bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictive value of metabolic activity detected by pre-operative 18F FDG PET/CT in ampullary adenocarcinoma
Authors: Park Young Mok , Seo Hyung Il 
Published: October 2021

Abstract
In ampullary adenocarcinoma cases, the clinical effects of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) have not yet been well-studied, unlike other prognostic factors that have been reported till date. This study aimed to investigate the clinical impact of maximum standardized uptake value (SUVmax) in predicting the prognosis of ampullary adenocarcinoma.
Thirty-eight patients who underwent pre-operative 18F-FDG PET/CT and curative-intent resection of ampullary adenocarcinoma at Pusan National University Hospital (Pusan, South Korea) between 2008 and 2017 were retrospectively analyzed in this study. We evaluated the clinicopathologic outcomes according to the SUVmax using univariate and multivariate Cox proportional hazard regression analyses and receiver operating characteristic analysis to arrive at a cutoff value.
Lymph node metastasis was detected in 9 patients, and 15 patients experienced a recurrence during the follow-up period. Among 38 patients, 33 showed an increased FDG uptake by the main tumor. SUVmax of 4.55 was selected as a significant independent predictive factor for patient survival along with poor tumor differentiation and high neutrophil-to-lymphocyte ratio in multivariate analysis (P = .016, hazard ratio = 5.040). Patients with SUVmax under 4.55 exhibited significantly longer overall survival than the rest (<4.55 vs ≥4.55), and the 5-year overall survival was 82.8% versus 57.4% (P = .049).
SUVmax of 4.55 on 18F-FDG PET/CT could be a predictive factor for tumor biology and long-term survival in patients with ampullary adenocarcinoma. Nevertheless, considering the cost aspect and its limited prognostic effect, this study seems to require more patient and multicenter studies.
Immunoglobulin A nephropathy in a patient with neurofibromatosis type 1
Authors: Rhee Harin , Kim Sungmi , Lee Wanhee , Jeon Hakeong , Kim Da Woon , Ye Byung-Min , Kim Hyo Jin , Kim Min Jeong , Kim Seo Rin , Kim Il Young , Song Sang Heon , Seong Eun Young , Lee Dong Won , Lee Soo Bong 
Published: October 2021

Abstract

Rationale:
Neurofibromatosis type 1 (NF-1) is an autosomal-dominant neurocutaneous disorder that affects the skin, bones, and nervous system. The most common manifestation of kidney involvement is renal artery stenosis; glomerulonephritis is extremely rare. In this case report, we present a patient with NF-1 and immunoglobulin A nephropathy (IgAN).

Patient concerns:
A 51-year-old Korean man previously diagnosed with NF-1 presented with persistent proteinuria and hematuria identified during a routine medical check-up. He had no history of hypertension or diabetes, and denied a history of alcohol use or smoking.

Diagnosis:
The contrast-enhanced computed tomography scan revealed normal-sized kidneys and no evidence of renal artery stenosis. On the day of the kidney biopsy, laboratory tests showed a serum creatinine level of 1.1 mg/dL, urine protein/creatinine ratio of 1.3 g/g, and urine red blood cell count of >10 to 15/HPF. The kidney biopsy sample revealed IgAN grade III, according to Lee glomerular grading system.

Intervention:
The patient was advised to take 4 mg of perindopril.

Outcome:
Three months after the treatment, the urine protein/creatinine ratio decreased to 0.6 g/g, with no change in the serum creatinine level (1.03 mg/dL).

Lessons:
A genetic link between NF-1 and IgAN or other glomerular diseases is not established. However, activation of the mTOR pathway may explain this association.
Response to toripalimab combined with radiotherapy in advanced non-small cell lung cancer-not otherwise specified
Authors: Jin Yonglong , Xiao Wenjing , Wang Xintong , Cui Yinshi , Li Bo , Liu Xiguang 
Published: October 2021

Abstract

Rationale:
The targeting of signal transduction through programmed cell death receptor-1 (PD-1) and its ligand programmed cell death-ligand 1 (PD-L1) in patients with non-small cell lung cancer (NSCLC) has been widely applied in clinical research. However, the subtypes and treatment patterns that predict responses to PD-1/PD-L1 inhibitors are not fully understood. Biomarkers, such as PD-L1 expression, tumor mutation load, and DNA mismatch repair defects, have been used to screen patients who respond to PD-1/PD-L1 inhibitors, but the appropriate treatment mode requires further investigation. Immune checkpoint inhibitors combined with radiotherapy provide benefits from remote effects, especially in NSCLC patients with increased PD-L1 expression.

Patient concerns:
We report a 64-year-old man who presented with left back pain for 40 days. A computed tomography scan showed a mass in the right upper lobe of the lung, with metastases in the right hilar and mediastinal lymph nodes.

Diagnosis:
NSCLC-not otherwise specified was diagnosed by computed tomography-guided lung biopsy.

Interventions:
After the failure of first-line chemotherapy, next-generation sequencing was performed for comprehensive gene analysis, and PD-L1 expression levels were evaluated by immunohistochemistry. The patient was treated with toripalimab (a PD-1 inhibitor) concurrently with radiotherapy for bone metastases.

Outcomes:
The detection results showed a high tumor mutation burden and increased PD-L1 expression. On the basis of these findings, the patient received toripalimab (PD-1 inhibitor) combined with radiotherapy for bone metastases. Partial response was achieved after 3 cycles, and the patient showed stable disease at the end of the sixth and ninth cycles of toripalimab. The patient was followed up for 26 months. At present, the patient is receiving toripalimab maintenance treatment, which has been well-tolerated without adverse events.

Lesson:
Toripalimab combined with radiotherapy may exert a synergistic anti-tumor effect through remote effects in advanced or metastatic NSCLC with high PD-L1 expression. However, the specific treatment mode requires further confirmation by the investigation of additional cases.
Managing social anxiety among undergraduate adult education and extra-mural studies students
Authors: Ezenwaji Chisom Ogochukwu , Aloh Henry Egi , Okeke Polycarp M.D. , Osilike Chioma C. , Ekwealor Nwakaego Ebele , Koledoye Uzoamaka Lucynda , Ilechukwu Leonard Chidi , Onwuadi Charles Chibuike 
Published: October 2021

Abstract

Background/Objective:
Anxiety is a significant problem affecting University students including undergraduate adult education and extra-mural studies students. This research evaluated the impact of a group rational-emotive behavioral education intervention (group rational-emotive behavioral education intervention [REBEI]) on social anxiety symptoms among undergraduate adult education and extra-mural studies students.

Method:
Eighty six students participated in the study by belonging to either treatment group (n = 43) or control group (n = 43). A REBEI treatment program was developed by the researchers was used to implement the experiment and data was collected using a 22-item questionnaire on social anxiety. Analyzes of data were done using repeated measures ANOVA and paired t-test.

Results:
Results showed that despite the social anxiety experienced before exposure to the intervention, the social anxiety symptoms of the undergraduate adult education and extra-mural studies students in the treatment group reduced significantly at post-treatment and follow-up compared to students in the control group.

Conclusion:
REBEI demonstrated its clinical usefulness in treating undergraduate adult education and extra-mural studies students with social anxiety problem.
Establishment and verification of a nomogram prediction model of hypertension risk in Xinjiang Kazakhs
Authors: Xu Yuezhen , Liu Jinbao , Wang Jiawei , Fan Qiongling , Luo Yuanyuan , Zhan Huaifeng , Tao Ning , You Shuping 
Published: October 2021

Abstract
Hypertension is the main risk factor for cardiovascular and renal diseases. It is of great importance to develop effective risk prediction models to identify high-risk groups of hypertension. This study is to establish and verify a nomogram model for predicting the risk of hypertension among Kazakh herders in Xinjiang, China.
This is a prospective cohort study. Totally, 5327 Kazakh herders from the Nanshan pastoral area of Xinjiang were enrolled. They were randomly divided into the modeling set of 3729 cases (70%) and the validation set of 1598 cases (30%). In the modeling set, univariate analysis, least absolute shrinkage and selection operator regression and multivariate Logistic regression were used to analyze the influencing factors of hypertension, and a nomogram prediction model was constructed. We then validated the model in the validation set, and evaluated the accuracy of the model using receiver operating characteristic and calibration curve.
Based on univariate analysis, least absolute shrinkage and selection operator regression and multivariate logistic regression analysis, we identified 14 independent predictors of hypertension in the modeling set, including age, smoking, alcohol consumption, baseline body mass index, baseline diastolic blood pressure, baseline systolic blood pressure, daily salt intake, yak-butter intake, daily oil intake, fruit and vegetable intake, low-density lipoprotein, cholesterol, abdominal circumference, and family history. The area under the receiver operating characteristic curve of the modeling set and the verification set was 0.803 and 0.809, respectively. Moreover, the calibration curve showed a higher agreement between the nomogram prediction and the actual observation of hypertension.
The risk prediction nomogram model has good predictive ability and could be used as an effective tool for the risk prediction of hypertension among Kazakh herders in Xinjiang.
Effectiveness of prealbumin as an indicator of growth in neonates
Authors: Kim Dong Hyun , Lee Na Mi , Kim Su Yeong , Yi Dae Yong , Yun Sin Weon , Chae Soo Ahn , Lim In Seok 
Published: October 2021

Abstract
We designed this study to assess the effectiveness of prealbumin as an indicator of growth as well as a nutritional marker in neonates.
Between March 2017 and June 2019, we measured serum prealbumin concentrations of 80 neonates in neonatal intensive care unit at birth, postnatal day 14 and 28, and classified them into 3 groups (early preterm, late preterm, and term infants). And we examined correlation among prealbumin levels, nutritional intake, and anthropometric measurements (weight, length, and head circumference) in neonates.
Prealbumin measured on the 14th postnatal day in early preterm infants showed significant correlations with the length, weight, and head circumference z-scores. Prealbumin levels increased with time in the late preterm and term groups. At birth, prealbumin levels were the lowest in late preterm babies, implying that they are nutritionally deficient and need nutritional support. At postnatal day 28, the prealbumin levels of many preterm infants did not reach those seen in term babies at birth, suggesting the presence of extrauterine growth restriction.
Prealbumin can be considered as an indicator of sufficient growth in early preterm infants.
99mTc-HMPAO-WBC SPECT/CT versus 18F-FDG-WBC PET/CT in chronic prosthetic joint infection: a pilot study
Authors: Teiler Johan , Ahl Marcus , Åkerlund Börje , Brismar Harald , Holstensson Maria , Gabrielson Stefan , Hedlund Håkan , Axelsson Rimma 
Published: October 2021

Purpose
The aim of this study was to compare 99mTc-HMPAO-WBC-SPECT/CT combined with 99mTc-nanocollloid SPECT/CT and 18F-FDG-WBC-PET/CT combined with 99mTc-Nanocollloid SPECT/CT for the diagnosis and treatment evaluation of chronic prosthetic joint infection (PJI).

Methods
Patients with suspected chronic PJI were examined with 99mTc-HMPAO-WBC SPECT/CT, 18F-FDG-WBC PET/CT, and 99mTc-nanocolloid SPECT/CT (to visualize bone marrow). The location and patterns of uptake were noted and compared between the two leukocyte examinations. Both leukocyte examinations were evaluated visually for infection. The PET examinations were also evaluated semiquantitatively. Chronic PJI was verified clinically by microbial culture and successfully treated PJI was confirmed by 12 months symptom-free follow-up after cessation of antibiotics.

Results
Nineteen patients were included with 10 hip prostheses and nine knee prostheses. Fourteen were diagnosed with chronic PJI and five with successfully treated PJI. The sensitivity of visual evaluation of 99mTc-WBC-HMPAO SPECT/CT for all joints was 0.31 and for 18F-FDG-WBC PET/CT 0.38. The specificity was 0.80 and 0.83, respectively. All patients with a true-positive SPECT examination had a false-negative PET examination and vice versa. Semiquantitative evaluation of the hips gave an area under the curve of 0.905 using the iliac crest as the background. Semiquantitative evaluation of the knees did not produce significant results.

Conclusion
This pilot study showed no difference in the sensitivity or specificity of 99mTc-HMPAO-WBC SPECT/CT and 18F-FDG-WBC PET/CT when combined with 99mTc-nanocollloid SPECT/CT in the diagnosis or treatment evaluation of suspected late chronic PJI.
What Matters Most? Predictors of Quality of Life and Life Satisfaction Among Young Breast Cancer Survivors
Authors: Martens Kellie , Ulrich Gillian R. , Ranby Krista W. , Kilbourn Kristin 
Published: October 2021

Background
Younger breast cancer survivors face unique challenges, and research is needed to better understand how to optimize their quality of life (QoL) and satisfaction with life (SwL).

Objective
The aim of this study was to examine a biopsychosocial model of QoL and SwL in young breast cancer survivors. Biological, psychological, and social/practical factors were hypothesized to be associated with both distressing and adaptive reactions during survivorship, which in turn were hypothesized to be associated with QoL and SwL.

Methods
Young (age = 19-45 years at diagnosis) breast cancer survivors (N = 284) completed an online survey assessing demographic and biopsychosocial factors, QoL, and SwL. Latent variables were created for adaptive and distressing reactions, and structural equation modeling was used to test the hypothesized relationships.

Results
The model fit the data (χ2(100) = 332.92, P < .001, comparative fit index = 0.86, root mean square error of approximation = 0.09, standardized root mean square residual = 0.05) and accounted for large proportions of variance in QoL (R
2 = 0.86) and SwL (R
2 = 0.62). Social support, parenting concerns, and fertility concerns each significantly predicted adjustment. Adaptive reactions positively predicted SwL (β = 0.58, P < .001) but not QoL. Distressing reactions negatively predicted SwL (β = −0.26, P < .01) and QoL (β = −0.87, P < .001).

Conclusions
Adjustment in survivorship mediated the association of social support, parenting concerns, and fertility concerns on QoL and SwL in young breast cancer survivors.

Implications for Practice
To support the psychological adjustment of young breast cancer survivors, attention should be given to survivors' social context including survivors' available social support and their concerns about fertility and parenting.
Case Series: Periodic Accommodative Fluctuations after Concussion
Authors: Houston Kevin E. , McDaniel Catherine E. , Greenspan Lynn , Tirandazi Pooyan 
Published: October 2021

SIGNIFICANCE
This is the first report recording an accommodative disorder after concussion characterized by periodic moderately sized myopic refractive error fluctuations without measurable other features of spasm of the near reflex.

PURPOSE
Objectively document a class of accommodative dysfunction that may be related to concussion.

CASE REPORTS
Case 1 involved two sports-related concussions 2 months apart with symptoms of headache and variable blur. Refractive stability was measured 28 months after injury with a binocular open-field refractometer documenting fluctuations from −0.25 to −1.75 D occurring 10 times during 4.2 seconds of recording with no evident miosis or convergent strabismus. The symptoms resolved with 1% atropine × 3 weeks. Case 2 involved a concussive blast injury (improvised explosive device) 7 years prior with symptoms of headache behind the eyes and occasional variable blur and reduced tolerance of electronic displays and other visually intensive tasks. Refractive fluctuations from +0.50 to −2.00 D occurred seven times over 44 seconds of recording with no appreciable miosis or change of interpalpebral fissure. The signs and symptoms were unresponsive to seven occupational therapy sessions involving task modifications and accommodative vision therapy activities.

CONCLUSIONS
In patients complaining of blurry vision, a careful evaluation of the stability of accommodation is indicated.
Differential Antimicrobial Efficacy of Multipurpose Solutions against Acanthamoeba Trophozoites
Authors: Walters Rhonda , Miller Elise , Campolo Allison , Gabriel Manal M. , Shannon Paul , McAnally Cindy , Crary Monica 
Published: October 2021

SIGNIFICANCE
This investigation examines the effectiveness of several common contact lens solutions in the disinfection of Acanthamoeba, which causes a serious eye infection most often resulting from dysfunctional or improper use of contact lens products.

PURPOSE

Acanthamoeba keratitis is an eye infection caused by a free-living amoeba, which can lead to extensive corneal damage and frequently blindness. Acanthamoeba keratitis is linked with contact lens use combined with noncompliance with contact lens care cleaning regimens. The patient's choice and use of multipurpose solutions (MPSs) continue to be a risk factor for Acanthamoeba keratitis. Thus, it is critical that the Acanthamoeba disinfection efficacy of the popular MPSs be determined. Here we compare the efficacy of seven major MPSs on the global market.

METHODS
Using standard methods of Acanthamoeba disinfection and quantification, Acanthamoeba ATCC 30461, 30868, 50370, and 50676 trophozoites were inoculated into each MPS and held for the manufacturer's recommended disinfection time. Acanthamoeba recovery plates were incubated for 14 days, after which positive wells were identified and cell concentrations determined using the 50% endpoint method.

RESULTS
Members of the OPTI-FREE products (Express, Replenish, and Puremoist [Alcon, Fort Worth, TX]) demonstrated significantly higher percentages of antimicrobial activity compared with the renu Advanced Formula (Bausch + Lomb, Rochester, NY), Biotrue (Bausch + Lomb), Acuvue RevitaLens (Johnson & Johnson, Santa Ana, CA), and Lite products (Cooper Vision, Scottsville, NY) for four of the trophozoite strains tested.

CONCLUSIONS
Many of the popular MPS biocides maintain little or no antimicrobial activity against Acanthamoeba trophozoites, and the number of biocides in an MPS does not necessarily indicate its antimicrobial activity.
Post-acute COVID-19 Syndrome Negatively Impacts Physical Function, Cognitive Function, Health-Related Quality of Life, and Participation
Authors: Tabacof Laura , Tosto-Mancuso Jenna , Wood Jamie , Cortes Mar , Kontorovich Amy , McCarthy Dayna , Rizk Dahlia , Rozanski Gabriela , Breyman Erica , Nasr Leila , Kellner Christopher , Herrera Joseph E. , Putrino David 
Published: October 2021

Objective
This report describes persistent symptoms associated with post-acute COVID-19 syndrome (PACS) and the impact of these symptoms on physical function, cognitive function, health-related quality of life, and participation.

Design
This study used a cross-sectional observational study design. Patients attending Mount Sinai’s post-acute COVID-19 syndrome clinic completed surveys containing patient-reported outcomes.

Results
A total of 156 patients completed the survey, at a median (range) time of 351 days (82–457 days) after COVID-19 infection. All patients were prevaccination. The most common persistent symptoms reported were fatigue (n = 128, 82%), brain fog (n = 105, 67%), and headache (n = 94, 60%). The most common triggers of symptom exacerbation were physical exertion (n = 134, 86%), stress (n = 107, 69%), and dehydration (n = 77, 49%). Increased levels of fatigue (Fatigue Severity Scale) and dyspnea (Medical Research Council) were reported, alongside reductions in levels of regularly completed physical activity. Ninety-eight patients (63%) scored for at least mild cognitive impairment (Neuro-Qol), and the domain of the EuroQol: 5 dimension, 5 level most impacted was Self-care, Anxiety/Depression and Usual Activities.

Conclusions
Persistent symptoms associated with post-acute COVID-19 syndrome seem to impact physical and cognitive function, health-related quality of life, and participation in society. More research is needed to further clarify the relationship between COVID-19 infection and post-acute COVID-19 syndrome symptoms, the underlying mechanisms, and treatment options.
Discriminatory Capacity of the Physical Domain Versus the Full-Scale Pediatric Quality of Life Inventory With Traumatic Brain Injury Severity in Children
Authors: Benipal Simranjeet , Kuppermann Nathan , Tancredi Daniel J. , Rivara Frederick P. , Wang Jin , Nishijima Daniel K. 
Published: October 2021

Abstract
A previous study demonstrated that the Pediatric Quality of Life Inventory, a health-related quality-of-life instrument consisting of physical and psychosocial domain scores, reliably differentiates between children with varying severities of traumatic brain injuries (N = 729) 3, 12, and 24 mos after injury. However, the Pediatric Quality of Life Inventory physical domain score alone may simplify evaluation outcomes in physical rehabilitation and clinical research when comparing different trauma interventions. Therefore, we performed a secondary analysis to evaluate and compare the discriminative capacity of traumatic brain injury severity for changes in the overall Pediatric Quality of Life Inventory or the Pediatric Quality of Life Inventory physical domain score alone. We used linear mixed models to assess the change of outcome scores from baseline compared with arm-injury controls. Somers’ D was calculated to compare discriminatory capacity with injury severity as a predictor of change in Pediatric Quality of Life Inventory outcome scores. We found that traumatic brain injury severity in children can be differentiated by the Pediatric Quality of Life Inventory physical domain score alone. However, at all follow-up time points, traumatic brain injury severity had higher discriminatory capacity for changes in the overall Pediatric Quality of Life Inventory. Our results suggest that the overall Pediatric Quality of Life Inventory should be used preferentially in children with traumatic brain injuries, although further investigation of the physical domain is warranted in conditions where physical injuries may predominate.