to March 2020 with hyperkalemia (serum potassium ≥5.5mmol/L) were included. History was obtained, and laboratory investigations and ECGs were performed at the presentation and before initiating hyperkalemia therapy. Hyperkalemia severity was divided into mild (5.5–5.9mmol/L), moderate (6.0–6.4mmol/L), and severe (≥6.5mmol/L). A cardiologist and emergency physician blinded to laboratory values, study design, and patients’ diagnoses interpreted ECGs and presenting symptoms independently to predict hyperkalemia.

Results
Sixty-seven hyperkalemic patients with a mean (±SD) serum potassium level of 6.5±0.7mmol/L were included in this study. The mean age was 63.9±15.1, and 58.2% were females. Hyperkalemia was mild in 10.4%, moderate in 40.3%, and severe in 49.3%. Almost two thirds of patients (71.6%) had hypertension, 67.2% diabetes, and 64.2% chronic kidney disease. About one-quarter of patients (22.4%) were asymptomatic, while fatigue (46.3%), dyspnea (28.4%), and nausea/vomiting (20.9%) were the most common presenting symptoms. Normal ECGs were observed in 25.4% of patients, while alterations in 74.6%. Atrial fibrillation (13.4%), peaked T wave (11.9%), widened QRS (11.9%), prolonged PR interval (10.5%), and flattening P wave (10.5%) were the most common. Peaked T wave was significantly more common in severe hyperkalemia (87.5%) than in mild and moderate hyperkalemia (12.5%, 0.0%, respectively) (p=0.041). The physicians’ sensitivities for predicting hyperkalemia were 35.8% and 28.4%, improved to 51.5% and 42.4%, respectively, when limiting the analyses to severe hyperkalemia. The mean (±SD) time to initial hyperkalemia treatment was 63.8±31.5 min. Potassium levels were positively correlated with PR interval (r=0.283, p=0.038), QRS duration (r=0.361, p=0.003), peaked T wave (r=0.242, p=0.041), and serum levels of creatinine (r=0.347, p=0.004), BUN (r=0.312, p=0.008), and CK (r=0.373, p=0.039).

Conclusions
The physicians’ abilities to predict hyperkalemia based on ECG and symptoms were poor. ECG could not be solely relied on, and serum potassium tests should be conducted for accurate diagnosis.
Early life vitamin D depletion and mechanical loading determine methylation changes in the RUNX2, RXRA, and osterix promoters in mice
Authors: Krstic Nevena , Bishop Nick , Curtis Beth , Cooper Cyrus , Harvey Nick , Lilycrop Karen , Murray Robert , Owen Robert , Reilly Gwen , Skerry Tim , Borg Steph 
Published: May 2022

Abstract
Background
Early life vitamin D exposure is linked to later skeletal health with maternal vitamin D status in pregnancy associated with neonatal bone mass. The MAVIDOS study has demonstrated that vitamin D supplementation leads to reduced RXRA DNA methylation. Mice exposed to early life vitamin D deficiency have reduced bone mass and bone accrual in response to mechanical loading. Using the tibiae of these mice, we have examined the effect of diet and mechanical loading on the DNA methylation of promoters of genetic loci important for bone growth and development and their association with bone strength.

Results
Mechanical loading of mouse tibiae leads to a reduction of RXRA DNA methylation. Early life vitamin D deficiency is associated with altered methylation of osterix and Runx2 in these bones. Tibia strength was also demonstrated to be associated with a change in DNA methylation status in CpGs of the vitamin D receptor (VDR), ostrix, and RXRA genes.

Conclusions
We have shown for the first time that mechanical loading of bone and early life vitamin D deficiency leads to changes in the epigenome of this tissue in key genes in the vitamin D and osteoblast differentiation pathway.