bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigating the role of immunotherapy for real-world patients with HER2-negative advanced gastric cancer between 2011 and 2023
Authors: Shimozaki Keitaro , Ooki Akira , Yoshino Koichiro , Tamba Mikako , Udagawa Shohei , Osumi Hiroki , Fukuoka Shota , Nakayama Izuma , Wakatsuki Takeru , Ogura Mariko , Takahari Daisuke , Shinozaki Eiji , Chin Keisho , Yamaguchi Kensei 
Published: February 2025

Background: Although the emergence of immunotherapy has benefited patients with advanced gastric cancer (AGC), the magnitude of the benefit among real-world patients with HER2-negative AGC remains unclear. Objectives: The current study aimed to evaluate the treatment features across various immunotherapy approval periods and investigate the utility of immunotherapy for patients with HER2-negative AGC in daily practice. Design: Retrospective observational study. Methods: We retrospectively evaluated the clinical outcomes of patients with HER2-negative AGC who received first-line platinum-based chemotherapy between 2011 and 2023 across different periods of immunotherapy approval in Japan: Group A (pre-immunotherapy approval): 2011–2017; Group B (approved for third-line treatment or later): 2018–2021; and Group C (approved for first-line treatment): 2022–2023. Results: A total of 949 patients were enrolled ( n = 477, 344, and 128 for Groups A, B, and C, respectively). Patient characteristics were comparable between the three groups, except for the proportion of those aged ⩾75 years ( p = 0.002), prior gastrectomy ( p = 0.03), and liver metastases ( p = 0.0005). The median overall survival (OS) was 16.2, 15.2, and 21.3 months in Groups A, B, and C, respectively, with no significant difference between the groups (log-rank p = 0.50). Patients who received first-line immunotherapy plus chemotherapy ( n = 173) showed significantly better OS than did those who did not receive any immunotherapy-containing treatment from 2011 to 2017 ( n = 382; hazard ratio (HR), 0.78; 95% confidence interval (CI), 0.61–0.99; p = 0.04). Multivariate analysis showed that the use of first-line immunotherapy was not significantly associated with worse OS, whereas the use of any-line immunotherapy was significantly associated with prognosis (HR, 0.54; 95% CI, 0.47–0.63; p < 0.0001). The proportion of patients receiving any second-line treatment was comparable between the groups: 76%, 80%, and 71%, respectively. Conclusion: Our study suggests that immunotherapy has a moderate impact on improving the survival of real-world patients with HER2-negative AGC, highlighting the need for appropriate treatment strategies, including efforts to identify biomarkers and the development of other agents.
Bilateral blindness in a cat after a dental procedure, suspected to be due to segmental chorioretinal ischaemia necrosis
Authors: Guerreiro Cleo , Heinrich Christine , Walsh Karen 
Published: February 2025

Case summary A 5-year-old female spayed domestic shorthair cat presented for sudden onset vision loss 3 days after a dental procedure. Bilateral blindness was confirmed on ocular examination, with fundoscopy revealing segmental wedge-shaped areas of retinal oedema and partial non-rhegmatogenous retinal detachments. An initial differential diagnosis included angioinvasive pulmonary carcinoma, based on previously reported fundoscopy images of this condition; however, general physical examination, blood pressure and chest radiographs were all normal. Four weeks after initial presentation, fundoscopy revealed the resolution of the retinal detachments; however, bilateral segmental chorioretinal necrosis was present. The cat regained some vision and remained well 13 months after the initial presentation. Considering the clinical findings, the onset of blindness after a lengthy dental procedure and improvement of vision over time, a diagnosis of pulmonary carcinoma was unlikely and instead a diagnosis of chorioretinal ischaemia secondary to maxillary artery blood flow restriction is proposed. Relevance and novel information Maxillary artery blood flow restriction has been well documented with varying degrees of jaw opening in cats. Presumed central blindness as a result of this blood flow restriction has also been documented. However, to the authors’ knowledge, vision loss due to retinal changes, documented by fundoscopic images and their progression over time following suspected chorioretinal ischaemia after a dental procedure, have not previously been reported. We propose that temporary occlusion of the maxillary artery can result in segmental chorioretinal necrosis and associated blindness in cats. This finding further supports the recommendation to minimise prolonged jaw opening during surgical procedures in cats.
Heals on Wheels: Development and Implementation of Community Outreach and Group Medical Visits for People Experiencing Chronic Pain
Authors: Justice Catherine , Haddow Susan , Shafto Katherine , Reeves Tegan , Knox Jadyn E. , Prasad Arti 
Published: February 2025

Background Chronic pain is a global problem affecting approximately 20% of adults. The prevalence of opioid use for chronic pain has contributed to a widespread crisis of addiction and inadequately managed pain. Though national and international guidelines recommend nonpharmacological, integrative, multi-modal therapies for chronic pain, numerous systemic barriers limit access to these services for those with the highest need and fewest resources. Objective This paper describes the development and testing of an innovative “Heals on Wheels” (HoW) community engagement and Group Medical Visit (GMV) program for underserved communities experiencing chronic pain in Hennepin County, Minnesota. Methods The HoW program’s curriculum was collaboratively adapted from pre-existing Hennepin Health care GMV programs for chronic pain. Free community-based “Appetizer” workshops were developed alongside an 8-week “Full Meal” GMV program titled Easing Pain Holistically (EPH). Three pain-affinity variations of EPH were created (the “Body”, “Head”, and “Heart”) and delivered to 6 cohorts (2 cohorts of each variation). Feasibility was measured by attendance, demographics, and insurance provider information. To evaluate program acceptability, thematic analysis of patients post-GMV weekly progress sheets was performed. Results The curriculum for the HoW program included experiential training and education in evidence-based integrative pain management strategies. Fourteen community appetizer workshops (n = 142) were offered in partnership with organizations representing underserved populations. Fifty-five patients completed EPH from 2022 to 2024 with the greatest number of patients in the Heart (n = 23), followed by the Body (n = 19), and the Head (n = 13). Feasibility for the GMV program was demonstrated with average attendance across 6 cohorts at 75.1%. Thematic analysis of qualitative data revealed themes highlighting appreciation for group connection (“sharing”) and the EPH program content. Conclusion The HoW program shows promise as a feasible and acceptable model of community outreach and engagement to improve access to evidence-based integrative pain care.
An educational programme for home mechanical ventilation in motor neuron disease
Authors: Riva-Rovedda Federica , Clari Marco , Conti Alessio , Esposito Tiziana , Tabbia Giuseppe , Mattei Alessio , Calvo Andrea , Solidoro Paolo , Dimonte Valerio 
Published: February 2025

Respiratory failure represents the leading cause of death among people with motor neuron disease (MND). Home mechanical ventilation supports respiratory function, but its management places a significant demand on patients and informal caregivers. The need for consistent support to deal with home mechanical ventilation is recognised. Regardless, specific educational interventions are infrequently reported. Within its multidisciplinary clinical care pathway, the Regional Expert Centre for MND of a Northern Italy university hospital offers patients and their caregivers an educational programme on how to deal with noninvasive ventilation (NIV) and invasive mechanical ventilation (IMV) at home.NIV education is usually performed in an outpatient setting. Pneumologists and nurses train patients and caregivers about ventilator functions, management of respiratory interfaces, inhalation therapy, skin integrity preservation and respiratory deterioration detection, while respiratory therapists train patients and caregivers about the use of an assisted cough device. IMV education is performed at the hospital. Respiratory therapists, supported by nurses, train caregivers about ventilator functions, management of tracheostomy cannula, tracheal suction, inhalation therapy and use of assisted cough devices. Finally, a certification of the skills acquired is released. Future studies should assess the effectiveness of this programme in terms of satisfaction and clinical outcomes.
Diaphragm dysfunction: how to diagnose and how to treat?
Authors: Jesus Filipa , Hazenberg Anda , Duiverman Marieke , Wijkstra Peter 
Published: February 2025

The diaphragm, crucial for respiratory function, is susceptible to dysfunction due to various pathologies that can affect the nervous system, neuromuscular junction or the muscle itself. Diaphragmatic dysfunction presents with symptoms ranging from exertional dyspnoea to respiratory failure, significantly impacting patients’ quality of life. Diagnosis involves clinical evaluation complemented by imaging and pulmonary function tests. Chest radiography, fluoroscopy, and ultrasonography are pivotal in assessing diaphragmatic movement and excursion, offering varying sensitivities and specificities based on the type and severity of dysfunction. Ultrasonography emerges as a noninvasive bedside tool with high sensitivity and specificity, measuring diaphragm thickness, thickening fraction, and excursion, and enabling monitoring of disease progression and response to treatment over time.Treatment strategies depend on the underlying aetiology and severity, ranging from conservative management to interventions such as surgical plication or diaphragmatic pacing. Ventilatory support, particularly noninvasive ventilation, plays a pivotal role in treatment, enhancing lung function and patient outcomes across unilateral and bilateral dysfunction.Despite advances in diagnostic techniques, awareness and systematic evaluation of diaphragmatic function remain inconsistent across clinical settings. This review consolidates the current understanding of diaphragmatic dysfunction, highlighting diagnostic modalities and treatment options to facilitate early recognition and management of this entity.
Morphologic changes in the model tintinnid Schmidingerella (Alveolata, Ciliophora) during the cell cycle, including the first volumetric analyses of the lorica-forming material
Authors: Agatha Sabine , Weißenbacher Birgit , Böll Laura , Ganser Maximilian H. 
Published: February 2025

Abstract

Background
Tintinnids are marine planktonic ciliates with tube-shaped or vase-shaped loricae (shells). During the cell cycle, lorica-forming material (LFM) is generated and accumulates in the proter (anterior division product). After transverse fission, the proter leaves the lorica and subsequently secretes the material, creating its own shell, while the opisthe (posterior division product) retains the parental one. The timing of material production and its final quantity are unknown.

Results
Our study focussed on Schmidingerella Agatha & Strüder-Kypke, 2012, a model tintinnid genus with transparent, champagne flute-shaped loricae. Protargol-stained field material from the Chesapeake Bay on the Northwest Atlantic provided detailed insights into the morphologic changes, including the LFM production, during the cell cycle. We defined five division stages based on features of the opisthe’s newly forming membranellar zone (oral primordium) recognisable both in live and fixed material. The start of LFM production in middle dividers and its intracellular distribution matched the findings obtained from monoclonal, methyl blue-eosin-stained culture material from the Northeast Pacific, in which the LFM was volumetrically analysed. Just before fission, the LFM occupied on average 6.7% of the cell volume. The wall volume of the finished lorica estimated by a shape function was at least 4.5-fold larger than the volume of the intracellular material.

Conclusions
The LFM is generated only during a certain period of the cell cycle, i.e., in early middle to late dividers. The difference in volume between the initially secreted LFM and the finished lorica wall suggests that significant structural changes take place in the material during lorica formation.
Prognostic nutritional index as an early predictor of mortality in patients with severe fever with thrombocytopenia syndrome: multicenter retrospective study in South Korea
Authors: Woo Hyun Ji , Kwon Tae-Kyu , Heo Sang Taek , Yoo Jeong Rae , Kim Misun , Oh Jaeseong , Bae In-Gyu , Bae Sohyun , Yoon Young-Ran , Hyun Miri , Kim Hyun ah , Jung Sook In , Kwon Ki Tae , Hwang Soyoon , Kim Uh Jin , Kang Gaeun , Kim Young Jun , Hwang Jeong-Hwan , Kim Min-Gul 
Published: February 2025

Abstract

Background and aim
Severe fever with thrombocytopenia syndrome (SFTS) is a fatal tick-borne infectious disease lacking effective treatments or vaccines. Early identification of prognostic factors is essential for optimizing clinical management. This study investigated the predictors for mortality in SFTS patients.

Methods
We conducted a retrospective multicenter cohort study of 413 SFTS patients hospitalized in South Korea from 2013 to 2024. Clinical and laboratory data were comprehensively analyzed to evaluate associations between in-hospital mortality and various inflammatory, immune, and nutritional biomarkers. Cox regression and time-dependent receiver operating characteristic (ROC) analyses were performed to identify risk factors.

Results
413 patients diagnosed with SFTS were included and In-hospital mortality was 17% (70/413). Multivariate Cox regression identified older age (HR: 1.042; 95% CI: 1.014–1.071), elevated PT(INR) (HR: 109.57; 95% CI: 19.79–606.57), and lower prognostic nutritional index (PNI) (HR: 0.937; 95% CI: 0.886–0.990) as early predictors of mortality. Time-dependent ROC analysis demonstrated predictive accuracy, with AUCs of 0.512 for age, 0.857 for PT(INR), and 0.694 for PNI at 30 days. Kaplan-Meier analysis revealed significant survival differences for patients stratified by PNI (< 40.75), PT(INR) (≥ 0.97), and age (≥ 59 years).

Conclusions
PNI, PT(INR), and age were identified as key early predictors of mortality in SFTS. PNI, as a novel biomarker, was found to be a useful index for risk level and treatment strategies in SFTS patients.

Clinical trial number
Not applicable.
Changes in inpatient mental health treatment and related costs before and after flexible assertive community treatment: a naturalistic observational cohort study
Authors: Brekke Eva , Lamu Admassu N. , Angeles Renira C. , Clausen Hanne , Landheim Anne S. 
Published: February 2025

Abstract

Background
Flexible Assertive Community Treatment (FACT) is currently implemented in Norwegian mental health services, aiming to ensure comprehensive and rights-based services for persons with severe mental illness and complex needs, but also motivated by assumed cost-effectiveness. We need knowledge about the consequences of this service innovation. The aim of this study was to investigate changes in total and involuntary inpatient mental health treatment and associated changes in costs of inpatient days before and after enrolment into FACT for persons with severe mental illness and complex needs in Norway.

Methods
In this naturalistic observational cohort study of 397 patients in eight Norwegian FACT teams, we compared total and involuntary admissions, total and involuntary inpatient days, and the costs of total and involuntary inpatient days, for two periods: 24 months before and 24 months after enrolment in FACT. We used paired t-test.

Results
There was a significant reduction in involuntary admissions, involuntary inpatient days, and total inpatient days after enrolment in FACT. We found a slight but non-significant reduction in total admissions to inpatient mental health treatment. There was a significant reduction in the costs of total inpatient days and involuntary inpatient days.

Conclusion
Patients in FACT were admitted to inpatient treatment as frequently as before enrolment in FACT, but involuntary admissions were less frequent. Furthermore, the duration of involuntary and total inpatient treatment was reduced, with a corresponding reduction in costs as expected. Results suggest that targeted and well-timed interventions from FACT may reduce the need for prolonged involuntary inpatient treatment, implying reduced disadvantages for the individual and more efficient allocation of health service funding.
A 6-month sustained-release formulation of triptorelin for locally advanced or metastatic prostate cancer: a real-world experience in Asia
Authors: Yee Chi-Hang , Chung Yuen-Hei , Ko Ivan Ching-Ho , Wong Chris Ho-Ming , Mok Alex , Teoh Jeremy Yuen-Chun , Chiu Peter Ka-Fung , Ng Chi-Fai 
Published: February 2025

Abstract

Objective
Long-acting triptorelin (LAT) (22.5 mg) is a gonadotropin-releasing hormone (GnRH) agonist used in men with prostate cancer. This study investigated the prescription pattern of LAT in a real-world setting and its efficacy.

Patients & methods
This was a retrospective review of patients in a tertiary center who were prescribed LAT for prostate cancer from January 2018 to March 2023 after the introduction of LAT in the territory. Demographic data were collected, and LAT prescription patterns were reviewed. These patterns included the indication and duration of prescription, testosterone suppression and characteristics of the primary prostate cancer.

Results
A total of 237 prostate cancer patients were prescribed LAT in the study period. The indications for LAT included metastatic prostate cancer (50.6%), neoadjuvant/adjuvant therapy for radiotherapy (28.7%) and neoadjuvant therapy for radical prostatectomy (5.1%). Among the cohort, 41.4% of the patients were receiving short-acting triptorelin (11.25 mg) before LAT initiation, 15.2% were receiving other GnRH agonists, and 15.6% were receiving GnRH antagonists. The median age at the first dose of LAT and the median treatment duration were 72 (53–94) years and 30 (6–72) months, respectively. During the study period, 92.0% of the patients did not receive another form of hormonal treatment other than LAT. A total of 121 (51.1%) patients had their testosterone level checked after LAT initiation. The median time interval of testosterone measurement after LAT initiation was 8 (1–47) months, with 98.3% of the patients having a testosterone level < 1.7 nmol/L and 92.6% having a level < 0.7 nmol/L. Among the cohort, 1 patient stopped LAT due to hot flashes and muscle weakness.

Conclusion
The LAT adherence rate was high in the setting of hormonal treatment for prostate cancer. Testosterone suppression was satisfactory after the initiation of LAT and was generally well tolerated.
Histopathological changes of the buccal mucosa and skin after botulinum neurotoxin intramuscular injection in rats (immunohistochemical study)
Authors: Hassan Gihan S. , Abouzaid Basant H. , Saleh Reda G. 
Published: February 2025

Abstract

Background
A surplus of clinical studies focused mainly on the clinical impacts of botulinum neurotoxin type A disregarding the histopathological changes stemming from its injection. This study was designed to inspect the potential effects of botulinum neurotoxin type A injection on the skin and buccal mucosa in both the injected and non-injected sides after one week and one month as no available studies have addressed its histopathological effects.

Methods
Twelve rats were injected with a single injection of 2.5 U of botulinum neurotoxin type A intramuscularly near the angle of the mouth on the right side. After one week, six injected rats were euthanized, and tissue samples were obtained from both the injection (n = 6) and the non-injection (n = 6) sides. After 4 weeks, six injected rats were euthanized, and tissue samples were obtained from both the injection (n = 6) and the non-injection (n = 6) sides. Six rats served as non-injected controls (n = 6). Samples were prepared for histological and immunohistochemical examination with caspase-3.

Results
Caspase-3 expression showed a highly significant increase (P = 0.005) in staining intensity in specimens of one week as compared to one month groups. At the non-injected side, the overall caspase-3 immunostaining score showed a significant elevation (P = 0.03) after one-month of botulinum neurotoxin type A injection.

Conclusion
Botulinum neurotoxin type A injection was associated with degenerative changes in the buccal mucosa and skin, nevertheless these changes declined after one month in the injected side. More degenerative changes were depicted in the non-injected side and increased after one month. Therefore, botulinum neurotoxin type A injection may affect not only the patient’s needs and expectations but also their health.
Defatted black soldier fly (Hermetia illucens) diets improved hemato-immunological responses, biochemical parameters, and antioxidant activities in Streptococcus iniae-infected Nile tilapia (Oreochromis niloticus)
Authors: Abd El-Gawad Eman A. , Zahran Eman , Youssuf Hadeer , Shehab Ahmed , Matter Aya F. 
Published: February 2025

Abstract

Background
Challenges of limited supply and increasing prices of fishmeal have driven the aquaculture nutritionists to seek alternative sustainable protein rich ingredients to keep manufacturing aquafeeds in a maintainable and cost-effective way. Black soldier fly, Hermetia illucenslarvae meal represent great potential as a sustainable alternative to fishmeal in aquafeeds.

Methods
Three replacement diets for fishmeal were prepared at different levels of defatted black soldier fly (Hermetia illucens) meal (DBSFM): Diet 1 (0 g DBSFM /kg diet, control), 33% (DBSFM-33%, 66 g DBSFM /kg diet), and 100% (DBSFM-100%, 200 g DBSFM /kg diet) to investigate their effects on biochemical parameters, immuno-hematological responses, antioxidant activities, and inflammatory gene expression in Nile tilapia, Oreochromis niloticus, a total of 270 (40.0 ± 0.50 g) before and after challenge with Streptococcus iniae (
S. iniae). The feeding trial lasted six weeks (pre-challenge) and two weeks (post-challenge).

Results
The results showed a significant improvement in white blood cell count (P < 0.01), lymphocyte count (P < 0.01), serum lysozyme activity (P < 0.001), and phagocytic activity (P < 0.001), mostly in the DBSFM-100% group following the pre-challenge phase compared to the control group. Post-challenge phase exhibited significant increases in blood indices in the DBSFM-treated groups compared to the control group. Following pre- and post-challenge periods, both DBSFM-supplemented groups experienced significant increases (P < 0.01, P < 0.001), in serum total protein levels. Albumin and globulin levels also experienced similar increases (P < 0.05, P < 0.01), but only post-challenge. Total antioxidant capacity exhibited a significant increase in both DBSFM-supplemented groups following the post-challenge, as did superoxide dismutase, catalase, and glutathione peroxidase in the liver and spleen. Conversely, levels of glucose, cortisol, and malondialdehyde followed the opposite trend. DBSFM-100% inclusion revealed significant (P < 0.05) up-regulation of interleukin 1β (IL-1β) in the pre-challenge phase compared to control, but no significance (P > 0.05) was seen for other genes. Anti-inflammatory-related genes transforming growth factor-β and interleukin-10 mRNA expression levels were up-regulated in DBSFM-supplemented groups compared to the control post-challenge, but the opposite was seen for IL-1β and tumor necrosis factor- α.

Conclusion
These findings suggest that Nile tilapia challenged with S. iniae may experience significant enhancements in hemato-immunological parameters, antioxidant capability, and anti-inflammatory gene expression when fish meal is replaced with DBSFM up to 100%.