bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of metformin and statin uses with the prognosis of colon cancer: a meta-analysis
Authors: Xu Yanyan , Che Hao , Liu Jiang , Ye Pingjiang 
Published: January 2024

Background
Metformin and statins are commonly used globally for the treatment of type 2 diabetes mellitus and dyslipidemia, respectively. Recently, multiple novel pathways have been discovered, which may contribute to the treatment of various types of cancer. Several meta-analysis studies have reported that the use of metformin or statins is associated with a lower risk of colon cancer compared to nonusers. In this study, our aim was to perform a meta-analysis and investigate the prognostic roles of these two medications in colon cancer.

Methods
To identify relevant articles, literature searches were performed in the PubMed and Web of Science databases using a combination of keywords related to metformin, statins and colon cancer prognosis until August 2023. The study utilized STATA 12.0 software (Stata Corporation, College Station, Texas, USA) to compute all the hazard ratios (HRs) and 95% confidence intervals (CIs) regarding the association between metformin or statin uses and prognostic-related outcomes.

Results
Our analysis revealed that the use of metformin was associated with a significantly lower overall mortality of colon cancer (HR = 0.63; 95% CI = 0.51–0.77; I
2 = 94.9%; P < 0.001), as well as lower cancer-specific mortality of colon cancer (HR = 0.68; 95% CI = 0.50–0.94; I
2 = 91.9%; P < 0.001). Similarly, the use of statins was also associated with a lower overall mortality of colon cancer (HR = 0.68; 95% CI = 0.60–0.78; I
2 = 93.8%; P < 0.001), as well as a lower cancer-specific mortality of colon cancer (HR = 0.74; 95% CI = 0.67–0.81; I
2 = 82.2%; P < 0.001).

Conclusion
Our meta-analysis study suggests that statins and metformin may have potential as adjuvant agents with significant benefits in the prognosis of colon cancer.
Evaluating the association between longitudinal exposure to a PFAS mixture and adolescent cardiometabolic risk in the HOME Study
Authors: Fleury Elvira S. , Kuiper Jordan R. , Buckley Jessie P. , Papandonatos George D. , Cecil Kim M. , Chen Aimin , Eaton Charles B. , Kalkwarf Heidi J. , Lanphear Bruce P. , Yolton Kimberly , Braun Joseph M. 
Published: January 2024

Background:
Exposure to per- and polyfluoroalkyl substances (PFAS) throughout gestation and childhood may impact cardiometabolic risk.

Methods:
In 179 HOME Study participants (Cincinnati, OH; recruited 2003–2006), we used latent profile analysis to identify two distinct patterns of PFAS exposure from serum concentrations of four PFAS measured at birth and ages 3, 8, and 12 years. We assessed the homeostatic model of insulin resistance, triglycerides-to-high-density lipoprotein cholesterol ratio, leptin-to-adiponectin ratio, systolic blood pressure, visceral fat, and hemoglobin A1c levels at age 12 years. We used multivariable linear regression to assess the association of membership in the longitudinal PFAS mixture exposure group with a summary measure of overall cardiometabolic risk and individual components.

Results:
One PFAS exposure profile (n = 66, 39%) had higher geometric means of all PFAS across all visits than the other. Although adjusted associations were null in the full sample, child sex modified the association of longitudinal PFAS mixture exposure group with overall cardiometabolic risk, leptin-to-adiponectin ratio, systolic blood pressure, and visceral fat (interaction term P values: 0.02–0.08). Females in the higher exposure group had higher cardiometabolic risk scores (ß = 0.43; 95% CI = −0.08, 0.94), systolic blood pressures (ß = 0.6; 95% CI = 0.1, 1.1), and visceral fat (ß = 0.44; 95% CI = −0.13, 1.01); males had lower cardiometabolic risk scores (ß = −0.52; 95% CI = −1.06, −0.06), leptin-to-adiponectin ratios (ß = −0.7; 95% CI = −1.29, −0.1), systolic blood pressures (ß = −0.14; 95% CI = −0.7, 0.41), and visceral fat (ß = −0.52; 95% CI = −0.84, −0.19).

Conclusions:
Exposure to this PFAS mixture throughout childhood may have sex-specific effects on adolescent cardiometabolic risk.
Concerted synergy between viral-specific IgG and CD8+ T cells is critical for clearance of an HCV-related rodent hepacivirus
Authors: Gridley John , Holland Brantley , Salinas Eduardo , Trivedi Sheetal , Dravid Piyush , Elrod Elizabeth , Jin Fengzhi , Kumari Anuradha , Batista Mariana N. , Thapa Manoj , Rice Charles M. , Marcotrigiano Joseph , Kapoor Amit , Grakoui Arash 
Published: January 2024

Background and Aims:
Evidence assessing the role of B cells and their antibodies, or lack thereof, in the spontaneous resolution of acute HCV infection is conflicting. Utilization of a strictly hepatotropic, HCV-related rodent hepacivirus (RHV) model circumvents many of the challenges facing the field in characterizing the immunological correlates of dichotomous infection outcomes. This study seeks to elucidate the importance of B cells in the clearance of acute RHV infection.

Approach and Results:
µMT mice were infected i.v. with RHV and found to develop chronic infection for over a year. Wild-type (WT) mice depleted of B cells also exhibited persistent viremia that resolved only upon B cell resurgence. The persistent infection developed by B1-8i and AIDcre/cre mice revealed that antigen-specific, class-switched B cells or their antibodies were crucial for viral resolution. Virus-specific CD8+ and CD4+ T cells were characterized in these mice using newly developed major histocompatibility complex class I and II tetramers and ex vivo peptide stimulation. Immunoglobulin G (IgG) was purified from the serum of RHV- or lymphocytic choriomeningitis virus Armstrong-infected mice after viral clearance and passively transferred to AIDcre/cre recipients, revealing viral clearance only in αRHV IgG recipients. Further, the transfer of αRHV IgG into B cell–depleted recipients also induced viral resolution. This ability of RHV-specific IgG to induce viral clearance was found to require the concomitant presence of CD8+ T cells.

Conclusions:
Our findings demonstrate a cooperative interdependence between immunoglobulins and the T cell compartment that is required for RHV resolution. Thus, HCV vaccine regimens should aim to simultaneously elicit robust HCV-specific antibody and T cell responses for optimal protective efficacy.
The ability of artificial intelligence chatbots ChatGPT and Google Bard to accurately convey pre-operative information for patients undergoing ophthalmological surgeries
Authors: Patil Nikhil S. , Huang Ryan , Mihalache Andrew , Kisilevsky Eli , Kwok Jason , Popovic Marko M. , Nassrallah Georges , Chan Clara , Mallipatna Ashwin , Kertes Peter J. , Muni Rajeev H. 
Published: January 2024

Introduction:
To determine whether the two popular artificial intelligence (AI) chatbots, ChatGPT and Bard, provide high-quality information concerning procedure description, risks, benefits, and alternatives of various ophthalmological surgeries.

Methods:
ChatGPT and Bard were prompted with questions pertaining to the description, potential risks, benefits, alternatives, and implications of not proceeding with various surgeries in different subspecialties of ophthalmology. Six common ophthalmic procedures were included in our analysis. Two comprehensive ophthalmologists and one sub-specialist graded each response independently using a five-point Likert scale.

Results:
Likert grading for accuracy was significantly higher for ChatGPT in comparison to Bard (4.5±0.6 vs 3.8±0.8, p<0.0001). Generally, ChatGPT performed better than Bard even when questions were stratified by type of ophthalmological surgery. There was no significant difference between ChatGPT and Bard for response length (2104.7±271.4 characters vs 2441.0±633.9 characters, p=0.12). ChatGPT responded significantly slower than Bard (46.0±3.0 seconds vs 6.6±1.2 seconds, p<0.0001).

Conclusions:
Both ChatGPT and Bard may offer accessible and high-quality information relevant to the informed consent process for various ophthalmic procedures. Nonetheless, both AI chatbots overlooked probability of adverse events, hence limiting their potential and introducing patients to information that may be difficult to interpret.
Evaluating the Accuracy of ChatGPT and Google BARD in Fielding Oculoplastic Patient Queries: A Comparative Study on Artificial versus Human Intelligence
Authors: Al-Sharif Eman M. , Penteado Rafaella C. , Dib El Jalbout Nahia , Topilow Nicole J. , Shoji Marissa K. , Kikkawa Don O. , Liu Catherine Y. , Korn Bobby S. 
Published: January 2024

Purpose:
This study evaluates and compares the accuracy of responses from 2 artificial intelligence platforms to patients’ oculoplastics-related questions.

Methods:
Questions directed toward oculoplastic surgeons were collected, rephrased, and input independently into ChatGPT-3.5 and BARD chatbots, using the prompt: “As an oculoplastic surgeon, how can I respond to my patient’s question?.” Responses were independently evaluated by 4 experienced oculoplastic specialists as comprehensive, correct but inadequate, mixed correct and incorrect/outdated data, and completely incorrect. Additionally, the empathy level, length, and automated readability index of the responses were assessed.

Results:
A total of 112 patient questions underwent evaluation. The rates of comprehensive, correct but inadequate, mixed, and completely incorrect answers for ChatGPT were 71.4%, 12.9%, 10.5%, and 5.1%, respectively, compared with 53.1%, 18.3%, 18.1%, and 10.5%, respectively, for BARD. ChatGPT showed more empathy (48.9%) than BARD (13.2%). All graders found that ChatGPT outperformed BARD in question categories of postoperative healing, medical eye conditions, and medications. Categorizing questions by anatomy, ChatGPT excelled in answering lacrimal questions (83.8%), while BARD performed best in the eyelid group (60.4%). ChatGPT’s answers were longer and potentially more challenging to comprehend than BARD’s.

Conclusion:
This study emphasizes the promising role of artificial intelligence-powered chatbots in oculoplastic patient education and support. With continued development, these chatbots may potentially assist physicians and offer patients accurate information, ultimately contributing to improved patient care while alleviating surgeon burnout. However, it is crucial to highlight that artificial intelligence may be good at answering questions, but physician oversight remains essential to ensure the highest standard of care and address complex medical cases.
Outcome Comparison of Transconjunctival Müller’s Muscle Recession With Levator Disinsertion (TMRLD) to Gold Weight Implantation in the Treatment of Paralytic Lagophthalmos
Authors: Park Ji Kwan , Campbell Benjamin , Shipchandler Taha , Lee Hui Bae Harold 
Published: January 2024

Purpose:
To compare clinical outcomes of transconjunctival Müller’s muscle recession with levator disinsertion (TMRLD) to the traditional gold weight implantation in patients with paralytic lagophthalmos.

Methods:
A retrospective nonrandomized comparative review of patients who had gold weight implantation and TMRLD surgeries for paralytic lagophthalmos from January 2016 to January 2023 was performed. The main outcome comparisons were measurement changes in lagophthalmos, marginal reflex distance 1, visual acuity, and corneal examination. Complication and reoperation rates were also compared.

Results:
Twenty-six cases of gold weight implantation and 20 cases of TMRLD surgeries were identified. The changes in logMAR visual acuity between gold weight implantation and TMRLD groups were not statistically significant (−0.10 ± 0.48 vs. +0.05 ± 0.14, p > 0.05). The percent improvement in lagophthalmos (62.2% ± 51.8% vs. 58.4% ± 21.1%) and final marginal reflex distance 1 (2.22 ± 1.42 vs. 2.25 ± 1.41 mm) were also comparable between groups (p > 0.05). Both groups showed similar changes in marginal reflex distance 1 (1.75 ± 1.31 vs. 2.83 ± 1.37 mm) and lagophthalmos (3.77 ± 3.92 vs. 3.36 ± 1.36 mm) (p > 0.05). The overall complication (15.4% vs. 15.0%) and reoperation rates (15.4% vs. 15.0%) were comparable over the follow-up duration (291.6 ± 437.3 vs. 121.0 ± 177.8 days) (p > 0.05).

Conclusion:
TMRLD is as safe and effective as the gold weight implantation in addressing paralytic lagophthalmos in patients with facial nerve palsy.
The Delivery Model of Perceived Medical Service Quality Based on Donabedian's Framework
Authors: Chen Chun-Cheng , Hsiao Chih-Tung , Chang Dong-Shang , Lai Wei-Chen 
Published: January 2024

ABSTRACT
The implementation of the National Health Insurance has transformed the medical care landscape in Taiwan, rendering perceived medical service quality (PMSQ) and patient satisfaction significant focal points in medical care management. Past studies mostly focused on the technical aspects of medical care services, while overlooking the patients' perception of services and the delivery process of PMSQ in the medical care experience. This study integrated the theoretical framework of the Donabedian SPO model and the SERVQUAL questionnaire. The survey was conducted among the outpatients of three types of medical institutions in northern Taiwan: academic medical centers, metropolitan hospitals, and local community hospitals. A total of 400 questionnaires were collected, and 315 valid questionnaires remained after eliminating the incomplete ones. This study established a PMSQ delivery model to explore patients' perceptions of medical service quality. It was found that the variable, Assurance, could deliver the PMSQ and enhance the Medical outcome (MO), while improving the variable, Tangible, in medical institutions could not significantly enhance the MO. These findings emphasize the importance of healthcare institutions prioritizing the professional background, demeanor of their healthcare staff, treatment methods, and processes over tangible elements.
A Qualitative Study of Factors Influencing Hospital Participation in the Healthcare Equality Index
Authors: Abdow V. Peter , Marable Julian K. , Moore Eileen S. 
Published: January 2024

ABSTRACT
Gender and sexual minority individuals experience higher rates of mistreatment and discrimination in healthcare compared with their non–lesbian, gay, bisexual, transgender, queer, and other nonheterosexual (LGBTQ+) peers. The Healthcare Equality Index (HEI) aims to create more inclusive environments and to provide metrics for quality improvement. Currently, only one adult hospital in the District of Columbia has earned the highest recognition from the HEI. Our institution is part of the same regional health system as this hospital, yet has never been evaluated by the HEI. This study explores the knowledge, attitudes, and perceptions surrounding the HEI at our institution to assess the feasibility of its participation. During the study period of July 2021 to June 2022, a total of 12 physicians, administrators, and educators from both hospitals and our affiliated school of medicine were interviewed. All participants expressed support after HEI requirements and improving inclusivity for LGBTQ+ patients. Participants at the other hospital cited unanimous support amongst hospital administrators as key for successful HEI implementation. Participants also mentioned cost, staff shortages, and the school of medicine's religious affiliation as potential barriers to this goal. Ultimately, hospital implementation of HEI guidelines is feasible despite shifting institutional priorities and resource limitations through greater stakeholder buy-in and streamlining a systemwide approach.
A radiogenomic multimodal and whole-transcriptome sequencing for preoperative prediction of axillary lymph node metastasis and drug therapeutic response in breast cancer: a retrospective, machine learning and international multicohort study
Authors: Lai Jianguo , Chen Zijun , Liu Jie , Zhu Chao , Huang Haoxuan , Yi Ying , Cai Gengxi , Liao Ning 
Published: January 2024

Background:Axillary lymph nodes (ALN) status serves as a crucial prognostic indicator in breast cancer (BC). The aim of this study was to construct a radiogenomic multimodal model, based on machine learning and whole-transcriptome sequencing (WTS), to accurately evaluate the risk of ALN metastasis (ALNM), drug therapeutic response and avoid unnecessary axillary surgery in BC patients.Methods:In this study, conducted a retrospective analysis of 1078 BC patients from The Cancer Genome Atlas (TCGA), The Cancer Imaging Archive (TCIA), and Foshan cohort. These patients were divided into the TCIA cohort (N=103), TCIA validation cohort (N=51), Duke cohort (N=138), Foshan cohort (N=106), and TCGA cohort (N=680). Radiological features were extracted from BC radiological images and differentially expressed gene expression was calibrated using technology. A support vector machine model was employed to screen radiological and genetic features, and a multimodal model was established based on radiogenomic and clinical pathological features to predict ALNM. The accuracy of the model predictions was assessed using the area under the curve (AUC) and the clinical benefit was measured using decision curve analysis. Risk stratification analysis of BC patients was performed by gene set enrichment analysis, differential comparison of immune checkpoint gene expression, and drug sensitivity testing.Results:For the prediction of ALNM, rad-score was able to significantly differentiate between ALN- and ALN+ patients in both the Duke and Foshan cohorts (P<0.05). Similarly, the gene-score was able to significantly differentiate between ALN- and ALN+ patients in the TCGA cohort (P<0.05). The radiogenomic multimodal nomogram demonstrated satisfactory performance in the TCIA cohort (AUC 0.82, 95% CI: 0.74–0.91) and the TCIA validation cohort (AUC 0.77, 95% CI: 0.63–0.91). In the risk sub-stratification analysis, there were significant differences in gene pathway enrichment between high and low-risk groups (P<0.05). Additionally, different risk groups may exhibit varying treatment responses (P<0.05).Conclusion:Overall, the radiogenomic multimodal model employs multimodal data, including radiological images, genetic, and clinicopathological typing. The radiogenomic multimodal nomogram can precisely predict ALNM and drug therapeutic response in BC patients.
Autogenous fibula head transplantation for aneurysmal bone cyst of distal radius: A case report followed up for 7 years
Authors: Wen Zhi , Kuang Gaoyan , Jiang Yong , Wu Yuyuan , Liu Enxu , Qiu Liguo , Xu Xiaotong , Lu Min 
Published: January 2024

Rationale:
Aneurysmal bone cyst (ABC) is a rare primary or secondary tumor that usually occurs in young women aged between 10 and 20 years, mostly in the long tubular bone and spine. However, there are no definite standards for its clinical treatment. To our knowledge, this is the first report of a young female patient with distal radius ABC who was successfully treated with tumor resection and autogenous fibular head transplantation.

Patient concerns:
A 28-year-old married Chinese young woman presented to our hospital with swelling and pain in her right wrist for 2 years and aggravation of wrist movement restriction for 1 week.

Diagnoses:
Pathological biopsy confirmed ABC.

Interventions:
We performed a pathological examination of the tumor on the right wrist and preliminarily confirmed the diagnosis of ABC. The right wrist joint was reconstructed by total surgical resection of the ABC tumor in the right wrist joint and autogenous fibular head transplantation.

Outcomes:
During follow-up within 7 years, good right wrist function was confirmed. The tumor did not recur, the swelling of the right wrist disappeared, the joint pain and limitation of movement significantly improved, and the function of the right wrist was not impaired in daily activities. Radiography showed that the fracture had healed.

Lessons:
Our results suggest that autofibular head transplantation is an effective treatment for reconstruction of wrist function in adult patients with ABC of the distal radius.
Whether specific genetic feature predicted immunotherapy efficacy: A case report
Authors: Chen Jun , Pang Linrong , He Lianxiang , Li Ting , Cheng Xiaochun 
Published: January 2024

Rationale:
Blockade of programmed death protein 1 (PD-1), have been observed to have quite good efficacy in recurrent and metastatic cervical cancer. Generally, we believe that the biomarkers of PD-1 inhibitors are programmed cell death-ligand 1, tumor mutational burden, high microsatellite instability, or deficient mismatch repair. However, in the case reported below, we observed that the patient with negative existing predictive biomarkers have significant benefits after zimberelimab monotherapy, indicating that there were other biomarkers that may predict immunotherapy efficacy. However, currently, no one has explored and studied the other potential biomarkers of PD-1 inhibitors.

Patient concerns:
A 51-year-old patient, diagnosed with cervical adenocarcinoma nearly 11 years ago, requested treatment.

Diagnoses:
The next-generation sequencing has shown PIK3CA E545K, SMAD4 1309-1G, and ALK E717K gene mutations, receptor tyrosine kinase 2 (ErbB-2) amplification, microsatellite stability, and low tumor mutational burden of 6.3 mutations per megabase. And immunohistochemistry revealed that the tumor was programmed cell death-ligand 1 negative.

Intervention:
Zimberelimab monotherapy was accepted as third-line treatment.

Outcomes:
The patient had received zimberelimab for nearly 10 months, the best tumor response was PR (Response Evaluation Criteria in Solid Tumours) and no noticeable adverse reactions were observed.

Lessons:
PIK3CA-E542K, ErbB2 amplification, and SMAD4 mutations could be potential biomarkers for PD-1 inhibitors, but a single instance is insufficient to validate the hypotheses. A larger number of patients or more clinical data will be necessary to determine whether these gene mutations are appropriate biomarkers for patients when treatment with PD-1 inhibitors.
Adrenomyeloneuropathy manifesting as adrenal insufficiency and bilateral lower extremity spastic paraplegia: A case report and literature review
Authors: Chen Yan , Li Daojing , Xu Peng , Zhang Aimei , Chen Xu , Chen Yun 
Published: January 2024

Rationale:
Adrenomyeloneuropathy (AMN) is a variant type of X-linked adrenoleukodystrophy, and it is a genetic metabolic disease with strong clinical heterogeneity so that it is easily misdiagnosed and underdiagnosed. Moreover, most patients with AMN have an insidious clinical onset and slow progression. Familiarity with the pathogenesis, clinical features, diagnosis, and treatment of AMN can help identify the disease at an early stage.

Patient concerns:
We present a case of 35-year-old male, who was admitted to our hospital due to “immobility of the lower limbs for 2 years and worsening for half a year,” accompanied by skin darkening and hyperpigmentation of lips, oral mucosa, and areola since puberty.

Diagnosis:
The level of very long-chain fatty acids was high and genetic testing depicted that exon 1 of the ABCD1 gene had a missense mutation of C.761c>T, which was diagnosed as AMN.

Interventions:
Baclofen was administered to improve muscle tension combined with glucocorticoid replacement therapy.

Outcomes:
The condition was relieved after half a year.

Lessons:
The clinical manifestations of AMN are diverse. When patients with adrenocortical dysfunction complicated with progressive spastic paraplegia of lower limbs are involved, AMN should be highly suspected, and the determination of very long-chain fatty acids and genetic testing should be performed as soon as possible to confirm the diagnosis because early treatment can help prevent or delay the progression of the disease.