bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hasselt Corona Impact Study: Impact of COVID-19 on healthcare seeking in a small Dutch town
Authors: Veldman Carlijn , Gijssel Erik A. Van , Rooij Annelot H. Van , Buitenhuis Lonneke , Berg Jan Willem K. Van den , Blanker Marco H. 
Published: October 2024

Abstract

Introduction
We explored reasons for healthcare avoidance during the first COVID-19 wave in a region with high infection rates.
Methods
We conducted a mixed-method study using primary care electronic health records (n=5,980), questionnaires (n=2,361), semi-structured interviews (n=12), and an AI model to identify COVID-19 patients in a Dutch small town.
Results
Of 2,391 respondents (39% response rate), 535 (23%) reported COVID-19-related symptoms. Of these, 180 sought help, mostly from their GP. The care-seeking rate did not differ significantly between those with or without relatives who experienced severe illness or death before their own illness (p=0.270). Interviews revealed that the primary reason for not seeking help was the perception of not being ill enough and the overstressed healthcare system, especially GP services.
Conclusion
Only a third of participants with symptoms sought help, mostly from GPs. No significant difference in seeking healthcare was related to the serious illness or death of loved ones.
A Phase I Study of MLN4924 and Belinostat in Relapsed/Refractory Acute Myeloid Leukemia or Myelodysplastic Syndrome
Authors: Maher Keri , Shafer Danielle , Schaar Dale , Bandyopadhyay Dipankar , Deng Xiaoyan , Wright John , Piekarz Richard , Rudek Michelle A. , Harvey R. Donald , Grant Steven 
Published: October 2024

Abstract

Purpose:
Relapsed and/or refractory acute myeloid leukemia and high-risk myelodysplastic syndrome continue to have a poor prognosis with limited treatment options despite advancements in rational combination and targeted therapies. Belinostat (an HDAC inhibitor) and Pevonedistat (a NEDD8 inhibitor) have each been independently studied in hematologic malignancies and have tolerable safety profiles with limited single-agent activity. Preclinical studies in AML cell lines and primary AML cells show the combination to be highly synergistic, particularly in high-risk phenotypes such as p53 mutant and FLT-3-ITD positive cells. Here, we present the safety, pharmacokinetics and pharmacodynamics of belinostat and pevonedistat in a dose escalation Phase I study in AML and High-Risk MDS.
Methods:
Eighteen patients (16 with AML, 2 with MDS) were treated at 5 dose levels (belinostat 800-1000mg/m2, pevonedistat 20-50mg/m2). Safety and tolerability were assessed according to protocol defined dose limiting toxicities (DLTs). Correlative pharmacokinetic and pharmacodynamic analyses were performed.
Results:
No dose limiting toxicities were noted. Most Grade 3 or 4 toxicities were hematologic in nature. The best response was stable disease in four patients, and complete remission in one patient who qualified as an exceptional responder. Pharmakokinetic studies revealed no association between drug exposure and best response. Pharmacodynamic RT-PCR studies demonstrated post-treatment increases in several proteins, including quantitative increases in the oxidative stress protein NQO1, ferroptosis protein SLC7A11, and GSR, linked to glutathione metabolism and oxidative stress, as did the anti-oxidants SRXN1 and TXNRD1.
Conclusions:
Patterns of post-treatment changes in correlative pharmacodynamic parameters may suggest possible mechanistic changes in the DNA damage response, oxidative damage, and ferroptosis pathways. The combination of pevonedistat plus belinosat is safe in an adult relapsed and/or refractory AML/High-Risk MDS population with modest but notable activity in this heavily treated, high risk population. Our findings also raise the possibility that certain extremely poor prognosis AML patients may respond to a regimen combining two targeted agents that have little or no activity when administered individually.
Trial Registration:
ClinicalTrials.gov ID NCT03772925, first posted 12/12/2018; CTEP Identifier 10246
Adjuvant chemotherapy in T1a/bN0 breast cancer with a high 21-Gene Recurrence Score (&gt;25): A 10-year follow-up in a real-world cohort
Authors: Katz Daniela , Feldhamer Ilan , Goldvaser Hadar , Hammerman Ariel , Goldstein Daniel 
Published: October 2024

Abstract

Background
In ER+/HER2- early breast cancer (BC), a 21-Gene Recurrence Score (RS) > 25 indicates a high-risk of distant-recurrence and a predictes benefit from adjuvant chemotherapy (aCT), independent of tumor size. However, T1a/b (≤ 1cm) node negative (N0) tumors, that are usually regarded clinically as of very low risk of recurrence, are under-represented in trials validating the prediction role of RS testing. We therefore aimed to investigate the benefit of aCT in patients with T1a/bN0 BC and RS > 25, where clinical and genomic risk indicators are discordant.
Methods
The study cohort included all patients with T1a/bN0 ER+/HER2- BC with RS > 25, tested within Clalit Health Services (CHS), Israel’s largest healthcare provider, between February 2006 and December 2019. Demographic, clinicopathological and treatment data were extracted from the CHS centralized registry. Patients who received aCT were matched 1:1 by propensity-scoring to patients receiving no aCT. Invasive disease-free survival (iDFS) events and freedom from iDFS were primary endpoints. Distant-recurrences and freedom from distant-recurrence were the secondary endpoints. Kaplan-Meier analysis with log-rank test was used for comparing the study outcomes.
Results
Among 9858 CHS patients tested for RS during the study period 156 met the inclusion criteria. aCT was administered to 74 (47.4%) patients. Median follow-up was 121.0 months (95% CI, 108.4 -133.6). Within the 148 matched-cases, eighteen iDFS events occurred, nine (12.1%) in each treatment group (χ2 = 0.72, p = 0.39). Four (5.4%) of the aCT treated and three (4.0%) of the untreated patients were diagnosed with a distant recurrence (\(\:\chi\:2=0.22,\:\)p=0.64).
Conclusions
In our cohort, with a mean follow-up of 10-years, patients with T1a/bN0 BC and RS > 25, did not show improved iDFS with aCT compared to those who did not receive aCT. The 21 Gene Recurrence Score (RS) > 25 was not predictive of iDFS, possibly due to the low number of events observed.
Effects of Adjuvant Dexmedetomidine in Dorsal Penile Block for Penile Prosthesis Implantation
Authors: Sugiyama Kikuye , Swanton Amanda , Shah Tejash , Reissmann Molly , Canelli Robert , Munarriz Ricardo 
Published: October 2024

Abstract

Inflatable penile prosthesis (IPP) surgery is the gold standard treatment for medication-refractory erectile dysfunction. While satisfaction rates are high, post-operative pain and narcotic requirement remain a concern. Intraoperative dorsal penile nerve block (DPNB) with long-acting local anesthetic can improve analgesia. Recent studies on peripheral nerve blocks in other fields have demonstrated prolonged analgesia and minimal adverse effects with blocks containing local anesthetic and dexmedetomidine. This retrospective study aimed to evaluate the effect of DPNB for IPP surgery with and without dexmedetomidine on postoperative analgesia. This is a single institution retrospective IRB-approved study of patients undergoing IPP surgery with preoperative DPNB and without dexmedetomidine. The DPNB used in the 2019 control group utilized 0.25% bupivacaine, while the 2020–2021 intervention group also included 70 µg dexmedetomidine. The primary outcome was pain scores at post-operative hours 0, 2, 6, 12, 18, and 24, while secondary outcomes were intraoperative and postoperative narcotic use, intraoperative hypotension (IOH), (MAP < 60 for > 5 minutes or requiring intervention), and intraoperative bradycardia, (HR < 50 for > 1 minute). 98 patients met inclusion criteria, 32 in the control group and 66 in the intervention group. 24-hour pain scores were significantly lower in the intervention group (1.1 vs 3.8, 1.6 vs 3.9, 3.1 vs 4.9, 2.4 vs 4.3, 2.9 vs 5.3, 2.3 µg vs 4.4 µg; p < 0.05). Postoperative narcotic requirement was lower for the intervention group (46 vs 65, P < 0.05). Adverse effects (IOH and bradycardia) occurred in 16 intervention cases, each mild and brief. Intraoperative DPNB with local anesthetic and dexmedetomidine can safely improve immediate post-operative analgesia and decrease opioid consumption in the first 24 hours. This type of combination DPNB may be useful for other penile and scrotal surgeries, requiring prospective randomized study.
TYMS overexpression is frequent and linked to grade progression in urothelial bladder cancer
Authors: Plage Henning , Hofbauer Sebastian , Furlano Kira , Weinberger Sarah , Roßner Florian , Schallenberg Simon , Elezkurtaj Sefer , Frericks Adrian , Lennartz Maximilian , Marx Andreas Holger , Samtleben Henrik , Fisch Margit , Rink Michael , Slojewski Marcin , Kaczmarek Krystian , Ecke Thorsten , Klatte Tobias , Koch Stefan , Simon Ronald , Sauter Guido , Zecha Henrik , Weischenfeldt Joachim , Minner Sarah , Horst David , Schlomm Thorsten , Kluth Martina 
Published: October 2024

Abstract

Purpose:
While elevated Thymidylate synthase (TYMS) levels are observed in many cancers, its specific role in bladder cancer remains unclear. This study aims to clarify its activity in a large tumor cohort.
Methods:
A tissue microarray (TMA) containing over 2,700 bladder tumors was analyzed using immunohistochemistry and fluorescence in-situ hybridization (FISH) to assess TYMS expression and gene amplification.
Results:
TMYS immunostaining was detectable in 83.1% of 1,799 analyzable bladder cancers. The fraction of cancers with moderate to strong TMYS positivity increased markedly from pTaG2 low (6.5%) to pTaG2 high grade (20.7%), and pTaG3 cancers (29.0%; p < 0.0001). There was also a significant increase of moderate to strong staining from pTa to advanced stage pT2-4 cancers (pTa 13.2% vs. pT2-4 32.9% p < 0.0001). In muscle-invasive cancers, the frequency of TMYS immunostaining increased with tumor grade (p = 0.0007), but there was no association between TYMS expression and patient prognosis (p = 0.4365). TYMS amplification was found in 3.1% of 1,775 analyzable bladder cancers. TYMS amplification increased from pTa (0.6%) to pT2-4 (3.7%; p < 0.0001), but in muscle invasive-cancers TYMS copy number alterations were unrelated to tumor phenotype and patient prognosis. Strong TYMS positivity was significantly associated with TYMS amplification (p = 0.0096) but only a subset (28.6%) of amplified cancers showed a strong TMYS staining and only 7.2% of cancers with strong TYMS expression had a TYMS amplification.
Conclusion:
TYMS overexpression plays a role in early bladder cancer development and grade progression, but its expression is largely unrelated to the disease course in muscle-invasive cancers. Gene amplification is not the primary driver of TYMS protein overexpression.
Laser ablation for bronchial stone induced airway stenosis: a case report
Authors: Wang Huipeng , Zhang Xiangwu , Pu Wei , Tian Tinggeng , Chen Wanling 
Published: October 2024

Abstract

Broncholithiasis is the presence of calcified substances in the bronchus, usually accompanied by symptoms that cause severe airway irritation or obstruction[1]. Bronchopolithiasis is a rare disease that is most common in areas where tuberculosis and histoplasmosis are prevalent. There are currently no clear guidelines on the treatment options for patients with bronchopolithiasis[3]. We treated a patient with central airway obstruction due to bronchial calculus and tumour growth with remarkable results. The course of treatment is reported as follows.
Outcome and complication following single-staged posterior minimally invasive surgery in adult spinal deformity
Authors: Yeh Chun , Hsiao Pang-Hsuan , Chen Hsien-Te , Chen Michael Jian-Wen , Lo Yuan-Shun , Tseng Chun , Lin Chia-Yu , Li Ling-Yi , Lai Chien-Ying , Chang Chien-Chun 
Published: October 2024

Abstract

Background: The aging population is experiencing a rising incidence of musculoskeletal problems and degenerative spinal deformities. Adult spinal deformity (ASD) presents challenges, with associated risks in open surgery. Minimally invasive surgery (MIS) is becoming increasingly popular due to its positive outcomes and potential benefits. This study aimed to explore the clinical outcome and complications of posterior approach MIS in patients with ASD.
Methods: We conducted a retrospective analysis of patients with adult spinal deformity who underwent posterior minimally invasive surgery. 46 patients meeting the criteria were identified between June 2017 and September 2023. Comprehensive data, including demographic information, surgical details, full-length radiographic measurements, and visual analog pain score (VAS) were gathered both before and after the surgery, as well as at the final follow-up.
Results: Totally 46 patients were included. The mean age was 68.58 years, with a minimum follow-up period of 6 months. The mean operative time was 327 min and blood loss were 307 ml. Pre-operative radiographic outcomes were as follows: Coronal Cobb angle, 18.60±11.35°; Lumbar lordosis (LL), 22.79±21.87°; pelvic incidence (PI), 53.05±14.13°; PI-LL mismatch, 30.26±23.48°; pelvic tilt (PT), 32.53±10.38°; T1 pelvic angle (TPA), 31.91±12.39°; and sagittal vertical axis (SVA), 77.77±60.47mm. At the final follow-up, coronal Cobb angle was 10.08±6.47° (𝑃<0.0001), LL was 26.16±16.92° (𝑃 = 0.4293), PI was 54.17±12.13° (𝑃= 0.6965), PI-LL mismatch was 28.00±17.03° (𝑃 = 0.6144), PT was 27.74±10.24° (𝑃= 0.0345), TPA was 25.10±10.95 (𝑃 = 0.0090) and SVA was 47.91±46.94 mm (𝑃= 0.0129). The mean Oswestry Disability Index (ODI) and VAS scores for back pain at baseline and at last follow-up were 34.9 to 23.6 and 8.4 to 3.4, respectively. The occurrence of complications related to surgery is 39.1%, associated with 4.3% low reoperation rate.
Conclusion: Single-staged posterior MIS effectively corrects global alignment in adult spinal deformities, satisfying patient demand and yielding positive clinical outcome with low re-operation rate.
Obstetric Violence and its Associated Factors Among Women Attending Intrapartum Care at Public Health Facilities of Addis Ababa, 2023.
Authors: Ayele Ermias Getaneh , Jember Dessalegn Abebaw 
Published: October 2024

Abstract

BACKGROUND: -Intrapartum violence and abuse create psychological distance between women and care providers and then drive women away from formal health care systems in fear of being subjected to such violence; these violence and abuses are sometimes more prominent hindrances than geographical or financial barriers to maternal health service utilization.
OBJECTIVE: This study aimed to assess the prevalence of obstetric violence and its associated factors among women receiving intrapartum care at public hospitals in Addis Ababa, Ethiopia,2023.
METHODS: An institution-based cross-sectional study was conducted at six hospitals in Addis Ababa, Ethiopia. A total of 423 postpartum mothers were included in this study. Study participants selected using systematic random sampling. An interviewer-administered questionnaire was used to obtain necessary information on the sociodemographic characteristics of the participants, health system-related factors, obstetric-related factors and intrapartum obstetric violence-related questions. To maintain data quality, a pretest was administered at another site, and the data were checked for completeness, cleaned and entered into Epi-Data version 3.1 and exported into SPSS version 25 for analysis. The descriptive part was presented in tables and figures. A bivariable binary logistic regression was used to identify potential candidate variables (p<0.25) for multivariable binary logistic regression analysis. Basic assumptions for binary logistic regression were made, and model fitness was checked before running multiple binary logistic regression analyses. To control for potential confounding variables, multiple binary logistic regression analyses were performed, and the regression results are presented as the mean odds ratio (COR) and AOR with 95% CI, with a p value less than 0.05 indicating statistical significance.
RESULTS: The magnitude of intrapartum obstetric violence was 56.5%. The findings of the study showed that age (AOR: 6.4, 95% CI (2.76, 14.89), occupation (AOR: .15895% CI (.072, 346), number of ANC visits (AOR: 7.2095% CI (2.66, 19.52), duration of hospitalization at HFs (AOR: 6.57, 95% CI (2.95, 14.64), duration of assisted delivery (AOR: .424, .227, .791), and sex of health professionals who attended (AOR: 2.14, 95% CI (1.07, 1.28)) were factors associated with intrapartum obstetric violence.
CONCLUSION AND RECOMMENDATION: The magnitude of intrapartum violence was high. Any responsible body should intervene in these factors.
Epidemiologic sequential analysis of pure red blood cell aplasia and T-cell large granular lymphocyte leukemia in Korea
Authors: Park Sooyong , Kim Hyun Kyung 
Published: October 2024

Abstract

Pure red cell aplasia (PRCA) is a rare hematologic syndrome characterized by anemia with marked reticulocytopenia and, in Asia, is often accompanied by T-cell large granular lymphocyte leukemia (T-LGL). Minimal research has been done on the epidemiology and sequential events of PRCA combined with T-LGL. This study identified 2801 PRCA and 840 T-LGL patients by using big data of the National Health Insurance Service between 2003 and 2022. The average annual crude incidence of PRCA was 2.77 per million and remained largely unchanged over the 20 year period. The average annual crude incidence of T-LGL was 0.82 per million with an increasing trend over the same 20 year period. This attribute is a consideration for increasing accessibility of several T-LGL diagnostic tests. The average age for PRCA and T-LGL onset in increased over the study period. Associated PRCA conditions are rheumatic diseases (10.5%), thymoma (4.7%), parvovirus infection (1.0%), inflammatory bowel diseases (0.8%), T-LGL (0.6%) and no specific cause (82.4%). Interestingly, among patients with PRCA and T-LGL, the critical sequence of events was the previous PRCA diagnosis followed by T-LGL diagnosis. This suggests that PRCA is initially caused by autoreactive T cells which suppress erythropoiesis and sequentially evolve into clonal T cell proliferation and, eventually, T-LGL occurrence. The annual incidence and age of onset in PRCA and T-LGL are affected by an aging society and clinical availability of diagnostic tests. Further study should identify the causal relationship of PRCA diagnosis followed by T-LGL diagnosis.
A giant congenital epiglottic cyst in a neonate: a case report
Authors: Deng Xiao , Diao Min , Zhou Jieshu 
Published: October 2024

Abstract

Congenital epiglottic cyst is a rare disease, but a recognized cause of upper airway obstruction in neonates and infants. Airway management of large epiglottic cysts in newborns may be challenging, since the patients are at risk of severe airway obstruction and death. We reported a case of difficult intubation in a neonate with a giant congenital epiglottic cyst and shared a reliable approach for a better view of the glottis and successful intubation.
Ectopic Rathke's Cyst With Xanthogranuloma Change: Case Report
Authors: Chen Zi , Fan Ye , Zhang Wei , Lu Wen-biao 
Published: October 2024

Abstract

A 52-year-old woman presented with a rare case of ectopic Rathke's cleft cyst with xanthomatous change, presenting as diplopia, easy falls, and progressive aggravation. Head CT and MRI scans revealed a mass in the right cerebellopontine angle area, prepontine cistern, and right parasellar region. The patient underwent surgical intervention. The lesions were cystic with thick capsules and septations, containing a viscous mixture of yellowish-brown liquid and solid components. Histopathological examination confirmed a single layer of columnar to cuboidal epithelium lining the cyst wall in the xanthogranulomatous lesion, supporting the diagnosis of Rathke's cleft cyst with xanthogranulomatous changes. The association of xanthogranuloma with ectopic Rathke cleft cyst has not been previously documented, and the underlying mechanism remains unclear. It is hypothesized that inflammatory stimulation from the rupture of the ectopic Rathke cleft cyst may lead to the development of xanthogranuloma.
Elevated Neuron Spesific Enolase Levels in Post-traumatic Stress Disorder
Authors: UYSAL Melike , CEYLAN Mehmet Fatih , HESAPÇIOĞLU Selma TURAL 
Published: October 2024

Abstract

Neuron spesific enolase (NSE) is a biomarker indicative neuronal cell damage. The aim of this study is to assess the NSE levels in patients diagnosed with post-traumatic stress disorder (PTSD) and major depressive disorder (MDD). Blood samples were collected from 43 individuals with PTSD (age range: 11–17), 43 individuals with MDD (age range: 10–17), and 40 age- and gender-matched healthy controls. The NSE levels were analyzed, and participants completed the Post-traumatic Stress Reaction Index, the Children's Depression Inventory, and the Screen for Child Anxiety Related Disorders. Additionally, the Clinical Global Impressions Scale was filled out by the researcher. Results indicated that the NSE levels in the PTSD group were significantly higher than those in both the MDD group and the healthy control group. No significant difference in NSE levels was observed between the MDD group and the healthy control group. The elevated NSE levels in the PTSD group suggest a potential association with neuronal pathology development following severe stress. The lack of significant difference in NSE levels between the MDD and control groups suggests that trauma may have a more pronounced impact on neuronal structures. These findings contribute to the existing literature on the biological effects of PTSD and MDD.
Near zero treatment gap for schizophrenia: Can it be reality in rural India?
Authors: Kalaivanan Rakesh Chander , Channaveerachari Naveen Kumar , Gowda Swetha , Kudumallige K Suresha , M Harisha D , Patley Rahul , Philip Sharad , Varshney Prateek , Basavaraju Vinay , Narayana Manjunatha , Math Suresh Bada , Thirthalli Jagadisha 
Published: October 2024

Abstract

Background: Treatment gap is a key indicator of adequacy of mental health services that drives policies and financial allocation for the sector. Impact of public health interventions on this gap is sparsely studied.
Methods: To demonstrate reduction in treatment gap for Schizophrenia in rural south Indian setting following a community intervention program running in two taluks of Karnataka, India (Thirthahalli and Turuvekere) between July 2018 and February 2019. Population based sampling of persons with Schizophrenia who consented were included and subjects who migrated, died, had changed/other diagnosis, did not consent were excluded Prevalence was measured by adding already existing cases with the ones identified by way of house-to-house survey, conducted by trained Accredited Social Health Activists (ASHAs). Screen-positives were further scrutinized by research social workers and psychiatrists to confirm the diagnosis. Gap was calculated by noting difference between target population and ones who had not contacted any service even once for psychiatric treatment.
Results: In Thirthahalli, out of 364 patients, 14 had not contacted any service even once, pegging the gap at 3.84%. In Turuvekere, out of 236 cases, 29 had not contacted, pegging the gap at 12.28%. Overall, 7.16% was the gap in both taluks. For the taluk of Thirthahalli, the previous treatment gap was measured as 58% for Schizophrenia in 2009 by the authors; thus, reducing it by almost 54% over one and a half decade of this intervention.
Conclusion: Meaningful reduction of gap for schizophrenia is a feasible target. Policies commensurate with this aim should be considered.