bluuebunny/crossref_metadata_2025_split huggingface dataset:
MRI Features of Hepatic Sarcomatoid Carcinoma Different From Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma
Authors: Zhang Hongbin , Chai Siyuan , Chen Lintao , Wang Yubizhuo , Cheng Yongna , Fang Quan , Wu Guosen , Wang Xiangming , Liang Wenjie , Xiao Wenbo 
Published: June 2021

IntroductionHepatic sarcomatoid carcinoma (HSC) is a rare type of liver cancer with a high malignant grade and poor prognosis. This study compared the clinical characteristics and magnetic resonance imaging (MRI) features of HSCs with those of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC), aiming to identify valuable features for HSC diagnosis.MethodsIn total, 17 pathologically confirmed HSC cases, 50 HCC cases and 50 common ICC cases were enrolled from two hospitals. The clinical characteristics and MRI features of all cases were summarized and statistically analyzed.ResultsOn the one hand, the incidence rates of elevated carbohydrate antigen (CA) 19-9 and elevated carcinoembryonic antigen (CEA) were significantly higher in the HSC cases than in the HCC cases (29.4% vs. 0%; 17.6% vs. 0%). The HSC enhancement patterns, primarily including progressive enhancement, were also significantly different from HCC cases. The incidence rates of heterogeneous signals on T2-weighted imaging and during the arterial phase were significantly higher in the HSC cases than in the HCC cases (94.1% vs. 66.0%; 100.0% vs. 72.0%). The diameter of HSCs was significantly larger than that in the HCC cases (6.12 cm vs. 4.21 cm), and the incidence rates of adjacent cholangiectasis, intrahepatic metastasis and lymph node enlargement were considerably higher in the HSC cases than in the HCC cases (52.9% vs. 6.0%; 47.1% vs. 12.0%; 41.2% vs. 2.0%). On the other hand, the incidence rate of elevated CA199 was significantly lower in the HSC cases than in the ICC cases (29.4% vs. 60.0%). The incidence rates of intratumoral necrosis and pseudocapsules were significantly higher in the HSC cases than in the HCC cases (35.3% vs. 8.0%; 47.1% vs. 12.0%). However, the incidence rates of target signs were significantly lower in the HSC cases than in the HCC cases (11.8% vs. 42.0%). In addition, there was no significant difference in the enhancement patterns between HSC cases and ICC cases.ConclusionsHSCs were frequently seen in elderly men with clinical symptoms and elevated CA199 levels. The MRI features, including large size, obvious heterogeneity, hemorrhage, progressive enhancement, pseudocapsule and lymph node enlargement, contributed to the diagnosis of HSC.
Preoperative Fibrosis-4 (FIB-4) Evaluation May Be Helpful to Evaluate Prognosis of Gastric Cancer Patients Undergoing Operation: A Retrospective Study
Authors: Xu Ke , Shi Mingming , Zhang Weiteng , Shi Yiyi , Dong Qiantong , Shen Xian , Chen Xiaolei , Lin Ji 
Published: June 2021

BackgroundLiver dysfunction and chronic inflammation influence the prognosis of many tumors and surgical outcomes. This study was performed to determine whether the Fibrosis-4 (FIB-4) index, originally defined as a noninvasive fibrosis marker, can predict the prognosis of patients with gastric cancer undergoing radical gastric cancer surgery.MethodsWe have retrospectively analyzed 594 consecutive patients with gastric cancer who underwent gastrectomy in our database. The FIB-4 index was calculated using laboratory data and age before gastrectomy. The clinical utility of FIB-4 was evaluated by X-tile. Patients were divided into two groups (high and low FIB-4 index groups), and their overall survival (OS) was investigated. Cox regression analysis was used to identify the independent parameters associated with prognosis. Finally, we developed a prognostic prediction model by using R statistical software.ResultsA total of 556 patients, including 422 men and 134 women, were enrolled. Of these, 61 (11.0%) and 495 (89.0%) patients had low and FIB-4 indexes, respectively. In addition to the indicators of FIB-4, preoperative age, tumor site, surgical procedure, TNM stage, and postoperative complications were found to be independent predictors of prognosis (P &lt; 0.05). Among patients, the FIB-4 index group had significantly shorter OS (log-rank P = 0.01) than the low FIB-4 index group. This association was also confirmed in the multivariate analysis (hazard ratio, 4.65; 95% confidence interval, 1.07-4.29; P = 0.031).ConclusionsPreoperative FIB-4 index can predict long-term outcomes of gastric cancer patients who had undergone gastrectomy.
Association of the 12-Gene Breast DCIS Score® Assay With Local Recurrence in Patients With Ductal Carcinoma In Situ Treated on Accelerated Partial Breast Radiotherapy Protocols
Authors: Leonard Charles E. , Tole Shannon P. , Turner Michelle P. , Bennett John P. , Howell Kathryn T. , Carter Dennis L. 
Published: June 2021

BackgroundThe following analysis explores clinicopathologic factors and the 12-gene Breast DCIS Score test result in order to better define an appropriate DCIS (ductal carcinoma in situ) population eligible for APBI (accelerated partial breast radiotherapy).MethodsThis exploratory analysis aimed to retrospectively measure the association between the 12-gene Oncotype DX Breast DCIS Score® assay (Redwood City, CA) and relevant clinicopathologic factors with locoregional recurrence in a pooled cohort of women treated with local excision and APBI on prospective phase II (NCT01185145) and phase III (NCT01185132) clinical trials. Univariable Cox proportional hazards regression was used to determine whether there was an association between local recurrence and DCIS Score result risk group (≥ 39 vs &lt; 39) and clinicopathologic factors.ResultsThis analysis included 104 evaluable patients (n = 18 from NCT01185145 and n = 86 from NCT01185132). The median age was 60 years (range: 40-79). Seventy-nine percent of patients were postmenopausal. The median span of DCIS was 10 mm (range 2-45 mm). Two-thirds of the cohort presented with necrosis (71%). The distribution of DCIS Score® results ranged from 0 to 82, with 69% of patients having a DCIS Score result &lt; 39. The median follow-up time was 8.2 years in NCT01185145 versus 3.0 years in NCT01185132. There were 6 local ipsilateral breast recurrences. DCIS Score result was significantly associated with local recurrence in univariable modeling, hazard ratio = 10.3 (95% CI 1.7, 198.4); p = 0.010. None of the clinicopathologic characteristics resulted in any significant association with locoregional recurrence.ConclusionThe Breast DCIS Score assay demonstrated risk stratification in this cohort of patients treated with local excision and APBI pooled from two clinical trials. These results are consistent with those recently published utilizing whole breast radiotherapy. Due to the small number of local recurrence events and limited follow-up time, further investigations are needed to confirm findings.
High Reflectivity and Low Reflectivity Properties on OCTA Influence the Detection of Macular Neovascularization in AMD
Authors: Arrigo Alessandro , Aragona Emanuela , Bordato Alessandro , Amato Alessia , Saladino Andrea , Bandello Francesco , Parodi Maurizio Battaglia 
Published: June 2021

Background: In this study, we aimed to discriminate high reflectivity and low reflectivity macular neovascularization (MNV) lesions secondary to age-related macular degeneration (AMD)and to assess the influence of blood flow features on the amount of MNV detected by optical coherence tomography angiography (OCTA).Methods: The study was designed as observational, cross-sectional. Type 1 and type 2 MNV lesions were included. All the patients underwent fluorescein angiography (FA), indocyanine green angiography (ICGA) and OCTA. MNV size was calculated on early FA for type 2 MNV and on both early and late phases of ICGA for type 1 lesions. From OCTA, we calculated both MNV size and MNV reflectivity. We assessed the agreement between FA/ICGA and OCTA MNV sizes. Moreover, we studied the relationship between MNV reflectivity properties and MNV OCTA detection.Results: Fifty eyes (50 patients) were included. MNV was identified as follows: 35 /70%) type 1 and 15 (30%) type 2. We found a good agreement between early ICGA size and OCTA size for type 1 MNV (2.10 ± 1.91 mm2 vs 2.09 ± 1.87 mm2; p &gt; 0.05), whereas MNV lesions turned out to be remarkably bigger on late ICGA phase (3.41 ± 2.87 mm2; p &lt; 0.01). Interestingly, OCTA well-matched with FA in terms of MNV size for type 2 lesions (2.36 ± 2.15 mm2 vs 2.37 ± 2.25 mm2). MNV reflectivity was higher in type 2 MNV and it was strongly associated with the OCTA ability to reconstruct the neovascular network.Conclusion: Our study quantitatively showed that MNV filling pattern and MNV blood flow reflectivity features influence the OCTA detection of the MNV in its entirety.
Associations of Childhood Neglect With the ACTH and Plasma Cortisol Stress Response in Patients With Type 2 Diabetes
Authors: Monzer Nelly , Hartmann Mechthild , Buckert Magdalena , Wolff Kira , Nawroth Peter , Kopf Stefan , Kender Zoltan , Friederich Hans-Christoph , Wild Beate 
Published: June 2021

Background: Cross-sectional as well as longitudinal studies have linked childhood maltreatment to type 2 diabetes in adulthood with childhood neglect showing the strongest effect on type 2 diabetes risk. However, the mechanisms that link childhood maltreatment to type 2 diabetes are still unclear. Alterations in the psychological and physiological stress response system, specifically the hypothalamus-pituitary-adrenal (HPA) axis are a common finding in samples with a background of childhood neglect and are associated with type 2 diabetes. In the present study, we investigated the association between childhood neglect and the physiological and psychological stress response in patients with type 2 diabetes and healthy control participants.Method: We assessed emotional and physical childhood neglect in a sample of n = 74 patients with type 2 diabetes and n = 50 healthy control participants. We used the trier social stress test (TSST) to induce a stress response. Blood ACTH and cortisol levels were measured before (T0), directly after (T1) as well as 30 (T2) and 60 (T3) min after the TSST. Participants' subjective experience was assessed via visual analog scales before, directly after as well as at 45 min after the TSST. We used multiple regression analyses to predict the change in self-reported tension between T0 and T1. Multilevel models were applied to predict cortisol and ACTH levels across all measurement points.Results: We found a significant association between moderate to severe childhood neglect and a stronger psychological stress response in patients with type 2 diabetes, that was not present in healthy controls. In type 2 diabetes patients, but not in healthy controls, higher ACTH levels across all measurement points were significantly associated with higher severity of emotional neglect and higher severity of physical neglect was significantly associated with a stronger increase in plasma cortisol from T0 to T1.Conclusions: This is the first study to investigate whether childhood maltreatment in patients with type 2 diabetes could be associated with a dysregulated stress response. Our results show a link between the psychological and physiological stress response and childhood neglect in type 2 diabetes patients. This pathway is thus a possible mechanism connecting type 2 diabetes and childhood neglect.
The Fort McMurray Mommy Baby Study: A Protocol to Reduce Maternal Stress Due to the 2016 Fort McMurray Wood Buffalo, Alberta, Canada Wildfire
Authors: Hyde Ashley , Verstraeten Barbara S. E. , Olson Joanne K. , King Suzanne , Brémault-Phillips Suzette , Olson David M. 
Published: June 2021

Introduction:Data show that maternal stress triggered by exposure to a natural disaster before, during or just after pregnancy is associated with adverse pregnancy and newborn outcomes. In this paper, the first aim is to describe our efforts to test a simple, low-cost intervention to large numbers of women following a major natural disaster. The second aim is to outline the challenges faced and lessons learned during the execution of this natural disaster study.Methods:The setting was the May 2016 Fort McMurray Wood Buffalo wildfire in northern Alberta, Canada. Women who were pregnant or preconception at the time of the disaster were invited to participate via social media. This prospective cohort study included a randomized controlled trial to test the effectiveness of an expressive writing intervention on the levels of prenatal maternal stress and maternal, birth, and early childhood outcomes. At recruitment and at multiple timepoints postpartum, a battery of questionnaires was administered to evaluate objective and subjective stress exposure to the fire as well as maternal mental health, resilience and its contributing factors as well as infant developmental milestones. Qualitative content analysis of the expressive writing was conducted.Discussion:There is an increasing need to develop effective, wide-spread, rapid, and low-cost interventions to reduce prenatal maternal stress, increase resilience, and improve pregnancy outcomes following a natural disaster. Though analysis of data is ongoing, we highlight the strengths of this study which include strong community participation, rapid recruitment of eligible participants, low-cost intervention and data acquisition, and successful testing of the intervention. We acknowledge the challenges we encountered including the high rate of participant disqualifications or losses due to incomplete collection of online data; evacuation, dispersal, and inconsistent return to homes; and the high levels of stress accumulated post-disaster which led to inability to complete the study. Despite potential challenges, there remains a need for such research amid natural disasters.
Entomological and Molecular Surveillance of Anopheles Mosquitoes in Freetown, Sierra Leone, 2019
Authors: Zhao Ning , Sesay Ishaq , Tu Hong , Yamba Frederick , Lu Liang , Guo Yuhong , Song Xiuping , Wang Jun , Liu Xiaobo , Yue Yujuan , Wu Haixia , Liu Qiyong 
Published: June 2021

Background: Malaria is endemic in Sierra Leone, with stable and perennial transmission in all parts of the country. At present, the main prevention and control measures for mosquito vectors here involve insecticide treated nets (ITN) and indoor residual spraying (IRS). The most recent entomological surveillance was conducted prior to the civil war, between 1990 and 1994. Therefore, a new entomological surveillance required to support targeted malaria control strategies.Methods:Anopheles mosquitoes were collected between June and December 2019 using the light trap method. On these, we conducted species identification, analyzed seasonal fluctuation and Plasmodium infection rate, and monitored insecticide resistance.Results: Surveillance of seasonal fluctuation showed that there were two peak of Anopheles density in July (mean 13.67 mosquitoes/trap/night) and October (mean 13.00 mosquitoes/trap/night). Meanwhile, the lowest Anopheles density was seen in early September. Ninety-one representatives of Anopheles gambiae s.l. were selected and identified as An. coluzzii (n = 35) and An. gambiae s.s. (n = 56) using PCR. An. coluzzii and An. gambiae s.s. were found to be heterozygous resistant to the knockdown resistance (kdr) L1014F mutation (100%). Meanwhile, the East African mutation (kdr L1014S) was absent in the tested mosquitoes. Three mosquitoes that tested positive for the parasite, had an individual Plasmodium falciparum infection rate of 12.50, 16.67, and 14.29%. The sampling dates of positive mosquitoes were distributed in the two periods of peak Anopheles mosquito density.Conclusion: This study identified the dominant Anopheles species in Freetown as An. gambiae while the predominant species within the An. gambiae complex was An. gambiae sensu stricto. Surveillance of seasonal fluctuations and high P. falciparum infection rates in Anopheles indicate that the alternation of drought and rainy seasons from June to July, and from October to November, are the key periods for malaria control and prevention in Freetown, Sierra Leone. The high frequency of kdr allele mutations in An. gambiae calls for close monitoring of vector susceptibility to insecticides and tracing of resistance mechanisms in order to develop more effective vector control measures and strategies.
Increased Incidence of Dysmenorrhea in Women Exposed to Higher Concentrations of NO, NO2, NOx, CO, and PM2.5: A Nationwide Population-Based Study
Authors: Lin Shih-Yi , Yang Yu-Cih , Lin Cheng-Chieh , Chang Cherry Yin-Yi , Hsu Wu-Huei , Wang I-Kuan , Lin Chia-Der , Hsu Chung-Y. , Kao Chia-Hung 
Published: June 2021

Background: Air pollution is speculated to affect the reproductive health of women. However, a longitudinal association between exposure to air pollution and dysmenorrhea has not been identified, which this study aimed to examine this point.Methods: Two nationwide databases, namely the Taiwan Air Quality Monitoring database and the Taiwan National Health Research Institutes database were linked. Women with a history of dysmenorrhea (International Classification of Disease, Ninth Revision, Clinical Modification code 625.3) before 2000 were excluded. All participants were followed from January 1, 2000 until the diagnosis of dysmenorrhea, withdrawal from National Health Insurance, or December 31, 2013. Furthermore, air pollutants were categorized into quartiles with three cut-off points (25th, 50th, and 75th percentiles). The Cox regression model was used to calculate the hazard ratios of dysmenorrhea.Results: This study enrolled 296,078 women. The mean concentrations of yearly air pollutants were 28.2 (±12.6) ppb for nitric oxides (NOx), 8.91 (±7.93) ppb for nitric oxide (NO), 19.3 (±5.49) ppb for nitrogen dioxide (NO2), 0.54 (±0.18) ppm for carbon monoxide (CO), and 31.8 (±6.80) μg/m3 for PM2.5. In total, 12,514 individuals developed dysmenorrhea during the 12-year follow-up. Relative to women exposed to Q1 concentrations of NOx, women exposed to Q4 concentrations exhibited a significantly higher dysmenorrhea risk [adjusted hazard ratio (aHR)= 27.9, 95% confidence interval (CI) = 21.6–31.3]; similarly higher risk was found for exposure to NO (aHR = 16.7, 95% CI = 15.4–18.4) and NO2 (aHR = 33.1, 95% CI = 30.9–37.4). For CO, the relative dysmenorrhea risk in women with Q4 level exposure was 28.7 (95% CI = 25.4–33.6). For PM2.5, women at the Q4 exposure level were 27.6 times (95% CI = 23.1–29.1) more likely to develop dysmenorrhea than those at the Q1 exposure level.Conclusion: Our results showed that women would have higher dysmenorrhea incidences while exposure to high concentrations of NO, NO2, NOx, CO, and PM2.5.
Effects of Physical Exercise Interventions on Spatial Orientation in Children and Adolescents: A Systematic Scoping Review
Authors: Morawietz Christina , Muehlbauer Thomas 
Published: June 2021

Background: Regular physical exercise plays an integral part in the psychomotor and psychosocial development of children and adolescents, with complex motor and cognitive processes closely linked. Spatial abilities, one aspect of cognitive functioning start to evolve from earliest childhood and reach adult-like levels by early adolescence. As they have been associated with good spatial orientation, wayfinding, map-reading skills, problem solving or analyzing spatial information, these skills facilitate independence and autonomy while growing up. Despite promising results, only few studies investigate this relation between physical exercise and spatial abilities. To use this benefit and develop purposive physical exercise interventions, it is essential to summarize the current evidence.Objectives: This literature review aims to systematically summarize findings regarding the impact of physical exercise interventions on spatial abilities in healthy children and adolescents and identify knowledge gaps.Methods: A systematic search of the literature according to the PRISMA guidelines was conducted on the databases Pubmed, Web of Science, Cochrane Library, SportDiscus, and PsycInfo from their inception date till March 2021. Additionally, Google Scholar and refence lists of relevant publications were searched. A descriptive analysis of results was conducted.Results: The literature search identified a total of N = 1,215 records, 11 of which met the inclusion criteria and were analyzed in this review. A total of 621 participants aged 4 to 15 years participated in the studies. Exercise interventions included sport-specific activities, motor-coordinative exercises, high-intensity functional training or spatial orientation/navigation training. Five studies evaluated training effects on mental rotation performance (i.e., Mental Rotation Test), four studies investigated visuo-spatial working memory function/spatial memory (i.e., Corsi Block Test, Virtual Reality Morris Water Maze) and two studies tested spatial orientation capacity (i.e., Orientation-Running Test). Overall, results show a potential for improvement of spatial abilities through physical exercise interventions. However, keeping the diversity of study designs, populations and outcomes in mind, findings need to be interpreted with care.Conclusions: Despite growing interest on the effects of physical exercise interventions on spatial abilities and promising findings of available studies, evidence to date remains limited. Future research is needed to establish how spatial ability development of healthy children and adolescents can be positively supported.
Feasibility of Microwave-Based Scissors and Tweezers in Partial Hepatectomy: An Initial Assessment on Canine Model
Authors: Dang Khiem Tran , Naka Shigeyuki , Yamada Atsushi , Tani Tohru 
Published: June 2021

Purpose: This study aimed to assess the feasibility of partial hepatectomy (PH) simplified by using microwave-based devices in animal experiments.Methods: PH was performed on 16 beagles using either Acrosurg Scissors (AS) or Acrosurg Tweezers (AT) without hepatic pedicle (HP) control. Parenchymal transection time, Glissonean pedicle (GP) seal time, bleeding volume, bile leak, and burst pressure were recorded. Probable complications were investigated after 4 weeks.Results: Transection time (6.5 [6.0–7.6] vs. 11.8 [10.5–20.2] min, p &lt; 0.001) with AT were significantly shorter than with AS. GP sealing times (60 [55–60] vs. 57 [46–91] s, p = 0.859) by both devices were nearly similar. Bleeding volume in the AT group was approximately one-fourth of that in the AS group (6.7 [1.4–22] vs. 28.8 [5.8–48] mL, p = 0.247). AT created higher burst pressure on the bile duct stumps (p = 0.0161). The two devices did not differ significantly in morbidity and mortality after four-week follow-up.Conclusion: Acrosurg devices achieved a safe PH without HP control owing to microwave-based sealing. AS could be used alone in PH, whereas the clamp-crushing function of AT seemed more advantageous in reducing the transection time and blood loss.