bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful treatment of iatrogenic internal carotid artery pseudoaneurysm following carotid endarterectomy with thrombin injection: a case report
Authors: Jiang Changchun , Liu Jiahui , Zhuo Na , Wei Jianqi , Fan Yu 
Published: June 2024

Abstract
Background
Iatrogenic pseudoaneurysms arising from the internal carotid artery subsequent to carotid endarterectomy are exceptionally infrequent. Herein, we present a case detailing an internal carotid artery pseudoaneurysm that manifested subsequent to a hybrid carotid endarterectomy and endovascular therapy intervention. Our approach to managing this condition involved a novel technique wherein thrombin was directly injected into the luminal cavity of the pseudoaneurysm under the guidance of a C-arm.

Case presentation
A 66-year-old male patient of Chinese ethnicity exhibited a 4-month history of headache and a 20-day history of gait disturbance. Digital subtraction angiography revealed occlusion in the cervical region of the left carotid artery. Following a hybrid surgical procedure, the patient reported mild pain and bruising surrounding the incision site of the left internal carotid artery endarterectomy. Subsequent angiography identified the presence of a carotid artery pseudoaneurysm. Utilizing C-arm guidance, thrombin was then directly injected into the luminal cavity of the pseudoaneurysm, resulting in complete healing during follow-up.

Conclusion
For the management of pseudoaneurysms arising post carotid endarterectomy, the direct injection of thrombin into the aneurysm cavity under the guidance of a C-arm is deemed both safe and efficacious.
Role of SYT11 in human pan-cancer using comprehensive approaches
Authors: Noh Kyunghee , Choi Hyunji , Jo Eun-Hye , Yoo Wonbeak , Park Kyung Chan 
Published: June 2024

Abstract
Background
Synaptotagmin 11 (SYT11) plays a pivotal role in neuronal vesicular trafficking and exocytosis. However, no independent prognostic studies have focused on various cancers. In this study, we aimed to summarize the clinical significance and molecular landscape of SYT11 in various tumor types.

Methods
Using several available public databases, we investigated abnormal SYT11 expression in different tumor types and its potential clinical association with prognosis, methylation profiling, immune infiltration, gene enrichment analysis, and protein–protein interaction analysis, and identified common pathways.

Results
TCGA and Genotype-Tissue Expression (GTEx) showed that SYT11 was widely expressed across tumor and corresponding normal tissues. Survival analysis showed that SYT11 expression correlated with the prognosis of seven cancer types. Additionally, SYT11 mRNA expression was not affected by promoter methylation, but regulated by certain miRNAs and associated with cancer patient prognosis. In vitro experiments further verified a negative correlation between the expression of SYT11 and miR-19a-3p in human colorectal, lung, and renal cancer cell lines. Moreover, aberrant SYT11 expression was significantly associated with immune infiltration. Pathway enrichment analysis revealed that the biological and molecular processes of SYT11 were related to clathrin-mediated endocytosis, Rho GTPase signaling, and cell motility-related functions.

Conclusions
Our results provide a clear understanding of the role of SYT11 in various cancer types and suggest that SYT11 may be of prognostic and clinical significance.
Feature reduction for hepatocellular carcinoma prediction using machine learning algorithms
Authors: Mostafa Ghada , Mahmoud Hamdi , Abd El-Hafeez Tarek , ElAraby Mohamed E. 
Published: June 2024

AbstractHepatocellular carcinoma (HCC) is a highly prevalent form of liver cancer that necessitates accurate prediction models for early diagnosis and effective treatment. Machine learning algorithms have demonstrated promising results in various medical domains, including cancer prediction. In this study, we propose a comprehensive approach for HCC prediction by comparing the performance of different machine learning algorithms before and after applying feature reduction methods. We employ popular feature reduction techniques, such as weighting features, hidden features correlation, feature selection, and optimized selection, to extract a reduced feature subset that captures the most relevant information related to HCC. Subsequently, we apply multiple algorithms, including Naive Bayes, support vector machines (SVM), Neural Networks, Decision Tree, and K nearest neighbors (KNN), to both the original high-dimensional dataset and the reduced feature set. By comparing the predictive accuracy, precision, F Score, recall, and execution time of each algorithm, we assess the effectiveness of feature reduction in enhancing the performance of HCC prediction models. Our experimental results, obtained using a comprehensive dataset comprising clinical features of HCC patients, demonstrate that feature reduction significantly improves the performance of all examined algorithms. Notably, the reduced feature set consistently outperforms the original high-dimensional dataset in terms of prediction accuracy and execution time. After applying feature reduction techniques, the employed algorithms, namely decision trees, Naive Bayes, KNN, neural networks, and SVM achieved accuracies of 96%, 97.33%, 94.67%, 96%, and 96.00%, respectively.
Genome-wide analysis and characterization of the peptides containing tyrosine sulfation (PSY) gene family in Triticum aestivum L. unraveling their contributions to both plant development and diverse stress responses
Authors: Kesawat Mahipal Singh , Kherawat Bhagwat Singh , Ram Chet , Manohar Swati , Kumar Santosh , Chung Sang-Min , Alharbi Sulaiman Ali , Ansari Mohammad Javed , Lenka Sangram K. 
Published: June 2024

Abstract
Background
Small-secreted peptides are increasingly recognized as a novel class of intracellular signal molecules, playing crucial roles in plant growth and development. However, the precise role and mechanism governed by peptides containing Tyrosine Sulfation (PSY) are still under investigation. Currently, there is a lack of accessible information concerning the PSY gene family in wheat.

Results
Therefore, in this investigation, we identified 29 PSY genes in Triticum aestivum, with the aim of unraveling their significance in plant development processes and their response to a variety of stress conditions. Phylogenetic analysis showed that TaPSY genes clustered into five groups. Additionally, an analysis of the gene structure of TaPSYs displayed a conserved evolutionary path. The syntenic relationship demonstrated the 69 orthologous gene pairs in T. dicoccoides, Ae. tauschii, T. turgidum, and H. vulgare, respectively. Furthermore, the Ka/Ks analysis indicated that TaPSY genes have experienced purifying selection during their evolutionary processes. The promoters of TaPSY genes were found to contain numerous CAREs, and these elements are known to perform essential functions in various development processes, phytohormone responses, as well as defense and stress mechanisms. In addition, the identification of potential miRNAs targeting TaPSY genes was followed by an examination of their expression patterns across various tissues. Among the 29 TaPSY genes, twenty miRNAs were discovered to target eighteen of them. Moreover, TaPSY genes displayed a distinct expression across different tissues and stress conditions.

Conclusions
Hence, these discoveries offer a significant reference point for forthcoming molecular investigations and hold promise for bolstering wheat yield and stress resilience through targeted genetic enhancements and strategic breeding approaches.

Graphical Abstract
A critical examination of advanced approaches in green chemistry: microbial bioremediation strategies for sustainable mitigation of plastic pollution
Authors: Agarwal Tushar , Atray Neeraj , Sharma Jai Gopal 
Published: June 2024

Abstract
Background
The escalating concern regarding the environmental impact of plastic waste necessitates the adoption of biodegradable methodologies to curtail its adverse effects. A profound comprehension of the intricate interplay between bacteria and polymers becomes imperative for devising effective solutions to address plastic-induced environmental challenges.

Main body of the abstract
Numerous microorganisms have evolved specialized mechanisms for the degradation of plastics, rendering them amenable to application in green chemistry for the elimination of hazardous plastics from the ecosystem. This article offers a comprehensive survey of contemporary microbial bioremediation approaches geared towards augmenting plastic waste management and ameliorating plastic pollution. Emphasis is placed on elucidating the potential of microorganisms in mitigating the deleterious repercussions of plastics on ecosystems and human health, underscoring the significance of advanced strategies in green chemistry for sustainable plastic pollution mitigation.

Short conclusion
Current research emphasizes the effectiveness of naturally occurring soil microorganisms, particularly fungi like Aspergillus and bacteria like Bacillus, in breaking down plastics. To harness this potential on a broader scale, optimization of microbial activity conditions and pre-treatment with environmentally beneficial compounds are essential.
Retrospective study of ivosidenib for patients with recurrent IDH mutant gliomas.
Authors: El-Ghoubaira Joseph , Drappatz Jan , Mantica Megan 
Published: June 2024

2040 Background: IDH mutant gliomas are the most common primary malignant brain tumors in adults under the age of 50 and accounts for approximately 12% of all glioma diagnoses each year. While lower grade gliomas (LGG) encompassing WHO grades II and III are less aggressive than their higher-grade counterparts, treatment is not curative, and most patients develop tumor recurrence in which there are a paucity of effective treatment options. Mutations in IDH1/ 2 occur upwards of 80% of patients with LGG and drive specific epigenetic programs to dysregulate and impair differentiation leading to tumorigenesis. As such, pharmacologic blockage of IDH mutant enzymes is being actively investigated as potential treatment option. Ivosidenib (AG-120), a second-generation IDH inhibitor, is an FDA approved medication for treatment of IDH-mutated acute myeloid leukemia and has demonstrated safety and clinical activity in patients with progressive IDH mutant gliomas. We explored the efficacy of Ivosidenib in IDH mutant gliomas. Methods: We retrospectively analyzed patients with IDHm gliomas treated with ivosidenib in our institution. We included patients with an IDH1 mutation who received at least one cycle of ivosidenib. Data collected included patient demographics, tumor histology, tumor location, grade, 1p/19q co-deletion, MGMT, CDKN2A, TERT, EGFR, P53, PTEN mutational status, prior treatment history, duration of treatment, toxicities, radiographic response, PFS, and OS. Descriptive statistics were used to summarize patients' characteristics. The distribution of mPFS was estimated by the Kaplan-Meier method. Results: Between April 2010 and December 2023, we identified 33 patients that received ivosidenib. 7 patients received ivosidenib in combination with bevacizumab, 3 patients received ivosidenib in combination with radiation, and 1 patient received ivosidenib and nivolumab. The median age was 52 (range 31-81). 21 (63%) were male. The median lines of medical therapy and radiation/surgery prior to starting ivosidenib were 3.03(range 0-6) and 1.5(range 0-4), respectively. 27(81%) were grade 2, 5(15%) were grade 3, and 1(3%) were grade 4. 19(57%) had 1p/19q co-deletion. As of 12/31/2023, 48%(16) patients were alive. The median PFS was 7.52 months (1-26) and median OS 12.7 months (3-25). 11(33%) patients experienced partial response (PR), 20(60%) experienced stable disease (SD) and 2(6%) demonstrated progressive disease (PD) at 12-week assessment. Nine patients experienced adverse events: grade 1 fatigue (3), grade 1 diarrhea (1), grade 2 fever (1), grade 2 weakness (1), and grade 3 confusion (1). One patient experienced grade 4 lobar hemorrhage thought to be related to concurrent bevacizumab use. Conclusions: Treatment with Ivosidenib therapy was associated with a manageable safety profile. In a subset of patients, there was disease stabilization in heavily pre-treated recurrent IDH mutant gliomas.
INB-200: Fully enrolled phase 1 study of gene-modified autologous gamma-delta (γδ) T cells in patients with newly diagnosed glioblastoma multiforme (GBM) receiving maintenance temozolomide (TMZ).
Authors: Lobbous Mina , Goswami Trishna , Lamb Lawrence S. , Rochlin Kate , Pillay Thriumaine , ter Haak Mariska , Nabors Louis B. 
Published: June 2024

2042 Background: γδ T cells can target NKG2D ligands that are upregulated on tumor cells after alkylating chemotherapy exposure. IN8bio’s DeltEx drug resistant immunotherapy (DRI) are genetically engineered γδ T cells expressing methylguanine-DNA methyltransferase (MGMT), which conveys TMZ resistance to enable concomitant therapy and continued surveillance against tumor cells. Updated results from the Phase 1 trial which fully enrolled adult newly diagnosed GBM patients with adequate organ function, KPS ≥ 70% follow. Methods: Cohorts (C) 1, 2 and 3 received 1, 3 or 6 doses (1 x 107 DRI cells/dose) into the resection cavity with 150 mg/m2 of IV TMZ on Day (D) 1 of each Stupp maintenance cycle. The primary endpoint is safety and secondary endpoints include survival; immunologic correlative analyses are included. Dose limiting toxicities (DLTs) are defined as treatment related ≥ grade (G) 3 cardiopulmonary or hepatic toxicity, G4 toxicity exceeding 72 hours or neurologic deterioration that exceeds 2 weeks. Results: 23 patients were enrolled, with 11 dosed and 2 awaiting dosing (61% male; median age 68 (range: 21-74); 92% IDH-WT, 54% MGMT unmethylated). No DLTs, cytokine release syndrome (CRS) or neurotoxicity (ICANS) are reported. Most common adverse events were decreased WBC/platelet count, asthenia, fatigue, hydrocephalus, headache, decreased appetite, urinary tract infection, thrombosis and balance disorder. Conclusions: γδ T cells successfully infused with peripheral TMZ-based lymphodepletion evidenced with near or below normal range T, B, and NK subsets for up to 1 year. The majority of dosed patients who received DRI exceeded the expected median PFS of 7 months (5.8-8.2 months) with Stupp alone and had manageable toxicity with a continued encouraging trend in PFS. Long-term follow-up for durability of PFS and OS continue. Clinical trial information: NCT04165941 . [Table: see text]
Out-of-pocket cost modeling of adjuvant radiation therapy duration in standard-of-care treatment of glioblastoma across Medicaid and Medicare plans.
Authors: Wu Victoria , Khlopin Martha , McClelland Shearwood 
Published: June 2024

2045 Background: The optimal radiation treatment (RT) length (6 weeks of 60 Gy in 30 fractions versus 3 weeks of 40 Gy in 15 fractions) for older adults with glioblastoma is debatable, with Level 1 evidence (PMID 15051755) revealing no difference in survival between RT regimens. However, there remains a paucity of evidence describing the role of insurance on out-of-pocket (OOP) costs for patients undergoing varying lengths of RT. This project aims to quantify expenses by insurance plans, enhancing transparency in treatment cost understanding. Methods: We utilized the National Comprehensive Cancer Network guidelines to determine the standard treatment protocol, including 30-fraction or 15-fraction RT with concurrent and post-radiation temozolomide for 12 cycles. The model assumes a Medicare- and/or Medicaid-eligible patient ≥ 65 years of age with glioblastoma. The total aggregate out-of-pocket (OOP) costs were determined from the sum of treatment costs, deductibles, and copays/coinsurance based on Medicaid, Original Medicare, Medigap Plan G, and Medicare Part D Rx plan over a two-year time horizon (not adjusted for inflation). All procedures were assumed to take place within the premises of an Ohio hospital. Results: Treatment charges include neurosurgery, neuro-oncology, and radiation oncology initial consultation, follow-up visits, diagnostic head CT, MRI, craniotomy with maximum safe resection, surveillance brain MRI, temozolomide, antiemetics, prophylactic TMP-SMX, weekly CBC, and tumor treating fields. RT-specific treatment charges include treatment planning, simulation and verification, RT delivery, and on-treatment visits. Original Medicare beneficiaries face an OOP cost of 20% for Medicare Part B claims with no cost cap for approved procedures after the deductible. Medications are covered under Medicare Part D with copays. This results in a total OOP treatment charge of $4,454.01 for 30 fractions and $3,913.86 for 15 fractions. Medigap Plan G beneficiaries face a total OOP charge of $2,387.22 for 30 fractions and $2,369.61 for 15 fractions. For Medicaid beneficiaries (assuming all treatments are approved by Medicaid), all expenses are covered without limit, resulting in no OOP expense for either treatment plan. Conclusions: Three-week versus six-week RT for GBM reduces OOP costs facing patients by 10%. By understanding the financial implications, healthcare providers, policymakers, and patients can make informed decisions about treatment options, and healthcare systems can develop strategies to mitigate the economic burden associated with GBM care.
Development of a novel risk stratification model for immune-related adverse events for patients with advanced melanoma and non-small cell lung cancer treated with immune checkpoint inhibitors.
Authors: Gao Yizhuo Kelly , Tran Andrew , Gupta Mehul , Heng Daniel Yick Chin , Cheng Tina , Stukalin Igor , Meyers Daniel E. , Cheung Winson Y. , Monzon Jose Gerard , Navani Vishal 
Published: June 2024

2649 Background: Immune checkpoint inhibitors (ICI) transformed treatment paradigm across cancers. There remain few reliable, clinically accessible predictors of ICI-induced immune related adverse events (irAEs). We derive a novel risk stratification model for irAEs using baseline patient, tumor and treatment variables in a large cohort of patients with advanced melanoma (AM) or non-small cell lung cancer (NSCLC) treated with ICI. Methods: We conducted a multi-centre retrospective observational cohort study of consecutive patients with AM or NSCLC receiving ≥ 1 cycle of single-agent or combination ICI, in any line, 2015 - 2023, in Alberta, Canada. Clinically significant irAEs, defined as those requiring treatment delay or systemic steroids/steroid sparing agents, were identified as outcome of interest. The association between irAEs, overall survival (OS), and time to next treatment (TTNT) was assessed with Cox Proportional Hazards regression. Stepwise logistic regression was used to select and weight baseline variables associated with development of irAEs to derive a predictive risk score. Model validation was carried out on 500 iterations of bootstrapped samples. Harrel’s C-index was calculated and internally validated to ascertain the model’s discriminatory performance. Results: 1,292 total patients were included, 519 (218/489 [44.6%] AM and 301/803 [37.5%] NSCLC) developing a clinically significant irAE. Using a subset of 801 patients with available baseline characteristics, the following variables were identified and weighted for creation of risk model (risk score attributed): tumor type (NSCLC) (+1), age >60 (+1), ECOG ≥1 (-1), BMI ≥ 25 (+1), ICI after first line (-1), combination ICI (+4), >10 cycles of ICI (+2), albumin level < LLN (+2), adrenal metastasis (+1), multiple sites of metastasis (-1). Patients were stratified into 3 irAE risk groups based on combined score: low (n = 230, risk score ≤ 0), intermediate (n = 412, risk score 1-2), high (n = 159, risk score ≥3). The risk model performed well with an optimism-corrected c-index of 0.707 in internal validation, and strong association with odds of irAE occurrence (Table). The development of irAE was associated with an improvement in OS (HR 0.48, 95% CI 0.41-0.44, p<0.001), with a median OS of 34.3 (95% CI 28.8-39.6) months compared to 12.0 (95% CI 10.6-14.3) months for those who did not develop an irAE. Similar robust stratification was also seen with TTNT. Conclusions: We presented and internally validated, a simple risk stratification tool that utilizes readily available baseline patient, tumor, and treatment characteristics to robustly stratify risk of irAE development. [Table: see text]
How Do the True Intraoperative Costs of Endoscopic Diskectomy Compare With Microdiskectomy for Lumbar Disk Herniations? A Time-Driven Activity-Based Cost Analysis
Authors: Leibold Adam , Sarikonda Advith , Tecce Eric , Sami Ashmal , Mansoor Ali Daniyal , Thalheimer Sara , Heller Joshua , Prasad Srinivas K. , Sharan Ashwini , Jallo Jack , Harrop James , Vaccaro Alexander R. , Sivaganesan Ahilan 
Published: June 2024

BACKGROUND AND OBJECTIVES:
Endoscopic lumbar diskectomy (ED) is a minimally invasive option for addressing lumbar disk herniations. With the introduction of value-based care systems, assessing the true cost of certain procedures is critical when creating reimbursement models and comparing procedures. Here, we compared the costs of performing a microdiskectomy (MD) and ED using time-driven activity-based costing.

METHODS:
Total cost for the intraoperative episode was calculated using time-driven activity-based costing methodology. Individual costs were obtained by direct observation and electronic medical records and through querying multiple departments (business operations, sterile processing, plant operations, and pharmacy). Timestamps for all involved personnel and material resources were documented. A retrospective analysis was performed on 202 patients who underwent lumbar diskectomy through either MD (n = 167) or ED (n = 35) from 2018 to 2022. Personnel cost was calculated by multiplying the cost per unit time for each personnel type by the length of time spent in the operating room. Supply cost was calculated by aggregating the cost of all individual supplies, from medications to consumables to surgical trays, used during the case. Univariate and multivariable regression analyses were performed comparing the costs between these procedures.

RESULTS:
The average intraoperative cost per case for ED and MD was $3915 ± $1025 and $3162 ± $954, respectively. Multivariable regression analysis revealed that ED had higher total cost (β-coefficient: $912 ± $281, P = <.01) and supply cost (β-coefficient: $474 ± $155, P = <.01) than MD. When accounting for surgeon as a covariate, however, total cost (P = .478) and supply cost (P = .468) differences between ED and MD were negligible.

CONCLUSION:
ED has shown to be a better value option in addressing lumbar disk herniations, mostly because of advantages in perioperative care. Here, we show that when correcting for surgeon-level effects, the cost between the two procedures is statistically insignificant, reaffirming the value provided by ED.