bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiomics Signature Facilitates Organ-Saving Strategy in Patients With Esophageal Squamous Cell Cancer Receiving Neoadjuvant Chemoradiotherapy
Authors: Li Yue , Liu Jun , Li Hong-xuan , Cai Xu-wei , Li Zhi-gang , Ye Xiao-dan , Teng Hao-hua , Fu Xiao-long , Yu Wen 
Published: February 2021

After neoadjuvant chemoradiotherapy (NCRT) in locally advanced esophageal squamous cell cancer (ESCC), roughly 40% of the patients may achieve pathologic complete response (pCR). Those patients may benefit from organ-saving strategy if the probability of pCR could be correctly identified before esophagectomy. A reliable approach to predict pathological response allows future studies to investigate individualized treatment plans.MethodAll eligible patients treated in our center from June 2012 to June 2019 were retrospectively collected. Radiomics features extracted from pre-/post-NCRT CT images were selected by univariate logistic and LASSO regression. A radiomics signature (RS) developed with selected features was combined with clinical variables to construct RS+clinical model with multivariate logistic regression, which was internally validated by bootstrapping. Performance and clinical usefulness of RS+clinical model were assessed by receiver operating characteristic (ROC) curves and decision curve analysis, respectively.ResultsAmong the 121 eligible patients, 51 achieved pCR (42.1%) after NCRT. Eighteen radiomics features were selected and incorporated into RS. The RS+clinical model has improved prediction performance for pCR compared with the clinical model (corrected area under the ROC curve, 0.84 vs. 0.70). At the 60% probability threshold cutoff (i.e., the patient would opt for observation if his probability of pCR was &gt;60%), net 13% surgeries could be avoided by RS+clinical model, equivalent to implementing organ-saving strategy in 31.37% of the 51 true-pCR cases.ConclusionThe model built with CT radiomics features and clinical variables shows the potential of predicting pCR after NCRT; it provides significant clinical benefit in identifying qualified patients to receive individualized organ-saving treatment plans.
Clinical and Dermoscopic Factors for the Identification of Aggressive Histologic Subtypes of Basal Cell Carcinoma
Authors: Pampena Riccardo , Parisi Gabriele , Benati Mattia , Borsari Stefania , Lai Michela , Paolino Giovanni , Cesinaro Anna Maria , Ciardo Silvana , Farnetani Francesca , Bassoli Sara , Argenziano Giuseppe , Pellacani Giovanni , Longo Caterina 
Published: February 2021

BackgroundInfiltrative basal cell carcinoma (BCC) has a higher risk for post-surgical recurrence as compared to the most common low-aggressive superficial and nodular BCC. Independent diagnostic criteria for infiltrative BCC diagnosis have not been still defined. Improving the pre-surgical recognition of infiltrative BCC might significantly reduce the risk of incomplete excision and recurrence.ObjectiveThe aim of this study is to define clinical and dermoscopic criteria that can differentiate infiltrative BCC from the most common low-aggressive superficial and nodular BCC.MethodsClinical and dermoscopic images of infiltrative, superficial, and nodular BCC were retrospectively retrieved from our database and jointly evaluated by two experienced dermoscopists, blinded for the histologic subtype. Pairwise comparisons between the three histologic subtypes were performed and multivariable logistic regression models were constructed in order to define clinical and dermoscopic factors independently associated with each subtype. To validate our findings, two experienced dermoscopists not previously involved in the study were asked to evaluate clinical and dermoscopic images from an external dataset, guessing the proper BCC subtype between infiltrative, nodular and superficial, before and after being provided with the study results.ResultA total of 481 histopathologically proven BCCs (51.4% nodular, 33.9% superficial, and 14.8% infiltrative) were included. We found that infiltrative BCC mostly appeared on the head and neck as an amelanotic hypopigmented plaque or papule, displaying ulceration on dermoscopic examination, along with arborizing and fine superficial telangiectasia. Shiny white structures were also frequently observed. Multivariate regression analysis allowed us to define a clinical-dermoscopic profile of infiltrative BCC.ConclusionsWe defined the clinical-dermoscopic profile of infiltrative BCC, allowing to differentiate this variant from superficial and nodular BCC. This will improve pre-surgical recognition of infiltrative forms, reducing the risk for post-surgical recurrence.
Use of Radiomics to Improve Diagnostic Performance of PI-RADS v2.1 in Prostate Cancer
Authors: Li Mou , Yang Ling , Yue Yufeng , Xu Jingxu , Huang Chencui , Song Bin 
Published: February 2021

ObjectiveTo investigate whether a radiomics model can help to improve the performance of PI-RADS v2.1 in prostate cancer (PCa).MethodsThis was a retrospective analysis of 203 patients with pathologically confirmed PCa or non-PCa between March 2015 and December 2016. Patients were divided into a training set (n = 141) and a validation set (n = 62). The radiomics model (Rad-score) was developed based on multi-parametric MRI including T2 weighted imaging (T2WI), diffusion weighted imaging (DWI), apparent diffusion coefficient (ADC) imaging, and dynamic contrast enhanced (DCE) imaging. The combined model involving Rad-score and PI-RADS was compared with PI-RADS for the diagnosis of PCa by using the receiver operating characteristic curve (ROC) analysis.ResultsA total of 112 (55.2%) patients had PCa, and 91 (44.8%) patients had benign lesions. For PCa versus non-PCa, the Rad-score had a significantly higher area under the ROC curve (AUC) [0.979 (95% CI, 0.940–0.996)] than PI-RADS [0.905 (0.844–0.948), P = 0.002] in the training set. However, the AUC between them was insignificant in the validation set [0.861 (0.749–0.936) vs. 0.845 (0.731–0.924), P = 0.825]. When Rad-score was added to PI-RADS, the performance of the PI-RADS was significantly improved for the PCa diagnosis (AUC = 0.989, P &lt; 0.001 for the training set and AUC = 0.931, P = 0.038 for the validation set).ConclusionsThe radiomics based on multi-parametric MRI can help to improve the diagnostic performance of PI-RADS v2.1 in PCa.
Individualized Surgical Reconstruction of the Right Ventricle Outflow Tract in Double Outlet Right Ventricle With Mirror Image-Dextrocardia
Authors: Chen Wangping , Iroegbu Chukwuemeka Daniel , Xie Xia , Zhou Wenwu , Wu Ming , Wu Xun , Fan Chengming , Borovjagin Anton V. , Yang Jinfu 
Published: February 2021

Introduction: The purpose of this study was to report our experience in the surgical reconstruction of the right ventricular outflow tract in double outlet right ventricle with a major coronary artery crossing the right ventricular outflow tract in the presence of mirror image-dextrocardia.Methods: From January 2005 to December 2019, 19 double outlet right ventricle patients (median age 4 years) with mirror image-dextrocardia and a major coronary artery crossing the right ventricular outflow tract received surgical repair. An autologous pericardial patch was used to enlarge the right ventricular outflow tract in four patients without pulmonary stenosis and three patients with mild pulmonary stenosis. A valved bovine jugular venous conduit was added to a hypoplastic native pathway in nine patients, among which six patients with moderate pulmonary stenosis received small-sized bovine jugular venous conduit implantation (diameter ≤ 16 mm). In comparison, a large-sized bovine jugular venous conduit (diameter &gt;16 mm) was adopted in a total of three patients with severe pulmonary stenosis. Finally, three patients with preoperative pulmonary hypertension (mean pulmonary artery pressure ≥40 mmHg) did not undergo further intervention of right ventricular outflow tract due to the adequate outflow tract blood flow.Results: There was no hospital mortality. One patient with sub-pulmonary ventricular septal defect and concomitant severe pulmonary hypertension died from respiratory failure 11 months after the operation. Kaplan-Meier survival was 94% at 5, 10 years. Within a mean echocardiographic follow-up of 6.9 ± 3.6 years, a total of two patients received reintervention due to valvular stenosis of the bovine jugular venous conduit (pressure gradient &gt; 50 mmHg at 4 and 9 years) after surgical operation. Actuarial freedom from reoperation was 90 and 72% at 5 and 10 years, respectively. During the last echocardiographic follow-up phase, all the survivors were in NYHA class I.Conclusions: Double outlet right ventricle with mirror image-dextrocardia is a rare and complicated congenital cardiac malformation. Surgical reconstruction of the right ventricular outflow tract should be individualized based on the degree of pulmonary stenosis and the specific anatomical features of each patient. Reconstructing the pulmonary artery using the various sizes of valved bovine jugular venous conduit is a safe and effective surgical method.
Body Mass Index Trajectories in the First 5 Years and Associated Antenatal Factors
Authors: Mattsson Molly , Murray Deirdre M. , Hawkes Colin P. , Kiely Mairead , Ní Chaoimh Carol , McCarthy Fergus P. , Biesma Regien , Boland Fiona 
Published: February 2021

Background: The increasing prevalence of childhood obesity is an important public health issue and the development of obesity in early life and associated risk factors need to be better understood. The aim of this study was to identify distinct body mass index trajectories in the first 5 years of life and to examine their associations with factors identified in pregnancy, including metabolic parameters.Methods: BMI measurements from 2,172 children in Ireland enrolled in the BASELINE cohort study with BMI assessments at birth, 2, 6, and 12 months, and 2 and 5 years were analyzed. Growth mixture modeling was used to identify distinct BMI trajectories, and multivariate multinomial logistic regression was used to assess the association between these trajectories and antenatal factors.Results: Three distinct BMI trajectories were identified: normal (89.6%); rapid gain in the first 6 months (7.8%); and rapid BMI after 12 months (2.6%). Male sex and higher maternal age increased the likelihood of belonging to the rapid gain in the first 6 months trajectory. Raised maternal BMI at 15 weeks of pregnancy and lower cord blood IGF-2 were associated with rapid gain after 1 year.Conclusion: Sex, maternal age and BMI, and IGF-2 levels were found to be associated with BMI trajectories in early childhood departing from normal growth. Further research and extended follow-up to examine the effects of childhood growth patterns are required to understand their relationship with health outcomes.
Long-Term Outcomes of Patients With Cocaine Use Disorder: A 18-years Addiction Cohort Study
Authors: Sanvisens Arantza , Hernández-Rubio Anna , Zuluaga Paola , Fuster Daniel , Papaseit Esther , Galan Sara , Farré Magí , Muga Robert 
Published: February 2021

Objective: Cocaine Use Disorder (CUD) has been associated with multiple complications and premature death. The purpose of the present study was to analyze the relationship between baseline medical comorbidity and long-term medical outcomes (i.e., hospitalization, death) in a cohort of patients primarily admitted for detoxification. In addition, we aimed to analyze cause-specific mortality.Methods: longitudinal study in CUD patients admitted for detoxification between 2001 and 2018. Substance use characteristics, laboratory parameters and medical comorbidity by VACS Index were assessed at admission. Follow-up and health-related outcomes were ascertained through visits and e-health records. Kaplan-Meier and Cox regression models were used to analyze survival and predictors of hospitalization and death.Results: 175 patients (77.7% men) were included. Age at admission was 35 years [IQR: 30–41 years], 59.4% of the patients being intranasal users, 33.5% injectors, and 7.1% smokers. Almost 23% of patients had concomitant alcohol use disorder, 39% were cannabis users and 9% opiate users. The median VACS Index score on admission was 10 points [IQR: 0–22]. After 12 years [IQR: 8.6–15 years] of follow-up there were 1,292 (80.7%) ED admissions and 308 (19.3%) hospitalizations. The incidence rate of ED admission and hospitalization was 18.6 × 100 p-y (95% CI: 15.8–21.8 × 100 p-y). Mortality rate was 1.4 × 100 p-y (95% CI: 0.9–2.0 × 100 p-y) and, baseline comorbidity predicted hospitalization and mortality: those with VACS Index &gt;40 were 3.5 times (HR:3.52, 95% CI: 1.19–10.4) more likely to dye with respect to patients with VACS &lt; 20.Conclusion: addiction care warrants optimal stratification of medical comorbidity to improve health outcomes and survival of CUD patients seeking treatment of the disorder.
Inhibition of 5-Lipoxygenase in Hepatic Stellate Cells Alleviates Liver Fibrosis
Authors: Pu Shiyun , Li Yanping , Liu Qinhui , Zhang Xu , Chen Lei , Li Rui , Zhang Jinhang , Wu Tong , Tang Qin , Yang Xuping , Zhang Zijing , Huang Ya , Kuang Jiangying , Li Hong , Zou Min , Jiang Wei , He Jinhan 
Published: February 2021

Background and Purpose: Activation of hepatic stellate cells (HSC) is a central driver of liver fibrosis. 5-lipoxygenase (5-LO) is the key enzyme that catalyzes arachidonic acid into leukotrienes. In this study, we examined the role of 5-LO in HSC activation and liver fibrosis.Main Methods: Culture medium was collected from quiescent and activated HSC for target metabolomics analysis. Exogenous leukotrienes were added to culture medium to explore their effect in activating HSC. Genetic ablation of 5-LO in mice was used to study its role in liver fibrosis induced by CCl4 and a methionine-choline-deficient (MCD) diet. Pharmacological inhibition of 5-LO in HSC was used to explore the effect of this enzyme in HSC activation and liver fibrosis.Key Results: The secretion of LTB4 and LTC4 was increased in activated vs. quiescent HSC. LTB4 and LTC4 contributed to HSC activation by activating the extracellular signal-regulated protein kinase pathway. The expression of 5-LO was increased in activated HSC and fibrotic livers of mice. Ablation of 5-LO in primary HSC inhibited both mRNA and protein expression of fibrotic genes. In vivo, ablation of 5-LO markedly ameliorated the CCl4- and MCD diet-induced liver fibrosis and liver injury. Pharmacological inhibition of 5-LO in HSC by targeted delivery of the 5-LO inhibitor zileuton suppressed HSC activation and improved CCl4- and MCD diet-induced hepatic fibrosis and liver injury. Finally, we found increased 5-LO expression in patients with non-alcoholic steatohepatitis and liver fibrosis.Conclusion: 5-LO may play a critical role in activating HSC; genetic ablation or pharmacological inhibition of 5-LO improved CCl4-and MCD diet-induced liver fibrosis.
A Simple Score to Identify Super-Responders to Sacubitril/Valsartan in Ambulatory Patients With Heart Failure
Authors: Moliner-Abós Carles , Mojón Álvarez Diana , Rivas-Lasarte Mercedes , Belarte Laia Carla , Pamies Besora Julia , Solé-González Eduard , Fluvià-Brugues Paula , Zegrí-Reiriz Isabel , López López Laura , Brossa Vicens , Pirla Maria José , Mesado Nuria , Mirabet Sonia , Roig Eulàlia , Álvarez-García Jesús 
Published: February 2021

IntroductionSacubitril/valsartan (SV) promotes cardiac remodeling and improves prognosis in patients with heart failure (HF). However, the response to the drug may vary between patients and its implementation in daily clinical practice has been slower than expected. Our objective was to develop a score predicting the super-response to SV in HF outpatients.MethodsThis is a retrospective analysis of 185 consecutive patients prescribed SV from two tertiary hospitals between September 2016 and February 2018. Super-responder was defined as a patient taking the drug and (i) without HF admissions, death, or heart transplant, and (ii) with a ≥50% reduction in NT-proBNP levels and/or an increase of ≥10 points in LVEF in a 12-month follow-up period after starting SV. Clinical, echocardiographic, ECG, and biochemical variables were used in a logistic regression analysis to construct a score for super-response to SV which was internally validated using bootstrap method.ResultsOut of 185 patients, 65 (35%) fulfilled the super-responder criteria. Predictors for super-response to SV were absence of both previous aldosterone antagonist and diuretic treatment, NYHA I-II class, female gender, previous 1-year HF admission, and sinus rhythm. An integrating score distinguished a low- (&lt;25%), intermediate- (∼46%), and high-probability (&gt;80%) for 1-year super-response to SV. The AUC for the model was 0.72 (95%CI: 0.64–0.80), remaining consistent after internal validation.ConclusionOne-third of our patients presented a super-response to SV. We propose an easy-to-calculate score to predict super-response to SV after 1-year initiation based on variables that are currently assessed in clinical practice.
On Change of Soil Moisture Distribution With Vegetation Reconstruction in Mu Us Sandy Land of China, With Newly Designed Lysimeter
Authors: Cheng Yiben , Yang Wenbing , Zhan Hongbin , Jiang Qunou , Shi Mingchang , Wang Yunqi , Li Xinle , Xin Zhiming 
Published: February 2021

BackgroundChina’s so-called Three North Shelterbelt Program (3NSP) has produced a vast area of lined forest reconstruction in the semi-arid regions. This study uses the lined rain-fed Pinus sylvestris var. mongolica (PSM) sand-fixing forest in the eastern part of Mu Us Sandy Land in Northwestern China as an example to investigate the ecohydrological process in this region. Rain gauges, newly designed lysimeters and soil moisture sensors are used to monitor precipitation, deep soil recharge (DSR) and soil water content, where DSR specifically refers to recharge that can reach a depth more than 200 cm and eventually replenish the underneath groundwater reservoir.ResultsThis study shows that there are two obvious moisture recharge processes in an annual base for the PSM forest soil: a snowmelt-related recharge process in the spring and a precipitation-related recharge process in the summer. The recharge depth of the first process can reach 180 cm without DSR occurring (in 2018). The second process results in noticeable DSR in 2018. Specifically, the DSR values over 2016–2018 are 1, 0.2, and 1.2 mm, respectively. To reach the recharge depths of 20, 40, 80, 120, 160, and 200 cm, the required precipitation intensities have to be 2.6, 3.2, 3.4, 8.2, 8.2, and 13.2 mm/d, respectively. The annual evapotranspiration in the PSM forest is 466.94 mm in 2016, 324.60 mm in 2017, and 183.85 mm in 2018.ConclusionThis study concludes that under the current precipitation conditions (including both dry- and wet-years such as 2016–2018), water consumption of PSM somewhat equals to the precipitation amount, and PSM has evolved over years to regulate its evapotranspiration in response to annual precipitation fluctuations in Mu Us Sandy Land of China.
Drawing on Dialogues in Arts-Based Dynamic Interpersonal Therapy (ADIT) for Complex Depression: A Complex Intervention Development Study Using the Medical Research Council (UK) Phased Guidance
Authors: Havsteen-Franklin Dominik , Oley Mary , Sellors Sarah Jane , Eagles Diane 
Published: February 2021

Aim: The aim of this paper is to present the development and evaluation of an art psychotherapy brief treatment method for complex depression for patients referred to mental health services.Background: Art Psychotherapy literature describes a range of processes of relational change through the use of arts focused and relationship focused interventions. Complex depression has a prevalence of 3% of the population in the West and it is recorded that in 2016 only 28% of that population were receiving psychological treatment. This study was developed to test the hypothesis of whether an accessible and acceptable approach to the treatment of complex depression could be developed in relation to existing evidence-based practice within mental health services.Method: The United Kingdom Medical Research Council phased guidance for complex intervention development was used (Phases I and II) to develop the intervention. The process included producing a literature overview, systematic description of clinical practice, including a logic model and a clinical protocol. The art psychotherapy protocol described an arts-based dynamic interpersonal therapy approach (ADIT), offered 1:1 over 24 sessions. Further to this the intervention was tested for referrer acceptability. The intervention is in the early stages of evaluation, using changes to the patient's depression and anxiety measured pre- and post-treatment with a follow-up measure at 3 months following completion of treatment.Results: Phase I of the study provided a good basis for developing a logic model and protocol. The authors found that there was good clinical consensus about the use of a structured clinical art psychotherapy method (ADIT) and the literature overview was used to support specific examples of good practice. The verification of clinical coherence was represented by a logic model and clinical protocol for delivering the intervention. The acceptability study demonstrated very high levels of acceptability for referrers reporting that (i) ADIT was acceptable for patients with complex/major depression, (ii) that they were likely to refer to ADIT in the future (iii) that the use of arts was likely to improve accessibility (iv) the use of arts was likely to improve outcomes and (v) that offering ADIT was an effective use of mental health resources.Discussion: Phase I of this intervention development study (following MRC guidance) demonstrated theoretical and practice coherence resulting in a clinical protocol and logic model. Whilst Phase II of this study showed promising results, Phase II would need to be sufficiently scaled up to a full trial to further test the intervention and protocol.