bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgery-related disseminated intravascular coagulation predicts postoperative complications
Authors: Imaoka Yuki , Ohira Masahiro , Imaoka Kouki , Bekki Tomoaki , Nakano Ryosuke , Kuroda Shintaro , Tahara Hiroyuki , Ide Kentaro , Kobayashi Tsuyoshi , Tanaka Yuka , Ohdan Hideki 
Published: April 2023

Abstract
Purpose
The rate of postoperative morbidity, including infectious complications, is still high after major hepatobiliary pancreatic (HBP) surgery. Although surgery-related disseminated intravascular coagulation (DIC) occurs in some cases, its significance has not been elucidated in HBP surgery. This study aimed to evaluate the influence of surgery-related DIC on the complication severity after HBP surgery.

Methods
We analyzed the records of 100 patients with hepatectomy in two or more segments, hepatectomy with biliary tract reconstruction, and pancreaticoduodenectomy. The baseline characteristics and complications were compared between patients with and without surgery-related DIC on postoperative day 1 (POD1) after HBP surgery between 2010 and 2018. Complication severity was assessed using the Comprehensive Complication Index (CCI).

Results
The DIC group (surgery-related DIC on POD1) had predictive factors, such as larger bleeding volume and higher liver enzyme levels. The DIC group exhibited significantly elevated rates of surgical site infection, sepsis, prolonged intensive care unit stay, more frequent blood transfusions, and higher CCI. Furthermore, compared with and without adjustment of DIC, odds ratio (OR) of AST level and operation time for the risk of high CCI decreased (OR of AST level: 1.25 to 1.19 and OR of operation time: 1.30 to 1.23) and the significant differences had vanished.

Conclusions
Surgery-related DIC on POD1 could be a partial mediator between AST level, operation time and higher CCI. The prevention or proper management of surgery-related DIC on POD1 can be an important target to reduce the severity of postoperative complications.
Predictive factors on postoperative venous thromboembolism after minimally invasive colorectal cancer surgery: a retrospective observational study
Authors: Wu Dabin , Gu Haitao , Tang Yunhao , Peng Linglong , Liu Hang , Jiang Yahui , Xu Zhiquan , Wei Qi , Wang Yaxu 
Published: April 2023

Abstract
Background
Venous thromboembolism (VTE) is a serious and preventable postoperative complication. However, the predictive significance of perioperative biochemical parameters for VTE after minimally invasive colorectal cancer surgery remains unclear.

Methods
A total of 149 patients undergoing minimally invasive colorectal cancer surgery were collected between October 2021 and October 2022. Biochemical parameters related to preoperative and postoperative day 1, day 3, and day 5 were collected, including D-Dimer, mean platelet volume (MPV), and maximum amplitude (MA) of thromboelastography (TEG). Receiver operating characteristic (ROC) curves were used to explore the predictive powers of meaningful biochemical parameters for postoperative VTE, and calibration curves were used to assess predictive accuracy.

Results
The overall cumulative incidence of VTE was 8.1% (12/149). The preoperative and postoperative day 3 D-Dimer, postoperative day 3, and day 5 MPV, and postoperative day 1, day 3, and day 5 TEG-MA was significantly higher in the VTE group than in the non-VTE group (P < 0.05). The results of both the ROC curve and the calibration curve indicated that these meaningful D-Dimer, MPV, and TEG-MA had moderate discrimination and consistency for postoperative VTE.

Conclusions
D-Dimer, MPV, and TEG-MA may predict postoperative VTE in patients undergoing minimally invasive surgery for colorectal cancer at specific times in the perioperative period.
Sexual and reproductive health and gender-based violence among female migrants in Morocco: a cross sectional survey
Authors: Acharai Laila , Khalis Mohamed , Bouaddi Oumnia , Krisht Ghida , Elomrani Sanae , Yahyane Abdelhakim , Assarag Bouchra 
Published: April 2023

Abstract
Background
Over the past decade, Morocco has increasingly become the chosen destination for a growing number of migrants from neighbouring countries and especially from Sub-Saharan Africa. The aim of this study is to describe the sexual and reproductive health (SRH), as well as sexual and gender-based violence (SGBV) among female migrants in Morocco.

Methods
This is a descriptive cross-sectional study conducted between July and December 2021. Female migrants were recruited from one university maternity hospital and two primary healthcare centres in Rabat. Data were collected using a structured face-to-face questionnaire, which included information about sociodemographic characteristics, SRH, history of SGBV and its impact, as well as the utilization of preventive and supportive SGBV services.

Results
A total of 151 participants were included in this study. The majority of participants (60.9%) were aged 18 to 34 years old and 83.3% were single. Many participants (62.1%) did not use contraceptives. More than half (56%) of the participants who were pregnant at the time of the study were receiving pre-natal care. About 29.9% of interviewed participants reported experiencing female genital mutilation, and a significant majority (87.4%) experienced SGBV at least once during their lifetimes, while 76.2% experienced SGBV during migration. The most commonly reported form of violence was verbal abuse (75.8%). Among the victims of SGBV, a minority have visited a health facility (7%) or filed a complaint (9%) in the aftermath of violence.

Conclusion
Overall, our findings showed low contraception coverage, moderate access to prenatal care, high prevalence of SGBV, and low utilization of preventive and supportive SGBV services among migrant women in Morocco. Further studies are needed to understand the contextual barriers to access, and utilization of SRH care and additional efforts should be undertaken to strengthen SGBV prevention and support systems.
Trends and factors associated with HIV testing among women aged 15–49 years in Belize: an analysis using the Multiple Indicator Cluster Survey 2006, 2011, and 2015–2016
Authors: Leonardo Naudia L. , Chien Li-Yin 
Published: April 2023

Abstract
Background
Belize has one of the highest human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome prevalence rates in Central America, with women of reproductive age being particularly vulnerable to HIV. Therefore, this study examined the factors associated with HIV testing among women of reproductive age in Belize and trends in HIV testing in 2006, 2011, and 2015–2016.

Methods
Cross-sectional data were analyzed using three Belize Multiple Indicator Cluster Surveys. The number of participants were 1,675, 4,096, and 4,699 women aged 15–49 years in 2006, 2011, and 2015–2016, respectively. We used variance-weighted least-squares regression to estimate annual changes. Multivariate logistic regression analysis was performed to evaluate the associated factors. Analyses were conducted using Stata version 15, and weights were applied for generalization to the population.

Results
HIV testing rates increased from 47.7% in 2006 to 66.5% in 2015, with an average annual change of 0.082 (95% confidence interval: 0.07–0.09). Logistic regression models showed that women aged 15–24 years were less likely to have been tested for HIV compared to women aged 25–34 years. Women from the Mayan ethnic group were less likely to have been tested than those from other ethnic groups. Compared to women who spoke Spanish, those who spoke English/Creole were more likely to have been tested for HIV; additionally, those who spoke minority languages were less likely to have been tested. Being married and having given birth were associated with increased odds of HIV testing. Living in rural areas and households with the poorest wealth indices were associated with decreased odds of being tested for HIV. Women with good HIV knowledge and accepting attitudes towards people living with HIV were more likely to be tested.

Conclusions
From 2006 to 2015, HIV testing in women of reproductive age showed an increasing trend in Belize. We recommend interventions to expand HIV testing for women of reproductive age in Belize, particularly those aged 15–24 years, speaking minority languages, living in rural areas, and having a low socioeconomic status.
“Value my culture, value me”: a case for culturally relevant mentoring in medical education and academic medicine
Authors: Sotto-Santiago Sylk , Mac Jacqueline , Genao Inginia 
Published: April 2023

Abstract
Introduction
Mentoring programs are one mechanism used to increase diversity and participation of historically underrepresented groups in academic medicine. However, more knowledge is needed about the mentoring experiences and how culturally relevant concepts and perspectives may influence diverse students, trainees, and faculty success. This case study utilized the Culturally Engaging Campus Environments (CECE) model which examines the experiences of students in higher education. We used this model to examine the mentoring experiences of Black and Latine faculty and offer practical implications for the medical education continuum.

Methods
Our research approach is best understood through qualitative inquiry stemming from a single-case study which allowed for in-depth understanding of the contexts informing the phenomenon. Phenomenology is well positioned to contribute to understanding science and health professions. Selection criteria included individuals who self-identified as Black or Latine; inclusive of all faculty ranks and tracks. This analysis focuses on 8 semi-structured interviews, averaging 3 h in length.

Results
Findings centered on the area of cultural relevance, and participant narratives revealed the connection of mentoring with cultural familiarity, culturally relevant knowledge, cultural service and engagement, and cultural validation.

Conclusion
The use of cultural relevance indicators can inform the creation and evolution of mentoring programs towards holistic support of historically underrepresented trainees and faculty. Implications also focus on the development of mentors and championing the incorporation of cultural humility in the mentoring process. The implications in praxis offers the possibility for a new framework for culturally relevant mentoring (CRM). Through this framework we aim to enhance and facilitate inclusive learning environments and career development.
Global Health in Undergraduate Education: Knowledge, Attitude, and Practice of Sudanese Medical Students towards Global Health Education: a cross-sectional study
Authors: Malik Sawazen , Alkoronky Asi , Elmahi Mugahid , Alsafi Safaa , Shehada Fares , Rahma Rawasi , Alam Elhuda Daffalla 
Published: April 2023

Abstract
Introduction
Globalization and other relevant phenomena such as healthcare workforce, ageing of the population, brain drain etc. all necessitate medical curricula to transcend national medicine and encompass a more global approach. This is especially true in the context of developing countries which currently act as passive recipients of ongoing global decisions, health inequities or pandemics. The aim of this research was to study the Knowledge, Attitude, and Practice of Sudanese medical students towards global health education and the impact of extra-curricular activities on their knowledge and attitudes.

Methods
This was a descriptive cross-sectional institutional based study. The study was conducted in five Sudanese Universities and participants were selected using systematic random sampling. An online-based, self-administered questionnaire was used, samples were collected between November 2019 until April 2020 and data was analyzed using SPSS version 25.

Results
1176 medical students were involved. The study revealed a poor level of knowledge among 72.4%, and only 2.3% of respondents revealed a good level of knowledge. Mean knowledge scores between Universities slightly vary and have shown positive correlation according to the grade of the medical student. Regarding attitude, the results demonstrated the high level of interest of medical students in global health, their agreement in including global health in their official medical education curriculum (64.8%) and their consideration of including global health as part of their future career (46.8%).

Conclusion
The study concluded that there is a knowledge gap among Sudanese medical students regarding global health education, although students showed good attitudes and willingness to include global health in their official curriculum.

Recommendations
Global health education should be implemented in the official curriculums of Sudanese Universities, and Universities should do global partnerships and increase the learning and teaching opportunities in this interesting field.
The P2X3 receptor antagonist filapixant in patients with refractory chronic cough: a randomized controlled trial
Authors: Friedrich Christian , Francke Klaus , Birring Surinder S. , van den Berg Jan Willem K. , Marsden Paul A. , McGarvey Lorcan , Turner Alice M. , Wielders Pascal , Gashaw Isabella , Klein Stefan , Morice Alyn H. 
Published: April 2023

AbstractBackgroundP2X3 receptor antagonists seem to have a promising potential for treating patients with refractory chronic cough. In this double-blind, randomized, placebo-controlled study, we investigated the efficacy, safety, and tolerability of the novel selective P2X3 receptor antagonist filapixant (BAY1902607) in patients with refractory chronic cough.MethodsFollowing a crossover design, 23 patients with refractory chronic cough (age: 60.4 ± 9.1 years) received ascending doses of filapixant in one period (20, 80, 150, and 250 mg, twice daily, 4-days-on/3-days-off) and placebo in the other. The primary efficacy endpoint was the 24-h cough frequency on Day 4 of each dosing step. Further, subjective cough severity and health-related quality of life were assessed.ResultsFilapixant at doses ≥ 80 mg significantly reduced cough frequency and severity and improved cough health-related quality of life. Reductions in 24-h cough frequency over placebo ranged from 17% (80 mg dose) to 37% (250 mg dose), reductions over baseline from 23% (80 mg) to 41% (250 mg) (placebo: 6%). Reductions in cough severity ratings on a 100-mm visual analog scale ranged from 8 mm (80 mg) to 21 mm (250 mg). No serious or severe adverse events or adverse events leading to discontinuation of treatment were reported. Taste-related adverse events occurred in 4%, 13%, 43%, and 57% of patients treated with filapixant 20, 80, 150, and 250 mg, respectively, and in 12% treated with placebo.ConclusionsFilapixant proved to be efficacious, safe, and—apart from the occurrence of taste disturbances, especially at higher dosages—well tolerated during the short therapeutic intervention.Clinical trial registrationEudraCT, eudract.ema.europa.eu, 2018-000129-29; ClinicalTrials.gov, NCT03535168
Development of an antibody-ligand fusion protein scFvCD16A-sc4-1BBL in Komagataella phaffii with stimulatory activity for Natural Killer cells
Authors: Li Yangyang , Xie Siqi , Chen Minhua , Li Hao , Wang Yehai , Fan Yan , An Kang , Wu Yu , Xiao Weihua 
Published: April 2023

Abstract
Background
Natural killer (NK) cell-based immunotherapies have demonstrated substantial potential for the treatment of hematologic malignancies. However, its application is limited due to the difficulty in the production of a large number of NK cells in vitro and the insufficient therapeutic efficacy against solid tumors in vivo. Engineered antibodies or fusion proteins targeting activating receptors and costimulatory molecules of NK cells have been developed to encounter these problems. They are mostly produced in mammalian cells with high cost and long processing times. Yeast systems, such as Komagataella phaffii, present a convenient manipulation of microbial systems with the key advantages of improved folding machinery and low cost.

Results
In this study, we designed an antibody fusion protein scFvCD16A-sc4-1BBL, composed of the single chain variant fragment (scFv) of anti-CD16A antibody and the three extracellular domains (ECDs) of human 4-1BBL in a single-chain format (sc) with the GS linker, aiming to boost NK cell proliferation and activation. This protein complex was produced in the K. phaffii X33 system and purified by affinity chromatography and size exclusion chromatography. The scFvCD16A-sc4-1BBL complex showed comparable binding abilities to its two targets human CD16A and 4-1BB as its two parental moieties (scFvCD16A and monomer ECD (mn)4-1BBL). scFvCD16A-sc4-1BBL specifically stimulated the expansion of peripheral blood mononuclear cell (PBMC)-derived NK cells in vitro. Furthermore, in the ovarian cancer xenograft mouse model, adoptive NK cell infusion combined with intraperitoneal (i.p) injection of scFvCD16A-sc4-1BBL further reduced the tumor burden and prolonged the survival time of mice.

Conclusion
Our studies demonstrate the feasibility of the expression of the antibody fusion protein scFvCD16A-sc4-1BBL in K. phaffii with favourable properties. scFvCD16A-sc4-1BBL stimulates PBMC-derived NK cell expansion in vitro and improves the antitumor activity of adoptively transferred NK cells in a murine model of ovarian cancer and may serve as a synergistic drug for NK immunotherapy in future research and applications.
MiR-3180 inhibits hepatocellular carcinoma growth and metastasis by targeting lipid synthesis and uptake
Authors: Hong Jie , Liu Jie , Zhang Yanan , Ding Lihua , Ye Qinong 
Published: April 2023

Abstract
Purpose
Reprogrammed lipid metabolism is a hallmark of cancer that provides energy, materials, and signaling molecules for rapid cancer cell growth. Cancer cells acquire fatty acids primarily through de novo synthesis and uptake. Targeting altered lipid metabolic pathways is a promising anticancer strategy. However, their regulators have not been fully investigated, especially those targeting both synthesis and uptake.

Methods
Immunohistochemistry was performed on samples from patients with hepatocellular carcinoma (HCC) to establish the correlation between miR-3180, stearoyl-CoA desaturase-1 (SCD1), and CD36 expression, quantified via qRT-PCR and western blotting. The correlation was analyzed using a luciferase reporter assay. Cell proliferation, migration, and invasion were analyzed using CCK-8, wound healing, and transwell assays, respectively. Oil Red O staining and flow cytometry were used to detect lipids. Triglycerides and cholesterol levels were analyzed using a reagent test kit. CY3-labeled oleic acid transport was analyzed using an oleic acid transport assay. Tumor growth and metastasis were detected in vivo in a xenograft mouse model.

Results
MiR-3180 suppressed de novo fatty acid synthesis and uptake by targeting the key lipid synthesis enzyme SCD1 and key lipid transporter CD36. MiR-3180 suppressed HCC cell proliferation, migration, and invasion in an SCD1- and CD36-dependent manner in vitro. The mouse model demonstrated that miR-3180 inhibits HCC tumor growth and metastasis by inhibiting SCD1- and CD36-mediated de novo fatty acid synthesis and uptake. MiR-3180 expression was downregulated in HCC tissues and negatively correlated with SCD1 and CD36 levels. Patients with high miR-3180 levels showed better prognosis than those with low levels.

Conclusions
Our investigation indicates that miR-3180 is a critical regulator involved in de novo fatty acid synthesis and uptake, which inhibits HCC tumor growth and metastasis by suppressing SCD1 and CD36. Therefore, miR-3180 is a novel therapeutic target and prognostic indicator for patients with HCC.
A rare metastatic mesenteric malignant PEComa with TSC2 mutation treated with palliative surgical resection and nab-sirolimus: a case report
Authors: Meredith Luke , Chao Timothy , Nevler Avinoam , Basu Mallick Atrayee , Singla Rajan K. , McCue Peter A. , Bowne Wilbur B. , Jiang Wei 
Published: April 2023

Abstract
Background
Malignant perivascular epithelioid cell tumors (PEComas) are exceedingly rare malignant mesenchymal neoplasms with characteristic morphological and immunohistochemical (IHC) patterns. However, some malignant PEComas are poorly differentiated with atypical histopathological features, making a definitive diagnosis difficult. PEComas are most commonly found in females and often show either TSC1 or TSC2 alterations, which result in the activation of the mTOR pathway, or TFE3 fusions. Given these molecular characteristics, mTOR inhibitors have recently been approved by the FDA in the treatment of malignant PEComas, particularly in those with TSC1/2 alterations. Therefore, molecular analyses may be helpful for both the diagnostic workup of and predicting response to mTOR inhibitors in cases of malignant PEComas.

Case presentation
Here, we report a case of an aggressive, 23 cm mesenteric malignant PEComa with multiple peritoneal metastases in a young male patient. Pathological examination of the initial biopsy showed a malignant epithelioid neoplasm with high-grade morphology and atypical immunoprofile, which precluded a definitive diagnosis. Because of the patient’s excessive transfusion requirements due to intra-tumoral hemorrhage, a palliative R2 resection was performed. Histopathological examination of the tumor revealed focal immunoreactivity for Melan-A, HMB-45, desmin, and CD117. Although a diagnosis of malignant PEComa was favored, other entities such as epithelioid gastrointestinal stromal tumor (GIST) or melanoma could not be definitively ruled out. Given the favored diagnosis, the patient was started on sirolimus, an mTOR inhibitor, rather than chemotherapy. Molecular analyses were performed and the tumor was found to harbor mutations in TP53 and TSC2, supporting a definitive diagnosis of malignant PEComa. The patient was then switched to nab-sirolimus, with initial stabilization of the disease.

Conclusions
This report details a multidisciplinary approach for the diagnosis and management of a highly aggressive, metastatic malignant PEComa in a young male patient. The basis for the treatment of malignant PEComas with the recently FDA-approved mTOR inhibitor, nab-sirolimus, is also reviewed. In summary, this case highlights the importance of molecular analysis, particularly TSC1/2 alterations, for both the definitive diagnosis of malignant PEComas and predicting their response to nab-sirolimus.