bluuebunny/crossref_metadata_2025_split huggingface dataset:
Higher protein intake may benefit in patients with prolonged mechanical ventilation
Authors: Chang Chiung-Hsin , Lin Chun-Yu , Lo Yu-Lun , Lin Ting-Yu , Hung Chen-Yiu , Hsieh Meng-Heng , Fang Yueh-Fu , Huang Hung-Yu , Lin Shu-Min , Lin Horng-Chyuan 
Published: October 2024

BackgroundPatients with prolonged mechanical ventilation (PMV) is usually associated with muscle wasting and diaphragm weakness, resulting in high medical costs and mortality. Adequate energy and protein intake were beneficial in sarcopenia patients. We aimed to investigate the impact of protein intake in weaning parameters in patients with PMV.Materials and methodsWe enrolled patients with PMV (mechanical ventilation ≥6 h/day for ≥21 days) from a respiratory care center (RCC) of a tertiary medical center from December 2020 to October 2022, and classified them into weaning success and weaning failure groups. The patients’ characteristics, nutrition records, weaning parameters and outcomes were analyzed.ResultsA total of 289 patients were included (mean age 73.5 years). Of the 289 patients, 149 were weaned successfully and 140 were not. The average protein intake was higher in the weaning success group than in the weaning failure group (1.22 ± 0.320 versus 0.99 ± 0.332 g/kg/day, p &lt; 0.001). No significant differences were noted in the average calorie intake and whey protein intake between the two groups. RSBI &lt;90 breaths/min/L (OR = 2.38, p = 0.045), serum albumin at 4th week ≥3 g/dL (OR = 2.89, p = 0.027), daily protein intake ≥1.01 g/kg/day (OR = 8.10, p &lt; 0.001), PaO2/FiO2 (PF) ratio ≥ 300 (OR = 2.56, p = 0.027) were independent predictors for weaning from ventilator. Weak positive correlations were found between average protein intake with PF ratio (r = 0.1576, p = 0.0227) and PaO2 (r = 0.13359, p = 0.0497).ConclusionDaily protein intake had positively correlated with PF ratio and had independently benefit for weaning in patients with PMV.
Case report: Advanced breast cancer with scalp metastases: a report of two cases
Authors: Yu Jiaxuan , Yao Tianze , Zhang Min , Li Bingxin , Yao Yongqiang 
Published: October 2024

BackgroundBreast cancer, identified as the most prevalent cancer worldwide, presents considerable difficulties in advanced stages, especially when involving metastatic spread. Scalp metastasis from breast cancer represents a rare and insufficiently explored occurrence. This paper seeks to illuminate this uncommon manifestation by presenting two cases of scalp metastatic breast cancer in Chinese women.Case reportCase 1: A 45-year-old Chinese woman with a history of invasive ductal carcinoma presented with a scalp lesion indicative of recurrence. Concurrently, she was diagnosed with bone metastases and recurrence at the original site. Despite undergoing various treatments, including chemotherapy and hormonal therapy, her condition worsened, ultimately leading to her passing. Case 2: A 40-year-old Chinese woman was initially diagnosed with bilateral breast invasive mucinous carcinoma presenting with bilateral breast masses and a scalp lesion. She also had multiple bone metastases. Following chemotherapy and hormonal therapy, her disease stabilized.ConclusionThese cases of scalp metastatic breast cancer underscore the complexities involved in managing advanced stages of the disease, especially with rare metastatic manifestations. They highlight the importance of comprehensive diagnostic methods, encompassing full-body skin evaluations, and draw attention to the socioeconomic challenges faced in cancer treatment. These findings point to the necessity for more targeted research on uncommon metastatic forms in breast cancer aiming to enhance patient outcomes and refine management approaches.
A real-world study on the clinicopathological profile, treatment outcomes and health-related quality of life, anxiety and depression among patients with desmoid tumor at two tertiary care centers in India
Authors: Tansir Ghazal , Sharma Aparna , Biswas Bivas , Sah Suryadev Narayan , Roy Somnath , Deo S. V. S. , Agarwala Sandeep , Khan Shah Alam , Bakhshi Sameer , Pushpam Deepam 
Published: October 2024

BackgroundThe medical management of DT comprises tyrosine kinase inhibitors (TKIs), hormonal agents, anti-inflammatory drugs with the recently approved gamma secretase inhibitor nirogacestat being the current standard of care. Real-world data on evolving treatment landscapes of DT remains scarce.MethodsThis is a retrospective study of patients with DT registered between 1995 and 2020 at All India Institute of Medical Sciences, New Delhi and Tata Medical Center, Kolkata. Baseline characteristics were analyzed in form of median values and interquartile range. Categorical and continuous variables were compared by chi square and independent samples T- tests respectively. Anxiety, depression and QoL were prospectively measured among 30 patients using Hospital Anxiety and Depression (HADS) and Functional Assessment of Cancer Therapy-General (FACT-G) scales respectively between 2022 to 2023.Results200 patients were included with a male-predominant (n=111, 55.5%) population and median age 26.5 (2.5-75) years. Extremity (n=100, 50%) and abdomen (n=65, 32.5%) were commonest primary sites and median of 2 (1–4) lines of treatment were received. First-line included surgery (n=116, 58%), systemic therapy (n=67, 33.5%), radiotherapy (10, n=5%) and active surveillance (n=7, 3.5%). First-line systemic agents included tamoxifen (n=55, 27.5%), imatinib (n=7, 3.5%), sorafenib (n=1, 0.5%) and chemotherapy (n=4, 2%). 2019 onward, 3% and 63% underwent active surveillance and surgery respectively. Best radiological response obtained with tamoxifen was stable disease (SD) (n=76, 59%) and partial response (PR) (n=31, 24.2%). Best radiological response obtained with sorafenib was PR (n=17, 60.7%) and SD (n=9, 32.1%). Thirty patients underwent HADS and FACT-G scale assessment. Mean HADS-Anxiety subscale score was 3.6 (+/-3.9 SD) and HADS-Depression sub-scale score was 2.6 (+/-3.5 SD) with clinically significant anxiety and depression in 2 (6.7%) patients each. The overall mean FACT-G score was 87.5 (+/-12.6 SD) and lower mean physical well-being (p=0.006) and emotional well-being (0.017) scores were significantly associated with higher HADS-anxiety (&gt;/=8) scores.ConclusionsAssessment of anxiety, depression and QoL are paramount to gauge the psychological impact of DT. This study gives an overview of clinical and management profile of patients with DT in India, with limitations of selection bias, heterogeneous population and small sample size for QoL assessment.
Prognostic prediction and treatment options for gastric signet ring cell carcinoma: a SEER database analysis
Authors: Yu Chengqing , Yang Jian , Li Haoran , Wang Jie , Jin Kanghui , Li Yifan , Zhang Zixiang , Zhou Jian , Tang Yuchen 
Published: October 2024

BackgroundIn recent years, the overall incidence of gastric cancer has decreased. However, the incidence of gastric signet ring cell carcinoma (SRCC) is still increasing year by year. Compared with other subtypes (non-SRCC) such as adenocarcinoma, SRCC usually exhibits a more aggressive biological behavior. Therefore, studying the prognostic differences and factors associated with SRCC is essential to improve the accuracy of diagnosis and prognosis. The purpose of this study was to investigate the prognostic factors influencing the prognosis of patients with SRCC and to develop personalized treatments for different subgroups of patients.MethodsThe data on gastric SRCC patients and gastric adenocarcinoma (AC) patients from 1992 to 2020 was obtained from the Surveillance, Epidemiology, and End Results (SEER) database. The data of gastric SRCC as the external validation group was reviewed from the First Affiliated Hospital of Soochow University. The overall survival (OS) and cancer specific survival (CSS) at 1 and 2 years were predicted for SRCC patients by constructing prognostic nomograms. A series of validation methods, including Akaike information criterion (AIC), decision curve analysis (DCA), calibration curve analysis, the concordance index (C-index) and the area under the receiver operating characteristic (AUC) curve, were used to verify the accuracy and reliability of the models.ResultsIn all, 549 patients with SRCC were included after propensity score matching (PSM). Multivariate Cox regression analysis showed that T stage, N stage, M stage and surgical approach were independent risk factors affecting the prognosis of SRCC patients. A prognostic nomogram was constructed and validated as an accurate model for SRCC patients after scoring by receiver operating characteristic curve (ROC) curves and calibration plots. The patients were further divided into high-risk and low-risk groups, and the Kaplan-Meier curves showed that SRCC patients in the low-risk group could receive only surgery without chemotherapy, while chemotherapy plus surgery was a better option for SRCC patients in the high-risk group.ConclusionThe prognosis for SRCC was less favorable than that of AC in terms of CSS. The nomograms were developed and validated to predict OS and CSS in patients with SRCC, helping in developing appropriate individualized treatment schedules.
Personalized three-year survival prediction and prognosis forecast by interpretable machine learning for pancreatic cancer patients: a population-based study and an external validation
Authors: Teng Buwei , Zhang Xiaofeng , Ge Mingshu , Miao Miao , Li Wei , Ma Jun 
Published: October 2024

PurposeThe overall survival of patients with pancreatic cancer is extremely low. We aimed to establish machine learning (ML) based model to accurately predict three-year survival and prognosis of pancreatic cancer patients.MethodsWe analyzed pancreatic cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2021. Univariate and multivariate logistic analysis were employed to select variables. Recursive Feature Elimination (RFE) method based on 6 ML algorithms was utilized in feature selection. To construct predictive model, 13 ML algorithms were evaluated by area under the curve (AUC), area under precision-recall curve (PRAUC), accuracy, sensitivity, specificity, precision, cross-entropy, Brier scores and Balanced Accuracy (bacc) and F Beta Score (fbeta). An optimal ML model was constructed to predict three-year survival, and the predictive results were explained by SHapley Additive exPlanations (SHAP) framework. Meanwhile, 101 ML algorithm combinations were developed to select the best model with highest C-index to predict prognosis of pancreatic cancer patients.ResultsA total of 20,064 pancreatic cancer patients from SEER database was consecutively enrolled. We utilized eight clinical variables to establish prediction model for three-year survival. CatBoost model was selected as the best prediction model, and AUC was 0.932 [0.924, 0.939], 0.899 [0.873, 0.934] and 0.826 [0.735, 0.919] in training, internal test and external test sets, with 0.839 [0.831, 0.847] accuracy, 0.872 [0.858, 0.887] sensitivity, 0.803 [0.784, 0.825] specificity and 0.832 [0.821, 0.853] precision. Surgery type had the greatest effects on three-year survival according to SHAP results. For prognosis prediction, “RSF+GBM” algorithm was the best prognostic model with C-index of 0.774, 0.722 and 0.674 in training, internal test and external test sets.ConclusionsOur ML models demonstrate excellent accuracy and reliability, offering more precise personalized prognostic prediction to pancreatic cancer patients.
Childhood onset C3 glomerulopathy: recurrence after kidney transplantation—a case series
Authors: Borovitz Yael , Landau Daniel , Dagan Amit , Alfandari Hadas , Haskin Orly , Levi Shelly , Hamdani Gilad , Levy Erez Daniella , Tzvi-Behr Shimrit , Weinbrand-Goichberg Jenny , Tobar Foigelman Ana , Rahamimov Ruth 
Published: October 2024

BackgroundC3 Glomerulopathy (C3G) is a complement-mediated disease, with predominant C3 deposits, where pathogenic genetic variants in complement system components and circulating autoantibodies result in loss of control of the alternative pathway, have been described. A high incidence of disease recurrence including graft failure has been reported after kidney transplantation (KTx). Currently treatment modalities for preventing and treating post KTx C3G recurrence (plasma exchange, rituximab and eculizumab) in adults have yielded inconsistent results. Data on post KTx C3G recurrence in childhood-onset C3G is still unknown.MethodsA comprehensive case study of patients diagnosed with C3G as children or adolescents, who underwent KTx between the years 2015–2023. Data collected included complement workup, treatment modalities, and outcomes.Results19 patients with C3G were identified during the study period. Five patients developed ESRD and received a kidney transplant. C3G recurrence was diagnosed post KTx in 100% of patients. Graft function improved in 3 of these patients (two with anti-factor H antibodies) after eculizumab treatment, one patient reached graft failure 9 months after transplantation despite eculizumab, recieved a second successful transplantation with pre-emptive eculizumab treatment and one patient showed histologic signs of disease recurrence without clinical signs.ConclusionsC3G recurrence after KTx in patients diagnosed as children or adolescents may be higher than previously described. Treatment with eculizumab is beneficial in some patients. New treatments are needed for improving post-transplant outcome in patients with C3G.
Atezolizumab plus bevacizumab and chemotherapy versus bevacizumab plus chemotherapy for metastatic cervical cancer: a cost-effectiveness analysis
Authors: Cai Hongfu , Fang Ling , Lin Jingwen , Zheng Zhiwei 
Published: October 2024

AimThe objective of this study is to conduct a cost-effectiveness analysis in order to evaluate the economic advantages of incorporating atezolizumab into a standard bevacizumab plus platinum regimen for the treatment of metastatic cervical cancer from the Chinese medical system perspective.MethodWe developed a partitioned survival model based on data obtained from the recently published BEATcc clinical trial and economic cost data. Our model utilized a tree-based decision analysis approach to simulate two different treatment strategies for metastatic cervical cancer: the standard bevacizumab plus platinum regimen, and the addition of atezolizumab to the standard treatment regimen. The economic assessment data included the costs of the drugs, costs related to treatment-induced adverse events. The cost-effectiveness metrics used in the analysis were quality-adjusted life-year (QALY) and incremental cost-effectiveness ratio (ICER). The robustness of our model was assessed through sensitivity analysis.ResultThe total costs of the atezolizumab group were $128179.56, while the costs of chemotherapy group were $42065.89. The atezolizumab group gained 3.52 QALYs, whereas the chemotherapy group gained 2.35 QALY. The atezolizumab regimen resulted in an increase of 1.17 QALYs at an incremental cost of $86113.67. This led to an ICER of $73601.43, which exceeds the willingness-to-pay (WTP) threshold of $39855.79 in China. Sensitivity analysis demonstrated none of the parameters within a margin of ±25% result in significant alterations to the analysis findings.ConclusionAtezolizumab plus bevacizumab and chemotherapy was not to be a cost-effective option for the treatment of metastatic cervical cancer compared to bevacizumab plus chemotherapy.
Cardiorenal ketone metabolism in healthy humans assessed by 11C-acetoacetate PET: effect of D-β-hydroxybutyrate, a meal, and age
Authors: St-Pierre Valérie , Richard Gabriel , Croteau Etienne , Fortier Mélanie , Vandenberghe Camille , Carpentier André C. , Cuenoud Bernard , Cunnane Stephen C. 
Published: October 2024

The heart and kidney have a high energy requirement, but relatively little is known about their utilization of ketones as a potential energy source. We assessed the metabolism of the ketone tracer, carbon-11 acetoacetate (11C-AcAc), by the left and right ventricles of the heart and by the kidney using positron emission tomography (PET) in n = 10 healthy adults under four experimental conditions: a 4-h fast (fasted) ± a single 12 g oral dose of D-beta-hydroxybutyrate (D-BHB), and a single complete, liquid replacement meal (hereafter referred to as the “fed” condition) ± a single 12 g oral dose of D-BHB. Under these experimental conditions, the kinetics of 11C-AcAc metabolism fitted a two-compartment model in the heart and a three-compartment model in the kidney. Plasma ketones were about 10-fold higher with the oral dose of D-BHB. During the four conditions, tracer kinetics were broadly similar in the myocardium and kidney cortex. 11C-AcAc metabolism by the kidney pelvis was similar in three of the four study conditions but, later, peaked significantly higher than that in the cortex; the exception was that the tracer uptake was significantly lower in the fed condition without D-BHB. 11C-AcAc uptake was significantly inversely correlated with age in the kidney cortex, and its oxidative metabolism was significantly positively correlated with age in the left ventricle. D-BHB blunted the insulin, gastric inhibitory peptide, and C-peptide response to the meal. This PET methodology and these acute metabolic perturbations would be suitable for future studies assessing cardiorenal ketone metabolism in conditions in which heart and kidney functions are experimentally modified or compromised by disease.
The combined influences of local heat application and resistance exercise on the acute mRNA response of skeletal muscle
Authors: McGlynn Mark L. , Rosales Alejandro M. , Collins Christopher W. , Slivka Dustin R. 
Published: October 2024

IntroductionThe development and maintenance of the skeletal muscle is crucial for the support of daily function. Heat, when applied locally, has shown substantial promise in the maintenance of the muscle. The purpose of this study was to determine the combined effects of local heat application and acute resistance exercise on gene expression associated with the human muscle growth program.Materials and methodsParticipants (n = 12, 26 ± 7 years, 1.77 ± 0.07 m, 79.6 ± 15.4 kg, and 16.1 ± 11.6 %BF) completed an acute bilateral bout of resistance exercise consisting of leg press (11 ± 2 reps; 170 ± 37 kg) and leg extension (11 ± 1 reps; 58 ± 18 kg). Participants wore a thermal wrap containing circulating fluid (40°C, exercise + heat; EX + HT) during the entire experimental period and 4 h post-exercise, while the other leg served as an exercise-only (EX) control. Biopsies of the vastus lateralis were collected (Pre, Post, and 4hPost) for gene expression analyses.ResultsIntramuscular temperatures increased (Post, +2.2°C ± 0.7°C, and p &lt; 0.001; 4hPost, +2.5°C ± 0.6°C, and p &lt; 0.001) and were greater in the EX + HT leg post-exercise (+0.35°C ± 0.3°C, and p = 0.005) and after 4hPost (+2.1°C ± 0.8°C and p &lt; 0.001). MYO-D1 mRNA was greater in the EX + HT leg vs. the EX (fold change = 2.74 ± 0.42 vs. 1.70 ± 0.28, p = 0.037). No other genes demonstrated temperature sensitivity when comparing both legs (p &gt; 0.05). mRNA associated with the negative regulator, myostatin (MSTN), decreased post-exercise (p = 0.001) and after 4 h (p = 0.001). mRNA associated with proteolysis decreased post-exercise (FBXO32, p = 0.001; FOXO3a, p = 0.001) and after 4 h (FBXO32, p = 0.001; FOXO3a, p = 0.027).ConclusionThe elevated transcription of the myogenic differentiation factor 1 (MYO-D1) after exercise in the heated condition may provide a mechanism by which muscle growth could be enhanced.
Enzyme catalytic efficiency prediction: employing convolutional neural networks and XGBoost
Authors: Alazmi Meshari 
Published: October 2024

IntroductionIn the intricate realm of enzymology, the precise quantification of enzyme efficiency, epitomized by the turnover number (kcat), is a paramount yet elusive objective. Existing methodologies, though sophisticated, often grapple with the inherent stochasticity and multifaceted nature of enzymatic reactions. Thus, there arises a necessity to explore avant-garde computational paradigms.MethodsIn this context, we introduce “enzyme catalytic efficiency prediction (ECEP),” leveraging advanced deep learning techniques to enhance the previous implementation, TurNuP, for predicting the enzyme catalase kcat. Our approach significantly outperforms prior methodologies, incorporating new features derived from enzyme sequences and chemical reaction dynamics. Through ECEP, we unravel the intricate enzyme-substrate interactions, capturing the nuanced interplay of molecular determinants.ResultsPreliminary assessments, compared against established models like TurNuP and DLKcat, underscore the superior predictive capabilities of ECEP, marking a pivotal shift in silico enzymatic turnover number estimation. This study enriches the computational toolkit available to enzymologists and lays the groundwork for future explorations in the burgeoning field of bioinformatics. This paper suggested a multi-feature ensemble deep learning-based approach to predict enzyme kinetic parameters using an ensemble convolution neural network and XGBoost by calculating weighted-average of each feature-based model’s output to outperform traditional machine learning methods. The proposed “ECEP” model significantly outperformed existing methodologies, achieving a mean squared error (MSE) reduction of 0.35 from 0.81 to 0.46 and R-squared score from 0.44 to 0.54, thereby demonstrating its superior accuracy and effectiveness in enzyme catalytic efficiency prediction.DiscussionThis improvement underscores the model’s potential to enhance the field of bioinformatics, setting a new benchmark for performance.
Astragalus membranaceus: A Traditional Chinese Medicine with Multifaceted Impacts on Breast Cancer Treatment
Authors: Tang Zhong , Tian Xuefei 
Published: October 2024

Breast cancer, the most prevalent malignant tumor among women globally, remains a critical area of focus for researchers striving to refine therapeutic approaches. As an important component of traditional Chinese medicine, Astragalus membranaceus (AM) has demonstrated potential for multifaceted impacts on breast cancer treatment through various mechanisms. To guide clinical practice and further explore the under-researched field of AM in breast cancer treatment, this paper mainly reviews the regulatory roles of AM-derived compounds and extracts on breast cancer cell proliferation, migration, invasion, and chemoresistance. Furthermore, this study delves into the synergistic effects observed when AM is co-administered with chemotherapeutic agents, including the enhancement of chemosensitivity, mitigation of toxic side effects, and reversal of drug resistance. This review indicates that AM holds promise not only as a therapy in breast cancer treatment but also paves the way for innovative integrated treatment approaches that combine the benefits of traditional medicine with modern pharmaceuticals. Nevertheless, future research endeavors are also urged to elucidate the in vivo pharmacological effects and underlying mechanisms of AM to inform more effective clinical treatment strategies.