bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic impact of muscle mass loss in elderly patients with oesophageal cancer receiving neoadjuvant chemoradiation therapy
Authors: Jang Jeong Yun , Oh Dongryul , Noh Jae Myoung , Sun Jong‐Mu , Kim Hong Kwan , Shim Young Mog 
Published: April 2024

AbstractBackgroundWe aimed to identify the impact of muscle mass on locally advanced oesophageal cancer (LAEC) in elderly patients receiving neoadjuvant chemoradiation therapy (NACRT).MethodsWe reviewed the medical records of 345 patients diagnosed with LAEC who underwent NACRT and surgery. Physical variables, including height, weight, skeletal muscle mass, and laboratory values, were obtained before and after NACRT. Body mass index (BMI, kg/m2), neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), and prognostic nutritional index (PNI) were calculated as height/(weight)2, ANC/ALC, platelet count/ALC, and (10 × albumin + 0.05 × ALC), respectively. The cutoff for low muscle mass was 43.0 cm2/m2 for BMI below 25 kg/m2 and 53.0 cm2/m2 for BMI 25 kg/m2 or higher. The skeletal muscle index (SMI) was defined as skeletal muscle area/(height)2 (cm2/m2). The ΔSMI (%/50 days) was defined as (SMI after NACRT − SMI before NACRT)/interval (days) × 50 (days) to compare changes over the same period. The excessive muscle loss (EML) group was defined as patients with ΔSMI ≤−10% following NACRT. An elderly patient was defined as aged ≥65 years. The primary outcome measure was overall survival (OS).ResultsDuring a median follow‐up of 32.8 months (range, 2.0–176.2), 192 patients died, with a median OS of 50.2 months. Elderly patients did not show inferior OS (young vs. elderly, 57.7% vs. 54.0% at 3 years, P = 0.247). 71.0% and 87.2% of all patients had low muscle mass before and after NACRT, respectively, which was not associated with OS (P = 0.270 and P = 0.509, respectively). Inflammatory (NLR and PLR) and nutritional index (PNI) values or their changes did not correlate with OS. However, the EML group had worse OS (41.6% vs. 63.2% at 3 years, P < 0.0001). In the multivariate analysis, EML was also a significant prognostic factor for OS. In the subgroup analysis by age, EML was a strong prognostic factor for OS in the elderly group. The 3‐year OS was 36.8% in the EML group and 64.9% in the non‐EML group (P < 0.0001) in elderly patients, and 47.4% and 62.1% (P = 0.063) in the young patients. In multivariate analysis of each subgroup, EML remained prognostic only in the elderly group (P = 0.008).ConclusionsEML may be strongly associated with a deteriorated OS in elderly patients undergoing NACRT, followed by surgery for LAEC. The strategies for decreasing muscle loss in these patients should be investigated.
Variables influencing students’ course quality evaluation: A cross‐sectional study for a bachelor's degree dental program
Authors: Abuljadayel Jameel , Abed Hassan 
Published: April 2024

AbstractPurposeThis cross‐sectional study aimed to evaluate and predict variables that influence the Students’ Course Evaluation Surveys (SCES) in a bachelor's degree of dental medicine and surgery program.Materials and methodsData from the Faculty of Dental Medicine for the academic year 2021–2022 were analyzed including 39 course reports, students' course evaluation surveys, students’ academic performance data, and the program specification. The survey contains 24 statements that evaluate five main domains of the courses, which are course syllabus, staff performance through the course, course learning resources, course execution, and course quality.ResultsChi‐squared Test revealed no significant association between the total average students’ evaluation score of the course against factors such as student's level, term, main mode of instruction, course category, department, and course director's gender, academic experiences, and nationality. On the other hand, pairwise comparisons revealed that grades from A+ to C were predictors of the total average SCES scores (p ≤ 0.004). Using the Paired Samples T‐Test, the student's evaluation scores for their course were found to be significantly higher for females than males (mean ± SD = 50.56 ± 24.3 vs. 41.00 ± 26.3, p = 0.042). Using Pearson correlations, results showed a significant association of total average students’ course evaluation scores against factors such as average course syllabus, staff performance, course learning resources, course execution, and course quality (p < 0.001).ConclusionsAverage course syllabus, staff performance, course learning resources, course execution, and course quality are major predictor variables that influence SCES scores in the examined program. Enhancing these domains will be of great importance to improve the quality of the courses at the dental bachelor level.
Evaluating the impact of an interdisciplinary integrated limb preservation service operating concurrently with a single‐specialty service
Authors: Bazikian Sebouh , Pyun Alyssa J. , Zheng Hanke , Padula William , Khan Tanzim , Ziegler Kenneth , Shin Laura , Magee Gregory A. , Rowe Vincent L. , Armstrong David G. 
Published: April 2024

AbstractBackgroundThis study examined the efficacy of an interdisciplinary limb preservation service (LPS) in improving surgical outcomes for diabetic foot ulcer (DFU) patients compared to traditional care.MethodsData from January 1, 2017 to September 30, 2020 were retrospectively reviewed. An interdisciplinary LPS clinic began on August 1, 2018, coexisting with a preexisting single specialty service. Primary outcomes were major/minor amputation rates and ratios and hospital length of stay. Surgical endpoints pre‐ and post‐LPS launch were compared.ResultsAmong 976 procedures for 731 unique DFU patients, most were male (80.4%) and Hispanic (89.3%). Patient demographics were consistent before and after LPS initiation. Major amputation rates decreased by 45.5% (15.4%–8.4%, p = 0.001), with outpatient procedures increasing over 5‐fold (3.3% pre‐LPS to 18.7% post‐LPS, p < 0.001). Hospital stay reduced from 10.1 to 8.5 days post‐LPS (p < 0.001). The major to minor amputation ratio declined from 22.4% to 12.7%.ConclusionsThe interdisciplinary LPS improved patient outcomes, marked by fewer major amputations and reduced hospital stays, suggesting the model's potential for broader application.
Accepting or declining preconception expanded carrier screening: An exploratory study with 407 couples
Authors: Van Tongerloo Ariane J. A. G. , Verdin Hannah , Steyaert Wouter , Coucke Paul J. , Janssens Sandra 
Published: April 2024

AbstractRapidly evolving genomic technologies have made genetic expanded carrier screening (ECS) possible for couples considering a pregnancy. The aim of ECS is to identify couples at risk of having a child affected with a severe disorder and to facilitate their reproductive decision‐making process. The ECS test we offer at our center, called BeGECS (Belgian Genetic ECS), consists of 1268 autosomal recessive (AR) and X‐linked pathogenic genes, including severe childhood‐onset disorders. However, thus far data are scarce regarding the actual uptake of preconception ECS in a clinical setting. Therefore, our aim was to describe the characteristics of 407 couples to whom ECS was offered at the Center for Medical Genetics of the University Hospital Ghent (CMGG). In addition, we aimed to identify their reasons for accepting or declining BeGECS. Between October 2019 and January 2023, 407 preconception couples were offered BeGECS and were asked to fill in a questionnaire after their decision. Of the 407 couples participating in the survey, 270 (66%) decided to take the test and 137 (34%) declined. We observed that age, highest education level as well as indication for consultation were statistically different between the group that accepted to take the test and the group that declined (p = 0.037). In particular, age and education level were substantially higher in the group that accepted the test. Major reasons for taking BeGECS include prevention, wishing to obtain all information possible, helping preparing their future reproductive decision and increasing their sense of control by being informed. However, couples that do not chose to take BeGECS stated that too much information would make them anxious, that the result would not change their decision to have children, that they do not want to spend money on something that will not happen and that they do not worry about their family history. These findings show that the majority of preconception couples that were offered ECS, accepted the test.
Medical students' impression of a generalist in Japan: A cross‐sectional study
Authors: Kinoshita Kai , Kaneko Makoto 
Published: April 2024

AbstractBackgroundDespite the increasing global demand, few medical students aspire to become generalists. To address this shortage, we investigated medical students' impressions of generalists in Japan.MethodsThis cross‐sectional study used a web‐based questionnaire from a previous study. The participants chose the impression of a generalist from four categories based on the previous report: family physician, hospital family physician, hospitalist, and general internal medicine.ResultsMedical students' impressions were as follows: family physicians (32%), hospitalists (28%), general internal medicine staff (20%), and hospital family physicians (18%). Students considered reasonable working hours, research opportunities, a clinical clerkship in generalist medicine, and information from university faculty as essential for making career choices.ConclusionsThe study demonstrated that the number of Japanese medical students who considered generalists to be family physicians/hospital family physicians and the number of those who considered generalists to be hospitalists/general internal medicine were almost equal. To increase the number of medical students who consider and choose to become generalists, understanding their impressions of generalist practice and their needs regarding work settings in that role is crucial.
Hypertriglyceridemia‐induced acute necrotizing pancreatitis: Poor clinical outcomes requiring revisiting management modalities
Authors: Abboud Yazan , Shah Meet , Simmons Benjamin , Mandava Kranthi , Morales John E M , Jaber Fouad , Alsakarneh Saqer , Ismail Mohamed , Hajifathalian Kaveh 
Published: April 2024

AbstractHypertriglyceridemia‐induced acute pancreatitis (HTG‐AP) is the third most common cause of AP after gallstones and alcohol. Supportive measures, intravenous insulin, and plasmapheresis are possible treatment modalities for HTG‐AP; however, definitive guidelines evaluating the best therapeutic approach are not clearly established. We present a rare case of a 42‐year‐old male without known comorbidities who was found to have HTG‐AP. Despite early initiation of intravenous insulin and plasmapheresis and the initial decline in his triglycerides level, his condition was complicated by necrotizing pancreatitis and subsequent multi‐organ failure. Future studies are warranted to evaluate the role of plasmapheresis in HTG‐AP and its efficacy.
Intra‐ and Peri‐tumoral Radiomics Based on Dynamic Contrast Enhanced‐MRI to Identify Lymph Node Metastasis and Prognosis in Intrahepatic Cholangiocarcinoma
Authors: Pan Yi‐Jun , Wu Sun‐jie , Zeng Yan , Cao Zi‐Rui , Shan Yan , Lin Jiang , Xu Peng‐Ju 
Published: April 2024

BackgroundLymph node metastasis (LNM) in patients with intrahepatic cholangiocarcinoma (iCCA) affects treatment strategies and prognosis. However, preoperative imaging is not reliable enough for identifying LNM.PurposeTo develop and validate a radiomics nomogram based on dynamic contrast enhanced (DCE)‐MR images for identifying LNM and prognosis in iCCA.Study TypeRetrospective.SubjectsTwo hundred four patients with pathologically proven iCCA who underwent curative‐intent resection and lymphadenectomy (training cohort: N = 107, internal test cohort: N = 46, and external test cohort: N = 51).Field Strength/SequenceT1‐ and T2‐weighted imaging, diffusion‐weighted imaging and DCE imaging at 1.5 T or 3.0 T.AssessmentRadiomics features were extracted from intra‐ and peri‐tumoral regions on preoperative DCE‐MR images. Imaging features were evaluated by three radiologists, and significant variables in univariable and multivariable regression analysis were included in clinical model. The best‐performing radiomics signature and clinical characteristics (intrahepatic duct dilatation, MRI‐reported LNM) were combined to build a nomogram. Patients were divided into high‐risk and low‐risk groups based on their nomogram scores (cutoff = 0.341). Patients were followed up for 1–102 months (median 12) after surgery, the overall survival (OS) and recurrence‐free survival (RFS) were calculated.Statistical TestsReceiver operating characteristic (ROC) curve, calibration, decision curve, Delong test, Kaplan–Meier curves, log rank test. Two tailed P < 0.05 was considered statistically significant.ResultsThe nomogram incorporating intra‐ and peri‐tumoral radiomics features, intrahepatic duct dilatation and MRI‐reported LNM obtained the best discrimination for LNM, with areas under the ROC curves of 0.946, 0.913, and 0.859 in the training, internal, and external test cohorts. In the entire cohort, high‐risk patients had significantly lower RFS and OS than low‐risk patients. High‐risk of LNM was an independent factor of unfavorable OS and RFS.Data ConclusionThe nomogram integrating intra‐ and peri‐tumoral radiomics signatures has potential to identify LNM and prognosis in iCCA.Evidence Level3Technical EfficacyStage 2
Enhancing drug development and clinical studies with patient‐centric sampling using microsampling techniques: Opportunities, challenges, and insights into liquid chromatography‐mass spectrometry strategies
Authors: Chen Zhuo , Goudarzi Christopher C. , Sikorski Timothy W. , Weng Naidong 
Published: April 2024

AbstractMicrosampling has revolutionized pharmaceutical drug development and clinical research by reducing sample volume requirements, allowing sample collection at home or nontraditional sites, minimizing animal and patient burden, and enabling more flexible study designs. This perspective paper discusses the transformative impact of microsampling and patient‐centric sampling (PCS) techniques, emphasizing their advantages in drug development and clinical trials. We highlight the integration of liquid chromatography‐mass spectrometry (LC–MS) strategies for analyzing PCS samples, focusing on our research experience and a review of current literatures. The paper reviews commercially available PCS devices, their regulatory status, and their application in clinical trials, underscoring the benefits of PCS in expanding patient enrollment diversity and improving study designs. We also address the operational challenges of implementing PCS, including the need for bridging studies to ensure data comparability between traditional and microsampling methods, and the analytical challenges posed by PCS samples. The paper proposes future directions for PCS, including the development of global regulatory standards, technological advancements to enhance user experience, the increased concern of sustainability and patient data privacy, and the integration of PCS with other technologies for improved performance in drug development and clinical studies. By advancing microsampling and PCS techniques, we aim to foster patient‐centric approaches in pharmaceutical sciences, ultimately enhancing patient care and treatment efficacy.
Correlating neighborhood‐level deprivation and pediatric metabolic dysfunction‐associated steatotic liver disease
Authors: Hickman Nicole E. , Price Mason , Crespo Noe C. , Feldstein Ariel E. 
Published: April 2024

AbstractObjectivesThe primary objective of this study is to further explore associations between social influencers of health and markers of disease severity at the time of presentation of patients with pediatric metabolic dysfunction‐associated steatotic liver disease (MASLD) using neighborhood‐level Area Deprivation Index (ADI) scores.MethodsA retrospective cross‐sectional study was conducted among 344 pediatric MASLD patients. Each patient received an ADI score based on their 9‐digit zip code. Groups were defined as low (≤5) and high (6≥) ADI. Associations between ADI and symptomatology and laboratory values at presentation, as well as initial liver biopsy pathology were tested via analyses of covariance, χ2 testing, and logistic regressions.ResultsThe mean ADI was 6.54 (standard deviation = 2.09). ADI groups did not significantly differ in age of presentation, type of presentation, or associated conditions, except for the higher ADI group having on average lower vitamin D levels (26.70 vs. 29.91, p = 0.02) and being two times more likely to also be diagnosed with low high‐density lipoprotein (HDL) levels (p = 0.04, 95% CI 1.04–3.89). Mean transaminases and histopathologic nonalcoholic fatty liver disease (NAFLD) Activity Scores did not significantly differ between ADI groups.ConclusionsPediatric patients with MASLD in this study span the entire spectrum of neighborhood deprivation. There were no differences in presentation characteristics or severity of MASLD, aside from lower HDL‐cholesterol and vitamin D values in the high ADI group. Area deprivation was not predictive of more severe disease as assessed by serum transaminases and liver biopsy NAFLD activity scores.
Generalised exanthematous pustular dermatophytids during Trichophyton violaceum tinea capitis
Authors: Kluger Nicolas 
Published: April 2024

AbstractDermatophytids are defined as the acute occurrence of noninfectious secondary lesions at distance from a primary dermatophytic infection. They are well‐known after intertrigo of the toes. We report an 8‐year‐old boy, who developed generalised pustular lesions during the treatment of tinea capitis caused by Trichophyton violaceum. He had a rapid response to local corticosteroid ointment, while oral terbinafine was efficient on the scalp condition. Dermatophytids are the result of a type IV delayed hypersensitivity reaction to dermatophytic antigens. They may occur after initiation of an antifungal treatment. Generalised exanthematous pustular dermatophytids is a clinical variant of dermatophytids. They present as nonfollicular, nonconfluent pustules with an erythematous base, of abrupt onset. Main differential diagnoses are acute generalised exanthematous pustulosis and pustular psoriasis. Medical history, clinical presentation, laboratory findings and, if necessary, biopsy will help to distinguish between those conditions. Evolution is rapidly favourable under local or oral corticotherapy and antifungal treatments should not be withdrawn. Dermatophytids are a differential diagnostic of acute generalised pustulosis during tinea capitis.
Blood, Sweat, and Tonsils: Bleeding After Abscess Tonsillectomy for Quinsy‐A Meta‐Analysis
Authors: Mughal Zahir , Gupta Keshav Kumar , Yeo Justin Jui Yuan , Metcalfe Christopher , Weller Matthew 
Published: April 2024

ObjectiveAbscess tonsillectomy is performed during an active episode of quinsy. Apprehensions regarding an elevated bleeding risk have hindered its widespread acceptance. This study aims to assess the prevalence of post‐tonsillectomy bleeding (PTB) associated with abscess tonsillectomy.Data SourcesA search was performed on August 27, 2023 in Medline, Embase, PubMed, Cochrane CENTRAL, and Web of Science databases.Review MethodsThe systematic review was conducted in adherence to the PRISMA guidelines. Pooled PTB rate was determined using a meta‐analysis of proportions. The JBI tool was used to assess the quality of the included studies.ResultsOf the 525 search records, 18 studies met the eligibility criteria for final analysis. These comprised of retrospective single‐center analyses. The pooled prevalence of PTB was 6.65% (95% C.I. 4.01–9.81), and the return‐to‐theatre rate was 2.35% (95% C.I. 1.48–3.37). There was no difference in PTB rate between unilateral and bilateral tonsillectomy. However, the bipolar technique was associated with a higher PTB rate compared to cold steel dissection. The overall quality of the body of evidence was moderate.ConclusionOur study highlights the complications associated with abscess tonsillectomy. These findings contribute valuable insights into this potential treatment option for quinsy.Level of EvidenceN/A Laryngoscope, 134:4186–4195, 2024
Ppomicsdb: A Multi‐Omics Database for Genetic and Molecular Breeding Applications in Pigeonpea
Authors: Singh Nisha , Ujinwal Megha , Singh Nagendra Kumar 
Published: April 2024

ABSTRACTCajanus cajan, commonly known as Arhar or tur in India, is a highly treasured plant species belonging to the Fabaceae family. Pigeonpea is a drought‐tolerant legume crop produced in the world's tropics and subtropics areas, rich source of protein, carbohydrates, fiber, and minerals. It is considered as “meat for vegetarian people” and addresses malnutrition issues globally. Despite its nutritional and economic importance, the lack of comprehensive knowledge about its genomic resources prevents it from being used wisely through molecular breeding programs and biotechnological intervention. Several genomic repositories on pigeonpea are available; however, there is no cohesive integrated multi‐omics database available for C. cajan. Here, we present a first report on comprehensive pigeonpea omics database, named as Ppomics database (db) available at https://ppomics.multiwebx.com/, which provides up‐to‐date various aspects of multi‐omics information devoted to the catalogs phenomics (both qualitative and quantitative), genomics, transcriptomics, and proteomics data. Ppomics db is an integrated multi‐omics platform for discovering important regulators of several qualitative and quantitative traits in pigeonpea, which can be utilized for superior breed development. Ppomics db has been made available to researchers to acquire the related omics information and perform multi‐omics data analysis.
Using oxygen isotopes in phosphate to assess biological phosphorus cycling in a small and shallow freshwater lake system
Authors: Yi Rong , Ishida Takuya , Song Peixue , Ikeya Tohru , Okuda Noboru , Paytan Adina , Ban Syuhei 
Published: April 2024

AbstractReducing excess phosphorus (P) loads that cause eutrophication in aquatic systems is essential for meeting water quality standards. The oxygen isotopic composition of phosphate (δ18Op) is a powerful tool for tracking P sources and cycling in diverse natural ecosystems. Here, we use δ18Op distribution in a small freshwater body (a lagoon–lake system) with high biological activity. We report δ18Op values seasonally along the water flow path in lagoon–lake system adjacent to Lake Biwa, Japan. The δ18Op values of inflowing water originating as agricultural runoff were constant throughout the study period at +16.3‰ ± 0.2‰. The δ18Op values in the system were generally offset from temperature‐dependent isotopic equilibrium with the surrounding water, ranging from +11.1‰ to +17.8‰. The δ18Op values of the lake water approached equilibrium values in July and October, when dissolved inorganic P (DIP) retention rates were high, consistent with extensive biologically mediated phosphate cycling. A δ18Op two end‐member mixing model, involving inflowing P and biologically recycled P, suggests that P turnover rates in the lagoon–lake system were high during the productive seasons. In contrast, the longer lake water residence time in the non‐irrigation season (winter) allowed δ18Op values to deviate toward lower values relative to both equilibrium and agricultural source δ18Op values, suggesting that P metabolism was dominated by extracellular/ecto‐enzymatic hydrolysis of dissolved organic P under low DIP concentrations. This work highlighted the utility of δ18Op for understanding P dynamics in shallow lake ecosystems.