bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum C-Reactive Protein-to-Body Mass Index Ratio Predicts Overall Survival in Patients With Resected Colorectal Cancer
Authors: Huang Lingxu , Liu Jungang , Huang Xiaoliang , Wei Chunyin , Mo Xianwei , Zhong Huage , Meng Yongsheng , Lai Hao , Zhang Lihua , Liang Dingyu , Liu Haizhou , Tang Weizhong 
Published: July 2021

Background and Purpose: Systemic inflammation and nutritional status have been shown to be associated with the prognosis of colorectal cancer. The purpose of this study was to evaluate the impact of the serum C-reactive protein-to-body mass index ratio on the prognosis of patients with curatively resected colorectal cancer. Methods: We conducted a retrospective analysis of a database of 2,471 eligible patients with colorectal cancer who underwent curative resection at our hospital between 2004 and 2019. The optimal cut-off for CPR-to-BMI ratio was determined using maximally selected rank statistics. Patients were divided into 2 groups according to the cut-off value of the serum C-reactive protein-to-body mass index ratio. Kaplan-Meier curves and Cox regression analysis were used to compare overall survival. A two-sided P-value < 0.05 was considered statistically significant. Results: The proportion of patients with a high C-reactive protein-to-body mass index ratio increased with increasing age, male sex, right-sided colon cancer, poorly differentiated tumors, advanced-stage disease, local/distant metastases, tumor–node–metastasis stage, and microsatellite instability. In subgroup analysis according to tumor–node–metastasis stage, the overall survival of the high C-reactive protein-to-body mass index ratio group was significantly shorter than that of the low C-reactive protein-to-body mass index ratio group ( P < 0.001). Multivariate analysis identified age, differentiation, tumor–node–metastasis stage, carcinoembryonic antigen level, and the C-reactive protein-to-body mass index ratio as independent poor prognostic factors for overall survival. Conclusions: The C-reactive protein-to-body mass index ratio predicts the prognosis of patients with curatively resected colorectal cancer and is an independent risk factor for overall survival in patients with colorectal cancer.
Outcomes of Surface Replacement Arthroplasty in Metacarpophalangeal Joints Affected by Noninflammatory Arthritis
Authors: Claxton Matthew R. , Wagner Eric R. , Rizzo Marco 
Published: July 2021

Background The purpose of this study was to investigate the outcomes of surface replacement arthroplasty (SRA) for noninflammatory arthritis of the metacarpophalangeal (MCP) joint. Methods Records from 20 SRAs performed between 1995 and 2017 in 17 patients with noninflammatory arthritis affecting the MCP joint were retrospectively reviewed. The mean follow up was 6.6 years. Results Three arthroplasties (15%) underwent 4 revision operations. The 2-, 5-, 10-, and 15-year rates of survival from surface replacement implant revision were 90%, 90%, 79%, and 79%, respectively. Major complications occurring in revised joints included arthrodesis (n = 1) and amputation (n = 1). The overall reoperation rate was 35%. The 2-, 5-, 10-, and 15-year rates of overall reoperation-free survival were 75%, 69%, 60%, and 60%, respectively. Conclusions Pain ratings and MCP arc of motion significantly improved following arthroplasty. Metacarpophalangeal SRA for noninflammatory arthritis can improve arc of motion and pain. Revision is uncommon; however, 1 in 3 joints requires reoperation.
Preliminary Study on the Effect of 4DCT-Ventilation-Weighted Dose on the Radiation Induced Pneumonia Probability (RIPP)
Authors: Bai Han , Li Wenhui , Xia Yaoxiong , Li Lan , Gao Jingyan , Liu Xuhong 
Published: July 2021

Purpose: The purpose of the present study was to evaluate the feasibility of using 4-dimensional computed tomography (4DCT)-ventilation-weighted dose analysis to predict radiation-induced pneumonia probability (RIPP). Methods and Materials: The study population for this retrospective analysis included 16 patients with stage III lung cancer. Each patient’s 4DCT images, including end-inhale and end-exhale sequences, were used for the deformable image registration, and the Hounsfield units (HU) density-change was used to calculate the ventilation. A previously established equation was used to convert the original dose (OD) D 0, i in the lungs in the original plan (OP) to the weighted-dose (WD) D w, i in the weighted plan (WP). The patients were divided into 2 groups, one with radiation-induced pneumonia (RIP), and one without. The Spearman correlation analysis was used to analyze the correlation of RIP with ΔV20 (ΔV x = V w, x in the WP – V 0, x in the OP), ΔMLD (ΔMLD = mean lung dose (MLD) in the WP – MLD in the OP), and ΔV5. Results: The results showed that 5 of the 16 patients were suffering from acute RIP, 4 of which had higher ΔV20 and ΔMLD values than the rest of the patients. The results of the Spearman correlation analysis for those 4 patients were as follows: RIP vs. ΔV20, r = 0.5123; RIP vs. ΔMLD, r = 0.5119; RIP vs. ΔV5, r = 0.1904. Conclusions: The 4DCT-ventilation-based weighted-dose analysis showed some correlation between RIPP and both ΔV20 and ΔMLD, when comparing the weighted-dose and the conventional dose-volume histogram (DVH) analyses.
Progressive multifocal leukoencephalopathy and immune reconstitution inflammatory syndrome in seven patients with sarcoidosis: a critical discussion of treatment and prognosis
Authors: Dohrn Maike F. , Ellrichmann Gisa , Pjontek Rastislav , Lukas Carsten , Panse Jens , Gold Ralf , Schulz Jörg B. , Gess Burkhard , Tauber Simone C. 
Published: July 2021

Progressive multifocal leukoencephalopathy (PML) is a subacute brain infection by the opportunistic John Cunningham (JC) virus. Herein, we describe seven patients with PML, lymphopenia, and sarcoidosis, in three of whom PML was the first manifestation of sarcoidosis. At onset, the clinical picture comprised rapidly progressive spastic hemi- or limb pareses as well as disturbances of vision, speech, and orientation. Cerebral magnetic resonance imaging showed T2-hyperintense, confluent, mainly supratentorial lesions. Four patients developed punctate contrast enhancement as a radiological sign of an immune reconstitution inflammatory syndrome (IRIS), three of them having a fatal course. In the cerebrospinal fluid, the initial JC virus load (8–25,787 copies/ml) did not correlate with interindividual severity; however, virus load corresponded to clinical dynamics. Brain biopsies ( n = 2), performed 2 months after symptom onset, showed spotted demyelination and microglial activation. All patients had lymphopenia in the range of 270–1150/µl. To control JC virus, three patients received a combination of mirtazapine and mefloquine, another two patients additionally took cidofovir. One patient was treated with cidofovir only, and one patient had a combined regimen with mirtazapine, mefloquine, cidofovir, intravenous interleukin 2, and JC capsid vaccination. To treat sarcoidosis, the four previously untreated patients received prednisolone. Three patients had taken immunosuppressants prior to PML onset, which were subsequently stopped as a potential accelerator of opportunistic infections. After 6–54 months of follow up, three patients reached an incomplete recovery, one patient progressed, but survived so far, and two patients died. One further patient was additionally diagnosed with lung cancer, which he died from after 24 months. We conclude that the combination of PML and sarcoidosis is a diagnostic and therapeutic challenge. PML can occur as the first sign of sarcoidosis without preceding immunosuppressive treatment. The development of IRIS might be an indicator of poor outcome.
IMbrave 151: a randomized phase II trial of atezolizumab combined with bevacizumab and chemotherapy in patients with advanced biliary tract cancer
Authors: Hack Stephen P. , Verret Wendy , Mulla Sohail , Liu Bo , Wang Yulei , Macarulla Teresa , Ren Zhenggang , El-Khoueiry Anthony B. , Zhu Andrew X. 
Published: July 2021

Background: Biliary tract cancers (BTCs) are heterogenous, highly aggressive tumors that harbor a dismal prognosis for which more effective treatments are needed. The role of cancer immunotherapy in BTC remains to be characterized. The tumor microenvironment (TME) of BTC is highly immunosuppressed and combination treatments are needed to promote effective anticancer immunity. Vascular endothelial growth factor (VEGF) drives immunosuppression in the TME by disrupting antigen presentation, limiting T-cell infiltration, or potentiating immune-suppressive cells. Many VEGF-regulated mechanisms are thought to be relevant to repressed antitumor immunity in BTC, making dual targeting of VEGF and programmed cell death protein 1 (PD-1)/PD-L1 pathways a rational approach. Gemcitabine and Cisplatin (Gem/Cis) can also modulate anticancer immunity through overlapping and complementary mechanisms to those regulated by VEGF. Anti-PD-L1/VEGF inhibition, coupled with chemotherapy, may potentiate antitumor immunity leading to enhanced clinical benefit. Methods: IMbrave 151 is a randomized, double-blind, placebo-controlled, multicenter, international phase II study to evaluate atezolizumab (a PD-L1 inhibitor) in combination with chemotherapy (gemcitabine and cisplatin) and bevacizumab (an anti-VEGF monoclonal antibody) as a first-line treatment for advanced BTC. Approximately 150 patients with previously untreated, advanced BTC will be randomized to either Arm A (atezolizumab + bevacizumab + Gem/Cis) or Arm B (atezolizumab + placebo + Gem/Cis). Randomization is stratified by the presence of metastatic disease, primary tumor location, and geographic region. The primary efficacy endpoint is investigator-assessed progression-free survival (PFS) per RECIST 1.1. Secondary endpoints include objective response rate (ORR), duration of response (DoR), disease control rate (DCR), overall survival (OS), and safety and patient reported outcomes (PROs). Tissue, blood, and stool samples will be collected at baseline and on-treatment in order to perform correlative biomarker analyses. Discussion: IMbrave 151 represents the first randomized study to evaluate combined PD-L1/VEGF blockade on a chemotherapy backbone in BTC. Trial registration: NCT identifier: NCT04677504; EUDRACT number: 2020-003759-14
There and back again: analyzing the effect of outpatient readmission on the quality of life of patients attending a rheumatology clinic
Authors: Madrid-García Alfredo , Montuenga-Fernández Isabel , Font-Urgelles Judit , León-Mateos Leticia , Pato Esperanza , Jover Juan A , Fernández-Gutiérrez Benjamín , Abasolo Lydia , Rodríguez-Rodríguez Luis 
Published: July 2021

Aims: The aim of this study was to assess the effect of “outpatient readmissions” on the health-related quality of life (HR-QoL) of outpatients from a rheumatology clinic, meaning the effect of the patient’s return to the outpatient clinic after having received care and been discharged. Methods: We conducted an observational longitudinal retrospective study, with patients selected from the Hospital Clínico San Carlos Musculoskeletal cohort, based on having received at least one discharge from the outpatient clinic and having returned (readmission) at least once after the discharge. The main outcomes were the patients’ baseline HR-QoL (measured on the first visit of each episode) and the ΔHR-QoL (difference between the HR-QoL in the last and the first visit of each episode). Successive episodes of admission and readmission were chronologically ordered, paired and analyzed using nested linear mixed models, nested by patients and by admission–readmission tandem. We carried out bivariable and multivariable analyses to assess the effect of demographic, clinical, treatment and comorbidity-related variables in both main outcomes. Results: For the first main outcome, 5887 patients (13,772 episodes) were analyzed. Based on the multivariable level, readmission showed no significant marginal effect on the baseline HR-QoL ( p-value = 0.17). Conversely, when analyzing the ΔHR-QoL, we did observe a negative and significant marginal effect ( p-value = 0.028), meaning that readmission was associated with a lower gain in the HR-QoL during the follow-up, compared with the previous episode. Conclusion: In the outpatient setting, readmission exerts a deleterious effect in patients undergoing this process. Identification of outpatients more likely to be readmitted could increase the value of the care provided.
Ecological Momentary Assessment of Positive and Negative Affect and Associations with Blood Glucose in Teens with Type 1 Diabetes
Authors: Shapira Amit , Volkening Lisa K. , Borus Joshua S. , Laffel Lori M. 
Published: July 2021

Background: Affect (i.e., emotions) can be associated with diabetes self-care and ambient glucose in teens with type 1 diabetes (T1D). We used momentary sampling to examine associations of daily affectwithblood glucose (BG) monitoring,BG levels,and BG variability in teens with T1D. Method: Over 2 weeks, 32 teens reported positive and negative affect (Positive and Negative Affect Scale) and BG levels on handheld computers 4x/day, coordinated with planned daily BG checks. BG values were classified as: in-range (70-180 mg/dL); low (<70 mg/dL); severe low (<54 mg/dL); high (>180 mg/dL); severe high (>250 mg/dL). Daily BG variability was derived from BG coefficient of variation (BGCV). To determine associations of positive and negative affect with BG checks, BG levels, and BGCV, separate generalized estimating equations were performed, adjusting for demographic and diabetes-related variables, for the overall sample and stratified by HbA1c (≤8%, >8%). Results: Teens (44% male, ages 14-18, 63% pump-treated, HbA1c 8.8 ± 1.4%) reported 51% in-range, 6% low (2% severe low), and 44% high (19% severe high) BG. In teens with HbA1c ≤8%, positive affect was associated with in-range BG (OR = 1.08, 95% CI = 1.04-1.13, P = .0002), reduced odds of very low glucose (OR = 0.35, 95% CI = 0.16-0.74, P = .006), and less daily BGCV (β = −0.9; 95% CI = −1.6, −0.2; P = .01). In teens with HbA1c >8%, negative affect was associated with less likelihood of checking BG (OR = 0.75, 95% CI = 0.64-0.87, P = .0003). Conclusions: Our findings shed light on individual differences in metabolic reactivity based on glycemic levels and the importance of incorporating affect into automated insulin delivery systems.
Human Platelet Lysate as an Alternative to Autologous Serum for Human Chondrocyte Clinical Use
Authors: Philippe Virginie , Laurent Alexis , Abdel-Sayed Philippe , Hirt-Burri Nathalie , Ann Applegate Lee , Martin Robin 
Published: July 2021

Objective A pivotal aspect of cartilage tissue engineering resides in cell culture medium supplementation, in view of maximizing in vitro cell proliferation and preserving cellular functionality. Autologous human serum (aHS) is commonly used as an inducive supplement for safe human articular chondrocyte (HAC) proliferation prior to clinical implantation. However, practical clinical use of aHS is hindered by constraining manufacturing requirements and quality assurance-driven downstream processing. The present study investigated potential alternative use of commercial human platelet lysate (hPL) supplements in HAC manufacturing workflows related to clinical therapeutic pathways. Design Differential effects of hPL, aHS, and fetal bovine serum were assessed on primary cultured HAC parameters (viability, proliferative rates, and morphology) in 2-dimensional in vitro systems. A 3-dimensional HAC pellet model served for postexpansion assessment of cellular functionality, by visualizing proteoglycan production (Alcian blue staining), and by using qRT-PCR relative quantification of chondrogenic marker ( SOX9, COL2-A1, and ACAN) genetic expression. Results We found that monolayer HAC culture with hPL or aHS supplements presented similar characteristics (elongated cell morphology and nearly identical growth kinetics). Chondrogenic activity appeared as conserved in HACs expanded with human or bovine supplements, wherein histologic analysis indicated a progressive sGAG accumulation and SOX9, COL2-A1, ACAN gene expression was upregulated in 3-dimensional HAC pellet models. Conclusion This study therefore supports the use of hPL as a functional equivalent and alternative to aHS for cultured HAC batch preparation, with the potential to effectively alleviate pressure on clinical and manufacturing bottlenecks in cell therapy approaches for cartilage regeneration.
Reference values of glomerular filtration rate for healthy adults in southern China: a cross-sectional survey
Authors: Ma Yaohui , Zhan Jinfeng , Xu Gaosi 
Published: July 2021

Background: Currently the global data on the glomerular filtration rate of healthy adults are insufficient, with relatively little data for other races and countries. Especially in China, there are no such figures. Methods: In this cross-sectional study, we included healthy Han adults in southern China. Participants completed a lifestyle and medical history questionnaire and had their blood pressure measured, and blood and urine samples collected. Serum creatinine was measured and used to estimated glomerular filtration rate (eGFR) by the Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulae. The normal range of eGFR is described, and the influence of gender and age on eGFR is analyzed by the statistical method. Results: We provided the largest sample size of eGFR research in China at present. The mean age of the 20,930 healthy individuals was 40.9 ± 12.3 years, 58.8% were women. The eGFRMDRD for women and men were 111.3 ± 17.4 mL/min per 1.73 m2 and 103.3 ± 15.9 mL/min per 1.73 m2, respectively. The eGFRCKD-EPI for women and men were 110.3 ± 12.1 mL/min per 1.73 m2 and 103.8 ± 13.3 mL/min per 1.73 m2, respectively. The eGFRMDRD of women and men in all age groups decreased continuously by 7.3 ml/min/1.73 m2/decade and 4.4 ml/min/1.73 m2/decade, respectively. The eGFRCKD-EPI of women and men in all age groups decreased continuously by 8.4 ml/min/1.73 m2/decade and 6.9 ml/min/1.73 m2/decade. Conclusions: The eGFR of women is higher than men and with the increasing age, the eGFR of women declines faster than men.
Perioperative nutrition care and dietetic practices in the scope of bariatric surgery in Saudi Arabia using adapted protocols for evaluation
Authors: Aljaaly Elham Abbas 
Published: July 2021

Objectives: This study evaluates the availability of perioperative nutritional care protocols and the practices of bariatric registered dietitians in Saudi Arabia. The primary outcomes of the study were conducted using an adapted American survey “with permission.” Methods: A cross-sectional survey of a selected 32 dietitians providing bariatric services completed a self-administered online questionnaire from 12 hospitals in Jeddah, Saudi Arabia. Results: All surveyed dietitians were females, mainly Saudi nationals (93.9%, n = 30), and accredited by the Saudi Commission for Health Specialties (93.8%, n = 30). Only 37.5% (n = 6) of the dietitians were specialized in bariatric surgery. Perioperative common practices of dietitians included a conduct of screening for nutrition risk before (44%, n = 14) and after surgery (62.5%, n = 20) and applied a nutrition management protocol that is mainly based on the application of nutrition care process (62.5%, n = 20). Dietitians (81%, n = 26) reported the importance of having standardized protocols for nutritional management of patients undoing bariatric surgery, where 69% (n = 22) confirmed the availability of pre-operative written protocols in hospitals and 75% (n = 24) confirmed the existence of post-operative protocols. Pre-operative practices included using approaches for weight loss before surgery, for example, very low and low-calorie diet. Dietitians (25%, n = 8) see two to ten patients per month. The sleeve gastrectomy procedure is the most often performed surgery. Conclusion: This is the first study to evaluate the perioperative nutrition care protocols and practices related to bariatric surgery in Saudi Arabia. Perioperative bariatric protocols are available, but some dietitians are not aware of their availability and contents. Researchers emphasize the importance of creating national protocols by the Saudi Credentials Body to standardize practices within the field.
Perceived physical accessibility, mother’s perception of quality of care, and utilization of skilled delivery service in rural Ethiopia
Authors: Hailemariam Shewangizaw , Gutema Lidya , Asnake Molla , Agegnehu Wubetu , Endalkachew Biruk , Molla Wondwosen 
Published: July 2021

Objective: Despite the concerted effort to improve skilled delivery service utilization in Ethiopia, a considerable proportion of births still occur at home by traditional birth attendants, notably in a rural setting. Hence, the aim of this study was to investigate whether mother’s perceived service quality and physical accessibility affect skilled delivery service utilization. Methods: A community-based cross-sectional study was conducted from 1 July 2019 to 30 August 2019, among mothers who gave birth in the last 12 months before the study, in selected five districts of Kaffa Zone, Ethiopia. Result: In this study, 262 (70.1%) of mothers utilized skilled delivery service in their recent childbirth. Mothers regarding the nearby health facility’s physical environment as “Good” (adjusted odds ratio = 2.48, 95% confidence interval = 1.44, 4.25), mothers mentioning time to reach to the nearby health facility “<1 h” (adjusted odds ratio = 1.92, 95% confidence interval = 1.11, 3.34), and mothers regarding prompt transport service from home to the nearby health facility “Available” (adjusted odds ratio = 2.01, 95% confidence interval = 1.11, 3.63) were positively associated with skilled delivery services’ utilization. Furthermore, completing secondary education and above, attending three and more antenatal care visits, and having good knowledge of danger signs during pregnancy showed a significant association. Conclusion: Although the study evidenced statistically significant association between perceived physical accessibility and perceived service quality, further study is recommended to investigate the relationship between actual physical accessibility and actual service quality. Targeted health education program intended to improve skilled delivery service utilization should give due emphasis on enhancing antenatal care service uptake, and raising mothers’ awareness on danger signs during pregnancy, with particular focus on those mothers with low schooling.
NMOSD-like and longitudinal extensive HTLV1-associated myelitis are extremes that flank an overlooked continuum
Authors: Bonnan Mickael , Olindo Stéphane , Signate Aissatou , Lobjois Quentin , Stephant Maeva , Boulos Dalia Dimitri , Cabre Philippe 
Published: July 2021

Background HTLV1-associated myelitis (HAM) is a slowly progressive myelopathy in which spinal cord MRI demonstrates no lesion or atrophy. Objective We examined the overlap between NMOSD features and HTLV1 infection. Methods We included all HTLV1-infected patients recruited in French West Indies (FWI) or referred from different centers, and suffering from at least one NMOSD feature. Literature connecting HTLV1-infection and NMOSD was reviewed. Results We included six NMOSD-like HAM with acute onset, seronegative against AQP4 and MOG-Abs. All displayed extensive longitudinal myelitis, and the optic nerve was involved in three. We gathered 39 cases of NMOSD-like HAM patients from the literature. Atypical signs of HAM were relapses (15.4%), sensory level (50%), upper limb symptoms (35.9%), optic neuritis (10.2%). Typical lesions involved lateral funiculi and featured a double rope sign (56.3%). Conclusion We propose that acute onset of NMOSD-like HAM could be more frequent than expected and should be evoked in high-risk patients. Extensive but often transient cord lesions could be the hallmark of an excessive inflammation of the funiculi targeted by HTLV1 infection. Although usually minor, a few HAM cases demonstrate specific MRI lesions, and the most severe cases may mimic NMOSD attacks.