bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acceleration of postoperative recovery with brief intraoperative vagal nerve stimulation mediated via the autonomic mechanism
Authors: Maisiyiti Alimujiang , Tian Ming , Chen Jiande D. Z. 
Published: June 2023

IntroductionPostoperative recovery is largely dependent on the restoration of gastrointestinal motility. The aim of this study was to investigate the effects and mechanisms of intraoperative vagus nerve stimulation (iVNS) on postoperative recovery from abdominal surgery in rats.MethodsThe Nissen fundoplication surgery was performed on two groups of rats: sham-iVNS group and iVNS group (VNS was performed during surgery). Animal’s behavior, eating, drinking and feces’ conditions were monitored at specific postoperative days. Gastric slow waves (GSWs) and electrocardiogram (ECG) were recorded; blood samples were collected for the assessment of inflammatory cytokines.Results(1) iVNS shortened initiate times to water and food intake (p = 0.004) and increased the number of fecal pellets (p &lt; 0.05, vs. sham-iVNS) and the percentage of water content in fecal pellets (p &lt; 0.05). (2) iVNS improved gastric pace-making activity at 6 h after surgery reflected as a higher percentage of normal slow waves (p = 0.015, vs. sham-iVNS). (3) iVNS suppressed inflammatory cytokines at 24 h after surgery compared to sham-iVNS (TNF-α: p = 0.001; IL-1β: p = 0.037; IL-6: p = 0.002). (4) iVNS increased vagal tone compared to sham-iVNS group at 6 h and 24 h after the surgery (p &lt; 0.05). Increased vagal tone was correlated with a faster postoperative recovery to start water and food intake.ConclusionBrief iVNS accelerates postoperative recovery by ameliorating postoperative animal behaviors, improving gastrointestinal motility and inhibiting inflammatory cytokines mediated via the enhanced vagal tone.
The clinicopathological analysis of ocular and orbit tumors in southeast of China
Authors: Lin Yuan , Liu Xiaodong , Zhang Yujie , Xie Zhiwen , Fang Xie , Shi Ke , Zhong Yanlin , Su Shengqi , Cai Minqing , Wu Huping , Ou Shangkun 
Published: June 2023

PurposeThe purpose of this study is to describe the clinicopathologic characteristics of ocular surface and orbit tumors in the Southeast of China and explore the method to differentiate the benign and malignant masses.Materials and methods3468 patients undergoing mass resection from January 2015 to December 2020 were selected as observation subjects and were classified into benign and malignant masses according to postoperative pathology. The clinicopathologic characteristics were collected, including gender, age, pathological tissue signs, and pathological signs. Multivariate Logistic regression analysis of independent risk factors of malignant mass was applied to establish a diagnostic model and the efficacy was evaluated by the subject working characteristics (ROC) curve.ResultsBenign tumors accounted for 91.5% of all cases, and malignant tumors accounted for 8.5%. The most common ocular benign tumors were nevi (24.2%), granuloma (17.1%), and cysts (16.4%). The most common ocular malignant tumors were malignant lymphoma (32.1%) and Basal cell carcinoma (20.2%). As for the histologic origin, melanocytic origin was on the list with 819 (23.6%), mesenchymal 661 (19.1%), epithelial 568 (16.3%), cystic 521 (15.0%), skin adnexal 110 (3.1%), lymphoid 94 (2.8%), and Neural 25(0.8%). Based on the gender, age, tumor location, and the pathological tissue image feature (including differentiation, structural atypia, covering epithelial, keratosis, nest structure/distribution, nuclear atypia, cytoplasmic change and nuclear division), the diagnostic model had predictive value to differentiate the benign and malignant masses.ConclusionMost ocular surface and orbit tumors are benign. Tumor diagnosis is relative to the patient’s age, gender, tumor location, and pathologic characteristics. We generated a satisfactory diagnostic model to differential diagnosis of benign and malignant masses.
Efficacy and safety of inetetamab-containing regimens in patients with HER2-positive metastatic breast cancer: a real-world retrospective study in China
Authors: Liu Xiaoyu , Zhang Peng , Li Chao , Song Xiang , Liu Zhaoyun , Shao Wenna , Li Sumei , Wang Xinzhao , Yu Zhiyong 
Published: June 2023

BackgroundInetetamab (cipterbin) is an innovative anti-HER2 humanized monoclonal antibody. The efficacy and safety of a combination of inetetamab and vinorelbine in the first-line treatment of human epidermal receptor positive (HER2+) metastatic breast cancer (MBC) have been confirmed. We aimed to investigate real-world data of inetetamab in complex clinical practice.MethodsWe retrospectively reviewed the medical records of patients who received inetetamab as a salvage treatment at any line setting from July 2020 to June 2022. The main endpoint was progression‐free survival (PFS).ResultsA total of 64 patients were included in this analysis. The median progression‐free survival (mPFS) was 5.6 (4.6–6.6) months. Of the patients, 62.5% received two or more lines of therapy before treatment with inetetamab. The most common chemotherapy and anti-HER2 regimens combined with inetetamab were vinorelbine (60.9%) and pyrotinib (62.5%), respectively. Patients treated with inetetamab plus pyrotinib plus vinorelbine benefited the most (p=0.048), with the mPFS of 9.3 (3.1–15.5) months and an objective response rate of 35.5%. For patients with pyrotinib pretreatment, inetetamab plus vinorelbine plus pyrotinib agents resulted in mPFS of 10.3 (5.2–15.4) months. Regimens (inetetamab plus vinorelbine plus pyrotinib vs. other therapeutic agents) and visceral metastases (yes vs. no) were independent predictors of PFS. Patients with visceral metastases treated with inetetamab plus vinorelbine plus pyrotinib had a mPFS of 6.1(5.1–7.1) months. The toxicity of inetetamab was tolerable, with the most common grade 3/4 adverse event being leukopenia (4.7%).ConclusionsHER2+ MBC patients pretreated with multiple-line therapies still respond to inetetamab-based treatment. Inetetamab combined with vinorelbine and pyrotinib may be the most effective treatment regimen, with a controllable and tolerable safety profile.
Bioinformatic-based genetic characterizations of neural regulation in skin cutaneous melanoma
Authors: Wang Fengdi , Cheng Fanjun , Zheng Fang 
Published: June 2023

BackgroundRecent discoveries uncovered the complex cancer–nerve interactions in several cancer types including skin cutaneous melanoma (SKCM). However, the genetic characterization of neural regulation in SKCM is unclear.MethodsTranscriptomic expression data were collected from the TCGA and GTEx portal, and the differences in cancer–nerve crosstalk-associated gene expressions between normal skin and SKCM tissues were analyzed. The cBioPortal dataset was utilized to implement the gene mutation analysis. PPI analysis was performed using the STRING database. Functional enrichment analysis was analyzed by the R package clusterProfiler. K-M plotter, univariate, multivariate, and LASSO regression were used for prognostic analysis and verification. The GEPIA dataset was performed to analyze the association of gene expression with SKCM clinical stage. ssGSEA and GSCA datasets were used for immune cell infiltration analysis. GSEA was used to elucidate the significant function and pathway differences.ResultsA total of 66 cancer–nerve crosstalk-associated genes were identified, 60 of which were up- or downregulated in SKCM and KEGG analysis suggested that they are mainly enriched in the calcium signaling pathway, Ras signaling pathway, PI3K-Akt signaling pathway, and so on. A gene prognostic model including eight genes (GRIN3A, CCR2, CHRNA4, CSF1, NTN1, ADRB1, CHRNB4, and CHRNG) was built and verified by independent cohorts GSE59455 and GSE19234. A nomogram was constructed containing clinical characteristics and the above eight genes, and the AUCs of the 1-, 3-, and 5-year ROC were 0.850, 0.811, and 0.792, respectively. Expression of CCR2, GRIN3A, and CSF1 was associated with SKCM clinical stages. There existed broad and strong correlations of the prognostic gene set with immune infiltration and immune checkpoint genes. CHRNA4 and CHRNG were independent poor prognostic genes, and multiple metabolic pathways were enriched in high CHRNA4 expression cells.ConclusionComprehensive bioinformatics analysis of cancer–nerve crosstalk-associated genes in SKCM was performed, and an effective prognostic model was constructed based on clinical characteristics and eight genes (GRIN3A, CCR2, CHRNA4, CSF1, NTN1, ADRB1, CHRNB4, and CHRNG), which were widely related to clinical stages and immunological features. Our work may be helpful for further investigation in the molecular mechanisms correlated with neural regulation in SKCM, and in searching new therapeutic targets.
Real-world outcomes of immunotherapy with or without chemotherapy in first-line treatment of advanced non-small cell lung cancer
Authors: Pelicon Veronika , Cufer Tanja , Knez Lea 
Published: June 2023

BackgroundImmunotherapy alone (mono-IT) or combined with chemotherapy (chemo-IT) has recently become the cornerstone of first-line treatment for advanced non-small cell lung cancer (NSCLC) patients. Here, real-world outcomes of first-line mono-IT and chemo-IT of advanced NSCLC treated within routine clinical practice at a single academic center in the Central Eastern European (CEE) region are presented.Materials and methodsA total of 176 consecutive patients with advanced NSCLC treated with mono-IT (118 patients) or chemo-IT (58 patients) were included. At the participating institution, all medical data relevant for providing oncology care are collected prospectively and in a standardized manner using purposely created pro-forms. Adverse events (AEs) were recorded and graded according to Common Terminology Criteria for Adverse Events (CTCAE). The Kaplan−Meier method was used to estimate median overall survival (mOS) and median duration of treatment (mDOT).ResultsThe 118 patients in the mono-IT cohort had a median age of 64 years, most were male (59%), 20% had ECOG PS ≥2, and 14% had controlled CNS metastases at baseline. With a median follow-up time (mFU) of 24.1 months, the mOS was 19.4 months (95% CI, 11.1-27.6), and the mDOT was 5.0 months (95% CI, 3.5-6.5). The 1-year OS was 62%. The 58 patients in the chemo-IT cohort had a median age of 64 years, most were male (64%), 9% had ECOG PS ≥2, and 7% had controlled CNS metastases at baseline. With a mFU of 15.5 months, the mOS was 21.3 months (95% CI, 15.9-26.7), and the mDOT was 12.0 months (95% CI, 8.3-15.6). The 1-year OS was 75%. Adverse events of severe grade were recorded in 18% and 26% of patients, and immunotherapy discontinuation due to AEs occurred in 19% and 9% in the mono-IT and chemo-IT groups, respectively. No treatment-related deaths were recorded.ConclusionThe results from the present real-world observational study from a CEE country suggest similar effectiveness and safety of first-line mono-IT and chemo-IT in patients with advanced NSCLC to those observed in randomized clinical trials. However, continuous follow-up will offer better insight into the magnitude of long-term benefits in routine clinical practice.
Urethral discharge as an early manifestation of urinary tract infection in children ≤24 months old
Authors: Fang Nai-Wen , Ou Shih-Hsiang , Huang Yu-Shan , Chiou Yee-Hsuan 
Published: June 2023

BackgroundChildren with febrile urinary tract infections (UTIs) are prone to kidney scarring if they are not treated promptly; however, ambiguous symptoms before fever onset makes the early detection of UTIs difficult. Our study aimed to identify urethral discharge as an early manifestation in children with UTI.MethodsThis study enrolled 678 children younger than 24 months with paired urinalysis and culture performed between 2015 and 2021; 544 children were diagnosed with UTIs. Clinical symptoms, urinalysis, and paired urine culture results were compared.ResultsUrethral discharge was observed in 5.1% of children with UTI and yielded a specificity of 92.5% for diagnosing UTI. Children with urethral discharge had a less severe UTI course, furthermore, nine of them received antibiotics before fever occurred and seven of them were free of fever during UTI course. Urethral discharge was associated with alkalotic urine and Klebsiella pneumonia infection.ConclusionsUrethral discharge is an early symptom in children with UTI; it may present before fever onset and help ensure prompt antibiotic intervention.
Cluster scattering in the non-local model
Authors: Timofeyuk N. K. , Gómez-Ramos M. 
Published: June 2023

Scattering of weakly bound nuclei with a pronounced cluster structure is strongly affected by their breakup. Usually, this mechanism is accounted for in a three-body model with pairwise potentials. The interaction potentials between complex systems are non-local due to the existence of excitation channels and antisymmetrization. However, a common practice is to use local optical potentials in cluster scattering studies. To assess the validity of replacing non-local optical potentials by their local equivalents, we extend the local-equivalent continuum-discretized coupled-channel (LECDCC) approach proposed by us for deuteron scattering in [Phys. Rev. C98, 011601(R) (2018)] to the case of cluster scattering. We consider the case of 6Li + 120Sn at 27 and 60 MeV, and compare the angular distributions and reaction cross sections for elastic and breakup cross sections with those obtained in the standard continuum-discretized coupled-channel (CDCC) method with local equivalents of non-local potentials. We found that while elastic scattering is not significantly affected by non-locality, the breakup observables could be affected by up to 20% depending on kinematical conditions of their observation.
Liberia health system's journey to long-term recovery and resilience post-Ebola: a case study of an exemplary multi-year collaboration
Authors: Ako-Egbe Louis , Seifeldin Redda , Saikat Sohel , Wesseh Sanford C. , Bolongei Moses Brown , Ngormbu Ballah Jusu , George Roseline , Ocan Charles , Peter Lasuba Clement Lugala 
Published: June 2023

This article is part of the Research Topic ‘Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'Liberia is one of the three countries worst hit by the 2014–2016 West Africa Ebola Virus disease (EVD) outbreak, during which it recorded over 10,000 cases, including health workers. Estimates suggest that the non-EVD morbidity and mortality resulting from the collapse of the health system exceeded the direct impact of EVD. Lessons from the outbreak were clear, not only for Liberia but also for the regional and global communities: that building health system resilience through an integrated approach is an investment in population health and wellbeing, as well as economic security and national development. It is therefore no surprise that Liberia made recovery and resilience a national priority from the time the outbreak waned in 2015. The recovery agenda provided the platform for stakeholders to work toward the restoration of the pre-outbreak baseline of health system functions while aiming to build a higher level of resilience, informed by lessons from the Ebola crises. Based on the co-authors' experiences of on-the-ground country-support work, this study sought to provide an overview of the Liberia Health Service Resilience project (2018–2023) funded by KOICA, and propose a set of recommendations for national authorities and donors, derived from the authors' perceptions of best practices and key challenges associated with the project. We used both quantitative and qualitative approaches to generate the data represented in this study by reviewing published and unpublished technical and operational documents, and datasets derived through situational and needs assessments and routine monitoring and evaluation activities. This project has contributed to the implementation of the Liberia Investment Plan for Building a Resilient Health System and the successful response to the COVID-19 outbreak in Liberia. Although limited in scope, the Health Service Resilience project has demonstrated that health system resilience could be operationalized by applying a catchment and integrated approach and encouraging multi-sectoral collaboration, partnership, local ownership, and promoting the Primary Health Care approach. Principles applied in this pilot could guide the operationalization of health system resilience efforts in other resource-limited settings similar to Liberia and beyond.
Strengthening and promoting digital health practice: results from a Global Digital Health Partnership’s survey
Authors: Cascini Fidelia , Gentili Andrea , Causio Francesco Andrea , Altamura Gerardo , Melnyk Andriy , Beccia Flavia , Pappalardo Ciro , Lontano Alberto , Ricciardi Walter 
Published: June 2023

Background and objectiveThe capacity to promote and disseminate the best evidence-based practices in terms of digital health innovations and technologies represents an important goal for countries and governments. To support the digital health maturity across countries the Global Digital Health Partnership (GDHP) was established in 2019. The mission of the GDHP is to facilitate global collaboration and knowledge-sharing in the design of digital health services, through the administration of surveys and white papers.ObjectiveThe scope of this study is to critically analyze and discuss results from the Evidence and Evaluation GDHP Work Stream’s survey, understand how governments and countries intend to address main obstacles to the digital health implementation, identify their strategies for a communication of effective digital health services, and promote the sharing of international based best practices on digital health.MethodsThis survey followed a cross-sectional study approach. A multiple-choice questionnaire was designed to gather data. Choices were extracted from research publications retrieved through a rapid review.ResultsOut of 29 countries receiving the survey, 10 returned it. On a scale from 1 to 5, eHealth systems/platforms (mean = 3.56) were indicated as the most important tool for centralized infrastructure to collect information on digital health, while primary care (mean = 4.0) represented the most voted item for healthcare services to collect information on digital health. Seven Countries out of 10 identified lack of organization, skepticism of clinicians, and accessibility of the population as a barriers to adopt digital health implementation, resulting to be the most voted items. Finally, the most endorsed priorities in digital health for Countries were the adoption of data-driven approaches (6 Countries), and telehealth (5 Countries).ConclusionThis survey highlighted the main tools and obstacles for countries to promote the implementation of evidence-based digital health innovations. Identifying strategies that would communicate the value of health care information technology to healthcare professionals are particularly imperative. Effective communication programs for clinicians and the general population in addition to improved digital health literacy (both for clinicians and citizens) will be the key for the real implementation of future digital health technologies.
Perceived occupational stress and associated factors among primary school teachers in the second wave of COVID-19 in Ethiopia: a multicenter cross-sectional survey
Authors: Tesfaye Amensisa Hailu , Abate Kassahun , Kabito Gebisa Guyasa , Azale Telake 
Published: June 2023

BackgroundOccupational stress (OS) is a psychological state that results from people’s perceptions of an imbalance between job demands and their abilities to cope with those demands. The COVID-19 pandemic has disrupted the teaching and learning process and compounded the stress level among teachers due to fear of transmission of the virus and school closures or the difficulty with adherence to the COVOD-19 prevention protocol. This survey study therefore aimed to investigate the prevalence of occupational stress and its associated factors among primary school teachers during the second wave of COVID-19 in western Ethiopia.MethodAn institution-based cross-sectional survey was employed from April to May 2021. The survey was conducted in Gimbi town among all 672 primary school teachers in western Ethiopia. The standardized Teacher Occupational Stress Scale was used to measure occupational stress in the past 4 months. The data were collected through a self-administered questionnaire. The collected data were entered into EpiData version 4.6 and analyzed using Stata version 14 software. A multivariable logistic regression analysis was conducted to identify factors associated with occupational stress. The statistical significance was considered at a value of p of &lt; 0.05 and a 95% confidence interval (CI) with an adjusted odds ratio (AOR) to evaluate the strength of associations.ResultsThe response rate was 96.8% (N = 651). The majority, 389 (59.8%) of the study participants were males. The mean (±SD) age was 35.8 (±9.3) years. The prevalence of occupational stress in the second wave of COVID-19 in the past 4 months was 50.1% (n = 326) [95% CI (46.1, 53.9)]. Job dissatisfaction [AOR: 2.06, 95% CI (1.43–2.97)] and high-risk perception of COVID-19 infection [AOR: 2.20; 95% CI (1.46–3.31)] were significantly associated with occupational stress.ConclusionThis survey disclosed a high prevalence of occupational stress among primary school teachers during the second wave of COVID-19. Job dissatisfaction and a high-risk perception of COVID-19 infection were significant predictors of the occurrence of occupational stress in school teachers. Enhancing stress management skills and focusing on primary prevention of identified risk factors were advised to curtail the condition.