bluuebunny/crossref_metadata_2025_split huggingface dataset:
Total aortic arch debranching with antegrade Thoracic Endovascular Aortic Repair (TEVAR) in acute non-A non-B aortic dissection
Authors: Gilani Aaron , Schachner Benjamin , Wood Elizabeth , Khawaja Zohaib , Imielski Bartlomiej 
Published: June 2024

Abstract
Background
The surgical evaluation and management of non-A non-B aortic dissections, in the absence of ascending aortic involvement, remains a grey area. It is in these scenarios when thorough evaluation of patient/family history, clinical presentation, but also overall lifestyle, is of immense importance when determining an optimal intervention.

Case presentation
We present a 38-year-old patient with a physically demanding lifestyle as a professional wrestler, uncontrolled hypertension due to history of medical non-adherence, and family history of aortic dissection who presented with acute non-A non-B aortic dissection. He was spared a total arch replacement by undergoing a hybrid approach of complete aortic debranching with antegrade Thoracic Endovascular Aortic Repair (TEVAR). The patient was able to benefit from reduced cardiopulmonary bypass (CPB) time, avoidance of aortic cross clamp, circulatory arrest, and hypothermic circulation.

Conclusions
This patient’s unique composition of a physically demanding lifestyle, personal history of medical non-adherence, family history of aortic dissection, and clinical presentation required a holistic approach to understanding an ideal intervention that would be best suited long-term. Due to this contextualization, the patient was able to be spared a total arch replacement, or suboptimal medical management, by instead undergoing a hybrid-approach with total aortic arch debranching with antegrade TEVAR.
Folliculogenesis and steroidogenesis alterations after chronic exposure to a human-relevant mixture of environmental toxicants spare the ovarian reserve in the rabbit model
Authors: El Fouikar Sara , Van Acker Nathalie , Héliès Virginie , Frenois François-Xavier , Giton Frank , Gayrard Véronique , Dauwe Yannick , Mselli-Lakhal Laila , Rousseau-Ralliard Delphine , Fournier Natalie , Léandri Roger , Gatimel Nicolas 
Published: June 2024

Abstract
Background
Industrial progress has led to the omnipresence of chemicals in the environment of the general population, including reproductive-aged and pregnant women. The reproductive function of females is a well-known target of endocrine-disrupting chemicals. This function holds biological processes that are decisive for the fertility of women themselves and for the health of future generations. However, insufficient research has evaluated the risk of combined mixtures on this function. This study aimed to assess the direct impacts of a realistic exposure to eight combined environmental toxicants on the critical process of folliculogenesis.

Methods
Female rabbits were exposed daily and orally to either a mixture of eight environmental toxicants (F group) or the solvent mixture (NE group, control) from 2 to 19 weeks of age. The doses were computed from previous toxicokinetic data to reproduce steady-state serum concentrations in rabbits in the range of those encountered in pregnant women. Ovarian function was evaluated through macroscopic and histological analysis of the ovaries, serum hormonal assays and analysis of the expression of steroidogenic enzymes. Cellular dynamics in the ovary were further investigated with Ki67 staining and TUNEL assays.

Results
F rabbits grew similarly as NE rabbits but exhibited higher total and high-density lipoprotein (HDL) cholesterol levels in adulthood. They also presented a significantly elevated serum testosterone concentrations, while estradiol, progesterone, AMH and DHEA levels remained unaffected. The measurement of gonadotropins, androstenedione, pregnenolone and estrone levels yielded values below the limit of quantification. Among the 7 steroidogenic enzymes tested, an isolated higher expression of Cyp19a1 was measured in F rabbits ovaries. Those ovaries presented a significantly greater density/number of antral and atretic follicles and larger antral follicles without any changes in cellular proliferation or DNA fragmentation. No difference was found regarding the count of other follicle stages notably the primordial stage, the corpora lutea or AMH serum levels.

Conclusion
Folliculogenesis and steroidogenesis seem to be subtly altered by exposure to a human-like mixture of environmental toxicants. The antral follicle growth appears promoted by the mixture of chemicals both in their number and size, potentially explaining the increase in atretic antral follicles. Reassuringly, the ovarian reserve estimated through primordial follicles number/density and AMH is spared from any alteration. The consequences of these changes on fertility and progeny health have yet to be investigated.
Randomized controlled trial of enteral vitamin D supplementation (ViDES) in infants <28 weeks gestational age or <1000 g birth weight: study protocol
Authors: Romero-Lopez Mar , Tyson Jon E. , Naik Mamta , Pedroza Claudia , Holzapfel Lindsay F. , Avritscher Elenir , Mosquera Ricardo , Khan Amir , Rysavy Matthew 
Published: June 2024

Abstract
Background
Vitamin D is necessary to develop healthy lungs and other organs early in life. Most infants born before 28 weeks’ gestation have low vitamin D levels at birth and a limited intake during the first month. Enteral vitamin D supplementation is inexpensive and widely used. The appropriate supplementation regimen for extremely preterm infants is controversial, and the effect of different regimens on their blood levels and outcomes is unclear.

Methods
Randomized, blinded comparative effectiveness trial to compare two vitamin D supplementation regimens for inborn infants <28 weeks gestation or <1000 g birth weight at a large academic center in the United States. Infants are stratified by birth weight and randomized within 96 h after birth to either routine supplementation (400 IU/day with established feedings) or increased supplementation (800 IU/day with any feedings) during the first 28 days after birth. We hypothesize that the higher and early vitamin D dose (800 IU/day with early feeding) compared to placebo plus routine dose (400 IU/day with established feeding) will substantially increase total 25-hydroxyvitamin D3 levels measured as state-of-art at 1 month, reduce respiratory support at 36 weeks’ postmenstrual age (on an ordinal scale predictive of later adverse outcomes), and improve or at least not worsen other important secondary outcomes. The infants in the study will follow up at 22–26 months’ corrected age (~2 years) with blinded certified examiners to evaluate neurodevelopmental outcomes. The sample size of a minimum of 180 infants provides >90% power to detect a >95% posterior probability of a 33% increase in serum 25-hydroxy vitamin D3 and >80% power to detect a >80% posterior probability of a relative risk decrease of 20% of reducing respiratory support by intention-to-treat Bayesian analyses using a neutral prior probability.

Discussion
Our study will help clarify the uncertain relationship of vitamin D supplementation and its associated serum metabolites to clinical outcomes of extremely preterm infants. Confirmation of our hypotheses would prompt reconsideration of the supplementation regimens used in extremely preterm infants and justify a large multicenter study to verify the generalizability of the results.

Trial registration
ClinicalTrials.gov NCT05459298. Registered on July 14, 2022.
Next-generation neuropeptide Y receptor small-molecule agonists inhibit mosquito-biting behavior
Authors: Zeledon Emely V. , Baxt Leigh A. , Khan Tanweer A. , Michino Mayako , Miller Michael , Huggins David J. , Jiang Caroline S. , Vosshall Leslie B. , Duvall Laura B. 
Published: June 2024

Abstract
Background
Female Aedes aegypti mosquitoes can spread disease-causing pathogens when they bite humans to obtain blood nutrients required for egg production. Following a complete blood meal, host-seeking is suppressed until eggs are laid. Neuropeptide Y-like receptor 7 (NPYLR7) plays a role in endogenous host-seeking suppression and previous work identified small-molecule NPYLR7 agonists that inhibit host-seeking and blood-feeding when fed to mosquitoes at high micromolar doses.

Methods
Using structure–activity relationship analysis and structure-guided design we synthesized 128 compounds with similarity to known NPYLR7 agonists.

Results
Although in vitro potency (EC50) was not strictly predictive of in vivo effect, we identified three compounds that reduced blood-feeding from a live host when fed to mosquitoes at a dose of 1 μM—a 100-fold improvement over the original reference compound.

Conclusions
Exogenous activation of NPYLR7 represents an innovative vector control strategy to block mosquito biting behavior and prevent mosquito–human host interactions that lead to pathogen transmission.

Graphical Abstract
Diagnosis and management of COVID toes in outpatients: a case report
Authors: Pouxe Marie , Abdulkarim Aziz , de Vallière Serge , Seremet Teofila , Favrat Bernard , Kokkinakis Ioannis 
Published: June 2024

Abstract
Background
Since the beginning of the coronavirus disease 2019 pandemic, the most common skin lesions observed due to infection with the severe acute respiratory syndrome coronavirus 2 are pseudochilblains (or coronavirus disease toes). However, this pathology remains infrequent and difficult to diagnose, as no specific test exists.

Case presentation
Two Caucasian women, 30 and 22 years old, presented to our General Medicine Unit with perniosis lesions on the feet during the first two waves of the coronavirus disease 2019 pandemic. They did not have respiratory or general symptoms of severe acute respiratory syndrome coronavirus 2 infection, the reverse transcription polymerase chain reaction on nasopharyngeal swabs was negative, and the serology was positive only in the first case. The clinical presentation differed for the two cases, as the second patient suffered from swelling and burning after cold application. The diagnosis was based on clinical presentation, temporality, exclusion of other differential diagnoses, and blood test results (positive serology in the first case and high level of CXCL13 and VEGF in the second), supported by current literature. Lesions resolved spontaneously in the first patient. The second case was hospitalized for pain management and received corticosteroid therapy with resolution of the symptoms.

Conclusion
These two cases with different clinical presentations illustrate the diagnostic approach to coronavirus disease 2019, a challenging disease with diverse manifestations, including, in some cases, coronavirus disease toes. We present a literature review that illustrates the progression of scientific research. Skin lesions associated with coronavirus disease 2019 infection could be the expression of an important interferon type 1 response and should be considered in the differential diagnosis in a primary care setting.
Identification of T2W hypointense ring as a novel noninvasive indicator for glioma grade and IDH genotype
Authors: Lu Yawen , Du Ningfang , Fang Xuhao , Shu Weiquan , Liu Wei , Xu Xinxin , Ye Yao , Xiao Li , Mao Renling , Li Kefeng , Lin Guangwu , Li Shihong 
Published: June 2024

Abstract
Background
This study aimed to evaluate the T2W hypointense ring and T2-FLAIR mismatch signs in gliomas and use these signs to construct prediction models for glioma grading and isocitrate dehydrogenase (IDH) mutation status.

Methods
Two independent radiologists retrospectively evaluated 207 glioma patients to assess the presence of T2W hypointense ring and T2-FLAIR mismatch signs. The inter-rater reliability was calculated using the Cohen’s kappa statistic. Two logistic regression models were constructed to differentiate glioma grade and predict IDH genotype noninvasively, respectively. Receiver operating characteristic (ROC) analysis was used to evaluate the developed models.

Results
Of the 207 patients enrolled (119 males and 88 females, mean age 51.6 ± 14.8 years), 45 cases were low-grade gliomas (LGGs), 162 were high-grade gliomas (HGGs), 55 patients had IDH mutations, and 116 were IDH wild-type. The number of T2W hypointense ring signs was higher in HGGs compared to LGGs (p < 0.001) and higher in the IDH wild-type group than in the IDH mutant group (p < 0.001). There were also significant differences in T2-FLAIR mismatch signs between HGGs and LGGs, as well as between IDH mutant and wild-type groups (p < 0.001). Two predictive models incorporating T2W hypointense ring, absence of T2-FLAIR mismatch, and age were constructed. The area under the ROC curve (AUROC) was 0.940 for predicting HGGs (95% CI = 0.907–0.972) and 0.830 for differentiating IDH wild-type (95% CI = 0.757–0.904).

Conclusions
The combination of T2W hypointense ring, absence of T2-FLAIR mismatch, and age demonstrate good predictive capability for HGGs and IDH wild-type. These findings suggest that MRI can be used noninvasively to predict glioma grading and IDH mutation status, which may have important implications for patient management and treatment planning.
MRI features and tumor-infiltrating CD8 + T cells-based nomogram for predicting meningioma recurrence risk
Authors: Han Tao , Liu Xianwang , Long Changyou , Li Shenglin , Zhou Fengyu , Zhang Peng , Zhang Bin , Jing Mengyuan , Deng Liangna , Zhang Yuting , Zhou Junlin 
Published: June 2024

Abstract
Objective
This study was based on MRI features and number of tumor-infiltrating CD8 + T cells in post-operative pathology, in predicting meningioma recurrence risk.

Methods
Clinical, pathological, and imaging data of 102 patients with surgically and pathologically confirmed meningiomas were retrospectively analyzed. Patients were divided into recurrence and non-recurrence groups based on follow-up. Tumor-infiltrating CD8 + T cells in tissue samples were quantitatively assessed with immunohistochemical staining. Apparent diffusion coefficient (ADC) histogram parameters from preoperative MRI were quantified in MaZda. Considering the high correlation between ADC histogram parameters, we only chose ADC histogram parameter that had the best predictive efficacy for COX regression analysis further. A visual nomogram was then constructed and the recurrence probability at 1- and 2-years was determined. Finally, subgroup analysis was performed with the nomogram.

Results
The risk factors for meningioma recurrence were ADCp1 (hazard ratio [HR] = 0.961, 95% confidence interval [95% CI]: 0.937 ~ 0.986, p = 0.002) and CD8 + T cells (HR = 0.026, 95%CI: 0.001 ~ 0.609, p = 0.023). The resultant nomogram had AUC values of 0.779 and 0.784 for 1- and 2-years predicted recurrence rates, respectively. The survival analysis revealed that patients with low CD8 + T cells counts or ADCp1 had higher recurrence rates than those with high CD8 + T cells counts or ADCp1. Subgroup analysis revealed that the AUC of nomogram for predicting 1-year and 2-year recurrence of WHO grade 1 and WHO grade 2 meningiomas was 0.872 (0.652) and 0.828 (0.751), respectively.

Conclusions
Preoperative ADC histogram parameters and tumor-infiltrating CD8 + T cells may be potential biomarkers in predicting meningioma recurrence risk.

Clinical relevance statement
The findings will improve prognostic accuracy for patients with meningioma and potentially allow for targeted treatment of individuals who have the recurrent form.
Prevalence, distribution and factors associated with modern contraceptive use among women of reproductive age in Uganda: evidence from UDHS 2016
Authors: Towongo Moses Festo , Kelepile Matlhogonolo 
Published: June 2024

Abstract
Background
Unintended pregnancies pose significant health risks, particularly in sub-Saharan Africa, where millions of cases are recorded annually, disproportionately affecting adolescent women. Utilization of modern contraceptives is crucial in managing fertility and reducing unintended pregnancies, abortions, and associated health complications. This study aimed to assess the prevalence, distribution and factors associated with modern contraceptives utilization among women aged 15–49 in Uganda.

Methods
The study used secondary data from the 2016 Uganda Demographic and Health Survey (UDHS). The study sample comprise of 9,235 women aged 15–49 who used any method to prevent pregnancy in the five years preceding 2016 UDHS survey. The outcome variable for this study is utilization of modern contraceptives. Univariate, bivariate, and multilevel binary logistic regression was used to examine the relationship between individual and contextual factors on the modern contraceptive use among women aged 15–49 in Uganda. Choropleth mapping and network analysis in ArcGIS 10.8.2 was used to visualize spatial distribution of modern contraceptive use and measure community access to health facilities respectively.

Results
The prevalence of modern contraceptive use was 53.19% (n = 4,919) in Uganda, with significant spatial variation by district. Higher prevalence (23.18%) was observed among women aged 20–29 compared to adolescents (4.1%). Only 21.9% of married women reported using modern contraceptives. At the individual-level, the factors that positively influenced use of modern contraceptives included: women’s marital status, wealth index and level of education while sex of the household head, ever terminated a pregnancy and religion negatively affected the use of modern contraceptives. At community-level, community access to health facilities was found to have negative influence on the use of modern contraceptives among women. In communities where women frequently visited health facilities in the 12 months preceding the survey, the use of modern contraceptives reduced by 3.9%. Accessibility analysis revealed challenges, with women in northeastern districts (rural districts) facing travel times exceeding four hours to reach health facilities.

Conclusion
Utilization of modern contraceptives are essential for promoting women’s health and well-being, particularly concerning maternal healthcare. This study highlights disparities in modern contraceptive use across age groups and the districts, emphasizing the need for targeted interventions. Policymakers and stakeholders must prioritize strategies that promote utilization of modern contraceptives and maternal healthcare services to address these disparities effectively. Such efforts are crucial for improving reproductive health outcomes and reducing the burden of unintended pregnancies and related complications in Uganda.
Iparomlimab (QL1604) in patients (pts) with unresectable/metastatic deficient mismatch repair (dMMR)/microsatellite instability high (MSI-H) solid tumors: A single-arm, multicenter, pivotal, phase II study.
Authors: Guo Weijian , Bi Feng , Dong Jian , Jin Chuan , Niu Zuoxing , Wang Yusheng , Sun Meili , Wang Teng , Yu Dajun , He Yifu , Zhang Ruixing , Yin Xianli , Feng Wenlei , Zhang Meijiang , Zhang Baihui , Li Lingyan , Kang Xiaoyan 
Published: June 2024

3578 Background: Iparomlimab, a novel anti-PD-1 antibody, demonstrated robust anti-tumor activity and well tolerated safety in pts with unresectable/metastatic dMMR/MSI-H solid tumors. At median follow-up of 17 mo, iparomlimab treatment demonstrated durable clinical benefit. Methods: This phase II study (NCT04326829) enrolled pts pathologically diagnosed as dMMR/MSI-H unresectable/metastatic solid tumors. Pts received iparomlimab (200 mg, iv, Q3W; 3 mg/kg for pts with body weight <40 kg). The primary endpoint was confirmed objective response rate (ORR) assessed by independent radiological review committee (IRRC) per RECIST 1.1. Eligible pts, who were enrolled and received at least 1 cycle of treatment, were included in the intention to treat (ITT) set. Among them, relapsed/refractory pts were included in the full analysis set (FAS) as primary efficacy analysis population. The FAS included pts with advanced colorectal cancer (CRC) failed from fluoropyrimidine, oxaliplatin, and irinotecan, pts with gastric cancer failed from at least two lines of standard of care, and other solid tumors failed from at least one prior treatment. Results: From Jun 19, 2020 to Jan 12, 2023, 120 pts were enrolled in ITT, with 60 pts in FAS. 117 (97.5%) pts were featured with stage IV disease. The median prior therapy lines were 2.0 in both ITT and FAS, respectively. CRC was diagnosed in 80 (66.7%) pts in ITT and 38 (63.3%) pts in FAS. As of Jan 20, 2024, the ORR were 58/120 (48.3%; 95% CI: 39.1%–57.6%) with 12 (10.0%) complete response (CR) and 46 (38.3%) partial response (PR) in ITT, and 30/60 (50.0%, 36.8%–63.2%) with 3 (5.0%) CR and 27 (45.0%) PR in FAS. In CRC pts, the ORR per IRRC were 37/80 (46.3%) and 22/38 (57.9%) in ITT and FAS, respectively. (Efficacy shown in Table) TRAEs of any grade occurred in 95 (79.2%) pts. The most frequent TRAE of any grade and grade ≥3 TRAE were both anemia, with incidence of 26.7% and 5.0%, respectively. irAEs of any grade were reported in 39/120 (32.5%) pts, with the most common occurring irAEs of hpothyroidism (12/120, 10.0%). TRSAEs occurred in 13/120 (10.8%) patients. No iparomlimab-related death occurred. Conclusions: At 17-mo follow-up, iparomlimab showed encouraging efficacy with durable response and tolerable safety in patients with unresectable/metastatic dMMR/MSI-H solid tumors in ITT and FAS. Clinical trial information: NCT04326829 . [Table: see text]