bluuebunny/crossref_metadata_2025_split huggingface dataset:
Kinetic Profiling of RAS Mutations With Circulating Tumor DNA in the Canadian Cancer Trials Group CO.26 Trial Suggests the Loss of RAS Mutations in Neo-RAS-Wildtype Metastatic Colorectal Cancer Is Transient
Authors: Wu Florence T.H. , Topham James T. , O'Callaghan Chris J. , Feilotter Harriet , Kennecke Hagen F. , Drusbosky Leylah , Renouf Daniel J. , Jonker Derek J. , Tu Dongsheng , Chen Eric X. , Loree Jonathan M. 
Published: August 2024

PURPOSE In metastatic colorectal cancer (mCRC), RAS mutations drive resistance to anti–epidermal growth factor receptor antibodies. It is unclear whether RAS mutations ever become clonally undetectable. METHODS CO.26 was a phase II clinical trial that assessed durvalumab + tremelimumab in heavily pretreated mCRC. RAS mutation status was tracked over time using circulating tumor DNA (ctDNA) sequencing at baseline, week 8, and on progression. RESULTS Among the 95 patients with KRAS/NRAS mutations in their archival tumor tissue, 6.3% (6/95) had undetectable RAS mutations in ctDNA collected at baseline or week 8 of the CO.26 study. Of these, 67% (4/6) of disappearances were transient, with the same mutation reappearing with progressive disease. In three cases, the simultaneous persistence of other preexisting CRC-associated truncal mutations could not be demonstrated, suggestive of low tumor shedding of ctDNA, leaving the incidence of true clonal reversion to RAS-wildtype (WT) possibly as low as 3.2% (3/95). Fewer patients in the neo- RAS-WT group (33%) had greater than four lesions at trial baseline compared with patients with persistent RAS mutations (75%), P = .046. The likelihood of synchronous metastases at cancer diagnosis (33% v 63%; P = .15) or liver metastases at trial baseline (50% v 68.5%; P = .17) was not significantly different between patients with disappearing versus persistent RAS mutations. Overall survival from stage IV diagnosis (hazard ratio, 0.77 [95% CI, 0.35 to 1.72]; P = .52) was not significantly different between those with disappearing versus persistent RAS mutations. The disappearance of RAS mutations was not associated with primary tumor sidedness ( P = .41), archival BRAF/MEK/ERK-mutant status ( P = .16/1.00/.09), nor baseline ctDNA HER2 amplifications ( P = 1.00). CONCLUSION We identified a 3.2%-6.3% prevalence of the neo- RAS-WT phenomenon in the CO.26 trial. However, 67% of apparent cases were transient with subsequent re-emergence.
Opioid Dose Variation in Cardiac Surgery: A Multicenter Study of Practice
Authors: Fisher Clark , Janda Allison M. , Zhao Xiwen , Deng Yanhong , Bardia Amit , Yanez N. David , Burns Michael L. , Aziz Michael F. , Treggiari Miriam , Mathis Michael R. , Lin Hung-Mo , Schonberger Robert B. 
Published: August 2024

BACKGROUND:
Although high-opioid anesthesia was long the standard for cardiac surgery, some anesthesiologists now favor multimodal analgesia and low-opioid anesthetic techniques. The typical cardiac surgery opioid dose is unclear, and the degree to which patients, anesthesiologists, and institutions influence this opioid dose is unknown.

METHODS:
We reviewed data from nonemergency adult cardiac surgeries requiring cardiopulmonary bypass performed at 30 academic and community hospitals within the Multicenter Perioperative Outcomes Group registry from 2014 through 2021. Intraoperative opioid administration was measured in fentanyl equivalents. We used hierarchical linear modeling to attribute opioid dose variation to the institution where each surgery took place, the primary attending anesthesiologist, and the specifics of the surgical patient and case.

RESULTS:
Across 30 hospitals, 794 anesthesiologists, and 59,463 cardiac cases, patients received a mean of 1139 (95% confidence interval [CI], 1132–1146) fentanyl mcg equivalents of opioid, and doses varied widely (standard deviation [SD], 872 µg). The most frequently used opioids were fentanyl (86% of cases), sufentanil (16% of cases), hydromorphone (12% of cases), and morphine (3% of cases). 0.6% of cases were opioid-free. 60% of dose variation was explainable by institution and anesthesiologist. The median difference in opioid dose between 2 randomly selected anesthesiologists across all institutions was 600 µg of fentanyl (interquartile range [IQR], 283–1023 µg). An anesthesiologist’s intraoperative opioid dose was strongly correlated with their frequency of using a sufentanil infusion (r = 0.81), but largely uncorrelated with their use of nonopioid analgesic techniques (|r| < 0.3).

CONCLUSIONS:
High-dose opioids predominate in cardiac surgery, with substantial dose variation from case to case. Much of this variation is attributable to practice variability rather than patient or surgical differences. This suggests an opportunity to optimize opioid use in cardiac surgery.
How to measure peripherality at the city scale. A model proposal
Authors: Grosel Mikołaj 
Published: August 2024

The phenomenon of peripherality is increasingly applied to urban space. At the same time, there is no scientific consensus on how to analyse and measure peripherality. This article presents a tool for analysing peripherality at the urban scale – the Opportunity Potential Model (OPM) – based on the intervening opportunity mechanism. The article describes how the model works and presents an example of its use: an analysis of the peripherality of the Jagodno neighbourhood in Wrocław (Poland). The model takes into account three dimensions of peripherality (geographical, material and social) to create a comprehensive analysis. The case study shows not only the degree of peripherality of the study area but, above all, the possibilities of the model – its advantages and disadvantages in the process of peripherality analysis and possible further uses.
Benefits of bariatric surgery on glycemic control in patients with type 2 diabetes mellitus. A narrative review.
Authors: Krzemińska Katarzyna , Kubas Maria , Kuszneruk Julia , Kłusek Magdalena , Czerwik Julia 
Published: August 2024

Introduction and purposes:
Obesity is a critical global health challenge, closely linked to a range of serious conditions, including metabolic syndrome, insulin resistance, and an increased likelihood of developing type 2 diabetes. Affecting over two billion people worldwide, obesity necessitates a multifaceted approach to treatment, encompassing lifestyle changes, pharmaceutical interventions, and surgical procedures. Among the surgical options, bariatric surgeries such as sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are particularly prominent.
Materials and Methods: A systematic literature search was conducted using PubMed and Google Scholar. The search employed terms such as 'glycemia', 'bariatric surgery', ‘metabolic surgery’ 'RYGB', 'diabetes type 2’, ‘Postprandial hyperinsulinemic hypoglycemia’ 'hypoglycemia' ‘dumping syndrome’. Articles published between 2019 and 2024 were included in the search.
Results: Bariatric surgery is well-documented for its significant impact on glycemic control and overall physical health, resulting in substantial reductions in both HbA1c levels and BMI. Remarkably, many patients with type 2 diabetes achieve remission of the disease following surgery, regardless of their pre-surgery BMI. However, the enhanced glycemic control achieved through bariatric procedures can also lead to an increased risk of developing postprandial hyperinsulinemic hypoglycemia (PHH). This condition arises as a complication from the surgery, where blood sugar levels drop excessively after meals due to an overproduction of insulin.
Conclusion: Despite this potential risk, the overall benefits of bariatric surgery in managing and potentially reversing type 2 diabetes are profound.
Comprehensive Review of TORCH Syndrome: Characterization and Prevention Strategies
Authors: Konopka Agata , Szczepaniak Zuzanna , Wdowiak Natalia , Lissak Karina , Komarów Małgorzata , Choinka Martyna , Karasińska Dominika , Kalisiak Jakub 
Published: August 2024

Abstract:
Introduction: TORCH syndrome refers to a group of symptoms caused by congenital infections with teratogenic pathogens, including Toxoplasma gondii, Varicella, Treponema pallidum, Parvovirus B19, Rubella, Cytomegalovirus (CMV), and Herpes simplex virus (HSV). It can also encompass infections like HIV, Zika virus (ZIKV), hepatitis B, and SARS-CoV-2. These pathogens can pass through the placenta, overcoming various placental barriers. Infections during pregnancy can result in severe consequences for both the fetus and the mother. Common symptoms in newborns include low birth weight, rashes, hepatosplenomegaly, cardiac anomalies, jaundice, chorioretinitis, and microcephaly, with 2% to 3% of congenital anomalies attributed to perinatal infections. The incidence of these infections varies globally.
Purpose of the work: This study aims to review and characterize TORCH syndrome and the prevention of TORCH infections.
Materials and methods: A comprehensive analysis of research papers available on PubMed, Google Scholar, Web of Science, Embase and Scopus was undertaken using the searchterms encompassing the following keywords: TORCH syndrome / infections during pregnancy / perinatal infections / Toxoplasmosis / Rubella / CMV infection / Herpes Simplex Virus infection / Parvovirus B19 / Treponema pallidum / vaccinations before and during pregnancy / maternal nutrition.
Results: TORCH syndrome is a significant issue causing congenital diseases, premature births, and intrauterine deaths, impacting babies throughout their lives. Most complications can be prevented with proper prophylaxis and early treatment. Increasing awareness and providing education for women from preconception through the early postnatal period is essential. Addressing TORCH syndrome remains a major medical challenge, but improving management offers hope for better outcomes.
A protocol for a cluster randomized controlled trial to assess the impact of Balika Bodhu: A combined empowerment and social norm based sexual and reproductive health and rights intervention for married adolescent girls in rural Bangladesh
Authors: Mamun Mahfuz Al , Mahmud Sultan , Antu Jannatul Ferdous , Talukder Aloka , Naved Ruchira Tabassum 
Published: August 2024

Introduction
Sexual and reproductive health and rights (SRHR) are vital for both individual well-being and development. Bangladesh has made long strides in improving SRHR over the last few decades. However, the progress has been uneven across various groups of reproductive-aged females, with the married adolescent girls (MAGs) often being more vulnerable to denial of SRHR than other women. This study intends to develop Balika Bodhu, a combined empowerment and social norm intervention for promoting SRHR among the MAGs and assess its impact.

Methods
The evaluation will employ a mixed-method two-arm Cluster Randomized Controlled Trial (CRCT) design, where Arm 1 receives the intervention, and Arm 2 serves as the control. The trial will cover 32 clusters (villages) in Rajbari Sadar sub-district, randomized into two equally distributed study arms. A total of 1,120 MAGs aged 15–19 years will be randomly selected from the clusters (35 per cluster) to form a cohort. The MAGs, their husbands, selected elderly women (26 per village) and influential community members (26 per village) will receive group sessions in the intervention clusters. The MAGs and their husbands will be interviewed at baseline and endline. A randomly selected cross-sectional sample of community members aged 35–59 years at baseline and endline will also be surveyed to measure attitudes and social norm regarding SRHR of MAGs. Qualitative data will be collected using 32 In-depth Interviews, six Key Informant Interviews, and eight Focus Group Discussions from two intervention villages. Intention-to-treat (ITT) analysis will be performed to assess the impact of the intervention. Narrative analysis and the Grounded Theory approach will be used to analyze the qualitative data.

Conclusion
Rigorous evaluation of Balika Bodhu should contribute to the literature on what works and what does not in addressing denial of SRHR to MAGs using empowerment and social norm intervention and inform policies and programs.

Trial registration
Clinicaltrials.gov: identifier: NCT06126770; Date: Oct 7, 2023. Version 1.
Barriers and facilitators to physical activity: A comparative analysis of transplant athletes competing in high intensity sporting events with other transplant recipients
Authors: Rienties Bart , Duncan Elaine , Judd Perry , Oakley Ben , Pengel Liset H. M. , Roelen Keetie , Topley Nicholas 
Published: August 2024

Background
There is widespread recognition that many transplant recipients struggle to become and remain physically active. However, some transplant recipients do undertake strenuous training and significant physical activity (PA) and participate in intensive sports.

Aim
This study sought to understand facilitators and barriers to be physically active for Transplant Athletes (TXA) compared to a group of Dutch transplantees. This explorative mixed methods study analysed race performance and interview data from TxA who participated in cycling and/or the sprint triathlon at the World Transplant Games 2023, and compared their lived experiences in terms of barriers and facilitators of PA with those of 16 transplantees in a study from the Netherlands previously published in this journal.

Methods
Using Patient and Public Involvement and engagement (PPI), race data from World Transplant Games 2023 and subsequent in-depth interviews were used from 27 TxA. A visual artefact of barriers and facilitators from the previous Dutch study was used to prompt identification and discussion of barriers and facilitators of PA. Interview data were coded by three coders.

Results
Many of the barriers to PA previously reported by Dutch transplant recipients were not shared by the majority of TxA in this study. The TxA in this study reported significantly lower physical limitations, lower fear to undertake exercise, and no comorbidity issues for TxA. Furthermore, TxA perceived they received substantial social support, had the strength to do PA, and were in control of their weight.

Conclusion
Several TxA reported a lack of understanding from medical and other professionals about the appropriate intensity of PA. An evidence-based framework of PA for transplant recipients and transplant athletes is needed for safe and appropriate PA.
Role and contribution of the nurse in caring for patients with palliative care needs: A scoping review
Authors: Moran Sue , Bailey Maria E. , Doody Owen 
Published: August 2024

Background
The provision of high-quality palliative care is important to nursing practice. However, caring for palliative care patients and their families is challenging within a complex everchanging health environment. Nonetheless the caring, artistic role of the nurse is fundamental to the care of the patient and family. However, this role is currently being overshadowed by the technical and scientific elements of nursing.

Methods
A scoping review was conducted utilising Arksey and O’Malley’s framework to identify the role and contribution of nurses in caring for patients with palliative care needs. An open time period search of eight electronic databases (MEDLINE, CINAHL, Academic Search Complete, PsycINFO, EMBASE, Web of Science, Scopus and Cochrane Library) was conducted on the 8th of March 2023 and updated on the 30th of April 2024. Screening was performed independently by two reviewers against eligibility criteria with meetings between authors to discuss included papers and form a consensus. Data was extracted relating to palliative care nursing, methodology, key findings, and recommendations. The analysed and summarised data was mapped onto Oldland et al seven domains framework: (a) medical/nursing and technical competence, (b) person centred care, (c) positive interpersonal behaviours, (d) clinical leadership and governance, (e) promotion of safety, (f) management of the environment, and (g) evidence-based practice.

Results
Fifty-five papers met the criteria for this review which describes the role and contribution of nurses in caring for palliative patients across all domains of professional practice. The review found the leading areas of nurse contribution were person centred, interpersonal and nursing care aspects, with leadership, managing the environment, patient safety and evidence-based practice evident but scoring lower. The contribution of the nurse in palliative care supports a biopsychosocial-educational approach to addressing the physical, emotional and social needs of patients with palliative care needs and their families across the care continuum.

Conclusion
Nurses in palliative care engage in a wide range of roles and responsibilities in caring for patients and their families with palliative care needs. However, there remains minimal evidence on the assessment, intervention, and evaluation strategies used by nurses to highlight the importance of their role in caring for patients and their families in this area. The findings of this review suggest that the artistic element of nursing care is being diluted and further research with a focus on evidencing the professional competence and artistic role of the nurse in the provision of palliative care is required. In addition, research is recommended that will highlight the impact of this care on patient and family care outcomes and experiences.
De Capitu a três Mulheres: notas sobre Paulo Emílio Sales Gomes
Authors: Corpas Danielle 
Published: August 2024

El artículo analiza aspectos del pensamiento de Paulo Emilio Sales Gomes teniendo en cuenta pasajes de sus escritos críticos y dos de sus producciones de ficción: el guion basado en la novela de Machado de Assis, Dom Casmurro (1899), escrito con Lygia Fagundes Telles para la película Capitu (dirigida por Paulo César Saraceni, 1968) y las narrativas del libro Três mulheres de três PPPs (1977). El objetivo es señalar las similitudes entre las perspectivas críticas sobre la vida social brasileña formalizadas en las composiciones de Machado y Paulo Emílio, así como en posiciones asumidas por el autor del ensayo Cinema: trajetória no subdesenvolvimento.
La militancia de la forma en Cabra marcado para morrer: distanciamiento, dispositivo reflexivo y creación de la realidad como estrategias de la segunda fase del documental de Eduardo Coutinho
Authors: Ferreira Vasconcelos Gabriel 
Published: August 2024

El trabajo consiste en un análisis de las estrategias formales de Eduardo Coutinho en el documental Cabra marcado para morrer (1984). Estas estrategias marcaron la segunda fase de su carrera. En ese período, Coutinho negaba el sesgo militante de su juventud y las convenciones televisivas, en un movimiento de búsqueda de las condiciones de producción de la verdad y la super-verité de los entrevistados (Jean Rouch). En pocas palabras, esto ocurrió gracias al distanciamiento brechtiano (presencia del equipo y el dispositivo técnico de la película), un dispositivo reflexivo (por ejemplo, narración reflexiva y anti normalizadora), el rodaje continuo y la construcción de la realidad mediante la creación de hechos no naturales.
Management of Esophageal Inflammatory Myofibroblastic Tumor With Endoscopic Submucosal Dissection
Authors: Zakharia Kais , Muddana Venkata 
Published: August 2024

ABSTRACT
Inflammatory myofibroblastic tumors are rare tumors that have been described in virtually all organs. Even though they are extremely rare in the esophagus, several cases have been described in the literature. Surgical resection has been the therapeutic modality used in most of those cases. In this report, we describe a case of inflammatory myofibroblastic tumor that was successfully managed endoscopically for the first time with the endoscopic submucosal dissection technique.
Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as potential diagnostic markers for rebleeding in patients with esophagogastric variceal bleeding
Authors: Chen Lei , Tong Cong , Zhao Xiangan , Xu Chunfang 
Published: August 2024

Abstract
The aim of the present study is to explore the potential prediction value of neutrophil-to-lymphocyte ratio (NLR) or peripheral blood platelet-to-lymphocyte ratio (PLR) for rebleeding in patients with esophagogastric variceal bleeding (EVB). We have enrolled 80 rebleeding patients with EVB and 113 EVB patients without rebleeding in the present study. The lymphocyte, platelet counts, the PLR, and the NLR of the candidates were calculated, and receiver-operating characteristic curve was drawn to examine whether NLR or PLR is a sensitive biomarker for distinguishing rebleeding patients from the EVB patients. We observed that NLR and PLR were all significantly increased in rebleeding patients with EVB compared with the non-rebleeding patients (p < 0.01); moreover, the area under the curve of NLR and PLR was 0.7037 (95% confidence interval [CI], 0.6281–0.7792) and 0.7468 (95% CI, 0.6793–0.8144), respectively, suggesting that NLR or PLR is a sensitive biomarker for distinguishing non-rebleeding patients from the rebleeding patients. We reported that NLR and PLR were significantly increased in the peripheral blood of patient with esophagogastric variceal rebleeding, suggesting that NLR and PLR may be potential early diagnostic and prognostic markers for the rebleeding among patients with EVB.
G protein-coupled receptor 1 participating in the mechanism of mediating gestational diabetes mellitus by phosphorylating the AKT pathway
Authors: Zhu Yanbin , Huang Shufeng , Chai Dan , Liang Lei 
Published: August 2024

Abstract
Gestational diabetes mellitus (GDM) is a metabolic disease that occurs during pregnancy. Herein, we investigate G protein-coupled receptor 1 (GPR1) in mediating GDM through the phosphorylation of serine/threonine kinase (AKT) pathway. Thirty pregnant SD rats were grouped into: normal pregnancy control group (NC), GDM model group, and GDM model + high-dose GPR1 antagonist treatment (GDM + Ari) group. GDM model was established, and the GDM + Ari group adopted GPR1 antagonist aripiprazole. The blood glucose level, insulin level, and insulin resistance (IR) were detected. The expression and phosphorylation of GPR1, AKT, and extracellular signal-regulated kinase (ERK) in placental tissue were detected using reverse transcription-polymerase chain reaction (RT-PCR) and western blotting (WB). The serum insulin concentration, glucose concentration, and glycated hemoglobin concentration during pregnancy in GDM group SD rats were significantly higher than those in the NC group (P < 0.05). The expression and phosphorylation levels of GPR1, AKT, and ERK in the placental tissue of SD pregnant rats in the GDM group were significantly lower than those in the NC group. Furthermore, compared with the GDM group, the expression of GPR1, AKT, and ERK in placental tissue was significantly reduced in the GDM + Ari group, while simultaneously enhancing the blood glucose level and IR level. In addition, the survival number, body weight, and malformation rate of the offspring of the GDM + Ari group were significantly improved, and there was no significant effect on the number of offspring. The expressions of GPR1, AKT, and ERK in placental tissue exhibited a significant decrease, while the glucose level and IR were observed to increase in the GDM + Ari group. Enhancing the expression of GPR1 may activate AKT phosphorylation to alleviate GDM. GPR1 could potentially serve as a novel target for diabetes treatment, offering new insights into managing GDM.