bluuebunny/crossref_metadata_2025_split huggingface dataset:
Precision medicine for cervical cancer
Authors: Manrriquez Erica N. , Zakhour Mae , Salani Ritu 
Published: October 2021

Purpose of review
To summarize the data on precision medicine for cervical cancer including the use of potential biomarkers. We also review ongoing areas of research in cervical cancer therapeutics.

Recent findings
In the current clinical practice, programmed death ligand 1 (PD-L1) expression is used to select patients with cervical cancer for treatment with checkpoint inhibitors. However, more recently presented data suggest that PD-L1 may not be a fully accurate biomarker for selection and further analysis is warranted. With the publication of the molecular landscape of cervical cancer, tumor profile-based therapy selection is of greater interest (i.e. targeting PI3K and HER2).

Summary
In this review, we discuss the role of potential biomarkers for cervical cancer that may assist with the selection of precision therapies. Enrolling patients on active clinical trials will help clarify the role of targeting specific mutations.
Children Have Similar Reverse Transcription Polymerase Chain Reaction Cycle Threshold for Severe Acute Respiratory Syndrome Coronavirus 2 in Comparison With Adults
Authors: Polese-Bonatto Márcia , Sartor Ivaine Tais Sauthier , Varela Fernanda Hammes , Giannini Gabriela Luchiari Tumioto , Azevedo Thaís Raupp , Kern Luciane Beatriz , Fernandes Ingrid Rodrigues , Zavaglia Gabriela Oliveira , de David Caroline Nespolo , Santos Amanda Paz , de Almeida Walquiria Aparecida Ferreira , Porto Victor Bertollo Gomes , Scotta Marcelo Comerlato , Stein Renato T. ,   for the COVIDa Study Group
Published: October 2021

Background:
The viral dynamics and the role of children in the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are not completely understood. Our aim was to evaluate reverse transcription polymerase chain reaction (RT-PCR) cycle threshold (Ct) values among children with confirmed SARS-CoV-2 compared with that of adult subjects.

Methods:
Patients (from 2 months to ≤18 years of age and adults) with signs and symptoms of acute SARS-CoV-2 infection for less than 7 days were prospectively enrolled in the study from May to November 2020. All participants performed RT-PCR assay for SARS-CoV-2 detection; Ct values of ORF1ab, N and S gene targets and the average of all the 3 probes were used as surrogates of viral load.

Results:
There were 21 infants (2 months to <2 years), 40 children (≥2 to <12 years), 22 adolescents (≥12 to <18 years) and 293 adults of 376 participants with confirmed SARS-CoV-2 infections. RT-PCR Ct values from all participants less than 18 years of age, as well as from all childhood subgroups, were not significantly different from adults, comparing ORF1ab, N, S and all the gene targets together (P = 0.453).

Conclusions:
Ct values for children were comparable with that of adults. Although viral load is not the only determinant of SARS-CoV-2 transmission, children may play a role in the spread of coronavirus disease 2019 in the community.
Visual outcomes of a new nondiffractive extended depth-of-focus intraocular lens targeted for minimonovision: 3-month results of a prospective cohort study
Authors: van Amelsfort Thomas , Webers Valentijn S.C. , Bauer Noël J.C. , Clement Laurentius H.H. , van den Biggelaar Frank J.H.M. , Nuijts Rudy M.M.A. 
Published: October 2021

Purpose:
To evaluate visual outcomes, spectacle independence, and optical phenomena after bilateral implantation of a nondiffractive extended depth-of-focus (EDoF) intraocular lens (IOL) targeted for minimonovision.

Setting:
University Eye Clinic Maastricht, the Netherlands.

Design:
Prospective case series.

Methods:
Patients with age-related cataract were bilaterally implanted with a nondiffractive EDoF IOL (Alcon AcrySof IQ Vivity), targeted for minimonovision. Outcome measures were the uncorrected distance visual acuity (UDVA), corrected distance visual acuity, uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), distance corrected intermediate visual acuity, distance corrected near visual acuity, refractive outcomes, defocus curves, spectacle independence, photic phenomena, and Catquest-9SF questionnaire.

Results:
44 eyes of 22 patients were included. The mean binocular UDVA, UIVA, and UNVA were −0.07 (±0.10), 0.04 (±0.09), and 0.23 (±0.12) logMAR, respectively. The percentage of eyes within ±1.0 diopters (D) and ±0.5 D of target was 100% and 95% for the dominant eye and 100% and 86% for the nondominant eye, respectively. The binocular defocus curve was better than 0.10 logMAR over a range from −2.0 D to +0.5 D. The percentage of patients who reported not or rarely using spectacles for distance, intermediate, and near viewing distance was 96%, 68%, and 38%, respectively. The percentage of patients who experienced no halos, glare, or starbursts were 91%, 91%, and 100%, respectively. The Catquest-9SF showed a high patient satisfaction for daily life activities.

Conclusions:
Bilateral AcrySof IQ Vivity IOL implantation targeted for minimonovision provided good visual acuity results for far and intermediate with functional near vision, high level of patient satisfaction and spectacle independence, and a monofocal disturbance profile.
Fill levels, cost comparisons, and expulsion force requirements of commonly used topical ophthalmic steroids
Authors: Gill Mohsain S. , Murphy David A. , Dvorak Justin D. , Shah Simren V. , Riaz Kamran M. 
Published: October 2021

Purpose:
To determine volume fill levels, estimated costs, and force expulsion requirements per bottle of topical ophthalmic steroids commonly used in the United States.

Setting:
Tertiary care academic referral center.

Design:
Prospective laboratory investigation.

Methods:
8 commercially available medications were tested: loteprednol 0.5%, loteprednol gel 0.5%, loteprednol gel 0.38%, difluprednate 0.05%, generic fluorometholone 0.1%, branded fluorometholone 0.1%, generic prednisolone 1.0%, and branded prednisolone 1.0%. 10 bottles of each medication were tested. A double-blinded method was used to measure actual bottle fill volume and number of drops dispensed per bottle. The total perioperative cost per drop was calculated for each medication using a mean cash price. Force requirements were measured using a customized force gauge apparatus. Formulations were compared using Kruskal-Wallis 1way analysis of variances.

Results:
All formulations were able to cover postoperative periods commensurate with commonly used dosing regimens for cataract surgery. All medications had greater than sticker volume. Loteprednol 0.5% suspension and branded fluorometholone had the highest and lowest number of drops among the medications tested, respectively. Loteprednol 0.38% gel was the most expensive medication, whereas generic prednisolone 1.0% was the least expensive. Gel and branded formulations of ophthalmic steroids required less expulsion force compared with other tested formulations.

Conclusions:
Volume fill levels, patient-incurred costs, and expulsion force requirements per bottle of topical steroid medications vary widely. Clinicians may wish to consider these findings when determining their perioperative prescribing regimen.
Physician burnout in ophthalmology: U.S. survey
Authors: Sedhom Jessica A. , Patnaik Jennifer L. , McCourt Emily A. , Liao Sophie , Subramanian Prem S. , Davidson Richard S. , Palestine Alan G. , Kahook Malik Y. , Seibold Leonard K. 
Published: October 2021

Purpose:
To determine the prevalence of physician burnout among ophthalmologists in the United States and identify associated risks.

Setting:
All practice types within the United States.

Design:
Cross-sectional study.

Methods:
A survey was distributed through email listservs to several national ophthalmology societies. Participants completed a modified Mini Z Burnout Survey, a 10-item questionnaire measured in 5-point Likert scales, followed by demographic questions. The Mini Z Burnout survey assessed 3 main outcomes: stress, burnout, and work satisfaction. The percentage of subgroups experiencing burnout were presented and comparisons made with odds ratios from logistic regression modeling.

Results:
Of the 592 ophthalmologists responding to the survey, 37.8% (224) self-reported symptoms of burnout with a low of 30.8% (12/39) for vitreoretinal specialists to a high of 45.4% (30/66) for uveitis specialists. Most of those reporting burnout were categorized as mild (65.2% [146/224]), followed by moderate (29.5% [66/224]) and severe (5.4% [12/224]). Women had almost twice the odds of reporting burnout (odds ratio [OR] = 1.9 [95% CI: 1.3-2.7]; P = .0005). Physicians employed in academic (OR = 2.0 [95% CI: 1.2-3.2]; P = 0.007) and hospital facilities (OR = 2.4 [95% CI: 1.3-4.6]; P = .008) reported higher rates of burnout compared with those in large private groups. Burnout was associated with self-reported low work control, insufficient time for documentation, and misalignment with departmental leaders (P < .0001).

Conclusions:
Ophthalmologists exhibited a high degree of self-reported burnout in the U.S. This study highlights sex, employment autonomy, and practice type as major factors associated with burnout.
Identification of hub genes and candidate drugs in hepatocellular carcinoma by integrated bioinformatics analysis
Authors: Chen Xiaolong , Xia Zhixiong , Wan Yafeng , Huang Ping 
Published: October 2021

Abstract

Background:
Hepatocellular carcinoma (HCC) is the third cancer-related cause of death in the world. Until now, the involved mechanisms during the development of HCC are largely unknown. This study aims to explore the driven genes and potential drugs in HCC.

Methods:
Three mRNA expression datasets were used to analyze the differentially expressed genes (DEGs) in HCC. The bioinformatics approaches include identification of DEGs and hub genes, Gene Ontology terms analysis and Kyoto encyclopedia of genes and genomes enrichment analysis, construction of protein–protein interaction network. The expression levels of hub genes were validated based on The Cancer Genome Atlas, Gene Expression Profiling Interactive Analysis, and the Human Protein Atlas. Moreover, overall survival and disease-free survival analysis of HCC patients were further conducted by Kaplan–Meier plotter and Gene Expression Profiling Interactive Analysis. DGIdb database was performed to search the candidate drugs for HCC.

Results:
A total of 197 DEGs were identified. The protein–protein interaction network was constructed using Search Tool for the Retrieval of Interacting Genes software, 10 genes were selected by Cytoscape plugin cytoHubba and served as hub genes. These 10 genes were all closely related to the survival of HCC patients. DGIdb database predicted 29 small molecules as the possible drugs for treating HCC.

Conclusion:
Our study provides some new insights into HCC pathogenesis and treatments. The candidate drugs may improve the efficiency of HCC therapy in the future.
Comprehensive analysis of prognostic immune-related genes in the tumor microenvironment of hepatocellular carcinoma (HCC)
Authors: Li Mengting , Li Hongliang , Zhou Canxin , Li Xianpeng , Gong Jiande , Chen Changxi , Zhang Yi 
Published: October 2021

Abstract
Growing evidence supports that the tumor microenvironment plays a key role in the development and progression of tumors. But immune microenvironment of hepatocellular carcinoma (HCC) has not yet been fully explored. In the present investigation, the clinical value and prognostic significance of immune-related genes in HCC were investigated.
The immune and stromal scores of HCC were calculated through the application of Estimation of Stromal and Immune cells in Malignant Tumor tissues using Expression data Algorithm based on the Cancer Genome Atlas database. Differentially expressed genes were identified using the “edgeR” package of the R software. Functional annotation and pathway enrichment were performed using “ggplots2” and “clusterProfiler” packages in R software. Protein-protein interaction network was constructed using STRING, and the hub genes were identified through the Cytoscape. Survival analysis was performed using Kaplan-Meier methods. Tumor Immune Estimation Resource algorithm was used to view the immune landscape of the microenvironment in HCC.
Firstly, the immune and stromal scores of HCC were calculated and we found that the immune and stromal scores of HCC were closely related to the patients’ prognosis. Then the differentially expressed genes were identified respectively stratified by the median value of the immune and stromal scores, and the immune-related genes that related to the prognosis in HCC patients were further identified. Functional enrichment analysis and protein-protein interaction networks further showed that these genes mainly participated in immune-related biological process. In addition, dendritic cells were found to be the most abundant in the microenvironment of HCC through Tumor Immune Estimation Resource algorithm and were significantly associated with the patients’ prognosis. To robust the results, the immune-related genes were validated in an independent dataset from the Gene Expression Omnibus database.
We arrived at a more comprehensive understanding of the microenvironment of HCC and extracted 7 immune-related genes that were significantly associated with the recurrence survival of HCC.
Vitreoretinal lymphoma occurring after systemic chemotherapy for primary conjunctival diffuse large B cell lymphoma
Authors: Niidome Erina , Usui Yoshihiko , Takahashi Reisuke , Nagao Toshitaka , Goto Hiroshi 
Published: October 2021

Abstract

Introduction:
Ocular adnexal lymphoma and vitreoretinal lymphoma are rare forms of non-Hodgkin lymphoma. They are regarded as distinct disease entities due to the differences in molecular mechanism, management, and outcome. We present a rare case of conjunctival diffuse large B cell lymphoma (DLBCL) that developed to vitreoretinal lymphoma after systemic chemotherapy.

Patient concerns:
A 60-year-old man presented with a left salmon-colored conjunctival mass.

Diagnosis:
A biopsy was performed, and histopathologic examination showed DLBCL. Immunohistochemical staining was positive for CD20 with increased κ to λ light chain ratio.

Interventions:
Bone marrow biopsy also revealed DLBCL. Gallium-67 scintigraphy showed abnormal uptake only in the left orbital lesion. Ann Arbor stage was estimated as IV. The patient underwent systemic combination chemotherapy and immunotherapy.

Outcomes:
Four months after the last course of chemotherapy, primary conjunctival DLBCL relapsed, manifesting vitreous opacity. Diagnostic vitrectomy confirmed a diagnosis of vitreoretinal lymphoma.

Lessons:
Conjunctival DLBCL and vitreoretinal lymphoma are both DLBCL. After systemic chemotherapy for conjunctival DLBCL, the lymphoma may relapse in intraocular sites as secondary vitreoretinal lymphoma.
Comparison of the sixth, seventh, and eighth editions of the American Joint Committee on Cancer Tumor-Node-Metastasis staging system for gastric cancer
Authors: Chen Mei-Wen , Yen Hsu-Heng 
Published: October 2021

Abstract
In 2018, the eighth edition of the American Joint Committee on Cancer Tumor-Node-Metastasis classification and staging system was implemented. Few reports were made comparing the performance of different editions of the American Joint Committee on Cancer (AJCC) system. Therefore, this study aimed to examine the prognostic predictability from the sixth to the eighth editions of the AJCC staging system for gastric cancer.
A total of 414 patients with gastric cancer who underwent surgery at Changhua Christian Hospital from January 2007 to December 2017 were enrolled in the study. To identify the prognostic factors for gastric cancer death, univariate and multivariate analyses were performed. The homogeneity and discrimination abilities of the sixth to eighth editions of the staging system were compared using the likelihood ratio chi-square test, linear trend chi-square test, and Akaike information criterion.
The sixth edition of the staging system had the lowest Akaike information criterion value, suggesting a better prognostic stratification than other editions. From the result of the likelihood ratio chi-square test, the T and N staging systems of the seventh and eighth editions had better homogeneity and discriminatory ability than the sixth edition. The eighth edition had better prognostic performance in patients at stage III compared with the seventh edition.
The AJCC seventh and eighth editions had improved prognostic predictability of the T and N factors compared with the sixth edition. However, the overall staging performance of the eighth edition is not superior compared to the sixth edition. Further studies with larger sample size should be conducted to compare the performance of different editions of the AJCC staging system for different ethnic populations.
Baseline neutrophil-lymphocyte ratio is associated with outcomes in patients with castration-resistant prostate cancer treated with Docetaxel in South China
Authors: Jiang Zhi-guo , Liao Shao-Guang 
Published: October 2021

Abstract
The aim of this study is to investigate the association between baseline neutrophil-to-lymphocyte ratio (NLR) and progression-free survival (PFS), overall survival (OS) and radiological response in castration-resistant prostate cancer patients treated with docetaxel.
Forty-one prostate cancer patients who were treated with docetaxel were selected. Univariable and multivariable Cox regression models were used to predict the association of baseline NLR as a dichotomous variable with PFS and OS after chemotherapy initiation.
In Kaplan–Meier analysis, the median PFS (9.8 vs 7.5 months, P = .039, Fig. 1) and OS (17.6 vs 14.2 months, P = .021, Fig. 2) was higher in patients who did not have an elevated NLR than in those with an elevated NLR. In univariate analysis, the pretreatment NLR was significantly associated with PFS (P = .049) and OS (P = .023). In multivariable analysis, patients with a NLR of >3 were at significantly higher risk of tumor progress (hazard ratio 2.458; 95% confidence interval 1.186–5.093; P = .016) and death (hazard ratio 3.435; 95% CI 1.522–7.750; P = .003)than patients with a NLR of ⩽3.
NLR may be an independent predictor of PFS and OS in castration-resistant prostate cancer patients treated with docetaxel. The findings require validation in further prospective, big sample-sized studies.
Gliflozins for the prevention of stroke in diabetes and cardiorenal diseases
Authors: Zhao Li-Min , Huang Jia-Nan , Qiu Mei , Ding Liang-Liang , Zhan Ze-Lin , Ning Jie 
Published: October 2021

Abstract

Background:
Individual randomized trials are not powered to assess the relationship between use of sodium–glucose transporter 2 inhibitors and risk of stroke. We sought to explore this issue by a meta-analysis incorporating relevant trials including several latest trials.

Methods:
Cardiovascular outcome trials of gliflozins were included. Primary outcome was stroke, while secondary outcome was major adverse cardiovascular events (MACE), which was a composite of stroke, myocardial infarction, or cardiovascular death. Meta-analysis was conducted stratified by with/without chronic kidney disease (CKD), with/without heart failure (HF), and with/without atherosclerotic cardiovascular disease (ASCVD), and stratified by different gliflozins.

Results:
We included 9 trials in this meta-analysis. Compared with placebo, gliflozins significantly lowered stroke (hazard ratio [HR] 0.68, 95% confidence interval [CI] 0.55–0.84) and MACE (HR 0.77, 95% CI 0.69–0.86) in type 2 diabetes (T2D) patients with CKD, but did not significantly affect stroke (HR 1.00, 95% CI 0.86–1.16) and MACE (HR 0.94, 95% CI 0.86–1.02) in T2D patients without CKD. Gliflozins had no significant effects on the stroke risk (HR 0.94, 95% CI 0.82–1.07) in T2D patients regardless of HF status (P
subgroup = .684) and ASCVD status (P
subgroup = .915), but significantly lowered MACE (HR 0.89, 95% CI 0.83–0.96) in T2D patients regardless of HF status (P
subgroup = .428) and ASCVD status (P
subgroup = .423). Canagliflozin (HR 0.84, 95% CI 0.69–1.01) showed the trend of a reduction in the stroke risk versus placebo, and sotagliflozin (HR 0.73, 95% CI 0.54–0.98) significantly lowered the stroke risk; whereas the other 3 gliflozins did not significantly affect that risk. Ertugliflozin (HR 0.97, 95% CI 0.85–1.11) had no significant effects on the MACE risk, whereas the other 4 gliflozins significantly lowered that risk.

Conclusions:
Gliflozins, especially canagliflozin and sotagliflozin, should be recommended in T2D patients with CKD to prevent stroke. Most gliflozins lower the risk of MACE in T2D patients regardless of HF status and ASCVD status, whereas ertugliflozin is not observed to lower that risk.
Workplace bullying among Nigerian artisans in building and construction industry
Authors: Omeje Hyginus Osita , Okereke Godwin Keres Okoro , Okeke Somtochukwu A.C. , Asogwa Japel Onyekachi , Obe Pauline Ijeoma , Nwaodo Samson Ikenna , Chukwu Uchenna Daniel , Ike Joshua Onyedikachi , Udogu Kingsley Chimezia , Ede Augustina Obioma , Ilechukwu Leonard C. , Kanu Catherine Chiugo , Ogbonna George Nwachukwu , Njoku Sylvanus Umunakwe 
Published: October 2021

Abstract
Bullying is a growing problem in the workplace. This study investigated the bullying experience of building and construction industry artisans.
We employed a cross-sectional analytic design to study 240 artisans in respect of workplace bullying (WPB) experience using a self-report questionnaire. Percentage, mean and standard deviation were used for data analysis and interpretation.
According to the study, a significant percentage (96.1%) of the artisans perceived themselves as victims of WPB within the past 6 months and these experiences also occurred once or more times weekly.
WPB is a considerable problem among building and construction industry artisans in Nigeria. Further studies that can influence the construction industry to create valuable programs to minimize bullying among artisans are required.