bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlation of noninvasive imaging of tumour-infiltrating lymphocytes with survival and BCG immunotherapy response in patients with bladder cancer: a multicentre cohort study
Authors: Chen Ke , Li Xiaoyang , Liu Libo , Wang Bo , Liang Weiming , Chen Junyu , Gao Mingchao , Huang Xiaodong , Liu Bohao , Sun Xi , Yang Tenghao , Zhao Xiao , He Wang , Luo Yun , Huang Jian , Lin Tianxin , Zhong Wenlong 
Published: August 2024

Background:
Tumour-infiltrating lymphocytes (TILs) are strongly correlated with the prognosis and immunotherapy response in bladder cancer. The TIL status is typically assessed through microscopy as part of tissue pathology. Here, the authors developed Rad-TIL model, a novel radiomics model, to predict TIL status in patients with bladder cancer.

Material and methods:
The authors enrolled 1089 patients with bladder cancer and developed the Rad-TIL model by using a machine-learning method based on computed tomography (CT) images. The authors applied a radiogenomics cohort to reveal the key pathways underlying the Rad-TIL model. Finally, the authors used an independent treatment cohort to evaluate the predictive efficacy of the Rad-TIL model for Bacillus Calmette-Guérin (BCG) immunotherapy.

Results:
The authors developed the Rad-TIL model by integrating tumoral and peritumoral features on CT images and obtained areas under the receiver operating characteristic curves of 0.844 and 0.816 in the internal and external validation cohorts, respectively. Patients were stratified into two groups based on the predicted radiomics score of TILs (RSTIL). RSTIL exhibited prognostic significance for both overall and cancer-specific survival in each cohort (hazard ratios: 2.27–3.15, all P<0.05). Radiogenomics analysis revealed a significant association of RSTIL with immunoregulatory pathways and immune checkpoint molecules (all P<0.05). Notably, BCG immunotherapy response rates were significantly higher in high-RSTIL patients than in low-RSTIL patients (P=0.007).

Conclusion:
The Rad-TIL model, a noninvasive method for assessing TIL status, can predict clinical outcomes and BCG immunotherapy response in patients with bladder cancer.
A pilot study of safety and efficacy comparison of low molecular heparin calcium sequential oral anticoagulants in the treatment of cirrhotic portal vein thrombosis
Authors: Zhang Jie , Dang Xiaohong , Zhang Lijuan , Li Wenhua 
Published: August 2024

Background
The objective of this study is to compare and assess the efficacy and safety of low-molecular-weight heparin calcium (LMWH-Ca), followed by either warfarin or rivaroxaban, as treatment options for portal vein thrombosis (PVT) in patients with cirrhosis.

Methods
In this pilot study, cirrhotic (with liver function score of Child-Pugh A) patients diagnosed with PVT who were not on anticoagulant therapy received 2 weeks of subcutaneous injections of LMWH-Ca. They were then randomized to either warfarin (a full course of oral warfarin for 6 months) or rivaroxaban (a full course of oral rivaroxaban for 2 months), with 30 cases in each group. After a treatment period of up to 6 months, a comparative analysis was performed to assess the efficacy and safety of both groups. Volumetric changes in PVT were monitored dynamically using enhanced computed tomography scans before treatment at week 2 and month 6.

Results
There were no statistically significant differences in the clinical characteristics of the patients between the two groups. Rivaroxaban treatment reduced PVT median volume from 1.83 cm3 at week 2 to 0.0 cm3 at month 6 and prevented the worsening of PVT after 6 months of treatment with LMWH-Ca (P < 0.001). On the other hand, warfarin treatment increased PVT median volume from 1.95 cm3 at week 2 to 3.78 cm3 at month 6 (P = 0.002). None of the 30 patients in the rivaroxaban group had clinically significant gastrointestinal bleeding, while 2 of the 30 patients (7%) in the warfarin group had gastrointestinal bleeding (P = 0.317).

Conclusion
Rivaroxaban followed by LMWH-Ca is an effective anticoagulant treatment strategy for PVT in cirrhosis.
Preoperative Chemotherapy With Gemcitabine for Pancreatic Cancer Causes Zinc Deficiency
Authors: Iseki Masahiro , Mizuma Masamichi , Shimura Mitsuhiro , Kokumai Takashi , Sato Hideaki , Kusaka Akiko , Aoki Shuichi , Inoue Koetsu , Nakayama Shun , Douchi Daisuke , Miura Takayuki , Maeda Shimpei , Ishida Masaharu , Nakagawa Kei , Kamei Takashi , Unno Michiaki 
Published: August 2024

Objectives
The aim of this study was to investigate how preoperative chemotherapy affected the serum zinc concentrations in patients with pancreatic cancer (PC).

Materials and Methods
Two hundreds thirty-one patients with PC who underwent pancreatectomy at our department from 2013 to 2019 were enrolled in this study and measured for the serum zinc concentrations before pancreatectomy. Patient characteristics, course of treatment, and laboratory data were analyzed.

Results
One hundred thirty-five patients underwent upfront pancreatectomy and 58 received preoperative gemcitabine + S1 (GEM + S1) and 29 received gemcitabine + nab-paclitaxel (GEM + nab-PTX). Comparing the serum zinc concentrations before and after preoperative treatment, it was found to decrease after treatment with statistical difference (79.3 μg/dL vs 68.7 μg/dL, P < 0.001). The result was consistent with the investigation for both the patients who received GEM + S1 and those who received GEM + nab-PTX (P = 0.019, P < 0.001, respectively).

Conclusions
The preoperative chemotherapy consistently reduced the serum zinc concentrations in the PC patients, regardless of their regimen such as GEM + S1 and GEM + nab-PTX. Monitoring the serum zinc concentration and appropriate zinc supplementation may be essential for PC patients undergoing preoperative chemotherapy and pancreatectomy.
Comparing the incidence of postoperative painful bladder spasm between malecot catheter and 3-way Foley catheter: a clinical trial
Authors: Farahani Mojtaba , Dehghani Keramat , Shojaei Parisa 
Published: August 2024

Background:
In this study, the effect of Pezzer (as a Pezzer catheter) and three-way Foley catheters, used for suprapubic catheterization after open prostatectomy, was investigated in terms of early incidence of painful bladder spasms.

Materials and methods:
In this single-blind clinical trial study, 160 patients diagnosed with LUTS/BPH were placed in two groups of 80 Pezzer catheter (Pezzer(size 28)) and three-way Foley catheters (size 24) for suprapubic catheterization. The evaluated variables in this study are age, prostate weight, narcotics dose, Spasm frequency, International Prostate Symptom Score (IPSS), visual analogue scale (VAS), catheterization period.

Results:
The frequency of spasm in Foley group was significantly lower (4.4±7.26 vs. 6.28±4.4; P value=0.000). There was no significant difference between the two groups regarding the frequency of dysuria (P value=0.3).

Conclusion:
The findings of our study showed that despite slightly favourable results in using suprapubic Foley catheter compared to Pezzer catheters in patients with open prostatectomy in terms of pain and spasm frequency, there was no significant difference between the use of these two types of catheters.
The effect of modified team-based learning method on the knowledge and skills of medical emergency personnel: a clinical trial
Authors: Alilu Leyla , Mohsenzadeh Assadollah , Habibzadeh Hossein , Rasouli Javad 
Published: August 2024

Background:
Trauma is one of the most important issues and problems considered in most countries in today’s modern and industrial society. Since pre-hospital care is the first component of a trauma care system, if done properly, it can reduce the problems associated with long-term disability and death due to trauma. Therefore, the present study was conducted to determine the impact of training based on a modified team-based learning (TBL) method on the skills of medical emergency personnel in managing trauma patients in 2022.

Materials and methods:
The present study was a two-group clinical before/after study in which 96 technicians were selected using a stratified random sampling method. The sample members were randomly divided into an intervention group and a control group. In the intervention group, skills for dealing with trauma patients were taught through a modified team-based learning method. The results were analyzed using SPSS software version 21.

Results:
The results of the repeated measures analysis of variance showed a significant difference between the intervention and control groups in learning skills for dealing with trauma patients (P<0.001), which were determined by examining the effect of test repetition and the effect of interaction. The changes in the studied variables in the TBL groups were significantly greater than those in the control group (P<0.001).

Conclusion:
The results indicate that training based on the modified team-based learning method is effective for the management of trauma patients by medical emergency personnel and improves the readiness of personnel in this field.
Baricitinib in the treatment of systemic lupus erythematosus: a systematic review of randomized controlled trials
Authors: Shah Hussain Haider , Ashfaque Faiza , Hadi Zeenat , Waseem Radeyah , Rauf Sameer Abdul , Hussain Tooba , Anas Zahra , Zehra Syeda Alishah , Hussain Muhammad Sheheryar , Wasay Zuberi Muhammad Abdul , Haque Md Ariful 
Published: August 2024

Background:
Baricitinib, a Janus Kinase (JAK) inhibitor, has emerged as a potential therapeutic option for systemic lupus erythematosus (SLE). This systematic review aims to synthesize evidence from randomized controlled trials (RCTs) evaluating the potential of baricitinib in treating SLE.

Methods:
A systematic search was conducted across electronic databases to identify relevant RCTs assessing baricitinib in patients with SLE. Studies reporting outcomes such as the Systemic Lupus Erythematosus Responder Index-4 (SRI-4), adverse events, and safety profiles were included. Data extraction and quality assessment were performed following PRISMA guidelines.

Results:
A total of four studies were evaluated for efficacy and safety of baricitinib therapy. Three studies reported SRI-4, British Isles Lupus Assessment Group (BILAG), and Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K), except for Dorner and colleagues Only Dorner and colleagues and Wallace and colleagues discuss the anti-dsDNA titres following treatment with baricitinib. The findings consistently demonstrated improved efficacy of baricitinib compared to placebo, particularly in terms of SRI-4 scores. Higher dosages of baricitinib showed significant improvement in disease activity and severity indices. Adverse events, including infections and gastrointestinal disturbances, were reported.

Conclusion:
Baricitinib holds promise for treating SLE, but caution is needed due to potential adverse events. Careful patient selection and monitoring are crucial. Future research should prioritize long-term safety and comparative effectiveness studies to better understand baricitinib’s role in managing SLE.
Pembrolizumab in combination with trastuzumab for treatment of HER2-positive advanced gastric or gastro-esophageal junction cancer
Authors: Qureshi Zaheer , Jamil Abdur , Fatima Eeshal , Altaf Faryal , Siddique Rimsha , Shah Shivendra 
Published: August 2024

Introduction:
Gastric cancer remains a challenging malignancy with a high global mortality rate. Recent advances in targeted therapy and immunotherapy have shown promise in improving patient outcomes. This paper reviews the impact of incorporating targeted agents such as trastuzumab and immunotherapeutic agents like pembrolizumab into standard chemotherapy regimens for gastric cancer treatment.

Methods:
A comprehensive analysis was conducted on pivotal clinical trials, including KEYNOTE-590, KEYNOTE-811, and ToGA, focusing on their methodologies, patient populations, treatment regimens, and outcome measures. The review also explored emerging research avenues in precision medicine, particularly genomic sequencing and biomarker identification.

Aim:
To assess the efficacy and survival benefits of adding trastuzumab and pembrolizumab to standard chemotherapy in the treatment of gastric cancer and to outline future directions in gastric cancer research.

Results:
Including trastuzumab and pembrolizumab in treatment regimens for human epidermal growth factor receptor 2 (HER2)-positive and PD-L1-expressing gastric cancers significantly improved progression-free and overall survival rates compared to chemotherapy alone. These findings highlight the potential of personalized therapy in enhancing treatment outcomes. Furthermore, ongoing research into the gastric cancer microenvironment and the role of the microbiome suggests novel targets for future therapeutic interventions.

Conclusion:
The integration of targeted and immunotherapeutic agents with traditional chemotherapy represents a pivotal shift in gastric cancer treatment, moving towards more personalized and effective regimens.
Metaizeau technique in stabilizing Monteggia equivalent 1b associated proximal radial physeal injury in a rural setting: a case report
Authors: Bhattarai Ashbin , Subedi Dipendra , Bhandari Jyotsna , Homagain Sushan , Ghimire Jeevan , Paudel Suruchi , Sapkota Bipin , Dangol Sunil 
Published: August 2024

Introduction:
The Monteggia equivalent type 1b fracture, consisting of an ulnar shaft fracture and radial head dislocation, is a rare condition first described by Giovanni Battista Monteggia. The Metaizeau technique, emphasizing percutaneous intramedullary fixation to preserve bone healing and prevent growth plate damage, has gained prominence in managing these fractures.

Case report:
A 10-year-old boy presented with left forearm pain, swelling, and deformity following a fall while playing football. X-rays revealed a proximal fourth ulnar fracture with dorsal and lateral angulation, along with a proximal radial metaphyseal fracture showing anterior rotation and physeal extension. This fracture pattern resembled a Monteggia fracture type III but differed in the lateral proximal radial disruption via a Salter–Harris type II fracture rather than radial epiphysis dislocation. Satisfactory reduction achieved for ulna was managed with standard nailing system but could not be achieved for radial physeal injury, which was managed with Metaizeau technique.

Discussion:
Type 1b Monteggia equivalents involving a Salter–Harris type 2 fracture of the proximal radius with an associated proximal ulnar fracture, adherence to Monteggia fracture reduction principles is vital. Closed reduction and internal fixation are preferred treatments, with the Metaizeau technique offering advantages such as minimal invasiveness and avoidance of implant-related complications. The Metaizeau technique is particularly beneficial for displaced radial neck fractures in children, providing stable fixation while preserving the fracture environment necessary for optimal healing.

Conclusion:
In cases of Monteggia fracture equivalents, most proximal radial fractures typically reduce to an acceptable level following ulnar reduction. However, proximal radial physeal fractures may require specific attention to achieve satisfactory reduction. The Metaizeau technique, commonly employed in the management of isolated radial neck fractures, can be utilized to achieve this reduction to an acceptable level.
Effect of transcutaneous electrical nerve stimulation on neuro-sensory disturbance after orthognathic surgery: a randomized clinical trial
Authors: Pourdanesh Fereydoun , Tabrizi Reza , Alam Mostafa , Farzan Avishan , Moslemi Hamidreza , Farzan Ava , Khorsand Ardeshir , Mohammadikhah Meysam , Farzan Ramyar 
Published: August 2024

Background:
The present study aims to determine the effect of Transcutaneous Electrical Nerve Stimulation (TENS) on neuro-sensory disturbance after orthognathic surgery.

Materials and methods:
In a randomized clinical trial, the participants via split-mouth sampling were randomly divided into two intervention (n=27) and control (n=27) groups. In the intervention group, participants received TENS physiotherapy. TENS physiotherapy was performed on the day after surgery, 1, 2, 3, and 4 weeks after surgery, along with prescriptions for the use of painkillers. On the control group, no physical therapy was performed and the patients only used painkillers (immediately after the operation). Paresthesia was evaluated using the 2-point discrimination (TPD) test and the semi-quantitative sensory-neural disorders test called brush stroke 6 months after the surgical procedures. Self-reported sensory-neural disorders were measured and reported for each patient before and 6 months after surgery using the visual analog scale (VAS).

Results:
A total of 54 patients participated in this study. The mean TPD score in the TENS group and the control group 6 months after the operation were 5.76 (SD=0.73) and 6.14 (SD=0.54), respectively (P=0.003). The mean VAS score in the TENS group and the control group 6 months after the operation was 6.48 (SD=0.50) and 5.80 (SD=0.63), respectively (P=0.005). Also, 66.7 and 38.9% in the TENS and control groups, respectively, performed the brush stroke test correctly (P=0.007).

Conclusion:
In sum, the benefits of TENS physiotherapy can be effective in reducing complications such as pain in dental surgery treatments or orthognathic surgeries.
Bacillus cereus infection of the penis: an unusual infection
Authors: Nasrallah Oussama G. , Mahdi Jana H. , Araj George F. , El Sayegh Noura , El Zakhem Aline , Bachir Bassel G. 
Published: August 2024

Background:
Bacillus cereus (B. cereus) is a Gram-positive, rod-shaped, motile organism, found in the environment and may exist in contaminated food sources such as reheated rice, vegetables and may lead to gastrointestinal symptoms after ingestion including diarrhea, nausea, and vomiting due to enterotoxigenic and emetic toxins. Non-gastrointestinal infections of Bacillus cereus have been reported in the literature, which include cutaneous and non-cutaneous infections in immunocompetent and immunocompromised individuals.

Case presentation:
A 38-year-old man presented with a one-week history of penile swelling and redness that started after an episode of severe diarrhea and vomiting, which soiled his genital region few hours after vigorous intercourse with his wife. This has led to infection of the penile skin by an unusual organism: Bacillus (B.) cereus. The patient was treated using fucidic acid ointment applications for 2 weeks achieving complete recovery.

Clinical discussion:
The recovery of B. cereus from the penile infection in our patient reveals the first case of such an unusual infection, though this pathogen has been reported to cause a wide range of non-GI tract infections, which include bacteremia, meningitis, endocarditis, endophthalmitis, pneumonia, and soft tissue diseases. Virulence factors allow this organism to induce diarrhea in addition to having dermonecrotic, cytotoxic, hemolytic properties resulting in a wide range of dermatologic presentations.

Conclusion:
The authors report a unique case of penile skin infection caused by B. cereus, an unusual culprit for an uncommon presentation successfully treated with fucidic acid ointment. This is the first case in literature describing such an entity.
Open versus laparoscopic completion cholecystectomy in patients with previous open partial cholecystectomy: a retrospective comparative study
Authors: Nafea Mohammed A. , Elshafey Mohammed H. , Hegab Ahmed , Seleem Abdelhafez , Rafat Walid , Khairy Mostafa , Elaskary Hany , Mohamed Yumna Mahmoud , Monazea Khaled , Salem Abdoh 
Published: August 2024

Background:
Some patients report recurrence or persistence of their manifestations after cholecystectomy, and retained gallstones may be a relevant etiology for their complaint. Completion cholecystectomy is advised for these cases to alleviate their manifestations. No previous studies have compared the outcomes of open versus laparoscopic outcomes in these patients, especially in patients who had initial open partial procedures. That is why we performed this study to report the perioperative outcomes of the two approaches in such patients.

Methodology:
This is a retrospective analysis of 80 patients who had a completion cholecystectomy in the authors’ center (40 open and 40 laparoscopic cases) after initial open partial cholecystectomy.

Results:
The duration elapsed since the primary procedure had an average of 18 months in the open group and 21 months in the laparoscopic group. Abdominal pain and dyspepsia were the most common presentations. Some patients had stump cholecystitis or jaundice. The intraoperative assessment revealed either the residual gallbladder or a long cystic duct stump. Laparoscopy yielded shorter operative time, earlier oral intake, and shorter hospitalization periods compared to the open approach (P<0.05). The latter was associated with a 20% wound infection rate that was never encountered after laparoscopy (P
=0.003).

Conclusion:
Previous open partial cholecystectomy does not hinder subsequent laparoscopic completion cholecystectomy. Additionally, laparoscopy is associated with better perioperative outcomes than the open approach.
Challenges in diagnosis and management of Langerhans Cell Histiocytosis in a 13-month-old child: a rare case report
Authors: Sedain Gopal , Khanal Kunjan , Pandey Asim , Parajuli Samriddhi , Sherpa Pasang L. , Adhikari Sujan , Thakuri Aruna , Kattel Aashiya 
Published: August 2024

Introduction:
Langerhans Cell Histiocytosis is a rare condition characterized by the proliferation of abnormal Langerhans cells in the skin and mucosa. It is mostly seen in children between 1 and 3 years old. Although the skeleton accounts for 80% of infiltration and the skin accounts for 33%, it can affect other organs as well.

Case presentation:
The authors report a case of a 13-month-old male with fever, rash, and nontender swelling in the frontal, temporal, and infraorbital regions. Imaging showed diffusion restriction in the frontal, left parietal, right sphenoid, right temporal bones, and right maxillary antrum. Biopsy and immunohistochemistry from the right maxilla confirmed the diagnosis. The patient was treated with vinblastine and prednisolone for 3 months, resulting in reduced swelling and no fever on follow-up.

Discussion:
Langerhans Cell Histiocytosis (LCH), formerly Histiocytosis X, has diverse clinical manifestations and is classified as localized or disseminated based on organ involvement. It is associated with viral infections, communication defects, and cytokine processes, with BRAF mutations and the MAPK/ERK pathway implicated. Diagnosis involves clinical, radiological, histological, and immunophenotypic methods, including identifying Birbeck granules in Langerin-positive cells. Treatment varies by disease extent, with vinblastine and prednisolone for children with multisystem disease and tailored approaches for adults.

Conclusion:
Despite atypical presentation, thorough evaluation confirmed Langerhans Cell Histiocytosis in a pediatric patient. This highlights the necessity of considering Langerhans Cell Histiocytosis in differential diagnoses for persistent cutaneous lesions and bony swellings. Prompt detection and timely action are essential for successful treatment and better results.