bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterization and predictive risk scoring of long COVID in a South Indian cohort after breakthrough COVID infection; a prospective single centre study
Authors: Nair Pranav , Nair Chithira V , Kulirankal Kiran G , Corley Elizabeth M , Edathadathil Fabia , Gutajhr Georg , Moni Merlin , Sathyapalan Dipu T 
Published: April 2023

Abstract
Background
The majority of existing literature on long COVID has been focused on hospitalised patients. However, in the real-world setting of the post-vaccination era where breakthrough infections are the norm, it becomes a priority to assess the clinical profile of long COVID symptoms among such individuals. Through our study, we aim to describe the incidence, characterise and stratify the risk of developing long COVID breakthrough infections.
Methods
This prospective observational study included adult patients with breakthrough COVID-19 infections diagnosed at a tertiary hospital in India. Post-COVID symptoms at weeks 2, 6 and 12 after testing negative were extracted using a questionnaire after which multi-variate analysis was done.
Results
Out of 414 patients analysed, 164 reported post-COVID symptoms beyond 6 weeks of the infection. Univariate analysis showed that the presence of long COVID was found to be significantly higher among patients above 65 years of age at 31.3% in comparison to the long COVID presence at 29.4% among those below age 65 (p < 0.001). Systemic hypertension was also significantly associated with the presence of long COVID (72.3%), along with bronchial asthma (68.8%) with a p-value of < 0.0001 in both instances. Backwards selection was used leading to a reduced model consisting of age OR 1.053, 95% CI 0.097–1.07), p < 0.001), hypertension (OR 2.59, 95% CI 1.46–4.59, p = 0.001) and bronchial asthma (OR 3.7176, 95% CI 1.24–11.12, p = 0.018) to be significant predictors of long COVID incidence. These were used to develop a propensity score (C statistics – 80.9%).
Conclusions
A significant presence of long COVID at 12 weeks among non-hospitalised breakthrough infections calls for a series of review check-ups for the early detection of long-term complications. The proposed predictive risk scoring based on significant risk factors may assist clinicians in identifying patients at risk of developing long COVID, leading to appropriate, individualised management.
Clinical features of Shwachman-Diamond syndrome: A systematic review
Authors: Xue Han , Shuanglong Lu , Changjuan Gu , Zhuli Bian , Xiaotian Xie , Xiaohong Qiao 
Published: April 2023

Abstract
Introduction Shwachman-Diamond syndrome (SDS) is an autosomal recessive inherited bone marrow failure (IBMF) with exocrine pancreatic dysfunction and diverse clinical phenotype. To summarize the clinical features, epidemiology and treatment of SDS, we reviewed internationally published reports of patients with SDS.
Materials and methods With "Shwachman-Diamond syndrome", "SDS", "SBDS gene" and "inherited bone marrow failure" as keywords, the search period was setted from January 2002 to October 2022, and the relevant literatures of WangFang Database and China national knowledge infrastructure database was collected. In addition, using "Shwachman-diamond syndrome" as the keyword, literature reports from Web of Science, PubMed, and MEDLINE databases from January 2002 to October 2022 were retrieved, and a child with SDS treated in Tongji Hospital was also included.
Results The clinical features of 156 SDS patients were summarized. Three major SDS clinical features were cytopenia (94%), exocrine pancreatic dysfunction (83%), and failure to thrive (83%). The detection rate of SDS gene mutation was 94.6% (125/132). Mutations in SBDS, DNAJC21, SRP54, ELF6 and ELF1 genes have been reported. The male to female ratio is about 1.3/1. The median age at onset was 1.9 months, but the median age at diagnosis was 15.6 months.
Conclusion Common initial symptoms were pancreatic exocrine insufficiency and growth failure. The onset age of SDS in children is early and the individual difference is obvious. Comprehensively collecting and analyzing case related data can help clinicians understand the clinical characteristics of SDS, which may improve early diagnosis and effective clinical intervention of SDS.
Continuous electroencephalogram (cEEG) findings and neurodevelopmental outcomes in neonates with congenital heart disease (CHD) at 12-24 months of age
Authors: Padiyar Swetha , Friedman Neil , Pestana-Knight Elia , Franic Linda , Worley Sarah , Aly Hany 
Published: April 2023

Abstract
Objective

This study aims to assess the role of continuous EEG (cEEG) background patterns and duration of cross-clamp time and cardiopulmonary bypass (CPB) to predict abnormal neurodevelopmental outcomes at 12–24 months on Bayley Scales of Infant and Toddler Development (BSID-III).
Study design: This retrospective cohort study included infants with CHD and cEEG monitoring, who underwent surgery by 44 weeks gestational age.
Results: 34 patients were included, who were operated at median age − 7 days. Longer duration of cross- camp time was associated with poor language composite scores (LCS) (p value = 0.036). A significant association existed between severity of encephalopathy in 24-hour post-operative period and poor LCS (p value = 0.026).
Conclusion: Majority of neonates with CHD have below average cognitive, language and motor composite scores on BSID-III. Longer duration of cross-clamp time and severity of encephalopathy during 24-hour post-operative EEG monitoring are associated with poor LCS.
Association between systemic lupus erythematosus and pulmonary hypertension: Evidence from Meta-Analysis and Mendelian Randomization
Authors: Wei Yining , Cheng Xiaoxue , Zhang Yu , Liu Anlin , Ruan Honglian , Wang Tao 
Published: April 2023

Abstract
Background
Pulmonary hypertension (PH) is one of the most severe pulmonary complications of systemic lupus erythematosus (SLE). Nevertheless, studies of the prevalence of PH in SLE diversify tremendously, and the prevalence has not been updated for a long time. With the aim of estimating a more accurate prevalence of PH in SLE patients, we commenced a meta-analysis. Further analysis using the mendelian randomization (MR) approach was conducted to investigate whether SLE has a causal association with PH.
Methods
Pubmed, Embase, Web of Science and Cochrane Library were searched until October 2022 to identify eligible studies. We performed a heterogeneity and evaluated publication bias. Regional subgroup analyses were also performed. To further investigate the causal relationship between genetically predisposed SLE and PH, a two example mendelian randomization was performed. With 86 single nucleotide polymorphisms (SNPs) of mixed ancestors from the latest GWAS of SLE and 39 SNPs from another cohort as the replication group, we applied the inverse variance weighted (IVW) method to further estimate the causality, and conducted sensitivity analysis to measure the robustness of our results.
Results
Random effect model analysis showed a combined prevalence of 3.2% (95%CI 2.3-4.0%). However, the funnel plot showed a certain publication bias (p = 0.009). Subgroup analyses carried out on the basis of different regions demonstrated a salient difference in PH prevalence in SLE patients. Correspondingly, the mendelian randomization results showed that systemic lupus erythematosus was causally related to a higher risk of pulmonary hypertension among mixed ancestors (OR 1.33; 95%CI 1.04–1.69; P = 0.023), while no significant result was observed among European patients (OR 1.06; 95%CI 0.95–1.19; P = 0.297). Moreover, the results of MR sensitive analysis confirm the robustness of our causal estimates.
Conclusion
Our study suggested that a relatively low prevalence of PH in SLE when using right heart catheterization (RHC) to diagnose, but it was significantly different between regions. MR analysis also suggested that SLE might contribute to the progression of PH. The underlying mechanism regarding the causality between the two diseases requires further investigations.
In Vitro Screening of Selected Medicinal Plants for Their Anti-bacterial Efficacy Against Few Clinical Isolates
Authors: Sharmah Himangsu , Manickam Mathiyazhagan , Chaubey Binay , K Meenakshi Sundaram , Prathap Lavanya 
Published: April 2023

Abstract
From ancient times, plants have been the primary source of several phytochemicals that have been crucial in maintaining human health. A variety of antibiotics including secondary metabolites that plants produce while under stress. Due to the advent of several multi-drug resistant strains, commonly available antibiotics lost their effectiveness, and it became the second biggest cause of death globally. It was critical to create brand-new, highly efficient antibacterial medications from plant sources that were affordable, had fewer side effects, and worked quickly to treat bacterial illnesses. This study examines the effectiveness of nine methanolic plant extracts against nine bacterial diseases that are frequently caused by bacteria.
Effect of Group-based Acceptance and Commitment Therapy on Elderly Stroke Survivors: study protocol for a randomized controlled trial
Authors: Chen Furong , Zhou Qiao , Wu Junqi , Xu Xianghua 
Published: April 2023

Abstract
Introduction: Elderly stroke survivors usually experience various psychology disorders, such as post-stroke depression (PSD), which may be associated with high empirical avoidance (EA) and can seriously affect their quality of life. To date, the efficacy of group-based acceptance and commitment therapy (ACT) for elderly stroke survivors has not been established. The aim of this study is to investigate the effectiveness of group-based ACT on EA, PSD, psychological distress, and quality of life in elderly stroke survivors after group-based ACT.
Methods and analysis: This study is a randomized, single-blind, wait-list controlled, parallel-arm trial. A total of 66 stroke survivors will be randomly assigned to wait-list control group or intervention group. Participants in wait-list control group will receive treatment as usual (TAU), while the intervention group will receive group-based ACT once a week for eight weeks. The primary outcome measure being EA, and the secondary outcome measures being PSD, psychological distress, and quality of life. Results of the two groups will be blindly assessed by professional evaluators at baseline (T0), post-treatment (T1), and one-month follow up (T2).
Discussion: The results of this study will provide the first evidence for the effectiveness of a group-based ACT intervention in reducing EA, PSD, psychological stress, and improving quality of life for post-stroke survivors.
Trial Registration: ChiCTR2200066361.
The Prognostic Value of Pretreatment A Composite Biomarker of Natrium and Myeloid to Lymphoid lineage ratio in Patients With Advanced or Metastatic Gastric Cancer Treated With Immunotherapy
Authors: Pan Yuting , Dai Guanghai 
Published: April 2023

Abstract
Background Immunotherapy is effective for only some patients with advanced gastric cancer (AGC). Screening and determining patients who are suitable for immunotherapy is a difficult task in the field of tumor immunology. Patients with tumors often have sodium ion imbalance and changes in tumor microenvironment. The correlation between serum sodium level and tumor prognosis has been incredibly concerning. Targeting the tumor immune microenvironment to enhance the anti-tumor ability of immune cells, and thus improving the effect of therapeutic treatment of tumors is a research hotspot in recent years. However, the correlation between serum sodium level and immunotherapy has not been reported. Therefore, we collected the clinical records and follow-up data of 268 patients with AGC who received immunotherapy, and deeply analyzed whether a composite biomarker of natrium (Na) and myeloid to lymphoid lineage ratio (M:L) is suitable as a prognostic indicator for screening patients for immunotherapy.
Methods The median of 3.58 was taken as the optimal cut-off value. The optimal cut-off value was determined according to M:L, and the patients were then divided based on M:L into two groups: Low-level group (< 3.58) and High-level group (≥ 3.58). The optimal cut-off value of serum Na was 135mmol/L, which was the lowest limit of the normal range of blood biochemical results in the Cancer Center Department of PLA General Hospital. According to the optimal cut-off value of serum Na and M:L, patients were divided into two groups: The good Na/M:L group (145mmol/L > Na ≥ 135mmol/L and M:L < 3.58) and intermediate/poor Na/M:L group (Na < 135mmol/L and M:L ≥ 3.58 ). The differences in progression-free survival (PFS) and overall survival (OS) in the two Na/M:L groups were compared by survival analysis and log-rank test. COX was used for univariate and multivariate analysis to determine the presence of correlation between Na/M:L grouping and OS and PFS.
Results Patients in the good Na/M:L group were associated with longer PFS and OS compared to the intermediate/poor Na/M:L group (6.3 vs 3.6 months, 15.8 vs 9.5 months). The intermediate/poor Na/M:L group was independently associated with a 1.9-fold greater risk of disease progression (HR=1.584; 95% CI, 1.206-2.080; P=0.001) and more than 1.4-fold greater risk of death (HR=1.466; 95% CI, 1.069-2.011; P=0.018), compared to the good group.
Conclusion This study confirms for the first time that the composite biomarker of Na and M:L is an independent factor affecting survival of AGC patients receiving immunotherapy. Thus, patients in the good Na/M:L group could be identified to benefit from immunotherapy.
A new discovery of folic acid derivatives to improve the efficacy of PF regimen in the treatment of nasopharyngeal carcinoma
Authors: Huang Bingjiang , Mao Yinyan , Liang Jiaxin , Yao Jing , Li Xuemin , Fidelis Chibhabha , Liang Zibin 
Published: April 2023

Abstract
Objective
The purpose of this study is to investigate the acute toxicity, progression-free survival and overall survival in patients of nasopharyngeal carcinoma (NPC) treated with or without calcium folinate.
Methods
1. Total of 422 patients with nasopharyngeal carcinoma were recruited from July 1, 2002 to December 31, 2014, including chemotherapy regimen of PF and CPF regimen.
2. The imformation of acute toxicities, recurrence and metastasis, and survival time were collected.
3. Data processing and analysis by Graphpad prism 6 software.
Results
1. The overall survival of the Group CPF as compared to the Group PF at 3, 5,10 and 12 years were 97.42% vs. 91.24%，94.61% vs. 87.44%，88.74% vs. 81.98% and 88.74% vs. 78.57%, respectively. The OS of Group CPF got higher than that of Group PF (P=0.0269).
2. The overall survival rate of CPF group was significantly higher than that of group PF in clinical stage I-III, the overall survival was 90.83% vs. 82.12%，respectively（P=0.0348）.
3. The local control rate of the Group CPF as compared to the Group PF were 97.06% vs. 73.91% in stage T4 (P=0.0133).
4. No significant difference in other indicators between the two groups in hematological toxicity, except for Grade 3 neutropenia.
5. The incident of side effects of digestive system, such as nausea and vomiting, the Group CPF as compared to the Group PF were 45.06% vs. 67.31% and 33.95% vs. 46.15%，respectively（P=0.0000，P=0.0036）.
Conclusions
1. Calcium folinate can significantly prolong the overall survival rate of patients with nasopharyngeal carcinoma, especially in Stage I-III（90.83%）.
2. Calcium folinate can significantly improve the local control rate in patients with T4（97.06%）.
3. It shows obvious protective effects on digestive system（33.95%）
A rare case of retroperitoneal teratoma with evidence of papillary thyroid carcinoma: a case report
Authors: Poljo Adisa , Klasen Jennifer M. , von Strauss Marco , Posabella Alberto , Taha-Mehlitz Stephanie , Hummer Barbara , Kern Beatrice 
Published: April 2023

Abstract

Background
Teratomas are germ cell tumors composed of somatic tissues from up to three germ layers. Primary retroperitoneal teratomas usually develop during childhood and are uncommon in adults and in the retroperitoneal space. While there are only a few cases of retroperitoneal thyroid tissue, we report a unique case of a retroperitoneal papillary thyroid carcinoma.
Case presentation
A 41-year-old woman presented in our institution due to intermitted unspecific abdominal pain. Magnetic resonance imaging detected a multi-cystic solid retroperitoneal mass ventral to the psoas muscle and the left iliac artery. After surgical removal of the retroperitoneal mass, histology sections of the specimen indicated evidence of papillary thyroid carcinoma cells. A staging computed tomography scan of the body showed no further manifestations. To reduce the risk of recurrence, total thyroidectomy was performed followed by radioiodine therapy with lifelong hormone substitution.
Conclusions
Primary retroperitoneal teratoma with evidence of papillary thyroid carcinoma is rare condition. Preoperative diagnosis is difficult due to its non-specific clinical manifestation and lack of specific radiologic findings. Histopathology analysis is necessary for diagnosis. Although surgery is considered the first line treatment, there is still discussion about the extent of resection and the need for total thyroidectomy with adjuvant radioiodine therapy.
Length of hospital stay and its predictors among burn patients in a resource limited setting; a multicenter prospective cohort
Authors: Baraka Samuel Mandro , Kiswezi Ahmed , Edyedu Isaac , Molen Fabrice Selamo , Muhumuza Joshua , Kyomukama Lauben , Zawadi Gift Vulwaghe , Okedi Francis Xaviour 
Published: April 2023

Abstract

Introduction
Burn injury is a critical and under-recognized public health issue that affects people all over the world. Majority of the burns occur in low and middle income countries like Uganda. There is paucity of data relating to length of hospital stay among burn patients managed in hospitals with no burn units, yet this constitute a big percentage of hospitals in low income countries. This study was aimed at determining the predictors of length of stay at 3 hospitals in resource limited setting.
Methods
This was a prospective cohort multicentre study that enrolled 101 burns patients with moderate and severe burns admitted in 3 tertiary hospitals in western Uganda. Follow up was done till to discharge, length of hospital stay and its predictors determining using logistic regression in SPSS version 26.
Results
Of the 101 participants, the mean age was 21.3 (SD = 16.8) years. Majority were males (69.3%) from a rural setting (61.4%) and were accidentally burnt (95.0%) from home (75.2%). The mean length of hospital stay was 9 days with a standard deviation of 5.7. At multivariate level of analysis, the variables that independently predicted increased length of hospital stay were time to medical attention (AOR = 14.912, CI = 2.743–81.079, P = 0.002), burn severity (AOR = 6.173, CI = 1.392–27.371, P = 0.017) and type of procedure done (AOR = 0.047, CI = 0.009–0.245, P < 0.001).
Conclusion
This study revealed that the length of hospital stay was comparable to that seen in other studies. The factors independently associated with increased length of hospital stay were; time to medical attention, burn severity, and type of procedure done. Measures to ensure timely medical attention can reduce the length of stay among patients with burns even in the absence of a burn unit.
Clinical prognostic value of elevated CK-MB in severe multiple trauma patients with nonmyocardial contusion
Authors: Huang Dan , Qi Jing , Sun ChuanZheng , Lei JingChao , Chen Xi , Cui Qiong 
Published: April 2023

Abstract
Background: Unintentional injury was the leading cause of death and disability among individuals younger than 49 years globally in 2019. However, the association between serum CK-MB levels and clinical value in polytrauma patients with nonmyocardial contusion remains unclear.
Methods: This was a single-center, retrospective study. Demographic and clinical data were extracted from the Hospital Information System (HIS) at the Third Xiangya Hospital of Central South University. A total of 287 patients were included in the study. Patients were divided into a normal group (CK-MB ≤25 U/L) and an abnormal group (CK-MB >25 U/L) based on a low CK-MB level. Further clinical and follow- up data were analyzed by using univariate and multivariate logistic regression.Finally, disease-free survival and overall survival were calculated by the Kaplan– Meier method.
Results: Multivariate logistic regression demonstrated that CK-MB (OR: 1.023, 95% CI: 1.006-1.040) was an independent risk factor for predicting in-hospital mortality in polytrauma patients with nonmyocardial contusion. Compared with normal CK-MB levels, CK-MB elevation was associated with a longer length of ICU stay (7.38±13.13 vs. 3.16±5.86 days, P =0.004) and total length of hospital stay (24.73±23.04 vs.
18.29±14.63 days, P =0.015) and was more likely to result in arrhythmia during hospitalization (19.29% vs. 10%, P =0.048). Moreover, the follow-up data showed that patients with CK-MB elevation were more likely to have cardiopalmus after discharge (15.00% vs. 5.68%, P =0.027).
Conclusion: Our findings suggested that elevated CK-MB played an important role in the prognosis of polytrauma patients with nonmyocardial contusion, and a higher level of CK-MB indicated a poor prognosis.
Variability in mechanical properties of additively manufactured 17-4 PH stainless steel produced by multiple vendors: Insights for qualification
Authors: Yin Denise , Gienger Edwin B. , Croom Brendan P. , Reider Lucy A. , Trethewey Bruce R. , Lark Alex R. , Nimer Salahudin M. , Carter Ryan H. , Post Zach J. , Montalbano Timothy J. , Chung Christine , Rettaliata Justin , Presley Michael 
Published: April 2023

Abstract
In applications where a combination of good strength and corrosion resistance is required, 17 − 4 precipitation hardenable (PH) stainless steel is a common material choice. This alloy is traditionally processed through a combination of casting, rolling, and machining. A variety of heat treatments are used to anneal and harden the material via precipitation strengthening. While additive manufacturing (AM) removes many geometric design constraints from these traditional forming processes, until recently, structures fabricated via laser powder bed fusion (L-PBF) were porous and contained undesirable columnar grain structures that contributed to unpredictable and anisotropic mechanical properties. However, recent advances in L-PBF processing technology including improved gas flow, powder atomization, and print parameter optimization enable printing of high-quality AM 17 − 4 PH with properties that are comparable to traditionally processed material. With the ultimate goal of establishing mechanical property baselines involving numerous L-PBF processes, six vendors (including this work) fabricated tensile and fatigue samples of 17 − 4 using a variety of machines. Ultimately, after standard solution annealing and heat treating, the microstructure and mechanical properties across vendors converged with very few, easily explainable exceptions. In particular, powder atomized in nitrogen promoted formation of retained austenite that lead to a yield point phenomenon in as-built conditions and high surface roughness from as-built surfaces reduced the fatigue strength. However, with conventional post-processing heat treatments and surface polishing, AM 17 − 4 PH behaved comparably and consistently to conventionally processed material.