bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perspectives on applying immuno-autonomics to rheumatoid arthritis: results from an online rheumatologist survey
Authors: Pappas Dimitrios A. , Brittle Christine , Concoff Andrew , Holman Andrew J. , Takasugi Dennis , Kremer Joel M. 
Published: April 2022

AbstractThe term “immuno-autonomics” has been coined to describe an emerging field evaluating the interaction between stress, autonomic nervous system (ANS), and inflammation. The field remains largely unknown among practicing rheumatologists. Our objective was to evaluate the perspectives of rheumatologists regarding the role of stress in the activity and management of rheumatoid arthritis (RA). A 31-item survey was conducted with 231 rheumatologists. Rheumatologists were asked to assess the role of stress in rheumatoid arthritis (RA) disease activity and were provided with information regarding immuno-autonomics. They were asked to consider how immuno-autonomics resonated with their patient management needs. The majority of rheumatologists are eager to better understand non-response, believe that stress biology and ANS dysfunction interfere with disease activity, and embrace the theory that measurement of ANS via next-generation HRV may be able to evaluate autonomic dysfunction and the biology of stress. Rheumatologists are open to the idea that quantitative measurement of ANS function using next-generation HRV can be a helpful tool to RA practice. The majority agree that ANS state influences RA disease control and that quantitative measures of ANS state are helpful to RA practice. Rheumatologists also agree that patients with poor ANS function may be at risk for not responding adequately to conventional, biologic, or targeted synthetic DMARDs. Almost all would use an in-office test to quantitatively measure ANS using next-generation HRV. This study shows that rheumatologists are open to embracing evaluation of ANS function as a possible tool in the management and treatment of RA.
Detection of perineural invasion in prostate needle biopsies with deep neural networks
Authors: Kartasalo Kimmo , Ström Peter , Ruusuvuori Pekka , Samaratunga Hemamali , Delahunt Brett , Tsuzuki Toyonori , Eklund Martin , Egevad Lars 
Published: April 2022

AbstractThe presence of perineural invasion (PNI) by carcinoma in prostate biopsies has been shown to be associated with poor prognosis. The assessment and quantification of PNI are, however, labor intensive. To aid pathologists in this task, we developed an artificial intelligence (AI) algorithm based on deep neural networks. We collected, digitized, and pixel-wise annotated the PNI findings in each of the approximately 80,000 biopsy cores from the 7406 men who underwent biopsy in a screening trial between 2012 and 2014. In total, 485 biopsy cores showed PNI. We also digitized more than 10% (n = 8318) of the PNI negative biopsy cores. Digitized biopsies from a random selection of 80% of the men were used to build the AI algorithm, while 20% were used to evaluate its performance. For detecting PNI in prostate biopsy cores, the AI had an estimated area under the receiver operating characteristics curve of 0.98 (95% CI 0.97–0.99) based on 106 PNI positive cores and 1652 PNI negative cores in the independent test set. For a pre-specified operating point, this translates to sensitivity of 0.87 and specificity of 0.97. The corresponding positive and negative predictive values were 0.67 and 0.99, respectively. The concordance of the AI with pathologists, measured by mean pairwise Cohen’s kappa (0.74), was comparable to inter-pathologist concordance (0.68 to 0.75). The proposed algorithm detects PNI in prostate biopsies with acceptable performance. This could aid pathologists by reducing the number of biopsies that need to be assessed for PNI and by highlighting regions of diagnostic interest.
Healthcare Resource Utilization After Surgical Treatment of Cancer: Value of Minimally Invasive Surgery
Authors: Ricciardi Rocco , Goldstone Robert Neil , Francone Todd , Wszolek Matthew , Auchincloss Hugh , de Groot Alexander , Shih I.-Fan , Li Yanli 
Published: April 2022

Abstract
Background
As the US healthcare system moves towards value-based care, hospitals have increased efforts to improve quality and reduce unnecessary resource use. Surgery is one of the most resource-intensive areas of healthcare and we aim to compare health resource utilization between open and minimally invasive cancer procedures.

Methods
We retrospectively analyzed cancer patients who underwent colon resection, rectal resection, lobectomy, or radical nephrectomy within the Premier hospital database between 2014 and 2019. Study outcomes included length of stay (LOS), discharge status, reoperation, and 30-day readmission. The open surgical approach was compared to minimally invasive approach (MIS), with subgroup analysis of laparoscopic/video-assisted thoracoscopic surgery (LAP/VATS) and robotic (RS) approaches, using inverse probability of treatment weighting.

Results
MIS patients had shorter LOS compared to open approach: − 1.87 days for lobectomy, − 1.34 days for colon resection, − 0.47 days for rectal resection, and − 1.21 days for radical nephrectomy (all p < .001). All MIS procedures except for rectal resection are associated with higher discharge to home rates and lower reoperation and readmission rates. Within MIS, robotic approach was further associated with shorter LOS than LAP/VATS: − 0.13 days for lobectomy, − 0.28 days for colon resection, − 0.67 days for rectal resection, and − 0.33 days for radical nephrectomy (all p < .05) and with equivalent readmission rates.

Conclusion
Our data demonstrate a significant shorter LOS, higher discharge to home rate, and lower rates of reoperation and readmission for MIS as compared to open procedures in patients with lung, kidney, and colorectal cancer. Patients who underwent robotic procedures had further reductions in LOS compare to laparoscopic/video-assisted thoracoscopic approach, while the reductions in LOS did not lead to increased rates of readmission.
Olanzapine (5 mg) plus standard triple antiemetic therapy for the prevention of multiple-day cisplatin hemotherapy-induced nausea and vomiting: a prospective randomized controlled study
Authors: Gao Jiali , Zhao Jun , Jiang Caihong , Chen Feng , Zhao Lanzhen , Jiang Ying , Li Hui , Wang Wenjuan , Wu Yungaowa , Jin Yilan , Da Lenggaowa , Liu Guang , Zhang Yajuan , Li Hongxia , Zhang Zewei , Jin Gaowa , Li Quanfu 
Published: April 2022

Abstract

Objective
A prospective randomized controlled trial was conducted to compare 5 mg olanzapine plus standard triple antiemetic therapy for the prevention of nausea and vomiting induced by multiple-day cisplatin chemotherapy.

Methods

Patients who received a 3-day cisplatin-based chemotherapy (25 mg/m2/d) were given either 5 mg olanzapine plus triple therapy with aprepitant, tropisetron, and dexamethasone (quadruple group) or 5 mg olanzapine plus tropisetron and dexamethasone, omitting aprepitant (triplet group). The primary endpoint was the complete response (CR) in the overall phase (OP) (0–120 h) between quadruple group and triplet group. The secondary endpoints were the CR in the acute phase (AP) (0–24 h) and delayed phase (DP) (25–120 h) between two groups. The first time of vomiting was also compared by Kaplan–Meier curves. The impact of chemotherapy-induced nausea and vomiting (CINV) on the quality of life was assessed by the Functional Living Index-Emesis (FLIE). Aprepitant-related adverse effects (AEs) were also recorded.

Results
(1) The primary endpoint CR during OP was 76.0% (45/59) vs 67.0% (41/61) between the quadruple group and triplet group (P = 0.271). The secondary endpoint CR during the AP was significantly higher in the quadruple group than in the triplet group, which was 100.0% (59/59) vs 93.0% (57/61) (P = 0.045). The difference of CR during delayed phase between the groups was especially higher in the quadruple group compared to the triplet group (76.0% (45/59) vs 67.0% (41/61) (P = 0.271)). The rate of patients who achieved total protection in the overall phase was also higher in the quadruple group than the triplet group (28.8% (17/59) vs 23.0% (14/61) (P = 0.463)). During the OP, the incidence of no vomiting in the quadruple group and the triplet group was 93.2% (55/59) vs 80.3% (49/61) (P = 0.038), respectively. (2) Kaplan–Meier curves of time to first emesis were obviously longer in the quadruple group compared with the triplet group (P = 0.031). According to FLIE, no impact of CINV on daily life was defined as total score of questionnaire > 108; this study exhibited identical life quality between two groups. (3) The most common aprepitant- or olanzapine-related AEs included sedation, fatigue, and constipation. The occurrences between two groups were identical.

Conclusion

It may been recommended that 5 mg olanzapine plus tropisetron and dexamethasone, omitting aprepitant triplet regimen as an alternative therapy in prevention CINV induced by multiple-day cisplatin chemotherapy due to the excellent CINV control rate and safety.
Expression of decitabine-targeted oncogenes in meningiomas in vivo
Authors: Canisius Julian , Wagner Andrea , Bunk Eva Christina , Spille Dorothee Cäcilia , Stögbauer Louise , Grauer Oliver , Hess Katharina , Thomas Christian , Paulus Werner , Stummer Walter , Senner Volker , Brokinkel Benjamin 
Published: April 2022

Abstract
Treatment of meningiomas refractory to surgery and irradiation is challenging and effective chemotherapies are still lacking. Recently, in vitro analyses revealed decitabine (DCT, 5-aza-2’–deoxycytidine) to be effective in high-grade meningiomas and, moreover, to induce hypomethylation of distinct oncogenes only sparsely described in meningiomas in vivo yet.Expression of the corresponding onco- and tumor suppressor genes TRIM58, FAM84B, ELOVL2, MAL2, LMO3, and DIO3 were analyzed and scored by immunohistochemical staining and RT-PCR in samples of 111 meningioma patients. Correlations with clinical and histological variables and prognosis were analyzed in uni- and multivariate analyses.All analyzed oncogenes were highly expressed in meningiomas. Expression scores of TRIM58 tended to be higher in benign than in high-grade tumors 20 vs 16 (p = .002) and all 9 samples lacking TRIM58 expression displayed WHO grade II/III histology. In contrast, median expression scores for both FAM84B (6 vs 4, p ≤ .001) and ELOVL2 (9 vs 6, p < .001) were increased in high-grade as compared to benign meningiomas. DIO3 expression was distinctly higher in all analyzed samples as compared to the reference decitabine-resistant Ben-Men 1 cell line. Increased ELOVL2 expression (score ≥ 8) correlated with tumor relapse in both uni- (HR: 2.42, 95%CI 1.18–4.94; p = .015) and multivariate (HR: 2.09, 95%CI 1.01–4.44; p = .046) analyses.All oncogenes involved in DCT efficacy in vitro are also widely expressed in vivo, and expression is partially associated with histology and prognosis. These results strongly encourage further analyses of DCT efficiency in meningiomas in vitro and in situ.
Skin regeneration, repair, and reconstruction: present and future
Authors: Kamolz Lars-Peter , Kotzbeck Petra , Schintler Michael , Spendel Stephan 
Published: April 2022

Summary
Background
Large skin defects caused by trauma (e.g., burns) or due to other reasons (e.g., tumor-related skin resections) require sufficient skin replacement. The constant improvement of innovative methods of skin replacement and skin expansion mean that even burn victims with more than 80% body surface burned have a realistic chance of survival. Due to these new developments, not only has survival rate increased, but also quality of life has increased tremendously over the past decades.

Methods
The aim of this review is to present an overview of current standards and future trends concerning the treatment of skin defects. The main focus is placed on the most important technologies and future trends.

Results
Autologous skin grafting was developed more than 3500 years ago. Several approaches and techniques have been discovered and established in burn care and plastic surgery since then. Great achievements were made during the 19th and 20th centuries. Many of these old and new techniques are still part of modern burn and plastic surgery. Today, autologous skin grafting is still considered to be the gold standard for many wounds, but new technologies have been developed, ranging from biological to synthetic skin replacement materials.

Conclusion
Today, old and new technologies are available which allow us new treatment concepts. All this has led to the reconstructive clockwork for reconstructive surgery of the 21st century.
Physical activity time and lifestyle correlates of cardiovascular disease status in older adults in Accra
Authors: Asiamah Nestor , Kouveliotis Kyriakos , Petersen Carl , Eduafo Richard , Borkey Richard 
Published: April 2022

Abstract
Aim
The maintenance of physical activity (PA) over the life course is considered a hallmark for ageing well, but individuals who practice PA also often pursue lifestyles (e.g., smoking) that may inhibit the medicinal impact of PA on them. PA is said to protect against cardiovascular diseases (CVDs), but the literature has little to say about the impact of PA on the risk of CVDs when it is associated with lifestyle factors, comorbidities, and personal characteristics. This study aimed to assess the association between PA time and CVDs, with relevant lifestyle factors, comorbidities, and personal characteristics treated as covariates.

Subject and methods
The study’s population was retired and working older people aged 60 years or more in Accra, Ghana. A total of 686 individuals responded to self-reported questionnaires. Pearson’s chi-square test and binary logistic regression were used to present findings.

Results
The study found that the risk of having one or more CVDs increases as time spent in moderate and vigorous PA increases, whereas individuals who drank alcohol a few days a week or most days a week are respectively 2 (OR = 2.415; p = 0.037) and 22 (OR = 21.933; p = 0.000) times more likely to have one or more CVDs compared to those who never drank alcohol.

Conclusion
Health education should not only encourage PA maintenance but should also make individuals aware of the need to avoid unhealthy behaviours to maximize the positive effect of PA on health.
A Systematic Review of Factors Critical for HIV Health Literacy, ART Adherence and Retention in Care in the U.S. for Racial and Ethnic Minorities
Authors: Mgbako Ofole , Conard Ryan , Mellins Claude A. , Dacus Jagadisa-devasri , Remien Robert H. 
Published: April 2022

AbstractDespite advances in antiretroviral treatment (ART), the HIV epidemic persists in the United States (U.S.), with inadequate adherence to treatment and care a major barrier to ending the epidemic. Health literacy is a critical factor in maximizing ART adherence and healthcare utilization, especially among vulnerable populations, including racial and ethnic minorities. This U.S-based systematic review examines psychosocial variables influencing health literacy among persons with HIV (PWH), with a focus on racial and ethnic minorities. Although findings are limited, some studies showed that HIV-related stigma, self-efficacy, and patient trust in providers mediate the relationship between health literacy and both ART adherence and HIV care retention. To inform effective, equitable health literacy interventions to promote adherence to HIV treatment and care, further research is needed to understand the factors driving the relationship between health literacy and HIV outcomes. Such work may broaden our understanding of health literacy in the context of racial equity.
Driving through dense fog: a study of the effects and control of sustainable public procurement of electric cars
Authors: Langseth Marius , Moe Helene Tronstad 
Published: April 2022

AbstractGovernments are large buyers of vehicles, thus contributing to pollution. To promote sustainability, policies have been shaped to replace government-owned fossil fuel cars with electric cars. Public procurement is seen as a strategic tool for the government to transition. This study identifies a research gap due to a lack of studies on how stakeholders at different levels identify and calculate the sustainability effects of public procurement of cars. Our approach uses a multilevel perspective to explore how various stakeholders perceive and assess the effects of sustainable public procurement. The data were obtained through a qualitative research design with documents and semi-structured interviews with stakeholders in Norway ranging from government agencies, public procurement officers, car suppliers, and end-users. (End-users in this setting are the ones who ultimately use the vehicles). The study’s findings are two-fold. First, it contributes to understanding that perceived effects of sustainable public procurement vary from the stakeholders' perspectives and that public procurement initiatives perceive to have cultural effects in addition to innovation, environmental, economic, and social impacts. Second, it contributes to understanding the importance of feedback mechanisms in public procurement to align the assessment of the effects. A better understanding of how effects are identified, and improved feedback mechanisms could help government representatives control the procurement system and accomplish the intended effects.
Enacting autonomy reform in schools: The re-shaping of roles and relationships under Local Schools, Local Decisions
Authors: Gavin Mihajla , Stacey Meghan 
Published: April 2022

AbstractLocal Schools, Local Decisions (LSLD) was a package of school autonomy reforms operating in the state of New South Wales, Australia from 2012 to 2020. The set of reforms centred on the devolution of additional powers and responsibilities to school principals, namely enhanced capacity to manage staffing and financial functions in response to local conditions. Using a conceptual lens of policy enactment, we analyse interview data gathered from 31 teachers and school leaders on how these reform areas were understood and enacted at the school level. Our findings highlight the tensions in enacting devolutionary reform in schools. While the centrality of the school principal’s role was emphasised, including in relation to contested levels of principal discretion, the enactment of devolved powers and responsibilities also produced a fracturing of staff relationships within schools, notably between principals and teaching staff. This finding is understood within a context of heightened workload and unclear expectations which attended the policy’s introduction. We contribute to the school autonomy literature through: (a) the inclusion of teachers’ voices, a stakeholder perspective often missing in the autonomy literature, enabling the impact of the reforms on interpersonal, relational dynamics to come to the fore; and (b) exploring implications for future reform suggested by the fate of LSLD. In doing so, this article deepens knowledge on the enactment of autonomy reforms in schools, drawing implications for understanding school autonomy reform around the globe.
Development of the Manchester framework for the evaluation of emergency department pharmacy services
Authors: Greenwood D , Tully MP , Martin S , Steinke D 
Published: April 2022

Abstract
Background
Many countries, including the United Kingdom, have established Emergency Department (ED) pharmacy services where some ED pharmacists now work as practitioners. They provide both traditional pharmaceutical care and novel practitioner care i.e. clinical examination, yet their impact on quality of care is unknown.

Aim
To develop a framework of structures, processes and potential outcome indicators to support evaluation of the quality of ED pharmacy services in future studies.

Method
Framework components (structures, processes and potential outcome indicators) were identified in three ways: from a narrative review of relevant international literature, and separate panel meetings with ED pharmacists and then other ED healthcare professionals. Structures and processes were collated into categories developed iteratively throughout data collection, with outcome indicators collated into six domains of quality as proposed by the Institute of Medicine. These raw data were then processed e.g. outcome indicators screened for clarity i.e. those which explicitly stated what would be measured were included in the framework.

Results
A total of 190 structures, 533 processes, and 503 outcome indicators were identified. Through data processing a total of 153 outcome indicators were included in the final framework divided into the domains safe (32), effective (50), patient centred (18), timely (24), efficient (20) and equitable (9).

Conclusion
The first framework specific to the quality evaluation ED pharmacy services, service evaluators should validate potential outcome indicators prior to their use. The minimum expected of a high-quality service should also be defined to enable interpretation of relevant measurements.
An evaluation of patient-reported outcomes in sickle cell disease within a conceptual model
Authors: Treadwell Marsha J. , Mushiana Swapandeep , Badawy Sherif M. , Preiss Liliana , King Allison A. , Kroner Barbara , Chen Yumei , Glassberg Jeffrey , Gordeuk Victor , Shah Nirmish , Snyder Angela , Wun Theodore ,   For the Sickle Cell Disease Implementation Consortium (SCDIC)
Published: April 2022

Abstract
Purpose
To examine the relations between patient-reported outcomes (PROs) within a conceptual model for adults with sickle cell disease (SCD) ages 18 – 45 years enrolled in the multi-site Sickle Cell Disease Implementation Consortium (SCDIC) registry. We hypothesized that patient and SCD-related factors, particularly pain, and barriers to care would independently contribute to functioning as measured using PRO domains.

Methods
Participants (N = 2054) completed a 48-item survey including socio-demographics and PRO measures, e.g., social functioning, pain impact, emotional distress, and cognitive functioning. Participants reported on lifetime SCD complications, pain episode frequency and severity, and barriers to healthcare.

Results
Higher pain frequency was associated with higher odds of worse outcomes in all PRO domains, controlling for age, gender and site (OR range 1.02–1.10, 95% CI range [1.004–1.12]). Reported history of treatment for depression was associated with 5 of 7 PRO measures (OR range 1.58–3.28 95% CI range [1.18–4.32]). Fewer individual barriers to care and fewer SCD complications were associated with better outcomes in the emotion domain (OR range 0.46–0.64, 95% CI range [0.34–0.86]).

Conclusions
Study results highlight the importance of the biopsychosocial model to enhance understanding of the needs of this complex population, and to design multi-dimensional approaches for providing more effective interventions to improve outcomes.