bluuebunny/crossref_metadata_2025_split huggingface dataset:
Malignant mesenchymoma: A demographic analysis of the National Cancer Database.
Authors: Alban Sierra , Moroz Mark , Grover Jasika , Chin Kat , Silberstein Peter T. , Heise Craig , Hsia Beau 
Published: June 2024

e23556 Background: Malignant mesenchymoma is a rare, aggressive soft tissue tumor characterized by the presence of two or more histologic subtypes of sarcoma. As a result of these characteristics, this cancer has a poor prognosis and a lack of proven treatment options. It may be epidemiologically beneficial to analyze the diagnostic trends to further understand the factors contributing to the disease. This study examines the demographic factors of malignant mesenchymoma, ICD-O-3 Code 8990, through the National Cancer Database (NCDB). Methods: The 2004-2020 NCDB was used for retrospective analysis. 72 patients were identified and their demographic factors such as age, sex, race, Hispanic status, educational attainment, insurance status, facility type and location, distance from facility, and Charlson-Deyo score were analyzed using descriptive statistics. Regression analysis was used to interpret incidence trends. Results: The NCDB contains 72 recorded cases of malignant mesenchymoma from 2004-2020 with an average age at diagnosis of 49.9 ± 21.3 years, with the incidence rate exhibiting variability (R2= 0.1028). Women had a considerably higher diagnosis rate (67%) compared to men (33%). The majority of patients were White (75%), and 11% of patients were Black. Most patients were of non-Hispanic origin (81%). A higher percentage of patients fell into the fourth quartile of income earners (32%) compared to the top three quartiles. A significant portion of patients (26%) did not have a high school degree. The sites with the highest cancer prevalence were the retroperitoneum (10%) and endometrium (10%). A majority of individuals (78%) had Charlson-Deyo comorbidity scores of 0. The size of the tumors ranged from 10.0 to 250.0 mm with an average size of 61.6 ± 67.4 mm. A majority of the patients (72%) underwent surgery at the primary site. Most (96%) patients survived at least thirty days following their primary surgery, with 94% surviving for ninety or more days. The mean survival time was 91.0 months. The cancer’s 2-year, 5-year, and 10-year survival rates were 61.5%, 45.5%, and 43.1% respectively. Conclusions: Based on our searches, this is the first NCDB study on malignant mesenchymoma to address epidemiological gaps in the literature. Most malignant mesenchymoma patients identified as non-Hispanic and White with a primary site of either the retroperitoneum or endometrium. The majority of patients fell into the fourth income quartile, and a significant amount did not have a high school degree. Due to this cancer’s rarity, recent literature exploring the factors contributing to the disease course is scarce. Additional research is necessary to understand how demographics influence the diagnosis, treatment, and long-term outcomes of individuals diagnosed with malignant mesenchymoma.
Epidemiological trends and socioeconomic factors in malignant peripheral nerve sheath tumors with rhabdomyoblastic differentiation: A National Cancer Database study.
Authors: Diagne Yaye Fatou , Brausch William , Chin Kat , Langas Isabel , Silberstein Peter T. , Heise Craig , Hsia Beau 
Published: June 2024

e23562 Background: Malignant peripheral nerve sheath tumor with rhabdomyoblastic differentiation, also called a malignant triton tumor (MTT) is both a rare and aggressive form of cancer with both the features of peripheral nerve sheath tumors as well as rhabdomyoblasts with high recurrence rates. There is a higher risk of patients with neurofibromatosis type 1 (NF1) developing MTT. Radiation can be used to excise higher grade large MTT, however, chemotherapy still has no consensus on efficacy. Despite the rarity of MTT with rhabdomyoblastic differentiation, increased efforts to understand epidemiological trends could increase overall understanding of the malignancy. Methods: We extracted data from 50 patients diagnosed with MTT(ICD-9561-3) using the 2004-2020 National Cancer Database (NCDB) to perform a retrospective cohort analysis. We focused on various demographic factors including age, sex, race, Hispanic status, income status, educational status, insurance status, facility type and location, distance from facility, and Charleson-Deyo score using descriptive statistics. Regression analysis was used to identify incidence trends. Results: In our study of 50 patients diagnosed with MTT, a majority of the patients were male (62%), identified as White, and were of non-Spanish/non-Hispanic (90%) ethnicity. The average age at diagnosis was 49 years (SD = 20, range = 3-90) most and patients were treated in academic/research facilities (32%) or integrated network cancer programs (18%). Most patients (48%) had private insurance, with a significant number relying on government-funded programs (44%). The majority of patients (88%) underwent surgery as their primary treatment, with 30% having no residual tumor post-surgery. Additional treatments included radiation therapy (38%), chemotherapy (34%) and the most frequent primary site was the retroperitoneum (30%).The average survival time post-treatment was 35 months, with a survival rate of 43% at 2 years, 23% at 5 years, and a 15% at 10 years. Patients qualified for the top quartile of median housing income( $74,063 ≈). Conclusions: This study is the first analysis of patients with MTT, using the NCDB. It fills a gap in our understanding of this rare and aggressive disease. The majority of MTT patients were male, Caucasian, with an average age at diagnosis of 49 years, which supports previous case report descriptions. In addition, this study reveals the socio-economic factors associated with these patients who mostly earned a median income of $74,063 or more, were insured primarily by private insurance or managed programs (48%), and were treated predominantly in academic or research institutions (32%). It is necessary to continue research to further understand the influence of demographic and socio-economic factors on the diagnosis, treatments, and overall survival of patients with MTT.
A phase I/II trial of neoadjuvant pegylated arginine deiminase (ADI-PEG 20) with ifosfamide and radiotherapy in soft tissue sarcomas (STS) of the trunk or extremity.
Authors: Weiss Mia C. , Haarberg Sasha , Luo Chongliang , Hirbe Angela C. , Apicelli Anthony J. , English D. Ian , Van Tine Brian Andrew 
Published: June 2024

TPS11591 Background: Outcomes for the treatment of metastatic STS remain poor. Better therapies are needed for local and distant control. Arginine is essential to neoplastic growth, yet up to 88% of STS do not express argininosuccinate synthetase (ASS1), an enzyme necessary to produce arginine. ADI-PEG 20 is a microbial enzyme that degrades arginine causing auxotrophy in cancer cells that are ASS1 negative. Pre-clinical data demonstrates that arginine deprivation shunts glutamine towards oxidation via the TCA cycle, thus depleting glutathione stores and increasing oxidative stress to the cell. We hypothesize that the combination of ADI-PEG 20, ifosfamide, and radiation therapy can potentiate cellular death. The encouraging safety and clinical data from the ADI-PEG 20 + radiation + temozolomide trial (NCT04587830) further support this combination. We are conducting a phase I/II trial examining the safety and tolerability to determine the recommended phase II dose (R2PD) and evaluate the efficacy of ADI-PEG 20 in combination with ifosfamide and radiation in patients with high-grade STS. Methods: Eligible patients include untreated intermediate or high-grade extremity or truncal STS planned for definitive resection with performance status 0-1 and adequate organ function. Metastatic disease is exclusionary as well as receiving prior treatment for the study cancer. The total number of patients to be enrolled is approximately 35. Up to 15 patients will be enrolled in the phase I portion with a 3 + 3 dose escalation design with ADI-PEG 20 in combination with escalating doses of ifosfamide and radiation. The primary objectives include determining safety and tolerability as well as the recommended phase II dose (RP2D). Patients will be treated neoadjuvantly with ADI-PEG 20 dosed once weekly starting on Cycle 1 Day -7 with ifosfamide for up to three cycles in combination with standard radiotherapy given over approximately 5 weeks. Ifosfamide will be administered on Days 1 - 5 of all 3 cycles. The phase II participants will receive the combination with ifosfamide at the RP2D determined during phase I. The primary objective of the phase II portion is to determine the percent necrosis and pathologic complete response (pCR) at the time of resection. These endpoints will be summarized by proportions along with the associated 2-sided exact 95% CIs. Assuming the true pCR rate is 25%, enrolling 20 patients will result in a 90% CI for estimating the pCR (10%, 45%). The trial has begun accrual and is soon to open at multiple sites. Clinical trial information: NCT05813327 .
Traumatic Brain Injury and Traumatic Spinal Cord Injury
Authors: Podell Jamie E. , Morris Nicholas A. 
Published: June 2024

ABSTRACT

OBJECTIVE
This article reviews the mechanisms of primary traumatic injury to the brain and spinal cord, with an emphasis on grading severity, identifying surgical indications, anticipating complications, and managing secondary injury.

LATEST DEVELOPMENTS
Serum biomarkers have emerged for clinical decision making and prognosis after traumatic injury. Cortical spreading depolarization has been identified as a potentially modifiable mechanism of secondary injury after traumatic brain injury. Innovative methods to detect covert consciousness may inform prognosis and enrich future studies of coma recovery. The time-sensitive nature of spinal decompression is being elucidated.

ESSENTIAL POINTS
Proven management strategies for patients with severe neurotrauma in the intensive care unit include surgical decompression when appropriate, the optimization of perfusion, and the anticipation and treatment of complications. Despite validated models, predicting outcomes after traumatic brain injury remains challenging, requiring prognostic humility and a model of shared decision making with surrogate decision makers to establish care goals. Penetrating injuries, especially gunshot wounds, are often devastating and require public health and policy approaches that target prevention.
Hearing loss in Australian First Nations children at 6-monthly assessments from age 12 to 36 months: Secondary outcomes from randomised controlled trials of novel pneumococcal conjugate vaccine schedules
Authors: Leach Amanda Jane , Wilson Nicole , Arrowsmith Beth , Beissbarth Jemima , Mulholland Kim , Santosham Mathuram , Torzillo Paul John , McIntyre Peter , Smith-Vaughan Heidi , Skull Sue A. , Oguoma Victor M. , Chatfield Mark D. , Lehmann Deborah , Brennan-Jones Christopher G. , Binks Michael J. , Licciardi Paul V. , Andrews Ross M. , Snelling Tom , Krause Vicki , Carapetis Jonathan , Chang Anne B. , Morris Peter Stanley 
Published: June 2024

Background
In Australian remote communities, First Nations children with otitis media (OM)-related hearing loss are disproportionately at risk of developmental delay and poor school performance, compared to those with normal hearing. Our objective was to compare OM-related hearing loss in children randomised to one of 2 pneumococcal conjugate vaccine (PCV) formulations.

Methods and findings
In 2 sequential parallel, open-label, randomised controlled trials (the PREVIX trials), eligible infants were first allocated 1:1:1 at age 28 to 38 days to standard or mixed PCV schedules, then at age 12 months to PCV13 (13-valent pneumococcal conjugate vaccine, +P) or PHiD-CV10 (10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine, +S) (1:1). Here, we report prevalence and level of hearing loss outcomes in the +P and +S groups at 6-monthly scheduled assessments from age 12 to 36 months. From March 2013 to September 2018, 261 infants were enrolled and 461 hearing assessments were performed. Prevalence of hearing loss was 78% (25/32) in the +P group and 71% (20/28) in the +S group at baseline, declining to 52% (28/54) in the +P groups and 56% (33/59) in the +S group at age 36 months. At primary endpoint age 18 months, prevalence of moderate (disabling) hearing loss was 21% (9/42) in the +P group and 41% (20/49) in the +S group (difference −19%; (95% confidence interval (CI) [−38, −1], p = 0.07) and prevalence of no hearing loss was 36% (15/42) in the +P group and 16% (8/49) in the +S group (difference 19%; (95% CI [2, 37], p = 0.05). At subsequent time points, prevalence of moderate hearing loss remained lower in the +P group: differences −3%; (95% CI [−23, 18], p = 1.00 at age 24 months), −12%; (95% CI [−30, 6], p = 0.29 at age 30 months), and −9%; (95% CI [−23, 5], p = 0.25 at age 36 months). A major limitation was the small sample size, hence low power to reach statistical significance, thereby reducing confidence in the effect size.

Conclusions
In this study, we observed a high prevalence and persistence of moderate (disabling) hearing loss throughout early childhood. We found a lower prevalence of moderate hearing loss and correspondingly higher prevalence of no hearing loss in the +P group, which may have substantial benefits for high-risk children, their families, and society, but warrant further investigation.

Trial registration
ClinicalTrials.gov NCT01735084 and NCT01174849
Antegrade anterior column acetabulum fracture fixation with cannulated compression headless screws—A biomechanical study on standardized osteoporotic artificial bone
Authors: Berk Till , Zderic Ivan , Schwarzenberg Peter , Pastor Torsten , Drenchev Ludmil , Skulev Hristo Kostov , Richards Geoff , Hierholzer Christian , Halvachizadeh Sascha , Pape Hans-Christoph , Gueorguiev Boyko 
Published: June 2024

Purpose
Due to the increase in life expectancy and high-energy traumas, anterior column acetabular fractures (ACFs) are also increasing. While open reduction and internal fixation (ORIF) is still the standard surgical procedure, minimally invasive, percutaneous fixation of osteoporotic acetabulum fractures (AF) are growing in popularity. The aim of this biomechanical study was to evaluate the biomechanical competence following antegrade fixation with a standard screw versus a cannulated compression headless screw.

Methods
Eight anatomical osteoporotic composite pelvises were given an anterior column fracture. Two groups of eight specimens each (n = 8) for fixation with either a 6.5 mm cannulated compression headless screw in group Anterior Acetabulum Canulated Compression Headless Screw (AACCH), or with a 6.5 mm partially threaded cannulated screw in group Anterior Acetabulum Standard Screw (AASS) where compared. Each specimen was biomechanically loaded cyclically at a rate of 2 Hz with monotonically increasing compressive load until failure. Motions were assessed by means of optical motion tracking.

Results
Initial construct stiffness trended higher in group AACCH at 152.4 ± 23.1 N/mm compared to group AASS at 118.5 ± 34.3 N/mm, p = 0.051. Numbers of cycles and corresponding peak load at failure, were significantly higher in group AACCH at 6734 ± 1669 cycles and 873.4 ± 166.9 N versus group AASS at 4440 ± 2063 cycles and 644.0 ± 206.3 N, p = 0.041. Failure modes were breakout of the screws around the proximal entry point.

Conclusion
From a biomechanical perspective, group AACCH was associated with superior biomechanical competence compared to standard partially threaded cannulated screws and could therefore be considered as valid alternative for fixation of anterior acetabulum fractures.
Accuracy and feasibility in building a personalized 3D printed femoral pseudoaneurysm model for endovascular training
Authors: Lee Suat Yee , Chew Shen Cheak Currina , Lee Pei Hua , Chen Hung Da , Huang Shao Min , Liu Chun Hung , Chew Fatt Yang 
Published: June 2024

Background
The use of three-dimensional(3D) printing is broadly across many medical specialties. It is an innovative, and rapidly growing technology to produce custom anatomical models and medical conditions models for medical teaching, surgical planning, and patient education. This study aimed to evaluate the accuracy and feasibility of 3D printing in creating a superficial femoral artery pseudoaneurysm model based on CT scans for endovascular training.

Methods
A case of a left superficial femoral artery pseudoaneurysm was selected, and the 3D model was created using DICOM files imported into Materialise Mimics 22.0 and Materialise 3-Matic software, then printed using vat polymerization technology. Two 3D-printed models were created, and a series of comparisons were conducted between the 3D segmented images from CT scans and these two 3D-printed models. Ten comparisons involving internal diameters and angles of the specific anatomical location were measured.

Results
The study found that the absolute mean difference in diameter between the 3D segmented images and the 3D printed models was 0.179±0.145 mm and 0.216±0.143mm, respectively, with no significant difference between the two sets of models. Additionally, the absolute mean difference in angle was 0.99±0.65° and 1.00±0.91°, respectively, and the absolute mean difference in angle between the two sets of data was not significant. Bland-Altman analysis confirmed a high correlation in dimension measurements between the 3D-printed models and segmented images. Furthermore, the accuracy of a 3D-printed femoral pseudoaneurysm model was further tested through the simulation of a superficial femoral artery pseudoaneurysm coiling procedure using the Philips Azurion7 in the angiography room.

Conclusions
3D printing is a reliable technique for producing a high accuracy 3D anatomical model that closely resemble a patient’s anatomy based on CT images. Additionally, 3D printing is a feasible and viable option for use in endovascular training and medical education. In general, 3D printing is an encouraging technology with diverse possibilities in medicine, including surgical planning, medical education, and medical device advancement.
Anal Mucinous Adenocarcinoma Presenting as a Superficial Lesion Without Luminal Involvement
Authors: Wozny David , Nguyen Minh Thu T. , Kumar Shruti Adidam , Schoenfeld Adam 
Published: June 2024

ABSTRACT
Anal mucinous adenocarcinoma arises from mucin-secreting columnar epithelium within anal glands and is extremely rare, comprising 2%–3% of all gastrointestinal malignancies. We present a unique case of 65-year-old developmentally disabled man with complaint of rectal pain. Examination showed an excoriated erythematous perianal region with mucinous film and subdermal nodularity. Surgical pathology of the lesion revealed poorly differentiated mucinous adenocarcinoma of intestinal type. Subsequent colonoscopy was without findings of intraluminal lesions. He established with oncology and later underwent a positron emission tomography scan that showed extensive metastasis. This case highlights a unique presentation of de novo mucinous adenocarcinoma with luminal sparing.
Treating Helicobacter pylori and Recurrent Clostridioides difficile Coinfection: A Delicate Balance in Management and a Need for Guidelines
Authors: Abboud Yazan , Richter Benjamin , Malhotra Raj , Vossough-Teehan Sima 
Published: June 2024

ABSTRACT
Treating Helicobacter pylori and Clostridioides difficile coinfection presents a challenging clinical dilemma. Treating H. pylori may increase the risk of C. difficile, and antibiotics generally have been shown to increase the risk of C. difficile infection/recurrence. While it may be reasonable to delay H. pylori treatment, this is especially challenging when there is an acute indication to treat H. pylori such as peptic ulceration or bleeding. There are no guidelines on the management of H. pylori and C. difficile coinfection. We report a patient who had H. pylori and recurrent C. difficile coinfection and suggest a management algorithm based on literature review and our institutional experience. Our patient received quadruple therapy for H. pylori along with vancomycin prophylaxis, taper, and a dose of bezlotoxumab and experienced good outcomes with resolution of his gastrointestinal bleeding and diarrhea.
slc26a12—A novel member of the slc26 family, is located in tandem with slc26a2 in coelacanths, amphibians, reptiles, and birds
Authors: Nagashima Ayumi , Torii Kota , Ota Chihiro , Kato Akira 
Published: June 2024

AbstractSolute carrier family 26 (Slc26) is a family of anion exchangers with 11 members in mammals (named Slc26a1‐a11). Here, we identified a novel member of the slc26 family, slc26a12, located in tandem with slc26a2 in the genomes of several vertebrate lineages. BLAST and synteny analyses of various jawed vertebrate genome databases revealed that slc26a12 is present in coelacanths, amphibians, reptiles, and birds but not in cartilaginous fishes, lungfish, mammals, or ray‐finned fishes. In some avian and reptilian lineages such as owls, penguins, egrets, and ducks, and most turtles examined, slc26a12 was lost or pseudogenized. Phylogenetic analysis showed that Slc26a12 formed an independent branch with the other Slc26 members and Slc26a12, Slc26a1 and Slc26a2 formed a single branch, suggesting that these three members formed a subfamily in Slc26. In jawless fish, hagfish have two genes homologous to slc26a2 and slc26a12, whereas lamprey has a single gene homologous to slc26a2. African clawed frogs express slc26a12 in larval gills, skin, and fins. These results show that slc26a12 was present at least before the separation of lobe‐finned fish and tetrapods; the name slc26a12 is appropriate because the gene duplication occurred in the distant past.
Nontrivial solutions for resonance quasilinear elliptic systems
Authors: Borgia Natalino , Cingolani Silvia , Vannella Giuseppina 
Published: June 2024

AbstractWe establish an Amann-Zehnder-type result for resonance systems of quasilinear elliptic equations with homogeneous Dirichlet boundary conditions, involving nonlinearities growing asymptotically(p,q)\left(p,q)-linear at infinity. The proof relies on a cohomological linking in a product Banach space where the properties of cones of the sublevels are missing, differently from the single quasilinear equation. We also perform critical group computations of the energy functional at the origin, in spite of the lack of itsC2{C}^{2}regularity, to exclude that the found mini-max solution is trivial. Finally, we furnish a local condition which guarantees that the found solution is not semi-trivial.
Edutainment and Dwelling-Related Assets in Poor Rural Areas of Peru
Authors: Chong Alberto , Valdivia Martin 
Published: June 2024

Abstract
We exploit a field experiment by (Chong, A., and M. Valdivia. 2023. “Edutainment, Savings, and Generational Differences in Rural Areas of Peru.” In Working Paper. Department of Economics, Georgia State University) and test whether poor women from rural areas in developing countries that are able to save seek dwelling-related assets and find causal evidence that this is indeed the case. Furthermore, we also find that the older cohort of women, those aged forty and higher, also prioritize material assets related to health-related expenditures, in particular, access to public sewerage system.