bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pipeline Embolization Device for the Treatment of Ruptured Intracerebral Aneurysms: A Multicenter Retrospective Study
Authors: Zhong Weiying , Kuang Hong , Zhang Ping , Yang Xinjian , Luo Bin , Maimaitili Aisha , Zhao Yuanli , Song Donglei , Guan Sheng , Zhang Hongqi , Wang Yang , Wang Donghai , Su Wandong , Wang Yunyan 
Published: September 2021

Background and Purpose: The utilization of flow diversion for ruptured intracerebral aneurysms (IAs) is still limited. We aimed to demonstrate our multicenter experience using the pipeline embolization device (PED) for ruptured IAs that were difficult to treat by clipping and coiling.Methods: Thirty-eight patients with ruptured IAs who underwent PED treatment from 2015 to 2020 were retrospectively reviewed. Factors associated with procedure-related stroke (ischemic and hemorrhagic) and clinical and angiography outcomes were analyzed.Results: There were 14 (36.8%) saccular IAs, 12 (31.6%) blister-like IAs, and 12 (31.6%) dissecting IAs. Perforator involvement was noted in 10 (26.3%) IAs. Early PED placement ( ≤ 15 days) and adjunctive coiling treatment were performed in 27 (71.1%) and 22 (57.9%) cases, respectively. The overall rate of stroke-related complications was 31.6% (12/38) (including rates of 10.5% for procedure-related hemorrhagic complications and 15.8% for procedure-related infarction). The mortality rate was 13.2% (5/38), and 84.2% of patients (32/38) had favorable outcomes. Thirty-two (84.2%) patients underwent follow-up angiographic evaluations; of these, 84.4% (27 patients) had complete occlusion and 15.6% had incomplete obliteration. Multivariate analysis revealed that early PED placement was not associated with a high risk of procedure-related stroke or an unfavorable outcome. Adjunctive coiling exhibited an association with procedure-related stroke (p = 0.073). Procedure-related hemorrhagic complications were significantly associated with an unfavorable outcome (p = 0.003). Immediate contrast stasis in the venous phase was associated with complete occlusion during follow-up (p = 0.050).Conclusion: The PED is a feasible and effective treatment to prevent rebleeding and achieve aneurysm occlusion, but it is associated with a substantial risk of periprocedural hemorrhage and ischemic complications in acute ruptured IAs. Therefore, the PED should be used selectively for acutely ruptured IAs. Additionally, adjunctive coiling might increase procedure-related stroke; however, it may reduce aneurysm rebleeding in acutely ruptured IAs. Patients with immediate contrast stasis in the venous phase were more likely to achieve total occlusion. A prospective study with a larger sample size should be performed to verify our results.
Association of Malnutrition, Left Ventricular Ejection Fraction Category, and Mortality in Patients Undergoing Coronary Angiography: A Cohort With 45,826 Patients
Authors: Mai Ziling , Huang Zhidong , Lai Wenguang , Li Huanqiang , Wang Bo , Huang Sumei , Shi Yingming , Yu Sijia , Hu Qizheng , Liu Jin , Zhang Lingyu , Liu Yong , Chen Jiyan , Liang Yan , Zhong Shilong , Chen Shiqun 
Published: September 2021

Background: The regulatory effect of the left ventricular ejection fraction (LVEF) categories on the association of malnutrition and all-cause mortality in patients undergoing coronary angiography (CAG) have not been adequately addressed.Methods: Forty-five thousand eight hundred and twenty-six patients consecutively enrolled in the Cardiorenal ImprovemeNt (CIN) study (ClinicalTrials.gov NCT04407936) from January 2008 to July 2018 who underwent coronary angiography (CAG). The Controlling Nutritional Status (CONUT) score was applied to 45,826 CAG patients. The hazard ratios of mortality across combined LVEF and/or malnutrition categories were estimated by Cox regression models. Variables adjusted for in the Cox regression models included: age, gender, hypertension (HT), DM, PCI, coronary artery disease (CAD), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TRIG), chronic kidney disease (CKD), statins, atrial fibrillation (AF), anemia, and stroke. Population attributable risk (PAR) was estimated for eight groups stratified by nutritional status and LVEF categories.Results: In our study, 42,181(92%) of patients were LVEF ≥ 40%, of whom, 41.55 and 9.34% were in mild and moderate or severe malnutrition status, respectively, while 46.53 and 22.28% in mild and moderate or severe malnutritional status among patients with LVEF &lt; 40%. During a median follow-up time of 4.5 years (percentile 2.8–7.1), 5,350 (11.7%) patients died. After fully adjustment, there is no difference of mortality on malnutrition in LVEF &lt; 40% group (mild, moderate and severe vs. normal, HR (95%CI): [1.00 (0.83–0.98)], [1.20 (0.95–1.51)], [1.41 (0.87–2.29)], respectively, p for trend =0.068), but malnutrition was related to markedly increased risk of mortality in LVEF ≥ 40% group (mild, moderate, and severe vs. normal, HR (95%CI): [1.21 (1.12–1.31)], [1.56 (1.40–1.74)], and [2.20(1.67–2.90)], respectively, p for trend &lt; 0.001, and p for interaction &lt; 0.001). Patients with LVEF ≥ 40% had a higher malnutrition-associated risk of mortality and a higher PAR than those with LVEF &lt; 40%.Conclusions: Malnutrition is common in CAG patients and it has a greater effect on all-cause mortality and a higher PAR in patients with LVEF ≥ 40% than LVEF &lt; 40%.
The Differences Between Multifocal and Unifocal Papillary Thyroid Carcinoma in Unilateral Lobe: A Meta-Analysis
Authors: Zhang Ting , He Liang , Wang Zhihong , Dong Wenwu , Sun Wei , Zhang Ping , Zhang Hao 
Published: September 2021

BackgroundAs many inconsistent reports on the clinical manifestations and prognosis between unilateral unifocal PTC (UUPTC) and unilateral multifocal PTC (UMPTC), identifying the difference should guide management. The purpose of this study was to investigate other additional differences between UUPTC and UMPTC in addition to their difference in the number of cancer foci.Data SourcesA systematic literature search was conducted in the PubMed and Web of Science databases for relevant studies published before December 31, 2020. Their reference lists were also reviewed.Review MethodsTwo reviewers independently extracted data and assessed the quality of eligible studies. Studies on patients who underwent an open thyroidectomy with or without neck dissection were included. Data were analyzed using the RevMan 5.3 software.ResultsFifteen studies comprising 9,665 patients were selected for the meta-analysis. UMPTC occurred in 10% to 36% of all PTC cases. There were no significant differences between UMPTC and UUPTC patients in age, gender, tumor size, and extrathyroidal extension (ETE). However, significant differences (P &lt; 0.05) between UMPTC and UUPTC patients were observed in central lymph node metastasis (CLNM), lateral lymph node metastasis (LLNM), tumor-node-metastasis (TNM) stage I+II, TNM stage III+IV, the recurrence/persistence of the UMPTC group after total thyroidectomy and overall recurrence/persistence.ConclusionUMPTC patients are more likely to have CLNM, LLNM, more advanced TNM stage, and recurrence/persistence than UUPTC patients. Compared with UUPTC, UMPTC patients should undergo central lymph node dissection, and pay more attention to LLNM, TNM stage and recurrence/persistence during the follow-up.
Prognostic Value of Plasma Epstein-Barr Virus DNA Levels Pre- and Post-Neoadjuvant Chemotherapy in Patients With Nasopharyngeal Carcinoma
Authors: Zhu Lisheng , Ouyang Tao , Xiong Ying , Ba Li , Li Qiuting , Qiu Mengjun , Zou Zhenwei , Peng Gang 
Published: September 2021

BackgroundIn this study, we evaluated the prognostic value of the plasma levels of Epstein-Barr virus (EBV) DNA in patients with nasopharyngeal carcinoma (NPC) at different treatment stages.MethodsWe retrospectively analyzed the Data of 206 patients with NPC. Pre-neoadjuvant chemotherapy (pre-NACT), post-NACT, post-radiotherapy, and post-treatment plasma EBV DNA levels were used to establish prognostic nomograms. The concordance index (C-index) and calibration curves were used to compare the prognostic accuracy of the nomograms. The results were confirmed in a validation cohort consisting of patients who were tested for EBV DNA levels at all four stages of treatment. The Kaplan-Meier method was used to calculate the progression-free survival (PFS) and overall survival (OS). Survival differences were calculated using the log-rank test.ResultsEBV DNA-positive patients had worse 3-year PFS and 5-year OS than EBV DNA-negative patients; this was true for pre-NACT (PFS: 82.7% vs. 57.3%, P &lt; 0.001; OS: 90.9% vs. 68.7%, P = 0.08) and post-NACT (PFS: 85.0% vs. 50.6%, P &lt; 0.001; OS: 91.7% vs. 65.7%; P = 0.001) EBV DNA levels but not for post-radiotherapy (PFS: 72.2% vs. 60.9%, P = 0.192; OS: 73.1% vs. 77.2%, P = 0.472) or post-treatment (PFS: 77.3% vs. 59.2%, P = 0.063; OS: 77.5% vs. 79.7%, P = 0.644) levels. Nomograms combining pre-NACT and post-NACT EBV DNA levels had a superior prognostic ability than those of post-radiotherapy and post-treatment EBV DNA levels.ConclusionPre-NACT EBV DNA levels combined with post-NACT EBV DNA levels can more reliably predict survival outcomes in patients with NPC.
Electrochemotherapy as a Trigger to Overcome Primary Resistance to Anti-PD-1 Treatment: A Case Report of Melanoma of the Scalp
Authors: Quaresmini Davide , Di Lauro Alessandra , Fucci Livia , Strippoli Sabino , De Risi Ivana , Sciacovelli Angela Monica , Albano Anna , Achille Gaetano , Montepara Massimo , Russo Sabino , Tassone Gabriella , Guida Michele 
Published: September 2021

BackgroundImmunotherapy with immune checkpoint inhibitors is one of the main therapies for advanced melanoma. Nevertheless, albeit remarkable, immunotherapy results are still unsatisfactory as more than half of patients progress, and resistance to treatment still has a dramatic impact on clinical outcomes. Local treatments such as radiotherapy or electrochemotherapy (ECT), in addition to local control with palliative intent, have been shown to release tumoral neoantigens that can stimulate a robust systemic antitumor immune response.Case PresentationWe report the case of a patient with multiple nodular melanoma lesions of the scalp initially treated with local ECT. Soon after the procedure, multiple new lesions appeared close to the treated ones, therefore the patient started a systemic treatment with the anti-PD-1 nivolumab. The lesions of the scalp did not respond to immunotherapy, presenting a loco-regional spreading. To control the bleeding and painful lesions, we performed a second ECT, while continuing systemic immunotherapy. The treated lesions responded to the second procedure, while the other lesions continued progressing in number and dimension. Unexpectedly, after 2 months from the second ECT, the patient presented a progressive shrinkage of both treated and untreated lesions until complete remission. Concomitantly, he developed immune-related adverse events including grade 4 thyroid toxicity, grade 2 vitiligo-like depigmentation and grade 2 pemphigoid. At present, after 18 months from the first ECT and 14 months from the starting of anti-PD-1 immunotherapy, the patient is in good clinical condition and complete remission of disease still persists.ConclusionThis case highlights the potential role of ECT in increasing tumor immunogenicity and consequently in inducing a powerful immune response overcoming primary resistance to checkpoint inhibitor immunotherapy.
Andrographolide Sulfonate Is a Promising Treatment to Combat Methicillin-resistant Staphylococcus aureus and Its Biofilms
Authors: Zhang Lulu , Wen Bo , Bao Mei , Cheng Yungchi , Mahmood Tariq , Yang Weifeng , Chen Qing , Lv Lang , Li Li , Yi Jianfeng , Xie Ning , Lu Cheng , Tan Yong 
Published: September 2021

Methicillin-resistant Staphylococcus aureus (MRSA) is a drug-resistant pathogen threatening human health and safety. Biofilms are an important cause of its drug resistance and pathogenicity. Inhibition and elimination of biofilms is an important strategy for the treatment of MRSA infection. Andrographolide sulfonate (AS) is an active component of the traditional herbal medicine Andrographis paniculata. This study aims to explore the inhibitory effect and corresponding mechanisms of AS on MRSA and its biofilms. Three doses of AS (6.25, 12.5, and 25 mg/ml) were introduced to MRSA with biofilms. In vitro antibacterial testing and morphological observation were used to confirm the inhibitory effect of AS on MRSA with biofilms. Real-time PCR and metabonomics were used to explore the underlying mechanisms of the effect by studying the expression of biofilm-related genes and endogenous metabolites. AS displayed significant anti-MRSA activity, and its minimum inhibitory concentration was 50 μg/ml. Also, AS inhibited biofilms and improved biofilm permeability. The mechanisms are mediated by the inhibition of the expression of genes, such as quorum sensing system regulatory genes (agrD and sarA), microbial surface components–recognizing adhesion matrix genes (clfA and fnbB), intercellular adhesion genes (icaA, icaD, and PIA), and a gene related to cellular eDNA release (cidA), and the downregulation of five biofilm-related metabolites, including anthranilic acid, D-lactic acid, kynurenine, L-homocitrulline, and sebacic acid. This study provided valuable evidence for the activity of AS against MRSA and its biofilms and extended the methods to combat MRSA infection.
Improved Dielectric Properties and Grain Boundary Effect of Phenanthrene Under High Pressure
Authors: Wang Xiaofeng , Wang Qinglin , Qin Tianru , Zhang Guozhao , Zhang Haiwa , Sang Dandan , Wang Cong , Li Jianfu , Wang Xiaoli , Liu Cailong 
Published: September 2021

In situ impedance measurements, Raman measurements and theoretical calculations were performed to investigate the electrical transport and vibrational properties of polycrystalline phenanthrene. Two phase transitions were observed in the Raman spectra at 2.3 and 5.9 GPa, while phenanthrene transformed into an amorphous phase above 12.1 GPa. Three discontinuous changes in bulk and grain boundary resistance and relaxation frequency with pressure were attributed to the structural phase transitions. Grain boundaries were found to play a dominant role in the carrier transport process of phenanthrene. The dielectric performance of phenanthrene was effectively improved by pressure. A significant mismatch between Z″ and M″ peaks was observed, which was attributed to the localized electronic conduction in phenanthrene. Theoretical calculations showed that the intramolecular interactions were enhanced under compression. This study offers new insight into the electrical properties as well as grain boundary effect in organic semiconductors at high pressure.
Anthropometric Markers With Specific Cut-Offs Can Predict Anemia Occurrence Among Malaysian Young Adults
Authors: Dutta Sulagna , Karkada Ivan Rolland , Sengupta Pallav , Chinni Suresh V. 
Published: September 2021

Objective:Anemia bears a high global prevalence with about 1.6 billion people living with this affliction. Malaysia carries the burden of 13.8% anemia prevalence which urges for extensive research directed to its prediction and amelioration. This is the first study that aims to (a) propose simple non-invasive predictive anthropometric markers and their specific cut-off values for early prediction of anemia among the young adults in Malaysia, (b) provide anemia prevalence based on both gender and ethnicity among young adults of Malaysia.Method:The present cross-sectional study included 245 participants (113 men and 132 women) aged between 18 and 30 years. Anthropometric parameters were measured following the standard protocols. Blood samples were collected and hemoglobin levels were determined using the HemoCue haemoglobinometer (Hb 201+ System, Angelhom, Sweden) to detect the presence of anemia. The receiver operating characteristics (ROC) curve was employed to assess and compare the efficacy of anthropometric indices in the prediction of anemia. Data were analyzed using SPSS (v. 22.0, IBM, Chicago, IL, USA) and MedCalc (v. 19.05, Ostend, Belgium).Result:The ROC analysis indicates that body mass index (BMI) is the best anthropometric marker with the highest area under the curve (AUC) and specificity (SP) for predicting the presence of anemia in young adults in Malaysia. Thus, the study proposes the optimal cut-off value of BMI for young men of Malaysia as 20.65 kg/m2(AUC: 0.889) and young women of Malaysia as 19.7 kg/m2(AUC: 0.904). The study also reports that Malaysian Indians have the highest prevalence of anemia (26.22%) followed by Malays (21.54%), “Others” (indigenous ethnic group) (20%), and Chinese (14.5%), with an overall higher prevalence of anemia in young adult women (21.96%) than in men (18.6%) of Malaysia.Conclusion:The proposed anemia-predictive anthropometric markers with optimal cut-off values will aid early detection of anemia among young adults in Malaysia, and given its simple, inexpensive, and intelligible approach, it can be widely used. The ease of anemia prediction together with the reported distribution of anemia prevalence based on gender and ethnicity will facilitate in gauging the necessary extent of strategies of anemia management in the young adult population of Malaysia.
Increases in RPE Rating Predict Fatigue Accumulation Without Changes in Heart Rate Zone Distribution After 4-Week Low-Intensity High-Volume Training Period in High-Level Rowers
Authors: Pind Rasmus , Hofmann Peter , Mäestu Evelin , Vahtra Eno , Purge Priit , Mäestu Jarek 
Published: September 2021

Purpose: The aim of this study was to investigate the interaction of training load quantification using heart rate (HR) and rating of perceived exertion (RPE)-based methodology, and the relationship between internal training load parameters and subjective training status (Fatigue) in high-level rowers during volume increased low-intensity training period.Methods: Training data from 19 high-level rowers (age 23.5 ± 5.9 years; maximal oxygen uptake 58.9 ± 5.8 ml·min−1·kg−1) were collected during a 4-week volume increased training period. All individual training sessions were analyzed to quantify training intensity distribution based on the HR time-in-zone method (i.e., HR Z1, HR Z2, and HR Z3) determined by the first and second ventilatory thresholds (VT1/VT2). Internal training load was calculated using session RPE (sRPE) to categorize training load by effort (i.e., sRPE1, sRPE2, and sRPE3). The Recovery-Stress Questionnaire for Athletes (RESTQ-Sport) questionnaire was implemented after every week of the study period.Results: No differences were found between the respective HR and effort-based zone distributions during the baseline week (p &gt; 0.05). Compared to HR Z1, sRPE1 was significantly lower in weeks 2–4 (p &lt; 0.05), while sRPE2 was higher in weeks 2–3 compared to HR Z2 (p &lt; 0.05) and, in week 4, the tendency (p = 0.06) of the higher amount of sRPE3 compared to HR Z3 was found. There were significant increases in RESTQ-Sport stress scales and decreases in recovery scales mostly during weeks 3 and 4. Increases in the Fatigue scale were associated with the amounts of sRPE2 and sRPE3 (p = 0.011 and p = 0.008, respectively), while no associations with Fatigue were found for HR-based session quantification with internal or external training load variables.Conclusion: During a low-intensity 4-week training period with increasing volume, RPE-based training quantification indicated a shift toward the harder rating of sessions with unchanged HR zone distributions. Moderate and Hard rated sessions were related to increases in Fatigue. Session rating of perceived exertion and effort-based training load could be practical measures in combination with HR to monitor adaptation during increased volume, low-intensity training period in endurance athletes.
Association Between Hyperactivity Symptoms and Somatic Complaints: Mediating and Moderating Mechanisms in Childhood Trauma and Life Events Among Chinese Male Adolescents
Authors: Wu Shuxian , Yang Tingyu , He Yuqiong , Cui Xilong , Luo Xuerong , Liu Jianbo 
Published: September 2021

Background: Prior research has found that attention deficit/hyperactivity disorder (ADHD) – particularly hyperactivity symptoms – is associated with various somatic complaints. The present study further tests the relationship between hyperactivity symptoms and somatic complaints in Chinese male adolescents and explores the underlying moderating and mediating mechanisms.Methods: Our sample included 1,586 males (age = 12–16) recruited as part of an epidemiological study of child and adolescent mental disorders from April to July, 2014. Hyperactivity symptoms and somatic complaints were assessed with Achenbach's Child Behavior Checklist (CBCL), and the Childhood Trauma Questionnaire Short Form (CTQ-SF) and Adolescent Life Events Scale (ASLEC) were used to assess exposure to childhood trauma and recent life events.Results: Adolescents with hyperactivity symptoms experienced more emotional abuse, physical abuse, life events, and reported more somatic complaints symptoms (p &lt; 0.0083 or p &lt; 0.05). Linear regression analysis showed that hyperactivity, total childhood trauma score/emotional abuse and sexual abuse and ASLEC score significantly predicted somatic complaints (all p &lt; 0.05). Emotional abuse and life events mediated the relationship between hyperactivity symptoms and somatic complaints. Furthermore, childhood trauma moderated the path between hyperactivity symptoms and ASLEC in the moderation mediation model for predicting somatic complaints (p &lt; 0.05).Conclusions: Hyperactivity symptoms had a significant impact on somatic complaints among Chinese male adolescents. Furthermore, childhood trauma and life events affected the relationship between hyperactivity symptoms and somatic complaints. Interventions for somatic complaints in male adolescents with hyperactivity symptoms should thus consider history of childhood trauma and life events.
Prevalence of Internet Addiction Disorder and Its Correlates Among Clinically Stable Adolescents With Psychiatric Disorders in China During the COVID-19 Outbreak
Authors: Li Zong-Lei , Liu Rui , He Fan , Li Shu-Ying , Zhao Yan-Jie , Zhang Wu-Yang , Zhang Yao , Cheung Teris , Jackson Todd , Tang Yi-Lang , Xiang Yu-Tao 
Published: September 2021

Background:Since the Coronavirus disease 2019 (COVID-19) pandemic emerged, Internet usage has increased among adolescents. Due to this trend, the prevalence of Internet addiction disorder (IAD) may have increased within this group. This study examined the prevalence of IAD and its correlates among clinically stable adolescents with psychiatric disorders in China during the COVID-19 outbreak.Method:A multi-center, cross-sectional study was carried out between April 29 and June 9, 2020 in three major tertiary mental health centers in China. IAD and depressive symptoms were assessed using the Internet Addiction Test (IAT) and the 9-item Patient Health Questionnaire (PHQ-9), respectively.Results:A total of 1,454 adolescent psychiatric patients were included in final analyses. The prevalence of IAD was 31.2% (95% CI: 28.8–33.6%) during the COVID-19 pandemic. A multiple logistic regression analysis revealed that poor relationships with parents (P&lt; 0.001, OR = 2.34, 95%CI: 1.49–3.68) and elevated total PHQ-9 scores (P&lt; 0.001, OR = 1.19, 95%CI: 1.16–1.21) were significantly associated with higher risk for IAD while longer daily physical exercise durations (P= 0.04, OR = 0.67, 95%CI: 0.46–0.98) and rural residence (P= 0.003, OR = 0.62, 95%CI: 0.46–0.85) were significant correlates of lower risk for IAD.Conclusions:IAD was common among adolescent patients with clinically stable psychiatric disorders during the COVID-19 pandemic; regular physical exercise, healthy relationships with parents and fewer symptoms of depression were associated with lower risk within this population.