bluuebunny/crossref_metadata_2025 huggingface dataset:
Data from ctDNA Dynamics and Mechanisms of Acquired Resistance in Patients Treated with Osimertinib with or without Bevacizumab from the Randomized Phase II ETOP-BOOSTER Trial
Authors: Soo Ross A. , Dafni Urania , Han Ji-Youn , Cho Byoung Chul , Nadal Ernest , Yeo Chong Ming , Carcereny Enric , de Castro Javier , Sala Maria Angeles , Coate Linda , Provencio Mariano , Britschgi Christian , Vagenknecht Patrick , Dimopoulou Georgia , Kammler Roswitha , Finn Stephen P. , Peters Solange , Stahel Rolf A.
Published: November 2024

AbstractPurpose:
The ETOP 10-16 BOOSTER study was a randomized phase II trial of osimertinib and bevacizumab therapy versus osimertinib therapy in patients with an acquired EGFR T790M mutation. The mechanisms of acquired resistance to osimertinib and bevacizumab have not been described previously.
Experimental Design:
Next-generation sequencing (Guardant360) was conducted in serial plasma samples. The association between ctDNA and efficacy outcomes was explored, and molecular alterations at progression were described.
Results:
A total of 136 patients (88% of 155 randomized) had plasma samples at baseline (68 per arm), 110 (71%) at week 9, and 65 (42%) at progression. In a multivariable model for progression-free survival (PFS), the treatment effect was found to differ by smoking status (interaction P = 0.046), with the effect of smoking also differing by baseline EGFR T790M (interaction P = 0.033), whereas both TP53 at baseline and the tissue EGFR exon 21 L858R mutation were significantly associated with worse PFS outcome. Smokers (current/former) without baseline EGFR T790M showed a significant improvement in PFS under combination treatment, albeit with small numbers (P = 0.015). Week-9 EGFR T790M clearance was associated with improved PFS in the osimertinib arm (P = 0.0097). Acquired EGFR C797S mutations were detected in 22% and 13% of patients in the combination and osimertinib arms, respectively.
Conclusions:
The differential effect of treatment by smoking was not explained by TP53 mutations or other molecular alterations examined. Molecular mechanisms of acquired resistance were detected, but no novel molecular alterations were identified in the combination arm.
Abstract A022: Novel technology affords real-time PCR the sensitivity required for minimal residual disease monitoring
Authors: Stischer Mary , Allen Nick , Barbari Stephanie , Kane Sarah
Published: November 2024

Monitoring minimal residual disease (MRD) provides invaluable information for disease progression and therapeutic decision making. However, there are many challenges to reliably detect key mutations or biomarkers, such as the accessibility, turnaround time, and sensitivity of current methods. High sensitivity is crucial due to the limited DNA available in certain sample types such as liquid biopsy. Next generation sequencing (NGS) is capable of highly sensitive detection but is dependent on high sample input and read depth, which is not always feasible due to the variable nature of circulating tumor DNA (ctDNA) in blood or plasma. In addition, NGS is not an economical nor rapid option for recurrent longitudinal monitoring. Digital PCR (dPCR) offers the sensitivity required for MRD monitoring but has yet to be widely adopted for this application. While real-time and qPCR are commonly used in oncology research, RT-PCR does not have the sensitivity required for early detection of key MRD mutations. Here, we present novel patent-pending technology that enhances the sensitivity of RT-PCR, allowing this common platform to be used to reliably detect low abundant mutations. We performed comparisons between GT Molecular’s patent-pending technology paired with RT-PCR and commercially available research use only dPCR and NGS assays to assess the sensitivity this new technology provides for RT-PCR. Cell-free DNA (cfDNA) was extracted from real patient or contrived plasma samples using the QIAamp Circulating Nucleic Acid Kit and analyzed using RT-PCR and dPCR assays targeting KRAS or ESR1 mutations. Samples with KRAS or ESR1 mutations were tested at variant allele frequencies (VAFs) varying between 1%-0.01% to evaluate the ability of GT Molecular’s new technology to detect low abundant mutations using RT-PCR. KRAS and ESR1 mutations were reliably detected with RT-PCR at VAFs as low as 0.01%, demonstrating sensitivity comparable to dPCR. Samples demonstrating positivity for KRAS or ESR1 mutations via dPCR were also positive via RT-PCR. With this patent-pending technology, RT-PCR is now capable of achieving the sensitivity required for MRD monitoring, providing critical information from liquid biopsy samples at a fraction of the cost.

Citation Format: Mary Stischer, Nick Allen, Stephanie Barbari, Sarah Kane. Novel technology affords real-time PCR the sensitivity required for minimal residual disease monitoring [abstract]. In: Proceedings of the AACR Special Conference: Liquid Biopsy: From Discovery to Clinical Implementation; 2024 Nov 13-16; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(21_Suppl):Abstract nr A022.
As Décimas Urbanas e novas abordagens sobre a história das cidades oitocentistas
Authors: Moura Nádia Mendes de , Borsoi Diogo Fonseca
Published: November 2024

The Décima Urbana tax was established in 1808, in the context of the Portuguese Crown's arrival in Brazil and consisted of charging 10% of the value of urban properties "in conditions to be inhabited", with the exception of properties belonging to Houses of Mercy. In recent years, researchers have advanced in documentary research, exploring new typologies beyond laws and royal directives. The surviving documents from this collection have become valuable sources for research on urban and city history, as they provide a material 'snapshot' of the city during a specific period, as well as insights into urban property ownership. This article aims, first, to present the source by exploring the context of its creation, the bureaucratic routine involved, the agents responsible for the collection, as well as its inaccuracies and limitations. It then conducts a literature review of research that has used this documentation, aiming to map approaches and methods of work. Finally, it aims to point out some potentialties of the document in other areas of work.
A contribuição de Giacomo Palumbo para a formação do subúrbio moderno recifense (1922-1934)
Authors: Cortez Karine Maria Gonçalves , Moreira Fernando Diniz
Published: November 2024

O arquiteto italiano Giacomo Palumbo (1891-1966) foi o profissional de maior destaque atuando na cidade do Recife durante as décadas de 1920 e 1930. Marcado por sua formação em Paris, produziu inúmeras obras públicas e privadas seguindo vocabulário clássico e eclético, como o Palácio de Justiça, o Hospital Centenário, o Hotel Central, a Faculdade de Medicina, além de várias residências. Apesar da magnitude de sua obra, existem grandes lacunas e omissões na historiografia sobre sua figura e arquitetura. Este artigo objetiva analisar a contribuição de sua arquitetura na conformação da imagem moderna para o Recife, que se expandia para áreas suburbanas, por meio de novas tipologias edilícias. Com base nos estudos de periódicos, documentos e iconografia de acervos, foram escolhidos para análise cinco edifícios, localizados entre os bairros vizinhos do Derby, Graças e Aflitos. Essas regiões passaram a atrair as elites devido aos melhoramentos de infraestrutura, paisagísticos e construções de edifícios que representavam as novas formas de morar, trabalhar e de se socializar. Percebe-se que Palumbo buscou trazer unidade e coerência para a cidade, por meio da arquitetura que se adaptava às diferentes demandas e desejos dos clientes. Longe de uma aplicação literal dos modelos europeus, na verdade, estes edifícios revelam uma série de adaptações aos aspectos técnicos e urbanísticos locais, ligados ao contexto político, social, econômico e cultural do Recife. O estudo busca uma maior aproximação das disciplinas da história urbana, urbanismo, paisagismo e arquitetura para um entendimento mais profundo da modernização de nossas cidades.
Validação de conteúdo do Protocolo de utilização da Escala e Régua de Mobilidade (PERMo) na avaliação da mobilidade do paciente pós acidente vascular cerebral na fase hospitalar
Authors: Vargas Isadora Martins Postiglioni de , Rodrigues Luciano Palmeiro , Candotti Claudia Tarragô , Dias Alexandre Simões
Published: November 2024

Limitações de mobilidade em pacientes pós acidente vascular cerebral (AVC) podem ser avaliadas por escalas, desde que tenham validade e confiabilidade confirmadas. Objetivo: Determinar a validade de conteúdo do Protocolo de utilização da Escala e da Régua de Mobilidade (PERMo) na avaliação da mobilidade do paciente pós AVC, na fase hospitalar. Métodos: Estudo observacional, no qual oito especialistas formaram o comitê de experts que avaliaram o conteúdo do PERMo. Para cada item do PERMo ser válido, todos os índices de validade de conteúdo (IVCs) deveriam ser >80%. Resultados: Foram necessários quatro rounds de avaliação do PERMo para confirmar sua validade de conteúdo. No terceiro round, apenas um item do PERMo apresentou IVC de 75%, relacionado a capacidade de rolar do paciente. No quarto round, todos os itens do PERMo foram considerados adequados, com IVCs variando de 88% a 100%. Nos quatro rounds, os experts propuseram alterações no PERMo, condizentes com sua avaliação quantitativa, as quais foram todas acatadas pelos pesquisadores. Conclusão: Os adequados IVCs obtidos na versão final do PERMo apontam o consenso entre os experts em entender que o instrumento é valido para a avaliação da mobilidade de pacientes pós AVC na fase hospitalar.
Functional limitations and the use of rehabilitation therapies among brazilian adults with chronic diseases
Authors: Boccolini Patricia de Moraes Mello , Duarte Cristina Maria Rabelais , Boccolini Cristiano Siqueira
Published: November 2024

Objective: We aim to analyze the functional limitations and the use of rehabilitation therapies among brazilian adults with chronic diseases. Methods: This is a population-based survey with data from the 2013 National Health Survey. There was selected a subsample of the adult population who reported chronic diseases (stroke, arthritis, work-related musculoskeletal disorder, chronic obstructive pulmonary disease, or reported back pain), and that also reported moderate to very intense limitations of their activities. The outcome was the use of rehabilitation therapies. A logistic regression model was estimated, with a 95% confidence interval, adjusted for sociodemographic variables. Results: Among brazilian adults, 24.8% were diagnosed with a stroke, arthritis, work-related musculoskeletal disorder, chronic obstructive pulmonary disease, or reported back pain. Among these, 34.6% reported having moderate, intense, or very intense limitations in their daily activities due to illnesses, and, among this population, 26.3% performed some rehabilitation therapy related to their conditions. The use of rehabilitation therapies was more frequent among the female population, with higher education, higher socioeconomic status, older, and living in the southern macro-region of Brazil. Conclusions: Among brazilians with functional limitations due to chronic diseases, the low frequency of rehabilitation therapies utilization may be associated with barriers to access health services.
Trombose e amputação na COVID-19 aguda: um relato de caso
Authors: Chagas Kleber Jessivaldo Gomes das , Faria Junior Nilson , Israel Iago , Oewel Thais de Souza , Sugawara André Tadeu , Oliveira Gerson Sobrinho Salvador de , Imamura Marta , Battistella Linamara Rizzo
Published: November 2024

During the outbreak of COVID-19, it has been discovered that the infection was associated to increased risk of venous or arterial thromboembolic events and many other dysfunctions in various systems of human body. In relation to thrombosis, in molecular/cellular levels numerous signaling pathways due to dysregulated RAAS may contribute to the observed coagulopathy in COVID-19. On the other hand, excessive innate immune response to SARS-CoV2 for which there is no prior acquired immunity mediates various pathways that may lead to thrombosis. Case report: This case report analyzes those hematologic disfunctions in a patient affected for a post COVID-19 conditions associated to a long-term hospitalization resulting in a bunch of sequels. We emphasized the transfemoral amputation was due to proximal arterial thrombosis and the functional loss related to it. We aborted the whole rehabilitation plan and its implementation since the beginning of the process of dehospitalization. We describe the role of each professional of the multi-professional team, the pharmacologic and non-pharmacologic treatment, the assistive technologies applied, the other sequels related to post COVID-19 conditions and long-term hospitalization and their functional gains. We used the Functional Independence Measure (MIF) to do the follow up of the case, 84 to 96. As results of the therapeutic program, the patient could achieve a high grade of modified independence for activities of daily living (ADLS) and Instrumental activities of daily living. Conclusion: Thrombosis and amputations are complications in COVID-19 patients. The absence of a multidisciplinary program of rehabilitation will cause to the patient an increasing risk of development of psychologic affections and great impact of their social life.
Boas práticas em saúde digital: a experiência do Instituto de Medicina Física e Reabilitação HCFMUSP na adoção das teleconsultas
Authors: Mineto Victória Bassan , Cichon Flavio Rodrigo , Ramos Vinicius Delgado , Tateishi Mariane , Battistella Linamara Rizzo
Published: November 2024

Apresentamos as estratégias para implantação do sistema de teleatendimento e os resultados preliminares desta modalidade em Saúde Digital a partir de 2023, perpassando o processo de digitalização da saúde pública no Brasil, para então abordar o Plano de Saúde Digital do HCFMUSP e seus desdobramentos no IMREA. Em conclusão, a partir das novas estratégias adotadas, foi possível perceber a criação de uma cultura de aceitação das teleconsultas, tendo maior adesão por parte de profissionais e pacientes no uso da plataforma. A descrição de algumas das boas práticas adotadas pelo Instituto apresenta-se como uma oportunidade de melhoria das atividades assistenciais na modalidade digital e a sua replicação por outras instituições de saúde que visam a transformação digital de seus serviços.
Apresentação - Revista África (número 44)
Authors: Macedo Tania Celestino de , Moutinho Laura , Souza Marina de Mello e , Moura Alex de Campos , Martinho Francisco Carlos Palomanes
Published: November 2024

A Revista África inaugura seu novo formato de publicação em fluxo contínuo com a edição número 44. Neste número, cinco artigos abordam temas diversos, convergindo na crítica às formas de conhecimento hegemônicas do ocidente. O artigo de Ricardo Aguinelo Aquixinco Gomes Cá discute o colonialismo e o racismo através de Frantz Fanon, enquanto Mamim Alfissene Baciro Baldé explora o "racismo epistêmico" e a importância de perspectivas africanas endógenas. Carla Ribeiro analisa o turismo afrodiaspórico no Senegal, destacando a busca por identidades perdidas pela diáspora. Monique dos Anjos investiga o racismo acadêmico, combinando experiências pessoais e acadêmicas para expor o racismo e a misoginia. Por fim, Silas Fiorotti critica as narrativas oficiais nos manuais escolares moçambicanos, apresentando uma visão mais complexa da história do país. Esses textos desafiam discursos hegemônicos, promovendo uma discussão sobre dominação e resistência às ordens estabelecidas.
Effects of different water temperatures on the ovarian development and biochemical composition of Portunus trituberculatus after mating (Decapoda, Portunidae)
Authors: Wan Litao , Wu Yiting , He Jie , Zhang Dongxu , Shi Huilai , Zhang Tao
Published: November 2024

This study investigated the effects of different water temperatures (20, 23, 26 and 29°C) on the ovarian development and biochemical composition of Portunus trituberculatus (a swimming crab) after mating. The results showed that the higher the water temperature was, the faster the ovarian development, especially the GSI in the 29°C group was significantly higher than that in the 20°C and 23°C groups (). The hepatosomatic index (HSI) decreased with increasing water temperature, but there was no significant difference between the groups at different water temperatures (). The muscle yield (MY) was basically maintained at approximately 34%. The condition factor (CF) of the crab reached 0.62 in the 29°C group, which was significantly higher than that in the 20°C and 23°C groups (). Histological observation revealed that the number of lipid droplets and the degree of homogenization of yolk granules in ovarian oocytes gradually increased with the increase of the water temperature. From the perspective of conventional biochemical composition, the moisture and crude protein contents in muscle and the crude fat content in hepatopancreas did not change much among the groups, but the crude protein content in the ovary of the 29°C group was as high as 24.65%, which was significantly higher than that in the other three groups (). In terms of fatty acid composition, there was little difference in the fatty acid content in the ovaries of the different water temperature groups. The contents of C22 : 2n6 and C18 : 3n3 in polyunsaturated fatty acids were significantly higher in the 29°C group than in the other three groups (). In the hepatopancreas, the contents of C22 : 5n3 (DPA) and C22 : 6n3 (DHA) in the 20°C group were the lowest, 0.07% and 0.15%, respectively, which were significantly lower values than in the 29°C group (). The change of amino acid content is mainly reflected in ovarian tissues, showing a gradual upward trend as a whole. Furthermore, the essential amino acid score (EAAS) and average score of the two tissues in the 20°C and 23°C groups were relatively close, and both reached the highest score in the 29°C group. Overall, with increasing water temperature, the rate of ovarian development significantly accelerated, and the nutritional quality of the tissues improved in these swimming crabs.
Insights into brachyuran crab phylogeny: exploring the mitochondrial genome of Arcotheres sinensis (Brachyura, Pinnotheridae)
Authors: Liang Xinjie , Duan Xinbing , Li Jiji , Ye Yingying
Published: November 2024

The phylogeny of species of Brachyura, particularly within the family Pinnotheridae, remains incompletely understood. To enhance the taxonomy and systematics of the Pinnotheridae, we conducted a comprehensive study aimed at elucidating the phylogenetic position of Arcotheres sinensis. Consequently, we sequenced and annotated the complete mitochondrial genome of A. sinensis, The results revealed that the circular mitogenome of A. sinensis spans 16 520 bp in length. Distinct from typical mitogenomes, A. sinensis contains 13 protein-coding genes (PCGs), 2 ribosomal RNA genes and 23 transfer RNA genes. The A + T content of the A. sinensis mitogenome is 71.63%, with both AT-skew and GC-skew being negative. The lengths of the 23 tRNA genes range from 62 to 72 bp. All tRNA genes exhibit typical cloverleaf structures, except for the trnS1 gene, which lacks the dihydrouridine (DHU) arm. Selection pressure analysis revealed that all PCGs are under evolutionary selection, with cox1 experiencing strongest purifying selection and atp8 undergoing weakest purifying selection. Compared to ancestral Brachyura, the gene order of A. sinensis has been rearranged from R-N--E to -E-N-R and the sequence I-Q-M has transitioned to Q-I-M. Phylogenetic analysis unequivocally positions A. sinensis within the taxonomic framework of the family Pinnotheridae, highlighting its intimate phylogenetic relationship with congeners within the same familial clade, notably Arcotheres purpureus and Pinnotheres excussus. These findings contribute to a better understanding of the status and evolutionary history of Pinnotheridae species.
Corn grain yield, residue production, and nutrient concentration and extraction is affected by different residue incorporation rates in two biannual crop rotations
Authors: Hirzel Juan , Undurraga Pablo , León Lorenzo , Vera Carola , Matus Iván
Published: November 2024

Conservation practices in agriculture using crop rotations and residue management benefit the productivity; these can vary depending on climate and soil conditions, crops, and amount of incorporated residue. The present study evaluated the effect of two biannual rotations; canola (Brassica napus L.) – corn (Zea mays L.) and bean (Phaseolus vulgaris L.) – corn rotations with four residue incorporation rates (0%, 50%, 100%, and 200%) of the preceding crop on corn grain yield, residue production, and nutrient concentration and extraction after two rotation cycles in a volcanic soil of moderate depth in south-central Chile. Grain yield varied between 17.04 and 17.40 Mg/ha, residue production between 16.41 and 16.50 Mg/ha. The preceding crop affected concentration and extraction of some nutrients in both grain and residue. The residue rate affected both concentration and extraction of some nutrients only in the grain. The Ca distribution to the corn grain was negatively affected by both the preceding bean crop and increasing residue incorporation rate. The ranking of total macronutrient extraction in the corn crop was K > N > Ca > P > Mg > S. The extraction means ranged from 320 to 326, 56.0 to 57.1, 365 to 374, 86.5 to 99.3, 39.4 to 42.4, and 22.6 to 23.7 kg/ha, whereas grain nutrient distribution coefficients ranged from 64.5 to 66.8, 90.1 to 90.9, 23.1 to 23.7, 1.3 to 2.0, 50.8 to 57.5, and 60.3 to 60.6 for N, P, K, Ca, Mg and S, respectively.
Pulmonary tuberculosis and renal amyloidosis: A rare entity in children
Authors: Tyagi Vernika , Mantan Mukta , Batra Vineeta V.
Published: November 2024

Amyloidosis is a group of disorders with extracellular accumulation of autologous fibrillary insoluble proteins in various tissues and organs such as the kidneys, liver, spleen, heart, and gastrointestinal tract leading to impaired function. Renal amyloidosis is usually considered to be a progressive disease manifesting as nephrotic syndrome and renal insufficiency with tuberculosis being one of the most common causes in adults. However, the occurrence of similar associations is rarely described in children. We report a case of an 11-year old girl who presented with nephrotic syndrome and pulmonary tuberculosis and attained disease remission with successful treatment of tuberculosis.
Maternal exposure to violence and early child behavioural development in Tirana, Albania: Methods, challenges, and fieldwork reflections
Authors: Ramaj Klea
Published: November 2024

This article delineates the methods of the author's PhD in Criminology, carried out at the University of Cambridge from 2019 to 2023. The main aim of the PhD was to explore the pathways between maternal exposure to violence and the behavioural development of two-to-three-year-old children in Tirana, Albania. To achieve this, the author spent 10 months in Tirana collecting data from a sample of 328 mothers and 59 nursery teachers in eight diverse socio-economic research sites. The purpose of this article is to reveal the details of the methodological approach, the meticulous planning, as well as the obstacles faced when implementing the PhD project. It provides a thorough description of the research design, sampling strategy, measurement tools, ethical considerations, data collection challenges, and fieldwork experiences.
“I am the mother of the kind of child you dread having”: Experiences of living with chronic sorrow among parents with a disabled child
Authors: Raap Edith , Weille Katie Lee , Dedding Christine
Published: November 2024

Chronic sorrow involves parents’ enduring grief due to their child’s disability. This stems not only from the recurring painful reality parents face, which differs from the life they had hoped for their children, families, and themselves but from also being confronted with societal and personal norms and expectations they cannot meet. There is a lack of research on the lived experiences of parents’ chronic sorrow. An Interpretative Phenomenological Analysis (IPA) study involving six parents with severely disabled children explored what it is like for parents to confront being “different.” Besides sorrow, the parents experienced intense ambiguity, guilt, and uncertainty while navigating societal expectations and their own perceptions of their children. Their ideas of parenthood and their self-identity as parents proved central to their strategies. This study provides insight into the intricacies of this particular aspect of chronic sorrow in parents, with relevance for research and practice.
Analysis of hydrofoil tip leakage vortex dynamic characteristics
Authors: Gang Yuanyuan , Zhou Ziyao , Li Jialing , Peng Liang , Liu Demin , Liu Xiaobing , Pang Jiayang
Published: November 2024

The clearance exists inevitably between the turbine guide vanes and the fixed wall, and the resulting tip leakage vortex leads to the increase of hydraulic loss. Based on the fluid simulation software ANSYS CFX, the hydrofoil was numerically simulated under different flow velocity conditions. The trajectory and energy dissipation of the tip leakage vortex are discussed. The results show that the jet entrainment with the main flow to form the tip leakage vortex, which is mainly divided into main leakage vortex and separation vortex. The flow evolution of tip leakage vortex can be divided into three stages. The evolution of tip leakage vortex can be divided into three stages: independent development of main leakage vortex and separation vortex, fusion stage, and dissipation of main leakage vortex. The strongest turbulent kinetic energy dissipation occurs in the clearance, which confirms that the clearance causes non-negligible energy dissipation for hydraulic machinery. The results provide guidance for tip leakage vortex control of hydraulic hydrofoil.
Erythropoietin for the prevention of postoperative neurocognitive disorder in older adult patients undergoing total joint arthroplasty: a randomized controlled study
Authors: Kim Eun Jung , Park Kwan Kyu , Choi Su Youn , Ju Hyang Mi , Kim Tae Lim , Kim Jeongmin , Kim Soo Yeon , Koo Bon-Nyeo
Published: November 2024

Background

Post-operative delirium (PD) is a common post-operative complication with significant clinical and financial impacts on patients. Erythropoietin (EPO), a multi-functional glycoprotein hormone, exhibits erythropoietic and non-erythropoietic anti-inflammatory properties. This study aimed to determine the role of perioperative EPO administration in the development of postoperative delirium in older adult patients undergoing total joint arthroplasty.

Methods

Seventy-one patients (> 65 years old) scheduled for total joint arthroplasty were randomly assigned to two groups: EPO-treated (EPO, n = 35) and placebo (control, n = 36). All patients completed the Mini Mental State Examination (MMSE) pre-operatively and on post-operative day (POD) 2. The confusion assessment method (CAM) was used to assess the patients until discharge (POD 5). Serum C-reactive protein (CRP) and inflammatory cytokine levels were measured and compared pre- and post-operatively. The development of delirium and cognitive dysfunction was evaluated post-operatively.

Results

One patient in the control group developed delirium on POD 2 (3.2%), whereas no patient in the EPO group developed PD (0% vs. 3.2%, p = 0.500). Post-operatively there was no significant difference in MMSE scores between groups. Both groups showed increases in pro- and anti-inflammatory cytokine levels, with no significant differences. Similarly, CRP levels, neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) showed no intergroup differences in post-operative inflammatory responses.

Conclusions

Perioperative EPO reduced the incidence of post-operative delirium, although not statistically significant, with no differences in post-operative cognitive function and inflammatory responses.

Trial registration

The trial was registered on December 12, 2023 at http//clinicaltrials.gov, registration number NCT06178835.
Facilitating the transition from hospital to home after hip fracture surgery: a qualitative study from the HIP HELPER trial
Authors: Welsh A , Hanson S , Pfeiffer K , Khoury R , Clark A , Grant K , Ashford P-A , Hopewell S , Logan PA , Crotty M , Costa ML , Lamb SE , Smith TO ,   on behalf of the HIP HELPER Study Collaborators, Clifford Penny , Freeman Lis , Gray Rene , Paget James , Cunningham Yan , Langford Sarah , Baxter Mark , Pawson Jessica , Taylor Melissa , Mellows Anna , Lacey Kate , Herring Alex , Williams Diane , Cromie Anna , Menton Gail , Corbett Warren , Jowett Helen , Joshi Vishwanath , Matharu Maninderpal , Baggot Maria , Barker David , Dutton Susan , Sahota Opinder , Sheehan Katie
Published: November 2024

Background

People post-hip fracture have reported experiences of fragmented care and poor discharge planning, therefore improvements in patient flow are required. This study reports the challenges people face during the discharge process and offers potential solutions for improving the transition from hospital to home from the perspectives of patients, carers, and health professionals.

Methods

This was a qualitative study embedded within a multi-centre, feasibility randomised controlled trial (HIP HELPER). We undertook semi-structured interviews with 10 patient-carer dyads (10 people with hip fracture; 10 unpaid carers) and eight health professionals (four physiotherapists, two occupational therapists, one nurse and one physiotherapy researcher) between November 2021 and March 2022. Data were analysed using the principles of Framework Analysis.

Results

Participants identified challenges in the transition from hospital to home post-hip fracture surgery: ineffective communication, disjointed systems, untimely services and ‘it’s more than just the hip’. Possible solutions and insights to facilitate this transition included the need for reassurance, collaborative planning, and individualisation.

Conclusion

The transition from hospital to home following hip fracture surgery can be a challenging experience for patients, and for friends and family who support them as carers, making them feel vulnerable, frustrated and uncertain. Enabling a coordinated, collaborative approach to discharge planning and early recovery provision is considered a positive approach to improving NHS care.

Trial registration

ISRCTN13270387. Registered 29th October 2020.
Factors associated with eating performance in nursing home residents living with dementia and other comorbidities
Authors: Liu Wen , Lee Kyuri , Galik Elizabeth , Resnick Barbara
Published: November 2024

Background

Eating performance is the functional ability to get food into the mouth and chew/swallow it. Nursing home residents with dementia commonly experience compromised eating performance and subsequent consequences. Prior work examined the association between resident eating performance and their cognitive and functional ability. Yet, the associations between resident eating performance and behavioral and psychological symptoms, psychotropic medication use, and comorbidities are less studied. This study aimed to examine the association between eating performance and cognition, functional ability, behavioral and psychological symptoms, psychotropic medication use, and comorbidities in nursing home residents with dementia.

Methods

This was a secondary analysis using baseline data from two randomized controlled trials, testing the impact of Function Focused Care on function and behavioral symptoms in 882 residents with moderate-to-severe dementia (mean age 86.55 years, 71% female, 30% non-white, 68.5% severe dementia) from 67 nursing homes in two states between 2014 and 2020. Eating performance (dependent variable) was measured using the single self-feeding item of Barthel Index. Independent variables included cognitive impairment, functional ability (Barthel Index total score excluding the self-feeding item score), behavioral and psychological symptoms (agitation, depression, resistiveness-to-care), psychotropic medication use (anti-depression, sedative, anti-psychotics, anti-seizure, anti-anxiety), and comorbidities.

Results

Nearly 39% of residents were dependent in eating. On average, residents had five documented comorbidities (SD = 3.06, range = 0–12) and were on approximately one psychotropic medication (SD = 1.25, range = 0–5). Eating performance was associated with cognitive impairment (OR = 0.53, 95% CI = 0.35, 0.79, p = .002), functional ability (OR = 1.05, 95% CI = 1.04, 1.06, p < .001), depressive symptoms (OR = 0.94, 95% CI = 0.89, 0.98, p = .007), and anxiolytic use (OR = 0.64, 95% CI = 0.42, 0.99, p = .046).

Conclusions

Findings supported that better eating performance was associated with less cognitive impairment, higher functional ability, fewer depressive symptoms, and less anxiolytic use. Targeted interventions to accommodate to cognitive function, optimize functional ability, minimize anxiolytic use, and manage depressive symptoms are encouraged to support eating performance in residents with dementia.
Adverse events after nivolumab and ipilimumab combined immunotherapy in advanced renal cell carcinoma: a multicentre experience in Poland
Authors: Pacholczak-Madej Renata , Drobniak Artur , Stokłosa Łukasz , Bidas Anna , Dobrzańska Jolanta , Grela-Wojewoda Aleksandra , Roman Agnieszka , Tusień-Małecka Daria , Walocha Jerzy , Blecharz Paweł , Puskulluoglu Mirosława
Published: November 2024

Background

Immune checkpoint inhibitors (ICIs) have been employed in the adjuvant and metastatic setting of renal cell carcinoma (RCC) treatment. Among ICIs, combined immunotherapy has the highest risk for immune-related adverse events (irAEs). We aimed to document the incidence of irAEs in RCC patients treated with nivolumab and ipilimumab as data from the European population remain limited.

Materials and methods

We analysed data from 88 RCC patients treated with nivolumab + ipilimumab between May 2022 and June 2024 across six high-volume oncology units in Poland. We reviewed irAEs and estimated their impact on survival parameters via univariate and multivariate Cox proportional hazards regression models, along with log-rank tests.

Results

With a median follow-up of 11.3 months, the median overall survival (OS) was not reached, whereas the median progression-free survival (PFS) was 12.8 months (6.3–19.3). A total of 74 irAEs were recorded in 50 patients. The most frequent events were endocrine (n = 20, 27%), hepatic (n = 15, 17%), general (n = 12, 13.6%), and cutaneous (n = 11, 12.5%). The occurrence of irAEs was associated with a 60% lower risk of disease progression (hazard ratio 0.44, 95% confidence interval 0.2–0.87, p = 0.018) without impacting OS and higher disease control rate (n = 45, 90% vs. n = 24, 63.2%, p = 0.004). In contrast, patients with hepatotoxicity had poorer outcomes, with a 2.6-fold greater risk of death (p = 0.05).

Conclusions

IrAEs may serve as a predictive factor for the efficacy of the nivolumab + ipilimumab regimen in RCC patients. Special attention is needed for hepatotoxicity, as it can significantly impact survival outcomes.
Emergency neurosurgery for traumatic brain injury by general surgeons at local hospitals in Sweden: a viable option when time is brain
Authors: Leal-Méndez Francisco , Holmberg Lina , Enblad Per , Lewén Anders , Linder Fredrik , Wettervik Teodor Svedung
Published: November 2024

Background

Timing of surgical evacuation of mass lesions in traumatic brain injury (TBI) is crucial. However, due to geographical variations, transportation time to the nearest neurosurgical department may be long. To save time, general surgeons at a local hospital may perform the operation, despite more limited experience in neurosurgical techniques. This study aimed to determine whether patient outcomes differed between those who had undergone emergency neurosurgery at local hospitals by general surgeons vs. at university hospitals by neurosurgeons.

Methods

A nationwide observational study was performed using data from the Swedish Trauma Registry (SweTrau) between 2018 and 2022. A total of 565 TBI patients (local hospitals, n = 21; university hospitals, n = 544) who underwent intracranial hematoma evacuation within 8 h after arrival at the hospital were included. Data on demography, admission variables, traumatic injuries, and outcome (Glasgow Outcome Scale [GOS]) at discharge were evaluated. Favourable vs. unfavourable outcomes were defined as GOS scores of 4–5 vs. 1–3.

Results

Compared with those treated at university hospitals, patients treated with intracranial hematoma evacuation at local hospitals had lower median Glasgow Coma Scale (GCS) scores (8 vs. 12, p < 0.001), higher rate of acute subdural hematomas (86% vs. 77%, p < 0.001), and lower rate of contusions (14% vs. 53%, p = 0.01). Being operated on at a local hospital was independently associated with higher mortality (p = 0.03) but with a similar rate of favourable outcome (p = 0.74) in multiple logistic regressions after adjustment for demographic and injury-related variables.

Conclusions

Although a slightly greater proportion of patients who underwent emergency neurosurgery at local hospitals died, there was no difference in the rate of favourable outcome. Thus, in patients with impending brain herniation, when time is of the essence, evacuation of traumatic intracranial bleeding by general surgeons at local hospitals remains a highly viable option.
Zoonotic Dirofilaria sp. “hongkongensis” in subcutaneous nodules from dogs and cats, Hong Kong SAR
Authors: Manathunga Thamali , Tse May , Perles Livia , Beugnet Frederic , Barrs Vanessa , Otranto Domenico
Published: November 2024

Background

Dirofilaria sp. “hongkongensis” is a putative Dirofilaria species, initially identified in subcutaneous nodules in humans in Hong Kong and in other South and Southeast Asian regions. While it differs genetically from the better-known zoonotic species, Dirofilaria repens and Dirofilaria immitis, information on the lesions caused by Dirofilaria sp. “hongkongensis” in the hosts as well as on its biology is scarce. This study documents for the first time the presence of this filarioid nematode in subcutaneous nodules in dogs and cats in Hong Kong, where it was originally described in human patients, therefore providing evidence for the zoonotic nature of this parasite.

Methods

Records of Veterinary Diagnostic Laboratory of City University of Hong Kong were searched between 2019 and 2024 for histological reports of possible filarioid-associated lesions. Tissue samples were collected by excisional surgical biopsy and processed with routine paraffin techniques. Selected slides were stained using various staining techniques [i.e., hematoxylin and eosin, periodic acid–Schiff (PAS), Grocott methenamine silver (GMS) or Ziehl–Neelsen (ZN) and Gram stain]. DNA from formalin-fixed paraffin-embedded tissue were extracted, submitted to conventional polymerase chain reaction (cPCR) and sequencing (i.e., cox1 and 12S rRNA genes) and phylogenetic analyzed.

Results

A total of five subcutaneous nodules from four cats and one from a dog with histopathology suggestive of filariosis were selected. The presence of Dirofilaria sp. “hongkongensis” was morphologically and molecularly confirmed in one dog and one cat. Both histopathological presentation and phylogenetic analysis enabled classification of this species close to D. repens and within the subgenus Nochtiella. In the remaining three cases, one showed histological evidence of aberrant nematode migration, while non-parasitic causes were identified in the other two.

Conclusions

This study provides the first evidence of Dirofilaria sp. “hongkongensis” in subcutaneous nodules in cats and dogs. The histology of clinical lesions of this filarioid species herein described is closely related to those caused by D. repens. Overall, this species should be considered in differential diagnoses of subcutaneous lesions in both animals and humans in the region.

Graphical Abstract
Predictive value of contrast-enhanced MRI for the regrowth of residual uterine fibroids after high-intensity focused ultrasound treatment
Authors: Liu Yang , Xiao Zhibo , Luo Yuanli , Qiu Xueke , Wang Lu , Deng Jinghe , Yang Mengchu , Lv Fajin
Published: November 2024

Objectives

To investigate whether the signal intensity (SI) ratio of residual fibroid (RF) to myometrium using Contrast-Enhanced Magnetic Resonance Imaging (CE-MRI) could predict fibroid regrowth after high-intensity focused ultrasound (HIFU) treatment.

Materials and methods

A retrospective analysis was conducted among 164 patients with uterine fibroids who underwent HIFU. To predict the RF regrowth, the SI perfusion parameters were quantified using the RF-myometrium SI ratio on CE-MRI on day 1 post-HIFU and then compared with the fibroid-myometrium SI ratio on the T2-weighted image (T2WI) and Funaki classification 1 year later. Thirty cases from another center were used as an external validation set to evaluate the performance of RF-myometrium SI ratio.

Results

The predictive performance of the RF-myometrium SI ratio on CE-MRI on day 1 post-HIFU (Area Under Curve, AUC: 0.869) was superior to that of the preoperative and postoperative fibroid-myometrium SI ratios on the T2WI (AUC: 0.724, 0.696) and Funaki classification (AUC: 0.663, 0.623). Multivariate analysis showed that the RF- myometrium SI ratio and RF thickness were independent factors. The RF-myometrium SI ratio reflects the long-term rate of re-intervention (r = 0.455, p < 0.001).

Conclusion

The RF-myometrium SI ratio on CE-MRI exhibits greater accuracy in predicting RF regrowth compared to the SI classification and the SI ratio on T2WI.

Critical relevance statement

The ratio of residual uterine fibroid to myometrial signal intensity on contrast-enhanced (CE)-MRI can reflect residual blood supply, predict regrowth of fibroids, and thus reflect long-term re-intervention rate and recovery situation of clinical high-intensity focused ultrasound (HIFU) treatment.

Key Points

Contrast-enhanced (CE)-MRI can indicate the blood supply of residual uterine fibroids after high-intensity focused ultrasound (HIFU) treatment.

The predictive capability of CE-MRI ratio surpasses T2WI ratio and the Funaki.

Residual fibroids can serve as a measure of the long-term efficacy of HIFU.

Graphical Abstract
Constructing and exploring neuroimaging projects: a survey from clinical practice to scientific research
Authors: Chen Ziyan , Adegboro Abraham Ayodeji , Gu Lan , Li Xuejun
Published: November 2024

Over the past decades, numerous large-scale neuroimaging projects that involved the collection and release of multimodal data have been conducted globally. Distinguished initiatives such as the Human Connectome Project, UK Biobank, and Alzheimer’s Disease Neuroimaging Initiative, among others, stand as remarkable international collaborations that have significantly advanced our understanding of the brain. With the advancement of big data technology, changes in healthcare models, and continuous development in biomedical research, various types of large-scale projects are being established and promoted worldwide. For project leaders, there is a need to refer to common principles in project construction and management. Users must also adhere strictly to rules and guidelines, ensuring data safety and privacy protection. Organizations must maintain data integrity, protect individual privacy, and foster stakeholders’ trust. Regular updates to legislation and policies are necessary to keep pace with evolving technologies and emerging data-related challenges.

Critical relevance statement

By reviewing global large-scale neuroimaging projects, we have summarized the standards and norms for establishing and utilizing their data, and provided suggestions and opinions on some ethical issues, aiming to promote higher-quality neuroimaging data development.

Key Points

Global neuroimaging projects are increasingly advancing but still face challenges.

Constructing and utilizing neuroimaging projects should follow set rules and guidelines.

Effective data management and governance should be developed to support neuroimaging projects.

Graphical Abstract
Computed tomography enterography-based deep learning radiomics to predict stratified healing in patients with Crohn’s disease: a multicenter study
Authors: Zhu Chao , Liu Kaicai , Rong Chang , Wang Chuanbin , Zheng Xiaomin , Li Shuai , Wang Shihui , Hu Jing , Li Jianying , Wu Xingwang
Published: November 2024

Objectives

This study developed a deep learning radiomics (DLR) model utilizing baseline computed tomography enterography (CTE) to non-invasively predict stratified healing in Crohn’s disease (CD) patients following infliximab (IFX) treatment.

Methods

The study included 246 CD patients diagnosed at three hospitals. From the first two hospitals, 202 patients were randomly divided into a training cohort (n = 141) and a testing cohort (n = 61) in a 7:3 ratio. The remaining 44 patients from the third hospital served as the validation cohort. Radiomics and deep learning features were extracted from both the active lesion wall and mesenteric adipose tissue. The most valuable features were selected using univariate analysis and least absolute shrinkage and selection operator (LASSO) regression. Multivariate logistic regression was then employed to construct the radiomics, deep learning, and DLR models. Model performance was evaluated using receiver operating characteristic (ROC) curves.

Results

The DLR model achieved an area under the ROC curve (AUC) of 0.948 (95% CI: 0.916–0.980), 0.889 (95% CI: 0.803–0.975), and 0.938 (95% CI: 0.868–1.000) in the training, testing, and validation cohorts, respectively in predicting mucosal healing (MH). Furthermore, the diagnostic performance of DLR model in predicting transmural healing (TH) was 0.856 (95% CI: 0.776–0.935).

Conclusions

We have developed a DLR model based on the radiomics and deep learning features of baseline CTE to predict stratified healing (MH and TH) in CD patients following IFX treatment with high accuracies in both testing and external cohorts.

Critical relevance statement

The deep learning radiomics model developed in our study, along with the nomogram, can intuitively, accurately, and non-invasively predict stratified healing at baseline CT enterography.

Key Points

Early prediction of mucosal and transmural healing in Crohn’s Disease patients is beneficial for treatment planning.

This model demonstrated excellent performance in predicting mucosal healing and had a diagnostic performance in predicting transmural healing of 0.856.

CT enterography images of active lesion walls and mesenteric adipose tissue exhibit an association with stratified healing in Crohn’s disease patients.

Graphical Abstract
Intussusception of the appendix secondary to endometriosis: a case report
Authors: Kawaguchi Yuta , Maekawa Kyoichiro , Hashimoto Toshiaki , Kitagawa Mizuki , Urabe Shigetoshi , Yoshimura Emi , Goto Takashi , Rikitake Mihoko , Iwata Tohru
Published: November 2024

Background

Intussusception of the appendiceal endometriosis is rare. Although approximately 200 cases of appendiceal intussusception have been reported in the literature, very few have ever been diagnosed preoperatively. Here, we report the case of intussusception of the appendiceal endometriosis with laparoscopic ileocecal resection.

Case presentation

A woman in her 50s presented to the out-patients clinic with epigastric pain lasting for a several month. Contrast-enhanced computed tomography (CT) scanning revealed ileocolic intussusception in which a cecum polypoid mass lesion extended to the hepatic flexure of the ascending colon. A colonoscopy showed a large pedunculated polyp in the cecum. Laparoscopic ileocecal resection was performed. Pathology confirmed an invaginated appendix demonstrating endometriosis implants.

Conclusions

Possible intrinsic causes of intussusception are varied, appendiceal intussusception secondary to endometriosis is extremely rare. Intussusception of the appendix is a rare finding, often mistaken for a polyp. We suggest considering inverted appendix as a differential diagnosis when investigating cecal lesions.