bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative prediction of the lymphovascular tumor thrombus of colorectal cancer with the iodine concentrations from dual-energy spectral CT
Authors: Yuan Xiang , Quan Xin , Che Xiao-ling , Xu Lu-Lu , Yang Chun-mei , Zhang Xiao-di , Shu Jian 
Published: August 2023

Abstract
Background
The aim of this study was to explore application value of iodine concentration from dual-energy spectral computed tomography (DESCT) in preoperative prediction of lymphovascular tumor thrombus in patients with colorectal cancer (CRC).

Methods
We finally retrospectively analyzed 50 patients with CRC who underwent abdominal DESCT before receiving any preoperative treatment and underwent surgery to obtain pathological specimens which were stained with hematoxylin-eosin (HE) staining. According to the presence of cancer cell nests in blood vessels and lymphatic vessels, the subjects were divided into the positive group and negative group of lymphovascular tumor thrombus. Two radiologists independently measured the normalized iodine concentration (NIC) values, effective atomic number (Zeff) and CT values of virtual monochromatic images (VMIs) at 40–90 keV of the primary tumors in the arterial phase (AP) and venous phase (VP). Used SPSS 17.0 to calculate the receiver operating characteristic (ROC) curve to evaluate diagnostic value.

Results
The patients were divided into lymphovascular tumor thrombus positive group(n = 16) and negative group(n = 34). The values of NIC-AP and NIC-VP in the positive group were 0.17 ± 0.09, 0.51 ± 0.13, respectively. And those in the negative group were 0.15 ± 0.06, 0.43 ± 0.12, respectively. There was significant difference in NIC-VP value between the two groups (p = 0.039), but there was no significant difference in NIC-AP value (p = 0.423). The optimal threshold value of NIC-VP value for diagnosis of lymphovascular tumor thrombus was 0.364. The sensitivity was 68.8% and the specificity was 67.6%.

Conclusions
The NIC-VP value of DESCT can be used to predict the presence or absence of the lymphovascular tumor thrombus in CRC patients before operation, which is helpful to select the best treatment scheme and evaluate its prognosis.
Double burden of malnutrition and its associated factors among women in low and middle income countries: findings from 52 nationally representative data
Authors: Alem Adugnaw Zeleke , Yeshaw Yigizie , Liyew Alemneh Mekuriaw , Tessema Zemenu Tadesse , Worku Misganaw Gebrie , Tesema Getayeneh Antehunegn , Alamneh Tesfa Sewunet , Teshale Achamyeleh Birhanu , Chilot Dagmawi , Ayalew Hiwotie Getaneh 
Published: August 2023

Abstract
Background
Double burden of malnutrition (DBM) is an emerging global public health problem. The United Nations member states adopted eradicating all forms of malnutrition as an integral component of the global agenda. However, there is evidence of a high burden of undernutrition among women and rising rates of overweight and obesity, especially in low and middle income countries (LMICs). Therefore, this study aimed to investigate the prevalence and associated factors of underweight, overweight, and obesity among women of reproductive age in LMICs.

Methods
Data for the study were drawn from a recent 52 Demographic and Health Surveys (DHS) conducted in LMICS. We included a sample of 1,099,187 women of reproductive age. A multilevel multinomial logistic regression model was used to identify factors associated with DBM. Adjusted relative risk ratio (RRR) with a 95% Confidence Interval (CI) was reported to show an association.

Results
The prevalence of underweight, overweight, and obesity in LMICs among women of reproductive age was 15.2% (95% CI: 15.1–15.3), 19.0% (95% CI: 18.9- 19.1), and 9.1% (95% CI: 9.0–9.2), respectively. This study found that women aged 24–34 years, aged ≥ 35 years, with primary, secondary, and above educational level, from wealthy households, using modern contraceptives, exposed to media (radio and television), and with high parity (more than one birth) were more likely to have overweight and obesity and less likely to have underweight. Moreover, the risk of having obesity (RRR = 0.59; 95% CI = 0.58–0.60 and overweight (RRR = 0.78; 95% CI = 0.77–0.79) were lower among rural women, while the risk of being underweight was (RRR = 1.13; 95% CI = 1.11–1.15) higher among rural women compared to urban women.

Conclusion
The prevalence of underweight, overweight, and obesity was high among women of reproductive age in LMICs. Underweight, overweight, and obesity are influenced by sociodemographic, socioeconomic, and behavioral-related factors. This study shows that, in order to achieve Sustainable Development Goal 2, a multifaceted intervention approach should be considered to prevent both forms of malnutrition in women of reproductive age. This can be achieved by raising awareness and promoting healthy behaviors such as healthy eating and physical activity, especially among educated women, women from wealthy households, and women exposed to the media.
Health-promoting work schedules among nurses and nurse assistants in France: results from nationwide AMADEUS survey
Authors: Fond Guillaume , Lucas Guillaume , Boyer Laurent 
Published: August 2023

Abstract
Background
The study aimed to investigate the relationship between different work schedules and self-reported working conditions and health risk behaviours among nurses and nurse assistants (NNA) in France. It hypothesized that work schedules, particularly long shifts, could impact work-life balance, workload, stress levels, burnout, and smoking habits. NNA had the option to work either with a 7-hour schedule, 5 days per week, or with long work schedules consisting of ten to twelve-hour shifts, three days per week. These schedules could potentially influence various aspects of their professional lives.

Methods
The survey followed the guidelines of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement and was administered to NNA working in public and private national healthcare facilities in France. The researchers used the Job Content Questionnaire to assess the work environment and the French version of the 22-item Maslach Burnout Inventory (MBI) scale to measure burnout.

Results
A total of 3,133 NNA participated in the study, including 2,369 nurses (75.6%) and 764 nurse assistants (24.4%). Among them, 1,811 individuals (57.8%) followed a 7-hour work schedule, while 1,322 individuals (42.2%) had a long work schedule. Multivariate analyses revealed that NNA working with long schedules reported higher psychological demands, more frequent burnout, a higher number of daily smoked cigarettes, and greater coffee consumption. These findings were independent of other factors such as sector of employment, type of healthcare facility, job status, work schedules, night shifts, department specialty, age, and family responsibilities.

Conclusions
While some NNA may choose long schedules to have more days off, those working with these schedules experience greater work-related burdens and engage in worse health risk behaviours as a coping mechanism. It emphasizes the importance of considering health-promoting work schedules to address the high psychological demands and burnout experienced by NNA with long schedules. Implementing changes in work schedules could potentially improve the overall well-being and job satisfaction of these healthcare professionals.
Association between the distal tibiofibular syndesmosis morphology classification and ankle osteoarthritis: a retrospective study
Authors: Huang Lei , Zhang XiaoHong , Yang Siyi , Qing Jiwen , Wu Wangyu , Shi Houyin , Wang Dingxuan , Zhang Lei 
Published: August 2023

Abstract
Background
Syndesmosis injury is proposed to contribute to ankle stability and osteoarthritis (OA). However, whether distal tibiofibular syndesmosis structure is closely related to ankle OA is unclear. We hypothesized that different DTS morphology classifications would affect the biomechanics properties in ankle OA. The study aimed to determine the association between the distal tibiofibular syndesmosis (DTS) morphological classification and ankle OA.

Methods
This is a retrospective study examining imaging data of 147 patients (87 males and 60 females) with ankle OA. Magnetic resonance imaging was used to access the DTS morphological classification, according to measuring various parameters. Joint space narrowing and osteophytes were measured using ankle weight-bearing radiography. The classification and parameters were analyzed to determine the relationship between the syndesmosis classification and the abnormality of ankle OA.

Results
Five morphological classifications of the DTS, including Chevron (19.6%), Widow’s peak (16.2%), Flat (22.3%), Trapezoid (32.0%), and Crescent (19.6%), were shown. There were statistical differences between DTS classification and tibial angle surface angle (TAS) (P = .009) and talar tilt angle (TTA) (P = .014). The TAS (degree) of the Crescent (86.47 ± 3.21) was less than Chevron (88.75 ± 2.72) (P = .006), Widow’s peak (89.26 ± 3.15) (P = .001), Flat (88.83 ± 3.62) (P = .003) and Trapezoid (88.11 ± 2.62) (P = .041), respectively. The TTA (degree) of Crescent (86.83 ± 5.30) was less than Chevron (89.28 ± 2.46) and Widow’s peak (89.82 ± 3.41). The men were greater than women for TAS (P = .008) and angle (P = .003), which are consistent with osteophyte (P = .019) and the modified Kellgren–Lawrence grades (P = .041) between gender.

Conclusions
DTS morphological classification might affect the biomechanics properties in TAS and TTA in ankle OA. In clinical practice, surgeons should pay attention to the effects of DTS on ankle OA.
Level of Evidence: Level III, retrospective study.
Prognostic implication of downregulated exosomal miRNAs in patients with sepsis: a cross-sectional study with bioinformatics analysis
Authors: Shin Beomsu , Lee Jin Young , Im Yunjoo , Yoo Hongseok , Park Junseon , Lee Joo Sang , Lee Ki-Young , Jeon Kyeongman 
Published: August 2023

Abstract
Background
Despite the understanding of sepsis-induced extracellular vesicles (EVs), such as exosomes, and their role in intercellular communication during sepsis, little is known about EV contents such as microRNA (miRNA), which modulate important cellular processes contributing to sepsis in body fluids. This study aimed to analyze the differential expression of exosomal miRNAs in plasma samples collected from sepsis patients and healthy controls, and to identify potential miRNA regulatory pathways contributing to sepsis pathogenesis.

Methods
Quantitative real-time PCR-based microarrays were used to profile plasma exosomal miRNA expression levels in 135 patients with sepsis and 11 healthy controls from an ongoing prospective registry of critically ill adult patients admitted to the intensive care unit. The identified exosomal miRNAs were tested in an external validation cohort (35 sepsis patients and 10 healthy controls). And then, functional enrichment analyses of gene ontology, KEGG pathway analysis, and protein–protein interaction network and cluster analyses were performed based on the potential target genes of the grouped miRNAs. Finally, to evaluate the performance of the identified exosomal miRNAs in predicting in-hospital and 90-day mortalities of sepsis patients, receiver operating characteristic curve (ROC) and Kaplan–Meier analyses were performed.

Results
Compared with healthy controls, plasma exosomes from sepsis patients showed significant changes in 25 miRNAs; eight miRNAs were upregulated and 17 downregulated. Additionally, the levels of hsa-let-7f-5p, miR-331-3p miR-301a-3p, and miR-335-5p were significantly lower in sepsis patients than in healthy controls (p < 0.0001). These four miRNAs were confirmed in an external validation cohort. In addition, the most common pathway for these four miRNAs were PI3K-Akt and mitogen-activated protein kinase (MAPK) signaling pathways based on the KEGG analysis. The area under the ROC of hsa-let-7f-5p, miR-331-3p, miR-301a-3p, and miR-335-5p level for in-hospital mortality was 0.913, 0.931, 0.929, and 0.957, respectively (p < 0.001), as confirmed in an external validation cohort. Also, the Kaplan–Meier analysis showed a significant difference in 90-day mortality between sepsis patients with high and low miR-335-5p, miR-301a-3p, hsa-let-7f-5p, and miR-331-3p levels (p < 0.001, log-rank test).

Conclusion
Among the differentially-expressed miRNAs detected in microarrays, the top four downregulated exosomal miRNAs (hsa-let-7f-5p, miR-331-3p miR-301a-3p, and miR-335-5p) were identified as independent prognostic factors for in-hospital and 90-day mortalities among sepsis patients. Bioinformatics analysis demonstrated that these four microRNAs might provide a significant contribution to sepsis pathogenesis through PI3K-Akt and MAPK signaling pathway.
Determinants of quality of life in adults with epilepsy: a multicenter, cross-sectional study from Germany
Authors: Siebenbrodt Kai , Willems Laurent M. , von Podewils Felix , Mross Peter Michael , Strüber Michael , Langenbruch Lisa , Bierhansl Laura , Gorny Iris , Schulz Juliane , Gaida Bernadette , Conradi Nadine , Süß Annika , Rosenow Felix , Strzelczyk Adam 
Published: August 2023

Abstract
Background
Assessment of quality of life (QoL) has become an important indicator for chronic neurological diseases. While these conditions often limit personal independence and autonomy, they are also associated with treatment-related problems and reduced life expectancy. Epilepsy has a tremendous impact on the QoL of patients and their families, which is often underestimated by practitioners. The aim of this work was to identify relevant factors affecting QoL in adults with epilepsy.

Methods
This cross-sectional, multicenter study was conducted at four specialized epilepsy centers in Germany. Patients diagnosed with epilepsy completed a standardized questionnaire focusing on QoL and aspects of healthcare in epilepsy. Univariate regression analyses and pairwise comparisons were performed to identify variables of decreased QoL represented by the overall Quality of Life in Epilepsy Inventory (QOLIE-31) score. The variables were then considered in a multivariate regression analysis after multicollinearity analysis.

Results
Complete datasets for the QOLIE-31 were available for 476 patients (279 [58.6%] female, 197 [41.4%] male, mean age 40.3 years [range 18–83 years]). Multivariate regression analysis revealed significant associations between low QoL and a high score on the Liverpool Adverse Events Profile (LAEP; beta=-0.28, p < 0.001), Hospital Anxiety and Depression Scale – depression subscale (HADS-D; beta=-0.27, p < 0.001), Neurological Disorders Depression Inventory in Epilepsy (NDDI-E; beta=-0.19, p < 0.001), revised Epilepsy Stigma Scale (beta=-0.09, p = 0.027), or Seizure Worry Scale (beta=-0.18, p < 0.001) and high seizure frequency (beta = 0.14, p < 0.001).

Conclusion
Epilepsy patients had reduced QoL, with a variety of associated factors. In addition to disease severity, as measured by seizure frequency, the patient’s tolerability of anti-seizure medications and the presence of depression, stigma, and worry about new seizures were strongly associated with poor QoL. Diagnosed comorbid depression was underrepresented in the cohort; therefore, therapeutic decisions should always consider individual psychobehavioral and disease-specific aspects. Signs of drug-related adverse events, depression, fear, or stigmatization should be actively sought to ensure that patients receive personalized and optimized treatment.

Trial Registration
German Clinical Trials Register (DRKS00022024; Universal Trial Number: U1111-1252-5331).
After the sun: a nanoscale comparison of the surface chemical composition of UV and soil weathered plastics
Authors: Foetisch Alexandra , Filella Montserrat , Watts Benjamin , Bragoni Maeva , Bigalke Moritz 
Published: August 2023

AbstractOnce emitted into the environment, macro- (MaP), micro- (MP) and nanoplastics (NP) are exposed to environmental weathering. Yet, the effects of biogeochemical weathering factors occurring in the soil environment are unknown. As the transport, fate, and toxicity of MP and NP depend directly on their surface properties, it is crucial to characterize their transformation in soils to better predict their impact and interactions in this environment. Here, we used scanning transmission x-ray micro spectroscopy to characterize depth profiles of the surface alteration of environmental plastic debris retrieved from soil samples. Controlled weathering experiments in soil and with UV radiation were also performed to investigate the individual effect of these weathering factors on polymer surface alteration. The results revealed a weathered surface on a depth varying between 1 µm and 100 nm in PS, PET and PP environmental plastic fragments naturally weathered in soil. Moreover, the initial step of surface fragmentation was observed on a PS fragment, providing an insight on the factors and processes leading to the release of MP and NP in soils. The comparison of environmental, soil incubated (for 1 year) and UV weathered samples showed that the treatments led to different surface chemical modifications. While the environmental samples showed evidence of alteration involving oxidation processes, the UV weathered samples did not reveal oxidation signs at the surface but only decrease in peak intensities (indicating decrease of the number of chemical C bonds). After a one-year incubation of samples in soil no clear aging effects were observed, indicating that the aging of polymers can be slow in soils.
Surgical repair of platypnea-orthodeoxia syndrome caused by patent foramen ovale, ascending aortic dilation, and pectus excavatum: a case report
Authors: Wada Yuki , Hirokami Jun , Nagasawa Atsushi , Marui Akira , Ohno Nobuhisa 
Published: August 2023

Abstract
Background
Platypnea-orthodeoxia syndrome (POS) is a relatively uncommon clinical syndrome characterized by dyspnea and deoxygenation accompanying postural changes, such as sitting or standing from a recumbent position.

Case presentation
We describe the case of a 76-year-old woman who was hospitalized with dyspnea in the sitting position, which was relieved in the right lateral decubitus position. The patient was diagnosed with POS caused by a patent foramen ovale (PFO), dilation and elongation of the ascending aorta, and pectus excavatum. We performed PFO closure and replacement of the ascending aorta via median sternotomy. The patient’s postoperative percutaneous oxygen saturation dramatically increased in the sitting position.

Conclusions
Elongated and dilated ascending aorta and pectus excavatum with PFO may be risk factors for POS. In older patients, surgical intervention is an important treatment option for POS caused by cardiac and aortic comorbidities.
Personalized medicine for brain metastases (BrMets) through patient-derived organoid (PDO) drug testing.
Authors: Morikawa Aki , Serhan Habib , Udager Aaron M. , Bao Liwei , Qin Zhaoping , Cheng Xu , Heth Jason , Soellner Matthew , Merajver Sofia , Merrill Nathan 
Published: August 2023

11 Background: Therapeutic development for BrMets remains a critical need. Our previous work on functional precision medicine using patient-derived xenografts (PDXs) from BrMets suggested that drug sensitivity testing may help prioritize drug selection. However, the time needed to establish PDXs makes the PDX platform less desirable for translation into the clinic. Thus, we examined the feasibility of PDOs from BrMets to evaluate the drug sensitivities in a clinically meaningful time frame. Methods: BrMets were prospectively collected from clinically indicated neurosurgery. We collected DNA and RNA and cultured tumors as 3D organoids. Drugs were curated for each case based on clinical characteristics and molecular profiles when known a priori. The drugs included standard of care and investigational drugs. Rapid Nanostring PanCancer profiling was conducted to examine if contemporary source tumor profiling would inform additional drug selection. Results: 21 patients with breast cancer were consented to the biobanking program. 3 patients had no tissues collected. 17 PDOs were established from 20 cases: 3 without PDO were necrosis without viable tumors or primary brain tumors. 2 patients had multiple collections (recurrence and synchronous lesions). Clinical subtypes included HR+/- HER2+ (N=7), HR+HER2- (N=2), HR-HER2- (N=8). The median number of drugs tested was 19.5 (range:7-32). The median time for drug testing was 12.5 days (range: 9-32). Nanostring profiling was conducted at the time of drug testing in 12/17 PDOs, and pathway analysis indicated potential targeted drugs. The most common alteration was TP53 mutation with additional NGS. The potentially targetable alterations included mutation to PIK3CA, EGFR, FGFR, CDK2NA, and CDK4. The pair of initial and recurrent lesions was molecularly similar but demonstrated differential response to select chemotherapies following patient exposure to radiation. On the other hand, the pair of synchronous lesions showed discordance in PIK3CA status and discordant sensitivity to Pi3K inhibitors. Conclusions: Predictive drug testing with BrMet PDOs in a clinically meaningful time frame is feasible. The use of real-time PDO drug testing along with molecular profiling could be potentially leveraged to further personalize therapy and discover novel therapy options for patients with BrMets. We are currently conducting clinical correlations and working toward clinical validation of our proposed drug testing platform.
Personalized K-Track assay to detect actionable mutations and minimal residual disease in solid tumors.
Authors: Tu Lan N , Nguyen Hoang Van-Anh 
Published: August 2023

110 Background: Minimal residual disease (MRD) refers to a small number of cancer cells that remain in the body after curative-intent treatment, causing relapse and metastasis. Current tumor biomarkers and imaging methods have limited sensitivity and specificity to monitor MRD for solid tumors. Circulating tumor DNA (ctDNA) in liquid biopsy has emerged as a promising biomarker to detect MRD but current ctDNA assays remain mostly inaccessible and unaffordable for developing countries. Methods: In this prospective multi-center study, 441 Vietnamese patients diagnosed with breast, colorectal, gastric, lung, liver and ovarian cancers, eligible for curative-intent surgery were recruited. Genomic DNA from tumor tissue and paired white blood cells were sequenced to profile all tumor-derived genomic alterations including actionable mutations in 95 cancer-associated genes. Our bioinformatic algorithm then ranked top alterations unique for individual patient, which were then used to monitor ctDNA presence in serial plasma samples collected before surgery and at scheduled visits after surgery by multiplex PCR and ultra-deep sequencing. Results: The assay had limit of detection for somatic mutations down to at least 0.05% variant allele frequency in liquid biopsy.The sensitivity to detect ctDNA in the pre-operative plasma was 91%, 95%, 70%, 77%, 69% and 47% for colorectal, liver, lung, ovarian, high-risk breast cancer and gastric cancer respectively; the specificity was >99%. After 18-month follow-up, our interim analysis revealed a promising 89% detection rate of post-operative ctDNA in all patients that had metastasis and recurrence (31/35), with the lead time of 2.5-13 months ahead of clinical diagnosis. Conclusions: The K-Track assay is streamlined and affordable with dual clinical utilities in residual cancer surveillance and actionable mutation profiling for targeted therapies. The assay could lay foundation to empower precision cancer medicine in Vietnam and developing countries.