bluuebunny/crossref_metadata_2025_split huggingface dataset:
A new prognostic scoring system for newly diagnosed multiple myeloma in the era of new drugs
Authors: Li Ye , Liu Junru , Deng Jingjing , Jian Yuan , Zhang Zhiyao , Zhou Huixing , Li Juan , Chen Wenming 
Published: October 2024

BackgroundWe developed a new predictive staging system to explore the heterogeneity of survival in newly diagnosed multiple myeloma (NDMM) patients in the real world.MethodsIn this retrospective study, we evaluated the predictive value of cytogenetic abnormal and clinical data in 375 patients with NDMM at our center. Established a weighted MM prognostic scoring system risk model and validated its predicted PFS and OS by external cohort.ResultsElevated lactate dehydrogenase levels (1 point), international staging system stage II/III (1 point), 1q21+ ≥ 52.75% (0.5 point), del (17p) ≥ 3.5% (0.5 point), and t (14;16) ≥ 35.25% (1 point) had independent prognostic significance. Patients were further divided into three risk groups: low (I) (score 0–0.5, 16.5%), intermediate (II) (score 1, 46.7%), and high (III) (score 1.5–3, 36.8%). In the training cohort, the 3-year PFS was 79.5% vs. 65.3% vs. 40.3% (p &lt; 0.001), and the 3-year OS was 87.7% vs.70.1% vs. 55% (p &lt; 0.001) for the three risk groups. In the external validation cohort, the 3-year PFS was 85.5% vs.61.2% vs. 43.1% (p &lt; 0.001) and the 3-year OS was 91.4% vs.83.5% vs. 56.9% (p &lt; 0.001) for the three risk groups.ConclusionThe risk stratification of this model shows good discrimination and calibration, and its application in clinical practice can improve the risk assessment of patients with NDMM and guide personalized treatment strategies.
Very early symptomatic metastasis pseudoprogression after stereotactic brain radiosurgery in a melanoma patient treated with BRAF/MEK inhibitors: a case report and review of the literature
Authors: Romano Edouard , Tran Sebastien , Ben Aissa Assma , Carvalho Goncalves Miguel , Durham André , Tsoutsou Pelagia 
Published: October 2024

IntroductionSignificant therapeutic changes have recently occurred in the management of melanoma brain metastases (BMs), both in the field of local treatments, with the rise of stereotactic radiotherapy (RT), as well as in systemic ones, with the advent of immunotherapy and targeted therapies (TT). These advances have brought about new challenges, particularly regarding the potential interactions between new TT (notably BRAF/MEK inhibitors) and irradiation. Through a clinical case, we will discuss a side effect not previously described in the literature: ultra-early pseudoprogression (PP) following brain stereotactic radiosurgery (SRS), in a patient treated with dabrafenib-trametinib.Case presentationA 61-year-old patient with BRAFV600E-mutated melanoma, receiving second-line dabrafenib-trametinib therapy, was referred for SRS on three progressing meningeal implants, without evidence of systemic progression. Four days after the first RT session (1x6 Gy on a fronto-orbital lesion prescribed 5x6 Gy, and 1x20 Gy single fraction on the other lesions), the patient presented with an epileptic seizure. An MRI, compared to the planning MRI ten days earlier, revealed significant progression of the irradiated lesions. The patient’s condition improved with dexamethasone and levetiracetam, and RT was halted out of caution. A follow-up MRI at one month demonstrated a size reduction of all treated lesions. Subsequent imaging at five months revealed further shrinking of the two lesions treated with an ablative dose of 20 Gy, while the under-treated fronto-orbital lesion progressed. These dynamics suggest an initial PP in the three irradiated lesions, followed by good response in the ablatively treated lesions and progression in the partially treated lesion.ConclusionTo our knowledge, this represents the first documented case of ultra-early PP following brain SRS in a patient receiving concomitant dabrafenib-trametinib. It highlights the need for particular vigilance when using tyrosine kinase inhibitors (TKIs) with SRS, and warrants further research into potential treatment interactions between RT and novel systemic agents, as well as the optimal treatment sequence of melanoma BMs.
Benefits of laparoscopic liver resection for liver tumors in obese patients: a meta-analysis
Authors: Zhang Jie , Zeng Cuifang , Chen Rui , Tang Gang , Zhou Rongxing 
Published: October 2024

ObjectiveThe superiority of laparoscopic liver resection (LLR) and open liver resection (OLR) in obese patients remains controversial. The study aims to assess the available literature and compare the perioperative outcomes of LLR and OLR for liver tumors in obese patients.MethodsWe searched PubMed, Cochrane Library, Embase, and Web of Science databases for studies comparing LLR and OLR. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated.ResultsNine studies were included, with a total of 1116 patients (LLR group: 482 patients; OLR group: 634 patients). Compared with OLR, LLR has lower overall morbidity (OR 0.47, 95% CI 0.34, 0.64), major complications (OR 0.45, 95% CI 0.25, 0.82), surgical site infection (OR 0.18, 95% CI 0.07, 0.48), bile leak (OR 0.45, 95% CI 0.22, 0.95), less blood loss (MD, -329.12 mL; 95% CI, -623.35, -34.88), and shorter length of stay (MD, -5.20 days; 95% CI, -7.43, -2.97). There were no significant differences in mortality, operation time, liver failure, and blood transfusion between the two groups.ConclusionsLLR for obese patients is safe and feasible. Compared to OLR, it offers better short-term outcomes. Further randomized controlled trials to verify the potential advantages of LLR over OLR are warranted.
Key data elements for a successful pediatric rheumatology virtual visit: a survey within the PR-COIN network
Authors: Goh Y. Ingrid , Ryan Meghan E. , Akoghlanian Shoghik , Pooni Rajdeep , Harris Julia G. , Bullock Danielle R. , Vora Sheetal S. , Lee Tzielan C. , Tse Shirley M.L. , Barbar-Smiley Fatima 
Published: October 2024

IntroductionJuvenile idiopathic arthritis (JIA) is the most common childhood rheumatic disease which is commonly monitored by a combination of history, physical examination, bloodwork, and imaging. The COVID-19 pandemic prompted a rapid shift to telemedicine to ensure that patients continued to receive healthcare. The shift to telemedicine changed the methodology and ability of healthcare providers to monitor their patients' progress, as they were unable to perform direct hands-on assessments. The following survey sought to understand the impact of switching pediatric rheumatology healthcare delivery from in-person to telemedicine modality. Specifically, it sought to examine the rate of collection of critical data elements (CDE) for monitoring JIA disease activity and outcomes, barriers and facilitators to its collection, opinions on difficulty and importance of collecting CDE over telemedicine, tools and electronic medical record modifications that facilitated CDE collection, and other data elements that were important to collect during telemedicine visits.MethodsA cross-sectional survey was sent to healthcare providers at all PR-COIN centers who saw patients using telemedicine. Qualitative data was analyzed using descriptive statistics and qualitative data was analyzed using an inductive approach.ResultsSurvey respondents reported that they documented the CDE at least 75% of the time. Barriers to assessing and documenting critical data elements included (1) the inability to palpate or visualize all joints over telemedicine, (2) connectivity issues, and (3) forgetfulness with collecting all CDE. Respondents suggested using reminders within the electronic medical record to prompt documentation completeness and improve reliability. They also suggested including medication adherence, quality of life, and patient/caregiver satisfaction with their telemedicine experience as part of their documentation. A few centers reported that they had established processes to assist with data collection in advance of the telemedicine visit; however, the variation in responses reflects the need to standardize the process of providing care over telemedicine.DiscussionMultiple barriers and facilitators to collecting CDE during telemedicine visits exist. Given that a proportion of the population will continue to be seen over telemedicine, teams need to adapt their practices to consistently provide high-quality care over virtual platforms, ensuring that patients at any institution receive a standardized level of service.
Blestriarene C exerts an inhibitory effect on triple-negative breast cancer through multiple signaling pathways
Authors: An Junsha , Han Mingyu , Tang Hailin , Peng Cheng , Huang Wei , Peng Fu 
Published: October 2024

IntroductionBreast cancer is the most common cancer worldwide, the leading cause of cancer death in women, and the fifth leading cause of cancer death. Triple negative breast cancer (TNBC), with high metastasis and mortality rates, is the most challenging subtype in breast cancer treatment. There is an urgent need to develop anti-TNBC drugs with significant efficacy, low side effects and good availability. In early drug screening, blestriarene C was found to have inhibitory effects on TNBC cells. In this article, we further explore the mechanisms associated with blestriarene C for breast cancer.MethodsIn this article, we take the approach of network pharmacology combined with in vivo and in vitro experiments. Network pharmacology analysis was used to predict the active components in Baiji, and to investigate the hub targets and related mechanisms of BC in TNBC treatment. The mechanism of anti-TNBC in vitro was evaluated by CCK-8 assay, cell apoptosis and cell cycle assays, wound healing assay, WB assay, and molecular docking analysis. The inhibition effect in vivo was test in subcutaneous tumor models established in mice.ResultsThrough network pharmacology analysis and experiments, we screened out BC as the main active ingredient, and found that BC could inhibit the Ras/ERK/c-Fos signaling pathway while downregulating the expression of HSP90AA1 and upregulating the expression of PTGS2, thereby promoting apoptosis, causing S-phase cycle arrest, and inhibiting the proliferation and migration of BT549 cells. The in vivo results illustrated that BC inhibited the growth of TNBC tumors and has a high safety profile. By integrating network pharmacology with in vitro and in vivo experiments, this study demonstrated that BC inhibited the proliferation and migration of TNBC cells by inhibiting the Ras/ERK/c-Fos signaling pathway, promoting apoptosis, and causing S-phase cycle arrest.DiscussionThis study provides new evidence for the use of BC as a novel drug for TNBC treatment.
Sphagnum cuspidatulum extract prevents acute kidney injury induced by high-fat diet and streptozotocin via alleviation of oxidative stress and apoptosis in pre-diabetic rats
Authors: Laorodphun Pongrapee , Chaisen Sutheera , Amattat Sarocha , Maphet Pornchita , Printrakul Narin , Pandith Hataichanok , Panya Aussara , Kongmali Burit , Swe Myat Theingi , Arjinajarn Phatchawan 
Published: October 2024

ContextObesity and pre-diabetes are associated with renal dysfunction via elevated oxidative stress. Peat moss, or Sphagnum cuspidatulum Müll. Hal., Sphagnaceae (SC), are rich in phenolic compounds that enhance antioxidant activity.ObjectiveSC might show beneficial effects in pre-diabetes-associated renal dysfunction.Materials and methodsMale Wistar rats, after 4 weeks on a high-fat diet, received low-dose streptozotocin to induce pre-diabetes. Then, the pre-diabetic rats were randomly divided into 4 groups: untreated pre-diabetic rats (P-DM), pre-diabetic rats treated with SC 50 or 100 mg/kg/day (P-DM50 or P-DM100), and pre-diabetic rats treated with metformin 100 mg/kg/day (MET). The drugs were fed by gavage for 4 weeks.ResultsTreatment with SC100 dramatically lowered serum creatinine (S.Cr.), blood urea nitrogen (BUN), and augmented creatinine clearance in pre-diabetic rats. Additionally, SC100 significantly decreased the malondialdehyde level. Furthermore, pre-diabetic rats treated with SC100 significantly upregulated the expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and its downstream mediators, with downregulated apoptotic markers.Discussion and conclusionOur findings provide a scientific basis for the clinical application of SC and a new strategy for the prevention of nephrotoxicity and other kidney disease in the future.
How parenting styles affect primary school students’ subjective well-being? The mediating role of self-concept and emotional intelligence
Authors: Gao Tiantian , Li Baoqian , Liang Shuxian , Zhou Wanmeng , Zhu Xinyi , Bai Lu , Li Guoqiang 
Published: October 2024

PurposeTo explore the relationship between parenting styles and self-concept, emotional intelligence, and subjective well-being among primary school students.MethodsIn total, 1,683 students from 10 primary schools in Hangzhou, China, were surveyed using a simple random sampling method. Participants completed the Parenting Style Scale, the Self-Concept Scale, the Emotional Intelligence Scale, and the Subjective Well-Being Scale.Results(1) Father’s and mother’s emotional warmth was significantly positively correlated with students’ subjective well-being (r = 0.513, p &lt; 0.01 and r = 0.478, p &lt; 0.01, respectively). Father’s and mother’s rejection was significantly negatively correlated with students’ subjective well-being (r = −0.257, p &lt; 0.01 and r = −0.285, p &lt; 0.01, respectively). Father’s overprotection was significantly negatively correlated with students’ subjective well-being (r = −0.178, p &lt; 0.01; r = −0.227, p &lt; 0.01). (2) Self-concept and emotional intelligence acted as chain mediators between father’s and mother’s emotional warmth and students’ subjective well-being (0.337, 0.477 and 0.366, 0.520, respectively). Self-concept and emotional intelligence acted as chain mediators between father’s and mother’s rejection and students’ subjective well-being (−0.590, −0.377 and −0.693, −0.460, respectively). Self-concept chain-mediated between father’s and mother’s overprotection and students’ subjective well-being (−0.380, −0.224 and −0.413, −0.264 respectively).ConclusionParenting styles can affect primary school student’s subjective well-being both directly and through mediating effects. Self-concept and emotional intelligence partially mediate the impact of emotional warmth and rejection parenting styles, and fully mediate the impact of father’s overprotective parenting on subjective well-being.
Effectiveness of a resilience school-based intervention in adolescents at risk: a cluster-randomized controlled trial
Authors: Llistosella Maria , Castellví Pere , García-Ortiz Mercedes , López-Hita Griselda , Torné Clara , Ortiz Ramona , Guallart Erika , Uña-Solbas Estefanía , Carlos Martín-Sánchez Juan 
Published: October 2024

IntroductionSchool offers a key context to promote resilience. The aim of this study was to assess the effectiveness of a school-based resilience intervention in 578 at-risk adolescents aged 12 to 15, emphasizing the significance of resilience improving mental health.MethodsA cluster-randomized controlled trial with parallel arms was conducted during the 2021/22 academic course. A specific training of six 55-minute sessions over 6 weeks was carried out for the students. Each session consisted of 5 minutes of mindfulness, followed by 45 minutes of the corresponding activity: introduction to resilience, self-esteem, emotional regulation strategies, social skills, problem solving, community resources, and peer support. Primary outcomes were assessed by the Child Youth Resilience Measure-32 at baseline (T1), post-intervention (T2), and then at the 24-week follow-up (T3). Both groups were compared using the Student’s t-test. The effect size was calculated using Cohen’s d and linear regression models were used.ResultsA total of 578 adolescents were included, 323 in the control group and 255 in the intervention group. Significant differences in both crude and adjusted analyses for Child Youth Resilience Measure were observed at 24 weeks follow-up, showing higher resilience for the intervention group [IG, M = 128.7, SD = 14.2; CG, M = 125.3, SD = 18.4; p = 0.027; d = 0.2; p = 0.043, d = 0.16]. Furthermore, in Depressive symptoms, lower values were found for the intervention group in both crude and adjusted analyses [IG, M = 2.3 (SD = 2.5); CG, M = 2.8 (SD = 2.5); p = 0.04; d = −0.20; p = 0.037, d = −0.18].DiscussionThis study contributes to fostering resilience and positive adolescent development. It also reinforces the potential of multicomponent interventions. More continuous follow-up assessments are needed to identify possible long-term changes in resilience.Clinical Trial RegistrationIdentifier: NCT05133115. https://clinicaltrials.gov/study/NCT05133115.
The relationship between BMI and depression: a cross-sectional study
Authors: Cui Hongyu , Xiong Ying , Wang Chengmin , Ye Jiaming , Zhao Weisen 
Published: October 2024

IntroductionMental health problems, especially depressive symptoms, are becoming increasingly prominent, posing a significant risk to public health. Changes in the body mass index (BMI) may impact an individual’s mental health, however, the relationship between BMI and depressive symptoms is unclear. The purpose of this study was to investigate the association between BMI and depressive symptoms.MethodsUsing a multi-stage sampling method, 10,686 adults in Longgang District, Shenzhen City, Guangdong Province, China, were selected for participation in this study. Surveys were distributed in 2020 and 2021 to measure participant demographic data and health. Binary logistic regression, restricted cubic spline regression, and subgroup analyses were performed to explore the relationship between BMI and depressive symptoms.ResultsThe results showed a U-shaped relationship between BMI and depression. Both obesity and underweight increased the risk of depression among the participants, especially in subgroups of participants who were young, highly educated, single and employed.ConclusionThese findings suggest that adults should try to maintain a normal body weight as a way to prevent depression and maintain their physical and mental health.
Cost-effectiveness analysis of Tumor Treating Fields treatment in Chinese patients with metastatic non-small cell lung cancer
Authors: Pei Zhengda , Xiao Ningping , Yang Pei 
Published: October 2024

BackgroundThe LUNAR trial demonstrated the significant efficacy and safety of Tumor Treating Fields (TTFields) plus standard-of-care (SOC) [immune checkpoint inhibitor (ICI) and docetaxel (DTX)] for patients with previously treated metastatic non-small cell lung cancer (mNSCLC). However, it remains uncertain as to whether the high costs are justified by the corresponding survival benefits. Here, the cost-effectiveness of using TTFields plus SOC for treating mNSCLC was evaluated from the perspective of the Chinese healthcare system.MethodsA Markov model with a 15-year time horizon was established and used to comparedeveloped to enable the simulation of treatment-associated costs and patient outcomes when comparing TTFields plus SOC to SOC alone. Primary outcomes for these analyses included total costs, life-years (LYs), quality-adjusted LYs (QALYs), and incremental cost-effectiveness ratio (ICER) values. The impact of paramere uncertainty on model outcomes was evaluated through sensitivity analyses. Additional subgroup and scenario analyses were also performed to extend these results.ResultsWhile TTFields plus SOC exhibited a $74,688 increase in total costs relative to SOC ($96,092 vs. $21,404), it was associated with 0.38 additional QALYs (1.08 vs. 0.82 QALYs) for an ICER of $284,490/QALY. This value exceeded the $35,983/QALY willingness-to-pay (WTP) threshold selected for these analyses by a wide margin. Relative to ICI and DTX treatment, the incremental costs of TTFields plus ICI and TTFields plus DTX were $78,115 and $71,307, respectively, with corresponding gains of 0.42 and 0.13 QALYs, yielding ICERs of $187,434/QALY, and $546,386/QALY. The parameter that most strongly impacted the results of these analyses was the cost of TTFields.ConclusionThe results indicated that given current treatment costs, TTFields plus SOC was insufficiently cost-effective in treating patients with mNSCLC in China, although TTFields plus ICI yields substantial health benefits.
Women’s self-reported symptoms of reproductive tract infection, medical consultations, and factors influencing them in less developed regions: perimenopausal and older women in need of urgent attention
Authors: Zhang Ruoyi , Kang Dan , Yang Siyuan , Hu Dehua , Bai Li , Ao Yongping , Chen Jiaojiao , Nie Yuxian , Zhao Xiaowei , Xu Wei , Shi Qiuling 
Published: October 2024

BackgroundReproductive tract infections (RTIs) represent a critical public health concern impacting women’s health, particularly pronounced in developing countries. We aim to investigates the prevalence of self-reported RTI symptoms in women aged 18 to 65 and the factors influencing gynecological examination behavior and associated risks are explored.MethodsFrom May 6, 2022, to September 20, 2022, a comprehensive survey engaged 20,864 women aged 18 to 65 in 19 townships in Lueyang, Shaanxi. Each survey team, comprising a gynecologist, two female health center staff, and a master’s student, conducted face-to-face questionnaire surveys in villages and households. The questionnaire featured three sections: prevalence of self-reported RTI symptoms, gynecological examination history, and factors influencing examination behavior.ResultsThe high response rate of 98.69% yielded 20,590 valid questionnaires. Among surveyed women, 42.04% reported RTI symptoms, with a higher prevalence in those aged 30 and above, peaking at 44.88% in the 50–59 age group. Vulvar itching (24.73%), abnormal vaginal discharge (17.41%), and urinary tract irritation signs (11.73%) were most common. Older adult women (≥60) reported higher frequency and longer duration of symptoms. Only 9.88% of symptomatic women underwent gynecological examinations in 2022. Examination likelihood decreased with age, presenting a critical gap in healthcare utilization among older women. Reasons for checkups included routine checkups (47.02%), symptom concerns (41.29%), and the availability of free medical checkup programs (9.82%). Barriers included perceived lack of serious symptoms (23.7%), lack of necessity (4.41%) and lack of time (3.98%). Among those examined, 40.58% had a diagnosis of gynecological disorders, including pelvic inflammatory disease, human papilloma virus infection and cervical cancer.ConclusionWidespread RTI symptoms, particularly in perimenopausal and older women, underscore the need for enhanced healthcare. Barriers to gynecological examinations include awareness, education, and accessibility issues. Strategies must prioritize health education, routine examinations, and improved healthcare infrastructure in underdeveloped regions.