bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management and Mechanisms of Diarrhea Induced by Tyrosine Kinase Inhibitors in Human Epidermal Growth Factor Receptor-2-Positive Breast Cancer
Authors: Sun Kena , Wang Xiaojia , Zhang Huanping , Lin Guang , Jiang Ruiyuan 
Published: August 2024

Breast cancer has the highest incidence among female malignancies, significantly impacting women’s health. Recently, numerous HER2-targeted therapies have achieved excellent clinical outcomes. Currently, anti-HER2 drugs are divided into three main categories: monoclonal antibodies, small-molecule tyrosine kinase inhibitors, and antibody-coupled drugs (ADCs). The main toxic side effects of small molecule TKI-based therapy are diarrhea, hand-foot syndrome, rash, nausea, and vomiting. Diarrhea is a potential predictor of tumor response, affecting up to 95% of cancer patients treated with TKIs. Severe gastrointestinal toxicity can result in the need for dose reductions and treatment interruptions. This not only compromises the efficacy of TKIs but also deteriorates human nutrition and quality of life. The majority of individuals develop diarrhea within 7 days of starting treatment, with approximately 30% developing grade 3 or higher diarrhea within 2-3 days of starting treatment. The severity of diarrhea typically correlates with the dosage of most TKIs. Current prevention and management strategies are primarily empirical, focusing on symptom alleviation rather than addressing the toxicological mechanisms underlying TKI-induced diarrhea. Consequently, anti-diarrheal drugs are often less effective in managing this condition in cancer patients receiving TKIs. Moreover, our understanding of the toxicological mechanisms responsible for such diarrhea remains limited, underscoring the urgent need to identify these mechanisms in order to develop effective anti-diarrheal medications tailored to this specific context. This review aims to elucidate management approaches and mechanisms for diarrhea induced by TKIs during HER2-positive breast cance.
An Empowerment-Based Intervention for Chinese Immigrant Women Experiencing Intimate Partner Violence: Feasibility and Acceptability
Authors: Li Yang , Bloom Tina , Bullock Linda F. C. , Rhee Hyekyun 
Published: August 2024

Background: Intimate partner violence (IPV) is a significant public health concern, particularly in vulnerable populations such as Chinese immigrant women. Aim: This study aimed to assess the feasibility and acceptability of an empowerment-based intervention integrated with relaxation and self-compassion techniques for Chinese immigrant women experiencing IPV. Methods: The present study was a part of a pilot randomized controlled trial (RCT). A total of 50 Chinese immigrant women who had experienced IPV in the past year were recruited online and randomized to either the intervention or the control group. The intervention group engaged in seven weekly sessions delivered with a phone call and a mobile application. Quantitative and qualitative data were collected through surveys and interviews to evaluate intervention adherence, participants’ perceptions, and areas for improvement. Results: 64% of the participants completed each weekly session, demonstrating favorable intervention adherence. The intervention was perceived to be helpful by most participants, with reported decreases in stress, anxiety, fatigue, pain, and family conflicts, and with reported improvements in emotion regulation and self-compassion. However, technical issues with the mobile platform and lack of personalization were identified as limitations. Conclusion: This study demonstrates the feasibility and acceptability of the intervention for Chinese immigrant women experiencing IPV and warrants a full-scale RCT to determine its efficacy. It will be essential to personalize the intervention and reduce any barriers to participation.
Characterization of RNA Processing Genes in Colon Cancer for Predicting Clinical Outcomes
Authors: Hu Jianwen , Ning Yingze , Ma Yongchen , Sun Lie , Chen Guowei 
Published: August 2024

Objective: Colon cancer is associated with multiple levels of molecular heterogeneity. RNA processing converts primary transcriptional RNA to mature RNA, which drives tumourigenesis and its maintenance. The characterisation of RNA processing genes in colon cancer urgently needs to be elucidated. Methods: In this study, we obtained 1033 relevant samples from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases to explore the heterogeneity of RNA processing phenotypes in colon cancer. Firstly, Unsupervised hierarchical cluster analysis detected 4 subtypes with specific clinical outcomes and biological features via analysis of 485 RNA processing genes. Next, we adopted the least absolute shrinkage and selection operator (LASSO) as well as Cox regression model with penalty to characterise RNA processing-related prognostic features. Results: An RNA processing-related prognostic risk model based on 10 genes including FXR1, MFAP1, RBM17, SAGE1, SNRPA1, SRRM4, ADAD1, DDX52, ERI1, and EXOSC7 was identified finally. A composite prognostic nomogram was constructed by combining this feature with the remaining clinical variables including TNM, age, sex, and stage. Genetic variation, pathway activation, and immune heterogeneity with risk signatures were also analysed via bioinformatics methods. The outcomes indicated that the high-risk subgroup was associated with higher genomic instability, increased proliferative and cycle characteristics, decreased tumour killer CD8+ T cells and poorer clinical prognosis than the low-risk group. Conclusion: This prognostic classifier based on RNA-edited genes facilitates stratification of colon cancer into specific subgroups according to TNM and clinical outcomes, genetic variation, pathway activation, and immune heterogeneity. It can be used for diagnosis, classification and targeted treatment strategies comparable to current standards in precision medicine. It provides a rationale for elucidation of the role of RNA editing genes and their clinical significance in colon cancer as prognostic markers.
Modified Ex Vivo Renal Reconstruction to Facilitate Fenestrated-Branched Endovascular Repair of a Thoracoabdominal Aortic Aneurysm
Authors: Stutz Jack , Lima Guilherme Baumgardt Barbosa , Huang Ying , Mendes Bernado C. , Macedo Thanila A. , Oderich Gustavo S. 
Published: August 2024

Purpose: To report the use of modified ex vivo renal artery (RA) reconstruction in a patient with 2 small right RAs (RRAs) in anticipation of planned fenestrated-branched endovascular aortic repair (FB-EVAR) of thoracoabdominal aortic aneurysm (TAAA). Case Report: A staged hybrid repair was utilized in a patient with Extent II TAAA involving celiac axis (CA), superior mesenteric artery (SMA), single left RA (LRA), and 2 small (<3 mm) RRAs. The first-stage operation consisted of hepato-renal bypass using modified ex vivo renal reconstruction with single end-to-end anastomosis to both RAs using a saphenous vein graft. A second stage FB-EVAR was performed using patient-specific manufactured stent-graft with 3 fenestrations for the CA, SMA, and LRA 6 weeks later. The patient recovered with no complications. At 4 years, the patient had widely patent hepato-renal bypass and target vessels with normal renal function. Conclusion: The use of adjunctive hybrid procedures may optimize or facilitate FB-EVAR. In this patient, salvage of 2 small RAs was not ideally suited for branch stenting but was possible using modified ex vivo RA reconstruction with preservation of kidney parenchyma and function. Clinical Impact This case report illustrates a hybrid approach to overcome one of the most frequent limitations to total endovascular incorporation of renal arteries, eg small diameter, early bifurcation and multiple vessels. The modified ex vivo technique allows meticulous renal artery reconstruction without the deleterious effect of warm ischemia and without the cumbersome reconstruction of ureter and vein that is needed with traditional on table ex vivo auto transplantation. The technique is used in a minority of cases and adds the morbidity of open approach. Case selection is of paramount importance.
Prospective Cohort Study of a Treatment Strategy for a Combination of the Left Common Iliac Vein Compression Stenosis and Pelvic Venous Insufficiency
Authors: Gavrilov Sergey G. , Lebedev Igor S. , Vasilyev Alexey V. , Churikov Dmitry A. , Mishakina Nadezhda Yu , Alenichev Alexander V. 
Published: August 2024

Purpose: To develop a strategy for the iliac vein stenting in patients with a combination of the left common iliac vein (LCIV) compression stenosis and pelvic venous insufficiency (PVI). Methods: This prospective comparative cohort study included 55 patients with hemodynamically significant LCIV stenosis out of 285 females with PVI screened in 2014–2022. All 55 patients underwent duplex ultrasound, multi-detector computed venography, ovarian venography, and multiplanar pelvic venography. Patients underwent LCIV stenting or the left gonadal vein (LGV) embolization as the primary intervention. The endpoints (chronic pelvic pain [CPP] relief, patency of stents, and reduction in pelvic venous reflux [PVR]) were evaluated 1 and 10 days, as well as 1, 6, and 12 months after the procedure. All patients received antithrombotic therapy after the interventions. Results: The primary LCIV stenting was performed in 49 patients and resulted in the CPP relief in 69.4%, pain reduction from 7.9±1.3 to 1.7±1.1 visual analog scale (VAS) scores (p=0.005), and substantial reduction of PVR in LGV (from 4.3±0.6 seconds to 1.9±0.3 seconds, p=0.003). The LGV embolization as the second stage of treatment was performed in 30.6% of patients with the LGV reflux greater than 5 seconds as a possible cause for the CPP persistence. The primary LGV embolization failed in 100% of patients (no changes in CPP and PVR). The LCIV stenting at the second stage resulted in the CPP relief within 10 days and the pelvic venous reflux (PVR) reduction. There were no complications of stenting, and the patency of stents in the follow-up period was 100%. Postembolization syndrome occurred in 9.5% of patients. No thromboses of the veins of the pelvis and lower extremities were identified. Conclusion: Treatment of patients with a combination of LCIV compression and PVI involves staged endovascular interventions: the LCIV stenting should be considered the first-line treatment, while the LGV embolization is performed when the PVI symptoms persist for more than 6 months and is not acceptable as the first-line treatment. Clinical Impact The developed strategy of endovascular treatment for the combination of left common iliac vein (LCIV) and pelvic venous insufficiency (PVI) provides an effective elimination of chronic pelvic pain (CPP) and reflux in the pelvic veins and avoids unnecessary embolizations of the gonadal veins, thereby eliminating possible risks related to complications of embolization. The use of antithrombotic therapy is an effective and safe approach for preventing venous thromboembolic events after endovascular interventions.
A Multimodal Point Cloud-Based Method for Tumor Localization in Robotic Ultrasound-Guided Radiotherapy
Authors: Song Lintao , Li Qixuan , Sai Zhang , Sun Kangkang , Chen Wei , Zhang Heng , Wang Yibo , Jiao Zhuqing , Ni Xinye 
Published: August 2024

Objectives Part of the tumor localization methods in radiotherapy have poor real-time performance and may generate additional radiation. We propose a multimodal point cloud-based method for tumor localization in robotic ultrasound-guided radiotherapy, which only irradiates computed tomography (CT) during radiotherapy planning to avoid additional radiation. Methods The tumor position was determined using the CT point cloud, and the red green blue depth (RGBD) point cloud was used to determine body surface scanning location corresponding to the tumor location. The relationship between the CT point cloud and RGBD point cloud was established through multi-modal point cloud registration. The point cloud was then used for robot tumor localization through coordinate transformation between camera and robot. Results The maximum mean absolute error of the tumor location in the X, Y, and Z directions of the robot coordinate system were 0.781, 1.334, and 1.490 mm, respectively. The average point-to-point translation mean absolute error between the actual and predicted positions of the localization points was 1.847 mm. The maximum error in the random positioning experiment was 1.77 mm. Conclusion The proposed method is radiation free and has real-time performance, with tumor localization accuracy that meets the requirements of radiotherapy. The proposed method, which potentially reduces the risks associated with radiation exposure while ensuring efficient and accurate tumor localization, represents a promising advancement in the field of radiotherapy.
Isolated Abdominal Aortic Dissection With and Without Abdominal Aortic Aneurysm
Authors: Gonzalez-Urquijo Mauricio , Marine Leopoldo , Valdes Francisco , Vargas Jose Francisco , Bergoeing Michel , Mertens Renato 
Published: August 2024

Objective The aim of this study was to report the clinical presentation and treatment outcomes of patients treated for IAAD with and without abdominal aortic aneurysm (AAA) in a single academic institution in South America. Materials and Methods A retrospective review of all patients with IAAD with or without concomitant AAA between January 2002 and December 2023 from a single academic hospital was performed. Results Eighteen patients with IAAD were diagnosed of whom 13 (72.2%) were males. Median age was 63 years (range: 43-88 years). Sixteen (88.8%) patients presented with symptoms, and in two (11.1%) asymptomatic patients IAAD was an incidental finding. Ten (55.5%) patients had concomitant abdominal aortic aneurysm (AAA), with a median size of the aneurysm of 49.5 mm (range: 44-66 mm). No statistical differences in baseline characteristics were seen between patients with concomitant IAAD and AAA and patients with only IAAD. Seven (38.8%) patients presented chronic dissection, and 11 (61.1%) patients had acute dissection. Five (27.7%) patients were treated conservatively with blood pressure, pain control, and antiplatelets; endovascular surgery was performed in eight (44.4%) patients and open surgery in five (27.7%) patients. The complication rate was 22.2% (n = 4), and the mortality rate was 0%. Median follow-up was 36 months (range: 6-240 months). Complete remodeling was seen in all patients except two patients who underwent conservative treatment. Of those, one had partial remodeling, and the other no changed. Conclusion Isolated aortic dissection of the abdominal aorta is an uncommon condition, with acceptable different treatment strategies, from conservative to invasive treatments. Sometimes IAAD can concur with AAA, and when so, invasive treatment might be considered. More studies describing the natural history of AAA and its association with IAAD are warranted, as well as further research reporting long-term outcomes on aortic remodeling after different treatment modalities.
Extending applications of WALANT for free flap harvest and transfer to repair the finger defects
Authors: Xing Shu Guo , Sun Shou Wei 
Published: August 2024

The use of wide-awake local anaesthesia no tourniquet (WALANT) in free flap surgery has been limited and discouraged because of the concern that the adrenaline will cause vasoconstriction. We report our positive experience in free flap harvesting and transfer. Level of evidence: IV
Enhancing the Capabilities of Continuous Glucose Monitoring With a Predictive App
Authors: Herrero Pau , Andorrà Magí , Babion Nils , Bos Hendericus , Koehler Matthias , Klopfenstein Yannick , Leppäaho Eemeli , Lustenberger Patrick , Peak Ajandek , Ringemann Christian , Glatzer Timor 
Published: August 2024

Background: Despite abundant evidence demonstrating the benefits of continuous glucose monitoring (CGM) in diabetes management, a significant proportion of people using this technology still struggle to achieve glycemic targets. To address this challenge, we propose the Accu-Chek® SmartGuide Predict app, an innovative CGM digital companion that incorporates a suite of advanced glucose predictive functionalities aiming to inform users earlier about acute glycemic situations. Methods: The app’s functionalities, powered by three machine learning models, include a two-hour glucose forecast, a 30-minute low glucose detection, and a nighttime low glucose prediction for bedtime interventions. Evaluation of the models’ performance included three data sets, comprising subjects with T1D on MDI (n = 21), subjects with type 2 diabetes (T2D) on MDI (n = 59), and subjects with T1D on insulin pump therapy (n = 226). Results: On an aggregated data set, the two-hour glucose prediction model, at a forecasting horizon of 30, 45, 60, and 120 minutes, achieved a percentage of data points in zones A and B of Consensus Error Grid of: 99.8%, 99.3%, 98.7%, and 96.3%, respectively. The 30-minute low glucose prediction model achieved an accuracy, sensitivity, specificity, mean lead time, and area under the receiver operating characteristic curve (ROC AUC) of: 98.9%, 95.2%, 98.9%, 16.2 minutes, and 0.958, respectively. The nighttime low glucose prediction model achieved an accuracy, sensitivity, specificity, and ROC AUC of: 86.5%, 55.3%, 91.6%, and 0.859, respectively. Conclusions: The consistency of the performance of the three predictive models when evaluated on different cohorts of subjects with T1D and T2D on different insulin therapies, including real-world data, offers reassurance for real-world efficacy.
Design Considerations for Virtual Reality Intervention for People with Intellectual and Developmental Disabilities: A Systematic Review
Authors: Yi Ye Ji , Heidari Matin Negar , Brannan Darin , Johnson Michael , Nguyen Anna 
Published: August 2024

Objectives This systematic review aims to explore virtual reality (VR) applications for rehabilitation purposes among people with intellectual and developmental disabilities (IDD), identify their effects on rehabilitation outcomes, explore themes to consider in VR intervention design, and provide guidance for designers and researchers in creating therapeutic environments using VR technology. Background VR has gained increasing attention in healthcare settings to assist in achieving rehabilitation goals for people with IDD. VR is particularly advantageous since it simulates the real world while providing controllable, safe, and versatile environments. It is necessary to expand the current body of knowledge on VR intervention's outcomes by synthesizing further information on VR application characteristics as well as identifying design considerations regarding feasibility, usability, safety, and other aspects that will benefit future VR intervention design and research. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framed the current review. Multiple databases were searched to identify studies published between 2001 and 2023. The review qualitatively organized VR environment design considerations according to three themes: feasibility, usability, and safety. Results This review included 27 articles and included 868 participants. The overall findings indicated that VR interventions are promising in enhancing rehabilitation outcomes among people with IDD, such as physical, cognitive, emotional, and functional independence domains. Conclusion This review provides design recommendations to create effective, usable, and safe VR interventions for individuals with IDD. The suggested design implications should be applied with the awareness that VR is a relatively emerging technology with rapidly evolving features.
Assessment of the knowledge, attitude, and practice of childbearing mothers in the geographically coastal region of Bangladesh for cleanliness and food safety of food security
Authors: Al Mamun Md Abdullah , A Ghani Ruhina Binta , Shill Lincon Chandra , Afroz Farjana , Chowdhury Akibul Islam , Akter Fouzia , Jahan Effat Ara , Rana Md Masud , Li Jianfeng 
Published: August 2024

Objectives: Household hygiene and food safety are essential parts of food security; better food safety and hygiene will help reduce the chances of illness for young children and family members rarely studied in the selected area of coastal Bangladesh. The study aimed to discover the knowledge, attitude, and practice levels for cleanliness, hygiene, and food safety in the household. Methods: In this study, we employed a cross-sectional survey with simple random sampling to collect data from 384 childbearing mothers. The survey used the pretested, validated, and standardized (knowledge, attitude, and practice) questionnaire-model-based interview guide. Results: According to our study analysis, the knowledge, attitude, and practice scores among mothers were inadequate for household cleanliness and hygiene management. In the area context, knowledge efficiency was related to family type (joint and nuclear). Family economic conditions strongly influenced mothers’ attitudes and behavior toward knowledge, attitude, and practice score. Unemployed and illiterate mothers have lower knowledge, attitude, and practice scores. Educated mothers have better knowledge, attitude, and practice score compared to illiterate mothers ( p < 0.014). Nuclear family knowledge, attitude, and practice attitude was much greater ( p < 0.04) and wealthier families showed better practice ( p < 0.001) toward cleanliness and food safety in the household level. Conclusions: The study discovered the mothers’ and household members’ attention need to improve the knowledge, attitude, and practice toward proper hygiene and food safety at the household level of marginalized populations in coastal Bangladesh.
Obesity and its related factors among university medical students in Syria: A cross-sectional study
Authors: Naeem Ahmad , AlJaber Yazen , Kakaje Ameer , Ghareeb Amjad , Al Said Bayan 
Published: August 2024

Introduction: Obesity is a worldwide pandemic that has many contributing factors. There is very scarce data available on this issue for the population in Syria. We aim to evaluate the body mass index and related obesity rates of medical students as they are the role model for the general population. We aim to explore the breadth of potential associated factors including psychological, physical activity, dietary, and a broad array of lifestyle and socio-demographic factors. Methods: This is a cross-sectional study that was conducted at a major university in Damascus. Paper-based questionnaires were distributed that included the International Physical Activity Questionnaire short version and the Depression, Anxiety and Stress Scale. Results: The mean body mass index was 23.5 (±4.2) kg/m2 with 540 participants enrolled in this study. Males had significantly higher body mass index than females by 2.5 kg/m2 ( p < 0.001, χ2 = 47.9, V = 0.3). In our sample, 304 (60.68%) had normal body mass index (18.5–24.99), 40 (7.98%) were considered underweight (body mass index ⩽ 18.5), 120 (23.95%) were considered overweight (body mass index = 25–29.99) and 37 (7.39%) were considered obese. While many factors were found to be significantly associated with body mass index and obesity, only physical activity, depression, having a first-degree family history with obesity and poor dietary habits were associated in regression analyses evaluating all predictors concurrently. Conclusion: The findings reflect an ongoing epidemic of obesity. Our findings can guide targeted intervention for this young population who will become doctors and health role models in the future. More studies should be conducted to find the best possible ways to tackle this issue in the future.