bluuebunny/crossref_metadata_2025 huggingface dataset:
Multi-institutional observational study evaluating the efficacy of anti-epidermal growth factor antibody re- challenge in RAS/BRAF wild-type metastatic colorectal cancer
Authors: Fukuda Koshiro , Osumi Hiroki , Yoshinami Yuri , Ooki Akira , Takashima Atsuo , Wakatsuki Takeru , Hirano Hidekazu , Nakayama Izuma , Ouchi Kota , Sawada Ryoichi , Fukuoka Shota , Ogura Mariko , Takahari Daisuke , Chin Keisho , Okita Natsuko , Kato Ken , Ishizuka Naoki , Boku Narikazu , Yamaguchi Kensei , Shinozaki Eiji
Published: April 2024

Purpose: We aimed to investigate the incidence of circulating tumor DNA (ctDNA) RAS mutant (MT) before salvage-line treatment and explore the clinicopathological features and molecular biological factors associated with the efficacy of anti-epithelial growth factor receptor (EGFR) monoclonal antibody (mAb) re-challenge for tissue RAS/BRAF wild type (WT) metastatic colorectal cancer (mCRC).
Methods: This multi-institutional retrospective observational study included 74 mCRC patients with tissue RAS/BRAF WT refractory to first-line chemotherapy containing anti-EGFR mAb, whose RAS status in ctDNA was assessed using the OncoBEAMTM RAS CRC Kit. We explored the clinicopathological features associated with RAS status in ctDNA and the factors related to the efficacy of re-challenge of anti-EGFR mAb in multivariate Cox proportional hazard regression.
Results: The incidence of RAS MT in ctDNA was 40.5% (30/74), which was associated with primary tumor resection (P=0.016), liver metastasis (P<0.001), and high tumor marker levels (P<0.001). Among the 39 patients treated with anti-EGFR mAb re-challenge, those with ctDNA RAS WT showed significantly longer progression-free survival (PFS) than those with ctDNA RAS MT (median 4.1 vs. 2.7 months, hazard ratio [HR]=0.39, P=0.045). Similarly, patients who responded to first-line anti-EGFR mAb showed significantly longer PFS than those with stable disease. In multivariate analysis, response to first-line anti-EGFR mAb was significantly associated with longer PFS (HR=0.21, P=0.0026) and overall survival (HR=0.23, P=0.026).
Conclusions: The incidence of ctDNA RAS MT mCRC was 40.5%, which was associated with liver metastases and high tumor volumes. Anti-EGFR mAb re-challenge may be effective for mCRC patients who responded to first-line chemotherapy containing anti-EGFR mAb. No patients with RAS MT in ctDNA responded to Anti-EGFR mAb re-challenge.
Effect and Safety of an Innovative Improved Totally implanted venous access port (TIVAP) Implantation (Noninvasive Chest Wall Implantation) via the Axillary Approach on Patients with Breast Cancer
Authors: Pan Chi , Zhang Kun , Wu Pan , Guo Xi , Zheng Ya Ping , Wang Li , Bao Han , Hu Kai Min , Tian Wei , Pan Tao , Chen Yi Ding
Published: April 2024

Purpose
The totally implanted venous access port (TIVAP) is widely applied to chemotherapy. The traditional approach is to implant the port by directly cutting skin at the chest wall, but surgical scarring on the chest wall may bring permanent psychological trauma to patients and affect the port once the incision is infected. In this study, the effect and safety of an improved port implantation (noninvasive chest wall implantation) via the axillary approach on breast cancer patients were evaluated.
Methods
This study discusses the surgical steps of the improved port implantation. The incidences of complication, comfort, convenience, aesthetics, and privacy from the improved operation were analyzed and compared with the traditional operation.
Results
All patients successfully presented improved infusion port implantation through the axillary access (noninvasive chest wall implantation). Two cases had a hemorrhage during the operation. One case had a postoperative subcutaneous hemorrhage, and one case had a folded catheter. Nevertheless, the patients did not need a secondary operation for adjustment. The average operation time of the improved infusion port implantation was 51.85 min (range: 37–69 min). The improved operation was significantly better than the traditional operation in terms of aesthetics and privacy. In terms of comfort and convenience, the difference between the two operations was not significant.
Conclusions
This study described the specific steps and particular aspects of the improved operation. The effectiveness and safety of the improved operation were reported for the first time. The improved operation has been proven safe and reliable, and it entails only a few intraoperative and postoperative complications.
Expression of Epithelial-Mesenchymal Transition Markers in Oral Cavity Squamous Cell Cancer: An Observational Study
Authors: Solanki Pratik , Malhotra Manu , Singh Ashok , Bose Bodhisattva , H Sunil , Singh Sunil Kumar , Mondal Avijit , SKS Mareshwari , Gupta Amit
Published: April 2024

Background
Epithelial-Mesenchymal transition (EMT) has evolved as a possible pathway in pathophysiology of tumor formation and progression; however, contribution of this phenomenon in human cancers especially oral malignancy lack sufficient evidence. This study aimed to evaluate the expression of EMT markers E-cadherin and N-cadherin and their correlation with clinicopathological factors in Oral Cavity Squamous Cell Cancer (OSCC).
Methods
This observational study was conducted on hundred histologically proven cases of OSCC based on inclusion and exclusion criteria. The expression level of Epithelial-Mesenchymal Transition markers (E-cadherin, N-cadherin) on these cases was performed and evaluated using Immunohistochemistry (IHC) staining. Expression of E-cadherin, N-cadherin was analysed and correlated with clinical and histopathological factors using appropriate statistical methods.
Results
Epithelial markers E-cadherin and N-cadherin were expressed in 18 (18%) and 58 (58%). Reduced expression of E-cadherin was observed in 82 (82%) patients. Significant association of N-Cadherin with clinical T-stage (p = 0.001) and clinical N-stage (p = 0.041) was observed. Pathological factors such as tumour size (p = 0.016), DOI (p = 0.001), pathological T-stage (p = 0.005) and stage (p = 0.017) showed statistically significant association with N-cadherin expression.
Conclusion
This study emphasizes the importance of EMT in the pathogenesis of OSCC. The use of biomarkers like E-Cadherin, N-cadherin might serve as valuable tool for developing targeted therapy in near future limiting invasion and metastasis in OSCC.
Peptidylarginine Deiminase 3 Modulates Response to Neratinib in HER2 Positive Breast Cancer
Authors: Pandiella Atanasio , Pérez Inés Romero , Rodriguez Elena Díaz , Montero Juan Carlos , Díaz Laura Sánchez
Published: April 2024

Background
Neratinib is a tyrosine kinase inhibitor that is used for the therapy of patients with HER2 + breast tumors. However, despite its clinical benefit, resistance to the drug may arise. Here we have created cellular models of neratinib resistance to investigate the mechanisms underlying such resistance.
Methods
Chronic neratinib exposure of BT474 human HER2 + breast cancer cells resulted in the selection of several clones resistant to the antiproliferative action of the drug. The clones were characterized biochemically and biologically using a variety of techniques.
Results
These clones retained HER2 levels similar to parental cells. Knockdown experiments showed that the neratinib-resistant clones retained oncogenic dependence on HER2. Moreover, the tyrosine phosphorylation status of BT474 and the resistant clones was equally sensitive to neratinib. Transcriptomic and Western analyses showed that peptidylarginine deiminase 3 was overexpressed in the three neratinib-resistant clones studied but was undetectable in BT474 cells. Experiments performed in the neratinib-resistant clones showed that reduction of PADI3 or inhibition of its function restored sensitivity to the antiproliferative action of neratinib. Moreover, overexpression of FLAG-tagged PADI3 in BT474 cells provoked resistance to the antiproliferative action of neratinib.
Conclusions
Together, these results uncover a role of PADI3 in the regulation of sensitivity to neratinib in breast cancer cells overexpressing HER2 and open the possibility of using PADI3 inhibitors to fight resistance to neratinib.
Mesenchymal stem cells improve osteoarthritis by secreting superoxide dismutase to regulate oxidative stress response
Authors: Yao Yao , Cao Juan , Ding Congzhu
Published: April 2024

Background
To investigate the therapeutic effect of intraarticular injection of mesenchymal stem cells (MSC) in a rabbit osteoarthritis (OA) model. And to suppose whether MSC play a pivotal role in OA therapy by improving oxidative stress through secreting superoxide dismutase (SOD).
Methods
MSC were isolated and cultured in vitro. SOD gene of MSC was silenced by siRNA technology to prepare the SOD-siRNA-MSC for in-vivo study. Twenty healthy adult New Zealand white rabbits underwent papain injection to induce OA and then received intra-articular injection with MSC, siRAN-MSC, or normal saline. The rabbits were divided into 4 groups (n = 5), such as the control group, the model group, the MSC group, the siRNA-MSC group. Cytokines determination was performed 2 and 4 weeks after treatment. Magnetic resonance imaging (MRI) and histopathology and immunohistochemistry determination were performed 4 weeks after treatment.
Results
COMP, TNF-α, MMP-2 and MMP-13 in the MSC group were significantly decreased compared to those in model group (P < 0.05). However, MMP2 and MMP13 in the siRNA-MSC group were not significantly decreased compared to the model group (P < 0.05). Magnetic resonance results revealed a significant improvement in cartilage and synovial membrane 4 weeks after MSC injection. Histopathology determination showed that cartilage structure was also significantly improved in MSC group. Immunohistochemical analysis revealed amelioration in the expression levels of proteoglycan, COL-2, P21 and P53 in MSC group. On the other hand, MRI, histopathologic and immunohistochemical analysis also indicated a decreased therapeutic effect with SOD-siRNA -MSC.
Conclusion
Our study demonstrated for the first time that MSC might be a promising therapy in OA through anti-apoptosis and regeneration in chondrocyte by secreting SOD and improving oxidative stress.
Wheat Growth and Yield in the Rice -Wheat Cropping System: Impact of Crop Establishment Techniques, Sowing Schedule and Nitrogen management
Authors: Chhabra Vandna , Sree S , Kaur Gurleen
Published: April 2024

A two-year field experiment was conducted at Lovely Professional University, Phagwara during the Rabi season of 2018–2019 and 2019-20 to study the effect of crop establishment methods and sowing schedule on the growth and yield of wheat under the rice-wheat cropping system. The experiment comprised different rice residue management-based wheat establishment methods, sowing dates, and varying nitrogen levels. The results confirmed that growth, yield and yield attributes were all influenced by different crop establishment methods, sowing dates and level of nitrogen application. The results showed that maximum plant height, number of tillers per plant, number of spikes per plant, spike length, number of grains per spike and grain yield were observed under 20th November sowing (timely sowing) and with 100% RDN. Moreover, the maximum number of spikes per plant, spike length and grain yield were significantly highest for residue incorporation method of wheat establishment. Optimum time of sowing also improved the grain yield of wheat. Among the different crop establishment methods, the best attainment of available nitrogen status in soil was found in residue incorporation treatment.
Fjords, Echinoderms and the Holocene: a new ecological proxy from the Ross Sea (Edisto Inlet)
Authors: Galli Giacomo , Morigi Caterina , Thuy Ben , Gariboldi Karen
Published: April 2024

High Latitude fjords can serve as sediment trap, bearing different type of proxies, from geochemical to micropaleontological ones, making them exceptional tools for paleoenvironmental reconstruction. However, some unconventional proxies can be present and can be used to depict a comprehensive and exhaustive interpretation of past changes. Here, studying a sediment core in Edisto Inlet (Ross Sea, Antarctica) we used irregular echinoid spines and ophiuroids (Ophionotus victoriae) ossicles to trace environmental changes throughout the last 3.6 kyrs BP. Irregular echinoids can serve as proxy for the organic matter content, while O. victoriae ossicles can be used as proxy for steady sea-ice cycle along with organic deposition events. O. victoriae release a high number of ossicles, making estimation about the population quite challenging; still, presence data, can be easily collected. By applying Generative Additive Models to the stratigraphical distribution of these data, we detected an environmental phase that was previously unnoticed by other traditional proxies: the Ophiuroid Optimum (2-1.5 kyrs BP). In conclusion, here we demonstrate how echinoderm presence can be used as a valuable source of information, while proving the potential of modelling binary data to detect long-term trend in Holocene stratigraphical records.
Participatory environmental management beyond the boundaries of Protected Areas: a democratic advancement or nature privatization? A systematic review
Authors: Souza Luísa Couto Gonçalves , Damásio Camila Braga , Andrade Lívia Maria Comini , Lamounier Wanderson Lopes , Drumond Maria Auxiliadora
Published: April 2024

In recent decades, environmental management has undergone changes that have dispersed decision-making power, from a model centralized in public authorities to one with power also distributed to other stakeholders, such as community members, companies, and non-governmental organizations. Participatory environmental management favors conflict reduction, increased legitimacy and compliance with decisions, and community empowerment, fostering more effective and equitable socio-environmental management. However, conciliation of divergent interests, the need for greater investments in time, logistics, capacity building, and power asymmetries are possible limitations to the outcomes of this model, enabling its use in favor of minority interests, especially outside Protected Areas. Numerous studies have been developed on the subject, but its relevance demands an analytical compilation of these works. This review aims to fill this gap by critically synthesizing participatory environmental management case studies in territories outside the Protected Areas, extracted from 145 systematically selected publications. The analysis of aspects such as study location, management group format, level of participation of civil society and traditional communities, factors influencing participation, financial support, difficulties, strategies, and outcomes indicates that, in many cases, the diversity of stakeholders has turned the decentralization of power into an aggravating factor for the vulnerability of weaker parties. Nevertheless, observed advancements in participation corroborate the feasibility and importance of inclusive management. This review provides a current, integrated, and critical overview, useful for the global understanding of the subject and studies improvement and participatory processes in the planning or execution phase.
Combined ecological-chemical-pharmacological analysis of the ecological suitability and quality zoning of the Tinosporae Radix
Authors: Huang Chengfeng , Lu Lijie , Zhu Xinglong , Huang Xulong , Zhou Yongfeng , Tang Linye , Du Jinyu , Pei Jin , Wu Qinghua
Published: April 2024

The Tinosporae Radix is favored as a treatment for pharyngitis and is now regarded as the first choice of traditional Chinese medicine as an alternative to antibiotics. However, its wild resources are on the verge of extinction due to over-excavation by human beings, and the quality of the cultivated products varies, so it is urgent to search for the key biological factors affecting the growth and development process of Tinosporae Radix as well as the suitable ecological zones. In this study, we used MaxEnt model and Arcgis spatial analysis technology to predict the suitable growing area of Tinosporae Radix, and found four key environmental factors affecting the quality of Tinosporae Radix. In this paper, we used UPLC analysis to obtain the fingerprints of Tinosporae Radix, and found that the most relevant components for the anti-inflammatory effect of Tinosporae Radix included columbin and several alkaloids, and the correlation analysis with the relevant biotic factors revealed that Tinosporae Radix is suitable for growing in Southwest China, and that Tinosporae Radix with higher content of columbin is suitable for growing in the region of the Yunnan-Guizhou Plateau, and that Tinosporae Radix with higher content of alkaloids is suitable for growing in the borders between Guangxi, Yunnan, Guizhou, and Hunan, which are all characterized by karst landscapes. And all these places are dominated by karst landscape. In vitro analysis of anti-inflammatory efficacy showed that the anti-inflammatory efficacy was good regardless of the high content of either type of components. In this paper, we evaluated the quality of Tinosporae Radix herbs in the suitable habitat obtained by model prediction through the method of "chemical evaluation" associated with "anti-inflammatory" efficacy, and obtained an innovative "ecological-chemical-pharmacological efficacy" evaluation method, which is a good method to evaluate the quality of Tinosporae Radix herbs in the suitable habitat. The results of this method can be used to guide the production of Tinosporae Radix with a high content of columbin or alkaloids, laying the foundation for the establishment of standardized artificial cultivation of Tinosporae Radix, and at the same time, providing theoretical support for the delineation of Tinosporae Radix's suitable areas, the utilization of its resources, and the extension of the industrial chain.
Quantification and profiling of early and late differentiation stage T-cells in mantle cell lymphoma reveals immunotherapeutic targets in subsets of patients
Authors: Lokhande Lavanya , Nilsson Daniel , Rodrigues Joana de Matos , Hassan May , Olsson Lina M , Pyl Paul-Theodor , Vasquez Louella , Porwit Anna , Gerdtsson Anna Sandstrom , Jerkeman Mats , Ek Sara
Published: April 2024

Background
The response to immune checkpoint inhibition has been limited in mantle cell lymphoma (MCL), and the association to variation in abundance and molecular profile of different T-cell subsets is underexplored. With the aim to advance understanding of immune regulation in MCL and to identify targetable T-cell subsets in patient subgroups, we set out to combine image analysis, spatial omic technology focused on both early and late differentiation stages of T-cells.
Methods
A population-based cohort of 102 MCL patients was available for image analysis and GeoMx spatial omics profiling of 69 proteins and 1812 mRNAs. CD20, CD3, CD8 and CD57 were used to identify tumor cells, T helper (TH) and cytotoxic (TC) cells of early (CD57-) and late (CD57+) differentiation stage. An image analysis workflow was developed based on fine-tuned CellPose models for cell segmentation and classification. Cell frequencies and spatial omics data was collected in tumor-rich regions (cells in MCL-dominated regions) and tumor-sparse (tumor-adjacent T-cell rich regions with no/few tumor cells).
Results
Both TC and CD57 + subsets were enriched in tumor-rich compared to tumor-sparse regions. Tumor-sparse regions had higher expression of several key tumor suppressive proteins, tentatively controlling T-cell expansion in regions close to the tumor. Comparison between individual subsets of T-cells (TH,57, TC,57−, TH,57+, TC,57+) infiltrating the MCL regions, showed that CD57 + late differentiation stage T-cells were associated with expression of immune inhibitory molecules such as TIGIT, PD-L1, PD-L2, and LAG3. CD47 and IDO1 expression on tumor cells was associated with T-cell rich MCL, while GITR was higher expressed in T-cell sparse MCL.
Conclusions
Through combined image analysis and spatial omics, we revealed that T-cells in late differentiation stages (CD57+) are enriched among MCL infiltrating T-cells and are predictive of increased expression of immune suppressive markers. CD47, IDO1 and CTLA-4 were identified as potential targets for patients with T-cell rich MCL TIME, while MCL patients with sparse T-cell infiltration may benefit from targeting GITR. In subgroups of patients with high degree of CD57 + TC-cell infiltration several immune checkpoint inhibitors, including TIGIT, PD-L1 and LAG3 were increased, emphasizing the immune-suppressive features of this T-cell subsets not previously described in MCL.
Weight Loss-induced Interaction Between Classical Lipolysis and the Autolysosome in Human Subcutaneous Adipose Tissue
Authors: Mariman Edwin , Baak Marleen van , Bouwman Freek
Published: April 2024

Background/objectives:During a period of weight loss lipolysis genes in human subcutaneous adipose tissue are downregulated despite the increase in plasma free fatty acids. It has been proposed that lipid breakdown is taken over by the autolysosome. Here we test the relation between lipolysis and the autolysosome.
Subjects/methods:Gene and protein expression data from the YoYo-study were used for correlation analysis including genes coding for lipases and regulators of lipolysis, for autolysosome proteins and lysosomal enzymes, and the genes coding for components of a previously identified integrin cluster. For all these genes the cell type and compartment of expression was obtained from databases. Correlation analysis was performed using the gene expression values before weight loss (WL), after WL, and after a subsequent weight stable period (WS), and using the expression changes during WL and WS.
Results:During WL a significant negative correlation originated between the lipolysis and autolysosome genes. Genes of the integrin cluster correlated negative with the lipolysis genes and positive with the autolysosome genes. Surprisingly, the lipolysis genes were expressed in mature adipocytes while the autolysosome genes were not, but were expressed in other types of cells of the adipose tissue. Most of the correlated autolysosome genes were secreted or on the plasma membrane. After WL most of the genes reversed their direction of expression. During WS the correlation between lipolysis and autolysosome genes lost significance and the correlation with the integrin genes disappeared.
Conclusions:Our findings do not support a transfer of lipid breakdown from lipolysis to the autolysosome in subcutaneous adipocytes during WL. Instead, we observe an intercellular interaction between lipolysis in mature adipocytes and the autolysosome of other cells in the adipose tissue. This interaction is probably mediated by integrin-mediated contact between the cells. A model for the observed interaction based on ECM-stress is presented.
Improving Post-Injury Follow-up Survey Response: Incorporating Automated Modalities
Authors: Scheuer Hannah , Conrick Kelsey M. , Mills Brianna , Solano Esther , Arbabi Saman , Bulger Eileen M. , Dotolo Danae , Vil Christopher St. , Vavilala Monica S. , Rowhani-Rahbar Ali , Moore Megan
Published: April 2024

Background
Incorporating post-discharge data into trauma registries would allow for better research on patient outcomes, including disparities in outcomes. This pilot study tested a follow-up data collection process to be incorporated into existing trauma care systems, prioritizing low-cost automated response modalities.
Methods
This investigation was part of a larger study that consisted of two protocols with two distinct cohorts of participants who experienced traumatic injury. Participants in both protocols were asked to provide phone, email, text, and mail contact information to complete follow-up surveys assessing patient-reported outcomes six months after injury. To increase follow-up response rates between protocol 1 and protocol 2, the study team modified the contact procedures for the protocol 2 cohort. Frequency distributions were utilized to report the frequency of follow-up response modalities and overall response rates in both protocols.
Results
A total of 178 individuals responded to the 6-month follow-up survey: 88 in protocol 1 and 90 in protocol 2. After implementing new follow-up contact procedures in protocol 2 that relied more heavily on the use of automated modalities (e.g., email and text messages), the response rate increased by 17.9 percentage points. The primary response modality shifted from phone (72.7%) in protocol 1 to the combination of email (47.8%) and text (14.4%) in protocol 2.
Conclusions
Results from this investigation suggest that follow-up data can feasibly be collected from trauma patients. Use of automated follow-up methods holds promise to expand longitudinal data in the national trauma registry and broaden the understanding of disparities in patient experiences.
The Benefit of Active Management in True Knot of the Umbilical Cord: A retrospective study.
Authors: Weissbach Tal , Lev Shir , Back Yonatan , Massarwa Abeer , Meyer Raanan , Miller Tal Elkan , Weissmann-Brenner Alina , Weisz Boaz , Mazaki-Tovi Shali , Kassif Eran
Published: April 2024

Purpose: To compare perinatal outcomes between active and routine management in true knot of the umbilical cord (TKUC).
Methods: A retrospective study of singletons born beyond 22 6/7 weeks with TKUC. Active management included weekly fetal heart rate monitoring(FHRM)≥ 30 weeks and labor induction at 36-37 weeks. Outcomes in active and routine management were compared, including composite asphyxia-related adverse outcome, fetal death, labor induction, Cesarean section (CS) or Instrumental delivery due to non-reassuring fetal heart rate (NRFHR), Apgar5 score <7, cord Ph <7, neonatal intensive care unit (NICU) admission and more.
Results: The Active (n=59) and Routine (n=1091) Management groups demonstrated similar rates of composite asphyxia-related adverse outcome (16.9% vs 16.8%, p= 0.97). Active Management resulted in higher rates of labor induction<37 weeks (22% vs 1.7%, p<0.001), CS (37.3% vs 19.2%, p=0.003) and NICU admissions (13.6% vs 3%, p<0.001). Fetal death occurred exclusively in the Routine Management group (1.8% vs 0%, p=0.6).
Conclusion: Compared with routine management, weekly FHRM and labor induction between 36-37 weeks in TKUC do not appear to reduce neonatal asphyxia. In its current form, active management is associated with higher rates of CS, induced prematurity and NICU admissions. Labor induction before 37 weeks should be avoided.
Financial toxicity in patients with chronic kidney disease undergoing peritoneal dialysis
Authors: kong hanhan , Li Huanhuan , Liao Yumei , Peng Wujian , Liu Yanqun , Gong Claire , Bai Jinbing , Zhang Liping
Published: April 2024

Aim: To investigate financial toxicity (FT) and its influencing factors in patients with chronic kidney disease undergoing peritoneal dialysis (PD).
Methods: A cross-sectional study was conducted on 148 PD patients recruited between August 2023 and December 2023. The Comprehensive Score for financial Toxicity (COST) was used to estimate the prevalence and degree of FT. Patient coping actions were investigated.T-test, ANOVA, Pearson’s chi-squared test and multiple linear regression analysis were used to evaluate the predictors of FT in patients with PD.
Results: 79 patients (53.38%) had mild FT, and 61 patients (41.21%) had moderate FT. Age, working status, monthly household income per capita and PD-related complications were significantly associated with FT in PD patients (p＜0.05). 115 patients (77.70%) reduced consumption due to illness, 67 patients (45.27%) had medical loans, 58 patients (39.19%) discussed lower-cost treatment plans with their physician, and 40 patients (27.03%) considered abandoning or delaying treatment due to financial difficulties. Patients with higher FT had lower living expenses, higher risk of debt, and were more likely to abandon or delay treatment than patients with lower FT(p＜0.05).
Conclusions: There were varying degrees of FT in PD patients. Measuring FT can help medical professionals develop treatment care strategies, reduce the financial burden on patients, and avoid treatment interruption.
Early-stage acral melanoma with a history of trauma associated with a poor prognosis:A multicenter data analysis of 468 cases
Authors: 滕 熠 , Wu Jin , Cai Xin , Zhang Weizhen , Jiang Kui , Zhou Hongfeng , Guo Zhen , Liu Jiwei , Wang Yan , Liu Fang , Lan Shijie , Meng Hongxue , Ji Xiang , Xiang Mei Mei , Li Yongqi , Wu Di
Published: April 2024

Background：Previous studies have suggested that trauma may be a risk factor for the development and prognosis of acral melanoma (AM), but the available evidence is limited.This study aimed to explore the impact of trauma on AM recurrence and survival.
Methods：This population-based retrospective cohort study included patients with acral melanoma with a clear history of trauma who were treated at five melanoma treatment centers in China from 2009 to 2023. Data were analyzed July 2023 to August 2023. Baseline characteristics of the two groups were analyzed using the chi-square test. Disease-free survival (DFS) and overall survival (OS) were analyzed using the Kaplan-Meier method. Factors associated with recurrence and survival were determined using univariate and multivariate Cox regression analysis.
Results：A total of 468 AM patients were included in this study, with 101 in the trauma group and 367 in the non-trauma group. In the overall population, the median follow-up time was 57.4 months (95%CI, 53.84-61.03), with 248 (53.0%) males and 220 (47.0%) females. The peak age of onset was between 60-69 years old (31.2%) . In the trauma group, the plantars area was the most frequently affected site (54.5%), followed by the hallux toe (17.8%) and thumb (9.9%). The proportion of patients with ulcer (P=0.027) , mitosis rate ≥1 (P=0.036), and Clark level IV-V (P=0.009) was significantly higher in the trauma group compared to the non-trauma group. Multivariate analysis demonstrated that trauma was an independent risk factor for both DFS and OS in stage I-II. Furthermore, the cumulative survival rate revealed that the I-II trauma group had significantly lower than the non-trauma group.
Conclusions：The results of this cohort study showed that trauma was found to be an independent risk factor for DFS in AM patients with stage I-II, affecting DFS and OS in AM.
Construction of Larger Dimensional Hulls of BCH Codes with Length $n=\frac{q^4-1}{q+1}$
Authors: Yan Ming , Yan Tongjiang , Sun Yuhua
Published: April 2024

Hulls of linear codes are widely applied in constructing self-orthogonal codes and quantum codes, as well as in various other aspects. Let $\mathbb{F}_q$ be the finite field of order $q$ and $n=\frac{q^4-1}{q+1}$, where $q$ is an odd prime power. Let $\mathcal{C}$ be a BCH code over $\mathbb{F}_q$ with length $n$ and dimension $k$. In this paper, we provide the necessary and sufficient conditions for $\mathcal{C}$ possessing a hull with dimension $k-1$ or $k^{\perp}-1$, where $k^{\perp}$ is the dimension of the dual code of $\mathcal{C}$, while also deriving several classes of self-orthogonal codes, including some optimal codes.
Between Beauty and the Law: Analyzing Cosmetic Filler Litigations in South Korea for Safer Medical Practices
Authors: Kang Daihun , Hong Seung Eun
Published: April 2024

Cosmetic filler injections have gained popularity in recent years, but the rise in complications has led to an increase in legal disputes. This study analyzes civil court rulings related to cosmetic filler injection lawsuits in South Korea from 2007 to 2023. A retrospective case analysis was performed using a systematic database search, and a mixed-methods approach was employed for data analysis. The study examined 27 cases, revealing a high success rate for plaintiffs. Skin necrosis and blindness were the most common complications, and intravascular filler injection was recognized as negligence. Violation of informed consent was found in most cases, with mean compensation awards of ￦193,019,107 KRW ($142,831 USD) for first instance cases and ￦81,845,052 KRW ($60,564 USD) for second instance cases. The findings emphasize the importance of practitioner awareness, adherence to precautionary measures, and proactive management of complications. Collaboration among stakeholders is crucial for developing strategies that prioritize patient safety and minimize legal disputes in the aesthetic medicine industry. This study provides valuable insights for enhancing medical practices and safeguarding patient well-being in the field of cosmetic filler injections.
Predictive Model for Early Fluid Imbalance in Severe Acute Pancreatitis
Authors: Jiamaliding Ayijiang , Sun Gaolei , Wang Junhong , Duan Minjie , Ma Qingbian
Published: April 2024

Background:
Fluid loss is a pathophysiological process in severe acute pancreatitis (SAP) that is important to control, but precise fluid therapy protocols are lacking. This study aims to build a prediction model for fluid loss in SAP by applying machine learning methods.
Method: This is a retrospective observational study. It included SAP patients with appropriate fluid therapy volume and who visited the Emergency Department of Peking University Third Hospital from January 2016 to December 2020 within 48 hours after onset of the disease. The 48-hour fluid volume was used as a measure of fluid loss. The amount of 48-hour fluid rehydration was taken as the predictive end point, and associated variables were screened using the Lasso algorithm. Prediction models were established with five machine learning algorithms: Gradient Boosting Decision Tree, eXtreme Gradient Boosting, Light Gradient Boosting Machine, Catboost, and multiple linear regression. The validation was carried out with the test set, and the mean absolute error (MAE)，root mean square error (RMSE), R2, and fitting curve were used to evaluate the prediction efficiency. The soft voting method was used to fuse the above five prediction models to improve the performance of model. The SHAP (SHapley Additive explanation) method was used to explain the optimal model. Finally, to facilitate practical clinical application, the model was evaluated by analyzing 10 cases from the test set.
Results:
A total of 308 cases were included, from which 90% of patients were randomly allocated as the training set, and the rest were included in the test set. The Lasso algorithm was used to screen the 16 variables most associated with the amount of 48-hour fluid replacement. Of the five machine learning algorithms that were used to build the prediction models, the MAE and RMSE values of the XGBoost algorithm were the smallest and the R2 was the closest to 1, which indicated that the XGBoost was the optimal model. After model fusion, the model performance was further improved.
In order to enhance the visualization of the model and to facilitate clinicians’ understanding of the model, we used the model interpretation tool SHAP to explain the optimal model, XGBoost. Application of the model in 10 actual cases showed that the difference between the predicted fluid loss and the actual 48-hour rehydration volume ranged from 31.07-329.80 mL, validating the model’s good predictive ability.
Conclusion: In this study, we developed the Fluid Imbalance Predicting Model for SAP (FIPM-SAP), which can predict the specific amount of fluid loss in SAP patients. The predictive performance was good, demonstrating that the model has practical application for guiding clinicians in their assessment of 48-hour rehydration volume.
Development Trends and Knowledge Framework of Artificial Intelligence (AI) Applications in Oncology by years: A Bibliometric Analysis from 1992 to 2022
Authors: Koçak Murat , Akçalı Zafer
Published: April 2024

Purpose: Oncology is the primary field in medicine with a high rate of artificial intelligence (AI) use. Thus, this study aimed to investigate the trends of AI in oncology, evaluating the bibliographic characteristics of articles. We evaluated the related research on the knowledge framework of Artificial Intelligence (AI) applications in Oncology through bibliometrics analysis and explored the research hotspots and current status from 1992 to 2022.
Methods: The research employed a scientometric methodology and leveraged scientific visualization tools such as Bibliometrix R Package Software, VOSviewer, and Litmaps for comprehensive data analysis. Scientific AI-related publications in oncology were retrieved from the Web of Science (WoS) and InCites from 1992 to 2022.
Results: A total of 7,815 articles authored by 35,098 authors and published in 1,492 journals were included in the final analysis. The most prolific authors were Esteva A (citaition = 5,821) and Gillies RJ (citaition = 4288). The most active institutions were the Chinese Academy of Science and Harward University. The leading journals were Frontiers ın Oncology and Scientific Reports. The most Frequent Author Keywords are " machine learning ", "deep learning," "radiomics", "breast cancer", “melanoma” and "artificial intelligence," which are the research hotspots in this field. A total of 10866 Authors' keywords were investigated. The average number of citations per document is 23. After 2015, the number of publications proliferated
Conclusion: The investigation of Artificial Intelligence (AI) applications in the field of Oncology is still in its early phases especially for genomics, proteomics, and clinicomics, with extensive studies focused on biology, diagnosis, treatment, and cancer risk assessment. This bibliometric analysis offered valuable perspectives into AI's role in Oncology research, shedding light on emerging research paths. Notably, a significant portion of these publications originated from developed nations. These findings could prove beneficial for both researchers and policymakers seeking to navigate this field.
Hole-Embedded Graphene Metamaterial for THz Absorption: A New Approach for Efficient Device Design
Authors: Mishra M. , Sahoo N. , Sahu T.
Published: April 2024

A new design is proposed for the realization of graphene metamaterials with enhanced robustness and absorption in the THz regime. The design uses the concept of embedding holes into a bilayer graphene sheet, which effectively works like a conventional fishnet-shaped metamaterial structure with better absorptance and spectral response features. Absorptance of both the structures are studied for multi-sheet configuration with sheet number (N), inter sheet distance (dil), and length of the resonating cavity (d). Interestingly the absorptance goes up with an increase in N for both the structures. Further, in the case of the proposed hole embedded structure, the rate of enhancement is more towards the higher N indicating improved performance. The study also reveals the effect of cavity length ‘d’ on absorptance. The absorptance of the metamaterials is optimized to a value of ~ 99%, for d = 22 µm, taking N = 8 and N = 7 for the cut-based and the hole embedded fishnet structure respectively. The proposed hole embedded design offers several benefits like it reduces design complexity, increases the robustness towards fabrication errors, needs less number of sheets, and shows a better spectral response. Such a design technique can be utilized to realize several other designs of meta materials.
Cerebral [18F]AIF-FAPI-42-based PET imaging of fibroblast activation protein for non-invasive quantification of fibrosis after ischaemic stroke
Authors: Tang Peipei , Liu Yang , Peng Simin , Cai Zhikai , Tang Ganghua , Zhou Zhou , Hu Kongzhen , Zhong Yuhua
Published: April 2024

The development of fibrosis after injury to the brain or spinal cord limits the regeneration of the central nervous system in adult mammals. However, the extent of fibrosis in the injured brain has not been systematically investigated in mammals in vivo. This study aimed to assess whether [18F]AlF-FAPI-42-based cerebral positron emission tomography (PET) can be utilized to assess the extent of fibrosis in ischaemic regions of the brain in vivo. Sprague-Dawley rats underwent permanent occlusion of the right middle cerebral artery (MCAO) or sham surgery (control). On days 3, 7, 14, and 21 post-MCAO, the uptake of [18F]AlF-FAPI-42 in the ischaemic region of the brain in the MCAO groups surpassed that in the control group. Specificity to FAP was confirmed through immunofluorescence staining. Histopathological analysis revealed higher collagen deposition in the ischaemic hemisphere of the rats in the MCAO group than the control level. [18F]AlF-FAPI-42 intensity correlated with the density of collagen fibres in the ischaemic hemisphere (p < 0.001). [18F]AlF-FAPI-42 PET/CT imaging revealed high FAP in the infarct zone of ischemic stroke patients. PET imaging by using [18F]AlF-FAPI-42 offers a promising non-invasive method for monitoring the progression of cerebral fibrosis caused by ischaemic stroke and may facilitate the clinical management of stroke patients.
Trial registration: chictr.org.cn ChiCTR2200059004. Registered April 22, 2022.
Long-term care system for people with dementia in China: A critical analysis
Authors: Chong Haiyan , Liu Li , Hu Xiuying
Published: April 2024

Background Chinese people with dementia account for approximately a quarter of the global burden of diseases, while the traditional long-term care system that heavily relies on families is eroding. In response, the Chinese Government has launched several policies for dementia.We aim to describe governance structure for long-term care, synthesizing the policy developments since 2010, and analyze current issues and challenges in the system, and provide policy recommendations.
Method A critical analysis was conducted by looking for government reports, news, and searching the PubMed, Web of Sciences and CNKI database on China’s long-term care system for dementia from 1 January 2010 to 30 August 2023.
Results We described Chinese long-term care system for people with dementia from three overarching aspects: governance and policy, service delivery, and the system of financing. We found that the system is characterized by no specificity and continuity in policy, as well as lacking sections of professional long-term care services. Moreover, inconsistent designs in financing sources and eligibility have also been fully concerned.
Conclusions This study demonstrated the vitality of the dementia service market has yet to be fully stimulated in the Chinese mainland, problems such as unbalanced and inadequate development, insufficient effective supply, and low service quality still exist, and the long-term care services needs for people with dementia have yet to be effectively met. Currently, China’s policy for people with dementia is developing. Lessons from international experiences are may able to help China conduct novel health policy. It’s urgent to establish a unified national services system to promote the healthy development of care services for people with dementia.
Investigating the Relationship of Handgrip Strength and the risk of Chronic Kidney Disease and Mortality though NHANES Studies
Authors: Huang Qiong , Ouyang Wenwei , Du Xiuben , Qin Xindong , Pi Ying , Wang Jing , Wu Yifan , Liu Xusheng
Published: April 2024

Background While research has highlighted an inverse correlation between handgrip strength (HGS) and chronic kidney disease (CKD) risk, the precise impact of HGS on CKD remains unquantified. Moreover, the association between HGS and all-cause mortality in CKD patients warrants further investigation.Method Our research employs logistic regression, cubic spline analysis, and Kaplan-Meier survival analysis to examine the relationship between HGS and the risk of CKD, as well as to assess the varying mortality risks among NHANES participants with and without CKD.Result During 9018 person-years of follow-up, 660 all-cause deaths occurred. After multivariable adjustment, NHANES data analysis reveals an inverse J-shaped relationship between combined HGS and CKD risk across genders, with risk increasing as HGS falls below 68 kg for women and 86 kg for men. High combined HGS is associated with a significant 71.6% reduction in the risk of all-cause mortality when compared to low combined HGS. In patients with CKD, a higher HGS is associated with lower cardiovascular disease (CVD) mortality, evidenced by hazard ratios (HRs) of 0.96 for males (95% CI: 0.9–0.98; p < 0.001) and 0.97 for females (95% CI: 0.95–0.99; p = 0.038). Additionally, an increase in HGS is linked to a decrease in all-cause mortality, with HRs of 0.98 for both males (95% CI: 0.96–0.99; p = 0.004) and females (95% CI: 0.96–0.99; p = 0.022). Conversely, no significant association between HGS and mortality was observed in individuals without CKD.Conclusion The strong evidence highlights the crucial role of HGS in diminishing the risk of CKD and its link to increased survival rates.
Mixed Methods for Exploring Medical Students’ and Teachers’ Perception of Paediatrics Clinical Education at the University of Khartoum, Sudan
Authors: Elshazali Osama Hafiz , Abdullahi Hala , Howden Stella
Published: April 2024

Introduction
The education environment is an important factor in supporting academic achievement, influencing student success in the short term as well as shaping professional careers. Students are key stakeholders in the academic process, and their perspectives should be considered when reviewing and enhancing the educational environment.
Objectives
The objective of the study was to explore medical students’ perception of paediatric educational environments in the context of primary medical education (MBBS) at the University of Khartoum.
Methods
The first phase was a quantitative, descriptive, cross-sectional study using the Dundee Ready Education Environment Measure (DREEM). In the second phase, the findings were shared with the paediatrics faculty, through a small group facilitated discussion to explore the educator’s views on the survey output and related actions in the last phase the faculty meeting recommendations were shared with the student representatives.
Results
The survey was distributed to all students in year 5 of the MBBS programme (total 308),191 (62%) students completed the DREEM questionnaire.
The total DREEM score mean was 113 ± 2.8 (56.5%), putting it in the ‘more positive than negative’ range, the mean item score for the study was 2.26. The highest overall perception was in the domain of perception of teachers (59.2%) followed by perception of learning (58%) and the lowest was for the students’ academic self-perception (53.7%).
The faculty meeting recommended enhancement of the programme organisation and delivery, the need for a faculty development programme and the need to explore enhancing student support.
Conclusions
Overall, the students had rated the programme as ‘more positive than negative’. The faculty has many strong areas that should be consolidated and other not so good areas that require enhancement. It is proposed that having a student support scheme and establishing a faculty development program would aid enhancement of the educational environment for the students.