bluuebunny/crossref_metadata_2025_split huggingface dataset:
Construction of a clinical prediction model for complications after femoral head replacement surgery
Authors: Li Kewei , Rong Shuai , Li Hao 
Published: August 2024

Abstract

Background: While femoral head replacement is widely used with remarkable efficacy, the complexity and diversity of postoperative complications pose a serious prognostic challenge.There is an urgent need to develop a clinical prediction model that can integrate multiple factors and accurately predict the risk of postoperative complications to guide clinical practice and optimize patient management strategies.
Objective: This study is dedicated to constructing a postoperative complication prediction model based on big data and machine learning techniques,in order to provide patients with a safer and more effective treatment experience.
Methods: A total of 186 patients who underwent femoral head replacement in the orthopedic department of our hospital were collected in this study.Forty-two of the patients had at least one postoperative complication, and 144 had no complications.The preoperative and postoperative data of patients were collected separately and medical history was collected to study the correlation factors affecting the occurrence of postoperative complications in patients and to establish a prediction model.
Results: Possibly relevant factors were included in a one-way logistic regression, which included the patient's gender, age, BMI, preoperative diagnosis of the mode of injury,osteoporosis or lack thereof, as well as medical history,surgical-related information, and laboratory indices.After analyzing the results, it was concluded that operation time, glutamic-pyruvic transaminase, glutamic-oxaloacetic transaminase, white blood cell count, serum albumin, and osteoporosis, were the risk factors affecting the development of complications after femoral head replacement in patients (P < 0.2);The data obtained were further included in a multifactorial regression, and the results showed that operation time,glutamic-oxaloacetic transaminase, white blood cell count, serum albumin, and osteoporosis were independent risk factors for complications after the patients underwent femoral head replacement (P < 0.05).
Conclusion: Based on the results of this study, five factors, including duration of surgery, glutamine aminotransferase, white blood cell count, serum albumin, and osteoporosis, were identified as independent risk factors for complications after patients underwent femoral head replacement;In addition, the prediction model developed in this study has a high scientific and clinical application value, providing clinicians and patients with an important tool for assessing the risk of complications after affected femoral head replacement.
Role of the alpha-1 antitrypsin towards progression and severity of COVID- 19 infection among Saudi patients
Authors: Ali Rabab A. , Mohammedsaeed Walaa A. , Fakher Hesham A. , Noor Hala K. , Qurashi Yasir M. Al 
Published: August 2024

Abstract

Background Alpha-1 antitrypsin (A1AT) is involved in pathophysiology of severe COVID-19, including thrombosis expansion. A1AT has anti-inflammatory, tissue-protective, and anticoagulant capabilities. We aimed to screen frequencies of A1AT gene polymorphism among COVID-19 Saudi patients and its relation to severity.
Methods Through cross-sectional study, we examined 100 COVID-19 Saudi patients to explore possible correlation between A1AT/interleukin 6 (IL-6) ratio and COVID-19 severity. The COVID-19 patients grouped as severe (31 patients) and non-severe (69 patients) cases. A1AT gene polymorphism was conducted using the PCR technique (ARMS) and ELISA.
Results A1AT, IL-6, and vitamin D (VIT-D) showed extreme statistical significance among COVID-19 patients (severe, mild, and asymptomatic). The prevalence of A1AT gene mutation was higher among COVID-19 cases compared with non-mutated patients (56% vs. 44%). Moreover, serum A1AT levels were lower while serum IL-6 levels were higher than reference range and highly significant among mutated cases compared with non-mutated cases. Also, IL-6/A1AT ratio in severe COVID-19 patients (mean 1.4) was significantly higher compared with asymptomatic or moderate patients (0.16, 0.21; respectively). Strictly, all COVID-19 patients have severed deficiency of VIT-D level significant among mutated and non-mutated cases (p<0.04 and p<0.03; respectively). The frequency of MM (wild type) was substantially high among asymptomatic cases compared with severe cases (67.2% vs.16.1%). Heterozygous MS+MZ genotypes showed lower frequency among asymptomatic cases compared with severe and mild cases (27.6% vs.48.4% and 72.7%; respectively). On the other hand, the more severe forms of SS+ZZ+SZ genotypes were all relatively rare with lower frequency among asymptomatic compared with mild and severe COVID-19 cases (5.2%, 27.3% and 35.5%; respectively). Interestingly, homozygous SS genotype elicited higher frequency among severe cases compared with mild or asymptomatic cases (22.6% vs.0% and 5.2%). The more severe forms homozygous ZZ genotype vanished among asymptomatic and mild cases. This extensively illuminated that, severe COVID-19 patients have diminished A1AT response towards inflammation.
Conclusion Two haplotypes (S) and (Z) alleles of A1AT have higher frequency and were clearly recognized among severe COVID-19 cases suggesting that SS and ZZ genotypes may be associated with an increased risk, while MM genotype may be protective against severe COVID-19 infection.
Elevated red blood cell count levels are associated with increased vascular calcification in hemodialysis patients
Authors: Zhang Fan , Li Guoli , Yu Jie , Fu Shuangshuang , Yang Yiya , Liang Yumei , Chen Yinyin , Luo Xun 
Published: August 2024

Abstract

Introduction: Coronary artery calcification (CAC) is a predictor of poor survival and cardiovascular outcome in end-stage renal disease patients.We conducted this study to assess the risk factors for vascular calcification in maintenance hemodialysis patients. Methods: A total of 71 cases of HD patients who underwent hemodialysis in Hunan Provincial People's hospital from January 2022 to September 2022 were enrolled. The general clinical data and Laboratory results of the patients were collected.Chest CT examination was performed,and the CAC score was calculated. Results: CAC occurred in 41 ( 57.75%) of the 71 HD patients in the study.In the logistic regression analysis, CAC in these patients was significantly predicted by an diabetes (OR [95% CI]: 6.20 [1.37–28.11], P = 0.02) and red blood cell count (OR [95% CI]: 2.29 [1.05–5.02], P = 0.04).The ROC curve was applied to analyzing the red blood cell count; the area under the curve (AUC) was 0.66 (P = 0.02) and clinical diagnostic cutoff value = 2.99 (sensitivity = 75.6% and specificity = 56.7%) . Conclusion: The incidence rate of CAC in HD patients was high.Diabetes and red blood cell count were independent risk factors for CAC in HD patients.
Clinicoradiological findings associated with prognostic indicators of sarcomatoid-NSCLC: A multicenter analysis of 135 patients
Authors: Tang Wenjian , Yin Yujin , Wen Chunju , Huang Jinsheng , Lan Bo , Kang Yuan , Zhang Zhiqiang , Liao zhongjian , Wu Zhen , Chen Qing , Wei Jiawang , Qiu Jing , Qiu Xingting , Chen Hua , Luo Shuhua , Peng Jidong , Zhong Junyuan , Jia Ming , Zhong Jianping 
Published: August 2024

Abstract

Purpose: To assess clinical data and preoperative CT findings associated with prognosis in sarcomatoid-NSCLC (s-NSCLC) patients.
Material and Methods: In this retrospective study, s-NSCLC patients who underwent contrast enhanced thoracic CT or PET/CT from January 2013 to June 2023 at three centers were enrolled. Clinicoradiological data, including sex, age, smoking history, TNM classification, tumor size, tumor location, calcification, vacuole/cavity, pleural invasion, low-attenuation area (LAA) ratio, hydrothorax, peritumoral ground-glass opacity (GGO), nodule or atelectasis and SUVmax were calculated. Clinicoradiological findings associated with overall survival were evaluated by a multivariate Cox regression model.
Results: A total of 135 with s-NSCLC were included. The s-NSCLC patients were more likely to be elderly male smokers. The mean age and tumor size at diagnosis was 62 years and 5.8 cm. The median survival time of patients with s-NSCLC was 9 (95% CI: 7, 11) months. The 1-, 3- and 5-year overall survival (OS) rates of the s-NSCLC patients were 28.9%, 11.9% and 5.9%, respectively. s-NSCLC is often peripherally locate (98/135, 70.4%). Calcification (19/135, 14.1%) and Vacuole/cavity (22/135, 16.2%) were rare in s-NSCLC lesions. Pleural invasion and hydrothorax was present in 75/135 (55.6%) and 36/135 (26.7%) of s-NSCLC patients. The s-NSCLC lesions usually present with LAA (87/135, 80.6%), the median LAA ratio was 30.8% (IQR: 10.6%, 50.7%). The SUVmax of s-NSCLC lesions were 20.2 (IQR: 14.0, 23.9). Surgical treatment [hazard ratio (HR) = 0.518] was associated with decreased mortality, while peritumoral GGO, nodule or atelectasis (HR = 1.995) were associated with increased mortality.
Conclusions: Peritumoral GGO, nodule or atelectasis is an independent risk indicator associated with poor prognosis, while complete surgical resection is essential for improving the prognosis in s-NSCLC patients.
Prevalence, pattern and associated risk factors of Dry eye disease: Results of a prospective patient database from a tertiary eye care centre in Central India
Authors: Sabarwal Sunita , . Priyanka , Moharana Bruttendu , Gupta Rituka , Sharma Bhavana 
Published: August 2024

Abstract

Purpose:
To assess the prevalence, pattern, and associated risk factors of dry eye disease at the tertiary eye care centre in Central India.
Methods:
This prospective cross-sectional study, over 24 months, enrolled patients with systematic random sampling. Evaluation of dry eye disease (DED) was done with subjective and objective methods comprising of Ocular Surface Disease Index (OSDI) questionnaire, slit lamp examination, Schirmer’s and FTBUT test. Patients were categorised into levels 1–4 DED. Association with various etiological factors like age, sex, occupation, diabetes mellitus, autoimmune disorders, and other systemic illnesses was assessed. The chi-square test/Fischer exact test was used to analyse categorical data. Bivariate logistic regression analysis was used to calculate the odds ratio (OR). Multivariate analysis was performed to identify independent risk factors.
Results:
A total of 2560 patients were evaluated, of which 640 patients (25%) had DED. Prevalence was higher in patients aged > 50 years, household workers, students, government employees and farmers. Uncorrected refractive status, cigarette smoking, ocular allergy and contact lens usage were associated with increasing odds of developing DED.
Conclusion:
The prevalence of DED was estimated to be 25%. Certain occupations like household workers, students, government employees, farmers, uncorrected refractive errors, cigarette smoking, ocular allergy and contact lens users were significant risk factors for dry eyes.
The efficacy and safety of nab-paclitaxel plus anlotinib in small-cell Lung Cancer for third- line therapy
Authors: Tian Li-Jun , Zhou Fei-Fei , Dai Min , Liu Jun-Li , Meng Fan-Chan , Xu Wen-Chao , Guo Qi-Sen 
Published: August 2024

Abstract

Background: Small-cell lung cancer (SCLC) has a poor prognosis after failure of second-line therapy. This study investigated the efficacy and safety of nab-paclitaxel plus anlotinib as a third-line treatment for recurrent SCLC.
Methods: In this retrospective study, patients with recurrent SCLC with disease progression after two chemotherapeutic regimens were enrolled. Patients were randomized to one of two groups. One group (ANLIB) received 12 mg of anlotinib daily for 14 days until disease progression or unacceptable toxicity. The other group (ANNAB) received 260mg/m2 of nab-paclitaxel on day 1 in combination with 12mg/d of anlotinib for 14 days. The ANNAB regimen was repeated every three weeks for up to 6 cycles, followed by maintenance with anlotinib until disease progression or unacceptable toxicity. The primary endpoints were progression-free survival (PFS) and overall survival (OS).
Results: Between January 1, 2021 and July 31, 2022, 48 patients were enrolled in this study and were randomly assigned to either the ANNAB or ANLIB group. The overall response rate (ORR) was significantly higher in the ANNAB group compared to the ANLIB group (37.5% vs. 8.3%, Fisher's exact test p = 0.0363). The median PFS was 6.0 months in the ANNAB group and 4.7 months in the ANLIB group (p = 0.0004). The median OS was 10.0 months in the ANNAB group compared with 7.3 months in the ANLIB group (p < 0.0001).
Conclusions: The combined-modality therapy of nab-paclitaxel and anlotinib as a third-line treatment for recurrent SCLC represents a promising therapeutic strategy with an acceptable toxicity profile.
Cross-cultural Adaptation and Validation to Brazilian Portuguese of the ‘knowledge of Gestational Diabetes (Gdm)’ Questionnaire for Women With Gdm
Authors: Pereira Laura Betat , Schroeder Helena Trevisan , Santos Juciela Keller dos , Capelari Paulo César Brizolla , Schaan Beatriz D. , Bock Patrícia Martins 
Published: August 2024

Abstract

Background
Gestational diabetes mellitus (GDM) is characterized by hyperglycemia during pregnancy. There are many diabetes-specific tools for collecting information validated in Brazilian Portuguese. However, there are no specific instruments to evaluate knowledge about GDM. The aim of this study was to cross-culturally adapt and validate the Brazilian Portuguese version of the Knowledge of Gestational Diabetes Mellitus questionnaire.
Methods
This study was conducted in southern Brazil from January to December 2023. Women with GDM or diabetes identified during pregnancy were considered eligible based on specific criteria. Clinical and demographic data were obtained by a medical records search. The Knowledge of Gestational Diabetes Mellitus questionnaire underwent a multistep adaptation process, including translation, back-translation, content validity assessment, and cognitive interviews. After administration to participants, internal consistency, item-total correlation, and intraclass correlation were evaluated. Confirmatory factor analysis was also conducted to ensure validity.
Results
In total, 155 pregnant women were recruited for the study. Most participants were aged 18–30 years, and hypertension was the main comorbidity (25,2%). Regarding schooling, most participants (58.7%) attended high school. The Brazilian Portuguese version of the Knowledge of Gestational Diabetes Mellitus instrument comprised 32 items. Intraclass correlation was established by two independent interviews with 57 participants, yielding a correlation coefficient of 0.79 (p < 0.01). The internal consistency (Cronbach’s α) was 0.81 overall but was less than 0.7 for the individual domains. Item-total correlations were computed, and confirmatory factor analysis indicated a good model fit. The final Brazilian Portuguese version of the questionnaire consisted of 32 items.
Conclusions
The Brazilian Portuguese version of the Knowledge of Gestational Diabetes Mellitus Questionnaire yielded a reliable and valid tool for evaluating diabetes knowledge in pregnant women.
Lung Autotransplantation Combined with Postoperative Chemotherapy and Immunotherapy: A Three-Year Follow-Up Case Report
Authors: Wang Jiang , Li Tong , Lu Hengxiao , Zhao Qiang 
Published: August 2024

Abstract

Background
Lung cancer remains a leading cause of cancer-related mortality worldwide. Autotransplantation has emerged as a potential surgical intervention in select cases, with the aim of achieving curative outcomes. This case report describes a novel approach combining lung autotransplantation with postoperative chemotherapy and immunotherapy, delineating the patient's journey over a period of three years.
Case Presentation:
We report on a 37-year-old patient with stage IIIA non-small cell lung cancer (NSCLC) who underwent lung autotransplantation. Despite the complexity of the procedure, the patient had a favorable postoperative course. Adjuvant therapy included a PD-1 inhibitor and a standard chemotherapy regimen. The patient’s follow-up involved regular clinical assessment, imaging, and functional status evaluation, demonstrating a remarkable disease-free survival at the three-year mark postoperatively.
Conclusion
This case highlights the potential for lung autotransplantation coupled with immunotherapy and chemotherapy to yield significant long-term survival benefits in patients with NSCLC. The favorable outcome suggests that this integrative treatment strategy warrants further investigation and may offer hope to patients with similarly advanced lung cancer.
Validation for revision of the stage IIIA(T1N2) in the forthcoming ninth edition of the TNM classification for lung cancer
Authors: Wu Tong , Cai Jingsheng , Li Yun , Chen Kezhong 
Published: August 2024

Abstract

Objectives
The 9th edition of the lung cancer tumor-node-metastasis (TNM) staging system downgrades certain non-small cell lung cancer (NSCLC) patients from stage IIIA (T1N2) to IIB. This study aimed to externally validate this stage adjustment.
Methods
Consecutive resected stage IIB and IIIA NSCLC patients were included. Subgrouping was done based on lymph node involvements: IIB N2a1 (single-station N2 without N1 involvement), IIB N2a2 (single-station N2 with N1 involvements) and IIB N0-1. Overall survival (OS) and disease-free survival (DFS) were compared using the Kaplan-Meier method, with propensity score matching (PSM) employed to mitigate potential biases. COX regression models were utilized to assess prognostic differences.
Results
224 stage IIB and 227 stage IIIA cases was included. There were 38, 66 and 120 patients in the IIB N2a1, IIB N2a2 and IIB N0-1 subgroups, respectively. Univariate COX analysis indicated comparable prognoses between the stage IIB N0-1 and IIB N2a1 patients, whereas stage IIB N2a2 patients exhibited poorer outcomes. Upon combining the stage IIB N2a1 and IIB N0-1 subgroups, multivariate COX analysis demonstrated a significantly worse prognosis for stage IIB N2a2 patients compared to those with stage IIB N2a1/0–1 tumors (OS, P = 0.035; DFS, P = 0.021). Further comparisons between stage IIB N2a2 and IIIA patients, following PSM analysis, indicated similar survivals (OS: P = 0.390; DFS: P = 0.210).
Conclusion
The prognosis of stage IIB N2a2 patients was worse than that of remaining stage IIB patients but comparable to that of stage IIIA patients. We proposed that stage IIB N2a2 patients should be maintained as stage IIIA.
Exploring the potential connection between myocardial cells and peripheral blood in patients with sepsis via bioinformatics method
Authors: Dong Qiufen , Li Gang , Liu Yang , Li Dan , Zhang Leilei , Long Qi 
Published: August 2024

Abstract

Background Mitochondrial dysfunction has been proven to be a characteristic change in the myocardium of patients with sepsis. In our previous research, we revealed that some mitochondrial dysfunctions occur synchronously in the peripheral blood of sepsis patients and affect mortality with inflammatory and other related genes. However, these mitochondrial dysfunctions are not described in detail. Whether mitochondrial dysfunction affects the mortality of sepsis patients as an independent risk factor still needs to be further validated.
Objects and methods In our study, we aimed to present the co-varied genes and pathways related to mitochondrial and aerobic respiratory function in myocardium and peripheral blood of sepsis patients, and to verify their effects regarding the mortality of sepsis. We applied weighted gene co-expression network analysis(WGCNA)to generate different modules from myocardium and blood datasets, and subsequent enrichment analysis was used to identify the mitochondrial-and aerobic respiratory-related modules. We obtained the co-varied differential expressed genes(DEGs)from the modules to separate sepsis patients into different subgroups and compare the survival rate between them. Machine learning algorithms were applied for mortality predictive model construction and validation.
Results Blue and magenta modules in blood and blue modules in the myocardium were identified as being related to mitochondrial and aerobic respiratory function. There was a strong overlap in gene expression and pathways between these modules, and DEGs from them separated sepsis patients into two groups, but there was no statistical difference in mortality between the different groups(p-value=0.078). However, models generated from these DEGs performed well in mortality prediction.
Conclusion Our research has found that some genes and pathways associated with mitochondrial aerobic respiratory dysfunction are generally altered in myocardium and peripheral blood, and the changes of these related genes can reflect the severity and mortality of sepsis. Therefore, we can expect the application prospect of these mitochondria-related genes as biomarkers of infectious cardiomyopathy.
Combination of the right hepatic vein occlusion and pringle maneuver in laparoscopic right posterior sectionectomy: protocol for a prospective non-randomized controlled study using propensity score-matched analysis
Authors: Yang Wugui , Peng Yufu , Yang Yubo , Liang Bin , Li Bo , Wei Yonggang , Liu Fei 
Published: August 2024

Abstract

Introduction:
Laparoscopic right posterior hepatectomy, particularly for standard anatomical resection, presents significant technical challenges. Achieving complete exposure of right hepatic vein (RHV) is the critical step in this procedure. To date, there is currently no universally accepted technique to ensure the safe exposure of RHV. To address this gap, this study designs a novel technique involving RHV occlusion and Pringle maneuver for enhancing the safety of RHV exposure in laparoscopic anatomical right posterior hepatectomy (LARPH). A comparative analysis between this innovative approach and traditional technique is performing to investigate the safety and efficacy of this innovative approach.
Methods and analysis:
This prospective non-randomized controlled trial is being conducted at West China Hospital and Sanya People’s Hospital. Patients undergoing LARPH using the novel technique (double occlusion) will be assigned to the experimental group, while those using the traditional technique (Pringle maneuver only) will be assigned to the control group. Perioperative outcomes and follow-up data will be collected and analyzed. PSM analysis with 1:1 ratio matching will be used to mitigate the potential selection deviation. The primary outcome is intraoperative blood loss. Secondary outcomes include the rate of successful RHV exposure, the incidence of CO2 embolism, postoperative complications, as well as morbidity and mortality at 30 days and 90 days.
Discussion
In this study, the outflow occlusion of the target area is innovative adopted: the RHV is selectively occluded in LARPH to control the outflow of S67. Combined with the pringle maneuver, our technique potential has the benefits of reduced the risk of hemorrhage and CO2 gas embolism. By developing and disseminating standardized protocols based on best practices and evidence from successful cases, this study aims to establish a safe, efficacy, and easily disseminated novel surgical technique.
Trial registration:
This study has been prospectively registered at Chinese Clinical Trial Registry (https://www.chictr.org.cn/index.html) on May 26, 2023. The identifier is ChiCTR2300071832 and the registry name is “Caudodorsal approach combined with the occlusion of the right hepatic vein and Pringle maneuver in laparoscopic right posterior sectionectomy”.