bluuebunny/crossref_metadata_2025_split huggingface dataset:
Main aspects of personalized approach to the treatment of patients with chemotherapy resistant metastatic colorectal cancer
Authors: Stukalova O. Yu. , Ishchenko R. V. , Polikarpov A. A. , Farmonkulova A. I. 
Published: December 2024

Purpose of the study. To improve the results of treatment of patients with unresectable metastases of colorectal cancer in the liver that are not controlled by systemic chemotherapy.Materials and methods. The study includes clinical data on the treatment of 76 patients with metachronous metastases of colorectal cancer in the liver that are not controlled by systemic chemotherapy. Patients underwent removal of the primary tumor according to urgent indications at the first stage of complex treatment, followed by systemic chemotherapy in an adjuvant mode. After 24.5 ± 0.2 months, patients were diagnosed with metastatic liver damage, and therefore systemic chemotherapy was initiated. After changing two lines of drug therapy with a registered progression of the oncological process, liver metastases were recognized as uncontrolled by systemic chemotherapy. After that patients were included in the given study and divided into two groups. The study group included 40 patients who underwent regional chemotherapy. The control group included 36 patients who continued systemic chemotherapy with subsequent line changes. The effectiveness was evaluated according to the RECIST 1.1 and mRECIST scales, as well as the overall one-year, two- and three-year survival rates.Results. The median overall survival of patients in the control and study groups was 30.0 ± 0.8 and 41.5 ± 0.5 months, respectively, p < 0.05. The total one-year, two- and three-year survival of patients in the control and study groups was 94.4 %, 69.4 %, 33.3 % and 100 %, 82.5 %, 57.5 %, respectively, p < 0.05. The median life expectancy of deceased patients in the control and study groups was 22.5 ± 0.4 and 27.0 ± 0.4 months.Conclusions. As a result of a comparative analysis of the detection of adverse events and complications of the treatment, patients of the study group underwent treatment much easier than patients of the control group – in patients in the group of systemic chemotherapy, moderate and severe complications were detected in 44.4 % of cases, in the study group – in 2.5 % of cases. According to the results of a clinical study, regional chemotherapy is an effective method of treating patients with colon cancer metastases in the liver that are not controlled by systemic chemotherapy and is associated with a statistically significant increase in overall survival (p < 0.05). For a more detailed study of the benefits of regional chemotherapy in this category of patients, further prospective clinical studies are necessary.
The role of tumor stem cells and the immune microenvironment in the pathogenesis of lung cancer: mechanisms of interaction and research prospects
Authors: Kharagezov D. A. , Antonyan A. A. , Zlatni E. Yu. , Sagakyants A. B. , Mirzoyan E. A. , Ayrapetova T. G. , Leyman I. A. , Milakin A. G. , Stateshny O. N. , Iozefi K. D. , Homidov M. A. , Alekseev E. A. 
Published: December 2024

Despite significant advances in the treatment of malignant neoplasms, the issue of therapy resistance mediated by cancer stem cells (CSCs) necessitates the development of new treatment strategies. Studying the role of CSCs and the immune microenvironment in the pathogenesis of cancer, particularly non-small cell lung cancer (NSCLC), is a pressing issue in modern oncology. This paper is based on an extensive analysis of recent research and aims to study the mechanisms underlying the development of NSCLC.The origin of CSCs, their markers, and the main signaling pathways involved in regulating their activity are considered. Special attention is paid to the influence of CSCs on the progression of lung cancer and the mechanisms underlying their therapy-mediated resistance. Various approaches to treating lung cancer targeting CSCs, focusing on targeted therapy aimed at specific molecular targets, are highlighted.The important role of the tumor immune microenvironment in the pathogenesis of lung cancer and its impact on CSCs is emphasized. Mechanisms of immune response regulation in tumors and the potential use of immunotherapy to improve lung cancer treatment outcomes are discussed. The article also reviews modern diagnostic and treatment methods, including molecular-genetic and immunohistochemical approaches.This paper work represents a review of current knowledge on the mechanisms of lung cancer development and is significant for understanding tumor biology and developing new treatment methods. The need for an interdisciplinary approach and comprehensive use of modern diagnostic and therapeutic methods to improve the prognosis and survival rates of NSCLC patients is emphasized. Special attention is given to the prospects of using combined therapeutic approaches, including targeted drugs and immunotherapy, aimed at suppressing CSC activity and modifying the tumor microenvironment.In conclusion, a deep understanding of the molecular mechanisms regulating CSC activity and their interaction with the tumor microenvironment opens new opportunities for developing effective treatment strategies. This review underscores the need for further research in this area to ensure more successful treatment and improved quality of life for lung cancer patients.
Biopolitical rulership and motifs in Bulawayo’s Glory: A Zimbabwean version of Orwellian society
Authors: Mavengano Esther 
Published: December 2024

In this study, I reread George Orwell’s remarkable text Animal Farm together with Noviolet Bulawayo’s second novel, titled Glory. Orwell’s allegoric novel remains astute in its account of the fate of living under the shadow of an autocratic state whose leadership is haunted by the paranoia of losing power. Orwell deploys symbolic animals, including dogs, hens, pigs, horses, sheep and donkeys, to function as salient embodiments permeated with figurative meanings about a corrupt regime which lashes out at its victims. I deploy Giorgio Agamben’s concepts of bare life, homo sacer, state of exception and suspension of law in reading the Zimbabwe electoral politics and biopolitical imaginings of the postcolonial state. I foreground contemporary power mechanisms, unruly manifestation and performativity on the body and mind of the homo sacer(s). I also interrogate the Napoleon forms of power exercised by state ‘security agents’ – renamed growling dogs and defenders in modern Zimbabwe. I conclude that biopolitical power, in an environment where the exception has become the rule, serves in the management of perturbed citizens.Contribution: Giorgio Agamben’s biopolitical conceptual framework has rarely been used to examine the intricate and often paradoxical relations between those in power (rulers) and ordinary citizens (the ruled) in present-day Zimbabwe. This study brings to attention spectacles of power, the fate of homo sacer figures and their conviviality – as central tropes complexly enunciated and thematised in both Orwell and Bulawayo’s fictional writings. The parallel analyses of the two novels from different historical periods and literary traditions in this study offer fresh reflections on the complexities that arise from living under autocratic rule.
Uncovering the Prevalence of Vitamin D Deficiency and Investigating its Impact on Bone Health in Geriatric Patients with Chronic Kidney Disease: A Cross Sectional Study
Authors: Alkathem Jafar Ali , Alzahrani Amal Abdullah , Alali Shahad Mufeed , Al Beshi Saeed Mubarak , Alobaydan Majd Abduljalil , Alharbi Ali Ibrahim , Alhodibi Mostafa 
Published: December 2024

Abstract

Introduction:
In this study, the prevalence of Vitamin D deficiency in patients with chronic kidney disease (CKD) was established, and its impacts on the spine health of these patients were also determined and they include osteoporosis and fractures. Moreover, there is a dearth of information regarding the correlation between Vitamin D status, osteoporosis and the presence of risk of fractures specifically in geriatric CKD patients. The current cross-sectional prevalent-based study sought to determine the relationship between Vitamin D deficiency, osteoporosis and fractures in the selected people.

Methods:
A total of 675 geriatric patients aged 65–75 years with CKD stages 3–5 participated. Data were collected through interviews, medical record reviews and physical assessments. Information obtained included demographics, falls history, Vitamin D levels, diagnoses of Vitamin D deficiency, osteoporosis and fractures. Associations between Vitamin D deficiency and osteoporosis/fractures were examined using Chi-square tests using SPSS version 27.

Results:
The finding on men showed the percentage prevalence of Vitamin D deficiency to be 42%. Eight per cent, while 30. 2% cent had osteoporosis. Vitamin D has been revealed to have a strong relationship with osteoporosis (P < 0.001), in which 86% of patients were defiantly Vitamin D insufficient. Three per cent of those deficient also has osteoporosis. In addition, 79. As compared with an incidence of 9% in subjects with Vitamin D deficiency, fractures developed after minimal trauma occurred in 44%. Seven per cent without (P < 0.001). With regard to adverse effects, there was no occurrence of hip fractures, but seven patients. The answers revealed that 7% of the patients fell at least once in the last year.

Conclusion:
As seen in this study, geriatric CKD patients had concerning levels of Vitamin D deficiency, a parameter which was positively correlated to osteoporosis as well as was significantly related to the likelihood of developing fractures for patients after they had been involved in minor accidents. The findings emphasise the importance of optimising Vitamin D levels in this population through supplementation and lifestyle modifications to possibly reduce osteoporosis and fracture burden. Further research is warranted to develop targeted Vitamin D intervention strategies.
Assessing the Long-term Outcomes, Quality of Life and cost-effectiveness in Saudi Patients Undergoing Cardiac Surgery for Coronary Artery Disease: A Cross-sectional Study
Authors: Aleid Abbas Fadeil , Alhumidhan Alhanouf Maher , Almutairi Aseelah Taye , Alshakhs Mohammed Afif , Bakudam Wed Adnan , Alsaloom Nasser Salman , Mufti Basem Muwaffaq , Albshaier Abdulelah Jamal , Alessa Mohammed Yousef 
Published: December 2024

Abstract

Introduction:
Cardiac surgery offers durable clinical benefits in managing coronary artery disease (CAD). However, data from the Saudi context are limited on long-term health impacts, quality of life (QoL) and value. This study aims to address this knowledge gap.

Subjects and Methods:
A cross-sectional survey involved 1377 Saudi patients who underwent cardiac surgery for CAD. A validated questionnaire assessed demographics, medical history, complications, health status, lifestyle modifications, QoL parameters and healthcare utilisation. Descriptive analyses characterised responses.

Results:
Most patients underwent coronary artery bypass grafting/percutaneous coronary intervention over 5 years ago, with 85% very satisfied. Half experienced complications, 79% required chronic medications and 34% needed further procedures. Chest pain prevalence exceeded 50%, whereas two-thirds rated cardiovascular health as excellent. QoL improvements entailed reduced angina and better physical/social functioning for many. Outpatient follow-up occurred regularly for 85%.

Conclusion:
Cardiac surgery conferred durable clinical benefits in alleviating angina and improving functionality. However, ongoing active medical management appeared necessary, given residual symptoms and readmission rates. Future prospective cohorts can confirm long-term costs and savings gained from life expectancies and disability prevention. Locally tailored programmes considering population risks may optimise outcomes further by facilitating lifestyle changes and complication mitigation.
Exploring the Relationship between Vitamin D Deficiency and Osteoporosis in Geriatric Patients with Chronic Kidney Disease: Cross Sectional Study
Authors: Alkathem Jafar Ali , Alzahrani Amal Abdullah , Alali Shahad Mufeed , Alkazim Mohammed Ali , Al Beshi Saeed Mubarak , Alobaydan Majd Abduljalil , Alharbi Ali Ibrahim , Alhodibi Mostafa 
Published: December 2024

Abstract

Introduction:
Vitamin D deficiency is common in patients with chronic kidney disease (CKD) and has been linked to poor bone health outcomes including osteoporosis and fractures. However, limited data exist on the relationship between Vitamin D status, osteoporosis and fracture risk among geriatric CKD patients. This cross-sectional study aimed to examine the associations between Vitamin D deficiency, osteoporosis and fractures in this population.

Methods:
A total of 675 geriatric patients aged 65–75 years with CKD stages 3–5 participated. Data were collected through interviews, medical record reviews and physical assessments. Information obtained included demographics, falls history, Vitamin D levels, diagnoses of Vitamin D deficiency, osteoporosis and fractures. Associations between Vitamin D deficiency and osteoporosis/fractures were examined using the Chi-square tests using the SPSS software version 27.

Results:
The prevalence of Vitamin D deficiency was 42.8%, whereas 30.2% had osteoporosis. A significant association was found between Vitamin D deficiency and osteoporosis (P < 0.001), with 86.3% of those deficient also having osteoporosis. In addition, 79.9% with Vitamin D deficiency experienced fractures after low-impact injuries versus 44.7% without (P < 0.001). While no patients had experienced hip fractures, 7.7% reported falls in the past year.

Conclusion:
This study demonstrates concerningly high rates of Vitamin D deficiency among geriatric CKD patients, which were significantly associated with both osteoporosis and risk of fractures after minor injuries. The findings emphasise the importance of optimising Vitamin D levels in this population through the supplementation and lifestyle modifications to possibly reduce osteoporosis and fracture burden. Further research is warranted to develop targeted Vitamin D intervention strategies.
Identifying Risk Factors and Complications Associated with Acute Otitis Media in Paediatric Patients in Saudi Arabia: A Cross-sectional Analysis
Authors: Alkhars Ola Ahmad , Althamin Maryam Abdullah , Alolyani Abdullah Nasir , Aljumaah Ahmad Suliman , Alkhayat Eyad Mohammed , Altalhi Rawan Abdullah , Alsulamy Nawaf Saadi , Alyahya Khalid Abdultaif 
Published: December 2024

Abstract

Introduction:
Acute otitis media (AOM) is a common early childhood infection, often emerging as a complication of upper respiratory tract infections. With an estimated 60%–70% of children experiencing AOM during childhood, it presents a significant health concern, especially in the paediatric population. The prevalence of AOM underscores its substantial burden on healthcare systems. However, there is a noticeable gap in research regarding the risk factors and complications of AOM, specifically in the child population of Saudi Arabia. This study aims to determine the prevalence of AOM among Saudi Arabian children, identify associated risk factors and investigate complications arising from AOM.

Methods:
This cross-sectional study, conducted from July to October 2023, targeted parents or guardians of Saudi Arabian children aged 0–12 years diagnosed with AOM. Non-Saudi children and those with chronic otitis media were excluded. Data were collected through a structured questionnaire in both English and Arabic, focusing on demographics, risk factors, day-care attendance and breastfeeding duration. The sample size was calculated using Raosoft software, requiring a minimum of 377 participants. Statistical analysis was performed using IBM SPSS Statistics version 28.0.

Results:
The study involved 952 participants. Key findings included a high prevalence of AOM symptoms in the past year, with 33.8% of children diagnosed by healthcare professionals. A significant correlation was found between AOM prevalence and day-care attendance (P < 0.001), with children attending day care for <10 h per week showing a higher incidence of AOM. The study also found a significant relationship between extended breastfeeding duration and decreased AOM prevalence and episodes. However, a substantial number of parents reported a lack of information regarding the AOM prevention benefits of breastfeeding.

Conclusion:
The study reveals that AOM is a significant health concern in Saudi Arabian children, with day-care attendance and breastfeeding practices showing varying associations with AOM incidence. These findings contribute to our understanding of AOM in this demographic and highlight the need for increased awareness and preventive measures, especially in day-care settings. They also underscore the potential role of breastfeeding in reducing AOM episodes and emphasise the importance of healthcare provider guidance in this context. Future research should focus on longitudinal studies to establish causal relationships and explore the long-term impacts of AOM.
Impact of Drug Therapy on Visual Acuity in Diabetic Retinopathy among Adults in Saudi Arabia: A Cross-sectional Analysis
Authors: Aleid Mohammed Sami , Alhazmi Roba A. , Altamimi Amal Meshari , Albarakati Effat , Abadan Maram Ali , Alasmari Raghad , Alosaimi Taif , Alhodibi Mostafa Habeeb 
Published: December 2024

Abstract

Introduction:
Diabetes mellitus, a global health concern, is increasingly prevalent and leads to various complications, notably diabetic retinopathy (DR), a major cause of visual impairment. This study aims to investigate the impact of pharmacological treatments on visual outcomes in DR patients, focusing on the Saudi Arabian population.

Methods:
This cross-sectional study was conducted in various healthcare centres across Saudi Arabia, enrolling 2233 DR patients aged 20 years and above. The methodology involved stratified random sampling to ensure diverse demographic representation. Data collection encompassed interviews, medical record analysis and standardised assessments, focusing on pharmacological treatment types, treatment duration, visual acuity outcomes and the presence of other diabetic complications. Statistical analysis was conducted using SPSS software version 28.

Results:
The study revealed that patients on oral medications, especially metformin, reported higher perceived improvements in visual acuity (53.9%) compared to those on anti-vascular endothelial growth factor treatments. A significant correlation was found between the duration of pharmacological treatment and the severity of DR. Furthermore, age and duration of diabetes were identified as influential factors in visual acuity outcomes. The study also noted that combination treatments did not significantly worsen visual acuity.

Conclusion:
This study underscores the importance of personalised pharmacological treatment strategies in managing DR in Saudi Arabia. Future research should focus on longitudinal studies to further explore the long-term impacts of these treatments. The study’s insights are crucial for optimising patient care and improving visual outcomes in DR patients.
Evaluating Multimodal Analgesia in Postoperative Pain Reduction for Rheumatoid Arthritis Patients in Saudi Arabia: Cross Sectional
Authors: Aleid Abdulsalam Mohammed , Almalky Nawwaf Abdullah , Allhybi Abdulaziz Khalid , Areeshi Rehaf Abdulrhman , Akoor Atheer Abdullah , Algmaizi Shahad Fahad , AShahrani Maram Ali , Aldanyowi Saud Nayef 
Published: December 2024

Abstract

Introduction:
Post-operative pain management is crucial for rheumatoid arthritis (RA) patients undergoing surgery. This study evaluated the effectiveness of multimodal analgesia in reducing post-operative pain and associated opioid usage in this patient group.

Methods:
A cross-sectional study involved 1368 Saudi patients with RA. Data on demographics, surgical history, post-operative pain levels, multimodal analgesia/opioid use, adverse effects and satisfaction were collected through questionnaire. Descriptive statistics characterised responses. Chi-square tests analysed associations between variables.

Results:
The sample comprised ages 35–55 years and included slightly more males. Half reported RA diagnosis <1 year ago. Post-operative pain severity in the first 24 h ranged from mild to severe for most. Multimodal analgesia effectively reduced pain to tolerable levels within 1–3 days by 25%. Those receiving multimodal analgesia experienced fewer opioid-related adverse effects such as nausea. Satisfaction levels were high. A significant association was found between multimodal analgesia use and reduced post-operative opioid intake (P < 0.001).

Conclusion:
Multimodal analgesia demonstrated effectiveness in managing post-operative pain in RA patients. The majority reported improvements within a few days and satisfaction with the treatment approach. Importantly, its use correlated with a decreased need for opioids and related complications. These findings underline multimodal analgesia’s potential role in improving post-operative outcomes through superior pain control and minimised opioid consumption in this vulnerable patient group. Larger longitudinal studies can further validate its benefits.