bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of malnutrition evaluated by the mini nutritional assessment on the prognosis of acute hospitalized older adults
Authors: Kang Min-gu , Choi Jung-Yeon , Yoo Hyun-Jung , Park Si-Young , Kim Yoonhee , Kim Ji Yoon , Kim Sun-wook , Kim Cheol-Ho , Kim Kwang-il 
Published: January 2023

BackgroundMalnutrition is prevalent among hospitalized older patients. Therefore, this study aimed to investigate the association between nutritional status [assessed using the Mini Nutritional Assessment (MNA) and serum albumin levels] and adverse outcomes in hospitalized older patients. We also aimed to compare the predictive utility of our findings.MethodsThis retrospective cohort study was conducted between January 2016 and June 2020. In total, 808 older patients (aged ≥ 65 years, mean age 82.8 ± 6.70 years, 45.9% male) admitted to the acute geriatric unit were included in our sample. Comprehensive geriatric assessments, including the MNA, were performed. Malnutrition and risk of malnutrition were defined as MNA &lt; 17, albumin &lt; 3.5 g/dL and 17 ≤ MNA ≤ 24, 3.5 g/dL ≤ albumin &lt; 3.9 g/dL, respectively. The primary outcome was that patients could not be discharged to their own homes. The secondary outcomes were overall all-cause mortality, 3-month all-cause mortality, and incidence of geriatric syndrome, including delirium, falls, and newly developed or worsening pressure sores during hospitalization.ResultsPoor nutritional status was associated with older age; female sex; admission from the emergency room; high risk of pressure sores and falls; lower physical and cognitive function; higher depressive score; and lower serum albumin, protein, cholesterol, and hemoglobin levels. In the fully adjusted model, malnutrition assessed using the MNA predicted discharge to nursing homes or long-term care hospitals [odds ratio (OR) 5.822, 95% confidence interval (CI): 2.092–16.199, P = 0.001], geriatric syndrome (OR 2.069, 95% CI: 1.007–4.249, P = 0.048), and 3-month mortality (OR 3.519, 95% CI: 1.254–9.872, P = 0.017). However, malnutrition assessed using albumin levels could only predict 3-month mortality (OR 3.848, 95% CI: 1.465–10.105, P = 0.006). The MNA predicted 3-month mortality with higher precision than serum albumin levels (P = 0.034) when comparing the areas under the receiver operating characteristic curve.ConclusionNutritional risk measured by the MNA was an independent predictor of various negative outcomes in hospitalized older patients. Poor nutritional status assessed by serum albumin levels, the most widely used biochemical marker, could predict mortality, but not the development of geriatric syndrome or discharge location reflecting functional status.
Early impairment of food intake in patients newly diagnosed with cancer
Authors: Molfino Alessio , Emerenziani Sara , Tonini Giuseppe , Santini Daniele , Gigante Antonietta , Guarino Michele Pier Luca , Nuglio Chiara , Imbimbo Giovanni , La Cesa Annalisa , Cicala Michele , Muscaritoli Maurizio 
Published: January 2023

BackgroundPatients with gastrointestinal or lung cancer often suffer from a loss of appetite (anorexia), resulting in reduced food intake (hypophagia) and body weight loss. This study evaluated the prevalence of anorexia, hypophagia, pre-cachexia and cachexia in patients with cancer at time of diagnosis.Patients and methodsPatients with newly diagnosed gastrointestinal or lung cancers were included. Body mass index (BMI) and weight loss over the prior 6 months were recorded. Patients were assessed for (pre-)cachexia and for anorexia using the Functional Assessment of Anorexia/Cachexia Therapy (FAACT) and a specific anorexia questionnaire (AQ). Energy and protein intake were calculated through food diaries. Patients were considered hypophagic if intake was ≤70% of guideline-recommended levels.ResultsOverall, 102 patients [53 male; median age: 67 (range, 21–88) years] were enrolled. Mean BMI (± standard deviation) was 23.1 ± 3.4 kg/m2; average percentage of weight loss was 10.1 ± 7.8%. At diagnosis, 68% (69/102) of patients had cachexia, and 11% (11/102) pre-cachexia. Prevalence of anorexia was 57% (58/102) and 75% (76/102) according to FAACT and AQ, respectively. Forty-eight percent (49/102) of patients had hypophagia. Patients with anorexia had lower daily energy (p = 0.002) and protein intake (p = 0.0257), and greater percentage of weight loss (p = 0.0005). In patients with hypophagia, negative correlations were observed between percentage of weight loss and total daily calorie (r = –0.40; p = 0.01) and protein intake (r = –0.340; p = 0.018).ConclusionAnorexia, inadequate nutritional intake and cachexia are highly prevalent in patients with gastrointestinal or lung cancer at diagnosis. Negative protein and energy balance may play an important role in the pathogenesis of cachexia. Early multimodal strategies to improve food intake are urgently needed.
Poor health literacy associated with stronger perceived barriers to breast cancer screening and overestimated breast cancer risk
Authors: Poon Paul K. M. , Tam King Wa , Lam Thomas , Luk Arthur K. C. , Chu Winnie C. W. , Cheung Polly , Wong Samuel Y. S. , Sung Joseph J. Y. 
Published: January 2023

BackgroundLow health literacy (HL) is negatively associated with mammography screening uptake. However, evidence of the links between poor HL and low mammography screening participation is scarce.MethodsWe conducted a cross-sectional questionnaire survey among participants of a cancer screening program. We measured HL using a validated Chinese instrument. We assessed breast cancer screening-related beliefs using the Health Belief Model and the accuracy of risk perception. We used multivariable regression models to estimate the relationship between HL and the outcomes.ResultsA total of 821 females were included. 264 (32.2%) had excellent or sufficient, 353 (43.0%) had problematic, and 204 (24.8%) had inadequate health literacy (IHL). Women with IHL were more likely to agree that high price (β = -0.211, 95% CI -0.354 to -0.069), lack of time (β = -0.219, 95% CI -0.351 to -0.088), inconvenient service time (β = -0.291, 95% CI -0.421 to -0.160), long waiting time (β = -0.305, 95% CI -0.447 to -0.164), fear of positive results (β = -0.200, 95% CI -0.342 to -0.058), embarrassment (β = -0.225, 95% CI -0.364 to -0.086), fear of pain (β = -0.154, 95% CI -0.298 to -0.010), fear of radiation (β = -0.177, 95% CI -0.298 to -0.056), lack of knowledge on service location (β = -0.475, 95% CI -0.615 to -0.335), and lack of knowledge on mammography (β = -0.360, 95% CI -0.492 to -0.228) were barriers. They were also less likely to have an accurate breast cancer risk perception (aOR 0.572, 95% CI 0.341 to 0.956).ConclusionWomen with lower HL could have stronger perceived barriers to BC screening and an over-estimation of their breast cancer risk. Tackling emotional and knowledge barriers, financial and logistical assistance, and guidance on risk perception are needed to increase their breast cancer screening uptake.
Gradient differences of immunotherapy efficacy in metastatic melanoma related to sunlight exposure pattern: A population-based study
Authors: Liu Mengsong , Li Wenyuan , Ma Xiao , Che Yuhui , Wei Bo , Chen Mulan , Zhong Lin , Zhao Siqi , Chen Anjing , Pang Yaobin , Zeng Jinhao , Guo Jing 
Published: January 2023

BackgroundImmune checkpoint inhibitors (ICIs) have revolutionized metastatic melanoma (MM) treatment in just a few years. Ultraviolet (UV) in sunlight is the most significant environmental cause of melanoma, which is considered to be the main reason for tumor mutation burden (TMB) increase in melanoma. High TMB usually predicts that PD-1 inhibitors are effective. The sunlight exposure pattern of MM might be a clinical feature that matches TMB. The relationship between sunlight exposure patterns and immunotherapy response in MM is unclear. This study aims to investigate the correlation between sunlight exposure patterns and immunotherapy response in MM and establish nomograms that predict 3- and 5-year overall survival (OS) rate.MethodsWe searched the Surveillance, Epidemiology, and End Results (SEER) database and enrolled MM cases from 2005-2016. According to the advent of ICIs in 2011, the era was divided into the non-ICIs era (2005-2010) and the ICIs era (2011-2016). Patients were divided into three cohorts according to the primary site sunlight exposure patterns: head and neck in the first cohort, trunk arms and legs in the second cohort, and acral sites in the third cohort. We compared survival differences for each cohort between the two eras, performed stratified analysis, established nomograms for predicting 3- and 5-year OS rate, and performed internal validation.ResultsComparing the survival difference between the ICIs and non-ICIs era, head and neck melanoma showed the greatest improvement in survival, with 3- and 5-year OS rate increasing by 10.2% and 9.1%, respectively (P=0.00011). In trunk arms and legs melanoma, the 3- and 5-year OS rate increased by 4.6% and 3.9%, respectively (P&lt;0.0001). There is no improvement in survival in acral melanoma (AM) between the two eras (P=0.78). The receiver operating characteristic (ROC) curve, area under the ROC curve (AUC) and calibration graphs show good discrimination and accuracy of nomograms. Decision curve analysis (DCA) suggests good clinical utility of nomograms.ConclusionsBased on the classification of sunlight exposure patterns, there is a gradient difference in immunotherapy efficacy for MM. The degree of sunlight exposure is positively correlated with immunotherapy response. The nomograms are sufficiently accurate to predict 3- and 5-year OS rate for MM, allowing for individualized clinical decisions for future clinical work.
Investigating the diagnostic efficiency of a computer-aided diagnosis system for thyroid nodules in the context of Hashimoto’s thyroiditis
Authors: Gong Liu , Zhou Ping , Li Jia-Le , Liu Wen-Gang 
Published: January 2023

ObjectivesThis study aims to investigate the efficacy of a computer-aided diagnosis (CAD) system in distinguishing between benign and malignant thyroid nodules in the context of Hashimoto’s thyroiditis (HT) and to evaluate the role of the CAD system in reducing unnecessary biopsies of benign lesions.MethodsWe included a total of 137 nodules from 137 consecutive patients (mean age, 43.5 ± 11.8 years) who were histopathologically diagnosed with HT. The two-dimensional ultrasound images and videos of all thyroid nodules were analyzed by the CAD system and two radiologists with different experiences according to ACR TI-RADS. The diagnostic cutoff values of ACR TI-RADS were divided into two categories (TR4 and TR5), and then the sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of the CAD system and the junior and senior radiologists were compared in both cases. Moreover, ACR TI-RADS classification was revised according to the results of the CAD system, and the efficacy of recommended fine-needle aspiration (FNA) was evaluated by comparing the unnecessary biopsy rate and the malignant rate of punctured nodules.ResultsThe accuracy, sensitivity, specificity, PPV, and NPV of the CAD system were 0.876, 0.905, 0.830, 0.894, and 0.846, respectively. With TR4 as the cutoff value, the AUCs of the CAD system and the junior and senior radiologists were 0.867, 0.628, and 0.722, respectively, and the CAD system had the highest AUC (P &lt; 0.0001). With TR5 as the cutoff value, the AUCs of the CAD system and the junior and senior radiologists were 0.867, 0.654, and 0.812, respectively, and the CAD system had a higher AUC than the junior radiologist (P &lt; 0.0001) but comparable to the senior radiologist (P = 0.0709). With the assistance of the CAD system, the number of TR4 nodules was decreased by both junior and senior radiologists, the malignant rate of punctured nodules increased by 30% and 22%, and the unnecessary biopsies of benign lesions were both reduced by nearly half.ConclusionsThe CAD system based on deep learning can improve the diagnostic performance of radiologists in identifying benign and malignant thyroid nodules in the context of Hashimoto’s thyroiditis and can play a role in FNA recommendations to reduce unnecessary biopsy rates.
Relationship between serum brain-derived neurotrophic factor and cognitive impairment in children with sleep-disordered breathing
Authors: Feng Yani , Ma Lina , Chen Xi , Zhang Yitong , Cao Zine , Yuan Yuqi , Xie Yushan , Liu Haiqin , Shi Yewen , Ren Xiaoyong 
Published: January 2023

BackgroundAs an important neuroprotective factor, the brain-derived neurotrophic factor (BDNF) may have a key role in cognitive impairment in children with sleep-disordered breathing (SDB). The main aim of this study was to compare the levels of BDNF and tyrosine kinase receptor B (TrkB) in normal children and those with obstructive sleep apnea (OSA) and primary snoring (PS) and to explore a possible link between BDNF/TrkB, inflammation, and SDB with cognitive impairment in children.MethodsA total of 44 OSA children and 35 PS children who completed polysomnography between October 2017 and October 2019 were enrolled. At the same time, 40 healthy children during the same period were included as a control. Enzyme-linked immunosorbent assay was used to measure serum indices of BDNF, TrkB, interleukin-1beta (IL-1β), and tumor necrosis factor-alpha (TNF-α). Correlation and pooled analyses were performed between the cognitive scores and four serological indicators. Logistic regression was used to analyze the risk factors for cognitive impairment.ResultsSignificant differences were found in serum BDNF, TrkB, IL-1β, and TNF-α between the three groups (all P &lt; 0.01). The serum BDNF and TrkB in the OSA and PS groups were lower than those in the control group, whereas the serum IL-1β and TNF-α were higher than those in the control group (all P &lt; 0.05). Moreover, among these four indices, the strongest correlation was found between BDNF and the Chinese Wechsler Intelligence Scale (all P &lt; 0.05). Logistic regression analysis revealed a correlation between OSA status, TrkB, and course of mouth breathing and cognitive status.ConclusionThe levels of serum BDNF and TrkB were related to cognitive impairment in children with SDB. Also, BDNF and TrkB could be used as noninvasive and objective candidate markers and predictive indices of cognitive impairment in children with SDB.
Efficacy and safety of weekly versus triweekly cisplatin treatment concomitant with radiotherapy for locally advanced nasopharyngeal carcinoma: A systematic review and pooled analysis
Authors: Tian Xin , Zhu Qiuxia , Zhang Zhenyong 
Published: January 2023

Background: Most nasopharyngeal carcinoma cases are diagnosed at an advanced stage due to their hidden anatomical structure and atypical clinical symptoms and often require chemoradiotherapy. Here, we present a systematic review and pooled analysis to synthesize existing research on the efficacy and adverse effects of weekly versus triweekly cisplatin chemotherapy concomitant with radiotherapy for locally advanced nasopharyngeal carcinoma (LANPC).Methods: We searched the PubMed, Embase, and Cochrane Library databases from inception to 1 September 2021, for relevant original research articles published in English. The literature search and data extraction were done independently by two investigators. We used random-effects models to provide point estimates [95% confidence interval (CI)] of overall response rate (ORR), overall survival (OS), progression-free survival (PFS), locoregional recurrence-free survival (LRFS), distant metastasis-free survival (DMFS) and the incidence rate of adverse effects (AEs) and with subgroup analysis according to each study type. The primary endpoints were ORR, OS, and PFS; LRFS, DMFS, and grade ≥3 acute AEs were secondary endpoints.Results: In total, 2,305 patients of eight studies were included in this review. We found that patients who were administered cisplatin weekly or triweekly had no differences in ORR, OS, PFS, DMFS, LRFS, severe mucositis, dermatitis, nausea/vomiting or nephrotoxicity. Patients who were administered weekly cisplatin were at a higher risk of hematological toxicity compared with patients who received the chemotherapy triweekly.Conclusion: Our findings suggest that both regimens could be recommended as the standard of care for the chemoradiotherapy treatment of LANPC, the perceived benefit of lower toxicity with weekly cisplatin could not be established.
Classifying epileptic phase-amplitude coupling in SEEG using complex-valued convolutional neural network
Authors: Li Chunsheng , Liu Shiyue , Wang Zeyu , Yuan Guanqian 
Published: January 2023

EEG phase-amplitude coupling (PAC), the amplitude of high-frequency oscillations modulated by the phase of low-frequency oscillations (LFOs), is a useful biomarker to localize epileptogenic tissue. It is commonly represented in a comodulogram of coupling strength but without coupled phase information. The phase-amplitude coupling is also found in the normal brain, and it is difficult to discriminate pathological phase-amplitude couplings from normal ones. This study proposes a novel approach based on complex-valued phase-amplitude coupling (CV-PAC) for classifying epileptic phase-amplitude coupling. The CV-PAC combines both the coupling strengths and the coupled phases of low-frequency oscillations. The complex-valued convolutional neural network (CV-CNN) is then used to classify epileptic CV-PAC. Stereo-electroencephalography (SEEG) recordings from nine intractable epilepsy patients were analyzed. The leave-one-out cross-validation is performed, and the area-under-curve (AUC) value is used as the indicator of the performance of different measures. Our result shows that the area-under-curve value is .92 for classifying epileptic CV-PAC using CV-CNN. The area-under-curve value decreases to .89, .80, and .88 while using traditional convolutional neural networks, support vector machine, and random forest, respectively. The phases of delta (1–4 Hz) and alpha (8–10 Hz) bands are different between epileptic and normal CV-PAC. The phase information of CV-PAC is important for improving classification performance. The proposed approach of CV-PAC/CV-CNN promises to identify more accurate epileptic brain activities for potential surgical intervention.
Psychological wellbeing, family cohesion, and purposeful life in male prisoners: A cross-sectional study
Authors: Ghazanfari Hooshang , Miri Sakineh , Taebi Mozhgan , Farokhzadian Jamileh 
Published: January 2023

BackgroundPsychological wellbeing, family cohesion, and purposeful life are important determinants of the prisoners’ overall wellbeing and health; therefore, their evaluation is extremely important in prisoners as a vulnerable group.ObjectiveThis study evaluated psychological wellbeing, family cohesion, purposeful life, and their correlations in male prisoners.MethodsThis cross-sectional study used simple random sampling to select 259 male prisoners. Data were collected using questionnaires of Ryff psychological wellbeing, Fischer family cohesion, and Crumbaugh and Maholick purpose in life.ResultsMajority of (78%) the participants were 20–40 years old and married (59%). The mean scores of psychological wellbeing, family cohesion, and purposeful life of the male prisoners were moderate. Psychological wellbeing was directly correlated to family cohesion in male prisoners, but it had no significant correlation with a purposeful life. Family cohesion was not significantly correlated to a purposeful life.ConclusionRegarding the moderate level of psychological wellbeing in prisoners, it is suggested to pay more attention to educational and supportive programs in prisons for promoting such indicators in prisoners.
Superomedial pedicle skin-reducing mastectomy in ptotic and large-sized breasts with two-stage reconstruction through transaxillary video-assisted technique: An effective surgical and anesthetic approach
Authors: Di Monta G. , Marone U. , Avino F. , Esposito E. , Cepparulo V. , Morra E. , Saponara R. , Bifulco F. , Cuomo A. , Cascella M. , Mori S. 
Published: January 2023

IntroductionSkin-reducing mastectomy has been applied to several surgical techniques in which subcutaneous mastectomy is associated with various types of skin reduction, with preservation of a lower dermal flap to reinforce the inferior lateral seat of an implant. The aim of the study is to present a case series of patients with pendulous/ptotic and/or large-sized breasts treated for breast cancer at the Breast Surgery Unit of Istituto Nazionale Tumori IRCCS Fondazione “G. Pascale”, Naples, Italy, with the superomedial pedicle skin-reducing mastectomy technique, two-stage reconstruction, and transaxillary video-assisted technique, when a postoperative radiotherapy was indicated. We verified its effectiveness by discussing its results, especially in patients who are candidates for postmastectomy radiotherapy.Materials and methodsA single-center retrospective study was performed between January 2020 and March 2021 on a prospectively filled database of conservative mastectomies. Of the 64 patients who underwent nipple/skin-sparing mastectomies in the mentioned period, 17 (mean age 46 years, range 30–62 years) were treated with superomedial pedicle skin-reducing mastectomy, with two-stage breast reconstruction through transaxillary video-assisted replacement expander with definitive prosthesis and contralateral symmetrization, selected for postmastectomy radiotherapy.ResultsWe had only three minor complications. No flap necrosis, no infections, no breast seromas, and no reconstructive failures were observed. During follow-up of the patients treated with video-assisted reconstruction, there were no cases of infection, hematoma, implant rupture, or suture dehiscence in the reconstructed breast.DiscussionSkin-reducing mastectomy with superomedial pedicle is a safe and reliable procedure to treat breast cancer in selected patients, i.e., those with pendulous/ptotic and or large-sized breasts. Particularly, in patients who undergo postmastectomy radiotherapy, the two-stage reconstruction with video-assisted transaxillary endoscopic approach can find its main indication, using incisions positioned far from the mammary region, offering numerous advantages.