bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of metabolic phase-specific modified nutrition risk in critically ill score: a prospective observational study in critically ill patients
Authors: Lee Geon Ho , Kim Ye Ju , Park So Hyang , Park Sunny , Lim Sung Yoon , Choi Soo An 
Published: September 2024

Background and aimsThe prevalence of malnutrition in intensive care units (ICU) is high and can be caused by poor intake or absorption of nutrients in the digestive track, as well as disease-related inflammation. As strong catabolism restricts nutrient supply and potentially leads to subsequent malnutrition, appropriate nutrition should be provided based on the metabolic status. However, nutritional support strategies for considering the metabolic phase are not well established. Therefore, this study aimed to establish a strategy for nutritional support in each phase by implementing a phase-specific modified Nutrition Risk in Critically Ill (mNUTRIC) score.MethodsThis prospective observational study was conducted on all adult patients admitted to the medical ICU for at least 36 h at Seoul National University Bundang Hospital between September 2020 and September 2022. Patient nutrition assessment (mNUTRIC score), clinical information, and nutritional supply (calories and proteins) were measured twice, in the acute phase (measured at 2 days) and late phase (measured at 7 days). The relationship between nutritional supply and 28-day mortality was analyzed using multiple logistic regression according to the mNUTRIC score in the acute and late phases. Risk factors related to 28-day mortality were analyzed using univariate and multivariate Cox proportional hazards regressions.ResultsOf the 631 patients admitted to the ICU during the study period, 613 were included in the acute phase and 361 patients were included in the late phase. Nutritional supply was associated with 28-day mortality, with high mNUTRIC scores in both the acute and late phases. Cox proportional hazards regression analysis demonstrated that a high mNUTRIC score [hazard ratio (HR) 3.20 and 2.52, respectively], lactate &gt;2.5 mg/dL were independent risk factors in both the acute and late phases. In addition, Albumin &lt;2.5 mg/dL, the presence of neoplasm, and the need for dialysis in the acute phase, calorie adequacy &lt;0.7 in the late phase (HR, 2.19) were identified as additional risk factors.ConclusionThe mNUTRIC score is a suitable tool for identifying critically ill patients who benefit from nutritional support. Nutritional supply should be considered for patients with high mNUTRIC scores in both the acute and late phases; however, careful supply should be provided in the acute phase and sufficient supply should be provided in the late phase.
Administration sequences in single-day chemotherapy regimens for breast cancer: a comprehensive review from a practical perspective
Authors: Wu Miaohui , Huang Xiaoyan , Chen Meijun , Zhang Yin 
Published: September 2024

IntroductionBreast cancer is one of the most prevalent malignant tumors globally, posing a severe threat to human life and health. Chemotherapy, a cornerstone in the treatment of breast cancer, often overlooks the sequence of drug administration within single-day regimens. This study aims to explore the impact of drug administration order on the efficacy and toxicity of combination chemotherapy protocols for breast cancer.MethodsThrough a comprehensive review and analysis based on current evidence from evidence-based medicine, we delved into how the order of drug administration affects both efficacy and toxicity. We systematically classified and analyzed commonly used combination drug regimens, providing graded recommendations and a reasoned analysis to offer valuable references for clinical decision-making.ResultsOur findings indicate that the sequence of drug administration in complex combination chemotherapy protocols is not arbitrary but necessitates multifaceted considerations. Rational drug sequencing can maximize synergistic effects between drugs, thereby augmenting therapeutic efficacy while effectively mitigating drug-related adverse effects. Additionally, some drug labels and clinical trials have explicitly highlighted the therapeutic benefits of specific drug sequences.ConclusionThis study underscores the importance of considering the sequence of drug administration in clinical practice. It is recommended to prioritize the sequential drug administration according to official drug product labeling, while also considering factors such as the administration sequence from large randomized controlled trials, cell proliferation kinetics specific to cancer types, drug interactions, chronopharmacology, drug irritability, clinical experiences, and patient preferences. By taking these factors into account, the goal is to maximize treatment efficacy and minimize the occurrence of adverse reactions.
TAS-102 (trifluridine/tipiracil) plus bevacizumab versus TAS-102 alone as salvage treatment options for metastatic colorectal cancer in routine clinical practice
Authors: Shin Ji Eun , Lim Sung Hee , Lee Jeeyun , Lim Ho Yeong , Park Young Suk , Kim Seung Tae 
Published: September 2024

IntroductionBoth regimens of TAS-102 (trifluridine/tipiracil) with and without bevacizumab are considered standard options for salvage treatment in patients with refractory metastatic colorectal cancer.Materials and methodsThis analysis included patients with metastatic colorectal cancer who received either TAS-102 plus bevacizumab or TAS-102 alone between July 2022 and November 2023 at Samsung Medical Center. We evaluated the objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and safety profile of both regimens.ResultsIn total, 139 patients were included in this analysis. Median age was 60.8 years, and median number of previous lines of therapy was four (range: 2.45–6.55). More than half of the subjects (56.8%) had RAS mutations and 92.9% received previous anti-VEGF therapy. 83 (59.7%) patients received the combination of TAS-102 and bevacizumab and 56 (40.3%) received TAS-102 alone. The number of patients with prior regorafenib treatment was 14 in the TAS-102 with bevacizumab group and 5 in the TAS-102 alone group. The disease control rate was 51.8% in the combination group and 32.1% in the TAS-102 alone group. The median PFS was 3.3 months (95% CI, 2.7–6.6) in the combination group and 2.5 months (95% CI, 2.0–3.8) in the TAS-102 alone group (HR, 0.56; 95% CI, 0.38–0.82; p=0.003). The median OS in these two groups was 10.8 months (95% CI, 8.4–NA) and 6.0 months (95% CI, 4.8–9.8), respectively (HR, 0.62; 95% CI, 0.40–0.97, p=0.033). In the exploratory analysis of TAS-102 + Bev group, patients with the KRAS G12 mutation had inferior OS compared to those without the mutation (HR, 2.01, 95% CI, 1.04–3.90, p=0.035). Commonly observed adverse events were hematologic-related, including neutropenia, anemia, and thrombocytopenia, as well as nausea. While any grade neutropenia was observed at similar frequencies in the two groups (57.8% and 57.1%), grade 3 or higher neutropenia was more frequent in the combination group than the TAS-102 alone group (31.3% vs. 17.9%). Among patients who received subsequent anticancer therapy after treatment failure, 74.1% received regorafenib.ConclusionsThe combination of TAS-102 and bevacizumab resulted in a better survival outcome than TAS-102 monotherapy, consistent with previous studies. This analysis supports the use of the combination of TAS-102 and bevacizumab as the best therapeutic option for patients with refractory metastatic colorectal cancer in clinical practice.
Safety and aesthetic outcomes of double purse-string suture nipple reconstruction in early breast cancer patients undergoing nipple resection and endoscopic skin-sparing mastectomy with breast reconstruction
Authors: Dai Hui , Chung Kawun , Liang Faqing , Xie Yanyan , Zhang Qing , Qiu Mengxue , Yang Huanzuo , Zhou Jiao , Feng Yu , Du Zhenggui 
Published: September 2024

BackgroundThe current surgical methods for managing incisions after nipple excision in breast reconstruction patients are limited. However, double purse-string suture (DPS) shows promise in the treatment of nipple excision. This study aimed to investigate the safety and aesthetic outcomes of DPS nipple reconstruction in early breast cancer patients who underwent endoscopic skin-sparing mastectomy (E-SSM) and breast reconstruction.MethodsWe retrospectively analyzed the clinical data of 87 early breast cancer patients with nipple excision who underwent E-SSM with breast reconstruction. According to the suture methods of nipple incision, all patients were divided into the spindle suture (SS) group, single purse-string suture (SPS) group, and DPS group, with SS and SPS groups combined as the traditional suture (TS) group. Then, we compared the groups’ differences in aesthetic outcomes, surgical safety, and oncological safety.ResultsA total of 87 patients with 88 breasts were enrolled in this study (SS n=17, SPS n=21, DPS n=50). Patients in the DPS group had significantly better nipple reconstruction satisfaction, Harris scale and any complications incidence than the TS group (all p &lt;0.05). For nipple reconstruction satisfaction and any complication, the adjusted OR (95%CI) of the DPS group were 6.314(1.095-36.415) (p=0.039) and 0.124(0.018-0.863) (p=0.035) compared with the SS group. One patient in the SS group had vertebral metastases, and no recurrence, metastasis, or death has been observed in the other two groups during the follow-up period.ConclusionsDPS is an effective and safe nipple reconstruction procedure for patients undergoing E-SSM with breast reconstruction, delivering excellent aesthetic outcomes.
Potential tumor-specific antigens and immune landscapes identification for mRNA vaccine in thyroid cancer
Authors: Wang Xiaoning , Wang Guixin , Xu Qiaoqiao , Li Yingxi , Song Wenbin , Liu Zhaoyi , Tian Yao , Wang Li , Zhao Ke , Wang Yizeng 
Published: September 2024

BackgroundTumor mRNA vaccines have been identified as a promising technology for cancer therapy in multiple cancer types, while their efficacy in thyroid cancer (THCA) is unclear. Immunotyping is strongly associated with the immune microenvironment and immune status in cancer, thus it is important in vaccination and therapeutic response. This study is to identify potential valuable antigens and novel immune subtypes of THCA for immune landscape construction, thus screening patients suitable for mRNA vaccination.MethodsThe clinical information and gene expression files of 568 THCA cases were obtained from the TCGA dataset. The DNA copy number variation and the somatic mutation of THCA were visualized by the cBioPortal database. TIMER was used to investigate the immune infiltrating correlation with candidate antigens. Consensus clustering analysis was conducted to cluster data using the ConsensusClusterPlus package. The immune landscapes of THCA patients were visualized using the Monocle package. The critical hub genes for THCA mRNA vaccines were identified by WGCNA package. To validate, the immunohistochemistry and real-time quantitative PCR (RT-qPCR) were performed to detect the expression level of potential antigen for mRNA vaccine in tissue and cell lines in THCA.ResultsThymidine kinase 1 (TK1) was identified as a potential biomarker of mRNA vaccine against THCA. It was confirmed to be significantly upregulated in THCA tissues and cells lines. Moreover, three novel immune subtypes of THCA were obtained based on the expression consistency of immune-associated genes. The S2 subtype was characterized as an immunological “cold” phenotype with a high expression of immunogenic cell death modulators. S1 and S3 subtypes were immunological “hot” phenotypes with immune checkpoints upregulation. Further, the immune landscape of THCA patients was visualized and ten hub genes for mRNA vaccines were identified.ConclusionTK1 was a tumor-specific antigen of mRNA vaccines. The patients belonging to the S2 subtype (“cold” tumor) were suitable for mRNA vaccine therapy in THCA. Notably, ten hub genes were conducted as potential biomarkers for identifying suitable patients for mRNA vaccination. These findings provided novel insights into mRNA vaccine development against THCA.
Paving the way ahead: protocol optimization of mouse models in crush syndrome related acute kidney injury research
Authors: Qiao Ou , Wang Xinyue , Li Zizheng , Han Lu , Chen Xin , Zhang Li , Bao Fengjiao , Hao Herui , Hou Yingjie , Duan Xiaohong , Saeed Sania , Li Ning , Gong Yanhua 
Published: September 2024

BackgroundsCrush syndrome (CS) is the leading cause of death after earthquakes, second only to direct trauma. Acute kidney injury (AKI) is the most severe complication of CS. Research based on the CS-AKI mouse model and kidney function assessment by glomerular filtration rate (GFR) helps to elucidate the pathogenesis of CS-AKI, which contributes to effective treatment measures.MethodsMice were modeled by the multi-channel small animal crushing platform. We set up different CS-AKI modeling parameters by applying different crushing weights (0.5 kg, 1.0 kg, 1.5 kg), crushing durations (6 h, 12 h, 16 h), and decompression durations (6 h, 12 h, 24 h). The GFR, serum creatinine (SCr), blood urea nitrogen (BUN), kidney tissue Kim-1 mRNA and Ngal mRNA expression levels, and HE staining were examined to evaluate the results of different protocols.ResultsThe results showed that with the crushing weight increased, the kidney function assessment’s gold standard GFR significantly decreased, and the levels of SCr and BUN increased. Meanwhile, the longer crushing durations found a higher extension of inflammatory cell infiltration in the kidney. The degree of kidney injury continued to worsen with the duration of decompression, indicating severe damage after reperfusion, which was associated with tubular injury and a sustained elevation of the inflammatory state.ConclusionWe successfully constructed CS-AKI mouse models with different severities under the above parameters. Applying 1.5 kg for 16 h and then decompressing for 24 h induced severe AKI. These findings provide clues for further exploration of the mechanism and treatment of traumatic AKI.
The effect of parental and teacher autonomy support and core self-evaluations: a three-wave longitudinal study of middle students’ career adaptability
Authors: Zhao Xiaoyun , Huang Shun , Shi Chaofan 
Published: September 2024

IntroductionAccording to career construction theory, middle school students are in a critical phase of growth and exploration that requires self-reflection on their interests, values, and aspirations. Career adaptability is a key indicator of career development for middle school students and a crucial ability for achieving career success. Research indicates that many Chinese middle school students face significant hurdles in their career development, including a lack of motivation, limited self-awareness, and unclear career trajectories.ObjectiveTo address these challenges, it is imperative to explore the factors influencing career adaptability, with a particular focus on the role of parental and teacher autonomy support within the framework of self-determination theory. This study aims to explore the correlation between parental autonomy support (PAS), teacher autonomy support (TAS), core self-evaluations (CSE), and career adaptability (CA) among middle school students.MethodologyThe longitudinal data for this study were collected from two middle schools in the Anhui province. Middle school students were recruited as research participants through a cluster sampling method. A total of 482 students were surveyed in three stages during a 1-year period, and a cross-lag model was employed to analyze the data.Results(1) From T1 to T2, T1PAS predicted T2CS, T1CSE predicted T2CA, and T1CA predicted T2TA; (2) from T2 to T3, T2PAS predicted T3CS, T2CSE predicted T3CA, and T2TAS predicted T3PAS; (3) TAS did not predict CSE and CA over time; (4) T2CSE mediated the relationship between T1PAS and T3CA.DiscussionThese findings suggest that autonomy support has a consistently positive influence on the career development of early adolescents. Valuing children’s autonomy is beneficial for fostering positive self-evaluations and shaping their career trajectories.ConclusionAutonomy support plays a pivotal role in enhancing middle school students’ career adaptability and promoting career development by strengthening self-evaluations. Additionally, the effect of parental autonomy support is more stable than that of teacher autonomy support.
Strategies for becoming a more desirable mate: evidence from Lithuania
Authors: Apostolou Menelaos , Sullman Mark , Markšaitytė Rasa , Šeibokaitė Laura , Lajunen Timo Juhani 
Published: September 2024

IntroductionMate-seekers employ several strategies to become more attractive as mates. In the present study, we examined the use of 10 strategies for becoming more desirable as a mate in the Lithuanian cultural context.MethodsUsing a sample of 295 Lithuanian-speaking participants, we explored the frequency and types of strategies employed to enhance mate appeal.ResultsThe most frequently used strategy was “Enhance looks,” followed by “Show off abilities and talents” and “Demonstrate similarity.” The least used strategies were “Show off and exaggerate wealth” and “Drastic appearance changes.” The 10 strategies could be classified into two domains or main strategies, with participants indicating a more frequent use of “Develop and demonstrate desirable traits” followed by “Deceive about undesirable traits.” Additionally, sex differences and age differences were identified for several strategies.DiscussionThe findings highlight the prominence of certain strategies over others in the Lithuanian context, with a notable emphasis on developing and demonstrating desirable traits. The study also reveals variations in strategy use based on sex and age, suggesting that these factors influence mate-seeking behaviors.
Research on the intervention effect of Five-Element Music combined with Eight-Section Brocade on depression among medical students in higher vocational colleges
Authors: Yao Xiyong , Xiong Lin , Ouyang Yiwen , Wang Hui , Zhu Lili 
Published: September 2024

BackgroundDepression is the main risk factor leading to suicidal ideation among college students. This study focused on observing and assessing how the combination of Five-Element Music and Eight-Section Brocade affected depression levels among medical students attending higher vocational colleges.MethodsFrom a total of 1,030 medical students studying in higher vocational colleges, we selected 160 students who showed depressive symptoms and met the specific criteria for the study. We used the SDS scale to identify these students and made them the participants of our experiment. Participants were randomly divided into four groups: the music intervention group (listening to traditional Chinese Five-Element Music for 15 min daily), the Eight-Section Brocade intervention group (practicing the Eight-Section Brocade exercises once daily, approximately 15 min), the combined intervention group (first practicing the Eight-Section Brocade exercises once, then listening to music for 15 min), and the control group (no intervention). Each group consisted of 40 participants. The three intervention groups (excluding the control group) underwent continuous intervention for 4 weeks. The SDS, SAS, and PSQI scales were used for evaluation before and after the intervention.ResultsExcept for the control group, the SDS, SAS, and PSQI scores of the other three groups were lower after the intervention than before the intervention (p &lt; 0.01). After the treatment, the scores on SDS, SAS, and PSQI tests did not vary much between the students who listened to music and those who practiced Eight-Section Brocade (the difference was not statistically significant, p &gt; 0.05). However, the students who did both music and Eight-Section Brocade showed significantly lower scores than those who did only one activity (both p &lt; 0.01).ConclusionFive-Element Music and Eight-Section Brocade can improve depression, anxiety, and sleep status among medical students in higher vocational colleges. The combined intervention of the two is more effective than a single method, and it is worth promoting and applying in higher vocational colleges.Clinical Trial Registrationhttps://www.chictr.org.cn/showproj.html?proj=210705.
Recent onset mental illness severity: pilot study on the role of cognition, sensory modulation, and daily life participation
Authors: Lipskaya-Velikovsky Lena , Hershkovitz Ayelet , Bukai Mira , Bar-Shalita Tami 
Published: September 2024

IntroductionEarly detection of individuals at risk for onset of severe illness is crucial for prevention and early intervention, aiming to mitigate the long-term impact on both the individual and the community. While well-established models exist for predicting the onset and prolonged severity of illness, there is a gap in understanding illness-onset severity. This pilot study aimed to investigate premorbid objective and subjective dimensions of participation in daily life occupations, as well as sensory and cognitive functions as potential markers of the recent-onset mental illness severity.MethodsA total of 50 participants (men: N=26, 52%; women: N=24, 48%), aged 18–40 (M=26.2, SD=5.8) with recent-onset mental illness completed standard, well-established assessments of illness severity, cognitive biases and failures, neurocognitive status, participation in daily life, and sensory responsiveness thorough cross-sectional design. The differences between the groups of the illness severity were explored with descriptive statistics, followed by a Kruskal–Wallis test. Discriminant analysis was used suggesting a multi-varied model for the separation between the groups of illness severity.ResultsThree groups of illness severity exhibited differences in premorbid cognitive functions (F(2)=5.8, p&lt;.01) and participation diversity (F(2)=3.8, p&lt;.05). Combining these two indices explained 92% of the variance between the groups (Wilks’ Λ = .68, χ2(4) = 17.7, p=.001), accurately classifying mild to marked illness severity (62.5–88.5%).ConclusionsThe study contributes to revealing factors involved in the formation of more severe mental illness and suggesting possible avenues for early intervention and prevention. Cognitive biases and sensory modulation dysfunction may contribute to the illness formation. Still, the most effective markers of more severe mental illness onset are functional cognition and limited participation diversity. Since addressing these markers is a unique specialization within occupational therapy, the findings highlight the potential contribution the profession can make to the early identification of the most vulnerable populations.