bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fluorescence detection of pituitary neuroendocrine tumour during endoscopic transsphenoidal surgery using bevacizumab-800CW: a non-randomised, non-blinded, single centre feasibility and dose finding trial [DEPARTURE trial]
Authors: Schmidt I. , Vergeer R. A. , Postma M. R. , van den Berg G. , Sterkenburg A. J. , Korsten-Meijer A. G. W. , Feijen R. A. , Kruijff S. , van Beek A. P. , den Dunnen W. F. A. , Robinson D. J. , van Dijk J. M. C. , Nagengast W. B. , Kuijlen J. M. A. 
Published: October 2024

Abstract

Purpose
Achieving endocrine remission by gross total resection is challenging in pituitary neuroendocrine tumours (PitNETs) with cavernous sinus invasion. This study aims to assess the safety, feasibility, and optimal dose for intraoperative fluorescence imaging as an added instrument to discriminate PitNET from surrounding tissue using bevacizumab-800CW, targeting vascular endothelial growth factor A (VEGF-A).

Methods
In part I, dose-escalation (0–4∙5-10-25 mg) was performed in 4 groups of 3 patients with PitNETs Knosp grade 3–4. In part II, after interim analysis, the 10 mg and 25 mg groups were expanded to a total of 6 patients. Quantitative fluoroscence molecular endoscopy consisted of wide field fluorescence molecular endoscopy and multi-diameter single fiber reflectance / single fiber fluorescence spectroscopy. Mean fluorescence intensity (MFI) of the fresh surgical specimen was calculated and VEGF-staining was performed.

Results
Eighteen patients were included. All doses were well tolerated. Three serious adverse events were registered, but none were tracer-related. Part I showed an adequate in-vivo tumour-to-background ratio for both 10 mg (TBR 2∙00 [1∙86, 2∙19]) and 25 mg (TBR 2∙10, [1∙86, 2∙58]). Part II revealed a substantially higher MFI in the 25 mg group. With both 10 mg and 25 mg a statistically significant difference between tumour and surrounding tissue was detected (p < 0∙0001). All surgical specimens had VEGF-A expression.

Conclusion
This study demonstrates the safety and feasibility of quantitative fluorescence molecular endoscopy during PitNET surgery. Both 10 mg and 25 mg bevacizumab-800CW result in clear differentiation in-vivo, with improved contrast ex-vivo (MFI) in the 25 mg group.

Trial registration
NCT 04212793 / Study Details| Detection of PitNET Tissue During TSS Using Bevacizumab800CW| ClinicalTrials.gov.
Risk factors for mortality in periprosthetic femur fractures about the hip-a retrospective analysis
Authors: Müller Katharina , Zeynalova Samira , Fakler Johannes K.M. , Kleber Christian , Roth Andreas , Osterhoff Georg 
Published: October 2024

Abstract
Purpose
Fractures around the hip are known to be an indicator for fragility and are associated with high mortality and various complications. A special type of fractures around the hip are periprosthetic femur fractures (PPF) after Total Hip Arthroplasty (THA). The aim of this study was to investigate the mortality rate associated with PPF after THA and to identify risk factors that may increase it.

Methods
Consecutive patients (N = 158) who were treated for a PPF after THA in our university hospital between 2010 and 2020 were identified and mortality was assessed using the residential registry. Univariate (Kaplan-Meier-Estimator) and multivariate (Cox-Regression) statistical analysis was performed to identify risk factors influencing mortality.

Results
One-year-mortality rate was 23.4% and 2-year mortality was 29.2%. Mortality was significantly influenced by age, gender, treatment, type of comorbidity and time of surgery (p < 0.05). Surgical treatment during regular working hours (8 to 18 h) reduced mortality by 53.2% compared to surgery on call (OR: 0.468, 95% CI 0.223, 0.986; p = 0.046). For every year of age, mortality risk increased by 12.9% (OR: 1,129, 95% CI 1.078, 1.182; p < 0.001). The type of fracture according to the Vancouver classification had no influence on mortality (p = 0.179). Plate fixation and conservative treatment were associated with a higher mortality compared to revision arthroplasty (plate: OR 2.8, 95% CI 1.318, 5.998; p = 0.007; conservative: OR 2.5, 95% CI 1.421, 4.507; p = 0.002).

Conclusion
Surgical treatment during regular working hours is associated with lower mortality compared to surgery outside these hours. In this retrospective cohort, time to surgery showed no significant impact on all-cause mortality, and revision arthroplasty was associated with lower mortality than conservative treatment or plate fixation.

Level of evidence
IV (Retrospective cohort study).
Utilisation of macroalgal habitats by juvenile rabbitfishes on an inshore reef
Authors: Martin Cecilia C. , McClure Eva C. , Webber Kelsey , Burgo Martina , Hoey Andrew S. 
Published: October 2024

AbstractMacroalgal beds are increasingly recognised as nursery habitats for coral reef fish; however, the extent to which they are used as a source of food and/or a refuge from predation remains largely unexplored. Here, we investigate the distribution, feeding behaviour, diet, and predation risk for juvenile rabbitfish in macroalgal habitats on Orpheus Island, Great Barrier Reef. Visual surveys revealed that juvenile and adult Siganus doliatus had different among-habitat distributions with juveniles being largely restricted to the reef flat and positively associated with macroalgal cover, while adults were abundant on the reef crest. Focal feeding observations show that within macroalgal habitats, juvenile S. doliatus targeted epiphytes on Sargassum (80% of bites), with relatively few bites taken on turfs or the Sargassum itself (27% and 8%, respectively). These observations were supported by stomach content analyses with filamentous algae being the dominant item in the stomach content of both small (< 4 cm total length, TL; 58%) and large juvenile S. doliatus (> 4 cm TL; 47%). The stomach content of juvenile S. doliatus, S. canaliculatus, and S. spinus collected from macroalgal habitats was similar, consisting primarily of filamentous algae and detritus. We found no relationship between the abundance of potential predators and juvenile rabbitfishes across the study sites. Collectively, our results suggest that juvenile rabbitfishes are using macroalgal habitats on this, and potentially other, inshore reefs as a food source and add to a growing body of literature highlighting the importance of these habitats for the early life stages of reef fish.
Negative impact of internal limiting membrane peeling in vitreous hemorrhage secondary to retinal vein occlusion with macular ischemia
Authors: Shiraki Akihiko , Shiraki Nobuhiko , Maruyama Kazuichi , wakabayashi Taku , Sakimoto Susumu , Maeno Takatoshi , Nishida Kohji 
Published: October 2024

Abstract
Purpose
To investigate the effect of internal limiting membrane (ILM) peeling on visual outcomes and postoperative epiretinal membrane (ERM) after pars plana vitrectomy (PPV) for vitreous hemorrhage (VH) associated with retinal vein occlusion (RVO) with various degrees of macular ischemia.

Methods
We compared the outcomes of eyes that underwent vitrectomy with and without ILM peeling from 2012 to 2021 with a minimum follow-up of 6 months.

Results
112 charts were analyzed, and 51 eyes met the inclusion criteria. There were 19 eyes with ILM peeling and 32 eyes with non-ILM peeling. Baseline characteristics did not differ significantly. The mean postoperative visual acuity significantly improved at 6 months compared with the mean preoperative visual acuity (P < 0.001). Visual improvement was significantly greater in the non-ILM peeling group(P < 0.05). Without ischemia within the arcade, there was no significant difference in the visual improvement. In patients with ischemia, the visual improvement in the ILM peeling group was significantly worse than that in the non-ILM peeling group. The incidence of postoperative ERM was significantly higher in the non-ILM peeling; however, there was no significant change in postoperative vision due to the presence of ERM.

Conclusions
Vitrectomy either with or without ILM peeling results in visual improvement in patients with VH associated with RVO; however, it should be uniformly avoiding ILM peeling in cases with pre-existing macular ischemia, as it may significantly lead to a deterioration in visual outcomes.

Key messages
What is known

Pars plana vitrectomy is effective for visual improvement in vitreous hemorrhage associated with retinal vein occlusion.

The incidence of postoperative epiretinal membrane is variable depending on the surgical approach.

What is new

Avoiding ILM peeling in cases of macular ischemia during vitrectomy is crucial for better visual outcomes.

Despite higher rates of epiretinal membrane post-surgery in non-ILM peeled eyes, their visual outcomes remain superior to those with ILM peeling.
Tumor budding in pre-neoadjuvant biopsy and post-neoadjuvant resection specimens is associated with poor prognosis in intrahepatic cholangiocarcinoma—a cohort study of 147 cases by modified ITBCC criteria
Authors: Wu Gaohua , Luo Rongkui , Xu Qianhui , Yang Liuxiao , Xia Hongping , Chew Valerie , Koh Ye Xin , Chang Kenneth Tou En , Zhou Jian , Fan Jia , Gao Qiang , Shi Ruoyu , Zhu Kai 
Published: October 2024

AbstractTumor budding (TB) has been associated with poor survival in a variety of cancers including intrahepatic cholangiocarcinoma (iCCA). As tumor histomorphological features are significantly altered after neoadjuvant therapy (NAT), our study aims to assess the prognostic significance of TB in iCCA patients before and after NAT, by the modified International Tumor Budding Consensus Conference (ITBCC) criteria. 147 NAT-treated iCCA cases were included in this study. In biopsy specimens obtained before NAT, the TB-positive subgroup had lower overall survival (OS) in univariate analysis (P = 0.010). In resection specimens obtained after NAT, the TB-positive subgroup had reduced OS (P = 0.002) and recurrence-free survival (RFS) (P = 0.013) in univariate analysis. In multivariate analysis including TNM stage, lymphovascular invasion and perineural invasion, TB-positive in post-NAT resection was also found as an independent prognostic factor for both OS and RFS (OS, HR, 3.005; 95% CI, 1.333–6.775, P = 0.008; RFS, HR, 1.748; 95% CI, 1.085–2.816, P = 0.022). In conclusion, assessing the presence of TB by modified ITBCC criteria provides robust prognostic information in the NAT setting of iCCA patients and can be considered to be included in routine pathological reporting.
Leishmania infantum infection in European badgers (Meles meles) from northeastern Spain: a histopathological and immunohistochemical investigation
Authors: Peris María Paz , Martínez-Durán David , García Patricia , González Chabier , Morales Mariano , Castillo Juan Antonio , Badiola Juan José , Moreno Bernardino 
Published: October 2024

AbstractThe European badger (Meles meles) is a common mustelid species known as a significant reservoir for various human and animal diseases. Studies investigating Leishmania infection in European badgers across Mediterranean regions have yielded inconsistent findings. In Spain, results are particularly controversial: some studies confirm the presence of Leishmania in badgers, while others do not. Our study aimed to conduct a retrospective histopathological and immunohistochemical analysis to detect Leishmania in tissues of nine European badgers from northeastern Spain, a region previously unevaluated for Leishmania infection in this species. Microscopic examination revealed lesions indicative of leishmaniosis in the lymph nodes and spleens of six badgers. In one of them, Leishmania-like structures were identified in multiple organs and confirmed via immunohistochemistry. Parasites were detected in the lymph nodes, spleen, adrenal glands, and pancreas. The parasite load was high in the adrenal glands, moderate in the lymph nodes and spleen, and low in the pancreas. No parasites were found in other examined organs. This finding represents a frequency of 11.11% (1/9) of Leishmania infection among the badgers we studied. Further investigation of wildlife and atypical reservoirs can enhance our understanding of the pathogenesis of this significant zoonotic disease.
Matching clinical and genetic data in pediatric patients at risk of developing cystic kidney disease
Authors: Bracciamà Valeria , Vaisitti Tiziana , Mioli Fiorenza , Faini Angelo Corso , del Prever Giulia Margherita Brach , Martins Vitor Hugo , Camilla Roberta , Mattozzi Francesca , Pieretti Silvia , Luca Maria , Romeo Carmelo Maria , Saglia Claudia , Migliorero Martina , Arruga Francesca , Carli Diana , Amoroso Antonio , Lonardi Pietro , Deaglio Silvia , Peruzzi Licia 
Published: October 2024

Abstract

Background
Cystic kidney disease is a heterogeneous group of hereditary and non-hereditary pathologic conditions, associated with the development of renal cysts. These conditions may be present both in children and adults. Cysts can even be observed already during the prenatal age, and pediatric patients with cysts need to be clinically monitored. An early clinical and genetic diagnosis is therefore mandatory for optimal patient management. The aim of this study was to perform genetic analyses in patients with echographic evidence of kidney cysts to provide an early molecular diagnosis.

Methods
A cohort of 70 pediatric patients was enrolled and clinically studied at the time of first recruitment and at follow-up. Genetic testing by clinical exome sequencing was performed and a panel of genes responsible for “cystic kidneys” was analyzed to identify causative variants. Sanger validation and segregation studies were exploited for the final classification of the variants and accurate genetic counseling.

Results
Data showed that 53/70 of pediatric patients referred with a clinical suspicion of cystic kidney disease presented a causative genetic variant. In a significant proportion of the cohort (24/70), evidence of hyper-echogenic/cystic kidneys was already present in the prenatal period, even in the absence of a positive family history.

Conclusions
This study suggests that cystic kidney disease may develop since the very early stages of life and that screening programs based on ultrasound scans and genetic testing play a critical role in diagnosis, allowing for better clinical management and tailored genetic counseling to the family.

Graphical Abstract
Effects of SGLT2 inhibitors on the onset of esophageal varices and extrahepatic cancer in type 2 diabetic patients with suspected MASLD: a nationwide database study in Japan
Authors: Kawaguchi Takumi , Fujishima Yoshiyuki , Wakasugi Daisuke , Io Fusayo , Sato Yuri , Uchida Saeko , Kitajima Yukiko 
Published: October 2024

Abstract
Background & aim
SGLT2 inhibitors (SGLT2i) improve hepatic steatosis in patients with type 2 diabetes mellitus (T2DM) and MASLD. We aimed to investigate the impact of SGLT2i on the incidence of liver-related events and extrahepatic cancer compared to DPP4 inhibitors (DPP4i) in patients with T2DM and suspected MASLD using a medical claims database in Japan.

Methods
We conducted a retrospective study using a Japanese medical claims database. Among patients with T2DM who were prescribed SGLT2i or DPP4i (n = 1,628,656), patients with suspected MASLD were classified into SGLT2i (n = 4204) and DPP4i (n = 4204) groups. Effects of SGLT2i on the following outcomes were compared to DPP4i: (1) changes in HbA1c and ALT levels after 6 months, (2) changes in hepatic fibrosis index, and (3) the incidence of liver-related events/extrahepatic cancer over 12 months.

Results
After 6 months, DPP4i significantly decreased HbA1c levels compared to SGLT2i. In contrast, SGLT2i significantly decreased ALT levels compared to DPP4i. SGLT2i significantly decreased FIB-4 index compared to DPP4i over 12 months. Although no significant difference was observed in the incidence of overall liver-related events between the two groups, SGLT2i significantly reduced the incidence of esophageal varices (HR 0.12, 95%CI 0.01–0.95, P = 0.044). Moreover, SGLT2i significantly suppressed the incidence of extrahepatic cancer (HR 0.50, 95%CI 0.30–0.84, P = 0.009) compared to DPP4i.

Conclusion
SGLT2i was more beneficial than DPP4i in improving the hepatic inflammation and fibrosis indices. Moreover, SGLT2i suppressed the incidence of esophageal varices and extrahepatic cancer compared to DPP4i. SGLT2i may suppress life-threatening events in patients with T2DM and suspected MASLD.
How much does an MRI change over a period of up to 2 years in patients with chronic low back pain? Is a repeated MRI really necessary in the follow-up of patients with chronic low back pain?
Authors: Tomé-Bermejo Félix , Otero-Romero Daniel , Javier-Martínez Elías , Sutil-Blanco Ángel , de la Rosa-Zabala Kelman Luis , Avilés-Morente Carmen , Oliveros-Escudero Beatriz , Núñez-Torrealba Alexa Anaís , Moreno-Mateo Fernando , Cervera-Irimia Javier , Mengis-Palleck Charles Louis , Garzón-Márquez Francisco , Plais Nicolas , Guerra-Gutiérrez Félix , Álvarez-Galovich Luis 
Published: October 2024

Abstract
Purpose
Clinical practices vary between healthcare providers when it comes to asking for a Magnetic Resonance Imaging (MRI) during follow-up for chronic low-back pain (LBP). The association between progressive changes on the MRI and the clinical relevance of these findings is not clearly defined. The objective of our study is to investigate to what extent do MRI findings change during a period less than or equal to two years in patients with chronic LBP. We question the efficacy of its routinary use as a tool for follow-up and we also study the correlation between new changes on MRI and modifications in therapeutic attitude.

Methods
Data was collected from 468 lumbar spine MRIs from 209 patients undergoing two or more MRIs between January 2015 and December 2019 with a mean of 2.24 MRIs per patient. The evaluated data included diagnosis, reason for request, MRI findings and treatment offered post-MRI. MRIs were assessed according to a standardized scoring system from 0 to 14 points according to the severity in findings (modified Babinska Score). Radiological changes were defined as increased severity of findings in the most affected segment.

Results
51.06% of MRI requests had no documented reason to be asked for. The average score of the findings on the first MRI was 5,733 (SD 2,462) and 6,131 (SD 2,376) on the second, not reaching a statistically significant difference (p = 0.062). There was no difference on the findings between the first and the second MRI in 40, 15% (n = 104) and up to 89, 96% with only mild changes (−1/ + 2 points over 14 possibles). After repeating the MRI, no modification to the treatment plan was made in 44, 79% of patients (n = 116) and only in 11.58% (n = 30) was surgical treatment indicated.

Conclusion
The rate of lumbar MRI has risen to an alarming pace without evidence of consequent improvements in patient outcomes. A significant number of repeated MRIs did not show radiological changes, nor did they give rise to further surgical treatment after obtaining these images. This study should help to review the real applications of clinical guides on the appropriate use for image tests.
Early mortality in STXBP1-related disorders
Authors: Furia Francesca , Rigby Charlene Son , Scheffer Ingrid E. , Allen Nicholas , Baker Kate , Hengsbach Christian , Kegele Josua , Goss James , Gorman Kathleen , Mala Misra-Isrie , Nicita Francesco , Allan Talia , Spalice Alberto , Weber Yvonne ,   European STXBP1 consortium (ESCO), Balagura Ganna , Benzeev Bruria , Bruining Hilgo , Darling Alejandra , Furia Francesca , Cazorla Ángeles García , Mala Misra-Isrie , Milh Mathieu , Møller Rikke Steensbjerre , Stamberger Hannah , Striano Pasquale , Syrbe Steffen , Thalwitzer Kim Marie , Verhage Matthijs , Weckhuysen Sarah ,   STXBP1 foundation, Rubboli Guido , Møller Rikke S. , Gardella Elena 
Published: October 2024

Abstract

Introduction
Pathogenic variants in STXBP1 cause a spectrum of disorders mainly consisting of developmental and epileptic encephalopathy (DEE), often featuring drug-resistant epilepsy. An increased mortality risk occurs in individuals with drug-resistant epilepsy and DEE, with sudden unexpected death in epilepsy (SUDEP) often the major cause of death. This study aimed to identify the rate and causes of mortality in STXBP1-related disorders.

Methods
Through an international call, we analyzed data on individuals with STXBP1 pathogenic variants, who passed away from causes related to their disease.

Results
We estimated a mortality rate of 3.2% (31/966), based on the STXBP1 Foundation and the STXBP1 Global Connect registry. In total, we analyzed data on 40 individuals (23 males) harboring pathogenic STXBP1 variants, collected from different centers worldwide. They died at a median age of 13 years (range: 11 months—46 years). The most common cause of death was SUDEP (36%), followed by pulmonary infections and respiratory complications (33%). The incidence of SUDEP peaked in mid-childhood, while non-SUDEP causes were more frequent in early childhood or adulthood (p = 0.006). In the most severe phenotypes, death was related to non-SUDEP causes (p = 0.018).

Conclusion
We found a mortality rate in STXBP1-related disorders similar to other DEEs, with an early age at death and SUDEP as well as pulmonary infections as the main cause of death. These findings assist in prognostic evaluation and genetic counseling for the families. They help to define the mortality risk of STXBP1-related disorders and implement preventative strategies.
Neoadjuvant chemotherapy in relation to long-term mortality in individuals cured of gastric adenocarcinoma
Authors: Leijonmarck Wilhelm , Mattsson Fredrik , Lagergren Jesper 
Published: October 2024

Abstract
Background
Late effects of chemotherapy could affect mortality amongst cancer survivors. This study aimed to clarify if neoadjuvant chemotherapy for gastric adenocarcinoma influences the long-term survival in individuals cured of this tumour.

Methods
This was a nationwide and population-based cohort study that included all individuals who underwent gastrectomy for gastric adenocarcinoma in Sweden between 2006 and 2015 and survived for ≥ 5 years after surgery. The cohort was followed up until death or end of study period (31 December 2020). Multivariable Cox proportional hazards regression was used to provide hazard ratios (HR) with 95% confidence intervals (CI). The HR were adjusted for age, sex, comorbidity, education, calendar year, tumour sub-location, in-hospital complications, and splenectomy. Data came from medical records and nationwide registers.

Results
Amongst 613 gastric adenocarcinoma survivors, neoadjuvant chemotherapy (used in 269 patients; 43.9%) was associated with a decreased crude mortality rate (HR 0.66, 95% CI 0.46–0.96). However, the association attenuated and became statistically non-significant after adjustment for all confounders (HR 0.83, 95% CI 0.56–1.23) and after adjustments solely for age and comorbidity (HR 0.82, 95% CI 0.56–1.20). Stratified analyses did not reveal any statistically significant associations between neoadjuvant chemotherapy and long-term mortality in categories of age, sex, comorbidity, calendar year and tumour sub-location.

Conclusion
Neoadjuvant chemotherapy did not decrease the long-term survival amongst gastric adenocarcinoma survivors. Patients who received neoadjuvant chemotherapy were a selected group characterised by younger age and fewer severe comorbidities and therefore with better chances of long-term survival.