bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel Visualization Methods Assisted Transurethral Resection for Bladder Cancer: An Updated Survival-Based Systematic Review and Meta-Analysis
Authors: Li Honglin , Cao Yubin , Ma Pingchuan , Ma Zhongkai , Li Chunjie , Yang Wenbin , Zhou Lingyun 
Published: August 2021

BackgroundPhotodynamic diagnosis and narrow-band imaging could help improve the detection rate in transurethral resection (TUR) of bladder cancer. It remained controversial that the novel visualization method assisted transurethral resection (VA-TUR) could elongate patients’ survival compared to traditional TUR.MethodsWe performed electronic and manual searching until December 2020 to identify randomized controlled trials comparing VA-TUR with traditional TUR, which reported patients’ survival data. Two reviewers independently selected eligible studies, extracted data, assessed the risk of bias. Meta-analysis was conducted according to subgroups of types of visualization methods (A) and clinical stage of participants. Publication bias was detected.ResultsWe included 20 studies (reported in 28 articles) in this review. A total of 6,062 participants were randomized, and 5,217 participants were included in the analysis. Only two studies were assessed at low risk of bias. VA-TURB could significantly improve the recurrence-free survival (RFS) (HR = 0.72, 95% CI: 0.66 to 0.79, P &lt;0.00001, I2 = 42%) and progression-free survival (PFS) (HR = 0.62, 95% CI: 0.46 to 0.82, P &lt;0.0008, I2 = 0%) compared with TUR under white light. The results remain stable whatever the type of visualization method. The difference could be observed in the non-muscle-invasive bladder cancer (NMIBC) population (P &lt;0.05) but not in the mixed population with muscle-invasive bladder cancer (MIBC) participants (P &gt;0.05).ConclusionVA-TUR could improve RFS and PFS in NMIBC patients. No significant difference is found among different types of VA-TUR. VA-TUR may be not indicated to MIBC patients.
Association of Serum Anti-PCSK9 Antibody Levels with Favorable Postoperative Prognosis in Esophageal Cancer
Authors: Ito Masaaki , Hiwasa Takaki , Oshima Yoko , Yajima Satoshi , Suzuki Takashi , Nanami Tatsuki , Sumazaki Makoto , Shiratori Fumiaki , Funahashi Kimihiko , Li Shu-Yang , Iwadate Yasuo , Yamagata Hiroki , Jambaljav Byambasteren , Takemoto Minoru , Yokote Koutaro , Takizawa Hirotaka , Shimada Hideaki 
Published: August 2021

BackgroundEsophageal cancer often appears as postoperative metastasis or recurrence after radical surgery. Although we had previously reported that serum programmed cell death ligand 1 (PD-L1) level correlated with the prognosis of esophageal cancer, further novel biomarkers are required for more precise prediction of the prognosis. Proprotein convertase subtilisin/kexin type 9 (PCSK9) is associated with the cholesterol metabolism. But there was no report of relationship between serum PCSK9 antibody and cancer. Therefore, we investigated whether anti-PCSK9 antibodies could be a novel biomarker for solid cancer.MethodsSerum levels of anti-PCSK9 antibodies and antigens in patients with solid cancer were analyzed using amplified luminescence proximity homogeneous assay-linked immunosorbent assay (AlphaLISA). The reactivity of serum antibodies against recombinant PCSK9 protein was investigated by Western blotting, and the expression of PCSK9 antigens in esophageal cancer tissues was examined by immunohistochemical staining.ResultsAlphaLISA showed that serum anti-PCSK9 antibody (s-PCSK9-Ab) levels were significantly higher in patients with esophageal cancer, gastric cancer, colorectal cancer, lung cancer, and breast cancer than in healthy donors, and patients with esophageal cancer had the highest levels. The presence of serum antibody in patients was confirmed by Western blotting. There was no apparent correlation between s-PCSK9-Ab and PCSK9 antigen levels. Immunohistochemical staining demonstrated the expression of PCSK9 antigen in both the cytoplasm and nuclear compartments of esophageal squamous cell carcinoma tissue but not in normal tissue. Compared with patients with low s-PCSK9-Ab levels, those with high s-PCSK9-Ab levels had a favorable postoperative prognosis after radical surgery for esophageal cancer. In the multivariate analysis, tumor depth and s-PCSK9-Ab level were identified as independent prognostic factors. In the univariate analysis of clinicopathological features, high PCSK9 antibody levels were not associated with sex, age, location, tumor depth, lymph node status, squamous cell carcinoma antigen, or p53-Ab, whereas they correlated significantly with PD-L1 levels, which were associated with unfavorable prognosis. Correlation between s-PCSK9-Ab and PD-L1 levels was also confirmed in the logistic regression analysis; therefore, low s-PCSK9-Ab levels could discriminate another poor prognosis group other than high-PD-L1 group.ConclusionsPatients with solid cancer had higher s-PCSK9-Ab levels than healthy donors. High s-PCSK9-Ab levels indicated better prognosis for overall survival after surgery in patients with esophageal cancer.
Does Extended Intraoperative Peritoneal Lavage Really Bring Benefit on Patients With Gastric Cancer? A Meta-Analysis of Published Clinical Trials
Authors: Tao Wei , Liu Xiao-Yu , Cheng Yu-Xi , Kang Bing , Zhang Hua , Yuan Chao , Zhang Bin , Peng Dong 
Published: August 2021

PurposeThe purpose of the current meta-analysis is to analyze whether extended intraoperative peritoneal lavage (EIPL) can bring benefit on short-term outcomes or survival for patients undergoing curative gastrectomy for gastric cancer.MethodsThe PubMed, Embase, and Cochrane Library databases were searched from inception to May 3, 2021, to find eligible studies. Postoperative complications, overall survival (OS), disease-free survival (DFS), and peritoneal recurrence–free survival (PRFS) were compared between EIPL group and No EIPL group.ResultsA total of five randomized controlled trials with 1,790 patients were included in the current meta-analysis. No difference was found in baseline information (p &gt; 0.05). After pooling up the data of overall postoperative complications, no significant difference was found between EIPL group and No EIPL group (OR = 0.88, 95% CI = 0.51 to 1.53, P = 0.65). Furthermore, there was no significant difference between EIPL group and No EIPL group in terms of OS (HR = 0.77, 95% CI = 0.36 to 1.64, P = 0.49), DFS (HR = 0.97, 95% CI = 0.71 to 1.33, P = 0.87), and PRFS (HR = 1.03, 95% CI = 0.74 to 1.43, P = 0.86). In terms of subgroup analysis of OS, no significant difference was found as well (HR = 1.05, 95% CI = 0.82 to 1.34, P = 0.69).ConclusionsEIPL did not bring benefit in terms of short-term outcomes or survival. Therefore, EIPL is not recommended for patients undergoing curative gastrectomy for gastric cancer.
The Benefit of Apparent Diffusion Coefficient in Evaluating the Invasiveness of Hepatocellular Carcinoma
Authors: Jing Mengyuan , Cao Yuntai , Zhang Peng , Zhang Bin , Lin Xiaoqiang , Deng Liangna , Han Tao , Zhou Junlin 
Published: August 2021

BackgroundThis study aimed to evaluate hepatocellular carcinoma (HCC) invasiveness using the apparent diffusion coefficient (ADC).MethodsEighty-one patients with HCC confirmed by pathology and examined by preoperative magnetic resonance imaging diffusion-weighted imaging from January 2015 to September 2020 were retrospectively analyzed. Clinical and pathological data were recorded. The minimum ADC (ADCmin), average ADC (ADCmean), and the ratio of ADCmean to normal-appearing hepatic parenchyma ADC (ADCnahp) were assessed. The associations between clinical information, ADC value, and HCC invasiveness (microvascular invasion [MVI], tumor differentiation, and Ki-67 expression) were evaluated statistically. Independent risk factors related to HCC invasiveness were screened using binary logistic regression, and the diagnostic efficiency was evaluated by the receiver operating characteristic curve and its area under the curve (AUC) value.ResultsTumor size was related to HCC MVI and tumor differentiation (P &lt; 0.05). HCC MVI was associated with ADCmin, ADCmean, and the ADCmean-to-ADCnahp ratio (all P &lt; 0.05) with AUC values of 0.860, 0.860, and 0.909, respectively. If these were combined with tumor size, the AUC value increased to 0.912. The degree of tumor differentiation was associated with ADCmin, ADCmean, and the ADCmean-to-ADCnahp ratio (all P &lt; 0.05) with AUC values of 0.719, 0.708, and 0.797, respectively. If these were combined with tumor size, the AUC value increased to 0.868. Ki-67 expression was associated with ADCmin, ADCmean, and the ADCmean-to-ADCnahp ratio (all P &lt; 0.05) with AUC values of 0.731, 0.747, and 0.746, respectively. Combined them, the AUC value increased to 0.763.ConclusionsThe findings indicated that the ADC value has significant potential for the non-invasive preoperative evaluation of HCC invasiveness.
Overall Survival of Patients With Unresectable or Metastatic BRAF V600-Mutant Acral/Cutaneous Melanoma Administered Dabrafenib Plus Trametinib: Long-Term Follow-Up of a Multicenter, Single-Arm Phase IIa Trial
Authors: Mao Lili , Ding Ya , Bai Xue , Sheng Xinan , Dai Jie , Chi Zhihong , Cui Chuanliang , Kong Yan , Fan Yun , Xu Yanjun , Wang Xuan , Tang Bixia , Lian Bin , Yan Xieqiao , Li Siming , Zhou Li , Wei Xiaoting , Li Caili , Guo Jun , Zhang Xiaoshi , Si Lu 
Published: August 2021

ObjectivesTo examine the long-term survival outcome of dabrafenib in combination with trametinib in Chinese patients with unresectable or metastatic acral/cutaneous melanoma with BRAF-V600 mutation and to explore potential predictors of effectiveness.MethodsThis was a long-term follow-up of Chinese patients with unresectable or metastatic BRAF V600-mutant acral/cutaneous melanoma administered dabrafenib (150 mg twice daily) plus trametinib (2 mg once daily) in an open-label, multicenter, single-arm, phase IIa study (NCT02083354). Efficacy endpoints included objective response rate (ORR), duration of response (DOR), progression-free survival (PFS), and overall survival (OS). The impacts of baseline characteristics on PFS and OS were analyzed.ResultsA total of sixty patients were included. The median age was 48 years, and 24 patients (40.0%) were male. Totally 12 individuals (20.0%) had acral melanoma, and 45 (75.0%) had failed previous systemic therapy. Up to July 2020, the median duration of follow-up was 37.0 (95% confidence interval [CI] 29.1-44.9) months. The updated ORR was 71.7% (95%CI 60.3%-83.1%). The 3-year OS rate was 28.8% (95%CI 19.1-43.6%) in the overall population, and 35.7% (95%CI 15.5–82.4%) in acral melanoma patients. The median DOR was 7.5 months (95%CI 4.5 to 10.5). Baseline normal lactic dehydrogenase (LDH), metastatic organ sites&lt;3 and complete response to combination therapy with dabrafenib plus trametinib were associated with improved PFS and OS.ConclusionDabrafenib combined with trametinib confer long-term survival in Chinese patients with BRAF V600-mutant, unresectable or metastatic acral/cutaneous melanoma.Clinical Trial Registrationhttps://clinicaltrials.gov/ct2/show/NCT02083354, identifier NCT02083354.
Temperature Monitoring Devices in Neonates
Authors: Lei Donna , Tan Kenneth , Malhotra Atul 
Published: August 2021

Introduction:Accurate temperature monitoring of neonates is vital due to the significant morbidities and mortality associated with neonatal hypothermia. Many studies have compared different thermometers in neonates, however, there is a lack of consensus regarding which of the currently available thermometers is most suitable for use in neonates.Objectives:The aim of this review was to identify and compare current methods available for temperature monitoring of neonates beyond the delivery room, including the accuracy, advantages and disadvantages of each.Methods:A recent search and narrative synthesis of relevant studies published between January 1, 1949 and May 5, 2021 on the OVID Medline, PubMed and Google Scholar databases.Results:A total of 160 papers were retrieved for narrative synthesis. The main methods available for temperature monitoring in neonates are human touch and mercury-in-glass, electronic, infrared tympanic and other infrared thermometers. Newer innovations that are also available include liquid crystal thermometers and the BEMPU TempWatch. This paper discusses the current evidence available regarding the utility of these devices, and identifies barriers to valid comparison of different thermometry methods.Conclusion:Many methods for temperature monitoring in neonates are currently available, each with their own advantages and disadvantages. However, the accuracies of different devices are hard to determine due to variable methodologies used in relevant studies and hence, further research that addresses these gaps is needed.
Case Report: A Case Report and Literature Review on Severe Bullous Skin Reaction Induced by anti-PD-1 Immunotherapy in a Cervical Cancer Patient
Authors: Li Xiang , Qu Li-Xin , Ren Yu-Mei , Hu Chang 
Published: August 2021

Background: Anti-programmed cell death protein 1 (PD-1) has been successfully used in carcinomas treatment. However, it causes significant adverse effects (AEs), including cutaneous reactions, particularly the life-threatening severe bullous skin reactions (SBSR) and toxic epidermal necrolysis (TEN).Case summary: Herein, we described for the first time a case report of SBSR induced by anti-PD-1 therapy in a cervical cancer patient. In addition, we revised existing literature on anti-PD-1 induced cutaneous reactions. We reported a cervical cancer patient who was treated with four successive cycles of Sintilimab and Toripalimab injections and developed systemic rashes, bullae, and epidermal desquamation, which worsened and led to infection, eventually causing death after being unresponsive to aggressive treatments.Conclusion: Anti-PD-1 antibodies commonly cause skin toxicity effects, some of which may be deadly. Therefore, healthcare providers should observe early symptoms and administer proper treatment to prevent aggravation of symptoms.
Scientific Challenges on Theory of Fat Burning by Exercise
Authors: Harris M. Brennan , Kuo Chia-Hua 
Published: August 2021

GRAPHICAL ABSTRACTExercise decreases abdominal fat mass, especially at high intensity. This outcome is not causally associated with fat burning, but better explained by carbon and nitrogen redistribution. Since abdominal fat tissue constantly releases fatty acids into circulation under post-absorptive condition with natural cell deaths, exercise diverts more post-meal carbon and nitrogen to muscle for energy repletion and cell regeneration after phagocytosis and stem cell homing. This in turn leads to concurrent fat mass loss and muscle mass gain. Respiratory ventilation during high-intensity aerobic exercise amplifies the competition for post-meal carbon and nitrogen against adipose tissues.
High Intensity Interval Training (HIIT) as a Potential Countermeasure for Phenotypic Characteristics of Sarcopenia: A Scoping Review
Authors: Hayes Lawrence D. , Elliott Bradley T. , Yasar Zerbu , Bampouras Theodoros M. , Sculthorpe Nicholas F. , Sanal-Hayes Nilihan E. M. , Hurst Christopher 
Published: August 2021

Background: Sarcopenia is defined as a progressive and generalized loss of skeletal muscle quantity and function associated predominantly with aging. Physical activity appears the most promising intervention to attenuate sarcopenia, yet physical activity guidelines are rarely met. In recent years high intensity interval training (HIIT) has garnered interested in athletic populations, clinical populations, and general population alike. There is emerging evidence of the efficacy of HIIT in the young old (i.e. seventh decade of life), yet data concerning the oldest old (i.e., ninth decade of life onwards), and those diagnosed with sarcopenic are sparse.Objectives: In this scoping review of the literature, we aggregated information regarding HIIT as a potential intervention to attenuate phenotypic characteristics of sarcopenia.Eligibility Criteria: Original investigations concerning the impact of HIIT on muscle function, muscle quantity or quality, and physical performance in older individuals (mean age ≥60 years of age) were considered.Sources of Evidence: Five electronic databases (Medline, EMBASE, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials [CENTRAL]) were searched.Methods: A scoping review was conducted using the Arksey and O'Malley methodological framework (2005). Review selection and characterization were performed by two independent reviewers using pretested forms.Results: Authors reviewed 1,063 titles and abstracts for inclusion with 74 selected for full text review. Thirty-two studies were analyzed. Twenty-seven studies had a mean participant age in the 60s, two in the 70s, and three in the 80s. There were 20 studies which examined the effect of HIIT on muscle function, 22 which examined muscle quantity, and 12 which examined physical performance. HIIT was generally effective in Improving muscle function and physical performance compared to non-exercised controls, moderate intensity continuous training, or pre-HIIT (study design-dependent), with more ambiguity concerning muscle quantity.Conclusions: Most studies presented herein utilized outcome measures defined by the European Working Group on Sarcopenia in Older People (EWGSOP). However, there are too few studies investigating any form of HIIT in the oldest old (i.e., ≥80 years of age), or those already sarcopenic. Therefore, more intervention studies are needed in this population.
Possible Vicarious Traumatization Among Psychiatric Inpatients During the Remission Phase of the COVID-19: A Single-Center Cross-Sectional Study
Authors: Zheng Yage , Xiao Ling , Huang Yonglan , Wang Qing , Xie Yinping , Wang Huiling , Wang Gaohua 
Published: August 2021

Background: Far from being a clinical disease, the COVID-19 pandemic has become a threatening social event worldwide exerting long-term impacts on human beings.Objective: This study was designed to determine if and to what extent psychiatric inpatients during the remission phase of the pandemic suffered from vicarious traumatization.Method: Totally 266 eligible participants from psychiatric and psychological wards in a hospital were recruited during October 26th, 2020 to February 4th, 2021 to finish a self-made online questionnaire consisting of Impact of Event Scale-Revised (IES-R), Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), Obsessive-Compulsive Inventory-Revised (OCI-R), Pittsburgh Sleep Quality Index-Revised (PSQI-R), Social Support Rating Scale (SSRS), Beck Suicide Ideation Scale (SSI), 12-Item Short-Form Health Survey (SF-12). Meanwhile, some socio-demographics and information related to the pandemic were also recorded.Results: The detection rate of vicarious traumatic symptoms (VTS) was 80.83%, including 40.98% for mild ones, 25.56% for moderate ones, and 14.29% for severe ones, among whom 98.14% possessed all three phenotypes. 27.07% of the sample were considered possible vicarious traumatization (pVT). Having acquaintances infected with or died from COVID-19, worries on re-outbreak of COVID-19, a higher score of OCI-R or lower score of SF-12, and long latency of VTS were independent risk factors of pVT.Conclusion: Our study showed that COVID-19 could have profound mental influences on psychiatric inpatients. It is high time we did some screening in the wards to seek for patients at risk.
Consumers' Knowledge, Attitudes, and Practices Toward Medicine Price Transparency at Private Healthcare Setting in Malaysia
Authors: Ahmad Nur Sufiza , Hatah Ernieda , Jalil Mohamad Ridha , Makmor-Bakry Mohd 
Published: August 2021

Background:Medicine price transparency refers to the practice of making prices available to consumers for them to identify, compare, and select the medicine that provides the desired value. This study aimed to evaluate consumer knowledge, attitudes, and practices regarding Malaysia's medicine price transparency initiative, as well as factors that may influence related good consumer practices in private healthcare settings.Methods:A cross-sectional, self-administered survey was conducted between May and July 2019 among consumers attending private healthcare institutions in Malaysia. The self-developed and validated survey consisted of four sections on the following: respondents' demographics, and 28 close-ended and graded Likert scale answer options on knowledge, attitudes, and practices toward medicine price transparency. Factors influencing good consumer practices toward the transparency initiative were modeled using binary logistic regression.Results:A total of 679 respondents were part of the study. The mean age of respondents was 38 ± 13.3, with the majority (n= 420, 61.9%) being female. The respondents' mean score of knowledge and attitudes toward the price transparency initiative was 5.6 ± 1.5 of the total score of 8 and 31.9 ± 4.0 of the total score of 40, respectively. The respondents had the lowest score in the practice of price transparency, with a mean score of 31.5 ± 5.6 of the total score of 60. Male gender, Chinese ethnicity, high score on knowledge and attitudes, and high expenses on medicines influenced respondents' good practices of medicine price transparency.Conclusion:Respondents had good knowledge and attitudes, but their usage and implementation of the medicine price transparency initiative was still inadequate. A number of factors influence this inadequacy, including gender, race, consumers' out-of-pocket spending on medication, and knowledge of and attitudes toward price transparency practices. Consumer-driven market price control would be impossible to achieve without the good consumer practices of medicine price transparency.
Health-Care Professionals' Assessments of, and Recommendations for, Sexual-Health Education and Service Provision for Young People in Tehran
Authors: Sheikhansari Narges , Abraham Charles , Denford Sarah 
Published: August 2021

Background: Only limited Sexual Health and Relationships Education (SHRE) is provided in Iranian schools and universities while research has highlighted demand and need for improved SHRE among young adults. We explored health-care professionals' (HCPs) assessments of, and recommendations for, SHRE and service provision for young people in Tehran.Design and Methods: Semi-structured interviews were conducted with a sample of 17 HCPs based in Tehran and verbatim transcripts were analyzed using thematic analysis.Results: Participants confirmed the need for improved SHRE and service provision for young adults. HCPs described how a lack of reliable educational resources for young adults, taboo and cultural barriers, and a lack of trust and confidentiality prevented young people from accessing information and services. They unanimously supported education and services to be augmented, and provided recommendations on how this could be achieved.Conclusions: A number of positive suggestions for the improvement of SHRE and Iranian sexual health services in Iran were identified.