bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low-dose apatinib in combination with chemotherapy for hormone receptor-positive, HER2-negative breast cancer with pulmonary lymphangitic carcinomatosis: A case report
Authors: Chen Liping , Feng Sha , Chen Xuelian , Du Caiwen 
Published: November 2024

Rationale:
Hormone receptor-positive, HER2-negative advanced breast cancer complicated by pulmonary lymphangitic carcinomatosis (PLC) poses significant therapeutic challenges due to the lack of standardized treatment protocols. Despite various therapeutic interventions and supportive care, prognosis remains dismal.

Patient concerns:
Herein, a 48-year-old Chinese woman presented with a persistent cough, unresponsive to anti-infective treatment for 1 month. A computed tomography (CT) scan revealed lymphatic vessel infiltration and a diffuse nodular pattern, suggestive of PLC.

Diagnoses:
Hormone receptor-positive, HER2-negative advanced breast cancer complicated by PLC.

Interventions:
The patient was treated with a regimen comprising low-dose apatinib, capecitabine, and albumin-bound paclitaxel.

Outcomes:
The patient achieved a partial response, with a progression-free survival exceeding beyond ten months. Symptoms of dyspnea and dry cough significantly improved, alongside a notable reduction in lymphangitic carcinomatosis.

Lessons:
This case highlights the potential antitumor activity of apatinib in breast cancer patients with presenting with PLC. While further studies are necessary, this therapeutic approach could represent a viable option for managing breast cancer in the context of a visceral crisis. The case also emphasizes the importance of individualized treatment strategies and further research to substantiate these promising findings.
Mesocolic schwannoma mimicking gastrointestinal stromal tumor: A case report and review of literature
Authors: Sun Qihang , Zhu Qingshun , Lu Xuren , Zhu Guangxu , Lang Wei , Zhang Jie , Qu Jianjun 
Published: November 2024

Rationale:
Schwannomas are common peripheral nerve tumors originating from Schwann cells, primarily occurring in the head and neck, limbs, and trunk. Schwannomas occurring in the mesocolon are rare and often have no specific manifestations. Abdominal schwannomas need to be differentiated from common abdominal tumors such as gastrointestinal stromal tumors.

Patient concerns:
We report a case of a mesocolic schwannoma in a 59-year-old female presenting with gastrointestinal symptoms of acid reflux. At an outside hospital, gastroscopy, colonoscopy, and abdominal computed tomography scans revealed a soft tissue mass adjacent to the greater curvature of the stomach, leading to a suspicion of a gastric mesenchymal tumor.

Diagnoses:
Mesocolic schwannoma.

Interventions:
Laparoscopy was performed at our hospital. Intraoperatively, the tumor was found to be closely related to the transverse colon and was initially diagnosed as a mass originating from the transverse colon. Consequently, a resection of the mass along with the adherent portion of the transverse colon was performed. Postoperative pathology and immunohistochemistry confirmed that the tumor was a schwannoma of the mesentery and did not originate from the transverse colon.

Outcomes and lessons:
Schwannomas can be distinguished from gastrointestinal stromal tumors by immunohistochemical staining, and surgical treatment is effective for benign schwannomas.
Prepatellar bursa mucosa: An unreported postoperative complication of patellar fracture
Authors: Lin Fukun , Yao Jihang , Liu Yiming , Qi Baochang 
Published: November 2024

Background:
Patellar fracture is a common injury caused by overstrain of the extensor mechanism or a direct trauma to the knee. The most common complications after patellar fracture are nonunion, infection, post-traumatic arthritis, joint fibrosis, symptomatic hardware, and extensor mechanism failure. These are attributed to the post-fracture flexion and extension movements, the primary damage to the articular cartilage, and the thin soft tissue coverage over the knee. To our knowledge, prepatellar bursa mucosa is an unreported postoperative complication of patellar fracture.

Methods:
We describe a case of a 58-year-old woman with a left patellar fracture from a fall. Complete healing was achieved after in 2 months postoperatively using the improved Kirschner wire tension band and a cable grip system; however, at 7 months postoperatively, a prepatellar skin mass appeared. The patient reported prepatellar discomfort with no pain and influence of movement of the knee and daily life. One year postoperatively, we surgically removed the implants and mass. The pathological result showed bursa mucosa.

Results:
The literature review shows that pain, secondary knee dysfunction, fracture nonunion, and malunion are postoperative complications of patellar fractures. However, prepatellar bursa mucosa have not been previously reported as a postoperative complication.

Conclusion:
This case highlights the need for appropriate placement of the intraoperative implant in adults with patellar fractures.
Type 2 diabetes and bone mineral density: A meta-analysis and systematic review
Authors: Li Minghan , Sun Hanqiao , Chen Honggu , Ma Weiwei , Li Ying 
Published: November 2024

Background:
Type 2 diabetes (T2D), a widespread chronic metabolic disorder, presents frequently in clinical settings. The relationship between T2D and bone mineral density (BMD) has been subject to ongoing investigation, yielding inconclusive results.

Methods:
A systematic literature search was conducted across several databases, including CNKI, VIP, CBM, Wanfang, PubMed, Cochrane Library, and Embase, targeting observational studies that explored the impact of microangiopathy associated with T2D on BMD or bone metabolism. The search spanned from the inception of each database to July 1, 2023. The Newcastle–Ottawa Scale was employed for quality assessment, and RevMan 5.3 software was utilized for data analysis. Stata 14.0 was used for the quantitative evaluation of publication bias regarding outcome measures.

Results:
The inclusion criteria were met by 30 observational studies, comprising 6470 participants—3121 with diabetes and 3349 without. The meta-analysis revealed no significant difference in overall BMD between the nondiabetic and T2D groups (mean difference [MD] = −0.07, 95% confidence interval [CI] [−0.17, 0.03], Z = 1.45, P = .15). However, BMD at the lumbar vertebrae was significantly higher in nondiabetic individuals compared with those with T2D (MD = −0.14, 95% CI [−0.22, −0.06], Z = 3.32, P = 0.0009), as was the case with femoral neck BMD (MD = −0.11, 95% CI [−0.18, −0.04], Z = 3.08, P = .002). A difference in femoral neck BMD between nondiabetics and individuals with T2D approached but did not reach statistical significance (MD = −0.14, 95% CI [−0.27, 0.00], Z = 1.94, P = .05). An inverted funnel plot analysis suggested possible publication bias, as evidenced by an asymmetrical distribution of studies around the axis of symmetry, with overlap observed in several cases.

Conclusion:
The findings indicate a significant association between T2D and reduced BMD at critical sites such as the lumbar vertebrae and femoral neck, highlighting an increased risk of osteoporosis or osteoporotic fractures in these regions.
Osteosarcopenia in patients with cancer: A systematic review and meta-analysis
Authors: Wang Chien-Chieh , Liu Hsuan-Chih , Lin Wen-Li , Wu Li-Min , Guo How-Ran , Huang Soon-Cen , Huang Wen-Tsung , Lin Cheng-Yao , Nguyen Thi-Hoang-Yen 
Published: November 2024

Background:
Osteosarcopenia is frequent, and the relative risk of fracture is higher among patients with sarcopenia. It is a strong predictor of poor outcomes in older adults undergoing cancer treatment, suggesting that osteosarcopenia is important in an aging society. This study aimed to evaluate the overall survival (OS) and disease-free survival (DFS) of patients with cancer with and without osteosarcopenia.

Methods:
Five electronic databases—Embase, PubMed, Web of Science, Scopus, and CINAHL—were searched for relevant articles published before February 2024. Studies that met the criteria were used to evaluate the OS and DFS of patients with cancer with and without osteosarcopenia. From the 603 initially identified articles, 8 involving 1608 participants were included in the meta-analysis.

Results:
We observed that patients with cancer diagnosed with osteopenia, sarcopenia, or osteosarcopenia had worse DFS than those without these conditions. Specifically, osteopenia (pooled hazard ratio [HR] = 1.70, P = .01) and osteosarcopenia (pooled HR = 2.17, P = .0001) emerged as independent predictors of DFS. However, sarcopenia was significantly associated with DFS. The quality of the included studies was generally good, and no publication bias was detected among them for either OS or DFS.

Conclusion:
These meta-analysis results suggest that osteopenia and osteosarcopenia are associated with worse DFS among patients with cancer. The use of different case definitions appeared to be a major source of heterogeneity among studies. Further studies are warranted to confirm our findings, especially those regarding OS and DFS.
Experience of physical activity in patients with stroke: A qualitative meta-synthesis
Authors: Li Xingru , Yang Xinchen , Fan Yifan , Tang Yun , Shu Yue 
Published: November 2024

Background:
Inadequate physical activity (PA) is increasingly common among stroke patients, we aim to comprehensively analyze the experience of stroke patients delivering physical activity, understand the obstacles and promoting factors of physical activity, and summarize clinical management strategies.

Methods:
An electronic search of PubMed, Web of Science, Cochrane Library, ProQuest, SinoMed, CNKI, and WanFang Database was conducted for qualitative studies on the experience of PA in stroke patients. The review was appraised using the Joanna Briggs Institute methodology, the subsequent findings were synthesized via the Thomas and Harden approach and the credibility of the research results was evaluated by the CERqual tool.

Results:
Six thousand five hundred forty-nine findings were yielded through the search, ultimately 11 studies were included through screening, a total of 194 stroke patients participated in the study, and 3 synthesized themes that emerged were identified: barriers to PA, facilitators to PA, and strategies to improve compliance with physical activity in stroke patients. All selected articles were of medium quality and all themes were of medium or high quality.

Conclusion:
The experience of PA among stroke patients should be given more attention. Healthcare professionals should provide physical activity-related knowledge education, social support, personalized care, improved environments, and create more opportunities for PA. In the future, more tailored interventions should be carried out to develop PA habits and improve compliance.
Utilization of Computer-Assisted Navigation Technology Within Craniomaxillofacial Fracture Surgery
Authors: Thuman Jenna , Andrade Erika , Brantley Rebecca , Herrera Fernando A. , Scomacao Isis Raulino 
Published: November 2024

Background
Use of intraoperative computer-assisted navigation (iCAN) has been well-established in otolaryngology and neurosurgery; however, its use in surgical management of facial fractures is yet to be reported on a large scale. This study aimed to review the existing literature to determine the outcomes, limitations, risks, and benefits of iCAN use in facial fracture management.

Methods
A systematic review of iCAN use in craniomaxillofacial fracture surgery was performed by 2 authors in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search was conducted on 3 databases, PubMed, Cochrane Library, and Embase, using the search terms “navigation,” “intraoperative,” and “brain lab” in combination with “facial fractures” or “facial reconstruction.” Study type, demographics, fracture characteristics, surgery characteristics, iCAN devices, intraoperative fracture fixation accuracy, postoperative outcomes, complications, navigation limitations, and risks and benefits were analyzed.

Results
There were 909 studies identified in the initial search, of which 42 were chosen for final use. iCAN use was most commonly reported in unilateral (57.1%) and complex (50%) facial fracture cases. Surgical accuracy ranged from 0.7 to 4 mm and postoperative discrepancy ranged from 0.05 to 8 mm. Benefits included improved intraoperative surgical accuracy (95.2%), improved postoperative surgical discrepancy (52.4%), and decreased total surgical time (35.7%). Limitations reported with iCAN device use included operative technical difficulties (23.8%) and persistent systematic errors during device registration (21.4%). None of the studies discussed cost analysis or risks compared to conventional fixation methods.

Conclusions
Advancements in and increasing familiarity with iCAN technology have preliminarily shown favorable surgical outcomes in facial fracture fixation, which include improved operative accuracy and discrepancy and decreased surgical time.
Intraocular Pressure Changes After Combined Orbital Decompression and Glucocorticoid Treatment for Graves Orbitopathy
Authors: Wang Mingyang , Li Dongmei 
Published: November 2024

Objective:
To evaluate the change in the intraocular pressure (IOP) in subjects with Graves orbitopathy (GO) after orbital decompression (OD) with glucocorticoids (GCs).

Methods:
Ninety-nine orbits of 76 patients with GO were retrospectively reviewed, with either OD (Group A), OD with intravenous glucocorticoids (i.v.GC) (Group B) or parabulbar GC (Group C) administration. The main outcome measures included pre-and post-operative IOP in the primary and upward gazes.

Results:
Mean postoperative IOPs in the primary gaze were lower than the preoperative values for groups A and C (P < 0.05). The IOPs during the upward gaze were higher than those in the primary gaze before and after OD (all groups, P < 0.05). The mean postoperative and preoperative IOPs during upward gaze were similar in all groups except group C (P = 0.001). The mean decrease in IOP in the primary gaze was 1.57 ± 6.00 mm Hg and 2.22 ± 2.62 mm Hg in groups A and C, respectively (P < 0.05). Only in group C, the mean IOPs during upward gaze decrease by 5.29 ± 4.89 mm Hg (active GO before OD), and the mean gaze-related IOP decreased from 7.75 ± 6.02 to 2.57 ± 4.21 mm Hg (P < 0.05).

Conclusions:
A pbGC treatment before OD can effectively reduce the primary and upward gaze IOPs and lead to a greater postoperative reduction in the upward gaze IOP to approximate that in the primary gaze. A pbGC treatment may be preferred for patients with GO in the active or congestive phase before OD considering the IOP.
Understanding Hemodynamic Incoherence: Mechanisms, Phenotypes, and Implications for Treatment
Authors: Huang Lin , Huang Qiaobin , Ma Weiquan , Yang Hong 
Published: November 2024

Abstract
The reversal of microcirculation dysfunction is crucial for assessing the success of shock resuscitation and significantly influences patient prognosis. However hemodynamic incoherence is observed when microcirculatory dysfunction persists despite the restoration of macrocirculatory function post-resuscitation. Recent advancements in technology have enabled bedside assessment of microcirculation in shock patients, allowing for direct visualization of microcirculatory morphology and quantitative evaluation of its functional status. This article reviews the pathophysiological mechanisms that lead to hemodynamic incoherence. It also introduces the current understanding and classification framework for the different phenotypes of hemodynamic incoherence. Existing evidence indicates that the diverse mechanisms leading to microcirculatory disorders result in varied manifestations among patients experiencing hemodynamic incoherence, highlighting the heterogeneity of this population. Some classification frameworks have been proposed to enhance our understanding of these phenotypes. By integrating pathophysiological mechanisms, clinical symptoms, indicators of macrocirculation, microcirculation, tissue metabolism, and biomarkers, we can summarize certain clinical features of phenotypes in hemodynamic incoherence to form a conceptual framework. Additionally, strategies for creating targeted treatments based on different phenotypes require further validation.
Implementing a Digital Platform for Recurrent Urinary Tract Infections
Authors: Arya Lily A. , Agrawal Surbhi , Ikpeama Ngozi , Harvie Heidi , Feldman Rebecca Hamm , Dutcher Lauren 
Published: November 2024

Importance
A patient-centered care model is needed for recurrent urinary tract infection (UTI) management.

Objective
The aim of this study was to develop a conceptual model for a digital platform to implement evidence-based guidelines for recurrent UTI management.

Study Design
This was a qualitative, 3-stage mixed methods study that included (1) developing an evidence-based prototype texting platform; (2) qualitative feedback from recurrent UTI patients using the platform; and (3) quantitative data on acceptability (proportion of patients engaging with the platform), accuracy (proportion of patient messages interpreted accurately by the platform), and usability (score 0–100).

Results
Thirty-one women with recurrent UTI (median age, 71 years; range, 60–74 years) participated in testing over 4 months. The prototype platform was modified through iterative rounds of qualitative and quantitative analysis until engagement ≥85%, accuracy ≥90%, and usability score of ≥80 were achieved in 10 patients. Qualitative feedback indicated that patients valued rapid access to treatment through fewest possible health encounters during an acute episode, evidence-based education about prevention, and ability to participate in self-management with support from health care providers. Based on this feedback, a conceptual model consisting of 3 main components was developed: (1) an algorithm to triage acute symptoms, (2) educational videos emphasizing prevention strategies, and (3) supportive messages. Patient feedback identified 4 key implementation outcomes—usability, acceptability (engagement), fidelity (accuracy), and cost—and 3 clinical outcomes—self-efficacy, health care utilization, and rate of unnecessary antibiotics for testing the model.

Conclusion
The proposed model can be used to implement and test a patient-centered evidence-based digital platform for the management of recurrent UTI.
Investigating the Role of Management Decisions in Subspecies Hybridization Across the Wild Turkey’s Range
Authors: Beckman Amanda K. , Hamer Sarah A. , Rosenthal Gil G. , Brennan Leonard A. , Hancock Zach B. 
Published: November 2024

ABSTRACTThe expanded geographic range and recovery to millions of wild turkeys across the country would not have been possible without management actions that included introducing and translocating individuals. However, the range-wide genetic impact of management decisions on one of North America’s greatest conservation success stories remains unknown despite the potential economic impact as hunters seek out easily identifiable subspecies for grand slams. In this study, we used DNA extracted from hunter-collected feathers from 29 states and Ontario to investigate genetic differences among turkeys in their historic and introduced ranges. Additionally, we compiled state-level management data to investigate how different management decisions are associated with the amount of admixture among subspecies. We found no difference in the amount of admixture in the turkey’s historic range compared to the introduced range. However, management decisions like as the number of subspecies introduced and the number of unique source states resulted in an increased level of admixture detected, but there was no relationship in admixture and the number of unique relocated counties. This first investigation into the hybridization among subspecies of wild turkey provides evidence that individual state’s management actions have influenced the genetic makeup of subspecies in that state.
Disease-Linked Regulatory DNA Variants and Homeostatic Transcription Factors in Epidermis
Authors: Porter Douglas F. , Meyers Robin M. , Miao Weili , Reynolds David L. , Hong Audrey W. , Yang Xue , Mondal Smarajit , Siprashvili Zurab , Srinivasan Suhas , Ducoli Luca , Meyers Jordan M. , Nguyen Duy T. , Ko Lisa A. , Kellman Laura , Elfaki Ibtihal , Guo Margaret , Winge Mårten CG , Lopez-Pajares Vanessa , Porter Imani E. , Tao Shiying , Khavari Paul A. 
Published: November 2024

AbstractIdentifying noncoding single nucleotide variants (SNVs) in regulatory DNA linked to polygenic disease risk, the transcription factors (TFs) they bind, and the target genes they dysregulate is a goal in polygenic disease research. Massively parallel reporter gene analysis (MPRA) of 3,451 SNVs linked to risk for polygenic skin diseases characterized by disrupted epidermal homeostasis identified 355 differentially active SNVs (daSNVs). daSNV target gene analysis, combined with daSNV editing, underscored dysregulated epidermal differentiation as a pathomechanism shared across common polygenic skin diseases. CRISPR knockout screens of 1772 human TFs revealed 108 TFs essential for epidermal progenitor differentiation, uncovering novel roles for ZNF217, CXXC1, FOXJ2, IRX2 and NRF1. Population sampling CUT&RUN of 27 homeostatic TFs identified allele-specific DNA binding (ASB) differences at daSNVs enriched near epidermal homeostasis and monogenic skin disease genes, with notable representation of SP/KLF and AP-1/2 TFs. This resource implicates dysregulated differentiation in risk for diverse polygenic skin diseases.
Fear, Stigma and Uncertainty: The short and long-term effects of Ebola on survivors, affected families, and community in Bundibugyo, Western Uganda
Authors: Namusisi Shamilah , Waila Jacinta Mukulu , Hoffman Sarah J. , Roberston Cheryl , Pelican Katey , Mahero Michael 
Published: November 2024

AbstractIn 2014, Uganda was identified as a high-risk country for Ebola Virus Disease (EVD), with a series of outbreaks recorded since 2000. In 2007, the second outbreak in Bundibugyo district resulted in 149 reported cases and 37 confirmed Ebola deaths. Through the outbreak response, a new strain of the Ebola virus (Bundibugyo ebolavirus)was discovered. Although much is known about the nature of Ebola, including disease signs and symptoms, transmission and management, there is limited understanding of the short and long-term sociocultural impacts of the disease in communities. The study team conducted a focused ethnography in Bundibugyo District 10 years after the 2007 outbreak. Data collection included a review of archival data, participant observation, field notes and 19 in-depth interviews with survivors and affected families. Results underscored time-limited social, cultural and economic disruptions caused by the outbreak. We interpreted findings through an Eco-health framework with an emphasis on ways that underlying stigma accentuated detrimental long-term effects of the outbreak. Affected women, particularly widows, experienced social exclusion, and economic strain, and acknowledged loss of opportunity for a better life for their orphaned children. Deepening fear of the possible recurrence of Ebola resulted in ethnic tension driven by speculations on the 2007 outbreak source. Survivors reported varying persistent health effects including impaired vision and general body weakness. Community members reported positive changes in health seeking behaviors. Health care workers described high levels of alert for early clinical signs of Ebola, a critical factor for early outbreak detection at the community level. Our findings can inform future Ebola response and recovery interventions, particularly those targeting community re-integration and a mitigation of the fear and stigma associated with survivorship.