bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical significance of peripheral blood and tumor tissue lymphocyte subsets in cervical cancer patients
Authors: Wu Yutuan , Ye Shuang , Goswami Shyamal , Pei Xuan , Xiang Libing , Zhang Xiaoming , Yang Huijuan 
Published: March 2020

Abstract
Background
Alterations in peripheral blood lymphocytes in cervical cancer have been reported, although conflicting views exist. The present study investigated the distributions of lymphocyte subsets in tumor tissue and peripheral blood samples from cervical cancer patients and precancerous lesion patients, and evaluated the correlations of lymphocyte subsets with clinicopathological and prognostic variables.

Methods
A total of 44 patients with stage IB1-IIA2 cervical cancer and 13 precancerous lesion patients were included. Lymphocytes were collected from the tumor tissue and the peripheral blood, and isolated by Lymphoprep density gradient centrifugation. The percentages of lymphocyte subsets were quantified by flow cytometry analysis, and the differences between lymphocyte subsets in the tumor tissue and peripheral blood were compared by SPSS. In addition, the relationships between lymphocyte subsets and clinicopathological and prognostic variables were analyzed.

Results
Our results revealed that the amount of total T lymphocytes, CD8+ T cells, granulocytes, pDCs, CD16+ monocytes and CD56high NK cells were significantly higher in the tumor tissue than in the peripheral blood in the cervical cancer patients, while those of CD4+ T cells, CD4+/CD8+ cell ratio, rdT cells, BDCA1+ mDCs, total monocytes, CD14+ monocytes, NK cells and CD56low NK cells exhibited the opposite trend (p < 0.05). The levels of total pDCs and BDCA1+ mDCs in the peripheral blood were significantly lower in the cervical cancer patients than in the precancerous lesion patients, while the proportion of CD16+ monocytes was elevated (p < 0.05). In addition, some lymphocyte subsets, especially CD4+ cells and CD8+ cells, and the CD4+/CD8+ cell ratio were closely associated with clinicopathological and prognostic parameters.

Conclusions
These results suggested that distinct alterations in infiltrating lymphocyte subsets occurred in the tumor and were associated with clinicopathological and prognostic parameters. Systemic impairment of the immune system may occur in the antitumor response of cervical cancer patients.
Prognostic value of tumor-infiltrating lymphocytes in patients with triple-negative breast cancer: a systematic review and meta-analysis
Authors: Gao Guoxuan , Wang Zihan , Qu Xiang , Zhang Zhongtao 
Published: March 2020

Abstract
Background
The objective of this systematic review and meta-analysis was to determine the prognostic value of total tumor-infiltrating lymphocytes (TILs) and subtypes of TILs (CD4+, CD8+, and FOXP3+) in triple-negative breast cancer (TNBC).

Methods
A systematic search of the MEDLINE, EMBASE, and Web of Science databases was conducted to identified eligible articles published before August 2019. Study screening, data extraction, and risk of bias assessment were performed by two independent reviewers. Risk of bias on the study level was assessed using the ROBINS I tool and Quality in Prognosis Studies (QUIPS) tool. We performed a meta-analysis to obtain a pooled estimate of the prognostic role of TILs using Review Manager 5.3.

Results
In total, 37 studies were included in the final analysis. Compared to TNBC patients with low TIL levels, TNBC patients with high TIL levels showed a higher rate of pathological complete response (pCR) to treatment (odds ratio [OR] 2.14, 95% confidence interval [CI] 1.43–3.19). With each 10% increase in percentage of TILs, patients with TNBC had an increased pCR (OR 1.09, 95% CI 1.02–1.16). Compared to TNBC patients with low TIL levels, patients with high TIL levels had better overall survival (OS; hazard ratio [HR] 0.58, 95% CI 0.48–0.71) and disease-free survival (DFS; HR 0.66, 95% CI 0.57–0.76). Additionally, with a continuous increase in TIL levels, patients with TNBC had improved OS (HR 0.90, 95% CI 0.87–0.93) and DFS (HR 0.92, 95% CI 0.90–0.95). A high CD4+ TIL level was associated with better OS (HR 0.49, 95% CI 0.32–0.76) and DFS (HR 0.54, 95% CI 0.36–0.80). A high CD8+ TIL level was associated better DFS only (HR 0.55, 95% CI 0.38–0.81), as no statistical association was found with OS (HR 0.70, 95% CI 0.46–1.06). A high FOXP3+ TIL level also was associated with only DFS (HR 0.50, 95% CI 0.33–0.75) and not OS (HR 1.28, 95% CI 0.24–6.88).

Conclusions
TNBC with a high level of TILs showed better short-term and long-term prognoses. High levels of specific phenotypes of TILs (CD4+, CD8+, and FOXP3+) were predictive of a positive long-term prognosis for TNBC.
Efficacy of bevacizumab combined with chemotherapy in the treatment of HER2-negative metastatic breast cancer: a network meta-analysis
Authors: Sun Zhengwu , Lan Xiaoyan , Xu Shizhao , Li Shen , Xi Yalin 
Published: March 2020

Abstract
Background
It is not known what combination of bevacizumab and chemotherapy agents is the best therapeutic regimen. Comparative study results among the efficacies of bevacizumab plus chemotherapy remain controversial in patients with HER2-negative metastatic breast cancer.

Methods
We searched Pubmed, Embase, and Cochrane Library Central Resister of Controlled Trials through were July 2019 for randomized controlled trials that evaluated the efficacy of bevacizumab plus chemotherapy in HER2-negative metastatic breast cancer. Data on included study characteristics, outcomes, and risk of bias were abstracted by two reviewers.

Results
A total of 16 RCT studies involving 5689 patients were included. The results showed that bevacizumab (Bev) - taxanes (Tax) - capecitabine (Cap) has highest-ranking and is probably more effective for prolonging progression-free survival (PFS) than Tax, Cap, Bev-Tax and Bev-Cap, which was no convincing differences among Bev-Cap-vinorelbine, Bev-Tax-everolimus, Bev-Tax-trebananib, Bev-exemestane, Bev-Cap-cyclophosphamide in Bev-containing regimens. For overall response rate (ORR), Bev-Tax-Cap is superior to Tax, Cap and Bev-Cap, while Bev-Tax-trebananib is superior to Cap. The cumulative probability ranking showed that Bev-Tax-Cap or Bev-Tax-trebananib may have best pathological response rate in HER2-negative metastatic breast cancer.

Conclusion
Our results provide moderate quality evidence that bevacizumab-taxanes-capecitabine maybe the most effective bevacizumab plus chemotherapy on PFS and ORR in HER2-negative metastatic breast cancer, however it should be also considered that bevacizumab may add toxicity to chemotherapy and whether improve overall survival (OS) or not.
Lymph node metastasis in young and middle-aged papillary thyroid carcinoma patients: a SEER-based cohort study
Authors: Liu Yuanchao , Wang Yizeng , Zhao Ke , Li Dongyang , Chen Zuoyu , Jiang Ruoyu , Wang Xiaoning , He Xianghui 
Published: March 2020

Abstract
Background
Lymph node metastasis (LNM) occurs frequently in young papillary thyroid carcinoma (PTC) patients, though the mortality rates are low. We aimed to analyze the relationship between age at diagnosis and LNM in PTC at a population level to elucidate the clinical behavior of PTC.

Methods
Data of adult patients with surgically treated PTC and follicular thyroid carcinoma (FTC) were identified from the Surveillance, Epidemiology, and End Results (SEER) database (2004–2015) to investigate the relationship between age and clinical characteristics by curve estimation. The adjusted odds ratio of age and LNM rate were determined.

Results
A total of 50,347 PTC (48,166) and FTC (2181) (median age: 45 and 50 years, respectively) patients met the inclusion criteria; 44.5% of those with PTC (21,428) had LNM. Rank-sum test analysis indicated differences in distribution of age in LNM-positive and LNM-negative PTC. The relationship between age, tumor size and LNM showed a quadratic curve in PTC. The mean tumor diameter and LNM rate correlated linearly with age in 18–59-year-old patients. LNM rate decreased with age (R2 = 0.932, P < .0001), especially women (R2 = 0.951, P < .0001).

Conclusion
In young and middle-aged PTC patients, LNM may resolve spontaneously with delayed diagnosis and management. Active surveillance of low-risk PTC is justified.
Serum miRNAs, a potential prognosis marker of loco-regionally advanced nasopharyngeal carcinoma patients treated with CCRT
Authors: Zhang Zhimin , Huang Jiangbiao , Wang Ge , Jin Feng , Zheng Jijun , Xiao He , Lei Lin , Luo Jia , Chen Chuan 
Published: March 2020

AbstractBackgroundSerum miRNA was once found as potential disease survival index,thus we investigated the role of miRNA in predicting prognosis in loco-regionally advanced NPC patients treated with CCRT.MethodsThis study included two phases: (i) We enrolled 3 NPC patients with recurrence or distant metastasis (experimental group, EG) and 3 NPC patients in clinical remission (control group, CG),who were treated with CCRT within 5 years. The paired serum was collected before and after treatment and biomarkers were discovered by LNA-TaqMan Human MicroRNA Arrays. (ii) we used the bioinformatic analysis, marker selection and an independent validation by qRT-PCR to analyse the serums of 29 NPC patients with recurrent disease or distant metastasis and 19 NPC patients in clinical remission treated with CCRT. Using the Kaplan-Meier method, log-rank test and Cox regression model to estimate the accuracy of the miRNAs to predict PFS and OS, and identified factors significantly associated with prognosis, respectively.ResultsUsing fold change≥2.0 or ≤ 0.5 andp ≤ 0.05 as cutoff levels, we identified 1 up-regulated and 6 down-regulated miRNAs, 1 up-regulated and 9 down-regulated miRNAs in EG versus CG before and after CCRT, respectively. After these down-regulated miRNAs were dealed with bioinformatics analysis and normalization, only 5 different miRNAs were significantly reduced, which there were no significant difference in the expression of miRNA-26b, miRNA-29a and miRNA-125b before CCRT, and the expression of miRNA-143 and miRNA-29b after CCRT in the serum samples of 48 NPC patients. Based on this, we calculated a risk score with the expression of miRNA-26b、miRNA-29a、miRNA-125b、miRNA-29b、miRNA-143 and then classified patients as high or low risk group. Cox regression model suggested that combining miRNA-29a and miRNA-125b before CCRT with miRNA-26b after CCRT was independent prognostic factors for PFS (HR = 3.149, 95%CI:1.018–9.115,p = 0.034), whereas combining the former two is independent for OS (HR = 5.146, 95%CI:1.674–15.817,p = 0.04).ConclusionsFor loco-regionally advanced NPC patients treated with CCRT, especially high-risk patients- serum miRNAs, such as miRNA-29a, miRNA-125b and miRNA-26b etc., play an important role in predicting prognosis factors of PFS and OS, which will contribute to the strategic direction for future research.
Evaluation of tear film and the morphological changes of meibomian glands in young Asian soft contact lens wearers and non-wearers
Authors: Gu Tianpu , Zhao Lu , Liu Zhuzhu , Zhao Shaozhen , Nian Hong , Wei Ruihua 
Published: March 2020

Abstract
Background
The aim of this study was to explore the differences in terms of tear film and meibomian glands (MGs) between young Asian soft contact lens (CL) wearers and non-wearers.

Methods
A prospective, cross-sectional observational study was conducted using 148 subjects (63 non-wearers, and 85 soft CL wearers who had been wearing CLs for more than 1 year) recruited from a clinic in Tianjin, China. All subjects first responded to an Ocular Surface Disease Index (OSDI) questionnaire and then underwent a standardized dry eye examination, which included measuring tear meniscus height (TMH), non-invasive tear breakup time (NIBUT), and corneal fluorescein staining (CFS). The MGs were evaluated via ImageJ, distorted MG count and the MG dropout were recorded.

Results
Compared to the control group (non-wearers), the CL group recorded higher OSDI and CFS scores, lower TMH and NITBUT values, a larger distorted MG count, and larger MG dropout (all P < 0.05). Pearson correlation analysis found a correlation between MG dropout and the duration of CL use (r = 0.440, P < 0.001), OSDI (r = 0.298, P = 0.006), and CFS scores (r = 0.442, P < 0.001).

Conclusion
CL wearers showed higher MG dropout and reduced TMH and NITBUT, which likely contributes to severe CL-related dry eye symptoms. CL use may lead to a higher MG dropout rate, and the extent of the MG dropout presumably influences the tear film status in CL wearers.
Are countries’ self-reported assessments of their capacity for infectious disease control reliable? Associations among countries’ self-reported international health regulation 2005 capacity assessments and infectious disease control outcomes
Authors: Tsai Feng-Jen , Tipayamongkholgul Mathuros 
Published: March 2020

Abstract
Background
This study aimed to evaluate associations among countries’ self-reported International Health Regulation 2005 (IHR 2005) capacity assessments and infectious disease control outcomes.

Methods
Countries’ self-reported assessments implemented by percentages as IHR Monitoring Tools (IHRMT) in 2016 and 2017 were used to represent national capacity regarding infectious disease control. WHO Disease Outbreak News and matched diseases reports on ProMED-mail were collected in 2016 to represent disease control outcomes of countries. Disease control outcomes were divided in good, normal and bad groups based on the development of outbreaks listed in the reports. The Human Development Index (HDI), density of physicians and nurses, health expenditure, number of arrivals of international tourists were also collected for control. Chi-square test and logistic regression were applied for analysis.

Results
A total of 907 cases occurred in 92 countries. For all diseases, cases occurring in high international travel volume countries presented twice the risk of having a bad disease control outcomes than cases occurring in low international travel volume countries (OR = 2.19 for IHR 2016, OR = 2.97 for IHR 2017). Cases occurring in low IHR average score countries had significant higher risk (OR = 7.83 for IHR 2016 and OR = 2.23 for IHR 2017) of having a bad disease control outcomes than countries with high IHR average scores. For only human diseases, cases occurring in high international travel volume countries presented twice the risk of having a bad disease control outcomes than cases occurring in low international travel volume countries for IHR 2017 (OR = 2.79). Cases occurring in low IHR average score countries had significant higher risk (OR = 11.16 for IHR 2016 and OR = 3.45 for IHR 2017) of having a bad disease control outcomes than countries with high IHR average scores. The HDI, health workforce density and total health expenditure were all positively associated with disease control outcomes.

Conclusions
Countries’ self-reported infectious disease control capacities positively correlated with their disease control outcomes. While the self-reported IHR scores were accountable to some degree, this approach was useful for understanding global capacity in infectious disease control and in allocating resources for future preparedness.
Lung transplant referral practice patterns: a survey of cystic fibrosis physicians and general pulmonologists
Authors: Bartley Bethany L. , Schwartz Carolyn E. , Stark Roland B. , Georgiopoulos Anna M. , Friedman Deborah , Richards Christopher J. , Dorkin Henry L. , Kinane T. Bernard , Neuringer Isabel P. , Yonker Lael M. 
Published: March 2020

Abstract
Background
Many individuals with cystic fibrosis (CF) die from respiratory failure without referral for lung transplant. Physician practices that may expedite, delay, or preclude referral, are poorly understood.

Methods
Two parallel, web-based surveys focusing on lung transplant referral triggers and barriers, as well as pre-referral evaluation, were emailed to pulmonologists practicing in the New England region. One questionnaire was sent to CF providers (n = 61), and the second to general pulmonary providers practicing at the same institutions (n = 61).

Results
There were 43 (70%) responses to the CF provider survey, and 25 (41%) responses to the general pulmonary (‘non-CF’) provider survey. Primary reasons for CF providers to refer their patients included: rapidly declining lung function (91%) and a forced expiratory volume in 1 s (FEV1) below 30% predicted (74%). The greatest barriers to referral for both CF and non-CF providers included active tobacco use (65 and 96%, respectively, would not refer), and active alcohol or other substance use or dependence (63 and 80%). Furthermore, up to 42% of CF providers would potentially delay their referral if triple-combination therapy or other promising new, disease-specific therapy were anticipated. In general, non-CF providers perform a more robust pre-referral medical work-up, while CF providers complete a psychosocial evaluation in higher numbers. Across both groups, communication with lung transplant programs was reported to be inadequate.

Conclusions
Physician-level barriers to timely lung transplant referral exist and need to be addressed. Enhanced communication between lung transplant programs and pulmonary providers may reduce these barriers.
Treatment of distal clavicle fractures using a Scorpion plate and influence of timing on surgical outcomes: a retrospective cohort study of 105 cases
Authors: Furuhata Ryogo , Takahashi Masaaki , Hayashi Teppei , Inagawa Miyu , Kono Aki , Matsumura Noboru , Kamata Yusaku , Arino Hiroshi , Morioka Hideo 
Published: March 2020

Abstract
Background
Plate fixation is an established method for treating unstable distal clavicle fractures. However, the appropriate timing of surgery for acute distal clavicle fractures remains unclear. The present study aimed to evaluate the clinical outcomes of osteosynthesis using a Scorpion plate and to assess the influence of surgery timing on the surgical outcomes for acute unstable distal clavicle fractures.

Methods
We retrospectively reviewed 105 patients who underwent fixation for acute unstable distal clavicle fractures (Neer type II and V) using the Scorpion plate between 2008 and 2018. Patients were divided into early (45 patients) and delayed (60 patients) treatment groups based on the timing of the surgical intervention (within or after 7 days). The outcomes were postoperative complications (nonunion, peri-implant fracture, plate loosening, plate-related pain, and stiffness). We evaluated the outcomes from X-ray radiographs and clinical notes.

Results
Among the 105 patients, nonunion, plate loosening, plate-related pain, and stiffness were observed in six patients (5.7%), four patients (3.8%), seven patients (6.7%), and one patient (1.0%), respectively. The nonunion rate was significantly higher in the delayed treatment group than that in the early treatment group (P = 0.036). Although the difference was not significant, plate loosening and stiffness were only observed in the delayed treatment group.

Conclusion
Our results demonstrated that osteosynthesis using Scorpion plates achieved satisfactory surgical outcomes for unstable distal clavicle fractures. In addition, this study suggested that performing surgery within 6 days after injury is recommended to reduce postoperative complications.
Early open reduction of dislocated hips using a modified Smith-Petersen approach in arthrogyposis multiplex congenita
Authors: Miao Mingyuan , Cai Haiqing , Wang Zhigang , Hu Liwei , Bian Jingxia , Cai Haoqi 
Published: March 2020

Abstract
Background
Arthrogryposis multiplex congenita (AMC) is a rare syndrome with multiple joint contractures. Within the medical community, there is controversy surrounding AMC in terms of the ideal surgical approach and age for performing a reduction of dislocated hips. The purpose of this retrospective study was to evaluate the clinical outcomes of early open reduction of infant hip dislocation with arthrogryposis multiplex congenita following a modified Smith-Petersen approach that preserves the rectus femoris.

Methods
From 2010 to 2017, we performed this procedure on 28 dislocated hips in 20 infants under 12 months of age with AMC. The clinical and radiology data were reviewed retrospectively. The mean age at surgery was 6.9 ± 5.1 months, with a mean follow-up of 42.4 ± 41.1 months.

Results
After open reduction, the average hip acetabular index (AI), the international hip dysplasia institute classification (IHDI), and the hip range of motion significantly improved (all P < 0.001). After the surgery, 16 patients were community walkers, and four patients were home walkers. Three hips in two patients required secondary revision surgery for residual acetabular dysplasia with combined pelvic osteotomy and femoral osteotomy. Seven of the hips that had been operated on showed signs of avascular necrosis (AVN). Among them, four were degree II, two were degree III, and one was degree IV. Multiple linear regression analysis demonstrated that greater age (in months) heightened the risk for secondary revision surgery (P = 0.032).

Conclusions
The modified Smith-Petersen approach preserving the rectus femoris is an encouraging and safe option for treating hip dislocation in young AMC patients (before 12 months). If surgery takes place at less than 12 months of age for patients with AMC, this earlier open reduction for hip dislocation may reduce the chances of secondary revision surgery.

Level of evidence
IV, retrospective non-randomized study.
Social ties influence teamwork when managing clinical emergencies
Authors: Rasmussen Maria B. , Tolsgaard Martin G. , Dieckmann Peter , Østergaard Doris , White Jonathan , Plenge Pernille , Ringsted Charlotte V. 
Published: March 2020

Abstract
Background
Our current understanding of medical team competence is traditionally influenced by an individualistic perspective focusing on individual team members’ knowledge, skills as well as on effective communication within the team. However, team dynamics may influence team performance more than previously anticipated. In particular, recent studies in other academic disciplines suggest that social ties between team members may impact team dynamics but this has not been explored for medical teams. We aimed to explore intensive care staff’s perceptions about teamwork and performance in clinical emergencies focusing particularly on the teams’ social ties.

Methods
Semi-structured interviews were conducted with a purposive sample of intensive care staff. We used a thematic analysis approach to data interpretation.

Results
Thematic saturation was achieved after three group interviews and eight individual interviews. Findings demonstrated that social ties influenced teamwork by affecting the teams’ ability to co-construct knowledge, coordinate tasks, the need for hierarchy, the degree to which they relied on explicit or implicit communication, as well as their ability to promote adaptive behavior.

Conclusions
Social ties may be an important factor to consider and acknowledge in the design of future team training, as well as for work planning and scheduling of team activities during clinical practice. More research is needed into the causal effect of social ties on team performance and outcome.