bluuebunny/crossref_metadata_2025_split huggingface dataset:
Allergic Bronchopulmonary Aspergillosis (ABPA) Manifesting As a Disappearing Lung Mass: a case report.
Authors: Alshammari Maha , Ismail Huda , Alfaraj Fatimah 
Published: June 2024

Abstract

Background:
Allergic bronchopulmonary aspergillosis ABPA is a complex immunological pulmonary condition triggered by a hypersensitivity response to Aspergillus fumigatus, with wide radiological presentations predominantly affecting those with athsma or cystic fibrosis. This case presentation represent a an atypical history and unremarkable physical exam with a rare radiological picture of ABPA.
Case presentation:
This case report outlines the clinical course of a 40 years old female who presented with chronic cough and hemoptysis, her medical history revealed excision of an eye mass, consistent with pathology proven sarcoidosis. Initial X-ray and CT revealed a right upper lobe mass with central branching hyperdenisties. Bronchoalveolar lavage (BAL) with cytology analysis led to consideration of ABPA. A follow-up CT chest after a few months showed complete resolution of the mass, with features consistent with ABPA, guidingthe physician to appropriate management strategies.
Conclusion:
This case presents a unique instance of Allergic Bronchoalveolar Aspergillosis (ABPA) and emphasizes the significance of imaging and BAL in suspected cases of ABPA. Treating physician should keep in mind that ABPA may manifest as a solitary lung mass, resembling lung cancer, follow up exams and correlation with BAL are essential for establishing the diagnosis.
Short and Long-Term Trajectories of the Post COVID-19 Condition: Results from the EuCARE POSTCOVID study
Authors: Santoro Andrea , Bai Francesca , Greco Maria Francesca , Rovito Roberta , Sala Matteo , Borghi Lidia , Piscopo Kyrie , Vegni Elena , Caporali Julia Fonseca de Morais , Marinho Carolina Coimbra , Leite Arnaldo Santos , Santoro Maria Mercedes , Silberstein Francesca Ceccherini , Iannetta Marco , Juozapaite Dovile , Strumiliene Edita , Almeida André , Toscano Cristina , Quinones Jesus Arturo Ruiz , Carioti Luca , Mommo Chiara , Fanti Iuri , Incardona Francesca , Marchetti Giulia 
Published: June 2024

Abstract

Background
Post COVID-19 condition (PCC) affects 10–40% of patients and is characterized by persisting symptoms at ≥ 4 weeks after SARS CoV-2 infection. Symptoms can last 7 or even more months. How long PCC persists and any changes in its clinical phenotypes over time require further investigation. We investigated PCC trajectories and factors associated with PCC persistence.
Material and methods
We included both hospitalized COVID-19 patients and outpatients from February 2020 to June 2023, who underwent at least one follow-up visit after acute infection at San Paolo Hospital, University of Milan. Follow-up visits were conducted at the post COVID-19 clinic or via telemedicine. During each follow-up examination, patients completed a short version of the WHO CRF for ongoing symptoms, the Hospital Anxiety and Depression Scale (HADS), and a screening tool for Post-Traumatic Stress Disorder (PTSD). Statistical analyses involved Chi-square, Mann-Whitney, Kruskal-Wallis tests, and logistic regression analysis.
Results
We enrolled 853 patients (median age 62, IQR 52–73; 41% females). 551/853 (64.6%), 152/418 (36.4%) and 21/69 (30.4%) presented PCC at median follow up of 3 (IQR 2–3), 7 (IQR 6–10) and 26 (IQR 20–33) months, respectively (p < 0.001). The main clinical phenotypes were fatigue, respiratory sequelae, brain fog and chronic pain; anosmia/dysgeusia was observed mostly in the first post-acute period. Female sex, acute disease in 2020, a longer hospital stay and no COVID-19 vaccination were associated with persistence or resolution of PCC compared to never having had PCC. Anxiety, depression and PTSD were more common in PCC patients. By fitting a logistic regression analysis, acute infection in 2020 remained independently associated with persistent PCC, adjusting for age, sex, preexisting comorbidities and disease severity (AOR 0.479 for 2021 vs 2020, 95%CI 0.253–0.908, p = 0.024; AOR 0.771 for 2022 vs 2020, 95%CI 0.259–2.297, p = 0.641; AOR 0.086 for 2023 vs 2020, 95%CI 0.086–3.830, p = 0.565).
Conclusions
There was a reduction in the PCC burden 7 months following the acute phase; still, one third of patients experienced long-lasting symptoms. The main clinical presentations of PCC remain fatigue, respiratory symptoms, brain fog, and chronic pain. Having had SARS CoV-2 infection during the first pandemic phases appears to be associated with persistent PCC.
Cardioprotective effects of Platycodon grandiflorum Granules in HER2-positive early breast cancer patients receiving Trastuzumab plus Pertuzumab: study protocol for a double blind randomized controlled trial
Authors: Hao Wei , Sun Chenping , Wu Chunyu , Shi Youyang , Qin Yuenong , Liu Sheng 
Published: June 2024

Abstract

Background
Breast cancer, particularly the Human epidermal growth factor receptor 2 (HER2) positive subtype, poses a significant health challenge for women worldwide. Trastuzumab plus Pertuzumab therapy has shown efficacy in treating HER2-positive breast cancer, but its use is limited by associated cardiotoxicity. Traditional Chinese Medicine (TCM) suggests that Platycodon grandiflorus A. DC. (PG) may have cardioprotective effects due to its ability to nourish qi and blood. This study aims to investigate the effective and safety of PG in preventing cardiotoxicity associated with anti-HER2 therapy.
Method
In this double-blinded, randomized, placebo-controlled trial, approximately 120 patients will be randomly assigned to either the PG or placebo groups, alongside undergoing 12 months of dual anti-HER2 therapies in a 1:1 ratio. Cardiotoxicity will be assessed at a median follow-up of 1 year. The primary outcome measure is left ventricular global longitudinal strain, with secondary outcomes including: (1) changes in left ventricular ejection fraction, (2) the occurrence of cardiotoxicity, (3) the occurrence of trastuzumab plus pertuzumab interruption, and (4) event free survival and overall survival rates among patients.
Discussion
This will be the first clinical study to determine whether PG can reduce the cardiotoxicity induced by trastuzumab plus pertuzumab treatment in HER2-positive early breast cancer patients.
Trial registration
Chinese Clinical Trial Registry (Registration Number ChiCTR2200061011)
Comparison of chondrogenic differentiation of mesenchymal stromal cells from human amniotic fluid and human adipose-derived tissue in chitosan-xanthan gum scaffolds
Authors: Damas Ingrid I. , Zuliani Carolina C. , Westin Cecília B. , Andrade Kleber C. , Kharmandayan Paulo , Moraes Ângela M. , Mobasheri Ali , Coimbra Ibsen Bellini 
Published: June 2024

Abstract

Introduction: After age and obesity, traumatic injuries represent the third most important risk factor for the development of osteoarthritis. Current treatments for cartilage injuries are not very effective. However, the use of stem cells, associated or not with scaffolds, has been proposed and investigated. In this study, we compared chondrogenic differentiation in human amniotic fluid mesenchymal stromal cells (hAF-MSC) and human adipose-derived mesenchymal stromal cells (hAD-MSC) grown in porous chitosan-xanthan gum scaffolds (CX) stimulated with TGF-β3, aiming at the possibility of direct implantation in the lesioned site.
Methods: hAF-MSC were collected from women in the second trimester of pregnancy and hAD-MSC from patients that underwent liposuction. In the case of hAF-MSC samples, CD117-positive cells were selected. The mesenchymal stromal cells (MSCs) from both sources were expanded and characterized considering their capacity to adhere to polystyrene culture flasks, by flow cytometry analysis and differentiation into cartilage, bone and fat cells. The MSCs were seeded into chitosan-xanthan gum scaffolds specially designed for use in cartilage tissue engineering and grown under TGF-β3 stimulation. Differentiation was confirmed and evaluated by scanning electron microscopy (SEM), histology, immunohistochemistry and immunofluorescence analysis.
Results: The results showed that MSCs from both sources exhibited high capacity for cell expansion, positivity for phenotypic markers, multipotency, chondrogenic potential and negativity for hematopoietic markers, in addition to differentiation capacity into the three above-mentioned mesenchymal lineages. Chondrogenic differentiation was confirmed by hematoxylin-eosin, alcian blue, picrosirius red and Masson's trichrome staining, indicating the presence of collagens and proteoglycans. Immunohistochemistry analysis showed positivity for collagen II and aggrecan, and immunofluorescence also showed positivity for collagen II. SEM revealed intense cell adhesion and collagen fibers adhered to the scaffold.
Conclusions: In summary, it was possible to differentiate in vitro stem cells from human amniotic fluid and human adipose tissue into chondrocytes directly in the scaffold of chitosan and xanthan in the presence of TGF-β3, with evident production of an ECM rich in collagen and PGs.
The influence of poverty on class engagement toward assignment submission in Community Schools of Nepal
Authors: Khatri Bishnu Bahadur , Thapa Yogendra 
Published: June 2024

Abstract

The relationship between poverty and education is complex and interdependent. Poverty limits access to quality schools and educational resources, leading to lower academic performance and class engagement. The objective of this study is to analyze the effectiveness of poverty on class engagement in assignment submission. A cross-sectional survey has been applied in a quantitative and positivist philosophical setting. Five hundred and thirty samples were randomly selected from 20 community schools in Jhapa and Morang using stratified sampling. Poverty identification was based on the Nepal Multidimensional Poverty Index (MMPI), 2021. Primary data is based on self-reports and non-standard questionnaires and analyzed through Stata 14 by taking support of logistic regression. The study found that 90 percent are far from better learning resources and about 50 percent of impoverished students have fewer opportunities to correct assignments regularly. The majority of poor students who do not complete homework within the deadline are punished physically. Similarly, more than 70 percent of students living in poverty have no access to interaction and learning support. According to the study's findings, students living in poverty participate less actively in class during the submission and correction of assignments. Poverty-stricken students have not taken full advantage of their educational prospects. The study suggests that quality education for students living in poverty is possible through the provision of quality educational resources, support to teachers and families, and the implementation of programs that address the specific needs of children.
Integrating multi-omics analysis and machine learning to identify molecular subtypes and construct prognostic models for lung squamous cell carcinoma
Authors: Dong Ya , Zhang Xiang , Wang Yuhan , Xu Tao 
Published: June 2024

Abstract

LUSC had a high morbidity and mortality rate in China, resulting in high social burdens. Most LUSC patients are already in the highly advanced cancer stage at diagnosis, and the clinical treatment is relatively difficult and the prognosis is relatively poor. The progress and application of sequencing technologies and machine learning algorithms offer new therapeutic perspectives and survival opportunities for LUSC patients. First, we gained multi-omics data on LUSC from the TCGA and GEO databases and performed batch effect. A total of ten different clustering methods were adopted to conduct multiomics consensus ensemble analysis. Then, we combined the integration analysis with ten machine learning algorithms to develop a CMLS. Besides, we explored the immune landscape and immunotherapeutic response of LUSC. Lastly, we identified potential therapeutic agents in LUSC. We independently identified two subtypes (CS1 and CS2) from ten multi-omics integrated clustering algorithms and CS2 showed the most favourable survival outcome among all subtypes. Subsequently, we identified 24 PRGs based on markers between subtypes and constructed CMLS using ten machine learning algorithms. In the TCGA-LUSC and META-LUSC sets, patients with high-CMLS group had a poorer clinical prognosis. Moreover, we evaluated the immunological landscape of LUSC using "IOBR" package. Low-CMLS group exhibited significantly higher levels of immune cell infiltration, including NK cells, T cells and B cells, suggesting that they may have better survival outcomes. CMLS might predict the prognosis and immune response of LUSC patients in some degree. In conclusion, our study provided novel ways to optimise the clinical diagnosis and therapeutic approaches of LUSC.
Striae gravidarum in the Han Chinese pregnant population: Identifying genetic markers and risk factors through a prospective cohort study
Authors: Xiong Lidan , Yang Lifeng , He Hailun , Chen Jianguo , Wang Yinshu , Dong Xiuju , Li Li , Han Yuanyuan 
Published: June 2024

Abstract

Background
Striae gravidarum (SG), commonly known as stretch marks, are a frequent connective tissue alteration observed in pregnant women. Postpartum women may feel damaged in their self-image due to SG which can lead to lower self-esteem and emotional problems such as anxiety and depression. The study aimed to evaluate the potential risk factors and genetic associations of SG in a Chinese Han population.
Methods
A multicenter trial was conducted involving 1017 pregnant women of Chinese Han descent who provided informed consent. Participants completed questionnaires regarding demographics, medical history, and lifestyle factors. Anthropometric measurements and obstetric data were gathered, followed by a genome-wide association study (GWAS).
Results
The study found that 59% of participants experienced SG. Significant correlations were observed between SG and factors including age, pre-pregnancy weight, maximum pregnancy weight during pregnancy, BMI before and during pregnancy, and maximum abdomen girth. Risk factors for SG included a positive family history, prior experience of striae distensae during adolescence, and specific skin types according to the Fitzpatrick classification. Multivariable logistic regression analysis indicated that age, family history, history of striae distensae, skin types, and pre-pregnancy BMI were notable predictors of SG. The GWAS identified several single nucleotide polymorphisms (SNPs) related to SG presence and severity, implicating genes such as FGF12, RAB38, MUC16, PTPRT, SIPA1L2, PPARGC1A, PTPRD, and ELOVL3.
Conclusion
The study presents a predictive model for SG risk that includes non-modifiable factors like family history and skin type, and modifiable factors such as pre-pregnancy weight and BMI. The findings provide insights into the genetic basis of SG and may aid in counseling patients on risk reduction strategies. The identified genetic variants offer potential targets for future research into the pathogenesis and prevention of SG.
Artificial Intelligence in Patient Care: A Study of Artificial Intelligence’s Responses to Blepharoplasty Concerns
Authors: Yassa Arsany , Ayad Olivia , Patel Aman , Vengsarkar Ved , Mikhael Mina 
Published: June 2024

Abstract

Purpose
Artificial Intelligence (AI) is rapidly advancing and profoundly influencing healthcare, offering the potential to revolutionize access to medical information. As medical misinformation proliferates and online searches for health-related advice increase, there is an escalating need for dependable patient information. This study evaluates the effectiveness of an AI chatbot in delivering information for blepharoplasty candidates.
Materials and Methods
Numerous frequently asked questions on blepharoplasty sourced from the ASPS website were asked to ChatGPT. The responses were then rigorously cross-referenced with relevant scholarly literature and meticulously reviewed by the research team to determine their accuracy. Additionally, the questions were classified into three categories, and the responses were evaluated using Flesch-Kincaid readability metrics, along with ANOVA and trend analysis tests.
Results
Despite minor variations, ChatGPT's responses to blepharoplasty FAQs largely aligned with current literature. Overall readability analysis showed a Flesch Reading Ease score of 31.48, indicating high school complexity with a Flesch-Kincaid Grade Level at 10.92, and 20.97% use of passive voice. The ANOVA results showed that there were no significant differences in readability between the categories (p-values: Flesch Reading Ease = 0.816, Flesch-Kincaid = 0.616, Passive Sentences = 0.115). Trend analysis also showed that the level of response complexity stayed the same across the questions.
Conclusion
ChatGPT is an evolving tool that holds potential for patients in accessing and comprehending medical information. While it can offer accurate insights, it's important to recognize that its answers might not consistently reach complete accuracy or be suitable for patients with varying educational levels.
A Decomposition Analysis of Inequality in Malnutrition Among Under Five Children in India: Findings from National Family Health Survey-5
Authors: Kabdwal Naresh Chandra , Yadav Niraj Kumar , Singh Kh. Jitenkumar , Yadav Jitendra 
Published: June 2024

Abstract

Background: Nutrition is essential for good health and human development, particularly during the early stages of life. Nutritional status of children is essential for their development and growth at early stage of lives, with implications extending into adult life. Malnutrition is recognized to be the biggest single threat to the public health worldwide, particularly in developing countries. Nutritional status can be determined anthropometrically which is the outcome of complex interactions between socio-economic and biological variables. This study aimed to measure malnutrition inequality among underfive children in India and we have used a regression-based decomposition analysis to see the impact of socioeconomic determinants on this inequality.
Methods: The study utilizes data from the National Family Health Survey (NFHS-5) conducted between 2019 and 2021. To examine the magnitude of socioeconomic inequality in child malnutrition, the concentration indices for stunting, underweight, and wasting are employed. Furthermore, decomposition analysis of the concentration indices is conducted to understand the role of socio-economic factors in child-hood malnutrition inequality.
Results: The obtained concentration indices of stunting, underweight, and wasting were respectively -0.126, -0.138, and -0.064. Socioeconomic inequality in underweight and stunting was statistically significant, with children in the lowest socioeconomic quintile bearing a higher burden of malnutrition; however, no socio-economic gradient was observed in wasting. Urban children in the lowest quintiles experienced a higher burden of stunting than rural children, according to the concentration index value derived from the area of residence. Furthermore, socioeconomic status significantly influenced malnutrition inequality, with approximately 36% of the inequality in stunting, 44% in underweight, and over 68% in wasting attributed to family socioeconomic status.
Conclusion: The average reduction in the national-level malnutrition indices reflects the impact of malnutrition among children in low-income families. To effectively address this issue, the government and policymakers must implement direct and targeted actions aimed at eliminating current inequities in the socio-economic determinants linked with malnutrition. By prioritizing interventions that specifically target vulnerable populations and address the underlying socioeconomic factors contributing to malnutrition, policymakers can work towards achieving equitable access to nutrition and improving the health outcomes of all children.
Variability of Thermal Subthreshold Retinal Laser Treatment Plans
Authors: Rahn Ulrike , Rahn Christian-Dennis , Arora Supriya , Ng Eugene , Kozak Igor , Chhablani Jay 
Published: June 2024

Abstract

Purpose
To investigate the variability in subthreshold laser treatment plans for patients with diabetic macular edema or central serous chorioretinopathy.
Methods
Diagnostic images from 20 patients were utilized, and 25 retina specialists generated subthreshold treatment plans along with a self-rated experience level. Evaluation comprised of i)Area Variability(AV): quantifies the consensus regarding the covered area and is the difference between the areas planned by 75% and 25% of the participants ii)mean Centroid Distance(CD): level of agreement on the localization of a treatment. Subgroup analysis investigated the impact of participants' experience levels, utilizing the Mann-Whitney-Wilcoxon test.
Results
The predominant plan style is a targeted treatment approach(92%) and avoidance of subfoveal region(89%). Mean CD is 71.0 ± 37.5 pixels (≈half disc diameter) and mean AV is 9.8%±8.9%. A slight difference is observed between the 50%-75% areas, but a notable distinction exists between the 25%-50% areas. Subgroup analysis revealed CD and AV value of 75.9 pixels and 24% in the lower experience level group as opposed to 55.9 pixels and 8.6% in the higher experience level group.
Conclusions
There is significant variability in treatment planning which reduces with increased experience of retina specialists. While consensus is observed around focal points, differences in the surrounding extents persist.
Incidence, Risk Factors and Therapy Response of Acute Graft-versus-Host Disease after Postransplant Cyclophosphamide
Authors: Gomez Ines , Cantó Pedro Asensi , Montoro Juan , Villalba Marta , Chorao Pedro , Solves Pilar , Santiago Marta , Madrid Pilar Lloret , Ruiz Jürgen Solís , Pell-Ilderton Clara Sopeña , Campuzano David Martínez , Granados Pablo , Eiris Juan , Louro Alberto , Rebollar Paula , Perla Aurora , Benavente Rafael , Rubia Javier de la , Sanz Miguel Ángel , Balaguer-Roselló Aitana , Caballer Jaime Sanz 
Published: June 2024

Abstract

Post-transplant cyclophosphamide, sirolimus and mycophenolate mofetil (PTCy/siro/MMF) constitutes an innovative and well-tolerated acute graft-versus-host disease (aGVHD) prophylaxis after allogeneic stem cell transplantation (allo-HSCT), but risk factors for aGVHD incidence and therapy failure in this setting are scarce. The study prospectively registered all consecutive adult patients with hematologic malignancies who received an allo-HSCT using PTCy/siro/MMF prophylaxis at our institution between 2017 and 2023. A total of 439 patients were included, of whom 40% were transplanted from matched sibiling donors, 34% from matched unrelated donors (MUD) and 26% from haploidentical donors. The 100-day cumulative incidence of grade II-IV and grade III-IV aGVHD was 22% (95% confidence interval [CI] 18–26%) and 11% (95% CI 8–14%), respectively. The use of MUD was associated with decreased risk of severe aGVHD while a diagnosis of myelodysplastic or myeloproliferative neoplasms (MDS/MPN) was deleterious. Among 92 patients receiving first-line systemic corticosteroids, 51% achieved a sustained complete response, while 22% and 23% developed steroid-dependent (SD-aGVHD) and steroid-refractory aGVHD (SR-aGVHD), respectively. Only grade III-IV aGVHD was a predictor of steroid failure. SR-aGVHD was associated with worse salvage treatment response and overall survival compared to SD-aGVHD. The 1-year cumulative incidence of aGVHD-related mortality was 5.7% (95% CI, 3.7–8.2). Risk factors for aGVHD-related mortality included haploidentical donors, older donors, diagnosis of MDS/MPN, and grade IV aGVHD. This study confirms a low incidence aGVHD with PTCy/siro/MMF prophylaxis. SR-aGVHD showed poorer response to salvage therapies and worse survival, while haploidentical donors and older donor age were negative predictors for aGVHD-related deaths.