bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utility of low-profile visualized intraluminal support (LVIS™) stent for treatment of acutely ruptured bifurcation aneurysms: A single-center study
Authors: Liu Changya , Guo Kaikai , Wu Xinxin , Wu Linguangjin , Cai Yike , Hu Xuebin , Fang BangJiang 
Published: March 2023

ObjectiveStent-assisted coiling has been increasingly used in the treatment of intracranial aneurysms. However, its application in ruptured bifurcation aneurysms remains controversial and challenging. This study aimed to present the safety and feasibility of low-profile visualized intraluminal support (LVIS™, LVIS, and LVIS Jr.) stent for acutely ruptured bifurcation aneurysms.MethodsA total of 41 patients with acutely ruptured intracranial aneurysms arising at the bifurcation were treated with LVIS™ stent-assisted coiling in our hospital between January 2017 and December 2021. The clinical data and angiographic results of the patients were analyzed.ResultsAmong these patients, all stents were successfully implanted. According to the immediate angiographic results, 29 aneurysms (70.7%) were completely occluded. Intraoperative thrombosis and hemorrhage occurred in two and one cases, respectively. No post-operative thrombosis or rebleeding events were observed. The clinical follow-up of all patients revealed that 38 (92.7%) cases had favorable outcomes (modified Rankin scale: 0–2). The angiographic results available for the 36 patients during the follow-up period revealed complete occlusion was achieved in 30 patients (83.3%) and residual neck in six patients.ConclusionThe LVIS™ stent-assistant coiling is a safe and feasible option for acutely ruptured bifurcation aneurysms. Further studies with a prospective design, a larger sample size, and long-term follow-up are needed to validate these findings.
Risk factors for intracerebral hemorrhage in patients undergoing maintenance hemodialysis
Authors: Yu-Huan Song , Guang-Yan Cai , Yue-Fei Xiao 
Published: March 2023

BackgroundIn patients undergoing hemodialysis, intracerebral hemorrhage (ICH) is the main cause of mortality among stroke subtypes. It is unclear whether, along with traditional cardiovascular risk factors, the risk factors unique to the uraemic environment, such as the abnormal metabolism of intact parathyroid hormone (iPTH), can contribute to the risk of ICH in these patients.MethodsThis retrospective case–control study included 25 patients undergoing hemodialysis with ICH at a single center between 30 June 2015 and 10 October 2022. The controls were 95 patients undergoing maintenance hemodialysis treated at the same dialysis center in July 2020. We compared the characteristics of patients with ICH with those of the control group to identify factors that contributed to the development of ICH.ResultsIntracerebral hemorrhage (ICH) was located in the basal ganglia (14/25), cerebellum (6/25), and brainstem (6/25) in 25 patients. A total of 17 patients died in the first 16 days due to neurological complications. Univariate analysis showed significant differences in systolic BP, diastolic BP, iPTH, and alkaline phosphatase between the two groups (p &lt; 0.05). Multivariate logistic regression analysis showed that higher systolic BP (OR, 1.053; 95% CI, 1.018–1.090; p = 0.003) and higher iPTH (OR, 1.007; 95% CI, 1.003–1.012; p = 0.001) were associated with the onset of ICH. ICH was predicted by systolic BP and iPTH by receiver operating characteristic (ROC) curve analysis, with areas under the curve (AUCs) of 0.732 and 0.624, respectively. The optimal cutoffs for systolic BP and iPTH were 151.9 mmHg and 295.4 pg./ml, respectively. Restricted cubic spline showed that the shape of the association of iPTH with the risk of ICH was approximately J-shaped (P for non-linearity &lt;0.05).ConclusionHigher systolic BP and abnormal iPTH metabolism might be associated with ICH in patients undergoing hemodialysis. Comprehensive control of hypertension and iPTH may be a fundamental preventive strategy for ICH in these patients.
Anti-seizure medication exposure and the risk of dementia: A meta-analysis of observational studies
Authors: Zhang Lei , Jiang Hai-yin , Liu Wen-juan 
Published: March 2023

ObjectiveThere is growing evidence of a relationship between anti-seizure medication (ASM) use and the risk of dementia. This study examined this association using a meta-analysis approach.MethodsPubMed, EMBASE, and Cochrane Library were systematically searched for peer-reviewed observational studies published up to February 2023. Study quality was evaluated using the Newcastle-Ottawa Scale, and an overall odds ratio (OR) was pooled using fixed or random-effects models.ResultsThe analysis included 9 publications with 10 studies. The results showed that overall ASM exposure was associated with an increased risk of dementia [OR: 1.09, 95% confidence interval (CI): 1.03–1.15; P = 0.003] in general population. However, this association disappeared (OR: 1.02, 95% CI: 0.97–1.07; P = 0.361) when the study data adjusted for drug indications were pooled. Subgroup analysis based on individual drugs found only a positive association among those exposed to valproate, carbamazepine, and clonazepam. Furthermore, an increased risk was found in patients with bipolar disorder exposed to ASMs (OR: 1.43, 95% CI: 1.07–1.92; P = 0.015).ConclusionsThe statistically significant association between ASM and dementia in general population may be driven by unmeasured confounding or several individual first-generation ASMs. However, a higher risk of dementia was observed among bipolar disorder patients treated with ASMs. Given the few included studies and evidence of high heterogeneity, further larger, prospective studies that control for important confounders are needed to verify our findings.
Machine learning based gray-level co-occurrence matrix early warning system enables accurate detection of colorectal cancer pelvic bone metastases on MRI
Authors: Jin Jinlian , Zhou Haiyan , Sun Shulin , Tian Zhe , Ren Haibing , Feng Jinwu , Jiang Xinping 
Published: March 2023

ObjectiveThe mortality of colorectal cancer patients with pelvic bone metastasis is imminent, and timely diagnosis and intervention to improve the prognosis is particularly important. Therefore, this study aimed to build a bone metastasis prediction model based on Gray level Co-occurrence Matrix (GLCM) - based Score to guide clinical diagnosis and treatment.MethodsWe retrospectively included 614 patients with colorectal cancer who underwent pelvic multiparameter magnetic resonance image(MRI) from January 2015 to January 2022 in the gastrointestinal surgery department of Gezhouba Central Hospital of Sinopharm. GLCM-based Score and Machine learning algorithm, that is,artificial neural net7work model(ANNM), random forest model(RFM), decision tree model(DTM) and support vector machine model(SVMM) were used to build prediction model of bone metastasis in colorectal cancer patients. The effectiveness evaluation of each model mainly included decision curve analysis(DCA), area under the receiver operating characteristic (AUROC) curve and clinical influence curve(CIC).ResultsWe captured fourteen categories of radiomics data based on GLCM for variable screening of bone metastasis prediction models. Among them, Haralick_90, IV_0, IG_90, Haralick_30, CSV, Entropy and Haralick_45 were significantly related to the risk of bone metastasis, and were listed as candidate variables of machine learning prediction models. Among them, the prediction efficiency of RFM in combination with Haralick_90, Haralick_all, IV_0, IG_90, IG_0, Haralick_30, CSV, Entropy and Haralick_45 in training set and internal verification set was [AUC: 0.926,95% CI: 0.873-0.979] and [AUC: 0.919,95% CI: 0.868-0.970] respectively. The prediction efficiency of the other four types of prediction models was between [AUC: 0.716,95% CI: 0.663-0.769] and [AUC: 0.912,95% CI: 0.859-0.965].ConclusionThe automatic segmentation model based on diffusion-weighted imaging(DWI) using depth learning method can accurately segment the pelvic bone structure, and the subsequently established radiomics model can effectively detect bone metastases within the pelvic scope, especially the RFM algorithm, which can provide a new method for automatically evaluating the pelvic bone turnover of colorectal cancer patients.
Identification of a centrosome-related prognostic signature for breast cancer
Authors: Fang Zhou , Gao Zhi-Jie , Yu Xin , Sun Sheng-Rong , Yao Feng 
Published: March 2023

BackgroundAs the major microtubule organizing center in animal cells, the centrosome is implicated with human breast tumor in multiple ways, such as promotion of tumor cell immune evasion. Here, we aimed to detect the expression of centrosome-related genes (CRGs) in normal and malignant breast tissues, and construct a novel centrosome-related prognostic model to discover new biomarkers and screen drugs for breast cancer.MethodsWe collected CRGs from the public databases and literature. The differentially expressed CRGs between normal and malignant breast tissues were identified by the DESeq2. Univariate Cox and LASSO regression analyses were conducted to screen candidate prognostic CRGs and develop a centrosome-related signature (CRS) to score breast cancer patients. We further manipulated and visualized data from TCGA, GEO, IMvigor210, TCIA and TIMER to explore the correlation between CRS and patient outcomes, clinical manifestations, mutational landscapes, tumor immune microenvironments, and responses to diverse therapies. Single cell analyses were performed to investigate the difference of immune cell landscape between high- and low-risk group patients. In addition, we constructed a nomogram to guide clinicians in precise treatment.ResultsA total of 726 CRGs were collected from the public databases and literature. PSME2, MAPK10, EIF4EBP1 were screened as the prognostic genes in breast cancer. Next, we constructed a centrosome-related prognostic signature and validated its efficacy based on the genes for predicting the survival of breast cancer patients. The high-risk group patients had poor prognoses, the area under the ROC curve for 1-, 3-, and 5-year overall survival (OS) was 0.77, 0.67, and 0.65, respectively. The predictive capacity of CRS was validated by other datasets from GEO dataset. In addition, high-risk group patients exhibited elevated level of mutational landscapes and decreased level of immune infiltration, especially T and B lymphocytes. In terms of treatment responses, patients in the high-risk group were found to be resistant to immunotherapy but sensitive to chemotherapy. Moreover, we screened a series of candidate anticancer drugs with high sensitivity in the high-risk group.ConclusionOur work exploited a centrosome-related prognostic signature and developed a predictive nomogram capable of accurately predicting breast cancer OS. The above discoveries provide deeper insights into the vital roles of the centrosome and contribute to the development of personalized treatment for breast cancer.
Lymphocyte-to-monocyte ratio after primary surgery is an independent prognostic factor for patients with epithelial ovarian cancer: A propensity score matching analysis
Authors: Hu Qian , Shen Guihua , Li Ye , Xie Ya , Ma Xiao , Jiang Lijuan , Lv Qiubo 
Published: March 2023

BackgroundThe aim of this study was to elucidate the prognostic value of preoperative lymphocyte-to-monocyte ratio (LMR) after primary surgery in epithelial ovarian cancer (EOC) patients using a propensity score matching (PSM) analysis.MethodsWe retrospectively reviewed consecutive EOC patients who underwent primary surgery between January 2008 and December 2019. Patients were divided into two groups according to the optimal cutoff value of preoperative LMR. PSM (1:1) was conducted to eliminate confounding factors. A Cox proportional hazards model and the Kaplan–Meier estimator were employed to investigate the potential prognostic factors.ResultsA total of 368 EOC patients were included in this study. The optimal cutoff value of LMR was identified as 4.65. Low preoperative LMR was significantly correlated with low albumin, high CA125 level, more blood loss, a high likelihood of ascites, advanced FIGO stage, and poor differentiation (all p &lt; 0.05). After matching, Kaplan–Meier curves showed that the group with LMR &lt; 4.65 experienced significantly shorter OS (p = 0.015). Multivariate Cox analysis revealed that low LMR (HR = 1.49, p = 0.041), advanced FIGO stage (HR = 5.25, p &lt; 0.001), and undefined residual disease (HR = 3.77, p = 0.002) were independent factors in predicting poor OS. A forest plot revealed that LMR had better prognostic value in younger EOC patients, patients with BMI ≥ 25 kg/m2 and albumin ≥ 35 g/L, CA125 ≥ 35 U/L, patients who had undergone optimal surgery, and those who had completed chemotherapy. Additionally, low-LMR patients who had undergone incomplete chemotherapy had a shorter median OS compared with those who completed chemotherapy treatment (48.5 vs. 105.9 months, p = 0.026).ConclusionsLMR could be used as an independent prognostic factor for EOC patients after primary surgery; a noticeable negative effect of LMR was observed among EOC patients with age &lt; 65, good preoperative nutritional status, and more aggressive tumor biology, and among those who underwent optimal surgery. Completing adjuvant chemotherapy is essential to improve survival outcomes among EOC patients with LMR &lt; 4.65 after surgery.
Factors associated with the survival outcomes of patients with untreated hepatocellular carcinoma: An analysis of nationwide data
Authors: Kwon Min Jung , Chang Soy , Kim Ji Hoon , Han Ji Won , Jang Jeong Won , Choi Jong Young , Yoon Seung Kew , Sung Pil Soo 
Published: March 2023

IntroductionIn this study, we examined the natural course of untreated hepatocellular carcinoma (HCC) and identified predictors of survival in an area where hepatitis B is the predominant cause of HCC.MethodsWe identified 1,045 patients with HCC who did not receive HCC treatment and were registered in the Korean Primary Liver Cancer Registry between 2008 and 2014, and were followed-up up to December 2018. Thereafter, we analyzed the clinical characteristics of patients who survived for &lt;12 or ≥12 months. A Cox proportional regression model was used to identify the variables associated with patient survival.Results and discussionThe mean age of the untreated patients at HCC diagnosis was 59.6 years, and 52.1% of patients had hepatitis B. Most untreated patients (94.2%) died during the observation period. The median survival times for each Barcelona Clinic Liver Cancer (BCLC) stage were as follows: 31.0 months for stage 0/A (n = 123), 10.0 months for stage B (n = 96), 3.0 months for stage C (n = 599), and 1.0 month for stage D (n = 227). Multivariate Cox regression analysis demonstrated that BCLC stage D (hazard ratio, 4.282; P &lt; 0.001), model for end-stage liver disease (MELD) score ≥10 (HR, 1.484; P &lt; 0.001), and serum alpha-fetoprotein (AFP) level ≥1,000 ng/mL (HR, 1.506; P &lt; 0.001) were associated with poor survival outcomes in patients with untreated HCC. In untreated patients with HCC, advanced stage BCLC, serum AFP level ≥1,000 ng/mL, and MELD score ≥10 were significantly associated with overall survival.
Temporal trend and factors associated with spatial distribution of congenital syphilis in Brazil: An ecological study
Authors: Dantas Janmilli da Costa , Marinho Cristiane da Silva Ramos , Pinheiro Yago Tavares , Ferreira Maria Ângela Fernandes , da Silva Richardson Augusto Rosendo 
Published: March 2023

ObjectiveThe study aimed to analyze the temporal trend of congenital syphilis in Brazil in the period from 2008 to 2018 and its spatial distribution in the Immediate Regions of Urban Articulation, and to identify spatial correlations with socioeconomic factors and prenatal care.MethodsSpatial correlations between the incidence of congenital syphilis and socioeconomic conditions and access to prenatal care were assessed. This ecological study conducted a time series analysis in Brazil and spatial analysis in 482 Immediate Regions of Urban Articulation. Cases of congenital syphilis reported in the Notifiable Diseases Information System and the Live Birth Information System from January 1, 2008, to December 31, 2018 were included. Socioeconomic conditions (percentage of individuals with inadequate water supply and sanitation) were extracted from the 2010 census, whereas the Live Birth Information System provided data on access to prenatal care (percentage of live births with 1–3 prenatal care appointments). The Joinpoint Regression software performed the temporal trend analysis, while the GeoDa software assessed territorial clusters using the Moran’s I and Local Spatial Association Indicator.ResultsThe incidence of congenital syphilis showed an upward trend (annual percent change 1 = 26.96; 95% CI: 18.2–36.3; annual percent change 2 = 10.25; 95% CI: 2.7–28.4) and was unevenly distributed across Immediate Regions of Urban Articulation in Brazil (Moran’s I = 0.264, p ≤ 0.05). It also presented a direct spatial correlation with the percentage of individuals with inadequate water supply and sanitation (Moran’s I = 0.02, p ≤ 0.05) and the percentage of live births with 1–3 prenatal care appointments (Moran’s I = 0.03, p ≤ 0.05).ConclusionAgrowth trend of congenital syphilis in Brazil was observed between 2008 and 2018. Moreover, inequalities in socioeconomic conditions and access to prenatal care influenced the spatial distribution of this disease.
Repeated small-volume exchange transfusion for hyperleukocytosis in pediatric acute leukemia: A retrospective analysis
Authors: Zhang Dongxiu , Lin Hailong , Huang Leting 
Published: March 2023

IntroductionLeukapheresis reduces hyperleukocytosis in children with acute leukemia. Although the usefulness of this procedure is under debate, a repeated small-volume exchange transfusion along with leukapheresis yielded satisfactory results.MethodsForty-seven patients with acute leukemia [32 acute lymphocytic leukemia (ALL) and 15 acute myeloblastic leukemia (AML)] were enrolled between January 2017 and June 2022 and underwent repeated small-volume exchange transfusion. The following were measured: demographic and clinical characteristics, time of the procedure, PWBC (peripheral white blood cell) count, hemoglobin, platelet count, blood biochemistry, electrolytes, coagulation, leukostasis, TLS (tumor lysis syndrome), DIC (disseminated intravascular coagulopathy), adverse events (AEs), and serious AEs (SAEs).ResultsThe demographic and clinical characteristics were not significantly different between ALL and AML patients, but differences were observed in PWBC counts (424.2 ± 135.6 vs. 223.8 ± 58.0 × 109/L). The procedures needed 3–8 processes, and the average procedure time was not significantly different between ALL and AML. The PWBC count gradually reduced to &lt;100 × 109/L; hemoglobin, platelet count, K+, Na+, and Ca2+ were unchanged. Alanine aminotransferase, aspartate aminotransferase, total bilirubin, blood urea nitrogen, creatinine, troponin-I, creatine kinase-MB, prothrombin time, and activated partial thromboplastin time maintained normal or recovered from abnormal ranges. The manifestations of leukostasis, TLS, and DIC improved or disappeared. No AEs and SAEs occurred. The required total blood volume was based on initial PWBC count, manifestations of leukostasis, and age.ConclusionsOur finding suggests that repeated small-volume exchange transfusion is effective and safe for treating hyperleukocytosis in children with acute leukemia.
No association between major congenital malformations and exposure to Kampo medicines containing rhubarb rhizome: A Japanese database study
Authors: Suzuki Satoko , Obara Taku , Ishikawa Tomofumi , Noda Aoi , Matsuzaki Fumiko , Arita Ryutaro , Ohsawa Minoru , Mano Nariyasu , Kikuchi Akiko , Takayama Shin , Ishii Tadashi 
Published: March 2023

Traditional Japanese (Kampo) medicines containing rhubarb rhizome are prescribed for constipation during pregnancy; however, detailed safety information of their use for pregnant women is lacking. The aim of current study was to clarify the association between prescription Kampo-containing rhubarb rhizome (KRR) in the first trimester of pregnancy and congenital malformations in newborns. Using a large Japanese health insurance claims database, we included pregnant women who enrolled the same health insurance society from 3 months before pregnancy to the delivery date, who gave birth between 2010 and 2019, and those with data related to their infants. Pregnant women who were prescribed magnesium oxide (MgO), commonly used for constipation, during the first trimester of pregnancy and their infants were extracted as controls. Associations between KRR prescribed in the first pregnancy trimester and major congenital malformations (MCM) in the infants were examined using multivariate logistic regression analysis. Of 75,398 infants, 4,607 (6.1%) were diagnosed with MCMs within the first year after birth. Furthermore, 9,852 infants were born to women prescribed MgO, among whom 680 (6.9%) had MCMs; 450 infants were born to women prescribed KRR, among whom 28 (6.2%) had MCMs. Multivariate logistic regression analysis identified no difference in MCM risk between the two types of prescriptions [crude odds ratio (OR) 0.895, 95% confidence interval (CI) 0.606–1.322, adjusted OR 0.889, 95% CI 0.599–1.320]. In conclusion, the risk of MCMs did not differ between those prescribed KRR or MgO in the first trimester of pregnancy.
Medication adherence with fixed-dose versus free-equivalent combination therapies: Systematic review and meta-analysis
Authors: Wei Qiran , Zhou Jiting , Li Hongchao , Wang Luying , Wu Yao , Ma Aixia , Guan Xin 
Published: March 2023

Objective: We conducted a large-scale meta-analysis and subgroup analysis to compare the effect of fixed-dose combination (FDC) therapy with that of free-equivalent combination (FEC) therapy on medication adherence.Methods: Studies published in Web of Science, PubMed, Cochrane Library, ScienceDirect, and Embase up to May 2022 were identified according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The primary assessed outcomes were the medication possession ratio (MPR) and proportion of days covered (PDC). We investigated the probability of being adherent to the prescribed treatment (MPR or PDC ≥80%) or the average estimate of these two parameters. Studies reporting such results were included in this meta-analysis. The summary measures were reported as the risk ratio (RR) and the weighted mean difference (MD) with 95% of confidence interval (CI) using the random-effects model of DerSimonian and Laird. The quality of the cohort studies was assessed using the Newcastle-Ottawa scale.Results: Of the 1,814 screened studies, 61 met the predefined inclusion criteria. The meta-analysis of the results showed that compared to FEC, FDC significantly improved the medication compliance of patients by 1.29 times (95% CI:1.23–1.35, p &lt; 0.00001). I2 of 99% represent high heterogeneity across studies. The mean difference in medication adherence between FDC and FEC was 0.10 (95% CI: 0.06–0.14, p &lt; 0.00001) with an I2 estimate of 100%. Subgroup analyses were performed for studies that reported adherence outcomes according to disease type, period of evaluation and compliance indicators. A sensitivity analysis was conducted to exclude the results of low-quality studies, as well as studies in which there was ambiguity in the method of calculating the estimator.Conclusion: Analysis of the assessed parameters for the intention-to-treat and subgroup populations suggests that FDC can improve adherence to treatment and its advantages over FEC may increase over time. Further research is needed to better understand how medical conditions affect the impact of reduced pill burden on adherence, particularly in diseases other than cardiovascular disease and type 2 diabetes mellitus.