bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pretreatment plasma vitamin D and response to neoadjuvant chemotherapy in breast cancer: evidence from pooled analysis of cohort studies
Authors: Shu Chi , Yang Qian , Huang Jun , Xie Xuan , Li Hong , Wu Hong , Wang Xin , Chen Xin , Xie Yuping , Zhou Yanhong , He Yazhou , Xu Chuan 
Published: November 2024

Background:
Biological evidence has revealed antitumor effect of vitamin D, but whether it could predict the response to neoadjuvant chemotherapy (NAC) in breast cancer (BC) patients remains inconclusive. The aim was to investigate the association between pretreatment vitamin D level and response to NAC and subsequent survival outcomes in BC patients.

Materials and methods:
The authors systematically searched the Medline, Embase, Cochrane Library, and Web of Science databases and clinical trial registries to identify relevant articles from inception to 8 October 2024. Eligible studies investigating the associations between pretreatment plasma vitamin D and response to NAC in BC patients were selected according to the predefined criteria, with the study characteristics extracted by two reviewers. The primary outcome was pathological complete response (pCR), while overall pathological response and event-free survival (EFS) were adopted as secondary outcomes. Summary effect estimates of odds ratios (ORs) or hazard ratios (HRs) with 95% CIs were pooled using a random-effects model. Subgroup and sensitivity analyses were performed based on study characteristics and methodological quality.

Results:
Six retrospective cohort studies involving 1291 BC patients were included. The authors observed a significant association between pretreatment vitamin D deficiency and 50% increased odds of non-pCR after NAC (OR=1.50, 95% CI: 1.11–2.03, P=0.008) with no heterogeneity (I
2=0%). The authors also identified a significant association of vitamin D with the overall pathological response (OR=1.33, 95% CI: 1.01–1.75, P=0.046). A similar association with EFS (HR=1.27, 95% CI: 0.92–1.75, P=0.139) was also noted although the effect estimate was not statistically significant. Sensitivity analyses based on methodological quality showed consistent findings.

Conclusion:
Pretreatment vitamin D deficiency is associated with an inferior response to NAC in BC patients. Our meta-analysis advocates further prospective studies with large sample sizes before vitamin D supplementation could be administered to improve NAC response and subsequent prognosis of BC patients.
Why protein-energy wasting leads to faster progression of chronic kidney disease
Authors: Narasaki Yoko , Rhee Connie M. , Kalantar-Zadeh Kamyar , Rastegar Mandana 
Published: November 2024

Purpose of review
Protein-energy wasting (PEW) is increasingly more prevalent as chronic kidney disease (CKD) progresses to more advanced stages. There is a global recognition of the importance of preventing and mitigating PEW in the CKD population not on dialysis given the goal of extending dialysis-free time and delaying dialysis initiation and growing evidence of the clinical consequences of PEW which include the risk of death, hospitalization and clinical conditions such as infections. We reviewed the association of PEW and the malnutrition characteristics indicative of PEW on CKD progression.

Recent findings
Studies show the association between low serum albumin levels, low BMI, and diets with inadequate dietary energy and protein intake and CKD progression. Limited studies suggest low muscle mass impacts CKD progression. Optimizing nutrition by dietary management, including a moderately low protein (0.6–0.8 g/kg/day) and plant-based (>50% of protein source, known as PLADO) diet and as needed with supplementation [e.g. during acute kidney injury (AKI) event] administrated orally, enterally, or parenterally are the basis for the prevention and treatment of PEW in CKD and delaying CKD progression. Furthermore, other therapeutic methods such as treating or avoiding comorbidities and AKI, ensuring appropriate exercise and incremental transition to dialysis treatment may help ameliorate and prevent PEW development in CKD patients.

Summary
Using tailored precision nutrition approaches and nutritional supplementation with or without other beneficial strategies may help prevent and treat PEW and its consequent occurrence of CKD progression.
Incremental hemodialysis transition in veterans and nonveterans with kidney failure
Authors: Rhee Connie M. , Kovesdy Csaba P. , Unruh Mark , Crowley Susan , Geller David , Goldfarb David S. , Kraut Jeffrey , Rastegar Mandana , Rifkin Ian R. , Kalantar-Zadeh Kamyar 
Published: November 2024

Purpose of review
Initiation of hemodialysis treatment with a thrice-weekly prescription is currently the standard of care irrespective of patients’ residual kidney function (RKF), comorbidities, and preferences.

Recent findings
Each year ∼12 000 Veterans with advanced kidney disease progress to end-stage kidney disease (ESKD) requiring dialysis and comprise greater than 10% of the US incident ESKD population. Dialysis is costly and is associated with impaired health-related quality of life (HRQOL) and high mortality risk, especially in the first year of treatment. Evidence suggests an incremental dialysis transition using twice-weekly hemodialysis provides various benefits, including more dialysis-free time, longer RKF preservation, less vascular access damage, and lower patient burden. Pragmatic studies are needed to inform the efficacy and safety of incremental hemodialysis as a personalized dialysis regimen, and could inform its consideration as a conservation strategy during times of supply shortages. Broadly implementing twice-weekly hemodialysis could also potentially allow more Veterans to receive care within VA-based dialysis units. The VA IncHVets Trial is a pragmatic, multicenter, randomized controlled trial comparing the efficacy and safety of twice-weekly incremental vs. thrice-weekly hemodialysis among Veterans transitioning to ESKD.

Summary
Further research is needed to determine whether incremental hemodialysis is well tolerated, effective, and facilitates a more favorable transition to dialysis.
Molecular matching tools for allocation and immunosuppression optimization. Ready for primetime?
Authors: Niemann Matthias , Matern Benedict M. 
Published: November 2024

Purpose of review
Molecular matching continues to be an important topic in organ transplantation. Over the years, several studies – larger and smaller – supported correlations of molecular incompatibility loads and clinical outcomes. However, their practical utility for clinical decision making remains controversial and there is no consensus on the context in which they should be used.

Recent findings
The recent literature on molecular matching can be divided into four main areas of research: several groups present improvements of the algorithmic pipelines (1), increasing the robustness of previous findings. Further clinical evidence is reported (2) in various cohorts and other organ transplant domains, such as liver and lung transplantation. Consideration is given to the application of molecular matching in the allocation of deceased organs (3), suggesting options to improve allocation equity and utility. Furthermore, evidence is provided for personalized immunosuppression based on immunological risk (4), including infection and post graft failure management.

Summary
There is ample evidence that current molecular matching algorithms add value to immunologic risk stratification for organ transplant recipients. First studies on how to translate these insights into patient management with respect to organ allocation and personalized medicine are underway and require further support.
Impact of Statin Use on Survival in Patients With Unresectable Pancreatic cancer Receiving Gemcitabine Plus Nab-Paclitaxel
Authors: Saito Kei , Nakai Yousuke , Sasaki Takashi , Takeda Tsuyoshi , Ueno Makoto , Tezuka Shun , Isayama Hiroyuki , Tomishima Ko , Kojima Yasushi , Yamamoto Natsuyo , Ito Yukiko , Oyama Hiroki , Toda Nobuo , Takagi Kaoru , Matsubara Saburo , Mohri Dai , Sato Tatsuya , Fujishiro Mitsuhiro 
Published: November 2024

Purpose
The aim of this multicenter retrospective study was to evaluate the impact of statin use on clinical outcomes in patients with unresectable pancreatic cancer (PC) receiving gemcitabine plus nab-paclitaxel (GnP) in a large Japanese cohort.

Materials and Methods
We retrospectively reviewed the medical records including data on the use of concomitant medications in patients with unresectable PC receiving GnP between January 2015 and January 2019 at 10 hospitals. Prognostic factors for progression-free survival (PFS) and overall survival (OS) were evaluated.

Results
A total of 1682 patients were included in the analysis; of which 322 patients (19%) received statins and 1360 (81%) did not receive statin. The median PFS and OS were 7.5 versus 7.3 months (P = 0.87) and 15.1 versus 14.4 months (P = 0.48) in cases with and without statin use. The use of statin was not associated with PFS (hazard ratio, 1.01; 95% confidence interval, 0.85–1.18, P = 0.93) or OS (hazard ratio, 1.05; 95% confidence interval, 0.91–1.21, P = 0.47) in the multivariable analyses. PFS and OS did not significantly differ by liposolubility of statins, either.

Conclusions
Stain use was not associated with PFS or OS in patients with unresectable PC receiving GnP.
Vascular Complications in Patients With Pancreatic Walled-Off Necrosis—A Retrospective, Single Cohort Study
Authors: Amin Nadia Emad Lotfi , Lahchich Mariam , Werge Mikkel Parsberg , Hadi Amer , Ebrahim Mohamed , Schmidt Palle Nordblad , Karstensen John Gásdal , Novovic Srdan 
Published: November 2024

Objectives
Acute pancreatitis (AP) may lead to the development of pancreatic walled-off necrosis (WON) and vascular complications. We analyzed the frequency of vascular complications and their clinical impact in patients with WON.

Materials and Methods
The development of bleeding and splanchnic venous thrombosis (SVT) was assessed in a retrospective, single cohort of 290 patients undergoing invasive treatment for symptomatic WON. Bleeding was defined as nonprocedure-related requiring transfusion, embolization, or surgery, whereas SVT was defined as the presence of a thrombus in one of the splanchnic veins on contrast-enhanced computed tomography.

Results
In total, 78 patients (27%) developed 87 vascular complications. Forty-four patients (15%) developed SVT, 25 patients (9%) bleeding, and 9 patients (3%) developed both. At the time of the index intervention, 44 patients (83%) had already developed SVT, and only 7 episodes of bleeding had occurred (21%). Patients with bleeding had a greater need for intensive care unit treatment and their in-hospital mortality was higher than patients without bleeding (59% vs 38%, P = 0.003 and 38% vs 13%, P < 0.0001, respectively).

Conclusions
Vascular complications are common in WON patients, but only bleeding is associated with increased morbidity and in-hospital mortality. Most SVT occur before an index intervention, while bleeding episodes primarily occur afterwards.
Long-term Outcomes of Surgical Treatment for Pancreatic Neuroendocrine Neoplasm With Synchronous Hepatic Metastasis
Authors: Xu Qiang , Yin Bohui , Han Xu , Ren Siqian , Jiang Jialin , Li Fang , Wijarnpreecha Karn , Wang Jingqiao , Liao Quan , Dai Menghua , Zhang Taiping , Sadula Abuduhaibaier , Lou Wenhui , Yuan Chunhui , Wu Wenming , Zhao Yupei 
Published: November 2024

Objective
To evaluate surgical impact on the overall survival (OS) of pancreatic neuroendocrine neoplasm (pNEN) with synchronous hepatic metastases (sHMs).

Methods
A total of 163 pNEN-sHM patients were recruited from 3 institutions in China, who were categorized into 3 groups: no resection, resection of the primary lesion, and resection of both primary and hepatic lesions (PHR). Cox regression was employed to evaluate surgical impact on the OS.

Results
In the overall cohort analysis, PHR demonstrated a significant protective effect on OS (hazard ratio, 0.302; 95% confidence interval, 0.127–0.721; P = 0.007). Nevertheless, subgroup analysis revealed PHR conferred a survival advantage in patients with pancreatic neuroendocrine tumor (pNET) located on the pancreatic body/tail (bt-pNET-sHM) (hazard ratio, 0.287; 95% CI, 0.087–0.946; P = 0.040), whereas surgical treatment did not significantly impact survival in the subgroups of pancreatic neuroendocrine carcinoma–sHM or pancreatic head/neck pNET-sHM (hn-pNET-sHM).

Conclusions
In this study, the survival benefit of surgery was observed only in the bt-pNET-sHM subgroup. Considering the multifactorial nature of decision-making, surgical intervention for pNEN-sHM management should be approached with a careful and comprehensive assessment, to prevent excessive surgery strategies.
Bodyweight-Adjusted Nonsteroidal Anti-inflammatory Drugs Dose in the Prevention of Post-endoscopic Retrograde Cholangiopancreatography Pancreatitis
Authors: Kayashima Atsuto , Horibe Masayasu , Iwasaki Eisuke , Bazerbachi Fateh , Kawasaki Shintaro , Kanai Takanori 
Published: November 2024

Objectives
Although rectal nonsteroidal anti-inflammatory drugs (NSAIDs) reduce the incidence of postendoscopic retrograde cholangiopancreatography pancreatitis (PEP), their optimal dosage is unknown. Given possible interindividual variability in the pharmacodynamics of NSAIDs, we hypothesized that the dose required to achieve adequate PEP prophylaxis varies with body weight.

Materials and Methods
We conducted an analysis using single-center, prospective, observational cohort study data. The primary outcome was PEP incidence by NSAID dosage per body weight (mg/kg). Patients meeting the inclusion criteria were classified into 3 groups.

Results
We included 891 patients, with 400, 454, and 37 patients in the control group with no NSAID therapy, the NSAID <1.0 mg/kg group, and the NSAID ≥1.0 mg/kg group, respectively. In the adjusted cohort, the odds ratio of PEP was 0.18 (95% confidence interval: 0.041–0.79; P = 0.023) for NSAID ≥1.0 mg/kg and 1.3 (95% confidence interval: 0.76–2.3; P = 0.31) for NSAID <1.0 mg/kg compared to the control group without NSAID.

Conclusions
PEP was not prevented by NSAID dosages below 1.0 mg/kg body weight whereas a dosage above 1.0 mg/kg body weight had a significant prophylactic effect. An NSAID dosage adjusted to body weight may be necessary to achieve an adequate prophylactic effect against PEP.
Development, Validation, and Visualization of a Web-Based Nomogram to Predict the Risk of Psychological Distress in Patients Undergoing Chemotherapy After Breast Cancer Surgery
Authors: Shi Xixi , Zhao Yanyan , Wang Jing , Yi Yingying , Yang Yinhao , Yang Xueqin 
Published: November 2024

Background
Psychological distress of postoperative chemotherapy patients with breast cancer is significant and has a serious impact on their quality of survival. Risk prediction models can efficiently assess patients’ psychological distress and risk factors.

Objectives
To investigate the factors influencing psychological distress in postoperative chemotherapy patients with breast cancer and construct a nomogram model to predict the occurrence of psychological distress in patients.

Methods
Two hundred forty-seven women in treatment for breast cancer who were postoperative and receiving chemotherapy were recruited. Participants completed a distress management screening measure, a numerical rating scale, the Pittsburgh Sleep Quality Index, and demographic and clinical items.

Results
Experiencing significant psychological distress was reported by 65.6% of participants. The psychological distress risk prediction model included 5 variables: financial problems, appearance/shape, distant metastases, the Numerical Rating Scale Pain score, and fatigue. A web calculator was designed based on the model (https://77nomogram.shinyapps.io/dynnomapp/).

Conclusions
This study found that financial and appearance/shape problems, distant metastases, pain scores, and fatigue were predictors of greater psychological distress in women undergoing chemotherapy after breast cancer surgery. The model constructed in this study has good predictive efficacy.

Implications for practice
This web-based nomogram model can help healthcare professionals quickly assess the likelihood of psychological distress in patients and screen for risk factors for psychological distress.
The Impact of Mindfulness-Based Meditation and Yoga on Stress, Body Image, Self-esteem, and Sexual Adjustment in Breast Cancer Patients Undergoing Modified Radical Mastectomy
Authors: Pehlivan Melike , Eyi Semra 
Published: November 2024

Background
Surgical interventions are commonly utilized in the treatment of breast cancer; however, they can elicit adverse effects on women’s perceptions of femininity, leading to stress, negative body image, diminished self-esteem, and challenges in sexual adjustment.

Objective
This study investigates the efficacy of mindfulness-based meditation and yoga in alleviating stress, enhancing self-esteem, improving body image, and facilitating sexual adjustment among women undergoing modified radical mastectomy.

Methods
Using a prospective (pretest, posttest, and second-month follow-up), 2-arm (1:1), randomized controlled experimental design, the study involved 39 women (intervention group = 19, control group = 20) undergoing modified radical mastectomy. The intervention group participated in face-to-face mindfulness-based meditation and yoga sessions lasting approximately 90 minutes each over an 8-week period.

Results
Following the intervention, significant reductions in perceived stress and the significance attributed to breasts in sexuality were observed (P < .05), accompanied by increases in self-esteem and body perception (P < .05). However, no significant differences were observed in sexual adjustment (P > .05).

Conclusions
Mindfulness-based meditation and yoga interventions demonstrated efficacy in mitigating perceived stress, enhancing self-esteem, and improving body perception among women undergoing modified radical mastectomy. The findings advocate for the integration of mindfulness-based stress reduction programs, particularly during the preoperative phase, to support oncological patients, particularly those with breast cancer.

Implications for Practice
Psychosocial aspects such as body image, self-esteem, and sexual adjustment following radical mastectomy are frequently overlooked in clinical care. This research highlights the potential benefits of incorporating mindfulness-based yoga and meditation techniques into nursing interventions to alleviate stress and enhance body confidence among women undergoing mastectomy.
Physical Activity and Exercise Interventions in Abdominal Wall Hernia Patients: Impact on Quality of Life and Health Outcomes - A Systematic Review and Meta-Analysis
Authors: Delgado José Luis Gil , Pagola Gonzalo Reverte , Barea Francisco Javier Pecci , Madueño Adrián Feria , Arteaga Alejandro Sánchez , Corrales y Borja Sañudo 
Published: November 2024

ABSTRACT

Objective
Abdominal wall hernias are a common pathology in the surgical field, often leading to symptoms such as pain and tightness that can significantly reduce quality of life. Some studies have suggested that exercise and physical activity may improve both quality of life and health outcomes. This study aimed to evaluate the impact of exercise on quality of life and health outcomes in abdominal wall hernia patients through a qualitative systematic review and a quantitative meta-analysis.

Design
The systematic review identified six studies (n = 2409) that met the inclusion criteria, all demonstrating that exercise and physical activity positively affected health outcomes in abdominal wall hernia patients. Due to the limited number of studies available, the meta-analysis focused specifically on the effects of exercise and physical activity on quality of life and pain.

Results
The meta-analysis results indicated significant improvements in quality of life between pre- and postsurgery after a physical exercise intervention. However, no significant differences were found in pain levels between pre- and postsurgery following the exercise program.

Conclusion
This systematic review and meta-analysis offer promising insights into the potential benefits of physical activity and exercise interventions on health outcomes for AWH patients.
Gaps in Physical Medicine and Rehabilitation for Blindness and Low Vision
Authors: Gersony Alyssa , Han Yangha (Hank) , Beheshti Mahya , Hamilton-Fletcher Giles , Stants Holly , Stolfi Angela , Roberts Pamela , Rao Smita , Rizzo John-Ross (JR) 
Published: November 2024

Abstract
Persons with blindness and low vision experience increased fall and injury risk beyond atypical biomechanics and balance impairments. Falling risk doubles with blindness, and more than triples with depth perception losses. Despite this, physical therapy focuses on musculoskeletal injuries postevent rather than taking a proactive and preventative approach for persons with blindness and low vision. We posit that physical therapy implemented preinjury, alongside orientation and mobility training of adapted movement protocols could positively affect injury avoidance and severity for persons with blindness and low vision. The global VISION 2020 initiative seeks increased access to rehabilitation services and treatments to enhance quality-of-life for persons with blindness and low vision. In support, this article reviews research studies in rehabilitation science that promote physical health and well-being, and stresses preventative skilled mobility and therapeutic exercise to mitigate injury. To reduce the personal, financial, and societal costs associated with blindness and low vision, as well as position patients for better outcomes, we review an evidence base that may generate immediate impact in this area. While these recommendations provide an initial framework, the role of physical therapy in prehabilitative care remains a critical gap that must be addressed. It is imperative that interventions, guidelines, impairment/severity-specific practices, and overall health promotion are re-evaluated and redesigned for persons with blindness and low vision, affording equity for health and mobility.
Complex Scalp Reconstruction in Moyamoya Disease Using Distant Flap After Free Tissue Transfer Failure
Authors: Kim Rah Yoon , Lee Chang Jun , Baek Sang Oon 
Published: November 2024

A preferred option among many surgeons for treating large defects in the head and neck area is reconstruction using autologous tissue, particularly free tissue transfer with microvascular anastomosis. However, some defects cannot be resolved with conventional microvascular techniques or algorithmic approaches. In this case study, a 55-year-old female, who previously underwent bypass surgery for Moyamoya disease, presented with a large scalp defect following surgical necrosis. After initial coverage using a free anterolateral thigh flap, partial necrosis developed, leaving a persistent 2×4 cm² defect. To resolve this, a distant thenar flap was harvested and successfully used for reconstruction. Postoperatively, the patient exhibited full recovery without complications. This case highlights the effectiveness of distant flap techniques, particularly when microvascular surgery is not feasible or has failed. The historical significance and continued applicability of distant flaps in challenging cases underscore their importance in the reconstructive armamentarium.