bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in Cervical and Anal Cancer Incidence and Mortality in the United States
Authors: McKinnish Tyler R. , Kuroki Lindsay M. , Schwarz Julie K. , Mazul Angela L. 
Published: December 2024

Objectives
This article describe trends in the incidence and mortality of cervical (CC) and anal (AC) cancers by race and neighborhood socioeconomic status.

Methods
The Surveillance, Epidemiology, and End Results (SEER) database was used to construct a cohort of CC and AC cases from 2006 to 2018. Incidence rates and survival were calculated by race and neighborhood socioeconomic status (nSES). Annual percent change (APC) in incidence was calculated using linear regression, and 5-year overall survival (OS) by the Kaplan-Meier method.

Results
Of the cases, 33,487 CC and 16,018 AC cases were identified. Women of low nSES were nearly 4 times more likely to be diagnosed with cervical cancer than those of high nSES. Cervical cancer incidence declined marginally in all groups except for low nSES women who are White (APC 0.0). Women who are Black had lower 5-year OS than their nSES counterparts of other races (most notably for Black women of low nSES 53% vs White 63%). Similarly, the low nSES AC cohort contained nearly 3 times the number of diagnoses as the high nSES cohort. AC incidence increased most in women who are White (APC 1.8 and 2.2 for low and high nSES) and men who are Black and low nSES (APC 3.3). Five-year OS was lowest for men who are Asian American and Pacific Islander (40% and 50% for low and high nSES, respectively).

Conclusions
These data suggest a strong correlation between nSES, race, and their interaction on the incidence and survival trends of HPV-related disease and highlight inconsistent effects between cervical and anal cancers.
Characterizing the Frequency and Severity of Clinical Signs and Architectural Changes in Vulvar Lichen Sclerosus
Authors: Ngo Madeline , Chang Hannah R. , Mauskar Melissa M. 
Published: December 2024

Abstract
Untreated vulvar lichen sclerosus (VLS) can have a significant negative impact on quality of life, increase the risk of neoplastic transformation, and lead to irreversible architectural changes. Early and appropriate management using ultrapotent topical steroids is crucial to alleviate symptoms and prevent long-term complications. This study aimed to characterize clinical signs and architectural changes of 364 VLS patients at a tertiary center. The majority of the patients had sought care from ≥1 provider previously, were referred by a physician, had undergone prior vulvar biopsies, and had previously tried topical steroids. The authors observed predominantly mild clinical signs alongside more frequent severe architectural changes. These findings highlight the increased need for nuanced clinical evaluation, sufficient lifelong maintenance therapy to prevent architectural changes, and improved clinical scoring systems to differentiate between active VLS disease and residual damage.
Oral Capsule FMT Combined With Bezlotoxumab Is a Successful Rescue Protocol Following Failure of FMT Alone in the Treatment of Recurrent C. difficile Infection
Authors: Hoeg Austin , Kuchma Nataliia , Krane Andrew , Graiziger Carolyn , Thomas Juana , Kelly Colleen R. , Khoruts Alexander 
Published: December 2024

Goals:
Evaluate the benefit of adding bezlotoxumab to repeat fecal microbiota transplantation (FMT) in patients with recurrent Clostridioides difficile infections after the failure of FMT alone.

Background:
The initial failure of FMT in breaking the cycle of recurrent Clostridium difficile(C. difficile) infections is associated with a greater risk of subsequent failure. Our previous analysis showed that FMT failure is associated with delayed repair of fecal microbiota at 1 week after administration. We hypothesized that increasing the symptom-free interval by adding bezlotoxumab would improve the outcomes of a second FMT.

Study:
A new rescue protocol that combines FMT with bezlotoxumab for patients who previously failed FMT alone was implemented in 2 academic medical centers. The clinical outcomes of a new protocol were captured in a prospective registry. The results were compared in a retrospective analysis of clinical outcomes of prior experience with repeat FMT by itself. All FMT preparations were standardized for dose. Bezlotoxumab administration was synchronized temporally with the second FMT to maximize its duration of action.

Results:
Our historical cure rate of second FMT in treatment of recurrent C. difficile infection was 48% (15/31 patients). Addition of bezlotoxumab to the second FMT resulted in a cure rate of 89% (24/27 patients).

Conclusions:
Addition of bezlotoxumab markedly improved the cure rate of the second FMT following initial FMT failure. The rationale for the protocol design highlights the importance of understanding the pharmacokinetics of both bezlotoxumab and FMT. Similar principles may apply to other live biotherapeutic products that are becoming available for prevention of C. difficile infection recurrence.
Goals of chronic obstructive pulmonary disease management: a focused review for clinicians
Authors: Raghavan Sairam , Hatipoğlu Umur , Aboussouan Loutfi S. 
Published: December 2024

Purpose of review
The diagnosis of chronic obstructive pulmonary disease (COPD) encompasses heterogeneous pathophysiological mechanisms which can shape an individual patient's experience. This paper reviews available therapeutic options for the clinician intending to individualize care toward patient goals.

Recent findings
The contemporary targeted interventions for COPD include the novel phosphodiesterase inhibitor ensifentrine, the interleukin-4 receptor (IL4R alpha subunit) antibody dupilumab, augmentation therapy for alpha-1 antitrypsin deficiency. Other interventions promoting physical and mental well being include re-envisioned pulmonary rehabilitation, self-management, targeting of comorbidities such as sarcopenia, and virtual health coaching interventions to expand patient access. Opioids did not relieve dyspnea and did not change total step count.

Summary
Advances in precision therapy are complemented by the discovery of novel pathophysiology pathways and behavioral and rehabilitation interventions as a holistic view of COPD management emerges. The management of COPD continues to evolve with new tools including precision medicine and individualized care. Comorbidities remain important determinants of health, yet their prevalence and impact are underestimated.
Preoperative blood tests provide diagnostic and prognostic information about patients with hepatocellular carcinoma
Authors: Kostakis Ioannis D. , Kotelis Nikolaos , Safavi Danial , Iype Satheesh 
Published: December 2024

Introduction
Our aim was to assess parameters derived from preoperative blood tests as diagnostic or prognostic markers in patients with operable hepatocellular carcinoma (HCC).

Methods
We included 210 patients who underwent liver resection as the first treatment for suspected hepatocellular adenoma (HCA) or HCC (January 2010–December 2022). Parameters originated from preoperative complete blood count and biochemical blood tests were examined for associations with clinicopathological parameters and survival.

Results
There were 31 cases of HCA and 179 cases of HCC. Fibrosis-4 index (FIB-4)≥0.77 provided the best diagnostic accuracy for differentiating between HCA and HCC [area under the curve: 0.914, P < 0.001, sensitivity: 93.8%, specificity: 82.8%, positive predictive value (PPV): 96.9%, negative predictive value (NPV): 69.9%]. Patients with T2–T4 tumours had higher levels of aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT) (P < 0.001), liver function tests index (P = 0.005), platelets-liver function tests index (PLFTI) (P = 0.011), and α-fetoprotein (AFP) (P < 0.001), but the diagnostic accuracy was mediocre. Patients with moderately or poorly differentiated tumours had higher levels of FIB-4 (P = 0.023), and AFP (P = 0.001), providing high PPV (89.4 and 95.1%, respectively). Albumin to alkaline phosphatase ratio (ALB/ALP)>0.508 [hazard ratio (HR): 0.501, P = 0.009], FIB-4>1.41 (HR: 2.272, P = 0.007), PLFTI>0.087 (HR: 1.849, P = 0.016), and AFP>3.1 (HR: 3.066, P = 0.006) provided statistically significant results in relation to disease-free survival, and ALB/ALP>0.389 (HR: 0.505, P = 0.036) provided statistically significant results in relation to overall survival.

Conclusion
Preoperative blood tests provide useful information in treatment-naive surgical candidates with suspected HCC regarding distinguishing from HCA, tumour differentiation, and risk of disease recurrence and death.
Role of immunotherapy in managing cancers prior to liver transplantation
Authors: Bredin Philip , Galvin Zita , O’Kane Grainne M. 
Published: December 2024

Purpose of review
Immune checkpoint inhibitors (ICIs) have transformed the treatment landscape in advanced hepatocellular carcinoma and increasingly are being evaluated in earlier stage disease. Herein we explore the role of ICIs pre-liver transplant for liver cancers.

Recent findings
Given the high response rates with combination approaches including locoregional treatments, more patients with liver confined disease, without vascular invasion, who have received ICIs are now being rendered eligible for potential liver transplant. This opportunity to expand the population who may benefit from liver transplant has also come with challenges recognizing the global shortage of organs. Post-liver transplant immunosuppression potentially competes with the immune-stimulating effects of ICIs and graft rejection has been a concern. ICIs may provide an opportunity to maintain patients on the waiting list but an understanding of who is likely to benefit is needed, to circumvent possible toxicities. In addition, ICIs are now considered standard of care, in combination with chemotherapy, for advanced cholangiocarcinoma, where the role of liver transplant is evolving.

Summary
As the eligibility criteria globally for liver transplant in the setting of malignancy continues to expand, the integration of ICIs becomes increasingly important.
Risk Factors and a Prediction Model for Hemorrhagic Transformation in Acute Ischemic Stroke With Atrial Fibrillation
Authors: Fu Wang , Zhang Jun , Bi Qianqian , Lu Yanqin , Liu Lili , Zhou Xiaoyu , Wang Jue , Wang Feng 
Published: December 2024

Objectives:
To identify the risk factors of hemorrhagic transformation (HT) and to establish a prediction model for HT in patients with acute ischemic stroke (AIS) and atrial fibrillation (AF).

Methods:
From January 2015 to December 2018, patients with AIS and AF were enrolled. Demographics, lesion features, and blood test results were collected. Univariate and multivariate logistic regression analyses were used to identify the independent risk factors of HT. The receiver operating curve (ROC) curve was utilized to determine the cutoff values and the efficiency of the variables. A predictive model was subsequently developed based on the identified independent risk factors.

Results:
A total of 259 patients were included. Age [odds ratio (OR): 1.094; 95% CI: 1.048-1.142; P<0.001], LDL-C (OR: 0.633; 95% CI: 0.407-0.983; P=0.042), uric acid (OR: 0.996; 95% CI: 0.991-0.999; P=0.031), Alberta Stroke Program Early CT Score (ASPECTS) (OR: 0.700; 95% CI: 0.563-0.870; P<0.001), cerebral cortex infarction (OR: 0.294; 95% CI: 0.168-0.515; P<0.001), and massive cerebral infarction (OR: 3.683; 95% CI: 3.025-5.378; P<0.001) were independently associated with HT. We have developed a model incorporating these variables. The area under the curve of the predictive model was 0.87 (95% CI: 0.83-0.92), demonstrating satisfactory predictive ability with a sensitivity of 83.5% and a specificity of 76.4%.

Conclusions:
Our predictive model, which integrates age, LDL-C, uric acid, ASPECTS, cerebral cortex infarction, and massive cerebral infarction, can be used to predict HT after AIS in patients with AF, thereby facilitating the mitigation of adverse outcomes.
Psychosocial factors account for a proportion of the difference in cognitive performance between persons with and without HIV
Authors: Dreyer Anna Jane , Le Roux Celine , Thomas Kevin G.F. , Sabin Caroline A. , Winston Alan , Khoo Saye , Joska John A. , Nightingale Sam 
Published: December 2024

Objective:
To investigate whether psychosocial factors account for a proportion of the difference in cognitive performance between persons with and without HIV.

Design:
Cross-sectional study of 273 participants (178 persons with HIV) from a low income area of Cape Town, South Africa,

Methods:
Participants completed comprehensive cognitive testing (7 domains) and 12 psychosocial measures (5 current: income, occupation, assets, accommodation, depressive symptoms, 7 from childhood: assets, quality of education, exposure to childhood trauma and violence, primary caregiver occupation and highest level of education), as well as demographic measures standard in cognition studies (age, sex, years of education). We investigated the HIV association with global cognitive performance after adjustment for standard demographic variables, exploratory psychosocial variables, and balancing characteristics of those with and without HIV using propensity score modelling.

Results:
Persons with HIV had significantly lower scores than persons without HIV in 8/12 psychosocial variables. Of these, 7/12 significantly predicted global T-score. In unadjusted regression, HIV status was associated with a reduction in global T-score of 3.72 units. Adjustment for standard variables, reduced the effect of HIV on global T score by 26.9% to 2.72, additional adjustment for psychosocial variables reduced by 40.3% to 2.22, and adjustment for propensity scores by 42.7% to 2.13.

Conclusions:
Persons with HIV in this setting have lower psychosocial indices, both current and in childhood, which are associated with lower cognitive test performance as an adult. This is incompletely mitigated by adjustments for standard demographic variables which risks overestimation of cognitive impairment on a population level.
The Snails: A Simple Technique for Reduction of Frontal Bossing in Children With Scaphocephaly
Authors: Stella Irene , Hayward Richard , Klein Olivier 
Published: December 2024

Objective:
Scaphocephaly represents the most frequent single-suture craniosynostosis, with a male prevalence. In many cases, prominent frontal bossing (sphenocephaly) is the major aesthetic concern, typically in school-aged children. This aspect is also usually found in patients with late presentation (after 1 year of age). Several techniques have been described for the correction of frontal bossing in these patients, most involving wide frontal bone exposure and reconstruction. The authors describe a different, less invasive technique, useful in severe sphenocephalic patients, independently from age.

Methods:
Thirteen children aged from 3.5 to 22 months were operated on in our institution between 2016 and 2023 using the snails technique, in addition to the treatment for the craniosynostosis itself. The technique is described, consisting in spiral frontal impacted craniotomies. Transfusional rate and duration of surgery are reported and compared with 15 randomly selected patients treated at the same time without Snails technique. Postoperative follow-up is almost 1 year.

Results:
Cosmetic postoperative results, based on parental and clinician’s satisfaction as well as on radiographic and photographic assessment, showed rapid improvement of frontal bossing, which remains stable during years. Transfusion rate during scaphocephaly repair with Snails technique is not different from control, even if time of procedure is longer.

Conclusion:
Among several techniques described to directly correct frontal bossing, the snail technique is more simple and less invasive, avoiding further craniotomies over the superior sagittal sinus, and does not imply consistent blood loss.
The Impact of Acupuncture on Pain Intensity, Nausea, and Vomiting for Laparoscopic Cholecystectomy: A Meta-analysis Study
Authors: Tang Xi , Qu Shijie 
Published: December 2024

Background:
Acupuncture may have some potential in pain relief after laparoscopic cholecystectomy, and this meta-analysis aims to explore the impact of acupuncture on pain intensity, nausea and vomiting for patients undergoing laparoscopic cholecystectomy.

Methods:
PubMed, EMbase, Web of science, EBSCO, Cochrane library databases, CNKI, VIP, and Wangfang were systematically searched, and we included randomized controlled trials (RCTs) assessing the effect of acupuncture on pain control for laparoscopic cholecystectomy.

Results:
Five RCTs and 366 patients were included in the meta-analysis. Overall, compared with control intervention for laparoscopic cholecystectomy, acupuncture was associated with significantly reduced pain scores at 6 hours [mean difference (MD)=−0.86; 95% CI=−1.37 to −0.34; P=0.001, 2 RCTs) and pain scores at 8 to 10 hours (MD=−0.71; 95% CI=−1.13 to −0.28; P=0.001, 2 RCTs), decreased incidence of nausea (odds ratio=0.10; 95% CI=0.03-0.34; P=0.0003, 3 RCTs), and vomiting (odds ratio=0.11; 95% CI=0.01-0.85; P=0.03, 3 RCTs), but demonstrated no obvious impact on pain scores at 12 to 24 hours (MD=−0.38; 95% CI=−1.02 to 0.27; P=0.25, 2 RCTs).

Conclusions:
Acupuncture may be effective to reduce pain intensity, nausea, and vomiting for laparoscopic cholecystectomy.
Pain Following Obstetric Anal Sphincter Injuries: A Prospective Cohort Study
Authors: Fazeli Yasamin , Lua-Mailland Lannah L. , Yao Meng , Wallace Shannon L. 
Published: December 2024

Importance
Studies characterizing pain and pain management following obstetric anal sphincter injury (OASI) are limited.

Objectives
Our primary objective was to analyze time to pain resolution following OASI. Secondary objectives included analyzing pain severity, location, triggers, and patterns of pain medication use.

Study Design
This was a prospective cohort study of patients with OASIs seen in a postpartum care clinic at a tertiary referral center between 2017 and 2022. We analyzed data on pain resolution, visual analog scale pain scores, pain triggers, pain location, and pain medications.

Results
A total of 362 patients were included in this study. In the Kaplan-Meier estimator, 58.5% of patients showed resolution of pain by 3 months following their initial postpartum care clinic visit, and 73.3% showed resolution of pain by 6 months. The median months to pain resolution was 2.2 (95% confidence interval: 1.6–3.0) for patients with third-degree lacerations and 2.3 (95% confidence interval: 1.6–6.8) for patients with fourth-degree lacerations. Visual analog scale scores showed the most improvement in the first 2 months. Common pain triggers included sitting and bowel movements in the first few months, as well as intercourse during later recovery. Pain location varied over time; bilateral pain in the levator ani muscles and obturator internus were most prevalent at each time point. Pain appeared to be predominantly managed by acetaminophen and ibuprofen.

Conclusions
Half of patients who experience OASI will have pain resolution by 2-3 months postpartum. Most patients will have resolution of their pain by 6 months postpartum.
Transcutaneous Tibial Nerve Stimulation for Urge Incontinence: A Randomized Clinical Trial
Authors: Shah Nemi M. , Lukacz Emily S. , Ferrante Kimberly L. , Menefee Shawn A. 
Published: December 2024

Importance
Overactive bladder is a distressing syndrome that significantly affects quality of life. Transcutaneous tibial nerve stimulation (TTNS) has been proposed as a home-based, patient-centered therapy that could improve access to treatment for this condition.

Objective
We aimed to determine the efficacy of 12 weeks of TTNS versus sham therapy in reducing symptomatic bother in ambulatory women with urgency urinary incontinence.

Study Design
This was a double-masked, sham-controlled randomized trial. The primary outcome was the change in Overactive Bladder Questionnaire scores. Secondary outcomes included those with 50% or greater reduction in urgency incontinence episodes on 3-day voiding diaries and Patient Global Impression of Improvement.

Results
One hundred women were randomized (65 intervention, 35 sham) and included in analysis. Both groups experienced clinically meaningful improvement in Overactive Bladder Questionnaire scores postintervention from baseline, which was not significant between groups (symptom severity: intervention −19.5 ± 20.2 vs sham −19.4 ± 20.4, P = 1.0; health-related quality of life −16.6 ± 18.5 vs −13.8 ± 16.8, P = 0.5). In the TTNS group, 58.8% of women achieved 50% or greater reduction in urgency incontinence episodes versus 41.7% of women in the sham group (P = 0.2), and 25% versus 18% were “much” or “very much improved” (P = 0.2). A sensitivity analysis confirmed these findings.

Conclusions
Clinically meaningful reductions in overactive bladder symptoms were observed in both TTNS and sham therapy without significant differences between groups; however, a trend toward greater reduction in incontinence episodes and overall impression of improvement was noted in the active treatment. The therapeutic benefit from regularly connecting with a clinician should be considered when developing new therapies.
Oceanic and ionospheric tidal magnetic fields extracted from global geomagnetic observatory data
Authors: Tyler Robert H. , Trossman David S. 
Published: December 2024

Ocean tide generated magnetic fields contain information about changes in ocean heat content and transport that can potentially be retrieved from remotely sensed magnetic data. To provide an important baseline towards developing this potential, tidal signals are extracted from 288 land geomagnetic observatory records having observations within the 50-year time span 1965–2015. The extraction method uses robust iteratively reweighted least squares for a range of models using different predictant and predictor assumptions. The predictants are the time series of the three vector components at each observatory, with versional variations in data selection and processing. The predictors fall into two categories: one using time-harmonic bases and the other that directly use lunar and solar ephemerides with gravitational theory to describe the tidal forces. The ephemerides predictors are shown to perform better (fitting more variance with fewer predictors) than do the time-harmonic predictors, which include the traditional ‘Chapman–Miller method’. In fitting the oceanic lunar tidal signals, the predictants with the highest signal/noise involve the ‘vertical’ magnetic vector component following principle-component rotation. The best simple semidiurnal predictor is the ephemeris series of lunar azimuth weighted by the inverse-cubed lunar distance. More variance is fitted with predictors representing the lunar tidal potential and gradients calculated for each location/time.
This article is part of the theme issue ‘Magnetometric remote sensing of Earth and planetary oceans’.