bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of microenvironment characteristics and MRI radiomics in the risk stratification of distant metastases in rectal cancer: a diagnostic study
Authors: Zhao Qing , Zhong Hongxia , Guan Xu , Wan Lijuan , Zhao Xinming , Zou Shuangmei , Zhang Hongmei 
Published: September 2024

Objectives:
To compare the value of tumor stroma ratio (TSR) and radiomic signature from baseline MRI for stratifying the risk of distant metastases (DM) in patients with locally advanced rectal cancer (LARC).

Materials and methods:
Data from 302 patients with LARC who underwent neoadjuvant chemoradiotherapy and total mesorectal excision in our hospital between 2015 and 2018 were retrospectively reviewed, and the patients were randomly allocated into the training and validation cohorts in a ratio of 7:3. Patients were followed-up for more than 3 years postoperatively with metachronous DM as the endpoint. Independent risk factors for DM-free survival (DMFS) were analyzed using Cox regression. The TSR of endoscopic biopsy specimens was scored automatically. Totally 1229 radiomic features of each tumor were extracted from baseline MRI, and the Radscore was calculated.

Results:
The median follow-up time was 54.3 (51.6–57.1) months, and the 3-year DMFS was 83.8%. The best cutoff value of the TSR to distinguish a patient’s DM risk was 0.477 (Sen=70.8%, Sep=78%, P<0.001). Increased TSR (HR=3.072, P=0.006) and Radscore (HR=719.231, P=0.023), advanced MR-evaluated T stage (HR=2.660, P=0.023) and ypN (HR=2.362, P=0.028) stage were independent risk factors for DMFS. The area under the curve of the combined model was significantly higher than that of the radiomic model (P=0.013) but without a significant advantage over the TSR model (P=0.086).

Conclusion:
TSR of colonoscopic biopsies can independently stratify DM risk in patients with LARC. The TSR model is the most convenient and efficient method for DM risk stratification in LARC.
Cumulative risk factors for flap failure, thrombosis, and hematoma in free flap reconstruction for head and neck cancer: a retrospective nested case-control study
Authors: Hsiung Pei-Hsin , Huang Ho-Yin , Chen Wei-Yu , Kuo Yur-Ren , Lin Ying-Chi 
Published: September 2024

Background:
Free flap construction enhances the quality of life for head and neck cancer (HNC) patients; however, complications, such as thrombosis and hematoma, threaten flap survival. This study aimed to identify factors influencing flap failure, thrombosis, and hematoma.

Methods:
A retrospective nested case-control study was conducted on HNC patients who underwent free flap reconstruction at a tertiary medical center between January 2019 and January 2022. All patients received antithrombotic prophylaxis consisting of prostaglandin E1, dextran, aspirin, and dipyridamole. Risk factors were analyzed using multivariate logistic regression.

Results:
Among 548 flaps analyzed, flap failure, thrombosis, and hematoma rates were 4.74%, 3.83%, and 9.65%, respectively. Risk factors for flap failure included thrombosis (OR 86.42, 95% CI 15.73–474.89), smoking (OR 49.44, 95% CI 1.28–>1000), posteromedial thigh (PMT) flap usage (OR 14.05, 95% CI 2.48–79.54), hematoma (OR 9.68, 95% CI 2.35–39.79), and younger age (OR 0.93, 95% CI 0.87–0.99). Thrombosis risk factors included PMT usage (OR 11.45, 95% CI 2.60–50.38) and anastomosis with the superior thyroid vein (SThV) as the recipient vein after multiple reconstructions (OR 7.91, 95% CI 2.06–30.39). Hematoma risk factors included fibula osteocutaneous flap usage (OR 9.22, 95% CI 2.71–31.42), double-flap usage (OR 8.88, 95% CI 1.80–43.81), liver cirrhosis (OR 6.28, 95% CI 1.44–27.47), and post-surgery hypertension (OR 2.77, 95% CI 1.39–5.50), whereas ipsilateral recurrence (OR 0.14, 95% CI 0.03–0.73) and using the external jugular vein (EJV) as the recipient vein (OR 0.22, 95% CI 0.08–0.61) were protective factors.

Conclusion:
Thrombosis poses a greater risk than hematoma for flap failure. Utilization of the PMT flap and the SThV markedly increased the risk of thrombosis and flap failure. These findings highlight the importance of antithrombotic prophylaxis and the selection of flaps and recipient veins in recurrent HNC patients.
Sexual Violence, Genital Cytokines, and Colposcopy Findings: A Cross-Sectional Study of Women Engaged in Sex Work in Mombasa, Kenya
Authors: Kwendakwema C. Natasha , Sabo Michelle C. , Roberts Sarah T. , Masese Linnet , McClelland R. Scott , Shafi Juma , Lehman Dara A. , Overbaugh Julie , Graham Susan M. 
Published: September 2024

Background
Sexual violence (SV) increases human immunodeficiency virus (HIV) susceptibility in a sustained manner. This study evaluated genital cytokines and colposcopy findings in women reporting both recent and more remote SV.

Methods
A cross-sectional study of HIV-1 negative Kenyan women who engage in sex work was performed. Cervicovaginal fluid was collected by menstrual cup and cytokines (IFNγ, TNFα, IL-1β, IL-6, IL-10, MIP-1α, MIP-1β, and CXCL10) measured using chemiluminescence. Cervical injury was assessed by colposcopy. Associations between recent (≤30 days prior), more remote (>30 days prior), and no (reference category) SV exposure and cytokine concentrations were evaluated using linear regression.

Results
Among 282 participants, 25 (8.9%) reported recent SV and 123 (43.6%) reported more remote SV. Only two cytokines (IL-10 and CXCL10) were associated with the 3-category SV variable in bivariable modeling at the prespecified cutoff (P < 0.2) and carried forward. In multivariable analyses, more remote SV (β = 0.72; 95% confidence interval [CI], 0.06–1.38; P = 0.03), but not recent SV (β = 0.20; 95% CI, −0.99 to 1.39; P = 0.74) was associated with cervicovaginal IL-10 compared with no SV. Recent (β = 0.36; 95% CI, −0.94 to 1.67; P = 0.58) and more remote (β = 0.51; 95% CI, −0.21 to 1.24; P = 0.16) SV were not associated with CXCL10 compared with no SV. Cervical epithelial friability (χ2 = 1.3, P = 0.51), erythema (χ2 = 2.9, P = 0.24), vascular disruption (χ2 = 1.4; P = 0.50), epithelial disruption (χ2 = 2.6, P = 0.27), or any colposcopy finding (χ2 = 1.2, P = 0.54) were not associated with SV category by χ2 test.

Conclusions
The mechanism linking SV to sustained increases in HIV susceptibility may not be related to persistent genital inflammation or injury.
Prehabilitation Research: A Bibliometric Analysis of Past Trends and Future Directions
Authors: Yoo Myungeun , Jang Chan Woong 
Published: September 2024

ABSTRACT

Objective
This study investigates the global research landscape of prehabilitation, identifying current trends, dominant disciplines, collaborative networks, and prominent articles in the field.

Design
For our analysis, we employed the published prehabilitation literature indexed in the Web of Science Core Collection database, spanning from 2002 to 2022. Additionally, we utilized CiteSpace (version 6.2; Drexel University), a widely used information visualization software to perform bibliometric analysis.

Results
Analyzing 553 research articles, we observe a consistent upward trend in prehabilitation publication and citation activity. Interdisciplinary co-occurrence analysis highlights strong connections with fields such as surgery, rehabilitation, oncology, sports sciences, orthopedics, gastroenterology, and hepatology. Initially centered around postoperative outcomes in major abdominal surgeries, particularly for colorectal, pancreatic, and prostate cancers, prehabilitation research expanded to include thoracic surgeries, focusing on conditions like lung cancer and aortic valve replacement. Preoperative exercise remains a core area, with increasing interest in multimodal prehabilitation and its effectiveness based on patient group characteristics. North America and Western Europe emerge as primary contributors to prehabilitation research.

Conclusion
Current research concentrates on tailoring prehabilitation programs for specific groups, and broadening their geographical scope would enhance the studies, contributing valuable insights for medical practitioners shaping future research efforts.
The Incidence and Nature of Adverse Events During Inpatient Rehabilitation: A Retrospective Case Series
Authors: Jiang Shangge , Othman Dalia , Langer Laura Kathleen , Bayley Mark , Fortin Christian , Mayo Amanda , Pelc Jordan , Robinson Lawrence R. , Soong Christine , Guo Meiqi 
Published: September 2024

Abstract

Objective
To describe and compare adverse event (AE) incidence, type, severity, and preventability in the Canadian inpatient rehabilitation setting.

Design
In this retrospective case series, AEs were identified through chart reviews from two Canadian academic tertiary post-acute care hospitals. AEs were characterized through descriptive statistics and compared using the Mantel-Haenszel and Fisher’s exact tests.

Results
During the study period, one site (n = 120) had 28 AEs and an incidence of 9.7 (95% CI 6.1–13.3) per 1000 patient days, and the other (n = 48) had 15 AEs and an incidence of 13.9 (95% CI 6.9–21) per 1000 patient days (p = 0.82). The two sites differed significantly in AE type (p = 0.033) and preventability (p = 0.002) but not severity. The most common AE type was medication/intravenous fluids-related (16/28, 57%) at one site and patient incidents (e.g., falls, pressure ulcers) at the other. Four percent (1/28) of AEs were preventable at one site, and 53% (8/15) at another. Most AEs at both sites were mild in severity.

Conclusions
AEs significantly differed in type and preventability between the two sites. These results suggest the importance of context and the need for an organization-specific and tailored approach when addressing patient safety in inpatient rehabilitation settings.
68Ga-FAPI PET/CT Depicted the Fibrosis of Ischemic Colitis
Authors: Zheng Jieling , Ru Qian , Yang Yun , Miao Weibing 
Published: September 2024

Abstract
Ischemic colitis is the most common form of ischemic bowel disease; identification of ischemic colitis with PET/CT is rare. We present a case of unexplained ischemic colitis in a 66-year-old man who underwent 18F-FDG PET/CT to exclude intestinal malignancy and was subsequently recruited in a clinical trial regarding 68Ga-FAPI. 18F-FDG PET/CT showed intense activity in the intestinal lumen where mucosa had chronic inflammation. Conversely, 68Ga-FAPI PET/CT revealed high tracer uptake in the intestinal wall and adjacent mesentery. Our case showed the different distribution pattern of 18F-FDG and 68Ga-FAPI in ischemic colitis.
Peritoneal Metastasis of Osteosarcoma in 99mTc-MDP SPECT/CT Imaging
Authors: Shen Chentian 
Published: September 2024

Abstract
An 11-year-old boy with history of conventional high-grade osteosarcoma in the left distal femur was referred to our department for 99mTc-MDP whole-body bone scan. In addition to multiple bone lesions and pleura, abnormal high radioactivity was found in the abdomen. SPECT/CT revealed diffuse peritoneal thickening with calcification and increased radioactive uptake, which suggest peritoneal metastases. The most common metastases of osteosarcoma can be found in bone and lungs, whereas peritoneal metastases are extremely rare.
Early Experience of Peer Advocate Program: Using Quality Improvement to Optimize Behavioral and Communication Disconnect in the Operating Room
Authors: Eckhouse Shaina R , Huston Margaret , Smith Eileen R , Thomson Emily , Theodorou Danielle , Chilson Kelly , Osborn Tiffany M , Ogden M Allison , Hoffman Russell , Martin Jackie L 
Published: September 2024

BACKGROUND:
The operating room (OR) remains a challenging and hierarchical work environment within healthcare, where the attending surgeon functions as a team captain. Unprofessional behavior or disconnects in this environment can lead to breakdowns in teamwork and reports within the safety event reporting system (SERS). Interventions focused on remediating adverse behaviors and team interactions should optimize team function and potentially enhance patient outcomes. The aim of the present study focused on decreasing the SERS reports regarding behavior and communication disconnects from November 2019 to March 2023.

STUDY DESIGN:
A multidisciplinary team designed a novel reporting system to separate mechanical and procedural safety events from communication and behavior-related disconnects in the OR. The following plan-do-study-act cycles were performed by the multidisciplinary team: (1) developed the role of the peer advocate (PA) to mediate conversations among team members when behavior and communication disconnects occur, (2) redirect behavior and communication disconnects reported in the SERS to the PA program, and (3) develop and discuss interpersonal skills to prevent disconnects from occurring.

RESULTS:
Thirty-nine disconnects were reported through the PA program during the 2-year trial. The most common initiating team member were nurses, and the most common identifying team member were surgeons. The number of monthly SERS reports regarding behavior and communication disconnects decreased with the described interventions.

CONCLUSIONS:
The multidisciplinary task force developed and adapted a process to address communication and behavioral concerns in an efficient and supportive manner, with the objective of restoring relationships among team members in the perioperative environment and deweaponizing the SERS.
Retrospective analysis of Acinetobacter baumannii bacteraemia risk factors, complications, and mortality in a tertiary university hospital in Saudi Arabia
Authors: Kaki Reham 
Published: September 2024

Introduction.
There are many multidrug-resistant isolates of the nosocomial pathogen, Acinetobacter baumannii causing severe healthcare-acquired infections in terminally ill patients with high mortality and morbidity rates.

Aim. This study aimed to retrospectively analyse Acinetobacter baumannii bacteraemia (ABB) cases in Saudi Arabia where the information is sparse regarding the prevalence, risk factors, clinical disease, antibiotic regimen, antibiotic susceptibility, treatment outcomes, and mortality associated with this infection.

Methods. A retrospective chart review was conducted between January 1st, 2015, and December 31st, 2022, to identify all patients 14 years and above with ABB. Demographic and clinical data, as well as results from laboratory analyses, were collected from patients’ electronic charts. Statistical analyses were performed on the data to identify factors associated with 90-day mortality.

Results. Of the 122 ABB cases, 71 (63.4%) died. The factors that were found to be associated with 90-day mortality were the Charlson comorbidity score, Pitt bacteremia score, quick Sequential Organ Failure Assessment (qSOFA) score (p < 0.001 for each), hospital ward (p < 0.02), short duration of antibiotic treatment (p < 0.01), and higher age (p < 0.05). The most common source of infection was Central Line-associated Bloodstream Infection in 52.7%. Also associated with mortality were inappropriate antimicrobial therapy (p < 0.02) and empirical use of colistin (p < 0.05). In many patients, ABB was caused by carbapenem-resistant A. baumannii (CRAB) (69.6%), and 74.4% of those patients died.

Conclusion. To prevent ABB-associated mortality, an appropriate regimen and duration of treatment are necessary. Hospitals should also practice proper hygiene to prevent the spread of ABB. CRAB is a growing threat in hospitals in Saudi Arabia especially in the critical care setting and carries a very high risk of mortality.
Associations between exposure to OPEs and rheumatoid arthritis risk among adults in NHANES, 2011-2018
Authors: Singh Sneha , Pirouz Elsa , Shahmoradi Amir 
Published: September 2024

AbstractRheumatoid arthritis (RA) has an intricate etiology that includes environmental factors as well as genetics. Organophosphate esters (OPEs) are frequently used as chemical additives in many personal care products and household items. However, there has been limited research on their potential effects on rheumatoid arthritis (RA). The specific associations between OPEs and RA remain largely unexplored. This study investigates any potential associations between adult rheumatoid arthritis risk and exposure to OPEs. We investigated data from the National Health and Nutrition Examination Survey (NHANES) 2011–2018 among participants over 20 years old. In two models, multivariable logistic regression was utilized to investigate the relationship between exposure to OPEs and RA. Furthermore, subgroup analyses stratified by age, gender, and dose exposure response were evaluated. Generalized additive models and smooth curve fits were used to characterize the nonlinear relationship between RA and OPEs. In conclusion, 5490 individuals (RA: 319, Non-RA: 5171) were analyzed. Higher quantiles (Q4) of DPHP and DBUP showed a higher prevalence of RA than the lowest quantiles. Our findings show that adult RA prevalence is higher in those who have been exposed to OPEs (DPHP, DBUP). Interestingly, these correlations seem to be stronger among women, the elderly, those with higher BMIs, and those who have diabetes. The dose-response curve for DPHP and DBUP demonstrated an upward-sloping trend. In contrast, BCEP and BCPP showed a U-shaped relationship and an inverted U-shaped relationship with the probability of RA.BDCPP demonstrated a complex relationship with a peak at lower concentrations followed by a decrease. Finally, our study also concludes that exposure to OPEs plays a crucial role in the pathogenesis of RA.HighlightsUrinary metabolites of OPEs (DPHP, DBUP) are associated with the increased prevalence of RA.BDCPP appears to have a protective effect, reducing the risk of RA.Associations are more prominent in females, participants over 60 years, and those with higher BMI.Exposure to OPEs plays a critical role in the pathogenesis of rheumatoid arthritis (RA).Graphical Abstract
Exploring COVID-19 Pandemic Perceptions and Vaccine Uptake among Community Members and Primary Healthcare Workers in Nigeria: A Mixed Methods Study
Authors: Sogbesan Abiodun , Bakare Ayobami , van Wees Sibylle Herzig , Salako Julius , Bakare Damola , Olojede Omotayo E , Akinsola Kofoworola , Bakare Oluwabunmi R. , Falade Adegoke , King Carina 
Published: September 2024

AbstractBackgroundThe COVID-19 pandemic significantly impacted global health, with diverse perceptions about the disease and control measures, including vaccination. Understanding these perceptions can help inform public health and vaccination strategies in future outbreaks. This study examined community members and healthcare workers’ (HCWs) perceptions of the COVID-19 pandemic and vaccines in Nigeria, exploring factors influencing vaccine acceptance and hesitancy.MethodsWe conducted a mixed-methods study, combining quantitative survey data from 2,602 respondents (2,206 community members and 396 HCWs) with qualitative interviews. Quantitative data were analyzed to identify factors associated with COVID-19 vaccine uptake and pandemic perceptions, while qualitative insights provided a deeper understanding of cultural perceptions, experiences, and hesitancy towards the COVID-19 vaccine.ResultsOverall, 43.4% of community members and 96.7% of HCWs received at least one dose of COVID-19 vaccine. Vaccine uptake was positively associated with increasing age, previous COVID-19 testing, male sex, government employment, and knowing someone diagnosed with COVID-19. Christianity was associated with lower uptake among community members. Perceptions varied, with 34.2% of community members and 17.7% of HCWs considering COVID-19 a death sentence, while 27.8% and 22.0% believed in ‘African immunity,’ respectively. Hesitancy was driven by the fear of side effects (32.6%), pregnancy-related concerns (25.9%), and convenience-related issues (13.5%). Qualitative data found misinformation, mistrust, fear of adverse reactions, logistical challenges, and belief in the sufficiency of childhood vaccination fuelled hesitancy towards the COVID-19 vaccine. Despite this, general trust in vaccine safety and efficacy remained high, with most respondents willing to be vaccinated against other diseases and future outbreaks.ConclusionOur findings underscore the need for tailored public health strategies to address specific sociodemographic factors, individual perceptions, and logistical challenges to enhance COVID-19 vaccine uptake. Public health campaigns should focus on debunking myths, improving vaccine literacy, and leveraging the social influence of respected community leaders to build trust.
Genetic ancestry in Puerto Rican Afro-descendants illustrates diverse histories of African diasporic populations
Authors: Nieves-Colón Maria A. , Ulrich Emma C. , Chen Lijuan , Torres Colón Gabriel A. , Rivera Clemente Maricruz ,   La Corporación Piñones Se Integra (COPI), Benn Torres Jada 
Published: September 2024

AbstractObjectivesGenetic studies of contemporary Puerto Ricans reflect a demographic history characterized by admixture between Indigenous American, African, and European peoples. While previous studies provide genetic perspectives on the general Puerto Rican population, less is known about the island’s sub-populations, specifically Afro-Puerto Ricans.Materials and MethodsIn this study, the genetic ancestry of Afro-Puerto Ricans is characterized and compared to other Caribbean populations. Thirty DNA samples collected among self-identified Puerto Ricans of African descent in Loíza (n=2), Piñones (n=13), San Juan (n=2), Mayagüez (n=9), and Ponce (n=4), were genotyped at 750,000 loci on the National Geographic Genochip. We then applied unsupervised clustering and dimensionality-reduction methods to detect continental and subcontinental African and European genetic ancestry patterns.ResultsAdmixture analyses reveal that on average, the largest genetic ancestry component for Afro-Puerto Ricans is African in origin, followed by European and Indigenous American genetic ancestry components. African biogeographic origins of Afro-Puerto Ricans align most closely with contemporary peoples of Lower Guinea and the Bight of Biafra, while the European genetic ancestry component is most similar to contemporary Iberian, Italian, and Basque populations. These findings contrast with the biogeographic origins of comparative Barbadian and Puerto Rican populations.DiscussionOur results suggest that while there are similarities in general patterns of genetic ancestry among African descendants in the Caribbean, there is previously unrecognized regional heterogeneity, including among Puerto Rican sub-populations. These results are also consistent with available historical sources, while providing depth absent from the documentary record, particularly with regard to African ancestry.
ACVR2A Facilitates Trophoblast Cell Invasion through TCF7/c-JUN Pathway in Pre-eclampsia Progression
Authors: Yang Shujing , Liu Huanyao , Hu Jieshi , Chen Bingjun , An Wanlu , Song Xuwen , Yang Yi , He Fang 
Published: September 2024

AbstractPre-eclampsia (PE) is a serious pregnancy disorder linked to genetic factors, particularly the ACVR2A gene, which encodes a receptor involved in the activin signaling pathway and plays a critical role in reproductive processes. Transcriptomic data analysis and experimental verification confirmed a downregulation of ACVR2A expression in placental tissues from PE patients. In this study, CRISPR/Cas9 technology was employed to investigate the effect of ACVR2A gene deletion on trophoblast cells using the HTR8/SVneo and JAR cell lines. Deletion of ACVR2A inhibits trophoblastic migration, proliferation, and invasion, underscoring its pivotal role in cellular function. RNA-seq data analysis unveiled an intricate regulatory network influenced by ACVR2A gene knockout, especially in the TCF7/c-JUN pathway. By employing RT-PCR and immunohistochemical analysis, a potential association between ACVR2A and the TCF7/c-JUN pathway was hypothesized and confirmed. The complexity of PE onset and the significance of genetic factors were emphasized, particularly the role of the ACVR2A gene identified in GWAS. This study established a robust foundation for delving deeper into the intricate mechanisms of PE, paving the way for focused early intervention, personalized treatment, and enhanced obstetric healthcare.