bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post‐CAR T‐Cell Therapy Failure Metabolic Parameters Predict Survival and Response in Large B‐Cell Lymphoma
Authors: Ababneh Hazim S. , Frigault Matthew J. , Ng Andrea K. , Patel Chirayu G. 
Published: December 2024

ABSTRACT18F‐fluorodeoxyglucose positron emission tomography‐computed tomography (18F‐FDG PET/CT) parameters have shown a significant prognostic role in relapsed/refractory large B‐cell lymphoma (LBCL) patients undergoing CD19‐targeted chimeric antigen receptor (CAR) T‐cell therapy. While a substantial body of evidence exists on the prognostic value of PET/CT parameters in peri‐CAR T setting, data available on the prognostic value of PET/CT parameters following CAR T‐cell therapy failure is lacking. Therefore, we sought to analyze the PET/CT scans of LBCL patients who experienced post‐CAR T relapsed/progressive disease and subsequently received salvage therapies. Thirty‐three LBCL patients who had PET‐CT scans done demonstrating post‐CAR T failure and then received salvage therapies [as a first salvage modality: RT alone, nine patients; combined modality therapy (CMT), seven patients; systemic therapy (ST) alone, 17 patients] were analyzed. The median follow‐up after CAR T‐cell infusion was 11.7 months [interquartile range (IQR): 5.1–24.4 months], and the median follow‐up after post‐CAR T salvage therapy was 7.3 months (IQR: 2.7–19.1 months). The median timeframe for the PET scan showing post‐CAR T failure was 2.4 months (IQR: 0.96–5.0 months). On univariable analysis from salvage therapy start date, high metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were associated with inferior overall survival (OS) (Hazard ratio –HR = 8.4, p < 0.0001; HR = 3.2, p = 0.01, respectively). High MTV was associated with a non‐significant trend of inferior progression‐free survival (PFS) (HR = 3.5, p = 0.09). High maximum standardized uptake value (SUVmax) was not associated with inferior OS or inferior PFS. On multivariable analysis from salvage therapy start date, high MTV (HR = 4.6, 95% CI: 1.5–14.3, p = 0.009) was identified to be an independent prognostic factor for inferior OS. High International Prognostic Index (IPI) (≥ 3) at the time of salvage therapy (HR = 2.5, 95% CI: 1.1–5.6, p = 0.02) was significantly associated with inferior PFS. Our study shows that semiquantitative PET/CT metrics, especially MTV, are significant prognostic indicators of overall survival in this highly refractory population after CAR T‐cell therapy failure, potentially refining prognostic and treatment approaches beyond conventional parameters like IPI.
Evaluation of a New Patellar Tendon Bearing Brace With Offloading Monitoring and Adjustability: A Pilot Study
Authors: Chamani Vahid , Bahramizadeh Mahmood , Khosravi Mobina , Biglarian Akbar , Amjad Gholamreza Ghorbani , Mousavi Seyyed Mohammad Ebrahim , Arazpour Mokhtar 
Published: December 2024

ABSTRACTBackground and AimsThe patellar tendon‐bearing (PTB) brace is a crucial device designed to lessen axial forces on the tibia. The newly designed PTB brace allows clinicians to measure offloading amount in the realtime. This study aimed to explore the relationship between a rise in displacement between the foot plate and calf shells of this new PTB brace and changes in the amount of offloading on the tibia.MethodsThis pilot study used a sample of five individuals with midshaft tibia fractures to investigate the effectiveness of the PTB brace under different conditions. The PTB brace was tested in six different conditions, with the displacement between the foot plate and calf shells varying in increments of 0.5 cm, from 1 cm to 3.5 cm.ResultsThe new PTB brace provided varying levels of offloading, ranging from 22% to 38%. As the vertical distance between the calf shells and foot plate increased, the offloading levels also increased significantly. The study observed significant differences in weight reduction (p = 0.02) and offloading percentages (p = 0.048) when comparing 1 cm and 1.5 cm displacement.ConclusionThe findings suggest that maintaining a distance of 1.5 cm or more between the calf shells and foot plate is effective in reducing weight and offloading on the tibia. These results have important implications for clinicians using PTB braces to treat tibia fractures, highlighting the importance of adjusting the displacement of the PTB brace to optimize patient outcomes.
Factors Predicting Renal Outcomes in Hypertensive Emergencies With Severe Renal Impairment: A Single‐Center Retrospective Study
Authors: Nakazato Rei , Mii Akiko , Kamijo Natsumi , Tani Takashi , Arakawa Yusuke , Otsuka Toshiaki , Sakai Yukinao , Kashiwagi Tetsuya , Iwabu Masato 
Published: December 2024

ABSTRACTBackground and AimsHypertensive emergencies, characterized by elevated blood pressure (BP) and multiple organ damage, have poor prognosis. Patients occasionally show gradual improvement in renal function with appropriate antihypertensive treatment despite renal impairment. However, reports analyzing factors predicting prognosis in patients with hypertensive emergencies and severe renal impairment are limited. This retrospective study aimed to investigate clinical features and predictors of renal outcomes in such patients.MethodsPatients admitted to our hospital diagnosed with hypertensive emergency with severe renal impairment (serum creatinine [Cr] level > 2.5 mg/dL) between 2007 and 2021, were enrolled and divided into two groups: those who received renal replacement therapy (RRT) after 3 years (RRT group) and those who did not (non‐RRT group); clinical characteristics and laboratory data were compared.ResultsFifteen patients were enrolled, with a median age and serum Cr level of 48 years and 5.97 mg/dL, respectively. No significant between‐group difference was observed in serum Cr levels or kidney size. However, the non‐RRT group exhibited significantly higher levels of serum lactate dehydrogenase (LDH) levels and significantly lower platelet counts (PLT), suggesting development of microangiopathic hemolysis due to severe endothelial damage. Furthermore, the non‐RRT group exhibited lower serum potassium levels than the RRT group, accompanied by high plasma renin activity and serum aldosterone levels, suggesting activation of the renin‐angiotensin system (RAS). In the non‐RRT group, serum Cr, LDH, potassium levels, and PLT improved significantly after treatment.ConclusionsSerum LDH, potassium levels, and PLT are useful predictors of renal prognosis in hypertensive emergencies with extremely poor renal function. In some cases, severe renal damage can be ameliorated by appropriate antihypertensive therapy. A positive response to treatment often signifies a favorable prognosis. Furthermore, early initiation of RAS inhibitors may be beneficial for lowering BP and providing renal protection.
An Exploratory‐Descriptive Qualitative Study on Accessing Eye Health Services at the Community Level in the Gamo and Gofa Zones, Southern Ethiopia
Authors: Alemu Tsegaye , Seyum Dawit , Gebre Mulate , Sisay Alemayehu 
Published: December 2024

ABSTRACTBackground and AimsAccess to eye health care, which has a substantial influence on quality of life, is crucial for preventing and treating vision impairments. The determinants of access to eye health care in Ethiopia, especially in the Gamo and Gofa Zones in southern Ethiopia, are not well known. Therefore, this study aimed to identify barriers to accessing eye health services at the community level.MethodsA community‐based, exploratory descriptive qualitative study was conducted among adult women and men residing in two zones from June 2 to July 10, 2023. A purposive sampling technique was utilized to collect qualitative data. In‐depth interviews and FGDs were included among the purposefully selected study participants. During the interviews and discussions, digital audio recording was carried out. The data were analysed via the inductive thematic analysis technique and direct quotations from participants' opinions. The respective themes and subthemes provided a detailed overview of the findings, and the Atlas software was used to support the analysis.FindingsNine FGDs were conducted among 90 participants. Moreover, a total of 26 in‐depth interview participants were included. The mean (±SD) age of the participants in the in‐depth interviews was 32.96 ± 4.8 years. The most commonly cited barriers (1) poor awareness and misperception, financial constraints and community‐based health insurance implementation gaps; (2) lack of social support; (3) lack of healthcare accessibility, shortage of basic medical equipment; (4) cultural eye care practices and (5) poor road access, rough topography, and difficulty reaching areas, which are identified as obstacles for accessing eye health services.ConclusionThis study identified pertinent barriers that hinder access to eye health care in the study area. Therefore, tailored strategies are needed to tackle the challenges. This approach is helpful for the local context and offers actionable insights for health policymakers and program designers.
Advancements in Molecular Diagnosis and Pharmacotherapeutic Strategies for Invasive Pituitary Adenomas
Authors: Xu Dingkai , Wang Ling , Zheng Maohua 
Published: December 2024

ABSTRACTBackgroundThe overwhelming majority of pituitary tumors consist of pituitary adenomas (PAs), which have recently also been termed pituitary neuroendocrine tumors (PitNETs). Clinically significant PAs occur in approximately one in every 1000 individuals, while other types of pituitary tumors, such as craniopharyngiomas and pituicytomas, are significantly less common. Although PAs are generally benign, a subset of them exhibits malignant‐like biological traits. They tend to infiltrate and grow aggressively into adjacent tissues and organs, including the dura mater, cavernous sinus, and sphenoid sinus. This invasive behavior often results in the destruction of the normal anatomical architecture of the sella turcica and skull base. Clinically, such tumors are classified as invasive PAs (IPAs), emphasizing their aggressive and destructive nature.Objective and SignificanceCurrently, the diagnostic indicators for IPAs frequently suffer from suboptimal sensitivity and specificity. The invasiveness assessment of PAs lacks a definitive gold standard and instead serves as a predictive tool, with a greater number of indicators met suggesting a higher likelihood of invasiveness. Consequently, a comprehensive approach that integrates imaging, pathological, molecular biological, and other disciplinary metrics is crucial for accurate evaluation. Despite surgery being the primary treatment modality for IPAs, their malignant‐like behavior complicates complete resection, resulting in lower resection rates and heightened postoperative recurrence, necessitating multiple surgeries. Therefore, adjunctive drug therapy is often necessary for IPA patients. Preoperative drug therapy can shrink tumor size, facilitating resection and postoperative recovery, mitigating hormone imbalances, delaying recurrence, and enhancing patients' quality of life.ConclusionsThis article comprehensively reviews the diagnostic criteria for assessing the invasiveness of PAs in the domains of imaging, pathology, and molecular biology, provides an overview of the current research status of drug therapy for these conditions, and deepens our insight into the biological and therapeutic aspects of the tumor microenvironment in PAs.
Colposcopy referrals and CIN3 detection after triage by host cell DNA methylation and/or HPV genotyping in HPV positive women with low‐grade cytology from a population‐based Dutch primary HPV screening trial
Authors: Verhoef Lisanne , Bleeker Maaike C. G. , Polman Nicole , Kroon Kelsi R. , Steenbergen Renske D. M. , Ebisch Renée M. F. , Melchers Willem J. G. , Bekkers Ruud L. M. , Molijn Anco C. , van Kemenade Folkert , Meijer Chris J. L. M. , Heideman Daniëlle A. M. , Berkhof Johannes 
Published: December 2024

AbstractHigh‐risk HPV (hrHPV)‐based screening has led to many unnecessary colposcopy referrals, mainly because of direct referral after low‐grade cytology (ASC‐US/LSIL). DNA methylation and genotyping tests on ASC‐US/LSIL samples have the potential to significantly improve the efficiency of screening. In this study, 12 triage strategies were constructed from FAM19A4/miR124‐2 or ASCL1/LHX8 methylation, HPV16/18 or HPV16/18/31/33/45 genotyping and 1‐year repeat cytology. The performance was evaluated on 215 hrHPV‐positive ASC‐US/LSIL samples from the IMPROVE trial (NTR5078). Performance was measured by colposcopy referral rate, positive predictive value (PPV) for detecting precancer (CIN3), and negative predictive value (NPV). To evaluate efficiency, strategies were ordered by the cumulative colposcopy referral rate after 1‐year cytology and compared by the marginal PPV to detect one additional CIN3 (mPPV). The most conservative strategy (referral when HPV16/18 and FAM19A4/miR124 methylation results are positive) had a direct referral rate of 5.2%, a cumulative referral rate after 1‐year cytology of 54.1%, and mPPV of 19.3%. Replacing HPV16/18 by HPV16/18/31/33/45 increased the cumulative 1‐year referral rate to 54.6%, and yielded an mPPV of 10.0%. Similar results were obtained for strategies with ASCL1/LHX8 methylation. Of all strategies, referral after an HPV16/18/31/33/45 positive, ASCL1/LHX8 methylation‐positive, and/or 1‐year cytology‐positive result yielded the highest direct and cumulative 1‐year colposcopy referral rates of 64.4% and 79.1%, respectively. The NPVs after 1‐year cytology varied between 98.1% and 99.4%, warranting a return to routine screening. Altogether, DNA methylation‐based triage strategies are recommended as they are discriminative for CIN3 and control the number of immediate colposcopy referrals.
Gehyra Geckos Prioritize Warm Over Humid Environments
Authors: Skelton Kade , Day Kimberley , Weitzman Chava L. , Schlesinger Christine , Moritz Craig , Christian Keith 
Published: December 2024

ABSTRACTMaintaining stable hydric and thermal states are dual challenges for reptiles that inhabit terrestrial environments with variable conditions across time and space. Under some conditions, reptiles face a conundrum where both physiological parameters cannot be simultaneously maintained at preferred levels by behavioral or physiological means. Prioritization of behavioral regulation of hydric or thermal state, and at which point this prioritization changes, was tested for nine species of congeneric tropical geckos by assessing their use of microhabitats with distinct thermal and hydric conditions in a controlled environment. Gehyra geckos were presented with two crevices of contrasting humidity levels, and time spent in either crevice was recorded across three ambient temperature treatments of 32°C, 27°C, and 22°C. Temperatures in the humid crevice matched ambient air temperature, whereas temperature in the dry crevice was maintained at 32°C. In these trials, all species showed greater use of the dry (and warm) crevice in the 27°C and 22°C treatments, while there was no strong preference for the humid or dry crevice in the 32°C treatment. Thus, Gehyra geckos prioritized thermoregulation and maintained thermal state through behavioral responses, and humid microhabitats were not selected even when it did not compromise the animal's thermal state. Although selection for preferred thermal conditions was prioritized in the short term, this does not preclude the possibility that hydric state can be regulated on a seasonal time scale.
Epstein‐Barr Virus Infection Presenting With Acute Gastrointestinal Involvement. Report of Two Cases of Epstein‐Barr Virus Colitis in Kidney‐Transplant Recipients and Scoping Review of the Literature
Authors: Díez‐Vidal Alejandro , Arroyo‐Acosta Carlos , Elvira‐Lafuente Carolina , Díaz‐Pollán Beatriz , Grandioso‐Vas David , Loeches Belén , Azores‐Moreno Javier , Marcelo‐Calvo Cristina , Martínez‐Martín Patricia , González‐García María Elena 
Published: December 2024

ABSTRACTEpstein‐Barr virus (EBV) is a herpesvirus capable of establishing lifelong latent infections, leading to a wide spectrum of diseases. It can affect multiple organs, including the gastrointestinal tract, typically through lymphoproliferative syndromes or gastric cancer, while acute gastrointestinal disease is rare and poorly understood. Two cases of EBV‐induced acute colitis in kidney transplant recipients were described. Additionally, a scoping review of the literature was conducted to identify all reported cases of EBV infection presenting with acute gastrointestinal involvement. A total of 11 174 articles from PubMed and Embase were analyzed, from which 30 articles were ultimately selected, encompassing 33 cases. Two distinct patient profiles emerged. Patients with gastric‐limited disease were typically healthy women and exhibited a benign course, characterized by a more acute presentation and complete recovery in all cases. In contrast, patients with intestinal disease were often immunocompromised, presenting with deep colonic ulcers frequently associated with rectal bleeding, high rates of perforation, frequent need for surgical intervention, and significant mortality. Antiviral therapy and reduction of immunosuppression were commonly employed, although no specific treatment approach demonstrated a clear benefit in reducing mortality or complications. In conclusion, EBV‐related gastrointestinal disease varies by patient immunocompetence and the site of involvement. Gastric‐limited disease usually has a favorable prognosis, while intestinal involvement in immunocompromised patients is linked to severe complications and higher mortality. Individualized treatment strategies and vigilant long‐term follow‐up are needed due to the lack of standardized treatment protocols and the risk of relapse or development of EBV‐associated lymphoproliferative disorders.
Association of Socio‐Environmental Burden and Inequality With Cancer Screening and Mortality
Authors: Zindani Shahzaib , Khalil Mujtaba , Rashid Zayed , Altaf Abdullah , Woldesenbet Selamawit , Pawlik Timothy M. 
Published: December 2024

ABSTRACTBackground and ObjectivesSocial and environmental injustice may influence accessibility and utilization of health resources, affecting outcomes of patients with cancer. We sought to assess the impact of socio‐environmental inequalities on cancer screening and mortality rates for breast, colon, and cervical cancer.MethodsData on cancer screening and environmental justice index social and environmental ranking (SER) was extracted from the CDC PLACES and ATSDR, respectively. Mortality rates were extracted using CDC WONDER. Screening targets were defined by Healthy People 2030.ResultsAmong census tracts, 14 659 were classified as “low,” 29 534 as “moderate,” and 15 474 as “high” SER (high SER denoting greater socioenvironmental injustice). Screening targets were achieved by 31.1%, 16.2%, and 88.6% of tracts for colon, breast, and cervical cancers, respectively. High SER tracts were much less likely to reach screening targets compared with low SER tracts for colon (OR: 0.06), breast (OR: 0.24), and cervical cancer (OR: 0.05) (all p < 0.001). Median mortality rates for low and high SER were 16.7, and 21.0, respectively, for colon, 13.4, 14.75, respectively, for breast, and 1.0, 1.6, respectively, for cervical cancer (all p < 0.05).ConclusionSocioenvironmental disparities negatively influence cancer screening and mortality, underscoring the need to reduce environmental injustices through measures like equitable cancer screening services.
Eruptive Xanthomata Manifesting in Tattoos
Authors: Stonesifer Connor , Morquette Alexandra , Li Jeffrey N. , Elman Scott A. , Elgart George W. 
Published: December 2024

ABSTRACTEruptive xanthomata represent a rare, but important pruritic dermatosis for which an accurate diagnosis can prevent life‐threatening complications. We present the case of a 29‐year‐old female with no prior medical history who presented to clinic for evaluation of a pruritic papular eruption of 2 weeks' duration. Notably, examination revealed numerous papules within the boundaries of her long‐standing tattoos. Biopsy of these lesions revealed a diagnosis of eruptive xanthomata. Eruptive xanthomata are observed in the setting of extreme hypertriglyceridemia (> 3000 mg/dL) and, importantly, they koebnerize to areas of acute and past trauma. Examination of tattoos is vital in dermatologic practice as changes, particularly induration, can be suggestive of systemic disease. This case emphasises that the differential of koebnerization within tattoos should include eruptive xanthomata.
Stream bryophytes promote “cryptic” productivity in highly oligotrophic headwaters
Authors: Thellman Audrey N. , Wooster Tammy , Malcom Heather , Rosi Emma J. , Bernhardt Emily S. 
Published: December 2024

AbstractRecent observations document increased abundance of algae in the headwater streams of Hubbard Brook Experimental Forest (HBEF). It is possible that this “greening up” of HBEF streams may be due to climate change, with rising temperatures, altering terrestrial phenology, and shifting hydrologic regimes. Alternatively, stream “greening” could be from the slow recovery of stream chemistry after decades of acid rain, which has led to rising pH, declining concentrations of toxic Al3+, and low solute concentrations. Four years of weekly algal measurements on artificial moss and ceramic tiles, along with six nutrient enrichment experiments, revealed new insights about the interactions between these two autotrophs. We found that in protected weir ponds and in stream channels, algal biomass was higher on artificial moss substrates than on tiles—with this effect amplified in the stream channels. These results suggest that bryophytes can provide physical protection from flood scour or may trap nutrients to support algal growth. In stream channels, algal biomass was higher in well‐lit habitats and time periods indicating strong light limitation. We only measured nitrogen and phosphorus limitation of algal biomass in nutrient enrichment experiments conducted within weir ponds, with higher light availability and lower flow. By comparison, results from the remaining four instream experiments provided little evidence for nutrient limitation, with only one trial showing increased algal growth in response to nutrient addition. The most striking implication of our study is the role of bryophytes in providing refugia, and potentially nutrients, to algae in shaded and oligotrophic headwater streams.
mRNA m5C Alteration in Azacitidine Demethylation Treatment of Acute Myeloid Leukemia
Authors: Chen Ziwei , Guo Yingyu , Zhang Zaifeng , Li Chang , Zhang Lili , Liu Ye , Sun Gaoyuan , Xiao Fei , Feng Ru , Zhang Chunli 
Published: December 2024

ABSTRACTThe DNA demethylating therapy with azacitidine (AZA) is a promising therapeutic strategy for elderly patients with acute myeloid leukemia (AML). AZA primarily inhibits DNA methylation, promotes cell differentiation and apoptosis in AML. However, as a cytosine nucleoside analog, AZA also has the potential to be incorporated into RNA molecules. To assess the impact of AZA on RNA m5C methylation during demethylating therapy, we conducted Nanopore direct‐RNA sequencing on samples from three AML patients pre and after demethylating therapy, as well as on HL‐60 cells pretreated with AZA. We performed an integrated analysis of the transcriptome and the m5C methylome, contrasting the states of complete remission with those of active disease (AML). Our results revealed an extensive demethylation effect at the RNA level attributable to AZA and found that mRNA m5C modification may play a pivotal role in the progression of AML. Additionally, S100P was identified as a biomarker with significant prognostic implications. We also conducted a conjoint analysis of the transcriptome and the m5C methylome of the full‐length transcripts, uncovering several dysregulated mRNA isoforms. Collectively, our findings indicate that mRNA m5C methylation is implicated during AML progression, and AZA exhibits an overall suppressive effect on this process.