bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring and predicting mortality among patients with end-stage liver disease without cancer: a machine learning approach
Authors: Yu Cheng-Sheng , Chen Yu-Da , Chang Shy-Shin , Tang Jui-Hsiang , Wu Jenny L. , Lin Chang-Hsien 
Published: April 2021

Objective
End-stage liver disease is a global public health problem with a high mortality rate. Early identification of people at risk of poor prognosis is fundamental for decision-making in clinical settings. This study created a machine learning prediction system that provides several related models with visualized graphs, including decision trees, ensemble learning and clustering, to predict mortality in patients with end-stage liver disease.

Methods
A retrospective cohort study was conducted: the training data were from patients enrolled from January 2009 to December 2010 and followed up to December 2014; validation data were from patients enrolled from January 2015 to December 2016 and followed up to January 2019. Hospitalized patients with noncancer-related chronic liver disease were identified from the hospital’s electrical medical records.

Results
In traditional multivariable logistic regression and Cox proportional hazard model, prothrombin time of international normalized ratio, which was significant with P value = 0.002, odds ratio = 2.790 and hazard ratio 1.363. Besides, blood urea nitrogen and C-reactive protein were also significant, with P value <0.001 and 0.026. The area under the curve was 0.771 in the receiver operating characteristic curve. In machine learning, blood urea nitrogen and age were regarded as the primary factors for predicting mortality. Creatinine, prothrombin time of international normalized ratio and bilirubin were also significant mortality predictors. The area under the curve of the random forest and AdaBoost was 0.838 and 0.792.

Conclusion
The machine learning techniques provided a comprehensive assessment of patient conditions; it could help physicians make an accurate diagnosis of chronic liver disease and improve healthcare management.
How extent of Barrett's metaplasia influences the risk of esophageal adenocarcinoma
Authors: Meyer Chase , Hejazi Reza , Bansal Ajay 
Published: April 2021

Purpose of review
This review will focus on how the extent of Barrett's metaplasia influences the risk of esophageal adenocarcinoma (EAC). More specifically, this review will discuss the concepts of long and short-segment Barrett's metaplasia and irregular Z line as they relate to EAC risk.

Recent findings
The Prague classification can standardize reporting of Barrett's metaplasia. Recent literature has found significant associations between the length of Barrett's metaplasia and increased progression risk to EAC in multiple geographically distinct populations. Length of Barrett's metaplasia has been incorporated into the Progression of Barrett's esophagus (PIB) model that can predict individualized life-time risks of progression. The risk of malignant transformation appears to be very low in patients with irregular Z line.

Summary
Length of Barrett's metaplasia has emerged as an important predictor that can influence the risk of EAC and should be reported using the Prague classification. The PIB model, if further validated, could help a practicing gastroenterologist to inform patients with Barrett's metaplasia about their personal risk of progression to tailor surveillance intervals. Current guidelines do not recommend surveillance in patients with irregular Z line, but careful examination is recommended.
Nonalcohol fatty liver disease: balancing supply and utilization of triglycerides
Authors: Santos-Baez Leinys S. , Ginsberg Henry N. 
Published: April 2021

Purpose of review
Nonalcoholic fatty liver disease (NAFLD) is defined as the abnormal accumulation of lipids in the liver, called hepatic steatosis, which occurs most often as a concomitant of the metabolic syndrome. Its incidence has surged significantly in recent decades concomitant with the obesity pandemic and increasing consumption of refined carbohydrates and saturated fats. This makes a review of the origins of NAFLD timely and relevant.

Recent findings
This disorder, which shares histologic markers found in alcoholic fatty liver disease, was named NAFLD to distinguish it from the latter. Recently, however, the term metabolic-associated fatty liver disease (MAFLD) has been suggested as a refinement of NAFLD that should highlight the central, etiologic role of insulin resistance, obesity, and diabetes mellitus. The complexity of the pathways involved in the regulation of hepatic triglyceride synthesis and utilization have become obvious over the past 10 years, including the recent identification of monogenic causes of metabolic-associated fatty liver disease. These include PNPLA3, transmembrane 6 superfamily member 2, GCKR, membrane-bound O-acyltransferase 7 suggest targets for new therapies for hepatic steatosis.

Summary
The current review can serve as a guide to the complex pathways involved in the maintenance of hepatic triglyceride levels as well as an introduction to the most recent discoveries, including those of key genes that have provided opportunities for new and novel therapeutics.
Effect of Two Interventions on Sleep Quality for Adolescent and Young Adult Cancer Survivors
Authors: Li Lijun , Wang Lu , Sun Qian , Xiao Panpan , Duan Yinglong , Liu Xiangyu , Zhou Jianda , Xie Jianfei , Cheng Andy S. K. 
Published: April 2021

Background
Sleep disturbance is common among adolescent and young adult (AYA) cancer survivors. Physical activity (PA) and behavioral activation (BA) therapy have been reported as enhancing sleep quality, but few studies exist on the effects of such interventions combined with technology to promote sleep quality in AYA cancer patients.

Objective
The aim of this study was to investigate the feasibility and effects of intelligent wearable device–based PA therapy and internet-based modified BA therapy to improve sleep quality among AYA cancer patients.

Methods
A randomized controlled trial with 143 AYA cancer patients was conducted. Participants were randomly assigned to a control group (n = 48), which performed routine care, a PA group (n = 47), which received 8-week PA therapy based on intelligent wearable devices, and a BA group (n = 48), which participated in internet-based modified BA therapy for 8 weeks.

Results
At 1 week and 3 months after the intervention for sleep quality, there were statistically significant differences between the PA group and the control group (P = .020), but no statistically significant difference between the BA group and the control group.

Conclusions
The intelligent wearable device–based PA therapy has more advantages than internet-based modified BA therapy in improving the overall state of AYA cancer patients, and the intervention effect was sustained for at least 3 months.

Implications for Practice
Developing and implementing PA plans for AYA cancer survivors can improve their sleep quality. Social media, intelligent wearable devices, and mobile health applications have unique advantages in promoting sleep quality for AYA cancer survivors.
Evaluation of the Use of Diverse Mental Health Simulation in Nursing Students' Learning Experience
Authors: Ozkara San Eda , Dikec Gul , Ata Elvan Emine , Sendir Merdiye 
Published: April 2021

Background
Simulated patients (SPs) in mental health nursing education provide a unique approach to assist student development in complex assessment skills.

Purpose
The purpose of this international multisite study was to evaluate the use of two diverse mental health SP simulation scenarios on nursing students' satisfaction and self-confidence in learning to care for patients with mental health disorders in the United States (n = 70) and Turkey (n = 90).

Methods
A multisite cross-sectional study design was used. Outcome measures included the Student Satisfaction and Self-confidence in Learning Scale and the adapted Simulation Effectiveness Tool–Modified. Results were analyzed using independent t tests.

Results
While students in the United States reported higher perceived self-confidence and satisfaction in learning, both student populations found the intervention effective to their learning (P < .05).

Conclusion
Using SPs in mental health education allow students to practice their assessment skills learned in classroom and transfer them to the clinical area.
An Integrated Mental Health and Acute Care Clinical Rotation on a Dedicated Education Unit
Authors: Walsh Lisa Marie , Goodson Mallory , Pfeiffer Katherine , Higgins Melinda , Robertson Bethany 
Published: April 2021

Background
Traditional mental health clinical experiences expose students to an environment that may not prepare them to address mental health needs in hospital settings.

Purpose
The purpose is of this project was to evaluate the implementation of an integrated mental health and acute care clinical model on a dedicated education unit (DEU).

Methods
In this pilot project, students provided dually focused medical and mental health care on assigned patients. A preclass and postclass survey measured their perceptions of mental health competency.

Results
There were no statistically significant differences between the 2 groups (integrated model on the DEU compared with a traditional experience on an acute care and inpatient behavioral health unit). All groups reported increased mental health competency.

Conclusions
Both groups showed similar improvements from the preclass to the postclass survey on perceived competence, suggesting that an integrated acute care and mental health clinical practicum may be equivalent to the traditional model.
Safety of Fibroblast Activation Protein–Targeted Radionuclide Therapy by a Low-Dose Dosimetric Approach Using 177Lu-FAPI04
Authors: Kuyumcu Serkan , Kovan Bilal , Sanli Yasemin , Buyukkaya Fikret , Has Simsek Duygu , Özkan Zeynep Gözde , Isik Emine Goknur , Ekenel Meltem , Turkmen Cuneyt 
Published: April 2021

Objectives
This study is set out to estimate the radiation-absorbed doses to normal organs and tumor tissue using low-dose 177Lu-FAPI04 dosimetry to determine the safety and theranostic potential of fibroblast activation protein–targeted radionuclide therapy.

Patients and Methods
Four patients with metastatic advanced-stage cancer were administered low-dose 177Lu-FAPI04 for dosimetry measurements. Data acquisition for dosimetry of normal organs and tumors was performed by whole-body and 3D SPECT/CT imaging at 4, 24, 48, and 96 hours after administering 177Lu-FAPI04. Blood samples were drawn at 5, 15, 30, 60, 60, 120, and 180 minutes, and at 24, 48, and 96 hours for bone marrow dosimetry calculations.

Results
Mean absorbed doses per megabecquerel were 0.25 ± 0.16 mGy (range, 0.11–0.47 mGy), 0.11 ± 0.08 mGy (range, 0.06–0.22 mGy), and 0.04 ± 0.002 mGy (range, 0.04–0.046 mGy) for kidneys, liver, and bone marrow, respectively. The respective maximum estimated amount of radioactivity to reach radiation-absorbed dose limits were 120.9 ± 68.6 GBq, 47.5 ± 2.8 GBq, 397.8 ± 217.1 GBq, and 52.4 ± 15.3 GBq for kidneys, bone marrow, liver, and total body. The mean absorbed dose per megabecquerel was 0.62 ± 0.55 mGy for bone metastases, 0.38 ± 0.22 mGy for metastatic lymph nodes, 0.33 ± 0.21 mGy for liver metastases, and 0.37 ± 0.29 for metastatic soft tissue. The maximum absorbed dose in a tumor lesion was 1.67 mGy/MBq for bone, 0.6 mGy/MBq for lymph node, 0.62 mGy/MBq for liver, and 1 mGy/MBq for soft tissue.

Conclusions
The mean absorbed dose to organs at risk with 177Lu-FAPI04 is reasonably low, allowing for low tumor-absorbed dose rates by administering a higher dose. Further research on optimizing therapeutic efficacy and using alternative radioisotopes is necessary, along with an individualized dosimetric approach.
Myeloid-Derived Suppressor Cells (MDSCs) and the Immunoinflammatory Response to Injury (Mini Review)
Authors: Sayyadioskoie Shannon R. , Schwacha Martin G. 
Published: April 2021

ABSTRACT
Myeloid-derived suppressor cells (MDSCs) are a heterogenous population of immature myeloid cells hallmarked by their potent immunosuppressive function in a vast array of pathologic conditions. MDSCs have recently been shown to exhibit marked expansion in acute inflammatory states including traumatic injury, burn, and sepsis. Although MDSCs have been well characterized in cancer, there are significant gaps in our knowledge of their functionality in trauma and sepsis, and their clinical significance remains unclear. It is suggested that MDSCs serve an important role in quelling profound inflammatory responses in the acute setting; however, MDSC accumulation may also predispose patients to developing persistent immune dysregulation with increased risk for nosocomial infections, sepsis, and multiorgan failure. Whether MDSCs may serve as the target for novel therapeutics or an important biomarker in trauma and sepsis is yet to be determined. In this review, we will discuss the current understanding of MDSCs within the context of specific traumatic injury types and sepsis. To improve delineation of their functional role, we propose a systemic approach to MDSC analysis including phenotypic standardization, longitudinal analysis, and expansion of clinical research.
Epidemic Models and Protective Mutations
Authors: Parmeggiani Claudio 
Published: April 2021

AbstractThe paper proposes and discusses an epidemic model which assumes that a population, affected to a disease, is (partially) protected from the disease. These protections may be generated by some inherited genetic mutations; mutations favoured by the presence, in the past, of a deadly endemic disease (the Haldane hypothesis). The protections can also have a non-genetic origin: the cause can be the age or the sex of the subjects; in this case the model can only be applied for short periods, typically in the early stages of the epidemic. Anyway we shall see that the presence of these protections, if wisely managed, not only does it benefit the whole population, but it also makes the measures taken to contain the epidemic more effective.
Short time effect of Covid 19 pandemic on HbA1c and acute metabolic complications in children with type 1 diabetes
Authors: Arslanoglu Ilknur , Akcali Figen , Yavuzyilmaz Fatma , Sungur Mehmet Ali 
Published: April 2021

AbstractBackgroundCOVID19 pandemic is currently affecting every aspect of daily life of communitiesy throughout the world. We aimed to check how this situation affects the metabolic control of children with type 1 diabetes.MethodsWe analyzed all patients with type 1 diabetes a HbA1c test after at least two months ensuing the start of the epidemic in Turkey. We compared the results with the most recent HbA1c test in the hospital’s automation system before the epidemic. In addition, diabetic ketoacidosis (DKA) and severe hypoglycemia rates were compared.ResultsAmong the eligible 219 cases 77.6% had decreased HbA1c levels according to their former result. Mean drop was about 9.71% compared to the former test in the whole group. Age, sex and time interval between two tests were not found to affect this tendency. Diabetic ketoacidosis rate was the same as before the pandemic, whereas severe hypoglycemia rates increased.ConclusionsDespite the potential of the pandemic to affect routine care of chronic diseases in a negative way the short term metabolic control of type 1 children with type 1 diabetes improved. Telemedicine support by the diabetes team and increased care in the family environment might be possible explanations.Grafik AbstractWhat is already known on this topic?Care of chronic diseases is a concern in the recent COVID-19 pandemic era.What this study adds?A marked improvement in HbA1 C levels of children with Type 1 diabetes in short term during COVID-19 pandemic was noted suggesting factors including closer follow-up by diabetes care team using telemedicine and more family support might be responsible.
Biophysical mechanisms of electroconvulsive therapy-induced volume expansion in the medial temporal lobe: a longitudinal in vivo human imaging study
Authors: Takamiya Akihiro , Bouckaert Filip , Laroy Maarten , Blommaert Jeroen , Radwan Ahmed , Khatoun Ahmad , Deng Zhi-De , Laughlin Myles Mc , Van Paesschen Wim , De Winter François-Laurent , Van den Stock Jan , Sunaert Stefan , Sienaert Pascal , Vandenbulcke Mathieu , Emsell Louise 
Published: April 2021

BackgroundElectroconvulsive therapy (ECT) applies electric currents to the brain to induce seizures for therapeutic purposes. ECT increases gray matter (GM) volume, predominantly in the medial temporal lobe (MTL). The contribution of induced seizures to this volume change remains unclear.MethodsT1-weighted structural MRI was acquired from thirty patients with late-life depression (mean age 72.5±7.9 years, 19 female), before and one week after one course of right unilateral ECT. Whole brain voxel-/deformation-/surface-based morphometry analyses were conducted to identify tissue-specific (GM, white matter: WM), and cerebrospinal fluid (CSF) and cerebral morphometry changes following ECT. Whole-brain voxel-wise electric field (EF) strength was estimated to investigate the association of EF distribution and regional brain volume change. The association between percentage volume change in the right MTL and ECT-related parameters (seizure duration, EF, and number of ECT sessions) was investigated using multiple regression.ResultsECT induced widespread GM volume expansion with corresponding contraction in adjacent CSF compartments, and limited WM change. The regional EF was strongly correlated with the distance from the electrodes, but not with regional volume change. The largest volume expansion was identified in the right MTL, and this was correlated with the total seizure duration.ConclusionsRight unilateral ECT induces widespread, bilateral regional volume expansion and contraction, with the largest change in the right MTL. This dynamic volume change cannot be explained by the effect of electrical stimulation alone and is related to the cumulative effect of ECT-induced seizures.
SARS-CoV-2 natural antibody response persists up to 12 months in a nationwide study from the Faroe Islands
Authors: Petersen Maria Skaalum , Hansen Cecilie Bo , Fríðheim Kristiansen Marnar , Fjallsbak Jógvan Páll , Larsen Sólrun , Hansen Jóhanna Ljósá , Jarlhelt Ida , Pérez-Alós Laura , á Steig Bjarni , Christiansen Debes Hammershaimb , Møller Lars Fodgaard , Strøm Marin , Andorsdóttir Guðrið , Gaini Shahin , Weihe Pál , Garred Peter 
Published: April 2021

AbstractOnly a few studies have assessed the long-term duration of the humoral immune response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).In this nationwide longitudinal study from the Faroe Islands with close to full participation of all individuals on the Islands with PCR confirmed COVID-19 during the two waves of infections in the spring and autumn 2020 (n=172 & n=233), samples were drawn at three longitudinal time points (3, 7 and 12 months and 1, 3 and 7 months after disease onset, respectively).Serum was analyzed with a direct quantitative IgG antibody binding ELISA to detect anti–SARS-CoV-2 spike RBD antibodies and a commercially available qualitative sandwich RBD ELISA kit measuring total antibody binding.The seropositive rate in the convalescent individuals was above 95 % at all sampling time points for both assays. There was an overall decline in IgG titers over time in both waves (p < 0.001). Pairwise comparison showed that IgG declined significantly from the first sample until approximately 7 months in both waves (p < 0.001). After that, the antibody level still declined significantly (p < 0.001), but decelerated with an altered slope remaining fairly stable from 7 months to 12 months after infection. Interestingly, the IgG titers followed a U-shaped curve with higher antibody levels among the oldest (67+) and the youngest (0– 17) age groups compared to intermediate groups (p < 0.001).Our results indicate that COVID-19 convalescent individuals are likely to be protected from reinfection up to 12 months after symptom onset and maybe even longer. We believe our results can add to the understanding of natural immunity and the expected durability of SARS-CoV-2 vaccine immune responses.
No evidence of significant cross-reactivity between the dengue virus (DENV) and SARS-CoV-2 IgG antibodies
Authors: Shurrab Farah M. , Humaira Fatima , Al-Absi Enas S. , Al-Sadeq Duaa W. , Qotba Hamda , Yassine Hadi. M. , Abu-Raddad Laith J. , Nasrallah Gheyath K. 
Published: April 2021

AbstractBackgroundSeveral studies reported serological cross-reaction between DENV and SARS-CoV-2 IgG antibodies using rapid point of care (POC) assays. Limited data are available about cross-reactivity when testing is done using advanced chemiluminescence immunoassay (CLIA) and ELISA assays.ObjectiveThis study aims to investigate potential serological cross-reactivity between SARS-CoV-2-IgG and DENV-IgG using CLIA and ELISA assays.Study-designA total of 90 DENV-IgG-ELISA positive and 90 negative pre-pandemic sera were tested for anti-SARS-CoV-2-IgG using the automated CL-900i CLIA assay. Furthermore, a total of 91 SARS-CoV-2-IgG-CLIA positive and 91 negative post-pandemic sera were tested for anti-DENV-IgG using the Novalis ELISA assay.ResultsThe DENV-IgG positive sera had 5 positives and 85 negatives for SARS-CoV-2-IgG. The DENV-IgG negative sera also had 5 positives and 85 negatives for SARS-CoV-2-IgG. No statistically significant difference in specificity between the DENV-IgG positive and DENV-IgG negative sera was found (p-value=1.00). The SARS-CoV-2-IgG positive sera had 43 positives, 47 negatives, and 1 equivocal for DENV-IgG. The SARS-CoV-2-IgG negative sera had 50 positives, 40 negatives, and 1 equivocal for DENV-IgG. No statistically significant difference in the proportion that is DENV-IgG positive between the SARS-CoV-2-IgG positive and SARS-CoV-2-IgG negative sera (p-value=0.58).ConclusionsNo evidence for cross-reactivity between the DENV and SARS-CoV-2 IgG antibodies was found.