bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self‐reliance or social accountability? The raison d'être of community health committees in Nigeria
Authors: Abimbola Seye , Drabarek Dorothy , Molemodile Shola K. 
Published: February 2022

AbstractSocial justice requires that communities demand social accountability. We conducted this study to inform ongoing efforts to facilitate social accountability through community health committees in Nigeria. We theorised that committees may see themselves in two ways – as outwardly‐facing (‘social accountability’) and/or as inwardly‐facing (‘self‐reliance’). We analysed the minutes of their meetings, alongside interviews and group discussions with committee members, community members, health workers, and health managers in four states across Nigeria. The committees' raison d'être reflects a bias for self‐reliance in three ways. First, seen as a platform for the community to co‐finance health services, members tend to be the local elite who can make financial contributions. Second, in a one‐sided relationship, they function more to achieve the goals of governments (e.g. to improve the uptake of services), than of the community (e.g. rights‐based demands for government support). Third, their activities in the community reflect greater concern to ensure that their community makes the most of what the government has already provided (e.g. helping to drive the uptake of existing services) than asking for more. Optimising the committees for social accountability may require support by actors who do not have conflicts of interests in ensuring that they have the necessary information and strategies to demand social accountability.
Physician perspectives on the implications of the diagnosis‐related groups for medical practice in Turkey: A qualitative study
Authors: Aktas Puren 
Published: February 2022

AbstractHospital reimbursement models might have unintended consequences for medical practice. In Turkey, a mixed reimbursement scheme, based on the diagnosis‐related group (DRG) model and global budget, was gradually introduced as part of the country's 2003 healthcare reforms. This article examines the impacts of the DRG model on medical practice in Turkey, as perceived by physicians working in public and private hospitals. This study draws on an analysis of 14 interviews with physicians. The findings reveal that the implementation of the DRG has transformed medical practice into a process of cost‐benefit optimisation which involves balancing the income and expenses of hospitals against patients' medical needs. To mitigate the negative effects of the DRG, the current model may need to be reformed, particularly to grant exemptions from the standard reimbursement structure for patients who are experiencing complications and/or multiple health conditions.
Bridging troubled water ‐ exploring improvement and patients' experiences using patient‐reported outcome measures in physiotherapy: A mixed‐method study
Authors: Bjorbækmo Wenche Schrøder , Mengshoel Anne Marit , Robinson Hilde Stendal 
Published: February 2022

AbstractBackground and AimsIncreased use of patient‐reported outcomes in health care has been emphasized. Our aim was to use the Patient‐Specific Functional Scale (PSFS) to examine improvement in neck pain patients' activity limitations during physiotherapy treatment, with the purpose to explore the patients' experiences of using PSFS. The study illuminates whether and how PSFS can be useful in clinical physiotherapy.MethodsSix patients participated. A mixed‐method study design was applied, triangulating ontological perspectives of realism and phenomenology, quantitative and qualitative methods. Single Subject Experimental Design with PSFS as outcome measure examined changes over time and phenomenological interviews examined its meaningfulness for patients. Patients defined their personal activity limitations due to neck pain and scored difficulties several times, during the physiotherapy treatment period, using PSFS. We used visual analyses of the quantitative data and thematic analyses of the qualitative data. Integration and combination of the results from the two designs are presented in the discussion.ResultsIn the quantitative analyses, PSFS showed improvement in most activity limitations during treatment. The qualitative analyses revealed that using PSFS required the patient to engage in different bodily awareness processes and handle the dilemma of a possible double function of scoring chosen activities. The mixed findings revealed improved functionality and that the context and the interaction between patient and therapist have a significant influence on the assessment process.ConclusionsTo be able to improve the utilization of PSFS, communication between patients and physiotherapists is of vital importance. When using PSFS, physiotherapists should direct their attention to the importance of interaction as always present and vital in assessments.
Repurposing autophagy regulators in brain tumors
Authors: Petrosyan Edgar , Fares Jawad , Cordero Alex , Rashidi Aida , Arrieta Víctor A. , Kanojia Deepak , Lesniak Maciej S. 
Published: February 2022

AbstractMalignant brain tumors, such as glioblastoma multiforme (GBM) and brain metastases, continue to be an unmet medical challenge. Despite advances in cancer diagnostics and therapeutics, tumor cell colonization in the central nervous system renders most treatment options ineffective. This is primarily due to the selective permeability of the blood‐brain barrier (BBB), which hinders the crossing of targeting agents into the brain. As such, repositioning medications that demonstrate anticancer effects and possess the ability to cross the BBB can be a promising option. Antidepressants, which are BBB‐permeable, have been reported to exhibit cytotoxicity against tumor cells. Autophagy, specifically, has been identified as one of the common key mediators of antidepressant's antitumor effects. In this work, we provide a comprehensive overview of US Food and Drug Administration (FDA)‐approved antidepressants with reported cytotoxic activities in different tumor models, where autophagy dysregulation was demonstrated to play the main part. As such, imipramine, maprotiline, fluoxetine and escitalopram were shown to induce autophagy, whereas nortriptyline, clomipramine and paroxetine were identified as autophagy inhibitors. Sertraline and desipramine, depending on the neoplastic context, were demonstrated to either induce or inhibit autophagy. Collectively, these medications were associated with favorable therapeutic outcomes in a variety of cancer cell models, including brain tumors.
PhaseIIstudy of durvalumab monotherapy in patients with previously treated microsatellite instability‐high/mismatch repair‐deficient orPOLE‐mutated metastatic or unresectable colorectal cancer
Authors: Oh Chung Ryul , Kim Jeong Eun , Hong Yong Sang , Kim Sun Young , Ahn Joong Bae , Baek Ji Yeon , Lee Myung‐Ah , Kang Myoung Joo , Cho Sang Hee , Beom Seung‐Hoon , Kim Tae Won 
Published: February 2022

AbstractThe aim of our study is to evaluate the clinical efficacy of durvalumab in patients with microsatellite instability‐high/mismatch repair‐deficient (MSI‐H/dMMR) or polymerase epsilon (POLE)‐mutated metastatic or unresectable colorectal cancer (mCRC) who had disease progression after standard chemotherapy. This prospective, open‐label, multicenter, phase II study enrolled patients with mCRC harboring MSI‐H/dMMR orPOLEmutations treated with at least one prior line of therapy. The participants received durvalumab (1500 mg) every 4 weeks intravenously. The primary endpoint was the objective response rate (ORR). Of the 33 patients, 30 had MSI‐H/dMMR and 3 hadPOLE‐mutated microsatellite stable (MSS) CRC. With a median follow‐up duration of 11.2 months (95% confidence interval [CI]: 7.3‐15.0), the ORR was 42.4% (95% CI: 25.5‐60.8). Among three patients withPOLE‐mutated CRC, one patient who had an exonuclease domain mutation (EDM) achieved an objective response, but the others with mutations in the non‐exonuclease domain had progressive disease. Overall, the median duration of response was not reached and 85.7% of the responses were ongoing at data cutoff. The progression‐free survival rate of 12 months was 58.2% (95% CI: 39.0‐73.1) and the 12‐month overall survival rate was 68.3% (95% CI: 48.8‐81.7). Grade 3 treatment‐related adverse events occurred in 36.4% of the patients and were manageable. In conclusion, durvalumab showed promising clinical activity with encouraging response rates and satisfactory survival outcomes in mCRC patients with MSI‐H/dMMR orPOLEEDM. In patients withPOLE‐mutated mCRC, clinical response to durvalumab may be restricted to those with EDM.
Meta‐analysis of agreement/concordance statistics in studies comparing self‐ vs clinician‐collected samples for HPV testing in cervical cancer screening
Authors: Arbyn Marc , Castle Philip E. , Schiffman Mark , Wentzensen Nicolas , Heckman‐Stoddard Brandy , Sahasrabuddhe Vikrant V. 
Published: February 2022

AbstractWe conducted a meta‐analysis of test agreement/concordance between human papillomavirus (HPV) testing in self‐collected vs clinician‐collected samples in 26 studies (10 071 participants) updating a previous meta‐analysis on accuracy for cervical precancer. Pooled overall agreement was 88.7% (95% CI: 86.3%‐90.9%), positive agreement was 84.6% (95% CI: 79.9%‐88.7%), negative agreement was 91.7% (95% CI: 89.1%‐94.0%) and kappa was 0.72 (95% CI: 0.66‐0.78). Subgroup meta‐analyses suggested higher overall agreement for target amplification‐based DNA assays (90.4%) compared to signal amplification‐based DNA assays (86.7%; P = .175) or RNA assays (82.3%; P < .001). HPV test agreement/concordance targets may provide criteria to extend existing validations toward alternative sampling approaches and devices/storage media.
Clinical and molecular characteristics of estrogen receptor‐positive ultralow risk breast cancer tumors identified by the 70‐gene signature
Authors: Johansson Annelie , Yu Nancy Y. , Iftimi Adina , Tobin Nicholas P. , van 't Veer Laura , Nordenskjöld Bo , Benz Christopher C. , Fornander Tommy , Perez‐Tenorio Gizeh , Stål Olle , Esserman Laura J. , Yau Christina , Lindström Linda S. 
Published: February 2022

AbstractThe metastatic potential of estrogen receptor (ER)‐positive breast cancers is heterogeneous and distant recurrences occur months to decades after primary diagnosis. We have previously shown that patients with tumors classified as ultralow risk by the 70‐gene signature have a minimal long‐term risk of fatal breast cancer. Here, we evaluate the previously unexplored underlying clinical and molecular characteristics of ultralow risk tumors in 538 ER‐positive patients from the Stockholm tamoxifen randomized trial (STO‐3). Out of the 98 ultralow risk tumors, 89% were luminal A molecular subtype, whereas 26% of luminal A tumors were of ultralow risk. Compared to other ER‐positive tumors, ultralow risk tumors were significantly (Fisher's test, P < .05) more likely to be of smaller tumor size, lower grade, progesterone receptor (PR)‐positive, human epidermal growth factor 2 (HER2)‐negative and have low Ki‐67 levels (proliferation‐marker). Moreover, ultralow risk tumors showed significantly lower expression scores of multi‐gene modules associated with the AKT/mTOR‐pathway, proliferation (AURKA), HER2/ERBB2‐signaling, IGF1‐pathway, PTEN‐loss and immune response (IMMUNE1 and IMMUNE2) and higher expression scores of the PIK3CA‐mutation‐associated module. Furthermore, 706 genes were significantly (FDR < 0.001) differentially expressed in ultralow risk tumors, including lower expression of genes involved in immune response, PI3K/Akt/mTOR‐pathway, histones, cell cycle, DNA repair, apoptosis and higher expression of genes coding for epithelial‐to‐mesenchymal transition and homeobox proteins, among others. In conclusion, ultralow risk tumors, associated with minimal long‐term risk of fatal disease, differ from other ER‐positive tumors, including luminal A molecular subtype tumors. Identification of these characteristics is important to improve our prediction of nonfatal vs fatal breast cancer.
Research on the synthesis of nanoparticles of betulinic acid and their targeting antitumor activity
Authors: Chen Xuan , Lu Shuting , Gong Fengrong , Sui Xiaoyu , Liu Tingting , Wang Ting 
Published: February 2022

AbstractBetulinic acid (BA), a natural pentacyclic lupine‐type triterpene, has shown its prominent efficiency on the selective antitumor activity. However, its poor water solubility and bioavailability have limited its application. Herein, targeting nanoparticles were prepared to improve BA‐based liposome (BL)'s restricted chemotherapeutic efficacy. Multi‐layers membranes from the cancer cells were added as highly penetrative targeting ligands to functionalize the BA‐based liposomes. In vitro experiments including the MTT assay and the fluorescence imaging of live/dead staining were adopted to prove its great inhibition in the growth of tumor cells. And it manifests that the antitumor efficacy of BL coated with cell membranes (BLCM) achieves nearly 4.3 times as that of BL under the same conditions in the MTT experiments. In addition, the fluorescence imaging stained with DAPI‐FITC was applied to prove the targeting positioning effects on the BLCM. In a nutshell, the nanomedicine has good targeting antitumor efficacy and has great potential in being applied for the personalized cancer clinical treatment.
Silencing of IGF2BP1 restrains ox‐LDL‐induced lipid accumulation and inflammation by reducing RUNX1 expression and promoting autophagy in macrophages
Authors: Liu Mingxin , Tao Guizhou , Cao Yiming , Hu Yu , Zhang Zhe 
Published: February 2022

AbstractAtherosclerosis (AS) is a chronic inflammatory disease with the formation and accumulation of macrophage‐derived foam cells in the subendothelial space of blood vessels as one major characteristic. Insulin‐like growth factor 2 messenger RNA (mRNA) binding protein 1 (IGF2BP1) is an RNA‐binding factor and its elevation has been reported to be associated with macrophage infiltration into the atherosclerotic vascular wall. This study aims to investigate the roles of IGF2BP1 in AS‐associated foam cell formation. Herein, ApoE−/− mice fed with high‐fat diet developed atherosclerotic lesions in the aorta, where IGF2BP1 expression was upregulated and autophagy was impaired. IGF2BP1 expressed in F4/80+ macrophages and coexisted with p62. In vitro, IGF2BP1 expression was upregulated in RAW264.7 macrophages exposed to oxidized low‐density lipoprotein (ox‐LDL) (100 μg/ml). Interestingly, silencing of IGF2BP1 ameliorated ox‐LDL‐induced lipid accumulation and inflammation, and enhanced autophagic flux in macrophages. Furthermore, the expression of RUNX family transcription factor 1 (RUNX1), a gene that is able to inhibit autophagy in multiple cell types, was elevated in atherosclerotic aortas and in ox‐LDL‐treated macrophages. In addition, RNA immunoprecipitation results revealed that IGF2BP1 is bound to RUNX1 mRNA. Alterations induced by IGF2BP1 knockdown in ox‐LDL‐treated macrophages were abolished by RUNX1 overexpression. Furthermore, after autophagy inhibitor 3‐methyladenine administration, silencing of IGF2BP1‐reduced lipid accumulation and inflammation were recovered in RAW264.7 cells. In summary, our study demonstrated that silencing of IGF2BP1 restrained ox‐LDL‐induced lipid accumulation and inflammation by reducing RUNX1 expression and facilitating autophagy in macrophages. IGF2BP1/RUNX1 axis may be considered as a potential therapeutic target in AS.
Prognostic value of prognostic nutritional index and its variations in advanced non‐small‐cell lung cancer patients treated with anlotinib monotherapy
Authors: Chen Tian , Liang Gaofeng , Xiang Zhenfei , He Jinxian , Xu Xiaoyu , Tang Mengqiu 
Published: February 2022

AbstractBackgroundAnlotinib is a third‐line or further therapy for advanced non‐small‐cell lung cancer (NSCLC). However, the lack of simple biomarkers to predict the curative effect of anlotinib creates significant unmet needs in exploring the markers. This study aimed to explore the relationship between the prognostic nutritional index (PNI) and its variations and efficacy of anlotinib.MethodsData for patients with advanced NSCLC who received anlotinib were collected at Ningbo Medical Center Lihuili Hospital. The data included the values of pretreatment PNI (pre‐PNI), posttreatment PNI (post‐PNI), and ΔPNI (post‐PNI minus the pre‐PNI). The Kaplan–Meier method was used to generate survival curves, whereas univariate and multivariate Cox regression analyses were used to analyze survival predictors.ResultsA high disease control rate was associated with a high pre‐PNI (p = 0.007), high post‐PNI (p = 0.000), and high ΔPNI (p = 0.006). Univariable analysis revealed that pre‐PNI ≤41.80, post‐PNI ≤42.48, and ΔPNI ≤0.20 were significant risk factors for poor survival. According to the multivariate analysis, progression‐free survival (PFS) in patients with post‐PNI ≤42.48 was significantly shorter than in patients with higher values (median PFS: 1.5 months vs. 4.0 months, p = 0.010).ConclusionsPre‐PNI, ΔPNI, and post‐PNI were found to be predictive factors for response in advanced NSCLC patients treated with anlotinib as a third‐line or further treatment. Only post‐PNI was a reliable predictor of PFS. Therefore, PNI and its variations, particularly post‐PNI, are affordable and accessible predictors of NSCLC patients treated with anlotinib in clinical work.
Handgrip strength asymmetry is associated with the risk of neurodegenerative disorders among Chinese older adults
Authors: Chen Zi , Ho Mandy , Chau Pui Hing 
Published: February 2022

AbstractBackgroundNeurodegenerative disorders, as the irreversible condition, have a long, silent preclinical period. Recognition of early physical signs of neurodegenerative disorders had important practical implications for identifying at‐risk population. The aim of this study was to investigate whether handgrip strength (HGS) asymmetry was associated with the incidence of neurodegenerative disorders among Chinese older adults.MethodsThis study used the data of participants aged 60 years and over from three waves (2011–2015) of China Health and Retirement Longitudinal Study. HGS asymmetry was measured with HGS ratio (maximal non‐dominant HGS/maximal dominant HGS), with the value less than 0.9 or more than 1.1 considered as HGS asymmetry. Physician‐diagnosed neurodegenerative disorders were identified by self‐reported or proxy‐reported information. Competing risk analysis was conducted to examine the association between HGS asymmetry and incident neurodegenerative disorders, with mortality treated as the competing event.ResultsA total of 4925 participants were included in the analysis [mean (SD) age: 68.1(6.68); female: 49.7%]. Eight hundred and eighty‐eight (18.0%) participants had low HGS and 2227 (45.2%) had HGS asymmetry. During the 4 years of follow‐up, there were 156 cases of neurodegenerative disorders and 422 cases of mortality. The incidence of neurodegenerative disorders was 8.7 per 1000 person‐years [95% confidence interval (CI): 7.4–10.2], and the incidence of mortality was 23.5 per 1000 person‐years (95% CI: 21.4–25.9). Both the cause‐specific model and the Fine–Gray subdistribution hazard model showed that participants with HGS asymmetry had increased hazard of neurodegenerative disorders [hazard ratio (HR) = 1.66, P = 0.002, 95% CI: 1.202–2.297; subdistribution hazard ratio (SHR) = 1.65, P = 0.002, 95% CI: 1.202–2.285]. Low HGS, but not HGS asymmetry, was related to the higher hazard of mortality (HR = 1.61, P < 0.001, 95% CI: 1.297–1.995; SHR = 1.58, P < 0.001, 95% CI: 1.286–1.951).ConclusionsHandgrip strength asymmetry was associated with the future risk of neurodegenerative disorders among Chinese older adults. Public healthcare providers could consider examining HGS asymmetry along with the maximal HGS as a way to identify those at elevated risk of neurodegenerative disorders.
Simulation‐based education for medical radiation students: A scoping review
Authors: Chau Minh , Arruzza Elio , Johnson Nathan 
Published: February 2022

AbstractSimulation‐based education is a significant aspect of teaching clinical skills in tertiary medical radiation science programmes, allowing students to experience the clinical setting in a safe environment. As an educational tool, simulation exists in many valid forms including role play, interprofessional simulation and virtual reality simulation. This scoping review looks at the current literature in this field to identify the evidence surrounding simulation‐based education for medical radiation students. The purpose of this review is to provide an evidence‐based guide for educators, identify gaps in the literature and suggest areas of future research. Data extraction was performed on 33 articles where the interventions could be categorised into either role play simulation, virtual simulation, simulation videos or online learning environments. Most studies demonstrated that simulation could improve clinical competence and increase preparedness and confidence for clinical placement. Student satisfaction remained high throughout the studies; however, it is the view of many that although simulation‐based education is a valid and effective tool, it is complementary to and not a replacement for clinical placement.
Physical proof and design of ternary full adder circuit in ternary quantum‐dot cellular automata technology
Authors: Ghadamgahi Seyed Mahdi , Sabbaghi‐Nadooshan Reza , Navi Keivan 
Published: February 2022

AbstractDownsizing computational modules can be effective in increasing computational speed, reducing energy consumption, and reducing the occupied area of the chip, but limitations associated with Complementary metal–oxide–semiconductor (CMOS) technology downsizing prompted researchers to look for alternative methods for transistors and circuit fabrication. A common issue in many of these methods is the move toward the production of components of logical circuits in nano dimensions. Quantum‐dot cellular automata (QCA) technology is inherently fast and is based on Coulomb interactions, and this property can make the design of computational circuits much easier. The main purpose of this paper is to design a new full adder circuit structure based on ternary quantum‐dot cellular automata technology with physical proofs. Accordingly, the proposed diagram block structure full adder circuit based on ternary QCA (TQCA) is presented, which includes 11 cells, the area is and, the circuit cost is 0.044. For validation, the proposed structure was simulated with TQCAsim software. The results show a significant improvement in circuit parameters.