bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unraveling the patterns and pathways of local recurrence of nasopharyngeal carcinoma: evidence for individualized clinical target volume delineation
Authors: Ou Xiaomin , Yan Wenbin , Huang Yangle , He Xiayun , Ying Hongmei , Lu Xueguan , Zhu Hui , Wu Bin , Wang Jiazhou , Hu Chaosu 
Published: March 2023

Abstract
Backgrounds
Despite publication of international guidelines, there are notable controversial points of clinical target volume (CTV) delineation in nasopharyngeal carcinoma (NPC). Recently, scholars proposed a novel way of delineation of CTV in NPC—individualization of CTV delineation based on T classification and spread patterns, which yielded excellent long-term local control with limited late toxicities. The aim of this study was to clarify the anatomic patterns and pathways of local recurrence of NPC and provide a clinical reference for the delineation of CTV.

Methods
A total of 869 patients with non-metastatic NPC were treated with intensity-modulated radiation therapy (IMRT) at our institution between 2009 and 2010. Among the 57 cases of local/locoregional recurrence, 52 cases with traceable radiotherapy plans and magnetic resonance imaging at the time of the first diagnosis of recurrence were included. Anatomical structures and gross tumor volume of local recurrence were contoured. The incidence of relapse of each anatomic structure, route of local recurrence, and their correlation were analyzed.

Results
Locally advanced disease had a significantly increased risk of recurrence in the posterior nasal cavity and a trend towards higher risk of recurrence in the clivus, lateral pterygoid muscle, and hypoglossal canal. Based on the incidence of local recurrence, we constructed a high-risk map for the early and locally advanced stages. Local recurrences were classified into five routes, where anterior extension accounted for the majority (30.8%), and caudal tumor extension pathway had the lowest incidence (5.8%). There was a significant correlation between the local recurrences of neural foramina and neighboring anatomical structures along each pathway. All cases relapsed at unilateral cavernous sinus, most at the same side of primary tumor. Based on our findings, we proposed some suggestions on delineations of CTV, based on T classification and local extension pattern.

Conclusions
Local recurrence of NPC varied according to T classification, followed a stepwise pattern, spread via neural foramina, and recurred at ipsilateral cavernous sinus. This provides meaningful clinical evidence for delineation of CTV, especially individualized delineation.
Chromatin remodeler Activity-Dependent Neuroprotective Protein (ADNP) contributes to syndromic autism
Authors: D’Incal Claudio Peter , Van Rossem Kirsten Esther , De Man Kevin , Konings Anthony , Van Dijck Anke , Rizzuti Ludovico , Vitriolo Alessandro , Testa Giuseppe , Gozes Illana , Vanden Berghe Wim , Kooy R. Frank 
Published: March 2023

Abstract
Background
Individuals affected with autism often suffer additional co-morbidities such as intellectual disability. The genes contributing to autism cluster on a relatively limited number of cellular pathways, including chromatin remodeling. However, limited information is available on how mutations in single genes can result in such pleiotropic clinical features in affected individuals. In this review, we summarize available information on one of the most frequently mutated genes in syndromic autism the Activity-Dependent Neuroprotective Protein (ADNP).

Results
Heterozygous and predicted loss-of-function ADNP mutations in individuals inevitably result in the clinical presentation with the Helsmoortel–Van der Aa syndrome, a frequent form of syndromic autism. ADNP, a zinc finger DNA-binding protein has a role in chromatin remodeling: The protein is associated with the pericentromeric protein HP1, the SWI/SNF core complex protein BRG1, and other members of this chromatin remodeling complex and, in murine stem cells, with the chromodomain helicase CHD4 in a ChAHP complex. ADNP has recently been shown to possess R-loop processing activity. In addition, many additional functions, for instance, in association with cytoskeletal proteins have been linked to ADNP.

Conclusions
We here present an integrated evaluation of all current aspects of gene function and evaluate how abnormalities in chromatin remodeling might relate to the pleiotropic clinical presentation in individual“s” with Helsmoortel–Van der Aa syndrome.
Sex-based analysis of treatment responses in animal models of sepsis: a preclinical systematic review protocol
Authors: Zhang MengQi , Fergusson Dean A. , Sharma Rahul , Khoo Ciel , Mendelson Asher A. , McDonald Braedon , Macala Kimberly F. , Sharma Neha , Gill Sean E. , Fiest Kirsten M. , Lehmann Christian , Shorr Risa , Jahandideh Forough , Bourque Stephane L. , Liaw Patricia C. , Fox-Robichaud Alison , Lalu Manoj M. ,   on behalf of the Canadian Critical Care Translational Biology Group, the Sepsis Canada National Preclinical Sepsis Platform, Avey Marc T. , Charbonney Emmanuel , Kristof Arnold , Vazquez-Grande Gloria , Veldhuizen Ruud , Winston Brent , Qureshi Salman , Zhou Juan 
Published: March 2023

Abstract
Background
The importance of investigating sex- and gender-dependent differences has been recently emphasized by major funding agencies. Notably, the influence of biological sex on clinical outcomes in sepsis is unclear, and observational studies suffer from the effect of confounding factors. The controlled experimental environment afforded by preclinical studies allows for clarification and mechanistic evaluation of sex-dependent differences. We propose a systematic review to assess the impact of biological sex on baseline responses to disease induction as well as treatment responses in animal models of sepsis. Given the lack of guidance surrounding sex-based analyses in preclinical systematic reviews, careful consideration of various factors is needed to understand how best to conduct analyses and communicate findings.

Methods
MEDLINE and Embase will be searched (2011-present) to identify preclinical studies of sepsis in which any intervention was administered and sex-stratified data reported. The primary outcome will be mortality. Secondary outcomes will include organ dysfunction, bacterial load, and IL-6 levels. Study selection will be conducted independently and in duplicate by two reviewers. Data extraction will be conducted by one reviewer and audited by a second independent reviewer. Data extracted from included studies will be pooled, and meta-analysis will be conducted using random effects modeling. Primary analyses will be stratified by animal age and will assess the impact of sex at the following time points: pre-intervention, in response to treatment, and post-intervention. Risk of bias will be assessed using the SYRCLE’s risk-of-bias tool. Illustrative examples of potential methods to analyze sex-based differences are provided in this protocol.

Discussion
Our systematic review will summarize the current state of knowledge on sex-dependent differences in sepsis. This will identify current knowledge gaps that future studies can address. Finally, this review will provide a framework for sex-based analysis in future preclinical systematic reviews.

Systematic review registration
PROSPERO CRD42022367726.
Clinicopathologic characteristics and long-term prognosis of intraductal papillary neoplasm of the bile duct: a retrospective study
Authors: Wu Xin , Li Binglu , Zheng Chaoji 
Published: March 2023

Abstract
Background
Intraductal papillary neoplasm of the bile duct (IPNB) is a premalignant neoplasm that can involve both the intrahepatic and extrahepatic bile ducts. Owing to the low incidence and confusing nomenclature, its clinicopathological features remain controversial. Additionally, only a few studies have reported on the long-term prognosis of IPNB to date. Therefore, the present study aimed to clarify the clinicopathological characteristics and prognosis of IPNB.

Methods
Medical records of patients with IPNB treated at our hospital between August 2000 and October 2021 were retrospectively reviewed. A database of demographic characteristics, test results, surgical details, pathological findings, and follow-up information was constructed for analysis. Patients were divided into intrahepatic and extrahepatic groups, and dysplasia and invasive carcinoma groups for comparison. Differences between study groups were analyzed using the χ2 test, Fisher’s exact test, t-test, or Mann–Whitney U test, as appropriate. Cumulative survival rates were estimated using the Kaplan–Meier method.

Results
In total, 43 patients (21 men and 22 women) with IPNB were included in the study. The median age at diagnosis was 62 (54–69) years. Thirty-eight patients underwent surgery. The mean operation time was (269.5 ± 94.9) min. Five patients underwent endoscopic retrograde cholangiopancreatography for biopsy. Twenty-one and 22 patients had intrahepatic and extrahepatic lesions, respectively. The extrahepatic group had more patients with intraluminal masses (p = 0.021) and abnormal bilirubin levels (p = 0.001), but fewer patients with hepatolithiasis (p = 0.021). The operation time was longer in patients with extrahepatic lesions (p = 0.002). Twenty patients had dysplasia and 23 had invasive carcinoma. The invasive carcinoma group had a longer operation time than the dysplasia group (p = 0.004). As of March 2022, 39 patients were followed up, with a mean follow-up time of (56.2 ± 38.2) months. Fifteen patients survived without tumors, two survived with tumors, and 22 patients died. The 1-, 3-, 5-, and 10-year cumulative overall survival rates were 86.9%, 65.8%, 49.8%, and 32.0%, respectively.

Conclusions
IPNB is a rare bile duct disease that occurs mainly in patients with advanced age. Surgery is the primary treatment strategy. Intrahepatic and extrahepatic lesions, as well as dysplasia and invasive carcinoma have their own unique characteristics. The long-term prognosis of IPNB is generally poor.
Transformation through (re-)politicisation of socio-technical futures: how cultural semiotics can improve transformative vision assessment
Authors: Dobroć Paulina , Lösch Andreas 
Published: March 2023

AbstractThe politicisation of the future is gaining attention, especially in research on the impact of emerging technologies on modern societies. This observation has motivated technology assessment (TA) and related research in science and technology studies (STS) to involve transformative practices in their examination of existing socio-technical futures in order to adapt them to societal needs. To this end, participation processes are initiated that aim to bring together different stakeholders, from research and development and beyond, to debate existing visions of the future and to confront the different stakeholders with their own ideas and the consequences thereof. Currently, however, especially in the context of responsible research and innovation (RRI), voices are also calling for reflection on the process of participation itself. We reflect on the process of framing discussions in society based on technical visions of the future from a cultural studies perspective.Building on cultural semiotic analysis and our definition of visions of the future as cultural techniques, this paper discusses the consequences of the orientation along the future in transformative research. Cultural semiotics provides a kind of meta-reflection on the role of research in TA and STS on the politicisation of the future. We fall back on the definition of visions of the future as cultural techniques to show that visions of the future not only originate in modern culture, but also contribute to its further development.Using the example of the transformative vision assessment project on 3D printing futures conducted within the research cluster “3D Matter Made to Order (3DMM2O)”, and based on the cultural semiotic approach, we reflect on the prerequisites and limitations of the politicisation of the future and the intervention of transformative vision assessment in politicisation processes. The limitation stems from the fact that vision assessment, and more generally TA, is oriented in its intervention towards visions of the future and thus itself contributes to the further politicisation of the future. To elaborate the preconditions of the dynamic and culture-changing effects of visions of the future, we turn to the concept of cultural mechanism to grasp different steps of the politicisation processes in which vision assessment practices are involved. The role of vision assessment in the politicisation process is unavoidable; however, it can be mitigated by meta-reflection on its own orientation to the future.
The role of social networks for combating COVID-19 pandemic: a study with reference to the Chinese new immigrants in Germany
Authors: Zhu Qian , Lu Ming , Qin Yanjia 
Published: March 2023

AbstractSocial network theories are used extensively to analyze the international migration of Chinese to overseas regions in the era of Market Economy Reform since 1978. Attention is paid especially on the role of social networks among overseas Chinese on disaster relief in China. Focusing on the ongoing COVID-19 pandemic, this paper investigates how social networks work as a crucial mechanism through which Chinese immigrants in Germany initiated and delivered monetary and material donations to China in early 2020 and then organized self-help in their everyday lives in Germany in late 2020. Different from previous studies, this paper scrutinizes social networks for disaster relief on the macro, meso, and micro levels. Multi-site ethnographic fieldwork in China and Germany combined with online and offline data collected from focus group sessions, interviews with individuals, participant observations, surveys, analysis of news reports on the pandemic, and analysis on relevant policies are utilized comprehensively to collect data on the three levels. This research discovers that internet tools – represented by WeChat – have integrated tightly into the traditional social networks of Chinese immigrants and consolidated the cultural cohesion from overseas Chinese to their connections in China. This paper aims at contributing to present studies on Chinese new immigrants, social network, and disaster management theories with an updated ethnographic case on the COVID-19 pandemic from Germany.
The health impact of long COVID: a cross-sectional examination of health-related quality of life, disability, and health status among individuals with self-reported post-acute sequelae of SARS CoV-2 infection at various points of recovery
Authors: Tak Casey R. 
Published: March 2023

Abstract
Objective
The novel Coronavirus (COVID-19) has continued to present a significant burden to global public health efforts. The purpose of this study was to estimate the health-related quality of life, disability, and health status of individuals with self-reported long COVID at various lengths of recovery.

Methods
We conducted a cross-sectional online survey of individuals with self-reported long COVID. Participants were asked to complete the five-item EuroQOL EQ-5D-5L and EQ visual analog scale, the 12-item World Health Organization Disability Assessment Schedule (WHODAS) 2.0 and the 10-item Patient Reported Outcome Measurement Information System (PROMIS) Global Health v1.2 short form. Descriptive and inferential statistics were used to characterize the responses and differences across groups.

Results
Eighty-two participants from 13 countries completed the EQ-5D-5L, 73 completed the WHODAS 2.0 and 80 participants completed the PROMIS. The mean EQ-5D-5L utility score was 0.51. The mean WHODAS score was 49.0. In the previous 30 days, participants reported their symptoms affected them for a mean of 24 days, they were totally unable to carry out usual activities for 15 days, and they cut back or reduced activities for 26 days. The mean PROMIS physical health and mental health scores were 10.7 and 8.6, respectively, corresponding to below-average health. No significant differences were detected across time or according to severity of acute infection.

Conclusions
Long COVID presents a significant chronic health burden to adults in the US and abroad. This health burden may persist for many months post-acute infection.
Metastases to breast from primary lung cancer
Authors: Fares Nevien Ragae 
Published: March 2023

Abstract
Background
Metastatic involvement of the breast is relatively rare and has an incidence of 0.5–3%. Lesions that metastasize to the breast may produce changes that look similar to those of primary breast cancer on mammography, but they are more likely to be multiple and are frequently bilateral.

Case presentation
A 38-year-old female complaining of progressive proptosis with bilateral palpable breast lumps. She was referred to the breast imaging unit to evaluate the nature of those breast lesions, diagnostic mammography, and complementary ultrasound was done that revealed multiple variable-sized well-defined masses scattered all over their parenchyma. True cut biopsy was taken from one of them that show metastatic carcinoma of non-mammary origin. Immunophenotyping revealed neuroendocrine carcinoma of lung origin. A metastatic workup was done that revealed horrible metastatic deposits in multiple organs and the primary was found in the lung.

Conclusions
Metastasis to the breast from extra-mammary carcinomas is extremely rare. The most common types are malignant melanoma, secondary lymphomas, and tumors of neuroendocrine origin like Small cell carcinoma. Histopathology and sometimes immunophenotyping can provide the diagnosis.
Annihilation of singlet fermionic dark matter into two photons via pseudo-scalar mediator
Authors: Ettefaghi M. M. , Moazzemi R. , Yazdani Najafabadi M. 
Published: March 2023

Abstract
We consider the indirect detection of dark matter within an extension of the standard model (SM) including a singlet fermion as cold dark matter (CDM) and a singlet pseudo-scalar as a mediator between dark matter and the SM particles. The annihilation cross-section of the CDM into two monochromatic photons is calculated and compared with the latest H.E.S.S. data. Although for dark matter masses below 1 TeV the predicted observable cross-sections are far from the sensitivity of the recent gamma-ray experiments, it can be comparable to the strongest H.E.S.S. upper bounds for some models with more massive CDM.
Selective Activation of NAc D1R-VP/LH Circuits Promotes Reanimation From Sevoflurane Anesthesia in Mice
Authors: Bao Weiwei , Ding Jiahui , Jiang Shan , Yao Zhen , Qu Weimin , Li Wenxian , Huang Zhili , Han Yuan 
Published: March 2023

BACKGROUND:
Emerging evidence has uncovered a vital role of nucleus accumbens (NAc) neurons that express the dopamine D1 receptor (D1R) and its upstream neural circuit in general anesthesia (GA) regulation. However, the underlying downstream neural basis of the modulation of GA emergence by NAcD1R neurons remains unknown. In the present study, we explored the downstream neural mechanism of NAcD1R neurons in the modulation of emergence from sevoflurane GA.

METHODS:
We traced the axonal projections of NAcD1R neurons using a cell type-specific anterograde tracing method and immunohistochemical techniques in D1R-Cre mice. Optogenetic stimulations combined with electroencephalogram/electromyogram recordings and behavioral tests were used to determine the effects of optogenetic activation of the axonal terminals of NAcD1R neurons on sevoflurane emergence during sevoflurane-induced continuous, steady-state general anesthesia (CSSGA) or burst-suppression oscillations.

RESULTS:
Labeled efferent fibers of NAcD1R neurons were highly distributed in the ventral pallidum (VP), lateral hypothalamus (LH), and substantia nigra pars compacta. Optogenetic activation of the NAcD1R–VP circuit during CSSGA with sevoflurane induced cortical activation (mean ± standard deviation [SD]; delta power: prestimulation versus during stimulation, 48.7% ± 5.7% vs 35.1% ± 3.3%, P < .0001; beta power: 7.1% ± 2.7% vs 14.2% ± 3.3%, P = .0264) and behavioral emergence, and restored the righting reflex in 66.7% of ChR2 mice. Optogenetic stimulation of the NAcD1R–LH circuit also produced cortical activation (delta power: prestimulation versus during stimulation, 45.0% ± 6.5% vs 36.1% ± 4.6%, P = .0016) and behavioral emergence, and restored the righting reflex in 100% of the ChR2 mice during CSSGA with sevoflurane. Under a sevoflurane-induced burst-suppression state, NAcD1R–VP/LH circuit activation produced evidence of cortical activation (burst-suppression ratio [BSR]: NAcD1R–VP circuit, prestimulation versus during stimulation, 42.4% ± 4.0% vs 26.3% ± 6.0%, P = .0120; prestimulation versus poststimulation, 42.4% ± 4.0% vs 5.9% ± 5.6%, P = .0002; BSR: NAcD1R–LH circuit, prestimulation versus during stimulation, 33.3% ± 13.4% vs 5.1% ± 4.9%, P = .0177; prestimulation vs poststimulation, 33.3% ± 13.4% vs 3.2% ± 4.0%, P = .0105) and behavioral emergence.

CONCLUSIONS:
Both NAcD1R–VP and NAcD1R–LH circuits are sufficient to promote reanimation from sevoflurane GA by simultaneously inducing cortical and behavioral emergence.
Case Report: Neglected case of duodenal strongyloidiasis in an immunocompromised patient
Authors: Mahat Smritee , Manandhar Usha , Thapa Pratima , Rokaya Nabin , Alam Mohammad Rizwan 
Published: March 2023

Strongyloides stercoralis, one of the common opportunistic parasitic infections, affects a large population in many parts of tropical and subtropical regions and is often a neglected tropical disease. The parasite completes its life cycle inside the human host with a unique feature of autoinfection, persisting in the host indefinitely in dormant form and having the notorious ability to cause fetal complications in an immunocompromised individual. Many factors like corticosteroid therapy, immunosuppressive therapy for autoimmune diseases, human T lymphotropic virus, malignancy, malnutrition etc. can transform asymptomatic strongyloidiasis to fatal outcomes, from hyperinfection syndrome to parasite dissemination leading to increased risk of high mortality rates. It has been neglected in screening unless and until some clinical suspicion appeared during the course of treatment. Early diagnosis and treatment can mitigate the rapid disease activation and evolution in an immunocompromised patient. A mandatory but reliable parasite screening method should always be carried out before administering immunosuppressants, even though simple stool tests and serology are only used when suspicion arises. Our case involved a 50-year-old female on cyclophosphane for systemic lupus erythematous (SLE) who experienced repeated bouts of vomiting and loose stools. Even several days after admission, there was no satisfactory outcome with medical management; a duodenal biopsy was carried out, which revealed numerous larvae of Strongyloides stercoralis.