bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inflammation drives tumor growth in an immunocompetent implantable metastasis model
Authors: Giles Connor , Lee Jungwoo 
Published: August 2024

Abstract

Nearly 90% of cancer deaths are due to metastasis. Conventional cancer therapeutics including chemotherapy, surgery, and radiotherapy, are effective in treating primary tumors, but may aggravate disseminated tumor cells (DTCs) into regaining a proliferative state. Models isolating the post dissemination environment are needed to address the potential risks of these therapies, however modeling post dissemination environments is challenging. Often, host organisms become moribund due to primary tumor mass before native metastatic niches can evolve. Implantable tissue engineered niches have been used to attract circulating tumor cells independent of the primary tumor. Here, we serially transplant such tissue engineered niches with recruited DTCs in order to isolate the post dissemination environment. After transplantaion, 69% of scaffolds developed overt post-dissemination cancer growth, however 100% of scaffolds did not grow to a life-threatening critical size within twelve weeks. Adjuvant chemotherapy, while initially effective, did not prevent long-term DTC growth in scaffolds. Subjecting these transplanted niches to surgical resection via biopsy punch enhanced CD31, MMP9, Ly6G, and tumor burden compared to control scaffolds. Biopsy punching was able to rescue tumor incidence from prior chemotherapy. This model of serial transplantation of engineered DTC niches is a highly controllable and flexible method of establishing and systematically investigating the post-dissemination niche.
Phosphate Supplementation and Target Serum Levels in Sepsis: Impact on Patient Outcomes
Authors: Li Zhaoyang , Shen Tingwen , Yue Zhen , Li Jinhai , Zhang Qun , Chen Xufeng 
Published: August 2024

Abstract

Objectives
There is no clinical protocol for the management of serum inorganic phosphate (Pi) in critically ill patients until now. We aimed to assess the effect of phosphate supplementation on the in-hospital mortality of septic patients with hypophosphatemia and explore the optimal threshold level of serum Pi in patients with sepsis.
Methods
A retrospective analysis of septic patients selected from the Medical Information Mart for Intensive Care (MIMIC)-IV database was carried out. Adjusted OR was used to examine the impact of phosphate supplementation on the hospital mortality. Serum Pi levels were divided into 6 bands. Multivariable logistic regression model was established for each band to investigate the optimal threshold Pi level.
Results
8067 admissions were enrolled and 88967 recorded Pi measurements were collected. The incidence of hypophosphatemia was 26.4% in septic patients. After adjusting for confounding factors, it was found that with phosphate supplemented, mortality tended to increase in septic patients with hypophosphatemia, though not significantly (OR 1.28, 95%CI 0.98–1.66, p = 0.33 in Model 2). The regression models indicated that the hospital mortality benefit accrues within the serum Pi level of 1.5–3.5 mg/dl.
Conclusions
Our findings suggest that phosphate supplementation without a standard protocol did not improve the prognosis of septic patients with hypophosphatemia. Target serum Pi level appears to be the dominant factor influencing the risk of hospital mortality. The optimal level was lower than the normal range in septic population in our study. Randomized studies are needed to improve the knowledge of management for serum Pi in septic patients.
Pre-alerts from critical care ambulance to trauma centers: a quantitative survey of trauma team leaders in Ontario, Canada
Authors: Williams Tara , Nolan Brodie , McGowan Melissa , Johnston Tania , Maria Sonja , von Vopelius-Feldt Johannes 
Published: August 2024

Abstract

Introduction
Pre-alerts from paramedics to trauma centers are important for ensuring the highest quality of trauma care. Despite this, there is a paucity of data to support best practices in trauma pre-alert notifications. Within the trauma system of Ontario, Canada, the provincial critical care transport organization, Ornge, provides pre-alerts to major trauma centers, but standardization is currently lacking. This study examined the satisfaction of trauma team leaders' (TTLs) satisfaction with current trauma pre-alerts and their preferences for logistics, content, and structure.
Methods
This was a quantitative survey of TTLs at adult and pediatric trauma centers across Ontario, Canada. Recruitment was through email to trauma directors, with follow-up efforts to target low-response sites to achieve good geographical representation. The survey was completed online and contained a combination of single or multiple-choice questions, Likert scales and free text options.
Results
In total, 79 TTLs from adult and pediatric lead trauma centers across Ontario responded to the survey, which took place over a 120-day period. The survey achieved good geographical representation. Given the current processes, TTLs describe moderate satisfaction with room for improvement (median score 3, IQR 3–4 on a 5-point Likert scale). Their overall preference was for timely and direct communication, with some concerns about multiple channels of communication around logistics. Most TTLs agreed on the important and less important content details found in common standardized framework tools. For structure, 28/79 TTLs strongly preferred the cognitive aid ATMIST, 13/79 preferred IMIST-AMBO, and 8/79 preferred MIST or SBAR as the most useful.
Conclusions
There is room for improvement through standardizing communication and streamlined pre-alert channels. Some disagreements exist between TTLs, particularly regarding logistics. Further research should examine TTL satisfaction after implementing the change in the pre-alert notification framework, which can address localized issues through stakeholder meetings with individual TTLs.
GDP-mannose 4,6-Dehydratase is a Key Driver of MYCN-amplified Neuroblastoma Core Fucosylation and Tumorigenesis
Authors: Rellinger Eric , Zhu Beibei , Pitts Michelle , Buoncristiani Michael , Bryant Lindsay , Lopez-Nunez oscar , Gurria Juan , Shedlock Cameron , Ribas Roberto , Keohane Shannon , Liu Jinpeng , Wang Chi , Gentry Matthew , Shelman Nathan , Allison Derek , Evers B. Mark , Sun Ramon 
Published: August 2024

Abstract

MYCN-amplification is a genetic hallmark of ~ 40% of high-risk neuroblastomas (NBs). Altered glycosylation is a common feature of adult cancer progression, but little is known about how genetic signatures such as MYCN-amplification alter glycosylation profiles. Herein, matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI-MSI) revealed increased core fucosylated glycan abundance within human MYCN-amplified NB tumors. GDP-mannose 4,6-dehydratase (GMDS) is responsible for the first committed step of de novo GDP-fucose synthesis. High GMDS expression was found to be associated with poor patient survival, advanced stage disease, and MYCN-amplification in human NB tumors. Chromatin immunoprecipitation and promoter reporter assays demonstrated that N-MYC directly binds and activates the GMDS promoter in NB cells. When GMDS was blocked through either genetic or pharmacological mechanisms, NBs were found to be dependent upon de novo GDP-fucose production to sustain cell surface and secreted core fucosylated glycan abundance, as well as adherence and motility. Moreover, when de novo fucose synthesis was inhibited in vivo, tumor formation and progression were blocked. These critical findings identify de novo GDP-fucose production as a novel metabolic vulnerability that may be exploited in designing new treatment strategies for MYCN-amplified NBs.
Factors linked to early adverse neonatal outcomes in diabetic pregnant women at selected Ugandan hospitals: A prospective cohort study
Authors: Namutebi Sharifah , Kasujja Musa , Bagambe Silver , Bwaga Ibrahim , Damulira Adam , Okello Peter , Baluku Asanairi 
Published: August 2024

Abstract

Background
Diabetes mellitus during pregnancy is associated with increased risks of adverse neonatal outcomes. Understanding the incidence and factors contributing to these outcomes is crucial for improving maternal and neonatal health in low-resource settings.
Methods
This prospective cohort study enrolled 150 pregnant women with diabetes mellitus delivering at Jinja, Hoima, and Lira Regional Referral Hospitals in Uganda. Data on socio-demographic characteristics, obstetric history, and neonatal outcomes were collected using standardized protocols. Logistic regression analyses were performed to assess associations between maternal characteristics and adverse neonatal outcomes.
Results
The incidence of adverse neonatal outcomes was 69.3%. Specific outcomes included macrosomia (45.3%), low APGAR scores (4–6: 28.0%, < 3: 7.3%), NICU admission (27.3%), hypoglycaemia (25.3%), respiratory distress (20.7%), early neonatal death (14.0%), birth injuries (7.3%). Significant factors associated with adverse outcomes included unemployment (aOR = 5.94, 95%CI = 1.70-20.67, p = 0.005), fewer than four antenatal care visits (aOR = 1.63, 95%CI = 1.24–16.49, p = 0.035), preterm delivery (aOR = 3.57, 95%CI = 1.06–12.03, p = 0.040), and not receiving treatment for maternal diabetes (aOR = 1.93, 95%CI = 1.05–4.36, p = 0.016). In contrast, a monthly income of ≥ 150,000 was protective against adverse outcomes (aOR = 0.18, 95%CI = 0.06–0.57, p = 0.004).
Conclusions
The study revealed a high incidence of adverse neonatal outcomes among mothers with diabetes, highlighting the urgent need for improved care. Key factors linked to these adverse outcomes included unemployment, fewer antenatal care visits, preterm delivery, and lack of maternal diabetes treatment, while higher monthly income was protective. Targeted interventions, such as enhanced antenatal care and effective diabetes management, are essential to reduce adverse neonatal outcomes. Future research should focus on evaluating specific interventions to mitigate these risks and improve maternal and neonatal health in similar low-resource settings.
Single‑cell and bulk RNA sequencing identifes T cell marker genes to predict the prognosis of ovrian caner
Authors: Sun Hengzi , Huo Xiao , Li Shuhong , Guo Liyuan 
Published: August 2024

Abstract

Background: Ovarian cancer, with high mortality and often late diagnosis, shows high recurrence despite treatment. The variable effectiveness of immunotherapy highlights the urgent need for personalized, advanced therapeutic strategies.
Methods: To investigate T-cell marker genes, single-cell RNA-sequencing (scRNA-seq) data were sourced from the Gene Expression Omnibus (GEO) database. Additionally, bulk RNA-sequencing data along with clinical information from ovarian cancer patients were retrieved from the Cancer Genome Atlas (TCGA) database to establish a prognostic signature. This study involved survival analysis to evaluate associations between different risk groups, and explored cellular communication and relevant pathway analyses, including metabolic pathways.
Results: We identified 41 genes showing varied expression between two T-cell subclusters, marking subcluster 0 with CCL5 and GZMA, and attributing the rest to subcluster 1. These markers delineate four prognostic groups within the TCGA OV dataset, with T-cluster 2 exhibiting the poorest survival, in contrast to T-cluster 3, which shows the best. Analysis suggests subcluster 1 T-cells might be dysfunctional, potentially exacerbating ovarian cancer progression. We also developed a T-cell scoring model using eight significant genes, showing improved survival in the low-score group. Moreover, cellular and metabolic pathway analyses underscored the importance of CCL, IL2 and MGMT pathways in these subclusters.
Conclusions: The study identifies CCL-5 as a biomarker for T-cell subtypes in ovarian cancer using scRNA-seq and bulk RNA-seq data. A T-cell scoring model based on eight genes predicts survival and progression rates, independent of clinical features. This model could be a prognostic indicator and CCL-5 a potential immunotherapy target in ovarian cancer.
Prediction of Early Mortality in Patients Undergoing Right Hemicolectomy Using Machine Learning Algorithms
Authors: Kement Metin , Alkan Murat , Irmak Deniz , Uzun Huseyin , Tasdogan Bagiş , Kuçuk Hasan Fehmi 
Published: August 2024

Abstract

Aim:This study aims to determine whether early mortality in patients undergoing right hemicolectomy can be predicted using artificial intelligence (machine learning) algorithms.
Method:The study included all cases of right hemicolectomy or extended right hemicolectomy performed in our clinic between January 2019 and December 2023. Data were collected retrospectively from a prospectively maintained database. Patients undergoing surgeries other than right hemicolectomy were excluded. A database was created using basic clinical data and processed in the Google Colab environment using TensorFlow, Keras, Pandas, Numpy, and Scikit-learn libraries. The TensorFlow. Keras Sequential model was used with “Dense” layers, and the “Adam” optimizer was chosen for optimization. Eighty percent of the database was used for training, and 20% was used for testing.
Results:The database included 410 patients, of whom 258 (62.9%) were male, and 152 (37.1%) were female, with a mean age of 63.5±14.2 years. Early mortality occurred in 39 (9.5%) patients. Data from 307 patients were used for machine learning training, and data from 103 patients were used for testing. The machine-learning model predicted early mortality with an accuracy range of 91% to 95% using basic clinical parameters..
Conclusion:This study demonstrates that early mortality in patients undergoing right hemicolectomy can be predicted with high accuracy using machine learning algorithms. The above 90% accuracy rate achieved using basic clinical parameters indicates the potential of this algorithm as a supportive tool in clinical decision-making processes.
The Effect of Retinal Structure on Surgical Success in Macular Holes
Authors: SOMUNCU AHMET MEHMET , KOLA MEHMET , ERDÖL HİDAYET , BÜSRA  , ESENÜLKÜ CENAP 
Published: August 2024

Abstract

Purpose: To evaluate the effects of preoperative hole structure and size on postoperative anatomical and functional success in patients with macular holes and determine the changes in retinal layers using optical coherence tomography (OCT).
Methods: This study included 48 eyes of 45 patients who underwent surgery with the diagnosis of macular hole between January 1, 2013, and August 1, 2019, and were followed up for at least six months in the postoperative period.
Results: Forty-five patients, 23 (51.1%) female and 22 (48.9%) male, were included in the study.
There was a statistically significant difference between the preoperative visual acuity and the postoperative third-month and sixth-month visual acuity values. After surgery, visual acuity significantly increased for up to six months. When examining the relationship between hole edge parameters and preoperative visual acuity, a negative correlation was detected between the minimum hole diameter, basal hole diameter and the visual acuities measured at the postoperative. The macular hole index (MHI) and The tractional hole index (THI) had a positive correlation with the postoperative visual acuities.
The assessment of the effect of the integrity of the outer limiting membrane (OLM) and the ellipsoid zone (EZ) on postoperative visual acuity at the third and sixth months revealed that visual acuity was higher in patients with OLM and/or EZ integrity at these evaluation times.
Conclusion: The surgical closure of macular holes provides anatomical and functional recovery. This study showed that the minimum hole diameter and basal hole diameter, as well as MHI and THI, among the edge parameters measured by preoperative OCT, had a significant effect on functional success.
Mortality and antidepressants among individuals with autism spectrum disorder: A population-based cohort study
Authors: Chen Vincent Chin-Hung , Huang Yu-Hsin , Chen Yi-Lung , Dewey Michael E. , Wu Shu-I 
Published: August 2024

Abstract

Aim
High risk of premature mortality has been identified among individuals with autism spectrum disorder (ASD). Although possible risk factors, such as epilepsy or other comorbidities, have been described, studies investigating the association between the use of antidepressants and different causes of mortality are scarce.
Methods
This retrospective population-based cohort design used Taiwan’s National Health Insurance Research Database. 31,458 individuals with ASD between 2001 to 2017 were identified. Among them, 4,659 ASD patients with antidepressant use and 4,659 propensity score (PS)- matched ASD patients without antidepressant use were selected. Main outcomes of this study are all-cause mortality, and mortality due to accident, suicide, or natural causes.
Result
Antidepressant exposure in individuals with ASD was associated with a significantly lower all-cause mortality (aOR = 0.65, 95%CI: 0.52 ~ 0.83), as reflected in accident mortality (aOR = 0.63, 95%CI: 0.47 ~ 0.82). Among those aged 18 and above, antidepressant use was associated with a significantly decreased risk of natural cause mortality.
Conclusions
This study revealed that antidepressant use in patients with ASD was associated with a decreased risk of all-cause mortality, in particular, mortality from accidents or natural causes. These results may demonstrate the importance of early detection and treatments for comorbid psychiatric disorders in patients with ASD.
A unique case of benign notochord cell tumor in which the cervical vertebral body and its accessories were eroded by the tumor
Authors: Huang Yao , Xue Jingbo , Tan Jinghua , Ouyang Xueqian , Meng Zhenyu , Ma Xiuwen , Yan Yiguo 
Published: August 2024

Abstract

Background Benign notochordal cell tumor is an extremely rare benign tumor. Usually, the central axis of the human body is found. we describe a rare case of BNCT involving the cervical vertebral body and its appendages, mainly focusing on its imaging and pathological features. To our knowledge, no similar cases have been previously reported.
Case presentation
The patient, a 50-year-old woman, had experienced neck pain and discomfort for 10 years. Radiography and computed tomography revealed a scattered high-density shadow located in the C4 vertebral body and its attachment area. Plain magnetic resonance imaging showed that the T1-weighted images had a uniformly low signal. Conversely, T2-weighted magnetic resonance imaging displayed a constantly high signal intensity, with no unmistakable enhancement signal observed in the enhanced images. Under a microscope, the cells from resected tissue had a lamellar structure with homogeneous adipocyte-like vacuolated and less-vacuolated eosinophils. Immunohistochemical staining showed positivity to immunohistochemical markers, such as AE1 / AE3 (CK-pan) and brachyury. Because of the rare nature of benign intraosseous chordal cell tumors, it is necessary to record and review them. This is a rare manifestation of BNCT.
Conclusion
BNCT can exist in the vertebral body and its appendages of the cervical spine at the same time or may suggest that BNCT has a certain degree of intraosseous erosion ability. For patients diagnosed with BNCT, the most appropriate treatment plan should be selected to avoid the adverse effects of overtreatment.
Optimizing Electrical Stimulation Parameters to Enhance Visual Cortex Activation in Retina Degeneration Rats
Authors: Xie Hui , Ye Zixin , Chan Leanne Lai Hang 
Published: August 2024

Abstract

In patients with degenerative diseases of the retina, such as retinitis pigmentosa and age-related macular degeneration, retinal prostheses offer a possible method of restoring partial vision. Epiretinal prosthesis remain the need for optimal stimulation parameters for better efficiency and power saving while showing encouraging preliminary clinical efficacy. In this study, we investigate the effects of retinal electrical stimulation parameters, including phase duration, frequency, and interphase interval, on the visual cortical electrically evoked potentials (EEPs) in both healthy (LE) and retinal degenerated (F1) rats. Our in vivoexperiments on both LE and F1 rats suggest that shorter phase durations (500 μs) activate the primary visual cortex (V1) at a lower charge threshold and result in a larger activated area. Our results also show that response to repetitive stimulation decreases profoundly at high frequencies (10 and 20 Hz) compared to low frequency (1 Hz). Additionally, we observe that the inclusion of an interphase interval enhances the level of cortical response but does not contribute to an increase in the activation ratio. The present work suggests epiretinal stimulation using shorter phase durations without interphase intervals as the optimal strategy to safely activate the target region in V1 in both LE and F1 rats.
No Smoke Left Behind- Knowledge, Attitudes and Usage of Smokeless Tobacco from the Lens of the Public: A Nationwide Cross-Sectional Study from Pakistan
Authors: Irshad Hammad Atif , Raja Sajjan , Jehanzeb Hamzah , Shaikh Wamiq Ali , Saleem Umair , Malik Shahzil Abdur Rehman , Shahzad Akmal , Shaikh Mamoon , Iqbal Nousheen , Khan Javaid Ahmed 
Published: August 2024

Abstract

Background Smokeless tobacco (SLT) encompasses products that are not burnt but instead consumed orally or nasally. One-third of tobacco is consumed in the smokeless form in South Asia. Despite its widespread usage, there has been limited empirical research on the prevalence of and factors influencing SLT consumption in Pakistan. This study aimed to provide an assessment of SLT knowledge, attitudes, and usage in Pakistan. Methods Using an online questionnaire, a cross-sectional survey was conducted across Pakistan. Convenience sampling was used to disseminate, and expert approval was sought followed by a pilot study to validate the questionnaire. A comprehensive questionnaire was developed using elements from the Global Adult Tobacco Survey and other tools which had previously been utilized within Pakistan. Participants' responses were described using descriptive statistics, and SPSS version 26 was used to perform linear and logistic regression. A p-value of less than 0.05 was considered statistically significant. Results Data was collected from 1,195 participants among which 85.86% of participants had heard of SLTs prior to the survey. Sex, province, household income and previous doctor visits were significant determinants to product knowledge through which 72.55% agreed that these products can lead to serious illnesses but 30% noted a lack of knowledge on legality. General attitudes agreed to a belief that it makes one unwell (44.1%), sense of guilt (43.85%) and more research is needed on it (54.39%). Negative health effects were the biggest deterrent from pursuing these products for 60.33% of participants. Among significant factors influencing the use of SLTs, the greatest odds of use were found with use as an alternative to cigarettes (OR 4.45) and secondly, due to its availability in a liked flavor (OR 2.27). About 31% reported to have used the product once, with 69.82% of current users expressing a desire to quit. Conclusions Although adequate knowledge and aligning attitudes exist for SLTs, light is shed in the face of a sustaining public health problem. We offer important insights that can guide the creation of focused interventions meant to lower SLT use, and the health hazards associated with it in the Pakistani community by highlighting important myths, incentives, and deterrents.