bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigation and Management of Recurrent Pregnancy Loss: A Comprehensive Review of Guidelines
Authors: Giouleka Sonia , Tsakiridis Ioannis , Arsenaki Elisavet , Kalogiannidis Ioannis , Mamopoulos Apostolos , Papanikolaou Evangelos , Athanasiadis Apostolos , Dagklis Themistoklis 
Published: July 2024

Importance:
Recurrent pregnancy loss (RPL) is one of the most frustrating clinical entities in reproductive medicine requiring not only diagnostic investigation and therapeutic intervention, but also evaluation of the risk for recurrence.

Objective:
The aim of this study was to review and compare the most recently published major guidelines on investigation and management of RPL.

Evidence Acquisition:
A descriptive review of guidelines from the Royal College of Obstetricians and Gynaecologists, the European Society of Human Reproduction and Embryology, the American Society for Reproductive Medicine, the French College of Gynecologists and Obstetricians, and the German, Austrian, and Swiss Society of Gynecology and Obstetrics on RPL was carried out.

Results:
There is consensus among the reviewed guidelines that the mainstays of RPL investigation are a detailed personal history and screening for antiphospholipid syndrome and anatomical abnormalities of the uterus. In contrast, inherited thrombophilias, vaginal infections, and immunological and male factors of infertility are not recommended as part of a routine RPL investigation. Several differences exist regarding the necessity of the cytogenetic analysis of the products of conception, parental peripheral blood karyotyping, ovarian reserve testing, screening for thyroid disorders, diabetes or hyperhomocysteinemia, measurement of prolactin levels, and performing endometrial biopsy. Regarding the management of RPL, low-dose aspirin plus heparin is indicated for the treatment of antiphospholipid syndrome and levothyroxine for overt hypothyroidism. Genetic counseling is required in case of abnormal parental karyotype. The Royal College of Obstetricians and Gynaecologists, the European Society of Human Reproduction and Embryology, and the French College of Gynecologists and Obstetricians guidelines provide recommendations that are similar on the management of cervical insufficiency based on the previous reproductive history. However, there is no common pathway regarding the management of subclinical hypothyroidism and the surgical repair of congenital and acquired uterine anomalies. Use of heparin for inherited thrombophilias and immunotherapy and anticoagulants for unexplained RPL are not recommended, although progesterone supplementation is suggested by the American Society for Reproductive Medicine and the German, Austrian, and Swiss Society of Gynecology and Obstetrics.

Conclusions:
Recurrent pregnancy loss is a devastating condition for couples. Thus, it seems of paramount importance to develop consistent international practice protocols for cost-effective investigation and management of this early pregnancy complication, with the aim to improve live birth rates.
Individualized medication of venetoclax based on therapeutic drug monitoring in Chinese acute myeloid leukemia patients using an HPLC method
Authors: Tang Yue , Rao Peng , Li Shuojiao , Yu Wenxian , Wang Ranran , Liu Jiatao 
Published: July 2024

Objective
The aim of this study was to establish a simple and sensitive high-performance liquid chromatography method for therapeutic drug monitoring of venetoclax (VEN) and optimize regimens.

Methods
The analysis required the extraction of a 50 μl plasma sample and the precipitation of proteins using acetonitrile extraction. The chromatographic method employed a mobile phase of acetonitrile: 0.5% KH2PO4 (pH 3.5) (60/40, v/v) on a Diamond C18 (4.6 mm × 250 mm, 5 μm) column at a flow rate of 1.0 ml/min. The quantitative method was validated based on standards described in ‘Bioanalytical Method Validation: Guidance for Industry’ published by the US Food and Drug Administration (FDA).

Results
The calibration curve was linear (R
2 = 0.9998) over the range of 75–4800 ng/ml, with limits of quantification of 25 ng/ml. The coefficients of intraday and interday validation, specificity, recovery, and stability all met the criteria of FDA guidance. The method was successfully applied to analyze VEN concentrations in 30 cases of acute myeloid leukemia patients. The peak concentration (C
max) was 1881.19 ± 756.61 ng/ml, while the trough concentration (C
min) was 1212.69 ± 767.92 ng/ml in acute myeloid leukemia patients.

Conclusion
Our study establishes a simple, precise, and sensitive high-performance liquid chromatography method for monitoring VEN and confirms its applicability for therapeutic drug monitoring of VEN in hematological cancers.
Accuracy of Medical Oncology Prognosis for Metastatic Cancer Patients Evaluated for Enrollment Onto an Ongoing Randomized Clinical Trial
Authors: McClelland Shearwood 
Published: July 2024

Objectives:
For patients with metastatic cancer, a key aspect of interdisciplinary care has involved the overall prognosis provided by Medical Oncology. This study represents prospective evaluation of Medical Oncology prognosis accuracy for patients considered for enrollment onto an ongoing randomized controlled trial.

Methods:
The Spine Patient Optimal Radiosurgery Treatment for Symptomatic Metastatic Neoplasms (SPORTSMEN) phase 2 randomized clinical trial examines optimal radiation therapy treatment of symptomatic spinal metastases with a primary end point of pain freedom at 3 months post-treatment. A key eligibility criterion for trial enrollment is overall prognosis exceeding 3 months, typically provided by Medical Oncology. During the first year of trial enrollment, Medical Oncology prognosis for patients considered for SPORTSMEN inclusion was prospectively assessed for accuracy.

Results:
Twenty-seven patients with documented Medical Oncology prognosis were considered for SPORTSMEN enrollment. The prognosis administered by Medical Oncology exceeded 3 months in 26 patients, and <3 months in 1 patient. The overall accuracy of Medical Oncology prognosis was correct for 15 of 27 patients (56%), significantly worse for inpatients than outpatients (P=0.0381).

Conclusions:
In patients with metastatic spine disease, the estimated prognosis provided by Medical Oncology is often optimistic, as nearly half of patients assigned a prognosis of >3 months failed to reach this threshold before experiencing death or hospice. These findings indicate that a more heuristic approach to assessing patient prognosis may be necessary to avoid unwarranted prognostic optimism, particularly for inpatients. Such an approach could potentially provide a more compassionate and cost-effective management of these patients’ remaining lifespan thereby optimizing quality of life.
Development and Validation of the Oxford Skin Cancer Treatment Scale, a Patient-Reported Outcome Measure for Health-Related Quality of Life and Treatment Satisfaction After Skin Cancer Treatment
Authors: Kantor Jonathan , Aasi Sumaira Z. , Alam Murad , Paoli John , Ratner Désirée 
Published: July 2024

BACKGROUND
Patient-reported outcome measures (PROMs) are necessary to assess the value of skin cancer treatment and to better compare therapeutic options.

OBJECTIVE
To develop and validate the Oxford Skin Cancer Treatment (OxSCanTr) scale, evaluating health-related quality of life and satisfaction after skin cancer treatment.

MATERIALS AND METHODS
After qualitative patient interviews, international expert consultation, and item reduction, 2 separate patient samples were used to assess the factor structure of the scale. Exploratory factor analysis with categorical variables and a polychoric correlation matrix followed by promax oblique rotation was performed to establish a factor structure on Group A. Confirmatory factor analysis with a Satorra–Bentler scaled test statistic evaluating the root mean squared error of approximation (RMSEA), standardized root mean squared residual (SRMR), and comparative fit index (CFI) was conducted on Group B. Reliability as internal consistency was assessed using McDonald omega. Convergent and discriminant validity were assessed using the Pearson correlation coefficient.

RESULTS
A total of 480 subjects returned completed surveys (completion rate 96%). A 12-item scale was developed encompassing 4 domains: aesthetic satisfaction, treatment choice satisfaction, treatment experience, and future concerns regarding recurrence/spread. Confirmatory factor analysis showed excellent goodness-of-fit characteristics, with RMSEA = 0.048, SRMR = 0.051, and CFI = 0.962 using the 4-factor model. Reliability was very good (McDonald omega 0.81–0.82), as was convergent validity with the FACE-Q skin cancer module appraisal of scars subscale (r = 0.55). Discriminant validity with a single question regarding being conservative was similarly excellent (r = −0.02).

CONCLUSION
The OxSCanTr scale is a parsimonious, feasible, and valid PROM for the holistic assessment of the experience of patients who have undergone skin cancer treatment.
Efficacy of 0.25% Lidocaine Versus 0.5% Lidocaine in Dermatologic Surgery: A Double-Blind, Randomized Controlled Trial
Authors: Dokic Yelena , Mireles Nabor Stephen , Hu Aileen Y. , Joshi Tejas P. , Shimizu Ikue , Ranario Jennifer Song 
Published: July 2024

BACKGROUND
Although lidocaine is widely used in dermatologic surgery, no formal standard concentration is established. Previous research indicates that more dilute concentrations may offer equally effective anesthesia while potentially reducing toxicity risks. In addition, diluting commercially available lidocaine conserves supplies—a significant benefit during periods of lidocaine shortage.

OBJECTIVE
To evaluate the efficacy of 0.25% lidocaine compared with that of 0.5% lidocaine in achieving anesthesia in cutaneous surgery.

MATERIALS AND METHODS
A prospective, double-blind study with 100 patients undergoing cutaneous surgery (Mohs surgery or excision) randomized to receive either 0.25% or 0.5% lidocaine for their percutaneous anesthesia. Patients completed a postoperative survey assessing pain level, satisfaction, and willingness to undergo future dermatologic surgery.

RESULTS
This study revealed no statistically significant differences between the 0.25% and 0.5% lidocaine groups regarding pain scores, patient satisfaction, total lidocaine volume, rescue lidocaine volume, or willingness to undergo the procedure again.

CONCLUSION
0.25% lidocaine is a safe and effective option for achieving anesthesia during Mohs surgery and standard excisions. The results suggest that 0.25% lidocaine can be used to optimize high-value care and enhance patient safety in dermatologic surgery.
Gonioscopy-Assisted Transluminal Trabeculotomy in Angle Recession Glaucoma
Authors: Elubous Khaled A. , Saheb Hady 
Published: July 2024

This case report outlines the successful management of angle recession (AR) with gonioscopy-assisted transluminal trabeculotomy (GATT). A 53-year-old man with a history of blunt trauma to the left eye resulting in AR presented with an IOP of 38 mm Hg on 4 antiglaucoma agents. After GATT, a notable reduction in IOP to 10 mm Hg was observed on the first postoperative day. Subsequent 1-year follow-up visits demonstrated sustained improvement, with IOP stabilizing at 18 mm Hg without the need for antiglaucoma medication. This is the first case report that demonstrates the role of GATT in the management of AR.
Occlusion of Xen Gel Stent With Descemet’s Membrane Relieved by Nd:YAG Laser
Authors: Strong Caldwell Anne , Gill Zafar S. , St. Peter Deidre M. 
Published: July 2024

Abstract:
The Xen gel stent is a minimally invasive glaucoma surgical implant designed to decrease intraocular pressure (IOP) by creating an aqueous outflow path into the subconjunctival space. Since FDA approval, it has demonstrated good safety and efficacy data; however, there are multiple reports of Xen stent occlusions with debris from the anterior chamber. Herein, we report a case of a Descemet’s membrane Xen stent occlusion in a 67-year-old woman with a past medical history of primary open angle glaucoma who underwent Xen stent placement through the ab externo approach. Her Descemet’s membrane occlusion was successfully managed by Nd:YAG laser lysis. Although uncommon, small Descemet’s tears or flaps can occlude the ostia of Xen stents causing elevated IOP or bleb failure. Few reports have described the use of Nd:YAG laser to successfully treat ostium occlusion of any kind with the Xen stent. We discuss the importance of early Nd:YAG laser to relieve Descemet’s membrane occlusions, lower IOP, and rescue the bleb from failure.
Keratoacanthoma
Authors: Nicpon Jennifer 
Published: July 2024

ABSTRACTKeratoacanthomas (KAs) are a type of skin tumor that rapidly grow (Bosch-Amate et al., 2022). A form of KAs was first identified in 1889 (Jeon et al., 2011). These types of lesions can be challenging to differentiate from cutaneous squamous cell skin carcinoma both through histopathology and clinically (Higgins et al., 2015; Ko et al., 2012; Mei et al., 2022). Adding to the complexity, there are no current evidence-based guidelines for treatment of KAs. Although KAs can be self-resolving, the persistence and growth of the KA is unpredictable (Bettoli et al., 2023; Ko et al., 2012). Treatment of KAs with surgical excision or Mohs are typically considered first line due to the possibility of misdiagnosis and invasion into local tissue (Ambur et al., 2022). Dependent upon the location and size of the KA, comorbidities, patient preference, and other considerations, surgical treatment may not be the most ideal treatment (Kiss et al., 2019). There are many nonsurgical options including intralesional injections of methotrexate, fluorouracil, corticosteroid, bleomycin, or interferon alpha (Kiss et al., 2019). Ionizing radiation, systemic agents, destructive therapy, topical imiquimod, and topical fluorouracil are also possibilities for treatment of KAs (Ambur et al., 2022). Even though conditions of KAs were first identified over 100 years ago, more research is needed to be able to accurately diagnose and appropriately treat KAs (Tisack et al., 2021).
Pembrolizumab in combination with LEnvatinib in participants with hepatocellular carcinoma before liver transplant as Neoadjuvant TherapY—PLENTY pilot study
Authors: Lv Zicheng , Xiang Xuelin , Yong June-kong , Zhou Yi , Wu Yichi , Li Linman , Wang Yuanhao , Zhang Zijie , Xia Qiang , Feng Hao 
Published: July 2024

Background:
The high recurrent rate after liver transplantation (LT) remains a clinical challenge, especially for those exceeding the Milan criteria (MC) and with high RETREAT scores. Therefore, the authors aim to investigate whether neoadjuvant systemic therapy allows safely administered and effectively reduces post-LT recurrence for those patients.

Methods:
In this prospective, randomized, open-label, pilot study, patients with HCC exceeding the MC were randomly assigned to PLENTY or control group before LT. The primary endpoint of the study was the recurrence-free survival after LT.

Results:
Twenty-two patients were enrolled and randomly assigned: 11 to the PLENTY group and 11 to the control group. The 30-month tumor-specific RFS was 37.5% in the PLENTY group and 12.5% in the control group. The 12-month tumor-specific RFS after LT was significantly improved in the PLENTY group (87.5%) compared to the control group (37.5%) (P=0·0022). The objective response rate in the PLENTY group was 30 and 60% when determined by RECIST 1.1 and mRECIST, respectively. Six patients (60%) had significant tumor necrosis, including three (30%) who had complete tumor necrosis at histopathology. No acute allograft rejection after LT occurred in the PLENTY and Control group.

Conclusion:
Neoadjuvant pembrolizumab plus lenvatinib before LT appears to be safe and feasible, associated with significantly better RFS for patients exceeding the MC. Despite the limitations of small sample size, this is the first RCT to evaluate neoadjuvant PD-1 blockade combined with tyrosine kinase inhibitors in LT recipients, the results of this study will inform future research.
Antibiotic use attenuates response to immune checkpoint blockade in urothelial carcinoma via inhibiting CD74-MIF/COPA: revealing cross-talk between anti-bacterial immunity and ant-itumor immunity
Authors: Song Yuxuan , Peng Yun , Qin Caipeng , Jiang Shan , Lin Jiaxing , Lai Shicong , Wu Jilin , Ding Mengting , Du Yiqing , Yu Luping , Xu Tao 
Published: July 2024

Background:
Immune checkpoint blockade (ICB) has emerged as a promising therapy for both resectable urothelial carcinoma (UC) patients preparing for radical surgery and unresectable UC patients, whereas the objective response rate of ICB remains unsatisfactory due to various factors. Antibiotic (ATB) use can influence intratumoral bacteria, which may further reduce ICB efficacy. The study aims to evaluate the effects of ATB use on prognosis and response in UC patients undergoing ICB, and explore potential molecular mechanisms of ATBs and intratumoral bacteria impacting UC immune microenvironment.

Materials and Methods:
Pooled analyses, synthesizing evidence from 3496 UC patients with ICB treatment, were conducted. In addition, single-cell RNA and single-cell microbiome data were analyzed based on eight UC samples and 63 185 single cells. Bulk RNA sequencing and clinical data from a single-arm, multicenter, atezolizumab-treated, phase 2 trial, IMvigor210, were used for validation.

Results:
ATB use exhibited worse overall survival (HR=1.46, 95% CI=[1.20–1.77], P<0.001 and lower objective response (OR=0.43, 95% CI=[0.27–0.68], P<0.001 in UC patients receiving ICB. Single-cell transcriptome and single-cell microbiome analyses identified the presence of intratumoral bacteria was obviously related to elevated antibacterial immune functions; and antibacterial immunity was positively correlated to antitumor immunity in UC immune microenvironment. Intratumoral bacteria could up-regulate CD74-MIF/COPA signaling of immune cells and activation of CD74-MIF/COPA mediated the promotion of T cell antitumor function induced by antibacterial immune cells. UC patients with higher CD74-MIF/COPA signaling carried better overall survival (HR=1.60, 95% CI=[1.19–2.15], P=0.002) in immunotherapy cohort.

Conclusion:
ATB use reduces overall survival and objective response to ICB in UC patients. Antibacterial immune cell functions induced by intracellular bacteria in the UC microenvironment might up-regulate the function of antitumor T immune cells via activating CD74-MIF/COPA, whereas ATB could inhibit the above process through killing intracellular bacteria and result in poorer clinical benefit of ICB. The use of ATB should be considered carefully during the neoadjuvant immunotherapy period for resectable UC patients preparing for radical surgery and during the immunotherapy period for unresectable UC patients.
Utilizing bifurcated allogeneic vein grafts: a novel approach for preventing sinistral portal hypertension following pancreaticoduodenectomy. A 10-year before and after study
Authors: Wang Jing , Lyu Shao-cheng , Cui Song-ping , Huang Jin-can , Wang Han-xuan , Hu Bin , He Qiang , Lang Ren 
Published: July 2024

Background:
Sinistral portal hypertension (SPH) may occur in patients with pancreatic carcinoma after pancreaticoduodenectomy (PD) with spleno-mesenterico-portal (S-M-P) confluence resection. This study aimed to evaluate outcomes with bifurcated allogeneic vein replacement in the prevention of SPH in pancreatic carcinoma patients.

Materials and methods:
A total of 81 patients were included. The authors retrospectively collected clinicopathological data from 66 patients underwent PD with S-M-P confluence resection in our hospital from January 2011 to December 2021, compared the correlation between different venous reconstruction methods using log-rank tests and clinical outcomes through univariate and multivariate analyses. Secondly, the authors prospectively collected clinical data and outcomes of 15 patients who underwent splenic vein reconstruction from January 2021 to January 2023.

Results:
In the retrospective study, 43 cases received reconstruction by bifurcated allogeneic vein (Reconstruction group) and 23 cases received simply SV ligation (Ligation group). The preoperative platelet counts and spleen volume were similar between two groups (P>0.05). Nevertheless, at 1 month, 3 months and 6 months after operation, the related indexes of SPH such as platelet count, spleen volume, spleen volume ratio and esophagogastric varices (EGV) grade in Reconstruction group were better than those in Ligation group (P<0.05). 6 months after surgery, the incidence of SPH in Ligation group was significantly higher than in Reconstruction group (36.4% vs. 8.1%, respectively). In the prospective study, the incidence of SPH in patients undergoing SV reconstruction was 6.7% (1/15).

Conclusions:
Without compromising surgical outcomes, reconstruction of the S-M-P confluence by bifurcated allogeneic vein is a better method to avoid SPH in patients with advanced pancreatic carcinoma.
Prediction of portal venous pressure in living donor liver transplantation: A retrospective study
Authors: Kurihara Takeshi , Itoh Shinji , Toshima Takeo , Toshida Katsuya , Tomiyama Takahiro , Kosai Yukiko , Tomino Takahiro , Yoshiya Shohei , Nagao Yoshihiro , Morita Kazutoyo , Ninomiya Mizuki , Harada Noboru , Yoshizumi Tomoharu 
Published: July 2024

Liver transplantation is the definitive treatment for advanced liver cirrhosis with portal hypertension. In Japan, the scarcity of deceased donors leads to reliance on living donors, often resulting in smaller grafts. Managing portal venous pressure (PVP) is critical to prevent fatal posttransplant complications. This study explored the possibility of predicting intraoperative PVP. We analyzed 475 living donor liver transplant cases from 2006 to 2023, excluding those with acute liver failure or prior splenectomy or splenic artery embolization. Patients were divided into a training group (n = 425) and a test group (n = 50). We evaluated the correlation between preoperative factors and PVP at laparotomy to predict PVP at laparotomy and closure. The predictive model was validated with the test group data. PVP at laparotomy could be predicted using correlated preoperative factors: prothrombin time (p < 0.001), predicted splenic volume (p < 0.001), and presence of a portosystemic shunt (p = 0.002), as follows: predicted PVP at laparotomy (mm Hg)=25.818 − 0.077 × (prothrombin time [%]) + 0.004 × (predicted splenic volume [mL]) − 2.067 × (1: with a portosystemic shunt) (p < 0.001; R = 0.346). In addition, PVP at closure could be predicted using correlated operative factors, including measured PVP at laparotomy, as follows: predicted PVP at closure (mm Hg)=14.268 + 0.149 × (measured PVP at laparotomy [mm Hg]) − 0.040 × (GV/SLV [%]) − 0.862 × (1: splenectomy [if yes]) − 3.511 × (1: splenic artery ligation without splenectomy [if yes]) (p < 0.001; R = 0.339). This study demonstrated the feasibility of predicting intraoperative PVP using preoperative factors in patients with decompensated cirrhosis undergoing liver transplant. This predictive approach could refine surgical planning, potentially improving patient outcomes.