bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a major amputation prediction model and nomogram in patients with diabetic foot
Authors: Chen Yi , Zhuang Jun , Yang Caizhe 
Published: July 2024

Abstract

Background
Diabetes mellitus, as one of the world’s fastest-growing diseases, is a chronic metabolic disease that has now become a public health problem worldwide. The purpose of this research was to develop a predictive nomogram model to demonstrate the risk of major amputation in patients with diabetic foot.

Methods
A total of 634 Type 2 Diabetes Mellitus (T2DM) patients with diabetic foot ulcer hospitalized at the Air Force Medical Center between January 2018 and December 2023 were included in our retrospective study. There were 468 males (73.82%) and 166 females (26.18%) with an average age of 61.64 ± 11.27 years and average body mass index of 24.45 ± 3.56 kg/m2. The predictive factors were evaluated by single factor logistic regression and multiple logistic regression and the predictive nomogram was established with these features. Receiver operating characteristic (subject working characteristic curve) and their area under the curve, calibration curve, and decision curve analysis of this major amputation nomogram were assessed. Model validation was performed by the internal validation set, and the receiver operating characteristic curve, calibration curve, and decision curve analysis were used to further evaluate the nomogram model performance and clinical usefulness.

Results
Predictors contained in this predictive model included body mass index, ulcer sites, hemoglobin, neutrophil-to-lymphocyte ratio, blood uric acid (BUA), and ejection fraction. Good discrimination with a C-index of 0.957 (95% CI, 0.931–0.983) in the training group and a C-index of 0.987 (95% CI, 0.969–1.000) in the validation cohort were showed with this predictive model. Good calibration were displayed. The decision curve analysis showed that using the nomogram prediction model in the training cohort and validation cohort would respectively have clinical benefits.

Conclusion
This new nomogram incorporating body mass index, ulcer sites, hemoglobin, neutrophil-to-lymphocyte ratio, BUA, and ejection fraction has good accuracy and good predictive value for predicting the risk of major amputation in patients with diabetic foot.
Nutritional guide to feeding wheat and wheat co-products to swine: a review
Authors: Stas Ethan B , DeRouchey Joel M , Goodband Robert D , Tokach Mike D , Woodworth Jason C , Gebhardt Jordan T 
Published: July 2024

Abstract
Inclusion of wheat grain can offer feeding opportunities in swine diets because of its high starch, crude protein (CP), amino acid (AA), and phosphorus (P) content. High concentrations of starch within wheat grain makes it a good energy source for swine. Mean energy content of wheat was 4,900 and 3,785 kcal/kg dry matter (DM) for digestible energy and metabolizable energy, respectively. CP concentration can vary based on the class of wheat which include hard red winter, hard red spring, soft red winter, hard white, soft white, and durum. The average CP of all wheat data collected in this review was 12.6% with a range of 8.5% to 17.6%. The AA concentration of wheat increases with increasing CP with the mean Lys content of 0.38% with a standardized ileal digestibility (SID) of 76.8%. As CP of wheat increases, the SID of AA in wheat also increases. Mean P of wheat was 0.27% and median P was 0.30%. Off-quality wheat is often associated with sprouts, low-test weight, or mycotoxin-contamination. Sprouted and low-test weight wheat are physical abnormalities associated with decreased starch within wheat kernel that leads to reductions in energy. The assumed energy value of wheat grain may need to be reduced by up to 10% when the proportion of sprouted to non-sprouted wheat is up to 40% whereas above 40%, wheat’s energy may need to be reduced by 15% to 20%. Low-test weight wheat appears to not influence pig performance unless it falls below 644 kg/m3 and then energy value should be decreased by 5% compared to normal wheat. Deoxynivalenol (DON) contamination is most common with wheat grain. When content is above the guidance level of 1 mg/kg of DON in the complete diet, each 1 mg/kg increase in a DON-contaminated wheat-based diet will result in a 11% and 6% reduction in ADG and ADFI for nursery pigs, and a 2.7% and 2.6% reduction in ADG and ADFI, in finishing pigs, respectively. Wheat co-products are produced from the flour milling industry. Wheat co-products include wheat bran middlings, millrun, shorts, and red dog. Wheat co-products can be used in swine diets, but application may change because of differences in the final diet energy concentration due to changes in the starch and fiber levels of each wheat co-product. However, feeding wheat co-products are being evaluated to improve digestive health. Overall, wheat and wheat co-products can be fed in all stages of production if energy and other nutrient characteristics are considered.
Long-Term Outcomes Following Inguinal Hernia Repair With Mesh Performed by Medical Doctors and Surgeons in Ghana
Authors: Beard Jessica H. , Ohene-Yeboah Michael , Kasu Emmanuel S. , Affram Nelson , Tabiri Stephen , Amoako Joachim K. A. , Abantanga Francis A. , Löfgren Jenny 
Published: July 2024

Objective:
To assess long-term outcomes following inguinal hernia repair with mesh performed by medical doctors and surgeons in Ghana.

Background:
Task sharing of surgical care with nonsurgeons can increase access to essential surgery. Long-term safety and outcomes of task sharing are not well-described for hernia repair.

Methods:
This prospective cohort study was conducted in Ho, Ghana. After completing a training course, 3 medical doctors and 2 surgeons performed inguinal hernia repairs with mesh on men with primary, reducible hernias. The primary outcome of this study was hernia recurrence at 5 years. The noninferiority limit was 5 percentage points. Secondary endpoints included pain and self-assessed health status at 5 years.

Results:
A total of 242 operations in 241 participants were included, including 119 hernia repairs performed by the medical doctors and 123 performed by the surgeons. One hundred and sixty-nine participants (70.1%) were seen in follow-up at 5 years, 29 participants (12.0%) had died and 43 (17.8%) were lost to follow-up. The overall 5-year recurrence rate was 4.7% (n = 8). The absolute difference in recurrence rate between the medical doctor group (2 [2.3%]) and the surgeon group (6 [7.3%]) was −5.0 (1-tailed 95% confidence interval, −10.5; P = 0.06), demonstrating noninferiority of the medical doctors. Participants experienced improvements in groin pain and self-assessed health status that persisted at 5 years.

Conclusions:
Long-term outcomes of elective mesh inguinal hernia repair in men performed by medical doctors and surgeons in Ghana were excellent. Task sharing is a critical tool to address the substantial morbidity of unmet hernia surgery needs in Ghana.
The Influence of Asymmetric Hearing Loss on Peripheral and Central Auditory Processing Abilities in Patients With Vestibular Schwannoma
Authors: Svobodová Veronika , Profant Oliver , Syka Josef , Tóthová Diana , Bureš Zbyněk 
Published: July 2024

Objectives:
Asymmetric or unilateral hearing loss (AHL) may cause irreversible changes in the processing of acoustic signals in the auditory system. We aim to provide a comprehensive view of the auditory processing abilities for subjects with acquired AHL, and to examine the influence of AHL on speech perception under difficult conditions, and on auditory temporal and intensity processing.

Design:
We examined peripheral and central auditory functions for 25 subjects with AHL resulting from vestibular schwannoma, and compared them to those from 24 normal-hearing controls that were matched with the AHL subjects in mean age and hearing thresholds in the healthy ear. Besides the basic hearing threshold assessment, the tests comprised the detection of tones and gaps in a continuous noise, comprehension of speech in babble noise, binaural interactions, difference limen of intensity, and detection of frequency modulation. For the AHL subjects, the selected tests were performed separately for the healthy and diseased ear.

Results:
We observed that binaural speech comprehension, gap detection, and frequency modulation detection abilities were dominated by the healthy ear and were comparable for both groups. The AHL subjects were less sensitive to interaural delays, however, they exhibited a higher sensitivity to sound level, as indicated by lower difference limen of intensity and a higher sensitivity to interaural intensity difference. Correlations between the individual test scores indicated that speech comprehension by the AHL subjects was associated with different auditory processing mechanisms than for the control subjects.

Conclusions:
The data suggest that AHL influences both peripheral and central auditory processing abilities and that speech comprehension under difficult conditions relies on different mechanisms for the AHL subjects than for normal-hearing controls.
Anterior Iliac Crest Bone Graft Harvest Using Acetabular Reamers
Authors: Page Brian J. , Ricci William M. 
Published: July 2024

Summary:
A 67-year-old man with a recalcitrant tibia nonunion with implant failure is presented. Treatment was a single-stage nonunion repair with dual-plating and anterior iliac crest bone graft using acetabular reamers. The technical aspects of acetabular reamer for iliac crest bone graft harvest and the principles of nonunion repair are discussed.

Video available at:

https://ota.org/education/ota-online-resources/video-library-procedures-techniques/anterior-iliac-crest-bone-0
Indocyanine Green–Based Fluorescence Imaging to Guide Local Tissue Rearrangement of a Complex Morel–Lavallee Lesion About a Hip: A Technical Trick
Authors: Post Joel M. , Hauch Adam , Trinh Alan 
Published: July 2024

Summary:
Morel–Lavellee (ML) lesions are challenging injuries that can be complicated by persistent fluid collection and superimposed infection. The use of indocyanine green (ICG)–based fluorescence in orthopedic trauma continues to advance. ICG can be used to assess tissue perfusion and guide local tissue rearrangement. Perforating vessels can be easily identified and protected without the use of microvascular techniques, which can augment traditional keystone island perforator flap techniques. This case presentation and accompanied video demonstrate the use of ICG-based fluorescence to guide local tissue rearrangement to successfully treat an infected complex Morel–Lavellee lesion about a hip.

Video available at:

https://ota.org/education/ota-online-resources/video-library-procedures-techniques/icg-based-fluorescence-imaging
Update of antibody–drug conjugates for hematological malignancies
Authors: Sun Wenyue , Hu Shunfeng , Wang Xin 
Published: July 2024

Purpose of review
Antibody–drug conjugates (ADCs), consisting of monoclonal antibodies (mAbs) covalently linked to cytotoxic drugs via chemical linkers, are a kind of promising tumor immunotherapy. ADCs also face a number of challenges, including unavoidable adverse effects, drug resistance, tumor targeting and payload release. To address these issues, in addition to optimizing the individual components of ADCs, such as new payloads, linkage sites and new targets, and using bispecific antibodies to increase precision, attention should be paid to optimizing the dosage of ADCs.

Recent findings
There are currently 7 ADCs approved for marketing by the Food and Drug Administration (FDA) for hematological malignancies, and dozens of other ADCs are either in clinical trials or in the process of applying for marketing. In recent clinical studies targeting ADCs in hematologic malignancies, in addition to validating effectiveness in different indications, researchers have attempted to combine ADCs with other chemotherapeutic agents in anticipation of increased therapeutic efficacy. Furthermore, the availability of bispecific antibodies may increase the safety and efficacy of ADCs.

Summary
This review summarized the progress of research on ADCs in hematological malignancies, the challenges being faced, and possible future directions to improve the efficacy of ADCs, which can provide novel insight into the future exploration of ADCs in the treatment of hematological malignancies.
The evolution of molecular management of carcinoma of unknown primary
Authors: Sivakumaran Tharani , Tothill Richard W. , Mileshkin Linda R. 
Published: July 2024

Purpose of review
There is significant need to improve diagnostic and therapeutic options for patients with cancer of unknown primary (CUP). In this review, we discuss the evolving landscape of molecular profiling in CUP.

Recent findings
Molecular profiling is becoming accepted into the diagnostic work-up of CUP patients with tumour mutation profiling now described in international CUP guidelines. Although tissue-of-origin (ToO) molecular tests utilising gene-expression and DNA methylation have existed some time, their clinical benefit remains unclear. Novel technologies utilising whole genome sequencing and machine learning algorithms are showing promise in determining ToO, however further research is required prior to clinical application. A recent international clinical trial found patients treated with molecularly-guided therapy based on comprehensive-panel DNA sequencing had improved progression-free survival compared to chemotherapy alone, confirming utility of performing genomic profiling early in the patient journey. Small phase 2 trials have demonstrated that some CUP patients are responsive to immunotherapy, but the best way to select patients for treatment is not clear.

Summary
Management of CUP requires a multifaceted approach incorporating clinical, histopathological, radiological and molecular sequencing results to assist with identifying the likely ToO and clinically actionable genomic alternations. Rapidly identifying a subset of CUP patients who are likely to benefit from site specific therapy, targeted therapy and/or immunotherapy will improve patient outcomes.
The role of signaling lymphocyte activation molecule family receptors in hematologic malignancies
Authors: Kwantwi Louis Boafo , Rosen Steven T. , Querfeld Christiane 
Published: July 2024

Purpose of review
In this review, we provide an overview of the current understanding of SLAM-family receptors in hematologic malignancies. We highlighted their contribution to the disease pathogenesis and targeting strategies to improve therapeutic outcomes.

Recent findings
Emerging studies have reported the tumor-promoting role of SLAM-family receptors in various hematologic malignancies, including chronic lymphocytic leukemia, acute myeloid leukemia, and multiple myeloma. Specifically, they regulate the interaction between malignant cells and the tumor microenvironment to promote apoptosis resistance, therapeutic resistance, impairment of antitumor and tumor progression.

Summary
SLAM-family receptors promote the progression of hematologic malignancies by regulating the interaction between malignant cells and the tumor microenvironment. This provides the rationale that SLAM-targeted therapies are appealing strategies to enhance therapeutic outcomes in patients.
Potential application of artificial intelligence in cancer therapy
Authors: Riaz Irbaz Bin , Khan Muhammad Ali , Haddad Tufia C. 
Published: July 2024

Purpose of review
This review underscores the critical role and challenges associated with the widespread adoption of artificial intelligence in cancer care to enhance disease management, streamline clinical processes, optimize data retrieval of health information, and generate and synthesize evidence.

Recent findings
Advancements in artificial intelligence models and the development of digital biomarkers and diagnostics are applicable across the cancer continuum from early detection to survivorship care. Additionally, generative artificial intelligence has promised to streamline clinical documentation and patient communications, generate structured data for clinical trial matching, automate cancer registries, and facilitate advanced clinical decision support. Widespread adoption of artificial intelligence has been slow because of concerns about data diversity and data shift, model reliability and algorithm bias, legal oversight, and high information technology and infrastructure costs.

Summary
Artificial intelligence models have significant potential to transform cancer care. Efforts are underway to deploy artificial intelligence models in the cancer practice, evaluate their clinical impact, and enhance their fairness and explainability. Standardized guidelines for the ethical integration of artificial intelligence models in cancer care pathways and clinical operations are needed. Clear governance and oversight will be necessary to gain trust in artificial intelligence-assisted cancer care by clinicians, scientists, and patients.
Treatment approaches for older Hodgkin lymphoma patients
Authors: Bröckelmann Paul J. 
Published: July 2024

Purpose of review
Hodgkin lymphoma (HL) occurs at two age peaks around 25 and 60 years of age. Due to varying fitness and co-morbidities older patients are a heterogeneous group that has relatively poor treatment outcomes. The evolving therapeutic landscape for older HL is summarized herein.

Recent findings
Due to lack of data from larger trials and approval of novel drugs, first-line treatment of limited-stage HL (i.e. early-stage favourable and unfavourable) remains largely A(B)VD and radiotherapy based. For patients with advanced-stage HL, the anti-CD30 antibody-drug conjugate brentuximab vedotin is approved in combination with AVD chemotherapy (BV-AVD). Due to toxicities such as febrile neutropenia or polyneuropathy and lack of improvement in progression-free and overall survival in the older subgroup, fully concomitant BV-AVD is however not used widely. More recently, promising early data was reported with the combination of nivolumab and AVD (N-AVD) in patients >60 years with advanced-stage HL. Second-line treatment depends on fitness and might include high-dose chemotherapy and autologous stem-cell transplantation for selected patients. For unfit or multiply relapsed patients, anti-PD1 antibodies are the preferred treatment option.

Summary
The increasing number of older HL patients constitutes a therapeutic challenge despite recent advances and the increased usage of targeted agents.
Cutaneous Involvement by Refractory Celiac Disease Type 2 Histologically Mimicking Mycosis Fungoides
Authors: Mei Angela , Allanson Benjamin , Hall Dustin , Ardakani Nima Mesbah , Harvey Nathan Tobias 
Published: July 2024

Abstract:
Refractory celiac disease (RCD) is a rare condition characterized by persistent malabsorptive symptoms and villous atrophy despite a gluten-free diet. While RCD type 1 has a normal intraepithelial lymphocyte phenotype, RCD type 2 is defined by the presence of immunophenotypically aberrant and monoclonal intraepithelial T lymphocytes, with a high propensity to transform to enteropathy-associated T-cell lymphoma (EATL). Although dermatological manifestations of celiac disease are common, presentation with cutaneous involvement by abnormal lymphocytes of RCD type 2 or EATL is rare, with few histologic descriptions in the literature. We describe the case of a 66-year-old man with a history of celiac disease presenting with a generalized, erythematous papular rash over his torso, upper arms, and legs. Biopsy of his skin lesions showed prominent hyperkeratosis with underlying spongiosis and interface change. Increased intraepithelial (epidermotropic) lymphocytes were observed, out of proportion to the level of spongiosis, but not overly atypical in appearance. Immunohistochemistry revealed an aberrant T-cell immunophenotype (CD3/2/7 positive; CD5/4/8 negative), raising suspicion for a cutaneous T-cell lymphoproliferative disorder. A duodenal biopsy demonstrated total villous atrophy with a morphologically bland population of epitheliotropic T lymphocytes showing the same aberrant immunophenotype. Similar cells were also identified by flow cytometry in the peripheral blood. In conjunction with the history of celiac disease, a diagnosis of RCD type 2 or ‘EATL in situ’ with cutaneous involvement was made. Cutaneous RCD type 2 or EATL should be considered as differential diagnoses in patients with a history of celiac disease and histopathology reminiscent of epidermotropic forms of cutaneous T-cell lymphoma.
Malignant Dendritic Cell Sarcomas in the Skin: 2 Cases of Rare Sarcoma Subtypes With Literature Review
Authors: Mehta Apoorva , Luyten Sophia , Abdulhak Abraham , Mahmud Haseeb , Gillen William , Gru Alejandro A. 
Published: July 2024

Abstract:
Interdigitating dendritic cell sarcoma is a rare, aggressive hematological malignancy primarily originating in lymph nodes, with only 10 reported cases presenting in the skin (primary cutaneous interdigitating dendritic cell sarcoma). Past presentations showed erythematous nodules on the proximal extremities, back, or face. Morphologically, these neoplasms are similar to melanomas and other dendritic cell (DC) tumors, making their diagnosis difficult. Here, we present 1 case of primary cutaneous interdigitating dendritic cell sarcomas and another 1 of malignant indeterminate dendritic cell tumor (indeterminate DC sarcoma). The first case is an 83-year-old man who presented with recent ulceration and bleeding of an asymptomatic, slow growing lesion on his right thigh with biopsy revealing a large, well-circumscribed polypoid spindle cell tumor in the dermis with atypical cells with vesicular nuclei in a lymphoplasmacytic background and immunohistochemistry positivity for CD45, CD68, S100, and Cyclin D1. The second case is a 74-year-old man who presented with a progressively darkening and enlarging abdominal skin lesion with biopsy revealing a diffuse infiltrate of atypical poorly differentiated pleomorphic nuclear cells and immunohistochemistry positivity for S100, CD1a, CD56, CD43, cyclin D1, CD31, CD4, and BRAF V600E. Our findings contribute to expand the reported literature on primary cutaneous DC sarcomas.
Hyaluronic Acid Filler Longevity in the Mid-face: A Review of 33 Magnetic Resonance Imaging Studies
Authors: Master Mobin , Azizeddin Arshia , Master Vahid 
Published: July 2024

Background:
Recent evidence challenges the conventional belief that hyaluronic acid (HA) fillers have a short lifespan of 3–12 months. This study, using extensive patient data and long-term imaging post-injection, suggests a need to reconsider refilling protocols and underscores the critical role of precise clinical photography for accurate comparisons.

Methods:
The study enrolled 33 patients who received HA fillers in the mid-face, excluding those with recent injections, permanent fillers, or specific medical histories. Magnetic resonance imaging (MRI) was conducted on 24 asymptomatic and nine edema-concerned patients over 2.5 years. Two blinded radiologists assessed filler presence and longevity based on requested MRI observations.

Results:
MRI scans confirmed HA presence in all 33 patients, with no complete dissipation observed over a 2-year period post injection. Among them, 21 had not received injections for 2–5 years, 12 for over 5 years, and some for up to 8–15 years. Varying volumes of HA were noted: mild in nine patients, moderate in 13, and severe in 11. The study reported HA longevity of up to 15 years across different products, with a 95% confidence interval of 84.47% ± 4.43%, demonstrating the persistence of cross-linked HA fillers in the mid-face.

Conclusions:
HA fillers remained detectable for at least 2 years in all 33 patients, with one patient showing filler longevity of up to 15 years. These findings suggest significant implications for filler management practices. Further research with larger cohorts and ongoing imaging follow-up is warranted to fully understand HA filler longevity and optimize clinical protocols.