bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proximal median nerve neuropathy: electrodiagnostic and ultrasound findings in 62 patients
Authors: Shields Lisa B. E. , Iyer Vasudeva G. , Zhang Yi Ping , Shields Christopher B. 
Published: December 2024

ObjectivesProximal median nerve (PMN) neuropathies are caused by lesions proximal to the carpal tunnel, which include the forearm, elbow, upper arm, and brachial plexus. Differentiating between carpal tunnel syndrome and PMN neuropathies is important to guide management and is based on clinical, electrodiagnostic (EDX), and ultrasound (US) findings. This study describes the clinical, EDX, and US features in 62 patients with PMNs.MethodsAll patients underwent EDX studies, and 52 (83.9%) had a US study. The patients were assigned to one of the following four localization zones of PMN neuropathies based on clinical and EDX criteria: Zone 1: extends from the fascicles in the brachial plexus contributing to the median nerve to the innervation of the pronator teres (PT); Zone 2: distal to the branch to the PT and proximal to the origin of the anterior interosseous nerve (AIN); Zone 3: involves the origin of the AIN; and Zone 4: distal to the origin of the AIN and proximal to the carpal tunnel. The localization was based on the pattern of muscle weakness, topography of EMG abnormalities, and US study findings.ResultsThe anatomical locations of the PMN neuropathies based on clinical, EDX, and US findings were as follows: Zone 1 in 38 patients (61.3%), Zone 2 in 6 patients (9.7%), Zone 3 in 7 patients (11.3%), and Zone 4 in 11 patients (17.7%). The most common etiology among all 62 patients was iatrogenic injury (30 [48.4%]), followed by non-iatrogenic trauma (20 [32.2%]). The following EDX findings were noted: prolonged distal motor latency (29 [46.8%]), decreased motor nerve conduction velocity in the forearm (22 [35.5%]), low amplitude or absent compound muscle action potentials (50 [80.6%]), and abnormal or absent sensory nerve action potentials (50 [80.6%]). Of the 52 (83.9%) patients who underwent US studies, a total of 22 (42.3%) patients showed an increased cross-sectional area of the median nerve. A neuroma was observed in 9 patients (17.4%).ConclusionIt is often possible to localize the site of the median nerve involvement and gain insight into the underlying cause based on clinical and EMG findings, but in certain cases, a US study may be necessary to confirm the location.
Comparative analysis of the clinical aspects of colorectal cancer in young adult and older adult patients in Saudi Arabia
Authors: Aldriwesh Marwh G. , Aljaian Amer R. , Alorf Khalid M. , Bayounis Mohammed A. , Alrayani Yazeed H. , Philip Winnie , Algarni Mohammed , Alselaim Nahar A. , Alotibi Raniah S. 
Published: December 2024

IntroductionRecent studies have shown an increase in the prevalence of early-onset colorectal cancer (CRC) in people aged 20–49 compared to those aged 50–74, with a more rapid increase in the younger age groups. Poorly differentiated, left-sided, and rectal tumors were more common in young adults than in older adult CRC patients. We aimed to improve the understanding of early-onset CRC and to guide primary care physicians on strategies to mitigate its impact.MethodsAdult patients with CRC identified within 2015–2022 were recruited and divided into young adult-onset (CRC identified at age ≤49 years) and older adult-onset (CRC identified at age ≥50 years). Clinical data were retrieved from electronic medical records, then analyzed. Multivariable analyses were performed to predict the CRC prognosis in both age groups.ResultsThe study cohort had 530 patients categorized into young adult (n=98; 18.5%) and older adult (n=432; 81.5%). Higher proportions of family histories of CRC, other malignancies, and inflammatory bowel disease in the young adult group were observed (P&lt;0.05). Gastrointestinal symptoms mainly abdominal pain and nausea were more often identified in the young adults. Mucinous adenocarcinoma, signet ring cells, and poorly differentiated tumors were higher in the young adults (P&lt;0.05). Lymphovascular invasion was an independent predictor for advanced stage CRC (AOR 8.638, 95%CI 2.152–34.673, P=0.002 for young adults and AOR 21.757, 95%CI 10.025–47.219, P=0.001 for older adults). Further, the mucinous (AOR 3.727, 95%CI 1.937–7.173, P=0.001 for young adults and AOR 3.534, 95%CI 1.698–7.354, P=0.001 for older adults) and lymphovascular invasion (AOR 3.371, 95%CI 2.107–5.393, P=0.001 for young adults and AOR 3.246, 95%CI 1.910–5.517, P=0.001 for older adults) were independent predictors for recurrence/late metastasis in both age groups.ConclusionWe recommended to raise awareness among healthcare providers of the importance of lowering the threshold of suspicion in young people presenting with worrisome gastrointestinal symptoms. Our findings suggested the importance of reconsidering the current CRC screening guidelines to lower the threshold of the recommended starting age.
Cutaneous adverse events due to checkpoint inhibitors – a retrospective analysis at a tertiary referral hospital in Switzerland 2019-2022
Authors: Furrer-Matcau Clara , Sieber Chloé , Lehnick Dirk , Brand Christoph Urs , Hug Balthasar 
Published: December 2024

IntroductionCheckpoint inhibitors are increasingly important in anti-cancer treatment. Therefore, knowledge of immune-related cutaneous adverse events (ir-cAE) is crucial for therapy management and continuation.ObjectiveThe study aimed to analyze the incidence of cutaneous adverse events caused by checkpoint inhibitor therapy, including their clinical presentation, management, and impact on further treatment.MethodsThis is a descriptive, monocentric retrospective study that uses data from the electronic health record system at a tertiary referral hospital in Central Switzerland from September 2019 to September 2022. The electronic health records of patients who received a therapy with checkpoint inhibitors were examined for age, sex, type of immunotherapy, time to occurrence of ir-cAEs, characteristics of the ir-cAEs, the treatment approach, and the continuation or cessation of the therapy due to ir-cAEs.ResultsOut of 431 patients, for 131 patients (30.4%) at least one ir-cAE event was documented. In particular, 109 (25.3%) experienced pruritus and 61 (14.2%) showed a maculopapular exanthema. The severity of the ir-cAE was mild in 88 patients (67.2% out of those with ir-cAEs). Ir-cAE were observed in 10 out of 20 patients (50%) treated with ipilimumab/nivolumab and in 15 out of 24 (62.5%) treated with durvalumab. In 15 patients (3.5%), checkpoint inhibitor therapy had to be discontinued due to cutaneous side effects.ConclusionsThis study showed that approximately one third of the patients experienced ir-cAEs. The most frequently observed ir-cAEs were pruritus, maculopapular exanthema and xerosis cutis. In general, the dermatological manifestations are mild and responsive to topical treatment or self-limiting with no requirement for treatment interruption.
Genome-wide identification and characterization of circular RNAs for exogenous trehalose-mediated heat stress responses in tea plants (Camellia sinensis)
Authors: Zheng Shizhong , Liu Chufei , Zhou Ziwei , Xu Liyi , Ruan Biyuan , Chen Xiaohui 
Published: December 2024

BackgroundHeat stress is one of the main environmental factors limiting the growth, yield and quality of tea plants (Camellia sinensis). Trehalose involved in plant responses to multiple adverse environmental stresses, including heat stress. However, the roles of circular RNAs (circRNAs) and their involvement in the trehalose response to heat stress remain unknown.MethodsIn this study, circRNA-sequencing was performed to analyze the characteristics of circRNAs in trehalose-induced responses to heat stress in tea plants. Kyoto Encyclopedia of Genes and Genomes enrichment analysis was used to determine the potential function of circRNAs, and the expression of differentially expressed circRNAs (DECs) and their host genes related to Non-homologous end-joining (NHEJ) and Homologous recombination (HR) were analyzed. To further explore the effect of trehalose on DNA double strand breaks (DSBs), the reactive oxygen species (ROS) contents, specially hydrogen peroxide (H2O2) and superoxide anion (O2−), in heat-stressed tea plants were investigated.ResultsA total of 11402 circRNAs were detected from CK, T (heat stress) and TT (heat stress + trehalose) samples. Among these circRNAs, 573, 620 and 550 circRNAs were identified as differentially expressed in the T vs. CK, TT vs. CK and TT vs. T comparison groups, respectively. The host genes of DECs were enriched in NHEJ and HR pathways, implying a critical role of circRNAs in DSBs repair. The expression level of circKu70-1 and circKu70-3 showed positive correlations with their host gene, ATP-dependent DNA helicase II 70 kDa subunit (CsKu70), while circKu70-2 exhibited an opposite expression trend. Similarly, circRad50 displayed a negative correlation with its host gene, DNA repair protein RAD50 (CsRad50). Notably, the expression of CsKu70 and CsRad50, which are crucial for initiating DSB repair, was decreased in the trehalose-treated (TT) samples. This finding suggests that trehalose may play a role in modulating the expression of circRNAs and their host genes involved in NHEJ and HR pathways, ultimately contributing to reduced DSB damage during heat stress. Moreover, exogenous trehalose significantly reduced H2O2 and O2− contents in tea plants under heat stress, suggesting that trehalose could mitigate heat-induced damage resulting from ROS overproduction.ConclusionOur results indicated that circRNAs play a crucial role in maintaining genome integrity. Specifically, they may function as molecular hubs that respond to changes of the levels of H2O2 and O2− induced by trehalose, and subsequently regulate the DSBs mediated by their host genes. This, in turn, further impacts genome stability, ultimately enhancing heat tolerance in tea plants. Our findings provided new insight into the potential applications of trehalose as an agrochemical in tea plants and revealed the potential role of circRNAs in tea plants heat tolerance.
Seeking professional help for sleep-related complaints
Authors: Rauch Lisa , Schneider Torsten , Wendt Claus 
Published: December 2024

IntroductionSleep-related complaints affect a significant proportion of the adult population in many societies. Despite the prevalence of symptoms and potential secondary and comorbid conditions, the utilization of professional help is quite low. The underlying reasons for this phenomenon have yet to be adequately investigated. To address this gap, we expand the conventional explanatory models to encompass the perceived cause as an explanatory factor. This is aimed to contribute to a better understanding of the help-seeking behavior and to create the basis for possible measures.Materials and methodsThe empirical basis of the study is a quantitative data set collected in Germany in 2015 comprising 3,000 individuals between the ages of 40 and 75. Of these individuals, 761 reported experiencing sleep-related complaints. In our logistic regression, the binary dependent variable is whether professional help has already been sought. In addition to the factors included in the behavioral model of health service use, we utilize the perceived cause as a predictor, categorizing the variable as follows: exclusively mental, partially mental, and not mental.ResultsOur analysis shows that individuals who attributed their sleep disturbances solely to their psyche were significantly less likely to seek professional help (AME: −0.158**). These differences remain significant after controlling for the severity of the complaints, their duration, and other covariates (AME: −0.117**). The data also suggest that this group is more likely to seek self-help through medication.DiscussionThe results indicate the importance of focusing healthcare systems and public health policy on sleep-related complaints and their management. The aim is not only to alleviate sleep complaints, but also to reduce the risk of secondary diseases and to identify possible comorbidities. Additionally, it is a factor in reducing safety risks for the general public. Therefore, various measures should be implemented, including destigmatizing, improving health literacy, a more comprehensive offer of cognitive-behavioral therapy (CBT-I), and a more thorough examinations by physicians.
Association of burnout and working environment conditions in respiratory care professionals in Saudi Arabia: a cross-sectional study
Authors: Al-Anazi Saad , Habib Syed Shahid , Al-khlaiwi Thamir , Alodhayani Abdulaziz Alhomaidi , Alotaibi Abdulmueen , Aldulejan Saja , Al Safadi Sufana , Alshammari Fahad Saad , Marar Aqeelah , Alrashdi Afaf , Almutairi Alhanouf G. , Alshahrani Mohammed 
Published: December 2024

IntroductionBurnout is a pervasive issue in healthcare, and it impacts both the wellbeing of healthcare professionals and the quality of patient care. This study examines factors associated with burnout and working environment among respiratory therapists in Saudi Arabia.MethodsA structured questionnaire was used to collect data from respiratory therapists. We collected 315 questionnaires including burnout assessment. Multinomial logistic regression was used to assess the relationship between various variables and the likelihood of experiencing severe burnout and personal achievement problems.ResultsMarital status was a significant predictor of severe burnout (p = 0.001), with single individuals having 8.2 times higher odds than married individuals. Working longer than 44 h per week was associated with a 19.3-fold increase in the odds of severe personal achievement issues compared to those working 40–44 h per week (p &lt; 0.001). Age, gender, living arrangements, education, employment status, and salary level were not significant predictors of severe burnout or personal achievement issues.Conclusion with discussionThe findings highlight that marital status and extended working hours are significantly associated with increased burnout among respiratory therapists in Saudi Arabia. These results underscore the importance of social support networks and work-life balance in mitigating burnout risks within this profession.
Prevalence of measurable residual disease in patients with refractory/relapsed multiple myeloma who reached complete response: a cross-sectional multicentric study
Authors: Neves Manuel , Gerivaz Rita , Esteves Graça , Bergantim Rui , Ferreira Gisela , Coelho Henrique , Afonso Celina , Duarte Delfim , Neves Anabela , Silva Helena Matos , Caetano Joana , Jaime Rita , Geraldes Catarina , Lúcio Paulo 
Published: December 2024

BackgroundMultiple myeloma (MM) is an incurable hematologic malignancy, and even though the complete response (CR) rate has been growing, a high percentage of patients continues to relapse. Recent research showed that most relapses may be related to the persistence of measurable residual disease (MRD). In this study, we intended to evaluate the MRD status in MM patients who reached CR in their second or third lines of treatment.MethodsThis was a cross-sectional, multicentre, non-interventional study to describe the MRD status in patients with relapsed or refractory MM (rrMM), with documented CR; adult male and female patients, from 11 Portuguese sites, in their second or third line of treatment were included. Bone marrow MRD was assessed through next-generation flow cytometry (NGF) technology.ResultsAmong the 68 subjects who gave informed consent, 48 were considered eligible for the study. Of the 48 subjects with confirmed CR, 31 (64.6%) had undetectable MRD levels. The incidence of undetectable MRD was lower in International Staging System (ISS) III patients compared with ISS I/II patients (60% vs. 70.8%; p = 0.45), and lower in patients treated without daratumumab-containing regimens compared with those treated with daratumumab-containing regimens (57.1% vs. 75.0%; p = 0.30). Notably, despite the small sample size, the incidence of undetectable MRD was significantly lower in patients with high-risk cytogenetics compared to those with standard risk (33.3% vs. 76.0%; p = 0.04).DiscussionOur results highlight the possibility of achieving undetectable MRD in the rrMM setting, especially in earlier stages and with highly effective protocols. We expect that this work leverages the implementation of larger real-world evidence studies in rrMM patients, in which MRD may also be defined as a primary endpoint.
Fabrication of a novel “all in one glove”- a functional tool for oral hygiene maintenance and the assessment of its effectiveness on plaque control in spastic cerebral palsy patients
Authors: Palanisamy Sucharitha , Cholan Priyanka , Parthasarathy Harinath , Tadepalli Anupama 
Published: December 2024

Background &amp; objectiveSpastic Cerebral Palsy (CP) is a neurological disorder from non-progressive brain injury or malformation during development, severely impairing movement, coordination, reflexes, posture, balance, and motor skills. Individuals with spastic CP experience limb spasticity, complicating tasks like precise gripping, particularly with toothbrushes. This study proposed a novel “all-in-one glove” for oral hygiene, assessing its efficacy and comparing it to conventional toothbrushes for spastic CP patients.Methods &amp; materialsThis randomized controlled trial was conducted on 30 clinically diagnosed spastic CP patients with Group 1 consisting of 15 Subjects with clinically diagnosed spastic CP with generalized gingival diseases using conventional oral hygiene techniques with weekly oral hygiene reinforcement and Group 2 consisting of 15 Subjects with clinically diagnosed spastic cerebral palsy with generalized gingival diseases using the novel “all in one glove” method for oral hygiene maintenance with weekly oral hygiene reinforcement. The Clinical Parameters assessed includes Full mouth plaque scores, Full mouth bleeding scores and OHI scores recorded at baseline, 3 and 6 months.ResultsA statistically significant reduction was observed in Full-mouth Plaque, Bleeding, and Oral Hygiene Index (OHI) scores in both the groups (48.87% &amp; 43.285%, 31.57% &amp; 26.66%, 57.29% &amp; 47.37% respectively). The Group 2 exhibited a marginally higher percentage reduction in all clinical parameters compared to the Group 1 at the measured time points.ConclusionThe utilization of the “All in one glove” has improved the effectiveness of oral hygiene maintenance and gingival health in spastic CP individuals.
Clinical Trial Registration[ClinicalTrials.gov], identifier, [REF/2022/06/055641].
NUTRITION EDUCATION MEDIA FOR DIABETES MELLITUS PATIENTS: VIDEO OF DAFTAR BAHAN MAKANAN PENUKAR (DBMP)
Authors: Nuswantari Atika , Dewi Yulia Lanti Retno , Rahardjo Setyo Sri 
Published: December 2024

Prevalensi penderita diabetes melitus (DM) di Jawa Timur menurut Survei Kesehatan Indonesia tahun 2023 meningkat (0,1%) dari sebelumnya tahun 2018, yakni 2,7%. Penelitian ini bertujuan untuk mengembangkan media daftar bahan makanan penukar sebagai media edukasi diet DM pada penderita DM. Penelitian ini menggunakan metode Research and Development (R&D) dengan model Analyze, Design, Development, Implementation, Evaluation (ADDIE) untuk mengembangkan media edukasi dan pada tahap implementation dilakukan dengan metode quasy experimental dengan rancangan pre post-test with a control group. Penelitian ini melibatkan partisipasi tiga validator ahli dan 10 penderita DM sebagai calon pengguna. Pengumpulan data melalui wawancara dan kuesioner penilaian media. Jumlah subjek pada tahap implementation terdiri atas 40 penderita DM. Analisis data menggunakan teknik deskriptif. Hasil penilaian kelayakan media oleh ahli diperoleh skor rata-rata 91.03% dengan kategori sangat layak dan uji coba media pada kelompok calon pengguna diperoleh skor rata-rata 92.5% dengan kategori sangat layak. Video DBMP dapat digunakan sebagai media edukasi gizi diet DM pada penderita DM. Uji beda skor pengetahuan diet DM menggunakan analisis statistik Paired Sample T-Test. Dari hasil penelitian diperoleh nilai p=0.031 pada kelompok intervensi di tahap evaluation dan nilai p=0,648 pada kelompok kontrol. Hal ini menunjukkan bahwa terdapat perbedaan skor pengetahuan yang signifikan pada kelompok intervensi setelah 3 kali pemberian konseling gizi diet DM. Tahap akhir evaluasi dianalisis menggunakan post hoc Mann Whitney u test, menunjukkan bahwa ada perbedaan yang signifikan (p=<0.001) antara kelompok kontrol dan kelompok intervensi (video DBMP).
Involvement of Mineralocorticoid Receptor Activation by High Mobility Group Box 1 and Receptor for Advanced Glycation End Products in the Development of Acute Kidney Injury
Authors: Otsuka Tomoyuki , Ueda Seiji , Yamagishi Sho-ichi , Nagasawa Hajime , Okuma Teruyuki , Wakabayashi Keiichi , Kobayashi Takashi , Murakoshi Maki , Nakata Masami , Gohda Tomohito , Matsui Takanori , Higashimoto Yuichiro , Suzuki Yusuke 
Published: December 2024

Key Points

Our study revealed that high mobility group box 1 activates the mineralocorticoid receptor (MR) through the receptor for advanced glycation end products (RAGE) in AKI.MR antagonists and RAGE aptamers inhibited high mobility group box 1–induced Rac1/MR activation and downstream inflammatory molecules in endothelial cells.MR antagonists and RAGE aptamers may represent promising therapeutic strategies for preventing AKI and CKD progression.

Background
Although AKI is associated with an increased risk of CKD, the underlying mechanisms remain unclear. High mobility group box 1 (HMGB1), one of the ligands for the receptor for advanced glycation end products (RAGE), is elevated in patients with AKI. We recently demonstrated that the mineralocorticoid receptor (MR) is activated by the RAGE/Rac1 pathway, contributing to chronic renal damage in hypertensive mice. Therefore, this study investigated the role of the HMGB1/RAGE/MR pathway in AKI and progression to CKD.

Methods
We performed a mouse model of renal ischemia–reperfusion (I/R) with or without MR antagonist (MRA). In vitro experiments were conducted using cultured endothelial cells to examine the interaction between the HMGB1/RAGE and Rac1/MR pathways.

Results
In renal I/R injury mice, renal MR activation was associated with elevated serum HMGB1, renal RAGE, and activated Rac1, all of which were suppressed by MRA. Renal I/R injury led to renal dysfunction, tubulointerstitial injury, and increased expressions of inflammation and fibrosis mediators, which were ameliorated by MRA. In vitro, RAGE aptamer or MRA inhibited HMGB1-induced Rac1/MR activation and upregulation of monocyte chemoattractant protein 1 and NF-κB expressions. Seven days after I/R injury, renal I/R injury mice developed CKD, whereas MRA prevented renal injury progression and decreased the mortality rate. Furthermore, in case of MRA treatment even after I/R injury, attenuated renal dysfunction compared with untreated mice was also observed.

Conclusions
Our findings suggest that HMGB1 may play a crucial role in AKI and CKD development by activating the Rac1/MR pathway through interactions with RAGE.