bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of chemo-immunotherapy in metastatic BRAF-mutated lung cancer: a single-center retrospective data
Authors: Yan Ningning , Zhang Huixian , Guo Sanxing , Zhang Ziheng , Xu Yingchun , Xu Liang , Li Xingya 
Published: January 2024

BackgroundThe effectiveness of combining immune checkpoint inhibitors (ICIs) with chemotherapy in treating non-small cell lung cancers (NSCLCs) with BRAF mutations has not been sufficiently explored.MethodsWe compiled data from 306 NSCLC patients with identified BRAF mutations. We looked at efficacy by assessing the objective response rate (ORR) and disease control rate (DCR), as well as survival through measuring progression-free survival (PFS) and overall survival (OS).ResultsOut of the patient pool, 44 were treated with a regimen of immune-chemotherapy. Patients undergoing ICI in combination with chemotherapy had a median PFS of 4 months, and the median OS was recorded at 29 months. There was a notable increase in OS in patients receiving first-line treatment versus subsequent lines (29 vs 9.75 months, p=0.01); however, this was not the case with PFS (9 vs 4 months, p=0.46). The ORR for patients on ICIs was 36.3%. PFS and OS rates did not significantly differ between patients with the BRAF-V600E mutation and those with non-V600E mutations (p=0.75 and p=0.97, respectively). Additionally, we found a significant variation in PD-L1 expression between those who responded to treatment and those who didn’t (p=0.04).ConclusionOur findings indicate that chemo-immunotherapy as an initial treatment may lead to improved OS in patients with BRAF-mutated NSCLC when compared to its use in subsequent lines of therapy. Further studies are needed to validate these results and to delve deeper into how specific types of BRAF mutations and PD-L1 expression levels might predict a patient’s response to treatments in NSCLC.
Optimizing the initial tacrolimus dosage in Chinese children with lung transplantation within normal hematocrit levels
Authors: Hu Ke , He Su-Mei , Zhang Cun , Zhang Yi-Jia , Gu Qian , Shi Hao-Zhe , Wang Dong-Dong 
Published: January 2024

BackgroundThe appropriate initial dosage of tacrolimus is undefined in Chinese pediatric lung transplant patients with normal hematocrit values. The purpose of this study is to optimize the initial dose of tacrolimus in Chinese children who are undergoing lung transplantation and have normal hematocrit levels.MethodsThe present study is based on a published population pharmacokinetic model of tacrolimus in lung transplant patients and uses the Monte Carlo simulation to optimize the initial tacrolimus dosage in Chinese children with lung transplantation within normal hematocrit levels.ResultsWithin normal hematocrit levels, for children with lung transplantation who do not carry the CYP3A5*1 gene and have no coadministration with voriconazole, it is recommended to administer tacrolimus at a dosage of 0.02 mg/kg/day, divided into two doses, for children weighing 10–32 kg, and a dosage of 0.03 mg/kg/day, also divided into two doses, for children weighing 32–40 kg. For children with lung transplantation who carry the CYP3A5*1 gene and have no coadministration with voriconazole, tacrolimus dosages of 0.02, 0.03, and 0.04 mg/kg/day split into two doses are recommended for children weighing 10–15, 15–32, and 32–40 kg, respectively. For children with lung transplantation who do not carry the CYP3A5*1 gene and have coadministration with voriconazole, tacrolimus dosages of 0.01 and 0.02 mg/kg/day split into two doses are recommended for children weighing 10–17 and 17–40 kg, respectively. For children with lung transplantation who carry the CYP3A5*1 gene and have coadministration with voriconazole, a tacrolimus dosage of 0.02 mg/kg/day split into two doses is recommended for children weighing 10–40 kg.ConclusionsIt is the first time to optimize the initial dosage of tacrolimus in Chinese children undergoing lung transplantation within normal hematocrit.
Predicting preterm birth using auto-ML frameworks: a large observational study using electronic inpatient discharge data
Authors: Kong Deming , Tao Ye , Xiao Haiyan , Xiong Huini , Wei Weizhong , Cai Miao 
Published: January 2024

BackgroundTo develop and compare different AutoML frameworks and machine learning models to predict premature birth.MethodsThe study used a large electronic medical record database to include 715,962 participants who had the principal diagnosis code of childbirth. Three Automatic Machine Learning (AutoML) were used to construct machine learning models including tree-based models, ensembled models, and deep neural networks on the training sample (N = 536,971). The area under the curve (AUC) and training times were used to assess the performance of the prediction models, and feature importance was computed via permutation-shuffling.ResultsThe H2O AutoML framework had the highest median AUC of 0.846, followed by AutoGluon (median AUC: 0.840) and Auto-sklearn (median AUC: 0.820), and the median training time was the lowest for H2O AutoML (0.14 min), followed by AutoGluon (0.16 min) and Auto-sklearn (4.33 min). Among different types of machine learning models, the Gradient Boosting Machines (GBM) or Extreme Gradient Boosting (XGBoost), stacked ensemble, and random forrest models had better predictive performance, with median AUC scores being 0.846, 0.846, and 0.842, respectively. Important features related to preterm birth included premature rupture of membrane (PROM), incompetent cervix, occupation, and preeclampsia.ConclusionsOur study highlights the potential of machine learning models in predicting the risk of preterm birth using readily available electronic medical record data, which have significant implications for improving prenatal care and outcomes.
Molecular marker identification, antioxidant, antinociceptive, and anti-inflammatory responsiveness of malonic acid capped silver nanoparticle
Authors: Fatima Tehrim , Abrar Hina , Jahan Noor , Shamim Sana , Ahmed Nazia , Ali Asma Basharat , Begum Irshad , Ahmed Waqas 
Published: January 2024

Nano-sized silver has drawn a great deal of attention in the field of health sciences owing to its remarkable therapeutic applications. Interestingly, the method applied to synthesize nanoparticles and the choice of reagents considerably influence their therapeutic potential and toxicities. Current research has explored the toxicity, anti-inflammatory, antinociceptive, and antioxidant responses of the malonic acid-capped silver nanoparticles (MA-AgNPs (C) by using sodium borohydride as a reducing agent at low temperatures by employing both in vitro and in vivo approaches. Furthermore, it has highlighted the synergistic effect of these novel compounds with conventional anti-inflammatory therapeutic agents. Acute and sub-acute toxicity analysis performed following OECD guidelines showed that the studied MA-AgNPs (C) are safer, and prominent toxic signs have not been detected at the highest studied dose of 2,000 mg/kg. Cytotoxicity evaluation through brine shrimp lethality revealed 20% lethality at the highest concentration of 169.8 μg/mL. Significantly, positive anti-inflammatory and analgesic responses alone as well as synergism with the standard were identified through in vitro as well as in vivo methods which were more potent at a lower dose (200 mg/kg). Notably synergistic outcomes were more pronounced than individual ones, indicating their prominent effect as a feasible drug delivery system. IL-6 and TNF-α assessment in excised paw tissue through RTPCR technique further supported their anti-inflammatory potential. DPPH assay revealed eminent in vitro antioxidant activity which was further corroborated by in vivo antioxidant assessment through evaluation of SOD in excised paw tissue.
Tirzepatide as a novel effective and safe strategy for treating obesity: a systematic review and meta-analysis of randomized controlled trials
Authors: Cai Wenting , Zhang Ruobin , Yao Yao , Wu Qiuhui , Zhang Jinping 
Published: January 2024

ObjectiveTo systematically evaluate the efficacy and safety of a new hypoglycemic drug, tirzepatide, for treating obesity based on indicators such as BMI, waist circumference, and body weight.MethodsA search formula was written using search terms such as “tirzepatide,” “overweight,” and “obesity.” A comprehensive search was conducted on databases such as PubMed, Cochrane Library, Embase, and Web of Science using a computer. Random controlled trial (RCT) literature was selected based on inclusion and exclusion criteria. After extracting the data, literature bias risk assessment and meta-analysis were conducted using RevMan 5.4 software. The search deadline is from the establishment of each database to May 2023.ResultsA total of 12 randomized controlled trials were included, with a total of 11,758 patients. Meta analysis results showed that compared with the glucagon like peptide-1 receptor agonist (GLP-1 RAs), placebo and insulin groups, tirzepatide could significantly reduce the BMI (body mass index) of patients [MD = −1.71, 95% CI (−2.46, −0.95), p &lt; 0.00001], [MD = −3.99, 95% CI (−3.69, −2.45), p &lt; 0.00001], [MD = −4.02, 95% CI (−4.72, −3.31), p &lt; 00.00001]. In terms of decreasing waist circumference, tirzepatide has a more significant advantage [MD = −4.08, 95% CI (−5.77, −2.39), p &lt; 0.00001], [MD = −7.71, 95% CI (−10.17, −5.25), p &lt; 0.00001], [MD = −9.15, 95% CI (−10.02, −8.29), p &lt; 0.00001]. In the analysis of body weight, tirzepatide showed a more significant reduction effect compared to the control group [MD = −5.65, 95% CI (−7.47, −3.82), p &lt; 0.001], [MD = −10.06, 95% CI (−12.86, −7.25), p &lt; 0.001], [MD = −10.63, 95% CI (−12.42, −8.84), p &lt; 0.001]. In comparison with placebo, tirzepatide had a prominent advantage in weight loss ≥20% and ≥25% [RR = 30.43, 95% CI (19.56, 47.33), p &lt; 0.00001], [RR = 37.25, 95% CI (26.03, 53.30), p &lt; 0.00001]. Subgroup analysis showed a dose-dependent therapeutic effect. In terms of safety, compared with the placebo and insulin groups, the incidence of gastrointestinal adverse reactions was markedly higher in the tirzepatide group, slightly higher to the GLP-1 RAs group. The hypoglycemic (&lt;70 mg/dL) risk of tirzepatide was slightly higher to that of placebo and GLP-1 RAs, but significantly lower than that of the insulin group [RR = 0.46, 95% CI (0.36, 0.58), p &lt; 0.001]. The incidence of other adverse events, including pancreatitis, cholecystitis, major adverse cardiovascular events-4, hypersensitivity reactions, and neoplasms did not show significant statistical differences compared to the control group (p &gt; 0.05).ConclusionTirzepatide, as a weight loss drug, significantly reduces BMI, waist circumference and body weight while gastrointestinal adverse reactions need to be vigilant. Overall, its efficacy is significant and its safety is high.
Non-linear association of years of experience and burnout among nursing staff: a restricted cubic spline analysis
Authors: Liao Tanghong , Liu Yufei , Luo Wenqun , Duan Zhizhou , Zhan Kangmin , Lu Hongjian , Chen Xiangfan 
Published: January 2024

BackgroundOccupational burnout is intricately linked to a spectrum of physical disorders encompassing respiratory, cardiovascular, and gastrointestinal conditions, as well as manifestations such as headaches, type 2 diabetes, elevated cholesterol levels, chronic fatigue, and muscle pain. Despite this association, there remains a paucity of research on the specific risk factors contributing to burnout among nurses in China.MethodsThis cross-sectional study utilized convenience sampling to recruit participants, with data analyzed from 1,774 nurse staffs. Psychosocial traits were assessed using the Three-Item Loneliness Scale for loneliness, the Generalized Anxiety Disorder 7-item scale (GAD-7) for anxiety symptoms, the 9-item Patient Health Questionnaire (PHQ-9) for depressive symptoms, the Connor Davidson Resilience Scale–10 item (CDRISC-10) for resilience, and the Maslach Burnout Inventory-Human Service Survey (MBI-HSS) for burn out. Restrictive cubic spline analysis to investigate the dose-response relationship between years of experience and burn out. Multivariate linear regression was employed to investigate the relationship between burnout and various risk factors.ResultsAfter controlling for basic demographic variables, good sleep quality was associated with a reduction in emotional exhaustion (β = −0.307, p &lt; 0.001), while loneliness (β = 1.334, p &lt; 0.001), depressive symptoms (β = 0.896, p &lt; 0.001), and anxiety symptoms (β = 0.504, p &lt; 0.001) were significantly associated with increased emotional exhaustion. Moreover, higher levels of resilience were positively associated with personal accomplishment (β = 0.635, p &lt; 0.001). Regarding depersonalization, loneliness (β = 0.577, p &lt; 0.001), depressive symptoms (β = 0.429, p &lt; 0.001), and anxiety symptoms (β = 0.152, p &lt; 0.01) were found to increase its level. Conversely, good resilience was associated with a decrease in depersonalization (β = −0.069, p &lt; 0.001). The non-liner association between year of experience and emotional exhaustion was significantly (p &lt; 0.05).ConclusionOur findings revealed that significant risk factors contributing to burnout among nursing staff including bad sleep quality, loneliness, lower level of resilience, anxiety symptoms, depressive symptoms. Moreover, a nonlinear correlation between years of experience and the likelihood of experiencing emotional exhaustion was exist.
Peri-Transplant Inflammation and Long-Term Diabetes Outcomes Were Not Impacted by Either Etanercept or Alpha-1-Antitrypsin Treatment in Islet Autotransplant Recipients
Authors: Abdel-Karim Tasneem R. , Hodges James S. , Herold Kevan C. , Pruett Timothy L. , Ramanathan Karthik V. , Hering Bernhard J. , Dunn Ty B. , Kirchner Varvara A. , Beilman Gregory J. , Bellin Melena D. 
Published: January 2024

The instant blood-mediated inflammatory response (IBMIR) causes islet loss and compromises diabetes outcomes after total pancreatectomy with islet autotransplant (TPIAT). We previously reported a possible benefit of etanercept in maintaining insulin secretion 3 months post-TPIAT. Here, we report 2-year diabetes outcomes and peri-operative inflammatory profiles from a randomized trial of etanercept and alpha-1 antitrypsin (A1AT) in TPIAT. We randomized 43 TPIAT recipients to A1AT (90 mg/kg IV x6 doses, n = 13), etanercept (50 mg then 25 mg SQ x 5 doses, n = 14), or standard care (n = 16). Inflammatory cytokines, serum A1AT and unmethylated insulin DNA were drawn multiple times in the perioperative period. Islet function was assessed 2 years after TPIAT with mixed meal tolerance test, intravenous glucose tolerance test and glucose-potentiated arginine induced insulin secretion. Cytokines, especially IL-6, IL-8, IL-10, and MCP-1, were elevated during and after TPIAT. However, only TNFα differed significantly between groups, with highest levels in the etanercept group (p = 0.027). A1AT increased after IAT in all groups (p &lt; 0.001), suggesting endogenous upregulation. Unmethylated insulin DNA ratios (a marker of islet loss) and 2 years islet function testing were similar in the three groups. To conclude, we found no sustained benefit from administering etanercept or A1AT in the perioperative period.
Weight trends among adults with diabetes or hypertension during the COVID-19 pandemic: an observational study using OpenSAFELY
Authors: Samuel Miriam , Park Robin Y , Eastwood Sophie V , Eto Fabiola , Morton Caroline E , Stow Daniel , Bacon Sebastian , Goldacre Ben , Mehrkar Amir , Morley Jessica , Dillingham Iain , Inglesby Peter , Hulme William J , Khunti Kamlesh , Mathur Rohini , Valabhji Jonathan , MacKenna Brian , Finer Sarah ,   the OpenSAFELY Collaborative
Published: January 2024

BackgroundCOVID-19 pandemic restrictions may have influenced behaviours related to weight.AimTo describe patterns of weight change among adults living in England with type 2 diabetes (T2D) and/or hypertension during the pandemic.Design and settingAn observational cohort study using the routinely collected health data of approximately 40% of adults living in England, accessed through the OpenSAFELY service inside TPP.MethodClinical and sociodemographic characteristics associated with rapid weight gain (>0.5 kg/m2/year) were investigated using multivariable logistic regression.ResultsData were extracted on adults with T2D (n= 1 231 455, 43.9% female, and 76.0% White British) or hypertension (n= 3 558 405, 49.7% female, and 84.3% White British). Adults with T2D lost weight overall (median δ = −0.1 kg/m2/year [interquartile range {IQR} −0.7–0.4]). However, rapid weight gain was common (20.7%) and associated with the following: sex (male versus female: adjusted odds ratio [aOR] 0.78 [95% confidence interval {CI} = 0.77 to 0.79]); age (older age reduced odds, for example, aged 60–69 years versus 18–29 years: aOR 0.66 [95% CI = 0.61 to 0.71]); deprivation (least deprived Index of Multiple Deprivation [IMD] quintile versus most deprived IMD quintile: aOR 0.87 [95% CI = 0.85 to 0.89]); White ethnicity (Black versus White: aOR 0.95 [95% CI = 0.92 to 0.98]); mental health conditions (for example, depression: aOR 1.13 [95% CI = 1.12 to 1.15]); and diabetes treatment (non-insulin treatment versus no pharmacological treatment: aOR 0.68 [95% CI = 0.67 to 0.69]). Adults with hypertension maintained stable weight overall (median δ = 0.0 kg/m2/year [IQR −0.6–0.5]); however, rapid weight gain was common (24.7%) and associated with similar characteristics as in T2D.ConclusionAmong adults living in England with T2D and/or hypertension, rapid pandemic weight gain was more common among females, younger adults, those living in more deprived areas, and those with mental health conditions.
The importance of preoperative evaluation to predict the outcome of percutaneous nephrostomy
Authors: Datu Ronald J. , Arianto Eko , Astram Ari , Toreh Christof 
Published: January 2024

Abstract: Percutaneous nephrostomy (PCN) is an invasive procedure equal to a grade 4 penetrating kidney trauma. It should be carefully considered whether has a greater benefit or risk. There are currently no parameters or scores to predict the outcome of nephrostomy in our center. This study aimed to conduct a review to find out whether there were parameters or scores that could be used to predict the outcome of nephrostomy. This research used relevant studies obtained from Clinical Key, PubMed, Semantic Scholar, Dimensions, and Science Direct published in the last 10 years and written in English. Studies on children and transplant cases were excluded. Studies that met the PICO criteria were selected. The results showed that of the 141 articles collected, and filtered with inclusion criteria, exclusion criteria, and PICO criteria, finally the remaining were three studies selected. The studies discussed about classification, SFU grading system, and complication of nephrostomy; significant variables affecting recoverability of renal function; patients’ characteristics and outcomes of double J ureteral stenting (DJS) and PCN; and 12-month-post-operative creatinine level change. Most patients who failed DJS had increased creatinine level. However, one of the indications for a nephrostomy was stenting failure. In conclusion, predictor factors that can affect the renal recovery after nephrostomy include kidney shape and size, pre-nephrostomy creatinine levels, urine output, state of infection, and degree of hydronephrosis. However, the evidence is still not enough. Further research is needed on the predictor factors for renal recovery after nephrostomy.
Keywords: percutaneous nephrostomy; hydronephrosis; kidney function; predictors
Hubungan Jenis dan Siklus Kemoterapi dengan Derajat Neuropati pada Pasien Keganasan
Authors: Haroen Harlinda , Gimon Indriaty 
Published: January 2024

Abstract: Antineoplastic chemotherapy agents in cancer treatment can cause peripheral neuropathy. Antineoplastic agents associated with chemotherapy-induced peripheral neuropathy include platinum-based drugs (carboplatin, cisplatin and oxaliplatin) and taxane (paclitaxel and docetaxel). This study aimed to evaluate the relationship between the type and cycle of chemotherapy with the level of neuropathy in malignant patients at Prof. Dr. R. D. Kandou Hospital, Manado, in 2022. The results obtained 43 cancer patients aged 18-65 who underwent chemotherapy, especially drugs from the platinum group (81.4%) such as oxaliplatin (62.8%). The majority of cases were colorectal adenocarcinoma (63%). Using the Toronto Score, the majority of subjects experienced mild neuropathy (55.8%), followed by without neuropathy (32.5%) and moderate neuropathy (11.6%). Although there was an indication of a relationship between the type of chemotherapy and the severity of neuropathy, the results were not statistically significant (p=0.069). In conclusion, there is no relationship between the type and cycle of chemotherapy with the level of neuropathy in cancer patients.
Keywords: neuropathy; chemotherapy cycles; types of chemotherapy

Abstrak: Agen kemoterapi antineoplastik dalam pengobatan kanker dapat menyebabkan neuropati perifer. Agen antineoplastik terkait neuropati perifer yang diinduksi kemoterapi termasuk obat berbasis platinum (carboplatin, cisplatin dan oxaliplatin) dan taxane (paclitaxel dan docetaxel). Penelitian ini bertujuan untuk mengetahui hubungan jenis dan siklus kemoterapi dengan keparahan neuropati pada pasien keganasan di RSUP Prof. Dr. R. D. Kandou Manado pada tahun 2022. Hasil penelitian mendapatkan 43 pasien kanker berusia 18-65 tahun yang telah menjalani kemoterapi, khususnya obat berbasis platinum (81,4%) seperti oxaliplatin (62,8%). Jenis keganasan yang terbanyak ialah adenokarsinoma kolorektal (63%). Dengan menggunakan Skor Toronto, didapatkan mayoritas subjek mengalami neuropati ringan (55,9%) diikuti tanpa neuropati (32,5%) dan neuropati sedang (11,6%). Meski ada indikasi hubungan antara jenis kemoterapi dengan tingkat neuropati, hasilnya tidak bermakna secara statistik (p=0,069). Simpulan penelitian ini ialah tidak terdapat hubungan antara jenis dan siklus kemoterapi dengan tingkat neuropati pada pasien keganasan.
Kata kunci: neuropati; siklus kemoterapi; jenis kemoterapi