bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is Dietary Iodine Intake Excessive According to the Theoretical Model of Healthy Dietary Intake Pattern in Pregnant Women and Schoolchildren: Water, Salt, or Food?
Authors: Candido Aline Carare , Ribeiro Sarah Aparecida Vieira , Macedo Mariana de Souza , Fontes Edimar Aparecida Filomeno , Souza Eliana Carla Gomes De , Lopes Duarte Maria Sonia , Priore Silvia Eloiza , Peluzio Maria do Carmo Gouveia , Milagres Regina Célia Rodrigues de Miranda , Franceschini Sylvia do Carmo Castro 
Published: December 2021

Introduction: Iodine deficiency during pregnancy can cause hypothyroidism and goiter; in schoolchildren, it can cause reduced intelligence quotient. In excess, iodine can cause thyroiditis, goiter, and Hashimoto's hypothyroidism. Currently, schoolchildren and pregnant women are classified as risk groups for excessive iodine intake and iodine deficiency, respectively. Thus, determining iodine from all sources of consumption is important for intervention planning.Objective: To construct a theoretical model for the iodine intake of schoolchildren and pregnant women of a city in the Zona da Mata Mineira region, considering a healthy diet, salt consumption and water intake.Methodology: The dietary iodine intake of pregnant women was analyzed based on a dietary iodine table compiled from an international database. A dietary plan was prepared following the Brazilian Food Guide. Iodine concentration of different salt brands sold in local establishments was checked, and drinking water samples from healthcare facilities were analyzed. A descriptive and exploratory statistical analysis was performed and the results were presented in absolute and relative frequencies, and measures of central tendency and dispersion.Results: According to the proposed diet, pregnant women and schoolchildren would have a daily intake of 71.6 μg and 71 μg, respectively. Thirteen salt brands were evaluated, 69.2% complied with the legislation and the mean iodine content was 29.88 mg. The mean concentration of iodine in water was 25 μg iodine/liter and 14 μg iodine/liter, respectively, in summer and autumn. Considering the intake of food, salt, and drinking water according to the proposed dietary plan, the daily intake for pregnant women would be 279.5 and 253.5 μg for schoolchildren.Conclusion: The daily iodine intake of schoolchildren and pregnant women according to this theoretical model was excessive, considering a healthy dietary pattern. This theoretical model can guide actions and public policies aimed at targeting all forms of iodine intake.
CT-Based Radiomics Nomogram for Differentiation of Anterior Mediastinal Thymic Cyst From Thymic Epithelial Tumor
Authors: Zhang Chengzhou , Yang Qinglin , Lin Fan , Ma Heng , Zhang Haicheng , Zhang Ran , Wang Ping , Mao Ning 
Published: December 2021

ObjectivesThis study aimed to distinguish preoperatively anterior mediastinal thymic cysts from thymic epithelial tumors via a computed tomography (CT)-based radiomics nomogram.MethodsThis study analyzed 74 samples of thymic cysts and 116 samples of thymic epithelial tumors as confirmed by pathology examination that were collected from January 2014 to December 2020. Among the patients, 151 cases (scanned at CT 1) were selected as the training cohort, and 39 cases (scanned at CT 2 and 3) served as the validation cohort. Radiomics features were extracted from pre-contrast CT images. Key features were selected by SelectKBest and least absolute shrinkage and selection operator and then used to build a radiomics signature (Rad-score). The radiomics nomogram developed herein via multivariate logistic regression analysis incorporated clinical factors, conventional CT findings, and Rad-score. Its performance in distinguishing the samples of thymic cysts from those of thymic epithelial tumors was assessed via discrimination, calibration curve, and decision curve analysis (DCA).ResultsThe radiomics nomogram, which incorporated 16 radiomics features and 3 conventional CT findings, including lesion edge, lobulation, and CT value, performed better than Rad-score, conventional CT model, and the clinical judgment by radiologists in distinguishing thymic cysts from thymic epithelial tumors. The area under the receiver operating characteristic (ROC) curve of the nomogram was 0.980 [95% confidence interval (CI), 0.963–0.993] in the training cohort and 0.992 (95% CI, 0.969–1.000) in the validation cohort. The calibration curve and the results of DCA indicated that the nomogram has good consistency and valuable clinical utility.ConclusionThe CT-based radiomics nomogram presented herein may serve as an effective and convenient tool for differentiating thymic cysts from thymic epithelial tumors. Thus, it may aid in clinical decision-making.
Survival of Black and White Patients With Stage IV Small Cell Lung Cancer
Authors: Shi Huashan , Zhou Kexun , Cochuyt Jordan , Hodge David , Qin Hong , Manochakian Rami , Zhao Yujie , Ailawadhi Sikander , Adjei Alex A. , Lou Yanyan 
Published: December 2021

BackgroundSmall cell lung cancer (SCLC) is associated with aggressive biology and limited treatment options, making this disease a historical challenge. The influence of race and socioeconomic status on the survival of stage IV SCLC remains mostly unknown. Our study is designed to investigate the clinical survival outcomes in Black and White patients with stage IV SCLC and study the demographic, socioeconomic, clinical features, and treatment patterns of the disease and their impact on survival in Blacks and Whites.Methods and ResultsStage IV SCLC cases from the National Cancer Database (NCDB) diagnosed between 2004 and 2014 were obtained. The follow-up endpoint is defined as death or the date of the last contact. Patients were divided into two groups by white and black. Features including demographic, socioeconomic, clinical, treatments and survival outcomes in Blacks and Whites were collected. Mortality hazard ratios of Blacks and Whites stage IV SCLC patients were analyzed. Survival of stage IV SCLC Black and White patients was also analyzed. Adjusted hazard ratios were analyzed by Cox proportional hazards regression models. Patients’ median follow-up time was 8.18 (2.37-15.84) months. Overall survival at 6, 12, 18 and 24 months were 52.4%, 25.7%, 13.2% and 7.9% in Blacks in compared to 51.0%, 23.6%, 11.5% and 6.9% in Whites. White patients had significantly higher socioeconomic status than Black patients. By contrast, Blacks were found associated with younger age at diagnosis, a significantly higher chance of receiving radiation therapy and treatments at an academic/research program. Compared to Whites, Blacks had a 9% decreased risk of death.ConclusionOur study demonstrated that Blacks have significant socioeconomic disadvantages compared to Whites. However, despite these unfavorable factors, survival for Blacks was significantly improved compared to Whites after covariable adjustment. This may be due to Blacks with Stage IV SCLC having a higher chance of receiving radiation therapy and treatments at an academic/research program. Identifying and removing the barriers to obtaining treatments at academic/research programs or improving the management in non-academic centers could improve the overall survival of stage IV SCLC.
Characterization of Acute Poisoning in Hospitalized Children in Southwest China
Authors: Li Zhu , Xiao Li , Yang Lin , Li Shaojun , Tan Liping 
Published: December 2021

Objective: Acute poisoning in children is characterized by regional differences. This study described the basic situation of childhood poisoning in southwest China based on hospitalized cases.Data and Methods: A total of 1,076 acute poisoning cases among hospitalized children admitted to Children's Hospital of Chongqing Medical University from January 2012 to December 2020 were included in this study. Clinical data such as gender, age, living environment, poisonous substance, and cause of poisoning were statistically described. Trends of length of hospital stay, population distribution, poisonous substances, and causes of acute poisoning in the hospitalized children were compared over time.Results: The cohort comprised 588 males and 488 females; 811 cases lived in rural areas and the rest resided in urban areas. Most cases were between early childhood and school age. Poisoning usually occurred at home (973 cases, 90.4%). Pesticides (381 cases, 35.4%) and drugs (275 cases, 25.6%) were the two most common poisonous substances. Two main causes of poisoning were accidental taking (755 cases, 70.2%) and suicide (177 cases, 16.4%). The results of univariate analysis of suicide showed significant correlations among gender, place of residence, age, poisonous substance, and place of suicide (P &lt; 0.001), while living environment (town), age (adolescence), and poisonous substance (pesticide, drug) were independent risk factors (P &lt; 0.05). There was no significant change in the length of hospital stay for poisoning over time. The overall number of hospitalizations presented a decreasing trend, while the number of urban children gradually increased. The proportion of adolescent poisoned children and suicidal children increased in the last 3 years.Conclusion: Optimizing the package and distribution channels of pesticides and drugs, raising safety awareness of children to avoid accidental injuries, and paying attention to children's mental health are measures that are necessary to prevent poisoning in children.
Galloflavin Relieves the Malignant Behavior of Colorectal Cancer Cells in the Inflammatory Tumor Microenvironment
Authors: Guo Li , Yang Yi , Sheng Yongjia , Wang Jin , Li Wenyan , Zhou Xiaohong , Ruan Shuiliang , Han Chenyang 
Published: December 2021

Background: In this study, we mainly aimed to explore the correlation between galloflavin and NLRP3 and its effect on colorectal cancer.Methods: NLRP3 was overexpressed in SW480 cells; LPS + ATP was used to mimic the inflammatory microenvironment. Wound healing assay and Transwell assay were utilized to detect cell migration and invasion abilities; CCK-8 assay was performed to detect cell viability alterations; colony formation assay was conducted to detect colony formation ability; Western blot was used to detect the levels of NLRP3, ASC, C-Myc, and P21. SW480 cells were pretreated with high-dose and low-dose galloflavin, followed by observation of their effects on cell metastasis and invasion. NLRP3 was knocked out in SW480 to construct the SW480-NLRP3−/− cell line, followed by high-dose galloflavin treatment and subsequent observation of cell metastasis and invasion abilities. Small molecule–protein docking and pull-down assay were performed to confirm the targeting relationship between galloflavin and NLRP3. After constructing a tumor-bearing mice model, galloflavin was intragastrically administered, followed by detection of tumor growth, expression of NLRP3 and ASC by immunohistochemistry, and tumor histopathology by H&amp;E staining.Results: After NLRP3 overexpression and LPS/ATP induction in SW480, the cell migration and invasion abilities were significantly enhanced, and cell viability was also enhanced. The activation of NLRP3 could promote the malignant behavior of colorectal cancer cells in the inflammatory microenvironment. Galloflavin treatment could significantly attenuate the malignant behavior of SW480 in the inflammatory microenvironment and inhibit the migration and invasion capabilities of SW480. The knockout of NLRP3 inhibited the effect of galloflavin, which did not significantly change the migration and invasion abilities. Molecular docking and pull-down assay revealed a targeted binding relationship between galloflavin and NLRP3 and that galloflavin is bound to NLRP3 not ASC protein. Moreover, galloflavin could inhibit tumor growth and decrease the expression of NLRP in tumor-bearing mice.Conclusion: In this study, we found that NLRP3 could promote the migration and invasion of colorectal cancer cells in the inflammatory microenvironment. Galloflavin could inhibit the malignant behavior of colorectal cancer cells by targeting NLRP3.
Increased Use of Antibiotics in the Intensive Care Unit During Coronavirus Disease (COVID-19) Pandemic in a Brazilian Hospital
Authors: Silva Alice Ramos Oliveira , Salgado Diamantino Ribeiro , Lopes Luis Phillipe Nagem , Castanheira Débora , Emmerick Isabel Cristina Martins , Lima Elisangela Costa 
Published: December 2021

Background: Microbial drug resistance is one of the biggest public health problems. Antibiotic consumption is an essential factor for the emergence and spread of multiresistant bacteria. Therefore, we aimed to analyze the antibiotics consumption in the Intensive Care Unit (ICU), identifying trends in the antibiotics use profile and microbiological isolates throughout the COVID-19 pandemic.Methods: We performed this retrospective observational study in intensive care units of a Brazilian tertiary hospital from January 2019 to December 2020. The primary outcome was antimicrobial consumption in the ICU, measured by defined daily doses (DDDs) per 100 bed-days. As a secondary outcome, bacterial infections (microbiological isolates) were calculated in the same fashion. Outcomes trends were analyzed using Joinpoint regression models, considering constant variance (homoscedasticity) and first-order autocorrelation assumptions. A monthly percent change (MPC) was estimated for each analyzed segment.Results: Seven thousand and nine hundred fifty-three patients had data available on prescribed and received medications and were included in the analyses. Overall, the use of antibiotics increased over time in the ICU. The reserve group (World Health Organization Classification) had an increasing trend (MPC = 7.24) from February to April 2020. The azithromycin consumption (J01FA) increased rapidly, with a MPC of 5.21 from January to April 2020. Polymyxin B showed a relevant increase from March to June 2020 (MPC = 6.93). The peak of the antibiotic consumption of Reserve group did not overlap with the peak of the pathogenic agents they are intended to treat.Conclusion: Overall antimicrobial consumption in ICU has increased in the context of the COVID-19 pandemic. The peaks in the antimicrobial’s use were not associated with the rise of the pathogenic agents they intended to treat, indicating an empirical use, which is especially concerning in the context of treating multidrug-resistant (MDR) infections. This fact may contribute to the depletion of the therapeutic arsenal for MDR treatment.
Maresin 1 Attenuates Lipopolysaccharide-Induced Acute Kidney Injury via Inhibiting NOX4/ROS/NF-κB Pathway
Authors: Li Jiameng , Zhang Zhuyun , Wang Liya , Jiang Luojia , Qin Zheng , Zhao Yuliang , Su Baihai 
Published: December 2021

Sepsis-associated acute kidney injury (S-AKI) is a common complication in hospitalized and critically ill patients, which increases the risk of multiple comorbidities and is associated with extremely high mortality. Maresin 1 (MaR1), a lipid mediator derived from the omega-3 fatty acid docosahexaenoic acid has been reported to protect against inflammation and promote the regression of acute inflammation. This study proposed to systematically investigate the renoprotective effects and potential molecular mechanism of MaR1 in septic acute kidney injury. We established a S-AKI animal model by a single intraperitoneal injection of lipopolysaccharide (LPS), 10 mg/kg, on male C57BL/6J mice. LPS-stimulated (100 μg/ml) mouse kidney tubular epithelium cells (TCMK-1) were used to simulate septic AKI in vitro. The results showed that pretreatment with MaR1 significantly reduced serum creatinine and blood urea nitrogen levels as well as tubular damage scores and injury marker neutrophil gelatinase-associated lipocalin in septic AKI mice. Meanwhile, MaR1 administration obviously diminished pro-inflammatory cytokines (TNF-α, IL-6, IL-1β, and MCP-1), downregulated BAX and cleaved caspase-3 expression, and upregulated BCL-2 expression in the injured kidney tissues and TCMK-1 cells. In addition, MaR1 reduced malondialdehyde production and improved the superoxide dismutase activity of renal tissues while inhibiting reactive oxygen species (ROS) production and protecting the mitochondria. Mechanistically, LPS stimulated the expression of the NOX4/ROS/NF-κB p65 signaling pathway in S-AKI kidneys, while MaR1 effectively suppressed the activation of the corresponding pathway. In conclusion, MaR1 attenuated kidney inflammation, apoptosis, oxidative stress, and mitochondrial dysfunction to protect against LPS-induced septic AKI via inhibiting the NOX4/ROS/NF-κB p65 signaling pathway.
Mind-Body Therapies From Traditional Chinese Medicine: Evidence Map
Authors: Fogaça Lissandra Zanovelo , Portella Caio Fabio Schlechta , Ghelman Ricardo , Abdala Carmen Verônica Mendes , Schveitzer Mariana Cabral 
Published: December 2021

Background: The mind-body therapies of traditional Chinese medicine include several intervention types and combine physical poses with conscious relaxation and breathing techniques. The purpose of this Evidence Map is to describe these different interventions and report related health outcomes.Methods: This evidence map is based on the 3iE Evidence Gap Map methodology. We searched seven electronic databases (BVS, PUBMED, EMBASE, PEDro, ScienceDirect, Web of Sciences, and PschyInfo) from inception to November 2019 and included systematic reviews only. Systematic reviews were analyzed based on AMSTAR 2. We used Tableau to graphically display quality assessment, the number of reviews, outcomes, and effects.Results: The map is based on 116 systematic reviews and 44 meta-analyses. Most of the reviews were published in the last 5 years. The most researched interventions were Tai Chi and Qi Gong. The reviews presented the following quality assessment: 80 high, 43 moderate, 23 low, and 14 critically low. Every 680 distinct outcome effect was classified: 421 as potential positive; 237 as positive; 21 as inconclusive/mixed; one potential negative and none no effect. Positive effects were related to chronic diseases; mental indicators and disorders; vitality, well-being, and quality of life. Potential positive effects were related to balance, mobility, Parkinson's disease, hypertension, joint pain, cognitive performance, and sleep quality. Inconclusive/mixed-effects justify further research, especially in the following areas: Acupressure as Shiatsu and Tuiná for nausea and vomiting; Tai Chi and Qi Gong for acute diseases, prevention of stroke, stroke risk factors, and schizophrenia.Conclusions: The mind-body therapies from traditional Chinese medicine have been applied in different areas and this Evidence Map provides a visualization of valuable information for patients, professionals, and policymakers, to promote evidence-based complementary therapies.
Economic Evaluation of First-Line Camrelizumab for Advanced Non-small-cell Lung Cancer in China
Authors: Xiang Guiyuan , Gu Lingna , Chen Xuan , Wang Fan , Chen Bohua , Zhao Jie , Lu Yun , Chang Feng , Zhu Yumei 
Published: December 2021

Background: As the first domestic PD-1 antibody approved for lung cancer in China, camrelizumab has exhibited proven effectiveness for non-small-cell lung cancer (NSCLC) patients. However, the cost-effectiveness of this new regimen remains to be investigated.Objective: To evaluate the cost-effectiveness of camrelizumab combination therapy vs. chemotherapy for previously untreated patients with advanced, non-squamous NSCLC without Alk or Egfr genomic aberrations from the perspective of China's healthcare system.Methods: Based on the CameL trial, the study developed a three-health state Markov model to evaluate the cost-effectiveness of adding camrelizumab to chemotherapy compared to chemotherapy alone in NSCLC patients. The analysis models were conducted for patients unselected by PD-L1 tumor expression (the base case) and the patient subgroup with PD-L1-expressing tumors (≥1%). Primary model outcomes included the costs in US dollars and health outcomes in quality-adjusted life-years (QALYs) as well as the incremental cost-effectiveness ratio (ICER) under a willingness-to-pay threshold of $31,500 per QALY. Additionally, a scenario analysis that adjusted within-trial crossover was employed to evaluate camrelizumab combination therapy compared to chemotherapy without subsequent use of PD1/PD-L1 antibodies.Results: Camrelizumab combination therapy was more costly and provided additional 0.11 QALYs over chemotherapy in the base case analysis (0.86 vs. 0.75 QALYs), 0.12 QALYs over chemotherapy in the subgroup analysis (0.99 vs. 0.88 QALYs), and 0.34 QALYs over chemotherapy in the scenario analysis (0.86 vs. 0.52 QALYs). Correspondingly, the ICER was $63,080 per QALY, $46,311 per QALY, and $30,591 per QALY, in the base case, the subgroup, and the scenario analysis, respectively. One-way sensitivity analyses revealed that ICERs of the base case and the subgroup analysis were most sensitive to the cost of camrelizumab, the cost of pemetrexed. Besides, the base case and subgroup analysis were more sensitive to the risk of neutrophil count decreased in the camrelizumab and the utility of stable disease, respectively.Conclusion: Although camrelizumab combination therapy is not cost-effective as first-line therapy for NSCLC patients in China in the base case, adjusting within-trial crossover would move the treatment regimen toward cost-effectiveness in the scenario analysis.
Prefrontal Cortex and Supplementary Motor Area Activation During Robot-Assisted Weight-Supported Over-Ground Walking in Young Neurological Patients: A Pilot fNIRS Study
Authors: van Hedel Hubertus J. A. , Bulloni Agata , Gut Anja 
Published: December 2021

Introduction:Rehabilitation therapy devices are designed for practicing intensively task-specific exercises inducing long-term neuroplastic changes underlying improved functional outcome. The Andago enables over-ground walking with bodyweight support requiring relatively high cognitive demands. In this study, we investigated whether we could identify children and adolescents with neurological gait impairments who show increased hemodynamic responses of the supplementary motor area (SMA) or prefrontal cortex (PFC) measured with functional near-infrared spectroscopy (fNIRS) when walking in Andago compared to walking on a treadmill. We further assessed the practicability and acceptability of fNIRS.Methods:Thirteen participants (two girls, 11 boys, age 8.0–15.7 years) with neurological impairments walked in the Andago and on a treadmill under comparable conditions. We measured hemodynamic responses over SMA and PFC during 10 walks (each lasting 20 s.) per condition and analyzed the data according to the latest recommendations. In addition, we listed technical issues, stopped the time needed to don fNIRS, and used a questionnaire to assess acceptability.Results:Hemodynamic responses varied largely between participants. Participants with a typical hemodynamic response (i.e., increased oxygenated hemoglobin concentration) showed large cortical activations during walking in Andago compared to treadmill walking (large effect sizes, i.e., for SMA:r= 0.91,n= 4; for PFC:r= 0.62,n= 3). Other participants showed atypical (SMA:n= 2; PFC:n= 4) or inconclusive hemodynamic responses (SMA:n= 5; PFC:n= 4). The median time for donning fNIRS was 28 min. The questionnaire indicated high acceptance of fNIRS, despite that single participants reported painful sensations.Discussion:Repetitive increased activation of cortical areas like the SMA and PFC might result in long-term neuroplastic changes underlying improved functional outcome. This cross-sectional pilot study provides first numbers on hemodynamic responses in SMA and PFC during walking in Andago in children with neurological impairments, reveals that only a small proportion of the participants shows typical hemodynamic responses, and reports that fNIRS requires considerable time for donning. This information is needed when designing future longitudinal studies to investigate whether increased brain activation of SMA and PFC during walking in Andago could serve as a biomarker to identify potential therapy responders among children and adolescents undergoing neurorehabilitation.