bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Real-World Experience of Efficacy and Safety of Belantamab Mafodotin in Relapsed Refractory Multiple Myeloma
Authors: Hashmi Hamza , Dileo Rachel , Mewawalla Prerna , Babu Kalaivani , Yin Yue , Strouse Christopher , Chen Ethan , Shaikh Hira , Davis James , Green Kimberly , Alkharabsheh Omar , Rashid Aliya , Pokhrel Bidushi , Ahmed Nausheen , Abdallah Al-Ola 
Published: November 2024

Abstract

While initial trials led to the accelerated approval of belantamab mafodotin, a BCMA directed antibody drug conjugate, confirmatory trials failed to establish benefit from this therapy for patients with relapsed refractory multiple myeloma (RRMM), eventually leading to its withdrawal from commercial use. With an imminent approval as an effective combination therapy as seen in recent randomized trials, we report real-world clinical outcomes with belantamab mafodotin in 81 RRMM patients. With median of 5 (range 2–15) prior lines of therapy, 92%, 45%, and 15% of the patients were triple-class refractory, penta-class refractory, and BCMA-refractory. More than half (57%) of the patients had high-risk cytogenetics, 37% had extramedullary disease (EMD), and 67% of the patients would have been considered ineligible for the DREAMM-2 trial. Best overall response (ORR) and complete response rates were 40.0% and 15.0%, respectively. ORRs were lower in patients with EMD, BCMA-refractory and penta-refractory disease at 23%, 17%, and 24%, respectively. All grade ocular toxicity was seen in 69% of patients with grade 3 + events in 43%. Grade 3 + hematological toxicities included neutropenia (20%), anemia (28%), and thrombocytopenia (31%). With a median follow-up of 11.3 (0.3–44.6) months for the entire population, median PFS and OS were 5 (1–20) months and 12 (3–28) months, respectively. Presence of EMD was the only predictor of both PFS and OS on multivariable analysis. Compared to the pivotal trial and despite several high-risk disease features, belantamab mafodotin demonstrated comparable efficacy and safety in this real-world patient population.
Examining Disparities in Glycemic Management: A Comprehensive Retrospective Study on Rural Population
Authors: Papazachariou Andria , Malikides Onoufrios , Malikides Vironas , Vasilaki Nektaria , Stamatelatou Maria , Papakitsou Ioanna , Papadokostaki Eleni , Filippatos Theodosios D. 
Published: November 2024

Abstract

Objectives:
Residing in rural or remote areas is often linked to compromised access to health services, directly affecting the feasibility of follow-up on patients with diabetes. An 8-month retrospective cohort study of factors affecting glycemic control among 932 individuals with diabetes, who sought medical care in a rural area. Demographics, comorbidities and laboratory measurements were retrieved through patient interviews, from the national electronic prescription system and hospital’s medical records
Data description:
Participants (n=632) resided within a half-hour proximity to reference center, demonstrated better glycemic control, with a mean HbA1c level of 7.20±0.7%, as opposed to those (n=300) who lived more than half-hour away, who exhibited a mean HbA1c level of 7.34±0.8% (p=0.016). HbA1c levels exhibit a significant correlation with both the time in minutes and the distance in kilometers from the rural area reference center. Linear regression analyses showed that distance in kilometers or in minutes is an independent factor influencing HbA1c levels. The distance to medical services is an important factor of glycemic control in patients with diabetes, underlying the importance of improvements in the health system in rural areas.
Assessing the quality of life of adolescents with sickle cell disease and their transition to adult medicine: experience in a remote area of the Democratic Republic of Congo
Authors: Mbiya-Mukinayi Benoît , Kalala-Mushinta Corneille , Kalombo-Munganga Schadrac , Kalala-Mwanza Alexandre , Kasongo-Tshiala Steve , Mpoyi-Kalenda John , Gulbis Béatrice 
Published: November 2024

Abstract

Background
Sickle cell disease is the most common genetic disease in the world, affecting mainly populations in sub-Saharan Africa. It causes high morbidity and mortality rates and is a real public health problem in the Democratic Republic of the Congo. Regular medical follow-up improves the quality of life of patients, especially adolescents, and raises the issue of their transition to adult medicine. This study aims to assess the quality of life and transition of sickle-cell adolescents, identifying key factors influencing their well-being.
Method
This was a cross-sectional descriptive and observational study conducted in the form of interviews with 106 sickle cell adolescents in Mbujimayi. The SF-36 short questionnaire was used to assess quality of life. A closed questionnaire (dichotomous or nominal) was used to assess the transition period.
Results
The results revealed an overall optimal quality of life, with an average SF-36 score of 60.6 ± 8. Improvement in pain management (75,21 ± 23,49) and misperception of role limitations related to emotional issues (47,79 ± 27,53). Pain is the main factor affecting quality of life. It is significantly associated with physical functioning (p 0.014), energy/fatigue (p 0.014), functional/physical role (p 0.001), emotional well-being (p 0.000), social functioning (p 0.000) and pain itself (p 0.000). The majority, 92% of the adolescents, were unaware of the transition, and 68% did not feel ready to move from pediatric care to adult care.
Conclusion
These findings highlight the importance of considering the quality of life of sickle cell adolescents and their transition to adult medicine in Mbujimayi, highlighting the challenges they face and the factors that affect their well-being in general.
Dietary acid load and mortality: Results from the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study
Authors: Unohara Taichi , Watanabe Takeshi , Arisawa Kokichi , Matsuura Akari , Kita Kahori , Torii Yuka , Ishizu Masashi , Katsuura-Kamano Sakurako , Nguyen Tien Van , Otonari Jun , Ikezaki Hiroaki , Tanaka Keitaro , Shianoe Chisato , Nagayoshi Mako , Kubo Yoko , Matsunaga Takashi , Okada Rieko , Oze Isao , Ito Hidemi , Michihata Nobuaki , Nakamura Yohko , Tanoue Shiroh , Koriyama Chihara , Suzuki Sadao , Nishiyama Takeshi , Koyama Teruhide , Ozaki Etsuko , Kuriki Kiyonori , Takashima Naoyuki , Kondo Keiko , Tamura Takashi , Matsuo Keitaro 
Published: November 2024

Abstract

Purpose:The impact of diet on the body acid-base balance may be related to the risk of various chronic diseases. Despite emerging evidence on the relationships between the dietary acid load and all-cause and cause-specific mortalities, further information is needed. This prospective cohort study examined the relationships between the dietary acid load and all-cause and cause-specific mortalities in a large Japanese population.
Methods: The data of 74,360 subjects (aged 35-69 years in the baseline survey) in the Japan Multi-Institutional Collaborative Cohort Study were analyzed. The dietary acid load was estimated using the net endogenous acid production (NEAP) score. Cox proportional hazards regression analyses were performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortalities according to the quartiles of the energy-adjusted NEAP score after adjustments for potential confounders. Sex-stratified analyses were also conducted.
Results: During a mean follow-up of 11.6 years, 3,761 deaths (2,467 male and 1,294 female subjects) were identified. A higher NEAP score was associated with higher all-cause mortality (HR 1.16, 95% CI 1.04-1.28) and cerebrovascular disease mortality (HR 1.69, 95% CI 1.08-2.65). Sex-stratified analyses showed that the NEAP score was associated with all-cause and cause-specific mortalities, including cerebrovascular disease mortality (HR 2.32, 95% CI 1.23 - 4.40), in male subjects, but not in female subjects.
Conclusion: The present results suggest that the dietary acid load is associated with a higher risk of all-cause and cause-specific mortalities, including cerebrovascular death, in Japanese male adults.
Seawater temperature and tidal action as modulators of Ulva spp. micropropagules density in a eutrophicated macrotidal coastal system
Authors: Caniguan Agustina Mariel , Becherucci Maria Eugenia , Gastaldi Marianela , Narvarte Maite Andrea , Saad Juan Francisco 
Published: November 2024

Abstract

Micropropagules are the reproductive and dispersal means of macroalgae, often linked to green macroalgal blooms in eutrophicated coastal areas. In San Antonio Bay (North Patagonia, Argentina), increased nutrients have led to Ulva spp. blooms in spring and early summer, coinciding with high Ulva spp. micropropagules (MPU) density at low tide. This study aimed to describe the variation in MPU densities throughout a year and in a tidal cycle and their relationship with environmental variables. For this, MPU density, macroalgal biomass, weight of mature and immature thalli, and seawater physical and chemical variables were determined: 1) monthly for a year at low tide, 2) during a tidal cycle at one-hour intervals covering the low tide period (approx. five hours), and 3) at different depths in the water column during daytime and nighttime high tides. Maximum MPU density (33983±9553 cel ml-1) occurred in February, while macroalgal biomass peaked in December. MPU density, seawater temperature, salinity, chlorophyll-a, and nutrients increased during low tide but decreased at high tide, with no evidence of vertical stratification. MPU density was positively associated with seawater temperature during low tide and throughout the year. We conclude that MPU variation is associated with seawater temperature annually and with tidal action daily. High MPU densities during summer raise chlorophyll and dissolved oxygen levels, while tidal flow dilutes and exports MPU. These results provide insights into the dynamics of the dispersal phase of an opportunistic and globally distributed green algal genus for the first time.
Characteristics and risk factors for postoperative bleeding following endoscopic resection of esophageal squamous neoplasms
Authors: Kitagawa Daiki , Kanesaka Takashi , Ishihara Ryu , Tani Yasuhiro , Okubo Yuki , Asada Yuya , Ueda Tomoya , Kizawa Atsuko , Ninomiya Takehiro , Ando Yoshiaki , Tanabe Gentaro , Fujimoto Yuta , Mori Hitoshi , Kato Minoru , Yoshii Shunsuke , Shichijo Satoki , Yamamoto Sachiko , Higashino Koji , Uedo Noriya , Michida Tomoki , Fujiwara Yasuhiro 
Published: November 2024

Abstract

Background
Reports on postoperative bleeding after esophageal endoscopic resection are limited.
Aims
This study aimed to identify the clinical characteristics and risk factors for postoperative bleeding following endoscopic resection of esophageal neoplasms.
Methods
This single-center, retrospective study included consecutive patients who underwent endoscopic resection for esophageal squamous cell carcinoma or squamous intraepithelial neoplasm between January 2018 and December 2022. We investigated the incidence, timing, severity, and risk factors for postoperative bleeding.
Results
Among the 1,288 patients, postoperative bleeding occurred in seven (0.5%) patients (95% confidence interval [CI] 0.2–1.1%; median postoperative day 8 [range, 4–17 days]). In these seven patients, hemoglobin concentration decreased by a median of 3.0 g/dL (range, 1.6–6.8 g/dL). Direct oral anticoagulants (DOACs) were identified as the most significant risk factor for postoperative bleeding (odds ratio [OR] 41.9, 95% CI 6.8–294.6; P < 0.001) and were significantly associated with postoperative bleeding even after propensity score matching (3/39 [8%] vs. 0/78 [0%], P = 0.035). Among 43 patients who received DOACs, postoperative bleeding occurred in four (9%) patients (95% CI 2.6–22.1%).
Conclusions
The overall bleeding rate following esophageal endoscopic resection was 0.5%, with a delayed onset, leading to anemia. DOACs emerged as the most significant risk factor for postoperative bleeding.
The ratio of omega-6 fatty acids to omega-3 fatty acids mediating the effect of gastroesophageal reflux disease on pancreatic cancer risk: a two-step mediation Mendelian randomisation study
Authors: Ouyang Jiqi , Zhang Runshun , Lv Wenliang , Lu Yanping 
Published: November 2024

Abstract

Introduction:
Pancreatic cancer (PC) is the third most common cause of cancer-related deaths worldwide, with the 5-year survival rate for patients with PC in developed countries being only 9–10%. Gastroesophageal reflux disease (GERD) is known to be a high-risk factor for several cancers. However, the relationship between GERD and PC remains controversial. Therefore, this study aimed to investigate the causal association between GERD and the risk of PC. Additionally, we sought to validate the role of omega-6/omega-3 polyunsaturated fatty acids (n-6/n-3 PUFA) as mediators in this pathway by calculating their mediating effect.
Methods
First, a two-step, two-sample Mendelian randomisation (TSMR) framework was established to test the causal relationship between GERD and PC and to determine whether n-6/n-3 PUFA could act as a mediator of the causal pathway. Subsequently, using multivariate Mendelian randomisation (MVMR), the proportion of mediators mediated by n-6/n-3 PUFA was calculated using the product of coefficients approach.
Results
The two-step TSMR results showed that GERD was positively associated with PC (n = 27 SNPs, OR 2.07 95% CI 1.27–3.39, p = 0.003 β = 0.73). Additionally, GERD was positively associated with n-6/n-3 PUFAs (n = 59 SNPs, OR 1.06, 95% CI 1.02–1.11 p = 9.0×10 − 4, β1 = 0.06), which are positively associated with PC (n = 28 SNPs, OR 1.23, 95% CI 1.04–1.46, p = 0.02, β = 0.20). The MRMV results demonstrated that after controlling for GERD, the n-6/n-3 PUFA had an impact on PC (n = 17 SNPs, se = 0.07, p = 0.004, β2 = 0.21). Furthermore, the causal effect of GERD on PC was partially mediated through the n-6/n-3 PUFA (n = 31 SNPs, se = 0.20, p = 0.03, β3 = 0.42) with a 2.9% mediating effect.
Conclusion
This study provides insights into the pathological processes that link GERD to PC. In addition, it offers a novel approach to PC prevention and early detection. In clinical practice, early screening and drug usage control in patients with GERD must be prioritised. Furthermore, dietary supplementation with n-3 PUFAs and proper n-6 PUFA reduction may minimise the prevalence of PC.
Multi-Layered Dual-Input Integrative Attention Model for Path Loss Prediction
Authors: Tikaria Mamta , Saxena Vineeta 
Published: November 2024

Abstract

Path loss perdition significantly influences the strategic placement of base stations within cellular networks. The perdition of path loss using traditional approaches results in extensive field testing which is notably time-consuming. To address such issues, the paper explored the role of machine learning (ML) based approaches for path loss prediction. But in recent research contributions, mostly unmoral systems are used for prediction of path loss. To advance these approaches, the paper presented a bimodal path loss prediction system that integrates environmental data as well as visual information that are extracted from satellite relocation images. The paper presented a multi-layered architecture named as Dual-Input Integrative Attention Model (DIIAM) for path loss prediction. The DIIAM is composed of three major layers, Dual-Input Feature Extraction Layer (DIFEL), Feature Weighted At-tention Layer (FWAL) and Learning Layer (LL). DIFEL extracts features from each input. Environmental or channel parameters are selected by applying data imputation, normalization and relevant feature selection using T-Test and Z-Test. Whereas the relo-cation visual features are extracted by applying pre-trained transfer learning model such as ResNet50. Integration of these steps for dual-input feature extraction. This makes the DIFEL lightweight and requires less computational resources. FWAL used the attention mechanism to generate weighted features. LL layer implement six different learning models such as support vector re-gressor (SVR), Random forest regressor (RFR), Backpropagation Neural Network (BPNN), Long-short term memory (LSTM), Bidirectional LSTM (BiLSTM), and Gated recurrent unit (GRU). The multi-layered and dual-input nature of the proposed DI-IAM effectively process and learn the complex relationships between environmental characteristics and visual features. The simu-lation result was performed on four publicly available datasets for unimodal and bimodal systems. The average RMSE of the proposed DIIAM model was approx. 1.5dB which outperforms better as compared to state-of-the-art methods.
Patterns of Failure after Stereotactic Radiosurgery for Brain Metastases from Small Cell Lung Cancer: Outcomes in the Immunotherapy Era
Authors: Marwaha Alexander S. , Liang Yun , Shepard Matthew J. , Yu Alexander , Karlovits Stephen M. , Wegner Rodney E. 
Published: November 2024

Abstract

Purpose/Objective(s): Small cell lung cancer (SCLC) is known to have high rates of development of brain metastases. Standard treatment has been whole brain radiation therapy (WBRT) but the role for more focused treatment and hippocampal avoidance has arisen in the past decade. In addition, with possible penetration of the central nervous system by more modern immunotherapies, the risk of distant failure may be lower. As such, we reviewed patients at our institution treated with stereotactic radiosurgery (SRS) to look at patterns, locations, and predictors of failure in the brain.
Materials/Methods: A retrospective review and analysis of charts was done on 46 patients treated with SRS (no history of prior WBRT) for their brain metastases from SCLC. Multivariate analysis was used to determine significant prognostic factors influencing survival and local/distant failure. We tracked timing and type of immunotherapy, if any, as well as if patients failed in the hippocampus or required WBRT.
Results: There were 46 patients with 97 total brain metastases treated with SRS in this study. Median number of metastases was 2 (1–5). The median dose of radiation was 20Gy (20–30) in 3 fractions (1–5) for all 97 tumors. 11 patients did not receive immunotherapy, whereas 35 patients had immunotherapy of some sort. Median overall survival (OS) for the entire cohort was 13 months, with a 12 month OS of 59% and 2-year OS of 30%. Cox regression did not reveal any significant predictors of OS, including age, sex, total volume, extracranial disease, KPS, immunotherapy, or number of metastases. 12 month and 24 month local control of disease was 95% and 80%, respectively. There were no significant predictors of local failure including volume, dose, or immunotherapy. 25 of the patients had distant brain failure, with a rate of distant failure of 38% and 64% for 6 and 12 months, respectively. Immunotherapy, number of metastases, total target volume, nor presence of extracranial disease was predictive of distant brain failure. WBRT free survival was also measured and found to be 73% at one year. There were no significant predictors for this measure. Lastly, 5 patients in this cohort showed failure in the hippocampus, where the rate of failure at 6 and 12 months was 16%.
Conclusion: Rates of distant brain failure in SCLC patients after SRS remain similar to those of NSCLC patients in the immunotherapy era. We did not show a decrease in distant failure rate based on immunotherapy use. The rate of hippocampal failure was quite low and should provide reassurance that SRS and techniques such as HA-IMRT can be reasonably used in these patients. Ongoing clinical trials will help provide more definitive answers in this arena.
Prevalence of Urinary Pathogen and Antimicrobial Susceptibility of isolates in cervical cancer patient attending BPKMCH Bharatpur, Chitwan
Authors: sedai Bishnu Ram , Neupane Promish , Nagila Amar , Pant Dhaka Raj , Pandit Prashant , Malla komal , Paudel Rajan , Chapagain Bipin , Regmi sanjib Mani 
Published: November 2024

Abstract

Introduction:
Cervical cancer is one of the many diseases in the wide family of cancers that include abnormal cell development and have the potential to infiltrate or spread to other regions of the body. Most cervical cancer patients are at high risk for urinary tract infections as a result of several treatment modalities, including invasive surgery, chemotherapy, radiation, and immunosuppressive or anticancer medication. Therefore, the purpose of this study was to identify urinary tract infections and test isolates from cervical cancer patients who were treated at BPKMCH Bharatpur, Chitwan, for antibiotic susceptibility.
Methodology:
Urine samples were received from the cervical cancer patients attending BPKMCH, Chitwan. The samples were processed following standard guidelines in the Microbiology Laboratory of B.P. Koirala Memorial Cancer Hospital. Isolates were identified using standard techniques and biochemical tests like catalase, coagulase, oxidase, and sugar utilization in TSI, motility, indole, H2S production in SIM media, citrate utilization and urea hydrolysis. Pure colonies were tested for antimicrobials susceptibility on Mueller Hinton agar (MHA) using Kirby- Baeur disc diffusion method following CLSI guideline 2017.
Results
Of total 350 specimens received from cervical cancer patient, 151 gave significant growth of microorganism which accounts for 43.1%. Among the isolates Escherichia coli had highest predominance accounting 35.9% (n = 54), followed by Klebsiella spp. Among the Gram positive organisms Staphylococcus aureus showed predominance which was 4 times more isolated than CONS. Most of the isolates were resistant to Ampicillin, followed by Cotrimoxazole and Cefixime. Polymyxin B and Imipenem were most effective for all Gram Negative bacilli while Vancomycin and Azithromycin were most effective for Gram positive cocci.
Conclusion
Out of 350 patients, 43.1% had a UTI. Cervical cancer patients are more likely to get UTI as a result of immunosuppressive medication therapy and invasive surgery. As a result, they should be evaluated on a regular basis for the development of UTI, and their treatment should include AST. Such hospital-based study should be conducted to establish empirical therapy of UTI among cervical cancer patients with UTI, as well as to ensure adequate treatment and care.
Evaluation of the Effectiveness of Greater Occipital Nerve Blockade in Menstrual Migraine
Authors: Cetin Guldeniz , Totuk Ozlem , Demir Serkan , Sahin Sevki 
Published: November 2024

Abstract

Objective: This study aimed to compare the short-term prophylactic efficacy of greater occipital nerve (GON) blockade in menstrual migraine (MM) subgroups and evaluate the long-term effects on patients' quality of life.
Methods: In this prospective study, 33 patients diagnosed with MM (15 with pure menstrual migraine [PMM] and 18 with menstrually related migraine [MRM]) received bilateral GON blockade once a month, one week before menstrual bleeding, for three months. Patients were evaluated before treatment (month 0) and after treatment completion (months 3 and 6) using the Visual Analog Scale (VAS), Headache Impact Test-6 (HIT-6), Migraine Disability Assessment (MIDAS), and Beck Depression Inventory (BDI) scores.
Results: MRM patients had a lower age of MM onset (p=0.024), higher headache frequency (p=0.004), and increased medication overuse (p=0.027) compared to PMM patients. After GON blockade, significant improvements were observed in VAS, HIT-6, MIDAS, and BDI scores in both subgroups, with no significant differences between them. The improvement persisted during the medication-free follow-up period (months 3-6). Patients with mild or no depression showed a more substantial increase in quality of life. Patients experiencing a 50% reduction in headache days demonstrated significant improvement in BDI scores.
Conclusion: GON blockade may be an effective option for short-term and long-term prophylaxis in the treatment of MM, reducing the frequency and severity of headaches and improving quality of life and psychological state. Further research with larger patient cohorts and placebo-controlled trials is necessary to validate these findings.