bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breast Cancer Subtypes and Mortality of Breast Cancer Patients With Brain Metastasis at Diagnosis: A Population-Based Study
Authors: He Dong-Jie , Yu De-Quan , Wang Qi-Ming , Yu Zong-Yan , Qi Yu-Hong , Shao Qiu-Ju , Chang Hao 
Published: November 2021

Background Brain metastasis is an important cause of breast cancer-related death. Aim We evaluated the relationships between breast cancer subtype and prognosis among patients with brain metastasis at the initial diagnosis. Methods The Surveillance, Epidemiology, and End Results database was searched to identify patients with brain metastasis from breast cancer between 2010 and 2015. Multivariable Cox proportional hazard models were used to identify factors that were associated with survival among patients with initial brain metastases. The Kaplan–Meier method was used to compare survival outcomes according to breast cancer subtype. Results Among 752 breast cancer patients with brain metastasis at diagnosis, 140 patients (18.6%) underwent primary surgery and 612 patients (81.4%) did not undergo surgery, while 460 patients (61.2%) received chemotherapy and 292 patients (38.8%) did not receive chemotherapy. Multivariable analysis revealed that, relative to HR+/HER2– breast cancer, HR–/HER2– breast cancer was associated with significantly poorer overall survival (hazard ratio: 2.52, 95% confidence interval: 1.99–3.21), independent of age, sex, race, marital status, insurance status, grade, liver involvement, lung involvement, primary surgery, radiotherapy, and chemotherapy. The median overall survival intervals were 12 months for HR+/HER2−, 19 months for HR+/HER2+, 11 months for HR−/HER2+, and 6 months for HR–/HER2– ( P < .0001). Relative to HR+/HER2– breast cancer, HR–/HER2– breast cancer was associated with a significantly higher risk of mortality among patients, and the association was stronger among patients who received chemotherapy ( p for interaction = .005). Conclusions Breast cancer subtype significantly predicted overall survival among patients with brain metastasis at diagnosis.
Complete Facial Paralysis Caused by Stabbing With a Car Key at the Stylomastoid Foramen
Authors: Yang Bo , Zhang Fang , Tian Ying , Yang Huijun 
Published: November 2021

Non-iatrogenic traumatic facial paralysis is most common in intratemporal facial nerve injury caused by temporal bone fracture, followed by intraparotid facial nerve branch injury. Facial paralysis caused by injury to the extratemporal trunk of the facial nerve is extremely rare. We present a case of a 60-year-old man suffering from immediate complete left peripheral facial paralysis due to blunt transection of extratemporal trunk of facial nerve by stabbing with a car key. There was a facial nerve defect about 1 cm in length. The great auricular nerve was grafted to repair the facial nerve. Over 12 months, his facial nerve function improved to a House–Brackmann III/VI.
The Effect of Posterior Tibial Slope on the Risk of Revision Surgery After Anterior Cruciate Ligament Reconstruction
Authors: Dæhlin Lene , Inderhaug Eivind , Strand Torbjørn , Parkar Anagha P. , Solheim Eirik 
Published: November 2021

Background: A significant proportion of patients undergoing anterior cruciate ligament (ACL) reconstruction (ACLR) later experience graft failure. Some studies suggest an association between a steep posterior tibial slope (PTS) and graft failure. Purpose: To examine the PTS in a large cohort of patients about to undergo ACLR and to determine whether a steep PTS is associated with later revision surgery. Study Design: Case-control study; Level of evidence, 3. Methods: A retrospective review of a cohort undergoing isolated ACLR between 2002 and 2012 (with 8-19 years of follow-up) was conducted. Preoperative sagittal radiographs of knees in full extension were used for measurements of the PTS. There were 2 independent examiners who performed repeated measurements to assess the reliability of the method. Statistical analyses were performed to compare the PTS in the groups with and without later revision surgery. Results: A total of 728 patients, with a mean age of 28 years at the time of surgery, were included. Overall, 10% (n = 76) underwent revision surgery during the observation period. The group of injured knees had a significantly steeper PTS compared with the group of uninjured knees (9.5° vs 8.7°, respectively; P < .05). The mean PTS in the no revision group was 9.5° compared with 9.3° in the revision group (not significant). Dichotomized testing of revision rates related to PTS cutoff values of ≥10°, ≥12°, ≥14°, ≥16°, and ≥18° showed no association of PTS steepness (not significant) to graft failure. Patients with revision were younger than the ones without (mean age, 24 ± 8 vs 29 ± 10 years, respectively) and had a shorter time from injury to ACLR (mean, 14 ± 27 vs 24 ± 44 months, respectively) as well as a smaller graft size (8.2 vs 8.4 mm, respectively; P = .040). Conclusion: The current study did not find any association between a steep PTS measured on lateral knee radiographs and revision ACL surgery. However, a steeper PTS was seen in the group of injured knees compared with the group of uninjured (contralateral) knees. Independent of the PTS, younger patients, those with a shorter time from injury to surgery, and those with a smaller graft size were found to undergo revision surgery more often.
Reactivation of EBV and CMV in Severe COVID-19—Epiphenomena or Trigger of Hyperinflammation in Need of Treatment? A Large Case Series of Critically ill Patients
Authors: Naendrup Jan-Hendrik , Garcia Borrega Jorge , Eichenauer Dennis Alexander , Shimabukuro-Vornhagen Alexander , Kochanek Matthias , Böll Boris 
Published: November 2021

Background Reactivation of viruses such as Epstein-Barr virus (EBV) and cytomegalovirus (CMV) are common in critically ill patients and have been described in patients with severe COVID-19. However, it is unclear whether these reactivations are associated with increased mortality and whether targeted treatments are beneficial. Methods In a retrospective single-center cohort study, patients with severe COVID-19 treated on our intensive care unit (ICU) were screened for EBV and CMV reactivation as detected by polymerase chain reaction. If present, patient characteristics, temporal connections to severe acute respiratory syndrome coronavirus 2 diagnosis and corticosteroid use, the use of targeted treatments as well as the course of disease and outcome were analyzed. As control group, non-COVID-19 patients with sepsis, treated within the same time period on our ICU, served as control group to compare incidences of viral reactivation. Results In 19 (16%) of 117 patients with severe COVID-19 treated on our ICU EBV reactivations were identified, comparable 18 (14%) of 126 in the non-COVID-19 control group ( P = .672). Similarly, in 11 (9%) of 117 patients CMV reactivations were identified, comparable to the 16 (13%) of 126 in the non-COVID-19 sepsis patients ( P = .296). The majority of EBV (58%) and CMV reactivations (55%) were detected in patients under systemic corticosteroid treatment. 7 (37%) of 19 patients with EBV reactivation survived the ICU stay, 2 (29%) of 7 patients with rituximab treatment and 5 (42%) of 12 patients without treatment ( P = .568). Five (50%) of 10 patients with CMV reactivation survived the ICU stay, 5 (83%) of 6 patients with ganciclovir treatment and 0 of 4 patients without treatment ( P = .048). Follow-up analysis in these patients showed that the initiation of treatment lead to decrease in viral load. Conclusion Critically ill patients with COVID-19 are at a high risk for EBV and CMV reactivations. Whether these reactivations are a cause of hyperinflammation and require targeted treatment remains uncertain. However, in patients with clinical deterioration or signs of hyperinflammation targeted treatment might be beneficial and warrants further studying.
Women, Infants, and Children Cash Value Benefit Redemption Choices in the Electronic Benefit Transfer Era
Authors: Zhang Qi , Zhang Junzhou , Park Kayoung , Tang Chuanyi , McLaughlin Patrick W. , Stacy Brian 
Published: November 2021

Purpose This study aims to examine the relationship between cash value benefit (CVB) redemption outcomes in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) across food processing types and socio-demographics. Design Cross-sectional and panel analyses. Setting Virginia. Subjects 98,067 Virginia WIC households. Measures CVB redemption rate. Results The predominant share of CVB redemption was for fresh produce (77.3%). Non-Hispanic whites and blacks redeemed a smaller share of fresh produce than Hispanic participants ( P < .001). Non-Hispanic black WIC households have a significantly lower CVB redemption rate than non-Hispanic white WIC households (β = −.008, P < .001). Households with a child participant tend to have a higher redemption rate (β = .01, P < .001). The redemption rates of fruits and of vegetables were positively correlated with household size. Conclusions Minority status and household size were significantly related to CVB redemptions among Virginia WIC participants.
Silver Nanoparticles Increase Nitrogen, Phosphorus, and Potassium Concentrations in Leaves and Stimulate Root Length and Number of Roots in Tomato Seedlings in a Hormetic Manner
Authors: Guzmán-Báez Gabriela Abigail , Trejo-Téllez Libia Iris , Ramírez-Olvera Sara Monzerrat , Salinas-Ruíz Josafhat , Bello-Bello Jericó J. , Alcántar-González Gabriel , Hidalgo-Contreras Juan Valente , Gómez-Merino Fernando C. 
Published: November 2021

Background Silver nanoparticles (AgNPs) display unique biological activities and may serve as novel biostimulators. Nonetheless, their biostimulant effects on germination, early growth, and major nutrient concentrations (N, P, and K) in tomato ( Solanum lycopersicum) have been little explored. Methods Tomato seeds of the Vengador and Rio Grande cultivars were germinated on filter paper inside plastic containers in the presence of 0, 5, 10, and 20 mg/L AgNPs. Germination parameters were recorded daily, while early growth traits of seedlings were determined 20 days after applying the treatments (dat). To determine nutrient concentrations in leaves, a hydroponic experiment was established, adding AgNPs to the nutrient solution. Thirty-day-old plants were established in the hydroponic system and kept there for 7 days, and subsequently, leaves were harvested and nutrient concentrations were determined. Results The AgNPs applied did not affect germination parameters, whereas their application stimulated length and number of roots in a hormetic manner. In 37-day-old plants, low AgNP applications increased the concentrations of N, P, and K in leaves. Conclusion As novel biostimulants, AgNPs promoted root development, especially when applied at 5 mg/L. Furthermore, they increased N, P, and K concentration in leaves, which is advantageous for seedling performance during the early developmental stages.
Effect of the fourth generation multi-theory model intervention on the quality of life in Iranian postmenopausal women: A randomized controlled trial
Authors: Yoshany Nooshin , Morowatisharifabad Mohammad Ali , Bahri Narjes , Jambarsang Sara , Sharma Manoj , Hanna Fahad 
Published: November 2021

Objectives Menopause is a natural part of women’s lives and is associated with a series of complications that can impair their quality of life. This study was conducted to determine the effect of specific educational interventions on the quality of life among postmenopausal women. Methods This randomized controlled trial was conducted on 80 menopausal women who met the inclusion and exclusion criteria and were selected through the multi-stage stratified random sampling method. The participants were randomly allocated to either the control or intervention group (40 per group). The intervention comprised 5 × 45-min educational sessions based on the Multi-Theory Model on the predetermined days of the week. The scores of the quality of life level were collected at baseline, immediately, and 3 months after the intervention using the Menopause-Specific Quality of Life questionnaire (MENQOL). The control group received a health advice. Results Analysis of variance of repeated measures showed a significant interaction between time and intervention. The comparison between the mean score of quality of life of the “before,” “immediately after intervention,” and “3 months after the intervention” showed a significant difference between the two groups. The intervention group quality of life improved significantly as the intervention went on compared to the control group. Conclusion Structured simple educational programs based on the Multi-Theory Model could be used as a simple and noninvasive intervention that help menopausal women improve their quality of life through menopausal symptoms relief. Further interventions with larger trials may be required to confirm these findings.
What Are the Main Risk Factors for Lower Extremity Running-Related Injuries? A Retrospective Survey Based on 3669 Respondents
Authors: Sanfilippo Damien , Beaudart Charlotte , Gaillard Allan , Bornheim Stephen , Bruyere Olivier , Kaux Jean-François 
Published: November 2021

Background: Despite the many studies on running-related injuries (RRIs), risk factors for injury remain unclear in the literature. Purpose: To investigate the risk factors of RRIs. Study Design: Case-control study; Level of evidence, 3. Methods: An online survey was conducted among 3669 injured and noninjured runners. Injury was defined as pain of various kinds, without attention to its consequences on running practice. The survey included 41 questions on 5 main categories—personal characteristics, daily lifestyle, training and running characteristics, practice of other sporting activities, and prevention habits—as well as information about the occurrence of RRI over the previous 12 months. Continuous and qualitative variables were analyzed by Student t test and chi-square test, respectively. Sixteen variables were selected for multivariate binary logistic analysis. Results: Among the 3669 runners, 1852 (50.5%) reported at least 1 injury over the previous 12 months. Overuse injuries were largely represented (60.6%). The variables associated with RRIs that remained significant in the fully adjusted model were previous injury (odds ratio [OR], 1.62; 95% CI, 1.42-1.86), higher weight (OR, 1.006; 95% CI, 1.00-1.012), competitive running (OR, 1.53; 95% CI, 1.19-1.98), running >2 h/wk (OR, 1.28; 95% CI, 1.01-1.62), running >20 km/wk (OR, 1.25; 95% CI, 1.001-1.55), and stretching before running (OR, 1.46; 95% CI, 1.25-1.71). Conclusion: Previous injury remains the most relevant risk factor for RRIs according to the current study and previous data. Many training characteristics seem to be involved but still have to be confirmed in view of conflicting data in the literature. Further research would help clinicians better understand RRIs and how to prevent them.
Associations between long-term conditions and upper gastrointestinal cancer incidence: A prospective population-based cohort of UK Biobank participants
Authors: Marley Jennifer , Nicholl Barbara I , Macdonald Sara , Mair Frances S , Jani Bhautesh D 
Published: November 2021

Background/Aims Upper gastrointestinal cancers (oesophageal/stomach) have high mortality rates and are often diagnosed after the disease has progressed, making it important to identify populations at greater risk of upper gastrointestinal (UGI) cancer to promote earlier diagnosis. This study aims to determine if there is an association between a broad range of long-term conditions (LTCs) and incidence of UGI cancers. Method A prospective-based cohort of 487,798 UK Biobank participants (age 37–73 years) after excluding previous UGI cancer. Least Absolute Shrinkage and Selection Operator (LASSO) regression used to identify candidate LTCs as predictors for UGI cancer. Strength of association was studied using Cox’s regression adjusting for demographics and lifestyle factors. Results After median follow-up period of 86 months, 598 participants developed oesophageal cancer; 397 developed stomach cancer. In fully adjusted models, participants with alcohol addiction (Hazard Ratio-HR 4.11, 95% Confidence Interval-CI 2.01–8.43), Barrett’s oesophagus (HR 5.68, 95% CI 3.36–9.58), bronchiectasis (HR 2.72, 95% CI 1.01–7.31), diabetes (HR 1.38, 95% CI 1.06–1.81), hiatus hernia (HR 1.69, 95% CI 1.16–2.45), Parkinson’s disease (HR 3.86, 95% CI 1.60–9.37) and psoriasis/eczema (HR 1.53, 95% 1.08–2.17) were observed to have a higher risk of oesophageal cancer. Stomach cancer incidence was higher among participants with anorexia/bulimia (HR 8.86, 95% CI 1.20–65.14), Barrett’s oesophagus (HR 3.37, 95% 1.39–8.14), chronic fatigue syndrome (HR 3.36, 95% CI 1.25–9.03), glaucoma (HR 2.06, 95% CI 1.16–3.67), multiple sclerosis (HR 4.60, 95% CI 1.71–12.34), oesophageal stricture (HR 1.04, 95% CI 1.46–74.46) and pernicious anaemia (HR 6.93, 95% CI 3.42–14.03). Conclusion Previously unrecognised LTCs may have a role in symptom appraisal and risk assessment of UGI cancer in primary care. Further research should explore mechanisms underpinning these findings and determine whether they are replicable in other populations.
Tiotropium treatment for bronchiectasis: a randomised, placebo-controlled, crossover trial
Authors: Jayaram Lata , Vandal Alain C. , Chang Catherina L. , Lewis Chris , Tong Cecilia , Tuffery Christine , Bell Jill , Fergusson Wendy , Jeon Gene , Milne David , Jones Stuart , Karalus Noel , Hotu Sandra , Wong Conroy 
Published: November 2021

BackgroundTiotropiumviathe HandiHaler device is an established long-acting, anticholinergic bronchodilator that prevents exacerbations and improves lung function in patients with chronic obstructive pulmonary disease. We hypothesised that tiotropium would reduce pulmonary exacerbations and improve lung function in patients with stable bronchiectasis and airflow limitation, and assessed the effect of tiotropium on these outcomes.MethodsIn a randomised, double-blind, two-period crossover trial, we recruited adult patients from three hospitals in New Zealand. Patients were excluded if they had a smoking history of >20 pack-years. Patients were assigned to either the tiotropium–placebo or placebo–tiotropium sequence in a 1:1 ratio, using randomly permuted blocks stratified by centre. Participants and investigators were masked to treatment allocation. Eligible patients received tiotropium 18 μgviaHandiHaler daily for 6 months followed by 6 months of placebo, orvice versa, with a washout period of 4 weeks. The primary end-point was rate of event-based exacerbations during the 6-month period. Primary analyses were carried out in an intention-to-treat set.Results90 patients were randomly assigned and 85 completed both treatment cycles. The rate of exacerbations was 2.17 per year under the tiotropium treatment and 2.27 per year under placebo (rate ratio 0.96, 95% CI 0.72–1.27; p=0.77). Tiotropium, compared with placebo, improved forced expiratory volume in 1 s by 58 mL (95% CI 23–92 mL; p=0.002). Adverse events were similar under both treatments.ConclusionsTiotropiumviaHandiHaler over 6 months significantly improved lung function but not frequency of exacerbations. Further research is required to understand the clinical context and significance of these findings.
The impact of long-term azithromycin on antibiotic resistance in HIV-associated chronic lung disease
Authors: Abotsi Regina E. , Nicol Mark P. , McHugh Grace , Simms Victoria , Rehman Andrea M. , Barthus Charmaine , Ngwira Lucky G. , Kwambana-Adams Brenda , Heyderman Robert S. , Odland Jon Ø. , Ferrand Rashida A. , Dube Felix S. 
Published: November 2021

Selection for resistance to azithromycin (AZM) and other antibiotics such as tetracyclines and lincosamides remains a concern with long-term AZM use for treatment of chronic lung diseases (CLD). We investigated the impact of 48 weeks of AZM on the carriage and antibiotic resistance of common respiratory bacteria among children with HIV-associated CLD.Nasopharyngeal (NP) swabs and sputa were collected at baseline, 48 and 72 weeks from participants with HIV-associated CLD randomised to receive weekly AZM or placebo for 48 weeks and followed post-intervention until 72 weeks. The primary outcomes were prevalence and antibiotic resistance ofStreptococcus pneumoniae(SP),Staphylococcus aureus(SA),Haemophilus influenzae(HI) andMoraxella catarrhalis(MC) at these timepoints. Mixed-effects logistic regression and Fisher's exact test were used to compare carriage and resistance, respectively.Of 347 (174 AZM, 173 placebo) participants (median age 15 years (IQR 13–18), female 49%), NP carriage was significantly lower in the AZM (n=159) compared to placebo (n=153) arm for SP (18%versus41%,p<0.001), HI (7%versus16%, p=0.01) and MC (4%versus11%, p=0.02); SP resistance to AZM (62% (18 out of 29)versus13% (8 out of 63),p<0.0001) or tetracycline (60% (18 out of 29)versus21% (13 out of 63),p<0.0001) was higher in the AZM arm. Carriage of SA resistant to AZM (91% (31 out of 34)versus3% (1 out of 31),p<0.0001), tetracycline (35% (12 out of 34)versus13% (4 out of 31), p=0.05) and clindamycin (79% (27 out of 34)versus3% (1 out of 31),p<0.0001) was also significantly higher in the AZM arm and persisted at 72 weeks. Similar findings were observed for sputa.The persistence of antibiotic resistance and its clinical relevance for future infectious episodes requiring treatment needs further investigation.
GLRX3, a novel cancer stem cell-related secretory biomarker of pancreatic ductal adenocarcinoma
Authors: Jo Jung Hyun , Kim Sun A , Lee Jeong Hoon , Park Yu Rang , Kim Chanyang , Park Soo Been , Jung Dawoon E. , Lee Hee Seung , Chung Moon Jae , Song Si Young 
Published: November 2021

Abstract
Background
Cancer stem cells (CSCs) are implicated in carcinogenesis, cancer progression, and recurrence. Several biomarkers have been described for pancreatic ductal adenocarcinoma (PDAC) CSCs; however, their function and mechanism remain unclear.

Method
In this study, secretome analysis was performed in pancreatic CSC-enriched spheres and control adherent cells for biomarker discovery. Glutaredoxin3 (GLRX3), a novel candidate upregulated in spheres, was evaluated for its function and clinical implication.

Results
PDAC CSC populations, cell lines, patient tissues, and blood samples demonstrated GLRX3 overexpression. In contrast, GLRX3 silencing decreased the in vitro proliferation, migration, clonogenicity, and sphere formation of cells. GLRX3 knockdown also reduced tumor formation and growth in vivo. GLRX3 was found to regulate Met/PI3K/AKT signaling and stemness-related molecules. ELISA results indicated GLRX3 overexpression in the serum of patients with PDAC compared to that in healthy controls. The sensitivity and specificity of GLRX3 for PDAC diagnosis were 80.0 and 100%, respectively. When GLRX3 and CA19–9 were combined, sensitivity was significantly increased to 98.3% compared to that with GLRX3 or CA19–9 alone. High GLRX3 expression was also associated with poor disease-free survival in patients receiving curative surgery.

Conclusion
Overall, these results indicate GLRX3 as a novel diagnostic marker and therapeutic target for PDAC targeting CSCs.