bluuebunny/crossref_metadata_2025_split huggingface dataset:
Getting ready for prime time: Recommended adaptations of an Empathic Communication Skills training intervention to reduce lung cancer stigma for a national multi-center trial
Authors: Banerjee Smita C , Malling Charlotte D , Shen Megan J , Williamson Timothy J , Bylund Carma L , Studts Jamie L , Mullett Timothy , Carter-Bawa Lisa , Hamann Heidi A , Parker Patricia A , Steliga Matthew , Feldman Jill , Pantelas Jim , Borondy-Kitts Andrea , Rigney Maureen , King Jennifer C , Fathi Joelle T , Rosenthal Lauren S , Smith Robert A , Ostroff Jamie S 
Published: August 2023

Abstract
Building upon prior work developing and pilot testing a provider-focused Empathic Communication Skills (ECS) training intervention, this study sought feedback from key invested partners who work with individuals with lung cancer (i.e. stakeholders including scientific and clinical advisors and patient advocates) on the ECS training intervention. The findings will be used to launch a national virtually-delivered multi-center clinical trial that will examine the effectiveness and implementation of the evidence-based ECS training intervention to reduce patients’ experience of lung cancer stigma. A 1-day, hybrid, key invested partners meeting was held in New York City in Fall 2021. We presented the ECS training intervention to all conference attendees (N = 25) to seek constructive feedback on modifications of the training content and platform for intervention delivery to maximize its impact. After participating in the immersive training, all participants engaged in a group discussion guided by semi-structured probes. A deductive thematic content analysis was conducted to code focus group responses into 12 distinct a priori content modification recommendations. Content refinement was suggested in 8 of the 12 content modification themes: tailoring/tweaking/refining, adding elements, removing elements, shortening/condensing content, lengthening/extending content, substituting elements, re-ordering elements, and repeating elements. Engagement and feedback from key invested multi-sector partner is a valuable resource for intervention content modifications. Using a structured format for refining evidence-based interventions can facilitate efforts to understand the nature of modifications required for scaling up interventions and the impact of these modifications on outcomes of interest.
ClinicalTrials.gov Identifier: NCT05456841.
Quality of Life in Palliative Post-mastectomy Reconstruction: Keystone versus Rotational Flap
Authors: Rini Irena Sakura , Gunardi Alberta Jesslyn , Yashinta  , Kevin Jonathan , Marsaulina Renate Parlene , Aryandono Teguh , Dachlan Ishandono , Dwiprahasto Iwan 
Published: August 2023

Background:
Late stage breast cancer presents with malignant wound causing skin infiltration, pain, bleeding, and malodour, which affect quality of life (QoL). Palliative mastectomy aims to eliminate wound symptoms and requires prolonged wound care to improve QoL. This study aimed to prospectively investigate QoL differences in 2 alternative reconstructive methods: keystone flap and rotational flap.

Methods:
Twenty-four late stage breast cancer patients with symptoms of cancer wounds were included in this study. They were divided into 2 groups: keystone flap and rotational flap. Each patient’s QoL was evaluated using EORTC QLQ-C30 and QLQ-BR23 before and 3 weeks after surgery.

Results:
Global health post-surgery was significantly improved compared with pre-surgery in all patients (P < 0.001), across both the keystone (P = 0.018) and rotational groups (P = 0.007). Breast symptoms post-surgery were also improved compared with pre-surgery in all patients (P = 0.035). However, when analyzed per group, breast symptoms were only improved significantly in the keystone group (P = 0.013) but not in the rotational group (P = 0.575). When compared between 2 groups, future perspective post-surgery in the keystone group [100 (0–100)] was better than the rotational group [66.7 (0–100)], (P = 0.020).

Conclusions:
Reconstructive surgery after mastectomy improves QoL in late stage breast cancer patients. The keystone flap is superior to the rotational flap in improving global health and breast symptoms.
Shewanella algae, an Emerging Pathogen, Causing Skin and Soft Tissue Infections
Authors: Kalathuru Sowmya , Singla Aakriti , Kumar Ashok , Swami Aditi 
Published: August 2023

Abstract

Shewanella species, gram-negative saprophytic bacteria, are frequently found in warmer marine environments and soil. Among the Shewanella genus, Shewanella algae and Shewanella putrefaciens cause human infections, with S. algae being more common. Shewanella species are opportunistic bacteria and are being identified as potential pathogens causing wide range of illnesses in both immunocompromised and immunocompetent patients. Diagnosis can be difficult because of limited awareness and microbiologic data. However, high index of clinical suspicion and history of recent exposure to marine environments can help in facilitating early diagnosis. Delay may lead to sepsis and multiorgan failure. Infections can be identified in cases without exposure to aquatic environments, as seen in our case. A 39-year-old man with no marine exposure presented with progressively worsening lower extremity cellulitis with positive wound cultures for S. algae. We aim to increase awareness of this rare emerging pathogen so that treatment can be tailored rapidly and appropriately.
Incidence, risk factors, and outcomes of venous thromboembolism in patients undergoing surgery for retroperitoneal tumors: a propensity-matched retrospective cohort study
Authors: Guo Qiang , Zhao Jichun , Du Xiaojiong , Hu Hankui , Huang Bin 
Published: August 2023

Background:
Venous thromboembolism (VTE) is a common postoperative complication; however, the incidence and risk stratification of postoperative VTE in patients with retroperitoneal tumor remains unclear. The authors aim to quantify the incidence, identify risk factors, and determine the outcomes of VTE in patients undergoing retroperitoneal tumor surgery.

Methods:
The authors retrospectively reviewed the characteristics, perioperative outcomes, and overall survival (OS) of patients (VTE and non-VTE) who underwent retroperitoneal tumor surgery between 2015 and 2020. Perioperative and oncologic outcomes were compared using propensity-matching and Cox analyses.

Results:
Of 1223 patients with retroperitoneal tumor surgery, 2.1% had VTE. Age [odds ratio (OR) 1.140, 95% CI: 1.053–1.239, P=0.004], recurrence (OR 1.851, 95% CI: 1.241–2.761, P=0.003), and vascular resection (OR 2.036, 95% CI: 1.054–3.934, P=0.034) were independent risk factors, with significant between-group differences regarding age, recurrence, sarcoma, organ resection, vascular resection, and operation time. No between-group differences in 30-day all-cause mortality (8 vs. 4%, OR 0.657, 95% CI: 0.375–1.151, P=0.427) and major complications (12 vs. 8%, OR 0.775, 95% CI: 0.483–1.244, P=0.572) were observed. Mean hospitalization duration (20.1 vs. 22.9 days, OR 1.153, 95% CI: 1.022–1.386, P=0.033) and ICU stay (3.2 vs. 5.5 days, OR 1.193, 95% CI: 1.034–1.347, P=0.012) were shorter in non-VTE versus VTE, respectively, with inferior OS (hazard ratio 2.090, 95% CI: 1.014–4.308, P=0.046) in VTE.

Conclusions:
Age, recurrence, and vascular resection are positively associated with VTE, which is associated with inferior OS.
Development and validation of a mutation-annotated prognostic score (MAPS) for intrahepatic cholangiocarcinoma after resection: a retrospective cohort study
Authors: Wang Xiang-Yu , Zhu Wen-Wei , Lu Lu , Li Yi-Tong , Zhu Ying , Yang Lu-Yu , Sun Hao-Ting , Wang Chao-Qun , Lin Jing , Huang Chong , Yang Xin , Fan Jie , Jia Hu-Liang , Zhang Ju-Bo , Yin Bao-Bing , Chen Jin-Hong , Qin Lun-Xiu 
Published: August 2023

Background:
The value of existing prognostic models for intrahepatic cholangiocarcinoma (ICC) is limited. The inclusion of prognostic gene mutations would enhance the predictive efficacy.

Methods:
In the screening cohorts, univariable Cox regression analysis was applied to investigate the effect of individual mutant genes on overall survival (OS). In the training set, multivariable analysis was performed to evaluate the independent prognostic roles of the clinicopathological and mutational parameters, and a prognostic model was constructed. Internal and external validations were conducted to evaluate the performance of this model.

Results:
Among the recurrent mutations, only TP53 and KRAS

G12
were significantly associated with OS across all three screening cohorts. In the training cohort, TP53 and KRAS

G12
mutations in combination with seven other clinical parameters (tumor size, tumor number, vascular invasion, lymph node metastasis, adjacent invasion, CA19-9, and CEA), were independent prognostic factors for OS. A mutation-annotated prognostic score (MAPS) was established based on the nine prognosticators. The C-indices of MAPS (0.782 and 0.731 in the internal and external validation cohorts, respectively) were statistically higher than those of other existing models (P<0.05). Furthermore, the MAPS model also demonstrated significant value in predicting the possible benefits of upfront surgery and adjuvant therapy.

Conclusions:
The MAPS model demonstrated good performance in predicting OS of ICC patients. It may also help predict the possible benefits of upfront surgery and adjuvant therapy.
A novel staging system derived from natural language processing of pathology reports to predict prognostic outcomes of pancreatic cancer: a retrospective cohort study
Authors: Li Bo , Wang Beilei , Zhuang Pengjie , Cao Hongwei , Wu Shengyong , Tan Zhendong , Gao Suizhi , Li Penghao , Jin Wei , Shao Zhuo , Zheng Kailian , Wu Lele , Gao Bai , Wang Yang , Jiang Hui , Guo Shiwei , He Liang , Yang Yan , Jin Gang 
Published: August 2023

Objective:
To construct a novel Tumor-Node-Morphology (TNMor) staging system derived from natural language processing (NLP) of pathology reports to predict outcomes of pancreatic ductal adenocarcinoma (PDAC).

Method:
This retrospective study with 1,657 participants was based on a large referral center and The Cancer Genome Atlas Program (TCGA) dataset. In the training cohort, NLP was used to extract and screen prognostic predictors from pathology reports to develop the TNMor system, which was further evaluated with the tumor-node-metastasis (TNM) system in the internal and external validation cohort, respectively. Main outcomes were evaluated by the log-rank test of Kaplan-Meier curves, concordance index (C-index) and area under receiver operating curve (AUC).

Results:
The precision, recall, and F1 scores of the NLP model were 88.83%, 89.89%, and 89.21%, respectively. In Kaplan-Meier analysis, survival differences between stages in the TNMor system were more significant than that in the TNM system. In addition, our system provided an improved C-index (Internal validation, 0.58 vs. 0.54, P< 0.001; External validation, 0.64 vs. 0.63, P< 0.001), and higher AUCs for 1, 2, and 3-year survival (Internal validation: 0.62 vs. 0.54, P< 0.001; 0.64 vs. 0.60, P=0.017; 0.69 vs. 0.62, P=0.001; External validation: 0.69 vs. 0.65, P=0.098; 0.68 vs. 0.64, P=0.154; 0.64 vs. 0.55, P=0.032, respectively). Finally, our system was particularly beneficial for precise stratification of patients receiving adjuvant therapy, with an improved C-index (0.61 vs. 0.57, P< 0.001), and higher AUCs for 1, 2, and 3-year survival (0.64 vs. 0.57, P< 0.001; 0.64 vs. 0.58, P< 0.001; 0.67 vs. 0.61, P< 0.001; respectively) compared with the TNM system.

Conclusion:
These findings suggest that the TNMor system performed better than the TNM system in predicting PDAC prognosis. It is a promising system to screen risk-adjusted strategies for precision medicine.
The predictive role of hematologic markers in resectable nsclc patients treated with neoadjuvant chemoimmunotherapy: a retrospective cohort study
Authors: Liu Wenliang , Ren Siying , Yang Lulu , Xiao Ying , Zeng Chao , Chen Chen , Wu Fang , Hu Yan 
Published: August 2023

Background:
Neoadjuvant chemoimmunotherapy is an important therapeutic modality for resectable non-small cell lung cancer (NSCLC). The roles of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) in predicting the efficacy and prognosis of patients with resectable NSCLC receiving neoadjuvant chemoimmunotherapy remain uncertain. This study aimed to explore the association of baseline and preoperative NLR, PLR, and LMR with the treatment response and survival of patients with resectable NSCLC treated with neoadjuvant chemoimmunotherapy.

Materials and Methods:
Data of patients with resectable NSCLC treated with neoadjuvant chemoimmunotherapy between May 2019 and July 2022 at our institute, were retrospectively analyzed. Peripheral blood cell counts were obtained at baseline and before surgery. Data that may affect treatment efficacy were also collected and analyzed, including age, sex, body mass index, cumulative smoking exposure, pathological type, clinical stage, PD-L1 tumor proportion score, immune checkpoint inhibitors, dosage of neoadjuvant therapy, duration from final therapy to surgery, and baseline and preoperative oncological markers. The present work has been reported in compliance with REMARK criteria and guidelines, Supplemental Digital Content 1, http://links.lww.com/JS9/A860.

Results:
A total of 116 patients were included in the study. Univariate logistic regression analysis showed that a higher baseline NLR (P=0.001) and preoperative NLR (P=0.001) were associated with a lower incidence of pathological complete response (pCR) following neoadjuvant therapy. Multivariate analysis indicated that a lower incidence of pCR was achieved in the high baseline NLR group (P=0.014). Higher baseline NLR (P=0.021), preoperative NLR (P=0.004) and higher preoperative CEA levels (P=0.059) were associated with shorter disease-free survival (DFS). Multivariate Cox proportional hazard regression analyses showed that shorter DFS was achieved in the high preoperative NLR group (P=0.033).

Conclusion:
In patients with resectable NSCLC treated with neoadjuvant chemoimmunotherapy, a higher baseline NLR was associated with a lower incidence of pCR, and a higher preoperative NLR was associated with shorter DFS. However, future prospective study with large sample size and long-term follow-up is needed to verify the predictive value of NLR in these patients.
Hepatic arterial infusion chemotherapy versus transarterial chemoembolization, potential conversion therapies for single huge hepatocellular carcinoma: a retrospective comparison study
Authors: Deng Min , Cai Hao , He Benyi , Guan Renguo , Lee Carol , Guo Rongping 
Published: August 2023

Background:
The treatment efficacy of transarterial chemoembolization (TACE) and hepatic arterial infusion chemotherapy (HAIC) for huge single hepatocellular carcinoma (HCC) has not been fully documented. The aim of this study was to compare TACE and HAIC for patients with solitary nodular HCCs ≥10 cm without vascular invasion and metastasis.

Methods:
From July 2015 to June 2020, a total of 147 patients with single nodular HCC ≥10 cm without vascular invasion and metastasis receiving TACE (n=77) or HAIC (n=70) were retrospectively enrolled. The tumor response, overall survival (OS), and progression-free survival (PFS) were investigated and compared. The treatment outcome of 2 transarterial interventional therapies was explored.

Results:
The objective response rate and PFS were higher in patients who received HAIC than in those who received TACE (44.3% vs. 10.4% and 8.9 vs. 4.2 mo, respectively; P=0.001 and P=0.030), whereas the disease control rate and OS were not significantly different (92.9% vs. 84.4% and 21.3 vs. 26.6 mo, respectively; P=0.798 and P=0.749). The decreased levels of alpha‐fetoprotein and protein induced by vitamin K absence or antagonist-II (PIVKA-II) in patients treated with HAIC were significantly higher than those treated with TACE (P=0.038 and P<0.001). Multivariable analysis showed that the aspartate aminotransferase/platelet ratio index was associated with OS, whereas albumin-bilirubin grade and PIVKA-II were associated with PFS.

Conclusions:
HAIC has better potential than TACE to control local tumors for huge single HCC without vascular invasion and metastasis and thus may be the preferred conversion therapy for these tumors.
Biodistribution of recombinant factor IX, extended half-life recombinant factor IX Fc fusion protein, and glycoPEGylated recombinant factor IX in hemophilia B mice
Authors: van der Flier Arjan , Hong Vu , Liu Zhan , Piepenhagen Peter , Ulinski Gregory , Dumont Jennifer A. , Orcutt Kelly D. , Goel Apollina , Peters Robert , Salas Joe 
Published: August 2023

Extended half-life recombinant FIX (rFIX) molecules have been generated to reduce the dosing burden and increase the protection of patients with hemophilia B. Clinical pharmacology studies with recombinant factor IX Fc fusion protein (rFIXFc) report a similar initial peak plasma recovery to that of rFIX, but with a larger volume of distribution. Although the pegylation of N9-GP results in a larger plasma recovery, there is a smaller volume of distribution, suggesting less extravasation of the latter drug.
In this study, we set out to compare the biodistribution and tissue localization of rFIX, rFIXFc, and glycoPEGylated rFIX in a hemophilia B mouse model.
Radiolabeled rFIX, rFIXFc, and rFIX-GP were employed in in vivo single-photon emission computed tomography imaging (SPECT/CT), microautoradiography (MARG), and histology to assess the distribution of FIX reagents over time.
Immediately following injection, vascularized tissues demonstrated intense signal irrespective of FIX reagent. rFIX and rFIXFc were retained in joint and muscle areas through 5 half-lives, unlike rFIX-GP (assessed by SPECT). MARG and immunohistochemistry showed FIX agents localized at blood vessels among tissues, including liver, spleen, and kidney. Microautoradiographs, as well as fluorescent-labeled images of knee joint areas, demonstrated retention over time of FIX signal at the trabecular area of bone.
Data indicate that rFIXFc is similar to rFIX in that it distributes outside the plasma compartment and is retained in certain tissues over time, while also retained at higher plasma levels. Overall, data suggest that Fc fusion does not impede the extravascular distribution of FIX.
Effects of frozen storage conditions and freezing rate on the stability of coagulation proteins in human plasma
Authors: Fenclova Tereza , Marecek Frantisek , Hrachovinova Ingrid 
Published: August 2023

Objectives
Degradation of coagulation proteins in frozen plasma may influence assay results. The aims of this study were to explore the changes in coagulation parameters in patient plasma and internal quality control (IQC) after different freezing and storage conditions during the short-term and long-term periods.

Methods
Platelet poor plasma was prepared from citrated peripheral blood collected from a group of healthy donors. The plasma was pooled, frozen and stored in a variety of freezing and storage conditions. The changes were monitored using routine coagulation assays, as well as factor VIII (FVIII) and protein S (PS) assays.

Results
Plasma stored in liquid nitrogen (LN2) or in −80°C showed long-term stable values for routine tests for a period of over 12 months, and 6 months for FVIII. Interestingly, the activated partial thromboplastin time (aPTT) showed a temporary significant prolongation over the first two weeks. Plasma frozen and stored in −40°C is not viable for aPTT and FVIII testing, otherwise it can be used for other parameters for up to 4 months. PS showed a significant increase in all frozen samples. Freezing rate has a significant impact on plasma quality and the final storage temperature influences the long-term stability.

Conclusion
The optimal storage conditions are ultra-low temperatures (LN2 or −80°C) and the highest freezing rate possible. However, frozen plasma is not viable for IQC of aPTT during a period of two weeks after freezing. This study is unique in its conception as a practical guide for the handling of frozen plasma samples in modern laboratory settings.
Left ventricular assist device thrombosis in the setting of supratherapeutic international normalized ratio (INR) and bleeding
Authors: Gupta Gaurav , Yan Crystal L. , Kalwar Tricia , Thakkar-Rivera Nina 
Published: August 2023

A 71-year-old female with heart failure who underwent left ventricular assist device (LVAD) placement presented for evaluation of low hemoglobin and dark stools. She also had leg pain, numbness, and weakness for which she was taking ibuprofen. She was found to have a gastrointestinal bleed, INR of 4.3, and arterial thrombi in the left leg. She was stabilized, had her anticoagulation held, and underwent mechanical thrombectomy. On hospital day 6, LVAD interrogation revealed signs of thrombosis, while subsequent labs revealed a persistently supratherapeutic INR of 5.2.
The patient had the LVAD removed and underwent further hematologic workup. Her platelets remained normal throughout the admission, indicating this was not acute disseminated intravascular coagulation (DIC), thrombotic thrombocytopenic purpura (TTP), or heparin induced thrombocytopenia (HIT). Echocardiography identified it as a primary thrombus.
This case illustrates the importance of appropriate anticoagulation to balance the bleeding risk with the risk of thrombi, as well as the importance of maintaining high suspicion for LVAD thrombosis regardless of INR.
Nutrition and thyroid disease
Authors: Duntas Leonidas H. 
Published: August 2023

Purpose of review
The aim of this review was to determine, based on the most recent findings, the involvement of trace elements and vitamins critical for thyroid function and combating thyroid disease.

Recent findings
Nutritional guidance is pivotal to reducing the risk of thyroid disease and to managing it when it arises, this meaning the prescription of diets rich in such micronutrients as iodine, selenium, iron, zinc, and vitamins B12, D3, and A. Most of the above micronutrients are good antioxidants, building up an anti-inflammatory profile, reducing thyroid autoantibodies and body fat, and improving thyroid function. Diets are increasingly being prescribed, especially for those suffering from Hashimoto's thyroiditis. Notable among prescribed diets is the Mediterranean diet. Rich in critical elements, it benefits patients at the immune endocrine and biomolecular levels.

Summary
Importantly, it is likely that widespread adherence to the Mediterranean diet, together with a reduction of meat consumption and potential elimination of gluten and lactose may improve inflammation and have an impact on public health while possibly diminishing thyroiditis symptoms. It is hoped that this review can direct policymakers towards undertaking cost-effective interventions to minimize deficiency of essential minerals and vitamins and thus protect both general and thyroid health.