bluuebunny/crossref_metadata_2025_split huggingface dataset:
The combination of ALPPS, interventional hepatoma therapy, targeted therapy, and immunotherapy: A novel conversion therapy model for unresectable HCC
Authors: Chen Zhu , Hu Haiyang , Chen Xingyu , Chen Kai , Xiao Heng , Du Chengyou , Lan Xiang 
Published: September 2024

Abstract

Purpose
We aimed to report a new conversion therapy model, which was the combination of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), interventional hepatoma therapy, targeted therapy, and immunotherapy (AITI), to provide more radical resection opportunities for patients with initially unresectable liver cancer.
Methods
Between September 2021 and April 2024, patients treated with the AITI model conversion therapy in our hospital were retrospectively analyzed. ALPPS for patients with insufficient residual liver volume but expected to be resected after physician evaluation was chose to perform. Interventional hepatoma therapy, targeted therapy, and immunotherapy was used before first-stage ALPPS or between stages.
Results
Five patients underwent AITI model conversion therapy. Three patients underwent traditional conversion therapy between the two stages of the ALPPS and achieved satisfactory hypertrophy, while two patients achieved radical resection through ALPPS following suboptimal conversion therapy. Among all patients, the mean residual volume before the first stage surgery was 580 ± 245 mL, and before the second stage surgery, it was 701 ± 295 mL. The mean duration of the first stage surgery was 175.00 ± 17.32 minutes with a blood loss of 210.00 ± 124.50 mL. For the second stage surgery, the mean duration was 234.00 ± 25.35 minutes with a blood loss of 400.00 ± 70.71 mL. The average duration of treatment was 136.8 ± 98.3 days. No recurrences and no metastasis were observed as of April,2024.
Conclusion
The AITI model conversion therapy is safe and affective. This approach can provide more opportunities for unresectable patients to achieve radical resection.
Evaluating perioperative stresses in children by noninvasive modalities using salivary cortisol and autonomic reactivity
Authors: Adachi Ayaka , Fujiwara Kentaro , Watayo Hiroko , Hu Ailing , Yamaguchi Takuji , Iida Hisae , Ishiyama Asuka , Shimizu Masahiro , Nojiri Shuko , Koga Hiroyuki , Kobayashi Hiroyuki , Lane Geoffrey J. , Yamataka Atsuyuki , Suda Kazuto 
Published: September 2024

Abstract

Purpose
Salivary cortisol (SalC) and low to high pulse ratio (LHR) were used for evaluating perioperative stresses in children.
Methods
Children aged 6 months-16 years having elective general (thoracic/abdominal) or minor (open/minimally invasive: MI) procedures underwent pulse monitoring during AM (08:00–12:00) and PM (17:00–21:00) saliva collections from the day before surgery (S-1) to 3 days after surgery (S + 3). SalC/LHR were correlated with age, sex, caregiver attendance, operative time, and surgical site/approach using mixed model analysis and face/numeric pain rating scales (FRS/NRS).
Results
Mean ages (years): minor-open (n = 31) 4.7 ± 2.0, thoracic-open (n = 2) 8.7 ± 4.9, thoracic-MI (n = 6) 9.6 ± 6.1, abdominal-open (n = 14) 4.3 ± 4.1, and abdominal-MI (n = 32) 8.0 ± 5.0. Postoperative SalC increased rapidly and decreased to preoperative levels by S + 3 (p < 0.001). LHR increased slightly without decreasing (p = 0.038). SalC correlated positively with operative time (p = 0.036) and open surgery (p = 0.0057), and negatively with age (p < 0.0001) and caregiver attendance (p < 0.001). SalC correlated positively with FRS (n = 51) at S + 2(PM) (p = 0.023), S + 3(AM) (p < 0.001), S + 3(PM) (p = 0.012) and NRS (n = 34) at S + 1(AM) (p = 0.031), S + 3(AM) (p < 0.044). LHR positively correlated with age (p = 0.0072), female sex (p = 0.0047), and caregiver attendance (p = 0.0026). Postoperative SalC after robotic-assisted MI was significantly lower than after open surgery at S + 2(AM) (p = 0.020).
Conclusions
SalC correlated with pain. Caregiver attendance effectively alleviated stress.
Inhibition of DNA ligase IV affects the DNA damage repair pathway and decreases the sensitivity of olaparib to platinum-sensitive BRCA wild-type ovarian cancer
Authors: Gu Yupeng , Pan Yichen , Wang Yue , Jiang Kui 
Published: September 2024

Abstract

Ovarian cancer is one of the most common gynecologic malignancies, and the mortality rate has always been the highest among gynecologic malignancies. Currently, the initial treatment mode after the first diagnosis of ovarian cancer is tumor cytoreductive surgery, platinum-based chemotherapy, and targeted drug maintenance therapy. Although PARP inhibitors are an important approach to maintenance therapy, relapse occurs in patients after a period of treatment. PARP inhibitors mainly exert anti-tumor effects by inhibiting the repair of tumor cell DNA damage to achieve synthetic lethality. After DNA damage, repair primarily occurs through two pathways: homologous recombination (HR) and non-homologous end joining (NHEJ). DNA ligase IV, as a crucial enzyme in NHEJ, plays a role in connecting DNA fragments during the DNA repair process. Through bioinformatics analysis, we found that the use of olaparib in platinum-sensitive BRCA wild-type ovarian cancer cells leads to a decrease in the expression levels of DNA ligase IV in patients. Furthermore, cell experiments revealed that the expression levels of DNA ligase IV affect the sensitivity of ovarian cancer cells to olaparib. Specifically, when the expression levels of DNA ligase IV are reduced, the sensitivity of ovarian cancer to olaparib decreases. This suggests that BRCA wild-type ovarian cancer patients with low expression of DNA ligase IV may not respond well to PARP inhibitors. Through comet assays and other methods, it was discovered that a decrease in DNA ligase IV levels makes DNA less susceptible to damage in platinum-sensitive BRCA wild-type cells. Additionally, alterations in DNA ligase IV affect the related pathway genes of DNA damage repair in platinum-sensitive BRCA ovarian cancer, resulting in changes in DNA damage repair mechanisms. Therefore, the changes in NHEJ caused by DNA ligase IV may be one of the reasons for the sensitivity of BRCA wild-type ovarian cancer cells to PARP inhibitors. In the future, it may be possible to improve the efficacy of PARP inhibitors in BRCA wild-type ovarian cancer patients by influencing changes in the expression levels of DNA ligase IV.
Pulmonary function tests for identifying pathological invasive stage I lung adenocarcinoma: A multiple-center retrospective cohort study
Authors: Liu Yu , Tan Xueyun , Ma Guanzhou , Zhao Dong , Cao Yaqi , Liang Mengyuan , Tang Jian , Yu Hongyin , Chang Yan , Guo Mengfei , Wang Sufei , Jin Yang 
Published: September 2024

Abstract

Background Preoperative biopsy can hardly be used to diagnose lung cancer invasion; therefore, supplementary methods to estimate pathological tumor invasiveness are needed to identify candidates for limited resection. We aim to ascertain the risk factors and create and verify a model for predicting lung cancer invasion likelihood. Methods A nomogram was trained and validated on retrospectively collected data of patients with primary lung cancer whose pulmonary function was examined within 3 months before surgery. Least absolute shrinkage and selection operator logistic regression were used for important factor selection. The nomogram was established by combining preoperative pulmonary function tests (PFTs) and clinical factors. The area under the receiver operating characteristic curve and decision curve analysis (DCA) were used to evaluate the model’s predictive performance and clinical utility, respectively. Results Lung function impairment was detected in 508 patients (38.72%, 508/1312). The prediction model, which included age (odds ratio [OR] = 1.02), tumor size (OR = 1.31), lung function (OR = 3.10), basophils (OR = 0.51), and direct bilirubin levels (OR = 1.15), showed good performance in both sets. The areas under the curve for predicting lung cancer invasion were 0.820 (95% confidence interval [CI]: 0.781–0.858), 0.758 (95% CI: 0.659–0.858), and 0.838 (95% CI: 0.797–0.879) in the training, internal validation, and external validation sets, respectively, indicating good performance. In the multivariable analysis, patients with restrictive ventilation impairment (OR 2.86 [95% CI 1.43–5.69]) and diffusion capacity impairment (OR 4.23 [95% CI 1.00-17.84]) had high tumor invasion risks. Conclusions Lung function impairment could potentially serve as a biomarker for stage I lung adenocarcinoma invasion.
Angiomyolipomatous Lesions of the Nasal Cavity (Sinonasal Angioleiomyoma with Adipocytic Differentiation): A Multi-Institutional Immunohistochemical and Molecular Study
Authors: Jones Victoria M. , Thompson Lester D. R. , Pettus Jason R. , Green Donald C. , Lefferts Joel A. , Shah Parth S. , Tsongalis Gregory J. , Sajed Dipti P. , Guilmette Julie M. , Lewis James S. , Fisch Adam S. , Tafe Laura J. , Kerr Darcy A. 
Published: September 2024

Abstract

Purpose
Mesenchymal neoplasms composed of vascular, smooth muscle, and adipocytic components are uncommon in the nasal cavity. While angioleiomyoma (AL) is a smooth muscle tumor in the Head & Neck WHO classification, it is considered of pericytic origin in the Skin as well as Soft Tissue and Bone classifications. For nasal AL with an adipocytic component, the terms AL with adipocytic differentiation and angiomyolipoma (AML) have been applied, among others. AML is a type of perivascular epithelioid cell tumor (PEComa), most often arising in the kidney, sometimes associated with the tuberous sclerosis complex (TSC). It is uncertain whether nasal cavity AML and AL are best considered hamartomas or neoplasms, as their genetics are largely unexplored.
Methods
We performed a multi-institutional retrospective study of nasal cavity mesenchymal lesions. Patient demographics, clinical histories, and histologic and immunohistochemical findings were collected. DNA and RNA were extracted from formalin-fixed, paraffin-embedded tissue and analyzed by SNP-based chromosomal microarray, targeted RNA fusion sequencing, and whole-exome sequencing.
Results
Fifteen lesions (3 to 42 mm) were identified predominantly in male (87%) patients with a median age of 60. Patients typically presented with obstructive symptoms, and none had a history of TSC. One AL was a recurrence from six years prior; 11 cases showed no recurrence (median 4.7 years, range: 0.88–12.4). Morphologically, 11 AMLs contained 30–80% smooth muscle, 10–25% vasculature, and 2–60% adipose tissue, while four ALs contained 70–80% smooth muscle and 20–30% vasculature. Other histologic observations included surface ulceration, vascular thrombosis, chronic inflammation, and myxoid change; no well-developed epithelioid cell morphology was identified. Immunohistochemically, all cases were positive for smooth muscle markers (actin and/or desmin) and negative for melanocytic markers. Molecular analysis revealed loss of 3p and 11q in a single AML. No other known pathogenic copy number or molecular alterations were seen, including in TSC1/2, TFE3, or NOTCH2.
Conclusion
Nasal cavity AML lacks morphologic, immunophenotypic, and genetic features of PEComa family AMLs. The significant histologic overlap between nasal AML and AL without distinguishing molecular features in either entity suggests “sinonasal angioleiomyoma with adipocytic differentiation” may be the most appropriate terminology for hybrid vascular and smooth muscle lesions containing adipocytic components.
Morphological changes in the biliary mucosa in pediatric patients with congenital biliary dilatation are more influenced by the duration of amylase exposure than by amylase levels in the gallbladder
Authors: Korai Takahiro , Nui Akihiro , Nishibori Shigeki , Yokoyama Shinichiro , Hashimoto Satsuki , Ishimura Riku , Hamada Hiromi 
Published: September 2024

Abstract

Purpose
We investigated the relationship between bile amylase (AMY) levels and biliary epithelial changes in pancreaticobiliary maljunction (PBM), a congenital anomaly characterized by pancreaticobiliary reflux due to duct fusion outside the duodenal wall
Methods
We enrolled 43 children with congenital biliary dilatation (CBD) of Todani types Ia, Ic, and IVa who underwent surgery at the Hokkaido Medical Center for Child Health and Rehabilitation between November 2007 and June 2023. We defined total AMY exposure in bile as bile AMY levels multiplied by the patient's age (months), representing amount of estimated AMY exposure until surgery. We retrospectively investigated the relationships between bile AMY levels and clinicopathological findings.
Results
All patients exhibited hyperplasia in the gallbladder and bile duct epithelium, with dysplasia observed in 13 cases, but no carcinoma. Exposure to bile AMY ≥ 662,400 IU/L×months was an independent risk factor for dysplasia.
Conclusion
The amount of estimated AMY exposure in bile rather than AMY levels in the bile is an independent risk factor for dysplasia in the biliary mucosa.
Exploring Familial Hypospadias: Genetic Insights from Copy Number Variants in a Quad Family
Authors: Kumar Sourabh , Sharma Jyoti , Gupta Dinesh , Sardar Rahila , Lal Preeti , Jain Vishesh , Dhua Anjan Kumar , Yadav Devendra Kumar , Agarwala Sandeep , Shamsi Monis Bilal , Almaramhy Hamdi Hameed , Singh Harpreet , Kumar Neeta , Goel Prabudh 
Published: September 2024

Abstract

The genetic aetiology of hypospadias is likely to be oligogenic with possible interactions between multiple genetic variants and contributory environmental factors. A pathogenic copy number variant (CNV) is usually harboured by 3–14% of patients with rare developmental disorders. With this background, a landscape of CNVs in a family with multiple affected and unaffected progeny is presented with an investigation into the potentially responsible, molecular pathways underlying the etiopathogenesis of hypospadias. The family consists of both parents, two sons with hypospadias, and two unaffected sons (whole exome data unavailable for one unaffected son). CNVkit pipeline was executed and the structural variant files were annotated. The identified CNVs were studied for distribution within the family, inheritance, gene-composition and correlated with available information for potential relevance to the phenotype. Cumulative analysis (F:father, M:mother, P1-P2:affected progeny, U:unaffected progeny) identified 152 unique CNVs[size:1.49 kb–6.53 Mb) comprising 139 deletions and 13 duplications. P1 & P2 have been represented by 29(of 52) & 22(of 50) de novo CNVs respectively. P1 & P2 have 16 common deletion CNVs:8/16 CNVs are absent in U (inherited:6, de novo:2); de novo CNVs: chr6:29100942:29306930:DEL & chr16:11379821:11441076:D. de novo CNVs encompass OR2J1 and OR14J1 genes expressed in testis and spermatozoa as major histocompatibility complex (MHC)-linked olfactory receptors. CNVs encompassing GREM1, RRN3, KIAA0753 and HNF1B genes relevant to hypospadias were identified. The landscape of CNVs in familial hypospadias has been presented to enhance the understanding of their distribution, frequency and impact on the development of hypospadias and a database has been generated for future research.
Formative Development of InTSHA: Interactive Transition Support for Adolescents with HIV using Social Media
Authors: Zanoni Brian C. , Archary Moherndran , Sibaya Thobekile , Goldstein Madeleine H. , Bergam Scarlett , Psaros Christina , Marconi Vincent C. , Haberer Jessica E. 
Published: September 2024

Abstract

Introduction:
Using human-centered design strategies and a strong theoretical framework, we describe the formative development of a mobile-phone-based intervention: InTSHA (Interactive Transition Support for Adolescents with HIV).
Methods
We performed in-depth, semi-structured interviews with adolescents (n = 20), caregivers (n = 10), and healthcare providers (n = 10) to develop an intervention based on modifiable factors within the Socioecological Model for Adolescent and young Adult Readiness Transition (SMART) and delivered through social media. We then created a preliminary digital, interactive intervention based on modifiable factors in the SMART along with existing transition protocols and adolescent support group curricula to be delivered through mobile phones. We then theatre-tested the intervention with new groups of adolescents (n = 19), caregivers (n = 10), and healthcare providers (n = 7) to obtain feedback on content, delivery, and redesign.
Results
Participants expressed that moderated, small, mixed-gender, closed group chats with focused content facilitated weekly through WhatsApp would likely increase peer support and connection to clinical staff. Separate, closed group chat discussions among only caregivers of the adolescents in the InTSHA group could improve communication with their adolescents. Major concerns included internet and phone security, cost of data plans, and potential accidental disclosure of HIV status. Individual messaging with healthcare providers was seen as potentially beneficial; however, some healthcare providers voiced concern about procedures in the event of disclosure of medical and/or psychiatric emergencies.
Conclusion
The preliminary InTSHA intervention was developed through human-centered design focused on adolescents with HIV during transition to adult care that will use group WhatsApp chats to improve engagement in care.
Comparison of CT and MRI findings of different types of pancreatic Serous cystic neoplasm: combined with histopathology
Authors: Li Guangmang , Lei Aichun , Niu Shangfu , Wang Peng , Ji Guanghai , Han Xiao , Li Peng , Li Bo 
Published: September 2024

Abstract

Objectives
A comparative analysis of the imaging findings across different types Serous Cystic Neoplasm（SCN）was conducted, the objective is to delineate distinct image characteristics, thus enhancing diagnostic accuracy.
Methods
The retrospective analysis involved 65 patients diagnosed with Serous Cystic Neoplasm (SCN) confirmed by pathology. Patients were categorised into macrocystic, microcystic, mixed, and solid types based on morphology. A comparative analysis of the imaging findings across different SCN types was conducted, elucidating their respective imaging characteristics. Additionally, microscopic pathological observations were juxtaposed to discern disparities among the various SCN types.
Results
Age, lesion location, clinical symptoms, and underlying diseases did not exhibit significant differences among the various types of Serous Cystic Neoplasm (SCN) (P > 0.05). However, the volume of lesions in the mixed type was notably larger than that in the microcystic type (P < 0.05). Additionally, the CT values of the mixed and microcystic types were higher than those of the macrocystic type in precontrast scans (P < 0.05). The enhancement degree of the macrocystic type significantly differed from that of the mixed and microcystic types (P < 0.05). Notably, central fibrous scars were evident in mixed and microcystic SCN interiors, contrasting with the absence of such scars in macrocystic types (P < 0.05). While the proportion of calcification and pancreatic duct dilatation was higher in mixed and microcystic types. Electron microscopic revealed that macrocystic types featured large cyst cavities with thin fiber separation and few blood vessels, whereas microcystic types exhibited small cavities with a high number of fibers and visible scar tissue. Mixed types represented a combination of macrocystic and microcystic features. Solid types displayed very small cavities, high proportions of fibrous stroma, and rich blood vessels.
Conclusion
Differences in CT and MR findings among different types of SCN suggest a correlation with their pathological basis.
Causal Relationship between Serum Metabolites, Plasma Lipids, and Hemorrhoidal Disease: A Mendelian Randomization Study
Authors: Yu Hongkai , Yang Yingqi , You Chang , Zhao Jiayu , Wang Luyao , Sun Haohan , Li Yutong , Fan Yu , Jiang Xiaomeng 
Published: September 2024

Abstract

Hemorrhoidal Disease (HD) is a common anorectal disorder that significantly impacts patients' quality of life over the long term and imposes a substantial economic burden. However, the potential link between HD and serum metabolites and lipids has been scarcely studied, and its pathogenesis remains unclear. In this study, the causal relationship between serum metabolite traits, plasma lipids, and HD was evaluated using Mendelian Randomization (MR). Three methods were employed to estimate the causal effect of exposure on outcomes. The study identified 27 serum metabolic traits and 4 plasma lipids with significant causal effects on HD. Among these, 11 serum metabolic traits were identified as risk factors, and the top three ones exhibiting the most significant causal effects on the outcomes are Cortolone glucuronide (1) levels(OR=1.544, 95%CI=1.124-2.123,p=0.007), 3-methyl-2-oxobutyrate levels(OR=2.079, 95%CI=1.189-3.635,p=0.010), and Glycocholate levels(OR=1.405, 95%CI=1.063-1.857, p=0.017). Additionally, 16 serum metabolic traits were found to be protective factors, with lipids or lipoids and their metabolites comprising the largest proportion. In the Mendelian randomization analysis of plasma lipids and HD,Phosphatidylcholine (18:2_20:4) (OR=1.588,95%CI=1.097-2.299,p=0.014) and Phosphatidylcholine (O-16:1_16:0) (OR=1.676，95%CI=1.109-2.533,p=0.014) were identified as risk factors for HD.
Implementing a Healthcare-Associated Bloodstream Infection Surveillance Network in India: a Mixed-Methods Study on the Best Practices, Challenges and Opportunities, 2022
Authors: Vedachalam Srividya K. , Siromany Valan A. , VanderEnde Daniel , Malpiedi Paul , Vasquez Amber , Dikid Tanzin , Walia Kamini , Mathur Purva 
Published: September 2024

Abstract

Background Healthcare-associated bloodstream infections (BSI) threaten patient safety and are the third most common healthcare-associated infection (HAI) in low- and middle-income countries. An intensive-care-unit (ICU) based HAI surveillance network recording BSIs was started in India in 2017. We evaluated this surveillance network’s ability to detect BSI to identify best practices, challenges, and opportunities in its implementation.Methods We conducted a mixed-methods descriptive study from January to May 2022 using the CDC guidelines for evaluation. We focused on hospitals reporting BSI surveillance data to the HAI network from May 2017 to December 2021, and collected data through interviews, surveys, record reviews, and site visits. We integrated quantitative and qualitative results and present mixed methods interpretation.Results The HAI surveillance network included 39 hospitals across 22 states of India. We conducted 13 interviews, four site visits, and one focus-group discussion and collected 50 survey responses. Respondents included network coordinators, surveillance staff, data entry operators, and ICU physicians. Among surveyed staff, 83% rated the case definitions simple to use. Case definitions were correctly applied in 280/284 (98%) case reports. Among 21 site records reviewed, 24% reported using paper-based forms for laboratory reporting. Interviewees reported challenges, including funding, limited human resources, lack of digitalization, variable blood culture practices, and inconsistent information sharing.Conclusion Implementing a standardized HAI surveillance network reporting BSIs in India has been successful, and the case definitions developed were simple. Allocating personnel, digitalizing medical records, improving culturing practices, establishing feedback mechanisms, and funding commitment are crucial for its sustainability.