bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of prognostic nomograms for large hepatocellular carcinoma after HAIC
Authors: Yao Wang , Wei Ran , Jia Jia , Li Wang , Zuo Mengxuan , Zhuo Shuqing , Shi Ge , Wu Peihong , An Chao 
Published: April 2023

Background and aims: Hepatic arterial infusion chemotherapy (HAIC) using the FOLFOX regimen (oxaliplatin plus fluorouracil and leucovorin) is a promising option for large hepatocellular carcinoma (HCC). However, post-HAIC prognosis can vary in different patients due to tumor heterogeneity. Herein, we established two nomogram models to assess the survival prognosis of patients after HAIC combination therapy. Methods: A total of 1082 HCC patients who underwent initial HAIC were enrolled between February 2014 and December 2021. We built two nomogram models for survival prediction: the preoperative nomogram (pre-HAICN) using preoperative clinical data and the postoperative nomogram (post-HAICN) based on pre-HAICN and combination therapy. The two nomogram models were internally validated in one hospital and externally validated in four hospitals. A multivariate Cox proportional hazards model was used to identify risk factors for overall survival (OS). The performance outcomes of all models were compared by area under the receiver operating characteristic curve (AUC) analysis with the DeLong test. Results: Multivariable analysis identified larger tumor size, vascular invasion, metastasis, high albumin–bilirubin grade, and high alpha-fetoprotein as indicators for poor prognosis. With these variables, the pre-HAICN provided three risk strata for OS in the training cohort: low risk (5-year OS, 44.9%), middle risk (5-year OS, 20.6%), and high risk (5-year OS, 4.9%). The discrimination of the three strata was improved significantly in the post-HAICN, which included the above-mentioned factors and number of sessions, combination with immune checkpoint inhibitors, tyrosine kinase inhibitors, and local therapy (AUC, 0.802 versus 0.811, p < 0.001). Conclusions: The nomogram models are essential to identify patients with large HCC suitable for treatment with HAIC combination therapy and may potentially benefit personalized decision-making. Lay summary Hepatic arterial infusion chemotherapy (HAIC) provides sustained higher concentrations of chemotherapy agents in large hepatocellular carcinoma (HCC) by hepatic intra-arterial, result in better objective response outperformed the intravenous administration. HAIC is significantly correlated with favorable survival outcome and obtains extensive support in the effective and safe treatment of intermediate advanced-stage HCC. In view of the high heterogeneity of HCC, there is no consensus regarding the optimal tool for risk stratification before HAIC alone or HAIC combined with tyrosine kinase inhibitors or immune checkpoint inhibitors treatment in HCC. In this large collaboration, we established two nomogram models to estimate the prognosis and evaluate the survival benefits with different HAIC combination therapy. It could help physicians in decision-making before HAIC and comprehensive treatment for large HCC patients in clinical practice and future trials.
Does evaluating oneself cause evaluations of others while observing a social interaction? An experimental investigation of the cognitive and emotional consequences following a false-feedback task
Authors: Ferguson Ryan J , Ouimet Allison J 
Published: April 2023

Introduction Despite decades of research on how people with social anxiety evaluate themselves and others, it remains unclear whether people who evaluate themselves negatively also evaluate others negatively. Findings from other-evaluation research are equivocal, perhaps attributable to methodology differences and inconsistent operationalization. Social-cognitive and cognitive-behavioural models suggest that negative self-evaluations may cause participants to subsequently evaluate a visibly anxious person negatively. We tested this hypothesis experimentally, using a video-recorded social interaction and novel false-feedback manipulation. Methods: 169 unselected participants completed baseline questionnaires and a 10-min impromptu conversation task with a confederate. We randomly assigned participants to receive positive, ambiguous, or negative false-feedback about their performance. Next, they evaluated their own performance and watched a recorded conversation between an anxious and confident speaker. Finally, they evaluated the anxious person’s performance. Results: Our manipulation was effective; participants in the negative-feedback condition rated themselves more negatively. However, no differences emerged between conditions on most cognitive and emotional outcomes. Discussion: Evaluating oneself negatively, on its own, may not lead people to evaluate a visibly anxious person in a recorded social interaction negatively in a single-session experiment within an unselected sample. Future studies should examine this relationship with a clinical sample across time and contexts.
PrEP policy implementation gaps and opportunities in Latin America and the Caribbean: a scoping review
Authors: Murphy Luke , Bowra Andrea , Adams Ellithia , Cabello Robinson , Clark Jesse L. , Konda Kelika , Perez-Brumer Amaya 
Published: April 2023

Background: Pre-exposure prophylaxis (PrEP) is an important tool for HIV prevention in Latin America and the Caribbean (LAC). Yet, little is known about the PrEP policies landscape in the region. Addressing this gap, this scoping review assessed current PrEP policies throughout LAC to better understand existing PrEP implementation gaps and identify opportunities to improve access. Methods: We conducted a scoping review, using a modified PRISMA extension, through 28 July 2022, to identify country-level PrEP policies. Data were collected in English, Spanish, French, and Portuguese utilizing online platforms for screening and data extraction (Google Forms, Zotero, and Excel). Extracted data were divided by data source, including country-level government policies, gray literature, and peer-reviewed literature, with at least one full-text reviewer and data extractor per publication. An iterative summative content analysis was performed to compare and interpret themes across phases and data sources. Results: Of the 33 countries in LAC, 22 (67%) had policies approving daily oral PrEP for HIV prevention, which outlined specific key populations, including men who have sex with men, transgender women, sex workers, and serodiscordant couples. Generic tenofovir disoproxil fumarate/emtricitabine has been approved in 15 of the 33 countries, and 13 of the 33 countries have incorporated PrEP into their public health system. No countries were found to have approved cabotegravir. Costing data were reported by only one country, Ecuador, in its national health ministry guidelines. Findings also document a lag between the media/gray-literature announcement of PrEP and implementation of policies. Conclusion: Findings underscore significant advances in PrEP policies in the region and signal opportunities for greater PrEP implementation. Since 2017, an increasing number of countries have begun to provide PrEP to communities at heightened need, although significant gaps remain. Policy approval is a key step to further increasing access to PrEP in LAC, necessary to reduce the burden of HIV in LAC, specifically among marginalized populations.
Skin Staining Following Intravenous Iron Extravasation in a Patient With Chronic Kidney Disease: A Case Report
Authors: Shi Ruolin , Marin Judith G. , Beaulieu Monica 
Published: April 2023

Rationale: Intravenous iron is commonly use in anemia related to chronic kidney disease. Skin staining due to iron extravasation is a rare adverse reaction that can leave a long-term staining of the skin. Presenting Concerns of the Patients: During iron derisomaltose infusion, patient reported iron extravasation. Five months after the incident, the skin stain related to the extravasation was still present. Diagnosis: A case of skin staining due to iron derisomaltose extravasation was diagnosed. Interventions/Outcomes: She was reviewed by dermatology and laser therapy was offered. Teaching Points: Patients and clinicians need to be aware of this complication, and protocol needs to be put in place to minimize extravasation and its complication.
Amyloidoses in Onco-Nephrology Practice: A Multidisciplinary Case-Based Conference Report
Authors: Kitchlu Abhijat , Chan Christopher T. , Jhaveri Kenar D. , Delgado Diego , Tam Paul 
Published: April 2023

Introduction and Objective: Amyloidoses are a heterogeneous group of disorders resulting from deposition of amyloid fibrils into extracellular tissues. While the kidneys are one of the most frequent sites of amyloid deposition, amyloid deposits can also affect a wide range of organ systems, including the heart, liver, gastrointestinal tract, and peripheral nerves. The prognosis of amyloidosis, especially with cardiac involvement, remains poor; however, a collaborative approach applying new tools for diagnosis and management may improve outcomes. In September 2021, the Canadian Onco-Nephrology Interest Group hosted a symposium to discuss diagnostic challenges and recent advances in the management of amyloidosis from the perspectives of the nephrologist, cardiologist, and onco-hematologist. Methods and Sources of Information: Through structured presentations, the group discussed a series of cases highlighting the varied clinical presentations of amyloidoses affecting the kidney and heart. Expert opinions, clinical trial findings, and publication summaries were used to illustrate patient-related and treatment-related considerations in the diagnosis and management of amyloidoses. Key findings: (1) Overview of the clinical presentation of amyloidoses and the role of specialists in performing timely and accurate diagnostic workup; (2) review of best practices for multidisciplinary management of amyloidosis, including prognostic variables and determinants of treatment response; and (3) update on new and emerging treatments in the management of light chain and amyloid transthyretin amyloidoses. Limitations: This conference featured multidisciplinary discussion of cases, and learning points reflect the assessments by the involved experts/authors. Implications: Identification and management of amyloidoses can be facilitated with a multidisciplinary approach and higher index of suspicion from cardiologists, nephrologists, and hemato-oncologists. Increased awareness of clinical presentations and diagnostic algorithms for amyloidosis subtyping will lead to more timely interventions and improved clinical outcomes.
An integrated targeted metabolomics and network pharmacology approach to exploring the mechanism of ellagic acid against sleep deprivation-induced memory impairment and anxiety
Authors: Wang Wenjun , Liu Tianlong , Zhang Yi 
Published: April 2023

Background As a neuroprotective agent, ellagic acid (EA) is extremely beneficial. Our previous study found that EA can alleviate sleep deprivation (SD)-induced abnormal behaviors, although the mechanisms underlying this protective effect have not yet been fully elucidated. Objective An integrated network pharmacology and targeted metabolomics approach was utilized in this study to investigate the mechanism of EA against SD-induced memory impairment and anxiety. Methods Behavioral tests were conducted on mice after 72 h of SD. Hematoxylin and eosin staining and nissl staining were then carried out. Integration of network pharmacology and targeted metabolomics was performed. Eventually, the putative targets were further verified using molecular docking analyses and immunoblotting assays. Results The present study findings confirmed that EA ameliorated the behavioral abnormalities induced by SD and prevented histopathological and morphological damage to hippocampal neurons. Through multivariate analysis, clear clustering was obtained among different groups, and potential biomarkers were identified. Four key targets, catechol- O-methyltransferase (COMT), cytochrome P450 1B1 (CYP1B1), glutathione S-transferase A2 (GSTA2), and glutathione S-transferase P1 (GSTP1), as well as the related potential metabolites and metabolic pathways, were determined by further integrated analysis. Meanwhile, in-silico studies revealed that EA is well located inside the binding site of CYP1B1 and COMT. The experimental results further demonstrated that EA significantly reduced the increased expression of CYP1B1 and COMT caused by SD. Conclusion The findings of this study extended our understanding of the underlying mechanisms by which EA treats SD-induced memory impairment and anxiety, and suggested a novel approach to address the increased health risks associated with sleep loss.
Severity and worsening of fatigue among individuals with multiple sclerosis
Authors: Salter Amber , Keenan Alexander , Le Hoa H , Gandhi Kavita , Ait-Tihyaty Maria , Lancia Samantha , Cutter Gary R , Fox Robert J , Marrie Ruth Ann 
Published: April 2023

Background Fatigue is associated with reduced quality of life and social participation, and poor employment outcomes. However, most studies examining fatigue are limited by small sample sizes or short follow-up periods. Objective To characterize the natural history of fatigue. Methods The North American Research Committee on Multiple Sclerosis Registry participants with ≥7 years of longitudinal data between 2004 and 2019 and a relapsing disease course were included. A subset of participants enrolled within 5 years of diagnosis was identified. The Fatigue Performance Scale assessed fatigue and ≥1-point increase in Fatigue Performance Scale sustained at the next survey defined fatigue worsening. Results Of 3057 participants with longitudinal data, 944 were within 5 years of multiple sclerosis diagnosis. Most participants (52%) reported fatigue worsening during follow-up. Median time to fatigue worsening ranged from 3.5 to 5 years at lower levels of index fatigue. Fatigue worsening was associated with lower annual income, increasing disability, lower initial fatigue level, taking injectable disease-modifying therapies and increasing depression levels in the relapsing multiple sclerosis participants. Conclusion Most multiple sclerosis participants early in their disease suffer from fatigue and at least half reported fatigue worsening over time. Understanding factors associated with fatigue may help to identify populations most at risk of fatigue worsening will be informative for the overall management of patients with multiple sclerosis.
The Responses of Pakistan and Turkey to Refugee Influxes: A Comparative Analysis of Durable Solutions to Protracted Displacements
Authors: Siddikoglu Hidayet , Sagiroglu Ali Zafer 
Published: April 2023

This research aims to study how Turkey and Pakistan (the world’s largest refugee hosting countries) have reacted to and managed protracted refugee challenges. In the context of Pakistan, the study explores the Afghan refugee influx since the late 1970, while for Turkey the focus is on the Syrian refugee inflow since 2011. While cognizant of contextual differences (time and space) between these two countries, we aim to comparatively explore policies, best practices, and short and long-term solutions developed to protracted displacement issues in each country. To do this we intend to comparatively explore the role of institutional environments and the international refugee regime in resolving protracted refugee issues in a chronological sequence. First, we investigate how each state’s “open-door policies” toward the first influx of refugees evolved into ad-hoc solutions in the course of protracted displacement. Second, we comparatively assess multilevel integration approaches and solution strategies at the macro (states and their cooperation with countries of origin and inter-governmental organizations such as the UN High Commissioner for Refugees (UNHCR) and International Organization for Migration (IOM)), meso (interventions/implementations), and micro levels (civil society and refugee-led initiatives). Third, we examine how refugee policies in each country are negotiated with national and international humanitarian and refugee agencies, including regional organizations and countries of origin. Theoretically, this article is grounded on a macro structural approach (state’s international humanitarian obligations and responsibilities), refugee diplomacy (state’s use of diplomatic tools, process administering refugees), and management theories.
Working Conditions Among Chinese Nurses Employed in Japan: A Cross-Sectional Survey-Based Study
Authors: Yang Yuchun , Hatanaka Kaori , Takahashi Kei , Shimizu Yasuko 
Published: April 2023

Introduction Although the number of Chinese nurses employed in Japan is increasing, the situation regarding their work conditions has not been clarified. It is necessary to understand such conditions to consider support for Chinese nurses in Japan. Objective This study examined the professional nursing practice environment, occupational career, and work engagement of Chinese nurses in Japan. Methods Using a cross-sectional study design, 640 paper questionnaires were mailed to 58 Japanese hospitals that employed Chinese nurses and included a QR code for online responses. A survey request form and URL were sent to the Wechat app, where Chinese nurses in Japan communicate. The contents include attribute-related questions, the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Career Scale, and Utrecht Work Engagement Scale. Either Wilcoxon's rank-sum or the Kruskal–Wallis test was performed to compare scores of the study variables between subgroups. Results A total of 199 valid responses were obtained, of which 92.5% were female, and 69.3% had a university degree or higher. The PES-NWI score was 2.74, and the work engagement score was 3.10. The group with a university degree or higher had significantly lower scores on PES-NWI and work engagement than those with diplomas. Regarding the subscale of occupational career, scores of forming and coordinating interpersonal relationships, self-development, and accumulating a variety of experience were 3.80, 2.58, and 2.71, respectively. The scores were significantly higher with more than 6 years of nursing experience in Japan than those with 0–3 years or 3–6 years. Conclusion Most participants had university degrees or higher, and their scores of PES-NWI and work engagement tended to be lower than those with diploma degrees. Participants showed low self-ratings in self-development and lacked a variety of experience. Understanding Chinese nurses’ work conditions in Japan enables hospital administrators to develop measures for continuing education and support.
Factors Associated With Poor Patient-Reported Outcomes in Isolated Gastrocnemius Recession for Heel Pain
Authors: Sanchez Thomas , Sankey Turner , Donley Connor , Schick Sam , Underwood Meghan , Brannigan Matthew , Singh Swapnil , Shah Ashish 
Published: April 2023

Background: Gastrocnemius recession is commonly performed for a variety of pathologies of the foot and ankle, yet studies characterizing risk factors associated with patient-reported outcomes are limited. In this cohort study, patient outcomes were compared against the general population for PROMIS scores with correlation analysis comparing demographics and comorbidities. Our primary goal in this study is to identify risk factors associated with poor patient-reported outcomes following isolated gastrocnemius recession for patients with plantar fasciitis or insertional Achilles tendinopathy. Methods: A total of 189 patients met inclusion criteria. The open Strayer method was preferred. However, if the myotendinous junction could not be adequately visualized without expanding the excision, then a Baumann procedure was performed. The decision between the two did not depend on preoperative contracture. Patient demographics and visual analog scale (VAS) scores were obtained via the electronic medical record. Telephone interviews were completed to collect postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) and Foot Function Index (FFI) scores. The data were analyzed using the type 3 SS analysis of variance test to identify individual patient factors associated with reduced PROMIS, FFI, and VAS scores. Results: No demographic variables were found to be significantly associated with postoperative complications. Patients who reported tobacco use at the time of surgery had significantly decreased postoperative PROMIS physical function ( P = .01), PROMIS pain interference ( P < .05), total FFI scores ( P < .0001), and each individual FFI component score. Patients undergoing their first foot and ankle surgeries reported numerous significant postoperative outcomes, including decreased PROMIS pain interference ( P = .03), higher PROMIS depression ( P = .04), and lower FFI pain scores ( P = .04). Hypertension was significantly associated with an increased FFI disability score ( P = .03) and, along with body mass index (BMI) >30 ( P < .05) and peripheral neuropathy ( P = .03), significantly higher FFI activity limitation scores ( P = .01). Pre- and postoperative VAS scores demonstrated improvement in patient-reported pain from a mean of 5.53 to 2.11, respectively ( P < .001). Conclusion: We found in this cohort that numerous patient factors were independently associated with differences in patient-reported outcomes following a Strayer gastrocnemius recession performed for plantar fasciitis or insertional Achilles tendinopathy. These factors include, but are not limited to, tobacco use, prior foot and ankle surgeries, and BMI. This study strengthens previous reports demonstrating the efficacy of isolated gastrocnemius recession and elucidates variables that may affect patient-reported outcomes. Level of Evidence: Level III, retrospective cohort study.
Postoperative liver dysfunction is associated with poor long-term outcomes in patients with colorectal cancer: a retrospective cohort study
Authors: Sumiyoshi Shutaro , Kiuchi Jun , Kuriu Yoshiaki , Arita Tomohiro , Shimizu Hiroki , Takaki Wataru , Ohashi Takuma , Yamamoto Yusuke , Konishi Hirotaka , Morimura Ryo , Shiozaki Atsushi , Ikoma Hisashi , Kubota Takeshi , Fujiwara Hitoshi , Okamoto Kazuma , Otsuji Eigo 
Published: April 2023

AbstractBackgroundPostoperative hepatobiliary enzyme abnormalities often present as postoperative liver dysfunction in patients with colorectal cancer. This study aimed to clarify the risk factors of postoperative liver dysfunction and its prognostic impact following colorectal cancer surgery.MethodsWe retrospectively analyzed data from 360 consecutive patients who underwent radical resection for Stage I–IV colorectal cancer between 2015 and 2019. A subset of 249 patients with Stage III colorectal cancer were examined to assess the prognostic impact of liver dysfunction.ResultsForty-eight (13.3%) colorectal cancer patients (Stages I–IV) developed postoperative liver dysfunction (Common Terminology Criteria for Adverse Events version 5.0 CTCAE v5.0 ≥ Grade 2). Univariate and multivariate analyses identified the liver-to-spleen ratio on preoperative plain computed tomography (L/S ratio;P = 0.002, Odds ratio 2.66) as an independent risk factor for liver dysfunction. Patients with postoperative liver dysfunction showed significantly poorer disease-free survival than patients without liver dysfunction (P < 0.001). Univariate and multivariate analyses using Cox’s proportional hazards model revealed that postoperative liver dysfunction independently was a poor prognostic factor (P = 0.001, Hazard ratio 2.75, 95% CI: 1.54–4.73).ConclusionsPostoperative liver dysfunction was associated with poor long-term outcomes in patients with Stage III colorectal cancer. A low liver-to-spleen ratio on preoperative plain computed tomography images was an independent risk factor of postoperative liver dysfunction.