bluuebunny/crossref_metadata_2025_split huggingface dataset:
No Operation After Short-Course Radiotherapy Followed By Consolidation Chemotherapy in Locally Advanced Rectal Cancer (NOAHS-ARC): Study Protocol for a Prospective, Phase II Trial
Authors: Quezada-Díaz Felipe F. , Bercz Aron , Romesser Paul B. , Escobar Jose L. , Caire Nicole , Díaz-Feldman Lucia E. , Manriquez Erik , Smith J. Joshua , Carvajal Gonzalo 
Published: August 2024

Abstract

Background
The landscape of locally advanced rectal cancer treatment has shifted over the past decade with the introduction of total neoadjuvant therapy (TNT), enhancing tumor response and oncologic outcomes. Consequently, the concept of organ preservation by means of a watch-and-wait (W&W) strategy has emerged as a viable option for select patients who demonstrate clinical complete responses (cCR) to TNT, thereby limiting the morbidity associated with multimodal treatment. Although there is increasingly robust evidence supporting the notion of organ preservation, the optimal treatment strategy and predictors of treatment response remain outstanding questions. Rectal cancer incidence is expected to rise sharply in developing countries, and the disease is already recognized as a significant public health issue in Chile. Prior to NOAHS-ARC, TNT-based treatment protocols and W&W programs had yet to be implemented in the country.
Methods
This is a single arm, multicenter phase II prospective trial accruing in Santiago, Chile. Patients with histologically proven rectal adenocarcinoma (< 7cm from anal verge) and stage II or III disease will be recruited and consented. Protocol treatment comprises induction short-course radiotherapy (25 Gy in 5 Gy fractions) followed by consolidation chemotherapy (FOLFOX x9 cycles or CAPOX x6 cycles). Patients will undergo response assessment four to eight weeks following completion of chemotherapy. Patients achieving cCR will be offered W&W management while those with incomplete clinical responses (iCR) will undergo total mesorectal exicision (TME). The primary endpoint is rate of complete tumor response, defined as the sum of pathologic complete responses (pCR) and sustained (> 1 year) cCR, which will be compared to the pCR rate of a historical cohort of patients treated with neoadjuvant chemoradiation alone. Accrual of 73 patients is anticipated assuming an estimated combined pCR/sustained cCR rate of 30%. Quality of life measures and functional bowel, urinary, and sexual outcomes will be studied. Additionally, a biorepository of longitudinally archived tissue and plasma samples will be established, in conjunction with serial endoscopic and MRI images.
Discussion
NOAHS-ARC aims to contribute to the ongoing dialogue on organ preservation while also pioneering the first standardized TNT protocol and W&W program in Chile. Additional emphasis on functional outcomes and meticulous data collection for exploratory research endeavors aim to improve patient care both locally and globally.
Trial Registration:
ClinicalTrials.gov identifier: NCT04864067. Registered April 28, 2021.
Murine Typhus as the Leading Cause of Non-focalized Fever in the Canary Islands
Authors: Vélez-Tobarias M , Torres-Vega AM , Carmelo E , Morais-Martín J , Pérez JA , Gonzalo-Hernández C , Clot G , Ascaso-Terrén C 
Published: August 2024

Abstract

The present prospective study aims to diagnose, through serology and PCR, the etiology of non-focalized fever lasting between 5 and 28 days in the islands of La Palma and El Hierro (Canary Islands, Spain) during the year 2021. The etiological profile described in this study is similar to that described in studies of fever of intermediate duration (FDI), with zoonoses being the main cause. Murine typhus (MT) is identified as the primary cause, followed by Q fever (QF). The incidence of MT is the highest published nationally and similar to the highest in Europe, with 39.6 cases in La Palma and 79.7 cases in El Hierro. QF, known to be endemic to the Canary Islands, presents incidences of 26.5 cases in La Palma and 15.6 cases in El Hierro. MT does not present gender differences, and its geographical distribution is homogeneous. However, QF is more prevalent in men and has a heterogeneous geographical distribution. The high incidence of MT found in both urban and peri-urban areas is particularly noteworthy, and its possible connection with climate change and/or the growth of the reservoir population in the Canary Islands is unknown. Its similarity with QF in terms of clinical signs and treatment, in addition to the absence of a specific protocol for early diagnosis, may have contributed to its underdiagnoses. MT can produce health concerns with risk of hospitalization, complications, and even death. Hence, the registration of cases for epidemiological control is deemed essential.
Clinical and functional outcomes associated with quality of life in patients with lymphangioleiomyomatosis: a cross-sectional study
Authors: Queiroz Douglas Silva , Silva Cibele Cristine Berto Marques da , Oliveira Martina Rodrigues , Amaral Alexandre Franco , Carvalho Carlos Roberto Ribeiro , Salge João Marcos , Baldi Bruno Guedes , Carvalho Celso R. F. 
Published: August 2024

Abstract

Background: Lymphangioleiomyomatosis (LAM) is a rare (twenty-one per million female inhabitants) neoplastic cystic lung disease that impairs health-related quality of life (HRQoL). However, the factors associated with impaired quality of life in patients with LAM are poorly understood.
Objective: To assess the clinical, psychosocial, and functional characteristics associated with impaired quality of life in patients with LAM.
Methods: This was a cross-sectional study performed on two nonconsecutive days. HRQoL (SF-36 and CRQ), lung function tests, anxiety and depression symptoms (HADS), maximal (CPET and ISWT), and submaximal exercise capacity (6MWT) were assessed. Linear associations among outcomes were assessed using Pearson's correlation and multivariate tests.
Results: Forty-five women with LAM (46±10.years; FEV1,74%pred) were evaluated. The lowest SF-36 scores were observed for general health and vitality and the highest for the physical and social domains. The lowest CRQ scores were observed for dyspnoea and fatigue, and the highest were for the emotional function and self-control domains. Sixteen (35%) women had anxiety, and 8 (17%) had depression symptoms. Most of the SF-36 and CRQ domains were associated with anxiety and depression symptoms (from r=0.4 to r=0.7; p<0.05) and exercise capacity (from r=0.3 to r=0.5; p<0.05). Lung function parameters were weakly or not associated with quality of life domains. After multiple linear regression, HRQoL was independently associated with depression symptoms and physical capacity but not with lung function.
Conclusion: Our results show that aerobic capacity and depression symptoms are the main factors, rather than lung function, related to quality of life in patients with LAM.
Associations between Anion Gap-to-Calcium Ratio and Mortality in Sepsis Patients with Diabetes Mellitus: A Retrospective Cohort Study
Authors: Cai Jing , Pu Lin , Yuan Nanbing , Liu Meng , Lin Ken , Gao Jie , Li Jingjing 
Published: August 2024

Abstract

We aimed to determine the association between anion gap-to-calcium ratio (ACR) and 30-day mortality in sepsis patients with diabetes mellitus (DM). Data for sepsis patients diagnosed with DM was extracted from Medical Information Mart for Intensive Care Database III. After screening, 1616 eligible subjects were included in our study finally. The receiver operating characteristic (ROC) curve is used to determine the cut-off value. Multivariable logistic regression with inverse probability of treatment weighting (IPTW) based on propensity score were used to detect the association between ACR and 30-day mortality. Our results showed that the patients with the high level of ACR had a higher risk of death within 30 days compared with those with low level of ACR (odds ratio 1.914, 95% confidence interval 1.477–2.480, P < 0.001). In a word, our results suggest that ACR may be an independent prognostic indicator for death with 30 days in critically ill patients with sepsis and DM.
West Nile virus surveillance at a fine scale in an Italian urban ecosystem
Authors: Carrieri Marco , Puggioli Arianna , Farina Marco , Romano Silvia , Tinarelli Roberto , Angelini Paola , Matteo Giulio , Dottori Michele , Calzolari Mattia , Torri Deborah , Grisendi Annalisa , Bellini Romeo 
Published: August 2024

Abstract

In the last fifteen years, the West Nile virus (WNV) has spread in the Po Valley plain in Italy, extending from Emilia-Romagna to Veneto in Friuli Venezia Giulia, Lombardy, and Piedmont regions. The principal vector of WNV in Italy is Culex pipiens, and lineage 2 of arbovirus can overwinter. The sensitivity of the mosquito surveillance network to the circulation of WNV in urban and rural areas and the impact of the ecological system on the dynamics and spillover of disease were investigated in this study. WNV circulation in mosquitoes collected in 2021–2023 and screened with RT-PCR differed between the two environments. The vector index (VI) was significantly higher for Culex pipiens collected in rural areas and near rural wetlands (VI = 0.08 ± 0.16 SD and VI = 0.15 ± 0.29 SD respectively) than in urban environments (from VI = 0.00 in urban parks to VI = 0.04 ± 0.13SD in peri-urban areas). The incidence of West Nile neuroinvasive disease was higher in rural (1.01 ± 0.59SD per 100.000 inhabitants) than in urban areas (0.43 ± 0.32SD cases per 100.000 inhabitants). Throughout the study duration, by monitoring the virus circulation in mosquitoes, the WNV surveillance in the urban ecosystem predicted spillover in humans with about 2–4 weeks of anticipation, allowing prompt activation of the control protocols defined in the Italian National Plan Surveillance and Control for Arboviruses. WNV circulation in mosquitoes was recorded in urban environments where the probability of the simultaneous presence of reservoirs and vectors was higher such as ecological corridors and peri-urban areas. No WNV circulation was found in mosquitoes in urban parks.
The impact of recreational cannabis legalization on cannabis-related acute care events among adults with schizophrenia
Authors: Kim Chungah , Bai Yihong , Cao Peiya , Ienciu Kristine , Chum Antony 
Published: August 2024

Abstract

Purpose
Patients with schizophrenia have a higher risk of cannabis use disorder and may be uniquely affected by the legalization of recreational cannabis. This study examined whether cannabis legalization led to changes in acute care utilization among patients with schizophrenia.
Method
Using linked health administrative data, we included adult patients with schizophrenia in Ontario from October 2015 to May 2021 (n = 121,061). We examined the differences in cannabis, psychosis, and mental health-related emergency department (ED) visits over three periods: pre-legalization, legalization of flowers and herbs (phase 1), and legalization of edibles, extracts, and topicals (phase 2) using interrupted time-series methods.
Results
Our study found that phase 1 was associated with decreases in cannabis-related, mental health-related, and cannabis + psychosis-related ED visits among the patients with schizophrenia. Notably, an immediate 25.8% (95% CI 13.8–37.6%) decrease in cannabis-related ED visits was observed in men, and an immediate 18.5% decrease in mental health-related ED visits (95% CI 6.0–31.2%) in women. These decreases were also shown in the comparative ITS models, demonstrating that the changes observed were distinct from trends in the general population. However, phase 2 was not associated with any significant changes.
Conclusions
Despite higher baseline rates of acute care utilization among patients with schizophrenia, cannabis legalization was associated with significant reductions, particularly during phase 1. Our findings suggest that regulatory measures accompanying legalization could enhance the quality and safety of cannabis products, potentially leading to fewer adverse health outcomes in vulnerable patient populations. Further research is needed to optimize healthcare responses for this vulnerable population.
Exploring the washback effects of a high-stakes final exam on primary English teaching from teachers’ perspectives: a case study in China
Authors: Gao Juechun , Karanasiou Panagiota-Penny 
Published: August 2024

Abstract

The washback effect of English tests has gained considerable attention among researchers in China, but little attention has been given to the angle of primary English education. To address this gap, this study draws on previous mechanism frameworks to investigate the washback effects of the Chengdu Primary School English Final Examination (CPEFE), a primary school diagnostic final exam, on young learners’ English teaching from the perspective of primary teachers in Chengdu, China. The participants were sixth-grade English teachers in primary school. Data were collected using in-depth semi-structured interview, as a qualitative case study method. The results revealed that the test’s emphasis on receptive skills, particularly reading skills, affected the teaching focus. Exam-oriented teaching content and traditional methods still persist, but a recognition of the importance of communicative language teaching (CLT) is emerging. It is hoped that stakeholders will recognise the importance of other constructs that are less emphasised in the CPEFE and leverage various teaching materials and methods to avoid negative washback and enhance pupils’ overall English proficiency.
Mining expressed sequence tag (EST) microsatellite markers to assess the genetic differentiation of five Hynobius species endemic to Taiwan
Authors: Chen Jou-An , Yu Pei-Ju , Jheng Sheng-Wun , Lin You-Zhu , Sun Pei-Wei , Ko Wen-Ya , Lin Chun-Fu , Ju Yu-Ten 
Published: August 2024

Abstract

Taiwan harbors five endemic species of salamanders (Hynobius spp.) that inhabit distinct alpine regions, contributing to population fragmentation across isolated “sky islands”. With an evolutionary history spanning multiple glacial-interglacial cycles, these species represent an exceptional paradigm for exploring biogeography and speciation. However, a lack of suitable genetic markers applicable across species has limited research efforts. Thus, developing cross-amplifying markers is imperative. Expressed sequence-tag simple-sequence repeats (EST-SSRs) that amplify across divergent lineages are ideal for species identification in instances where phenotypic differentiation is challenging. Here, we report a suite of cross-amplifying EST-SSRs from the transcriptomes of the five Hynobius species that exhibit an interspecies transferability rate of 67.67%. To identify individual markers exhibiting cross-species polymorphism and to assess interspecies genetic diversity, we assayed 140 individuals from the five species across 82 sampling sites. A set of EST-SSRs with a high interspecies polymorphic information content (PIC = 0.63) effectively classified these individuals into five distinct clusters, as supported by discriminant analysis of principal components (DAPC), STRUCTURE assignment tests, and Neighbor-joining trees. Moreover, pair-wise FST values > 0.15 indicate notable between-cluster genetic divergence. Our set of 20 polymorphic EST-SSRs are suitable for assessing population structure within and among Hynobius species, as well as for long-term monitoring of their genetic composition.
Density of wild animal populations and their conflicts with nearby farmers in southwest Ethiopia, Mankira Forest
Authors: Asaye Birhanu , Tekalign Wondimagegnehu , Dobamo Taye 
Published: August 2024

Abstract

Farmers' survival is seriously threatened by wild animal species' coexistence and joint use of limited resources. A study on the density of wild animals and their conflicts with nearby farmers was conducted from December 2022 to May 2023 in southwest Ethiopia, Mankira Forest. Using the distance sampling technique, the densities of the wild animal population were estimated. The incidence of conflict between humans and wild animals was measured using a questionnaire given to 241 randomly selected household heads. The estimated densities of spotted hyenas (0.40 ± 0.54), Anubis baboons (11.83 ± 4.4), grivet monkeys (15.18 ± 5.12), black-backed jackals (0.60 ± 0.14), porcupines (0.70 ± 0.12), and warthogs (1.2 ± 0.20 individuals/km2) were recorded. Potatoes, wheat, and maize were the most severely damaged cereal crops. The most prevalent and top-ranked crop-raiding species was the Anubis baboon (N = 104, 43%), which was followed by the grivet monkey (N = 82), the warthog (N = 31), and the porcupine (N = 24). Depredated livestock were cattle, poultry, sheep, donkeys, dogs, horses, and mules. The spotted hyena (N = 118), black-backed jackal (N = 65), primates (N = 39), and leopard (N = 19) were the most commonly recorded predators. Various human activities that impact wildlife include deforestation, charcoal production, livestock grazing, agricultural expansion, and settlement. Guarding was the primary mitigating strategy. Locals living near forest boundaries were particularly susceptible to the impact of wild animals. Reducing livestock damage and crop loss can be achieved through continuous ecological surveying of wild animals and raising community awareness.
Use of interferon-gamma release assay (IGRA) and CXCL-10/IP-10 for screening of latent tuberculosis infection (LTBI) in chronic kidney disease and hemodialysis patients
Authors: Silva Juliana Cristina Borges da , Vieira Nathália Barcellos , Ribeiro-Alves Marcelo , Ribeiro Roberto Stefan Almeida , Lemos Carla Cavalheiro Silva , Mendes Renata , Gomes Conrado Lysandro Rodrigues , Santos Ana Paula , Suassuna José Hermógenes , Bregman Rachel , Rodrigues Luciana Silva 
Published: August 2024

Abstract

Background
There is growing evidence that patients with chronic kidney disease (CKD) show a high risk of acquiring latent tuberculosis infection (LTBI) or of developing active TB. However, diagnosing LTBI is still a challenge based on current tests which reflect the cellular immunity against Mycobacterium tuberculosis infection – that may be compromised in this population. Herein, we evaluated the prevalence of LTBI among patients with CKD and those in routine hemodialysis, and LTBI predictors.
Methods
A prospective cross-sectional study was conducted in a tertiary nephrology reference hospital, Rio de Janeiro, Brazil. LTBI was diagnosed using interferon-gamma release assay (IGRA; QuantiFERON-TB Gold Plus [QFT-Plus]). CXCL-10/IP-10 release assay was determined from QFT-Plus supernatants.
Results
A total of 123 patients were enrolled in the study, 111 (90.2%) from the CKD group and 12 (9.8%) from the hemodialysis (HD). IGRA showed 39 (31.7%) positive results in the general study population: 36/111 (32.4%) in CKD and 3/12 (25%) in HD groups. Indeterminate IGRA results were observed in 4/123 (3.3%) patients. CXCL-10/IP-10 positive results were seen in 39/123 (39.8%) patients. Multivariate regression analysis identified that non-vaccination with BCG (aOR 7.41 [CI 2.15–25.48]; p = 0.0014) and the positivity for CXCL-10/IP-10 assay (aOR 4.48 [CI 1.87–10.76]; p = < 0.001) were independent risk factors for LTBI among DRC and HD patients.
Conclusion
The IGRA QFT-Plus was shown to be a useful method in the surveillance of LTBI in critical stages of CKD and routine hemodialysis. Mtb-specific CXCL-10/IP-10 responses were associated with a positive IGRA and could provide an useful adjuvant LTBI biomarker in this population.
Estimating the Effect of Inclisiran on Dyslipidemia and Primary Prevention of Cardiovascular Disease: The NHANES 1999-2018 Study
Authors: Li Haonan , Zhao Song , Wu Jiawen , Han Jun , Xu Yawei , Zhang Yi 
Published: August 2024

Abstract

Background
Dyslipidemia has been delineated as independent predictors of cardiovascular disease (CVD). Inclisiran, an innovative small interfering RNA (siRNA) agent, is anticipated to engender a notable reduction of approximately 50% in low-density lipoprotein cholesterol (LDL-C) levels. Given its transformative impact, we scrutinized the eligibility of US population for inclisiran treatment and evaluated its potential effects on dyslipidemia and the primary prevention of CVD.
Methods
We applied eligibility criteria from the ORION 10 and 11 trials to the 1999–2018 National Health and Nutrition Examination Survey dataset to estimate the eligible population size for atherosclerotic cardiovascular disease (ASCVD) and ASCVD-risk equivalents. Utilizing lipid reduction data from the ORION 10, we predicted the impact of inclisiran on LDL-C levels and dyslipidemia prevalence among ASCVD patients. Similarly, leveraging the ORION 11's lipid reduction data, we forecasted inclisiran's effect on 10-year CVD risk change and preventable CVD events in the ASCVD-risk equivalents population, employing the Framingham CVD Risk Score.
Results
We identified 613 ASCVD patients (5.28 million) and 377 ASCVD-risk equivalents (2.63 million) who met the eligibility criteria of the ORION 10 and 11. Among ASCVD population, 3.71 million (70.3%) would achieve ≥ 50% LDL-C reduction post-treatment. Furthermore, 4.86 million (91.9%) with high LDL-C, 0.22 million (4.2%) with low high-density lipoprotein cholesterol, 1.19 million (22.5%) with high total cholesterol, and 0.5 million (9.5%) with high triglycerides would attain target lipid profiles. For ASCVD-risk equivalents population, the estimated 10-year CVD risk would decrease from 25.2–17.6% (7.6% absolute, 30.2% relative) post-inclisiran treatment, potentially preventing 199,878 CVD events over a decade, including 136,217 coronary heart disease cases, 37,024 strokes, and 23,619 heart failures.
Conclusions
Inclisiran holds the potential to substantially diminish the prevalence of dyslipidemia and mitigate the occurrence of nearly 200 thousand CVD events in eligible US adults.
Early Pregnancy Metal Levels in Maternal Blood and Pregnancy Outcome
Authors: Goldberg Ifat Baram , Sheiner Eyal , Bal Maayan Hagbi , Bergman Doron , Damri Noam Tomasis , Rosenbaum Ron , Haimov Ayal , Wainstock Tamar 
Published: August 2024

Abstract

This study examines the association between early pregnancy maternal blood levels of Lead (Pb), arsenic (As), cadmium (Cd), and selenium (Se) and adverse pregnancy outcomes, while also addressing the differences between low-risk and high-risk groups based on having a history of preterm birth (PTB). This prospective cohort study recruited multigravida women at 11–13 gestational weeks, categorized into low-risk and high-risk groups. Participants completed a questionnaire, and heavy metal levels were measured in blood samples. Pregnancy outcomes were recorded following delivery. Multivariable analyses were conducted to evaluate the independent associations between heavy metal levels and pregnancy outcomes, while adjusting for variables associated with the metals levels based on the univariable analyses. Among 404 participants, the mean (± SD) levels were Pb: 3.12 ± 1.82 µg/L, As: 0.41 ± 0.4 µg/L, Cd: 0.26 ± 0.34 µg/L, and Se: 119.84 ± 21.05 µg/L. Significant differences in Pb, Se, Cd and As levels were observed between the low-risk and high-risk groups, with higher levels in the low-risk group. However, no significant associations were found between heavy metal levels and PTB, low birth weight (LBW), gestational age at delivery, birth weight, and head circumference in either univariable comparison or multivariable models, which adjusted for maternal age, BMI, employment, smoking, fertility treatments, and education. While significant differences in heavy metal levels were found between low-risk and high-risk groups, early pregnancy heavy metal levels showed no association with adverse pregnancy outcomes. These findings highlight the need for further research to understand the potential impact of these metals on pregnancy, considering population-specific factors and exposure timing.