bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hepatic artery infusion chemotherapy with systemic capecitabine and camrelizumab for treating unresectable hilar cholangiocarcinoma: An initial investigation of efficacy and safety
Authors: Li Long , Liu Song , Wang Qingdong , Wang Yanhua , Yu Guangji 
Published: April 2024

ABSTRACTObjective:This study aimed to evaluate the efficacy and safety of sequential treatment of continuous transcatheter hepatic artery infusion chemotherapy (HAIC) with systemic capecitabine monotherapy and camrelizumab for treating unresectable hilar cholangiocarcinoma (HCCA).Methods:This study retrospectively analyzed patients with unresectable HCCA admitted to Linyi Cancer Hospital in Shandong Province from October 2019 to December 2021. All enrolled patients were treated with HAIC (mFOLFOX7) + camrelizumab for 2–6 cycles and administered systemic therapy with capecitabine and camrelizumab. The objective response rate (ORR), disease control rate (DCR), and adverse reactions of patients were assessed. The Kaplan–Meier method was used to describe overall survival (OS), and univariate and multivariate Cox regression models were utilized to analyze the influencing factors of OS.Results:This study included 34 patients, ORR was 61.76% (21/34), and DCR was 97.06% (33/34) after two HAIC cycles. The median follow-up time was 17.5 months, with an average of 18.32 ± 8.06 months, and the median OS was 20.0 months. HAIC-related adverse reactions included mainly gastrointestinal symptoms and hematological toxicity caused by chemotherapy drugs, all of which were grades 1–2. Further, adverse events for camrelizumab treatment included fatigue, skin rash, and hypothyroidism, all of which were grade <3. Cox regression analysis revealed that the periductal infiltrating type of growth pattern indicated a worse OS, whereas more HAIC cycles (5 ~ 6) were a protective factor for OS.Conclusion:HAIC sequentially combined with systemic capecitabine chemotherapy and a programmed death-1 inhibitor displayed favorable effects for unresectable HCCA, with controllable adverse reactions.
New advances in the treatment of chondrosarcoma under the PD-1/PD-L1 pathway
Authors: Yin Jiawei , Ren Peng 
Published: April 2024

ABSTRACT
Bone sarcomas encompass a group of spontaneous mesenchymal malignancies, among which osteosarcoma, Ewing sarcoma, chondrosarcoma, and chordoma are the most common subtypes. Chondrosarcoma, a relatively prevalent malignant bone tumor that originates from chondrocytes, is characterized by endogenous cartilage ossification within the tumor tissue. Despite the use of aggressive treatment approaches involving extensive surgical resection, chemotherapy, and radiotherapy for patients with osteosarcoma, chondrosarcoma, and chordoma, limited improvements in patient outcomes have been observed. Furthermore, resistance to chemotherapy and radiation therapy has been observed in chondrosarcoma and chordoma cases. Consequently, novel therapeutic approaches for bone sarcomas, including chondrosarcoma, need to be uncovered. Recently, the emergence of immunotherapy and immune checkpoint inhibitors has garnered attention given their clinical success in various diverse types of cancer, thereby prompting investigations into their potential for managing chondrosarcoma. Considering that circumvention of immune surveillance is considered a key factor in the malignant progression of tumors and that immune checkpoints play an important role in modulating antitumor immune effects, blockers or inhibitors targeting these immune checkpoints have become effective therapeutic tools for patients with tumors. One such checkpoint receptor implicated in this process is programmed cell death protein-1 (PD-1). The association between PD-1 and programmed cell death ligand-1 (PD-L1) and cancer progression in humans has been extensively studied, highlighting their remarkable potential as biomarkers for cancer treatment. This review comprehensively examines available studies on current chondrosarcoma treatments and advancements in anti-PD-1/PD-L1 blockade therapy for chondrosarcoma.
Anti-epileptic drug use during adjuvant chemo-radiotherapy is associated with poorer survival in patients with glioblastoma: A nationwide population-based cohort study
Authors: Lee Peng-Yi , Wei Yu-Ting , Chao Kun-San Clifford , Chu Chin-Nan , Chung Wen-Hui , Wang* Ti-Hao 
Published: April 2024

ABSTRACT

Introduction:
There are emerging but inconsistent evidences about anti-epileptic drugs (AEDs) as radio- or chemo-sensitizers to improve survival in glioblastoma patients. We conducted a nationwide population-based study to evaluate the impact of concurrent AED during post-operative chemo-radiotherapy on outcome.

Material and Methods:
A total of 1057 glioblastoma patients were identified by National Health Insurance Research Database and Cancer Registry in 2008–2015. Eligible criteria included those receiving surgery, adjuvant radiotherapy and temozolomide, and without other cancer diagnoses. Survival between patients taking concurrent AED for 14 days or more during chemo-radiotherapy (AED group) and those who did not (non-AED group) were compared, and subgroup analyses for those with valproic acid (VPA), levetiracetam (LEV), or phenytoin were performed. Multivariate analyses were used to adjust for confounding factors.

Results:
There were 642 patients in the AED group, whereas 415 in the non-AED group. The demographic data was balanced except trend of more patients in the AED group had previous drug history of AEDs (22.6% vs. 18%, P 0.078). Overall, the AED group had significantly increased risk of mortality (HR = 1.18, P 0.016) compared to the non-AED group. Besides, an adverse dose–dependent relationship on survival was also demonstrated in the AED group (HR = 1.118, P 0.0003). In subgroup analyses, the significant detrimental effect was demonstrated in VPA group (HR = 1.29,P 0.0002), but not in LEV (HR = 1.18, P 0.079) and phenytoin (HR = 0.98, P 0.862).

Conclusions:
Improved survival was not observed in patients with concurrent AEDs during chemo-radiotherapy. Our real-world data did not support prophylactic use of AEDs for glioblastoma patients.
Application of statistics in biomedical research
Authors: Padhee Sourav , Ahmed Sakir 
Published: April 2024

Abstract
Statistical tools for data analysis vary depending on the kind of data and measurement scales used. The objective of this review is to offer a deep insight into these various data types and measuring systems. This overview offers comprehensive details on the various data kinds and measurement scales along with examples. Applying the proper statistical techniques and drawing reliable conclusions require knowledge of the relevant data type or analysis procedure.
Demystifying the pink enigma: A succinct overview on the interdental papilla
Authors: Kshirsagar Jaishree Tukaram , Monika A. , Nithiyaraj S. , Sathyasree S. , Sharma K. Shyam 
Published: April 2024

Abstract
Nowadays, the scope of dentistry has extended beyond the realm of functionality to include the elusive domain of esthetics as well. Gingival black triangle (GBT) is a cosmetic aberration caused by the absence of the papilla, resulting in black gaps or exposed embrasures. Loss of interdental papilla is significantly linked to advancing age, periodontal diseases, and orthodontic therapy. The lack of an interdental papilla raises the concerns about phonetics, food accumulation, and plaque deposition, all of which exacerbate the current situation and cause esthetic issues. In dental procedures, replacing the missing interdental papilla is a difficult and unpredictable process. Because of its complicated anatomy and numerous contributing elements, attaining a successful reconstruction is not always assured. This review article discusses the anatomy of interdental papilla, different classifications of interdental papillary loss, the etiology of the GBT, and the currently available nonsurgical and surgical treatment modalities recommended for preservation of interdental papilla and management of interdental papilla loss.
ProTaper universal retreatment retreatment potential in oval-shaped canals filled with different obturation techniques—A micro-computed tomography study
Authors: Zongova-Adem Sherihan E , Tsenova-Ilieva Irina Kalinova , Dogandzhiyska Violeta Dimitrova , Topalova-Pirinska Snezhanka Zaprinova , Karova Emilia Goshova 
Published: April 2024

Abstract

Aim:
The objective of this in vitro micro-computed tomography investigation is to assess the efficacy of the ProTaper Universal Retreatment System in retreating oval-shaped root canals filled with three obturation procedures.

Materials and Methods:
Thirty-six lower incisors with a single oval root canal were prepared using XP-Endo Shaper up to size 30/0.04, and allocated into three equal groups based on the filling technique: Group 1: Warm vertical condensation technique; Group 2: GuttaCore obturators; Group 3: Cold lateral condensation technique. All samples were further retreated using the ProTaper Universal Retreatment system. Micro-CT analysis was performed before and after the retreatment procedure. Statistical analysis was performed with a significance level of 0.05. Data analysis was conducted using the Kolmogorov-Smirnov and Kruskal–Wallis H tests.

Results:
The best performance of the files was achieved when the removal of the filling in the entire canal was considered. However, this outcome was not statistically significant when compared with the other observed root canal levels. The retreatment procedure could not ensure thorough cleanliness of the canal walls from filling remnants, regardless of the obturation technique and observational level.

Conclusions:
The ProTaper Universal Retreatment system used for the removal of gutta-percha and sealer in oval-shaped root canals demonstrated equal effectiveness, regardless of the obturation technique used.
Family Caregivers’ Experiences of Caring for Patients with Heart Failure: A Qualitative Study
Authors: Tunsi Afnan , Idrees Maha , Al-faifi Najwa , Heliebi Nouf , Al-zahrani Shuaa , Alaamri Marym , Alhofaian Aisha 
Published: April 2024

Background:
Heart failure (HF) is a global health concern. People living with the disease require continuous care and support, which is frequently provided by informal caregivers. Although HF caregivers occupy a key position in improving patients’ outcomes and reducing health-care costs, many of them experience adverse impacts on their physical and psychological health, which is largely unknown.

Objective:
The purpose of this study was to explore the experiences, needs, and challenges facing HF caregivers in Saudi Arabia to identify priority areas for developing tailored interventions.

Materials and Methods:
An exploratory descriptive qualitative study was conducted using semi-structured interviews with 12 caregivers (age range, 18–57; mean, 32). Interview data were analyzed thematically following Braun and Clarke’s approach.

Results:
Analysis of the interviews yielded four distinct overarching themes: role definition; coping and support; unmet caregiver needs; and emotional impact.

Conclusion:
Caregiving is a complex and life-altering role with many health and well-being implications. An in-depth understanding of HF caregivers’ experiences and needs provides valuable insight into how they can be supported in their roles to improve both caregivers’ and patients’ outcomes.
Efficacy of an Oral Solution Containing Five Herbal Extracts in the Treatment of Urolithiasis: A Randomized, Single-blind, Placebo-controlled Clinical Trial
Authors: Samandarian Sahand , Soltani Rasool , Hajhashemi Valiollah , Dehghani Mehdi , Matinfar Mohammad , Mahboubi Mohaddese , Mohsenzadeh Afsaneh 
Published: April 2024

Objective:
The high prevalence of urolithiasis and its recurrence entail the preparation of an efficient drug with the least side effects. Tribulus terrestris, Urtica dioica, Adiantum capillus-veneris, Stigma maydis (corn silk), and Cucumis melo are herbal remedies utilized in traditional medicine for urolithiasis. This study aimed to assess the efficiency of these plants’ extracts in treating urolithiasis.

Methods:
In a randomized, single-blind, placebo-controlled clinical trial, participants meeting inclusion criteria were randomly allocated to the drug (n = 27) and placebo (n = 27) groups to take herbal or placebo solutions, respectively, at a dose of 60 drops 3 times daily for 4 weeks with standard treatment. Before and after the intervention, 24-h urine volume and the quantities of calcium, sodium, citrate, oxalate, urea, creatinine, and uric acid in 24-h urine, and urinary pH were measured. The number and size (diameter in mm) of stones were determined by ultrasonography and recorded for each patient.

Findings:
Except for 24 h urine volume, other urinary parameters did not alter significantly at the end of the intervention compared to baseline. Furthermore, the two groups had no significant difference regarding these indices. Regarding stone parameters, the stone size decreased significantly in the drug group compared to the placebo group (P = 0.049). The number of cases with complete stone expulsion in the drug group was significantly higher than in the placebo group (12 cases vs. 4 cases, respectively, P = 0.017).

Conclusion:
Oral consumption of the herbal solution causes stone size reduction and stone expulsion in patients with urolithiasis.
RV in COPD – The complicated matters of the heart – Correlation of ECHO and biomarker with COPD severity and outcome
Authors: Bhat Rajesh , Kamath Sindhu , Jain Arpit , Acharya Vishak , Antony Thomas , Holla Ramesh , Jha Abhavya 
Published: April 2024

Background:
Patients with chronic obstructive pulmonary disease (COPD) have an increased risk of cardiovascular involvement, which is among the leading causes of morbidity and mortality worldwide. Echocardiography (ECHO) could be a reliable, non-invasive tool for predicting the risk of cardiovascular modalities in patients with COPD. Combining the ECHO parameters with highly selective cardiac troponin could predict the severity and outcome of patients with COPD.

Methods:
This prospective observational study was conducted at a tertiary care hospital in South India. All patients who met the criteria were included. Patients with other concomitant chronic lung diseases were excluded. An echocardiographic examination was performed, and blood samples for hs-Tnt were taken on admission for patients admitted with COPD. Categorical variables were analyzed using Pearson’s Chi-square test, and the T-test was used to compare the means. One-way analysis of variance (ANOVA) followed by the Bonferroni multiple comparison tests was done to compare different echo parameters concerning COPD severity.

Results:
The mean tricuspid annulus plane systolic excursion (TAPSE) and right ventricle (RV) fraction area change (FAC) values were lower with the increase in the disease severity (P < 0.001). There was a significant increase in the mean systolic pressures in the right atrium and ventricle in patients with severe COPD (P < 0.001). The mean hs-TnT values were significantly higher in patients with severe COPD (18.86 ± 18.12) and correlated well with the increase in the severity of the disease (P < 0.001). Changes in the echo parameters, such as mean TAPSE and RV FAC values, negatively correlated with COPD severity. There was an increase in systolic pressure in both atria and ventricles with the progression of COPD. Troponin helped predict mortality during hospitalization.

Conclusion:
Comprehensive echocardiographic parameters, such as TAPSE and RV FAC, help assess the disease’s severity, predict mortality, and evaluate whether the proper ventricular function is reliable. Troponin is a valuable adjunct that is an independent and strong predictor of overall mortality in patients with COPD.
Clinical behaviour and mortality in idiopathic vs secondary nonspecific interstitial pneumonia
Authors: Wijayaratne Thisarana , Owen James , Fahim Ahmed 
Published: April 2024

Rationale:
Nonspecific interstitial pneumonia (NSIP) is a subtype of interstitial lung disease which can either be idiopathic or secondary to other conditions. Idiopathic NSIP is a relatively rare entity and diagnosis should be considered carefully as it is mainly a diagnosis of exclusion. The aim of this retrospective study was to evaluate a cohort of NSIP patients with a view to identifying any clinical and mortality differences between idiopathic and secondary varieties.

Methods:
We screened 700 patients from our interstitial lung disease database and identified 44 cases of NSIP retrospectively. Statistical analysis was conducted to evaluate if there was a difference in demographics such as gender and ethnicity, physiological parameters including forced vital capacity, diffusing capacity, average oxygen saturations, and immunology profile between two groups. Furthermore, a difference in mortality was evaluated between idiopathic and secondary NSIP.

Results:
The data analysis showed that 63.6% (28 of 44) of patients had idiopathic NSIP versus 36.4% (16 of 44) of patients had secondary NSIP. Majority of the secondary NSIP patients had an underlying connective tissue disease. In the idiopathic variety, there was a male preponderance (64.2%, P = .02) which was statistically different compared to relatively equal gender divide in secondary NSIP which was statistically insignificant (male vs. female: 43.8% vs. 56.3%, respectively, P = .42). The mean age of the idiopathic group was 74 years compared to 64 years in the secondary group which was statistically different (P = .01). In both groups (idiopathic and secondary NSIP), more than two-thirds (68%) were of White British ethnicity. Immunology profile was similar across both groups with no statistical difference in IgM, IgG, or IgA levels. At the time of analysis, there were 17.9% deaths (5 of 28) in the idiopathic NSIP group versus 6.3% (1 of 16) in the secondary NSIP group but this was not statistically significant (P = .14). Similarly, there was no statistically significant difference in the forced vital capacity (P = .59), diffusing capacity (P = .88), and resting oxygen saturations (P = .28) between idiopathic and secondary NSIP varieties.

Conclusion:
Our analysis showed that there was a statistically significant difference in gender (male preponderance in idiopathic NSIP only) and mean age difference among both varieties. There were no statistically significant differences in the clinical features and outcomes including mortality, physiological, and immunological parameters between idiopathic and secondary NSIP. Idiopathic NSIP was more common than secondary NSIP and secondary NSIP is mostly due to underlying connective tissue disease.
The effect of anticonvulsant drugs on serum lipid profile
Authors: Neethu T. T. , Sreedharan Syam , Vijayan Beena Vasanthy , Palappallil Dhanya Sasidharan 
Published: April 2024

BACKGROUND AND OBJECTIVES:
Epilepsy is a potentially life-shortening brain disorder, the symptoms of which can be successfully treated in most patients with one or more antiepileptic drug (AED). The literature explains the association of AED therapy and dyslipidemia. The changes in lipid fraction may vary with different AED, age group, and study population. The present study was planned to assess the serum lipid profile of adult epileptic patients receiving phenytoin, carbamazepine or sodium valproate therapy and attending Neurology Outpatient Department of Government Medical College, Kottayam, compared to normal healthy controls.

METHODOLOGY:
A total of 150 epileptic patients on AED monotherapy attending the outpatient department of neurology were evaluated for serum lipid profile. Demographic data and medical history of consenting participants were collected by the use of a semi-structured questionnaire. Fifty age- and sex-matching healthy controls also underwent similar investigation.

RESULTS AND DISCUSSION:
Over 12 months, 150 patients were recruited with a mean age of 35.54 ± 10.72 years (male-to-female ratio 1:1.27). When compared to normal control population observed statistically significant high mean total cholesterol, triglyceride level in the group receiving phenytoin therapy for more than 1 year. Only significant hypertriglyceridemia is observed in carbamazepine and sodium valproate treated patients. A significant correlation between the duration of anticonvulsant therapy and lipid profile was established.

CONCLUSION:
Conventional anticonvulsants induce dyslipidemia and monitoring of lipid profile should be done routinely to decrease the morbidity and preserve the quality of life in these (asymptomatic) patients.
The level of discomfort during the use of different circuits of the mechanical ventilator
Authors: Liu Meng-Yi , Hsu Pei-Shan , Wu Chiu-Feng , Wu Yao-Kuang , Yang Mei-Chen , Su Wen-Lin , Tzeng I-Shiang , Lan Chou-Chin 
Published: April 2024

ABSTRACT

Objectives:
Endotracheal tube (ETT) intubation is a life-saving procedure in patients with respiratory failure. However, the presence of an ETT can cause significant discomfort. A tracheostomy tube is used to administer a mechanical ventilator, resulting in a more stable airway and fewer serious injuries. Noninvasive ventilators (NIPPVs) administer ventilation through masks and must be tightly fixed to the face. ETT, tracheostomy, and NIPPV are the most common methods of ventilator maintenance. However, these interventions often cause discomfort to patients. This study aimed to compare discomfort associated with ETT, tracheostomy, and NIPPV.

Materials and Methods:
Forty-nine conscious patients with postextubation NIPPV and eight conscious patients who underwent postextubation tracheotomy were evaluated for discomfort. A questionnaire survey on discomfort was performed before and after NIPPV or tracheostomy. These patients reported their level of discomfort on a visual analog scale.

Results:
The levels of sore throat, nasal pain, body pain, activity limitation, respiratory discomfort, oral discomfort, difficulty coughing sputum, worry about respiratory tube disconnection, back pain, anxiety, worry about long-term admission, sleep disturbance, and general discomfort during ETT intubation were higher than during tracheostomy or NIPPV (all P < 0.05). The mean level of discomfort was approximately 5–6 points (moderate) in patients with ETT and 2–3 points (mild) in patients with NIPPV or tracheostomy.

Conclusion:
The level of discomfort was higher in patients who underwent ETT intubation than in those who underwent NIPPV or tracheostomy. However, the level of discomfort was similar between the patients with NIPPV and those who underwent tracheostomy.
Reduction in Acute Post-Streptococcal Glomerulonephritis Incidence in Counties Manukau, New Zealand, after the COVID-19 Pandemic
Authors: Taylor Amanda , Neutze Jocelyn , Moreland Nicole J. , Webb Rachel 
Published: April 2024

ABSTRACT.
The COVID-19 pandemic has altered the epidemiology of many common childhood infections, including Group A streptococcal (GAS) disease. Acute post-streptococcal glomerulonephritis (APSGN) is a nonsuppurative complication of GAS pharyngitis and pyoderma. It remains the most common cause of pediatric acute glomerulonephritis globally. In Counties Manukau, New Zealand, APSGN rates have previously been shown to be the highest in the country, with marked ethnic and socioeconomic disparities. We performed a retrospective review of children aged 0–14 years who were discharged from Kidz First Hospital, Counties Manukau, between 2015 and 2023 and met the Strep A Vaccine Global Consortium consensus definition of APSGN. We describe a marked, sustained reduction in APSGN hospitalizations, temporally associated with the COVID-19 pandemic. This ongoing reduction in APSGN incidence is notable in light of contrasting reports of increasing incidence of rheumatic fever in New Zealand and invasive GAS disease internationally.