bluuebunny/crossref_metadata_2025_split huggingface dataset:
WRN Helicase: Is There More to MSI-H than Immunotherapy?
Authors: Wainberg Zev A. 
Published: August 2024

Summary:In this issue, Picco and colleagues provide further evidence that WRN inhibitors are synthetically lethal in microsatellite instability-high (MSI-H) cancers and function by blocking the helicase domain of select WRN residues. They demonstrate that WRN inhibitors may be even more effective in a subset of MSI-high tumors with (TA)n repeat expansions, which represents a possible strategy in clinical development.See related article by Picco et al., p. 1457 (1).
Bajuni – A Language Peninsula
Authors: Nurse Derek , Mahazi Jasmin 
Published: August 2024

Abstract
The article deals with the northern Swahili dialect Bajuni. It is viewed as a language peninsula rather than island, attached to neighbouring and related dialects to the south but jutting north into Somali-speaking areas. It is currently severely endangered, having been largely replaced by Somali in Somalia, and Swahili in Kenya during the late twentieth century, so it is regarded essentially as a historical language peninsula. It is treated under these headings: geography and population; history; political, sociocultural, and economic context; linguistics; regularity/complexity/stability; contact phenomena; sociolinguistics; language use and attitudes; networks.
Clinical Outcomes and Treatment Strategy of Mirizzi’s Syndrome Treated With Surgery
Authors: Sui Xiaojun , Li Ming , Zhang Dapeng 
Published: August 2024

Background There is currently no standardized treatment for Mirizzi’s syndrome (MS). We aim to explore the surgical treatment strategy for MS by analyzing its clinical characteristics and treatment outcomes. Methods This retrospective study analyzed the clinical data of 130 patients with MS who underwent surgery at our hospital from April 2013 to April 2020. Results The study population comprised 130 patients with MS, with an approximately balanced sex ratio and a median age of 58.5 years. The preoperative diagnostic rate was 82.3%. The diagnostic accuracy of ERCP was 92.5%, higher than that of MRCP and ultrasound. All patients underwent surgical treatment, with 74 cases of laparoscopic surgery, 43 cases of laparotomy, and 13 cases of laparoscopic surgery converted to laparotomy. A total of 23 patients experienced short-term and long-term complications after surgery, with a complication rate of 17.7%. There was no statistical difference between laparoscopic surgery and open surgery in terms of intraoperative hemorrhage, operative time, and postoperative complication rate. However, the length of hospital stay was shorter in the laparoscopic surgery compared to the open surgery, which was statistically different from each other. Conclusion ERCP is the gold standard for the diagnosis of MS, especially for identifying the type of MS. ERCP plays an important role in both the preoperative and postoperative phases of MS. Our study demonstrated that laparoscopic surgery was a safe and feasible option for MS treatment, even requires less hospitalization than open surgery.
Effect of cadmium sulfide spheres on structural, mechanical, and optical properties of polyvinyl butyral/cadmium sulfide nanocomposite films
Authors: Alziyadi Mohammed O , Alkabsh Asma , Amal M Said Basmat , Shalaby Mustafa S. 
Published: August 2024

Herein, cadmium sulfide (CdS) nanospheres were synthesized using the hydrothermal method and then inserted into a polyvinyl butyral (PVB) matrix at different concentrations (0%, 2%, and 4% wt.) using the solution casting method. This work examines the effects of varying percentages of CdS spheres on the structural characteristics, mechanical properties, surface/volume energy loss functions, dielectric constants, and linear/non-linear optical properties of PVB nanocomposite films. The findings confirmed the successful synthesis of sphere-like CdS with a cubic structural phase. The stress-strain curves of PVB and its composites with nano CdS spheres were examined. The PVB has a direct/indirect energy gap of 5.1 eV (4.1 eV). With a CdS doping level of 2% and 4%, the values correspondingly decreased to 4.76 eV (3.36 eV) and 4.49 eV (2.45 eV). The EU values for PVB, PVB-2 wt.% CdS, and PVB-4 wt.% CdS nanocomposite are 15.3, 11.2, and 14.1 meV, respectively. CdS nanospheres decreased the volume and surface energy losses (VELF & SELF) of PVB films. The research demonstrates that the mechanical properties and optical parameters of PVB/CdS nanocomposite films positively correlate with the concentration of CdS nanospheres. These attributes make them well-suited for incorporation into flexible electronic devices.
HPV self-sampling in organized cervical cancer screening program: A randomized pilot study in Estonia in 2021
Authors: Hallik Reeli , Innos Kaire , Jänes Jaak , Jõers Kai , Ratnik Kaspar , Veerus Piret 
Published: August 2024

Background Cervical cancer incidence in Estonia ranks among the highest in Europe, but screening attendance has remained low. This randomized study aimed to evaluate the impact of opt-in and opt-out human papillomavirus (HPV) self-sampling options on participation in organized screening. Methods A random sample of 25,591 women were drawn from the cervical cancer screening target population who were due to receive a reminder in autumn 2021 and thereafter randomly allocated to two equally sized intervention arms (opt-out and opt-in) receiving a choice between HPV self-sampling or clinician sampling. In the opt-out arm, a self-sampler was sent to home address by regular mail; the opt-in arm received an e-mail containing a link to order a self-sampler online. The remaining 30,102 women in the control group received a standard reminder for conventional screening. Participation by intervention arm, age and region of residence was calculated; a questionnaire was used to assess self-sampling user experience. Results A significant difference in participation was seen between opt-out (41.7%) (19.8% chose self-sampling and 21.9% clinician sampling), opt-in (34.1%) (7.9% self-sampling, 26.2% clinician sampling) and control group (29.0%, clinician sampling only). All age groups and regions in the intervention arms showed higher participation compared to the control group, but the size of the effect varied. Among self-sampling users, 99% agreed that the device was easy to use and only 3.5% preferred future testing at the clinic. Conclusion Providing women with a choice between self-sampling and clinician sampling significantly increased participation in cervical cancer screening. Opt-in and opt-out options had a different effect across age groups, suggesting the need to adapt strategies.
A comprehensive study of adverse effects of chemotherapy on female breast cancer patients in NORI Cancer Hospital, Islamabad in a developing country
Authors: Abid Areesha , Saeed Humza , Iftikhar Uswa , Arshad Muhammad Khubaib , Shahid Muhammad Uzair , Rasool Tayyab , Fazal Faizan , Goyal Aman , Akbar Anum 
Published: August 2024

Introduction Breast cancer is one of the top three malignancies worldwide. While radiotherapy, hormone replacement therapys, and chemotherapy are treatments, chemotherapy causes adverse effects that hinder daily life activities. Objectives To assess the prevalence, severity, and association of symptomatic toxicities in female breast cancer patients affecting various organ systems post systemic chemotherapy (adjuvant and neoadjuvant), and their impact on daily activities. Additionally, to determine the severity of adverse effects in specific age groups and their association with family history and disease stage. Methodology An observational study was conducted on 253 female breast cancer patients receiving chemotherapy at NORI Cancer Hospital from May to October 2023. Data collection tools included the NCI-PRO-CTCAE standardized questionnaire and patient medical records. Analysis was performed using descriptive statistics, T-tests, and Chi-square tests. Results Among the 253 patients, 41.4% were aged 41–50. Significant weight changes ( p = 0.034) were observed with more than three chemotherapy cycles. Notable associations included increased chemotherapy cycles with gastrointestinal (mouth/throat sores p = 0.031, vomiting p = 0.021), respiratory (cough p = 0.04), cardiovascular (arm/leg swelling p = 0.007, palpitations p = 0.052), integumentary (hair loss p = 0.000, skin dryness p = 0.054), and musculoskeletal (fatigue p = 0.002) adverse effects. Positive family history and the 18–30 age group also showed significant associations with adverse effect severity. Disease stage significantly influenced the nervous system (stage 2 p = 0.007, stage 3 p = 0.01). Conclusion The severity of adverse effects varies among age groups, depending on disease stage, genetics, and treatment duration. These patient-reported outcomes highlight the need for better management strategies considering prognostic factors and treatment adverse effects.
Safety outcomes of teclistamab accelerated dose escalation
Authors: Kawasaki Yumena , Steele Aaron Paul , Rosenberg Aaron , Guglielmo Julie 
Published: August 2024

Introduction Teclistamab, a bispecific T-cell engaging antibody targeting B-cell maturation antigen (BCMA), is indicated for the treatment of relapsed or refractory multiple myeloma after at least four lines of therapy. It has boxed warnings for life threatening cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). To mitigate these risks, teclistamab is initiated using step-up doses. This article examines safety event rates following the implementation of a 2-day separation between step-up doses at one institution to streamline patient care. Methods This was a retrospective, single-center study encompassing all patients who received teclistamab within a 1-year period. The primary endpoint was the overall incidence of CRS and ICANS. Secondary endpoints included hospital length of stay, hematological toxicities, infection rates, among other adverse events. Results A total of 27 patients were included in the analysis and stratified into accelerated (days 1,3,5) or standard (days 1,4,7) dosing groups. CRS occurred in 48% (11) of patients for the accelerated dosing and 50% (2) for the standard dosing group. ICANS was seen in 17% (4) of patients in the accelerated dosing group and none in the standard dosing group. Average length of stay in the accelerated dose was 7.6 days versus 9.2 days in the standard dose group. Conclusion Accelerated dose escalation of teclistamab yielded safety event rates comparable to those in the literature. These findings may support outpatient administration for teclistamab. Accelerated dose escalation strategy allowed for the optimization of hospitalization and resources.
Pembrolizumab related perforated appendicitis
Authors: Kiracı Murat , Akturk Esen Selin , Turkay Duriye Ozer , Kos Fahriye Tugba 
Published: August 2024

Introduction Pembrolizumab is a humanized monoclonal antibody IgG4 programmed cell death protein 1 antagonist, and its use in oncology has been increasing in recent years, providing durable and favorable responses and tolerable toxicity profiles in various types of cancer. We describe a case of pembrolizumab related perforated appendicitis in a patient with stage 3C malignant melanoma (MM). Case report A 70-year-old male patient who had no known disease was diagnosed with MM as a result of the excision of the mass on his right shoulder. The disease stage was stage 3C (pT4aN1bM0). Subsequently, adjuvant pembrolizumab treatment was started. A few days after the fourth maintenance course, he presented to the emergency department complaining of abdominal pain, nausea and vomiting. Emergency abdominal tomography showed a significant increase in the diameter of the appendix vermiformis, peritoneal thickening and appendiceal wall defects that could be significant in terms of perforation. Management and outcome The mentioned finding and given the clinical presentation, was attributed to a perporating of the appendix, so the patient was hospitalized in the Department of Surgery and the patient underwent emergency appendectomy. Histological findings were consistent with appendicitis. After a day in the hospital, the abdominal pain subsided, C-reactive protein tended to decrease and the patient was discharged. Discussion In patients who develop acute abdominal pain with or without diarrhea during immunotherapy, urgent imaging, endoscopic and clinical evaluation should be performed, and bowel perforation, although rare, should be considered as a potential complication of any immunotherapy.
A randomised study comparing performance and safety of Eyestil Plus® vs Vismed Multi® in moderate-to-severe dry eye syndrome patients
Authors: Pisella PJ , Gain P , Cochener B , Baillif S , Kodjikian L , Creuzot-Garcher C , Touboul D , Gonzalvez M , Gabisson P , El Amali S , Galarreta D , Merayo Lloves J , Cano-Ortiz A , Ruiz Mesa R , Civiale C , Mazzone MG , Montero J 
Published: August 2024

Purpose This clinical investigation compared the performance and safety of Eyestil Plus® (SIFI) and Vismed Multi® (TRB Chemedica) for reducing keratitis lesions in moderate-to-severe dry eye disease (DED) patients. Materials and methods This was a randomised, double-blind, multicentre investigation. 96 adults (>18 years of age) with moderate-to-severe DED received Eyestil Plus® ( N = 48) or Vismed Multi® ( n = 48) 6 times daily for 3 months. The primary objective clinical performance after 1 month as global corneal and conjunctival staining scores. The secondary objectives were clinical performance after 3 months, tear film stability (tear break up time (TBUT), tear production (Schirmer test), patient-reported outcomes (PROs), investigator satisfaction, and safety. Results 96 participants were randomised to receive the clinical investigations’ treatments, 82.3% of them were female and their mean age was 65.8 years. The non-inferiority of Eyestil Plus® for moderate-to-severe DED was demonstrated at 1 month. No statistical difference was found for any of the study's objectives: change at 1 and 3 months of the global corneal and conjunctival staining score ( p-value = 0.506 and 0.661, respectively), change at 1 and 3 months ( p-value = 0.538 and 0.302) for TBUT test; change at 3 months for Schirmer test ( p-value = 0.540). There were no changes for PROs either. Investigator satisfaction was high for both products. 16.6% of the participants experienced adverse events. Conclusion This clinical investigation showed the non-inferiority of Eyestil Plus® compared to Vismed Multi® regarding performance and safety in a moderate-to-severe DED population.
“Long-term safety and efficacy of injection mitomycin C(MMC) versus sponge application in trabeculectomies”
Authors: Maheshwari Devendra , Pillai Madhavi Ramanatha , HM Priya , Kader Mohideen Abdul , Rengappa Ramakrishnan , Pawar Neelam 
Published: August 2024

Aims To compare the long-term safety and efficacy of subconjunctival injection mitomycin C(MMC) with conventional sponge applied MMC during trabeculectomy. Methods and Material Retrospective analysis of 98 eyes of 90 patients who underwent trabeculectomy with Mitomycin C were divided into two groups, group 1- sponge (n = 52) and group 2- Injection(n = 46). Follow-up data were collected on day one, day 15, one month, three months, six months, one year, two years and three years. Data from baseline and follow-up visits were analyzed and compared to study the significant difference in intraocular pressure (IOP), number of antiglaucoma medications (AGM) and best corrected visual acuity (BCVA) . P-value of <0.05 was considered statistically significant. Results Mean preop IOP was 34.61 ± 13.3 mmHg in group one and 33.07 ± 9.6 mmHg in group two, which reduced to 11.43 ± 3.2 and 11.59 ± 3.2 mmHg at three years ( p < 0.001 in both groups) with no significant difference between the groups. Mean number of preoperative AGM was 2.28 ± 0.8 and 2.42 ± 0.7 in group one and two respectively which reduced to 1.19 ± 1.1( p = 0.405) and 0.88 ± 0.9( p = 0.001) at three years. Complete and overall success rates (complete + qualified) were 59.3% and 78.9% in group one and 60.9% and 80.4% in group two at three years. No statistically significant difference was found in complication rates, post-operative interventions, and final visual outcome in both groups. Conclusions Subconjunctival Injection MMC was a safe and effective alternative to sponge application with comparable long term surgical outcomes.
Health outcomes of telemonitoring of patients with type-2 diabetes mellitus: One-year results from a randomized controlled trial (Optimizing care of Patients via Telemedicine In Monitoring and aUgmenting their control of diabetes Mellitus)
Authors: Lee Cia S , Tyagi Shilpa , Ling Koh Eileen Y , Gong Pei P , Ang Seng B , Gerald Koh Choon H , Tan Ngiap C 
Published: August 2024

Introduction Telehealth increases care accessibility to patients with type-2 diabetes mellitus but the duration of its implementation to sustain optimal glycaemic control remains unclear. This study aimed to assess the health outcomes of these patients using the Optimizing care of Patients via Telemedicine In Monitoring and aUgmenting their control of diabetes Mellitus (OPTIMUM) home tele-monitoring (HTM) system 6 months post-intervention, compared to standard care. Methods An open-labelled randomized controlled trial involving 330 participants with type-2 diabetes mellitus, aged 26–65 years, and suboptimal glycaemic control (HbA1c = 7.5%–10%) was conducted. Intervention group received OPTIMUM HTM for 6 months followed by usual care for another 6 months, while control group received usual care for 12 months. OPTIMUM HTM includes in-app video-based tele-education, tele-monitoring of the blood pressure, capillary glucose and weight via Bluetooth devices and mobile applications, followed by algorithm-based tele-management by the OPTIMUM HTM team. Assessments using self-care inventory scale and medication adherence were administered for both groups at baseline, 6-month, and 12-month timepoints. Results Complete data from 156 (intervention) and 159 (control) participants, with comparable demographic profiles, were analysed. Both groups showed a significant reduction in HbA1c from baseline ( p < 0.001). From 6-month to 12-month time-points, the intervention group was twice as likely to maintain their HbA1c ≤ 8% (adjusted odds ratio = 2.02, 95%CI = 1.18–3.49; p < 0.011). The intervention group demonstrated higher scores for self-care behaviours (adjusted odds ratio = 3.83 [95%CI = 1.68–5.97], p = 0.001) and not skipping medications (adjusted odds ratio = 2.32 [95%CI = 1.09–4.97], p = 0.030) at 12 months. Discussion The OPTIMUM HTM system enabled patients to maintain their glycaemic control beyond the intervention period. The favourable outcomes could be the effect of telehealth in sustaining self-care behaviour and medication adherence.
Revision total elbow arthroplasty is associated with a high rate of 30-day complications: A descriptive analysis of a national database
Authors: El-Najjar Dany , Mehta Apoorva , Gupta Puneet , Peterson Joel R , Marigi Erick M , Rogalski Brandon , Trofa David P , Levine William N , Jobin Charles M 
Published: August 2024

Introduction Revision total elbow arthroplasty (TEA) is indicated for component loosening, periprosthetic joint infection, and fractures. Previous investigations into revision TEA complications have small sample sizes and limited exploration of acute complications. This study aims to characterize the 30-day complications and associated demographics of patients undergoing revision TEA using a large national database. Methods The 2015–2020 American College of Surgeons National Surgical Quality Improvement Program database was used to identify all revision TEA patients. Results The analysis included 158 patients (average age 62.6 years). The overall complication rate was 13.9% ( n = 22). The most common 30-day complications were organ/space surgical site infection (3.8%, n = 6), unplanned readmission (3.2%, n = 5), intraoperative or postoperative transfusion (3.2%, n = 5), and unplanned reoperation (1.9%, n = 3). Patients with a history of dyspnea or steroid/immunosuppressant use for a chronic condition had significantly higher rates of bleeding requiring transfusion ( p = .029 and p = .021, respectively). Additionally, patients aged 80 years or older had a significantly higher rate of unplanned readmission ( p = .032). Conclusion Revision TEA has a 13.9% rate of complications within 30-days of surgery, with most involving surgical site infection, unplanned readmission, and blood transfusion. Level of Evidence IV.
Evaluation of multiple deep neural networks for detection of intracranial dural arteriovenous fistula on susceptibility weighted angiography imaging
Authors: Sivan Sulaja Jithin , Kannath Santhosh K , Kalaparti Sri Venkata Ganesh Viswanadh , Thomas Bejoy 
Published: August 2024

Background The natural history of intracranial dural arteriovenous fistula (DAVF) is variable and early diagnosis is crucial in order to positively impact the clinical course of aggressive DAVF. Artificial intelligence (AI) based techniques can be promising in this regard, and in this study, we used various deep neural network (DNN) architectures to determine whether DAVF could be reliably identified on susceptibility-weighted angiography images (SWAN). Materials and Methods A total of 3965 SWAN image slices from 30 digital subtraction angiographically proven DAVF patients and 4380 SWAN image slices from 40 age-matched patients with normal MRI findings as control group were included. The images were categorized as either DAVF or normal and the data was trained using various DNN such as VGG-16, EfficientNet-B0, and ResNet-50. Results Various DNN architectures showed the accuracy of 95.96% (VGG-16), 91.75% (EfficientNet-B0), and 86.23% (ResNet-50) on the SWAN image dataset. ROC analysis yielded an area under the curve of 0.796 ( p < .001), best for VGG-16 model. Criterion of seven consecutive positive slices for DAVF diagnosis yielded a sensitivity of 74.68% with a specificity of 69.15%, while setting eight slices improved the sensitivity to above 80.38%, with a decrease of specificity up to 56.38%. Based on seven consecutive positive slices criteria, EfficientNet-B0 yielded a sensitivity of 73.21% with a specificity of 45.92% and ResNet-50 yielded a sensitivity of 72.39% with a specificity of 67.42%. Conclusion This study shows that DNN can extract discriminative features of SWAN for the classification of DAVF from normal with good accuracy, reasonably good sensitivity and specificity.