bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a Nomogram Combining Clinical Risk Factors and Dual-Energy Spectral CT Parameters for the Preoperative Prediction of Lymph Node Metastasis in Patients With Colorectal Cancer
Authors: Cao Yuntai , Zhang Jing , Bao Haihua , Zhang Guojin , Yan Xiaohong , Wang Zhan , Ren Jialiang , Chai Yanjun , Zhao Zhiyong , Zhou Junlin 
Published: October 2021

ObjectiveThis study aimed to develop a dual-energy spectral computed tomography (DESCT) nomogram that incorporated both clinical factors and DESCT parameters for individual preoperative prediction of lymph node metastasis (LNM) in patients with colorectal cancer (CRC).Material and MethodsWe retrospectively reviewed 167 pathologically confirmed patients with CRC who underwent enhanced DESCT preoperatively, and these patients were categorized into training (n = 117) and validation cohorts (n = 50). The monochromatic CT value, iodine concentration value (IC), and effective atomic number (Eff-Z) of the primary tumors were measured independently in the arterial phase (AP) and venous phase (VP) by two radiologists. DESCT parameters together with clinical factors were input into the prediction model for predicting LNM in patients with CRC. Logistic regression analyses were performed to screen for significant predictors of LNM, and these predictors were presented as an easy-to-use nomogram. The receiver operating characteristic curve and decision curve analysis (DCA) were used to evaluate the clinical usefulness of the nomogram.ResultsThe logistic regression analysis showed that carcinoembryonic antigen, carbohydrate antigen 199, pericolorectal fat invasion, ICAP, ICVP, and Eff-ZVP were independent predictors in the predictive model. Based on these predictors, a quantitative nomogram was developed to predict individual LNM probability. The area under the curve (AUC) values of the nomogram were 0.876 in the training cohort and 0.852 in the validation cohort, respectively. DCA showed that our nomogram has outstanding clinical utility.ConclusionsThis study presents a clinical nomogram that incorporates clinical factors and DESCT parameters and can potentially be used as a clinical tool for individual preoperative prediction of LNM in patients with CRC.
MR-Linac Radiotherapy – The Beam Angle Selection Problem
Authors: Bijman Rik , Rossi Linda , Janssen Tomas , de Ruiter Peter , van Triest Baukelien , Breedveld Sebastiaan , Sonke Jan-Jakob , Heijmen Ben 
Published: October 2021

BackgroundWith the large-scale introduction of volumetric modulated arc therapy (VMAT), selection of optimal beam angles for coplanar static-beam IMRT has increasingly become obsolete. Due to unavailability of VMAT in current MR-linacs, the problem has re-gained importance. An application for automated IMRT treatment planning with integrated, patient-specific computer-optimization of beam angles (BAO) was used to systematically investigate computer-aided generation of beam angle class solutions (CS) for replacement of computationally expensive patient-specific BAO. Rectal cancer was used as a model case.Materials and Methods23 patients treated at a Unity MR-linac were included. BAOx plans (x=7-12 beams) were generated for all patients. Analyses of BAO12 plans resulted in CSx class solutions. BAOx plans, CSx plans, and plans with equi-angular setups (EQUIx, x=9-56) were mutually compared.ResultsFor x&gt;7, plan quality for CSx and BAOx was highly similar, while both were superior to EQUIx. E.g. with CS9, bowel/bladder Dmean reduced by 22% [11%, 38%] compared to EQUI9 (p&lt;0.001). For equal plan quality, the number of EQUI beams had to be doubled compared to BAO and CS.ConclusionsComputer-generated beam angle CS could replace individualized BAO without loss in plan quality, while reducing planning complexity and calculation times, and resulting in a simpler clinical workflow. CS and BAO largely outperformed equi-angular treatment. With the developed CS, time consuming beam angle re-optimization in daily adaptive MR-linac treatment could be avoided. Further systematic research on computerized development of beam angle class solutions for MR-linac treatment planning is warranted.
Subphrenic Lymph Node Metastasis Predicts Poorer Prognosis for Nasopharyngeal Carcinoma Patients With Metachronous Metastasis
Authors: Zhang Xue-Fang , Zhang Yan , Liang Xu-Wei , Chen Jia-Luo , Zhi Sheng-Fang , Yin Wen-Jing , Wang Meng-Yao , Dong En-Lai , Chen Dong-Ping 
Published: October 2021

AimWe retrospectively analyzed the distribution of distant lymph node metastasis and its impact on prognosis in patients with metastatic NPC after treatment.MethodsFrom 2010 to 2016, 219 NPC patients out of 1,601 (182 from the Affiliated Cancer Hospital and Institute of Guangzhou Medical University, and 37 from the Affiliated Dongguan Hospital, Southern Medical University) developed distant metastasis after primary radiation therapy. Metastatic lesions were divided into groups according to location: bones above the diaphragm (supraphrenic bone, SUP-B); bones below the diaphragm (subphrenic bone, SUB-B); distant lymph nodes above the diaphragm (supraphrenic distant lymph nodes, SUP-DLN); distant lymph nodes below the diaphragm (subphrenic distant lymph nodes, SUB-DLN), liver, lung, and other lesions beyond bone/lung/distant lymph node above the diaphragm (supraphrenic other lesions, SUP-OL); other lesions beyond bone/liver/distant lymph node below the diaphragm (subphrenic other lesions, SUB-OL); the subtotal above the diaphragm (supraphrenic total lesions, SUP-TL); and the subtotal below the diaphragm (subphrenic total lesions, SUB-TL). Kaplan–Meier methods were used to estimate the probability of patients’ overall survival (OS). Univariate and multivariate analyses were applied using the Cox proportional hazard model to explore prediction factors of OS.ResultsThe most frequent metastatic locations were bone (45.2%), lung (40.6%), liver (32.0%), and distant lymph nodes (20.1%). The total number of distant lymph node metastasis was 44, of which 22 (10.0%) were above the diaphragm, 18 (8.2%) were below the diaphragm, and 4 (1.8%) were both above and below the diaphragm. Age (HR: 1.02, 95% CI: 1.00, 1.03, p = 0.012), N stage (HR: 1.26, 95% CI: 1.04, 1.54, p = 0.019), number of metastatic locations (HR: 1.39, 95% CI: 1.12, 1.73, p = 0.003), bone (HR: 1.65, 95% CI: 1.20, 2.25, p = 0.002), SUB-B (HR: 1.51, 95% CI: 1.07, 2.12, p = 0.019), SUB-DLN (HR: 1.72, 95% CI: 1.03, 2.86, p = 0.038), and SUB-O L(HR: 4.46, 95% CI: 1.39, 14.3, p = 0.012) were associated with OS. Multivariate analyses revealed that a higher N stage (HR: 1.23, 95% CI: 1.00, 1.50, p = 0.048), SUB-DLN (HR: 1.72, 95% CI: 1.02, 2.90, p = 0.043), and SUB-OL (HR: 3.72, 95% CI: 1.14, 12.16, p = 0.029) were associated with worse OS.ConclusionSubphrenic lymph node metastasis predicts poorer prognosis for NPC patients with metachronous metastasis; however, this needs validation by large prospective studies.
Diagnostic Performance of FDG-PET/CT Scan as Compared to US-Guided FNA in Prediction of Axillary Lymph Node Involvement in Breast Cancer Patients
Authors: Assi Hazem I. , Alameh Ibrahim A. , Khoury Jessica , Bou Zerdan Maroun , Akiki Vanessa , Charafeddine Maya , El Saheb Ghida I. , Sukhon Fares , Sbaity Eman , Baydoun Serine , Shabb Nina , Berjawi Ghina , Haidar Mohamad B. 
Published: October 2021

PurposeThe aim of this study was to evaluate the diagnostic ability of 2-deoxy-2-[fluorine-18]fluoro-d-glucose (18F-FDG) PET/non-contrast CT compared with those of ultrasound (US)-guided fine needle aspiration (FNA) for axillary lymph node (ALN) staging in breast cancer patients.Patients and MethodsPreoperative 18F-FDG PET/non-contrast CT was performed in 268 women with breast cancer, as well as ALN dissection or sentinel lymph node (SLN) biopsy. One hundred sixty-four patients underwent US-guided FNA in combination with 18F-FDG PET/CT. The diagnostic performance of each modality was evaluated using histopathologic assessments as the reference standard. The receiver operating characteristic (ROC) curves were compared to evaluate the diagnostic ability of several imaging modalities.ResultsAxillary 18F-FDG uptake was positive in 180 patients, and 125 patients had axillary metastases according to the final pathology obtained by ALN dissection and/or SLN dissection. Of the patients with positive 18F-FDG uptake in the axilla, 21% had false-positive results, whereas 79% were truly positive. Eighty-eight patients had negative 18F-FDG uptake in the axilla, among which 25% were false-negative. 18F-FDG-PET/CT had a sensitivity of 86.59% and a specificity of 63.46% in the assessment of ALN metastasis; on the other hand, US-guided FNA had a sensitivity of 91.67% and a specificity of 87.50%. The mean primary cancer size (p = 0.04) and tumor grade (p = 0.04) in combination were the only factors associated with the accuracy of 18F-FDG PET/CT for detecting metastatic ALNs.ConclusionThe diagnostic performance of 18F-FDG PET/CT for the detection of axillary node metastasis in breast cancer patients was not significantly different from that of US-guided FNA. Combining 18F-FDG PET/CT with US-guided FNA or SLN biopsy could improve the diagnostic performance compared to 18F-FDG PET/CT alone.
High-Throughput Strategies for the Discovery of Anticancer Drugs by Targeting Transcriptional Reprogramming
Authors: Huang Lijun , Yi Xiaohong , Yu Xiankuo , Wang Yumei , Zhang Chen , Qin Lixia , Guo Dale , Zhou Shiyi , Zhang Guanbin , Deng Yun , Bao Xilinqiqige , Wang Dong 
Published: October 2021

Transcriptional reprogramming contributes to the progression and recurrence of cancer. However, the poorly elucidated mechanisms of transcriptional reprogramming in tumors make the development of effective drugs difficult, and gene expression signature is helpful for connecting genetic information and pharmacologic treatment. So far, there are two gene-expression signature-based high-throughput drug discovery approaches: L1000, which measures the mRNA transcript abundance of 978 “landmark” genes, and high-throughput sequencing-based high-throughput screening (HTS2); they are suitable for anticancer drug discovery by targeting transcriptional reprogramming. L1000 uses ligation-mediated amplification and hybridization to Luminex beads and highlights gene expression changes by detecting bead colors and fluorescence intensity of phycoerythrin signal. HTS2 takes advantage of RNA-mediated oligonucleotide annealing, selection, and ligation, high throughput sequencing, to quantify gene expression changes by directly measuring gene sequences. This article summarizes technological principles and applications of L1000 and HTS2, and discusses their advantages and limitations in anticancer drug discovery.
Risk Factors for the Development of Hemophagocytic Lymphohistiocytosis in Children With Severe Adenovirus Pneumonia: A Single-Center Retrospective Study
Authors: Zhang Hua-yong , Xiao Min , Yan Fan , Zhang Mao-rong , Zhang Yong 
Published: October 2021

Objective: To investigate and analyze the relevant risk factors for hemophagocytic lymphohistiocytosis (HLH) in children with severe adenovirus pneumonia (SAP).Methods: A retrospective study of children with SAP was performed in 30 cases developing HLH and 94 cases not developing HLH from December 2018 to August 2019. The binary logistic regression analysis was used to identify risk factors that were significantly associated with the development of HLH after the univariate analysis, and the receiver operating characteristic (ROC) curve was performed to find out the cut-off value for the significant relevant factors.Results: Two factors were associated with the development of HLH, which were the length of fever (OR = 1.331, 95%CI: 1.002–1.769) and triglycerides (TG) (OR = 17.345, 95%CI: 1.358–221.538). The cut-off value of the length of fever was 12.5 days, and the cut-off value of TG was 3.02 mmol/L.Conclusion: Children with SAP who had a duration of fever over 12.5 days and the TG level over 3.02 mmol/L are more likely to develop HLH.
Hospitalization and Morbidity Rates After Pediatric Traumatic Brain Injury: A Nation-Wide Population-Based Analysis
Authors: Bruns Nora , Trocchi Pietro , Felderhoff-Müser Ursula , Dohna-Schwake Christian , Stang Andreas 
Published: October 2021

Background: Even though traumatic brain injury (TBI) is a major cause of morbidity and mortality in children around the globe, population-based and nation-wide data to assess the burden of TBI is scarce.Methods:Based on diagnosis related groups from nation-wide hospital data, we extracted data on all TBI-related hospitalizations in children &lt;18 years in Germany between 2014 and 2018. We calculated crude, age-specific and standardized incidence rates for hospitalizations, imaging, intracranial injury, neurosurgery, and mortality.Results:Out of 10.2 million hospitalizations, we identified 458,844 cases with TBI as primary or secondary diagnosis, resulting in a crude incidence rate of 687/100,000 child years (CY). Age-specific rates of computed tomography were below 30/100,000 CY until the age of 10 years and increased to 162/100,000 CY until 17 years of age. Intracranial injury was diagnosed in 2.7%, neurosurgery was performed in 0.7% of patients, and 0.7% were mechanically ventilated. Mortality was 0.67/100,000 CY (0.1%).Conclusions:Despite substantial hospitalization rates for pediatric TBI in Germany, the rates of imaging, the need for mechanical ventilation, neurosurgery and mortality were overall very low. Reasons for hospitalization and measures to reduce unnecessary admissions warrant further investigation.
The Measurement and Conceptualization of Coping Responses in Pediatric Chronic Pain Populations: A Scoping Review
Authors: Nabbijohn A. Natisha , Tomlinson Rachel M. , Lee Soeun , Morrongiello Barbara A. , McMurtry C. Meghan 
Published: October 2021

Background: Pediatric chronic pain is a prevalent condition that requires significant coping to encourage optimal functioning; however, relevant research is vast, heterogeneous, and difficult to interpret. To date, no attempt has been made to map and summarize the measurement and conceptualization of coping responses in the context of pediatric chronic pain.Objectives: A scoping review was conducted to map and summarize the participant characteristics, methodologies, theoretical frameworks, and measures used to assess coping responses in youth with chronic pain. The extent to which authors used definitions and examples of coping responses (conceptual clarity) as well as consistently used measures (measurement consistency) and their corresponding conceptualizations (conceptual consistency) relative to how they were intended to be used were assessed.Methods: Searches were conducted through MEDLINE (PubMed) and PsycINFO. Following title/abstract screening, full-text extractions were performed on 125 English-language publications on coping in youth with chronic pain.Results: Of the 125 studies, only 12.8% used a theoretical framework to explain the coping responses assessed, and even fewer (7.2%) used theory to guide measure selection. Conceptual clarity was rated “low/very low” (i.e., no definitions and/or examples) for 47.2% of studies. The majority of studies were conducted in the United States (67%) and a preponderance of White and female participants was sampled. The research primarily used quantitative methods (85%) and cross-sectional designs (67%). Parent- or self-report questionnaires were the most common methods for assessing coping (86%). Of the 95 studies that utilized one of the 14 questionnaires with known psychometric properties, 33.7 and 55.8% had one or more discrepancies for conceptual and measurement consistency, respectively.Conclusions: This review highlights the lack of clear descriptions and theoretical frameworks of coping responses for pediatric chronic pain. Inconsistencies in the measurement and conceptualization of coping responses limit research and clinical advancements. As a field, we need to strive toward using well-developed theory to create fewer, more well-established standardized measures with clearly defined coping responses. Opportunities for qualitative and observational research in more diverse patient populations should be considered for theory construction and measure validation.Clinical Trial Registration:https://osf.io/xvn2a/?view_only=eff04e0c0b9649be89d403b10e9ff082.
The Impact of Psychopathology Associated With Childhood Trauma on Quality of Life in Portuguese Adolescents: A Two-Wave Longitudinal Study
Authors: Pinto Ricardo , De Castro Maria Vieira , Silva Laura , Jongenelen Inês , Maia Angela , Levendosky Alytia A. 
Published: October 2021

Introduction: The aim of this study was to explore the mediating effect of psychopathology between childhood adversity and trauma and quality of life (QOL) in adolescents. The second aim of the study was testing the moderation by social support of this mediation effect.Methods: Self-reports of childhood adversity and trauma, QOL, social support, and psychopathology were collected from 150 Portuguese adolescents' who had been exposed to at least one traumatic event or one childhood adversity (Mage = 16.89, SD = 1.32). The surveys were administered at two time points with an approximate time interval of 1 year.Results: Indirect effects were observed for depression (B = −0.33, CI [−0.62, −0.11]), somatization (B = −0.52, CI [−0.82, −0.23]), and post-traumatic stress symptoms (PTSS) (B = −0.23, CI [−0.45, −0.01]), but not for anxiety (B = 0.20, CI [−0.08, 0.50]). A moderated mediation was found between social support and depression (B = −0.10, CI [−16, −0.04]), and PTSS (B = 0.03, CI [−0.1, −0.05]), but not for somatization (B = −0.02, CI [−0.8, 0.05]).Conclusions: We found that depression and somatization were strong mediators of the relationship between adversity/trauma and QOL, whereas PTSS was moderately mediated this relationship. Anxiety did not mediate this relationship. The moderated-mediation effect of social support was only found for depression and PTSS. The improvement of QOL in adolescents exposed to childhood adversity and trauma should include the assessment of psychopathology symptoms and social support, with the aim of identifying risk and protective factors.
The Association Between Depressive Symptomology, Psychological Burden Related to COVID-19, and Engagement in Physical Exercise Among College Students
Authors: Vally Zahir , Helmy Mai 
Published: October 2021

Introduction:The coronavirus (COVID-19) pandemic has resulted in substantial changes to the normalcy of daily life. Research conducted in Western Europe point to elevated levels of depression, rumination and worry as well psychological burden. These in turn impact the capacity of individuals to adhere to lockdown measures and health-protective behaviours. Investigations of these pandemic-related mental health constructs in the Middle East appears sparse. Moreover, there is an immense need to investigate the potential for simple strategies that might be used by individuals whilst in lockdown to combat the onset of mental health difficulties. Regular physical exercise may prove valuable in this regard.Objective:To investigate the potential mediational role of engagement in physical exercise on the association between depression and psychological burden related to COVID-19.Method:A sample of 1,322 participants (mage= 19.50 years, SD = 1.54) completed measures of depression and psychological burden related to COVID-19 and self-reported their frequency of physical exercise. Data were collected between February and May 2021 in Egypt and the United Arab Emirates.Results:Analyses revealed statistically significant associations between depression and psychological burden as well as between elevated depression and reduced physical exercise. Mediation analyses in which the potential mediational role of physical exercise was examined were not significant.Conclusions:Depression and psychological burden related to the pandemic appear to be prevalent in these Middle Eastern locations. Whilst physical exercise appears to be beneficial in combating depression, it does not appear to be a sufficient strategy for impeding the experience of psychological burden. Investigation of the contribution of additional strategies is required.
Indicators for Public Mental Health: A Scoping Review
Authors: Peitz Diana , Kersjes Christina , Thom Julia , Hoelling Heike , Mauz Elvira 
Published: October 2021

Background: To monitor population mental health, the identification of relevant indicators is pivotal. This scoping review provides a comprehensive overview of current indicators representing the various fields of public mental health core topics. It was conducted as a first step to build up a Mental Health Surveillance for Germany.Methods: We conducted a systematic MEDLINE search via PubMed. This search was supplemented by an extensive examination of the websites of relevant national as well as international institutions in the context of public mental health and an additional internet search via Google. To structure the data, an expert-based focus group identified superordinate topics most relevant to public mental health to which the identified indicators could be assigned to. Finally, the indicator set was screened for duplicates and appropriate content to arrive at a final set.Results: Within the various search strategies, we identified 13.811 records. Of these records, a total of 365 records were processed for indicator extraction. The extracted indicators were then assigned to 14 topics most relevant to public mental health as identified by the expert-based focus group. After the exclusion of duplicates and those indicators not meeting criteria of specificity and target group, the final set consisted of 192 indicators.Conclusion: The presented indicator set provides guidance in the field of current concepts in public mental health monitoring. As a comprehensive compilation, it may serve as basis for future surveillance efforts, which can be adjusted and condensed depending on the particular monitoring focus. Our work provides insights into established indicators included in former surveillance work as well as recent, not yet included indicators reflecting current developments in the field. Since our compilation mainly concludes indicators related to mental health in adults, it should be complemented with indicators specific to children and adolescents. Furthermore, our review revealed that indicators on mental health promotion and prevention are underrepresented in current literature of public mental health and should hence be focused on within future research and surveillance.
Cost-Effectiveness Analysis of Ultrasound Screening for Thyroid Cancer in Asymptomatic Adults
Authors: Yang Nan , Yang Han , Guo Jeff Jianfei , Hu Ming , Li Sheyu 
Published: October 2021

Objectives: This study evaluated the long-term cost-effectiveness of ultrasound screening for thyroid cancer compared with non-screening in asymptomatic adults.Methods: Applying a Markov decision-tree model with effectiveness and cost data from literature, we compared the long-term cost-effectiveness of the two strategies: ultrasound screening and non-screening for thyroid cancer. A one-way sensitivity analysis and a probabilistic sensitivity analysis were performed to verify the stability of model results.Results: The cumulative cost of screening for thyroid cancer was $18,819.24, with 18.74 quality-adjusted life years (QALYs), whereas the cumulative cost of non-screening was $15,864.28, with 18.71 QALYs. The incremental cost-effectiveness ratio of $106,947.50/QALY greatly exceeded the threshold of $50,000. The result of the one-way sensitivity analysis showed that the utility values of benign nodules and utility of health after thyroid cancer surgery would affect the results.Conclusions: Ultrasound screening for thyroid cancer has no obvious advantage in terms of cost-effectiveness compared with non-screening. The optimized thyroid screening strategy for a specific population is essential.