bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dysphagia’s Effects on Quality of Life, Functional Disabilities, and Psychological Distress in Head and Neck Cancer Patients: Outcomes of Cancer Rehabilitation from an Observational Single-Centre Study
Authors: Matko Špela , Knauseder Christina , Riedl David , Grote Vincent , Fischer Michael J. , Vorbach Samuel Moritz , Pfaller-Frank Karin , Frank Wilhelm , Licht Thomas 
Published: December 2024

Abstract

Purpose
Many patients with head and neck cancer (HNC) suffer from speech or swallowing disorders. We investigated the effects of dysphagia on health-related quality of life (HRQoL), functioning, and distress in HNC survivors, and the extent to which rehabilitation can alleviate these effects.
Methods
Cancer survivors undergoing inpatient cancer rehabilitation at an Austrian rehabilitation centre were asked to complete electronic patient-reported outcomes before admission (T0) and at discharge (T1). The EORTC QLQ-C30 questionnaire was assessing HRQoL, symptoms, and functioning, and the Hospital Anxiety and Depression Scale (HADS) to assess psychological distress.
Results
Of 63 HNC patients, 22 had dysphagia, 23 did not need speech therapy (control group C1), and 18 without dysphagia needed speech therapy (control group C2). Before rehabilitation, HRQoL, physical, social, and emotional functioning were significantly lower in dysphagia patients than in controls. Dysphagia patients suffered from more severe general symptoms, including fatigue, pain, sleep disturbances, nausea/vomiting, diarrhoea, and financial worries. In addition, emotional and social functioning of C2 patients who needed speech therapy but did not show dysphagia was significantly worse than of C1 patients. Social, emotional, and role functioning, fatigue, nausea/vomiting, insomnia, and appetite loss significantly improved by T1 in all HNC patients. Improvements in HRQoL were most noticeable in dysphagia patients. Psychooncological counselling reduced depression in dysphagia and in C2 patients to levels seen in the general population.
Conclusion
Dysphagia patients suffer severely from impaired functioning and systemic symptoms, but benefit substantially from cancer rehabilitation.
Development and validation of a multifactorial risk prediction model for frailty in patients with malignant digestive system tumors
Authors: pan Wenting , Wang Jun , Yang Ya , Zhu Li , Wang Haiyan , Li Ying , Li Xiaoyu , Sun Chenglong , Zhang Minglan , Yin Ping , Xu Liang-mei , Ding Xia 
Published: December 2024

Abstract

Purpose: This study aimed to develop and validate a multifactorial predictive model for frailty risk in patients with digestive malignancies.
Methods: This study enrolled 450 patients from a tertiary hospital in Anhui, analyzing 15 indicators such as nutrition, diet, lab tests, disease factors, and psychosocial status. The data were randomly divided into training (70%) and validation (30%) sets. Frailty was assessed using the Frail scale, and a logistic regression model was built to identify frailty risks. Model accuracy was evaluated using calibration curves, AUC, and DCA.
Results: Logistic regression analysis revealed that nutritional risk, radiotherapy, and anxiety were independent risk factors for frailty in patients with malignant tumours of the digestive system, while a low-fat dietary pattern rich in vegetables and fruits was a protective factor. The AUC values for the training and validation groups were 0.838 (95% CI: 0.771-0.905) and 0.761 (95% CI: 0.641-0.881), respectively. The Hosmer-Lemeshow test yielded P-values of 0.749 and 0.237. The calibration curves demonstrated high consistency between the actual and predicted values, and the ROC and DCA indicated that the model had a satisfactory predictive performance.
Conclusion: The developed predictive model exhibits good predictive ability and can be utilized to assess the risk of frailty in patients with malignant tumours of the digestive system. Patients with a frailty risk score exceeding 0.395 should undergo regular monitoring for frailty and receive personalized interventions.
Development and Validation of a Risk Prediction Model for ADL Dysfunction in the Elderly
Authors: Lin Fangbo , Liu Chao 
Published: December 2024

Abstract

Background: Aging populations have led to increased chronic diseases, economic challenges, and labor shortages, significantly impacting China's public health. The elderly often seek to maintain independence, making research crucial to understand factors that lead to daily life dysfunction. This study aimed to develop and validate a predictive tool to identify risks of daily life dysfunction in the elderly.
Methods: Data from 5081 participants aged 60 to 80 in the China Health and Retirement Longitudinal Survey(CHARLS) wave 3 was analyzed. Participants were divided into training and testing groups. Predictive factors were identified using Least Absolute Shrinkage and Selection Operator(LASSO) and multivariable logistic regression, resulting in a nomogram model. The model's performance was evaluated using Receiver Operating Characteristic(ROC) curves, the calibration plots, and Decision Curve Analysis(DCA).
Results: It identified 12 factors as risk factors for daily life dysfunction in the elderly, which were integrated into the final model. The nomogram's predictive performance was deemed acceptable, with ROC curve values of 0.788 (95% CI: 0.771-0.804) for the training set and 0.794 (95% CI: 0.773-0.814) for the testing set. The calibration curve confirmed the model's accuracy, and the DCA showed it had good clinical utility.
Conclusions: Twelve key factors were chosen to create a nomogram predicting daily life dysfunction in the elderly. This nomogram demonstrates strong evaluation performance and serves as a dependable tool for forecasting daily life dysfunction in the elderly.
How to pre-evaluate the risk of systemic inflammatory response syndrome in patients undergoing one-stage flexible ureteroscopy lithotripsy？
Authors: Zhou Yuan , Zhang Haiyan , Zhang Rentao , Ding Yinman , Wang Zhengquan , Lin Changming 
Published: December 2024

Abstract

Background Flexible ureteroscopy lithotripsy (FURL) is widely used to treat Upper urinary tract stone (UUTS). Evaluating whether a patient develops systemic inflammatory response syndrome (SIRS) during and after surgery is one of the most important factors in determining whether a ureteral stent should be placed before FURL. Materials and methods A total of 340 patients with UUTS who underwent one-stage FURL from April 2021 to May 2024 were analyzed retrospectively. Least absolute shrinkage and selection regression and multivariate logistic regression analysis were used to screen out independent risk factors and then developed a nomogram. Concordance index (C-index), receiver operating characteristic curve and calibration curve were used to internal evaluated the predictive ability. We further evaluated the risk of SIRS in one-stage FURL based on the influence of available variables. Results Age, urinary white blood cells, urine bacterial culture and systemic immune-inflammation index (SII) were combined to establish nomogram for prediction the risk of SIRS in one-stage FURL. The SII had the highest odds ratio (OR = 30.356) to SIRS. The C-index (0.964, 95%CI = 0.932–0.996), area under curve (0.935), and calibration curve demonstrated the favourable predictive ability of nomogram prediction. We further developed a scoring system and classified the risk of SIRS into four grades. Conclusion The established nomogram and risk scoring system have favourable predictive ability and clinical serviceability to personalize predict the SIRS risk in UUTS patients undergoing one-stage FURL. A ureteral stent should be placed before FURL in patients with SII greater than 1300 and one of the following: age>60 years, urinary white blood cell 1+/2+/3+, or urine bacterial culture positive. We present the first study to evaluate the value of preoperative SII on FURL. The proposed new insights may help clinicians select safer treatment for UUTS patients.
White Matter Integrity Abnormalities in 1-to 5-Year-Olds with Global Developmental Delays: A Diffusion Study Utilizing Tract-Based Spatial Statistics and ROI-Based Analysis
Authors: Yang Jinze , Shen Yanyong , Wang Kaiyu , Cheng Meiying , Lu Lin , Zhou Liang , Liu Shipeng , Lu Yu , Feng Liujuan , Li Sike , Zhang Xiaoan , Zhao Xin 
Published: December 2024

Abstract

Objects We aimed to use diffusion kurtosis imaging (DKI) and its derived white matter integrity metrics to characterize white matter integrity in children with global developmental delay（GDD） and explore the relationship between diffusion parameters and development quotient（DQ）.
Methods and Materials Thirty-four children with GDD and 44 healthy control children were included in this study, and MRI images were acquired. Diffusion parameters were preprocessed and obtained by Pydesigner and FSL software, including fractional anisotropy (FA), mean diffusivity (MD), axonal diffusivity (AD), radial diffusivity (RD), anisotropy (MO), mean kurtosis (MK), axial kurtosis (AK), kurtosis fractional anisotropy (FAK), radial kurtosis (RK), and WMTI parameters: the axial diffusivity of the extra-axonal space (EAS_AD), the radial diffusivity of the extra-axonal space (EAS_RD), the diffusivity of the intra-axonal space (IAS_DA), the axonal water fraction (AWF), and the tortuosity of the extra-axonal space (EAS_TORT). Afterward, the Tract-based spatial statistics analysis was used to compare the diffusion parameters of the whole brain. We also performed covariance analysis to compare the diffusion parameters in the genu, body, and splenium of the corpus callosum. Lastly, we used partial correlation analysis to assess the correlation between diffusion parameters and DQ.
Results In the results of TBSS, we found that FA, AD, MO, MK, RK, and EAS_TORT were significantly reduced(P＜0.05); RD, AK, KFA, AWF, EAS_AD, and EAS_RD significantly increased in children with GDD compared to healthy controls (P<0.05). In the corpus callosum, FA, MO, IAS_DA, and EAS_TORT were significantly reduced(P＜0.05); AK, KFA, and AWF were significantly increased (P<0.05). In the correlation analysis, fine motor skills DQ was negatively correlated with AK and AWF(P<0.05) and positively correlated with MO(P<0.05). In addition, Adaptability DQ was negatively correlated with AWF(P<0.05).
Conclusion DKI and its derived WMTI parameters can characterize the white matter integrity of children with GDD and have a certain correlation with the DQ, which helps understand the specific pathological changes inside and outside axons and assists clinical diagnosis.
Evaluation of Mechanical Ventilation Modes in the Laparoscopic Perioperative Period with Electrical Impedance Tomography
Authors: Li Zhiwei , Wu Yang , Yu Yao , Liu Kai , Tian Hang , Yao Jiafeng , Cheng Qiuju 
Published: December 2024

Abstract

Purpose: The lung protective ventilation strategy has been advocated during the laparoscopic perioperative period. However, uncertainty remains as to which mode of mechanical ventilation is more appropriate in the laparoscopic perioperative period. We hypothesized the pressure controlled ventilation - volume guaranteed (PCV-VG) mode is a better option than the volume controlled ventilation (VCV) mode in the laparoscopic perioperative period.
Method: The trial was a self-controlled study. The laparoscopic perioperative period is divided into five phases: before induction of anesthesia (AWAKE), after induction of anesthesia (BEGIN), the first phase of the surgery (MIDDLE-1), the second phase of the surgery (MIDDLE-2), and before postoperative wakefulness (END). The BEGIN phase and MIDDLE-1 phase use the VCV mode, and the MIDDLE-2 phase and END phase use the PCV-VG mode. EIT data are recorded at each phase and the parameters of EIT were calculated to quantify the performance of pulmonary ventilation in space and time.
Results: During the non-surgical period, compared with VCV mode, PCV-VG mode had a significant increase in CoV (48.7 ± 2.6 vs. 47.0 ± 3.7, P < 0.01*), a significant decrease in RVDI (8.5 ± 3.1 vs. 10.1 ± 3.9) and no significant difference in GI (0.80 ± 0.10 vs.0.77 ± 0.08, P = 0.067). During the surgical period, compared with VCV mode, PCV-VG mode had a significant increase in CoV (46.0 ± 3.6 vs. 42.5 ± 3.3, P < 0.001*), a significant decrease in GI (0.87 ± 0.15 vs. 1.03 ± 0.28; P < 0.01*) and a significant decrease in RVDI (11.1 ± 3.8 vs. 15.4 ± 5.1; P < 0.001*)
Conclusion: EIT ventilation parameters between VCV mode and PCV-VG mode have significant differences in the laparoscopic perioperative period. The PCV-VG mode could improve ventilation inhomogeneity and elevated ventilation delay due to changes in position and pneumoperitoneum during surgery. The PCV-VG mode might be better used to meet the changing demands for ventilation at different surgical stages. We believe that PCV-VG is a more alternative during laparoscopic surgery.
Penguin guano: an important source of climate-relevant aerosol in Antarctica
Authors: Boyer Matthew , Quéléver Lauriane , Brasseur Zoé , McManus J , Herndon Scott , Agnese Mike , Nelson David , Roscioli Joseph , Weis Frederik , Sel Sergej , Marincovich Giselle , Quarin Francisco , Buchholz Angela , Xavier Carlton , Perchivale Pablo , Kerminen Veli-Matti , Kulmala Markku , Petäjä Tuukka , He Xu-Cheng , Sofieva Svetlana , Timonen Hilkka , Aurela Minna , Barriera Luis , Virkkula Aki , Asmi Eija , Worsnop Douglas , SIPILA Mikko 
Published: December 2024

Abstract

Gaseous ammonia, while influential in atmospheric processes, is critically underrepresented in atmospheric measurements. This limits our understanding of key climate-relevant processes, such as new particle formation, particularly in remote regions. Here, we present highly sensitive, online observations of gaseous ammonia from a coastal site in Antarctica, which allows us to constrain the mechanism of new particle formation in this region in unprecedented detail. Our observations show that penguin colonies are a large source of ammonia in coastal Antarctica, whereas ammonia originating from the Southern Ocean is, in comparison, negligible. In conjunction with sulfur compounds sourced from oceanic microbiology, ammonia initiates new particle formation and is an important source of cloud condensation nuclei. Dimethyl amine, likely originating from penguin guano, also participates in the initial steps of particle formation, effectively boosting particle formation rates up to 10000 times. These findings emphasize the importance of local fauna (penguin/bird colonies and oceanic phytoplankton/bacteria) on climate-relevant aerosol processes in coastal Antarctica. This demonstrates an important connection between ecosystem and atmospheric processes that impact the Antarctic climate, which is crucial given the current rate of environmental changes in the region.
A single-center 9-year experience in pediatric continuous kidney replacement therapy
Authors: Puspitasari Henny Adriani , Hidayati Eka Laksmi , Fahlevi Reza , Yuniar Irene , Pardede Sudung O. , Aryadevi Ni Nyoman Berlian 
Published: December 2024

Abstract

Background
Acute kidney injury (AKI) is a commonly found complication found in critically ill children. One of the key treatments in these children is continuous kidney replacement therapy (CKRT), especially in those who are hemodynamically unstable. However, due to its costly and complex procedure, there has been some challenges in implementing this treatment in developing countries. Therefore, the aim of this study is to present a comprehensive analysis of clinical profiles of our pediatric patients during a 9-year CKRT experience at our center.
Methods
We conducted a retrospective analysis of medical records from January 2015 to June 2023. Demographic data; clinical and laboratory profiles; hospitalization duration; use of inotropic support and mechanical ventilation; and the presence of sepsis, AKI, acute lung injury (ALI), acute respiratory distress syndrome (ARDS), and encephalopathy were recorded and compared between survivors and non-survivors.
Results
Fifty-six critically ill children received CKRT. The median age was 7.4 years, while the median body weight was 22.2 kg. CKRT was more commonly indicated in those with sepsis-associated AKI (41.1%), non-sepsis AKI (23.2%), and acute-on-chronic kidney disease (21.4%). The median CKRT duration was 52.2 hours, with median total delivered dose and mean blood flow rate per kg of 22.2 (5.8–71.7) and 3.1 ± 0.9 mL/kg/min, respectively. The survival rate was 25%.
Conclusion
Although we have similar patient demographics and CKRT prescription compared to other center, we have lower survival due to notable challenges we encountered with limited resources. Despite its challenges, CKRT remains a preferred treatment option for critically ill children.
Management of Challenging Post-hepatectomy Bile Leakage with Concurrent Bile Duct Stenosis
Authors: Matsuo Yasuko , Yasuda Satoshi , Nagai Minako , Nakamura Kota , Terai Taichi , Doi Shunsuke , Kohara Yuichiro , Sakata Takeshi , Sho Masayuki 
Published: December 2024

Abstract

Purpose
Bile leakage remains a serious complication following hepatic resection, with particularly high incidence in procedures involving hilar manipulation. Such cases are often complicated by bile duct strictures, presenting unique management challenges. This study evaluated our institutional experience in managing post-hepatectomy bile leakage, focusing on high-risk procedures and complex cases with concurrent bile duct stenosis.
Methods
We retrospectively analyzed patients who underwent liver resection without biliary reconstruction between January 2008 and December 2023. Based on established risk factors, patients were stratified into high- and low-risk procedure groups. Treatment approaches and outcomes were compared between groups, with detailed analysis of cases complicated by bile duct stenosis.
Results
Of 894 patients, 73 (8.0%) developed bile leakage: 45 in the low-risk and 28 in the high-risk group. Approximately 75% of low-risk cases resolved with drainage alone, compared to 52.0% in the high-risk group (P = 0.041). Among patients requiring endoscopic intervention, bile duct stenosis was significantly more common in the high-risk group (63.6% vs. 0%, P = 0.013). Five high-risk cases with concurrent stenosis required complex management, presenting with both proximal and peripheral leakage. These cases were successfully managed using a combination of surgical resection, transarterial embolization, and advanced interventional techniques.
Conclusion
Post-hepatectomy bile leakage management is particularly challenging in high-risk procedures, frequently complicated by bile duct stenosis. Successful outcomes require accurate characterization of leakage patterns and appropriate selection of therapeutic interventions. Our proposed algorithm emphasizes systematic evaluation and stepwise intervention, including bridging stent placement and alternative approaches for complex cases.
Comprehensive Analysis of the NF1 gene Using Long-Read Sequencing Improved Neurofibromatosis type 1 Molecular Diagnosis
Authors: Zheng Yu , Chen Miaomiao , Zhang Shuju , Peng Yu , Wu Xinghan , Guo Danni , Liu Yaoxi , Mao Aiping , Li Danhua , Xie Tiantian , Mei Haibo , Zhu Guanghui , Wang Hua 
Published: December 2024

Abstract

Clinical diagnosing Neurofibromatosis type 1 (NF1) in pediatrics are facing challenges because of limited presence of age-dependent phenotypes, and the limited detection rate by current approaches for the complexity of the NF1 gene. Here we developed a comprehensive analysis of NF1 (CANF1) combining 14 long-range locus-specific PCR, 25 gap primers and long-read sequencing (LRS) for sequence analysis of the NF1 gene. In this blind retrospective study, the clinical utility of CANF1 was evaluated in 191 samples (181 pediatric probands, 10 NF1 parents) by comparing to the control methods, mainly next generation sequencing (NGS). The results exhibited 176 probands (176/181 = 97.2%) having concordant results, and the other 5 probands (2.8%) with improved findings including: one was established a new diagnosis (c.5812 + 332A > G in deep intron) and four were improved with precise CNV breakpoints. In 127 pediatric NF1 probands with limited clinical manifestations, this assay received a detection rate of 92.9%, which is higher than NGS. In conclusion, this study constructed a comprehensive analysis of NF1 employing LRS, which can reliably identify various type variants of the NF1 gene in one assay. This CANF1 assay can help in screening NF1 with more precise molecular diagnosis than conventional methods, particularly for individuals with unfulfilling NF1 diagnosis solely by clinical phenotypes.
Factors Affecting Inflammatory Changes in Congenital Lung Malformations
Authors: Zulli Andrea , Tocchioni Francesca , Oreglio Chiara , Caporalini Chiara , Buccoliero Anna Maria , Morabito Antonino , Morini Francesco 
Published: December 2024

Abstract

AIM OF THE STUDY
Patients with congenital lung malformation (CLM) may present pulmonary inflammatory changes. However, little is known about the factors influencing local inflammation. Aim of this study was to evaluate the factors that may affect inflammatory changes in CLM.
METHODS
Patients with CLM operated upon between 2005 and 2021 were included. The grade of inflammation was defined with a purpose-made inflammatory score (IS) ranging from 0 to 5. The association of type of CLM and age at surgery with IS was analyzed. Results are means (standard deviation).
MAIN RESULTS
Data from 105 patients with CLM were collected, 56 had congenital pulmonary airways malformation (CPAM), 24 bronchopulmonary sequestration (BPS), and 25 congenital lobar emphysema (CLE). 91 patients (87%) had inflammatory changes. IS was 2.1 (1.5), 1.2 (1.0), and 1.3 (1.5) in CPAM, BPS, and CLE respectively (One-way ANOVA p=0.0101). CPAM showed a significantly higher IS as compared with BPS (p = 0.0242) and CLE (p = 0.0495). Age at operation significantly correlated to IS (r2=0.14; p <0.0001). Patients aged below 6 months at operation had lower IS [1.4 (1.2)] as compared to those over 6 months [2.0 (1.6)] (p =0.018). Age at operation significantly correlated with the IS in CPAM (r2=0.17; p=0.0016) and CLE (r2=0.47; p<0.0001) patients.
CONCLUSIONS
Patients with CLMs often present inflammatory changes in their lungs. Grade of inflammation significantly correlates with age at surgery and type of anomaly, with CPAMs having the highest grade. These findings support early resection in patients with CLM, especially in case of CPAM.