bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oropharyngeal stenosis in patient with oral submucous fibrosis: a case report with 8-year follow-up
Authors: Al-Aroomi Maged Ali , Chen Jie , Jiang Canhua 
Published: June 2024

AbstractOral submucous fibrosis (OSF) is a chronic, progressive condition affecting the oral mucosa associated with areca nut consumption. It leads to restricted tongue movement, loss of papillae, blanching and stiffening of the mucosa, difficulty in opening the mouth, and challenges in eating due to inflammation and fibrosis. This report presents a rare case of oropharyngeal stenosis secondary to OSF in a 43-year-old male with a history of chewing betel nut. A surgical procedure similar to Uvulopalatopharyngoplasty was performed to excise the submucous oropharyngeal stenosis and to reconstruct the uvula, palatoglossal arch, and palatopharyngeal arch. At 8 years postoperatively, the patient exhibited a normal mouth opening and oropharyngeal aperture.
Palliative care education in undergraduate medical and nursing programs in Colombia: a cross-sectional analysis
Authors: Sánchez-Cárdenas Miguel Antonio , Tibaquirá Camila Andrea Navarro , Mantilla-Manosalva Nidia , Fonseca David Andrade , Morales Alexandra Marin , Delgado Martha Ximena León 
Published: June 2024

Abstract
Background
The number of people suffering from chronic diseases requiring palliative care (PC) is increasing rapidly. Therefore, PC teaching in undergraduate health science programs is necessary to improve primary PC based on international recommendations and available scientific evidence.

Methods
A descriptive cross-sectional study was conducted. Active undergraduate medical and nursing programs that were approved by the Colombian Ministry of Education and integrated PC teaching into their curricula were included in the study. The total sample consisted of 48 programs: 31 nursing and 17 medical programs.

Results
PC competencies are distributed throughout the curriculum in 41.67% of programs, in elective courses in 31.25%, and in mandatory courses in 27.08% of the programs. The average PC teaching hours is 81 for nursing and 57.6 for medicine. PC clinical rotations are not offered in 75% of the programs. For undergraduate nursing programs, the most frequent competencies taught are the definition and history of PC and identifying common symptoms associated with advanced disease. In undergraduate medicine, the most common competencies are pharmacological and non-pharmacological pain management and identification of PC needs.

Conclusions
PC teaching in undergraduate health science programs mainly addresses the conceptual and theoretical aspects of PC, which are part of the competencies present throughout the programs’ curricula. Low availability of PC clinical rotations was identified. Future studies should assess whether the low availability of clinical rotations in PC limits the ability of students to develop the practical competencies necessary to provide quality PC.

Trial registration
Not applicable.
Online-based survey on health literacy and health situation of school principals and vice principals in Pakistan during the COVID-19 pandemic
Authors: Zakar Rubeena , Shahzad Ruhma , Tariq Fizza , Zakar Muhammad Zakria , Dadaczynski Kevin , Okan Orkan , Fischer Florian 
Published: June 2024

Abstract
Background
This study aimed to evaluate health literacy and general health status among school principals and vice principals in Pakistan, (1) to identify work-related factors associated with them, and (2) to determine their association with physical and mental health, particularly in the context of the COVID-19 pandemic.

Methods
An online-based cross-sectional survey was conducted among 350 school principals and vice principals in Punjab province, Pakistan. The study was conducted under the COVID Global Health Literacy Network. Data related to socio-demographic characteristics, health literacy, general health status, chronic illnesses and impairment, well-being, psychosomatic complaints, and emotional exhaustion were collected. We applied bivariate analyses as well as binary and multivariable logistic regression analyses.

Results
Over half of the respondents (66.6%) had sufficient levels of health literacy. A good general health status was reported by 80.3%. One of the strongest predictors of health literacy and general health status was school position (principals vs. vice principals). Additionally, those with sufficient health literacy were less likely to have frequent emotional exhaustion; while those having good general health status were less likely to report low well-being, frequent emotional exhaustion, and psychosomatic complaints. The study also found that females were less likely to have a good general health status (OR  0.45) and were more likely to have frequent emotional exhaustion (OR  1.75) as well as psychosomatic complaints (OR  1.94) than males.

Conclusions
Limited health literacy in school leaders requires interventions for better decision-making on health matters, emphasizing the need for targeted training programs.
Time synchronization between parietal–frontocentral connectivity with MRCP and gait in post-stroke bipedal tasks
Authors: Phang Chun-Ren , Su Kai-Hsiang , Cheng Yuan-Yang , Chen Chia-Hsin , Ko Li-Wei 
Published: June 2024

Abstract
Background
In post-stroke rehabilitation, functional connectivity (FC), motor-related cortical potential (MRCP), and gait activities are common measures related to recovery outcomes. However, the interrelationship between FC, MRCP, gait activities, and bipedal distinguishability have yet to be investigated.

Methods
Ten participants were equipped with EEG devices and inertial measurement units (IMUs) while performing lower limb motor preparation (MP) and motor execution (ME) tasks. MRCP, FCs, and bipedal distinguishability were extracted from the EEG signals, while the change in knee degree during the ME phase was calculated from the gait data. FCs were analyzed with pairwise Pearson’s correlation, and the brain-wide FC was fed into support vector machine (SVM) for bipedal classification.

Results
Parietal–frontocentral connectivity (PFCC) dysconnection and MRCP desynchronization were related to the MP and ME phases, respectively. Hemiplegic limb movement exhibited higher PFCC strength than nonhemiplegic limb movement. Bipedal classification had a short-lived peak of 75.1% in the pre-movement phase. These results contribute to a better understanding of the neurophysiological functions during motor tasks, with respect to localized MRCP and nonlocalized FC activities. The difference in PFCCs between both limbs could be a marker to understand the motor function of the brain of post-stroke patients.

Conclusions
In this study, we discovered that PFCCs are temporally dependent on lower limb gait movement and MRCP. The PFCCs are also related to the lower limb motor performance of post-stroke patients. The detection of motor intentions allows the development of bipedal brain-controlled exoskeletons for lower limb active rehabilitation.
Evaluation of diagnostic techniques for early detection of heartworm in experimentally infected dogs: identification of Dirofilaria immitis-derived microRNA in the initial 28 weeks post-inoculation
Authors: Murillo Daniel Felipe Barrantes , Campbell Elyssa J. , Moorhead Andrew R. , Wang Chengming 
Published: June 2024

Abstract
Background
Dirofilaria immitis, commonly known as heartworm (HW), is a parasitic nematode transmitted by various mosquito species, leading to heartworm disease (HWD) in dogs. Diagnosis of HW typically involves antigen or microfilariae detection, or visualization of adult worms through imaging or post mortem examination. Polymerase chain reaction (PCR) and micro RNA (miRNA) detection have been explored for HW diagnosis.

Methods
Three dogs, previously experimentally infected with HW, underwent blood sampling every 4 weeks for 7 months. Samples were assessed for antigen presence after heat treatment, PCR amplification, and microfilaria examination using Giemsa-stained thick smears. Additionally, whole blood aliquots underwent miRNA deep sequencing and bioinformatic analysis.

Results
Heartworm antigen was detectable after heat treatment at 20 weeks post-inoculation and via PCR at 24 weeks, with microfilariae observed in peripheral blood smears at 28 weeks. However, deep miRNA sequencing revealed that the miRNA candidate sequences are not consistently expressed before 28 weeks of infection.

Conclusions
While ancillary molecular methods such as PCR and miRNA sequencing may be less effective than antigen detection for detecting immature larval stages in an early stage of infection, our experimental findings demonstrate that circulating miRNAs can still be detected in 28 weeks post-infection.

Graphical Abstract
Digital in-line holographic microscopy for label-free identification and tracking of biological cells
Authors: Kim Jihwan , Lee Sang Joon 
Published: June 2024

AbstractDigital in-line holographic microscopy (DIHM) is a non-invasive, real-time, label-free technique that captures three-dimensional (3D) positional, orientational, and morphological information from digital holographic images of living biological cells. Unlike conventional microscopies, the DIHM technique enables precise measurements of dynamic behaviors exhibited by living cells within a 3D volume. This review outlines the fundamental principles and comprehensive digital image processing procedures employed in DIHM-based cell tracking methods. In addition, recent applications of DIHM technique for label-free identification and digital tracking of various motile biological cells, including human blood cells, spermatozoa, diseased cells, and unicellular microorganisms, are thoroughly examined. Leveraging artificial intelligence has significantly enhanced both the speed and accuracy of digital image processing for cell tracking and identification. The quantitative data on cell morphology and dynamics captured by DIHM can effectively elucidate the underlying mechanisms governing various microbial behaviors and contribute to the accumulation of diagnostic databases and the development of clinical treatments.
Minimally invasive elective gastrectomy after preoperative chemotherapy in a patient with frailty who presented with locally far advanced-stage gastric cancer: a case report
Authors: Shirakami Naoto , Kanaji Shingo , Shimada Atsushi , Mukoyama Tomosuke , Sawada Ryuichiro , Harada Hitoshi , Tanaka Tomonori , Urakawa Naoki , Goto Hironobu , Hasegawa Hiroshi , Yamashita Kimihiro , Matsuda Takeru , Kakeji Yoshihiro 
Published: June 2024

Abstract
Background
Herein, we report a case of gastric antrum cancer with multiple invasions to other organs that was completely cured with laparoscopic distal gastrectomy after preoperative chemotherapy in a patient with poor general condition.

Case presentation
An 80-year-old male patient was diagnosed with anemia during follow-up for cerebral lacunar infarction at another hospital. He was diagnosed with advanced-stage gastric antrum cancer and was referred to our hospital. On esophagogastroduodenoscopy, type 2 advanced-stage gastric cancer was detected at the greater curvature of the antrum, and the biopsy results revealed tubular adenocarcinoma. Contrast-enhanced computed tomography scan revealed multiple invasions to other organs, thick gastric wall with contrast effect, and superior mesenteric vein tumor thrombus. However, there was no evidence of distant metastasis on positron emission tomography/computed tomography scan. The clinical diagnosis was stage IVA gastric cancer. Pancreatoduodenectomy with portal vein resection could be important at this point. However, preoperative chemotherapy with S-1 and oxaliplatin was administered instead of performing extended surgery because the patient had poor general condition (performance status score of 3). The patient received three cycles of preoperative chemotherapy at the hospital along with rehabilitation and nutritional management with oral nutritional supplements. After treatment, the performance status score of the patient improved from 3 to 1. Furthermore, in terms of clinical therapeutic effect, the patient achieved partial response. Hence, laparoscopic distal gastrectomy with D2 lymph node dissection and partial transverse colectomy was performed. After surgery, the patient was admitted for oral intake on postoperative day 6 and was discharged on postoperative day 21. Based on the histopathological examination, gastric cancer had disappeared, and there were no evident malignant findings. Therefore, gastric cancer was classified as grade 3 according to the histological treatment efficacy criteria. The patient did not present with recurrence at 2 years after surgery.

Conclusions
By actively administering preoperative chemotherapy, minimally invasive radical surgery with maximum preservation of the surrounding organs can be performed for locally far advanced-stage gastric cancer in older patients with poor general condition.
Charting the cascade of physical activities: implications for reducing sitting time and obesity in children
Authors: Esmaeilzadeh Samad , Hakala Pirjo , Berg Päivi , Salmon Jo , Rinne Tiina , Pesola Arto J 
Published: June 2024

Abstract
Objective
Traditional intensity-based physical activity measures and variable-centered statistics may not fully capture the complex associations between sitting time, physical activity, and obesity indices. This study investigates the associations between device-measured sitting, standing and different modes of physical activity (i.e., slow walking, brisk-walking, cycling and high-intensity activity) and measured body mass index (BMI) in children using person-based latent profile analyses and Partial Least Squared-structural equation modeling (PLS-SEM).

Methods
A total of 344 children (11.5 ± 0.81 years, boys n = 139) wore a triaxial accelerometer (Fibion®) on their thigh for eight days, and their weight and height were measured at school. Latent profile analysis formed profiles including BMI, total sitting time, and physical activities, and their associations were further studied with PLS-SEM.

Results
The latent profile analysis indicates that high levels of physical activity always coincide with low sitting time. Both normal weight and overweight/obesity can coexist with low physical activity and prolonged sitting. The PLS-SEM results highlight a cascade-like sequence in the relationship between various types of physical activity, sitting time, and BMI. This sequence begins with light-intensity activities, such as standing, progresses to higher-intensity activities, and ultimately through reduced sitting time (sample mean= -0.01; effect size = 0.0001; p = 0.02), mediates a decline in BMI (sample mean= -0.06; effect size = 0.0036; p = 0.01). The most positive effects on sitting time and BMI occur when this pattern is adhered to consistently, suggesting that omitting steps could negatively impact the associations.

Conclusion
These findings suggest that persuading children to increase physical activity incrementally, starting from low-intensity activities such as standing and slow walking to activity types with higher intensities, possibly influence BMI by mediating reduced sitting time. This approach is particularly inclusive for overweight and obese children, taking into account the potential challenges they may encounter when performing activity types with high intensity. These cross-sectional associations need to be verified with longitudinal and experimental designs.
Updated efficacy results of olverembatinib (HQP1351) in patients with tyrosine kinase inhibitor (TKI)-resistant succinate dehydrogenase (SDH)-deficient gastrointestinal stromal tumors (GIST) and paraganglioma.
Authors: Qiu Haibo , Zhou Zhi-wei , Zhou Ye , Chen Jie , Wan Xiangbin , Li Ning , Tao Kaixiong , Li Yong , Wu Xin , Chen Zi , Liu Lihui , Yang Chen , Men Lichuang , Wang Hengbang , Liang Eric , Wang Cunlin , Jiang Lixin , Yang Dajun , Zhai Yifan , Xu Rui-Hua 
Published: June 2024

11502 Background: SDH-deficient GIST is a rare type of GIST, mainly observed in the stomach of children and adolescents or young adults < 30 years of age. No active targeted therapies have been identified in this subset of GIST. Olverembatinib, approved in China for treatment of patients with chronic myeloid leukemia, has shown promising clinical efficacy in SDH-deficient GIST. We report here updated efficacy data in SDH-deficient GIST and preliminary efficacy data in paraganglioma, which is an SDH-deficient–related tumor. Methods: The aim of this study was to evaluate the safety and efficacy (per RECIST v1.1) of olverembatinib in patients with TKI-resistant SDH-deficient GIST and other solid tumors. Olverembatinib was administered orally once every other day (QOD) in 28-day cycles. Results: As of December 27, 2023, 26 patients with SDH-deficient GIST (confirmed by IHC) had received ≥ 1 dose of olverembatinib (median [range] age, 30 [13-56] years), and 25 had received 1 to 4 TKIs (42.3% of patients, ≥ 3; Table 1). Olverembatinib was administered QOD in doses ranging from 30 to 50 mg (30 mg [n = 6]; 40 mg [n = 14]; 50 mg [n = 6]). The median (range) treatment duration was 15.6 (1.8-42.3) months. A total of 6 of 26patients experienced partial response (PR) as the best response. A further 18 patients had stable disease (SD) lasting > 4 cycles. The clinical benefit rate (CBR; complete response [CR] + PR + SD > 4 cycles) was hence 92.3% (24/26) and the longest treatment duration was 40 months. After a median follow-up of 17.0 (4.1-57.5) months, the median progression-free survival (PFS) was 25.7 months (12.1-not reached [NR]). Among the 6 patients with paraganglioma enrolled in this study, best responses were observed in 5, with SD lasting > 4 cycles (CBR, 83.3%), and the median PFS was 8.25 (1.87-NR) months. The adverse event profile was the same as previously reported (Qiu H et al, J Clin Oncol 41:11540), with no newly emergent safety issues observed. Conclusions: Olverembatinib was well tolerated. The CBR exceeded 90%, and the estimated median PFS was significantly prolonged, indicating potential benefit of this treatment and providing a benchmark for future studies in this rare subtype of GIST. Clinical trial registration: NCT03594422; internal study identifier: SJ-0003. Clinical trial information: NCT03594422 .[Table: see text]
A phase II study of anlotinib and an anti-PDL1 antibody in patients with alveolar soft part sarcoma: Results of expansion cohorts.
Authors: Tan Zhichao , Wu Yan , Fan Zhengfu , Liu Jiayong , Gao Tian , Bai Chujie , Xue Ruifeng , Li Shu , Zhang Lu , Wang Xinyu 
Published: June 2024

11515 Background: The combination of the anti-angiogenesis tyrosine kinase inhibitor (TKI), anlotinib, with the anti-programmed death-ligand 1 (PDL1) antibody (TQB2450) demonstrated commendable antitumor efficacy in a phase II clinical trial for pan-sarcoma patients, particularly within the alveolar soft part sarcoma (ASPS) cohorts (Liu et al., 2022, PMID: 35675031). An expansion of the ASPS cohort has been underway since 2019. Herein, we present the observed efficacy within this ASPS-specific expansion cohort. Methods: ASPS patients naïve to TKIs or immunotherapy received TQB2450 (1200mg) intravenously on day 1, in combination with oral administration of anlotinib (12mg) from day 1 to 14, repeated every 3 weeks. The primary endpoint was best objective response rate (ORR, per RECIST v1.1). Secondary endpoints comprised median progression free survival (PFS), median overall survival (OS), duration of response (DOR), and adverse events (AEs). Formalin-fixed paraffin-embedded (FFPE) slides were taken for immunohistochemistry and examined for lymphocyte marker expression. Results: Twenty-nine patients were enrolled in the phase II trial. The median age was 29 years (range: 19-46), with female 48.3%. A subset of patients (20.7%) had undergone prior lines of chemotherapy. Twenty-eight patients were evaluable for efficacy (one withdrew). The ORR for evaluable patients reached 79.3%, characterized by 3 complete responses and 20 partial responses. The median PFS (months) was not reached (95%CI: 20.7, not-reached). The median DOR (months) for responders was not reached (95%CI: 18.0, not-reached). No mortalities occurred during the follow-up. Treatment demonstrated favorable tolerability, with predominant grade 1 and 2 AEs. Thirteen patients (44.83%) experienced grade ≥3 AEs, principally hypertriglyceridemia (13.79%), lipase elevation (6.90%), amylase elevation (3.45%), and hypertension (3.45%). A detailed analysis of the tumor microenvironment in 7 patients, including 3 good responders and 4 poor responders, revealed a significant discrepancy in the presence of tertiary lymphoid structures (TLS) between the two groups (refer to Table). Conclusions: The combination of anlotinib and TQB2450 exhibits promising efficacy in ASPS patients, markedly enhancing ORR and extending PFS with favorable tolerability. Notably, TLS emerges as a potential predictive indicator of immunotherapeutic efficacy in ASPS. Clinical trial information: CTR20190938 . [Table: see text]
Use of histologic and immunologic factors in sarcoma to predict response rates to immunotherapy.
Authors: Lee Alex Qiang , Hao Clara , Pan Minggui , Ganjoo Kristen N. , Bui Nam 
Published: June 2024

11569 Background: Sarcomas are rare mesenchymal neoplasms with substantial histologic and tumor microenvironment heterogeneity, leading to varied treatment responses, particularly to immunotherapy. Because of the heterogeneity of response rates and high risk of disease progression, further determinations of which patients are most likely to benefit from immunotherapy are crucial. In this study, we aim to characterize factors associated with response to immune checkpoint inhibitors (ICIs). Methods: 216 patients with advanced sarcoma treated with ICIs between 2016-2023 at Stanford Health Care were analyzed. Overall survival (OS), progression free survival (PFS), objective response rates per RECIST criteria (ORR), and reason for ICI discontinuation were analyzed across histologic subtype, ICI regimen, tumor mutational burden (TMB), and PD-L1. Results: The most common histologic subtypes analyzed were leiomyosarcoma (LMS, n=48), liposarcoma (LPS, n=27), and undifferentiated pleomorphic sarcoma (UPS, n=18). Immunotherapy regimens primarily consisted of ipilimumab and nivolumab (77.8%), pembrolizumab (14.8%), and nivolumab monotherapy (6.0%). Median OS for all patients was 12.8 months. Response rates across all sarcomas were complete response (CR) 3.2%, partial response (PR) 13.4%, stable disease (SD) 30%, and progression of disease (PD) 53.2%. The ORR was higher in patients treated with pembrolizumab (21.9%) than with ipilimumab and nivolumab (14.3%). The histologic subtypes with the highest ORR were Kaposi sarcoma (KS, 66.7%), alveolar soft part sarcoma (ASPS, 50%), angiosarcoma (AS, 33.3%), myxofibrosarcoma (MFS, 28.6%), and UPS (27.8%). The subtypes with the lowest ORR were osteosarcoma (OS, 0%), synovial sarcoma (SS, 0%), and LPS (3.7%). The subtypes with the highest median PFS were KS (median not reached, NR), ASPS (NR), MFS (27.3 mo), and UPS (11.3 mo). Overall TMB (n=118) was low with a median of 2 mut/MB. Only 4 patients (3.3%) had a TMB ≥10, with a corresponding ORR of 25%. Overall PD-L1 expression (n=93 with TPS or CPS) was also low with a median of 0%. However, positive PD-L1 (n=36/93, > 1%) was associated with better ORR (27.8%, 10/36). 16.2% of patients discontinued immunotherapy due to autoimmune adverse effects; the most common were pneumonitis (18.4%), colitis (15.8%), arthritis (13.2%), and hepatitis (13.2%). Conclusions: Response and PFS were highly variable across sarcoma histologic subtype. In this large analysis, KS, ASPS, AS, MFS, and UPS demonstrated the best ORR and longest PFS while OS, SS, and LPS were the lowest. TMB ≥10 and PD-L1 expression also correlated with increased ORR. Our findings provide further insight into understanding the sarcoma histologic and immunologic factors that correspond with response to ICIs. [Table: see text]