bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Muscle Mass as a Prognostic Factor for Failed Waiting Time Prior to Heart Transplantation
Authors: Roehrich Luise , Suendermann Simon H. , Just Isabell Anna , Kopp Fernandes Laurenz , Schnettler Jessica , Kelle Sebastian , Solowjowa Natalia , Stein Julia , Hummel Manfred , Knierim Jan , Potapov Evgenij , Knosalla Christoph , Falk Volkmar , Schoenrath Felix 
Published: October 2021

Objectives: Clinical deterioration during the waiting time impairs the prognosis of patients listed for heart transplantation. Reduced muscle mass increases the risk for mortality after cardiac surgery, but its impact on resilience against deterioration during the waiting time remains unclear.Methods: We retrospectively analyzed data from 93 patients without a VAD who were listed in Eurotransplant status “high urgent (HU)” for heart transplantation between January 2015 and October 2020. The axial muscle area of the erector spinae muscles at the level of thoracic vertebra 12 indexed to body surface area (TMESA/BSA) measured in the preoperative thoracic computed tomography scan was used to measure muscle mass.Results: Forty patients (43%) underwent emergency VAD implantation during the waiting time and four patients (4%) died during the waiting time. The risk of emergency VAD implantation/death during the waiting time decreased by 10% for every cm2/m2 increase in muscle area [OR 0.901 (95% CI: 0.808–0.996); p = 0.049]. After adjusting for gender [OR 0.318 (95% CI: 0.087–1.073); p = 0.072], mean pulmonary artery pressure [OR 1.061 (95% CI: 0.999–1.131); p = 0.060], C-reactive protein [OR 1.352 (95% CI: 0.986–2.027); p = 0.096], and hemoglobin [OR 0.862 (95% CI: 0.618–1.177); p = 0.360], TMESA/BSA [OR 0.815 (95% CI: 0.698–0.936); p = 0.006] remained an independent risk factor for emergency VAD implantation/death during the HU waiting time.Conclusion: Muscle area of the erector spinae muscle appears to be a potential, easily identifiable risk factor for emergency VAD implantation or death in patients on the HU waiting list for heart transplantation. Identifying patients at risk could help optimize the outcome and the timing of VAD support.
Case Report: Two Cases of Salivary Duct Carcinoma in Workers With a History of Chromate Exposure
Authors: Seçin Imran , Uijen Maike J. M. , Driessen Chantal M. L. , van Herpen Carla M. L. , Scheepers Paul T. J. 
Published: October 2021

Background: Salivary duct carcinoma (SDC), one subtype of the 22 different salivary gland cancers, is a rare malignancy. Risk factors for the development of salivary gland cancer and SDC are largely unknown, although pollution has been described as one of the risk factors. In other cancers, especially in lung cancer, the carcinogenicity of chromium VI [Cr(VI)] is well-known. Here we report on two SDC patients who were occupationally exposed to Cr(VI) and discuss a potential relation between their Cr(VI) exposure and the occurrence of SDC.Case Presentation: The work history of two SDC patients was analyzed for chemical exposures. Both patients had a history of Cr(VI) exposure, with maintenance of military equipment considered as the source for this exposure. Inhalation of Cr(VI) containing particles from the removal of old paint by mechanical abrasion was identified as a probable source of exposure for both patients, and one of these patients also applied new paint. Both patients reported not to have used any respiratory protection which may have resulted in substantial inhalation of Cr(VI)-containing chromates. Furthermore, in one patient inhalation of fumes from soldering may have resulted in relevant co-exposure.Conclusion: A causal relation between Cr(VI) exposure and SDC, a rare cancer, cannot be demonstrated on an individual basis but detection in a population-based study is also unlikely because of the extremely low prevalence. Nevertheless, the work history is considered a relevant risk factor in the onset of SDC as occupational exposures to Cr(VI) occurred in poorly ventilated working environment and without using appropriate respiratory protective equipment.
Isolated Increased Nuchal Translucency in First Trimester Ultrasound Scan: Diagnostic Yield of Prenatal Microarray and Outcome of Pregnancy
Authors: Stuurman Kyra E. , van der Mespel-Brouwer Marjolein H. , Engels Melanie A. J. , Elting Mariet W. , Bhola Shama L. , Meijers-Heijboer Hanne 
Published: October 2021

Background: Increased nuchal translucency (NT) is associated with aneuploidy. When the karyotype is normal, fetuses are still at risk for structural anomalies and genetic syndromes. Our study researched the diagnostic yield of prenatal microarray in a cohort of fetuses with isolated increased NT (defined as NT ≥ 3.5 mm) and questioned whether prenatal microarray is a useful tool in determining the adverse outcomes of the pregnancy.Materials and Methods: A prospective study was performed, in which 166 women, pregnant with a fetus with isolated increased NT (ranging from 3.5 to 14.3 mm with a mean of 5.4 mm) were offered karyotyping and subsequent prenatal microarray when karyotype was normal. Additionally, all ongoing pregnancies of fetuses with normal karyotype were followed up with regard to postnatal outcome. The follow-up time after birth was maximally 4 years.Results: Totally, 149 of 166 women opted for prenatal testing. Seventy-seven fetuses showed normal karyotype (52%). Totally, 73 of 77 fetuses with normal karyotype did not show additional anomalies on an early first trimester ultrasound. Totally, 40 of 73 fetuses received prenatal microarray of whom 3 fetuses had an abnormal microarray result: two pathogenic findings (2/40) and one incidental carrier finding. In 73 fetuses with an isolated increased NT, 21 pregnancies showed abnormal postnatal outcome (21/73, 28.8%), 29 had a normal outcome (29/73, 40%), and 23 were lost to follow-up (23/73, 31.5%). Seven out of 73 live-born children showed an adverse outcome (9.6%).Conclusions: Prenatal microarray in fetuses with isolated increased NT had a 5% (2/40) increased diagnostic yield compared to conventional karyotyping. Even with a normal microarray, fetuses with an isolated increased NT had a 28.8% risk of either pregnancy loss or an affected child.
Native T1 Mapping in Assessing Kidney Fibrosis for Patients With Chronic Glomerulonephritis
Authors: Wu Jianhua , Shi Zhaoyu , Zhang Yuan , Yan Jiaxin , Shang Fangfang , Wang Yao , Lu Huijian , Gu Hongmei , Dou Weiqiang , Wang Xinquan , Yuan Li 
Published: October 2021

Purpose: To assess the utility of non-contrast enhanced native T1 mapping of the renal cortex in assessing renal fibrosis for patients with chronic glomerulonephritis (CGN).Methods: A total of 119 patients with CGN and 19 healthy volunteers (HVs) were recruited for this study. Among these patients, 43 had undergone kidney biopsy measurements. Clinical information and biopsy pathological scores were collected. According to the results of the renal biopsy, the patients were classified into the high (25–50%), low (&lt;25%) and no renal interstitial fibrosis (IF) (0%) groups. The correlations between the T1 value in the renal cortex and each of the clinical parameters were separately analyzed. The relationships between each fibrosis group and the T1 value were also evaluated and compared between groups. Binary logistic regression analysis was further used to determine the relationship between the T1 value and renal fibrosis. Receiver operating characteristic (ROC) curves were plotted to analyze the diagnostic value of the T1 value for renal fibrosis.Results: Compared with those of the HVs, the T1 values were significantly higher in patients at all stages of chronic kidney disease (CKD) (all p &lt; 0.05). Significant T1 differences were also revealed between patients with different stages of CKD (p &lt; 0.05). Additionally, the T1 value correlated well with CKD stage (p &lt; 0.05), except between CKD 2 and 3. In addition, the T1 value was positively correlated with cystatin C, neutrophil gelatinase-associated lipocalin, and serum creatinine and negatively correlated with hemoglobin, kidney length, estimated glomerular filtration rate and hematocrit (all p &lt; 0.05). Compared with those of the no IF group, the T1 values were increased in the low- and high-IF groups (both p &lt; 0.05). Logistic regression analysis showed that an elevated T1 value was an independent risk factor for renal fibrosis. ROC analysis suggested that the optimal critical value of T1 for predicting renal fibrosis was 1,695 ms, with a specificity of 0.778 and a sensitivity of 0.625.Conclusion: Native T1 mapping demonstrated good diagnostic performance in evaluating renal function and was an effective noninvasive method for detecting renal fibrosis in CGN patients.
Analysis of Prognostic Alternative Splicing Reveals the Landscape of Immune Microenvironment in Thyroid Cancer
Authors: Wu Jian , Sun Yifang , Li Junzheng , Ai Maomao , You Lihua , Shi Jianbo , Yu Feng 
Published: October 2021

BackgroundThe incidence of thyroid cancer (THCA) continues to increase in recent decades. Accumulating evidence showed that the unbalanced alternative splicing (AS) promotes the occurrence of cancers and leads to poor prognosis of patients. However, the research on alternative splicing events in THCA is lacking, and its underlying mechanism is not fully understood. This study identifies a novel prognostic signature based on AS events to reveal the relationship of AS with tumor immune microenvironment.MethodsBased on the AS data, transcriptional data, and clinical information, the differentially expressed alternative splicings (DEASs) were screened out. Least absolute shrinkage and selection operator (LASSO) regression and multi-Cox regression analyses were employed to identify prognostic results related to AS events and establish a prognostic signature. The predictive ability of the signature was assessed by Kaplan-Meier (K-M) survival curve, risk plots, and receiver operating characteristic (ROC) curves. Furthermore, correlations between tumor-infiltrating immune cells, immune checkpoints, immune score and prognostic signature were analyzed.ResultsAccording to the LASSO regression analysis, a total of five AS events were selected to construct the signature. K-M survival curve showed that the higher the risk score, the worse the OS of the patients. Risk plots further confirmed this result. ROC curves indicated the high predictive efficiency of the prognostic signature. As for tumor immune microenvironment, patients in the high-risk group had a higher proportion of immune cells, including plasma cell, CD8+ T cell, macrophages (M0 and M2), and activated dendritic cell. Immune checkpoint proteins, such as PDCD1LG2, HAVCR2, CD274, etc., were significantly higher in the high-risk group. We also found that the ESTIMATE score, stromal score, and immune score were lower in the high-risk group, while the result of tumor purity was the opposite.ConclusionsCollectively, a prognostic signature consisting of five AS events in THCA was established. Furthermore, there was an inextricable correlation between immune cell infiltration, immune checkpoint proteins, and AS events. This study will provide a basis for THCA immunotherapy in the future.
Factors Influencing the Acceptance of Pediatric Telemedicine Services in China: A Cross-Sectional Study
Authors: Shi Jingjin , Yan Xueming , Wang Miao , Lei Ping , Yu Guangjun 
Published: October 2021

Background: Pediatrician workforce shortages have aroused great attention from health authorities in China. Telemedicine services have been known to enhance the management of children's health, yet the rate of adoption and usage in Chinese hospitals still at a quite low level, and the factors influencing the acceptance of telemedicine services remains unclear.Objective: The purpose of this empirical study was to evaluate the reliability and validity of a technology acceptance measurement instrument applied in healthcare, to investigate the perception of telemedicine services on the provider-side and demand-side, and to determine the factors that may drive individuals to adopt telemedicine services.Methods: A cross-sectional survey study based at Shanghai Children's Hospital, Shanghai Jiao Tong University, was conducted in March 2020. A total of 456 valid responses were obtained by convenience sampling. The internal consistency of items was assessed by Cronbach's alpha (α), composite reliability (CR) and average variance extracted (AVE) to evaluate both the reliability and validity of the questionnaire. Structural equation modeling analysis was used to test and verify the interrelationships among relevant variables.Results: Price value is the strongest predictor (β = 0.30, p = 0.02), facilitating conditions (β = 0.28, p = 0.01) and hedonic motivation (β = 0.13, p = 0.04) also have significantly positive direct effects on telemedicine acceptance. The results showed the perception of child patients' families were significantly more acceptable to telemedicine services than pediatricians (t = −2.99, p &lt; 0.01). Participants with no prior experience and lower education may be more willing to adopt telemedicine.Conclusion: Telemedicine will likely continue to have an integral role in pediatric health care delivery, and the findings can assist policy makers and hospital administrators in determining the more valued characteristics of telemedicine services from a behavioral perspective. Future attention will be paid to the pricing, training and service quality of telemedicine in China.
Protective Effect of Oxytocin on Ventilator-Induced Lung Injury Through NLRP3-Mediated Pathways
Authors: Yang Xiaomei , An Xiaona , Wang Cheng , Gao Feng , Lin Yicheng , Chen Wenjing , Deng Qiming , Xu Dongsheng , Li Shengqiang , Zhang Peng , Sun Baozhu , Hou Yuedong , Wu Jianbo 
Published: October 2021

Mechanical ventilation is an indispensable life-support treatment for acute respiratory failure in critically ill patients, which is generally believed to involve uncontrolled inflammatory responses. Oxytocin (OT) has been reported to be effective in animal models of acute lung injury. However, it is not clear whether Oxytocin has a protective effect on ventilator-induced lung injury (VILI). Therefore, in this study, we aimed to determine whether OT can attenuate VILI and explore the possible mechanism of this protection. To this end, a mouse VILI model was employed. Mice were pretreated with OT 30 min before the intraperitoneal injection of saline or nigericin and ventilation for 4 h, after which they were euthanized. Pathological changes, lung wet/dry (W/D) weight ratio, myeloperoxidase (MPO) activity, the levels of inflammatory cytokines [i.e., interleukin (IL)-1β, IL-6, and IL-18] in lung tissues and bronchoalveolar lavage fluid (BALF), and expression of NLRP3, Toll-like receptor 4 (TLR4), caspase-1, nuclear factor (NF)-κB, and GSDMD in lung tissues were measured. OT treatment could reduce pathological injury, the W/D ratio, and MPO activity in VILI mice. Our data also indicated that OT administration alleviated the expression of TLR4/My-D88 and the activation of NF-κB, NLRP3, and caspase-1 in lung tissues from the VILI mice model. Furthermore, OT also decreased the levels of IL-1β, IL-6, and IL-18 in the bronchoalveolar lavage fluid. Moreover, the OT administration may alleviate the activation of GSDMD partially through its effects on the NLRP3-mediated pathway. Collectively, OT exerted a beneficial effect on VILI by downregulating TLR4-and NLRP3-mediated inflammatory pathways.
Influence of the GABA Receptor Subunit Gene Polymorphism and Childhood Sexual Abuse on Processing Speed in Major Depression and Suicide Attempt
Authors: Yin Honglei , Guo Jia , Xin Qianqian , Zheng Shuqiong , Xue Xiang , Li Enze , Liu Ting , Yan Na , Keilp John , Mann J. John 
Published: October 2021

Background: Suicide is moderately heritable and also more common in those who report childhood abuse. Previously, it was found that allele A of GABRG2 (GABA A receptor subunit gamma2) polymorphism rs211034 was protective in a suicide attempt (SA). Hence, it was proposed that rs211034 may interact with childhood trauma to influence cognitive deficits related to SA or depression risk. Genetic variants may predict the benefits of certain cognitive treatments.Methods: A total of 52 individuals who had attempted suicide, 59 individuals with major depressive disorder (MDD) or bipolar depression who had not previously attempted suicide, and 90 healthy volunteers were subjected to the modified Suicide Stroop task and were clinically assessed using the Childhood Trauma Questionnaire (CTQ) and Hamilton Depression Scale-24 items (HAMD-24). rs211034 was genotyped using Sanger sequencing.Results: After correcting for covariates, depressed participants displayed longer reaction times for all emotional conditions, including suicide-related words, compared with healthy controls. Depressed suicide attempters displayed longer reaction times for negative words than depressed non-attempters. Depressed non-attempters displayed higher interference scores for negative words compared with healthy controls. There was an interaction between rs211034 risk allele and the effects of reported childhood sexual abuse (CSA) on reaction time for all emotional words and suicide-related words. Carriers of the rs211034 risk allele A exhibited shorter reaction times, but the protective effects of this allele were eliminated in those exposed to reported CSA.Conclusion: Only limited results were found regarding effects of a past suicide attempt on response times to emotional and suicide-related words, but there was an overall effect of major depression on slower response time. Protective genetic effects of the rs211034 A allele on this slowing were eliminated in those with a history of sexual abuse during childhood. Further research is needed to better characterize the mechanisms underlying the effects of childhood trauma on these genetic effects.
Local Excision ± Chemoradiotherapy vs. Total Mesorectal Excision for Early Rectal Cancer: Case-Matched Analysis of Long-Term Results
Authors: Pacevicius Julius , Petrauskas Vidas , Pilipavicius Lukas , Dulskas Audrius 
Published: October 2021

Background: Our aim was to compare the bowel function and oncologic outcomes following these two treatment modalities.Materials and methods: This was a single-center study with 67 patients included between 2009 and 2018. A total of 32 patients underwent total mesorectal excision (TME) group and 35 transanal local excisions (LE) ± chemoradiation. We performed a case-matched analysis: we matched the patients by age, cancer stage, and comorbidities. Duration of operation, postoperative complications, length of hospital stay, and long-term functional and oncological outcomes were compared. We calculated oncological outcomes using Kaplan–Meier Cox diagrams. In addition, we used a low anterior resection syndrome (LARS) score for the bowel function assessment.Results: Mean operation time in the LE group was 58.8 ± 45 min compared with the TME group that was 121.1 ± 42 min (p = 0.032). Complications were seen in 5.7% in LE group and 15.62% in TME group (p = 0.043). ~85.2% of the patients had no LARS in LE group compared with 54.5% in TME group (p = 0.018). Minor LARS was 7.4% in LE group compared with 31.8% in TME group (p = 0.018); major LARS was 7.4 and 13.7%, respectively (p = 0.474). Hospital stay was 2.77 days in LE group compared with 9.21 days in TME group (p = 0.036). The overall survival was 68.78 months in LE group compared with 74.81 months in TME group (p = 0.964).Conclusion: Our results of a small sample size showed that local excision ± chemoradiation is a rather safe method for early rectal cancer compared with gold standard treatment. In addition, better bowel function is preserved with less postoperative complications and shorter hospital stays.
Enfoque práctico del paciente con ictericia
Authors: Montero Rojas Maria Angelica , Peña Montenegro Andrea , Loaiza Sáenz Luis Felipe , Oviedo Pérez Kevin Josué , Baltodano Torres Breidy 
Published: October 2021

La ictericia, patología sumamente común en cualquier escenario clínico, la bilirrubina al ser un metabolito de la descomposición del grupo Heme que debe ser metabolizado en el hígado y ser parte de la absorción de ciertos nutrientes en el tracto intestinal, presenta muchos puntos donde su metabolismo o función se puede ver afectado, abriendo una gran gama de posibles etiologías para su aparición, donde la edad del paciente, estilo de vida y comorbilidades deben ser tomados en cuenta, dada la mayor probabilidad de ciertas patologías dependiendo del grupo en el que se encuentre el paciente. Una historia clínica minuciosa de síntomas actuales, antecedentes familiares, medicamentos utilizados, entre otros, es esencial en conjunto con un examen físico detallado, no solo buscando signos directos pero indirectos de alguna patología causante. Los exámenes de gabinete apoyan las sospechas clínicas como las enzimas hepáticas, pruebas de coagulación y anticuerpos virales, además el avance de la tecnología y mayor disponibilidad de ultrasonidos, tomografía y resonancia magnética facilitan el diagnóstico en estos pacientes, así dando mayor facilidad y rapidez al tratar a estos pacientes.
Estreñimiento funcional en pediatría
Authors: Hernández Quirós Thania , Villachica Madriz Allison 
Published: October 2021

El estreñimiento es un problema común que se ve a lo largo de la infancia. Las intervenciones tempranas son vitales para evitar las complicaciones y realizar el manejo oportuno.
Su definición está dada por los criterios de Roma IV, y su manejo dependerá de la causa subyacente.
La introducción de alimentos sólidos, el entrenamiento de control de esfínteres y la entrada a la escuela, se mencionan entre los principales desencadenantes del estreñimiento funcional en la edad pediátrica.
Los bebés con estreñimiento grave o recurrente, y especialmente aquellos con síntomas desde el nacimiento, deben ser evaluados cuidadosamente por posibles causas orgánicas, incluyendo la enfermedad de Hirschsprung, anomalías anorectales y fibrosis quística. La disquezia infantil es una causa común de síntomas similares al estreñimiento en bebés pequeños.
PENGARUH PROFESIONALISME, PENGALAMAN, DAN PENGETAHUAN AUDITOR TERHADAP KUALITAS AUDIT (STUDI EMPIRIS PADA KANTOR AKUNTAN PUBLIK DI MAKASSAR)
Authors: Malik Aan Digita 
Published: October 2021

Abstrak : Penelitian ini bertujuan untuk menguji pengaruh profesionalisme, pengalaman, dan pengetahuan auditor terhadap kualitas audit dalam hal ini ketepatan dalam pemberian opini auditor pada KAP di Makassar. Data dalam penelitian ini diperoleh dari masing - masing KAP di Kota Makassar yang bersedia menjadi responden. Penulis menggunakan pendekatan kuantitatif untuk menjawab permasalahan tersebut menggunakan data primer dalam bentuk kuesioner.. Sebelum melakukan analisis data, peneliti melakukan uji validitas dan reliabilitas terhadap 34 responden untuk menunjukkan sejauh mana kuesioner tersebut dapat dipercaya dan diandalkan. Teknik analisis data yang digunakan dalam penelitian ini adalah teknik analisis regresi berganda.Hasil penelitian menunjukkan bahwa: secara parsial, variabel profesionalisme, pengalaman, dan pengetahuan auditor berpengaruh secara positif dan signifikan terhadap kualitas audit.