bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utility of lung ultrasound in adjustment of the initial mechanical ventilation settings in patients with acute respiratory distress syndrome
Authors: Mohamed Menna A.M. , Khalil Magdy M. , Diab Haytham S. , EL-Maraghy Ashraf A.S. 
Published: February 2023

Background
Bedside lung ultrasound (US) is an essential tool in assessing lung aeration in severely ill patients.

Aim
The goal of this study was to determine the use of lung US in evaluating changes in lung aeration in dependent lung areas during positive end expiratory pressure (PEEP) titration in patients with acute respiratory distress syndrome (ARDS).

Patients and methods
A total of 52 mechanically ventilated patients with ARDS admitted in the ICU of Abbassia Chest Hospital were enrolled in this study. Transthoracic sonography was performed at the posterior axillary line on either side after 30 min of initial ventilator settings; recruitment at the end of expiration was sonographically assessed while changing PEEP. Arterial blood gases were performed before and after recruitment maneuver along with continuous monitoring of hemodynamics and oxygen saturation throughout the procedure. The procedure was terminated if the plateau pressure exceeded 30 cmH2O or if there was hemodynamic compromise.

Results
A total of 52 mechanically ventilated patients with ARDS were enrolled in the study. Overall, 80% had severe ARDS. Initial US assessments were done, and subpleural consolidation (C) was found in 18 patients, whereas exaggerated B lines (B) were found in 33 patients. After PEEP titration, under US guidance, 13 patients changed the US pattern from C to B and 22 patients changed from B to A (A-line pattern). These results correlated with improvement of PaO2/FiO2 ratio from 69.98 ± 27.93 to 86.21 ± 31.64 and increased compliance from 26.49 ± 8.63 to 28.73 ± 8.74. However, there was an increase in plateau pressure from 25.12 ± 3.88 to 27.98 ± 3.18, and also PaCO2 increased from 51.00 ± 16.05 to 58.52 ± 15.93. The mean arterial blood pressure decreased from 84.87 ± 7.91 to 81.60 ± 8.72.

Conclusion
US is an effective tool in achieving PEEP titration in mechanically ventilated patients with ARDS. US finding of aeration correlates well with improvement in oxygenation and compliance. However, the patients should be monitored for safe limits of pressures, hemodynamics, and PaCO2 level that may rise.
Evaluation of Ventilatory Functions in Hypothyroid Patients
Authors: Garg Nitika , Kumar Vipul , Gupta Krishnan B. , Garg Sumit 
Published: February 2023

Introduction
Respiratory muscle weakness is proportional to the degree of thyroid function and is reversible by replacement therapy with thyroxine.

Aim
To evaluate the changes in pulmonary functions in newly diagnosed hypothyroid patients as compare with healthy controls by spirometry and to observe the improvement in pulmonary functions after hormone replacement therapy.

Patients and methods
A total of 30 newly diagnosed hypothyroid patients and 30 healthy controls of age between 18 to 50 years of either sex were included in our study. Clinical criteria and biochemical tests were registered, and spirometry was done.

Results
Approximately 17% of the hypothyroid patients were normal, whereas 33% had mild restrictive lung impairment and the rest 50% had moderate to severe restrictive impairment on spirometry.

Conclusion
On comparing the hypothyroid patients with normal healthy person of same age group through spirometer, the ventilatory functions were diminished and these pulmonary functions improved after levothyroxine therapy for 6 months but could not reach the normal healthy values. A spirometric evaluation should be considered in hypothyroid patients, even in the absence of respiratory illness.
Role of lung point navigation bronchoscopy in diagnosis of peripheral pulmonary lesions
Authors: Allam Amira H. , Eisa Sherif A. , El-Sayed Abd El-Rahim Mahmoud , Amin Nashwa A. 
Published: February 2023

Background
Cancer of the lung is the leading cause of mortality worldwide. There is a continuing problem to treat patients with pulmonary lesions in the peripheral lung. Technology like virtual bronchoscopic imaging is based on assisted-computed tomography pictures that lead the bronchoscopist to the target peripheral lesion.

Objectives
The purpose of this research was to evaluate the safety and effectiveness of the lung point navigation system in the identification of peripheral pulmonary lesions.

Patients and methods
A total of 20 patients took part in this cross-sectional investigation, which used analytical methods. Finally, tissue samples from peripheral pulmonary lesions were collected using virtual bronchoscopic navigation.

Results
Overall, 90% of the cases analyzed were correctly diagnosed using lung point navigation, whereas 10% of the cases were incorrectly diagnosed. The lesion was on average 22.4 mm×23 mm in size, 17.2 mm away from the costal border, and 102.5 mm away from the diaphragm. The average navigation time was 7.4 min, whereas the average planning time was 5 min, and the overall examination duration was 31 min.

Conclusion
The navigation bronchoscopic method is a promising innovation in the field of lung disease diagnostics. Cost, operational skills, and the learning curve have all conspired to keep it from being widely used thus far.
Proposed predictive score for visual outcome in cataracts with comorbidities following small-incision cataract surgery
Authors: Shah Mehul , Shah Shreya , Kataria Apeksha , Korane Ashvini 
Published: February 2023

Introduction:
Cataract with comorbidity having poor prognosis, it is important to predict visual outcome in these eyes.

Materials and Methods:
This was a prospective cohort study to develop scoring system to predict visual outcome in case of cataracts with comorbidities. We enrolled all cataracts with comorbidities fulfilling inclusion criteria between August 2019 and 2020. For all enrolled cases, data were collected in pretested online format in electronic medical records. A specially designed form was used to calculate preoperative score which was categorized and compared with postoperative visual outcome. All data were exported and analyzed with SPSS 22 using descriptive, cross-tabulation, and one-sample test functions.

Results:
Our cohort consisted of 230 eyes of 230 patients with a mean age of 44 ± 21.22 years with 121/230 (52.6%) females and 109/230 (47.4%) males. Out of total 230 eyes Traumatic cataracts were in 64, cataract with corneal opacity in 45, postuveitic cataract in 43, neglected cataracts in 39 eyes. We found a significant difference in pre- and postoperative visual outcome. When we studied preoperative score, we found a significant difference between outcomes.

Conclusion:
Preoperative score for cataracts with comorbidities undergoing small-incision cataract surgery SICS is a very useful tool to predict visual outcome and universalize for comparison.
Intratumoral heterogeneity contributes to the chemotherapy prognosis of breast cancer
Authors: Li Yang , Wang Maohua , Yang Siyuan , Kuang Licheng , Tao Xinling , Yang Jilan , Zhao Wentao , Zhang Ji 
Published: February 2023

Context:
Previous studies have shown that intratumoral heterogeneity (ITH) is associated with poor clinical outcomes and is thought to be a mechanism of resistance to chemotherapy and radiotherapy.

Aims:
We aimed to determine how ITH affects the response to drug therapy in breast cancer (BC).

Settings and Design:
We assessed ITH using mutated allele tumor heterogeneity (MATH) data from BC patients in the TCGA database.

Methods and Material:
The study enrolled 515 patients with BC treated with chemotherapy from the TCGA database who had available data on survival, whole-exome sequencing, and genome-wide transcriptome sequencing. Additionally, 399 MSK-BRCA cohort patients were treated with chemotherapy.

Statistical Analysis Used:
All statistical analyses were conducted using R. All comparisons were made using the two-sided Mann–Whitney test, Pearson's Chi-squared test, and the Kruskal–Wallis test. Statistical significance was defined as P values less than 0.05 (*P < 0.05). The survival package in R was used to conduct the analysis.

Results:
Additional analysis was performed on 515 BC patients receiving adjuvant chemotherapy. MATH was associated with overall survival (OS) in multivariate analysis (hazard ratio (HR), 1.432; 95% confidence interval, 1.073–1.913; P = 0.015). Pathway enrichment and immune cell analysis revealed that the low MATH group had significantly higher infiltration of 24 different types of immune cells than the high MATH group.

Conclusions:
Individuals with low MATH scores had a longer OS than those with high MATH scores. Immune responses were significantly enhanced in breast cancer patients with low MATH scores.
Necrosis onstaging 18F FDG PET/CT is associated with worse progression-free survival in patients with stage IIIB non-small cell lung cancer
Authors: Eren Gulnihan , Kupik Osman 
Published: February 2023

Objective:
The presence of pathological necrosis in the tumor is known to be a factor indicating worse survival. Our study defined necrosis in staging 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in patients with stage IIIB non-small-cell lung cancer (NSCLC) to investigate whether this is a poor prognostic marker.

Methodology:
A total of 77 patients with NSCLC were evaluated. To evaluate necrosis on 18F FDG PET/CT, we drew a region of interest (ROI) in the area showing visually very low/or no FDG uptake on PET and PET/CT fusion images. If SUVmax was less than blood pool SUVmax and showed significantly less attenuation [10 to 30 Hounsfield units (HUs)] than surrounding tissue on low-dose correlative CT with non-intravenous contrast, we defined it as necrotic (PETNECROSIS). We evaluated the relationship of SUVmax, tumor size, and PETNECROSIS with progression-free survival (PFS) using a Cox proportional hazard regression model.

Results:
A PFS analysis was performed on 16 patients treated with standard chemoradiotherapy (CRT) regimen. Tumor size ≤42 mm versus >42 mm (P = 0.044, HR: 6.103, 95 CI%: 1.053–35.358) and PETNECROSİS presence/absence (P = 0.027, HR: 6.719, 95 CI%: 1.245–36.264) were independent predictors for PFS. Patients with tumor size ≤42 mm and PETNECROSİS absence were associated with higher 1-year PFS rate than patients with tumor size >42 mm and PETNECROSİS presence (86% vs. 63.5% P = 0.005 and 87.5% vs. 29%, P = 0.001, respectively).

Conclusion:
PETNECROSİS is helpful to distinguish the patients who would suffer worse survival in stage IIIB NSCLC.
Preliminary study on establishing the discriminant equation in pathological grading of hepatocellular carcinoma using immunohistochemical marker parameters
Authors: Han Xiao , Huang Tianren , Li Qiang , Han Junqing , Luo Xiaoling 
Published: February 2023

Context:
Identifying the pathological diagnosis for patients with primary hepatocellular carcinoma (HCC) depends on recognizing the microscopic cytological morphology and pathological molecular marker expressions. However, there are nearly 100 markers of primary HCC, most of which are discretely distributed. Thus, the diagnostical process lacks certainty.

Aims:
Settings and Design: A preliminary study.

Methods and Material:
A total of 37,012 pathological molecular markers were selected in this study from 1,034 randomly selected patients with primary HCC from January 2014 to June 2019. Patient information included demographic and pathological characteristics, immunohistochemical and blood biochemical indicators, and other biological laboratory data.

Statistical Analysis Used:
The discriminant analysis method (parametric and non-parametric) was used in two-thirds of the dataset to quantitatively establish the discriminant equation of gender, age, and positive variables determined by the Cochran–Armitage trend test for pathologic grading. The remaining one-third dataset was used to verify the discriminative ability.

Results:
According to the fitted discriminant equation, only CD34, CD68, Glypican-3, HepPar-1, and Ki-67 (%) exhibited high sensitivity for the diagnosis of primary HCC. Among these five indicators, glypican-3 demonstrated a relatively high correlation with Ki-67 (%). CK19 and CK7 were highly correlated. Glypican-3 demonstrated a higher positive rate in poorly differentiated tumors, whereas HepPar-1 exhibited a higher positive rate in well-differentiated tumors.

Conclusions:
Gender, age, HepPar-1, Ki-67 (%), and Glypican-3 demonstrated higher accuracy in discriminating the pathological grades of I/II, but the ability to discriminate pathological grades III/IV was insufficient. Additionally, other factors were found to affect pathological grading.
Effects of the CRYAB gene on stem cell-like properties of colorectal cancer and its mechanism
Authors: Dai Ang , Guo Xiaohong , Yang Xiaoqing , Li Min , Fu Yanxin , Sun Qing 
Published: February 2023

Aims:
Alpha B-crystallin (CRYAB), a known molecular chaperone, is involved in the occurrence and development of various tumor types. However, the function of CRYAB in colorectal cancer stem cells (CSCs) remains unknown. This study aimed to elucidate the role and possible regulatory mechanisms of CRYAB in the cancer stem cell-like phenotype of colorectal cancer (CRC).

Subjects and Methods:
The expression of CRYAB in patients with CRC and lymph node metastasis at various stages and its relationship with overall survival were detected using the TCGA database. In this study, CRC-CSCs were enriched from HCT116 and Caco2 cells with serum-free suspension culture. The CRYAB gene, stemness-related genes, and mesenchymal markers were detected via quantitative real-time PCR (qRT-PCR) in CRC cells. Then, CRYAB-HCT116S and CRYAB-Caco2S cell lines were established by lentivirus-mediated overexpression of CRYAB. Self-renewal ability and stemness features were measured by the sphere formation assay and flow cytometry. The tumorigenesis capacity in vivo was inspected in nude mice. The functions of CRYAB on CSC proliferation, migration, and invasion were examined using colony formation and the transwell assay. Finally, the Wnt/β-catenin pathway-related mRNAs and proteins were detected via qRT-PCR and western blotting.

Results:
The expression of CRYAB in CRC is related to the clinical phase and prognosis, except with lymphoid metastasis. CRYAB expression was elevated in CSCs. Upregulation of CRYAB enhanced the expression of CSC-related genes and mesenchymal markers. The capacity to form colonospheres, tumorigenesis, cell proliferation, and metastasis were significantly advanced in CRYAB-overexpressed cells. Moreover, CRYAB dramatically suppressed β-catenin degradation and downregulated the expression of p-GSK-3β.

Conclusions:
CRYAB maintains CSC formation via the Wnt/β-catenin pathway in CRCs, which may, therefore, function as vital molecular targets for CRC therapeutic strategies.
Osteoradionecrosis of the jaws
Authors: Dholam Kanchan P. , Sharma Madhura R. , Gurav Sandeep V. , Singh Gurkaran Preet , Sadashiva Karthik M. , Laskar Sarbani Ghosh 
Published: February 2023

Introduction:
Radiotherapy (RT) combined with chemotherapy and surgery is the indicated treatment for head and neck cancers. Even with the advent of modern technological advances in RT and improved oral hygiene awareness, osteoradionecrosis (ORN) still remains as one of the most debilitating side effects of RT.

Methodology:
This is a retrospective review assessing 72 patients aged over 18 years of age reporting in the Dental Department, for treatment of ORN from April 2010 to July 2019. Each patient was clinically examined and treated according to standard protocol. The stage of ORN was noted at the diagnosis and at follow-up. The demographic data, the tumor characteristics, and the treatment of patients were evaluated using descriptive statistics.

Results:
At the time of diagnosis, 84.7% of the study population was found to have Epstein Type II chronic persistent nonprogressive lesions and 11.1% of the cohort had Type III active progressive lesions. Statistically significant correlation (
P
= 0.00) was found for ORN grade at diagnosis and at follow-up. ORN being a chronic pathology, stabilization of the disease was observed in 72.3% of cases. The resolution of the necrotic lesion and down staging of the disease was seen only in 2.8% of patients.

Conclusion:
ORN is mainly a chronic long standing pathology which is difficult to treat completely. Stabilization of symptoms and preventing further spread of the necrotic lesion should be the ultimate aim of the treatment to improve the quality of life of the patients.
The relationship between adjuvant chemotherapy and thiol-disulfide compounds
Authors: Akyol Pınar , Dede Didem Şener , Bilgin Burak , Ulaş Arife , Nahit Şendur Mehmet Ali , Akıncı Muhammed Bülent , Başer Salih , Erol Cihan , Hızal Mutlu , Yalçın Bülent 
Published: February 2023

Aim:
Thiols are the organic compounds of the antioxidant system. There is limited data in the literature concerning chemotherapy (CT) in cancer and thiol balance. In this study, we aimed to evaluate the possible changes of thiol/disulfide levels with the recurrent CT cycles and type of cancer.

Materials and Methods:
The 40 healthy individuals and 40 patients who had been newly diagnosed with early-stage breast, ovary and endometrium cancer receiving adjuvant CT. Blood samples were taken from all patients three times as basal and after the first and second CT sessions.

Results:
We compared preadjuvant treatment levels of thiol and disulfide parameters in the patients group with the control group. The median of native thiol and total thiol was found to be higher in the control group than in the study group (P < 0.001). In addition, disulfide/native thiol and disulfide/total thiol rates were found to be higher in the patient group (P = 0.001). When we look at the comparison before and after CT in the patient group, disulfide/native thiol and disulfide/total thiol rates, which represent increased oxidative stress (OS) levels were found to be higher after CT than before CT measurement (P < 0.016).

Discussion:
This is the first study, which has researched the relationship between cancer type and thiol compounds and changes of thiol compounds during CT therapy, by using the method designed by Erel and Neşelioğlu. In this study, we found that pre-CT thiol disulfide balance in cancer patients shifted toward disulfide direction and OS levels may increase after repetitive CT sessions.
Circ-CCS enhances autophagy during imatinib resistance of gastrointestinal stromal tumor by regulating miR-197-3p/ATG10 signaling
Authors: Sui Shujing , Ma Fei , Mi Lei , Gao Li , Yu Wei , Li Ming , Feng Zhi , Huang Yan , Wang Qingcai 
Published: February 2023

Context:
Drug resistance in gastrointestinal stromal tumors (GISTs) is connected with autophagy activation. Accumulating data demonstrates the critical role of circular RNAs (circRNAs) dysregulation in this development.

Aim:
To explore the possible function of hsa_circ_0092306 (circ-CCS) in GIST imatinib resistance.

Materials and Methods:
Quantitative real-time reverse transcription PCR (RT-qPCR) was used to determine the expression levels of circ-CCS and miR-197-3p. The vitality and apoptosis of cells were determined using the Cell Counting Kit-8 and TUNEL assays, respectively. Western blot analysis was used to evaluate the relative protein expression. A dual-luciferase reporter assay was used to validate the link between circ-CCS, miR-197-3p, and ATG10.

Statistical Analysis Used:
Comparisons of two groups were analyzed using Student's t tests, and analysis of variance (ANOVA) with Tukey's post hoc test was used to compare three or more groups.

Results:
Circulating-CCS expression was considerably increased in the serum of imatinib-resistant GIST patients (P < 0.001). Circulating-CCS deficiency decreased cell proliferation and autophagy in GIST-882 and GIST-T1 cells, but promoted apoptosis (P < 0.05). Additionally, circ-CCS was predominantly found in the cytoplasm. Mechanically, circ-CCS targeted miR-197-3p, which may influence autophagy by downregulating ATG10, in order to modulate GIST cells' malignant tendencies. Moreover, silencing miR-197-3p reversed the effect of circ-CCS knockdown on apoptosis and autophagy in GIST cells.

Conclusions:
By modulating the miR-197-3p/ATG10 axis, circ-CCS increased imatinib resistance in GIST cells, establishing a potential target for reversing medication resistance in such patients.
Evaluation of a Web Application for Nursing Records of Multiple Trauma Patients in an Emergency Department
Authors: Phaken Chananta , Pearkao Chatkhane , Potisopha Wiphawadee , Angkasith Phati 
Published: February 2023

Introduction:
Multiple traumatic injuries cause death among traumatized patients. Nurses at the emergency department (ED) must assess, provide nursing care, and record their interventions. Recording all patient information and nursing care procedures, however, is more challenging due to time constraints in emergency care.

Methods:
The aim of this study was to evaluate the use of a web application for nursing records of multiple trauma patients in an ED and the user’s satisfaction. A web application developed based on the guidelines of Advanced Trauma Life Support was implemented in a resuscitation room of a university hospital in Khon Kaen, Thailand, from January to March 2022. The quality of nursing records through the web application for 40 trauma patients was evaluated. Thirty-seven nurses were surveyed for their satisfaction. The data were analyzed using descriptive statistics.

Results:
Overall, the comprehensive nursing process record through web application had 80.3% completeness. Some items were not recorded or partially recorded, including vital sign monitoring and patients’ vital signs and symptoms summary records before discharge. Nurses expressed their satisfaction with the web application at a high level, with an average score of 3.99 (standard deviation [SD]: 0.68). They were most satisfied with the components of the nursing process for multiple trauma patients (mean: 4.14 and SD: 0.71).

Conclusions:
The use of a web application ensures the completeness of nursing records. Nurses are satisfied with implementing the web application in their clinic. A study of its effectiveness in reducing documentation time and improving patient outcomes is needed in the future.