bluuebunny/crossref_metadata_2025_split huggingface dataset:
A 6 transcription factors-associated nomogram predicts the recurrence-free survival of thyroid papillary carcinoma
Authors: Wang Tao , Tian Kun , Ji Xie , Song Feixue 
Published: October 2021

Abstract
Various researches demonstrated that transcription factors (TFs) played a crucial role in the progression and prognosis of cancer. However, few studies indicated that TFs were independent biomarkers for the prognosis of thyroid papillary carcinoma (TPC). Our aim was to establish and validate a novel TF signature for the prediction of TPC patients’ recurrence-free survival (RFS) from The Cancer Genome Atlas (TCGA) database to improve the prediction of survival in TPC patients.
The genes expression data and corresponding clinical information for TPC were obtained from TCGA database. In total, 722 TFs and 545 TPC patients with eligible clinical information were determined to build a novel TF signature. All TFs were included in a univariate Cox regression model. Then, the least absolute shrinkage and selection operator Cox regression model was employed to identify candidate TFs relevant to TPC patients’ RFS. Finally, multivariate Cox regression was conducted via the candidate TFs for the selection of the TF signatures in the RFS assessment of TPC patients.
We identified 6 TFs that were related to TPC patients’ RFS. Receiver operating characteristic analysis was performed in training, validation, and whole datasets, we verified the high capacity of the 6-TF panel for predicting TPC patients’ RFS (AUC at 1, 3, and 5 years were 0.880, 0.934, and 0.868, respectively, in training dataset; 0.760, 0.737, and 0.726, respectively, in validation dataset; and 0.777, 0.776, and 0.761, respectively, in entire dataset). The result of Kaplan–Meier analysis suggested that the TPC patients with low scores had longer RFS than the TPC patients with high score (P = .003). A similar outcome was displayed in the validation dataset (P = .001) and the entire dataset (P = 2e-05). In addition, a nomogram was conducted through risk score, cancer status, C-index, receiver operating characteristic, and the calibration plots analysis implied good value and clinical utility of the nomogram.
We constructed and validated a novel 6-TF signature-based nomogram for predicting the RFS of TPC patients.
Clinical predictive risk factors prolonged the duration of SARS-CoV-2 clearance in 279 moderate COVID-19 patients
Authors: Wu Xinxin , Zhou Shuang , Liu Changya , Huang Tingrong , Zheng You , Zhang Wen , Qu Yao , Fang Bangjiang 
Published: October 2021

Abstract
The results of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid as one of the criteria has been widely applied to assess whether the coronavirus disease 2019 (COVID-19) patients could discharge, however, the risk factors that affect the duration of the SARS-CoV-2 clearance remained to be an enigma. Our research was to identify risk factors correlated with prolonged duration of the SARS-CoV-2 clearance in moderate COVID-19 patients.
We retrospectively analyzed 279 consecutive ordinary COVID-19 patients in 3 hospitals in Hubei province including Huangshi Hospital of Infectious Disease, Wuhan Thunder God Mountain Hospital, and Tongji Hospital. Eight clinical characters were contained as risk factors. We used a logistic regression model and nomogram to assess the possibility that the SARS-CoV-2 nucleic acid may turn negative in 14 days.
Time from symptoms onset to diagnosis (odds ratio [OR] = 3.18; 95% confidence interval [CI] 1.56–6.46; P = .001), time from onset use of antiviral drugs to onset of symptoms (OR = 0.41; 95% CI 0.23–0.72; P = .02), and bacterial coinfection (OR = 0.07; 95% CI 0.01–0.86; P = .038) were independent risks factors for the duration of SARS-CoV-2 nucleic acid clearance. The regression model showed good accuracy and sensitivity (area under the curve  = 0.96). Nomogram was also provided to predict the negative conversion rate of SARS-CoV-2 nucleic acids within 14 days.
Time from symptoms onset to diagnosi, time from onset use of antiviral drugs to onset of symptoms, and bacterial coinfection were independent risk factors for the time of SARS-CoV-2 nucleic acid turning negative in ordinary COVID-19 patients. However, the age, gender, underlying disease, fungal coinfection, and duration use of antiviral drugs were irrelevant factors.
The impact of venous resection in pancreatoduodectomy
Authors: Filho João Emílio Lemos Pinheiro , Tustumi Francisco , Coelho Fabricio Ferreira , Júnior Sérgio Silveira , Honório Fernanda Cavalcanti Cabral , Henriques Alexandre Cruz , Dias André Roncon , Waisberg Jaques 
Published: October 2021

Abstract

Background:
Vein resection pancreatoduodenectomy (VRPD) may be performed in selected pancreatic cancer patients. However, the main risks and benefits related to VRPD remain controversial.

Objective:
This review aimed to evaluate the risks and survival benefits that the VRPD may add when compared with standard pancreatoduodenectomy (PD).

Methods:
A systematic review and meta-analysis of studies comparing VRPD and PD were performed.

Results:
VRPD was associated with a higher risk for postoperative mortality (risk difference: −0.01; 95% confidence interval [CI] −0.02 to −0.00) and complications (risk difference: −0.05; 95% CI −0.09 to −0.01) than PD. The length of hospital stay was not different between the groups (mean difference [MD]: −0.65; 95% CI −2.11 to 0.81). In the VRPD, the operating time was 69 minutes higher on average (MD: −69.09; 95% CI −88.4 to −49.78), with a higher blood loss rate (MD: −314.04; 95% CI −423.86 to −195.22). In the overall survival evaluation, the hazard ratio for mortality during follow-up on the group of VRPD was higher compared to the PD group (hazard ratio: 1.13; 95% CI 1.03–1.23).

Conclusion:
VRPD is associated with a higher risk of short-term complications and mortality and a lower probability of survival than PD. Knowing the risks and potential benefits of surgery can help clinicians to properly manage pancreatic cancer patients with venous invasion. The decision for surgery with major venous resection should be shared with the patients after they are informed of the risks and prognosis.
A refractory human T-cell leukemia virus type 1-associated myelopathy/tropical spastic paraparesis patient with lymphoma-type adult T-cell leukemia/lymphoma
Authors: Tamaki Keiko , Mera Hidekazu , Takeshita Sho , Fujioka Shinsuke , Goto Maki , Matsumoto Taichi , Yamano Yoshihisa , Takamatsu Yasushi , Tsuboi Yoshio 
Published: October 2021

Abstract

Rationale:
Adult T-cell leukemia/lymphoma (ATL) and human T-cell leukemia virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) are caused by HTLV-1, but the coexistence of both disorders is rare. The estimated incidence is approximately 3%.

Patient concerns:
A 54-year-old man was unable to stand up because of spastic paraparesis 1 month after the onset. He developed lymphadenopathy in the left supraclavicular fossa 5 months after the onset. The spastic paraplegia and sensory symptoms below the thoracic spinal cord level worsened.

Diagnoses:
Both blood and cerebrospinal fluid (CSF) tests were positive for anti-HTLV-1 antibodies. The patient was diagnosed with rapidly progressive HAM/TSP. He was also diagnosed with lymphoma-type ATL by the biopsy specimen of the lymph node. CSF examination at the time of symptom exacerbation showed abnormal lymphocytes, suggesting central infiltration of the ATL in the central nervous system.

Interventions:
Methylprednisolone pulse therapy and oral prednisolone maintenance therapy were administered for rapidly progressive HAM/TSP. Intrathecal injection of methotrexate was administered for the suggested central infiltration of the ATL.

Outcomes:
Methylprednisolone pulse therapy and intrathecal injection of methotrexate did not improve the patient's exacerbated symptoms. Five months later, clumsiness and mild muscle weakness of the fingers appeared, and magnetic resonance imaging showed swelling of the cervical spinal cord. Clonality analysis showed monoclonal proliferation only in the DNA of a lymph node lesion, but not in the CSF and peripheral blood cells.

Lessons:
This was a case of rapidly progressive HAM/TSP associated with lymphoma-type ATL that was refractory to steroids and chemotherapy. The pathogenesis was presumed to involve ATL cells in the brain and spinal cord because of the presence of abnormal lymphocytes in the CSF, but DNA analysis could not prove direct invasion. This case suggests that when we encounter cases with refractory HAM/TSP, it should be needed to suspect the presence of ATL in the background.
The effect of infliximab dose escalation in inflammatory bowel disease patients with antibodies to infliximab
Authors: Tun Gloria S.Z. , Robinson Kerry , Marshall Laura , Wright Alison , Thompson Laura , Wild Graeme , Sargur Ravishankar , Brooks Alenka J. , Hale Melissa F. , Chew Thean S. , Lobo Alan J. 
Published: October 2021

Background
Infliximab dose escalation (DE) can be used in inflammatory bowel disease patient; however, the long-term benefit remains unclear, especially in those with antibodies to infliximab (ATI). The aim was to assess the effect of DE in patients with ATI on drug level, clinical response and ATI status.

Methods
All patients undergoing infliximab DE (a reduction in dose interval between infusions <8 weeks ± an increase in dose up to 10 mg/kg) at a referral centre between April 2016 and August 2019 were included.

Results
Ninety-two patients were DE: 51 were men, 50 had CD and 63 were receiving immunosuppression. A total of 87 people received DE for a median of 44 weeks (range 4–176). Five stopped infliximab after 1 dose of DE: 2 for loss of response and 3 for infusion reaction. In patients with ATI ≤10 vs. >10 AU/mL, DE significantly increased drug levels: median infliximab levels of 1.4 and 0.9 at baseline, respectively, to 3.2 and 3.5 at week 24. After DE, 21/35 ATI-positive patients had a fall in ATI ≤10 AU/mL. At week 24 following DE 62/92 patients were in clinical remission. Duration of clinical remission was shorter in those with ATI >10 AU/mL (median 24 weeks, range 0–88) than in those with transient/ATI ≤10 AU/mL (median 36 weeks, range 0–126, P = 0.06).

Conclusions
A strategy of DE for selected patients receiving infliximab is associated with an increase in drug levels and reduced ATI positivity. This is associated with clinical remission in approximately 70% of patients at 6 months.
Three-dimensional semiquantitative analysis of gastric emptying SPECT
Authors: Kuan Tzu-Wei , Shen Chih-Chieh , Chen Jyh-Cheng , Tu Kao-Yin , Tsao Chin-Ho , Chen Tzu Hsuan 
Published: October 2021

Objective
We used dynamic single-photon emission computed tomography (D-SPECT) to overcome the interference of the planar dynamic imaging due to the overlap of internal organs, thus more accurate physiological function can be obtained.

Methods
3D printed gastric phantom was used to simulate gastric emptying (GE). First, the planar dynamic liquid GE procedure was used and served as the reference value; second, D-SPECT followed by repeated liquid GE procedures with three gamma cameras were used. The emptying flow rate of the gastric phantom simulated three flow rates of liquid, semisolid and solid. Third, we simulated the intestinal activity that interfered with the residual value obtained by 2D dynamic imaging, which was compared with D-SPECT. Then, we brought the 3D VOI data into the postprocessing program to obtain the residual activity curve and residual percentage.

Results
The residual amount obtained in the phantom at 60th minutes in the first stage is 14.57%; the residual amount of liquid emptying are Siemens: 3.33%, GE: 15.06%, PHILIPS: 1.12%; residual amount for semisolid are Siemens: 47.36%, GE: 54.25%, PHILIPS: 51.57%; residual amount for solids are Siemens: 63.98%, GE: 66.88%, PHILIPS: 63.76%. All values are within the normal range. Then, we simulated the intestinal activity that interfered with the residual value obtained by 2D dynamic imaging: 75–90 min: 10.42, 19.48, 19.51 and 11.02%; however, the residual values obtained with 3D SPECT VOI data: 75–90 min: 1.42, 1.41, 1.35 and 1.02%. These results show that the emptying data errors caused by intestinal overlap can be effectively corrected (P = 0.017).

Conclusion
D-SPECT imaging can overcome the interference in the semiquantitative data of residual GE caused in 2D mode.
FDG PETCT for assessing marrow involvement at staging pediatric nonhematological round cell malignancies
Authors: Shah Sneha , Purandare Nilendu , Kembhavi Seema , Puranik Ameya , Agrawal Archi , Bedmutha Akshay , Qureshi Sajid , Chinnaswamy Girish , Vora Tushar , Prasad Maya , Parambil Badira , Rangarajan Venkatesh 
Published: October 2021

Background and hypothesis
Bone and lung are the common sites of metastasis in pediatric round cell tumors and its presence indicates poor outcomes. Staging workup for these malignancies thus includes bone marrow biopsy (BMB) along with evaluation of thorax, and tissue analysis for N MYCN status in neuroblastoma. BMB is an invasive procedure requiring general anesthesia with known disadvantages.
With an aim of avoiding an invasive BMB a study was taken up to evaluate efficacy of FDG PET CT in detecting marrow involvement in neuroblastoma and rhabdomyosarcoma at staging.

Materials and method
Prospective observational study evaluated 83 newly diagnosed treatment naïve patients of neuroblastoma (n = 43) and rhabdomyosarcoma (n = 42) who underwent conventional imaging of PETCT with CECT of local region along with a CT thorax and BMB (both iliac crest) done within 1 week. Findings of FDG PETCT were compared with bone marrow histology and accuracy parameters were calculated.

Result
The overall sensitivity, specificity, accuracy, positive-predictive value (PPV), negative-predictive value (NPV) of FDG PETCT for detection of marrow disease was 100%, 86.1%, 89.4%. 68.9% and 100%, respectively. Subset analysis showed sensitivity, specificity, PPV and NPV of 100%, 66%, 71.4% and 100%, respectively, for neuroblastoma, with rhabdomyosarcoma patients having few events NPV of 100% accuracy of 97.6%.

Conclusion
FDG PETCT with sensitivity and NPV of 100% can be considered as a first stop imaging and biopsy can be avoided in patients with a negative scan.
Prognostic value of lung shunt fraction in hepatocellular carcinoma and unresectable liver dominant metastatic colorectal cancer undergoing transarterial radioembolisation
Authors: Gosavi Atul , Puranik Ameya D. , Shah Sneha , Agrawal Archi , Purandare Nilendu C. , Shetty Nitin , Gala Kunal , Kulkarni Suyash , Patkar Shraddha , Goel Mahesh , Shrikhande Shailesh , Ramaswamy Anant , Ostwal Vikas , Rangarajan Venkatesh 
Published: October 2021

Aim
To assess the overall survival and determine whether pre-TARE shunt fraction, tumor volume and tumor marker impact the outcome.

Methods
This is a retrospective study of 75 patients who were referred for 90Y-glass microsphere radioembolisation by a joint clinic decision between 1 January 2010 and 31 December 2014. All patients underwent pre-TARE CECT and 99mTc-MAA lung shunt fraction (LSF) imaging.

Results
Overall survival was 19 months for hepatocellular carcinoma (HCC) and 24 months for metastatic colorectal carcinoma. For hepatocellular carcinoma-LSF higher than 6.51 % was predictive of significantly decreased survival (P value 0.00). A progressive disease in survival was observed as LSF increased from less than 6.51 % to more than 20%. Tumor volume and tumor marker did show correlation with patient outcomes. For metastatic colorectal carcinoma-LSF and tumor marker did not show significant correlation with survival and tumor volume showed significant correlation with survival with P value of 0.049.
Associations of whole-body 18F-FDG PET/CT parameters and SCC-Ag level with overall survival in patients with cervical cancer
Authors: Guan Lili , Zuo Rui , Wang ZhengJie , Xu Lu , Liu Shuang , Pang Hua 
Published: October 2021

Objective
To explore the whole-body metabolic tumour volume (WBMTV), whole-body total lesion glycolysis (WBTLG) and tumour whole-body maximum standardised uptake value (WBSUVmax) of post-treatment 18F-fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) in predicting the overall survival (OS) in patients with cervical squamous cell carcinoma (SCC).

Methods
The clinical data of 74 patients with cervical SCC who received 18F-FDG PET/CT were retrospectively analysed. WBMTV, WBTLG and WBSUVmax, as well as the serum SCC-Ag level, were measured. The Kaplan–Meier method and Cox regression were used to analyse the relationships of PET/CT parameters with OS.

Results
The risk of death was 13.942-fold greater in the PET-positive group than in the PET-negative group (P < 0.001). In the PET-positive group, univariate analysis showed that OS was significantly correlated with WBMTV and WBTLG; it was not correlated with WBSUVmax, SCC-Ag, age, pathological stage or treatment after PET (P > 0.05). Patients with positive PET findings were divided into two groups according to the median of WBMTV or WBTLG; there was a significant difference in OS between the two groups. The risk of death in patients with positive PET imaging findings and high SCC-Ag level was 18.356-fold greater than in patients with negative PET imaging findings (P < 0.001).

Conclusions
WBMTV and WBTLG have important prognostic value in the prediction of OS in post-treatment patients with cervical SCC. OS was significantly decreased in patients who had both positive PET imaging findings and high SCC-Ag level.
Can the Enhanced Liver Fibrosis Score Be Used to Diagnose Children With Liver Fibrosis?
Authors: Thusing Iben , Antonsen Steen , Hoffmann‐Petersen Benjamin Søgaard , Rasmussen Helene Marlies , Wittenhagen Per 
Published: October 2021

ABSTRACTObjectives:The noninvasive Enhanced Liver Fibrosis (ELF) score is used in adults with liver fibrosis as a diagnostic aid. The ELF score combines 3 serum markers of extracellular matrix remodeling and fibrogenesis: hyaluronic acid (HA), the N‐terminal pro‐peptide of collagen type III (PIIINP), and tissue inhibitor of metalloproteinase‐1 (TIMP‐1). We aimed to evaluate the clinical use of the ELF score in children.Methods and Results:A reference interval for the ELF score was established using 343 liver‐healthy children ages 6 to 17 years. The median ELF score of 8.9 in healthy children was significantly increased compared with healthy adults. ELF scores increased significantly in both female and male healthy controls with peak levels at puberty, driven by elevated levels of HA and PIIINP likely explained by increased growth. If adult normal values were applied to the group of liver‐healthy children, only 6.4% were in the normal range. Prospectively, we analysed ELF scores in patients with possible or confirmed liver fibrosis because of autosomal recessive polycystic kidney disease (ARPKD). All ELF scores in children with ARPKD were within the reference intervals generated from the group of healthy children.Conclusions:The usual diagnostic cut‐off ranges for the ELF score in adults are not applicable; instead age and gender‐appropriate cut‐off values should be used in children. The clinical value of ELF scores in children is questionable as children during pubertal growth showed elevated ELF scores and patients with ARPKD and liver fibrosis showed normal levels.
Impact of Patient Engagement and Social Determinants of Health on Care of Eosinophilic Gastrointestinal Disorders Patients
Authors: Kothawala Saad , Wang Yanzhi , Gupta Sandeep K. 
Published: October 2021

ABSTRACTThe purpose of this study was to identify factors that influence eosinophilic gastrointestinal disorders (EGID) patients to switch gastroenterologists, assess the prevalence of social determinants of health (SDoH) in EGID patients, and the impact of SDoH on provider switching. 191 patients/caregivers participated in this cross‐sectional, online study distributed through Patient Advocacy Groups. The 35‐question survey took about 20 minutes to complete and was divided into three sections: demographics; 10 questions about provider switching; and nine‐domain SDoH screen.Patients with EGIDs often switch providers, most commonly due to dissatisfaction with engagement in decision making. Additionally, these patients commonly have SDoH, some of which are associated with increased provider switching. Our results highlight the need to mindfully engage patients in decision‐making and disease management. Providers also need to look beyond the “clinic space” and into SDoH. These low‐cost/high‐impact changes in provider behavior can promote continuity of care and patient engagement.
Continued Basal Zone Expansion After Resolution of Eosinophilia in a Child With Eosinophilic Esophagitis on Benralizumab
Authors: Wenzel Amanda A. , Wadhwani Nitin , Wechsler Joshua B. 
Published: October 2021

ABSTRACTA 20‐year‐old woman presented with dysphagia at 8 years of age. She underwent esophagogastroduodenoscopy with biopsies (EGD), which was diagnostic of eosinophilic esophagitis. Diet elimination resulted in improvement in symptoms, reduction in eosinophilia, and resolution of basal zone hyperplasia (BZH) on repeat EGD; however, food reintroduction resulted in recurrence of eosinophilia. Subsequently, her pulmonologist started benralizumab, a monoclonal antibody against the interleukin‐5 receptor (IL5Rα) on eosinophils, for her asthma. Seven months after starting benralizumab, she underwent EGD for persistent dysphagia, which was notable for resolution of esophageal eosinophilia but demonstrated marked BZH in association with high numbers of CD3+ T cells and tryptase+ mast cells. She transitioned to dupilumab and had resolution of dysphagia. EGD was performed 10 months after starting dupilumab and demonstrated resolution of BZH and mast cell inflammation with significant reduction in T cells. Review of other patients at our center treated with biologics, most commonly dupliumab, reveals varying degrees of BZH in association with mostly CD3+ lymphocyte inflammation. Mast cells and T cells appear to be capable of coordinating mucosal inflammation and symptoms of EoE independent of eosinophilia in a subset of patients.