bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anatomic Subtype Differences in Extramammary Paget Disease
Authors: Kibbi Nour , Owen Joshua L. , Worley Brandon , Wang Jake X. , Harikumar Vishnu , Aasi Sumaira Z. , Chandra Sunandana , Choi Jennifer N. , Fujisawa Yasuhiro , Iavazzo Christos , Kim John Y. S. , Lawrence Naomi , Leitao Mario M. , MacLean Allan B. , Ross Jeffrey S. , Rossi Anthony M. , Servaes Sabah , Solomon Michael J. , Alam Murad 
Published: March 2024

ImportanceExtramammary Paget disease (EMPD) is a rare, highly recurrent cutaneous malignant neoplasm of unclear origin. EMPD arises most commonly on the vulvar and penoscrotal skin. It is not presently known how anatomic subtype of EMPD affects disease presentation and management.ObjectiveTo compare demographic and tumor characteristics and treatment approaches for different EMPD subtypes. Recommendations for diagnosis and treatment are presented.Data SourcesMEDLINE, Embase, Web of Science Core Collection, and Cochrane Reviews CENTRAL from December 1, 1990, to October 24, 2022.Study SelectionArticles were excluded if they were not in English, reported fewer than 3 patients, did not specify information by anatomic subtype, or contained no case-level data. Metastatic cases on presentation were also excluded.Data Extraction and SynthesisAbstracts of 1295 eligible articles were independently reviewed by 5 coauthors, and 135 articles retained. Reporting was in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. The analysis was cunducted in August 2019 and updated in November 2022.FindingsMost vulvar EMPD cases were asymptomatic, and diagnosis was relatively delayed (mean, 25.1 months). Although most vulvar EMPD cases were intraepidermal (1247/1773 [70.3%]), radical surgeries were still performed in almost one-third of cases. Despite this aggressive surgical approach, 481 of 1423 (34%) recurred, commonly confined to the skin and mucosa (177/198 [89.4%]). By contrast, 152 of 1101 penoscrotal EMPD cases (14%) recurred, but more than one-third of these recurrences were regional or associated with distant metastases (54 of 152 [35.5%]). Perianal EMPD cases recurred in one-third of cases (74/218 [33.9%]), with one-third of these recurrences being regional or associated with distant metastasis (20 of 74 [27.0%]). Perianal EMPD also had the highest rate of invasive disease (50% of cases).Conclusions and RelevanceThe diagnosis and treatment of EMPD should differ based on anatomic subtypes. Considerations for updated practice may include less morbid treatments for vulvar EMPD, which is primarily epidermal, and close surveillance for local recurrence in vulvar EMPD and metastatic recurrence in perianal EMPD. Recurrences in penoscrotal subtype were less common, and selective surveillance in this subtype may be considered. Limitations of this study include the lack of replication cohorts and the exclusion of studies that did not stratify outcomes by anatomic subtype.
Virtual Reality and Transcranial Direct Current Stimulation for Posttraumatic Stress Disorder
Authors: van ’t Wout-Frank Mascha , Arulpragasam Amanda R. , Faucher Christiana , Aiken Emily , Shea M. Tracie , Jones Richard N. , Greenberg Benjamin D. , Philip Noah S. 
Published: March 2024

ImportancePosttraumatic stress disorder (PTSD) is a common psychiatric disorder that is particularly difficult to treat in military veterans. Noninvasive brain stimulation has significant potential as a novel treatment to reduce PTSD symptoms.ObjectiveTo test whether active transcranial direct current stimulation (tDCS) plus virtual reality (VR) is superior to sham tDCS plus VR for warzone-related PTSD.Design, Setting, and ParticipantsThis double-blind randomized clinical trial was conducted among US military veterans enrolled from April 2018 to May 2023 at a secondary care Department of Veterans Affairs hospital and included 1- and 3-month follow-up visits. Participants included US military veterans with chronic PTSD and warzone-related exposure, recruited via referral and advertisement. Patients in psychiatric treatment had to be on a stable regimen for at least 6 weeks to be eligible for enrollment. Data were analyzed from May to September 2023.InterventionParticipants were randomly assigned to receive 2-mA anodal tDCS or sham tDCS targeted to the ventromedial prefrontal cortex, during six 25-minute sessions of standardized warzone VR exposure, delivered over 2 to 3 weeks.Main Outcomes and MeasuresThe co–primary outcomes were self-reported PTSD symptoms, measured via the PTSD checklist for DSM-5 (PCL-5), alongside quality of life. Other outcomes included psychophysiological arousal, clinician-assessed PTSD, depression, and social/occupational function.ResultsA total of 54 participants (mean [SD] age, 45.7 [10.5] years; 51 [94%] males) were assessed, including 26 in the active tDCS group and 28 in the sham tDCS group. Participants in the active tDCS group reported a superior reduction in self-reported PTSD symptom severity at 1 month (t = −2.27, P = .02; Cohen d = −0.82). There were no significant differences in quality of life between active and sham tDCS groups. Active tDCS significantly accelerated psychophysiological habituation to VR events between sessions compared with sham tDCS (F5,7689.8 = 4.65; P &amp;lt; .001). Adverse effects were consistent with the known safety profile of the corresponding interventions.Conclusions and RelevanceThese findings suggest that combined tDCS plus VR may be a promising strategy for PTSD reduction and underscore the innovative potential of these combined technologies.Trial RegistrationClinicalTrials.gov Identifier: NCT03372460
Robotic Technology in Emergency General Surgery Cases in the Era of Minimally Invasive Surgery
Authors: Lunardi Nicole , Abou-Zamzam Aida , Florecki Katherine L. , Chidambaram Swathikan , Shih I-Fan , Kent Alistair J. , Joseph Bellal , Byrne James P. , Sakran Joseph V. 
Published: March 2024

ImportanceAlthough robotic surgery has become an established approach for a wide range of elective operations, data on its utility and outcomes are limited in the setting of emergency general surgery.ObjectivesTo describe temporal trends in the use of laparoscopic and robotic approaches and compare outcomes between robotic and laparoscopic surgery for 4 common emergent surgical procedures.Design, Setting, and ParticipantsA retrospective cohort study of an all-payer discharge database of 829 US facilities was conducted from calendar years 2013 to 2021. Data analysis was performed from July 2022 to November 2023. A total of 1 067 263 emergent or urgent cholecystectomies (n = 793 800), colectomies (n = 89 098), inguinal hernia repairs (n = 65 039), and ventral hernia repairs (n = 119 326) in patients aged 18 years or older were included.ExposureSurgical approach (robotic, laparoscopic, or open) to emergent or urgent cholecystectomy, colectomy, inguinal hernia repair, or ventral hernia repair.Main Outcomes and MeasuresThe primary outcome was the temporal trend in use of each operative approach (laparoscopic, robotic, or open). Secondary outcomes included conversion to open surgery and length of stay (both total and postoperative). Temporal trends were measured using linear regression. Propensity score matching was used to compare secondary outcomes between robotic and laparoscopic surgery groups.ResultsDuring the study period, the use of robotic surgery increased significantly year-over-year for all procedures: 0.7% for cholecystectomy, 0.9% for colectomy, 1.9% for inguinal hernia repair, and 1.1% for ventral hernia repair. There was a corresponding decrease in the open surgical approach for all cases. Compared with laparoscopy, robotic surgery was associated with a significantly lower risk of conversion to open surgery: cholecystectomy, 1.7% vs 3.0% (odds ratio [OR], 0.55 [95% CI, 0.49-0.62]); colectomy, 11.2% vs 25.5% (OR, 0.37 [95% CI, 0.32-0.42]); inguinal hernia repair, 2.4% vs 10.7% (OR, 0.21 [95% CI, 0.16-0.26]); and ventral hernia repair, 3.5% vs 10.9% (OR, 0.30 [95% CI, 0.25-0.36]). Robotic surgery was associated with shorter postoperative lengths of stay for colectomy (−0.48 [95% CI, −0.60 to −0.35] days), inguinal hernia repair (−0.20 [95% CI, −0.30 to −0.10] days), and ventral hernia repair (−0.16 [95% CI, −0.26 to −0.06] days).Conclusions and RelevanceWhile robotic surgery is still not broadly used for emergency general surgery, the findings of this study suggest it is becoming more prevalent and may be associated with better outcomes as measured by reduced conversion to open surgery and decreased length of stay.
Glucagon-Like Peptide-1 Receptor Agonist Use and Residual Gastric Content Before Anesthesia
Authors: Sen Sudipta , Potnuru Paul P. , Hernandez Nadia , Goehl Christina , Praestholm Caroline , Sridhar Srikanth , Nwokolo Omonele O. 
Published: March 2024

ImportanceGlucagon-like peptide-1 receptor agonist (GLP-1 RA) use is rapidly increasing in the US, driven by its expanded approval for weight management in addition to hyperglycemia management in patients with type 2 diabetes. The perioperative safety of these medications, particularly with aspiration risk under anesthesia, is uncertain.ObjectiveTo assess the association between GLP-1 RA use and prevalence of increased residual gastric content (RGC), a major risk factor for aspiration under anesthesia, using gastric ultrasonography.Design, Setting, and ParticipantsThis cross-sectional study prospectively enrolled patients from a large, tertiary, university-affiliated hospital from June 6 through July 12, 2023. Participants followed preprocedural fasting guidelines before an elective procedure under anesthesia. Patients with altered gastric anatomy (eg, from previous gastric surgery), pregnancy, recent trauma (&amp;lt;1 month), or an inability to lie in the right lateral decubitus position for gastric ultrasonography were excluded.ExposureUse of a once-weekly GLP-1 RA.Main Outcomes and MeasuresThe primary outcome was the presence of increased RGC, defined by the presence of solids, thick liquids, or more than 1.5 mL/kg of clear liquids on gastric ultrasonography. Analysis was adjusted for confounders using augmented inverse probability of treatment weighting, a propensity score–based technique. Secondarily, the association between the duration of drug interruption and the prevalence of increased RGC was explored.ResultsAmong the 124 participants (median age, 56 years [IQR, 46-65 years]; 75 [60%] female), the prevalence of increased RGC was 56% (35 of 62) in patients with GLP-1 RA use (exposure group) compared with 19% (12 of 62) in patients who were not taking a GLP-1 RA drug (control group). After adjustment for confounding, GLP-1 RA use was associated with a 30.5% (95% CI, 9.9%-51.2%) higher prevalence of increased RGC (adjusted prevalence ratio, 2.48; 95% CI, 1.23-4.97). There was no association between the duration of GLP-1 RA interruption and the prevalence of increased RGC (adjusted odds ratio, 0.86; 95% CI, 0.65-1.14).Conclusions and RelevanceUse of a GLP-1 RA was independently associated with increased RGC on preprocedural gastric ultrasonography. The findings suggest that the preprocedural fasting duration suggested by current guidelines may be inadequate in this group of patients at increased risk of aspiration under anesthesia.
Evaluation of Osteoarthritis Disease Burden in China During 1990–2019 and Forecasting Its Trend Over the Future 25 Years
Authors: Chen Haowei , Zhang Lei , Shi Xiaorui , Zhou Zhounan , Fang Xiaofeng , Yang Hao , Hunter David J. , Ding Changhai , Zhu Zhaohua 
Published: March 2024

ObjectiveThis study aimed to estimate the temporal trend of osteoarthritis (OA) burden in China by age, sex, and joint sites from 1990 to 2019 and predict the long‐term trend over the next 25 years.MethodsUsing data from the Global Burden of Disease Study 2019, we estimated incident cases, prevalent cases, disability‐adjusted life years (DALYs) of OA, and DALYs of OA attributed to high body mass index (BMI), as well as corresponding age‐standardized rates (ASRs) for aforementioned indicies. Estimated annual percentage change (EAPC) and Nordpred age‐period‐cohort model were used to describe temporal trend changes and predict future disease burden.ResultsFrom 1990 to 2019, the ASR of OA incidence increased from 472.53 per 100,000 to 509.84 per 100,000 people (EAPC: 0.36, 95% confidence interval [CI] 0.29–0.44); the ASR of OA prevalence increased from 5,880.58 per 100,000 to 6,330.06 per 100,000 people (EAPC 0.35, 95% CI 0.28–0.42); the ASR of OA DALYs increased from 206.38 per 100,000 to 224.78 per 100,000 people (EAPC 0.40, 95% CI 0.32–0.48). The ASR of OA DALYs attributed to high BMI increased rapidly, especially in men and patients with hip OA. Projections suggest an increasing trend in the incidence, prevalence, and DALYs of OA from 2019 to 2044, with the prevalent cases and DALYs of OA in China expected to increase by approximately 1.5 times over the next 25 years.ConclusionThe disease burden of OA has increased in China over the past 30 years and is expected to continue rising over the next 25 years.
Having More Tender Than Swollen Joints is Associated With Worse Function and Work Impairment in Patients With Early Rheumatoid Arthritis
Authors: Meng Charis F. , Lee Yvonne , Schieir Orit , Valois Marie‐France , Butler Margaret , Boire Gilles , Hazlewood Glen , Hitchon Carol , Keystone Edward , Tin Diane , Thorne Carter , Bessette Louis , Pope Janet , Bartlett Susan , Bykerk Vivian 
Published: March 2024

ObjectivePatients with early rheumatoid arthritis (RA) may present with more tender than swollen joints, which can persist. Elevated tender‐swollen joint difference (TSJD) is often challenging, because there may be multiple causes and it may contribute to overestimating disease activity. Little is known about the phenotype and impact of TSJDs on patient function. Our objective was to evaluate the impact of TSJD on functional outcomes in early RA and to see whether associations vary by joint size.MethodsData were from patients with active, early RA (≤12 months) enrolled in the Canadian Early Arthritis Cohort, who completed assessments of general function (Multidimensional Health Assessment Questionnaire [MDHAQ]), upper extremity (UE) function (Quality of Life in Neurological Disorders [Neuro‐QoL] UE scale), and work/activity impairment (Work Productivity and Activity Impairment RA) over their first year of follow‐up. A total of 28 joint counts were performed. TSJDs were calculated. Adjusted associations between TSJDs and functional outcomes were estimated in separate multivariable linear mixed effects models. Separate analyses were performed for large‐ versus small‐joint TSJD.ResultsPatients (N = 547) were 70% female, mean age 56 (SD 15) years, mean disease duration 5.3 (SD 2.9) months. At baseline, 287 (52%) had TSJD >0 (43% involved large joints and 34% small joints), decreasing to 32% at 12 months. A one‐point increase in TSJD was significantly associated with worse function (MDHAQ: adjusted mean change 0.10, 95% confidence interval [CI] 0.08–0.13; Neuro‐QoL UE function T score: adjusted mean change −0.59, 95% CI −0.76 to −0.43; and greater work impairment: adjusted mean change 1.95%, 95% CI 0.85%–3.05%). Higher large‐joint TSJDs were associated with the worst functional outcomes.ConclusionHaving more tender than swollen joints is common in early RA and is associated with worse function, most notably when involving large joints. Early identification and targeted intervention strategies may be needed.
Platinum Nanoparticles‐Enhanced Ferritin–Mn2+ Interaction for Magnetic Resonance Contrast Enhancement and Efficient Tumor Photothermal Therapy
Authors: Liu Shuangqing , Tian Liya , Mu Mengyao , Liu Ziyan , Dong Mengzhen , Gong Yufang , Liu Hui , Wang Ximing , Meng Qingwei , Zhang Haidong , Sun Xiao 
Published: March 2024

AbstractNanoplatforms with high Mn2+ coordination can display efficient T1 magnetic resonance imaging (MRI) contrast enhancement. Herein, an earth gravity‐like method for enhanced interaction between Ferritin (Fn) and Mn2+ by the growth of platinum nanoparticles (PNs) in Fn's cage structure via a biomineralization method is first proposed. Fn has good biocompatibility and can provide a suitable growth site for PNs. PNs with negative charge have certain attraction to Mn2+ with positive charge, improving Fn's loading capacity of Mn2+ by attraction force; and thus, achieving efficient MRI contrast enhancement. In addition, PNs can be applied for efficient photothermal therapy (PTT) under near infrared ray (NIR) irradiation. Systemic delivery of this nanoplatform shows obvious MRI contrast enhancement and tumor progression inhibition after NIR irradiation, as well as no obvious side effects. Therefore, this nanoplatform has the potential to contribute to nanotheranostic for clinical transformation.
Supramolecular Heterodimer Peptides Assembly for Nanoparticles Functionalization
Authors: Mathieu Clélia , Ghosh Shayamita , Draussin Julien , Gasser Adeline , Jacquot Guillaume , Banerjee Mainak , Gupta Tanushree , Schmutz Marc , Mirjolet Céline , Tillement Olivier , Lux François , Klymchenko Andrey S. , Donzeau Mariel , Pivot Xavier , Harlepp Sébastien , Detappe Alexandre 
Published: March 2024

AbstractNanoparticle (NP) surface functionalization with proteins, including monoclonal antibodies (mAbs), mAb fragments, and various peptides, has emerged as a promising strategy to enhance tumor targeting specificity and immune cell interaction. However, these methods often rely on complex chemistry and suffer from batch‐dependent outcomes, primarily due to limited control over the protein orientation and quantity on NP surfaces. To address these challenges, a novel approach based on the supramolecular assembly of two peptides is presented to create a heterotetramer displaying VHHs on NP surfaces. This approach effectively targets both tumor‐associated antigens (TAAs) and immune cell‐associated antigens. In vitro experiments showcase its versatility, as various NP types are biofunctionalized, including liposomes, PLGA NPs, and ultrasmall silica‐based NPs, and the VHHs targeting of known TAAs (HER2 for breast cancer, CD38 for multiple myeloma), and an immune cell antigen (NKG2D for natural killer (NK) cells) is evaluated. In in vivo studies using a HER2+ breast cancer mouse model, the approach demonstrates enhanced tumor uptake, retention, and penetration compared to the behavior of nontargeted analogs, affirming its potential for diverse applications.
Scale‐Up Preparation of Manganese‐Iron Prussian Blue Nanozymes as Potent Oral Nanomedicines for Acute Ulcerative Colitis
Authors: Hu Chengyun , Yuan Xue , Zhao Ronghua , Hong Biao , Chen Chuang , Zhu Qingjun , Zheng Yanmin , Hu Jinming , Yuan Yue , Wu Zhengyan , Zhang Jia , Tang Chaoliang 
Published: March 2024

AbstractPrussian blue (PB) nanozymes are demonstrated as effective therapeutics for ulcerative colitis (UC), yet an unmet practical challenge remains in the scalable production of these nanozymes and uncertainty over their efficacy. With a novel approach, a series of porous manganese‐iron PB (MnPB) colloids, which are shown to be efficient scavengers for reactive oxygen species (ROS) including hydroxyl radical, superoxide anion, and hydrogen peroxide, are prepared. In vitro cellular experiments confirm the capability of the nanozyme to protect cells from ROS attack. In vivo, the administration of MnPB nanozyme through gavage at a dosage of 10 mg kg−1 per day for three doses in total potently ameliorates the pathological symptoms of acute UC in a murine model, resulting in mitigated inflammatory responses and improved viability rate. Significantly, the nanozyme produced at a large scale can be achieved at an unprecedented yield weighting ≈11 g per batch of reaction, demonstrating comparable anti‐ROS activities and treatment efficacy to its small‐scale counterpart. This work represents the first demonstration of the scale‐up preparation of PB analog nanozymes for UC without compromising treatment efficacy, laying the foundation for further testing of these nanozymes on larger animals and promising clinical translation.
Tumor Microenvironment Remodeling‐Mediated Sequential Drug Delivery Potentiates Treatment Efficacy
Authors: Xu Yajun , Lv Jianlin , Liu Fuyao , Wang Jinqiang , Liu Ya , Kong Chaoying , Li Yanran , Shen Na , Gu Zhen , Tang Zhaohui , Chen Xuesi 
Published: March 2024

AbstractToll‐like receptor 7/8 agonists, such as imidazoquinolines (IMDQs), are promising for the de novo priming of antitumor immunity. However, their systemic administration is severely limited due to the off‐target toxicity. Here, this work describes a sequential drug delivery strategy. The formulation is composed of two sequential modules: a tumor microenvironment remodeling nanocarrier (poly(l‐glutamic acid)‐graft‐methoxy poly(ethylene glycol)/combretastatin A4, termed CA4‐NPs) and an immunotherapy nanocarrier (apcitide peptide‐decorated poly(l‐glutamic acid)‐graft‐IMDQ‐N3 conjugate, termed apcitide‐PLG‐IMDQ‐N3). CA4‐NPs, as a vascular disrupting agent, are utilized to remodel the tumor microenvironment for enhancing tumor coagulation and hypoxia. Subsequently, the apcitide‐PLG‐IMDQ‐N3 could identify and target tumor coagulation through the binding of surface apcitide peptide to the GPIIb‐IIIa on activated platelets. Afterward, IMDQ is activated selectively through the conversion of “‐N3” to “‐NH2” in the presence of hypoxia. The biodistribution results confirm their high tumor uptake of activated IMDQ (22.66%ID/g). By augmenting the priming and immunologic memory of tumor‐specific CD8+ T cells, 4T1 and CT26 tumors with a size of ≈500 mm3 are eradicated without recurrence in mouse models.
Femtosecond Electron Diffraction Reveals Local Disorder and Local Anharmonicity in Thermoelectric SnSe
Authors: Li Jingjun , Qi Yingpeng , Yang Qing , Yue Luye , Yao Changyuan , Chen Zijing , Meng Sheng , Xiang Dao , Cao Jianming 
Published: March 2024

AbstractIn addition to long‐range periodicity, local disorder, with local structures deviating from the average lattice structure, dominates the physical properties of phonons, electrons, and spin subsystems in crystalline functional materials. Experimentally characterizing the 3D atomic configuration of such a local disorder and correlating it with advanced functions remains challenging. Using a combination of femtosecond electron diffraction, structure factor calculations, and time‐dependent density functional theory molecular dynamics simulations, the static local disorder and its local anharmonicity in thermoelectric SnSe are identified exclusively. The ultrafast structural dynamics reveal that the crystalline SnSe is composed of multiple locally correlated configurations dominated by the static off‐symmetry displacements of Sn (≈0.4 Å) and such a set of locally correlated structures is termed local disorder. Moreover, the anharmonicity of this local disorder induces an ultrafast atomic displacement within 100 fs, indicating the signature of probable THz Einstein oscillators. The identified local disorder and local anharmonicity suggest a glass‐like thermal transport channel, which updates the fundamental insight into the long‐debated ultralow thermal conductivity of SnSe. The method of revealing the 3D local disorder and the locally correlated interactions by ultrafast structural dynamics will inspire broad interest in the construction of structure–property relationships in material science.