bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring the perceptions of former ICU patients and clinical staff on barriers and facilitators to the implementation of virtual reality exposure therapy: A qualitative study
Authors: Twamley Jacqueline , Hamer Oliver , Hill James , Kenyon Roger , Twamley Huw , Casey Rob , Zhang Jennifer , Williams Alexandra , Clegg Andrew 
Published: December 2022

AbstractBackgroundVirtual reality (VR) as a digital technology has developed rapidly, becoming more realistic, portable, sensory and easier to navigate. Although studies have found VR to be effective for many clinical applications, patients and clinicians have described several barriers to the successful implementation of this technology. To remove barriers for implementation of VR in health care, a greater understanding is needed of how VR can integrate into clinical environments, particularly complex settings such as an intensive care unit.AimThis study aimed to explore the perceived barriers and facilitators for the implementation of VR exposure therapy for intensive care patients and clinical staff.Study DesignA qualitative study using an Interpretative Description approach was undertaken. Semi‐structured focus groups were conducted with 13 participants: nine patients and four health care professionals. Focus groups explored barriers and facilitators of using virtual reality (VR) exposure therapy in intensive care. Thematic analysis was employed to produce codes and themes.ResultsIn total, eight themes describing the perceived barriers and facilitators to implementing VR exposure therapy were identified. Four themes related to the perceived barriers of implementing VR exposure therapy in intensive care were identified: psychological, sensory, environmental and staff competency and confidence. There were a further four themes related to the perceived facilitators to the implementation of VR exposure therapy: staff training, patient capacity, orientation to technology and support during the intervention.ConclusionsThis study identified novel barriers and facilitators that could be expected when implementing VR exposure therapy for patients' post‐intensive care unit stay. The findings suggest that psychological barriers of fear and apprehension were expected to provoke patient avoidance of exposure therapy. Perceived barriers for staff focused on preparedness to deliver the VR exposure therapy and a lack of technological competence. Both patients and staff stated that a comprehensive induction, orientation and training could facilitate VR exposure therapy, improving engagement.Relevance to Clinical PracticeThis study has identified that with appropriate staff training, resources, and integration into current patient care pathways, VR exposure therapy may be a valuable intervention to support patient recovery following critical illness. Prior to undertaking VR exposure therapy, patients often need reassurance that side‐effects can be managed, and that they can easily control their virtual exposure experience.
Comparison of Three‐Dimensional Navigation‐Guided Percutaneous Iliosacral Screw and Minimally Invasive Percutaneous Plate for the Treatment of Zone II Unstable Sacral Fractures
Authors: Pei Xuan , Zhou Wei , Wang Guo‐dong , Cai Xian‐hua , Zheng Yi fan , Liu Xi‐ming 
Published: December 2022

ObjectiveThe percutaneous IS screws and the minimally invasive percutaneous plate are the most popular internal methods for Zone II unstable sacral fractures. However, the choice of fixation remains controversial for orthopaedic surgeons. The purpose of study was to evaluate and compare the clinical results of percutaneous iliosacral (IS) screw fixation under three‐dimensional (3D) navigation and minimally invasive percutaneous plate fixation in the treatment of Zone II unstable sacral fractures.MethodsA retrospective study was performed, including 64 patients with Zone II unstable sacral fractures who underwent percutaneous IS screw fixation under 3D navigation (navigation group) and minimally invasive percutaneous plate fixation (plate group) from January 2011 and March 2021 in our department. The age, gender, fracture type, mechanism of injury, injury severity score (ISS), time from admission to operation, operative time, intraoperative blood loss, hospital stay, incision length, follow‐up time, time to clinical healing, and complications were recorded and analyzed. Matta standard was used to assess fracture reduction outcomes. The Majeed function system assessed functional outcomes at the last follow‐up.ResultsThe average follow‐up time was (14.42 ± 1.57) months in the navigation group and (14.79 ± 1.37) months in the plate group. No statistical difference between the two groups in age, gender, fracture type, mechanism of injury, ISS, time from admission to operation, and time to clinical healing. However, significant differences were detected in operative time, intraoperative blood loss, hospital stay, and incision length (p < 0.001). According to Matta standard at 2 days postoperatively, the excellent and good rate was 91.42% in the navigation group, and it was 93.10% in the plate group. There was no significant difference between the two groups (p = 0.961). According to Majeed function system at the follow‐up, the excellent and good rate was 97.14% in the navigation group, and 93.10% in the plate group. The difference between the two groups was not statistically significant (p = 0.748). There were no neurovascular injuries associated with this procedure. The incidence of complications was 44.82% (13/29) in the plate group, while 14.28% (5/35) in the navigation group (p = 0.007).ConclusionThis study found that compared with minimally invasive percutaneous plate fixation, percutaneous IS screw fixation under 3D navigation is a suitable option for the treatment of Zone II unstable sacral fractures. This approach is characterized by its shorter operation time, less surgical trauma, less bleeding, less hospital time, and fewer complications.
Alloimmunization following antigen‐negative red blood cell transfusion
Authors: Jacobs Jeremy W. , Binns Thomas C. , Abels Elizabeth , Iyer Krishna , Figueroa Villalba Cristina A. , Verma Anuj , Sostin Nataliya , Tormey Christopher A. 
Published: December 2022

AbstractBackgroundRed blood cell (RBC) alloimmunization can occur secondary to transfusion or pregnancy. It is observed most frequently among patients with hemoglobinopathies and myeloid neoplasms. Although previous antigen exposure is generally required for alloimmunization, some alloantibodies may develop naturally without prior exposure. Other alloantibodies may become evanescent, only to reemerge at a detectable titer following a stimulatory event. In a minute fraction of cases, ‘non‐naturally occurring’ alloantibodies may appear without a known antigenic stimulus.Methods and MaterialsAll testing (antibody detection tests and identification, antigen phenotyping, and crossmatching) was performed using the same method and reagents, but occurred at two hospitals within the Yale New Haven Hospital delivery network, and was performed by technologists utilizing different instruments and reagent lots.ResultsWe present two cases of seemingly de novo alloimmunization (anti‐E and anti‐K), and one case of re‐emergence of a known, previously evanescent alloantibody (anti‐K) following transfusion of RBCs that were antigen‐negative for the corresponding antibodies.ConclusionWhile the exact mechanism underlying the development and/or re‐emergence of RBC alloantibodies in the absence of antigenic stimulation remains unclear, these cases highlight this unusual phenomenon, underscoring the general immunogenicity, as well as the potential consequences, of RBC transfusion and reiterates the importance of concluding an alloantibody specificity, even in the absence of known transfusion of RBCs with a particular antigen.
Shuttle Running Within a Small-Sided Game: Effects on Internal and External Workloads, in Young Elite Soccer Players
Authors: Panascì Marco , Ferrando Vittoria , Bisio Ambra , Filipas Luca , Ruggeri Piero , Faelli Emanuela 
Published: December 2022

Purpose: To compare the effects of 2 small-sided games (SSGs), shuttle running within the bout (SSG-S) versus possession play only (SSG-P) on acute physiological and metabolic responses, perception of effort, and performance. Methods: Ten young elite male soccer players (age 18.6 [1.9] y) performed two 5vs5 SSG formats (SSG-S and SSG-P) consisting of 4 × 4 minutes with 1 minute of passive recovery between bouts, 2 times each, once a week, and in a randomized order. Heart rate, blood lactate concentration, and rating of perceived exertion were assessed as indices of internal workload. Total and relative distances, distance at moderate and high speed, distances traveled in accelerations (≥2 m·s−2) and decelerations (≤−2 m·s−2; DDEC), and average metabolic power were chosen as indices of external workload and collected with a 10-Hz portable global positioning system device. Results: Total distance, distances traveled in acceleration, distances traveled in deceleration, average metabolic power (always P < .01 and g > 1.62—large effect), and distance at moderate speed (P = .03 and g = 0.84—large effect) were significantly higher in SSG-S than in SSG-P. Moreover, the SSG-S showed higher blood lactate concentration (P = .0001, g = 12.58—large effect) and rating of perceived exertion (P = .03, g = 1.14—large effect) values than SSG-P. No significant differences in peak heart rate, relative distance, and distance at high speed were found. Conclusions: Our study showed, in young competitive male soccer players, the effectiveness of an SSG format that includes shuttle running within each bout in the development of more relevant internal and external workloads. These experimental data should encourage coaches to use this new SSG regimen within the traditional weekly training program.
Surgical management of a congenital genital tract abnormality in a patient with Lynch syndrome
Authors: Olayato-Aribo Eniola , Wood Nicholas , Nagaiah Divya , Underwood Thomas 
Published: December 2022

Lynch syndrome (LS), also known as hereditary non-polyposis colorectal cancer, is an inherited cancer syndrome which increases the risk of developing colorectal cancer and endometrial cancer. Individuals with LS have an increased risk of cancers of the ovary, urinary tract, stomach, small intestine, pancreas, biliary tract, brain and skin. Cancer risk reduction is recommended through chemoprevention (aspirin), surveillance (colonoscopy, assessment of the endometrium and ovaries via USS, aspiration biopsy and tumour marker monitoring; CA125) or risk reduction surgery, that is, total hysterectomy and bilateral salpingo-oophorectomy.This is a case of a nulliparous woman in her early 30s with LS and a congenital genital tract malformation. She had a unicornuate (left) uterus and a vestigial (right) uterine horn. There was an inability to obtain a conclusive set of endometrial biopsies in this patient due to the nature of the patient’s congenital uterine abnormality. In this case, surgery was recommended to excise the vestigial horn and fallopian tube in order to optimise surveillance and fertility.
Outcome of COVID-19 in patients with rheumatic and inflammatory diseases
treated with mycophenolic acid: data from the French RMD COVID-19
cohort
Authors: Truchetet Marie-Elise , Drumez Elodie , Barnetche Thomas , Martin Claire , Devaux Mathilde , Goulenok Tiphaine , Maria Alexandre , Schmidt Jean , Abdallah Nassim Ait , Melki Isabelle , Hachulla Eric , Richez Christophe 
Published: December 2022

Background
Patients with inflammatory rheumatic and musculoskeletal diseases
(iRMD) receiving mycophenolic acid (MPA) may have a less favourable
outcome from COVID-19 infection. Our aim was to investigate whether MPA
treatment is associated with severe infection and/or death.

Methods
IRMD patients with and without MPA treatment with highly
suspected/confirmed COVID-19 were included in this observational
multicentre study. The primary outcome was death rate from COVID-19 with
secondary objectives to determine the severity of infection and length
of hospital stay. Outcome comparisons were made using regression models
with and without adjustment on prespecified confounding factors. ORs,
sub-HR (sHR) and 95% CIs were calculated using patients not treated with
MPA as a reference group.

Results
Of the 1977 patients, 1928 were not treated with MPA (393 were MPA
eligible), and 49 patients were treated with MPA. MPA-treated patients
had more severe disease, longer hospital stays and higher death rate
from COVID-19 than non-MPA patients (OR 8.02 (95% CI 3.35 to 19.20),
p<0.001; sHR 0.57 (95% CI 0.33 to 0.98), p=0.040; OR 11.58 (95% CI
4.10 to 32.69), p<0.001). In adjusted analyses, however, no outcome
was independently associated with MPA treatment. Death rate, severity
and length of hospital stay of MPA-treated patients were not
significantly different from those of not treated but MPA-eligible
patients.

Conclusion
MPA therapy is not associated with a more severe COVID-19 infection.
However, due to increased vulnerability of developing a severe form of
COVID-19, careful consideration should be taken with iRMD patients
likely to be treated with MPA.

Trial registration number
NCT04353609.
The Timing of Intracytoplasmic Sperm Injection Relative to Oocyte Retrieval: A Systematic Review and Meta-Analysis
Authors: Gupta Isha , Thorrowgood Mathilda , Ashton Kevin J. , Rathbone Evelyne , Chapple Vincent , Liu Yanhe 
Published: December 2022

Background: It is currently inconclusive whether different intracytoplasmic sperm injection (ICSI) timings post oocyte retrieval (POR) lead to altered chance of clinical pregnancy and live birth following in vitro fertilization (IVF) treatment. This study, therefore, aimed to synthesize literature-based evidence for better clinical guidance regarding ICSI practice. Methods: A systematic review and meta-analysis were performed according to PRISMA guidelines. Studies were searched for in PubMed, MEDLINE, EMBASE, and the Cochrane Library. Outcome endpoints included clinical pregnancy and live birth rates (LBRs). Results: A total of 605 records were retrieved in the initial search. After exclusion, 30 articles were included for further screening for eligibility. For meta-analysis, 1 prospective and 5 retrospective cohort studies were included for pooled analysis, from which clinical pregnancy rates (CPRs) were evaluated in 6 studies while LBRs were evaluated in 3 studies. CPRs were comparable when ICSI was performed at (a) [Formula: see text] hours POR (risk ratio or RR = 1.00, [Formula: see text] confidence interval [CI] 0.94–1.08) vs [Formula: see text] hours, (b) [Formula: see text] hours (RR = 1.01, [Formula: see text] CI 0.88–1.16) vs [Formula: see text] hours, (c) [Formula: see text] hours (RR = 0.99, [Formula: see text] CI 0.93–1.05) vs [Formula: see text] hours, (d) [Formula: see text] hours (RR = 0.98, [Formula: see text] CI 0.93–1.02) vs [Formula: see text] hours, and (e) [Formula: see text] hours (RR = 1.05, [Formula: see text] CI 0.90–1.23) vs [Formula: see text] hours. However, LBR was reduced when ICSI was performed [Formula: see text] hours POR vs [Formula: see text] hours (RR = 0.94, [Formula: see text] CI 0.89–0.99), but such reduction disappeared when comparing [Formula: see text] hours POR (RR = 1.09, [Formula: see text] CI 0.85–1.38) vs [Formula: see text] hours. Conclusions: CPRs remain comparable when ICSI is performed at a range of timings up to 6-hour POR. However, LBR may benefit slightly by scheduling ICSI between 5- and 6-hour POR.
Inclusive Technology Performance Evaluation in the Production of Teff (Eragrostis tef (Zucc.) Trotter)
Authors: Mihiretu Ademe , Asresu Melaku 
Published: December 2022

Different management practices likely to enhance teff production are used in Ethiopia, however, evidence on their relative performance is little studied or unavailable. This on-farm experiment was conducted to assess the performance of different management practices for teff productivity, profitability, and acceptability in subtropical districts of North East Amhara. Four trial treatments (viz., IKIM, IBIM, LBIM, and LBFM) were laid out in an unreplicated simple block considering farmers as replication during the main cropping seasons of 2019 and 2020. Tukey’s (HSD) test following one-way ANOVA, partial budget analysis, and weighted matrix ranking were used to explain the significance level, profitability, and preference traits, respectively. Results presented a significant (

p

≤ 0.01) treatment difference across districts in days to maturity, grain, and biomass yields. Among treatments, IKIM had short maturity days at Sekota (94), Dehana (105), and Lasta (95) districts. The grain yields were on average 1.75 ton ha−1, 1.45 ton ha−1, and 1.63 ton ha−1 at Sekota, Dehana, and Lasta districts, respectively. The lowest grain yields of 0.70 ton ha−1, 0.58 ton ha−1, and 0.63 ton ha−1 were recorded from LBFM. Despite the higher total variable costs, IKIM was gainful having 51400 ETB, 40579 ETB, and 46928 ETB net benefits at Sekota, Dehana, and Lasta districts, respectively. The MRR showed that a marginal profit of 13.77, 9.76, and 9.23 ETB was gained per each 1.00 ETB investment for shifting the practice (LBFM to IKIM). Therefore, we recommend IKIM as best management practice for consistent teff production in similar agroecological conditions.
Safety and Efficacy of MEDI0457 plus Durvalumab in Patients with Human Papillomavirus–Associated Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma
Authors: Aggarwal Charu , Saba Nabil F. , Algazi Alain , Sukari Ammar , Seiwert Tanguy Y. , Haigentz Missak , Porosnicu Mercedes , Bonomi Marcelo , Boyer Jean , Esser Mark T. , Cheng Lily I. , Agrawal Sonia , Jennings Emily C. , Durham Nicholas M. , Fraser Karl , Lissa Delphine , Gong Maozhen , Ceaicovscaia Natalia , Gascó Hernández Amaya , Kumar Rakesh 
Published: December 2022

Abstract

Purpose:
Tumoral programmed cell death ligand-1 (PD-L1) expression is common in human papillomavirus (HPV)–associated head and neck squamous cell carcinoma (HNSCC). We assessed whether a DNA vaccine targeting HPV-16/18 E6/E7 with IL12 adjuvant (MEDI0457) combined with the PD-L1 inhibitor durvalumab could enhance HPV-specific T-cell response and improve outcomes in recurrent/metastatic HPV-16/18–associated HNSCC.

Patients and Methods:
In this phase Ib/IIa study, immunotherapy-naïve patients with ≥1 previous platinum-containing regimen (neoadjuvant/adjuvant therapy or for recurrent/metastatic disease) received MEDI0457 7 mg intramuscularly with electroporation on weeks 1, 3, 7, and 12, then every 8 weeks, plus durvalumab 1,500 mg intravenously on weeks 4, 8, and 12, then every 4 weeks, until confirmed progression and/or unacceptable toxicity. Coprimary objectives were safety and objective response rate (ORR; H0: ORR ≤ 15%); secondary objectives included 16-week disease control rate (DCR-16), overall survival (OS), and progression-free survival (PFS).

Results:
Of 35 treated patients, 29 were response evaluable (confirmed HPV-associated disease; received both agents). ORR was 27.6% [95% confidence interval (CI), 12.7–47.2; four complete responses, four partial responses]; responses were independent of PD-L1 tumor-cell expression (≥25% vs. &lt;25%). DCR-16 was 44.8% (95% CI, 26.5–64.3). Median PFS was 3.5 months (95% CI, 1.9–9.0); median OS was 29.2 months (15.2–not calculable). Twenty-eight (80.0%) patients had treatment-related adverse events [grade 3: 5 (14.3%); no grade 4/5], resulting in discontinuation in 2 (5.7%) patients. HPV-16/18–specific T cells increased on treatment; 4 of 8 evaluable patients had a &gt;2-fold increase in tumor-infiltrating CD8+ T cells.

Conclusions:
MEDI0457 plus durvalumab was well tolerated. While the primary efficacy endpoint was not reached, clinical benefit was encouraging.
Abstract A009: ZMYND8 is an epigenetic regulator of 27-hydroxycholesterol that promotes tumorigenicity of breast cancer stem cells
Authors: Luo Weibo , Luo Maowu 
Published: December 2022

Abstract
27-hydroxycholesterol (27-HC) is the most abundant oxysterol that increases the risk of breast cancer progression. However, little is known about epigenetic regulation of 27-HC metabolism and its role in breast tumor initiation. Using genetic mouse mammary tumor and human breast cancer models, we showed here that the histone reader ZMYND8 was selectively expressed in breast cancer stem cells (BCSCs) and promoted epithelial-mesenchymal transition (EMT), BCSC maintenance and self-renewal, and oncogenic transformation through its epigenetic functions, leading to breast tumor initiation. Mechanistically, ZMYND8 was a master transcriptional regulator of 27-HC metabolism. It increased cholesterol biosynthesis and oxidation but blocked cholesterol efflux and 27-HC catabolism leading to accumulation of 27-HC in BCSCs. Consequently, 27-HC promoted EMT, oncogenic transformation, and tumor initiation through activation of liver X receptor. These findings reveal that ZMYND8 is an epigenetic booster that drives breast tumor initiation through metabolic reprogramming.
Citation Format: Weibo Luo, Maowu Luo. ZMYND8 is an epigenetic regulator of 27-hydroxycholesterol that promotes tumorigenicity of breast cancer stem cells. [abstract]. In: Proceedings of the AACR Special Conference: Cancer Epigenomics; 2022 Oct 6-8; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2022;82(23 Suppl_2):Abstract nr A009.
Abstract A012: Transcription factor expression repertoire basis for epigenetic and transcriptional subtypes of colorectal cancers
Authors: Bhandari Yuba R. , Krishna Vinod , Powers Rachael , Parmar Sehej , Thursby Sara-Jayne , Gupta Ekta , Kulak Ozlem , Gokare Prashanth , Reumers Joke , Van Wesenbeeck Liesbeth , Bachman Kurtis E. , Baylin Stephen B. , Easwaran Hariharan 
Published: December 2022

Abstract
Colorectal cancers (CRCs) form a heterogenous group classified into epigenetic and transcriptional subtypes. The basis for the epigenetic subtypes, exemplified by varying degrees of promoter DNA hypermethylation, and its relation to the transcriptional subtypes is not well understood. We now link cancer-specific transcription factor (TF) expression dysregulation to methylation alterations near TF-binding sites at promoter and enhancer regions in CRCs and their pre-malignant precursor lesions to provide mechanistic insights into the origins and evolution of the CRC molecular subtypes. A gradient of TF-expression changes forms a basis for the subtypes of abnormal DNA methylation, termed CpG-island promoter DNA methylation phenotypes (CIMP), in CRCs and other cancers. CIMP is tightly correlated with cancer-specific hypermethylation at enhancers, which we term CpG-enhancer methylation phenotype (CEMP). CIMP/CEMP coordination appears to be driven by augmented downregulation of TFs with common binding sites at the hypermethylated enhancers and promoters. The dysregulated expression of TFs related to CIMP/CEMP subtypes occurs early during CRC development, detectable in pre-malignant adenomas. TF-based profiling further identifies patients with worse overall survival. Importantly, altered expression of these TFs discriminates the transcriptome-based consensus molecular subtypes (CMS), thus providing a common basis for CIMP and CMS subtypes.
Citation Format: Yuba R. Bhandari, Vinod Krishna, Rachael Powers, Sehej Parmar, Sara-Jayne Thursby, Ekta Gupta, Ozlem Kulak, Prashanth Gokare, Joke Reumers, Liesbeth Van Wesenbeeck, Kurtis E. Bachman, Stephen B. Baylin, Hariharan Easwaran. Transcription factor expression repertoire basis for epigenetic and transcriptional subtypes of colorectal cancers. [abstract]. In: Proceedings of the AACR Special Conference: Cancer Epigenomics; 2022 Oct 6-8; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2022;82(23 Suppl_2):Abstract nr A012.