bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neoadjuvant pertuzumab plus trastuzumab in combination with chemotherapy for human epidermal growth factor receptor 2 positive breast cancer: a real-world retrospective single-institutional study in China
Authors: Peng Dong-Mei , Li Juan , Qiu Jia-Xin , Zhao Lin 
Published: April 2024

Abstract
Introduction
Real-world studies on neoadjuvant dual anti-HER2 therapy combined with chemotherapy for breast cancer (BC) are scarce in China. This study aimed to evaluate the efficacy and safety of neoadjuvant dual anti-HER2 therapy combined with chemotherapy in a real-world setting. Moreover, differences in estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and proliferation cell nuclear antigen (Ki-67) expression pre- and post-neoadjuvant therapy were analyzed.

Methods
Clinical and pathological data of patients with HER2-positive BC who received neoadjuvant dual anti-HER2 therapy combined with chemotherapy at Liaoning Cancer Hospital & Institute, China, between September 2021 and September 2023, were retrospectively reviewed.

Results
Among 179 included patients, a pathologic complete response (pCR) was achieved in 109 patients (60.9%). The univariate analysis results indicated that the hormone receptor (HR) status (P = 0.013), HER2 status (P = 0.003), and cycles of targeted treatment (P = 0.035) were significantly correlated with pCR. Subsequent multivariable analysis showed that HR negative and HER2 status 3 + were independent predictive factors of pCR. Anemia was the most common adverse event (62.0%), and the most common grade 3–4 adverse event was neutropenia (6.1%). The differences in HER2 (34.5%) and Ki-67 (92.7%) expression between core needle biopsy and the residual tumor after neoadjuvant therapy were statistically significant, whereas the differences were insignificant in terms of ER or PR status.

Conclusions
The combination of neoadjuvant trastuzumab and pertuzumab with chemotherapy showed good efficiency, and the toxic side effects were tolerable in patients with BC. In cases where pCR was not achieved after neoadjuvant therapy, downregulation of HER2 and Ki-67 expressions was observed.
Extracellular vesicle encapsulated Homer1a as novel nanotherapeutics against intracerebral hemorrhage in a mouse model
Authors: Fei Xiaowei , Wang Li , Dou Ya-nan , Fei Fei , Zhang Yanyu , Lv Weihao , He Xin , Wu Xiuquan , Chao Wangshu , Chen Hongqing , Wei Jialiang , Gao Dakuan , Fei Zhou 
Published: April 2024

AbstractHomer1a and A2 astrocytes are involved in the regulation of inflammation induced by intracerebral hemorrhage (ICH). However, there is no anticipated treatment strategy based on the anti-inflammatory effect of Homer1a and A2 astrocytes. Here, we successfully induced A2 astrocytes in vitro, and then we report an efficient method to prepare Homer1a+ EVs derived from A2 astrocytes which making it more stable, safe, and targetable to injured neurons. Homer1a+ EVs promotes the conversion of A1 to A2 astrocytes in ICH mice. Homer1a+ EVs inhibits activation and nuclear translocation of NF-κB, thereby regulating transcription of IL-17A in neurons. Homer1a+ EVs inhibits the RAGE/NF-κB/IL-17 signaling pathway and the binding ability of IL-17A: IL17-AR and RAGE: DIAPH1. In addition, Homer1a+ EVs ameliorates the pathology, behavior, and survival rate in GFAPCreHomer1fl/−Homer1a± and NestinCreRAGEfl/fl ICH mice. Our study provides a novel insight and potential for the clinical translation of Homer1a+ EVs in the treatment of ICH.
Surgical management of multiple coronary artery to coronary sinus fistulas with giant left circumflex artery and multivalvular infective endocarditis
Authors: Shin Sang Bin , Park Won Kyoun , Choi Jae Won , Jung Jong Pil , Park Chang Ryul , Lee Yong Jik , Kim Gwan Sic 
Published: April 2024

AbstractCoronary artery fistula (CAF) is characterized as a congenital or acquired abnormal communication between a coronary artery and any of the four chambers of the heart (coronary–cameral fistula) or great vessels (coronary arteriovenous fistula) bypassing the capillaries within myocardium. CAF is a rare disease, challenging to diagnose and treat depending on the anatomical location and type of the fistula and accompanying diseases. This study aims to report a case with multiple coronary artery to coronary sinus (CS) fistulas with giant left circumflex artery and multivalvular infective endocarditis.
Effective Apixaban removal using hemoadsorption during emergent open-heart surgery: a case report and narrative literature review
Authors: Mendes Vitor , Mamode Jaid , Jolou Jalal , Malki Mourad , Ellenberger Christoph , Cikirikcioglu Mustafa , Huber Christoph 
Published: April 2024

Abstract
Background
The management of hemostasis in patients medicated with apixaban (Eliquis) undergoing emergency cardiac surgery is exceedingly difficult. The body’s natural elimination pathways for apixaban prove ineffective in emergency situations, and the impact of hemodialysis is limited. The application of Cytosorb® may attenuate the concentration of apixaban, thereby facilitating the stabilization of these patients.

Case presentation
An 84-year-old man treated with apixaban, underwent emergency ascending aorta replacement surgery due to an acute type A aortic dissection. To address the challenges induced by apixaban, we integrated Cytosorb® cartridge into the Cardiopulmonary bypass circuit. There was a 63.7% decrease in perioperative apixaban-specific anti-factor Xa activity. The patient’s postoperative course was favourable.

Conclusion
Hemoadsorption with Cytosorb® may offers a safe and feasible approach for reducing apixaban concentration in emergency cardiac surgery, thereby mitigating the risk of hemorrhagic complications.
Serum protein profiling reveals an inflammation signature as a predictor of early breast cancer survival
Authors: Karihtala Peeter , Leivonen Suvi-Katri , Puistola Ulla , Urpilainen Elina , Jääskeläinen Anniina , Leppä Sirpa , Jukkola Arja 
Published: April 2024

Abstract
Background
Breast cancers exhibit considerable heterogeneity in their biology, immunology, and prognosis. Currently, no validated, serum protein-based tools are available to evaluate the prognosis of patients with early breast cancer.

Methods
The study population consisted of 521 early-stage breast cancer patients with a median follow-up of 8.9 years. Additionally, 61 patients with breast fibroadenoma or atypical ductal hyperplasia were included as controls. We used a proximity extension assay to measure the preoperative serum levels of 92 proteins associated with inflammatory and immune response processes. The invasive cancers were randomly split into discovery (n = 413) and validation (n = 108) cohorts for the statistical analyses.

Results
Using LASSO regression, we identified a nine-protein signature (CCL8, CCL23, CCL28, CSCL10, S100A12, IL10, IL10RB, STAMPB2, and TNFβ) that predicted various survival endpoints more accurately than traditional prognostic factors. In the time-dependent analyses, the prognostic power of the model remained rather stable over time. We also developed and validated a 17-protein model with the potential to differentiate benign breast lesions from malignant lesions (Wilcoxon p < 2.2*10− 16; AUC 0.94).

Conclusions
Inflammation and immunity-related serum proteins have the potential to rise above the classical prognostic factors of early-stage breast cancer. They may also help to distinguish benign from malignant breast lesions.
Utility of visual rating scales in primary progressive aphasia
Authors: Falgàs Neus , Sacchi Luca , Carandini Tiziana , Montagut Nuria , Conte Giorgio , Triulzi Fabio , Galimberti Daniela , Arighi Andrea , Sanchez-Valle Raquel , Fumagalli Giorgio Giulio 
Published: April 2024

Abstract
Introduction
Differential diagnosis among subjects with Primary Progressive Aphasia (PPA) can be challenging. Structural MRI can support the clinical profile. Visual rating scales are a simple and reliable tool to assess brain atrophy in the clinical setting.
The aims of the study were to establish to what extent the visual rating scales could be useful in the differential diagnosis of PPA, to compare the clinical diagnostic impressions derived from routine MRI interpretations with those obtained using the visual rating scale and to correlate results of the scales in a voxel-based morphometry (VBM) analysis.

Method
Patients diagnosed with primary progressive aphasia (PPA) according to current criteria from two centers—Ospedale Maggiore Policlinico of Milan and Hospital Clínic de Barcelona—were included in the study. Two blinded clinicians evaluated the subjects MRIs for cortical atrophy and white matter hyperintensities using two protocols: routine readings and the visual rating scale. The diagnostic accuracy between patients and controls and within PPA subgroups were compared between the two protocols.

Results
One hundred fifty Subjects were studied. All the scales showed a good to excellent intra and inter-rater agreement. The left anterior temporal scale could differentiate between semantic PPA and all other variants.
The rater impression after the protocol can increase the accuracy just for the logopenic PPA. In the VBM analysis, the scores of visual rating scales correlate with the corresponding area of brain atrophy.

Conclusion
The Left anterior temporal rating scale can distinguish semantic PPA from other variants. The rater impression after structured view improved the diagnostic accuracy of logopenic PPA compared to normal readings. The unstructured view of the MRI was reliable for identifying semantic PPA and controls. Neither the structured nor the unstructured view could identify the nonfluent and undetermined variants.
Neuropsychiatric symptoms with focus on apathy and irritability in sporadic and hereditary cerebral amyloid angiopathy
Authors: Kaushik Kanishk , de Kort Anna M. , van Dort Rosemarie , van der Zwet Reinier G.J. , Siegerink Bob , Voigt Sabine , van Zwet Erik W. , van der Plas Maaike C. , Koemans Emma A. , Rasing Ingeborg , Kessels Roy P.C. , Middelkoop Huub A.M. , Schreuder Floris H.B.M. , Klijn Catharina J.M. , Verbeek Marcel M. , Terwindt Gisela M. , van Etten Ellis S. , Wermer Marieke J.H. 
Published: April 2024

Abstract
Background
Neuropsychiatric symptoms (NPS) may affect cognition, but their burden in cerebral amyloid angiopathy (CAA), one of the main causes of intracerebral hemorrhage (ICH) and dementia in the elderly, remains unclear. We investigated NPS, with emphasis on apathy and irritability in sporadic (sCAA) and Dutch-type hereditary (D-)CAA.

Methods
We included patients with sCAA and (pre)symptomatic D-CAA, and controls from four prospective cohort studies. We assessed NPS per group, stratified for history of ICH, using the informant-based Neuropsychiatric Inventory (NPI-Q), Starkstein Apathy scale (SAS), and Irritability Scale. We modeled the association of NPS with disease status, executive function, processing speed, and CAA-burden score on MRI and investigated sex-differences.

Results
We included 181 participants: 82 with sCAA (mean[SD] age 72[6] years, 44% women, 28% previous ICH), 56 with D-CAA (52[11] years, 54% women, n = 31[55%] presymptomatic), and 43 controls (69[9] years, 44% women). The NPI-Q NPS-count differed between patients and controls (sCAA-ICH+:adj.β = 1.4[95%CI:0.6–2.3]; sCAA-ICH-:1.3[0.6-2.0]; symptomatic D-CAA:2.0[1.1–2.9]; presymptomatic D-CAA:1.2[0.1–2.2], control median:0[IQR:0–3]), but not between the different CAA-subgroups. Apathy and irritability were reported most frequently: n = 12[31%] sCAA, 19[37%] D-CAA had a high SAS-score; n = 12[29%] sCAA, 14[27%] D-CAA had a high Irritability Scale score. NPS-count was associated with decreased processing speed (adj.β=-0.6[95%CI:-0.8;-0.4]) and executive function (adj.β=-0.4[95%CI:-0.6;-0.1]), but not with radiological CAA-burden. Men had NPS more often than women.

Discussion
According to informants, one third to half of patients with CAA have NPS, mostly apathy, even in presymptomatic D-CAA and possibly with increased susceptibility in men. Neurologists should inform patients and caregivers of these disease consequences and treat or refer patients with NPS appropriately.
Patients' perspectives on buprenorphine subcutaneous implant: a case series
Authors: Pierlorenzi Claudio , Nunzi Marco , Cirulli Sabino , Direnzo Giovanni Francesco Maria , Curatella Lucia , Liberatori Sandra , Pascucci Annalisa , Petrone Edoardo , Ventre Generoso , Varango Concettina , Pulito Maria Luisa , Varango Antonella , Dandolo Cosimo , Occupati Brunella , Marenzi Roberta , Leonardi Claudio 
Published: April 2024

Abstract

Background
Considering the enormous burden represented by the opioid use disorder (OUD), it is important to always consider, when implementing opioid agonist therapy (OAT), the potential impact on patient’s adherence, quality of life, and detoxification. Thus, the purpose of the study is to evaluate how the introduction of a novel OAT approach influences these key factors in the management of OUD.

Case presentation
This article marks the pioneering use of OAT through buprenorphine implant in Europe and delves into the experience of six patients diagnosed with OUD at a relatively young age. The patients, comprising both males and a female, are of Caucasian Italian and African Italian ancestry (case 4) and exhibit an age range from 23 to 63, with an average drug abuse history of 19 ± 12 years. All patients were on stable traditional OAT before transitioning to buprenorphine implants. Despite the heterogeneity in social and educational backgrounds, health status, and drug abuse initiation histories, the case series reveals consistent positive treatment outcomes such as detoxification, absence of withdrawal symptoms and of side effects. Notably, all patients reported experiencing a newfound sense of freedom and improved quality of life.

Conclusions
These results emphasise the promising impact of OAT via buprenorphine implants in enhancing the well-being and quality of life in the context of OUD.
Lung ultrasound and procalcitonin, improving antibiotic management and avoiding radiation exposure in pediatric critical patients with bacterial pneumonia: a randomized clinical trial
Authors: Guitart Carmina , Bobillo-Perez Sara , Rodríguez-Fanjul Javier , Carrasco José Luis , Brotons Pedro , López-Ramos Maria Goretti , Cambra Francisco José , Balaguer Mònica , Jordan Iolanda 
Published: April 2024

Abstract
Background
Pneumonia is a major public health problem with an impact on morbidity and mortality. Its management still represents a challenge. The aim was to determine whether a new diagnostic algorithm combining lung ultrasound (LUS) and procalcitonin (PCT) improved pneumonia management regarding antibiotic use, radiation exposure, and associated costs, in critically ill pediatric patients with suspected bacterial pneumonia (BP).

Methods
Randomized, blinded, comparative effectiveness clinical trial. Children < 18y with suspected BP admitted to the PICU from September 2017 to December 2019, were included. PCT was determined at admission. Patients were randomized into the experimental group (EG) and control group (CG) if LUS or chest X-ray (CXR) were done as the first image test, respectively. Patients were classified: 1.LUS/CXR not suggestive of BP and PCT < 1 ng/mL, no antibiotics were recommended; 2.LUS/CXR suggestive of BP, regardless of the PCT value, antibiotics were recommended; 3.LUS/CXR not suggestive of BP and PCT > 1 ng/mL, antibiotics were recommended.

Results
194 children were enrolled, 113 (58.2%) females, median age of 134 (IQR 39–554) days. 96 randomized into EG and 98 into CG. 1. In 75/194 patients the image test was not suggestive of BP with PCT < 1 ng/ml; 29/52 in the EG and 11/23 in the CG did not receive antibiotics. 2. In 101 patients, the image was suggestive of BP; 34/34 in the EG and 57/67 in the CG received antibiotics. Statistically significant differences between groups were observed when PCT resulted < 1 ng/ml (p = 0.01). 3. In 18 patients the image test was not suggestive of BP but PCT resulted > 1 ng/ml, all of them received antibiotics. A total of 0.035 mSv radiation/patient was eluded. A reduction of 77% CXR/patient was observed. LUS did not significantly increase costs.

Conclusions
Combination of LUS and PCT showed no risk of mistreating BP, avoided radiation and did not increase costs. The algorithm could be a reliable tool for improving pneumonia management.
Clinical Trial Registration: NCT04217980.
A low-energy particle experiment for both ion and electron measurements using a single microchannel plate-based detector
Authors: Yokota Shoichiro , Saito Yoshifumi , Asamura Kazushi 
Published: April 2024

AbstractWe have developed a low-energy particle experiment that alternately measures ions and electrons in space. The ability to switch between ion and electron measurements is achieved by simply adding ultra-thin carbon foils and positive and negative outputs to a conventional top-hat electrostatic analyzer and a high-voltage power supply, respectively. The advantage of this experiment is that it can perform both ion and electron measurements using only one MCP-based detector for electrons, since it detects secondary electrons emitted from the carbon foils. For the SS520-3 sounding rocket program, we prepared two identical energy analyzers, one for ions and the other for electrons to demonstrate this technique. Laboratory tests confirmed that the performance of the two analyzers was comparable to that of conventional analyzers for ion and electrons. The SS520-3 rocket experiment in the high latitude auroral region yielded observations that captured typical features of ions and electrons, which were similar to previous observations.
Graphical Abstract
Responding to unauthorized residence: on a dilemma between ‘firewalls’ and ‘regularizations’
Authors: Schmid Lukas 
Published: April 2024

AbstractResidence of unauthorized immigrants is a stable feature of the Global North’s liberal democracies. This article asks how liberal-democratic policymakers should respond to this phenomenon, assuming both that states have incontrovertible rights and interests to assert control over immigration and that unauthorized residence is nevertheless an entrenched fact. It argues that a set of liberal-democratic commitments gives policymakers strong reason to implement both so-called ‘firewall’ and ‘regularization’ policies, thereby protecting unauthorized immigrants’ basic needs and interests and officially incorporating many of them in society. It then explains that the background imperative of immigration control creates a dilemmatic tension between these policies, as regularization is envisaged alongside the removal of the ineligible, which is in turn hindered by the implementation of firewalls. This creates a dilemma between the pursuit of two policy goals that are both underwritten by the same value commitments. Though it cannot be entirely dissolved, I argue that the best way to mitigate this dilemma is to design regularization policy in a way that leaves only a small number of unauthorized immigrants subject to removal.
Cannabis use associated with lower mortality among hospitalized Covid-19 patients using the national inpatient sample: an epidemiological study
Authors: Igwe Joseph-Kevin , Alaribe Ugo 
Published: April 2024

Abstract
Background
Prior reports indicate that modulation of the endocannabinoid system (ECS) may have a protective benefit for Covid-19 patients. However, associations between cannabis use (CU) or CU not in remission (active cannabis use (ACU)), and Covid-19-related outcomes among hospitalized patients is unknown.

Methods
In this multicenter retrospective observational cohort analysis of adults (≥ 18 years-old) identified from 2020 National Inpatient Sample database, we utilize multivariable regression analyses and propensity score matching analysis (PSM) to analyze trends and outcomes among Covid-19-related hospitalizations with CU and without CU (N-CU) for primary outcome of interest: Covid-19-related mortality; and secondary outcomes: Covid-19-related hospitalization, mechanical ventilation (MV), and acute pulmonary embolism (PE) compared to all-cause admissions; for CU vs N-CU; and for ACU vs N-ACU.

Results
There were 1,698,560 Covid-19-related hospitalizations which were associated with higher mortality (13.44% vs 2.53%, p ≤ 0.001) and worse secondary outcomes generally. Among all-cause hospitalizations, 1.56% of CU and 6.29% of N-CU were hospitalized with Covid-19 (p ≤ 0.001). ACU was associated with lower odds of MV, PE, and death among the Covid-19 population. On PSM, ACU(N(unweighted) = 2,382) was associated with 83.97% lower odds of death compared to others(N(unweighted) = 282,085) (2.77% vs 3.95%, respectively; aOR:0.16, [0.10–0.25], p ≤ 0.001).

Conclusions
These findings suggest that the ECS may represent a viable target for modulation of Covid-19. Additional studies are needed to further explore these findings.
Performance evaluation of the Bilate and Furfuro irrigation schemes in Silti Zone, southern Ethiopia
Authors: Abo Mulugeta Abebo , Assefa Shemelies , W/Michael Abraham 
Published: April 2024

AbstractMany irrigation schemes are performing poorly for a number of reasons, and this should be improved to increase the efficiency and productivity of the schemes. This study attempted to determine the performance of the Bilate and Furfuro irrigation schemes in Silti Zone, southern Ethiopia. For field data measurements, three farmers’ fields were selected at the head, middle, and tail end of each scheme. Average conveyance efficiencies were 53% and 56.1%, average field application efficiencies were 55.9% and 58.0%, average water storage efficiencies were 53% and 46.5%, irrigation uniformity was 91.03% and 92.9%, and overall irrigation efficiency was 28% and 32% for Bilate and Furfuro schemes respectively. This implied that the two schemes were performing inefficiently and inadequately, but water was distributed uniformly. The reason might be most canal sections had unreasonable losses of water in two schemes. Additionally, relative water supply was 0.68 and 0.79, relative irrigation supply was 0.61 and 0.77, output per unit irrigated area was 4140.4 and 1781.5 ($/ha), output per unit command area was 4510.3 and 1968.5 ($/ha), output per unit irrigation supply was 0.94 and 0.28 ($/m3), output per unit water consumed was 0.99 and 0.39 ($/m3), sustainability of irrigation area was 1.05 and 1.02, and irritation ratio was 1.11 and 1.09 for Bilate and Furfuro schemes respectively. This revealed that the applied water was not satisfied the crop water demand, but their irrigated lands were expanded for two irrigation schemes. Furfuro scheme was better than Bilate in terms of relative water supply and relative irrigation supply, but their results obtained were below acceptable values. However, Bilate scheme had significantly better land and water productivity than Furfuro scheme. This may be use high value crops, better agricultural inputs, and removal of grass cover and sedimentation from canal systems. Hence, Bilate irrigation scheme was better performing than Furfuro scheme. Therefore, adopt the best practices learned from Bilate irrigation scheme for the Furfuro scheme.