bluuebunny/crossref_metadata_2025_split huggingface dataset:
CT imaging indications correlate with the degree of lung adenocarcinoma infiltration
Authors: He Wenchen , Guo Gang , Du Xiaoxiang , Guo Shiping , Zhuang Xiaofei 
Published: March 2023

BackgroundGround glass nodules (GGN) of the lung may be a precursor of lung cancer and have received increasing attention in recent years with the popularity of low-dose high-resolution computed tomography (CT). Many studies have discussed imaging features that suggest the benignity or malignancy of GGN, but the extent of its postoperative pathological infiltration is poorly understood. In this study, we identified CT imaging features that indicate the extent of GGN pathological infiltration.MethodsA retrospective analysis of 189 patients with pulmonary GGN from January 2020 to December 2021 at Shanxi Cancer Hospital was performed. Patients were classified according to their pathological type into non-invasive adenocarcinoma [atypical adenomatous hyperplasia (AAH) and adenocarcinoma in situ (AIS) in a total of 34 cases], micro-invasive adenocarcinoma (MIA) in 80 cases, and invasive adenocarcinoma (IAC) in a total of 75 cases. The general demographic data, nodule size, nodule area, solid component, CT indications and pathological findings of the three groups of patients were analyzed to predict the correlation between GGN and the degree of lung adenocarcinoma infiltration.ResultsNo statistically significant differences were found among the three groups in general information, vascular signs, and vacuolar signs (P &gt; 0.05). Statistically significant differences among the three groups were found in nodule size, nodule area, lobar signs, pleural traction, burr signs, bronchial signs, and solid components (P &lt; 0.05). Logistic regression equation tests based on the statistically significant indicators showed that nodal area, lobar sign, pleural pull, burr sign, bronchial sign, and solid component were independent predictors of lung adenocarcinoma infiltration. The subject operating characteristic (ROC) curve analysis showed that nodal area is valuable in predicting GGN infiltration.ConclusionCT-based imaging indications are useful predictors of infiltrative adenocarcinoma manifested as pulmonary ground glass nodules.
18F-FDG PET/CT radiomics signature and clinical parameters predict progression-free survival in breast cancer patients: A preliminary study
Authors: Xu Xiaojun , Sun Xun , Ma Ling , Zhang Huangqi , Ji Wenbin , Xia Xiaotian , Lan Xiaoli 
Published: March 2023

IntroductionThis study aimed to investigate the feasibility of predicting progression-free survival (PFS) in breast cancer patients using pretreatment 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) radiomics signature and clinical parameters.MethodsBreast cancer patients who underwent 18F-FDG PET/CT imaging before treatment from January 2012 to December 2020 were eligible for study inclusion. Eighty-seven patients were randomly divided into training (n = 61) and internal test sets (n = 26) and an additional 25 patients were used as the external validation set. Clinical parameters, including age, tumor size, molecularsubtype, clinical TNM stage, and laboratory findings were collected. Radiomics features were extracted from preoperative PET/CT images. Least absolute shrinkage and selection operators were applied to shrink feature size and build a predictive radiomics signature. Univariate and multivariate Cox proportional hazards models and Kaplan-Meier analysis were used to assess the association of rad-score and clinical parameter with PFS. Nomograms were constructed to visualize survival prediction. C-index and calibration curve were used to evaluate nomogram performance.ResultsEleven radiomics features were selected to generate rad-score. The clinical model comprised three parameters: clinical M stage, CA125, and pathological N stage. Rad-score and clinical-model were significantly associated with PFS in the training set (P&lt; 0.01) but not the test set. The integrated clinical-radiomics (ICR) model was significantly associated with PFS in both the training and test sets (P&lt; 0.01). The ICR model nomogram had a significantly higher C-index than the clinical model and rad-score in the training and test sets. The C-index of the ICR model in the external validation set was 0.754 (95% confidence interval, 0.726–0.812). PFS significantly differed between the low- and high-risk groups stratified by the nomogram (P = 0.009). The calibration curve indicated the ICR model provided the greatest clinical benefit.ConclusionThe ICR model, which combined clinical parameters and preoperative 18F-FDG PET/CT imaging, was able to independently predict PFS in breast cancer patients and was superior to the clinical model alone and rad-score alone.
ELISA-like QDB method to meet the emerging need of Her2 assessment for breast cancer patients
Authors: Yu Guohua , Lyu Yan , Jiang Lei , Wang Yunjun , Yin Ying , Zhang Jiandi , Yang Maozhou , Tang Fangrong 
Published: March 2023

Inherent issues of subjectivity and inconsistency have long plagued immunohistochemistry (IHC)-based Her2 assessment, leading to the repeated issuance of guidelines by the American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) for its standardization for breast cancer patients. Yet, all these efforts may prove insufficient with the advent of Trastuzumab deruxtecan (T-Dxd), a drug with the promise to expand to tumors traditionally defined as Her2 negative (Her2−). In this study, we attempted to address these issues by exploring an ELISA-like quantitative dot blot (QDB) method as an alternative to IHC. The QDB method has been used to measure multiple protein biomarkers including ER, PR, Ki67, and cyclin D1 in breast cancer specimens. Using an independent cohort (cohort 2) of breast cancer formalin-fixed paraffin-embedded (FFPE) specimens, we validated cutoffs developed in cohort 1 (Yu et al., Scientific Reports 2020 10:10502) with overall 100% specificity (95% CI: 100–100) and 97.56% sensitivity (95% CI: 92.68–100) in cohort 2 against standard practice with the dichotomized absolutely quantitated values. Using the limit of detection (LOD) of the QDB method as the putative cutoff point, tumors with no Her2 expression were identified with the number comparable to those of IHC 0. Our results support further evaluation of the QDB method as an alternative to IHC to meet the emerging need of identifying tumors with low Her2 expression (Her2-low) in daily clinical practice.
Safety of the COVID-19 vaccination in children with juvenile idiopathic arthritis—A observational study from two pediatric rheumatology centres in Poland
Authors: Opoka-Winiarska Violetta , Lipinska Joanna , Michalak Arkadiusz , Burzyński Jacek , Kądziołka Olga , Smolewska Elżbieta 
Published: March 2023

IntroductionThe safety of COVID-19 vaccines in children with juvenile idiopathic arthritis (JIA) is the concern of patients and their parents and doctors in the current pandemic reality. The main objective of the study was to evaluate the safety of COVID-19 vaccine in patients with JIA.MethodA cohort study based on short clinical follow-up of 43 children with JIA was conducted in the years 2021–2022 in two centres of paediatric rheumatology in Poland. All patients received mRNA COVID-19 vaccine. The patients' data were collected using appropriate validated questionnaire. Disease activity was evaluated using Juvenile Arthritis Disease Activity Score 27-joint count (JADAS-27).ResultsTen (22.7%) children had COVID-19 infection before getting COVID-19 vaccine. After first dose of COVID-19 vaccine 25/43 (58.1%) patients presented typical adverse events: arm pain or oedema at the application side or weakness. Also, twenty five (58.1%) children had side effects after second dose of this vaccine, however the spectrum of the symptoms was wider (additionally: headache, fever, lymphadenopathy, arrhythmia). Thirteen out of 43 (30.2%) patients had active disease before and 8/43 (18.6%) after COVID-19 vaccination, while the degree of JADAS-27 activity was higher in the study group before COVID-19 vaccination (p = 0.047).ConclusionsOur study found out that children and adolescents with JIA with remission without treatment or on the long-term treatment—cDMARDs or even bDMARDs, can be safely vaccinated for COVID-19. Moreover, the study found that COVID-19 vaccination does not interfere with the JIA treatment and does not exacerbate symptoms of the disease and that vaccination protected against developing COVID-19 in children with JIA even on treatment.
Addition of metformin for non-small cell lung cancer patients receiving antineoplastic agents
Authors: Wang Yan , Hu Yuanyuan , Wang Ting , Che Guowei , Li Lu 
Published: March 2023

Background and purpose: Previous studies have found that metformin can inhibit tumor growth and improve outcomes for cancer patients. However, the association between the addition of metformin to the treatment regimen and survival in non-small cell lung cancer (NSCLC) patients receiving antineoplastic agents such as chemotherapy drugs, epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), and immune checkpoint inhibitors (ICIs) remains unclear. This study aimed to evaluate the effect of metformin in NSCLC patients who received the aforementioned antineoplastic therapies.Methods: Several electronic databases were searched for relevant studies published by 10 September 2022. The primary and secondary outcomes were overall survival (OS) and progression-free survival (PFS); eligible studies were those comparing patients with and without the addition of metformin. Hazard ratios (HRs) and 95% confidence intervals (CIs) were combined, with all statistical analyses performed using STATA 15.0.Results: A total of 19 studies involving 6,419 participants were included, of which six were randomized controlled trials. The overall pooled results indicate that the addition of metformin improved OS (HR = 0.84, 95% CI: 0.71–0.98, p = 0.029) and PFS (HR = 0.85, 95% CI: 0.74–0.99, p = 0.039). However, subgroup analysis based on treatment type and comorbidity of diabetes mellitus demonstrated that improvements in OS and PFS were observed only in diabetic and EGFR-TKI-treated patients (OS: HR = 0.64, 95% CI: 0.45–0.90, p = 0.011; PFS: HR = 0.59, 95% CI: 0.34–1.03, p = 0.061).Conclusion: Overall, this meta-analysis found that metformin use could improve outcomes for diabetic patients receiving EGFR-TKIs. However, no significant association between the addition of metformin and the survival of non-diabetic NSCLC patients receiving chemotherapy or ICI therapy was identified based on the current evidence.
Father trait anger: Associations with father–infant bonding and subsequent parenting stress
Authors: Francis Lauren M. , Youssef George J. , Greenwood Christopher J. , Enticott Peter G. , Curtis Ashlee , Graeme Liam G. , Mansour Kayla A. , Olsson Craig A. , Skouteris Helen , Milgrom Jeannette , Williams Joanne , Knight Tess , Macdonald Jacqui A. 
Published: March 2023

IntroductionParent anger presents a risk to family safety and child development. Father trait anger may also compromise the early relational context of fathers and offspring, yet evidence is lacking. The aim of this study is to examine effects of father trait anger on parenting stress in the toddler years, and the mediational role of father–infant bonding.MethodData were from 177 Australian fathers of 205 children. Trait anger (total, angry temperament, and angry reaction), father–infant bonding subscales (patience and tolerance, affection and pride, and pleasure in interaction), and subsequent parenting stress (parental distress, difficult child, and parent–child dysfunctional interaction) were assessed. At each of the subscale levels, mediational path models examined whether father–infant bonding explained the relationship between trait anger and parenting stress. Models were presented where there was at least a small association between the mediator and both the predictor and outcome.ResultsPatience and tolerance was the only domain of father–infant bonding correlated with both trait anger and all parenting stress outcomes. Patience and tolerance partially mediated the effect of total trait anger on parental distress and fully mediated effects on difficult child and parent–child dysfunctional interaction. Patience and tolerance fully mediated relationships between angry temperament and all domains of parenting stress. Angry reactions only had a direct effect on parental distress.DiscussionFather trait anger both directly and indirectly (through patience and tolerance in the father–infant bond) impacts their experiences of parenting stress in the toddler years. Early interventions to manage father trait anger and improve father–infant bonding may benefit fathers and children.
Characteristics and influencing factors of early childhood teachers’ work stress and burnout: A comparative study between China, Ghana, and Pakistan
Authors: Chen Siyuan , Ntim Seth Yeboah , Zhao Yilun , Qin Jinliang 
Published: March 2023

IntroductionMany studies have documented the stress and burnout experienced by early childhood teachers. However, few have focused on comparisons among countries, particularly developing ones. Meanwhile, female teachers, who are more sensitive and tend to provide emotional responses, are often overlooked as a major force of emotional involvement. This study examined the similarities and differences of early childhood teachers’ stress, burnout, and gender in China, Ghana, and Pakistan.MethodsThis study adopted a cross-sectional design. The participants included 945 preschool and lower primary school teachers recruited from Zhejiang Province in China, the Ashanti Region in Ghana, and Punjab, Pakistan. The analyses were conducted using structural equation modeling. First, the study estimated all parameters separately and without constraints between the groups for all models. Second, the study compared the latent mean difference and of stressors and burnout between teachers’ personal and job characteristics. Third, a structural equation model was used to assess the relationship between teachers’ stressors and burnout.ResultsAcross the three countries, female teachers are more stressed out, with higher emotional demands and work-family conflicts, and are more prone to burnout with a greater level of emotional exhaustion and a lower level of personal accomplishments than their male counterparts are. Moreover, Chinese teachers were found to be the most stressed-out group with the highest level of burnout. In comparison to teachers in China and Pakistan, early childhood teachers in Ghana possess the lowest level of emotional demands. With the lowest level of emotional exhaustion and the highest level of personal accomplishments, Pakistani teachers were unlikely to experience burnout.DiscussionThis study comparatively analyzed the characteristics of stress and burnout among ECTs in different cultural settings and educational systems in three developing countries (China, Ghana, and Pakistan), and revealed workplace characteristics and circumstances for ECTs. In addition, this study takes gender as the main influencing factor and explores its effect on ECTs’ stress and burnout, and it highlights and verifies "emotionality" in ECTs' profession. As a result, policymakers and stakeholders in different countries may be encouraged to improve ECE quality and the well-being of ECTs.
“The heart in a bag”: The lived experience of patient-caregiver dyads with left ventricular assist device during cardiac rehabilitation
Authors: Rapelli Giada , Giusti Emanuele Maria , Donato Silvia , Parise Miriam , Pagani Ariela Francesca , Pietrabissa Giada , Bertoni Anna , Castelnuovo Gianluca 
Published: March 2023

ObjectiveThe Left Ventricular Assist Device (LVAD) has increasingly become a primary therapeutic option for longer-waiting heart transplant lists. Although survival rates are growing, the device requires complex home care. Therefore, the presence of a caregiver trained in the LVAD management is important for the success of the therapy. The LVAD leads both patients and their caregivers to experience new challenges and adapt to new lifestyle changes and limitations – but their subjective beliefs before home management remained little explored.DesignThis study identified, using a phenomenological hermeneutic approach, the main components of the LVAD experience of six patient-caregiver dyads interviewed during cardiac rehabilitation.ResultsWe identified 4 master themes: Being between life and death, Being human with a heart of steel, Sharing is caring (and a burden), and Being small and passive.ConclusionThe knowledge from this study can be used as a guide for healthcare providers in counseling LVAD recipients and their caregivers.
Adolescents' perceptions and user experiences with a virtual reality-based alcohol prevention tool in Germany: A focus group study
Authors: Hrynyschyn Robert , Prediger Christina , Lyk Patricia , Majgaard Gunver , Helmer Stefanie Maria , Stock Christiane 
Published: March 2023

BackgroundExcessive alcohol consumption is a major public health problem, with substance use early in life contributing to higher levels of use later in life. Virtual reality (VR) is an innovative technology for alcohol prevention among adolescents that could solve the problem of insufficient outreach to the target group of young people. The co-created German Virtual LimitLab simulation is one of the few examples of VR-based alcohol prevention tools and consists of a virtual house party simulation. The aims of Virtual LimitLab are to increase the users' awareness of how social pressure can influence their own decision-making as well as to enable various actions and communication strategies in order to train competencies when dealing with alcohol. The present study thus aims to explore adolescents' content- and technique-specific perceptions of Virtual LimitLab in order to gain insights into user experiences and to test the prototype with the German target group.MethodsFour semi-structured focus groups with adolescents aged 15–18 years (n = 13) were conducted and analyzed using thematic analyses. A user experience questionnaire (UEQ–S) was applied in order to quantitatively assess adolescents' satisfaction with Virtual LimitLab.ResultsThree main themes were identified (VR experience, content, and technical aspects). Participants positively assessed both the content and the technical aspects of Virtual LimitLab. This trend was also seen by the UEQ–S data, which yielded positive ratings for both pragmatic and hedonic quality. The broad variety of options in the simulation that allow the user to try new behaviors was perceived particularly positively. In general, Virtual LimitLab was regarded as an innovative tool that encourages adolescents to think critically about their personal alcohol consumption. Technical errors in the simulation and users' difficulties in identifying with the simulation were the main points of criticism.ConclusionsFeedback from adolescent users revealed positive and therefore promising results when using Virtual LimitLab as a gaming alcohol-prevention tool. Some technical aspects still need to be improved in order to further refine the prototype, and suggestions for expanding the content of the application have already been made.
Associations of brominated flame retardants exposure with chronic obstructive pulmonary disease: A US population-based cross-sectional analysis
Authors: Han Lu , Wang Qi 
Published: March 2023

BackgroundsWhether there existed an association between brominated flame retardants (BFRs) and chronic obstructive pulmonary disease (COPD) prevalence in humans is still a mystery.ObjectiveTo investigate the association between serum single or mixture BFRs and COPD prevalence.MethodsData of 7,591 participants from NHANES 2007–2016 was utilized. Serum BFRs, including PBDE-28, PBDE-47, PBDE-85, PBDE-99, PBDE-100, PBDE-154, PBDE-183, PBDE-209, and PBB-153 were enrolled. The survey-weighted generalized logistic regression model, restricted cubic splines (RCS), weighted quantile sum (WQS) regression, and quantile-based g-computation (QGC) analysis were performed.ResultsAfter adjustment for all confounding factors, log-transformed continuous serum PBDE-28 (OR: 1.43; 95% CI: 1.10–1.85; P = 0.01), PBDE-47 (OR: 1.39; 95% CI: 1.11–1.75; P = 0.005), PBDE-85 (OR: 1.31; 95% CI: 1.09–1.57; P = 0.005), PBDE-99 (OR: 1.27; 95% CI: 1.05–1.54; P = 0.02), PBDE-100 (OR: 1.33; 95% CI: 1.08–1.66; P = 0.01), PBDE-154 (OR: 1.29; 95% CI: 1.07–1.55; P = 0.01), PBDE-183 (OR: 1.31; 95% CI: 1.04–1.66; P = 0.02), and PBB-153 (OR: 1.25; 95% CI: 1.03–1.53; P = 0.03) were positively correlated with the prevalence of COPD. Restricted cubic splines curves displayed that PBDE-209 was significantly associated with CPOD in an inverted U-shape (P = 0.03). A significant interaction between being male and a high prevalence of COPD was observed for PBDE-28 (P for interaction &lt;0.05), PBDE-47 (P for interaction &lt;0.05), PBDE-85 (P for interaction &lt;0.05), PBDE-99 (P for interaction &lt;0.05), PBDE-100 (P for interaction &lt;0.05), and PBB-153 (P for interaction &lt; 0.05). Mixture BFRs exposure was positively associated with COPD prevalence in WQS regression (OR: 1.40; 95% CI: 1.14–1.72, P = 0.002) and in QGC analysis (OR: 1.49; 95% CI: 1.27–1.74, P &lt; 0.001).ConclusionsOur study confirms that individual and mixture BFRs had positive associations with COPD, and further studies are required in larger-scale populations.
On the Impact of Quarantine Policies and Recurrence Rate in Epidemic Spreading Using a Spatial Agent-Based Model
Authors: Topîrceanu Alexandru 
Published: March 2023

Pandemic outbreaks often determine swift global reaction, proven by for example the more recent COVID-19, H1N1, Ebola, or SARS outbreaks. Therefore, policy makers now rely more than ever on computational tools to establish various protection policies, including contact tracing, quarantine, regional or national lockdowns, and vaccination strategies. In support of this, we introduce a novel agent-based simulation framework based on: (i) unique mobility patterns for agents between their home location and a point of interest, and (ii) the augmented SICARQD epidemic model. Our numerical simulation results provide a qualitative assessment of how quarantine policies and the patient recurrence rate impact the society in terms of the infected population ratio. We investigate three possible quarantine policies (proactive, reactive, and no quarantine), a variable quarantine restrictiveness (0–100%), respectively, and three recurrence scenarios (short, long, and no recurrence). Overall, our results show that the proactive quarantine in correlation to a higher quarantine ratio (i.e., stricter quarantine policy) triggers a phase transition reducing the total infected population by over 90% compared to the reactive quarantine. The timing of imposing quarantine is also paramount, as a proactive quarantine policy can reduce the peak infected ratio by over ×2 times compared to a reactive quarantine, and by over ×3 times compared to no quarantine. Our framework can also reproduce the impactful subsequent epidemic waves, as observed during the COVID-19 pandemic, according to the adopted recurrence scenario. The suggested solution against residual infection hotspots is mobility reduction and proactive quarantine policies. In the end, we propose several nonpharmaceutical guidelines with direct applicability by global policy makers.