bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Lung Cancer Patient Harboring a Rare Oncogenic EGFR Exon 20 V786M Mutation Responded to a Third-Generation Tyrosine Kinase Inhibitor: Case Report and Review of the Literature
Authors: Zhu Qi , Jiang Mingyun , Li Wenfei , Sun Shuangli , Li Jisheng , Stebbing Justin , Liang Xiaodong , Peng Ling 
Published: May 2022

BackgroundEpidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are effective treatments for non-small cell lung cancer (NSCLC) patients with activating EGFR mutations. There are many uncommon and rare mutations in the EGFR gene. The efficacy of the EGFR-TKIs is largely unknown for cancers harboring uncommon or rare EGFR mutations.Case PresentationA 69-year-old woman was diagnosed with adenocarcinoma cT4N2M1c, stage IVB. Next-generation sequencing (NGS) confirmed a rare EGFR V786M mutation. During chemotherapy, immune checkpoint inhibitor (ICI), and anti-angiogenic treatment, no radiological response was observed. Subsequent third-generation EGFR TKI showed a remarkable therapeutic effect. Structural prediction revealed that the V786M mutation induces conformational change at the dimer interface, without altering the ATP binding to the EGFR tyrosine kinase domain (TKD). Consistently, docking simulations indicated that the affinity of ATP to the V786M mutant was not disturbed, which explained the TKI sensitivity.ConclusionsOur data confirmed the activating role on EGFR V786M mutation. Together with structural predictions and clinical evidence for activity of TKIs against EGFR V786M mutations, these findings warrant further investigation.
Effect of First Mother's Own Milk Feeding Time on the Risk of Moderate and Severe Bronchopulmonary Dysplasia in Infants With Very Low Birth Weight
Authors: Zhu Yiming , Chen Xiaohui , Zhu Jingai , Jiang Chengyao , Yu Zhangbin , Su Ailing 
Published: May 2022

Objective:To explore the effect of mother's own milk (MOM) feeding time on the risk of moderate and severe bronchopulmonary dysplasia (BPD) in infants with very low birth weight (VLBW).MethodsClinical data from 630 infants with VLBW were retrospectively analyzed. Participants were divided into the early mother's own milk (EMOM) feeding group (first mother's own milk feeding time ≤72 h after birth, n = 397) and the late mother's own milk (LMOM) feeding group (first mother's own milk feeding time &gt;72 h after birth, n = 233). Differences in the incidence of moderate and severe BPD among the two groups were analyzed using the chi-square test. Effects of MOM feeding time on the incidence of moderate and severe BPD were evaluated using univariate and multivariate logistic regression analysis.ResultsThe incidences of moderate and severe BPD in the EMOM feeding group and the LMOM feeding group were 13.9% (55/397) and 21.0% (49/233), respectively (P = 0.019). Variate logistic regression analysis showed that the LMOM feeding group had an increased risk of moderate and severe BPD compared with the EMOM feeding group (OR = 1.656, 95% CI:1.083–2.532). The results of multivariate logistic regression analysis showed that the LMOM feeding group had an increased risk of moderate and severe BPD compared with the EMOM feeding group (OR = 1.894, 95% CI:1.127–3.185).ConclusionThe first time of MOM feeding within 72 h after birth and the persistence of mother's own milk feeding during hospitalization can reduce the incidence of moderate and severe BPD in infants with VLBW.
Italian Version of the Cornell Assessment of Pediatric Delirium: Evaluation of the Scale Reliability and Ability to Detect Delirium Compared to Pediatric Intensive Care Unit Physicians Clinical Evaluation
Authors: Fazio Paola Claudia , Daverio Marco , Masola Maristella , D’Angelo Igor , Frison Sara , Zaggia Cristina , Simeone Silvio , Pucciarelli Gianluca , Gregori Dario , Comoretto Rosanna , Amigoni Angela 
Published: May 2022

BackgroundDelirium is an acute brain dysfunction associated with increased length of hospitalization, mortality, and high healthcare costs especially in patients admitted to the pediatric intensive care unit (PICU). The Cornell Assessment of Pediatric Delirium (CAPD) is a screening tool for evaluating delirium in pediatric patients. This tool has already been used and validated in other languages but not in Italian.ObjectivesTo test the reliability of the Italian version of the CAPD to screen PICU patients for delirium and to assess the agreement between CAPD score and PICU physician clinical evaluation of delirium.MethodsProspective double-blinded observational cohort study of patients admitted to a tertiary academic center PICU for at least 48 h from January 2020 to August 2021. We evaluated intra- and inter-rater agreement using the Intraclass Correlation Coefficient (ICC). The ability of the scale to detect delirium was evaluated by comparing the nurses’ CAPD assessments with the clinical evaluation of a PICU physician with expertise in analgosedation using the area under the ROC curve (AUC).Measurements and Main ResultsSeventy patients were included in the study. The prevalence of pediatric delirium was 54% (38/70) when reported by a positive CAPD score and 21% (15/70) when diagnosed by the PICU physician. The CAPD showed high agreement levels both for the intra-rater (ICC 1 0.98, 95% CI: 0.97–0.99) and the inter-rater (ICC 2 0.93, 95% CI: 0.89–0.96) assessments. In patients with suspected delirium according to the CAPD scale, the observed sensitivity and specificity of the scale were 0.93 (95% CI: 0.68–1.00) and 0.56 (95% CI: 0.42–0.70), respectively. The AUC observed was 0.75 (95% CI: 0.66–0.8490).ConclusionThe Italian version of the CAPD seems a reliable tool for the identification of patients at high risk of developing delirium in pediatric critical care settings. Compared to the clinical evaluation of the PICU physician, the use of the CAPD scale avoids a possible underestimation of delirium in the pediatric population.
Comprehensive Analysis of Necroptosis in Pancreatic Cancer for Appealing its Implications in Prognosis, Immunotherapy, and Chemotherapy Responses
Authors: Fang Kun , Tang De-Sheng , Yan Chang-Sheng , Ma Jiamin , Cheng Long , Li Yilong , Wang Gang 
Published: May 2022

Objective: Necroptosis represents a new target for cancer immunotherapy and is considered a form of cell death that overcomes apoptosis resistance and enhances tumor immunogenicity. Herein, we aimed to determine necroptosis subtypes and investigate the roles of necroptosis in pancreatic cancer therapy.Methods: Based on the expression of prognostic necroptosis genes in pancreatic cancer samples from TCGA and ICGC cohorts, a consensus clustering approach was implemented for robustly identifying necroptosis subtypes. Immunogenic features were evaluated according to immune cell infiltrations, immune checkpoints, HLA molecules, and cancer–immunity cycle. The sensitivity to chemotherapy agents was estimated using the pRRophetic package. A necroptosis-relevant risk model was developed with a multivariate Cox regression analysis.Results: Five necroptosis subtypes were determined for pancreatic cancer (C1∼C5) with diverse prognosis, immunogenic features, and chemosensitivity. In particular, C4 and C5 presented favorable prognosis and weakened immunogenicity; C2 had high immunogenicity; C1 had undesirable prognosis and high genetic mutations. C5 was the most sensitive to known chemotherapy agents (cisplatin, gemcitabine, docetaxel, and paclitaxel), while C4 displayed resistance to aforementioned agents. The necroptosis-relevant risk model could accurately predict prognosis, immunogenicity, and chemosensitivity.Conclusion: Our findings provided a conceptual framework for comprehending necroptosis in pancreatic cancer biology. Future work is required for evaluating its relevance in the design of combined therapeutic regimens and guiding the best choice for immuno- and chemotherapy.
Evaluation of Consumers Perspective on the Consumption of Antibiotics, Antibiotic Resistance, and Recommendations to Improve the Rational use of Antibiotics: An Exploratory Qualitative Study From Post-Conflicted Region of Pakistan
Authors: Khan Faiz Ullah , Mallhi Tauqeer Hussain , Khan Farman Ullah , Hayat Khezar , Rehman Asim.Ur , Shah Shahid , Khan Zakir , Khan Yusra Habib , Ahmad Tawseef , Gudi Sai Krishna , Karataş Yusuf , Fang Yu 
Published: May 2022

Background: Antibiotics misuse is a global challenge, and the situation is likely to deteriorate in conflict zones with insufficient health services. The misuse of antibiotics is not only associated with antimicrobial resistance but may also lead to serious consequences. This study was aimed to investigate the knowledge, attitude, and practices on antibiotic consumption, antibiotic resistance (ABR), and related suggestions among residents of conflicted zones in Pakistan.Methods: Semi-structured interviews were conducted at community pharmacies between June 2020 and January 2021. The primary findings were ascertained through thematic content analysis. Themes, sub-themes, and categories were drawn from the final analysis. Data analysis was carried out in six steps from getting to know the data to final report development.Results: A total of 20 consumers were interviewed with a mean interview duration of 25.4 min. The average age of participants was 35.1 years, and most of them were males. ABR was unfamiliar to the participants. Most of the participants understood the term “antibiotics,” but they did not know how to use them properly. The participants were unable to distinguish between bacterial and viral illnesses. Thirteen participants believed that antibiotics have a faster effect than any other drug. Most of the participants perceived that every antibiotic could cause diarrhea, and pharmacy staff sometimes prefer other medicines such as multivitamins. Consumer practices regarding antibiotic usage and ABR were found to be poor. Most participants recommended that health officials must ensure qualified staff at pharmacies with strict regulations. Five participants said that a leaflet with antibiotic instructions in Urdu (national language) is usually beneficial, especially when making solutions from powder.Conclusions: This study underscored poor knowledge, attitude, and practices among residents of conflicted zones towards antibiotics and ABR. Low literacy rate, unavailability of healthcare facilities, absence of pharmacists at community pharmacies, and uncontrolled sales of antibiotics are some factors attributed to serious hazards, ABR, and irrational use of drugs.
Emerging Nanotheranostics for 5-Fluorouracil in Cancer Therapy: A Systematic Review on Efficacy, Safety, and Diagnostic Capability
Authors: How Chee Wun , Teoh Siew Li , Loh Jian Sheng , Tan Stella Li Kar , Foo Jhi Biau , Ng Hui Suan , Wong Stephenie Yoke Wei , Ong Yong Sze 
Published: May 2022

The conventional concept of using nanocarriers to deliver chemotherapeutic drugs has advanced to accommodate additional diagnostic capability. Nanotheranostic agents (NTA), combining both treatment and diagnostic tools, are an ideal example of engineering-health integration for cancer management. Owing to the diverse materials used to construct NTAs, their safety, effectiveness, and diagnostic accuracy could vary substantially. This systematic review consolidated current NTAs incorporating 5-fluorouracil and elucidated their toxicity, anticancer efficacy, and imaging capability. Medline and Embase databases were searched up to March 18, 2022. The search, selection, and extraction were performed by the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines to ensure completeness and reproducibility. Original research papers involving 5-fluorouracil in the preparation of nanoparticles which reported their efficacy, toxicity, and diagnostic capability in animal cancer models were recruited. The quality of included studies was assessed using the Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies (CAMARADES) checklist. Nine studies were eligible for the systematic review. There was no significant toxicity reported based on animal weight and organ histology. Complete tumor remission was observed in several animal models using chemo-thermal ablation with NTAs, proving the enhancement of 5-fluorouracil efficacy. In terms of imaging performance, the time to achieve maximum tumor image intensity correlates with the presence of targeting ligand on NTAs. The NTAs, which are composed of tumor-targeting ligands, hold promises for further development. Based on the input of current NTA research on cancer, this review proposed a checklist of parameters to recommend researchers for their future NTA testing, especially in animal cancer studies.Systematic Review Registration: website, identifier registration number.
Sinusoidal Optic Flow Perturbations Reduce Transient but Not Continuous Postural Stability: A Virtual Reality-Based Study
Authors: Ketterer Jakob , Ringhof Steffen , Gehring Dominic , Gollhofer Albert 
Published: May 2022

Optic flow perturbations induced by virtual reality (VR) are increasingly used in the rehabilitation of postural control and gait. Here, VR offers the possibility to decouple the visual from the somatosensory and vestibular system. By this means, it enables training under conflicting sensorimotor stimulation that creates additional demands on sensory reweighting and balance control. Even though current VR-interventions still lack a well-defined standardized metric to generate optic flow perturbations that can challenge balance in a repeatable manner, continuous oscillations of the VR are typically used as a rehabilitation tool. We therefore investigated if continuous sensory conflicts induced by optic flow perturbations can challenge the postural system sustainably. Eighteen young adults (m = 8, f = 10, age = 24.1 ± 2.0 yrs) were recruited for the study. The VR was provided using a state-of-the-art head-mounted display including the virtual replica of the real environment. After familiarization in quiet stance without and with VR, bipedal balance was perturbed by sinusoidal rotations of the visual scenery in the sagittal plane with an amplitude of 8° and a frequency of 0.2 Hz. Postural stability was quantified by mean center of mass speed derived from 3D-kinematics. A rmANOVA found increased postural instability only during the first perturbation cycle, i.e., the first 5 s. Succeeding the first perturbation cycle, visual afferents were downregulated to reduce the destabilizing influence of the sensory conflicts. In essence, only the transient beginning of sinusoidal oscillation alters balance compared to quiet standing. Therefore, continuous sinusoidal optic flow perturbations appear to be not suitable for balance training as they cannot trigger persisting sensory conflicts and hence challenge the postural system sustainably. Our study provides rationale for using unexpected and discrete optic flow perturbation paradigms to induce sustainable sensory conflicts.
Efficacy of a Combined Acceptance and Commitment Intervention to Improve Psychological Flexibility and Associated Symptoms in Cancer Patients: Study Protocol for a Randomized Controlled Trial
Authors: García-Torres Francisco , Gómez-Solís Ángel , Rubio García Sebastián , Castillo-Mayén Rosario , González Ruíz-Ruano Verónica , Moreno Eliana , Moriana Juan Antonio , Luque-Salas Bárbara , Jaén-Moreno María José , Cuadrado-Hidalgo Fátima , Gálvez-Lara Mario , Jablonski Marcin , Rodríguez-Alonso Beatriz , Aranda Enrique 
Published: May 2022

Psychological flexibility is a key concept of acceptation and commitment therapy (ACT). This factor has been linked with psychological wellbeing and associated factors, such as quality of life, in cancer patients. These and other positive results of acceptation and commitment therapy in cancer patients found in previous research could be enhanced by using mhealth tools. A three-arm randomized superiority clinical trial, with a pre-post-follow-up repeated measures intergroup design with a 1:1:1 allocation ratio is proposed. A hundred and twenty cancer patients will be randomly assigned to one of the following interventions: (1) face-to-face ACT + mobile application (app), (2) face-to-face ACT, and (3) Waitlist control group. The primary expected outcome is to observe significant improvements in psychological flexibility acceptance and action questionnaire- II (AAQ-II) in the face-to-face ACT + app group, after comparing baseline and post-treatment scores, and the scores will remain stable in the two assessment points, 3 and 6 months after the intervention. Secondary expected outcomes are significant increasing scores in quality of life (EORTC QLQ C-30) and post-traumatic-growth (PTGI-SF), and significant decreasing scores in anxiety and depression (HADS), insomnia (ISI) and fatigue (BFI) at the same assessment points. Also, it is expected that the scores of this group will be higher than the scores of the face-to-face ACT group and the waitlist control group. This study aims to assess the efficacy of a combined intervention (face-to face ACT + app) for psychological flexibility and associated symptoms in cancer patients. The results of this protocol may help to consider the use of acceptation and commitment therapy and mhealth applications in cancer settings as a valid therapeutic choice.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [NCT05126823].
Network Analysis of Eating Disorders Symptoms Co-occurring With Impulsive Personality Traits and Negative Mood States in Patients With Bulimia Nervosa
Authors: Chen Yan , Guo Lei , Wu Mengting , Zhang Lei , He Qianqian , Zheng Yuchen , Wu Lin , Zheng Hui , Chen Jue 
Published: May 2022

BackgroundBulimia nervosa (BN) is characterized by recurrent episodes of eating large amounts of food without control. Studies have found positive correlations of BN symptoms with impulsive traits and negative affect. However, the network relationship supporting BN symptoms is unclear.MethodsThe study participants included female BN patients (146) and healthy controls (HCs, 146). The participants were matched for age. All participants completed the Eating Disorder Examination Questionnaire 6.0, Barratt Impulsiveness Scale-11, Beck Anxiety Inventory, and Beck Depression Inventory. We characterized the centrality parameters of BN, impulsiveness, and anxiety and depression symptoms of BN patients compared with HCs.ResultsAmong all symptoms in the constructed BN group network, Shape dissatisfaction had the highest strength. In the BN group network, three clusters of symptoms (“ED-specific symptoms,” “impulsivity,” and “anxiety and depression”) were linked to each other by several symptoms. Compared to the HC network, impulsiveness was strongly associated with Concerns about Others Seeing One Eat in the BN network.ConclusionThis study shows that ED-specific symptoms, i.e., Shape dissatisfaction, play a key role in BN. The cognition of “shape dissatisfaction” is a basis, and impulsivity and emotional symptoms are maintaining factors that may lead to BN development.
The Evolution of Vigilance and Its Atrophy Preceding the COVID-19 Global Pandemic
Authors: Witek Theodore J. , Schwartz Robert 
Published: May 2022

IntroductionRecent infectious outbreaks preceding the COVID-19 crisis resulted in the evolution of vigilance for preparedness against the next pandemic. This vigilance was maintained to varying degrees in different jurisdictions.ObjectiveTo evaluate the evolution of vigilance following previous epidemics and pandemics and the subsequent atrophy of vigilance prior to the COVID-19 global pandemic.MethodsWe evaluated documentation discussing US, Canada, and South Korea from March 2002 to October 2021. Our policy search strategy was rooted in academic literature, government documents and media reports.ResultsIn the US, there were examples of atrophy of vigilance; however, there was clear understanding of pandemic readiness actions that were simply not executed amongst political chaos. In Canada, political mishaps were less evident at the time the pandemic unfolded. Nevertheless, atrophy was evident with erosion in preparedness programs following SARS. South Korea appeared least subjected to atrophy of vigilance. The more recent MERS outbreak prompted evolution of sustained vigilance and compliance with basic public health measures such as mask wearing.RecommendationsPolicy options need to be explored and instituted that increase protection of preparedness programs through institutional safeguards and accountability measure.
Impact of the COVID-19 Pandemic on China's Stock Market Volatility, During and After the Outbreak: Evidence From an ARDL Approach
Authors: Jin Cheng 
Published: May 2022

PurposeIn this study, we empirically investigate the impact of the COVID-19 pandemic on China's stock price volatility during and after its initial outbreak, using time-series daily data covering the period from July to October, 2020 and 2021, respectively.Design/Methodology/ApproachIn the estimation, the ARDL bounds test approach was employed to examine the existence of co-integration and the relationship of long-run and short-run between the new infection rates and stock price volatility, as stable and unstable variables are mixed. The inner-day and inter-day volatility, based on the Shanghai (securities) composite index, are estimated in separate empirical models. In addition, the Inter-bank overnight lending rate (IBOLR) is controlled in order to consider the effect of liquidity and investment cost.Findings and ImplicationsWe find that in the initial year (2020) of the epidemic, the new infection rate is negatively correlated to stock prices in the short-term, whereas no significant evidence existed in the long-term, regardless of model specifications. However, after the epidemic's outbreak (2021), the result depicts that new infections increased stock prices in the long-term, and depressed its inner-day volatility in the short-term, which is inconsistent with most investigations. This phenomenon may be due to the fact that investors were more concerned about the withdrawal of monetary easing and fiscal stimulus, which were introduced to fight against the epidemic's impact on economy, than the epidemic itself. This study complements the limitations of most existing studies, which just focus on the period of the epidemic's outbreak, and provides insight into macroeconomic policy making in the era of the post COVID-19 epidemic such as the structural and ordered exit of the stimulating policies, intervention in IBOLR and balance social and economic sustainability.
Model-Based Computational Analysis on the Effectiveness of Enhanced Recovery after Surgery in the Operating Room with Nursing
Authors: Li Wenji , Huang Shu , Xie Yong , Chen Guanyu , Yuan Jun , Yang Yun 
Published: May 2022

ObjectiveIn order to better understand the relative surgical process, this work used a model-based computational analysis on the effectiveness of enhanced recovery after surgery (ERAS) in the operating room with nursing.MethodsA total of 360 surgical patients in the First Affiliated Hospital, Sun Yat-sen University, from the period June 2020 to March 2021, were randomly divided into two groups, namely, observation group and control group, with 180 cases in each group. Routine nursing was used in the control group, while ERAS was implemented in the observation group from the point of view of four aspects, namely, preoperative visit, intraoperative cooperation, postoperative return visit, and psychological intervention.ResultsPostoperative complications, average hospital stay, nursing satisfaction, and postoperative quality of life in the observation group were significantly better than those in the control group (all p &lt; 0.05).ConclusionThe application of ERAS for surgical patients can enhance team awareness, optimize the process of cooperation, reduce surgical complications and improve nursing quality, and prognosis, and it is worth popularizing in the operating room.