bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance of Bioelectrical Impedance and Anthropometric Predictive Equations for Estimation of Muscle Mass in Chronic Kidney Disease Patients
Authors: Bellafronte Natália Tomborelli , Vega-Piris Lorena , Cuadrado Guillermina Barril , Chiarello Paula Garcia 
Published: May 2021

Background: Patients with chronic kidney disease (CKD) are vulnerable to loss of muscle mass due to several metabolic alterations derived from the uremic syndrome. Reference methods for body composition evaluation are usually unfeasible in clinical settings.Aims: To evaluate the accuracy of predictive equations based on bioelectrical impedance analyses (BIA) and anthropometry parameters for estimating fat free mass (FFM) and appendicular FFM (AFFM), compared to dual energy X-ray absorptiometry (DXA), in CKD patients.Methods: We performed a longitudinal study with patients in non-dialysis-dependent, hemodialysis, peritoneal dialysis and kidney transplant treatment. FFM and AFFM were evaluated by DXA, BIA (Sergi, Kyle, Janssen and MacDonald equations) and anthropometry (Hume, Lee, Tian, and Noori equations). Low muscle mass was diagnosed by DXA analysis. Intra-class correlation coefficient (ICC), Bland-Altman graphic and multiple regression analysis were used to evaluate equation accuracy, linear regression analysis to evaluate bias, and ROC curve analysis and kappa for reproducibility.Results: In total sample and in each CKD group, the predictive equation with the best accuracy was AFFMSergi (men, n = 137: ICC = 0.91, 95% CI = 0.79–0.96, bias = 1.11 kg; women, n = 129: ICC = 0.94, 95% CI = 0.92–0.96, bias = −0.28 kg). AFFMSergi also presented the best performance for low muscle mass diagnosis (men, kappa = 0.68, AUC = 0.83; women, kappa = 0.65, AUC = 0.85). Bias between AFFMSergi and AFFMDXA was mainly affected by total body water and fat mass. None of the predictive equations was able to accurately predict changes in AFFM and FFM, with all ICC lower than 0.5.Conclusion: The predictive equation with the best performance to asses muscle mass in CKD patients was AFFMSergi, including evaluation of low muscle mass diagnosis. However, assessment of changes in body composition was biased, mainly due to variations in fluid status together with adiposity, limiting its applicability for longitudinal evaluations.
Primary Intracranial Leiomyosarcoma Secondary to Glioblastoma: Case Report and Literature Review
Authors: Zhao Liyan , Jiang Yining , Wang Yubo , Bai Yang , Sun Ying , Li Yunqian 
Published: May 2021

BackgroundLeiomyosarcoma is a highly malignant soft-tissue sarcoma with a poor prognosis. In recent years, treatment for leiomyosarcoma has not shown much progress. Primary intracranial leiomyosarcoma (PILMS) is a much rarer type of neoplasm, which occurs more frequently in immunocompromised patients. PILMS cases reported in the literature are scarce and treatment strategy and prognosis are still under debate. In this study, a case of PILMS secondary to the total resection of giant cell glioblastoma is reported.Case DescriptionA 38-year-old male was hospitalized with a three-month history of a temporal opisthotic bump. His medical history included a total resection of a tumor located in the right temporal lobe performed 4 years earlier. Pathological examination led to a diagnosis of giant cell glioblastoma, and the patient underwent postoperative chemotherapy with temozolomide for 6 weeks plus simultaneous radiotherapy with 63.66 Gary. Four years later, during regular follow-up, a preoperative MRI brain scan resulted in a well-defined signal pointing out two nodule-like features located at the right temporal lobe and subcutaneous soft tissue, respectively, and near the area where the previous giant cell glioblastoma was located. The mass was completely removed by a transtemporal approach and postoperative pathology revealed that the mass was a leiomyosarcoma. The patient underwent postoperative radiotherapy and no recurrence occurred until now.ConclusionsTo date, research on soft-tissue sarcoma, especially PILMS, has not made much progress, and a limited number of studies have provided few details on the management of PILMS. The treatment of choice for PILMS is aggressive multimodal treatment based on total tumor resection and radiotherapy. Moreover, systemic treatment with chemotherapy and targeted therapy, such as olaratumab, as well as further research still needs to be performed as many questions are left unanswered. To our knowledge, this is the first report on a case of PILMS secondary to glioblastoma, which might serve as a potential reference for clinicians and clinical studies.
High Expression of ACE2 and TMPRSS2 at the Resection Margin Makes Lung Cancer Survivors Susceptible to SARS-CoV-2 With Unfavorable Prognosis
Authors: Wang Qianqian , Li Liangyu , Qu Tianyu , Li Jie , Wu Lingxiang , Li Kening , Wang Ziyu , Zhu Mengyan , Huang Bin , Wu Wei , Wu Min , Ding Rong , Zhang Zhihong , Wang Qianghu , Xia Xinyi , Li Pengping , Zhang Zhi , Guo Renhua 
Published: May 2021

BackgroundCoronavirus disease 2019 (COVID-19) has rapidly spread worldwide. Systematic analysis of lung cancer survivors at molecular and clinical levels is warranted to understand the disease course and clinical characteristics.MethodsA single-center, retrospective cohort study was conducted in 65 patients with COVID-19 from Wuhan Huoshenshan Hospital, of which 13 patients were diagnosed with lung cancer. The study was conducted from February 4 to April 11, 2020.ResultsDuring the course of treatment, lung cancer survivors infected with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) had shorter median time from symptom onset to hospitalization (P = 0.016) and longer clinical symptom remission time (P = 0.020) than non-cancer individuals. No differences were observed among indicators such as time from symptom onset to hospitalization and symptom remission time between medium-term and short-term survivors. The expression of ACE2 (P = 0.013) and TMPRSS2 (P &lt;0.001) was elevated in lung cancer survivors as compared with that in non-cancer individuals.ConclusionsACE2 and TMPRSS2 levels were higher at resection margins of lung cancer survivors than those in normal tissues of non-cancerous individuals and may serve as factors responsible for the high susceptibility to COVID-19 among lung cancer survivors. Lung cancer patients diagnosed with COVID-19, including medium-term survivors, have worse outcomes than the general population.
A Clinical Analysis of Pharyngeal Bronchogenic Cysts in the Pharynx of Children
Authors: Xu Ying , Han Fugen , Seng Dongjie , Jiang Lan , Wang Shengcai , Ni Xin , Zhang Jie 
Published: May 2021

Objective: This study was designed to summarize the clinical characteristics, diagnosis and treatment of pharyngeal bronchogenic cysts in children to help in making the correct diagnosis and developing an appropriate treatment plan.Methods: The clinical data of 13 children with bronchogenic cysts in the pharynx, who were treated in otolaryngology head and neck surgery department between September 2013 and July 2019, were analyzed retrospectively. The clinical characteristics were evaluated, and the related factors for diagnosis and treatment were analyzed. Clinical characteristics and imaging features of three cases whose lesions located in the nasopharyngeal, oropharynx, and laryngopharyngeal were demonstrated.Results: All 13 children were male, the youngest being 4 days old, the oldest 6 years and 6 months, and the median age being 1 year and 4 months. Eight patients were diagnosed during a physical examination, and five patients visited the doctor with different degrees of upper airway obstruction. The mass was located in the nasopharynx in one patient, in the oropharynx in eight patients, and in the laryngopharynx in the other four patients. Computed tomography (CT) scanning, which is helpful for a topical diagnosis, showed a dense homogeneous mass. Electronic nasopharyngoscopy showed cystic masses of different sizes in the pharynx. All the children underwent cyst resection under general anesthesia, and the postoperative pathology result was a bronchogenic cyst. One child was lost to follow-up, but the remaining 12 children were followed up for between 6 months and 6 years, during which no recurrence of a cyst was found.Conclusion: Bronchogenic cysts are a rare cyst of the head and neck, and the most common site of the cyst is the oropharynx. The impact on airway obstruction depends on the location and size of the cyst. CT scanning is of great significance for diagnosis. Surgical treatment should be carried out as soon as possible after diagnosis, as surgery is the most effective way to treat bronchogenic cysts. Follow-ups should be carried out regularly to prevent cyst recurrence.
Diagnostic Accuracy of Plasma Ghrelin Concentrations in Pediatric Sepsis-Associated Acute Respiratory Distress Syndrome: A Single-Center Cohort Study
Authors: Yuan Xiu , Li Shaojun , Zhou Liang , Tang Tian , Cheng Yuwei , Ao Xiaoxiao , Tan Liping 
Published: May 2021

Background: Ghrelin is the endogenous ligand of growth hormone secretagogue receptor 1a, which plays a role in regulating immunity and inflammation. The aim of this study is to assess the diagnostic value of plasma ghrelin in sepsis-associated pediatric acute respiratory distress syndrome (PARDS).Methods: We recruited patients who were admitted to the pediatric ICU (PICU) of the Children's Hospital of Chongqing Medical University between January 2019 and January 2020 and met the diagnostic criteria for sepsis. Data on clinical variables, laboratory indicators, plasma ghrelin concentrations, and inflammatory factors were collected and evaluated, and patients were followed up for 28 days. The area under the receiver-operating characteristic curves (AUROC) were determined using logistic regression to calculate and test cut-off values for ghrelin as a diagnostic indicator of sepsis-associated PARDS. The log-rank test was used to compare survival according to ghrelin levels.Main results: Sixty-six PICU patients (30 with ARDS and 36 without ARDS) who met the diagnostic criteria of sepsis were recruited. The ghrelin level was significantly higher in the ARDS group than in the non-ARDS group. The AUROC of ghrelin was 0.708 (95% confidence interval: 0.584–0.833) and the positivity cutoff value was 445 pg/mL. Sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of plasma ghrelin for the diagnosis of PARDS-associated sepsis were 86.7, 50.0, 59.1, 81.8, 1.734, and 0.266%, respectively. The survival rate of sepsis patients were significantly improved when the ghrelin level was &gt;445 pg/mL.Conclusions: Ghrelin plasma levels were higher in sepsis-associated PARDS, and accompanied by increased levels of inflammatory factors. High ghrelin levels are a positive predictor of ICU survival in sepsis patients. Yet, there is no evidence to prove that elevated ghrelin is a promising diagnostic indicator of sepsis-associated PARDS.Trial registration: Clinicaltrials, ChiCTR1900023254. Registered 1 December 2018 - Retrospectively registered, http://www.clinicaltrials.gov/ChiCTR1900023254.
Effects of Pharmacist-Led Clinical Pathway/Order Sets on Cancer Patients: A Systematic Review
Authors: Tan Zhiyuan , Yu Zhiheng , Chen Ken , Liu Wei , Zhao Rongsheng 
Published: May 2021

Background: Pharmacist-led clinical pathways/order sets (PLCOs) were first applied for designated diseases and surgical operations, such as cancer. They were not used in pharmacotherapy until recently. After screening a large number of publications, we found that PLCOs were rarely accessible.Objective: To evaluate the effects and the changes of relevant medical outcomes of PLCOs.Methods: Articles from PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang database, and China Biology Medicine disc (CBM) were systematically retrieved. Clinical research comparing cancer patients’ clinical effects with or without clinical pathway/order sets was performed. Two reviewers performed quality assessment, and the data were abstracted independently. A narrative synthesis of the extracted data was performed due to heterogeneity.Results: Nine studies were identified, including six uncontrolled before–after studies and three case-series studies. The scopes of PLCOs of included research can be divided into two types, one focusing on chemotherapy agents and the other on the managements of chemotherapy-induced complications. The PLCOs shortened hospital length of stay, decreased initial antibiotic time intervals in patients with febrile neutropenia, reduced medication error incidence, and increased physicians’ adherence rate to clinical pathway/order sets. Moreover, three articles included economic effects showing positive savings on medication costs through PLCOs.Conclusion: PLCOs can have beneficial effects on medication effectiveness, safety, and economic outcomes. Nevertheless, clinical pathway/order sets need to be further optimized and expanded to other clinical areas.
Characterization of B- and T-Cell Compartment and B-Cell Related Factors Belonging to the TNF/TNFR Superfamily in Patients With Clinically Active Systemic Lupus Erythematosus: Baseline BAFF Serum Levels Are the Strongest Predictor of Response to Belimumab after Twelve Months of Therapy
Authors: Piantoni Silvia , Regola Francesca , Masneri Stefania , Merletti Michele , Lowin Torsten , Airò Paolo , Tincani Angela , Franceschini Franco , Andreoli Laura , Pongratz Georg 
Published: May 2021

Background:Patients with systemic lupus erythematosus (SLE) show increased serum levels of tumor necrosis factor (TNF)/TNF receptor (R) superfamily member, e.g. BAFF (B lymphocyte stimulator). Belimumab, a monoclonal antibody against soluble BAFF, is used for treatment of SLE. Although B cells are the main target, a BAFF-dependent T-cell activation pathway also plays a role. High levels of anti-DNA antibodies and low complement at baseline are known predictors of response to Belimumab.Objectives:To explore the association of circulating lymphocytes and serum levels of B- cell related TNF/TNFR superfamily members with response to Belimumab in SLE patients.Methods:Twenty-one SLE patients received Belimumab. Clinical evaluation and laboratory tests were performed at baseline, at 6 and 12 months. TNF super-family members (BAFF, APRIL, sBCMA, sCD40L, sTACI, TWEAK) were tested by high-sensitivity ELISA in all patients, and lymphocyte immunophenotyping was performed by flow cytometry in ten subjects. SLE-disease activity was assessed by SLEDAI-2K score. Linear regression modeling was used to investigate parameters influencing SLEDAI-2K and anti-dsDNA antibody titers over time and for predictive models.Results:Clinical improvement was observed in all patients. A global reduction of circulating B cells, especially naïve, was detected, without variation in the T-cell compartment. All TNF family members decreased, whereas APRIL remained constant. The increase in serum levels of C3 (p= 0.0004) and sTACI (p= 0.0285) was associated with a decrease of SLEDAI-2K. The increase of C4 (p= 0.027) and sBCMA (p= 0.0015) and the increase of CD8+T cells (p= 0.0160) were associated with a decrease, whereas an increase of sCD40L in serum (p= 0.0018) and increased number of CD4+T cells (p= 0.0029) were associated with an increase, in anti-dsDNA antibody titers, respectively. Using stepwise forward inclusion, the minimal model to predict SLEDAI-2K response at 12 months included BAFF (p= 3.0e− 07) and SLEDAI-2K (p= 7.0e− 04) at baseline. Baseline APRIL levels also showed an association, although the overall model fit was weaker.Conclusion:In our real-life cohort, baseline serum levels of BAFF were the best predictor of response to Belimumab, confirming post-hoc results of the BLISS study and suggesting the utility of this particular biomarker for the identification of patients who are more likely to respond.
Rapid Evidence Assessment of Mental Health Outcomes of Pandemics for Health Care Workers: Implications for the Covid-19 Pandemic
Authors: Waring Sara , Giles Susan 
Published: May 2021

Background: Little is known about the long-term mental health (MH) impact of the Covid-19 pandemic on health care workers (HCWs). However, synthesizing knowledge from past pandemics can help to anticipate this, along with identifying interventions required, when, and target populations most in need. This paper provides a balanced evaluation of what is currently known about short- and long-term MH impacts of pandemics on HCWs and effect of methodological limitations on knowledge claims.Method: A rapid evidence assessment (REA) was conducted on 41 studies published in the past two decades that examined MH outcomes for HCWs in relation to pandemics.Results: Findings of literary synthesis highlight common MH outcomes across pandemics, including increased stress, distress, burnout, and anxiety in the short-term, and post-traumatic stress and depression in the long-term. Findings also show the key role that organizations and public health bodies play in promoting adaptive coping and reducing health worries and the emotional and psychological distress caused by this. Evidence highlights particular groups at risk of developing MH issues (contact with patients that are infected, having children), and time points where risk may increase (initial response phase, when quarantined). However, inconsistencies in measures, analysis, and reporting all create limitations for pooling data.Conclusions: Findings can be used by researchers to provide a knowledge framework to inform future research that will assist HCWs in responding to pandemics, and by policy makers and service planners to provide an evidence-led brief about direction and evidence base for related policy initiatives, interventions or service programmes.
Systematic Review and Meta-Analysis of Virtual Reality in Mental Healthcare: Effects of Full Body Illusions on Body Image Disturbance
Authors: Turbyne Collin , Goedhart Abe , de Koning Pelle , Schirmbeck Frederike , Denys Damiaan 
Published: May 2021

Background: Body image (BI) disturbances have been identified in both clinical and non-clinical populations. Virtual reality (VR) has recently been used as a tool for modulating BI disturbances through the use of eliciting a full body illusion (FBI). This meta-analysis is the first to collate evidence on the effectiveness of an FBI to reduce BI disturbances in both clinical and non-clinical populations.Methods: We performed a literature search in MEDLINE (PubMed), EMBASE, PsychINFO, and Web of Science with the keywords and synonyms for “virtual reality” and “body image” to identify published studies until September 2020. We included studies that (1) created an FBI with a modified body shape or size and (2) reported BI disturbance outcomes both before and directly after the FBI. FBI was defined as a head-mounted display (HMD)-based simulation of embodying a virtual body from an egocentric perspective in an immersive 3D computer-generated environment.Results: Of the 398 identified unique studies, 13 were included after reading full-texts. Four of these studies were eligible for a meta-analysis on BI distortion inducing a small virtual body FBI in healthy females. Significant post-intervention results were found for estimations of shoulder width, hip width, and abdomen width, with the largest reductions in size being the estimation of shoulder circumference (SMD = −1.3; 95% CI: −2.2 to −0.4; p = 0.004) and hip circumference (SMD = −1.0; 95% CI: −1.6 to −0.4; p = 0.004). Mixed results were found in non-aggregated studies from large virtual body FBIs in terms of both estimated body size and BI dissatisfaction and in small virtual body FBI in terms of BI dissatisfaction.Conclusions: The findings presented in this paper suggest that the participants' BIs were able to conform to both an increased as well as a reduced virtual body size. However, because of the paucity of research in this field, the extent of the clinical utility of FBIs still remains unclear. In light of these limitations, we provide implications for future research about the clinical utility of FBIs for modulating BI-related outcomes.
Effects of Manure and Chemical Fertilizer on Bacterial Community Structure and Soil Enzyme Activities in North China
Authors: Liu Zhiping , Xie Wenyan , Yang Zhenxing , Huang Xuefang , Zhou Huaiping 
Published: May 2021

The application of organic fertilizer affects soil microbes and enzyme activities. In this study, we explored the effects of various long-term different fertilization treatments (manure, M; chemical fertilizer, NP; manure + chemical fertilizer, MNP; and no fertilizer, CK) on bacterial community structure and soil sucrase, urease, and alkaline phosphatase activities in Shaping, Hequ, China. High-throughput sequencing was used to amplify the third to the fourth hypervariable region of the 16S ribosomal RNA for analysis of the bacterial community structure. Enzyme activities were determined by colorimetry. Soil treated with MNP had the highest bacterial Abundance-based Coverage Estimator index and enzyme activities. The principal coordinates analysis results showed significant differences among the various fertilization treatments (p < 0.001). Proteobacteria, Actinobacteria, Acidobacteria, Gemmatimonadetes, and Chloroflexi were consistently dominant in all soil samples. The redundancy analysis and Monte Carlo permutation tests showed that the soil bacterial communities were significantly correlated with alkali-hydrolyzable nitrogen, organic matter, urease, and alkaline phosphatase. Our results reveal the fundamentally different effects that organic and inorganic fertilizers have on soil bacterial communities and their functions.
Oxidative Stress-Induced Unscheduled CDK1–Cyclin B1 Activity Impairs ER–Mitochondria-Mediated Bioenergetic Metabolism
Authors: Chang Jan-Gowth , Tien Ni , Chang Yi-Chih , Lin Meng-Liang , Chen Shih-Shun 
Published: May 2021

Targeting the activities of endoplasmic reticulum (ER)–mitochondrial-dependent metabolic reprogramming is considered one of the most promising strategies for cancer treatment. Here, we present biochemical subcellular fractionation, coimmunoprecipitation, gene manipulation, and pharmacologic evidence that induction of mitochondria-localized phospho (p)-cyclin dependent kinase 1 (CDK1) (Thr 161)–cyclin B1 complexes by apigenin in nasopharyngeal carcinoma (NPC) cells impairs the ER–mitochondrial bioenergetics and redox regulation of calcium (Ca++) homeostasis through suppressing the B cell lymphoma 2 (BCL-2)/BCL-2/B-cell lymphoma-extra large (BCL-xL)-modulated anti-apoptotic and metabolic functions. Using a specific inducer, inhibitor, or short hairpin RNA for acid sphingomyelinase (ASM) demonstrated that enhanced lipid raft-associated ASM activity confers alteration of the lipid composition of lipid raft membranes, which leads to perturbation of protein trafficking, and induces formation of p110α free p85α–unphosphorylated phosphatase and tensin homolog deleted from chromosome 10 complexes in the lipid raft membranes, causing disruption of phosphatidylinositol 3-kinase (PI3K)−protein kinase B (Akt)−GTP-ras-related C3 botulinum toxin substrate 1 (Rac1)-mediated signaling, thus triggering the p-CDK1 (Thr 161))–cyclin B1-mediated BCL-2 (Thr 69/Ser 87)/BCL-xL (Ser 62) phosphorylation and accompanying impairment of ER–mitochondria-regulated bioenergetic, redox, and Ca++ homeostasis. Inhibition of apigenin-induced reactive oxygen species (ROS) generation by a ROS scavenger N-acetyl-L-cysteine blocked the lipid raft membrane localization and activation of ASM and formation of ceramide-enriched lipid raft membranes, returned PI3K−Akt−GTP-Rac1-modulated CDK1–cyclin B1 activity, and subsequently restored the BCL-2/BCL-xL-regulated ER–mitochondrial bioenergetic activity. Thus, this study reveals a novel molecular mechanism of the pro-apoptotic activity of ASM controlled by oxidative stress to modulate the ER–mitochondrial bioenergetic metabolism, as well as suggests the disruption of CDK1–cyclin B1-mediated BCL-2/BCL-xL oncogenic activity by triggering oxidative stress−ASM-induced PI3K−Akt−GTP-Rac1 inactivation as a therapeutic approach for NPC.