bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of CT images at different reconstruction energies on radiotherapy planning of patients diagnosed with nonsmall cell lung cancer
Authors: Xiufang Tian , Kun Liu , Jing Wang , Cuihua Li , Jiandong Zhang , Hou Yong 
Published: March 2023

Objective and Aims:
We conducted this study to explore the influence of spectral computer tomography (CT) images at different reconstruction energies on the radiotherapy plan of patients with nonsmall-cell lung cancer (NSCLC).

Subject and Methods:
Here, 38 NSCLC patients were selected to undergo energy spectral scanning. All energy spectral images obtained were then transferred to the Discover™ CT postprocessing workstation to generate 40k eV, 60 keV, 80keV, 100keV, 120keV, and different 140keV single-energy images. Subsequently, the images were imported to the Eclipse planning system, after which an oncologist contoured the target area and organs at risk (OARs) on these single-energy images described above. Furthermore, a physicist then designed radiotherapy plans to conduct statistical analysis on the tissue CT value and target volume of each single-energy image, to compare the dosimetry of different plans about the OARs and the target area.

Results:
The CT values of gross tumor volumes (GTV), heart, lung, and spinal cord samples subjected to different energy CT images were statistically different (P < 0.05). Among them, the CT value of each tissue obtained in the 40 keV group was the largest and decreased with the increase in energy. As shown, no statistically significant differences were observed in the homogeneity index and conformity index, including the maximum, minimum, and average doses of GTV delineated on the CT images of different energies (P > 0.05), as well as the OARs.

Conclusions:
When CT images of different energies obtained from the energy spectral CT scans were used in the design of radiotherapy planning, no significant differences were observed in the target area outlines and in the doses caused by energy factors. However, the differences in tissue CT values had statistical significance.
Risk of pneumothorax caused by computerized tomography-guided percutaneous core needle biopsy of the lung in elderly and young patients
Authors: Zhou Wei , Yu Xuejuan , Song Yang , Yang Fengxia , Li Chunhai , Liu Bo , Jia Haipeng , Wang Dexiang 
Published: March 2023

Context:
The incidences and risk factors caused by computed tomography (CT)-guided percutaneous computed tomography-guided needle biopsies (PCNBs) in elderly and young patients were not very clear.

Aims:
This study explored the different incidences of pneumothorax caused by PCNBs and related risk factors in elderly and young patients.

Settings and Design:
The medical records of 1100 patients who underwent CT-guided PCNBs in a hospital from January 2018 to December 2019 were retrospectively reviewed.

Subjects and Methods:
Data relating to the patients, lesions, techniques, and diagnoses were collected according to the ethical standards of the institutional research committee (registration number: KYLL-202008-145).

Statistical Analysis Used:
The variables were significant by univariate analysis and further analyzed by multivariate logistic regression analysis.

Results:
In the 1100 patients with PCNBs, the incidence of pneumothorax in groups ≥65 years old and <65 years old was 15.2% and 12.9%, respectively. There was no significant difference in the incidence of pneumothorax between the young and elderly patients. In elderly and young patients, emphysema along the needle path and dwell time was independent predictors. However, in young patients, lesion-abutting pleura was an independent risk factor for pneumothorax, but not in elderly patients.

Conclusions:
The risk of pneumothorax caused by CT-guided percutaneous core needle biopsy of the lung does not increase in elderly patients. Emphysema along the needle path and dwell time is independent predictors of pneumothorax in elderly and young patients.
The survival outcomes of very young and elderly patients with high-risk prostate cancer after radical treatments
Authors: Ma Kai , Song Pan , Qing Yuxin , Li Yayin , Shu Mengxuan , Yang Luchen , Dong Qiang 
Published: March 2023

Objective:
This study evaluated the survival outcomes of young (<50 years) and elderly patients (>80 years) with high-risk prostate cancer (PCa) postradical local treatments.

Materials and Methods:
We identified <50 and >80-year-old patients with high-risk PCa between 2004 and 2015 in the Surveillance, Epidemiology, and End Results database. The patients aged 65 and 66 years were also identified as the control group. The propensity-score matching method was adopted to compare the young and elderly patients with the control group. Kaplan–Meier analysis and Cox regression were conducted to evaluate the PCa-specific survival (PCSS) and overall survival.

Results:
A total of 17726 patients were identified, and 3355 were under 50 years old, whereas 4798 of them were >80 years old. The young patient group (<50 years) had similar PCSS with the control group (65–66 years) in both the overall cohort (hazard ratio [HR]: 0.88, 95% confidence interval [CI] [0.73–1.06], P = 0.132) and matched cohort (HR: 0.96, 95% CI [0.74–1.24], P = 0.527). Young patients with both high-risk and very high-risk PCa after radical prostatectomy (RP) treatment had apparent longer mean cancer-specific survival time than those after external-beam radiotherapy (EBRT) and/or brachytherapy (BT) treatment (high-risk group: 153.38 ± 0.82 months vs. 149.72 ± 3.03 months; very high-risk group: 148.3 ± 1.84 months vs. 139.33 ± 3.25 months). For the elderly patients (>80 years), the PCSS outcomes were significantly worse than the control group (65–66 years) in both overall cohort (HR: 2.69, 95% CI [2.31–3.13], P < 0.001) and matched cohort (HR: 1.61, 95% CI [1.34–1.94], P < 0.001). Patients receiving RP treatment had similar PCSS outcomes with those receiving EBRT and/or BT in the high-risk PCa group (139.45 ± 9.98 months vs. 139.41 ± 1.84 months), and better PCSS in very high-risk PCa group (132.73 ± 13.56 months vs. 128.82 ± 3.43 months).

Conclusion:
The PCSS outcomes of young PCa patients (<0 years) were identical to those of the control group (65–66 years). RP had similar or better PCSS benefits than EBRT and/or BT in both young (<50 years) and elderly patients (>80 years).
A study of microwave ablation for small cell lung cancer
Authors: Wang Jiao , Hu Likuan , Yang Xia , Ye Xin , Ni Yang , Meng Min , Huang Guanghui , Zhang Tiehong , Li Wenhong , Han Xiaoying , Wei Zhigang , Dai Jianjian , Zou Zhigeng 
Published: March 2023

Purpose:
To reveal the survival and safety of percutaneous microwave ablation (MWA) combined with chemoradiotherapy (CRT) in treating small cell lung cancer (SCLC).

Materials and Methods:
Clinical data of 48 SCLC patients who underwent MWA were retrospectively collected; survival and incidence of major complications were analyzed.

Results:
Totally, 48 SCLC patients underwent 51 MWA procedures. The median overall survival (OS) for all SCLC was 27.0 months (95% confidence interval 22.4–31.6 months). The OS of limited-stage (LS-SCLC) was longer than the extensive-stage (ES-SCLC) (median 48.0 months vs. 25.0 months, P = 0.022). The OS of SCLC with tumor diameter ≤3.0 cm was longer than that of tumor diameter >3.0 cm (median 48.0 months vs. 27.0 months, P = 0.041). For LS-SCLC, the 1-, 2-, 3-, and 5-year survival rate was 91.67%, 72.22%, 66.67%, and 61.11%, respectively. For ES-SCLC, the 1-, 2-, and 3-year survival rates were 83.33%, 50.0%, and 8.33%. Major complications included pneumothorax needing tube placement (29.4%), rarely arrhythmia (2.0%), empyema (2.0%), pulmonary fungal infection (2.0%), and shingles (2.0%).

Conclusion:
For SCLC patients, who received MWA combined with CRT, OS of LS-SCLC and tumor diameter ≤3.0 cm was better than that of the ES-SCLC and tumor diameter >3.0 cm. For inoperable SCLC, MWA was safe.
Microwave ablation of non-small cell lung cancer tumors changes plasma levels of cytokines IL-2 and IFN-γ
Authors: Xu Hui , Tan Xiaojing , Kong Yongmei , Huang Yahan , Wei Zhigang , Ye Xin 
Published: March 2023

Background:
Combined therapy with immune checkpoint inhibitors (ICIs) and microwave ablation (MWA) is known to improve outcome in non-small cell lung cancer (NSCLC). However, the mechanism underlying the synergistic effect of these two treatments is unknown. Tumor immune microenvironment is known to affect the efficacy of ICI. Therefore, in the present study, we evaluated changes in the levels of peripheral cytokines at 48 h and 1-month post-ablation in patients with NSCLC.

Materials and Methods:
A total of 44 patients with primary NSCLC were retrospectively enrolled. All patients underwent MWA of the primary tumors. Plasma samples were collected pre- and post-ablation to examine the levels of various cytokines, including interleukin (IL)-2, IL-4, IL-6, IL-10, IL-12, IL-17, tumor necrosis factor (TNF)-α, and interferon-gamma (IFN-γ).

Results:
Although the levels of the majority of cytokines remained within normal range, levels of IL-2 and IFN-γ were significantly decreased at 48 h post-ablation and increased at 1-month post-ablation. In the subgroup analyses, changes in IL-2 and IFN-γ levels were commonly identified. Moreover, the Eastern Cooperative Oncology Group status, sex, pathology type, tumor site, and tumor size were associated with cytokines' levels pre-ablation or post-ablation.

Conclusion:
MWA of NSCLC tumors influenced the plasma levels of cytokines IL-2 and IFN-γ.
The efficacy of PD-1 inhibitors in the maintenance treatment of diffuse large B-cell lymphoma
Authors: Wei Li-ya , Xie Jing , Wang Yue-qiao , Liu Xuan-yong , Chen Xiao , Zhang Yi-huizhi , Wang Qiang , Guo Zhi 
Published: March 2023

Purpose:
To explore the impact of PD-1 maintenance therapy on the relapse-free survival (RFS) of patients with diffuse large B-cell lymphoma (DLBCL).

Methods:
We retrospectively analyzed patients with DLBCL admitted to our center between January 2018 and July 2019 who achieved complete remission (CR) after induction chemotherapy. Forty-five patients who received PD-1 inhibitor maintenance therapy were considered the treatment group. Forty-five patients who did not undergo maintenance treatment during the same period were selected as the control group. The base levels of the two groups of patients were similar. The 2-year RFS rate of the two groups was compared. The correlation between the adverse prognosis factors of the patients and the RFS rate was performed subgroup analysis.

Results:
The 2-year RFS rates of the treatment and control groups were 86.7% VS 75.6% (P = 0.178), respectively, until July 2021. A single factor analysis showed that patients with International Prognostic Index (IPI) score ≥ 3, non-GCB DLBCL receiving PD-1 inhibitor maintenance treatment, can improve their 2-year RFS (72.2% VS 30.8%, P = 0.022; 88.5% VS 62.5%, P = 0.032). For non-GCB patients, the 2-year RFS of the treatment group can reach 88.5%, while the 2-year RFS of the control group is 62.5%, which is statistically significant (P = 0.032). In all patients treated with PD-1 inhibitors, the adverse reactions were all grade I–II, and there were no grade III–IV adverse reactions. There were no clear adverse events in the follow-up patients in the control group.

Conclusion:
Maintenance treatment with PD-1 inhibitors can improve the 2-year RFS rate of patients with IPI score of ≥3 and non-GCB DLBCL. This prompts the potential advantage of PD-1 inhibitors in DLBCL maintenance treatment. However, longer follow-ups remain needed to obtain more definite data.
Effect of microwave ablation on platelet and coagulation function in patients with BCLC-A hepatocellular carcinoma
Authors: Zhao Wenpeng , Li Honglu , Li Wei , Guo Jiang , Cai Liang , Duan Youjia , Hou Xiaopu , Diao Zhenying , Shao Xihong , Du Hongliu , Li Wei , Li Changqing 
Published: March 2023

Aim:
To preliminarily evaluate the effect of microwave ablation (MWA) alone on platelet (PLT) and coagulation function in patients with BCLC-A hepatocellular carcinoma (B-A-HCC) using a retrospective method.

Materials and Methods:
A total of 36 patients with 48 B-A-HCCs were radically treated with MWA alone under the guidance of ultrasound between April and October 2018. PLT coagulation indexes were measured before and after MWA at 1 day, 3 days, 1 week, and 2 weeks, and blood samples (after morning fasting) were collected from cubital veins. Coagulation indexes included prothrombin time (PT), prothrombin activity (PTA), thrombin time (TT), Activated Partial Thromboplastin Time (APTT), international standardized ratio (INR), plasma fibrinogen (FIB), plasma antithrombin III (AT-III), and D dimer (DD). Overall survival (OS), recurrence-free survival (RFS), local tumor progression (LTP), and adverse reactions were also recorded.

Results:
All patients were radically treated with MWA alone. The median size of the lesion was 2.6 (1.5–7.0) cm 3. On the first day after MWA, the level of PLT decreased significantly compared with the values before MWA and gradually returned to preoperative levels one week after MWA. One day after MWA, the levels of PT, INR, and AT-III increased markedly and the level of PTA decreased significantly, all of them gradually returned to baseline after 3 days to a week of time. 1, 3, and 7 days after MWA, the levels of FIB, and DD increased significantly, and the level of TT decreased significantly; all of them gradually returned to baseline at 2 weeks. At 6 months posttreatment, the OS and RFS rates were 100% and 91.7%, the LTP rates was 5.6%, no significant adverse reactions.

Conclusion:
PLT and coagulation indexes were abnormal in patients with B-A-HCC who were radically treated with MWA alone after treatment; without specific treatment, they all gradually returned to baseline within a week or two.
Efficacy and safety of sintilimab-based regimens against advanced gastric and gastroesophageal junction adenocarcinoma
Authors: Wang Yusheng , Zhao Jian , Yu Hongmei , Wang Jie , Zhang Ninggang , Cao Bangwei 
Published: March 2023

Aims:
Our study assessed the efficacy and safety of sintilimab-based regimens for real-world treatment of advanced gastric and gastroesophageal junction adenocarcinoma (G/GEJAC).

Materials and Methods:
Cases of advanced nonresectable G/GEJAC treated with sintilimab-based regimens in the Department of Gastroenterology of Shanxi Provincial Cancer Hospital between December 2018 and September 2020 were retrospectively examined. Endpoints included median progression-free survival (mPFS), median overall survival (mOS), disease control rate (DCR), objective response rate (ORR), and adverse events (AEs). Univariate and multivariate analyses were conducted to determine the effect of stratification factors on efficacy.

Results:
Among the 37 included patients, mPFS and mOS were 4.27 and 7.3 months, respectively. Efficacy was evaluated at least once in 32 of 37 patients. The ORR and DCR were 12.5% and 65.63%, respectively. Among four patients with mismatch repair deficiency/microsatellite instability-high (dMMR/MSI-H) lesions, two achieved partial remission, and two displayed stable disease, resulting in a DCR of 100%. The most observed AEs included leukopenia, neutropenia, thrombocytopenia, nausea, and skin rash. mPFS was 4.90 months in patients who received sintilimab in the first- or second-line setting, versus 3.00 months in other patients. A significant survival difference was found between these groups in univariate and multivariate analyses.

Conclusions:
The application of sintilimab-based regimens achieved good disease control and tolerability for the real-world treatment of advanced G/GEJAC. The treatment was more effective when administered in the first- or second-line setting. Patients with dMMR/MSI-H lesions may also benefit from sintilimab-based regimens.
Risk Factors and Prediction of Postoperative Delirium in Aortic Arch Replacement: A Retrospective Cohort Study
Authors: Fang Miaoxian , Li Jiaxin , Zeng Rong , Huang Yuming , Xiao Yingkai , Peng Wenying , Liu Siyi , Wang Han , Xiong Weiping , Chen Chunbo , Lei Liming 
Published: March 2023

ABSTRACT

Objective:
This study aimed to explore the risk factors and prediction of postoperative delirium (POD) in aortic arch replacement.

Methods:
The preoperative, intraoperative, and postoperative clinical data of patients undergoing aortic arch replacement in our hospital from January 1, 2018, to March 31, 2019, were retrospectively analyzed. According to whether POD occurred, cases were divided into delirium group and control group. The clinical data of the patients were firstly screened by univariate analysis, and then the meaningful variables were analyzed by multivariate logistic regression analysis. The receiver operating characteristic curve was used to analyze the meaningful factors in predicting the occurrence of POD after aortic arch replacement.

Results:
A total of 162 patients were included in the study. The prevalence of POD was 46.9% (n = 76). The results of univariate and multivariate analyses showed that the intraoperative minimum mean arterial pressure (MAP) (odds ratio [OR] = 0.635, 95% confidence interval [CI] = 0.5510.731, P < 0.001), postoperative C-reactive protein (OR = 1.010, 95% CI = 1.0031.018, P = 0.005), and postoperative infection (OR = 3.148, 95% CI = 1.1188.867, P = 0.030) were the independent risk factors for POD in aortic arch replacement. Among them, the intraoperative minimum MAP has the best prediction effect. When its cutoff value reaches ≤ 49 mmHg, the specificity for predicting POD is 84.88% and the sensitivity is 81.58%. Conclusions: A lower intraoperative minimum MAP is an independent risk factor and has the predictive value for POD in aortic arch replacement.
A qualitative study of the experience of mothers with mental illness during the COVID-19 pandemic: Learnings from a perinatal psychiatry service
Authors: Almas Saima , Kennedy Vanathi , Kar Nilamadhab 
Published: March 2023

Abstract

BACKGROUND/OBJECTIVES:
Pregnancy and childbirth are one of the vulnerable periods in women's lives, and women with mental illness require additional support during this period. The COVID-19 pandemic along with its impact on clinical services brought challenging situations. We intended to study the experiences of women with mental illness in their perinatal period reflecting about the perinatal psychiatric services.

METHODS:
It was a qualitative, interview-based study. Information was collected through a discussion with the patients through telephone. Both open- and closed-ended questions were used to explore their experiences and facilitate the content. The content was analyzed into various themes.

RESULTS:
There were a few major themes in the following areas: the effect of COVID on life during pregnancy and postnatal period, the effect of COVID on prenatal and postnatal care, a preference for in-person, face-to-face assessment and care, areas where the perinatal psychiatry services performed well, and suggestions from patients for improvement of the services.

CONCLUSIONS:
The study findings can help to improve existing perinatal psychiatric services to make these more accessible and responsive to the needs of the patients, especially during challenging times.
Choosing my gender: Challenges faced by transgender persons in India
Authors: Mohapatra Ankita , Mohapatra Prasanta Kumar 
Published: March 2023

Abstract
The golden thread that runs through the equality scheme of the Indian Constitution (Articles 14, 15, 16, 19, and 21) is the “enjoyment of life by all citizens and an equal opportunity to grow as human beings irrespective of their race, caste, religion, community, social status, and gender.” One of the basic tenets of the equality scheme lies in the recognition and acknowledgment of the right of choice and self-determination. Nonrecognition of transgender in the Indian legal framework has resulted in the systematic denial of equal protection of the law and widespread socioeconomic discrimination in society at large as well as in Indian workplaces. The article below brings into discussion the significant challenges faced by the transgender population that further fuel their inability to uplift themselves in Indian society.
Colonizing and Virulence Factors in Enterotoxigenic Escherichia coli from Peru
Authors: Rivera Fulton P. , Medina Anicia , Riveros Maribel , Ochoa Theresa J. , Pons Maria J. , Ruiz Joaquim 
Published: March 2023

ABSTRACT.
Enterotoxigenic Escherichia coli (ETEC) ranks among the most relevant diarrheagenic pathogens. Efforts to design vaccines to fight ETEC have been focused on colonizing factors (CFs) and atypical virulence factors (AVF). An effective vaccine must account for differences in the regional prevalence of these CFs and AVFs to be truly effective in a given area. In the present study, the presence of 16 CFs and 9 AVFs, as well as the heat-stable (ST) variants (STh or STp), was established by polymerase chain reaction in 205 Peruvian ETEC isolates (120 from diarrhea cases and 85 from healthy controls). Ninety-nine (48.3%) isolates were heat-labile, 63 (30.7%) ST, and 43 (21.0%) presented both toxins. Of ST isolates, 59 (28.8%) possessed STh, 30 (14.6%) STp, five (2.4%) both STh and STp, and 12 (5.8%) were not amplified for any variant tested. The presence of CFs was associated with diarrhea (P < 0.0001). The presence of eatA as well as concomitant presence of CSI, CS3, and CS21 and of C5 and C6 was statistically related to diarrhea cases. The present results suggests that, if effective, a vaccine considering CS6, CS20, and CS21, together with EtpA, would provide protection against 64.4% of the isolates analyzed, whereas the addition of CS12 and EAST1 would lead to 83.9% coverage. Large studies are needed to establish both the ideal candidates to be considered to develop a vaccine effective in the area, and continuous surveillance is needed to detect displacement of circulating isolates that may compromise future vaccines.
Stably semiorthogonally indecomposable varieties
Authors: Pirozhkov Dmitrii 
Published: March 2023

A triangulated category is said to be indecomposable if it admits no nontrivial semiorthogonal decompositions. We introduce a definition of a noncommutatively stably semiorthogonally indecomposable (NSSI) variety. This propery implies, among other things, that each smooth proper subvariety has indecomposable derived category of coherent sheaves, and that if $Y$ is NSSI, then for any variety $X$ all semiorthogonal decompositions of $X \times Y$ are induced from decompositions of $X$. We prove that any variety whose Albanese morphism is finite is NSSI, and that the total space of a fibration over NSSI base with NSSI fibers is also NSSI. We apply this indecomposability to deduce that there are no phantom subcategories in some varieties, including surfaces $C \times \mathbb{P}^1$, where $C$ is any smooth proper curve of positive genus.Comment: 15 pages; published version