bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of the use of food ingredients and additives on the estimation of ultra-processed foods and beverages
Authors: Zancheta Ricardo Camila , Duran Ana Clara , Grilo Mariana Fagundes , Rebolledo Natalia , Díaz-Torrente Ximena , Reyes Marcela , Corvalán Camila 
Published: January 2023

IntroductionIncreasing consumption of ultra-processed foods (UPF), defined by the NOVA classification, has been associated with obesity and other health outcomes. However, some authors have criticized the UPF definition because it is somewhat subjective. Most studies identify UPF using food descriptions; nevertheless, NOVA developers described a list of ingredients, including substances not commonly used for cooking and “cosmetic additives” that could be used to identify UPF. Assessing the impact of the use of different UPF definitions is particularly relevant with respect to children’s diet, because several dietary policies target this age group. Thus, our study compared the frequency of UPF among foods and beverages and their share in the diet of Chilean preschoolers using three different methods of identifying UPF.MethodsWe used cross-sectional 24-h dietary recall data from 962 preschoolers enrolled in the Food and Environment Chilean Cohort (FECHIC) in 2016. All foods and beverages consumed were classified according to NOVA, considering their description (classic method), the presence of ingredients markers of UPF (ingredient marker method), and the presence of markers plus all cosmetic additives (food additive method). We also estimated the caloric share and quintiles of UPF consumption using the three methods. We used kappa coefficients, consistency-of-agreement intra-class correlation (CA-ICC), absolute agreement intra-class correlation (AA-ICC), and weighted kappa coefficients for assessing agreement between methods.ResultsThe proportion of UPF products were 65% in the “classic,” 67% in the “ingredient marker,” and 73% in the “food additive” method, and kappa coefficients between methods varied from 0.79 to 0. 91. The caloric share of UPF was 47, 52, and 58% with “classic,” “ingredient marker,” and “food additive” methods, respectively. Consistency-of-agreement was higher than the absolute agreement between the methods (CA-ICC = 0.81; AA-ICC = 0.74). For quintiles of UPF consumption, we found weighted kappa of 0.65 as measure of agreement between “classic” and “ingredient marker,” and 0.51 between “classic” and “food additive” methods.ConclusionSearching for all possible markers of UPF in the list of ingredients increased the proportion of food products identified as UPF compared to the classic method. These differences affected the estimated caloric share of UPF in Chilean preschoolers’ diets.
Toxic epidermal necrosis associated with afatinib: A case report and literature review
Authors: Yang Wei , Lu Yansong , Wu Ze , Niu Jun 
Published: January 2023

ObjectiveTo report a case of afatinib-induced toxic epidermal necrosis (TEN), in a patient with metastatic non-small cell lung cancer (NSCLC) and compare these findings with that of evaluate similarities and differences to other cases reported in the literature.MethodsWith use of the algorithm of drug causality for epidermal necrolysis (ALDEN), the effects of afatinib were evaluated in a NSCLC patient who developed TEN. In addition, previous case reports on this topic were included to provide a review of patients’ clinical characteristics, treatment regimens and therapy outcomes in response to afatinib treatment.ResultsIn our case, toxic epidermal necrolysis was observed at five days after afatinib therapy, while other Stevens-Johnson syndrome/toxic epidermal necrolysis responses, as associated with afatinib, did not seem to be induced until a latency period of over thirty days post-afatinib. Treatment with corticosteroids resulted in significant improvements of these clinical symptoms, and eventually to a complete remission.ConclusionAfatinib can result in grade four cutaneous adverse effects like SJS/TEN, with an uncertain latency period. The skin lesions which appear during this period of afatinib treatment should be closely monitored.
Incidence of second primary malignancies in women with different stages of breast cancer
Authors: Lin Cheng-Yao , Hsiao Sheng-Yen , Huang Wen-Tsung , Tsao Chao-Jung , Ho Chung-Han , Su Shih-Bin , Guo How-Ran 
Published: January 2023

IntroductionBreast cancer (BC) is the most common cancer in women worldwide. Because of the extended survival of patients with BC, the occurrence of second primary malignancies (SPMs) after BC is an important issue.MethodsWe identified female patients with BC in the Breast Cancer Health Database of Taiwan, which includes four cancer registry datasets between 2002 and 2014 from Taiwan Cancer Registry. We compared the incidence of SPM between patients who received chemotherapy and/or radiotherapy with those who did not. Stratified analyses were performed according to the American Joint Committee on Cancer (AJCC) stage. The Cox regression model was used to identify the risk factors for SPM and evaluate their effects.ResultsWe enrolled 85,947 eligible patients with BC, and 2,656 (3.09%) patients developed SPM. The median duration of SPM was 2.70 (1.14–5.14) years. Radiotherapy was administered in 40,946 (47.64%) patients, and chemotherapy was administered in 52,120 (60.64%). The most common SPMs were digestive tract cancers (876, 31.89%). The risk factors for SPM included the AJCC stage, chemotherapy, radiotherapy, age, and underlying comorbidities. Neither chemotherapy nor radiotherapy was associated with an increased risk of SPM in any stage. In contrast, after adjusting for other risk factors, patients at stage III/IV who received both therapies had lower risks of SPM compared with those who did not (p = 0.047).ConclusionThe risk of SPM was different across BC stages. Neither chemotherapy nor radiotherapy was associated with an increased risk of SPM in women with BC.
Conditional survival analysis and real-time prognosis prediction for cervical cancer patients below the age of 65 years
Authors: Meng Xiangdi , Jiang Yingxiao , Chang Xiaolong , Zhang Yan , Guo Yinghua 
Published: January 2023

BackgroundSurvival prediction for cervical cancer is usually based on its stage at diagnosis or a multivariate nomogram. However, few studies cared whether long-term survival improved after they survived for several years. Meanwhile, traditional survival analysis could not calculate this dynamic outcome. We aimed to assess the improvement of survival over time using conditional survival (CS) analysis and developed a novel conditional survival nomogram (CS-nomogram) to provide individualized and real-time prognostic information.MethodsCervical cancer patients were collected from the Surveillance, Epidemiology, and End Results (SEER) database. The Kaplan–Meier method estimated cancer-specific survival (CSS) and calculated the conditional CSS (C-CSS) at year y+x after giving x years of survival based on the formula C-CSS(y|x) =CSS(y+x)/CSS(x). y indicated the number of years of further survival under the condition that the patient was determined to have survived for x years. The study identified predictors by the least absolute shrinkage and selection operator (LASSO) regression and used multivariate Cox regression to demonstrate these predictors’ effect on CSS and to develop a nomogram. Finally, the CSS possibilities predicted by the nomogram were brought into the C-CSS formula to create the CS-nomogram.ResultsA total of 18,511 patients aged &lt;65 years with cervical cancer from 2004 to 2019 were included in this study. CS analysis revealed that the 15-year CSS increased year by year from the initial 72.6% to 77.8%, 84.5%, 88.8%, 91.5%, 93.5%, 94.8%, 95.7%, 96.4%, 97.3%, 98.0%, 98.5%, 99.1%, and 99.4% (after surviving for 1-13 years, respectively), and found that when survival exceeded 5-6 years, the risk of death from cervical cancer would be less than 5% in 10-15 years. The CS-nomogram constructed using tumor size, lymph node status, distant metastasis status, and histological grade showed strong predictive performance with a concordance index (C-index) of 0.805 and a stable area under the curve (AUC) between 0.795 and 0.816 over 15 years.ConclusionsCS analysis in this study revealed the gradual improvement of CSS over time in long-term survived cervical cancer patients. We applied CS to the nomogram and developed a CS-nomogram successfully predicting individualized and real-time prognosis.
Diagnostic value of [68Ga]Ga-FAPI-04 in patients with colorectal cancer in comparison with [18F]F-FDG PET/CT
Authors: Lin Xinfeng , Li Yingjie , Wang Shuailiang , Zhang Yan , Chen Xuetao , Wei Maomao , Zhu Hua , Wu Aiwen , Yang Zhi , Wang Xuejuan 
Published: January 2023

PurposeThis study aimed to compare the diagnostic performance of [68Ga]Ga-FAPI-04 PET/CT and [18F]F-FDG PET/CT in primary and metastatic colorectal cancer (CRC) lesions.MethodsThis single-center preliminary clinical study (NCT04750772) was conducted at the Peking University Cancer Hospital &amp; Institute and included 61 participants with CRC who underwent sequential evaluation through PET/CT with [18F]F-FDG and [68Ga]Ga-FAPI-04. Their PET/CT images were analysed to quantify the uptake of the two tracers in the form of maximum standardised uptake (SUVmax) values and target-to-background ratio (TBR), which were then compared using Wilcoxon’s signed-rank test. The final changes in the tumour–node–metastasis (TNM) stage of all participants were recorded.ResultsOf all the participants, 21 were treatment naïve and 40 had been previously treated. In primary CRC lesions, the average TBRs of [68Ga]Ga-FAPI-04 and [18F]F-FDG were 13.3 ± 8.9 and 8.2 ± 6.5, respectively. The SUVmax of [68Ga]Ga-FAPI-04 in signet-ring/mucinous carcinomas (11.4 ± 4.9) was higher than that of [18F]F-FDG (7.9 ± 3.6) (P = 0.03). Both median SUVmax in peritoneal metastases and TBR in liver metastases of [68Ga]Ga-FAPI-04 were higher than those of [18F]F-FDG (5.2 vs. 3.8, P &lt; 0.001; 3.7 vs. 1.9, P &lt; 0.001, respectively). Compared with [18F]F-FDG PET/CT, clinical TNM staging based on [68Ga]Ga-FAPI-04 PET/CT led to upstaging and downstaging in 10 (16.4%) and 5 participants (8.2%), respectively. Therefore, the treatment options were changed in 13 participants (21.3%), including 9 with additional chemo/radiotherapy and/or surgery and others with avoidance or narrowed scope of surgery.Conclusion[68Ga]Ga-FAPI-04 showed potential as a novel PET/CT tracer to detect lymph nodes and distant metastases, which improved CRC staging, thus prompting the optimisation or adjustment of treatment decisions.
Cervical cancer in Northern Tanzania—What do women living with HIV know
Authors: Mrema Dorah , Ngocho James Samwel , Mremi Alex , Amour Maryam , Machange Rogathe , Shayo Benjamin C. , Alloyce Julius P. , Ndosi Evaline , Shirima Beatus T. , Fande Device , Shehoza Rahma , Balandya Emmanuel , Sunguya Bruno , Mshana Stephen E. , Mteta Alfred K. , Lyamuya Eligius , Bartlett John , Mmbaga Blandina T. 
Published: January 2023

BackgroundCervical cancer (CC) is more prevalent in women living with human immunodeficiency virus (HIV) infection compared to the general population. The magnitude is high among all countries burdened with HIV—Tanzania is no exception. Despite the unprecedented risk, women living with HIV (WLHIV) may not be aware of the risk and might have unfounded beliefs thereof. This study aimed to determine the knowledge, awareness, and beliefs on CC screening among WLHIV attending a clinic at the Kilimanjaro Christian Medical Centre (KCMC) in Northern Tanzania.MethodsThis hospital-based cross-sectional study was conducted among 327 WLHIV attending care and treatment clinic (CTC) at KCMC. A pre-tested questionnaire was used to collect quantitative data. Both descriptive and regression methods were used to determine CC knowledge, awareness, and beliefs as well as factors associated with knowledge of CC among WLHIV using SPSS version 23.ResultsParticipants’ mean age was 46 ± 10.4 years. Although just half (54.7%) of WLHIV had insufficient knowledge of CC, the majority of the participants (83.5%) were able to recognize at least three risk factors, but with limited understanding of symptoms and prevention. The majority held positive beliefs on CC and screening practices. Factors associated with good knowledge of CC included being married (AOR: 3.66, 95% CI: 1.84–7.28), having used ART for at least 2 years (AOR: 4.08, 95% CI: 1.36–12.21), and having previously screened for CC (AOR: 1.62, 95% CI: 1.01–2.59).ConclusionWLHIV attending care and treatment center had insufficient knowledge about CC screening. To further improve screening and treatment for CC, at both facility and community levels, targeted awareness and education campaigns are warranted.
Investigations into an overlooked early component of painful nociceptive withdrawal reflex responses in humans
Authors: Thorell Oumie , Ydrefors Johannes , Svantesson Mats , Gerdle Björn , Olausson Håkan , Mahns David A. , Nagi Saad S. 
Published: January 2023

IntroductionThe role of pain as a warning system necessitates a rapid transmission of information from the periphery for the execution of appropriate motor responses. The nociceptive withdrawal reflex (NWR) is a physiological response to protect the limb from a painful stimulus and is often considered an objective measure of spinal nociceptive excitability. The NWR is commonly defined by its latency in the presumed Aδ-fiber range consistent with the canonical view that “fast pain” is signaled by Aδ nociceptors. We recently demonstrated that human skin is equipped with ultrafast (Aβ range) nociceptors. Here, we investigated the short-latency component of the reflex and explored the relationship between reflex latency and pain perception.MethodsWe revisited our earlier work on NWR measurements in which, following convention, only reflex responses in the presumed Aδ range were considered. In our current analysis, we expanded the time window to search for shorter latency responses and compared those with pain ratings.ResultsIn both cohorts, we found an abundance of recordings with short-latency reflex responses. In nearly 90% of successful recordings, only single reflex responses (not dual) were seen which allowed us to compare pain ratings based on reflex latencies. We found that shorter latency reflexes were just as painful as those in the conventional latency range.ConclusionWe found a preponderance of short-latency painful reflex responses. Based on this finding, we suggest that short-latency responses must be considered in future studies. Whether these are signaled by the ultrafast nociceptors remains to be determined.
Functional tic-like behaviours during the COVID-19 pandemic: Follow-up over 12 months
Authors: Prato Adriana , Saia Federica , Milana Maria Chiara , Scerbo Miriam , Barone Rita , Rizzo Renata 
Published: January 2023

BackgroundFunctional tics are included in the wide spectrum of functional movement disorders (FMDs). Their distinction from organic tics is challenging because they both phenomenologically present common features. During the COVID-19 pandemic, there has been an increase in functional tic-like behaviours in vulnerable children and adolescents after social media exposure. This study explores the phenomenology and course of a cohort of newly diagnosed functional tic-like behaviors.MethodsWe analysed clinical data of 243 patients affected by tic disorders collected at outpatient Tourette Clinic, Child and Adolescent Neurology and Psychiatry Unit, Catania University. Among the clinical cohort with functional tic-like behaviors, we evaluated the clinical course of symptoms at follow-up visits after 6 and 12 months.ResultsAmong the cohort of 243 patients referred for evaluation at our centre, 11 were diagnosed with functional tic–like behaviours. The majority of participants with functional tic–like behaviours were female with a mean age of 15 years old and presented an explosive symptom's onset. At follow-up visit after 12 months, patients with functional tic-like behaviors showed a significant variation in the severity of tics and anxiety symptoms. Conversely, depressive, and obsessive-compulsive symptoms did not significantly differ during the follow-up.ConclusionOur data suggest that several characteristics in clinical course and their phenomenology can help clinicians to distinguish functional tic–like behaviours from organic tics. Our results also suggest a better outcome for tics and anxiety symptoms respect on other comorbidities. A prompt diagnosis and management not only of tics but also comorbidities are recommended, as generally conventional pharmacotherapy for tics does not have positive effects on these patients.
Reduced circulating growth hormone and insulin-like growth factor-1 and delayed growth of premature rats are aggravated by longer daily duration of chronic intermittent hypoxia exposure
Authors: Zhang Chi , Du Xiaowan , Li Jingjing , Zhang Junbo , Yin Guoping 
Published: January 2023

ObjectiveThis study mainly aimed to investigate the effect of daily duration of chronic intermittent hypoxia (CIH) exposure on circulating growth hormone (GH)/insulin-like growth factor-1 (IGF-1) concentrations and body weight changes of premature rats.Methods40 healthy male SD rats aged six weeks were enrolled in this study. These rats were randomly divided into four groups (n = 10 per group), including normal control (NC) group (normal oxygen exposure every day), CIH-1 group (daily CIH exposure for 2 h), CIH-2 group (daily CIH exposure for 4 h), and CIH-3 group (daily CIH exposure for 8 h). The serum GH/IGF-1 concentrations and body weights in all rats were determined after 30 days of normal oxygen or CIH exposure.ResultsNo significant difference was found with respect to the baseline body weight among the four groups of rats. After establishments of animal models with a duration of 30 days, significant differences were found respect to body weight, body weight changes, and serum GH/IGF-1 concentrations among the four groups of rats with a same trend (all P &lt; 0.05): the highest values were all in NC group rats, followed CIH-1 group, CIH-2 group, and CIH-3 group rats. Among all the rats, the body weight changes correlated significantly with both serum GH and IGF-1 concentrations (both P &lt; 0.05).ConclusionCIH decreases circulating GH/IGF-1 concentrations and causes growth delay in premature rats. Such effects could be aggravated by increased daily duration of CIH exposures.
Reoperation frequency after transverse preputial Island flap urethroplasty “Duckett’s technique” in treatment of severe hypospadias: A single center study
Authors: Li Jiayi , Liu Pei , Yang Zhenzhen , Wang Xinyu , Fan Songqiao , Li Zonghan , Song Hongcheng , Zhang Weiping 
Published: January 2023

PurposeTransverse Preputial Island Flap Urethroplasty (TPIFU) is one of the most common techniques for treating severe hypospadias. Studies on the reoperation frequency after TPIFU is lacking. In the present study, we reported our clinical outcomes of severe hypospadias treated with one-staged TPIFU and analyzed the operation frequency.MethodsWe retrospectively analyzed the clinical data of severe hypospadias patients who underwent one-stage TPIFU from December 2018 to December 2019 in the department of Urology at Beijing Children's Hospital. A stepwise approach was used to manage the curvature. Severe hypospadias was defined as those residual curvature was higher than 30° after degloving. Urethroplasty complications included fistula, urethral stricture, and diverticulum. The short-term cure was identified as no complications occurring for 12 months after the date of last-time surgery. The reoperation rate and operation frequency of TPIFU were analyzed.ResultsA total of 136 patients who underwent one-stage TPIFU were included in the study. The follow-up after primary urethroplasty ranged from 22 to 50 months. The median age at primary surgery was 22.5 months (range from 13 to 132 months). After primary TPIFU surgery, 53 (39%) patients underwent additional surgical interventions to treat postoperative complications. Among them, 24 patients (17.6%) developed fistula, 17 patients (12.5%) developed urethral stricture and 11 patients (8.1%) developed diverticulum. After the second surgery, five patients remained fistula, five patients remained urethral stricture, and seven patients remained diverticulum. Overall, 61% (85 patients) met the cured standard after the primary operation, and the two operations cure rate was 87.5% (119 patients). 91.2% (124 patients) were cured in three operations.ConclusionsAlthough the complication rates after primary TPIFU were relatively high, more than half of patients achieved short-term cured through a single operation, and the cure rate after two or three operations was acceptable.
Brief research report: Chest radiographic thoracic area in term ventilated infants without respiratory disease
Authors: Dassios Theodore , Adu John , Greenough Anne 
Published: January 2023

ObjectiveTo report values of the chest radiographic thoracic area (CRTA) in ventilated, term-born infants without respiratory disease and to evaluate whether CRTA is related to demographic data at birth.MethodsRetrospective, observational cohort study in a tertiary neonatal unit at King's College Hospital NHS Foundation Trust, London, UK.Newborn infants born after 36 completed weeks of gestation, ventilated for poor perinatal adaptation or hypoxic ischaemic encephalopathy without respiratory disease and admitted in a recent eight-year period (2014–2022).The CRTA was assessed by free-hand tracing of the perimeter of the thoracic area as outlined by the diaphragm and the rib cage excluding the mediastinal structures and was calculated using the Sectra PACS software.ResultsOne hundred and twenty-one infants (75 male) were included with a median (IQR) gestation of 40 (38–41) weeks and birth weight of 3.41 (3.04–3.75) kg. The median (IQR) CRTA was 2,589 (2,167–2,943) mm2 and was significantly related to birth weight (r = 0.316, p = 0.003), gestation at birth (r = 0.193, p = 0.032) and birth weight z-score (r = 0.187, p = 0.038).ConclusionsWe report values of the chest radiographic thoracic area in ventilated term-born infants which could be used as reference for determining respiratory disease severity.