bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in blood lipid levels and influencing factors among treatment-naïve adult male HIV/AIDS patients following BIC/FTC/TAF vs. 3TC+EFV+TDF
Authors: Wang Xi , Liu An , Li Zaicun , Zhang Hongwei , Wu Ruojun Esther , Shao Ying , Li Jianwei , Ye Jiangzhu , Liu Wei , Sun Lijun 
Published: May 2024

Abstract

Background:
Antiretroviral therapy (ART) was often associated with dyslipidemia among human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients. This study aimed to assess treatment-naïve adult male patients with HIV/AIDS who initiated ART with either co-formulated bictegravir, emtricitabine, and tenofovir alafenamide (BIC/FTC/TAF) or lamivudine, efavirenz, and tenofovir disoproxil fumarate (3TC+EFV+TDF), monitoring at weeks 4, 12, 24, and 48.

Methods:
A case-control retrospective study was conducted. The newly diagnosed HIV-infected individuals attending the sexual transmission disease (STD)/AIDS clinic of Beijing Youan Hospital, Capital Medical University, from January to December 2021. The patients were divided into BIC/FTC/TAF group or 3TC+EFV+TDF group. High-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and total cholesterol (TC) at different time points over 48 weeks between two groups were compared. A multivariate Cox regression model was used to identify relevant influencing factors for the population at high risk of increased LDL-C.

Results:
A total of 870 participants, with 510 in BIC/FTC/TAF group and 360 in 3TC+EFV+TDF group. There were no statistically significant differences in median age, baseline CD4/CD8 ratio, median body mass index (BMI) between the two groups. In both two groups, levels of TG, TC, and LDL-C were higher at 4 weeks, 12 weeks, and 24 weeks of treatment (all P <0.05), and there were no statistically significant differences at 48 weeks compared to those at baseline (all P >0.05). In addition, the differences in average changes of the level of TG, TC, HDL-C, and LDL-C from weeks 4, 12, 24, and 48 to baseline between two groups were not statistically significant (all P >0.05). Multivariate Cox proportional risk model analysis showed that initiating ART with HIV RNA ≥105 copies/mL (compared with <105 copies/mL) was associated with an increased risk of elevated LDL-C (hazard ratio = 1.26, 95% confidence interval: 1.07–1.48, P = 0.005).

Conclusions:
Transient elevations in blood lipid levels (TC, TG, HDL-C, and LDL-C) were observed in treatment-naïve adult male HIV/AIDS patients with BIC/FTC/TAF at 4 weeks, 12 weeks, and 24 weeks of treatment. However, these levels did not differ significantly from baseline after 48 weeks of treatment, regardless of whether patients were in the BIC/FTC/TAF or 3TC+EFV+TDF group.
Understanding the factors associated with nurse employment in clinics: Experiences in Taiwan
Authors: Ma Hsin , Chiang Shu-Chiung , Lin Ming-Hwai , Chang Hsiao-Ting , Ming Jin-Lain , Chen Tzeng-Ji , Chen Yu-Chun 
Published: May 2024

Background:
The shortage and distribution of nurses affect healthcare access in aging societies. Limited research has explored the nursing workforce in clinics, which is vital for healthcare delivery. This study aimed to investigate the shortage and distribution of nurses in clinics in Taiwan, considering geographical, institutional, and specialty variations.

Methods:
We conducted a cross-sectional analysis of the national nursing workforce in Western medicine clinics in Taiwan using open government data. The nursing practice rate (NPR) was calculated. The ratio of clinics employing nurses (RCN) was determined by calculating the percentage of clinics with nurses in each category. A logistic regression model was fitted to examine the factors associated with nurse employment, including urbanization level and different specialty clinics. Adjusted odds ratios (OR) and 95% CIs were calculated.

Results:
The study revealed an overall NPR as low as 59.1%, and a decreasing trend with age. Among the 11 706 clinics in the study, nearly a quarter did not employ nurses, with an overall RCN of 72.3%. Urbanization level and clinic specialty were associated with nurse employment (p < 0.05). After adjusting for urbanization level, the fitted regression model identified the top three specialties as plastic surgery (OR = 11.37, RCN = 96.8%), internal medicine (OR = 1.94, RCN = 84.1%), and orthopedics (OR = 1.89, RCN = 83.6%), while the bottom three were otolaryngology (OR = 0.59, RCN = 61.5%), psychiatry (OR = 0.49, RCN = 57.1%), and rehabilitation medicine (OR = 0.30, RCN = 45.2%). Nurses were more likely to be employed in areas at urbanization level 1 (OR = 1.17), 3 (OR = 1.37), and 6 (OR = 1.48), which represent highly urbanized areas within the urban, suburban, and rural categories, respectively, than in urbanization level 4.

Conclusion:
Clinics in Taiwan showed nursing shortages and maldistribution, with 72.3% RCN and variations based on urbanization and specialty. These factors may be considered in nursing research conducted in other countries to inform future workforce planning.
Preventive Effects of Ramelteon, Suvorexant, and Lemborexant on Delirium in Hospitalized Patients With Physical Disease
Authors: Henmi Ryuji , Nakamura Tomoyuki , Mashimoto Masaya , Takase Fumitake , Ozone Motohiro 
Published: May 2024

Abstract

Background
New sleep-inducing drugs (eg, ramelteon, suvorexant, and lemborexant) have been shown to prevent delirium in high-risk groups. However, no single study has simultaneously evaluated the delirium-preventing effects of all novel sleep-inducing drugs in hospitalized patients. Therefore, this study aimed to clarify the relationship between sleep-inducing drugs and delirium prevention in patients hospitalized in general medical-surgical settings for nonpsychiatric conditions who underwent liaison interventions for insomnia.

Methods
This retrospective cohort study included patients treated in general medical-surgical settings for nonpsychiatric conditions with consultation-liaison psychiatry consult for insomnia. Delirium was diagnosed by fully certified psychiatrists using the Diagnostic and Statistical Manual of Mental Disorders 5th edition. The following items were retrospectively examined from medical records as factors related to delirium development: type of sleep-inducing drugs, age, sex, and delirium risk factors. The risk factors of delirium development were calculated using adjusted odds ratios (aORs) via multivariate logistic regression analysis.

Results
Among the 710 patients analyzed, 257 (36.2%) developed delirium. Suvorexant (aOR, 0.61; 95% confidence interval [CI], 0.40–0.94; P = 0.02) and lemborexant (aOR, 0.23; 95% CI, 0.14–0.39; P < 0.0001) significantly reduced the risk of developing delirium. Benzodiazepines (aOR, 1.90; 95% CI, 1.15–3.13; P = 0.01) significantly increased this risk. Ramelteon (aOR, 1.30; 95% CI, 0.84–2.01; P = 0.24) and Z-drugs (aOR, 1.27; 95% CI, 0.81–1.98; P = 0.30) were not significantly associated with delirium development.

Conclusions
The use of suvorexant and lemborexant may prevent delirium in patients with a wide range of medical conditions.
Correlation between depression and adherence to respiratory function exercise in elderly frail patients with tuberculosis: A cross-sectional survey
Authors: Si Qin , Guo Jing , Feng Yin-Ping , Luo Shui-Rong , Liu Zhong-Da , Zhou Guang-Nao 
Published: May 2024

Background:
We investigated the current state of frailty in elderly patients with tuberculosis and analyzed the factors that influence it.

Methods:
Using a convenience sampling method, 120 elderly patients with tuberculosis were selected from the Department of Infectious Diseases at Lishui Hospital of Traditional Chinese Medicine in Zhejiang Province. A cross-sectional survey was conducted using general demographic questionnaires, the FRAIL (fatigue, resistance, aerobic capacity, illnesses, and loss of weight) screening scale, the self-rating depression scale (SDS), and a questionnaire on respiratory function exercise adherence. The influencing factors for depression were analyzed using logistic regression.

Results:
The average depression score of the 120 elderly patients with frailty and tuberculosis was 54.88 ± 5.61, indicating a mild level of depression. The correlation between this score and respiratory function exercise adherence was negative. According to a logistic regression analysis, marital status and payment methods were influencing factors for depression in these elderly patients with frailty and tuberculosis.

Conclusion:
There is a need to increase respiratory function exercise adherence among elderly patients with frailty and tuberculosis who have a high incidence of depression. Medical staff should assess adverse emotions in patients and their adherence to respiratory function exercises on a periodic basis.
Prostate tuberculosis mimicking malignancy on 18F-FDG PET/CT in a patient with diffuse large B-cell lymphoma: A case report
Authors: Bai Min , Yu Qinchuan , Yuan Ling , Zhao Yuanyuan , Zheng Meijing , Su Liping , Wang Lieyang 
Published: May 2024

Background:
Prostate tuberculosis (TB) is a rare and often underdiagnosed condition due to its nonspecific symptoms and imaging features, which can mimic malignancies on 18F-fluorodeoxyglucose positron emission tomography (PET) scans. This resemblance poses a challenge in differentiating TB from prostate cancer, especially in patients with preexisting tumors such as diffuse large B-cell lymphoma. The purpose of this study is to highlight the importance of considering TB in the differential diagnosis of patients with atypical imaging findings, even in the presence of known malignancies.

Case:
We present a case of a 60-year-old man with diffuse large B-cell lymphoma who was initially misdiagnosed with a prostate tumor based on 18F-fluorodeoxyglucose PET/computed tomography scans. The subsequent ultrasound-guided prostate biopsy confirmed the presence of prostate TB, not malignancy.

Conclusions:
This case report underscores the critical role of considering TB as a potential diagnosis in patients with hematological tumors and atypical imaging results. It serves as a reminder for clinicians to exercise caution when interpreting PET/computed tomography scans and to incorporate TB into their differential diagnoses, thereby avoiding misdiagnosis and inappropriate treatment.
Mucinous epidermoid carcinoma of the lung with ALK mutation: Case report and literature review
Authors: Yang Lijiao , Ren Yanyan , Yin Xing 
Published: May 2024

Rationale:
Pulmonary mucoepidermoid carcinoma (PMEC) is a rare lung malignancy, especially in combination with ALK mutations, whose clinical presentation lacks specificity and for which there are no standardized treatment guidelines.

Patient concerns:
We report a case of a patient with PMEC-predominant primary lung cancer combined with an ALK mutation.

Diagnoses:
One patient was diagnosed with PMEC combined with ALK mutation.

Interventions:
After diagnosis by puncture pathology, the patient was treated with oral targeted drugs.

Outcomes:
The patient’s cough and fever were controlled, her diet improved significantly, and she gained 20 pounds in 6 months. During this period, the primary and metastatic foci in the lungs were significantly reduced on repeat chest CT.

Conclusion:
PMEC combined with ALK mutation is an extremely rare primary lung cancer, and the diagnosis is mainly based on pathology, histology and immunohistochemistry. The application of molecularly targeted drugs to patients with mutations can significantly improve the prognosis of patients with PMEC, which is expected to be a new breakthrough in the treatment of PMEC.
Adjuvant therapy in renal cell carcinoma: Tyrosine kinase inhibitor versus immune checkpoint inhibitor
Authors: Zhou Qingbo , Liu Jianjiang , Xie Shaoqin 
Published: May 2024

Background:
To date, no meta-analysis has been conducted to compare the effectiveness and safety of adjuvant tyrosine kinase inhibitors (TKIs) and adjuvant immunotherapies (IMTs) in renal cell carcinoma (RCC) patients using reconstructed individual patient data (IPD). This study aims to fill that gap by assessing the efficacy and safety profiles of these treatments in such patients.

Methods:
This study employed a systematic approach for identifying relevant literature from the PubMed and EMBASE databases. We included articles published in English from the inception of these databases until November 11, 2023, focusing specifically on appropriate phase III randomized controlled trials (RCTs). To reconstruct survival curves, we utilized a semiautomated tool, WebPlotDigitizer, in conjunction with a novel shiny application integrated with R software. For adverse events (AEs), the summary measures were incidences, expressed as a 95% confidence interval (CI), calculated using a random-effects model with a logit transformation.

Results:
The analysis included 8 RCTs with a total of 9119 patients. Compared to adjuvant TKIs, adjuvant IMTs showed a similar disease-free survival (DFS) (hazard ratio [HR] 1.03, 95% CI [0.98–1.09], P = .281). However, the overall survival (OS) rates between the 2 groups couldn’t be directly compared due to unmatched control groups in the IMT and TKI studies. Against placebo, adjuvant IMTs demonstrated superior DFS (HR 0.82, 95% CI [0.71–0.94], P = .004) but comparable OS (HR 0.79, 95% CI [0.59–1.06], P = .120). Against placebo, adjuvant TKIs showed superior DFS (HR 0.85, 95% CI [0.79–0.92], P < .0001) and marginally better OS (HR 0.89, 95% CI [0.80–0.996], P = .042). Regarding severe AEs and discontinuation rates due to AEs, adjuvant IMTs had a significantly lower incidence of severe AEs (25% [320/1282] vs 59% [2192/3716], odds ratio [OR] 0.23, 95% CI [0.20–0.27], P < .0001) and a markedly better discontinuation rate (39% [499/1282] vs 52% [2068/4018], OR 0.60, 95% CI [0.53–0.68], P < .0001) compared to TKIs.

Conclusion:
This paper presents a thorough analysis of DFS, OS, and treatment-related AEs across various groups in RCC patients, offering a valuable resource for clinicians in everyday practice. Our findings indicate that while adjuvant IMTs and adjuvant TKIs demonstrate similar DFS, IMTs are notably superior in terms of safety and compliance.
Prognostic value of pretreatment platelet count, fibrinogen and d-dimer levels in osteosarcoma patients: A meta-analysis
Authors: Li Xianfeng , Ren Honghong , Peng Lipeng , Li Jie 
Published: May 2024

Background:
Previous studies explored the prognostic value of pretreatment platelet count, fibrinogen, and d-dimer level in patients with several types of cancer, however, a comprehensive conclusion has not been reached in osteosarcoma patients.

Methods:
PubMed, Web of Science, Embase, and CNKI databases were systematically searched for eligible studies up to May 09, 2023, and pooled hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) were calculated to assess the prognostic impact of these indicators in osteosarcoma patients.

Results:
Twelve studies from China consisting of 1682 patients were finally included. Our findings revealed that an elevated level of pretreatment platelet or d-dimer was associated with a worse outcome of overall survival (platelet: HR = 1.63, 95% CI: 1.18–2.26, P = .003; d-dimer: HR = 2.29, 95% CI: 1.58–3.31, P < .001).

Conclusion:
Based on current evidence, pretreatment platelet count and d-dimer level could be good prognostic biomarkers for Chinese osteosarcoma patients. However, future validation is also needed.
Multifocal Papillary Thyroid Carcinomas With Discordant Molecular Drivers
Authors: Rivera Jonathan P. , Yeh Yi-Chen , Chen Paul Chih-Hsueh , Hang Jen-Fan 
Published: May 2024

Multifocal papillary thyroid carcinomas (PTCs) are common and the majority of the tumors harbor mutual BRAF p.V600E mutation. This study aimed to investigate a contemporary series of multifocal PTCs with discordant molecular drivers. Consecutive thyroidectomies diagnosed with multifocal PTCs ≥0.5 cm between 2019 and 2023 were reviewed. Immunohistochemistry (IHC) for BRAF VE1 was performed for all tumors. Cases with discordant BRAF IHC results or morphologic discrepancy were identified, and BRAF IHC-negative tumors were subjected to RAS Q61R IHC and/or targeted RNA next-generation sequencing. A total of 770 patients with a main PTC ≥0.5 cm were identified; 255 (33.1%) had multifocal disease, and 142 (18.4%) had at least another PTC ≥0.5 cm. Among them, 13 cases (9.2%, 13/142) had discordant molecular drivers. Twelve cases had one or more BRAF-positive PTCs accompanied by a BRAF-negative PTC (3 with CCDC6::RET fusion, 1 with NCOA4::RET fusion, 1 with ACBD5::RET fusion, 2 with ETV6::NTRK3 fusion, 1 with TG::FGFR1 fusion, 1 with LMTK2::BRAF fusion, 1 with AGK::BRAF fusion and RAS p.Q61R mutation, 1 with RAS p.Q61R mutation, and 1 without detectable molecular drivers). The last case had tumors with discordant fusion drivers (VIM::NTRK3 and TNS1::BRAF). Most cases showed tumors that were morphologically distinct (92.3%, 12/13) and occurred in the contralateral lobes (76.9%, 10/13). Notably, we identified 4 cases (30.8%) that presented as collision tumors and 6 cases (46.2%) that showed lymph node metastases, including 2 with simultaneous involvement by tumors with discordant molecular drivers, as novel findings. In summary, a subset (9.2%) of multifocal PTCs had discordant molecular drivers and 84.6% of them were a combination of BRAF-positive and kinase gene fusion-associated PTCs, most with distinct morphologies. Almost half of the cases had nodal metastasis and a third of them showed simultaneous involvement by tumors with discordant molecular drivers. The results highlight the clinical importance of identifying such cases, given the potentially different treatments.
Impact of enhanced adherence counselling on viral re-suppression among adolescents and young persons with persistent viremia
Authors: Wasilwa Anne , Amadi Emmanuel , Ramadhani Habib O. , Lascko Taylor , Ndaga Angela , Makokha Violet , Abuya Kepha , Oneya Daniel , Nyabiage Lennah , Ng’eno Caroline 
Published: May 2024

Objective:
Kenya ART guidelines recommend three sessions of enhanced adherence counselling (EAC) following detectable viral load. The objective of this study was to assess completion of EAC sessions and factors associated with viral re-suppression amongst adolescents and young persons (AYPs) with persistent viremia in Western Kenya.

Methods:
A retrospective analysis of routinely collected data abstracted from viral load registers was done. AYP with persistent viremia (consecutive viral load ≥1000 copies/ml) between October 2017 to September 2019 were followed for 12 months; those with more than one follow-up viral load results were analyzed. EAC was satisfactory if at least three sessions attended, barriers identified and addressed. Morisky scores 0 and at least 1 indicated optimal and sub-optimal adherence, respectively. Logistic regression models were used to assess predictors of viral load suppression (VLS).

Results:
Of 124 AYPs with persistent viremia, 118 (95.2%) had documented follow-up viral load results and 119 (96%) completed three EAC sessions. Overall, 55 (47%) clients re-suppressed during the study period. AYPs who had satisfactory EAC sessions had higher odds of achieving VLS [odds ratio (OR) = 3.7, 95% confidence interval (CI): 1.6–8.1]. Similarly, AYPs with an optimal adherence had eight times (OR = 8.1, 95% CI: 3.5–18.5) higher odds of achieving VLS, and those who were suppressed at 6 months post-ART initiation had higher odds of achieving VLS at 12-months (OR = 2.5, 95% CI: 1.1–5.8).

Conclusion:
Satisfactory EAC sessions and optimal ART adherence was strongly associated with viral re-suppression among AYPs with persistent viremia. Continued support to EAC intervention is critical to improve treatment outcome among AYP living with HIV.
Rehabilitation of Severely Atrophic Maxilla with Le Fort I Advancement Surgery and Subperiosteal Implant in a Patient With Ectodermal Dysplasia
Authors: Ayhan Mustafa , Yey Özkeskin Sabahat Zeynep 
Published: May 2024

Objectives:
In this case, the patient with ectodermal dysplasia lost his teeth and acquired maxillary insufficiency. The aim of this case is to advance the maxilla using Le Fort I surgery and make fixation with a subperiosteal implant.

Methods:
On the three-dimensional model, a surgical guide for Le Fort I osteotomy and subperiosteal implant design was planned. In the surgery, Le Fort I osteotomy was made according to the guide, and maxillary advancement was obtained, then a subperiosteal implant was fixated. Prosthetic rehabilitation was made after 1 month.

Results:
Maxillary repositioning is obtained according to virtual planning and subperiosteal implant is used for both fixation and prosthetic rehabilitation. Proper fixation is ensured and full arch prosthetic rehabilitation supported by a subperiosteal implant is performed.

Conclusion:
With this technique, in the rehabilitation of atrophic maxilla, sagittal insufficiency is corrected with Le Fort 1 surgery, whereas the patient’s treatment period is shortened by placing a subperiosteal implant at the same time.
Multi-omics data integration reveals molecular mechanisms of carfilzomib resistance in multiple myeloma
Authors: Malyutina Alina , Sergeev Philipp , Huber Julia , Miettinen Juho J. , Bolomsky Arnold , Bao Jie , Parsons Alun O. , Muller André , Marella Nara , van Duin Mark , Ludwig Heinz , Tang Jing , Heckman Caroline A. 
Published: May 2024

AbstractMultiple myeloma represents a complex hematological malignancy, characterized by its wide array of genetic and clinical events. The introduction of proteasome inhibitors, such as carfilzomib or bortezomib, into the therapeutic landscape has notably enhanced the quality of life and survival rates for patients suffering from this disease. Nonetheless, a significant obstacle in the long-term efficacy of this treatment is the inevitable development of resistance to PIs, posing a substantial challenge in managing the disease effectively. Our study investigates the molecular mechanisms behind carfilzomib resistance by analyzing multi-omics profiles from four multiple myeloma cell lines: AMO-1, KMS-12-PE, RPMI-8226 and OPM-2, together with their carfilzomib-resistant variants. We uncovered a significant downregulation of metabolic pathways linked to strong mitochondrial dysfunction in resistant cells. Further examination of patient samples identified key genes - ABCB1, RICTOR, PACSIN1, KMT2D, WEE1 and GATM - potentially crucial for resistance, guiding us towards promising carfilzomib combination therapies to circumvent resistance mechanisms. The response profiles of tested compounds have led to the identification of a network of gene interactions in resistant cells. We identified two already approved drugs, benidipine and tacrolimus, as potential partners for combination therapy with carfilzomib to counteract resistance. This discovery enhances the clinical significance of our findings.