bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dietary acid load as well as dietary phytochemical index, and association with multiple sclerosis: results from a case–control study
Authors: Hatami Alireza , Ahmadi-Khorram Maryam , Keykhaei Fatemeh , Hashemi Mohtaram , Javid Reihane , Hashempour Mehrara , Esfehani Ali Jafarzadeh , Nematy Mohsen 
Published: July 2024

Abstract
Introduction
Multiple sclerosis (MS) is a chronic inflammatory disease characterized by central nervous system (CNS) lesions. Although the etiology and pathogenesis of MS remains unclear, nutrition is among the environmental factors that may be involved in developing MS. Currently, no specific diet has been associated with MS. This study aimed to investigate the relationship between the dietary phytochemical index (DPI), dietary acid load (DAL), and the risk of developing MS.

Methods
This case‒control study was conducted on 174 patients with MS and 171 healthy individuals in Mashhad, Iran. Data were collected using a 160-item semiquantitative food frequency questionnaire (FFQ). The study investigated the association between DPI, DAL, and MS, considering anthropometric measures, dietary intake, smoking habits, and sex. DPI, potential renal acid load (PRAL), and net endogenous acid production (NEAP), as indicators of DAL, were calculated based on the FFQ.

Results
The study analyzed 345 participants, comprising 174 (50.4%) MS patients and 171 (49.6%) healthy individuals. The mean age of the participants was 32.45 ± 8.66 years. The DPI score was significantly lower among MS patients, while the NEAP and PRAL scores were significantly higher among MS patients compared to the healthy group. There was no relationship between NEAP (OR 1.001; 95% CI 0.959–1.044; P = 0.974) and PRAL (OR 1.019; 95% CI 0.979–1.061; P = 0.356) and MS incidence.

Conclusions
The study found higher smoking and obesity rates in MS patients, with a reduced DPI score and increased DAL. Further studies are needed before recommending plant-based foods and dietary acid–base balance evaluation as therapeutic approach.

Graphical Abstract
The Helping Hand in Ukraine: feasibility and potential impact
Authors: Raknes Solfrid , Chorna Tetiana 
Published: July 2024

Abstract
Background
New services are needed to prevent the mental health consequences of the war in Ukraine. Ten adolescents self-recruited to use and evaluate the Ukrainian version of the Helping Hand (HH) in Odesa, Ukraine. From April to June 2023, they participated in a 10-session group program where they played the cognitive behavioral game app, shared stories, and engaged in activities to enhance their coping skills.

Methods
A mixed-method, quantitative–qualitative design was used to get insight into the feasibility and potential impact of the HH on Ukrainian adolescents’ mental health and well-being during the war. A questionnaire to the adolescents assessed the feasibility of the intervention; anxiety and depression symptoms were assessed before and after the intervention by a standardized and validated adolescent-completed questionnaire. An interview with the psychologist who implemented the intervention was used to interpret the data completed by the adolescents.

Results
Eight of 10 adolescents completed the HH intervention, and the psychologist found the HH helpful and culturally appropriate. The average anxiety and depression symptoms decreased from before the intervention (M = 20.4) to after (M = 15.0), showing a moderate effect size.

Conclusion
The results indicated that the HH has a high potential to prevent mental health consequences in Ukraine.
Students’ affective engagements in peer feedback across offline and online English learning environments in Thai higher education
Authors: Peungcharoenkun Tipaya , Waluyo Budi 
Published: July 2024

AbstractThis study investigated the effectiveness and dynamics of peer feedback in online and offline learning environments, focusing on English as a Foreign Language (EFL) students’ affective engagement and its impact on learning outcomes. Utilizing an explanatory sequential mixed methods design, the research divided participants into groups that studied through Zoom and traditional classrooms over 12 weeks, analyzing their engagement with peer feedback. Data were gathered from Likert-scale and open-ended questionnaires, along with performance scores on key tasks, and analyzed using descriptive statistics, t-tests, linear regressions, and thematic analysis. The findings indicated that students valued peer feedback in both settings, with online learners showing higher engagement levels. However, this engagement did not translate into improved writing skills, highlighting the need for further research into other factors that could enhance EFL writing proficiency.
Sirtuin3 and Sirtuin7 are promising biomarkers in systemic sclerosis
Authors: Makarem Yasmine S. , Fathi Nihal , El-Morabaa Mai H. , Salem Gehan Ibrahim , Badawy Eman R. , Abdelaziz Marwa Mahmoud 
Published: July 2024

Abstract
Background
Systemic sclerosis (SSc) is an autoimmune disease that results in micro-vasculopathy, leading to organ dysfunction. Sirtuins are known for their role in cellular processes such as the cell cycle, aging, and inflammation, Sirtuins also play an important role in regulating fibrotic responses, inhibiting collagen production and myofibroblast differentiation, implying that its dysregulation is involved in the pathogenesis of systemic sclerosis. The aim of this study was to determine the circulating Sirtuin3 and Sirtuin7 levels in patients suffering from systemic sclerosis with a focus on how they might be associated with the different clinical features and subsets of the disease.

Methods
This prospective cross-sectional case–control study included 56 participants 41 SSc patients and 15 healthy controls. Demographics, clinical, and laboratory data were analyzed. Quantitative determination of human Sirtuin3 and Sirtuin7 concentrations was done.

Results
Among systemic sclerosis patients, the age of SSc patients was 42.27 ± 10.46 years. The mean serum levels of Sirtuin3 and Sirtuin7 were significantly lower in SSc patients than in healthy controls (p < 0.001). SIRT3 and SIRT7 levels among SSc patients showed a statistically significant positive correlation (p < 0.001). SIRT7 level was insignificantly decreased in dcSSc (14.16 ± 5.93) than in lcSSc (20.01 ± 8.34). Regarding the SIRT3 level, there was an insignificant difference between dcSSc and lcSSc. Modified Rodnan’s skin score correlated negatively with Sirtuin3 and Sirtuin7 levels. In systemic sclerosis patients with interstitial lung disease (56.1%), there was an insignificant difference in SIRT3 and SIRT7 levels (0.12 ± 0.01and 21.23 ± 8.23) compared with systemic sclerosis patients without interstitial lung disease (0.10 ± 0.01 and 17.47 ± 8.57), with p = 0.408 and 0.258, respectively. The receiver operating characteristic curve for SSc prediction with Sirtuin3 has an accuracy of 83.0%, sensitivity of 85.4%, and specificity of 80.0% and p < 0.001. Regarding Sirtuin7, it has an accuracy of 89.5%, sensitivity of 85.4%, and specificity of 93.3% and p < 0.001.

Conclusion
Sirtuin3 and Sirtuin7 levels were found to have a significant positive correlation in SSc patients. Sirtuin3 and Sirtuin7 levels are both good diagnostic biomarkers for detecting and diagnosing SSc, with Sirtuin7 being more accurate, specific, and predictive of the disease than Sirtuin3. Sirtuin7 is thought to be a new biomarker for SSc disease.
Relapsing polychondritis associated with pustular psoriasis successfully treated with secukinumab: a case-based review
Authors: Song Qicheng , Wang Zhankui 
Published: July 2024

Abstract
Rationale
Relapsing polychondritis (RP) is an immune-mediated systemic inflammatory disease involving cartilage and proteoglycan-rich tissues. Pustular psoriasis (PP) is a psoriasis subtype characterized by skin erythema and sterile pustules. In previous studies, there were few reports on patients with RP combined with psoriasis, and treatment strategies are not standardized.

Patient concerns
An 80-year-old Chinese woman with a 7-year history of atrial fibrillation, a 1-year history of coronary atherosclerotic heart disease, and no familial history, had a 2-month history of skin rash, erythema, swelling and pain in both hands, swollen bilateral auricles, and fingertip gangrene.

Diagnosis
Based on the diagnostic criteria for generalized pustular psoriasis proposed by Fujita et al. in 2018 and RP proposed by McAdam et al. in 1975, we diagnosed RP with PP as the predominant manifestation.

Interventions
We started therapy with subcutaneous secukinumab 150 mg weekly for the first month, then 150 mg monthly thereafter.

Outcomes
After 2 weeks of secukinumab administration, the patient showed significant remission of pustular skin lesions, with almost no joint pain, swollen bilateral auricles, and no adverse reaction.

Conclusions
Pustular lesions secondary to RP-associated gangrene and swollen auricles were observed, demonstrating a potential immune correlation between RP and psoriasis in some patients. Although data related to the use of secukinumab for RP and PP is very limited due to the rarity of the two conditions presented together, secukinumab provides a novel therapeutic option. Further prospective studies are needed to support our findings.
Examination of irAE and treatment discontinuation irAE in patients with RCC with T effector phenotype.
Authors: Fahey Catherine , Reddy Anupama , Ancell Kristin Kathleen , Schaffer Kerry Roe , Rini Brian I. , Beckermann Katy 
Published: July 2024

4549 Background: The standard of care for renal cell carcinoma (RCC) is physician-choice of dual immunotherapy with ipilimumab/nivolumab (IO/IO) or a combination a VEGF inhibitor with immunotherapy (VEGF/IO). The IMmotion 151 trial identified gene expression signatures that differentiate likelihood of response to IO/IO (cluster 4 and 5 – T effector) versus VEGF/IO (cluster 1 and 2 - Angiogenic). Given that the T effector RNA-seq signature consists of higher expression of genes associated with inflammation, we hypothesized that patients with the T effector phenotype would have higher rates of immune-related adverse events (irAE) on IO-based therapy. Methods: Patients with metastatic RCC treated with systemic IO-based therapy had RNA sequencing completed on the primary tumor or metastatic site. Charts of patients who had a T effector RNA-seq signature were manually curated to identify development of irAE by reading the most recent clinic note and searching ‘steroids’, ‘irAE’, ‘rash’, ‘thyroid’. Hits from searches were investigated by manual chart review. Results: 118 patients underwent RNA sequencing and 105 passed quality control. Nineteen patients (18%) were assigned the T effector phenotype. Of the 17 metastatic patients, twelve of these patients received at least one dose of IO/IO in the first or second line of therapy, five were treated with VEGF/IO Among patients treated with IO/IO, 8 developed any grade irAE (66%; 41% grade 3+), 5 (41%) required steroid treatment, 5 (41%) required hospitalization, and 4 (33%) discontinued treatment due to irAE. Grade 3 toxicities in this group included colitis, adrenal insufficiency, and hypophysitis. Of the 5 patients treated with VEGF/IO, 3 developed any grade irAE (60%; 20% grade 3+), none were treated with steroids, and none were hospitalized. The grade 3 toxicity in this group was adrenal insufficiency. Conclusions: Patients with a T effector RNA-seq signature had higher rates ofirAE than historic controls when treated with IO/IO leading to high rates of steroid use and treatment discontinuation. VEGF/IO-treated patients with the T effector RNA-seq signature had similar rates of irAE to historic controls. The ongoing OPTIC clinical will expand on these results by studying treatment assignment in a prospective manner.
Association of ephrinB2 (B2) expression on overall survival (OS) and resistance to PD1/L1 inhibitors (inh) in metastatic urothelial carcinoma (mUC).
Authors: Sadeghi Sarmad , Mar Nataliya , Tsao-Wei Denice , Ashouri Karam , Siddiqi Imran , Cogan Jon P , Jackovich Alexandra , Freeman Dory , O'Toole Jillian , Flaig Thomas W. , gill parkash S. , Rezazadeh Arash , Sonpavde Guru P. , Bellmunt Joaquim 
Published: July 2024

4577 Background: B2 is a ligand for EphB4 (B4) which enhances tumor invasion, proliferation, survival and promotes angiogenesis. TCGA data (N= 409) bladder cancer patients (pts) showed B2 high expression (34%) had poor OS vs. low expression (66%) (Hazard Ratio- HR- 0.7 p=0.02). Our phase II trial of sEphB4-HSA, a B2 inhibitor, combined with pembrolizumab in pre-treated mUC (N=70) showed an objective response rate (ORR) of 37%. Pts with high B2 had 52% ORR with 24% complete response (CR) (JCO PMID 35984996). This retrospective study examined the OS and ORR to PD1/L1 inh in pts with mUC and its correlation with B2 expression. Methods: Pts with mUC who received PD1/L1 inh were eligible if they had radiographic response data and tumor tissue for B2 testing. Demographics and disease characteristics were abstracted. Radiographic was assessed using RECIST 1.1. Tumor specimens were analyzed for B2 expression using in-situ hybridization (ISH). Scores of 2-4 were marked High (Hi) and 0-1 Low (Lo). Descriptive statistics summarized the results. Cox Model, logrank and Fisher’s exact test were used for the association of B2 status with OS and ORR, respectively, using SAS 9.4. Results: 143 (N) pts from University of Southern California (USC, n = 49), Dana Farber (DFCI, n = 55), and University of California, Irvine (UCI, n = 39) were included. 101 pts were male (71%). Median age was 73. PD1/L1 inh included pembrolizumab (n = 111, 78%), atezolizumab (n = 25, 17%), nivolumab, avelumab, and durvalumab in 3%, 1%, and 1%, respectively. ORR defined as CR + partial response (PR) was 21% (95% CI 14%, 29%) (N = 136 evaluable). ORR was 12% vs 33% in B2 Hi vs Lo, p = 0.005. The median OS was 17.2 months (mo) (95% CI 13.5, 23.8) (N = 143). Median OS was 14.5 (95% CI 9.4, 21.0) mo vs 24.0 (95% CI 13.7, 60.8) mo for B2 Hi vs Lo, logrank p = 0.022 (HR 1.65 95% CI:1.07, 2.55 Wald p = 0.023). Conclusions: B2 Hi is associated with poor OS and poor ORR in PD1/L1 inh monotherapy treated mUC acting as a biomarker of disease outcome. These data suggest B2-B4 pathway to be a mechanism of resistance to PD1/L1 inh and a therapeutic target. [Table: see text]
Disparities in the Use of Preoperative Breast Magnetic Resonance Imaging After Breast Cancer Diagnosis
Authors: Ginzberg Sara P. , Grady Connor B. , Fayanju Oluwadamilola M. , Edmonds Christine E. 
Published: July 2024

PURPOSE
Preoperative magnetic resonance imaging (MRI) after breast cancer diagnosis is increasingly used to improve locoregional staging, particularly among women with dense breasts, extensive ductal carcinoma in situ, and lobular histology. The goals of this study were to (1) assess whether use of preoperative MRI varies by race and insurance type; and (2) determine whether preoperative MRI is associated with downstream surgical management.

MATERIALS AND METHODS

We performed a retrospective cohort study of women with stage 0-III breast cancer who were treated with surgical resection within our academic health system (2016-2019). Patients were categorized by race and insurance type. The primary outcome was receipt of preoperative MRI. Secondary outcomes included surgery extent (lumpectomy
v
mastectomy) and receipt of a second operation.

RESULTS

A total of 1,410 women (27% Black, 73% White; 67% private insurance, 26% Medicare, 6% Medicaid) were included. Black patients were significantly less likely to undergo preoperative MRI than White patients (odds ratio [OR], 0.54 [95% CI, 0.38 to 0.76];
P
< .001). There was no association between insurance type and preoperative MRI (Medicare
v
private: OR, 0.77 [95% CI, 0.52 to 1.15];
P
= .208; Medicaid
v
private: OR, 0.67 [95% CI, 0.36 to 1.25];
P
= .210). White patients who underwent preoperative MRI were less likely to undergo lumpectomy versus those who did not (OR, 0.53 [95% CI, 0.37 to 0.76];
P
< .001). Likelihood of re-excision was lower for Black women who had undergone MRI versus those who had not (OR, 0.43 [95% CI, 0.20 to 0.93];
P
= .031).

CONCLUSION
Black patients were less likely than White patients to undergo preoperative MRI, yet Black women who underwent MRI were less likely to require re-excision. Standardizing preoperative MRI use may mitigate provider- and system-level biases and promote more equitable care.
North American Cancer Center Clinical Research Capacity and Benchmarking in the Postpandemic Era
Authors: Kasner Margaret , Fritsche Angela H. , Leong Man Chong , Cameron Kendra , Lee Carrie B. , Lin Tara L. , Lee Ji-Hyun , Brogan Frances , Kovak Matthew R. , Honeycutt Hailey , Shaw Kate , George Thomas J. 
Published: July 2024

PURPOSE
Cancer center clinical trial offices (CCTOs) support trial development, activation, conduct, regulatory adherence, data integrity, and compliance. In 2018, the Association of American Cancer Institutes (AACI) Clinical Research Innovation (CRI) Steering Committee conducted and published survey results to benchmark North American CCTOs, including trial volume, accrual, full time equivalents (FTEs), and budget. The survey was readministered in 2023 to assess contemporary CCTO performance and capacity with results presented here.

METHODS
The 28 question 2023 survey was sent to directors of AACI's clinical member cancer centers. Survey participation was voluntary, no compensation was provided, and data requested covered operations during 2022. Definitions were consistent with National Cancer Institute (NCI) CCTO reporting requirements and AACI staff anonymously compiled results for descriptive statistical reporting.

RESULTS
The survey response rate was 61% (60/99). The median annual CCTO budget was $11.5 million (M) US dollars (USD) versus $8.2M USD in 2018. These budgets support a median of 150 FTEs versus 104 previously, and a median total of 384 versus 280 interventional treatment trials and a median of 479 versus 531 interventional treatment accruals. Sources of support for CCTO annual budgets were primarily from industry revenue (45.3%) or institutional support (31.7%). Nearly 60% of centers reported activating NCI-sponsored studies within 90 days but only 9% reported meeting a 90-day activation timeline for industry sponsored studies.

CONCLUSION
Contemporary benchmarks for CCTO operations through this survey demonstrate larger staff sizes, larger budgets, more trials supported, but fewer patients enrolled to interventional treatment trials in comparison with 2018. These data shine a critical light on the increasing complexity of cancer clinical trials, the importance of external funding sources, and necessary operational efficiency upgrades to provide cutting-edge cancer research and care.
Acute pancreatitis after EGD: case presentation and literature review of this rare post-procedure complication
Authors: Gaddameedi Sai Rakshith , Rathod Malay , Ravilla Jayasree , Chinchwadkar Ojas , Vangala Anoohya , Terrany Ben , Du Doantrang 
Published: July 2024

Background: Acute pancreatitis is a common cause of hospitalisation characterised by inflammation of the pancreas. While mechanical, toxic and iatrogenic factors typically cause it, post-oesophagogastroduodenoscopy (EGD) pancreatitis is extremely rare. This report examines a case of acute pancreatitis following EGD, aiming to highlight this rare but significant complication. Case description: A 46-year-old woman with a history of breast cancer, anxiety, vitamin D deficiency and gastro-oesophageal reflux disease underwent an EGD, which revealed and led to the removal of duodenal polyps. Six hours post-procedure, she presented with severe abdominal pain radiating to her back, accompanied by nausea. Laboratory results indicated elevated lipase levels, and a computed tomography (CT) scan confirmed acute pancreatitis. The patient was managed with aggressive fluid resuscitation, bowel rest and pain management, leading to an improvement in her condition and subsequent discharge. We believe that the pancreatitis was likely caused by the use of cautery during the endoscopic mucosal resection of duodenal polyps. Conclusion: This case underscores the need for clinicians to recognise acute pancreatitis as a potential complication of EGD, especially in the absence of other common risk factors.
Virtual reality reduces anxiety of children in the plaster room: a randomized controlled trial
Authors: Poppelaars Maximilaan A. , van der Water Lisa , Koenraadt-van Oost Iris , Boele van Hensbroek Pieter , van Bergen Christiaan J. A. 
Published: July 2024

AimsPaediatric fractures are highly prevalent and are most often treated with plaster. The application and removal of plaster is often an anxiety-inducing experience for children. Decreasing the anxiety level may improve the patients’ satisfaction and the quality of healthcare. Virtual reality (VR) has proven to effectively distract children and reduce their anxiety in other clinical settings, and it seems to have a similar effect during plaster treatment. This study aims to further investigate the effect of VR on the anxiety level of children with fractures who undergo plaster removal or replacement in the plaster room.MethodsA randomized controlled trial was conducted. A total of 255 patients were included, aged five to 17 years, who needed plaster treatment for a fracture of the upper or lower limb. Randomization was stratified for age (five to 11 and 12 to 17 years). The intervention group was distracted with VR goggles and headphones during the plaster treatment, whereas the control group received standard care. As the primary outcome, the post-procedural level of anxiety was measured with the Child Fear Scale (CFS). Secondary outcomes included the children’s anxiety reduction (difference between CFS after and CFS before plaster procedure), numerical rating scale (NRS) pain, NRS satisfaction of the children and accompanying parents/guardians, and the children’s heart rates during the procedure. An independent-samples t-test and Mann-Whitney U test (depending on the data distribution) were used to analyze the data.ResultsThe post-procedural CFS was significantly lower (p < 0.001) in the intervention group (proportion of children with no anxiety = 78.6%) than in the control group (56.8%). The anxiety reduction, NRS pain and satisfaction scores, and heart rates showed no significant differences between the control group and the intervention group. Subanalyses showed an increased effect of VR on anxiety levels in young patients, females, upper limb fractures, and those who had had previous plaster treatment.ConclusionVR effectively reduces the anxiety levels of children in the plaster room, especially in young girls. No statistically significant effects were seen regarding pain, heart rate, or satisfaction scores.Cite this article: Bone Joint J 2024;106-B(7):728–734.