bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trabecular Bone Score as a More Sensitive Tool to Evaluate Bone Involvement in MEN1-related Primary Hyperparathyroidism
Authors: Song An , Chen Rong , Guan Wenmin , Yu Wei , Yang Yi , Wang Jiajia , Nie Min , Jiang Yan , Li Mei , Xia Weibo , Xing Xiaoping , Wang Ou 
Published: August 2023

Abstract

Context
The skeletal involvement of multiple endocrine neoplasia type 1-related primary hyperparathyroidism (MHPT) is not exactly the same as that of sporadic primary hyperparathyroidism (SHPT). Trabecular bone score (TBS) as a texture parameter has been reported to reflect trabecular bone damage.

Objective
This study aimed to compare the clinical characteristics, especially the skeletal involvement, between patients with MHPT and SHPT.

Methods
The clinical characteristics were retrospectively collected in 120 patients with MHPT and compared with 360 patients with SHPT in the same period. Dual-energy X-ray absorptiometry were conducted in some patients with MHPT, in whom bone mineral density (BMD) and calculated TBS derived from lumbar spine dual-energy X-ray absorptiometry images were compared with those of patients with SHPT.

Results
Although the duration of disease in the MHPT group was longer, the age at hospital visit was significantly lower than that in the SHPT group (43.5 [interquartile range, 31.5-52.0] vs 52.0 [interquartile range, 40.5-61.0], P &lt; .001). The proportion of skeletal involvement in the MHPT group was significantly lower. However, in the subgroup of MHPT cases (n = 86) with data of BMD, there was no significant difference in skeletal involvement from SHPT cases matched for gender and age. Although the BMD and TBS in the lumbar spines of patients with MHPT were lower than those of patients with SHPT (BMD: 0.91 ± 0.18 g/cm2 vs 1.01 ± 0.17 g/cm2; TBS: 1.22 ± 0.14 vs 1.29 ± 0.11, P &lt; .001). According to TBS, among 34 patients with MHPT with normal BMD, 15 patients had bone microstructure damage.

Conclusion
The cancellous bone microarchitecture was more severely damaged in patients with MHPT according to TBS, which suggested that TBS could be a sensitive supplemental index in addition to BMD to identify bone-involvement risk in patients with MHPT.
Early-onset tufting enteropathy in HAI-2-deficient mice is independent of matriptase-mediated cleavage of EpCAM
Authors: Szabo Roman , Kawaguchi Makiko , Kataoka Hiroaki , Bugge Thomas H. 
Published: August 2023

ABSTRACT
Congenital tufting enteropathy (CTE) is a life-threatening intestinal disorder resulting from loss-of-function mutations in EPCAM and SPINT2. Mice deficient in Spint2, encoding the protease inhibitor HAI-2, develop CTE-like intestinal failure associated with a progressive loss of the EpCAM protein, which is caused by unchecked activity of the serine protease matriptase (ST14). Here, we show that loss of HAI-2 leads to increased proteolytic processing of EpCAM. Elimination of the reported matriptase cleavage site strongly suppressed proteolytic processing of EpCAM in vitro and in vivo. Unexpectedly, expression of cleavage-resistant EpCAM failed to prevent intestinal failure and postnatal lethality in Spint2-deficient mice. In addition, genetic inactivation of intestinal matriptase (St14) counteracted the effect of Spint2 deficiency in mice expressing cleavage-resistant EpCAM, indicating that matriptase does not drive intestinal dysfunction by excessive proteolysis of EpCAM. Interestingly, mice expressing cleavage-resistant EpCAM developed late-onset intestinal defects and exhibited a shortened lifespan even in the presence of HAI-2, suggesting that EpCAM cleavage is indispensable for EpCAM function. Our findings provide new insights into the role of EpCAM and the etiology of the enteropathies driven by Spint2 deficiency.
Validation and Clinical Utility of a Prediction Model for the Risk of Upstaging to Invasive Breast Cancer After a Biopsy Diagnosis Ductal Carcinoma In Situ
Authors: Meurs Claudia J. C. , van Bekkum Sara , van Rosmalen Joost , Menke-Pluijmers Marian B. E. , Siesling Sabine , Westenend Pieter J. 
Published: August 2023

Abstract
Background
This study aimed to validate the DCIS-upstage model, a previously developed model to predict the risk of upstaging to invasive breast cancer in patients with biopsy-proven ductal carcinoma in situ (DCIS) in a more recent cohort and to assess the model’s clinical utility.

Methods
The model was validated in a registry cohort (n = 2269) and in an institution cohort (n = 302). A calibration plot was made, followed by a decision curve analysis (DCA). The model’s area under the curve (AUC) was compared with the AUC of another published model and with the AUCs of new models using the risk factors of the DCIS-upstage model and additional risk factors.

Results
The DCIS-upstage model had an AUC of 0.67 at development; in the validation, the AUC was 0.65 in the registry cohort and 0.73 in the institution cohort. The DCA showed that the model has clinical utility. The other published model had an AUC of 0.66 in the institution cohort. Adding risk factors to the DCIS-upstage model slightly increased the AUC.

Conclusions
The DCIS-upstage prediction model is valid in other cohorts. The model has clinical utility and may be used to select patients with biopsy-proven DCIS for sentinel lymph node biopsy.
Evidence-based research impact praxis: Integrating scholarship and practice to ensure research benefits society
Authors: Jensen Eric A. , Reed Mark , Jensen Aaron M. , Gerber Alexander 
Published: August 2023

Effective research impact development is essential to address global challenges. This commentary highlights key issues facing research impact development as a nascent professional field of practice. We argue that those working on research impact should take a strategic, ‘evidence-based’ approach to maximize potential research benefits and minimize potential harms. We identify key features of evidence-based good practice in the context of research impact work. This includes integrating relevant research and theory into professional decision-making, drawing on a diversity of academic disciplines offering pertinent insights. Such an integration of scholarship and practice will improve the capacity of research impact work to make a positive difference for society. Moving the focus of research impact work to earlier stages in the research and innovation process through stakeholder engagement and anticipatory research can also boost its effectiveness. The research impact evidence base should be combined with the right kind of professional capacities and practical experience to enhance positive impact. Such capacities need to be developed through relevant education and training, for example, in participatory methods and social inclusion. Such training for research impact work needs to forge strong links between research impact scholarship and practice. Finally, there is a need for improvements in the evidence base for research impact to make it more practically useful.
Devonian–Carboniferous extension and Eurekan inversion along an inherited WNW–ESE-striking fault system in Billefjorden, Svalbard
Authors: Koehl Jean-Baptiste P. , Allaart Lis , Noormets Riko 
Published: August 2023

Background: The Billefjorden area in central Spitsbergen hosts thick Lower–lowermost Upper Devonian, late–post-Caledonian collapse deposits presumably deformed during the Late Devonian Svalbardian Orogeny. These rocks are juxtaposed against Proterozoic basement rocks along the Billefjorden Fault Zone and are overlain by uppermost Devonian–early Permian deposits of the Billefjorden Trough, a N–S-trending Carboniferous rift basin bounded by the Billefjorden Fault Zone. Methods: We interpreted seismic reflection (also depth-converted), bathymetric, and exploration well data. Results: The data show abundant Early Devonian, WNW–ESE-striking (oblique-slip) normal faults segmenting the Billefjorden Trough, and a gradual decrease in tectonic activity from the Early Devonian (collapse phase) to early Permian (post-rift phase). Early Devonian–Middle Pennsylvanian WNW–ESE-striking faults were mildly reactivated and overprinted and accommodated strain partitioning and decoupling in the early Cenozoic. This resulted in intense deformation of Lower Devonian sedimentary rocks and in the formation of bedding-parallel décollements, e.g., between the Lower Devonian Wood Bay and the uppermost Pennsylvanian–lowermost Permian Wordiekammen formations. This suggests that intense deformation within Devonian rocks in Dickson Land can be explained by Eurekan deformation alone. Eurekan deformation also resulted in the formation of WNW–ESE- and N–S- to NNE–SSW-trending, kilometer-wide, open folds such as the Petuniabukta Syncline, and in inversion and/or overprinting of Early Devonian to Early Pennsylvanian normal faults by sinistral-reverse Eurekan thrusts. WNW–ESE-striking faults merge at depth with similarly trending and dipping ductile shear zone fabrics in Proterozoic basement rocks, which likely formed during the Timanian Orogeny. Conclusions: A NNE-dipping shear zone, which is part of a large system of Timanian thrusts in the Barents Sea, controlled the formation of WNW–ESE-striking Devonian–Mississippian normal faults and syn-tectonic sedimentary rocks in Billefjorden. Eurekan strain partitioning and decoupling suggest that the Svalbardian Orogeny did not occur in Svalbard.
Going for a job. Part 2/2: the interview itself
Authors: Peate Ian 
Published: August 2023

Part one (BJHCA, June 2023) of this two-part series addressed the job-application process, with an emphasis on preparation. In this second article, attending an interview will be discussed. Attending for interviews can be anxiety-provoking, but there are many ways of approaching the interview, both beforehand and on the day. Preparation can help make you feel more confident. The article addresses pre-interview, interview and post-interview matters. The ‘STAR’ technique is discussed; this is one approach that can help you to articulate your responses at interview.
Combining the age-male-albumin-bilirubin-platelets score and shear wave elastography stratifies carcinogenic risk in hepatitis C patients after viral clearance
Authors: Masaoka Rion , Gyotoku Yoshinori , Shirahashi Ryosaku , Suda Toshikuni , Tamano Masaya 
Published: August 2023

BACKGROUND
The treatment of hepatitis C with direct-acting antiviral agents (DAAs) produces a high rate of sustained virological response (SVR) with fewer adverse events than interferon (IFN) therapy with a similar effect in inhibiting carcinogenesis as IFN therapy. The age-male-albumin-bilirubin-platelets (aMAP) score is useful for stratifying the risk of hepatocellular carcinoma in chronic hepatitis patients, and the velocity of shear waves (Vs) measured by shear wave elastography has also been shown to be useful for diagnosing the level of fibrotic progression in hepatitis C and predicting carcinogenic risk. Combining these two may improve the prediction of carcinogenic risk.
AIM
To determine whether combining the aMAP score with Vs improves carcinogenic risk stratification in medium-to-high-risk hepatitis C patients.
METHODS
This retrospective, observational study involved hepatitis C patients treated with DAAs who achieved SVR. Vs was measured before treatment (baseline), at the end of treatment (EOT), and 12 wk (follow-up 12) and 24 wk (follow-up 24) after treatment. The patients were followed for at least six months after EOT to determine whether cancer developed. Multiple regression analysis was used to identify factors contributing to hepatic carcinogenesis. The diagnostic performances of clinical parameters for predicting the presence of hepatocellular carcinoma were evaluated using receiver-operating characteristic (ROC) curve analyses.
RESULTS
A total of 279 patients (mean age 65.9 years, 118 males, 161 females) were included in the analysis. Multiple regression analysis was performed with carcinogenesis as the target variable and alanine aminotransferase, platelets, α-fetoprotein, Vs, and the Fib-4 index as explanatory variables; only Vs was found to be significant (P = 0.0296). The cut-off value for Vs for liver carcinogenesis calculated using the ROC curve was 1.53 m/s. Carcinoma developed in 2.0% (3/151) of those with Vs < 1.53 m/s and in 10.5% (9/86) of those with Vs ≥ 1.53 m/s.
CONCLUSION
In hepatitis C patients after SVR, combining the aMAP score and Vs to stratify the risk of carcinogenesis is more efficient than uniform surveillance of all patients.
Pathological complete response to neoadjuvant alectinib in unresectable anaplastic lymphoma kinase positive non-small cell lung cancer: A case report
Authors: Wang Lu-Ming , Zhao Peng , Sun Xu-Qi , Yan Feng , Guo Qian 
Published: August 2023

BACKGROUND
The development of anaplastic lymphoma kinase (ALK)-tyrosine kinase inhibitors (TKIs) has remarkably improved the prognosis of patients with ALK-positive advanced non-small cell lung cancer (NSCLC). Alectinib, the second-generation ALK-TKI, has been approved as first-line treatment for advanced or metastatic NSCLC patients with ALK rearrangement. Neoadjuvant therapy can achieve tumor downstaging and eradicate occult lesions in patients with potentially resectable disease. Whether neoadjuvant alectinib can be a conversion therapy in ALK-positive advanced NSCLC patients remains unclear.
CASE SUMMARY
A 41-year-old man was pathologically diagnosed with locally advanced ALK-positive stage IIIB NSCLC. Alectinib was prescribed to induce tumor downstaging and facilitate the subsequent surgical resection. The tumor was successfully downstaged and pathological complete response was achieved. Left upper lobectomy with mediastinal lymphadenectomy was performed after tumor downstaging. The patient has continued to receive alectinib as adjuvant therapy during postoperative follow-up with a recurrence-free survival of 29 mo as of writing this report.
CONCLUSION
This case sheds light on the feasibility and safety of alectinib as a neoadjuvant treatment for stage IIIB NSCLC patients with ALK rearrangement. Its efficacy needs to be validated in prospective clinical trials.
Electrocardiogram and echocardiography findings and the outcomes of patients with myocardial infarction: Retrospective study in tertiary care hospitals in Northwest Ethiopia
Authors: Tsega Wondale , Awoke Worku , Sendekie Ashenafi Kibret , Dagnew Ephrem Mebratu , Bayih Habtamu 
Published: August 2023

BackgroundMyocardial infarction (MI) is diagnosed when there is a rise in cardiac biomarkers along with supportive evidence in the form of typical symptoms, suggestive electrocardiographic (ECG) changes, or imaging evidence of a new loss of viable myocardium or a new regional wall motion abnormality. The data regarding the use of ECG and echocardiography (Echo) findings and their impact on mortality are still lacking in Ethiopia. This study assessed the utilization of ECG and Echo findings and outcomes of patients with MI in tertiary care hospitals in Northwest Ethiopia.MethodsA retrospective chart review was conducted on patients with MI who were admitted to the adult intensive care units (ICUs) of two selected hospitals between January 2018 and July 30, 2021. Data was entered and analyzed using the SPSS 25 software. Logistic regression analysis was used to assess the association between in-hospital mortality and other variables. A P-value < 0.05 was considered significant.ResultsAmong the 203 participants, 67.5% were male, and the mean age of the participants was 59 (13.8). Around two-thirds (66.5%) of patients had STEMI and a regional all-motion abnormality. More than half (54.1%) of the cases were in the anteroapical region. For MI, there was a 23.2% inconsistency between ECG and Echo findings. The rate of in-hospital mortality for patients with MI was 23%. Pulmonary hypertension [AOR = 7.8, 95% CI: 1.72–34.93], inferobasal regional wall motion abnormality [AOR = 7.9, 95% CI: 1.340–46.093], Killip’s classes III and IV [AOR = 2.7, 95% CI: 1.103–6.314], infection [AOR = 3.2, 95% CI: 1.108–10.65], and ischemic stroke [AOR = 1.9, 95% CI: 1.091–5.222] were significantly associated with in-hospital mortality compared with their counterparts.ConclusionsThe mortality of patients with MI in this study was higher than in other reports. Killip’s class, pulmonary hypertension, infection, ischemic stroke, and inferobasal regional wall motion abnormalities were significantly associated with the in-hospital mortality of the patients with MI. There was a higher degree of inconsistency between ECG and Echo findings. The treatment of patients with MI should be tailored to their specific risk factors and causes.
Perceived dignity is an unrecognized source of emotional distress in patients with rheumatic diseases: Results from the validation of the Mexican version of the Patient Dignity Inventory
Authors: Pascual-Ramos Virginia , Contreras-Yáñez Irazú , Cuevas-Montoya Maximiliano , Guaracha-Basáñez Guillermo A. , García-Alanís Cesar Mario , Rodríguez-Mayoral Oscar , Chochinov Harvey Max 
Published: August 2023

Introduction
Dignity has rarely been explored in patients with rheumatic diseases (RMDs), which contrasts with patients´ observations that dignity is a relevant area for research focus. The study’s primary objective was to adapt and validate the Mexican version of the Patient Dignity Inventory (PDI-Mx) in patients with RMDs, and to estimate the proportion of patients with distress related to perceived dignity (DPD) assessed with the PDI-Mx.

Methods
This cross-sectional study was developed in 2 phases. Phase 1 consisted of pilot testing and questionnaire feasibility (n = 50 patients), PDI-Mx content validity (experts’ agreement), construct validity (exploratory factor analysis), discriminant validity (Heterotrait-Monotrait correlations’ rate [HTMT]), criterion validity (Spearman correlations) and PDI-Mx reliability with internal consistency (Cronbach’s alpha) and test-retest (intra-class correlation coefficients [ICC]) in 220 additional outpatients (among whom 30 underwent test-retest). Phase 2 consisted of quantifying DPD (PDI-Mx cut-off ≥54.4) in 290 outpatients with RMDs.

Results
Overall, patients were representative of typical outpatients with RMDs from a National tertiary care level center. The 25-item PDI-Mx was found feasible, valid (experts’ agreement ≥82%; a 4-factor structure accounted for 68.7% of the total variance; HTMT = 0.608; the strength of the correlations was moderate to high between the PDI-Mx, the Depression, Anxiety, and Stress scale dimensions scores, and the Health Assessment Questionnaire Disability Index score) and reliable (Cronbach’s ɑ = 0.962, ICC = 0.939 [95%CI = 0.913–0.961]). DPD was present in 78 patients (26.9%).

Conclusions
The PDI-Mx questionnaire showed good psychometric properties for assessing DPD in our population. Perceived dignity in patients with RMDs might be an unrecognized source of emotional distress.
Indications, techniques, and graft survival of mini and corneo-scleral tectonic keratoplasties: A retrospective single-center case series
Authors: Wiedenmann Cornelius Jakob , Böhringer Daniel , Maier Philip , Lapp Thabo , Wacker Katrin , Heinzelmann Sonja , Reinhard Thomas , Lang Stefan Johann 
Published: August 2023

Purpose
Tectonic keratoplasties (TK) are used to treat corneal and scleral perforations and to prevent the loss of the eye. In this study, we retrospectively analyzed indications, surgical procedures, and outcomes of eccentric mini and corneo-scleral tectonic keratoplasties with respect to anatomical survival and clear graft survival rates to identify risk factors for graft failure.

Methods
This retrospective study includes 33 eccentric mini (graft diameter <6 mm) and/or corneo-scleral TK of 32 consecutive patients of a total of 41 TK carried out between 2005 and 2020 in the Eye Center, University of Freiburg, Germany, making up 0.7% of all keratoplasties performed during this period (n = 5557). Patient and graft specific data were extracted from medical files. Anatomical survival—defined as achieving integrity of the globe without further surgical interventions—and clear graft survival—defined as persisting graft clarity—were estimated using the Kaplan-Meier method. We also fitted Cox proportional hazard models to account for factors influencing anatomical and clear graft survival.

Results
Median duration of anatomical success was 72.5 months (95% confidence interval (CI) 18.1—infinite (inf.)) and median duration of clear graft survival was 29.6 months (95% CI 12.5-Inf.). The 1-year survival rate for anatomical survival was 67.6% (95% CI 52.2% - 87.6%) and for clear graft survival 66.4% (95% CI 50.5%– 87.1%). No enucleation was necessary during this time-period. Non-inflammatory primary causes (n = 14) presented a trend towards better anatomical survival rates (median remained above 0.75 during follow-up) compared to inflammatory primary causes (n = 19, median 18.1 months (95% CI 2.8 - inf.)) and longer clear graft survival (median 29.6 months (95% CI 12.5 - inf.) versus 13.1 months (95% CI 3.2 - inf.)). Corneo-scleral grafts (n = 18) compared to corneal grafts (n = 15) showed a trend towards better anatomical survival (more than 50% of eyes did not fail during follow-up period (95% CI 21.9-Inf. months) versus 18.1 months (95% CI 2.4-Inf.)) and clear graft survival (median 29.6 months (95% CI 12.6-Inf.) versus 6.2 months (95% CI 2.8-Inf.)). Old age (n = 11, 75.2 – 90.1 years) compared to young age (n = 11, 6.2 – 60.2 years) was the only hazard ratio (hazard ratio 0.04 (95% CI 0.002–0.8)) that reached the level of significance (p = 0.03).

Conclusion
Eccentric TK is helpful in the successful treatment of a variety of severe eye diseases. Patients at young age, with pre-existing inflammatory conditions or corneal TK are at higher risk for anatomical failure as well as clear graft failure and therefore need to be monitored closely.
A data-driven model for early prediction of need for invasive mechanical ventilation in pediatric intensive care unit patients
Authors: Bose Sanjukta N. , Defante Andrew , Greenstein Joseph L. , Haddad Gabriel G. , Ryu Julie , Winslow Raimond L. 
Published: August 2023

Rationale
Acute respiratory failure is a life-threatening clinical outcome in critically ill pediatric patients. In severe cases, patients can require mechanical ventilation (MV) for survival. Early recognition of these patients can potentially help clinicians alter the clinical course and lead to improved outcomes.

Objectives
To build a data-driven model for early prediction of the need for mechanical ventilation in pediatric intensive care unit (PICU) patients.

Methods
The study consists of a single-center retrospective observational study on a cohort of 13,651 PICU patients admitted between 1/01/2010 and 5/15/2018 with a prevalence of 8.06% for MV due to respiratory failure. XGBoost (extreme gradient boosting) and a convolutional neural network (CNN) using medication history were used to develop a prediction model that could yield a time-varying "risk-score"—a continuous probability of whether a patient will receive MV—and an ideal global threshold was calculated from the receiver operating characteristics (ROC) curve. The early prediction point (EPP) was the first time the risk-score surpassed the optimal threshold, and the interval between the EPP and the start of the MV was the early warning period (EWT). Spectral clustering identified patient groups based on risk-score trajectories after EPP.

Results
A clinical and medication history-based model achieved a 0.89 area under the ROC curve (AUROC), 0.6 sensitivity, 0.95 specificity, 0.55 positive predictive value (PPV), and 0.95 negative predictive value (NPV). Early warning time (EWT) median [inter-quartile range] of this model was 9.9[4.2–69.2] hours. Clustering risk-score trajectories within a six-hour window after the early prediction point (EPP) established three patient groups, with the highest risk group’s PPV being 0.92.

Conclusions
This study uses a unique method to extract and apply medication history information, such as time-varying variables, to identify patients who may need mechanical ventilation for respiratory failure and provide an early warning period to avert it.