bluuebunny/crossref_metadata_2025_split huggingface dataset:
Waist circumference is a strong predictor of a positive outcome evaluated one year after sleeve gastrectomy
Authors: Bracha Marietta , Jaroch Alina , Wojtasik Jakub , Soja-Kukieła Natalia 
Published: December 2024

Abstract

Purpose
Bariatric surgeries, such as laparoscopic sleeve gastrectomy (LSG), not only result in significant weight loss but also improve the inflammatory state in obese patients. This study aimed to investigate the effects of LSG on weight loss and inflammation status in bariatric patients one year post-procedure.
Materials and Methods
This prospective cohort study was conducted from September 2022 till May 2024. Fifty obese adults were enrolled for LSG. All patients underwent assessments of body measurements, as well as levels of interleukin-6 (IL-6), interleukin-10 (IL-10) at baseline, and then at 3 and 12 months post-surgery.
Results
Twelve months post-surgery, body measurements showed a significant reduction, with a median excess weight loss (%EWL) of 56.8%, indicating clinical success of the bariatric procedure. %EWL showed a strong correlation with waist circumference (R= -0.738, p < 0.00001). A logistic regression model indicated that a reduction of just one centimeter in initial waist circumference increases the likelihood of a positive outcome in laparoscopic sleeve gastrectomy by 12%. Moreover, a significant increase was observed for IL-10 (p < 0.0001), simultaneously with a significant decrease in IL-6 (p < 0.0001).
Conclusions
This study provides valuable evidence supporting the benefits of laparoscopic sleeve gastrectomy for both weight loss and reducing inflammation. Waist circumference emerged as a strong predictor of metabolic success one year post-surgery, while increased IL-10 levels signaled positive immunological changes.
Step to it – can physical activity improve kids’ cognition? A six-month longitudinal study
Authors: McPherson Adrian , Duncan Scott , MacKay Lisa , Kunkel Jule 
Published: December 2024

Abstract

Background
Identifying the relationships among physical activity, cognition, and academic performance in children is important for targeted public health and education initiatives. However, the majority of research has been cross-sectional in nature; we have a limited understanding of the causal direction of these associations. Therefore, aim of this study was to utilise longitudinal data to explore causal relationships among physical activity, cognition and academic performance in elementary school children.
Methods
Data were sourced from 675 New Zealand children aged 5–11 years. Weekday home, weekday school, and weekend physical activity was measured by multiple pedometer step readings, cognition by four measures from the CNS Vital Signs assessment, and academic performance from the New Zealand Ministry of Education Assessment Tools for Teaching and Learning (asTTle) reading and maths scores. Measures were taken at baseline, two months, and six-month intervals. Data were analysed for 632 students identified with data for at least half of the 27 variables. A generalised linear mixed model was used to investigate changes in physical activity, cognition and academic performance over those three time periods while adjusting for gender, school, age, and socioeconomic status.
Results
No significant relationships were identified between physical activity and three of the cognitive domains. However, significant, positive relationships were observed between physical activity change at two-months and (1) composite memory change at six-months, (2) maths proficiency change at two-months, and (3) math proficiency change at six-months. Regression coefficients suggest that a child who doubles step count - a 100% increase in PA - will affect a 3.7% improvement in maths proficiency after two months, and after six months affect a 2.6% improvement in maths proficiency and a 4.7% improvement in composite memory.
Conclusions
This six-month longitudinal analysis identified that an increase physical activity led to small but significant improvements in composite memory and maths proficiency. The small associations suggest that substantial improvements in PA would be required to generate meaningful improvements in cognition and academic achievement. However, timeframes longer than six-months are recommended to identify long-term changes.
Neoadjuvant Short-course Radiotherapy and Subsequent Immunotherapy Plus Chemotherapy Followed by Surgery in Locally Advanced Rectal Cancer: a Retrospective Analysis
Authors: Han Xiaodan , Song Di , Shi Yonggang , Wang Huanhuan , Gu Zhuoyu , Zuo Xiaoxiao 
Published: December 2024

Abstract

Background
Neoadjuvant short-course radiotherapy (SCRT) followed by immunotherapy and chemotherapy has exhibited a higher pathological complete response (pCR) rate than long-course chemoradiotherapy in clinical trials for locally advanced rectal cancer (LARC). This study aimed to determine whether SCRT followed by immunotherapy plus chemotherapy could improve oncological outcomes compared to SCRT followed by chemotherapy alone as neoadjuvant treatment for LARC.
Patients and Methods:
Patients who were diagnosed with LARC and received SCRT at the First Affiliated Hospital of Zhengzhou University from July 2018 to May 2023 were collected. The patients who underwent surgery were divided into immunotherapy and non-immunotherapy groups based on whether immunotherapy was performed. Propensity score matching was performed between the two groups. The postoperative pathological response, treatment-related adverse events (TRAEs), overall survival (OS) and disease-free survival (DFS) were compared between the two groups. The associations with a pCR were investigated using univariate and multivariate analyses. Additionally, the effects of total mesorectal excision (TME) on the OS and DFS of patients, who achieved clinical complete remission (cCR), were evaluated.
Results
The immunotherapy group had a higher pCR rate than the non-immunotherapy group among patients who underwent surgery. No significant differences were observed in level 3–4 TRAEs, 3-year OS or DFS rates between the two groups. Univariate and multivariate analyses revealed that 1–3 and ≥ 4 cycles of immunotherapy were independently associated with a pCR. The cCR patients who selected the organ preserving strategy had a comparable 3-year OS rate but a lower 3-year DFS rate compared to those who received TME surgery.
Conclusions
SCRT and subsequent immunotherapy plus chemotherapy have an extraordinary pCR rate and manageable toxicity compared to SCRT plus chemotherapy, but they do not affect short-term OS and DFS rates. The selection of an organ preserving strategy should be discussed with LARC patients who have achieved a cCR.
Clinical evaluation of fiber reinforced resin composite either with short glass or polyethylene fibers versus nanohybrid resin composite in restoration of class II MOD cavities in posterior teeth: An 18-Month randomized controlled clinical trial
Authors: Mohamed Mohamed Hamdy , Mosallam Rania Sayed , Abouauf Eman Ali 
Published: December 2024

Abstract

Background: An optimal restoration for the reconstruction of carious teeth should provide superior marginal integrity, high fracture toughness and maximize conservation of remaining tooth structure. This study was conducted to evaluate the clinical performance of fiber reinforced resin composites with either short glass or polyethylene fibers compared with that of nanohybrid resin composite in restoring of class II MOD cavities over an 18-month follow-up period.
Methods: Forty-five participants with class II MOD cavities were randomly enrolled. The participants were allocated to three groups (n=15): Group (1): “fiber reinforcement” technique using short glass fiber reinforced resin composite (EverX Posterior) while Group (2): “fiber reinforcement” technique using polyethylene fibers (Ribbond-Ultra). Both groups (1) and (2) were layered with surface layer of nanohybrid composite (Filtek Z250). Group (3): conventional nanohybrid resin composite. The modified USPHS criteria were used to evaluate the restorations at baseline; and at three, six, 12 and 18 months. The categorical data was reported as frequency and percentage. Intergroup comparisons were analyzed using Chi-Square test after Bonferroni correction (P ≤ 0.016). Comparisons within each group were analyzed using Cochran's Q test after Bonferroni correction (P ≤ 0.005).
Results: Intergroup comparisons revealed no statistically significant difference regarding all evaluated criteria except for color match. Compared with the other groups, the short glass fiber-reinforced restorations group presented significantly lower color match at different follow-up periods
Conclusions: Direct fiber-reinforced resin composite class II MOD restorations showed satisfactory clinical performance similar to nanohybrid resin composite during an 18-month follow-up period.
Clinical Significance: Fiber reinforcement of resin composites with either short glass or polyethylene fibers could be a reliable technique for restoring posterior cavities.
Psychological Flexibility, Sleep Quality, Anxiety, and Depression in Women with Breast and Gynecologic Cancer: A Structural Equation Modeling Analysis
Authors: Kiyak Sibel , Polat Hilal Türkben 
Published: December 2024

Abstract

Background
Patients with breast and gynecological cancers frequently encounter various psychological and physical challenges that impact their overall health. This study aims to describe the relationship between anxiety, depression, sleep quality, and psychological flexibility in these patients.
Methods
This descriptive study was conducted with 212 patients with breast and gynecological cancers in the day treatment unit of an oncology department of a medical facility of a state university. Data were collected with participant information form, Hospital Anxiety and Depression Scale, Psychological Flexibility Scale, and Pittsburgh Sleep Quality Index.
Results
Of the studied patients, 36.3% and 55.3% were in the risk group for anxiety and depression, respectively. Furthermore, 75.3% of participants had poor sleep quality and medium–high psychological flexibility. While psychological flexibility has a positive effect on anxiety and depression, poor sleep quality and high body mass index have a negative effect. Psychological flexibility, sleep quality, and BMI explained 27% variance in anxiety and depression levels.
Conclusions
Poor sleep quality, low psychological flexibility, and BMI negatively affected anxiety and depression levels in patients.
Malignant upgrade in lesions of uncertain malignant potential in the breast (B3 lesions) – is open excision always necessary?
Authors: Heindl Felix , Schiel Janina , Hack Carolin C. , Amann Niklas , Jud Sebastian M. , Preuss Caroline I. , Häberle Lothar , Hartmann Arndt , Schulz-Wendtland Rüdiger , Wetzl Matthias , Beckmann Matthias W. , Erber Ramona 
Published: December 2024

Abstract

Purpose Unclear or suspicious breast findings are typically clarified by interventional breast biopsy. Lesions with uncertain malignant potential are grouped as B3 lesions in histopathology. The B3 group according to the European Working Group for Breast Screening Pathology (EWGBSP) comprises various breast lesions with different upgrade rates to invasive breast cancer (BC) or ductal carcinoma in situ (DCIS) if surgical removal is performed. The objective of this study was to investigate malignant upgrade rates to DCIS and/or invasive breast cancer (BC) after open surgical excision for the different B3 lesions.Methods A total of 192 patients with histologically verified B3 lesions were followed up retrospectively for this analysis. Patients with the B3 lesions atypical ductal hyperplasia (ADH), flat epithelial atypia (FEA), and classical lobular neoplasia (LN1-2) were combined into one group, while cellular fibroepithelial lesions (CFL) and phyllodes tumors without suspicion of malignancy, as well as papillomas and radial scars/complex sclerosing lesions (RS/CSL) were summarized in two other groups. We investigated the association of the different B3 lesions with invasive BC or DCIS after open surgical excision.Results Histopathological investigation revealed in 21 (10.9%) of the 192 patients invasive BC or DCIS after open surgical excision. The rate of patients with BC and/or DCIS significantly differed between the patient groups (p < 0.01, Fisher’s exact test): The highest rate was 17.5% (95% confidence interval (CI), 10.7–26.2) in patients within the group of ADH, FEA, and LN1-2. In the other two groups, fewer malignant lesions occurred. In the group with papillomas and RS/CSL the malignant upgrade rate was 4.3% (95% CI, 0.9–12.2), while within the group with CFL and phyllodes tumors without suspicion of malignancy no malignant upgrade was observed (0.0%, 95% CI, 0.0-16.9).Conclusions B3 lesions harbor the risk of malignant upgrade after surgical excision. In our collective ADH, FEA, and LN1-2 had significant higher upgrade rates than other B3 lesions.
Comparative Analysis of Trifecta and Pentafecta Outcomes in T1a and T1b Renal Tumors Following Robotic Partial Nephrectomy: A Retrospective Study
Authors: Sharma Rakesh , S Lohith , Mohan Amaresh , Reddy Bhasker , Singh Rohit , Kharadae Manoj , Meyyappan Vivek , Srir Srikanth 
Published: December 2024

Abstract

Purpose:
This study aims to conduct a comparative analysis of Trifecta and Pentafecta outcomes between T1a and T1b renal tumors in patients undergoing robotic partial nephrectomy (RAPN). We explore the influence of clinical factors, including the RENAL nephrometry score components, on these outcomes.
Methods:
A retrospective multicentre study was conducted on 133 patients who underwent RAPN for T1a (n = 51) and T1b (n = 82) renal tumors between 2017 and 2023. We assessed Trifecta and Pentafecta outcomes, and statistical comparisons were made. Univariate and multivariate analyses were conducted to evaluate the impact of tumor size and RENAL components on these outcomes.
Results:
Trifecta was achieved in 74.5% of T1a tumors and 68.3% of T1b tumors (p = 0.429). Pentafecta outcomes were achieved in 56.9% of T1a and 47.6% of T1b tumors (p = 0.297). Warm ischemia time was significantly longer in T1b tumors (p = 0.037). In the univariate analysis, warm ischemia time and tumor size were significant predictors of Trifecta and Pentafecta outcomes, respectively. Nearness to the collecting system was also a significant factor in univariate analysis (p = 0.045). Other clinical factors such as exophytic/endophytic properties and location relative to polar lines did not significantly impact outcomes.
Conclusion:
RAPN is equally effective for T1a and T1b renal tumors, providing comparable Trifecta and Pentafecta outcomes. Warm ischemia time, tumor size, and nearness to the collecting system are important factors influencing these outcomes.
The Use of the Venous Excess Ultrasound Score as a Bedside Tool to Predict Incidence of Acute Kidney Injury in Patients with Septic Shock, a prospective observational study
Authors: Elfeky Hanady Mohammed , AttaAllah Hatem Amin , Fathy Yasser Ibrahim , Fawzi Gehad Mahmoud , Helwa Ahmed Taha 
Published: December 2024

Abstract

Background
Assessment of venous congestion in septic shock patients is important, but it is often lacking due to the absence of a noninvasive bedside tool. The Venous Excess Ultrasound Grading System (VExUS) is an ultrasound score that has been associated with acute kidney injury (AKI) in cardiac patients. The objectives of this study were to assess the grade of congestion using VExUS in septic shock patients and to evaluate the correlation between serial VExUS scores and AKI, as well as the associations between VExUS scores and fluid balance, fluid overload, intensive care unit (ICU) stay duration, mechanical ventilation duration, and in-hospital mortality.
Methods
This was a prospective observational cohort study. We included 40 adult septic shock patients admitted to the ICU at Menoufia University Hospitals, following approval by the Ethics Committee. Patients with pregnancy, heart failure, portal hypertension, inferior vena cava thrombosis, and liver cirrhosis were excluded. Daily VExUS examinations were performed on the included patients, who were then monitored for the onset of new AKI. On day 7, patients were categorized based on changes in their VExUS scores into improving, unchanged, and worsening groups. Patients who developed AKI were followed until either the resolution of the AKI or the initiation of dialysis.
Results
The study enrolled forty patients, and those with AKI had higher VExUS scores (VExUS 2 and 3) than those without AKI, with significant differences on Days 2, 3, 4, and 6 of admission. Regarding VExUS status after one week, 50% of patients who developed AKI had worsening VExUS scores, compared to 16.7% of those without AKI, which is statistically significant. Furthermore, among AKI patients, 50% who improved their AKI parameters also showed improved VExUS scores, whereas none with worsening AKI parameters did. However, this change was not statistically significant. VExUS scores ≥ 2 demonstrated good specificity (83.3%) with a low false-positive rate. However, sensitivity was low (25%). Patients with worsening VExUS scores required dialysis more often (41.7%) than those with stable VExUS scores (12.5%), had longer durations of mechanical ventilation, and experienced higher mortality compared to other patients.
Conclusion
The VExUS score may be a useful predictor of AKI in patients with septic shock.
Clinical trial registration: The study was registered in the Pan African Clinical Trials Registry: PACTR202409715853957, date:2/9/2024.
Changes in CD4 + T-cells subsets in patients with alcohol-related cirrhosis
Authors: Zuluaga Paola , Zurera Coral , Fuster Daniel , Hernandez-Rubio Anna , Teniente-Serra Aina , Martínez-Cáceres Eva , Muga Roberto 
Published: December 2024

Abstract

Alcohol-related cirrhosis (AC) is a condition that impacts in immunity. We analyzed changes over time in CD4+subsets in AC-patients. We included patients with alcohol use disorder admitted at least twice for treatment. Patients without evidence of liver disease were the control group (CG). We analyzed naïve, memory, TEMRA, Th1, Th2, Th17, early-activated, and late-activated subsets. During the follow-up, TEMRA were increased (1.2 ± 1.1 vs. 2.1 ± 1.1, p = 0.03) in AC-patients (n = 5) and Th17 were decreased (14.1 ± 4.3 vs. 12.3 ± 6.4, p = 0.03) in the CG (n = 22). Late-activated cells were associated with a decrease in memory cells in both the groups. This association was stronger in AC-patients (r=-0.90, p = 0.04). The proportion of memory cells was correlated with an increased of Th1/Th2/Th17 in the CG (r = 0.70, r = 0.68, r = 0.63; p < 0.01, respectively), whereas in AC-patients was correlated with a decrease in Th17 (r=-0.90, p = 0.03). AC-patients showed an increase in the proportion of TEMRA, loss of heterogeneity and decreased CD4+ differentiation.
Radiography may not be accurate in assessing acute ankle sprains in children
Authors: Li Xiongtao , Shen Xiantao , Wang Si , Sun Jie , Liu Zhaoting 
Published: December 2024

Abstract

Background: Acute ankle sprains are among the most frequent injuries in children and are often associated with chondral avulsion fractures and ligament injuries. However, radiography may not be sufficiently accurate for assessing cartilage and ligament injuries in children. The primary purpose of this study was to evaluate the necessity of radiography in the diagnosis of acute ankle sprains in children. A secondary purpose was to assess whether ultrasonography can effectively enhance the diagnostic accuracy of acute ankle sprains in children.
Methods: We collected medical data from 78 children with acute ankle sprains who underwent both radiological and ultrasound examinations, 59 patients of whom also had ankle MRI results. The agreement between radiographic and ultrasonographic findings in these 78 patients was assessed using Cohen's kappa and McNemar tests. Using MRI results as the gold standard, the sensitivity, specificity, positive predictive value, and negative predictive value of the radiography and ultrasonography were evaluated for the 59 patients. Cohen's kappa and McNemar's test were also utilized to assess the reliability of the radiography and ultrasonography in comparison to MRI.
Results: Among the 78 children with acute ankle sprains, 29 patients did not show fractures on radiological examination, but these fractures were detected by ultrasound examination. Of these 29 fractures, 20 were chondral avulsion fractures of the distal fibula, and 9 were avulsion fractures of the lateral talus process. The agreement between radiography and ultrasonography was fair (Kappa = 0.250), and the difference was statistically significant (P < 0.001). Using MRI as the gold standard, radiography resulted in 17 false negative cases for lateral ankle fractures, with a sensitivity of only 47%. Ultrasonography had only one false negative case, achieving a sensitivity of 97%. Ultrasonography showed substantial agreement with MRI (Kappa = 0.797), while radiography showed fair agreement with MRI (Kappa = 0.384).
Conclusions: Acute ankle sprains in children frequently result in a high incidence of chondral avulsion fractures. However, radiography may be inadequate for accurately diagnosing these fractures. Reliance on radiography alone may lead to a substantial number of false negative cases. Compared to radiography, ultrasonography demonstrates high accuracy in the diagnosis of chondral avulsion fractures and ligament injuries in children. We believe that ultrasonography, as a non-invasive, radiation-free, and cost-effective dynamic diagnostic method, is particularly suitable for the early diagnosis of acute ankle sprains in children.
Level of evidence: Level III; Diagnostic Study
Circ0066187 promotes pulmonary fibrogenesis through targeting STAT3-mediated metabolism signal pathway
Authors: Liu Bo , Liu Weili , Li Hongbo , Zhai Nailiang , Lv Changjun , Song Xiaodong , Yang Shuanying 
Published: December 2024

Abstract

Idiopathic pulmonary fibrosis (IPF) is a chronic and progressive interstitial pneumonia, with increasing incidence and prevalence. One of the cellular characteristics is the differentiation of fibroblasts to myofibroblasts. However, the metabolic-related signaling pathway regulated by circular RNAs (circRNAs) during this process remains unclear. Here, we demonstrated that circ0066187 promoted fibroblast-to-myofibroblast differentiation by metabolic-related signaling pathway. Mechanism analysis research identified that circ0066187 directly targeted signal transducer and activator of transcription 3 (STAT3)-mediated metabolism signal pathway to enhance fibroblast-to-myofibroblast differentiation by sponging miR-29b-2-5p, resulting in pulmonary fibrosis. Integrative multi-omics analysis of metabolomics and proteomics revealed three pathways co-enriched in proteomics and metabolomics, namely, protein digestion and absorption, PI3K-Akt signaling pathway, and FoxO signaling pathway. In these three signaling pathways, seven differentially expressed metabolites such as L-glutamine, L-proline, adenosine monophosphate (AMP), L-arginine, L-phenylalanine, L-lysine and L-tryptophan, and six differentially expressed proteins containing dipeptidyl peptidase-4 (DPP4), cyclin D1 (CCND1), cyclin-dependent kinase 2 (CDK2), fibroblast growth factor 2 (FGF2), collagen type VI alpha 1 (COL6A1) and superoxide dismutase 2 (SOD2) were co-enriched. Gain-and loss-of-function studies and rescue experiments were performed to verify that circ0066187 promoted STAT3 expression by inhibiting miR-29b-2-5p expression to control the above metabolites and proteins. As a result, these metabolites and proteins provided the material basis and energy requirements for the progression of pulmonary fibrosis. In conclusion, circ0066187 can function as a profibrotic metabolism-related factor, and interference with circ0066187 can prevent pulmonary fibrosis. The finding supported that circ0066187 can be a metabolism-related therapeutic target for IPF treatment.