bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adverse Childhood Experiences and Suboptimal Self-Rated Health in Adulthood: Exploring Effect Modification by Age, Sex and Race/Ethnicity
Authors: Osibogun Olatokunbo 
Published: October 2024

Purpose This study examined whether the relationship between adverse childhood experiences (ACEs) and self-rated health among adults in a nationally representative population is modified by age, sex, or race/ethnicity. Design Cross-sectional study. Setting United States. Sample Data from the 2020 and 2021 Behavioral Risk Factor Surveillance System were obtained from 185 731 (weighted N = 47 862 016) persons 18 years or older. Measures The ACE cumulative score (range: 0-11) was calculated using 11 questions about childhood emotional abuse, physical abuse, sexual abuse, and household dysfunction before age 18 and classified as 0 (reference), 1, 2, 3, or ≥4. Self-rated health was divided into (excellent/very good/good [reference]) and suboptimal (fair/poor) categories. Analysis Multivariable-adjusted logistic regression was conducted to test for the interaction with age, sex, and race/ethnicity with ACEs. After adjustment for potential confounders, an increasing number of ACEs had statistically significantly higher odds of suboptimal self-rated health in a graded manner except for 1 ACE (1 ACE: aOR:1.09; 95% CI: 1.00-1.20, 2 ACEs: 1.16; 1.03-1.30, 3 ACEs: 1.17; 1.03-1.32 and ≥4 ACEs: 1.39; 1.26-1.53). There was a significant interaction between ACEs and age. Younger age (18-24 years) had the strongest association for ≥4 ACEs compared to the older age groups. There was no effect modification by sex or race. Conclusion ACEs should be considered when creating health-promoting interventions to improve health.
Transformational Leadership as a Catalyst for Entrepreneurial Success: An Evidence from Empirical Research
Authors: Sukhadeve Varsha S. , Tarar Ashish Manohar 
Published: October 2024

Purpose This study explores how transformational leadership affects entrepreneurial success and identifies key mechanisms. Originality It bridges the gap between existing literature on transformational leadership and entrepreneurial success by providing empirical insights. Methodology A mixed-methods approach using surveys and case studies from 100 entrepreneurs, analysed with structural equation modelling (SEM) and interviews. Future Scope Future research could assess the long-term effects of transformational leadership on entrepreneurial success and explore moderating factors like industry type and cultural context. Implications Findings show transformational leadership enhances entrepreneurial success through innovation and motivation, highlighting its importance for business growth. It suggests incorporating these skills into entrepreneurship programmes. Conclusion Transformational leadership is vital for entrepreneurial success, aiding in navigating challenges and achieving sustainable growth.
Research Progress of Traditional Drug Therapies for Nasopharyngeal Carcinoma by the PI3K/Akt Signaling Pathway
Authors: Fang Qiong , Wang Junjie , Wu Tingting , Cai Yining , Wang Huimin , Cai Jitang 
Published: October 2024

Background Nasopharyngeal carcinoma (NPC) is an uncommon type of epithelial carcinoma, characterized by unique features and a higher prevalence in certain populations. Traditional medicines are commonly employed in the treatment of various cancers, including NPC. Early-stage NPC patients who undergo radiotherapy alone or in combination with chemotherapy can experience significant improvements in clinical outcomes; however, these treatments often come with substantial side effects. Given that NPC is typically diagnosed at an advanced stage, there is a significant likelihood of local recurrence, distant metastasis, and drug resistance, which limits treatment options and results in poor clinical outcomes. Consequently, the development of highly active antitumor drugs with minimal side effects has become a major focus in current cancer research. Purpose This study aims to summarize the current clinical treatments for NPC and explore the role of the phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) signaling pathway in NPC. Additionally, it reviews the effects of traditional Chinese medicine (TCM) compounds and monomers on NPC through the PI3K/Akt signaling pathway. Methods The main keywords chosen for this study were “Traditional Chinese Medicine (TCM)”, “nasopharyngeal carcinoma (NPC),” “natural plant,” and “PI3K/Akt signaling pathway.” We conducted a comprehensive literature search using multiple online databases, including CNKI, Web of Science, and PubMed, along with other publication resources. Results The findings suggest that current first-line treatments for NPC fall short of fully addressing clinical needs. The PI3K/Akt signaling pathway is crucial in the development and progression of NPC. Several components of TCM have been shown to impact NPC development and progression through the modulation of the PI3K/Akt signaling pathway. Conclusion The regulatory mechanisms of NPC involve multiple signaling systems, with the PI3K/Akt pathway identified as a critical mechanism for effective modulation of the disease. This review highlights traditional medicines that target the PI3K/Akt pathway, demonstrating promising anti-NPC effects by inhibiting cell growth, inducing apoptosis, and modulating the PI3K/Akt/mammalian target of rapamycin (mTOR) pathway. The review concludes by underscoring the potential of the PI3K/Akt pathway as a therapeutic target for NPC and the importance of continued research to optimize treatment strategies.
The Transport Profile and Outcomes of Sick Outborn Neonates Admitted to Tertiary Care Hospital in Uttar Pradesh: A Cross-sectional Study
Authors: Jaiswal Rahul , Tanigasalam Vasanthan , Gupta Girish 
Published: October 2024

Objective The primary objective of this study was to investigate the transport profile and prevalence of mortality among outborn neonates. The secondary objective was to compare the morbidity characteristics at admission with mortality rates. Methods All outborn neonates consecutively admitted during the study period were included. The study detailed the neonatal transport services level, clinical features at admission, and the calculation of the Score for Neonatal Acute Physiology with Perinatal Extension (SNAPPEII) score, a widely used tool to predict neonatal mortality based on various clinical and physiological parameters. Mortality rates were then compared with the morbidity characteristics at admission. Results A total of 59 neonates were enrolled, with the primary reason for referral being sepsis (25, 42%). Most neonates (40, 68%) were transported in private ambulances. A mortality rate of 6 (10%) was observed, attributed to complications of sepsis. Notably, 2 neonates expired within 12 hours of admission, and 5 had a SNAPPEII score exceeding 40. Furthermore, shock because of multiple reasons (24, 41%) and disseminated intravascular coagulation (DIC) (10, 17%) were associated ( P < .05) with neonatal mortality. Conclusion The prevalence of mortality among outborn neonates, as revealed by this study, is 10%. The association of shock (because of hypothermia, sepsis, hypoglycaemia, prematurity, etc), DIC, and a SNAPPEII score exceeding 40 at admission with mortality highlight the need for further research and the development of targeted interventions.
Use of tourniquet in anterior cruciate ligament reconstruction: Is it truly necessary? A prospective randomized clinical trial
Authors: D’Ambrosi Riccardo , Valli Federico , Di Feo Fabrizio , Marchetti Pietro , Ursino Nicola 
Published: October 2024

Purpose To examine the effects of tourniquet use in arthroscopic anterior cruciate ligament reconstruction in terms of (1) intraoperative visualization, (2) surgical time, (3) consumption of sterile saline, and (4) postoperative pain. Methods In this prospective randomized clinical trial, patients were assigned to Tourniquet Group or No Tourniquet treatment groups. The primary outcomes were intraoperative visualization, with scores ranging from 0 to 10 (0 = no visibility; 10 = clear and perfect display), surgical time, and the consumption of sterile saline. The secondary aim was to measure postoperative pain (24 h after surgery) with the visual analog scale (VAS) for pain. Results A total of 71 patients were included in the No Tourniquet group, and 75 were included in the Tourniquet group, with mean ages of 26.73 ± 8.05 years and 26.95 ± 10.11 years, respectively ( p = .88). In the No Tourniquet group, 37 concomitant meniscal lesions were treated, whereas in the Tourniquet group, 38 ( p = .99) were treated. The mean surgical times were 51.07 ± 6.90 and 50.03 ± 7.62 ( p = .325), respectively, while the mean amount of saline consumed was 6.17 ± 1.18 L versus 5.89 ± 1.23 L ( p = .217). Both groups achieved optimal visualization, with a sum of all surgical steps of 65.49 ± 1.86 for the no tourniquet group and 65.39 ± 1.88 for the Tourniquet group ( p = .732). Postoperative pain was significantly lower in the No Tourniquet group (VAS score: 2.82 ± 1.33 vs 5.80 ± 1.22). Conclusions Tourniquet use during ACL reconstruction does not improve intraoperative visualization and does not reduce surgical time but leads to greater postoperative pain with a risk of well-known tourniquet-related complications. Level of evidence Level I – Randomized clinical trial.
Association of Extraosseous Arterial Diameter With Talar Dome Osteochondral Lesions
Authors: Aslan Lercan , Ghandour Samir , Ashkani-Esfahani Soheil , Gedik Cemil Cihad , Guss Daniel , Waryasz Gregory , Bejarano-Pineda Lorena , DiGiovanni Christopher W. , Kwon John Y. 
Published: October 2024

Background: Etiology of osteochondral lesions of the talus (OLT) is multifactorial and may develop from trauma, genetics, or hypovascularity. The talar dome is supplied by the posterior tibial artery (PTA) and, to a lesser degree, the sinus tarsi artery (STA). The role of talar dome hypovascularity on OLT remains poorly studied. We aimed to determine any relationship between the diameter of PTA (dPTA) and STA (dSTA) and the incidence and characteristics of talus OLT. Methods: This retrospective study included 77 patients with OLT and 77 subjects as a matched control group (age range: 30-40 years). Using magnetic resonance imaging, the dPTA was measured 1 cm above the tibial plafond, at the plafond, and at the level of medial malleolar tip. Likewise, dSTA was measured at the level of the talar neck. The area, volume, depth, localization, and surgical intervention for OLT were recorded as well. Results: The study group had significantly smaller dPTA at all 3 levels (1.05 ± 0.22 mm, 0.99 ± 0.18 mm, 0.98 ± 0.31 mm, proximal to distal, respectively) compared with controls (1.25 ± 0.23 mm, 1.20 ± 0.22 mm, 1.14 ± 0.18 mm, respectively) ( P < .001). The dSTA was also significantly smaller in the study group compared with the control group (0.5 ± 0.11 mm vs 0.57 ± 0.08 mm, respectively; P = .001). The mean dPTA (of all 3 levels) cutoff value for predicting the occurrence of OLT was 1.1 mm with 74% sensitivity and 75% specificity. A significant inverse correlation was observed between OLT area and arterial diameters ( P < .001). Conclusion: Smaller luminal dPTA and dSTA appear to be associated with higher incidence of OLT, with defect size inversely correlated to arterial diameter.
Modified monitoring of abiraterone acetate-induced hepatotoxicity in prostate cancer patients
Authors: Mishra Sweta , Spencer Hannah , Kelly Katherine 
Published: October 2024

Introduction Abiraterone is a standard treatment for prostate cancer and is a preferred treatment option at the Veterans Affairs North Texas Health Care System (VANTXHCS) due to its formulation, cost, and overall tolerability. In the combined data of five randomized controlled trials, grade 3 and 4 liver enzyme increases were reported in 6% of patients, most commonly within the first three months of initiating abiraterone. Therefore, the prescribing information recommends measuring serum transaminases and bilirubin levels (liver function tests, LFTs) every two weeks for the first three months of treatment and monthly thereafter. VANTXHCS utilizes a modified monitoring approach in which LFTs are evaluated two weeks after initiating abiraterone and less frequently thereafter. The purpose of this study is to assess if the modified monitoring approach leads to an increase in incidence and/or severity of abiraterone-induced hepatotoxicity. Methods A retrospective analysis was conducted within the VANTXHCS electronic record system to include adult patients diagnosed with prostate cancer who initiated abiraterone between January 1, 2014 and December 31, 2022. Patients were excluded if they were enrolled in clinical trials or were receiving care from an outside provider due to lack of accessible laboratory data. The primary outcome was to assess the incidence and severity of LFT elevations up to six months after initiation. Select secondary outcomes include time to LFT elevation, management of LFT elevation, and incidence and severity of LFT elevation up to 12 months after initiation. Results A total of 274 patients were included in the analysis, of which 72 (26.3%) experienced any grade LFT elevations during the 6-month period. Of those with LFT elevations, grade 1 elevations occurred in 48 (17.5%) patients, grade 2 in 20 (7.3%) patients, grade 3 in 3 (1.1%) patients, and grade 4 in 1 (0.4%) patient. The median time to detecting LFT elevations was 8 (4–16) weeks. The median time to resolution was 4 (3–7) weeks. Seventy-five percent of the patients with LFT elevations within 6 months of therapy were monitored without any interruptions in abiraterone therapy. Conclusion The current findings suggest that the modified monitoring approach to abiraterone does not result in an increase in incidence and/or severity of hepatotoxicity compared to the previously published clinical trial data. The modified monitoring approach may have a beneficial impact on healthcare resources.
Perianaesthetic complications in cats undergoing MRI of the brain
Authors: Daly Erica , Cardy Thomas J , McFadzean William , Taylor-Brown Frances E 
Published: October 2024

Objectives This study aimed to describe perianaesthetic complications in cats undergoing MRI of the brain and investigate if previously reported factors for anaesthetic mortality in cats are associated with an increased risk of anaesthetic complications in this population. Methods Records were reviewed of all cats that underwent MRI of the brain in a private referral veterinary hospital between June 2020 and January 2023. Cats that underwent additional procedures other than cerebral spinal fluid (CSF) sampling during the same general anaesthetic (GA) were excluded from the data set. Data were then collected regarding the signalment, presenting clinical signs, physical and neurological examination, GA protocol, complications experienced under GA and known survival time. Selected data were then compared between cats with an intracranial lesion and those without. Results A total of 43 cats were included in the study. In total, 41 cats experienced a perianaesthetic complication, which were subclassified as mild (n = 39) and severe (n = 15). Cats with intracranial lesions were more likely to experience severe perianaesthetic complications (odds ratio [OR] 12.4; 95% confidence interval [CI] 2.7–56.7; P <0.001), to receive mannitol under GA (OR 1.8; 95% CI 1.2–2.7; P <0.001) and to experience a delayed extubation (OR 1.2; 95% CI 1.0–1.6; P <0.014) than those without intracranial lesions. Cats with intracranial lesions were more likely to have an abnormal neurological examination than those without intracranial lesions (OR 42.1; 95% CI 8.8–228.6; P <0.001). Conclusions and relevance Cats that experienced perianaesthetic complications were more likely to have an intracranial lesion. Abnormal mentation on neurological examination was the best indicator of the likelihood of the cat experiencing perianaesthetic complications. Previously reported risk factors for anaesthetic mortality were not found to be associated with increased risk of anaesthetic complications in this population.
Utility of Circulating Tumor DNA Assay in Identifying Mutations and Guiding Matched Targeted Therapy in Lung Cancers
Authors: Li Kun , Zhang Nana , Xu Bing , Liu Zichen , Zhao Dan , Dong Yujie , Mu Jing , Lin Haifeng , Shan Guangyu , Gao Sihang , Yu Bo , Pan Xiaoxi , Wang Yanrong , Zhang Dongxing , Che Nanying , Ji Xiaoyong 
Published: October 2024

Background: Tumor genomic profiling has a significant impact on the selection of targeted therapy. Circulating tumor DNA (ctDNA) has emerged as a noninvasive, and reproducible assay compared with tissue biopsy. We aimed to evaluate its utility in identifying mutations and guiding targeted therapy for lung cancer. Methods: A total of 173 lung cancer patients underwent next-generation sequencing (NGS) using a targeted enrichment panel covering 20 lung cancer-related genes. The performance of the ctDNA NGS assay in identifying genetic mutations or alterations was compared with tissue biopsy and droplet digital PCR (ddPCR). The treatment response to epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapies based on the ctDNA assay results was also assessed. Results: The ctDNA was detected in 61.85% of patients. Tissue mutations were detected in paired ctDNA in 38.57% of cases, while ctDNA mutations were detected in paired tissues in 89.1% of cases. The ctDNA increased the number of advanced non-small cell lung cancer (NSCLC) patients who received NCCN-recommended genetic testing by 12%. The concordance between ddPCR and ctDNA was relatively high reaching 99.43%. EGFR T790M/C797S c.G2390C and EGFR T790M/C797S c.T2389A were detected in tissue and ctDNA, respectively, in patient 01015. Moreover, ctDNA assay identified the EGFR T790M mutation, which was missed by tissue biopsy in patient 01149, who developed drug resistance after 1 year of EGFR-TKI therapy. Of the 17 patients who received EGFR-TKI targeted therapies based on the ctDNA NGS results, 12 patients achieved a partial response and two patients had stable disease. Conclusions: The results demonstrated that the ctDNA assay could partially overcome tumor heterogeneity in detecting mutations and provide complementary information on tumor genomic profiles. Moreover, the presence of EGFR mutations in ctDNA could offer valuable guidance for selecting appropriate EGFR-TKI treatment for advanced lung cancer patients. However, it is important to note that the ctDNA NGS assay has certain limitations in fully identifying all genomic alterations present in the tumor.
Dendritic Cells Loaded With Heat Shock Inactivated Glioma Stem Cells Enhance Antitumor Response of Mouse Glioma When Combining With CD47 Blockade
Authors: Tan Qijia , Li Feng , Wang Jun , Liu Yi , Cai Yingqian , Zou Yuxi , Jiang Xiaodan 
Published: October 2024

Background: For glioma patients, the long-term advantages of dendritic cells (DCs) immunization remain unknown. It is extremely important to develop new treatment strategies that enhance the immunotherapy effect of DC-based vaccines. DCs exposed to glioma stem cells (GSCs) are considered promising vaccines against glioma. Methods: Glioma stem cells were isolated from mouse glioma GL261 cells (GCs). Both were subjected to severe (47°C) and mild (42°C) heat shock to induce immunogenic cell death (ICD). Membrane mobilization of calreticulin (CRT) and release of heat shock proteins (HSPs) were detected by flow cytometry. Dendritic cells were then exposed to heat-inactivated cells and co-culturing of T cells tested for immunotherapeutic efficacy in vitro. In vivo, we investigated the GSC targeting effect of the GSC-DC vaccine combined with CD47 blockade. Results: Heat shock induced ICD in GCs and GSCs, as indicated by significant release of calreticulin, HSP70, and HSP90. Heat shock condition ICD lysates induce maturation and activation-associated marker expression on monocyte-derived DCs. Accordingly, DCs pulsed with GCs and GSCs inactivated reduced colony formation, sphere formation, migration, and invasion of glioma and GSCs in vitro. Glioma stem cell-DC vaccine in combination with anti-CD47 antibody significantly enhanced survival in mice with glioma, induced production of interferon (IFN)-γ, and enhanced T-cell expansion in vivo. Of note, DCs pulsed with inactivated GSCs were more effective to control tumor growth than DCs pulsed with inactive GCs. Conclusions: Severe heat shock induces ICD in vitro. These data showed that administration of anti-CD47 antibody combined with GSC-DC vaccine may represent an effective immunotherapeutic strategy for cancer patients in clinical.
Expression of CREBBP and EP300 Associated With Tumor Volume in Patients With Grade-3 Glioma: A Retrospective Analysis
Authors: Chen Cuiwei , Yuan Meiqin , Xia Liang , Wu Xin , Zhong Xingguang , Zhang Huangjie , Zhang Lidan , Liu Xuan , Wang Zeng , Sun Caixing 
Published: October 2024

Background: Reliable predictive data are crucial for making accurate treatment decisions in glioma patients, but it can be challenging to obtain due to limited information in many cases. Numerous research studies have indicated the involvement of cyclic adenosine monophosphate (cAMP)-response element binding protein (CREBBP) and E1A binding protein p300 (EP300) in tumorigenesis and tumor progression across various types. Methods: The messenger RNA (mRNA) expression levels of CREBBP and EP300 were retrospectively analyzed in 17 grade-3 glioma patients. The SYBR Green real-time polymerase chain reaction (RT-PCR) technique was employed for mRNA expression analysis, with the glyceraldehyde-3-phosphate dehydrogenase gene ( GAPDH) used as a reference gene for data normalization. In addition, the relationship between CREBBP, EP300 expression and patients’ clinical information, imaging features, histologic features, immune factors, and overall survival was assessed through univariate analyses. Results: The analysis of the data unveiled a statistically significant upregulation of CREBBP and EP300 mRNA expression levels in large gliomas as compared with their smaller counterparts ( P < .05). Histological examination using hematoxylin and eosin (H&E) staining exhibited marked cellular heterogeneity, with heightened cell density observed specifically within tumors displaying elevated CREBBP expression levels. In contrast, there was a substantial downregulation of complement 3 and complement 4 within larger tumor volumes when compared with smaller ones ( P < .05). However, these findings do not serve as clinically relevant prognostic indicators for glioma. Conclusions: It is suggested that higher expression levels of CREBBP and EP300 are positively associated with increased tumor volume. Inhibition of CREBBP and EP300 enhances local immunogenicity, leading to the recruitment of immune cells and release of cytokines for effective tumor eradication, ultimately resulting in the inhibition of tumor growth.