bluuebunny/crossref_metadata_2025_split huggingface dataset:
Creatinine-to-cystatin C ratio and body composition predict response to PD-1 inhibitors-based combination treatment in metastatic gastric cancer
Authors: Ji Hongjuan , Liu Bona , Jin Peng , Li Yingchun , Cui Lili , Jin Shanxiu , Wu Jingran , Shan Yongqi , Zhang Zhenyong , Ming Jian , Zhang Liang , Du Cheng 
Published: April 2024

BackgroundCreatinine-to-cystatin C ratio (CCR) and body composition (BC) parameters have emerged as significant prognostic factors in cancer patients. However, the potential effects of CCR in gastric cancer (GC) remains to be elucidated. This multi-center retrospective study explored the predictive and prognostic value of CCR and BC-parameters in patients with metastatic GC receiving PD-1 inhibitors-based combination therapy.MethodsOne hundred and thirteen GC patients undergoing PD-1 inhibitors-based combination therapy were enrolled at three academic medical centers from January 2021 to July 2023. A deep-learning platform based on U-Net was developed to automatically segment skeletal muscle index (SMI), subcutaneous adipose tissue index (SATI) and visceral adipose tissue index (VATI). Patients were divided into two groups based on the median of CCR or the upper tertile of BC-parameters. Logistic and Cox regression analysis were used to determine the effect of CCR and BC-parameters in predicting response rates and survival rates.ResultsThe CCR was positively correlated with SMI (r=0.43; P&lt;0.001), but not with SATI or VATI (P&gt;0.05). Multivariable logistic analysis identified that both low CCR (OR=0.423, P=0.066 for ORR; OR=0.026, P=0.005 for DCR) and low SATI (OR=0.270, P=0.020 for ORR; OR=0.149, P=0.056 for DCR) were independently associated with worse objective response rate (ORR) and disease control rate (DCR). Patients with low CCR or low SATI had significantly lower 8-month progression-free survival (PFS) rate and 16-month overall survival (OS) rate than those with high CCR (PFS rate, 37.6% vs. 55.1%, P=0.011; OS rate, 19.4% vs. 44.9%, P=0.002) or those with high SATI (PFS rate, 37.2% vs. 53.8%, P=0.035; OS rate, 8.0% vs. 36.0%, P&lt;0.001). Multivariate Cox analysis showed that low CCR (HR=2.395, 95% CI: 1.234-4.648, P=0.010 for PFS rate; HR=2.528, 95% CI: 1.317-4.854, P=0.005 for OS rate) and low SATI (HR=2.188, 95% CI: 1.050-4.560, P=0.037 for PFS rate; HR=2.818, 95% CI: 1.381-5.752, P=0.004 for OS rate) were both independent prognostic factors of poor 8-month PFS rate and 16-month OS rate. A nomogram based on CCR and BC-parameters showed a good performance in predicting the 12- and 16-month OS, with a concordance index of 0.756 (95% CI, 0.722-0.789).ConclusionsLow pre-treatment CCR and SATI were independently associated with lower response rates and worse survival in patients with metastatic GC receiving PD-1 inhibitors-based combination therapy.
Stainless steel selection tool for water application: pitting engineering diagrams
Authors: Hägg Mameng Sukanya , Wegrelius Lena , Hosseinpour Saman 
Published: April 2024

Introduction: This work systematically investigates the effect of chloride level, temperature, and the water system’s oxidative power on the pitting corrosion performance of stainless steels in pH-neutral environments.Methods: Two test programs were set to a) develop a robust method for constructing the pitting engineering diagrams and b) construct the pitting engineering diagrams based on the obtained method from the first test program. The various electrochemical techniques were selected to assess and understand factors that affect the corrosion behavior of stainless steel. Extensive testing was performed with short-term electrochemical measurements and long-term immersion tests.Results and Discussion: The obtained results demonstrate that the electrochemical methods are sufficient to define pitting diagrams showing the boundaries between pitting and no pitting as a function of chloride concentration, temperature, and the water system’s oxidation potential. The laboratory long-term electrochemical test results correspond the best to real applications and clearly underline the importance of an induction time for pit initiation. Accordingly, two sets of pitting engineering diagrams were constructed based on the water system’s oxidation potential. Measurements at the applied potential of 150 mV vs. saturated calomel electrode (SCE) correspond to applications in sterile tap water, whereas the applied potential of 400 mV vs. SCE corresponds to slightly chlorinated water or water with some biological activity. Pitting engineering diagrams were proved to be very useful tools to aid material selection in water application. However, it is important to realize that additional factors, such as different surface conditions and the presence of other environmental species, crevice design, or weld will affect the exact position of the boundaries between pitting and no pitting.
Antibacterial and anti-inflammatory polyethyleneimine/polyacrylic acid hydrogel loaded with CeO2 quantum dots for wet tissue wound dressings
Authors: Hou Wenxue , Lin Zehui , Xia Xiaomin , Sun Sa , Niu Zhaojun , Liu Jie , Lu Jiqing , Yin Dongming , Li Xue 
Published: April 2024

Searching for an antibacterial and anti-inflammatory dressing that can stably adhere to wet tissues remains a momentous clinical challenge, especially in the context of treatment failure due to multi-drug-resistant bacteria. Using a hard template method in combination with an in situ chelating strategy, three-dimensional nitrogen-doped graded porous carbon anchored 1.5–2.5 nm CeO2 quantum dots (CeO2-QDs) were tailor-designed in this study. Using the size effect, CeO2-QDs have a higher percentage of Ce3+ and oxygen vacancies that could amplify their antibacterial effects. Polyethyleneimine/polyacrylic acid (PEA) powder could self-gel and be adhesive due to its strong physical interactions, which make it an ideal carrier for CeO2-QDs. PEA@50 (mg/mL) CeO2-QDs hydrogel and PEA@75 (mg/mL) CeO2-QDs hydrogel with moderate doses of CeO2-QDs show a superior antibacterial effect against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) strains. Furthermore, PEA@50CeO2-QDs hydrogels possess excellent anti-inflammatory capacity through their antioxidant activity, which could promote macrophage M2 phenotype polarization. More importantly, cytotoxicity assays on L929 fibroblasts show that PEA@CeO2-QDs hydrogels have no significant toxicity, and a significant proliferative effect could be observed. Overall, PEA@50CeO2-QDs hydrogels have the potential to become a multifunctional wet tissue dressing with anti-inflammatory and antiseptic properties to promote the healing of infected wounds.
Improving the stability and transdermal permeability of phycocyanin loaded cubosomes
Authors: Zhu Chune , Duan Wenjuan , Jing Hui , Long Jieyu , Huang Ying , Huang Di , Wu Chuanbin 
Published: April 2024

Instability and low transdermal permeability of protein antioxidants are major obstacles to resist oxidative stress in transdermal drug delivery system. To overcome these shortcomings, cubosomes were developed as an advanced transdermal delivery system to improve stability and transdermal absorption of the model antioxidant phycocyanin in this study. Glyceryl monooleate and poloxamer 407 (P407) were used to prepare cubosomes as carrier matrix and stabilizer, respectively. Phycocyanin loaded cubosomes (PC-cubosomes) were prepared by the emulsification and homogenization method. A 33 full factorial design was used to optimize the cubosome formulations. The final optimal PC-cubosomes possessed an average particle size of 183.2 ± 0.5 nm and a negative surface charge as well as achieved a high encapsulation efficiency of 87.2% ± 2.7%. PC-cubosomes appeared as nano-sized and well-shaped spheres with highly ordered cubical structures. The residual amount of phycocyanin in PC-cubosomes was 3-fold higher than that in the free drug solution after 10 days ultraviolet radiation exposure. In vitro release kinetics of phycocyanin from PC-cubosomes fitted to the Higuchi kinetic model, indicating that phycocyanin released from cubosomes mainly attributed to drug diffusion and dissolution. PC-cubosomes also exhibited higher permeability (39.79 μg⋅cm−2⋅hour−1) across the rat skin than phycocyanin solution (16.33 μg⋅cm−2⋅hour−1). Furthermore, PC-cubosomes were easily taken up by keratinocytes, thereby achieving a prolonged anti-oxidative stress effect. These results therefore suggested that cubosomes could be a promising transdermal delivery system to improve the stability and transdermal permeability of phycocyanin.
Global trends of acupuncture clinical research on analgesia from 2010 to 2023: a bibliometric and visualization analysis
Authors: Li Zhi-Qiang , Wang Xue-Feng , Feng Cao , Fei Yu-Tong , Liu Jian-Ping 
Published: April 2024

ObjectiveAcupuncture, acknowledged as a potent non-pharmacological therapy, is frequently employed to alleviate pain. Despite its widespread use, there has been a lack of overarching bibliometric analysis of clinical research on acupuncture analgesia. We aimed to summarize current patterns, hotspots, and development trends in this field through bibliometric analysis.MethodsThis study evaluates academic publications retrieved from the Web of Science database (2010.01–2023.09) concerning acupuncture analgesia in clinical settings. All primary and secondary studies on humans were included. To track global developmental trends, we employed several software for analyzing annual publication volumes, countries/regions, institutions, authors, cited authors, journals, cited journals, references, and keywords and to draw collaborative networks and reference co-citation network maps.ResultsThe final search encompassed 7,190 relevant studies, including 1,263 randomized controlled trials (RCTs) and 1,293 systematic reviews and meta-analyses. The results indicated a gradual increase in the number of annual publications on acupuncture analgesia in clinical practice. Among countries and institutions, China (2,139) and Chengdu University of Traditional Chinese Medicine (258) ranked first. Liang FR (89 articles) was the most prolific author, while MacPherson H (604) was the most cited author. MEDICINE (455) was the most productive journal, and Pain (2,473/0.20) ranked first in both the frequency and centrality of cited journals. Notably, the most frequently cited reference was a systematic review of individual patient data on acupuncture carried out for chronic pain that was published by Vickers Andrew J in 2012 (156). Burst analysis identified frontier research areas for 2010–2020, encompassing network meta-analysis, case reports, dry needling, lumbar disc herniation, cancer, post-herpetic neuralgia, insomnia, and bibliometric analysis.ConclusionThis study outlines current trends and potential future research hotspots in clinical acupuncture analgesia over the past decade. Findings emphasize the necessity for enhanced international collaboration to improve research output and translation.
Research on active and passive schemes for safety improvement of nuclear energy hydrogen production system
Authors: Gao Qunxiang , Sun Qi , Zhang Ping , Zhao Gang , Peng Wei 
Published: April 2024

Nuclear hydrogen production has the advantages of large-scale and low carbon emissions, and is expected to play an active role in the energy transition process. However, the storage and transportation of hydrogen pose potential risks of leakage and diffusion when connected to high-pressure hydrogen storage tanks and pipelines. To address this concern, this study focused on designing three distinct safety improvement schemes tailored for potential hydrogen leakage accidents. These schemes encompassed a passively distributed arrangement of obstacles (Scheme 1), a passively centralized arrangement of obstacles (Scheme 2), and an active fan array blowing (Scheme 3). Numerical simulation methods were applied on extensive spatial scales for relevant calculations. The results revealed that all three schemes effectively reduced the diffusion distance of combustible hydrogen. Specifically, at lower ambient wind speeds, Scheme 1, Scheme 2, and Scheme 3 achieved the shortest diffusion distances of 123 m, 56 m, and 46 m, respectively. Meanwhile, at higher ambient wind speeds, the corresponding distances were 282 m, 100 m, and 79 m. These results collectively offer valuable insights to mitigate the risk of leakage accidents in nuclear hydrogen production systems.
Establishment of a prognostic model for gastric cancer patients who underwent radical gastrectomy using machine learning: a two-center study
Authors: Lu Tong , Lu Miao , Liu Haonan , Song Daqing , Wang Zhengzheng , Guo Yahui , Fang Yu , Chen Qi , Li Tao 
Published: April 2024

ObjectiveGastric cancer is a prevalent gastrointestinal malignancy worldwide. In this study, a prognostic model was developed for gastric cancer patients who underwent radical gastrectomy using machine learning, employing advanced computational techniques to investigate postoperative mortality risk factors in such patients.MethodsData of 295 patients with gastric cancer who underwent radical gastrectomy at the Department of General Surgery of Affiliated Hospital of Xuzhou Medical University (Xuzhou, China) between March 2016 and November 2019 were retrospectively analyzed as the training group. Additionally, 109 patients who underwent radical gastrectomy at the Department of General Surgery Affiliated to Jining First People’s Hospital (Jining, China) were included for external validation. Four machine learning models, including logistic regression (LR), decision tree (DT), random forest (RF), and gradient boosting machine (GBM), were utilized. Model performance was assessed by comparing the area under the curve (AUC) for each model. An LR-based nomogram model was constructed to assess patients’ clinical prognosis.ResultsLasso regression identified eight associated factors: age, sex, maximum tumor diameter, nerve or vascular invasion, TNM stage, gastrectomy type, lymphocyte count, and carcinoembryonic antigen (CEA) level. The performance of these models was evaluated using the AUC. In the training group, the AUC values were 0.795, 0.759, 0.873, and 0.853 for LR, DT, RF, and GBM, respectively. In the validation group, the AUC values were 0.734, 0.708, 0.746, and 0.707 for LR, DT, RF, and GBM, respectively. The nomogram model, constructed based on LR, demonstrated excellent clinical prognostic evaluation capabilities.ConclusionMachine learning algorithms are robust performance assessment tools for evaluating the prognosis of gastric cancer patients who have undergone radical gastrectomy. The LR-based nomogram model can aid clinicians in making more reliable clinical decisions.
Plasma miRNA expression profile in pediatric pineal pure germinomas
Authors: Fakhry Mona , Elayadi Moatasem , Elzayat Mariam G. , Samir Omar , Maher Eslam , Taha Hala , El-Beltagy Mohamed , Refaat Amal , Zamzam Manal , Abdelbaki Mohamed S. , Sayed Ahmed A. , Kieran Mark , Elhaddad Alaa 
Published: April 2024

BackgroundPure germinomas account for 40% of pineal tumors and are characterized by the lack of appreciable tumor markers, thus requiring a tumor biopsy for diagnosis. MicroRNAs (miRNA) have emerged as potential non-invasive biomarkers for germ cell tumors and may facilitate the non-invasive diagnosis of pure pineal germinomas.Material and methodsA retrospective chart review was performed on all patients treated at the Children’s Cancer Hospital Egypt diagnosed with a pineal region tumor between June 2013 and March 2021 for whom a research blood sample was available. Plasma samples were profiled for miRNA expression, and DESeq2 was used to compare between pure germinoma and other tumor types. Differentially expressed miRNAs were identified. The area under the curve of the receive;r operating characteristic curve was constructed to evaluate diagnostic performance.ResultsSamples from 39 pediatric patients were available consisting of 12 pure germinomas and 27 pineal region tumors of other pathologies, including pineal origin tumors [n = 17; pineoblastoma (n = 13) and pineal parenchymal tumors of intermediate differentiation (n = 4)] and others [n = 10; low-grade glioma (n = 6) and atypical teratoid rhabdoid tumor (n = 4)]. Using an adjusted p-value &lt;0.05, three miRNAs showed differential expression (miR-143-3p, miR-320c, miR-320d; adjusted p = 0.0058, p = 0.0478, and p = 0.0366, respectively) and good discriminatory power between the two groups (AUC 90.7%, p &lt; 0.001) with a sensitivity of 25% and a specificity of 100%.ConclusionOur results suggest that a three-plasma miRNA signature has the potential to non-invasively identify pineal body pure germinomas which may allow selected patients to avoid the potential surgical complications.
Unusual coexistence: branchial cleft cyst harboring papillary thyroid carcinoma with lymph node metastasis — a rare case report and clinical insights
Authors: Wang Wei-Tao , Ni Xi-Hao , Gu Yong-Xue , An Ran , Wang Chang-Liang , Zhang Jun 
Published: April 2024

BackgroundThe simultaneous occurrence of Branchial Cleft Cyst (BCC) and Papillary Thyroid Carcinoma (PTC) represents an unusual malignant tumor, with cases featuring associated lymph node metastasis being particularly rare. This combination underscores an increased potential for metastasis, and the assessment of neck masses, particularly on the lateral aspect, may inadvertently overlook the scrutiny of the thyroid. Therefore, healthcare providers should exercise vigilance, especially in patients over the age of 40, regarding the potential for neck masses to signify metastasis from thyroid malignancies. Currently, surgical intervention stands as the primary effective curative method, while the postoperative administration of radioactive iodine therapy remains a topic of ongoing debate.Case reportIn the presented case, a 48-year-old male patient with a right neck mass underwent surgical intervention. The procedure included the excision of the right neck mass, unilateral thyroidectomy with isthmus resection, and functional neck lymph node dissection under tracheal intubation and general anesthesia. Postoperative pathology findings revealed the coexistence of a BCC with metastatic PTC in the right neck mass, as well as papillary carcinoma in the right thyroid lobe. Lymph node metastasis was observed in the central and levels III of the right neck.ConclusionThe rare amalgamation of a BCC with PTC and concurrent lymph node metastasis underscores the invasive nature of this malignancy. Healthcare professionals should be well-acquainted with its clinical presentation, pathological characteristics, and diagnostic criteria. A multidisciplinary approach is strongly recommended to enhance patient outcomes.
Content validity of the electronic faces thermometer scale for pain in children: is a picture worth more than a thousand words?
Authors: Höök Angelica , Castor Charlotte , Björk Maria , Forsgren Emma , Muszta Anders , Nilsson Stefan 
Published: April 2024

IntroductionEarly recognition of pain in children is crucial, and their self-report is the primary source of information. However, communication about pain in healthcare settings can be challenging. For non-verbal communication regarding different symptoms, children prefer digital tools. The electronic Faces Thermometer Scale (eFTS) utilizes a universal design with colors, face emojis, and numbers on an 11-point scale (0–10) for pain assessment. The aim of this study was to establish content validity of the eFTS for pain assessments in children.MethodsA mixed methods design was used. The study took place at a university hospital in eastern Sweden, involving 102 children aged 8–17 years who visited outpatient clinics. Participants were presented with 17 pictures representing varying pain levels and asked to assess hypothetical pain using the eFTS. A think-aloud approach was employed, prompting children to verbalize their thoughts about assessments and the eFTS. Quantitative data were analyzed using descriptive and comparative statistics, together with a qualitative approach for analysis of think-aloud conversations.ResultsA total of 1,734 assessments of hypothetical pain using the eFTS were conducted. The eFTS differentiated between no pain (level 0–1) and pain (level 2–10). However, no clear agreement was found in the differentiation between hypothetical pain intensity levels (level 2–10). The analysis revealed that children utilized the entire scale, ranging from no pain to high pain, incorporating numbers, colors, and face emojis in their assessments.DiscussionThe variability in assessments was influenced by prior experiences, which had an impact on the statistical outcome in our study. However, employing the think-aloud method enhances our understanding of how children utilize the scale and perceive its design, including the incorporation of emotion-laden anchors. Children express a preference for using the eFTS to assess their pain during hospital visits.
Cumulative sum learning curve analysis of tubularized incised plate repair for hypospadias: a study of a single surgeon with a single surgical procedure
Authors: Li Jiaqiang , Zhang Jiaqian , Diao Hongwang , He Zhuoyuan , Li Shoulin , Yin Jianchun 
Published: April 2024

PurposeTo ascertain the quantity of instances by which a single surgeon achieves competency and proficiency in using tubularized incised plate (TIP) technique for the repair of distal and mid-shaft hypospadias using the cumulative sum (CUSUM) analysis.MethodsWe retrospectively evaluated patients with distal and mid-shaft hypospadias who were treated by a single surgeon between 2015 and 2021, using a single primary TIP technique with a de-epithelialized Byars flap. Data including type of hypospadias, age at surgery, curvature, operation time (OT), length of the reconstructed urethra, and postoperative outcomes were collected and assessed. CUSUM was used to assess the trends in OT and complication rate (CR) in order to generate the learning curve. The evolution of OT and CR can be divided into three phases: learning, competence, and proficiency.ResultsCUSUM identified three phases in the learning curves of all TIP repairs. The median OT decreased from 135 min [interquartile range (IQR) = 125–155] to 92 min (IQR = 80–100) (P &lt; 0.001), CR decreased from 28 (28%) to 8 (5.3%) (P &lt; 0.001), and reoperations decreased from 15 (15.2%) to 4 (2.6%) (P &lt; 0.001). According to the CUSUM learning curve, technical competency plateaued after the 99th case, and both OT and CR entered a significantly declining proficiency phase after the 231st case. Further, when the neourethral length exceeded the total average, total complications, urethrocutaneous fistula, and reoperations increased (P = 0.013, P = 0.006, and P = 0.028, respectively).ConclusionsOur study suggests that surgeons performing TIP repair may reach technical competency and achieve proficiency after operating on 99,231 cases, respectively. Moreover, the longer the neourethral length, the higher is the CR.