bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Long Term Prediagnostic Aspirin Intake on the Prognosis of Esophageal Squamous Cell Carcinoma Receiving Radical Surgery
Authors: Jia Wenqiao , Wang Cong , Lu Ming , Cheng Yufeng 
Published: May 2021

Abstract
Background:The effect of long term prediagnostic aspirin intake on the prognosis of esophageal squamous cell carcinoma (ESCC) is unclear. We aimed to reveal the effect of long term prediagnostic aspirin intake on survival of ESCC patients receiving radical surgery. Methods:147 eligible ESCC patients who received radical surgery for primary treatment were enrolled in this study. Patients who had used aspirin regularly for more than 3 months before diagnose were classified as aspirin group and patients who had never used aspirin before diagnose and surgery were served as non-aspirin group. The recurrence rate, disease-free survival (DFS) and overall survival (OS) were compared between the two groups to verify the effect of aspirin. Results:Patients were clarified into aspirin group (n=57) and non-aspirin group (n=90). The DFS and OS were both significantly shorter in aspirin group than non-aspirin group (DFS: 23.1±18.0 months vs. 30.9±19.8 months, P=0.018; OS: 29.8±17.4 months vs. 35.2±18.2 months, P=0.082). Survival analysis revealed that OS decreased in aspirin group than in non-aspirin group, however, it did not reach significance (P=0.074). DFS decreased significantly in aspirin group than non-aspirin group in both univariate (P=0.007) and multivariate (P=0.002) survival analysis. Subgroup analysis revealed that in pTNM stage 2, OS and DFS were reduced in non-aspirin group compared with aspirin group (P=0.048 and P=0.003, respectively), while no difference was found in stage 3.Conclusions:Long term prediagnostic aspirin intake may cause poor DFS in ESCC patients receiving radical surgery, especially for those in pTNM stage 2.
Accuracy of SD Malaria Ag P.f/Pan® As A Rapid Diagnosis Test of Malaria in French Amazonia
Authors: pujo jean marc , Lemmonier Sarah , Houcke Stéphanie , Frémery Alexis , Blanchet Denis , Djossou Felix , Kallel Hatem , Demar Magalie 
Published: May 2021

Abstract
BackgroundFrench Guiana (FG) is, with Mayotte island, one of the two French overseas territories where malaria is still endemic. Ten years ago, French health authorities implemented a strategy to eradicate malaria disease in the region. The current incidence rate is 0,74‰ inhabitants, and Plasmodium Vivax is widely predominating even though Plasmodium Falciparum is still present due to imported cases, mainly from the Africa continent. In FG, RDT (SD Malaria Ag P.f/Pan®) test is based on detection of pan-pLDH, PfHRP2, and PfHRP3 antigens. While, in South America, the share of deletion of PfHRP2 gene is significantly increasing. So, we wondered if RDTs remained reliable in this context.MethodsOur study is a retrospective analysis conducted over four years and analyzed 12880 rapid diagnosis tests (RDTs) whose result was compared with Blood Film Tests (BFTs) sampled for malaria diagnosis.ResultsThe global assessment of the diagnosis accuracy of RDT in the diagnosis of malaria shows PPV (Positive Predictive Value) and NPV (Negative Predictive Value) more than 95%, except for PPV of RDT in the diagnosis of malaria to P falciparum (88%). Overall, the concordance rate between RDT and BFT (positive/positive; negative/negative) was 99.5%. The PPV of the RDT in the follow-up of patients diagnosed with P falciparum was the lowest during the 28 first days after diagnosis. The PPV of the RDT in the follow-up of patients diagnosed with P vivax was the lowest during the 21 first days after diagnosis. The global sensitivity of SD Malaria Ag P.f/Pan® test was, on average, 96% (88.2 – 1) for P falciparum and 93% (90.6 – 94.2) for P vivax. The global specificity was high, with a rate of 99.8% (99.5 – 1) for all species included.ConclusionSD Malaria Ag P.f/Pan® is still a reliable rapid test used for the first-line diagnosis in remote healthcare centers. The test reading should be nuanced by the recent medical history of patients and the date of arrival in FG. RDT result has always to be confirmed by BFT that is still the gold standard for the malaria diagnosis. FG is still a PfHRP2 gene deletion-free area.
Real-World Pharmacokinetics and Pharmacodynamics of Everolimus in Metastatic Breast Cancer
Authors: Fukudo Masahide , Ishibashi Kei , Kitada Masahiro 
Published: May 2021

Abstract
PurposeThis study investigated the relationship between the pharmacokinetics and pharmacodynamics of everolimus in patients with metastatic breast cancer (mBC) in real-world practice.MethodsTwenty-two patients with mBC treated with everolimus plus exemestane were enrolled. Blood everolimus concentrations were measured at outpatient visits. The inhibition of the mammalian target of rapamycin (mTOR) activity in peripheral blood mononuclear cells (PBMCs) was examined. The efficacy and safety endpoints were progression-free survival (PFS) and the cumulative incidence of dose-limiting toxicities (DLTs), respectively.ResultsBlood samples were obtained from 19 consenting patients. Everolimus did not completely inhibit mTOR activity in PBMCs at therapeutic concentrations (~56% maximal inhibition). The most common adverse event was stomatitis (any grade 77%). The trough concentration (Ctrough) was significantly higher in patients experiencing DLTs than in those without any DLTs (P = 0.030). The optimal Ctrough cutoff predicting DLT development was 17.3 ng/mL. The cumulative incidence of DLTs was significantly higher in patients with Ctrough ≥17.3 ng/mL than in other patients (sub-hazard ratio 4.87, 95% confidence interval [CI] 1.53–15.5; P = 0.007). Furthermore, the median PFS was numerically longer in patients who maintained a steady-state Ctrough below the threshold than in those who did not (327 days [95% CI 103–355 days] vs 194 days [95% CI 45 days–not estimable]; P = 0.35). ConclusionThe suggested upper threshold for the therapeutic window of everolimus Ctrough was 17.3 ng/mL. Pharmacokinetically guided dosing may improve the efficacy and safety of everolimus for mBC, warranting further investigation in a larger study.
The First Steps Towards Professionalism? A Qualitative Study of Medical Students’ Experiences With Patients’ Emotional Issues During a Medical Interview
Authors: Brodahl Knut Ørnes , Storøy Hanne-Lise Eikeland , Finset Arnstein , Pedersen Reidar 
Published: May 2021

Abstract
Background: There is evidence that self-reported empathy decreases as medical students go through clinical training, but few in-depth studies have investigated students’ own experiences with empathy during medical interviews. We therefore wanted to explore this topic qualitatively by studying medical students’ perceptions, experiences, and reflections during communication with patients expressing emotional issues in an arranged medical interview.Methods: A qualitative content analysis of semi-structured interviews with third year medical students (N=11) was conducted using video-stimulated recall from their own medical interview with a simulated chronically ill patient. Students were led to believe that the patient was real. Results: Six themes which may influence student empathy during history-taking were identified through analysis of interview data: (1) Giving priority to medical history taking, (2) Interpreting the patient’s worry as lack of medical information, (3) Conflicts between empathy and professional identity, (4) Empathy as a technical communication skill, (5) Striving for a professional form of empathy and (6) Disagreements on whether communication of empathy must be heart-felt.Conclusions: The participating students described conflicts between a medical agenda, rules and norms for professional conduct and the students’ own judgments when trying to empathize with the patient. Educators should actively encourage group discussion and reflection on these underlying conflicting norms and values as part of the formal curriculum, and consider possible side-effects of the medical curriculum, including the communication skills teaching, on students’ empathy.
Homologous Recombination Deficiency as a Novel Therapeutic Target in Various Solid Tumors
Authors: Kim Hana , Kim Hongsik , Hong Jung Yong , Lee Jeeyun , Park Se Hoon , Park Joon Oh , Park Young Suk , Lim Ho Yeong , Kang Won Ki , Kim Kyoung-Mee , Kim Seung Tae 
Published: May 2021

Abstract
Background: Homologous recombination deficiency (HRD) is related to tumorigenesis. Currently, the possibility of HRD as a prognostic biomarker to immune check point inhibitors is unknown.Methods: The status of homologous recombination deficiency (HRD) was assessed with the next-generation sequencing (NGS) TruSightTM Oncology 500 assay in 501 patients with advanced solid tumor including gastrointestinal (GI), genitourinary (GU), or rare cancer. Results: Among the 501 patients, HRD was observed as follows: 74.7% (347/501) patients; GU cancer (92.0%, 23 of 25), colorectal cancer (CRC) (86.1%, 130 of 151), hepatocellular carcinoma (HCC) (83.3%, 10 of 12), pancreatic cancer (PC) (76.2%, 32 of 42), biliary tract cancer (BTC) (75.0%, 36 of 48), sarcoma (65.0%, 39 of 60), melanoma (52.4%, 11 of 21), other GI cancers (50.0%, 11 of 22), and rare cancer (50.0%, 2 of 4). Sixty-five of the 501 patients had received immune checkpoint inhibitors (ICIs) during the course of the disease. Tumor types of 65 patients treated with ICIs are as follows: melanoma (95.2%, 20 of 21), HCC (33.3%, 4 of 12), rare cancer (25.0%, 1 of 4), GC (12.2%, 14 of 116), BTC (10.4%, 5 of 48), and sarcoma (5.0%, 3 of 60). Patients without HRD exhibited an objective response rate (ORR) of 33.3% (4 of 12), and patients with HRD exhibited an ORR of 34.0% (18 of 53). There was no significant difference in ORR between patients with and without HRD (p = 0.967). Progression-free survival (PFS) was 6.5 months (95% CI: 0.000 – 16.175) in patients without HRD and 4.1 months (95% CI: 2.062 – 6.138) in patients with HRD, revealing no statistical significance (p = 0.441). Conclusion: Herein, we reported the status of HRD using a cancer-panel for various solid tumor patients in routine clinical practice and demonstrated that HRD as a single biomarker was not sufficient to predict efficacy of ICIs in solid tumor patients.
PD-1 Antibody Combined With Decitabine Is Effective in the Treatment of Refractory Peripheral T-cell Lymphoma Not Otherwise Specified: a Case Report
Authors: han xiao , Wen Qin , Liu Xue , Wan Kai , Yan Hongju , Zhang Cheng , Zhang Xi 
Published: May 2021

Abstract
Background: Peripheral T-cell lymphoma not otherwise specified (PTCL-NOS) is a highly aggressive lymphoma with a poor response to chemotherapy, frequent relapses, low overall survival, and poor prognosis, and is the most common form of PTCL. For relapsed/refractory (R/R) PTCLs, the efficacy of traditional chemotherapy is even worse, so clinical trials and new drugs become their therapeutic hopes. Here, We report on a 43-year woman with refractory PTCL-NOS has a good response to PD-1 antibody combined with decitabine. Case presentation: A 43-year-old woman with refractory PTCL-NOS, who has a poor efficacy in the first-line and second-line treatments, even the disease progresses after treatment with histone deacetylase inhibitors and proteasome inhibitors, however, has a good response to PD-1 antibody combined with decitabine. The patient got significant tumor regression and some of the masses even disappeared.Conclusions: The PD-1 monoclonal antibody combined with decitabine may be a good choice to improve prognosis when used early if conventional first- and second-line regimens, histone deacetylase inhibitors, and proteasome inhibitors are ineffective.
Decision making and risk in Strongylocentrotus droebachiensis in competitive and non-competitive foraging environments
Authors: O'del Jenna Nadia , Walsh Sierra Rose Mae , Spada Nathaniel N , Harris Larry Garland 
Published: May 2021

Abstract
Foraging behavior is known to have drastic impacts across the animal kingdom, from the behavior of vertebrates as well as invertebrates. Green sea urchins (Strongylocentrotus droebachiensis) are well known omnivorous echinoderms that display a wide diversity of behavioral responses to chemical and tactile stimuli. Green sea urchins likely consider the stimuli of conspecific presence especially in foraging environments where competition can be high. The foraging behavior, specifically ability to reach a food item, of urchins was examined in four distinct trials with urchins under competitive and non-competitive environments with conspecifics after determining the preferred animal protein. Two trials examined the effect of cover type, and the other two considered urchins with no available cover in different water flow regimes. Overall, urchins competing with conspecifics were faster to reach food than those that were alone. However, when cover was available, non-competitive urchins most often did not reach the food item in the time allotted. Urchins likely weigh the risk and benefits of moving towards high value food with the competitive environment and cover type. These results indicate the importance of considering the conspecific environment in urchin behavioral studies and can have implications for aquaculture.
Accuracy of neutrophil to lymphocyte and monocyte to lymphocyte ratios as new inflammatory markers in acute coronary syndrome
Authors: Shumilah Ahmed Mohammed , Othman Arwa Mohammed , Al-Madhagi Anwar Kasim 
Published: May 2021

Abstract
Background: Inflammation plays a key role in the development of atherosclerosis and in the pathogenesis of acute coronary syndrome (ACS). Leukocytes and leukocytes ratios were recognized as inflammatory markers in predicting the presence and severity of ACS. Methods: This study aimed to investigate the diagnostic accuracy of neutrophil to lymphocyte ratio (NLR) and monocyte to lymphocyte ratio (MLR) with ACS. One hundred patients admitted to the Cardiac Center who were confirmed to have ACS and 100 healthy controls confirmed not to have ACS were enrolled in this study. ECG and troponin I test were used as gold standards to make sure that the participants with or without ACS. Total Wight blood cells (WBCs) count, NLR, and MLR values were estimated. Results: Total WBC, neutrophil, and monocyte counts were significantly higher while lymphocyte counts were significantly lower in ACS patients than in the healthy controls (p <0.001). NLR and MLR were significantly higher in ACS patients than in the healthy controls (p <0.001). Among all the studied markers, NLR was found to be the strongest predictor of ACS (OR: 3.3, p <0.001), whereas MLR was non-significant (p >0.05). A cutoff value of 2.9 of NLR had 90% sensitivity and 88% specificity while 0.375 cutoff value of MLR had 79% sensitivity, 91% specificity for predicting presence of ACS. Conclusions: NLR is inexpensive, widely available, and simple inflammatory marker that can take a role in the diagnosis of ACS with a cutoff of 2.9 in our population.
The intersectional impact of sex and social factors on subjective health: analysis of the Canadian Longitudinal Study on Aging (CLSA)
Authors: Vafaei Afshin , Yu Janelle , Phillips Susan P. 
Published: May 2021

Abstract
BACKGROUND Self-rated health (SRH) is a widely validated measure of the general health of older adults. Our aim was to understand what factors shape individual perceptions of health and how those perceptions vary for men and women and across social locations.METHODS We used data from the Canadian Longitudinal Study on Aging (CLSA) of community-dwelling adults aged 45 to 85. SRH was measured via subjective questions. Multiple Poisson regression identified individual, behavioural, and social factors related to SRH. Intersections between sex, education, wealth, and rural/urban status, and individual and joint cluster effects on SRH were quantified using multilevel models.RESULTS After adjustment for relevant confounders, women were 43% less likely to report poor SRH. The strongest cluster effect was for groupings by wealth (21%). When wealth clusters were subdivided by sex or education the overall effect on SRH reduced to 15 percent. The largest variation in SRH (13.6%) was observed for intersections of sex, wealth, and rural/urban status. In contrast, interactions between sex and social factors were not significant, demonstrating that the complex interplay of sex and social location was only revealed when intersectional methods were employed.CONCLUSIONS Sex and social factors affected older adults' perceptions of health in complex ways that only became apparent when multilevel analyses were carried out. Utilizing intersectionality analysis is a novel and nuanced approach for disentangling explanations for subjective health outcomes.
Associations Between Anthropometric Measures and Body Fat Percentage in Iranian Adolescents: a Quantile Regression Analysis
Authors: Ardalan Arash , Heydari Seyyed Taghi , Alamolhoda Marzieh 
Published: May 2021

Abstract
Background: The puerpose of this study was to assess the association between anthropometric measures and skinfold thickness as well as parental obesity and physical activity with body fat percentage (BFP) percentiles using a quantile regression (QR) model within a representative sample of Iranian adolescents. Methods: In this cross-sectional study, 2873 school children (1472 girls) aged 14-20 years old were selected by multi-stage random sampling approach from different areas of two cities of Fars Province in southern Iran. Demographic characteristics, parental history of obesity, physical activity were collected by using a self-reported questionnaire. Height, weight, waist (WC), hip (HC), arm (AC) circumferences, triceps (TST), abdominal (AST), clavicle muscle (CMST) skinfold thicknesses, and BFP were measured. A QR analysis was used to evaluate the association between the obesity measures with BFP at different quantiles.Results: The results of QR models showed that circumference measures and skinfold thicknesses were statistically significant positive associations with BFP across all quantiles (P< 0.05). Among boys, having a history of obesity in mothers associated with higher BFP at the 15th to 95th percentiles (the parameter estimates ranged from 1.9 to 4.9, P<0.05). However, there were statistically significant positive associations between parental obesity with BFP in girls at the 25th to 95th and all percentiles for maternal and paternal obesity, respectively (the prameter estimates ranged 1.6-2.6 and 2.7- 5.6 with P<0.05). Moreover, physical activity negatively associated with the lower BFP at 50th to 95th only in grils (prameter estimates ranged -2.5 to -1.7 with P<0.05). Conclusions: This study revealed that anthropometric measures and SF measures associated with higher BFP at all quantiles in Iranian adolescents. The findings of the study also showed that having a history of parental obesity as well as a high physical activity associated with higher and lower BFP, respectively.
A COVID-19 Pretest Probability Calculator
Authors: Hayden Frederick 
Published: May 2021

Abstract
Background: COVID-19 presents with a wide variety of symptoms which also vary in severity. Clinical gestalt is required to help distinguish between COVID-19 and other viral illness. As the pandemic heads into the second year, patient compliance with isolation and quarantine precautions is starting to diminish. The COVID-19 Pretest Probability Calculator is proposed to help offer pre-test probability of COVID-19 to assist in medical decision making. Methods: Patient’s presenting with COVID-19 like illness were grouped to high, intermediate, or low pretest probability risk based on total scores from reported criteria, which was correlated with the resulting SARS-CoV-2 PCR nasal swab. The calculator was applied in both a prospective and retrospective fashion. Results: A total of 412 patients were recorded, with a total of 132 positive results. Of low-risk patients, only one patient resulted as positive, while 85% or 111 of total positive results being categorized as high-risk. Overall demonstrated sensitivity was 99% with 50% specificity. Individual criteria were analyzed with anosmia and dysgeusia being the most significant. These symptoms demonstrated 92% specificity, and no low-risk patients reported these symptoms. Conclusion: The COVID calculator demonstrates strong rule-out capability for patients who are low risk. Furthermore, 85% of positive patients were high risk which suggests the need for longer isolation or retesting especially when an alternative diagnosis cannot be established. If a patient reports anosmia or dysgeusia a higher index of suspicion for COVID-19 should be considered.
Anti-pseudo-allergic Components in Licorice Extract Inhibit Mast Cell Degranulation and Calcium Influx
Authors: Wang Lu , Hu Guizhou , Lu Yin , Kong Desong , Jiang Shujun , Qi Jin , Su Hua , Fan Zhimin 
Published: May 2021

Abstract
Background

Pseudo-allergic reactions (PARs) widely occur upon the application of drugs or functional foods. Anti-pseudo-allergic ingredients from natural products have attracted much attention. This study aimed to investigate anti-pseudo-allergic compounds in licorice.
Methods

The anti-pseudo-allergic effect of licorice extract was evaluated in rat basophilic leukemia 2H3 (RBL-2H3) cells. Anti-pseudo-allergic compounds were screened by using RBL-2H3 cell extraction and the effects of target components were verified in RBL-2H3 cells, mouse peritoneal mast cells (MPMCs) and mice. Molecular docking was performed to determine the potential ligands of MAS-related G protein-coupled receptor-X2 (MRGPRX2), a pivotal target of PARs.
Results

Glycyrrhizic acid (GA) and Licochalcone A (LA) were screened and shown to inhibit Compound48/80-induced degranulation and calcium influx in RBL-2H3 cells. GA and LA also inhibited degranulation in MPMCs and increase of histamine and TNF-α in mice. LA could bind to MRGPRX2, as determined by molecular docking.
Conclusions

Our study provides a strong rationale for using GA and LA as novel treatment options for PARs. LA is a potential ligand of MRGPRX2.