bluuebunny/crossref_metadata_2025_split huggingface dataset:
The efficacy and safety of trastuzumab biosimilar HLX02 compared with reference trastuzumab plus pertuzumab in combination with chemotherapy as the first-line treatment for HER2 positive metastatic breast cancer: A real-world study in China.
Authors: Yan Ying , Li Huiping 
Published: July 2024

e13016 Background: Dual-targeted anti-HER2 therapy with trastuzumab (H) and pertuzumab (P) significantly improves outcomes in HER2-positive breast cancer and has become the first-line standard treatment for patients with advanced HER2-positive breast cancer in China in 2019 based on the results of the CLEOPATRA and PUFFIN study. HLX02 (Zercepac) was the first trastuzumab biosimilar manufactured in China. Here, we present the first real-world comparison of HLX02 versus reference trastuzumab (RTZ) and pertuzumab with chemotherapy as the first-line treatment for HER2-positive metastatic China.Between January 2019 and August 2023, 121 patients with HER2-positive MBC patients were enrolled at Beijing Cancer Hospital in China. These patients received HLX02 or RTZ in combination with pertuzumab and various chemotherapies as first-line treatment. We retrospectively analyzed survival outcomes, efficacy, and adverse events. Methods: Between January 2019 and August 2023, 121 patients with HER2-positive MBC patients were enrolled at Beijing Cancer Hospital in China. These patients received HLX02 or RTZ in combination with pertuzumab and various chemotherapies as first-line treatment. We retrospectively analyzed survival outcomes, efficacy, and adverse events. Results: Both groups, 68 received RTZ and 53 received HLX02, showed similar characteristics of age, disease status (de novo or recurrent), metastatic sites (visceral or non-visceral), and treatment history. A total of 118 (97.5%) received trastuzumab plus pertuzumab combined with chemotherapy as the first-line palliative therapy, with a median number of 6 cycles in each group. Taxanes were the most commonly used chemotherapy regimen in both groups (91.2 vs. 92.5%), including nab-paclitaxel (44.1 vs. 45.3%), docetaxel (41.2 vs. 17.0%), paclitaxel (5.9 vs. 30.2%). With a median follow-up of 15.0 months (range 1.0 - 58.0), the results showed no significant difference in PFS between the RTZ and HLX02 arms (median PFS: 22.0 vs. 19.0 months, p=0.900). Additionally, the efficacy outcomes, including objective response rate (ORR), disease control rate (DCR), and safety profiles did not show significant differences between the two groups. Among 121 patients, 20 patients (16.5%) experienced CNS progression. For these patients, the median time from the first-line therapy to the CNS progression was 15.0 months (95% CI 12.8 - 17.2). Conclusions: The real-world data suggest similar efficacy and safety of HLX02 and RTZ plus pertuzumab with different chemotherapy regimens as the first-line treatment for patients with HER2-positive advanced breast cancer patients in China. Overall, the PFS was consistent with the CLEOPATRA trial in both groups, and there was no new safety signal.
Clinical efficacy of pyrotinib combined with stereotactic radiosurgery in HER2-positive breast cancer brain metastases.
Authors: Zhen Junjie , Bashir Shoaib , Yang Yanying , Wang Hui , Lai Mingyao , Cai Linbo 
Published: July 2024

e13017 Background: Up to 50% of patients with breast cancer (BC) and human epidermal growth factor receptor 2 (HER2) positive present with disease progression in brain metastases (BM). Pyrotinib, an oral irreversible pan-HER receptor tyrosine kinase inhibitor, has shown efficacy in active central nervous system(CNS) metastases. However, clinical efficacy of pyrotinib combining with stereotactic radiosurgery (SRS) in BCBM is unclear. Methods: This retrospective, observational study collected data from 52 HER2+ BC patients with brain metastasis who received pyrotinib-based therapy in Guangdong Sanjiu brain hospital from 2019 to 2023. Among these patients, 36 received pyrotinib-based therapy combining with SRS concurrently, or within 1 months. Age, stage at diagnosis, dates of BM, primary tumor subtypes, prior systemic therapy, CNS-directed local therapy, the objective response and survival status were collected. The assessment of adverse effects was based on CTCAE 4.0. Results: 34 patients were evaluable for efficacy (median age: 51.5). With a median follow-up duration of 19.6 months, 1 patient (0.3%) achieved CR, while 27 patients (79.4%) had PR, resulting in an ORR of 82.3%. The median CNS PFS was 13.2 months (95% CI, 4.9-21.7). Median overall survival (OS) was 22.6 months (95% CI, 17.5-27.6). The most common grade 3 or worse treatment-emergent adverse event was diarrhea (6 [17.6%]). Conclusions: Our results suggest that pyrotinib combining with SRS is associated with promising efficacy and a satisfactory safety profile for Her2+ breast cancer brain metastases.
Multi-dimensional cell-free DNA-based liquid biopsy for sensitive detection of head and neck squamous cell carcinomas.
Authors: Fang Han , Mou Yakui , Zhang Wenbin , Bao Hua , Wu Min , Chen Xiaoxi , Wu Xuxiaochen , Yang Ruowei , Zhu Dongqin , Song Xicheng 
Published: July 2024

e18054 Background: Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer type worldwide. The mortality from HNSCC is closely linked to stage. However, the majority of HNSCC patients were diagnosed at an advanced stage. Therefore, a non-invasive assay for the early detection of HNSCCs is highly desirable for reducing the associated mortality. Methods: We collected a study cohort of 281 participants including 140 pathologically confirmed with head and neck squamous cell carcinomas (HNSCCs) and 141 with non-cancerous conditions. A plasma sample was collected from each participant along with general health screening examinations before any invasive examinations. We performed low-pass whole-genome sequencing with plasma samples and profiled three types of cell-free DNA (cfDNA) characteristics, fragment size pattern (FSP), copy number variation (CNV), and single nucleotide substitution (SNS). We developed an ensemble model with these differential profiles to identify HNSCC patients from non-cancer individuals. We further collected a validation cohort consisting of 90 HNSCC patients and 95 non-cancer individuals to validate the cfDNA-based assay. Results: The liquid biopsy assay that incorporated three types of cfDNA characteristics was able to identify HNSCC patients from non-cancer individuals at an AUROC of 0.989 in the study cohort and 0.984 in the validation cohort. At a specificity of 95.7% (135/141), it achieved a sensitivity of 95.7% (134/140) in the study cohort. With this threshold (0.580), in the validation cohort, 93.7% (89/95) of non-cancer individuals and 93.3% (84/90) of HNSCC patients were correctly identified. Specifically, the sensitivities in early stage (I&II) HNSCCs were 94.5 % (52/55) and 87.5% (28/32) in the study and validation cohort, respectively. Of note, the inferred probabilities of cancer showed consistent trends to increase with pathological stages in both cohorts (P=0.032 and 0.047, respectively). On the contrary, the differentiation grades and sub-locations did not significantly affect the performance of the assay. Conclusions: We introduced a liquid biopsy assay using multiple dimensions of cfDNA characteristics that could accurately identify HNSCCs from non-cancerous conditions. As a cost-effective non-invasive approach, it may be conveniently incorporated into annual general physical examinations to provide supplementary information about the risk of HNSCCs.
Insights into Dyspareunia: From Diagnosis to Multimodal Treatment Approaches
Authors: Kołodziej Klaudia , Mańdziuk Dominika , Niewinna Patrycja , Zaroda Przemysław , Dąda Paweł , Pawlik Paweł , Kołodziej Wojciech , Żuchowski Michał , Wawrzkowicz Jakub , Korga Monika 
Published: July 2024

Introduction and Purpose:
Dyspareunia is a sexual disorder associated with pain in women. It refers to pain related to sexual intercourse. Pain can occur during penetration attempts, during penetration, during intercourse, and shortly after penetration. Studies conducted in the United States indicate that the problem of pain during intercourse affects as much as 10-20% of women. [1] In Poland, this number is estimated to be around 13%.[1] The aim of this review is to delve into the existing literature on the diagnosis of dyspareunia in women and to raise awareness of its extensive nature, emphasizing an interdisciplinary approach to patient care.
A Brief Description of the State of Knowledge:
The etiology of dyspareunia is multifactorial and may arise from pathological changes in the vulva and vagina, inflammatory changes, contact irritations, as well as vulvar conditions such as lichen sclerosus and flat. [3] Additionally, hormonal changes, pelvic floor injuries, postpartum gynecological procedures also play a significant role. Psychological factors such as trauma, anxiety, and depression are also important [4].
Conclusions:
Dyspareunia is a condition that significantly affects the quality of life of women in various ways, thus necessitating effective therapeutic approaches. Collaboration among diverse specialists such as gynecologists, sexologists, psychotherapists, psychiatrists, and physiotherapists is crucial. Further research focusing on multimodal strategies is needed to effectively tailor treatments and mitigate the systemic effects of chronic pain.
Skin or Skim? Inside Investment and Hedge Fund Performance
Authors: Gupta Arpit , Sachdeva Kunal 
Published: July 2024

Hedge fund managers contribute substantial personal capital, or “skin in the game,” into their funds. Although these allocations may better align incentives, managers may also strategically allocate their private capital in ways that negatively affect outside investors. We find that funds with more inside investment outperform other funds within the same family. This relationship is driven by managerial decisions to invest their own capital in their least-scalable strategies and restrict the entry of new outsider capital into these funds. Our results suggest that insider capital may work as a rent-extraction mechanism at the expense of fund participation of outside investors. This paper was accepted by Gustavo Manso, finance. Funding: This work was supported by Columbia University and the Leonard N. Stern School of Business, New York University. Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2024.4984 .
A comprehensive guide to removable partial dentures. Part 1: patient selection, design principles and decision algorithms for component selection
Authors: Eachempati Prashanti , Lambourn Guy , Agarwal Himanshi , Salian Kiran Kumar Krishnappa , McColl Ewen , Nooji Devi Prasad 
Published: July 2024

This two-part series provides a comprehensive guide to fabricating definitive metal partial dentures, addressing the challenges dental practitioners face in mastering prosthesis design. Part 1 explores diagnostic procedures, indications for metal partial dentures, design principles, and surveying techniques. It emphasizes the understanding of biomechanical forces and discusses design principles such as support, retention and stability, along with the components that provide these functions in a metal partial denture. Decision algorithms for selecting various components are presented to guide clinical practitioners in efficient designing. The series aims to equip dental professionals with a thorough understanding of the theoretical foundations and practical methods for effective metal partial denture fabrication. CPD/Clinical Relevance: This series provides essential knowledge and practical techniques for designing and fabricating effective metal partial dentures.
The unilateral sagittal split osteotomy: A useful tool in the armamentarium for deeply impacted mandibular third molars
Authors: Leader Ross , Kerai Ashwin , Wade Laura , Houghton David 
Published: July 2024

The unilateral sagittal split osteotomy may not be a particularly popularized method to access and remove impacted mandibular third molars (M3Ms). However, in unusual cases of deep impaction, it can provide a surgical option that minimizes bone removal and may reduce the risk of iatrogenic mandibular fracture and inferior alveolar nerve (IAN) injury, depending on the position of the third molar relative to the neurovascular bundle. CPD/Clinical Relevance: The unilateral sagittal split osteotomy may present an alternative method for removing impacted mandibular third molar teeth in certain situations.
The rehabilitation of a combined mid-facial defect using a magnetretained intra- and extra-oral prosthesis: a case report
Authors: Hawrot Hollie , Jablonski Rachael Y , Ali Zaid 
Published: July 2024

There are several treatment options available to restore function and appearance in patients with combined mid-facial defects. Owing to the size of the defect and the associated size and weight of the prostheses, adequate retention can be challenging to achieve. Retention of a facial prosthesis can be improved using several techniques, such as medical grade adhesives, attachments, or osseo-integrated implants. For patients with a history of radiotherapy, surgical rehabilitation may be less favourable than non-surgical approaches owing to the risk of osteoradionecrosis and a reduced blood supply in the surgical fields. This clinical case report highlights the conservative rehabilitation of a combined mid-facial defect using a magnet-retained intra-oral and extra-oral prosthesis. CPD/Clinical Relevance: A thorough medical and clinical assessment will highlight factors that will influence the treatment planning process when managing a combined mid-facial defect.
Augmented and virtual reality in dentistry: an introduction
Authors: Slaymaker Jack 
Published: July 2024

This report introduces the reader to the concepts and applications of augmented and virtual reality in dentistry. Virtual reality (VR) is the computer-generated three-dimensional simulation of a virtual environment accessed through a headset. Augmented reality (AR) is the superimposition of computer-generated imagery or graphics onto the real world, accessed through phones, tablets and headsets. The technology has advanced in recent years with early applications to the medical field revolving around anxiety management, teaching and surgical planning. Uses for surgical orthognathic and other restorative interventions are also in an early phase of development and adoption. CPD/Clinical Relevance: VR and AR have promising applications, but more research must be carried out to determine the technology's validity in dentistry.
INTRAOPERATIVE USE OF DEFENSIVE ANTIBACTERIAL COATING (DAC) FOR COMPLEX SURGERIES IN COMPLEX HOSTS
Authors: Roberts R. H. R. , Shams N. , Ingram-Walpole S. , Barlow D. , Syed A. , Joshi Y. , Malek I. 
Published: July 2024

Periprosthetic joint infections (PJIs) and osteosynthesis-associated infections (OSIs) present significant challenges in trauma and orthopaedic surgery, substantially impacting patient morbidity, mortality, and economic burden. This concern is heightened in patients with pre-existing comorbidities, such as diabetes mellitus, which are not always modifiable at presentation. A novel intraoperative strategy to prevent these infections is the use of Defensive Antibacterial Coating (DAC), a bio-absorbable antibiotic-containing hydrogel applied to implant surfaces at implantation, acting as a physical barrier to prevent infection.The purpose of this study is to assess the use of a commercially available hydrogel (DAC), highlighting its characteristics that make it suitable for managing PJIs and OSIs in orthopaedics and traumatology. Twenty-five patients who underwent complex orthopaedic procedures with intraoperative application of DAC between March 2022 and April 2023 at a single hospital site were included. Post-operative assessment encompassed clinical, laboratory, and radiographic examinations.In this study, 25 patients were included, with a mean age of 70 ± 14.77 years and an average ASA grade of 2.46 ± 0.78. The cohort presented an average Charleston Comorbidity score of 5.45 ± 2.24. The procedures included 8 periprosthetic fractures, 8 foot and ankle surgeries, 5 upper limb surgeries, and 4 elective hip and knee surgeries. Follow-up assessments at 6 weeks and 6 months revealed no evidence of PJI or OSI in any patients, nor were any treatments for PJI or OSI required during the interim period.DAC demonstrated efficacy in preventing infections in high-risk patients undergoing complex orthopaedic procedures. Our findings warrant further investigation into the use of DAC in complex hosts with randomized control trials.
TOTAL HIP ARTHROPLASTY IN PAGET'S DISEASE: COMPARISON OF OUTCOMES AFTER CEMENTED VERSUS UNCEMENTED ARTHROPLASTY. A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Mohammed F. , Jones S. , Mansoor Z. , Mehta S. , Rathore S. , Azam A. 
Published: July 2024

Paget's disease of bone (PDB) is characterised by increased bone resorption and development of an erratic bone structure that is highly fragile and susceptible to fracture. In addition, altered joint biomechanics lead to arthritis, more often in the hip and pelvis, resulting in disability and a Total hip Arthroplasty (THA) may be required. THA in PDB is associated with more complications compared to normal population. There is no consensus on the type of arthroplasty that performs better in people with PDB. To our knowledge, there is no meta-analysis in literature on this rare problem.We undertook a systematic review and meta-analysis to compare the effectiveness of cemented versus cementless THA in patients with PDB. PRISMA guidelines were followed. Search strings were generated based on Boolean operators for identification of the reference articles.31 studies were included overall. Revision rate was lower in the cementless group compared to the cemented group (chi square=4.36, p=0.04), aseptic loosening was lesser in the cementless group compared to the cemented group (chi square=4.13, p=0.04). The type of the arthroplasty did not affect the infection rate (chi square=2.51, p=0.11), pre and post op Harris Hip Score showed statistically significant difference, but there was no difference between types of arthroplastyWe conclude that THA with uncemented components is better and provided lower revision and aseptic loosening when compared to cemented groups in patients with PDB.
COMPLIANCE WITH THE SUSPECTED CAUDA EQUINA SYNDROME (CES) PATHWAY IN BETSI CADWALADR UNIVERSITY HEALTH BOARD (BCUHB) WEST: A RETROSPECTIVE AUDIT AGAINST NATIONAL STANDARDS
Authors: Jackson B. , Wilson C. , Blocker O. 
Published: July 2024

ObjectiveGuidelines published by the British Association of Spine Surgeons (BASS) and Society of British Neurological Surgeons (SBNS) recommend urgent MRI imaging and intervention in individuals suspected of having CES. The need for an evidence based protocol is driven by a lack of 24/7 MRI services and centralisation of neurosurgery to tertiary centres, compounded by CES's significant medico-legal implications. We conducted an audit to evaluate the pathway for suspected CES in BCUHB West between 2018 and 2021.MethodsA retrospective audit of patients managed for suspected CES between 01/11/2018 and 01/05/2021 was performed, using the SBNS/BASS guidelines as the standard.ResultsA total of 252 patients received an emergency MRI for suspected CES between 2018 and 2021. 99% of patients were scanned in compliance with SBNS/BASS standards. Radiological evidence of CES was found in 18% of patients. 33% of emergency scans were performed by out-of-hours services. 4% of patients had repeated scans within the same 6-month period. The majority of referrals originated from Orthopaedics surgeons (78%), or staff in the Emergency Department (8%). 92% of ambulatory patients were not admitted to hospital. During the peak of the COVID-19 pandemic, referrals increased from 2.5 to 3.5 per week.ConclusionSBNS/BASS standards were largely met, avoiding life changing disability and medico-legal consequences. The department should continue to follow SBNS/BASS guidance on the management of individuals with suspected CES. Challenges regarding the use of repeated scans should be addressed to avoid unnecessary costs. Introduction of new early recognition guidelines and Same Day Emergency Care (SDEC) has likely driven an increase in suspected CES referrals, and subsequent MRI demand. This audit should be utilised as an ongoing tool to ensure best practice continues, and to implement simple measures which may improve compliance with the pathway.
COMPARATIVE STUDY BETWEEN THE FAILURE RATES OF THE TROCHANTERIC FIXATION NAIL-ADVANCED (TFNA) AND GAMMA NAILS IN PROXIMAL FEMUR FRACTURE FIXATION
Authors: Sarhan M. , Moreau J. , Francis S. , Page P. 
Published: July 2024

Hip fractures frequently occur in elderly patients with osteoporosis and are rapidly increasing in prevalence owing to an increase in the elderly population and social activities. We experienced several recent presentations of TFNA nails failed through proximal locking aperture which requires significant revision surgery in often highly co-morbid patient population.The study was done by retrospective data collection from 2013 to 2023 of all the hip fractures which had been fixed with Cephalomedullary nails to review and compare Gamma (2013–2017) and TFNA (2017–2023) failure rates and the timing of the failures. Infected and Elective revision to Arthroplasty cases were excluded.The results are 1034 cases had been included, 784 fixed with TFNA and 250 cases fixed Gamma nails. Out of the 784 patients fixed with TFNA, 19 fixation failed (2.45%). Out of the 250 cases fixed with Gamma nails, 15 fixation failed (6%). Mean days for fixation failure were 323 and 244 days in TFNA and Gamma nails respectively.We conclude that TFNA showed remarkable less failure rates if compared to Gamma nails. At point of launch, testing was limited and no proof of superiority of TFNA over Gamma nail. Several failures identified with proximal locking aperture in TFNA which can be related to the new design which had Substantial reduction in lateral thickness at compression screw aperture.
Efectos de la musicoterapia neurológica en personas con demencia grave: estudio piloto
Authors: Forn Villanova Lourdes , Muñiz Sergi , Farràs-Permanyer Laia , Alavedra Cristina , Signo Sara , Bruna Olga 
Published: July 2024

Antecedentes: La Musicoterapia Neurológica (MTN) se ha desarrollado durante las últimas décadas como una disciplina estructurada, basada en la evidencia y con bases teóricas surgidas de estudios neurocientíficos. Se aplica a Personas con Demencia Grave (PcDG) para estimular funciones cognitivas y mejorar el estado emocional y conductual. Objetivos: estudiar los efectos cognitivos, emocionales y conductuales de la MTN en PcDG e introducir el uso de la escala de musicoterapia validada al español: Music in Dementia Assessment Scale (MiDAS-ESP). Método: Estudio cuasi experimental de medidas repetidas pre-post con un grupo experimental de 30 personas. Se registraron variables sociodemográficas, clínicas, cognitivas, de comportamiento, emocionales y de calidad de vida. La intervención consistió en 10 sesiones de MTN, realizada por un musicoterapeuta acreditado. Resultados: Se objetivaron diferencias estadísticamente significativas entre las puntuaciones registradas antes y después de la intervención, indicando mejoría emocional, comportamental y de calidad de vida. No se encontraron diferencias estadísticamente significativas en cognición global, a pesar de observar mejoría. Se objetivaron diferencias significativas en la escala MiDAS-ESP, mostrando incremento de satisfacción durante la terapia. Conclusiones: La MTN contribuye positivamente a mejorar el estado de ánimo, el comportamiento, la calidad de vida y la satisfacción en PcDG.