bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and Effectiveness of Ultrasound-Guided Artificial Ascites-Assisted Puncture and Sclerotherapy for Ovarian Cysts
Authors: Meng Bin , Wang Xiaotao , Li Qian , Xu Mingmin 
Published: October 2024

Abstract

Background
Ovarian cysts are a common gynecological condition that can cause significant morbidity. Ultrasound-guided sclerotherapy is a minimally invasive treatment option. This study aims to assess the safety and effectiveness of ultrasound-guided artificial ascites-assisted puncture and sclerotherapy for ovarian cysts.
Methods
A retrospective analysis was conducted on 100 ovarian cyst patients treated from January 2019 to June 2023 at Zhejiang Rongjun Hospital. Patients were divided into observation (44 cases) and control (56 cases) groups based on the use of artificial ascites. The primary endpoints included the incidence of pain and vagal reflex during and after surgery, and the cure rate and effective rate of sclerotherapy assessed by ultrasound at 3, 6, and 12 months post-treatment.
Results
The observation group experienced significantly lower rates of pain (11.36%) and vagal reflexes (4.55%) compared to the control group (35.71% and 25.00% respectively, P < 0.01). The cure rate was 93.18% in the observation group and 82.14% in the control group (P < 0.05). The effective rate was 100% in the observation group, while it was 91.07% in the control group (P < 0.05). No post-operative infections were observed in either group.
Conclusion
Ultrasound-guided artificial ascites-assisted puncture and sclerotherapy significantly enhances the safety and efficacy of sclerotherapy for ovarian cysts, reducing complications during and after the procedure. It is recommended for widespread clinical use.
Decision Support Guided Fluid Challenges and Stroke Volume Response during High-Risk Surgery: A Post Hoc Analysis of a Randomized Controlled Trial
Authors: Coeckelenbergh Sean , Rinehart Joseph , Desebbe Olivier , Rogoz Nicolas , Mastouri Amira Dagachi , Maghen Bryan , Cannesson Maxime , Vincent Jean-Louis , Duranteau Jacques , Joosten Alexandre 
Published: October 2024

Abstract

Purpose
Intravenous fluid is administered during high-risk surgery to optimize stroke volume (SV). To assess ongoing need for fluids, the hemodynamic response to a fluid bolus is evaluated using a fluid challenge technique. The Acumen Assisted Fluid Management (AFM) system is a decision support tool designed to ease the application of fluid challenges and thus improve fluid administration during high-risk surgery. In this post hoc analysis of data from a randomized controlled trial, we compared the rates of fluid responsiveness (defined as an increase in SV of ≥ 10%) after AFM-guided or clinician-initiated (control) fluid challenges.
Methods
Patients undergoing high-risk abdominal surgery were randomly allocated to AFM-guided or clinician-initiated groups for fluid challenges titration, which consisted of 250-mL boluses of crystalloid or albumin given over 5 mins. The fluid responsiveness rates and the mean SV increase in the two groups were compared.
Results
The original study included 86 patients (44 in the AFM group and 42 in the clinician-initiated group) and this sub-study analysed 85 patients with a total of 448 fluid challenges. The median rate of fluid responsiveness was greater in the AFM than in the control group (50 [44–71] % vs 33 [20–40] %, p < 0.001). The mean increase in SV after fluid challenge was also higher in the AFM than in the control group (12 [9–16] % vs 6 [3–10] %, p < 0.001).
Conclusion
AFM-initiated fluid challenges were more often associated with the desired increase in SV than were clinician-initiated fluid challenges, and absolute SV increases were greater.
Clinical effect of treating hyperextension injuries of the thoracolumbar spine in patients with ankylosing spondylitis, without active intervention on the anterior distraction defect
Authors: Ye Zhiyuan , Yang Jian , Zhao Xushen , Bai Jinyu , Song Fanglong , Dai Jun , Zhou Zhentao , Shan Bingchen , Zhou Xiaozhong 
Published: October 2024

Abstract

Background
To observe the treatment effect of hyperextension fracture on thoracolumbar in patients with ankylosing spondylitis (AS) and determine whether anterior distraction defect can achieve union without active intervention.
Methods
From 2013 to 2023, we retrospectively searched our database to identify all individuals who had experienced extension-type fractures in the thoracolumbar region. The patients received either surgical or conservative management for treatment. The assessment of the extent of the anterior distraction defect was conducted in all patients. The evaluation of clinical effectiveness mainly involves the utilization of the visual analogue scale (VAS) to measure the severity of back pain and the Oswestry Disability Index (ODI) to assess functional limitations. Computed tomography imaging is used to assess the progress of fracture healing.
Results
A total of 32 individuals diagnosed with AS received medical treatment for thoracolumbar hyperextension fractures at our institution and met the inclusion criteria. All patients were followed up for a minimum of 12 months, with an average age of 58.7 ± 13.1 years. The mean extent of the anterior distraction defect was 10.3 (5.4, 16.1) mm, with 18 (56.3%) patients exhibiting an anterior defect extent exceeding 10 mm. All the patients expressed satisfaction with the outcomes, and all patients exhibited successful healing of their fractures. The mean VAS and ODI values were recorded as 1 (0, 2) and 9 (4, 9) %, respectively, during the final follow-up. Compared to surgery patients, the anterior defect was smaller in patients who received conservative treatment (P > 0.05). The anterior defect was larger after the operation compared to preoperative, but there was no statistically significant difference (P > 0.05). No significant complications or deaths occurred during the treatment, except for one patient who experienced a delayed neurologic deficit.
Conclusion
Both surgical and conservative treatments can achieve favorable outcomes in patients with AS accompanied by thoracolumbar hyperextension fracture. Regarding the anterior distraction defect resulting from hyperextension, fracture healing can be achieved without active intervention.
Trends in Fatal and Non-Fatal Injuries in the United States: Analyzing Incidence and Costs from 2015 to 2022
Authors: Wu Scott , Soetikno Alan , Sheehan Karen , Lundberg Alexander 
Published: October 2024

Abstract

Background In addition to the emotional toll on patients, families, and communities, injury is financially costly for the United States healthcare system. Costs associated with injury can be medical or non-medical, with medical costs limited to acute medical care and non-medical costs including work or quality of life losses. The objective of this study is to characterize recent incidence and cost trends for fatal and non-fatal injuries in the United States. Methods This descriptive retrospective study analyzes data published by the Centers for Disease Control and Prevention (CDC) Web-Based Injury Statistics Query and Reporting System (WISQARS) database from 2015–2022. The top ten injury types across all age groups by total cost in three injury outcome categories were compared, with the top three types in each category further discussed. Results Unintentional drug poisoning was the costliest fatal injury at $1.13T in 2022, a 123% increase from its total cost in 2015 ($503B). Suicide by drug poisoning was the only fatal injury type to decrease in total cost. Unintentional falls were the costliest non-fatal hospitalization-and-release and emergency department-and-release injury at $474B and $931B in 2022, respectively. Relative to fatal injuries, a greater proportion of costs were attributed to medical care in the non-fatal injury categories. Conclusions There is considerable heterogeneity in the trends of injury outcomes (i.e. fatal, non-fatal) and specific injury types (i.e. unintentional falls, firearm suicides), driven by changes in incidence and per-injury cost. Unintentional drug overdose and unintentional falls are the costliest fatal and non-fatal injuries, respectively, by wide margins. Recent injury incidence and cost trends highlight increased mortality, as well as increased hospitalization with decreased emergency department utilization for non-fatal injuries.
Evaluating impaired consciousness after acquired brain injury using a virtual-reality-based eye-tracking system
Authors: Lee Hyun Haeng , Hyun Cheolhwan , Kang Chung Hwan , Moon Won-Jin , Lee Jongmin 
Published: October 2024

Abstract

Background
Virtual reality (VR) can provide an experimental basis for inferring consciousness using information obtained from the responses of persons with disorders of consciousness (DOC) to denoised exogenous stimuli. Although integration of eye-tracking technologies has been proposed for evaluating levels of DOC, the calibration process poses substantial challenges or may be infeasible for persons with DOC. We aimed to demonstrate the validity and clinical utility of biomarkers obtained from pupil movements in response to visuoauditory stimuli presented in a VR environment using eye-tracking technology, while addressing the limitations of uncalibrated pupil trajectories.
Methods
We enrolled persons with prolonged DOC caused by acquired brain injury who showed continuous eye-opening for at least 15 min, along with healthy individuals. Participants were shown nine visuoauditory stimuli in a three-dimensional VR space while pupil movements were measured using an eye-tracking system. We calculated the relative pupil tracking length for visual and auditory stimuli (RPTL-V and RPTL-A). We established their cut-off values based on their congruence with the evoked potential test result to ascertain the presence of a “visuoauditory response by the RPTL.” Based on these results and the “visuoauditory response by Coma Recovery Scale-Revised (CRS-R),” the individuals were classified into “overt tracking,” “covert tracking,” and “no sign of tracking” groups. After 1 year, we assessed whether the participants could obey a simple command.
Results
Fifteen persons with prolonged DOC (median age, 67 [interquartile range {IQR}, 64.5–72.5] years; 9 [60%] women) and six healthy individuals (median age, 55 [IQR, 52.3–58.3] years; 3 [50%] women) participated. The RPTL-V and RPTL-A distribution varied according to the level of DOC and integrity of the visual or auditory pathway. The RPTL-V and RPTL-A cut-off values were 14.737 and 30.019, respectively. Frequencies of simple command obeying in the groups were: overt tracking, 5/8 (62.5%); covert tracking, 2/4 (50%); and no sign of tracking, 0/3 (0%). In 1/15 persons with DOC, a visuoauditory response not detected through the CRS-R was identified via the RPTL.
Conclusions
A VR-based eye-tracking system can quantitatively assess DOC, offering valid and clinically useful support for diagnosis and prognosis in conjunction with the CRS-R.
Functional profiling of murine glioma models highlights targetable immune evasion phenotypes
Authors: Mikolajewicz Nicholas , Tatari Nazanin , Wei Jiarun , Savage Neil , Farias Adrian Granda , Dimitrov Vassil , Chen David , Zador Zsolt , Dasgupta Kuheli , Aguilera-Uribe Magali , Xiao Yu-Xi , Lee Seon Yong , Mero Patricia , McKenna Dillon , Venugopal Chitra , Brown Kevin R. , Han Hong , Singh Sheila , Moffat Jason 
Published: October 2024

Abstract

Cancer intrinsic immune evasion mechanisms and pleiotropy represent a barrier to effective translation of cancer immunotherapy. This is acutely apparent for certain highly fatal cancers such as high-grade gliomas and glioblastomas. In this study, we use functional genetic screens, single-cell transcriptomics and machine-learning approaches to deeply characterize murine syngeneic glioma models in vitro and in vivo, and compare-and-contrast their value as preclinical models for human glioblastoma (GBM). Systematic genome-wide co-culture killing screens with cytotoxic T cells, natural killer cells or macrophages established NFkB signaling, autophagy/endosome machinery, and chromatin remodeling as pan-immune cancer intrinsic evasion mechanisms. Additional fitness screens identified dependencies in murine gliomas that partially recapitulated those seen in human GBM (e.g., UFMylation). Different models associated with contrasting immune infiltrates including macrophages and microglia, and both models recapitulate hallmark immune gene programs seen in human GBM, including hypoxia, interferon and TNF signaling. Moreover, in vivo orthotopic tumor engraftment is associated with phenotypic shifts and changes in proliferative capacity, with models recapitulating the intratumoral heterogeneity observed in human GBM, exhibiting propensities for developmental- and mesenchymal-like phenotypes. Notably, we observed common transcription factors and cofactors shared with human GBM, including developmental (Nfia, Tcf4), mesenchymal (Prrx1 and Wwtr1), as well as cycling-associated genes (Bub3, Cenpa, Bard1, Brca1, and Mis18bp1). Perturbation of these genes led to reciprocal phenotypic shifts suggesting intrinsic feedback mechanisms that balance in vivo cellular states. Finally, we used a machine-learning approach to identify evasion genes that revealed two gene programs, one of which represents a clinically relevant phenotype and delineates a subpopulation of stem-like glioma cells that predict response to immune checkpoint inhibition in human patients. This study offers relevant insights and serves to bridge the knowledge gap between murine glioma models and human GBM.
Nutritional education interventions on the components of metabolic syndrome in Bangladeshi adults
Authors: Akter Shammy , Azhar Bably Sabina , Kamruzzaman Md. , Roshid Md. Mamunur , Alvin Bose 
Published: October 2024

Abstract

Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that includes central obesity, hypertension, dyslipidemia, and disturbed glucose metabolism. To the best of our knowledge, no research in Bangladesh has evaluated the effect of nutritional interventions on MetS.The main objective was to explore the effects of nutritional interventions on participants with MetS. A cross-sectional study was carried out on 500 Bangladeshi adults (30 to 69 years; both males and females) who provided informed consent. Modified NCEP ATP III criteria for Asians were used to diagnose the subjects. This study revealed that the overall percentages of men and women with MetS were 59.6% and 59.1%, respectively.The present study revealed a 2.69 cm reduction (p < 0.05) in waist circumference in females after 4 months of in-depth nutritional counseling and a 0.24 cm reduction after 4 months of single-intervention nutritional counseling. Similarly, a 2.64 cm reduction (p > 0.05) in males after 4 months of in-depth nutritional counseling and a 1.57 cm increase after a single intervention of nutritional counseling were found to be significant (p < 0.05). A 1.08 mmol/L decrease in FBG was found after in-depth nutritional counseling for 4 months, while no significant difference was detected after a single intervention. A 9.37 mg/dl increase in HDL-C was found (p < 0.05) for females, but for males, the levels of HDL-C remained nearly the same in both intervention groups. A reduction in the MetS proportion was found in the intervention groups (p < 0.05). The loads of MetS components 3, 4, and 5 were 44–23.5%, 47.1–11.8%, and 8.8–5.9% (p > 0.05), respectively, in the in-depth intervention group, whereas in the single intervention group, they were 50.0–32.3%, 41.9–35.5%, and 9.7–22.6%, respectively. Thus, community-based in-depth nutritional counseling reduced the proportion of individuals with MetS and significantly improved several metabolic parameters in Bangladeshi adults with MetS.
3-Month Prognostic Value of the Systemic Inflammatory Response Index Combined with Blood Glucose/ Potassium Ratio Score in Acute Ischemic Stroke Patients Receiving Intravenous Thrombolysis
Authors: Wen Zhijun , Cai Hanyu , Chen Nan , Ren Jie , Cheng Jianhua , Huang Yirui 
Published: October 2024

Abstract

Objective
In recent years, an increasing number of studies have focused on the use of readily available inflammatory markers to predict the prognosis of intravenous thrombolysis (IVT) in acute ischemic stroke (AIS). The systemic inflammatory response index combined with blood glucose/potassium ratio (SIRI-GPR) score is a new combination index that can reflect the inflammatory and stress status. However, whether this index can predict the prognosis of patients with AIS underwent IVT has not been reported. The purpose of our study was to investigate the role of the SIRI-GPR(systemic inflammatory response index combined with blood glucose/potassium ratio) score in predicting the prognosis of patients with AIS(acute ischemic stroke) who underwent IVT at 3 months.
Methods
We analyzed 247 patients with AIS admitted to the emergency department of the neurology department of the First Affiliated Hospital of Wenzhou Medical University from July 2021 to July 2022. The primary outcome was a 3-month prognosis. Univariate analysis and multivariate logistic regression were used to analyze the possible influencing factors of 3-month poor prognosis in patients with AIS after IVT. Independent factors were included in the construction of the clinical prediction model. We assessed the nomogram models using ROC and calibration curves.
Results
A total of 119 patients with AIS were finally included in the cohort study. Multifactorial logistic regression analysis showed no significant association between SIRI or GPR and 3-month functional prognosis, however, the SIRI-GPR score was found to be an independent predictor of 3-month dysfunction, In addition, it was also investigated whether large artery occlusion (OR = 5.836, 95% CI 1.123 ~ 30.337, P = 0.036) and NIHSS score within 24h after IVT (OR = 1.371, 95% CI 1.167 ~ 1.612, P < 0.001) were the independent influences of poor prognosis at 3 months (P < 0.05). The nomogram prediction model we constructed showed that the SIRI-GPR score was a good predictor of 3-month prognosis for these patients.
Conclusion
The SIRI-GPR score can predict the 3-month prognosis in stroke patients treated with IVT.
Phase I First-in-Human Dose Escalation Study of the oral Casein Kinase 1α and Cyclin Dependent Kinase 7/9 inhibitor BTX-A51 in advanced MDS and AML
Authors: Ball Brian , Xiao Wenbin , Borthakur Gautam , Nguyen Le Xuan Truong , Valerio Melissa , Venkatachalam Avanthika , Marcucci Guido , Stein Anthony , Thai Dung Luong , Cook David , Chan Kyle , Persaud Sonali , Levine Ross , Abdel-Wahab Omar , Ben-Neriah Yinon , Stein Eytan 
Published: October 2024

Abstract

BTX-A51, a first-in-class oral small molecule inhibitor of casein kinase 1α (CK1α) and cyclin dependent kinase (CDK) 7 and 9, induces apoptosis of leukemic cells by activating p53 and inhibiting expression of Mcl1. Here, we report on the results of the phase 1 clinical trial of BTX-A51 in patients with relapsed or refractory AML and MDS. Thirty-one patients were enrolled into 8 dose-escalation cohorts at BTX-A51 doses ranging from 1mg to 42mg dosed three days/week for 21 or 28 days out a 28-day cycle. The recommended phase 2 dose was 21mg dosed three days/week for 4 weeks of a 28-day cycle. BTX-A51 increased expression of p53 and reduced expression of MCL1 and RNA polymerase II phosphorylation on pre- and post-treatment immunocytochemistry studies. Overall, 3 patients (10%) experienced complete remission with incomplete count recovery (CRi). All 3 responding patients had RUNX1 mutations and the CR/CRi rate for RUNX1-mutated patients receiving BTX-A51 at efficacious doses (11mg or higher) was 30%. Ex-vivo studies confirmed higher efficacy of BTX-A51 on RUNX1-mutated myeloblasts and demonstrate synergy with azacitidine and venetoclax. Although the overall efficacy was modest, this study lays the groundwork for future studies with improved patient selection and combination approaches.
The Holistic Model of Leukaemia Survivorship Care: derived from a qualitative exploration of leukaemia survivorship
Authors: Kirsten Shaun , Laidsaar-Powell Rebekah , Shaw Joanne , Dhillon Haryana 
Published: October 2024

Abstract

Purpose
Increasing survival rates have left many leukaemia survivors with debilitating side- and late-effects. However, little is known about the persistent unmet needs of people living with leukaemia.
Methods
We aimed to qualitatively explore the experiences of individuals living with leukaemia and suitability of the Clinical Oncology Society of Australia’s (COSA) Model of Survivorship Care (2016) to reflect leukaemia survivorship. We used an inductive qualitative approach, conducting semi-structured interviews with leukaemia survivors recruited via social media and cancer advocacy organisations. Interviews were continued until information power was deemed appropriate. Reflexive Thematic Analysis (RTA) was used to describe and interpret key themes and meta-themes in the data.
Results
Overall findings were examined alongside the COSA Model. Twenty-four leukaemia survivors were interviewed, six themes were identified: (1) leukaemia is impactful, life-altering, and unexpected; (2) leukaemia is enduring, life-limiting, and uncertain; (3) survivorship is a team effort; (4) centrality of work as identity, focus, and financial security; (5) the dynamic landscape of coping; and, (6) survivorship as adjusting. Overall, participants described leukaemia survivorship as: (1) recursive; and (2) holistic.
Conclusions
Our findings, while broadly corresponding with the COSA Model, demonstrate it lacks nuances specific to leukaemia survivorship. We recommended the HMLS be used to guide future leukaemia-specific development of the COSA Model and survivorship services.
Implications for Cancer Survivors:
We identified key domains and stages common across leukaemia survivorship, presented in our proposed Holistic Model of Leukaemia Survivorship (HMLS), addressing these domains are critical to the provision of quality survivorship care.
Per capita reproductive success decreases with group size in a communally breeding bird
Authors: Mann Quinlan M. , Grieves Leanne A. , Schmaltz Gregory , Quinn JAMES Scott 
Published: October 2024

Abstract

The benefits of cooperative breeding include anti-predator defense, access to resources, and inclusive fitness via kin-selection. Smooth-billed anis (Crotophaga ani) are communally breeding birds in which co-breeding females lay eggs in a shared nest. Within-group relatedness is low, so kin selection is not driving this system. Group size ranges widely, and larger groups often exhibit intense ovicide, suggesting it is costly to breed in large groups. Assuming there are tradeoffs between group size and reproductive success, we predicted that with increasing group size i) group reproductive success would increase, while ii) per-capita reproductive success would decrease, and iii) the probability of offspring surviving to a subsequent developmental stage would increase due to the presence of additional caregivers. Using data from 364 nests, we show that larger groups laid, incubated, and hatched more eggs and fledged more chicks, whereas per capita reproductive success decreased with increasing group size across all four measures. Group size did not affect the probability of offspring surviving to a subsequent developmental stage, and anis frequently breed in larger-than-optimal groups. We conclude that communal breeding in large groups is likely driven by ecological constraints, factors that increase long-term fitness of individuals, and conflicting selection pressures among individuals trying to join groups and those already in groups. Our findings highlight the complex selection pressures that likely influence communal breeding in non-kin groups with highly variable group structure.