bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resistin Upregulates Fatty Acid Oxidation in Synoviocytes of Metabolic Syndrome-Associated Knee Osteoarthritis via CAP1/PKA/CREB to Promote Inflammation and Catabolism
Authors: Ding Lu , Ren Jinyi , Huang Yi-Fan , Bai Zi-Ran , Leng Yi , Tian Jun-Wei , Wei Jing , Jin Min-Li , Wang Guan , Li Xia , Qi Xin 
Published: October 2024

Abstract

Background: To explore whether there were metabolism disorder which promote inflammatory and catabolic phenotype in fibroblast-like synoviocytes (FLS) from KOA patients with MetS (MetS-KOA-FLS), and the roles and mechanisim of resistin in MetS-KOA-FLS.
Methods: Comparative analysis of synovium and fibroblast-like synoviocytes (FLS) from MetS-associated KOA (MetS-KOA) and non-MetS-associated KOA (nMetS-KOA) of females to detect the differences in inflammation, catabolism and glycolipid metabolis. Serum from MetS-KOA stimulated nMetS-KOA-FLS to detect the effect of MetS microenvironment on inflammation, catabolism and glycolipid metabolism of nMetS-KOA-FLS. Resistin stimulated MetS-KOA-FLS to explore the effect of resistin on inflammation and catabolism of MetS-KOA-FLS and its specific mechanism.
Results: Compared with nMetS-KOA-FLS, MetS-KOA-FLS expressed higher inflammatory related factors, catabolic enzymes, and showed stronger adhesive and invasive ability. Resistin was found to be an important factor in the serum and internal environment of MetS-KOA patients, and it mediated the differences in fatty acid oxidation (FAO) between the two groups. Resistin activated the PKA/CREB pathway through CAP1 and upregulated FAO, promoting the inflammatory and catabolic phenotype of MetS-KOA-FLS.
Conclusions: This study clarifies the mechanism by which MetS causes synovitis from a metabolic perspective and provides new ideas for further research and treatment of MetS-KOA.
Longitudinal graphics of physical function and other patient-reported outcomes in patients treated for hematologic malignancies
Authors: Thanarajasingam Gita , Bhatnagar Vishal , Noble Brie , Chen Ting-Yu , Fiero Mallorie , Hoffman Ron , Jeffery Molly , Mazza Gina , Mascarenhas John , Mesa Ruben , Murugappan Meena , Ross Joseph , Sidana Surbhi , Warsame Rahma , Kluetz Paul , Dueck Amylou 
Published: October 2024

Abstract

Background
The US Food and Drug Administration (FDA) released a draft guidance document detailing core patient-reported outcomes in cancer clinical trials, including physical function (PF). This study aimed to develop analytic methods and visualizations of patient-reported PF in patients with cancer.
Methods
We applied an estimand framework to a patient-reported tolerability endpoint to develop data summaries cross-sectionally and over time, along with visualizations. We accomplished this through iterative feedback with clinicians, statisticians, and FDA stakeholders using three clinical trial datasets in hematologic malignancies. Graphical approaches were applied to three datasets in hematologic malignancies: (1) patients with myeloproliferative neoplasms enrolled in MPN-RC 111/112 trials completed EORTC QLQ-C30 over 12 months; (2) patients with hematologic malignancies undergoing CAR-T cell therapy or autologous transplant who completed FACT questionnaires over 6 months; and (3) patients with multiple myeloma or amyloidosis who completed the PROMIS-29 questionnaire over 6 months. Zoom polls were administered to two stakeholder groups (clinicians/clinical investigators and patient advocates) to elicit feedback.
Results
Visualizations included stacked bar charts, line plots of arithmetic mean changes from baseline, pie charts, waffle plots, and waterfall plots of PF data. Graphics considered scaled scores and individual items and included delineation of PRO completion rate at each time point. Confidence intervals and reference lines were included as applicable, and colorblind accessible colors were implemented to ensure inclusivity of all visualizations. Data summaries over time reporting “worst” change were difficult to interpret. In terms of stakeholders’ preference, patients preferred stacked bar charts while clinicians equally favored stacked bar charts and line plots; both patients and clinicians preferred waterfall plots to pie charts. Patient feedback highlighted the need for various graphics to convey group level trends and granular individual-patient level information.
Conclusion
Patient-reported PF informs the evaluation of treatment tolerability in cancer trials. Data summaries and visualizations of physical function developed through an iterative process were reviewed favorably by patients, clinicians and FDA stakeholders in this study. Future work to systematically assess accuracy of interpretation of the various analytic and visualization methods is a necessary next step across clinical, regulatory, payer and patient stakeholders.
Trial registration
NCT01259817, NCT01259856
Prognostic factors of recurrence in patients with recurrent postoperative pancreatic cancer treated with adjuvant TS-1 as the main outcome
Authors: Abe Kyohei , Furukawa Kenei , Fukuda Mizuki , Gocho Takeshi , Tsunematsu Masashi , Hamura Ryoga , Shirai Yoshihiro , Haruki Koichiro , Fujioka Shuichi , Ikegami Toru 
Published: October 2024

Abstract

Purpose
Prognosis of pancreatic cancer is improved by combining postoperative adjuvant chemotherapy and preoperative adjuvant chemotherapy with surgery, while the importance of extended dissection surgery has decreased. Here, to better understand prognostic factors of recurrence, we focused on the timing of postoperative adjuvant chemotherapy in patients with pancreatic cancer.
Materials and Methods
One hundred patients who underwent pancreatectomy or pancreaticoduodenectomy and chemotherapy for pancreatic cancer were classified into early and late postoperative adjuvant therapy initiation groups. Prognosis was evaluated retrospectively using known prognostic factors.
Results
On receiver operating characteristic analysis, optimum cut-off between the early (< 52 days; n = 60) and late adjuvant initiation groups (≥ 52 days; n = 40) was 52 days. The two groups were well-matched, except the early initiation group had more surgeries with D2 lymph node dissection (75% vs 48%; p = 0.01); fewer postoperative complications (17% vs 59%; p = 0.04), including less postoperative pancreatic fistula (13% vs 35%; p = 0.03); and longer disease-free survival (0.7 years v 0.5 years; p = 0.02). On multivariate evaluation, early initiation of adjuvant therapy and completion of adjuvant therapy were associated with increased overall survival, while early initiation was associated with prolonged disease-free survival.
Conclusion
Prognosis of patients with pancreatic cancer is improved by earlier rather than later initiation of postoperative adjuvant therapy. While surgery remains a key treatment approach, its main contribution to prognosis may derive from minimization of dissection and complications.
Advancing the Understanding and Diagnosis of Histoplasmosis: Insights from a Tertiary Care Hospital in India
Authors: Soni Jinal , Gogia Atul , Aggarwal Anivita 
Published: October 2024

Abstract

Background Histoplasma capsulatum, a dimorphic fungus, is a significant cause of endemic mycosis, particularly in immunocompromised individuals. While considered endemic to the Gangetic Plains in India, reports from nonendemic regions have been increasing. This study aims to enhance the understanding and diagnosis of histoplasmosis by describing cases from a tertiary care hospital in New Delhi, India.Methods A retrospective study involving adult patients diagnosed with histoplasmosis was conducted at Sir Ganga Ram Hospital, New Delhi, India, from July 2019 to March 2024. Clinical data were extracted from the hospital’s electronic medical records and analysed via SPSS software.Results Eleven patients with a mean age of 48.4 years were identified. The majority were male (90.9%) and had risk factors such as immunosuppressive therapy, HIV (human immunodeficiency virus) and diabetes. Common symptoms included fever (90.9%) and weight loss (72.7%). Hematological abnormalities such as anemia and leukopenia (36.3%) and radiological findings of splenomegaly (72.7%) and hepatomegaly (63.6%) were most common. Complications such as hemophagocytic lymphohistiocytosis (HLH) and multiple organ dysfunction syndrome (MODS) occurred in 27.2% of patients, with a mortality rate of 18.18%.Discussion Histoplasmosis often mimics tuberculosis (TB) in terms of symptoms and radiological findings, complicating its diagnosis in regions with high TB burdens. Immunosuppressive therapy, HIV, and diabetes are significant risk factors. Clinical presentations vary, including fever, weight loss, and uncommon manifestations like gastrointestinal (GI) and central nervous system (CNS) involvement, posing diagnostic challenges. Unlike those in the western literature, all patients in our study had disseminated histoplasmosis, suggesting the underdiagnosis of milder forms in India. Most patients respond well to intravenous L-AmB (liposomal amphotericin-B) followed by oral itraconazole, although complications such as HLH and MODS are common. The mortality rate was 18.18%, emphasizing the need for timely diagnosis and treatment.Conclusion This study reinforces the importance of heightened clinical suspicion and awareness for diagnosing histoplasmosis. Improved diagnostics with rapid and reliable tests are essential for better patient management and outcomes. Public health strategies should focus on educating healthcare providers about diverse presentations and mandating case notifications. An enhanced understanding of histoplasmosis can mitigate misdiagnosis rates and improve treatment outcomes.
Three-Dimensional Agitated Saline Contrast Transesophageal Echocardiography for the Diagnosis of Patent Foramen Ovale
Authors: Gwak Seo-Yeon , Kim Kyu , Lee Hyun-Jung , Cho Iksung , Hong Geu-Ru , Ha Jong-Won , Shim Chi Young 
Published: October 2024

Abstract

Background
Patent foramen ovale (PFO) is a three-dimensional (3D) and dynamic structure, making it challenging to diagnose with 2D imaging. We aimed to develop a practical protocol for 3D agitated saline contrast (ASC) transesophageal echocardiography (TEE), evaluate its feasibility, and identify implications for the diagnosis of patent foramen ovale (PFO) in patients with ischemic stroke.
Methods
In 158 patients (52 women; age: 63.6 ± 14.0 years) with ischemic stroke who were referred for TEE to evaluate the cardiac source of embolism, TEE was performed using the EPIQ CVx ultrasound system (Philips Medical Systems, Andover, MA) with a 2–8 MHz transesophageal matrix array transducer (X8-2t). ASC tests were performed with 2D and 3D images. According to the results of each method, patients were classified into four groups: no shunt, possible PFO, definite PFO, and intrapulmonary shunt.
Results
The practical 3D ASC protocol consisted of two images: one in the 90°–120° bicaval view and another in the 40°–70° short-axis view. These images were acquired to include both the left upper pulmonic vein and interatrial septum at the mid-esophageal position. Image acquisition and analysis of 3D TEE images were feasible in 150 patients (94.9%). By applying the 3D ASC protocol, 32 patients (21.3%) were reclassified into another group, and 16 (10.7%) had their diagnosis changed. Definite PFO cases increased from 20 (13.3%) to 35 (23.3%) patients.
Conclusion
The practical 3D TEE protocol for diagnosing PFO was feasible in patients with ischemic stroke. Adding a practical 3D ASC protocol to 2D TEE aids in the accurate diagnosis of PFO.
Gender Matters: On Recurrence Risk of Cardiovascular Complications for Type 2 Diabetes Subjects
Authors: Gentili Michele , Leonardi Stefano , Silvestri Fabrizio , Croce Federico , Rosati Riccardo , Grani Giorgio , Candido Riccardo , Cianni Graziano Di , Mannino Domenico , Ponzani Paola , Russo Giuseppina , Nicolucci Antonio , Frieder Ophir , Maranghi Marianna 
Published: October 2024

Abstract

Background
Previous reports suggest that, despite men facing higher absolute risks of cardiovascular complications, women with type 2 diabetes (T2DM) experience greater relative risks of cardiovascular events. Studies prior to 2000 indicated a significant impact of cardiovascular disease (CVD) in women with diabetes, but recent research shows inconsistent results. The uncertainty persists on whether sex differences in the impact of diabetes on CVD and mortality exist, and if so, whether they depend on age or other cardiovascular risk factors.
Methods
This study analyzed data from Italian Diabetes Outpatient clinics (2005–2018) for more than 300,000 patients. We leveraged sequential data mining techniques such as the incremental risk score (lift score) to investigate whether T2DM is associated with a higher risk of recurrent macrovascular events in women compared to men. We used Cohen's d to compare risk factors in men and women and Chi-square test to compare the number of treatments prescribed.
Results
The incremental risk for women was significantly higher (20% on average) as compared to men for most of the analyzed sequence of major cardiovascular events. A deep analysis of risk factors and therapeutic treatment did not provide a clear explanation for this risk difference .
Conclusions
In this nationwide study, we observed that although men have higher absolute rates of first-occurrence of macro vascular complications, the relative risk of recurrent cardiovascular complications are higher in women across all ages. The study suggests that the treatment and care for cardiovascular complications in diabetic patients should reflect the differences in the risk for subsequent major cardiovascular events in men and women.
The Impact of Social Capital on Condom Use at Lat Sex Among Sexually Active Young People in Ghana.
Authors: Ananga Mark Kwame , Bonsra Emmanuel Abu , Agbefu Rosemary Kafui , Komesuor Joyce 
Published: October 2024

Abstract

Background: Social capital, the resources found within social relationships, is increasingly recognised in public health. Although the literature extensively documents the factors associated with risky sexual behaviours among youth, most studies concentrate on individual-level factors. However, these behaviours can also be influenced by social factors beyond individual control, as young people are often embedded in social organizations. This study aimed to investigate the relationship between social capital variables and condom use at last sex among sexually active young people in Ghana.
Method: A cross-sectional quantitative study design was conducted using a community-based household survey among young people aged 15 -24 years in the South Tongu district of Ghana. A multi-stage cluster sampling method was employed to sample 792 youth for the study. Data collection utilized well-designed semi-structured questionnaires. Analysis of the data was done using STATA version 16.
Results: Significant associations were found between several dimensions of social capital and condom use at last sex. Specifically, participants with stronger network connections had a 1.84 times higher likelihood of condom use (AOR=1.84, 95% CI=1.20-2.82, p=0.005). Additionally, participants who reported higher empowerment were more likely to use condoms (AOR=2.75, 95% CI=1.90-3.97, p<0.001). Conversely, higher trust in people and institutions was associated with lower odds of condom use (AOR=0.70, 95% CI=0.51-0.97, p=0.033).
Conclusion: The current findings underscore the crucial impact of social capital on condom use among adolescents and young adults. Strengthening social networks and empowering individuals can enhance condom use, though high levels of trust in others may pose challenges.
PARPis after PARPis in patients with recurrent epithelial ovarian cancer: A single institutional experience
Authors: Yuan Hua , Wang Tonghui , Yao Hongwen , Wu Lingying , Li Ning 
Published: October 2024

Abstract

Objective
Negligible evidence exists for PARPis maintenance treatment rechallenge in patients with recurrent epithelial ovarian cancer (EOC) in China.
Methods
We included patients diagnosed with primary EOC who received 2 lines of PARPis maintenance treatment after achieving complete response (CR) or partial response (PR) with the previous chemotherapies. The patients’ full medical records were included in this study. Clinical and pathologic variables, treatment modalities, and outcomes were assessed. We investigated the treatment patterns and time to next treatment (TTNT).
Results
A total of 31 ovarian cancer patients in our center were included. Among these patients, 20 of them (64.5%) had BRCA1/2 gene mutations. The median duration of PARPi1 and PARPi2 in the entire cohort was 11.2 months (range: 2.0-30.4 months) and 4.8 months (range: 1.0-16.7 months), respectively.
Median TTNT1 and TTNT2 for the entire cohort was 12.4 and 7.7 months, respectively. Patients with BRCA1/2 mutation had a significantly better TTNT1 (median TTNT1: 17.3 vs 10.4 months, P=0.005) than those without. A non- significantly better TTNT2 was observed in patients with BRCA1/2 mutation than those without (median TTNT2: 8.2 vs 5.0 months, P=0.890). The association between previous chemotherapy response and TTNT was also analyzed. Patients who had a CR to previous chemotherapy had a significantly better TTNT1 (median TTNT1: 16.4 vs 7.6 months, P=0.001) and TTNT2 (median TTNT2: 11.1 vs 4.9 months, P=0.003) than those who had a PR.
No grade Ⅲ-IV anemia occurred. Grade III PARPis-related thrombocytopenia was found in only 1 patient (3.2%, 1/31) who received PARPi2 treatment. For patients who developed PARPis-related anemia (n=9) or thrombocytopenia (n=7) during PARPi1 treatment, 7 patients (77.8%, 7/9) and 6 patients (85.7%, 6/7) developed anemia or thrombocytopenia again during PARPi2 treatment, respectively.
Conclusions
Patients with PARPis resistant recurrent EOC may derive benefit from PARPis re-treatment, especially for those with complete response to the last chemotherapy. Patients with BRCA1/2 mutation were more likely to benefit from PARPis retreatment than those with wild-type. Anemia and thrombocytopenia were more common in PARPis retreatment patients. A small proportion of patients had a longer benefit from PARPis retreatment than from previous PARPis treatment.
Proportional Correlation Between Systemic Inflammation Response Index and Gastric Cancer Recurrence Time
Authors: In Kyung Ryun , Kang Sun Hyung , Lee Hyun Seok , Eun Hyuk Soo , Moon Hee Seok , Lee Eaum Seok , Kim Seok Hyun , Sung Jae Kyu , Lee Byung Seok 
Published: October 2024

Abstract

Disease recurrence is the primary cause of death in patients with gastric cancer who have undergone complete surgical resection. No prognostic factors for recurrence, other than the tumor, node, metastasis (TNM) stage, have been established. However, even within the same TNM stage, recurrence rates differ. Therefore, we developed a new prognostic confidence measure for gastric cancer recurrence and demonstrated its practical utility. In this retrospective study, we enrolled patients diagnosed with stage II/III gastric cancer who underwent complete surgical resection and adjuvant chemotherapy at the Chungnam National University Hospital, South Korea over the past 12 years. The associations among seven variables, including the systemic inflammation response index (SIRI), and gastric cancer recurrence was analyzed. A total of 296 patients were enrolled. Although other factors did not exhibit significance, the SIRI showed a positive correlation with gastric cancer recurrence risk, confirmed through Cox regression testing (hazard ratio, 1.231; 95% confidence interval, 1.04–1.45). Linear regression analysis revealed a significant association between higher SIRI values and shorter recurrence time (p = 0.044; β = −0.225). Other than the SIRI, effective prognostic factors related to gastric cancer recurrence were not verified. SIRI shows potential as an independent prognostic factor.
Coronary Artery Calcium on Lung Cancer Radiation Planning CT Aids Cardiovascular Risk Assessment
Authors: Lui Matthew , Kim Noah , Zaghlol Raja , Joolharzadeh Pouya , Deych Elena , Robinson Clifford , Badiyan Shahed , Woodard Pamela K. , Mitchell Joshua D. 
Published: October 2024

Abstract

Background:
Patients with non-small cell lung cancer (NSCLC) undergoing thoracic radiation are at high cardiovascular risk. Semiquantitative assessment of coronary artery calcification (CAC) on baseline planning non-gated chest computed tomography (CT) scans may help further risk stratify patients.
Objectives:
This study aimed to characterize the association between CAC and major adverse cardiovascular events (MACE; myocardial infarction or stroke) and assess the utility of semiquantitative assessment of CAC.
Methods:
Patients with NSCLC with non-contrast planning chest CT scans were evaluated for CAC. Planning scans were visually graded using the CAC-DRS method, stratifying patients into no, mild, moderate, and severe CAC groups. Demographics, comorbidities, and radiation treatment characteristics were gathered, and CAC groups were assessed for the incidence of MACE after initiation of radiation therapy.
Results:
Out of 137 patients, 39 patients had no CAC, and 98 patients had any CAC (38 with mild CAC, 34 with moderate CAC, and 26 with severe CAC). There was 1 MACE event in the no CAC group and 11 in patients with any CAC. The presence of CAC was associated with increased MACE compared to no CAC (p = 0.034). Semiquantitative CAC analysis correlated with formal CAC scoring.
Conclusion:
There is a significantly lower incidence of MACE in patients with no CAC on planning CT compared to patients with higher burdens of CAC. CAC burden is an important risk factor for adverse cardiovascular events in patients with NSCLC undergoing thoracic radiation. Semiquantitative CAC scoring may be a useful proxy when formal CAC scoring is unavailable.
Evaluation of Anesthesia-Related Videos in Patients With Obesity on The Youtube Platform İn Terms of Quality, Reliability And Usefulness: An Observational Study
Authors: EVRAN Turan , İlhan Seher 
Published: October 2024

Abstract

Purpose
The purpose of this study is to assess the quality, reliability, and usefulness of anesthesia-related YouTube videos for obese patients by analyzing their content and evaluating their usefulness based on the source of the video.
Method
This research analyzed the top 108 most-watched YouTube videos tagged with “bariatric anesthesia” and “anesthesia in obese patients.” We recorded data such as the upload year, number of views, days since upload, daily average views, length of videos, and the number of likes and comments. Videos were grouped into three categories: healthcare institutions, educational institutions, and personal websites. The accuracy and reliability of the videos were evaluated using standards set by the American Medical Association. The quality was assessed via a global quality scale, and usefulness was determined through a newly developed Obesity Anesthesia Benefit Index.
Fındıngs
The study revealed that 38.9% of the YouTube videos reviewed were posted by educational institutions, and 91.7% by doctors. The general usefulness of these videos was rated low. There was a notable correlation between the Obesity Anesthesia Benefit Index usefulness scores and both the video durations and the time since upload (p=0.000; p=0.037). Videos from educational institutions notably scored higher on the Global Quality Scale and according to the American Medical Association’s standards compared to other sources (p<0.000; p<0.000).
Results
Our evaluation using the Obesity Anesthesia Benefit Index revealed that the usefulness of the YouTube videos was lower than initially hypothesized.