bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tislelizumab plus AG regimen for long-term CR in 2 patients with metastatic BRCA-mutation pancreatic cancer: A case report
Authors: Gao Feng , Xu Xue , Chen Chunhong , Lv Lili 
Published: December 2024

Rationale:
An increased risk of pancreatic cancer (PC) is associated with breast cancer susceptibility gene (BRCA) mutations. Given limited therapies, there remains an urgent need to explore novel treatment strategies.

Patient concerns:
We report 2 metastatic PC patients with BRCA mutations who initially did not respond to standard therapies.

Diagnoses:
Case 1 was diagnosed with metastatic PC harboring a BRCA1 mutation, and case 2 was diagnosed with metastatic PC harboring a BRCA2 mutation.

Interventions:
Both patients received a modified AG regimen (albumin-bound paclitaxel plus oxaliplatin) combined with tislelizumab, followed by maintenance therapy with olaparib plus tislelizumab after 6 cycles.

Outcomes:
Both patients achieved complete response, with complete response lasting for 19 months in case 1 and 18 months in case 2.

Lessons:
The combination of triple therapy followed by maintenance therapy shows promise as a potential treatment option for PC patients with BRCA mutations. Further clinical investigation is needed to confirm its efficacy and safety.
Stress management strategy of Education Scientists with high blood pressure: A case for multivariate analysis and implications for school management system
Authors: Anyaegbunam Ngozi , Igabari Queen E. , Egbule Elizabeth Osita , Agbigwe Ifeanyichukwu B. , Ede Kelechi R. , Agu Uzoamaka Patricia , Ezeaku Felicia Ngozi , Ezugwu Ifesinachi Jude , Ngwainmbi Desmon , Andor Sebastine Ebunmereh , Tijjani Jazuli , Oluka Beth Nnenne , Okereke Innocent Ebere , Okoro Ifeanyichukwu D. , Nwabuani Ogochukwu Vivian , Oneli Joy Obiageli 
Published: December 2024

Background:
When under stress, the body secretes a large amount of hormones. These hormones cause the heart to beat more quickly and the blood vessels to constrict, leading to a temporary increase in blood pressure. The release of stress hormones and an accelerated heartbeat are 2 ways that improper stress reactions can raise blood pressure and increase the risk of a heart attack. Keeping this in mind, the current study aimed to investigate the effectiveness of the rational emotive behavior therapy (REBT) approach in reducing stress among Education Scientists with high blood pressure in higher institutions of learning in southeastern Nigeria.

Methods:
The study utilized a simple randomized controlled trial design, which included a pretest, posttest, and follow-up test. The study population consisted of 78 participants who were randomly assigned to either the treatment or control group, with 39 participants in each group. The treatment involved following a modified REBT manual.

Results:
The findings of the study indicated that REBT was successful in reducing the stress levels of academic staff who underwent the treatment. This effect was sustained during the follow-up test.

Conclusion:
Stress was found to be a result of irrational thoughts and erroneous beliefs. However, through the implementation of REBT principles and strategies, individuals were able to address their negative thought patterns, which were characterized by inflexibility, rigidity, and extremism. Further research is needed to confirm the impact of REBT on reducing depression, anxiety, and mental exhaustion in populations from institutions outside the southeastern region of Nigeria.
Risk factors and predictive model for acute postoperative pain after hip and knee arthroplasty
Authors: Chen Wanling , Chen Wenjie , Wan Weiliang 
Published: December 2024

Background:
This study aims to identify key factors influencing acute postoperative pain (APP) following hip and knee arthroplasty, and to develop a predictive model to optimize pain management.

Methods:
The study included 492 patients who underwent hip or knee replacement surgery at our institution from July 2021 to July 2024. Preoperative, intraoperative, and postoperative data were collected. Least Absolute Shrinkage and Selection Operator regression and multivariate logistic regression analyses were utilized to identify factors significantly associated with the occurrence of APP.

Results:
The findings indicated that factors such as body mass index, diabetes, history of long-term use of analgesics, preoperative Visual Analogue Scale scores, Pain Catastrophizing Scale scores, duration of surgery, and intraoperative blood loss were closely linked to the occurrence of APP. Additionally, the preoperative use of prophylactic analgesics, postoperative use of analgesic pumps, and implementation of nerve blocks significantly reduced the risk of APP.

Conclusion:
This study identified several factors closely related to APP after hip and knee arthroplasty and provided a basis for postoperative pain management through the developed predictive model. The research underscores the importance of comprehensive preoperative assessment and the implementation of targeted pain prevention measures. Future studies are recommended to expand the sample size and include multiple centers to enhance the generalizability and practicality of these findings.
Pulmonary mucinous adenocarcinoma: A case report and literature review
Authors: Qian Minghui , Lyu Ruibing , Xiao Long , Shi Benqi , Liu Nian , Yuan Yaqian , Wang Wenju , Li Xin 
Published: December 2024

Rationale:
Pulmonary mucinous adenocarcinoma (PMA) is a rare subtype of lung adenocarcinoma. Computed tomography images of PMA show pneumonia-like findings, solitary pulmonary nodules or ground-glass opacity with consolidation. Misdiagnosis can delay genetic diagnosis. This article reported a case of PMA presenting with unique imaging findings.

Patient concerns:
An 85-year-old female patient was admitted to our hospital with persistent-cough and expectoration. Anti-infection treatment was largely ineffective.

Diagnoses:
Bronchoscopy with bronchoalveolar lavage and liquid-based cytology revealed the presence of tumor cells. Lung biopsy confirmed the diagnosis of PMA.

Interventions:
Symptomatic treatment was administrated, including anti-infection, relief of cough and expectoration. Bronchoscopy and lung puncture were performed to help clarify the cause of the disease.

Outcomes:
The patient’s course was uneventful, and she was discharged in good condition. After admission, the patient continued to receive anti-tumor immunotherapy in the oncology department.

Lessons:
PMA is a subtype of lung adenocarcinoma and has a low incidence. PMA usually presents with atypical clinical symptoms and signs, and it is difficult to be diagnosed based on imaging findings. It is often undiagnosed and misdiagnosed. Clinicians must increase awareness about the need for timely diagnosis, so as to develop more targeted treatment and achieve a better prognosis.
Revision after knee arthroplasty due to Mycoplasma hominis infection: A case report and literature review
Authors: Liu Kang , Yang Zhi , Xie Weipeng , Wang Sicheng , Hu Shouye 
Published: December 2024

Rationale:
Mycoplasma hominis is an opportunistic pathogen commonly found in the human genitourinary system. However, infections caused by Mycoplasma hominis following knee arthroplasty are relatively rare.

Patient concerns:
A 68-year-old male patient underwent bilateral total knee arthroplasty 2 years ago due to osteoarthritis. Over the past 3 months, he developed persistent swelling and pain in both knees, along with the formation of a mass in the left knee. The patient also has a history of type 2 diabetes and hypoalbuminemia.

Diagnoses:
Joint fluid samples from both knees were collected for metagenomic sequencing (mNGS), which detected Mycoplasma hominis infection. Histopathological examination confirmed chronic infection.

Interventions:
The patient underwent 1-stage revision surgery for the left knee, followed by intravenous doxycycline (100 mg, q12h) and intra-articular injections of vancomycin (0.5 g/d) and meropenem (0.5 g/d) for 2 weeks. Afterward, the patient was switched to oral rifampin (450 mg daily) and moxifloxacin (400 mg daily) for six weeks. Following improvement in the left knee symptoms, 1-stage revision surgery was performed on the right knee. The same antibiotic regimen was used postoperatively.

Outcomes:
The patient experienced significant postoperative improvement, with marked pain relief and no signs of recurrent infection. The knee remained stable, and functional recovery was observed. To date, there have been no signs of infection recurrence during follow-up.

Lessons:
After joint arthroplasty, if a patient has persistent infection symptoms, does not respond to beta-lactam antibiotics, and has negative blood cultures, Mycoplasma infection should be considered. In this instance, the use of mNGS proved highly effective in diagnosing this atypical pathogen. The patient improved significantly after 1-stage revision surgery and targeted antibiotic therapy, though longer follow-up is needed to confirm long-term outcomes. Additionally, limited access to mNGS in some regions may delay diagnosis and treatment.
The American Rescue Plan Act and Access to Health Care for Latinos According to Citizenship Status
Authors: Lopez Mercado Damaris , Mortensen Karoline , Rivera-González Alexandra C. , Stimpson Jim P. , Vargas Bustamante Arturo , Roby Dylan H. , Chen Jie , Barajas Clara B. , Ortega Alexander N. 
Published: December 2024

Objective:
We studied patterns in health care access between Latino and non-Latino White adults according to citizenship status before and after the American Rescue Plan Act (ARPA) of 2021 was enacted to determine whether inequities changed.

Methods:
This study used 2019–2022 National Health Survey Interview data. Differences in predicted probabilities from logistic regression models were used to estimate changes in health care access outcomes (any insurance coverage, private insurance coverage, delaying care due to cost, and having a usual source of care) among Latino citizens, Latino noncitizens, and non-Latino White citizens in periods before and after ARPA’s enactment (2019–2020 vs 2021–2022).

Results:
Adjusted models observed that inequities in health care access did not change between Latino and non-Latino White citizens from the 2019–2020 period to the 2021–2022 period. Moreover, the health insurance gap widened by 5.8 percentage points between Latino noncitizens and non-Latino White citizens (P < 0.01) and by 5.2 percentage points between Latino noncitizens and Latino citizens (P < 0.05) from the 2019–2020 period to the 2021–2022 period. The private insurance coverage gap widened by 6.8 percentage points between Latino noncitizens and non-Latino White citizens (P < 0.01) and by 6.9 percentage points between Latino noncitizens and Latino citizens (P < 0.01) from the 2019–2020 period to the 2021–2022 period.

Conclusion:
ARPA may have helped increase White citizens’ insurance coverage, but this benefit did not extend to Latinos, regardless of citizenship status. Developing more inclusive health policies that do not have restrictions based on citizenship and legal authorization status is an important step toward reducing health care inequities.
Knowledge of Medical Interpretation Rights Among Individuals With Non-English Language Preference
Authors: Linares Miguel , Lipsitz Stuart , Shaykevich Shimon , Samal Lipika , Rodriguez Jorge A. 
Published: December 2024

Objectives:
We aimed to identify demographic, acculturation, and health care factors associated with self-reported knowledge of the right to medical interpretation among individuals with non-English language preference (NELP) in California.

Background:
NELP is a significant social determinant of health contributing to adverse health outcomes through barriers in communication, limited health literacy, and biases in care delivery. The ability of patients with NELP to self-advocate for interpreter services is crucial yet hindered by various factors, including a lack of knowledge about their rights.

Methods:
This cross-sectional study used pooled data from the California Health Interview Survey from 2012 to 2021. Subjects were 12,219 adults with NELP, representing 2,516,157 individuals in California. The primary outcome was self-reported knowledge of the right to medical interpretation. Covariates included demographic, acculturation, and health care factors.

Results:
Of the participants, 28.6% were unaware of their rights to interpretation. Married females had higher odds of knowledge, while recent immigrants (≤5 y in the United States), those with mixed language households, no doctor visits in the past year, no insurance, and self-reported poorer health had lower odds. Sociodemographic factors like age, race, ethnicity, education, and geography﻿ showed no significant association.

Conclusions:
Nearly one-third of individuals with NELP lack awareness of their right to medical interpretation. Factors such as recent immigration, poor health, and limited health care contact are significant barriers. In addition to system and policy level changes, interventions targeting these vulnerable groups are needed to improve health equity and empower patients to use interpreter services.
Push-Pull Motivators and Perceived Health Care Quality on Remote Health Management Intentions—Evidence From the Indian Internet Population
Authors: Bright Helen Pradheep , Lysander Manohar Hansa 
Published: December 2024

Background and Objectives:
Hospitals offered remote health care services to enable seamless and safe execution of health care operations during the pandemic while ensuring all stakeholders’ quality of life and well-being. We explore various push and pull motivational factors that can influence customers’ intentions to adopt remote health care services. We also examine the mediating role of perceived health care quality in light of their hedonic experience during the pandemic.

Methods:
We develop our conceptual framework based on push-pull motivational theory and investigate remote health management intentions. We carried out a case study in a multispecialty hospital in India. We collected data from 482 internet users who accessed their remote services during the pandemic, and we performed statistical analysis.

Results:
Our findings show the push and pull motivators significantly influencing internet populations’ remote health management intentions. The results also highlight the mediation of perceived health care quality between push factors and remote health management intentions.

Conclusions:
The push-pull motivators significantly regulate remote health care intentions among the internet population. Technologists and researchers must address these factors while introducing future remote services to widen adoption. This is one of the pioneering studies investigating people’s remote health care intentions post-pandemic.
123I-MIBG SPECT/CT in Evaluating Symptomatic Urinary Bladder Pheochromocytoma
Authors: Algodayan Sarah , Almehaidib Abdullah , Priftakis Dimitrios 
Published: December 2024

Abstract
Pheochromocytoma of the urinary bladder is a rare tumor that occurs in <1% of the extra-adrenal pheochromocytomas. Patients usually present with occult complaints, which can be misdiagnosed. We present a case of a patient with longstanding nonspecific debilitating symptoms. Functional imaging is crucial in diagnosing, localizing, staging, and guiding surgical planning of neuroendocrine tumors.
A Pilot Report on Extracting Symptom Onset Date and Time from Clinical Notes in Patients Presenting with Chest Pain
Authors: George Anjaly , Maisa Aashrith , Dreisbach Caitlin , Suba Sukardi 
Published: December 2024

ABSTRACTAcute coronary syndrome (ACS) is an acute heart disease that often evolves rapidly. In ACS patients presenting with no-ST-segment elevation (NSTE-ACS), the timing of symptom onset pre-hospital may inform the disease stage and prognosis. We pilot-tested two off-the-shelf natural language processing (NLP) pipelines, namelyparsedatetimeandregular expression(regex), to extract date and time (DateTime) information of patient-reported chest pain symptoms from electronic health records (EHR) clinical notes. We included three types of clinical notes (N=71): History and Physical (n=49), Emergency Department Screening (n=3), and Triage Notes (n=19). All notes were manually annotated for the true DateTime of symptom onset.Parsedatetimereturned matching DateTime outputs in 36 notes (50.7%), whileregexreturned zero matched outputs.Parsedatetimeperformed better thanregex, although it was still suboptimal. Both pipelines require constant refinement and custom improvements. Methods for a large-scale, automated DateTime extraction from EHR clinical notes further investigation.
Association between long-term stimulant treatment and the functional brain response to methylphenidate in adolescents and adults with attention-deficit/hyperactivity disorder
Authors: van der Pal Zarah , Reneman Liesbeth , Mutsaerts Henk JMM , Kaiser Antonia , Bottelier Marco A , Geurts Hilde M , Schrantee Anouk 
Published: December 2024

AbstractBackgroundStimulant medication is commonly used by children and adolescents with attention-deficit/hyperactivity disorder (ADHD), however its long-lasting effects on the developing brain remain unclear. In a previous randomized controlled trial (RCT) we found that short-term stimulant treatment influences the functional brain response to an acute methylphenidate-challenge in an age-dependent manner, in line with animal studies suggesting persisting effects on brain development.MethodsIn this 4-year naturalistic follow-up of the initial RCT, we investigated the long-term age-dependent effects of stimulant treatment on the functional brain response to methylphenidate in male children and adults with ADHD (n=56; adolescents aged 10-17 years, adults aged 23-43 years). At baseline and 4-year follow-up, we used pharmacological MRI to estimate relative cerebral blood flow (rCBF) before a single-dose methylphenidate-challenge (resting rCBF) and the rCBF-response to a single-dose methylphenidate-challenge. Linear mixed models were constructed to evaluate the effect of stimulant medication use, age and visit on resting rCBF and rCBF-response.ResultsWe found no evidence for long-term age-dependent effects of stimulant treatment, suggesting that our previously identified short-term effects may be transient. We did identify age-dependent associations between rCBF-response in the medial prefrontal cortex and stimulant treatment, which were already present before treatment initiation but were unrelated to ADHD symptom severity. Moreover, rCBF-response was associated with dopamine D1 receptor distributions in adolescents only.ConclusionsThe identified age-dependent associations may potentially be mediated by changes in dopamine- and noradrenaline-related functioning, and may hold predictive value for (extent of) stimulant medication use after ADHD diagnosis in children and adolescents.
Cost-utility of aripiprazole once-monthly versus paliperidone palmitate once-monthly injectable for schizophrenia in China
Authors: An Yiping , Ding Jinxi , Li Wei , Fang Gang , Pi Zhipeng , Zhang Yumeng 
Published: December 2024

AbstractObjectivesFrom the perspective of Chinese healthcare system, this study compared the cost-utility of aripiprazole once-monthly (AOM) and paliperidone palmitate once-monthly injectable for the treatment of adult Chinese patients with schizophrenia.MethodsA 5-state Markov model was constructed to assess the cost-utility of 10 years of treatment with long-acting injections (LAI) for schizophrenia. The long-term costs and quality-adjusted life years (QALYs) were estimated. The outcome was the incremental cost-effectiveness ratio (ICER). The annual discount rate was set at 5 %. Willingness-to-pay (WTP) threshold of 1x GDP was used to judge the economics of intervention.ResultsIn the base-case, the incremental costs of AOM relative to PP1M after 10 years of treatment were US$1,926.373 with an incremental QALYs of 0.306. The ICER for AOM was US$6,285.303/QALY, which was lower than the WTP threshold of US$12,538.306/QALY. The one-way sensitivity analysis and probability sensitivity analysis verified the robustness of the base-case. Scenario analysis showed that from 10 to 30 years, as the horizon increased, the ICER became smaller, and all were below the WTP.ConclusionsThis analysis showed that compared with PP1M, AOM represents a long-term cost-utility advantages for schizophrenia treatment in China.
Impact of bacterial translocation in stroke outcome. Soluble CD14 as early clinical marker and effect of TLR4
Authors: Granados-Martinez Cristina , Alfageme-Lopez Nuria , Diaz-Benito Blanca , Moraga Ana , Sevillano-Fernandez David , Alou-Cervera Luis , Encarnación Fernandez-Valle M. , Castejon-Ferrer David , Calleja-Castaño Patricia , Angeles Moro M. , Hernandez-Jimenez Macarena , Lizasoain Ignacio , Pradillo Jesus M. 
Published: December 2024

AbstractBacterial infections are among the most common complications in stroke patients. While some factors triggering these infections are well established, bacterial translocation (BT) from the intestine to other organs represents another significant factor to consider. In our study, we observed a high percentage of animals with intestinal barrier dysfunction (GBD) and BT following stroke, with typical intestinal bacteria even detected in the lungs. Moreover, this process not only exacerbates peripheral/central inflammation but also increases lesion size. In this context, our data in stroke patients demonstrate the presence of GBD, associated with elevated levels of soluble CD14 as a marker, and its strong correlation with neurological status, infarct volume, and the development of infections. Finally, our findings highlight the neuroprotective effects of the absence or pharmacological inhibition of TLR4 using ApTOLL, which not only reduces infarct volume and inflammation but also mitigates GBD/BT processes following experimental stroke.
Astrocyte-derived extracellular matrix proteins regulate synapse remodeling in stress-induced depression
Authors: Zhang Ran , Rodriguez-Rodriguez Patricia , Medrihan Lucian , Chang Jerry C. , Ferraro Tatiana , Del Cioppo Vasques Pedro , Wang Wei , Menard Caroline , Cathomas Flurin , Chan Kenny L. , Parise Lyonna , Shaham Shai , Roussarie Jean-Pierre , Troyanskaya Olga , Russo Scott J. , Milosevic Ana 
Published: December 2024

AbstractMajor depressive disorder (MDD) is a common mood condition affecting multiple brain regions and cell types. Changes in astrocyte function contribute to depressive-like behaviors. However, while neuronal mechanisms driving MDD have been studied in some detail, molecular mechanisms by which astrocytes promote depression have not been extensively explored. To uncover astrocyte contributions to MDD, we subjected male mice to chronic social defeat stress precipitated by encounters with a dominant male. Animals exposed to this treatment exhibit symptoms indicative of MDD, including reduced social interactions, anxiety, despair, and anhedonia. We then measured astrocyte translating mRNA expression changes in mice that underwent chronic social defeat and control animals using ribosome affinity purification. Bioinformatic analyses reveal significant alterations in the prefrontal cortex (PFC), consistent with previous studies implicating this brain region in MDD. Expression of genes encoding extracellular matrix (ECM) proteins, cell-cell interaction proteins, and proteins controlling glutamatergic synaptic function are significantly altered. These changes correlate with perturbation of glutamatergic transmission, measured by electrophysiology, and increased synaptic cleft size. Among ECM genes, increased expression of mRNA encoding the synaptic remodeling proteinsecretedproteinacidic andrich incysteine (Sparc) correlates the most with the depressive phenotype. Furthermore, presence of SPARC and other ECM proteins in synaptosomes is also increased and overexpressingSparcin PFC partially alleviates stress symptoms. Our results raise the possibility that increased expression ofSparcmay be a natural protective mechanism against stress-induced synaptic dysfunction in depression.