bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictive value of qSOFA score for death in emergency department resuscitation room among adult trauma patients：a retrospective study
Authors: Huang Wenjuan , Yang Peng , Xu Feng , Chen Du 
Published: January 2021

Abstract
Background To explore the predictive value of quick Sequential Organ Failure Assessment (qSOFA) score for death in emergency department (ED) resuscitation room among adult trauma patients.Methods During the period November 1, 2016 to November 30, 2019, we retrospectively collected data of adult trauma patients triaged to ED resuscitation room of the First Affiliated Hospital of Soochow University. Take death occurred in ED resuscitation room as the study endpoint. Univariate and multivariate analyses were performed to explore the association between qSOFA score and death. Receiver operating characteristic (ROC) curve analysis was also performed for death.Results A total of 1739 trauma victims were admitted, including 1695 survivors and 44 non-survivors. The death proportion raised with qSOFA score: 0.60% for qSOFA=0, 3.28% for qSOFA༝1, 12.06% for qSOFA༝2, and 15.38% for qSOFA༝3, p < 0.001. Subgroup of qSOFA = 0 was used as a reference. In univariate analysis, crude OR for death with qSOFA = 1 was 5.65 [95% CI 2.25 to 14.24, p < 0.001], qSOFA = 2 was 22.85 [95% CI 8.84 to 59.04, p < 0.001], and qSOFA = 3 was 30.30 [95% CI 5.50 to 167.05, p < 0.001]. In multivariate analysis, with an adjusted OR (aOR) of 2.87 (95% CI 0.84 to 9.87, p༝0.094) for qSOFA༝1, aOR 6.80 (95% CI 1.79 to 25.90, p = 0.005) for qSOFA༝2, and aOR 24.42 (95% CI 3.67 to 162.27, p = 0.001) for qSOFA༝3. The Area Under the Curve (AUC) for predicting death in ED resuscitation room among trauma patients was 0.78 [95% CI, 0.72–0.85].Conclusions qSOFA score can assess the severity of emergency trauma patients and has good predictive value for death in ED resuscitation room.
Association between Deep White Matter Hyperintensities and Right-to-left Shunt in Migraine (CAMBRAIN): A Cross-sectional Multicenter Study
Authors: Xing Yingqi , Zhang YiShui , Zhao HongLing , Wang SiBo , Cui YingHua , Fang YaLang , Guo Rong , Li YaJie , Wan Qi , Zhang Kaili , Cui Yan , Wei HuiXing , Lin Pan , You Yong , Huang Hong , Su Yan 
Published: January 2021

Abstract
BackgroundDeep white matter hyperintensities (DWMHs), often identified by hyperintense lesions on T2-weighted magnetic resonance imaging (MRI), were discovered to have a higher prevalence in migraine patients. A right-to-left shunt (RLS), which is also prevalent in migraineurs, could potentially contribute to the formation of DWMHs by induction of controversial embolism and endothelial dysfunction. In this cross-sectional study, we aim to evaluate the association between RLS and the prevalence of DWMHs in patients with migraine.MethodsIn this study, we consecutively enrolled patients with migraine aged between 18 and 50 years from the 14 headache clinics of participating hospitals. DWMHs were rated using Scheltens scale on digital MRI images obtained from 1.5T scanners, and RLS was detected via contrast-enhanced transcranial Doppler. Analyses on DWMH prevalence and loads by RLS grading or subtype were performed. A logistic regression analysis on DWMH prevalence was also performed.ResultsIn all, 237 migraine patients (age: 39.3 ± 11.7, 78.1% women, 13% migraine with aura) were enrolled. RLS was detected in 48.5% of the subjects and DWMHs were identified in 138 (58.2%) patients. Prevalence of DWMHs did not differ significantly between RLS+ (57.4%) and RLS− patients (59.0%, p = 0.74). No statistical difference in DWMH loads was found between different RLS grades or subtypes. Instead of RLS grades (p = 0.75), age (OR 1.067; 95%CI 1.034–1.101; p < 0.001) and aura (OR 4.063; 95%CI 1.492–11.061; p = 0.006) were statistically significant independent risk factors for increased DWMH prevalence in migraine patients.ConclusionsOur findings do not support an association between RLS and DWMHs in migraine patients, regardless of RLS grades or subtypes.Clinical Trial Registration: NCT 03418766; Date of registration: February 1, 2018
The Pathological Features of Leukaemic Cells Infiltrating Renal Interstitium in Chronic Lymphocytic Leukaemia/small Lymphocytic Lymphoma Within 10 Years in a Large Single Chinese Centre
Authors: Wang Hui , Yu Xiaojuan , Zhang Xu , Wang Suxia , Zhao Minghui 
Published: January 2021

Abstract
Background Chronic lymphocytic leukemia/Small Lymphocytic Lymphoma (CLL/SLL) was rare in Asians and patients with CLL/SLL rarely undergo kidney biopsy. Little information is available on the histopathological features and clinical relevance of CLL/SLL tubulointerstitial injury. Hence, we attempted to describe the clinical characteristics, renal pathology and clinical outcome of a well characterized population of CLL/SLL patients with CLL infiltration in renal interstitium from a large single center in China.Methods Between January 1st, 2010 to September 31st, 2020, 31946 reanl biopsy pathology were performed at Peking University First Hospital and 10 patients with CLL infiltration in renal interstitium were included. Complete clinical data were collected from these 10 patients and the renal specimens were examined by routine light microscopy, immunonuorescence and electron microscopy examination.Results The extent of infiltrating CLL cells was diverse between different patients, from 10% to 90%. Five patients presented interstitial infiltration with the percent of infiltrate CLL cells≥50%. Proliferation centers were formed in the renal interstitium of 6 patients (6/10, 60%). Intrestingly, we found three patients (3/10, 30%) expressed monoclonal immunoglobulin in infiltrating CLL cells and special crystal structures were found in these cells in two of the three patients for the first time. Conclusions The finding confirmed CLL cells infiltrating in renal interstitium can secret monoclonal immunoglobulins directly, indicating that CLL cells in renal interstitium probably directly involved in local lesion injurys by secrecting monoclonal immunoglobulin. This finding will help understanding the mechanism of renal injury with CLL infiltration, thereby improving our current therapeutic efforts.
Co-Modification With Mesenchymal Stem Cells Membrane and PDA Prevents Fe3O4-Induced Pulmonary Toxicity in Micevia AMPK-ULK1 Axis
Authors: Yao Hua , Yan Jun , Shao Pu , Wang Yuzhuo , Liu Tianxin , Jiang Jinlan , Liu Te 
Published: January 2021

Abstract
Background: Fe3O4 nanoparticles are widely used in the diagnosis and treatment of diseases, but the toxicity should not be ignored. It has been reported that PDA modification can reduce the toxicity of Fe3O4 and increase the biocompatibility. However, a better modification method is still worth studying. We have developed a new method to coat Fe3O4@PDA nanoparticles with mesenchymal stem cells membrane (MSCM) and evaluated the lung toxicity of the modified particles to mice.Result: We found that MSCM modification significantly reduced the lung injury induced by Fe3O4 nanoparticles in mice. Compared with Fe3O4@PDA nanoparticles, co-modification with MSCM and PDA modification significantly reduced autophagy and apoptosis of mouse lung tissue, and reduced the activation of autophagy pathway AMPK-ULK1 axis. Thus, co-modification with MSCM and PDA prevents Fe3O4-induced pulmonary toxicity in mice by inhibiting the AMPK-ULK1 derived autophagy.Conclusion: MSCM coated Fe3O4@PDA nanoparticles were demonstrated to prevent lung damage from autophagy and reduce the toxicity of iron oxide nanomaterials. The co-modification of PDA and MSCM can improve the biocompatibility and facilitate their further bioapplication.
Preliminary Efficacy of Tocilizumab Treatment in The Patients With COVID-19.
Authors: Chen Yu , Zhang Xijing 
Published: January 2021

Abstract
Background: Interleukin-6 (IL-6) was considered to be with the severity and mortality in COVID-19 patients, which implies a potential therapeutic target for treatment. We aimed to evaluate the safety and initial efficacy of Tocilizumab treatment for COVID-19 patients.Methods: In the retrospective study, sixty-one patients with COVID-19 with the mean age of 69 were enrolled from Feb 27 to Mar 14, 2020 in Wuhan Huoshenshan Hospital. Twenty-nine of them received one dose (400 mg) of add-on Tocilizumab treatment as the treated group and remaining 32 cases served as control group. The clinical manifestations and laboratory examinations were compared between the two groups.Results: The average duration of symptoms to admission was 28.2 days. Compared with the cases in control group, the treated cases exhibited a significant increase of serum IL-6 on the seventh day since Tocilizumab injection, however, there were no differences in whole blood white cell count, circulating lymphocyte count, serum C-reactive protein, and respiratory parameters or other clinical manifestations between the treated and control groups. There were no adverse events associated with Tocilizumab treatment in the treated COVID-19 patients.Conclusions: In the elder moderate and severe patients with COVID-19, one dose of Tocilizumab treatment was safe but no clinical benefit was observed on the seventh day in this study.Trial registration: Chinese Clinical Trail Registry, ChiCTR2000033705. Registered June 10, 2020 - Retrospectively registered, http://www.chictr.org.cn/showprojen.aspx?proj=54989.
A Region Within the Third Extracellular Loop of Rat AQP6 Precludes Its Trafficking to Plasma Membrane in a Heterologous Cell Line.
Authors: Soler David , Kowatz Thomas , Sloan Andrew , McCormick Thomas , Cooper Kevin , Stepanyan Ruben , Engel Andreas , Vahedi-Faridi Ardi 
Published: January 2021

Abstract
The inability to over-express AQP6 in the plasma membrane of heterologous cells has hampered efforts to further characterize the function of this aquaglyceroporin membrane protein at atomic detail. Using the AGR reporter system we have identified a region within loop C of AQP6 that is responsible for severely hampering its plasma membrane localization. Serine substitution corroborated that amino acids present within AQP6194-213 of AQP6 loop C contribute to intracellular retention. This intracellular retention signal may preclude proper plasma membrane trafficking and severely curtail expression of AQP6 in heterologous cells.
Deep Learning Method for Prediction of Patient-Specific Dose Distribution in Breast Cancer
Authors: Ahn Sang Hee , Kim EunSook , Kim Chankyu , Cheon Wonjoong , Kim Myeongsoo , Lee Se Byeong , Lim Young Kyung , Kim Haksoo , Shin Dongho , Kim Dae Yong , Jeong Jong Hwi 
Published: January 2021

Abstract
BackgroundPatient-specific dose prediction improves the efficiency and quality of radiation treatment planning and reduces the time required to find the optimal plan. In this study, a patient-specific dose prediction model was developed for a left-sided breast clinical case using deep learning and its performance was compared with that of conventional knowledge-based planning using RapidPlan™.MethodsPatient-specific dose prediction was performed using a contour image of the planning target volume (PTV) and organs at risk (OARs) with a U-net-based modified dose prediction neural network. A database of 50 volumetric modulated arc therapy (VMAT) plans for left-sided breast cancer patients was utilized to produce training and validation datasets. The dose prediction deep neural network (DpNet) feature weights of the previously learned convolution layers were applied to the test on a cohort of 10 test sets. With the same patient data set, dose prediction was performed for the 10 test sets after training in RapidPlan. The 3D dose distribution, absolute dose difference error, dose-volume histogram, 2D gamma index, and iso-dose dice similarity coefficient were used for quantitative evaluation of the dose prediction.ResultsThe mean absolute error (MAE) and one standard deviation (SD) between the clinical and deep learning dose prediction models were 0.02 ± 0.04%, 0.01 ± 0.83%, 0.16 ±0.82%, 0.52 ± 0.97% -0.88 ± 1.83%, -1.16 ± 2.58%, and -0.97 ± 1.73% for D95%, Dmean in the PTV, and the OARs of the body, left breast, heart, left lung, and right lung, respectively, and those measured between the clinical and RapidPlan dose prediction models were 0.02 ± 0.04%, 0.87 ± 0.63%, -0.29 ± 0.98%, 1.30 ± 0.86%, -0.32 ± 1.10%, 0.12 ± 2.13, and -1.74 ±1.79%, respectively.ConclusionsIn this study, a deep learning method for dose prediction was developed and was demonstrated to predict patient-specific doses for left-sided breast cancer accurately. Using the deep learning framework, the efficiency and accuracy of the dose prediction were compared to those of RapidPlan. The doses predicted by deep learning were superior to the results of the RapidPlan-generated VMAT plan. The proposed model will be able to maintain treatment plan quality and increase efficiency through patient dose prediction.
Assessment of Toxicity After&nbsp;68Ga-PSMA-PET-Imaging Based Treatment Planning and Dose-Escalation in Radiation Therapy in Prostate Cancer Patients
Authors: Schiller Kilian , Dewes Sabrina , Pfetsch Lisa , Vogel Marco MME , Devecka Michal , Sage Eva , Eiber Matthias , Gschwend Jürgen E , Combs Stephanie E 
Published: January 2021

Abstract
PURPOSE: Effective tumor control in prostate cancer demands elevated radiation doses given its low alpha/beta ratio. We investigated in primary and recurrent prostate cancer whether dose-escalated-radiation therapy (DE-RT) based on 68Ga-PSMA-PET positive lesions yields increased toxicity. METHODS: We evaluated 90 patients (salvage DE-RT: 67 patients, DE-re-RT: 11 patients, definite DE-RT: 12 patients) who were treated based on a pre-treatment hybrid 68Ga-PSMA. Findings from pre-treatment hybrid 68Ga-PSMA-PET could result in an adaption of radiation planning. Common Toxicity Criteria of Adverse Effects (Version 4.03) were used to assess toxicity, this was done before the initiation and at the end of DE-RT, as well as at the first and last follow-up (F/U) examination. We evaluated the change in toxicity for each interval for the collective as well as in a per-patient analysis.RESULTS: Findings in 68Ga-PSMA-PET-imaging resulted in a change of TNM-stage in 61.1% and an adapted treatment concept in 71.1% of patients. When comparing overall toxicity before DE-RT and at the last follow-up, 5.9% treatment-related side effects (grade 1-3) occurred with 1.7% of them being severe (grade 3). In a patient-centered approach we examined the intra-individual changes in toxicity before and after DE-RT. At the last F/U, the majority out of 80 patients (range: 61.3-93.8%) stated unchanged toxicity rates compared to the toxicity examined at the initiation of RT.CONCLUSION: The rate of treatment-related toxicity (grade 1-2) due to DE-RT in our cohort is 4.2%. For grade 3 toxicity it is 1.7%, respectively. The overall level of toxicity is highest during and shortly after completion of DE-RT (+7.4%) and improves over time until the last reported F/U (+5.9%). Compared to historical data, the toxicity profile of DE-RT is not increased. Therefore it is possible to apply DE-RT with the aim to increase tumor control by precisely treating all involved areas according to PSMA-PET-imaging.
The Impact of the Fidelity of Simulation on Medical Undergraduate Education: A Meta-Analysis
Authors: Hua Yan , Cen Xiao-yan , Niu Sha , Yu Tao 
Published: January 2021

Abstract
Background: With the development of science and technology, simulation-based education has also developed rapidly. However, whether the fidelity level of simulators has a positive correlation with medical students' learning outcomes is controversial. This study aims to compare the theoretical knowledge, skill performance and confidence of undergraduate medical students through meta-analysis according to the fidelity level of the simulator.Methods: Two researchers independently searched the PubMed database, the Cochrane Library, and the Embase database through October 20, 2020, to retrieve articles on the differences in effectiveness between high-fidelity simulators and low-fidelity simulators in undergraduate medical education. The Cochrane risk of bias tool was used to evaluate all included literature. Quantitative meta-analysis of the included literature was performed with Review Manager 5.3.Results: Fifteen studies met the inclusion criteria, 11 of which were meta-analysed. Meta-analysis showed whether there were differences in students’ theoretical knowledge [standardized mean difference -0.51; 95% CI -1.30～0.29，P=0.21], skill performance [standardized mean difference -0.26; 95% CI -0.87～0.35, P = 0.40], and confidence [standardized mean difference 2.53; 95% CI -1.05～6.10, P = 0.17]: there were no significant differences between high-fidelity simulators and low-fidelity simulators.Conclusions: In medical undergraduate education, students who experience low-fidelity simulator training are not inferior to students who learn from high-fidelity simulators in their theoretical knowledge, skill performance, or confidence.
Using Markov Chain Model to Evaluate Medical Students’ Trajectory on Progress Tests and Predict USMLE Step 1 Scores
Authors: Wang Ling , Laird-Fick Heather S. , Parker Carol J. , Solomon David 
Published: January 2021

Abstract
Medical students must meet curricular expectations and pass national licensing examinations to become physicians. The Michigan State University College of Human Medicine implemented progress testing in place of discipline-specific examinations as its primary assessment of knowledge in 2016. Ideally this innovative assessment strategy will characterize students’ growth in basic science knowledge over time and predict licensing examination performance.Markov chain method was employed to: 1) identify latent states of acquiring scientific knowledge based on progress tests, 2) estimate students’ transition probabilities between states, and 3) predict United States Medical Licensing Examination Step 1 results based on the students’ predicted probabilities in each state. A total of 358 students were included in the analysis. Four latent states were identified based on students’ progress test results: Novice, Advanced Beginner I, Advanced Beginner II and Competent States. At the end of the first year, students predicted to remain in the Novice state had lower mean Step 1 scores compared to those in the Competent state (209, SD = 14.8 versus 255, SD = 10.8 respectively) and had more first attempt failures (11.5% versus 0%). On regression analysis, it is found that at the end of the first year, if there was 10% higher chance staying in Novice State, Step 1 scores will be predicted 2.0 points lower (P< .01); while 10% higher chance in Competent State, Step 1scores will be predicted 4.3 points higher (P< .01). Similar findings were also found at the end of second year medical school.Using the Markov chain model to analyze longitudinal progress test performance offers a flexible and effective estimation method to identify students’ transitions across latent stages for acquiring scientific knowledge. The results can help identify students who are at-risk for licensing examination failure and may benefit from targeted academic support.
Systemic Sclerosis Patients With Negative Antinuclear Antibodies Have Distinctive Clinical Manifestations: a Multicenter CRDC&nbsp;Cohort in China
Authors: Hui Min , Zhou Jiaxin , Zhang Liyun , Duan Xinwang , Li Mengtao , Wang Qian , Zhao Jiuliang , Hou Yong , Xu Dong , Zeng Xiaofeng 
Published: January 2021

Abstract
Objective: The presence of circulating antinuclear antibodies (ANAs) is a hallmark of immune dysregulation in patients with systemic sclerosis (SSc). A variety of ANAs are associated with unique sets of disease manifestations and are widely used in clinical practice for diagnosis, clinical subgrouping, and prediction of future organ involvement and prognosis in SSc. This study aimed to investigate the clinical features of SSc patients negative for ANAs in a Chinese Rheumatism Data Center (CRDC) multicenter cohort in China.Methods: Based on the CRDC database, patients were prospectively recruited between April 2008 and June 2019 from 154 clinical centers nationwide, and all cases fulfilled the 2013 ACR/EULAR classification criteria for systemic sclerosis. Results for antinuclear antibodies were intensively collected. Demographic, clinical, and laboratory data were compared between ANA-positive SSc patients and those negative for ANAs.Results: Antinuclear antibodies were detected in 2129 of 2809 patients enrolled in the study; 4.2% patients were negative. There was a significant difference between patients negative and positive for ANAs based on sex (29/60 vs 294/1746, p＜0.001). The presence of Raynaud’s phenomenon was less common (71.8% vs 91.8%, p＜0.001) in the ANA-negative patients. In addition, the incidence of certain critical organ involvement, including gastroesophageal reflux (5.6% vs 18.5%, p=0.002), interstitial lung disease (65.2% vs 77.9%, p=0.015) and pulmonary arterial hypertension (11.5% vs 29.0%, p=0.006), was significantly lower in ANA-negative patients than in ANA-positive patients. The proportion of abnormal ESR (32.4% vs 47.6%, p=0.013) and IgG elevation (14.3% vs 37.0%, p=0.003), an indicator of disease activity, was significantly lower in ANA-negative patients than in ANA-positive patients.Conclusion: Antinuclear antibodies are strongly associated with the clinical manifestations of systemic sclerosis, with ANA-negative SSc patients tending to exhibit relatively milder disease.
Molecular detection of Epstein-Barr virus in paraffin-embedded tissue samples of patients suffering gastric cancer in Ahvaz, Iran: a case-control study
Authors: Gharibzadeh Mehdi , Azaran Azarakhsh , Jalilian Shahram , Seyedian Seyed Saeid , Makvandi Manoochehr 
Published: January 2021

Abstract
Background

Gastric cancer (GC) is the third most common cause of cancer-related mortality. Epstein-Barr virus (EBV) is associated with gastric cancer. The present research was performed to investigate the prevalence of EBV-associated gastric cancer (EBVaGC) among Iranian patients.
Materials and Methods

Seventy formalin-fixed paraffin-embedded (FFPE) cases of gastric cancer and 30 FFPE cases of gastric ulcer were studied from 2011–2018 in the case-control study. The specimens were investigated for the presence of the EBV genome by Nested-PCR for EBNA1. The positive samples for the EBNA1 region were again tested for the EBER gene by the PCR method. Positive samples were sequenced and aligned to construct the EBV phylogenetic tree.
Results

Five out of 70 cases (7%) indicated positive results for EBV by EBNA1, while all EBNA1 positive samples were negative for EBER. Additionally, EBV was detected in none of the gastric ulcer patients. The mean age for patients with EBV-positive gastric carcinomas was 64.5 years. Three (60%) male patients and 2 (40%) female cases were positive for EBV. Three out of 24 (60%) diffuse-type cases were EBV associated, and 2 out of 46(40%) intestinal-type were EBV positive. most cases of EBVaGC were seen in grade Ⅰ.
Conclusion

The present study shows that the frequency of EBVaGC in Iran is low. Differences in EBVaGC incidence in different countries may represent epidemiologic factors and dietary habits. Further analysis of clinical pathology characteristics of EBVaGC using a greater number of cases will offer useful insights into its etiology.