bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors of secondary infection/recurrence after ablation for liver cancers
Authors: Yin Gang , Zhang Nengwei , BuHe AMin , Yan Wei , Li Tianxiong , Peng Jirun 
Published: February 2023

Background:
This study aimed to systemically explore the risk factors of secondary infection/recurrence after ablation in patients with liver cancer.

Methods:
Relevant literature in PubMed, EMbase, and Cochrane Library databases were searched with keywords including “liver cancer or carcinoma,” “ablation,” “infectious or infection or recurrence,” and “risk factor or relevant factor or correlative factor or influencing factor.” Meta-analyses were performed and forest plots were drawn for risk factors, including the tumor size and location, number of tumor nodules, hepatitis B virus (HBV) DNA levels, serum alpha fetal protein (AFP) levels and serum albumin levels, Child-Pugh Class, and lack of antiviral therapy. A funnel plot was drawn to assess the publication bias.

Results:
A total of 23 studies were included from the initial 701 potentially relevant articles. Our meta-analyses showed that a large tumor size (odds ratio [OR] = 1.58; 95% confidence interval [CI]: 1.31–1.92); proximity to the colon, large vessels, and large hepatic vein (OR = 4.10; 95% CI: 2.26–7.43); multinodular tumor (OR = 2.10; 95% CI: 1.46–3.03), the higher HBV DNA levels (OR = 1.34; 95% CI: 1.09–0.64); higher serum AFP levels (OR = 1.56; 95% CI: 1.18–2.05), lower serum albumin levels (OR = 1.67; 95% CI: 1.06–2.65); Child-Pugh Class B and Class C (OR = 1.27; 95% CI: 1.05–1.54); and lack of antiviral therapy (OR = 1.75; 95% CI: 0.93–3.28) were associated with an increased risk of post-ablation infection/recurrence in patients with liver cancers.

Conclusion:
Our results indicated that the tumor size and location, number of tumor nodules, HBV DNA levels, serum AFP levels and serum albumin levels, Child-Pugh Class, and lack of antiviral therapy were the risk factors for post-ablation infection/recurrence in patients with liver cancer. Here, we have provided directions for the clinical prevention of secondary infection/recurrence in patients with liver cancer who underwent ablation therapy.
A novel targeted iron oxide nanocarrier for inhibiting M2-type macrophages in the tumor microenvironment
Authors: Tian Kaixuan , Feng Ruiqing , Wang Xiaoqing , Wu Xiangyu , Li Long , Liu Wei , Wu Rongde 
Published: February 2023

Background:
Tumor-associated macrophages (TAMs) are vital to the tumor microenvironment. They are classified as antitumor M1-type or protumor M2-type macrophages. M2-type macrophages accumulate in the tumor stroma and are related to poor prognosis. Iron oxide nanoparticles are used as drug delivery vehicles because of the structure of carboxyl groups on their surface and their ability to be easily phagocytosed by macrophages.

Aim:
The signal transducer and activator of transcription 6 (STAT6) signaling pathway controls M2 macrophage polarization, but the STAT6 signaling pathway inhibitor AS1517499 lacks efficient targeting in vivo. Thus, our study aimed to block the polarization of TAMs to M2-type macrophages.

Methods and Material:
We used ultrasmall superparamagnetic iron oxide nanoparticles (USPIONs) as drug carriers coated with the STAT6 signaling pathway inhibitors AS1517499 and CD163 monoclonal antibodies to synthesize the targeted nanocomplex AS1517499-USPION-CD163 utilizing the carbodiimide method. Then, we determined its physicochemical properties, including hydrodynamic size distribution, ultrastructure, iron concentration, protein content and activity of the CD163 monoclonal antibody, AS1517499 content, and selectivity for M2-type macrophages, and its biological applications.

Results:
The hydrodynamic size distribution was stable (average size = 95.37 nm). Regarding biological applications, the targeted nanocomplex selectively inhibited M2-type macrophages.

Conclusions:
The targeted nanocomplex AS1517499-USPION-CD163 showed high selectivity for M2-type macrophages. Therefore, iron oxide nanoparticles targeting TAMs may be an effective approach to TAM therapy.
Correlation analysis of body image level and female sexual dysfunction in young patients with postoperative breast cancer
Authors: Du Hua , Chen Chen , Yuan Fangzhen , Hu Anni , Han Jiangying 
Published: February 2023

Objective:
To determine the relationship between female body image and female sexual dysfunction (FSD) in young patients (20–40 years) with postoperative breast cancer.

Methods:
Using the convenient sampling method, we identified 276 young patients with postoperative breast cancer from June 2017 to 2019 in the Department of Oncology and Radiotherapy of the First Affiliated Hospital of Anhui Medical University to be included in the study. A general situation questionnaire for body image scale (BIS) and female sexual function index (FSFI) scale was used to evaluate the correlation between body image level and the prevalence of FSD in young patients with postoperative breast cancer.

Results:
The total score for BIS was 10.98 ± 7.19, indicating that patients were moderately dissatisfied with their body image The total prevalence of FSD was 63.41%. Pearson correlation analysis showed a negative correlation between the total score, each dimension score of BIS, total FSD, and the incidence of each dimension disorder (range, r: −0.414 to −0.717, all P values <0.05).

Conclusion:
There is a negative correlation between the body image level and the prevalence of FSD in young patients with postoperative breast cancer. This suggests that clinical medical workers should develop an intervention plan to improve the body image level of postoperative young breast cancer patients according to the unique physiological and psychological characteristics of these patients while also reducing the prevalence of FSD.
Analysis of antitumor immunity in mouse glioma microenvironment through intercellular communication
Authors: Zhang Yan , Lu Fenghua , Cai Nannan , Tang Lanjing , Zhou Yao , Li Yalin , Liu Kai , Song Wengang , Kang Li , He Hao 
Published: February 2023

Objective:
This study aimed to map the antitumor immunity in the glioma microenvironment by analyzing intercellular communication.

Materials and Methods:
The single-cell RNA-sequencing (scRNA-Seq) data were obtained from fresh mouse gliomas. Tumor cells were inferred by estimating genomic copy number profiles. CellMarker database was used to identify cell types. Intercellular communication was inferred using CellChat. Flow cytometry was used to detect the effect of microglia or stroma-educated monocytes on CD4+ T cell proliferation.

Results:
Mouse glioma contained at least eight cell populations, and T cells were the only infiltrating immunocytes. Whether in signal outgoing or signal incoming, intercellular communication could be divided into four patterns by which cell populations in the tumor microenvironment (TME) cooperate with each other. By analyzing the complex communication between brain cell populations and infiltrating T cells in TME, we found that the brain cell populations used 25 signaling pathways to connect to T cells, and T cells used 21 signaling pathways to connect to brain cell populations. We also found that microglia from normal mice and brain stroma-educated monocytes exhibited immunosuppressive activity against CD4+ T cell proliferation.

Conclusions:
We described the previously underestimated complex communication between infiltrating T cells and brain cell populations. Our data suggest that the tolerogenic property of glioma TME is related to the immune privilege of CNS.
Utility of the Modified Nutritional Risk in the Critically ill Score as an Outcome Predictor in All-Cause Acute Respiratory Distress Syndrome and Acute Febrile Illness-Induced Acute Respiratory Distress Syndrome
Authors: Todur Pratibha , Nileshwar Anitha , Chaudhuri Souvik , Maddani Sagar S , Rao Shwethapriya , Thejesh S. 
Published: February 2023

Introduction:
Nutritional risk in the Critically Ill (NUTRIC) score is a predictor of adverse outcomes in the critically ill, and its utility in a specific population of critically ill has been recommended. We aimed to study the utility of modified NUTRIC (mNUTRIC) score as a mortality predictor in acute febrile illness (AFI)-induced acute respiratory distress syndrome (ARDS) and all-cause ARDS patients.

Methods:
We recorded data from two prospective observational ARDS studies conducted at a single-center tertiary care hospital to evaluate the utility of the mNUTRIC score as an independent mortality predictor in all-cause ARDS and AFI-ARDS. A total of 216 all-cause ARDS patients were included, of which 73 were AFI-ARDS and 143 were non-AFI ARDS.

Results:
Mortality of AFI-ARDS was 16/73 (21.9%) compared to 62/143 (43.35%) in non-AFI ARDS (P = 0.002). There were no significant differences in severity of ARDS in AFI-ARDS and non-AFI ARDS groups (P = 0.504). The mNUTRIC score was found to be an independent predictor of mortality in all-cause ARDS patients (n = 216) and AFI-ARDS patients (n = 73) after Cox regression multivariable analysis. In all-cause ARDS, the mNUTRIC score had an area under the curve (AUC) of 0.778, cutoff ≥4, 82.1% sensitivity, and 65.9% specificity as a predictor of mortality. In AFI-ARDS, the mNUTRIC score had an AUC of 0.769, cutoff ≥4, 81.3% sensitivity, 66.67% specificity, and P = 0.001 as a predictor of mortality.

Conclusion:
The mNUTRIC score is an independent mortality predictor for all-cause ARDS and AFI-ARDS patients. AFI-ARDS has significantly lesser mortality than non-AFI ARDS.
Prescription Pattern of Empirical Antibiotic Therapy in the Burn Unit of a Tertiary Care Setting in the Kingdom of Saudi Arabia
Authors: Moinuddin Khaja , Alanazi Deemah Sattam , Alsomali Bushra Abdulrahman , Alotaibi Maram , Parameaswari Parthasarathy Jaganathan , Ali Sheraz 
Published: February 2023

Background:
It is crucial to follow rational prescribing practices while prescribing antibiotics for burn patients, thus leading to better patient outcomes. The objective of this study was to assess the initiation of empirical antibiotics in the burn unit.

Methods:
A prospective cross-sectional study was conducted in a large tertiary care setting of the Kingdom of Saudi Arabia between August 2016 and December 2018.

Results:
A total of 102 hospitalized burn patients were included in this study, of whom 84 (82.4%) were males. Burns were classified as first degree, second degree, third degree, or fourth degree depending on their severity and extent of penetration into the skin. The majority (81.3%) of the patients suffered from flame burn, followed by scald (9.85), chemical (6.9%), and electrical (2%) types of burns. Broad-spectrum antibiotic such as piperacillin/tazobactam (40.57%) was the most common empirically prescribed antibiotic. In 35 patients (34.3%), there was a change in antibiotic after culture findings.

Conclusion:
This study demonstrated that 40% of antibiotic therapy decisions followed the recommended clinical guidelines. This study also found that Gram-negative microorganisms such as Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus were ubiquitous in our burn unit. The study results will facilitate to develop antibiogram for our study setting, thus reducing antibiotic resistance. Further studies are needed to explore the extent and consequences of irrational antibiotic prescriptions in critically ill burn patients.
Assessment of a Pharmacovigilance Module
Authors: Palaian Subish , Ibrahim Mohamed Izham Mohamed , Mishra Pranaya , Shankar Pathiyil Ravi 
Published: February 2023

Background:
The aim of the study was to assess the impact of a pharmacovigilance module on the knowledge, attitude, and practice (KAP) of pharmacy students and elucidate their feedback on the module.

Methodology:
Bachelor of pharmacy students at Pokhara University, Nepal, were assessed for their baseline KAP on drug safety and related issues using a KAP questionnaire (Cronbach alpha 0.70) consisting of 25 questions. Students’ baseline KAP was assessed and after that, they were grouped into either control (2nd and 4th year) or test (1st and 3rd year) groups. The later received the pharmacovigilance training in three 1-h sessions spread over 6 months at 0, 90, and 180 days; the sessions covered introduction to pharmacovigilance, theoretical aspects of pharmacovigilance, and adverse drug reaction reporting procedures. KAP scores and student feedback were analyzed at 5% significance level.

Results:
A total of 124 students (control = 56 and test = 68) were studied. The median (interquartile ranges [IQRs]) of the baseline scores prior to grouping the students into control and test groups was 20 (18.25–21.00) for knowledge, 19.5 (18.00–21.00) for attitude/practice, and 39 (37.00–41.00) for the total score. Males (n = 81) had a slightly higher median score of 40 (37–42) than females (n = 43), who had a median score of 38 (36–41). The KAP score for the control group was 40 (38–42) at baseline, 42 (20–44) during first follow-up, 41.5 (40–44) during second follow-up, and 41 (39–44.5) during third follow-up. For the test group, upon intervention, the KAP scores improved from 39 (36.25–40.75) at baseline to 42 (39.50–44.00) at the 1st follow-up, 43 (41–45) at the 2nd follow-up, and 44 (42–45) at the 3rd follow-up (P < 0.001). The median feedback score (IQR) was 86 (81.5–90.0).

Conclusions:
Pharmacy students had good attitude/practice scores and relatively poor knowledge scores at baseline, which improved postintervention. Student feedback about the module was positive.
Metformin Use in Gestational Diabetes
Authors: Daud Nur Aizati Athirah , Mohiuddin Syed Ghouse , Ong Yi Ping , Yusof Faridah , Yusoff Fadhleena , Harun Sabariah N. , Ghadzi Siti Maisharah S. 
Published: February 2023

Background:
Metformin has been added in the Malaysian clinical practice guideline (CPG) as one of the first-line options in the management of gestational diabetes mellitus (GDM); however, the uptake on this practice among healthcare professionals is unknown.

Objective:
The objective of the study is to determine the awareness, attitude, and practice and their predictors on the use of metformin for GDM among healthcare professionals in Malaysia.

Materials and Methods:
This was a multicenter, cross-sectional study in three tertiary hospitals in Malaysia. Medical doctors and pharmacists working in several departments were invited to participate in a survey using self-administered questionnaires.

Results:
From 350 questionnaires distributed, 225 were completed by medical doctors (43.1%), pharmacists (40.4%), and specialists (7.5%). Less than 30% of them were aware on the option of using metformin as one of the first-line agents in GDM. Education level, department, and profession were found to be associated with the awareness level (P = 0.016, P = 0.004, and P = 0.001, respectively). 70.2% of the respondents showed a positive attitude toward metformin use in GDM. Only 64 (28.4%) of the respondents have prescribed/dispensed metformin for GDM before, although more than half will consider doing so in the future. Having postgraduate qualifications increased the likelihood of having a good awareness (odds ratio [OR]: 2.44, 95% confidence interval [CI] 1.23–4.85) and to consider prescribing/dispensing metformin for GDM patients (OR: 2.27, 95% CI 1.08–4.78).

Conclusion:
Despite a positive attitude toward metformin use in GDM among healthcare professionals in Malaysia, their awareness level on this practice was low as they currently prefer the use of insulin over metformin.
Role of Hematological and Immunological Parameters in COVID-19 Patients
Authors: Kumar Avanindra , Sepolia Shipra , Shilpa R. H. , Rezayani Gilda , Kumari Soni , Aastha  , Gupta Shivangi 
Published: February 2023

Background:
The ongoing pandemic of coronavirus disease 2019 (COVID-19) which was caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to efforts from the medical and scientific community in understanding the biological basis of COVID-19 pathophysiological mechanisms. Thus, analysis of various hematological and immunological parameters may be helpful for COVID-19 infection evaluation for risks involved and effectiveness in management.

Aim:
The aim of this study was to analyze the role of various hematological and immunological parameters in patients infected with SARS-CoV-2.

Materials and Methods:
This retrospective analysis was performed on 300 patients who tested positive for SARS-CoV-2 by quantitative reverse transcription–polymerase chain reaction analysis. All participants of the study were divided into – (a) Group I: patients with mild symptoms and normal chest radiographic findings; (b) patients with moderate disease presenting with fever and cough along with other respiratory symptoms, and (c) patients suffering from severe disease. Data collection was done from all patients at the time of hospital admission for hematological and immunological parameters – (a) total leukocyte count, (b) lymphocyte count, (c) lymphocytic subset count, (d) lactate dehydrogenase (LDH) levels, (e) D-dimer, (f) C-reactive protein (CRP), and (g) ferritin levels. SPSS 22.0 software was used for determining P values by independent t-test and Chi-square test.

Results:
The median age was 65 years (interquartile range –57–71 years). While comparing white blood cell and lymphocyte counts, extremely significant P values were obtained. D-dimers and ferritin levels demonstrated extremely significant P values while both LDH and CRPs showed statistical significance. Correlation of lymphocytic subsets showed extreme significance in total lymphocyte counts in mild-to-moderate as compared to severely infected patients while both CD4+ and CD8+ counts demonstrated statistical significance in mild-moderate infected cases. Statistical significance was noted in D-dimer, CRP, and LDH levels also.

Conclusion:
Assessment of hematological and immunological parameters can be used to plan the management of COVID-19 patients.
Utility and Impact of Early Diagnostic Assessment of Sepsis on Mortality in an Emergency Department of a Tertiary Hospital in Lagos, Nigeria
Authors: Akase Iorhen Ephraim , Akujobi Henry Chukuma , Oghide Oziegbe , Olusegun-Joseph Akinsanya Daniel , Agbarakwe Chukwuemeka Abraham , Opawoye Adefolarin 
Published: February 2023

Context:
Currently, little is known about the timely application of clinical screening tools and blood sampling for decision-making in the management of patients with suspected sepsis in the accident and emergency units of hospitals in Nigeria.

Aim:
The aim of the study was to ascertain the association between the time taken for the conduct of serum lactate and blood culture investigations following a clinical suspicion of sepsis, and the mortality of patients admitted to a Nigerian tertiary hospital.

Methods:
Over a 6-month period (November 2021 to April 2022), 119 patients hospitalised for sepsis or septic shock at the Lagos University Teaching Hospital were followed until discharge or death. The proportion of patients whose serum lactate, serum procalcitonin and blood culture samples was taken was also determined. Predictors of mortality were determined using bivariate analysis and logistic regression. Kaplan–Meier plots were used to predict survival using sepsis diagnostic criteria.

Results:
Eighty (67%) of 119 sepsis patients met systemic inflammatory response syndrome or quick sequential (sepsis-related) organ failure assessment criteria. Only 3 (2.5%) patients had blood cultures and serum procalcitonin and 0 (0%) had serum lactate tests. Forty-one (34.5%) patients died, but clinical and laboratory procedures for sepsis management were not linked to death. A shorter hospital stay increased the death risk (χ2 = 14.83, P = 0.002).

Conclusion:
This study revealed low compliance with sepsis care guidelines and no impact of timely clinical and laboratory procedures on sepsis mortalities. Further study is needed to explore patient care models that can improve the objective assessment and treatment of sepsis patients in emergency departments of busy tertiary hospitals.
Legalisation of Abortion in a Poor-Resource Setting
Authors: Fehintola Funmito Omolola , Ajibola Idowu , Olowookere Samuel Anu , Akande Yemisi Roseline , Komolafe Tolulope , Eledah Emmanuel , Faneye Eniola , Oyewale Seun 
Published: February 2023

Background:
Abortion is one of the leading causes of morbidity and mortality amongst Nigerian women in a country with restrictive abortion laws. Despite being illegal, abortions are still performed, and about 50% of abortions are performed by untrained persons in unhygienic conditions. This study assessed the determinants of attitude of undergraduates to legalisation of safe abortion in Nigeria.

Methods:
It is a descriptive cross-sectional study. We used a three-stage sampling technique to select 423 undergraduates using a pre-tested questionnaire. The predictors of attitude towards abortion and its legalisation were identified during multivariate analysis.

Results:
Good knowledge of abortion and its sequelae was found in about two-thirds (62.2%) of the participants, while over half (56.3%) had a negative perspective to abortion legalisation in Nigeria. Older participants were more likely to have positive perspectives to legalisation of abortion compared to their younger counterparts (odds ratio [OR] = 4.72, confidence interval [CI]: 2.61–8.55). Furthermore, respondents from upper social class and those with good knowledge were more likely to have positive perspectives to legalisation of abortion compared to their counterparts (OR = 5.63, CI: 3.12–10.16 and OR = 4.50, CI: 2.89–7.01).

Conclusion:
The study showed that respondents' knowledge of abortion was relatively low amongst the study population, and more than half of the respondents did not want abortion to be legalised. Increasing awareness on the importance of abortion and its complications in Nigeria will curb the menace of death due to abortion now and in the future.
Contraceptive Use and Fertility Control in Rural and Urban Communities of Lagos Nigeria
Authors: Wright Kikelomo Ololade , Akinyinka Modupe Rebekah , Fagbemi Temiloluwa , Aderibigbe Adedayo , Banke-Thomas Aduragbemi , Wusu Onipede 
Published: February 2023

Background:
It is predicted that the population of sub-Saharan Africa will be thrice its size by the end of the 21st century. Our study compared patterns, incentives and disincentives for the uptake of contraceptives in rural and urban communities of Lagos, Nigeria.

Materials and Methods:
This is a population-based cross-sectional study on 1445 women of reproductive ages 15–49 years using a cluster sampling technique and a pre-tested, interviewer-administered electronic questionnaire in 2020. Data were analysed using the Statistical Package for the Social Sciences (SPSS) software version 26.0 and ethical approval was obtained for the study.

Results:
About 32.4% of the respondents were rural dwellers and 67.6% were urban residents. The overall mean age was 31.7 ± 7.8 years. In terms of pattern, slightly over half (53.3%) of all respondents had ever used family planning (FP), including modern contraceptives and slightly less than a third (30.8%) currently use FP methods in both rural and urban communities, respectively. Predominant disincentives for non-use of FP include a desire to retain fertility, lack of further need, unbearable side effects and lack of spousal support. The odds of being an urban dweller currently using a method of contraceptive method is 4.169 times higher for earners above N60,000, which is twice the minimum wage compared to those without income (adjusted odd's ratio: 4.169, 95% confidence interval: 1.395–12.462).

Conclusion:
Sustained effort is required to improve contraceptive uptake, FP service delivery and demand satisfaction for modern contraceptives to enable the achievement of demographic dividends and gains.