bluuebunny/crossref_metadata_2025_split huggingface dataset:
A network meta-analysis of therapeutic and prophylactic management of vasospasm on aneurysmal subarachnoid hemorrhage outcomes
Authors: Chousterman Benjamin , Leclère Brice , Morisson Louis , Eude Yannick , Gayat Etienne , Mebazaa Alexandre , Cinotti Raphael 
Published: August 2023

BackgroundVasospasm and cerebral ischemia after aneurysmal subarachnoid hemorrhage are associated with mortality and poor neurological outcomes. We studied the efficacy of all available strategies targeting vasospasm and cerebral ischemia on outcomes in a network meta-analysis.MethodsWe searched EMBASE and MEDLINE databases from 1 January 1990 and 28 November 2021 according to PRISMA guidelines. Randomized controlled trials and longitudinal studies were included. All curative or preventive strategies targeting vasospasm and/or cerebral ischemia were eligible. A network meta-analysis was performed to compare all interventions with one another in a primary (randomized controlled trials only) and a secondary analysis (both trials and longitudinal studies). Mortality by 3 months was the primary outcome. Secondary outcomes were vasospasm, neurological outcome by 3 months, and dichotomized as “good” or “poor” recovery according to each study definition.ResultsA total of 2,382 studies were screened which resulted in the selection of 192 clinical trials (92 (47.9%) and 100 cohorts (52.1%) and the inclusion of 41,299 patients. In randomized controlled studies, no strategy decreased mortality by 3 months. Statins (0.79 [0.62–1]), tirilazad (0.82 [0.69–0.97]), CSF drainage (0.47 [0.29–0.77]), and clazosentan (0.51 [0.36–0.71]) significantly decreased the incidence of vasospasm. Cilostazol was the only treatment associated with improved neurological outcomes by 3 months in the primary (OR 1.16, 95% CI [1.05–1.28]) and secondary analyses (OR 2.97, 95% CI [1.39–6.32]).DiscussionIn the modern era of subarachnoid hemorrhage, all strategies targeting vasospasm failed to decrease mortality. Cilostazol should be confirmed as a treatment to improve neurological outcomes. The link between vasospasm and neurological outcome appears questionable.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=116073, identifier: PROSPERO CRD42018116073.
Developing and validating a nomogram for cognitive impairment in the older people based on the NHANES
Authors: Ma Xiaoming , Huang Wendie , Lu Lijuan , Li Hanqing , Ding Jiahao , Sheng Shiying , Liu Meng , Yuan Jie 
Published: August 2023

ObjectiveTo use the United States National Health and Nutrition Examination Study (NHANES) to develop and validate a risk-prediction nomogram for cognitive impairment in people aged over 60 years.MethodsA total of 2,802 participants (aged ≥ 60 years) from NHANES were analyzed. The least absolute shrinkage and selection operator (LASSO) regression model and multivariable logistic regression analysis were used for variable selection and model development. ROC-AUC, calibration curve, and decision curve analysis (DCA) were used to evaluate the nomogram’s performance.ResultsThe nomogram included five predictors, namely sex, moderate activity, taste problem, age, and education. It demonstrated satisfying discrimination with a AUC of 0.744 (95% confidence interval, 0.696–0.791). The nomogram was well-calibrated according to the calibration curve. The DCA demonstrated that the nomogram was clinically useful.ConclusionThe risk-prediction nomogram for cognitive impairment in people aged over 60 years was effective. All predictors included in this nomogram can be easily accessed from its’ user.
Application of tangent-arc technology for deep inspiration breath-hold radiotherapy in left-sided breast cancer
Authors: Li Yucheng , Zhan Wenming , Jia Yongshi , Xiong Hanchu , Lin Baihua , Li Qiang , Liu Huaxin , Qiu Lingyun , Zhang Yinghao , Ding Jieni , Fu Chao , Chen Weijun 
Published: August 2023

ObjectiveTo explore the advantages of dosimetry and the treatment efficiency of tangent-arc technology in deep inspiration breath-hold radiotherapy for breast cancer.MethodsForty patients with left-sided breast cancer who were treated in our hospital from May 2020 to June 2021 were randomly selected and divided into two groups. The first group’s plan was a continuous semi-arc that started at 145° ( ± 5°) and stopped at 325° ( ± 5°). The other group’s plan, defined as the tangent-arc plan, had two arcs: the first arc started at 145° ( ± 5°) and stopped at 85° ( ± 5°), and the second arc started at 25° ( ± 5°) and stopped at 325° ( ± 5°). We compared the target dose, dose in organs at risk (OARs), and treatment time between the two groups.ResultsThe target dose was similar between the continuous semiarc and tangent-arc groups. The V5 of the right lung was significantly different between the two groups (Dif 5.52, 95% confidence interval 1.92-9.13, t=3.10, P=0.004), with the patients in the continuous semi-arc and tangent-arc groups having lung V5 values of (9.16 ± 1.62)%, and (3.64 ± 0.73)%, respectively. The maximum dose to the spinal cord was (1835.88 ± 222.17) cGy in the continuous semi-arc group and (599.42 ± 153.91) cGy in the tangent-arc group, yielding a significant difference between the two groups (Dif 1236.46, 95% confidence interval 689.32-1783.6, t=4.57, P&lt;0.001). The treatment times was (311.70 ± 60.45) s for patients in the continuous semi-arc group and (254.66 ± 40.73) s for patients in the tangent-arc group, and there was a significant difference in the mean number of treatment times between the two groups (Dif 57.04, 95% confidence interval 24.05-90.03, t=3.5, P=0.001).ConclusionBoth the continuous semi-arc and tangent-arc plans met the clinical prescription dose requirements. The OARs received less radiation with the tangent-arc plan than the continuous semi-arc plan, especially for the lung (measured as V5) and the spinal cord (measured as the maximum dose). Tangent-arc plan took significantly less time than the continuous semi-arc, which can greatly improve treatment efficiency. Therefore, tangent-arc plans are superior continuous semi-arc plans for all cases.
Real-world study of patients with locally advanced HNSCC in the community oncology setting
Authors: Black Christopher M. , Ramakrishnan Karthik , Nadler Eric , Tseng Wan-Yu , Wentworth Chuck , Murphy John , Fulcher Nicole , Wang Liya , Alexander Melannie , Patton Gregory 
Published: August 2023

IntroductionThere is a need to understand the current treatment landscape for LA HNSCC in the real-world setting.MethodsThis retrospective study assessed real-world outcomes and treatment patterns of 1,158 adult patients diagnosed with locally advanced (stage III-IVB) HNSCC initiating chemoradiotherapy (CRT) within the period January 2015 to December 2017 in a large network of US community oncology practices. Structured data were abstracted from electronic health records. Demographic, clinical and treatment characteristics were analyzed descriptively overall and stratified by index treatment (cisplatin + radiotherapy [RT], cisplatin + other chemotherapy + RT, or cetuximab + RT). Time to next treatment (TTNT) and overall survival (OS) were measured using the Kaplan-Meier method, and median duration of treatment was assessed. OS was compared across treatment cohorts using multinomial logistic regression with inverse probability treatment weighting. To identify covariates associated with OS, a multivariable adjusted Cox proportional hazard model was used.ResultsThis study examined 22,782 records, of which 2124 had stage III to stage IVB and no other cancers, and 1158 met all eligibility criteria. Among the treatment cohorts analyzed (cisplatin + RT, cisplatin + other chemotherapy + RT, or cetuximab + RT), cisplatin + RT was the most common concurrent chemotherapy (65.8%). Among 1158 patients, 838 (72.4%) did not initiate subsequent treatment and 139 (12.0%) died. The median TTNT and median OS were only reached by the cetuximab + RT cohort. Among patients with oropharynx primary tumor location, patients with human papilloma virus (HPV) positive status had the longest time on treatment and highest survival at 60 months. Covariates associated with improved survival were never/former tobacco use, HPV positive status, and overweight or obese body mass index. Covariates associated with poorer survival were age of 60+ years, primary tumor location of hypopharynx or oral cavity and Eastern Cooperative Oncology Group performance status score of 2+.ConclusionThese data describe real-world treatment patterns in locally advanced head and neck squamous cell cancer and sets the baseline to assess outcomes for future studies on the community oncology population.
GLS as a diagnostic biomarker in breast cancer: in-silico, in-situ, and in-vitro insights
Authors: Zhang Danfeng , Wang Man , Huang Xufeng , Wang Longbin , Liu Ying , Zhou Shujing , Tang Yidan , Wang Qi , Li Zhengrui , Wang Geng 
Published: August 2023

BackgroundRecently, a novel programmed cell death mechanism, Cuproptosis, has been discovered and found to play an important role in the development and progression of diverse tumors. In the present study, we comprehensively investigated the core gene of this mechanism, GLS, in breast cancer.Materials and methodsBulk RNA sequencing data were curated from the TCGA repository to investigate the aberrant expression of GLS over diverse cancer types. Then, we examined its efficacy as a diagnostic biomarker in breast cancer by Area Under Curve (AUC) of the Receiver Operative Characteristic (ROC) curve. Furthermore, by applying siRNA technique, we knocked down the GLS expression level in cancerous cell lines, measuring the corresponding effects on cell proliferation and metastasis. Afterward, we explored the potential implications of GLS expression in the tumor immune microenvironment quantitatively by using several R packages and algorithms, including ESTIMATE, CIBERSORT, etc.ResultsPan-cancer analysis suggested that GLS was aberrantly over-expressed in many cancer types, with breast cancer being typical. More in-depth analyses revealed the expression of GLS exerted a high ROC-AUC value in breast cancer diagnosis. Through the knock-down of GLS expression, it was found that GLS expression was strongly relevant to the growth and metastasis of tumor. Furthermore, it was also found to be correlated with the immune tumor microenvironment.ConclusionWe highlighted that GLS expression might be applicable as a diagnostic biomarker in breast cancer and possess significant implications in the growth and metastasis of tumor and the immune tumor microenvironment, sharing new insights into ontological and personalized medicine.
Primary tumour category, site of metastasis, and baseline serum S100B and LDH are independent prognostic factors for survival in metastatic melanoma patients treated with anti-PD-1
Authors: Janka Eszter Anna , Ványai Beatrix , Szabó Imre Lőrinc , Toka-Farkas Tünde , Várvölgyi Tünde , Kapitány Anikó , Szegedi Andrea , Emri Gabriella 
Published: August 2023

BackgroundPrognostic classification of metastatic melanoma patients treated with anti-PD-1 is of great interest to clinicians.ObjectiveWe aimed to determine the anti-PD-1 treatment related prognostic performance of demographics, clinical and histological prognostic markers and baseline serum S100B and LDH levels in advanced melanoma.MethodsA total of 200 patients with unresectable metastatic melanoma were included in this retrospective study. 34.5% had stage M1c disease and 11.5% had stage M1d disease at the start of therapy. 30% had pT4b primary melanoma. 55.5% had elevated baseline serum S100B levels and 62.5% had elevated baseline serum LDH levels. We analysed the risk of death using univariate and multivariate Cox proportional-hazards models and the median overall (OS) and progression-free (PFS) survival using the Kaplan-Meier estimator.ResultsThe median follow-up time from the start of anti-PD-1 treatment in patients who were alive at the end of the study (N=81) was 37 months (range: 6.1–95.9). The multivariate Cox regression analysis showed that M1c stage (vs. M1a, p=0.005) or M1d stage at the start of therapy (vs. M1a, p=0.001), pT4b category (vs. pT1a, p=0.036), elevated baseline serum S100B levels (vs. normal S100B, p=0.008) and elevated LDH levels (vs. normal LDH, p=0.049) were independently associated with poor survival. The combination of M1d stage, elevated baseline serum S100B and LDH levels and pT4b category was associated with a very high risk of death (HR 4.72 [1.81; 12.33]). In the subgroup of patients with pT4b primary melanoma, the median OS of patients with normal serum S100B levels was 37.25 months [95% CI 11.04; 63.46]), while the median OS of patients with elevated serum S100B levels was 8.00 months [95% CI 3.49; 12.51]) (p&lt;0.001); the median OS of patients with normal serum LDH levels was 41.82 months [95% CI 11.33; 72.32]), while the median OS of patients with elevated serum LDH levels was 12.29 months [95% CI 4.35; 20.23]) (p=0.002).ConclusionOur real-world study indicates that the prognostic role of primary melanoma parameters is preserved in anti-PD-1 treated stage IV patients. Furthermore, there seems to be perspective in combining clinical, histological and serum prognostic markers in a prognostic model.
Prognostic impact of the Controlling Nutritional Status Score in patients with biliary tract cancer: a systematic review and meta-analysis
Authors: Liu Zhuoran , Zhou Haoge , Zhou Yu , Yu Menglin , Cheng Yonglang , Li Jing 
Published: August 2023

BackgroundBiliary tract cancer (BTC) is a malignancy associated with unfavorable outcomes. Advanced BTC patients have a propensity to experience compromised immune and nutritional status as a result of obstructive jaundice and biliary inflammation. Currently, there is a lack of consensus on the impact of the Controlling Nutritional Status (CONUT) score in the context of BTC prognosis. The purpose of this study is to conduct a meta-analysis on the association between CONUT and the prognosis of patients suffering from BTC.MethodsA defined search strategy was implemented to search the PubMed, Embase, and Web of Science databases for eligible studies published until March 2023, with a focus on overall survival (OS), relapse-free survival/recurrence-free survival(RFS), and relevant clinical characteristics. The prognostic potential of the CONUT score was evaluated using hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs).ResultsIn this meta-analysis, a total of 1409 patients from China and Japan were involved in 9 studies. The results indicated that the CONUT score was significantly correlated with worse OS (HR=2.13, 95% CI 1.61-2.82, P&lt;0.0001) and RFS (HR=1.83, 95% CI 1.44–2.31, P&lt;0.0001) in patients with BTC. And, the analysis showed that a high CONUT score was significantly associated with clinical characteristics such as jaundice (OR=1.60, 95% CI=1.14–2.25, P=0.006), poorly differentiated tumor (OR=1.43, 95% CI=1.03–1.99, P=0.03), pT3 and 4 stage of the tumor (OR=1.87, 95% CI=1.30–2.68, P=0.0007), and complications of Clavien-Dindo classification grade IIIa or higher (OR=1.79, 95% CI=1.03–3.12, P=0.04).ConclusionThis meta-analysis indicates that a high CONUT score can serve as a significant prognostic indicator for survival outcomes among patients diagnosed with BTC.
AI-based diagnosis in mandibulofacial dysostosis with microcephaly using external ear shapes
Authors: Hennocq Quentin , Bongibault Thomas , Marlin Sandrine , Amiel Jeanne , Attie-Bitach Tania , Baujat Geneviève , Boutaud Lucile , Carpentier Georges , Corre Pierre , Denoyelle Françoise , Djate Delbrah François , Douillet Maxime , Galliani Eva , Kamolvisit Wuttichart , Lyonnet Stanislas , Milea Dan , Pingault Véronique , Porntaveetus Thantrira , Touzet-Roumazeille Sandrine , Willems Marjolaine , Picard Arnaud , Rio Marlène , Garcelon Nicolas , Khonsari Roman H. 
Published: August 2023

IntroductionMandibulo-Facial Dysostosis with Microcephaly (MFDM) is a rare disease with a broad spectrum of symptoms, characterized by zygomatic and mandibular hypoplasia, microcephaly, and ear abnormalities. Here, we aimed at describing the external ear phenotype of MFDM patients, and train an Artificial Intelligence (AI)-based model to differentiate MFDM ears from non-syndromic control ears (binary classification), and from ears of the main differential diagnoses of this condition (multi-class classification): Treacher Collins (TC), Nager (NAFD) and CHARGE syndromes.MethodsThe training set contained 1,592 ear photographs, corresponding to 550 patients. We extracted 48 patients completely independent of the training set, with only one photograph per ear per patient. After a CNN-(Convolutional Neural Network) based ear detection, the images were automatically landmarked. Generalized Procrustes Analysis was then performed, along with a dimension reduction using PCA (Principal Component Analysis). The principal components were used as inputs in an eXtreme Gradient Boosting (XGBoost) model, optimized using a 5-fold cross-validation. Finally, the model was tested on an independent validation set.ResultsWe trained the model on 1,592 ear photographs, corresponding to 1,296 control ears, 105 MFDM, 33 NAFD, 70 TC and 88 CHARGE syndrome ears. The model detected MFDM with an accuracy of 0.969 [0.838–0.999] (p &lt; 0.001) and an AUC (Area Under the Curve) of 0.975 within controls (binary classification). Balanced accuracies were 0.811 [0.648–0.920] (p = 0.002) in a first multiclass design (MFDM vs. controls and differential diagnoses) and 0.813 [0.544–0.960] (p = 0.003) in a second multiclass design (MFDM vs. differential diagnoses).ConclusionThis is the first AI-based syndrome detection model in dysmorphology based on the external ear, opening promising clinical applications both for local care and referral, and for expert centers.
Comparison of the clinical efficacy and toxicity of nebulized polymyxin monotherapy and combined intravenous and nebulized polymyxin for the treatment of ventilator-associated pneumonia caused by carbapenem-resistant gram-negative bacteria: a retrospective cohort study
Authors: Wu Zhenping , Zhang Siying , Cao Yelin , Wang Qiyu , Sun Keyuan , Zheng Xia 
Published: August 2023

Objective: To investigate the clinical efficacy and toxicity of nebulized polymyxin monotherapy and combined intravenous and nebulized polymyxin for the treatment of VAP caused by CR-GNB. Additionally, among patients treated with nebulized polymyxin monotherapy, we compared the clinical efficacy and toxicity of polymyxin B and polymyxin E.Methods: This study was a single-center, retrospective study. Included patients received aerosolized polymyxin for at least 72 h with or without intravenous polymyxin for the management of CR-GNB VAP. The primary endpoint was clinical cure at the end of polymyxin therapy. Secondary endpoints included AKI incidence, time of bacteria-negative conversion, duration of MV after inclusion, length of stay in ICU, and all-cause ICU mortality.Results: 39 patients treated with nebulized polymyxin monotherapy were assigned to the NL-polymyxin group. 39 patients treated with nebulized polymyxin combined with intravenous use of polymyxin were assigned to the IV-NL-polymyxin group. Among the NL-polymyxin group, 19 patients were treated with polymyxin B and 20 with polymyxin E. The clinical baseline characteristics before admission to the ICU and before nebulization of polymyxin were similar between the two groups. No differences were found between the two study groups in terms of microorganism distribution, VAP cure rate, time of bacteria-negative conversion, duration of MV after inclusion, length of stay in ICU and all-cause ICU mortality. Similarly, survival analysis did not differ between the two groups (χ2 = 3.539, p = 0.06). AKI incidence was higher in the IV-NL-polymyxin group. When comparing the clinical efficacy and toxicity to polymyxin B and polymyxin E, there was no difference between the two groups in terms of VAP cure rate, time of bacteria-negative conversion, duration of MV after inclusion, length of stay in ICU, SOFA score, CPIS, AKI incidence and all-cause ICU mortality.Conclusion: Our study found that nebulized polymyxin monotherapy was non-inferior to combination therapy with intravenous polymyxin in treating CR-GNB-VAP. Furthermore, we observed no differences in clinical efficacy or related toxic side effects between polymyxin B and polymyxin E during nebulized polymyxin therapy as monotherapy. However, future prospective studies with larger sample sizes are required to confirm these findings.
Investigation of factors enhancing droplets spreading on leaves with burrs
Authors: Wang Pei , Xu Chengrui , Li Chengsong , Wang Lihong , Niu Qi , Li Hui 
Published: August 2023

IntroductionSpread effect is one of the aspects on deposition quality evaluation of pesticide droplets. It could be affected by many factors such as the microstructure of the target plant leaf surface, physical features of the droplets, and the concentration of spray additives.MethodsIn this study, using a high-speed photography system, 2.3% glyphosate ammonium salt solution with different concentration of the additive was applied to investigate the impact process of single droplet deposition on the plant leaf surface with burrs. Effect of droplet sizes and velocities on spreading area and dynamic deposition procedure was analyzed using image processing programs.ResultsThe diffusion factor in the process of droplet spreading was changed over time. The occurrence of bubbles in the droplets was observed in the results. With the bubble generation, the droplet diameter expands and a better diffusion effect is obtained. As a result, better spreading effect was obtained as the droplet diameter was expanded with the generation of bubbles. The significant effects of each physical property of droplets on droplet spreading and the interaction effects between the influencing factors were analyzed. A significant correlation was found between additive concentration, droplet impact velocity, droplet diameters and droplet spreading area. All interactions of concentration:velocity, concentration:diameter, velocity:diameter, and concentration:velocity:diameter had a significant effect on the spreading area of droplets. The study of the factors influencing the process of pesticide droplet impact on the leaf surface contributes to the efficient use of pesticides. Thus, the consumption of pesticides and the resulting impact on the environment can be reduced.
Assessing self-forgiveness through the Enright Self-Forgiveness Inventory in the Spanish population: a validation study
Authors: Molinero Clara , Kasprzak Agata , Bonete Saray , Gallo-Giunzioni Karla 
Published: August 2023

IntroductionSelf-forgiveness has been a complex construct to define, which has resulted in a shortage of instruments that adequately measure it as a process. In Spain, until now there is only one validated instrument to measure self-forgiveness, for this reason the present study aims to validate the Enright Self-Forgiveness Inventory (ESFI).MethodA sample of 276 people (84 men, 192 women) aged from 18 to 25 years, completed the Enright Self-Forgiveness Inventory (ESFI) after its adaptation to Spanish, as well as the Enright Forgiveness Inventory-30 (EFI-30), the Narcissistic Personality Inventory (NPI), the Short form of Social Desirability Scale (M-C SDS), the Scale of psychological wellbeing (RYFF) and the Depression, Anxiety and Stress Scale-21 (DASS-21).ResultsThe Confirmatory Factor Analysis showed a good fit for the original six-factors structure (CFI = 0.93, TLI = 0.92, RMSEA = 0.063). The results showed good psychometric qualities (both validity and reliability) and association between self-forgiveness and social desirability, depression, anxiety, narcissistic traits, and purpose in life as expected theoretically.DiscussionThe ESFI-30 shows good psychometric properties within the Spanish context and is an appropriate instrument for evaluating self-forgiveness for research and clinical intervention.