bluuebunny/crossref_metadata_2025_split huggingface dataset:
Establishment and Validation of Nomogram Based on Combination of Pretreatment C-Reactive Protein/Albumin Ratio–EBV DNA Grade in Nasopharyngeal Carcinoma Patients Who Received Concurrent Chemoradiotherapy
Authors: Huang Zhang-Zan , Wen Wen , Hua Xin , Song Chen-Ge , Bi Xi-Wen , Huang Jia-Jia , Xia Wen , Yuan Zhong-Yu 
Published: July 2021

BackgroundA higher ratio of pretreatment C-reactive protein/albumin ratio (CAR) is associated with poor prognosis in nasopharyngeal carcinoma (NPC), and Epstein–Barr virus (EBV) DNA level is known to not only participate in the occurrence of nasopharyngeal carcinoma but also affect the development and prognosis of the disease. Herein, we proposed that a combination of both these markers could improve the predictive prognostic ability.MethodsIn all, 842 NPC patients who received concurrent chemoradiotherapy (CCRT) were entered in this study. We collected all patients’ blood samples and EBV DNA copy numbers within one week before any treatment. Receiver operating characteristic (ROC) curve was used to determine the optimal cut-off. We employed the Kaplan–Meier method for survival analyses and the univariate and multivariate analyses (Cox proportional hazards regression model) for statistical analysis. A nomogram was constructed based on multivariate analyses results of the validation set. The model was internally validated using 1000 bootstrap samples to avoid overfitting. Another validation of 10-fold cross-validation was also applied. Calibration curves and concordance index (C-index) were calculated to determine predictive and discriminatory capacity.ResultsIn the whole cohort, we observed that higher CAR, EBV DNA level, and CAR-EBV DNA (C-E) grade were associated with shorter overall survival (OS) and distant metastasis-free survival (DMFS) (all P&lt;0.05). In univariate and multivariate analyses, C-E grade was an independent prognostic factor (all P&lt;0.05). In the training set, we gained the similar results with the whole set. According to multivariate analyses of the training set, we constructed a nomogram. The results of bootstrap samples and 10-fold cross-validation showed favorable predictive efficacy. And calibration curves of the model provided credibility to its predictive capability.ConclusionC-E grade was confirmed as an independent prognostic predictor in patients with NPC who received CCRT. Higher level of pretreatment C-E grade could signify a higher risk of metastasis and shorter OS. The prognostic nomogram based on C-E grade was dependable in nasopharyngeal carcinoma patients.
Prospective Multicenter Study of Chemotherapy-Induced Clostridium (Clostridioides) difficile Infection in Patients With Lung Cancer: North Japan Lung Cancer Study Group Trial 1204
Authors: Toi Yukihiro , Kobayashi Takao , Harada Toshiyuki , Nakagawa Taku , Mori Yoshiaki , Kuda Tomoya , Sugawara Shunichi 
Published: July 2021

BackgroundDiarrhea post-antibiotic use is primarily attributed to mucosal lesions induced by Clostridium (Clostridioides) difficile (C. difficile) infection (CDI). Cancer patients undergoing chemotherapy might have a higher risk of CDI even when prior antibiotics are not used. Thus far, the relationship between lung cancer chemotherapy and the incidence of diarrhea remains unclear. This prospective multicenter study aimed to determine the incidence of CDI in lung cancer patients undergoing chemotherapy.MethodsThe presence of C. difficile and its toxins was investigated in lung cancer patients experiencing diarrhea during chemotherapy including paclitaxel (PTX), nanoparticle albumin-bound paclitaxel (nab-PTX), docetaxel (DOC), tegafur-gimeracil-oteracil (S-1), or irinotecan (CPT-11). If grade 2 or higher diarrhea occurred, then a stool culture was performed to detect anaerobic organisms and C. difficile toxins A and B. Additional data were collected through patient interviews and medical chart review.ResultsA total of 263 consecutive patients were enrolled in the study; grade 2 or higher diarrhea was observed in 22 patients (8.4%); CDI was confirmed in five of them (1.9%). The incidence of CDI was 22.7% of all diarrhea cases, and 50% of patients treated with PTX were CDI positive; the incidence of CDI was significantly higher in patients treated with PTX (P=0.039). Among the diarrhea cases, CDI patients had significantly worse ECOG performance status (PS) (P=0.043) and a significantly higher neutrophil count (P=0.028) than non-CDI patients. No CDI patients received antibiotics before cancer chemotherapy.ConclusionsAlthough diarrhea does not always affect a large portion of lung cancer chemotherapy recipients, clinicians should consider the possibility of CDI occurrence in lung cancer patients receiving chemotherapy, particularly PTX, without prior antibiotic exposure.
Naringin Ameliorates Monocrotaline-Induced Pulmonary Arterial Hypertension Through Endothelial-To-Mesenchymal Transition Inhibition
Authors: Wu Yonghui , Cai Changhong , Xiang Yijia , Zhao Huan , Lv Lingchun , Zeng Chunlai 
Published: July 2021

Pulmonary arterial hypertension (PAH) caused by enhanced arterial pressure increases vessel resistance in the lung. Endothelial-to-mesenchymal transition (EndMT) plays key roles in the vascular remodeling in PAH. Naringin, a protective gaseous mediator is commonly extracted from tomatoes and citrus fruits (such as grapefruits), and demonstrates anti-inflammation, anti-oxidant, anti-proliferation, and anti-tumor effects. Meanwhile, the association of Naringin and the process of EndMT is still unclear. In this study, monocrotaline (MCT) administration (60 mg/kg) was delivered for the induction of PAH in rats. Following this, Naringin (concentrations: 25, 50, and 100 mg/kg/day) was used for treatments. Human Umbilical Vein Endothelial Cells (HUVECs) were stimulated with Naringin and transforming growth factor β1 (TGFβ1, 10 ng/ml). As the result, Naringin was demonstrated to inhibit EndMT and alleviate PAH progression. In particular, in HUVECs, Naringin significantly suppressed the mesenchymal marker expression induced by TGFβ1 treatment, enhanced the endothelial marker expression, and inhibited the activation of ERK and NF-κB signaling pathways. To conclude, this study provided novel evidence suggesting the beneficial effects of Naringin in PAH through the inhibition of the ERK and NF-κB signaling pathways and the EndMT progression in pulmonary arteries.
The Inhomogeneity of Composition Along the Magnetic Cloud Axis
Authors: Song Hongqiang , Hu Qiang , Cheng Xin , Zhang Jie , Li Leping , Zhao Ake , Wang Bing , Zheng Ruisheng , Chen Yao 
Published: July 2021

Coronal mass ejections (CMEs) are one of the most energetic explosions in the solar system. It is generally accepted that CMEs result from eruptions of magnetic flux ropes, which are dubbed as magnetic clouds (MCs) in interplanetary space. The composition (including the ionic charge states and elemental abundances) is determined prior to and/or during CME eruptions in the solar atmosphere and does not alter during MC propagation to 1 AU and beyond. It has been known that the composition is not uniform within a cross section perpendicular to the MC axis, and the distribution of ionic charge states within a cross section provides us an important clue to investigate the formation and eruption processes of flux ropes due to the freeze-in effect. The flux rope is a three-dimensional magnetic structure intrinsically, and it remains unclear whether the composition is uniform along the flux rope axis as most MCs are only detected by one spacecraft. In this study, we report an MC that was observed by Advanced Composition Explorer at ∼1 AU during March 4–6, 1998, and Ulysses at ∼5.4 AU during March 24–28, 1998, sequentially. At these times, both spacecraft were located around the ecliptic plane, and the latitudinal and longitudinal separations between them were ∼2.2° and ∼5.5°, respectively. It provides us an excellent opportunity to explore the axial inhomogeneity of flux rope composition, as both spacecraft almost intersected the cloud center at different sites along its axis. Our study shows that the average values of ionic charge states exhibit significant difference along the axis for carbon, and the differences are relatively slight but still obvious for charge states of oxygen and iron as well as the elemental abundances of iron and helium. Besides the means, the composition profiles within the cloud measured by both spacecraft also exhibit some discrepancies. We conclude that the inhomogeneity of composition exists along the cloud axis.
Resilience and Subjectively Experienced Stress Among Paramedics Prior to and During the COVID-19 Pandemic
Authors: Piotrowski Andrzej , Makarowski Ryszard , Predoiu Radu , Predoiu Alexandra , Boe Ole 
Published: July 2021

IntroductionParamedics play a vital role in the healthcare system by providing professional support in situations of direct threat to patient health and life. They experience numerous difficulties during their work, which result in occupational stress. During the COVID-19 pandemic, their work has become even more demanding. The aim of the current study was to examine the role of resilience in the subjective experience of stress among paramedics during the COVID-19 pandemic.Materials and methodsThe study was carried out in two phases, in October-November 2019 (N = 75) and in May-June 2020 (N = 84), using the Sense of Stress Questionnaire (Skala Poczucia Stresu) and the Resilience Scale (Skala Pomiaru Prężności).ResultsParamedics exhibited higher intrapsychic stress before the COVID-19 pandemic. Tolerance of failure and treating life as a challenge were higher during the pandemic, in contrast to optimism and the ability to mobilize in difficult situations. Paramedics who were in contact with patients with COVID-19 experienced higher stress. Perseverance and determination, openness to new experiences and sense of humor, as well as competences and tolerance of negative emotions were revealed to play a key part in mitigating subjectively experienced stress.ConclusionParamedics’ subjectively experienced stress was lower during the COVID-19 pandemic. Paramedics who were in direct contact with patients with COVID-19 experienced higher stress. They had sufficient psychological resources, in the form of resilience (perseverance and determination, openness to new experiences, sense of humor, and competences and tolerance of negative emotions), which allowed them to cope with the situation of the COVID-19 pandemic.
Maintenance Electroconvulsive Therapy Is an Essential Medical Treatment for Patients With Catatonia: A COVID-19 Related Experience
Authors: Ghaziuddin Neera , Yaqub Tareq , Shamseddeen Wael , Reddy Priyanka , Reynard Hannah , Maixner Daniel 
Published: July 2021

Aim: Describe naturalistic clinical course over 14 weeks in a mixed adolescent and a young-adult patient group diagnosed with developmental delays and catatonia, when the frequency of maintenance electroconvulsive therapy (M-ECT) was reduced secondary to 2020 COVID-19 pandemic restrictions.Methods: Participants were diagnosed with catatonia, and were receiving care in a specialized clinic. They (n = 9), F = 5, and M = 4, ranged in age from 16 to 21 years; ECT frequency was reduced at end of March 2020 due to institutional restrictions. Two parents/caregivers elected to discontinue ECT due to concern for COVID-19 transmission. Majority (n = 8) were developmentally delayed with some degree of intellectual disability (ID). Observable symptoms were rated on a three point scale during virtual visits.Results: All cases experienced clinically significant decline. Worsening of motor symptoms (agitation, aggression, slowness, repetitive self-injury, stereotypies, speech deficits) emerged within the first 3 weeks, persisted over the 14 week observation period and were more frequent than neurovegetative symptoms (appetite, incontinence, sleep). Four participants deteriorated requiring rehospitalization, and 2 among these 4 needed a gastrostomy feeding tube.Conclusion: Moderate and severe symptoms became apparent in all 9 cases during the observation period; medication adjustments were ineffective; resuming M-ECT at each participant's baseline schedule, usually by week 7, resulted in progressive improvement in some cases but the improvement was insufficient to prevent re-hospitalization in 4 cases. In summary, rapid deterioration was noted when M-ECT was acutely reduced in the setting of COVID-19 related restrictions.
Stigma and Associated Correlates of Elderly Patients With Parkinson's Disease
Authors: Hou Miaomiao , Mao Xiaowei , Hou Xiaojun , Li Kunpeng 
Published: July 2021

Background: Stigmatizing experiences is common in Parkinson's disease (PD) and appears to provide a negative contribution to the quality of life. Our aim of this study was to investigate the extent of stigma and its predictive factors in patients with PD from our hospital in Shanghai, China.Methods: In 276 individuals with PD (135 women and 141 men), stigma was measured by the 24-item Stigma Scale for Chronic Illness (SSCI). Multivariate linear regression model was used to assess predictors of stigma including demographics (age and gender), disease duration, stage (Hoehn and Yahr Scale), motor function (Unified Parkinson's Disease Rating Scale Part 3, UPDRS-III), non-motor symptoms (Non-Motor Symptoms Scale, NMSS), cognitive level (Mini-Mental State Examination, MMSE), as well as anxiety (Hamilton Anxiety Rating Scale, HAM-A) and depressive disorders (Hamilton Depression Rating Scale, HAM-D-24).Results: The total score of SSCI was 49.9 ± 14.3, and 48.5% of the patients checked “rarely” to “sometimes.” For the total sample, the full model accounted for 47.8% of the variance in stigma (P &lt; 0.05). Higher UPDRS-III scores, longer course of disease, younger age, tremor-dominant subtype, and higher depression scores were significantly associated with stigma among individuals with PD.Conclusion: Our finding suggested a mild-to-moderate level of stigma in patients with PD. Tremor-dominant subtype, longer course of disease, younger age, severe motor symptoms, and depression are the predictors of stigma in PD.
The Missing Professional Perspective: Medical, Veterinary, and Dual Degree Public Health Student Perceptions of One Health
Authors: Roopnarine Rohini , Boeren Ellen , Regan Julie-Anne 
Published: July 2021

Introduction: One Health (OH) is an important concept to design appropriate public health responses to emerging diseases such as COVID-19. How trainee health professionals understand this concept is important to its implementation. In this study, we explored how medical (MD), veterinary (DVM), and dual degree MD and DVM Master of Public Health (MPH) students define OH and its relevance to practice.Methods: Students participated in a survey that included the Readiness for Interprofessional Learning Scale (RIPLS), and two questions requiring them to define and explain the relevance of OH. The transcripts of the OH responses underwent thematic analysis. Role theory was used to explain the variation in how students from these different programmes viewed the concept.Results: The responses of the MD and DVM students in contrast to the dual degree MPH students reflected gaps in their understanding of the concept that pertained to the specific health impacts of global warming; antimicrobial resistance, food security; social, cultural and environmental determinants of zoonoses occurrence, and health policy formation.Discussion: Mitigation of the global risks to public health require a collaborative approach by health professionals. Our findings suggest that MD and DVM students are unaware of many factors that impact patient health outside of their own discipline. The inclusion of dual degree students revealed novel insights that undertaking an MPH may have enabled them to be more aware about the interdisciplinary relevance of OH to their professional practice. We recommend that structured incorporation of OH should inform future medical and veterinary curricula.
Prognostic Significance of Signet-Ring Cell Components in Patients With Gastric Carcinoma of Different Stages
Authors: Dong Xiaoyuan , Sun Guorui , Qu Hui , He Qingsi , Hao Zhaofan 
Published: July 2021

Background: Gastric carcinoma (GC), which contains signet ring cell (SRC) components are frequently observed in postoperative pathological assessment. This study aims to study the prognostic significance of SRC components in GC patients.Methods: From 2003 to 2017, surgically resected primary GC patients were retrospectively reviewed. All enrolled patients were divided into three groups according to the proportion of SRC. The overall survival (OS) and disease-free survival (DFS) of GC patients with different tumor stages were analyzed.Results: Patients with SRC or mixed-SRC were more associated with female, younger age, middle or lower third of the stomach, larger tumor, higher pN stage, and more lymphovascular invasion. For GC patients in stage I, multivariate survival analysis showed that age &gt;60, SRC components &gt;50%, and pT stage were independent prognostic factors for OS (all p &lt; 0.05). The 5-year OS of patients with SRC were higher than that of patients with pure adenocarcinoma (p = 0.021). For GC patients in stage II/III, multivariate survival analysis showed that age &gt;60, SRC proportion, surgical types, Borrmann's type, pT stage, pN stage, and lymphovascular invasion were independent prognostic factors for OS (all p &lt; 0.05). The 5-year OS/DFS of patients with SRC were lower than that of patients with pure adenocarcinoma (p &lt; 0.001).Conclusions: SRC seemed to be a favorable prognostic factor in GC patients in stage I. However, for GC patients in stage II/III, the SRC components were associated with poor prognosis, independent of other clinicopathological factors.
Bisegmentectomy 7–8 for Small-for-Size Remanant Liver for Cirrhotic Patients Under Right Hemi-hepatectomy With Hepatocellular Carcinoma: A Case-Matched Comparative Study
Authors: Wang Xishu , Lei Yongrong , Huan Hongbo , Chen Shu , Ma Kuansheng , Feng Kai , Lau Wan Yee , Xia Feng 
Published: July 2021

Aim: To compare the short- and long-term treatment outcomes of bisegmentectomy 7–8 vs. right hepatectomy for patients with hepatocellular carcinoma and cirrhosis.Methods: Thirty six cirrhotic HCC patients with infiltration of right hepatic vein in segments 7–8 underwent bisegmentectomy 7–8 for small-for-size remanant liver under right hemi-hepatectomy. Its outcome was compared with a case-matched control group of cirrhotic HCC patients who underwent right hemi-hepatectomy during the study period.Results: The study group consisted of 36 patients and the control group 36 patients selected from 1,526 patients matched with age, tumor size, tumor location, and Pugh-Child staging. There were no significant differences between the two groups in operative parameters and in perioperative main complications which included hemorrhage, bile leakage, ascites, pleural effusion, and liver failure. The overall morbidity rate and morbidity rate classified according to Clavien's classification were similar. There was no in-hospital mortality or 90 day post-operative mortality. The mean follow-up was 30 and 32 months for the study group and control group, respectively. The disease free survival rate (DFS) for the study group was just significantly better than the control group. The median DFS was 24 months for the study group and 8 months for the control group (P = 0.049). Meanwhile, the median cumulative overall survival was 35 months for the study group and 27 months for the control group (P = 0.494).Conclusion: Bisegmentectomy 7–8 was safe and feasible for selected cirrhosis patients, and did not increase the perioperative risk and inferior long-term overall survival outcomes. It extended the indications for liver resection in patients with borderline volumes of future liver remnant for HCC cirrhotic liver.
INTELLIGENT DISTRIBUTED DYNAMIC FOG COMPUTING FRAMEWORK
Authors: ВОЛКОВ А.Н. 
Published: July 2021

Одним из направлений развития сетей связи 5G и сетей связи 2030 является интегрирование в сеть распределенных вычислительных структур, таких как системы пограничных и туманных вычислений (Fog), которые призваны выполнить децентрализацию вычислительной части сетей. В связи с этим необходимо исследовать и определить принципы предоставления услуг на основе распределенной вычислительной инфраструктуры, в том числе в условиях ограниченности ресурсов отдельно взятых составных частей (Fog-устройства). Предлагается новый фреймворк распределенной динамической вычислительной системы туманных вычислений на основе микросервисного архитектурного подхода к реализации, развертыванию и миграции программного обеспечения предоставляемых услуг. Исследуется типовая архитектура микросервисного подхода и ее имплементация в туманные вычисления, а также рассматриваются два алгоритма: алгоритм K-средних для нахождения центра пользовательской нагрузки и алгоритм роевой оптимизации для определения устройства тумана с необходимыми характеристиками для последующей миграции микросервиса.
One of the directions of 5G and 2030 communications networks development is the network-integrated distributed structures, such as edge computing (MEC) and Fog computing, which are designed to decentralize the computing part of networks. In this regard, it is necessary to investigate and determine the principles of providing services based on a distributed computing infrastructure, including in conditions of limited resources of individual components (Fog devices). This article proposes a new framework for a distributed dynamic computing system of fog computing based on a microservice architectural approach to the implementation, deployment, and software migration of the services. The article examines the typical architecture of the microservice approach and its implementation in fog computing, and also investigates two algorithms: K-means for finding the center of user load, swarm optimization (PSO) to determine the fog device with the necessary characteristics for the subsequent migration of the microservice.