bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of diagnostic guidelines on the diagnosis of hypersensitivity pneumonitis
Authors: Huang Yuh Chin , Gu Jessie P. 
Published: March 2023

IntroductionHypersensitivity pneumonitis (HP) is an immune-mediated interstitial lung disease from exposure to environmental antigens. Diagnosing HP could be challenging. The American College of Chest Physicians (CHEST) and American Thoracic Society/Japanese Respiratory Society/and Asociación Latinoamericana del Tórax (ATS/JRS/ALAT) have published diagnostic guidelines in 2021 and 2020 respectively. The CHEST guideline uses four grades of confidence: confident (&gt;90%), provisional high (70–89%), provisional low (51–69%), and unlikely (≤50%). The ATS/JRS/ALAT guideline uses five grades of confidence: definite (&gt;90%), high (80–89%), moderate (70–79%), low (51–69%) and not excluded (≤50%). In this study, we determined how these two guidelines could have affected the diagnosis of HP made before the guidelines.MethodsTwo hundred and fifty-nine adult patients from a previous cohort with HP (ICD-9:495) made between Jan. 1, 2008, and Dec. 31, 2013, at Duke University Medical Center were included. We simplified the diagnostic confidence into three categories so we could compare the guidelines: high (≥90%), intermediate (51–89%), and low (≤50%).ResultsThere were 156 female and 103 male. Mean age was 58 (range: 20–90). 68.8% of the patients had restrictive defects (FVC &lt; 80% pred) and 48.6% had lung biopsy. The CHEST guideline classified 33.6% of the patients into high, 59.5% into intermediate and 6.9% into low confidence categories. The ATS/JRS/ALAT guideline classified 29.7% of the patients into high, 21.2% into intermediate and 49.0% into low confidence categories (p &lt; 0.0001 vs. CHEST). Cohen's kappa was 0.331. In patients with identifiable inciting agents (IAs) (N = 168), the CHEST guideline classified 32.1% of the patients into high, 64.3% into intermediate and 3.6% into low confidence categories. The ATS/JRS/ALAT guideline classified 29.2% of the patients into high, 20.8% into intermediate, and 50.0% into low confidence categories. Cohen's kappa was 0.314.DiscussionIn our HP cohort with two-thirds of the patients with restrictive defects, we found the two guidelines had fair agreement in diagnosing HP with or without identifiable IAs. They agreed more when the diagnostic confidence was high. When the diagnostic confidence was lower, however, the ATS/JRS/ALAT guideline was more stringent. Clinicians should be aware of the differences between the two guidelines when evaluating patients suspicious of HP.
MRI arterial spin labeling in evaluating hemorrhagic transformation following endovascular recanalization of subacute ischemic stroke
Authors: Wu Liheng , Liu Yanghui , Zhu Liangfu , Li Tianxiao , Wang Li’na , Zhang Yang , Zhou Zhilong , Xing Ying , Wang Meiyun , Gao Bulang 
Published: March 2023

ObjectiveTo investigate the value of the MRI arterial spin labeling (ASL) in evaluating the blood-brain barrier permeability of anterior circulation ischemic lesions in subacute ischemic stroke (SIS) and the risk of hemorrhage transformation (HT) after endovascular recanalization.Materials and methodsPatients with anterior circulation SIS treated with endovascular recanalization were prospectively enrolled. The imaging presentations in the MRI ASL sequences, dynamic contrast-enhanced (DCE) sequence, and Xper CT were studied. The relative cerebral blood flow (rCBF), volume transfer constant (Ktrans), and the weighted Kappa coefficient (rKtrans) were analyzed.ResultsAmong 27 eligible patients, HT occurred in 7 patients (25.92%). Patients with HT had significantly higher rCBF value (1.56 ± 0.16 vs. 1.16 ± 0.16), Ktrans, (0.08 ± 0.03 min vs. 0.03 ± 0.01 min) and rKtrans (3.02 ± 0.89 vs. 1.89 ± 0.56). The ASL imaging sequence had a high consistency with the DCE sequence and Xper CT with a high weighted Kappa coefficient of 0.91 for the DCE sequence and 0.70 for the Xper CT imaging. The DCE sequence was also highly consistent with the Xper CT in imaging classification with a high weighted Kappa coefficient of 0.78. The rCBF value in the 21 patients with the subcortical and basal ganglia infarction was significantly lower than that in the other 6 patients with the cortical infarction (1.222 ± 0.221 vs. 1.413 ± 0.259, t = 1.795, P = 0.004).ConclusionThe MRI ASL sequence has an important role in evaluating the blood-brain barrier permeability and the risk of hemorrhagic transformation of anterior circulation SIS following endovascular recanalization.
Survival rate of colorectal cancer in China: A systematic review and meta-analysis
Authors: Wang Ren , Lian Jie , Wang Xin , Pang Xiangyi , Xu Benjie , Tang Shuli , Shao Jiayue , Lu Haibo 
Published: March 2023

BackgroundThis study aims to comprehensively summarize the colorectal survival rate in China. Method: In PubMed and Web of Science, keywords such as “colorectal cancer”, “survival” and “China” were used to search literatures in the past 10 years. Random effect models were selected to summarize 1-year, 3-year, and 5-year survival rates, and meta-regression and subgroup analyses were performed on the included studies.ResultsA total of 16 retrospective and prospective studies providing survival rates for colorectal cancer in China were included. The 1-year, 3-year, and 5-year survival rates of colorectal cancer in China were 0.79, 0.72 and 0.62, respectively. In the included studies, the 5-year survival rates of stage I (5474 cases), stage II (9215 cases), stage III (8048 cases), and stage IV (4199 cases) colorectal cancer patients were 0.85, 0.81, 0.57 and 0.30, respectively. Among them, the 5-year survival rates of colorectal cancer were 0.82, 0.76, 0.71, 0.67, 0.66, 0.65 and 0.63 in Tianjin, Beijing, Guangdong, Shandong, Liaoning, Zhejiang and Shanghai, respectively.ConclusionThe 5-year survival rate in China is close to that of most European countries, but still lower than Japan and South Korea, and the gap is gradually narrowing. Region, stage, differentiation, pathological type, and surgical approach can affect 5-year survival in colorectal cancer.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/ identifier, CRD42022357789.
Comparison of the efficacy and safety of fruquintinib and regorafenib in the treatment of metastatic colorectal cancer: A real-world study
Authors: Deng Ya-Ya , Zhang Xin-Yue , Zhu Peng-Fei , Lu Hong-Rui , Liu Qian , Pan Shuang-Yue , Chen Zhe-Ling , Yang Liu 
Published: March 2023

BackgroundFruquintinib and regorafenib have been approved for the third-line therapy of metastatic colorectal cancer (mCRC) in China. However, at present, there is a lack of head-to-head clinical trials on the comparison of efficacy and safety between the two drugs.Materials and methodsThe data of patients with mCRC who were treated with fruquintinib or regorafenib after the standard chemotherapy in Zhejiang Provincial People’s Hospital from October 2018 to November 2021 were collected and analyzed. The primary endpoints were overall survival (OS), progression-free survival (PFS) and adverse events. The secondary endpoints were the appropriate sequence, objective remission rate (ORR) and disease control rate (DCR) of fruquintinib and regorafenib.ResultsA total of 105 patients were enrolled in this study. The ORR of fruquintinib group (n=55) and regorafenib group (n=50) were 6.1% and 2.0%; the DCR were 65.3% and 54.2%, respectively. There was no significant difference in median OS (mOS) and PFS (mPFS) between the two groups (mOS:14.2 vs12.0 months, p=0.057; mPFS:4.4 vs 3.5 months, p=0.150). Combined immunotherapy showed a synergistic effect. The mPFS and mOS of fruquintinib combined with anti-PD-1 therapy were longer than those of fruquintinib monotherapy (mPFS:5.9 vs 3.0 months, p=0.009; mOS:17.5 vs 11.3 months, p=0.008). The mOS of patients treated with regorafenib combined with anti-PD-1 therapy was 14.8 months higher than that of regorafenib monotherapy (p=0.045). When combined with anti-PD-1 therapy, the mPFS and mOS of fruquintinib was significantly longer than regorafenib (mPFS:5.9 vs 3.8 months, p=0.018; mOS:17.5 vs 14.8 months, p=0.044). In the treatment sequence, the OS of patients treated with regorafenib and then fruquintinib was significantly longer than that of the reverse treatment sequence (15.0 vs 8.3 months, p=0.019). The adverse reactions were generally similar, but the incidence of hand-foot syndrome of regorafenib was higher than that of fruquintinib, while fruquintinib was more prone to grade 3 hypertension.ConclusionFruquintinib monotherapy showed better disease control rate and objective remission rate in the post-line therapy of metastasis colorectal cancer. Notably, the combination of PD-1 immunotherapy brought the additional effect, especially in the fruquintinib combined with anti-PD-1 therapy. Patients treated with regorafenib and then fruquintinib was significantly longer than that of the reverse treatment sequence. The toxicity of fruquintinib and regorafenib are similar.
Comprehensive analysis of autophagy-related clusters and individual risk model for immunotherapy response prediction in gastric cancer
Authors: Yao Yanxin , Hu Xin , Ma Junfu , Wu Liuxing , Tian Ye , Chen Kexin , Liu Ben 
Published: March 2023

IntroductionAutophagy can be triggered by oxidative stress and is a double-edged sword involved in the progression of multiple malignancies. However, the precise roles of autophagy on immune response in gastric cancer (GC) remain clarified.MethodsWe endeavor to explore the novel autophagy-related clusters and develop a multi-gene signature for predicting the prognosis and the response to immunotherapy in GC. A total of 1505 patients from eight GC cohorts were categorized into two subtypes using consensus clustering. We compare the differences between clusters by the multi-omics approach. Cox and LASSO regression models were used to construct the prognostic signature.ResultsTwo distinct clusters were identified. Compared with cluster 2, the patients in cluster 1 have favorable survival outcomes and lower scores for epithelial-mesenchymal transition (EMT). The two subtypes are further characterized by high heterogeneity concerning immune cell infiltration, somatic mutation pattern, and pathway activity by gene set enrichment analysis (GSEA). We obtained 21 autophagy-related differential expression genes (DEGs), in which PTK6 amplification and BCL2/CDKN2A deletion were highly prevalent. The four-gene (PEA15, HSPB8, BNIP3, and GABARAPL1) risk signature was further constructed with good predictive performance and validated in 3 independent datasets including our local Tianjin cohort. The risk score was proved to be independent prognostic factor. A prognostic nomogram showed robust validity of GC survival. The risk score was significantly associated with immune cell infiltration status, tumor mutation burden (TMB), microsatellite instability (MSI), and immune checkpoint molecules. Furthermore, the model was efficient for predicting the response to tumor-targeted agent and immunotherapy and verified by the IMvigor210 cohort. This model is also capable of discriminating between low and high-risk patients receiving chemotherapy.ConclusionAltogether, our exploratory research on the landscape of autophagy-related patterns may shed light on individualized therapies and prognosis in GC.
Clinical features and prognostic factors in patients diagnosed with lymphovascular invasion of testicular germ-cell tumors: Analysis based on the SEER database
Authors: Ke Hu , Jiang Shengming , He Ziqi , Song Qianlin , Yang Dashuai , Song Chao , Dong Caitao , Liu Junwei , Su Xiaozhe , Zhou Jiawei , Xiong Yunhe 
Published: March 2023

BackgroundLymphovascular invasion (LVI) is a high-risk factor for testicular germ-cell tumors (TGCT), but a prognostic model for TGCT-LVI patients is lacking. This study aimed to develop a nomogram for predicting the overall survival (OS) of TGCT-LVI patients.MethodsA complete cohort of 3288 eligible TGCG-LVI patients (training cohort, 2300 cases; validation cohort, 988 cases) were obtained from the Surveillance, Epidemiology, and End Results database. Variables screened by multivariate Cox regression analysis were used to construct a nomogram, which was subsequently evaluated using the consistency index (C-index), time-dependent receiver operating characteristic curve (ROC), and calibration plots. The advantages and disadvantages of the American Joint Committee on Cancer (AJCC) staging system and the nomogram were assessed by integrated discrimination improvement (IDI) and net reclassification improvement (NRI). Decision-analysis curve (DCA) was used to measure the net clinical benefit of the nomogram versus the AJCC staging system. Finally, Kaplan–Meier curves were used to evaluate the ability to identify different risk groups between the traditional AJCC staging system and the new risk-stratification system built on the nomogram.ResultsNine variables were screened by multivariate Cox regression analysis to construct the nomogram. The C-index (training cohort, 0.821; validation cohort, 0.819) and time-dependent ROC of 3-, 5-, and 9-year OS between the two cohorts suggested that the nomogram had good discriminatory ability. Calibration curves showed good consistency of the nomogram. The NRI values of 3-, 5-, and 9-year OS were 0.308, 0.274, and 0.295, respectively, and the corresponding values for the validation cohort were 0.093, 0.093, and 0.099, respectively (P&lt;0.01). Additionally, the nomogram had more net clinical benefit as shown by the DCA curves, and the new risk-stratification system provided better differentiation than the AJCC staging system.ConclusionsA prognostic nomogram and new risk-stratification system were developed and validated to assist clinicians in assessing TGCT-LVI patients.
The effects of early combined training on the physical development of preterm infants with different gestational ages
Authors: He Fang , Wu Na , Ma Xiuwei , Liu Xiaofang , Gao Ming , Feng Zhichun 
Published: March 2023

ObjectiveTo investigate the effects of early combined training on the physical development of preterm infants of different gestational ages.MethodsA total of 144 preterm infants from our hospital's neonatal intensive care unit (NICU) between 2019 and 2020 were selected as the research participants and randomly divided into an intervention group (77 cases) and a control group (67 cases). The physical development and catch-up growth satisfaction rate of preterm infants in the intervention and control groups were compared at 40 weeks, 3 months, 6 months and 12 months of corrected age.ResultsAt 40 weeks of gestational age and corrected 3 months of gestational age, the physical growth indexes of the intervention group were higher than those of the control group, with a statistical difference (P &lt; 0.05). At the corrected age of 12 months, the body weight and length of preterm infants in the &lt;29 weeks intervention group were still higher than those in the control group (P &lt; 0.05). The body weight of preterm infants in the 29–32 weeks and 32–34 weeks intervention groups was higher than in the control group (P &lt; 0.05). There was no statistical difference between the intervention and control groups in the 34–37 weeks category (P &gt; 0.05). The catch-up growth satisfaction rates of all the physical growth indexes in the intervention group were higher than those of the control group at the corrected 3 months for all the gestational ages (P &lt; 0.05). While those indexes in the three &gt;29 weeks intervention groups were higher than those in the &lt;29 weeks intervention group at the corrected age of 12 months (P &lt; 0.05).ConclusionEarly combined training can promote the early catch-up growth of preterm infants, especially in the early gestational age groups (&lt;34 weeks), and the catch-up growth promotion can last for 12 months. The older the gestational age, the sooner catch-up growth satisfaction will occur.
Kidney transplant-related knowledge and influencing factors in Chinese kidney transplant candidates and recipients: A cross-sectional study
Authors: Ma Hangxia , Hu Maosen , Wan Jingjing 
Published: March 2023

ObjectiveTo investigate the kidney transplantation knowledge of kidney transplant (KT) candidates and recipients, and to explore the related influencing factors.MethodsFrom March to July 2022, a total of 170 KT candidates and 270 KT recipients were investigated in two tertiary and Grade A hospitals in Hunan Province, China, using demographic questionnaires and the Kidney Transplant Understanding Tool (K-TUT). Multiple linear regression was used to explore the influencing factors of related knowledge of kidney transplantation.ResultsThe scores of kidney transplantation knowledge of the two groups were 50.67 (Ranged: 0–63) and 52.79 (Ranged: 0–62), indicating a middle level of knowledge. Education level and whether they have received health education were significantly associated with the knowledge level of kidney transplantation in both KT candidates and recipients. In addition, age and fertility status were only significantly associated with the knowledge level of kidney transplantation in KT recipients.ConclusionOur finding shows that the knowledge level of KT candidates and recipients is not optimistic, which suggests that healthcare providers should pay more attention to the health education of this population. In addition, future health education interventions should consider the education level, age, and fertility status factors affecting kidney transplantation knowledge in KT candidates and recipients.
High-risk population and factors of stroke has changed among middle-aged and elderly Chinese—Evidence from 1989 to 2015
Authors: Zhang Xue , Dai Jing , Li Wei , Yang Yunjuan 
Published: March 2023

BackgroundStroke is an acute cerebrovascular disease with high mortality and disability. This study aimed to investigate the trend of stroke prevalence from 1989 to 2015 in China, explore the transition of high-risk population and high-risk factors, and provide some evidence to develop more targeted stroke intervention strategies.Material and methodsWe derived the baseline data from China Health and Nutrition Survey (CHNS). Participants responded to face-to-face interviews and examinations containing demographic information, behavioral health information, disease history, and physical examination. We applied chi-square test, shapley value decomposition model, and decision tree model to evaluate the changes of high-risk population and high-risk factors of stroke.ResultsAcross 42,419 middle-aged and elderly residents, the prevalence of stroke was decreasing from 1989 to 2015. Hypertension was the leading risk factor of stroke, while its contribution rate was weakened with the increasing of medicine taking rate. As the second risk factor of stroke, the contribution of age decreased either. Meanwhile, the contribution rate of historical health factors, lifestyle factors, and regional factors, such as body mass index, diabetes, and living area to the impact of stroke was increasing. In addition, the first high-risk population of stroke changed from hypertension patients aged 75 years and above to without spouse residents living in stroke belt such as Beijing and Liaoning. The second risk population of stroke transformed from male hypertensive patients under 75 years old into male hypertensive patients living in urban. The third high-risk group turned from the elderly aged 75 and above into the female patients with hypertension and diabetes.ConclusionsThis study demonstrated that the high-risk population and high-risk factors of stroke changed in China and revealed the direction and internal mechanism of transition of stroke. Targeted stroke intervention strategies should be renewed. Health education for the high-risk population of stroke should be carried out, healthy living habits need be advocated, and the use of antihypertensive drugs for the hypertensive patients should be standardized.
Nutrition literacy differs based on demographics among University students in Bengbu, China
Authors: Gao Tianjing , Duan Ying , Qi Qi , Mo Guangju , Han Siyue , Liu Huaqing , Zhang Min 
Published: March 2023

BackgroundNutrition literacy (NL) encompasses the knowledge and skills that inform individuals' food choices. This cross-sectional study explored factors associated with NL among Chinese university students in Bengbu, China.MethodsA cross-sectional survey was carried out. Two thousand one hundred thirty-three university students were selected by stratified cluster sampling. A 43-item NL questionnaire was used to assess NL. Binary logistic regression was used to determine odds ratios (ORs) along with 95% confidence intervals (CIs) for NL and to test the interaction effects of multiple factors on total NL and its six dimensions.ResultsOf these participants, 1,399 (65.6%) were women and 734 (34.4%) were men. Students who were from urban areas (OR = 1.36, 95% CI: 1.08–1.72), were living with both parents (OR = 1.30, 95% CI: 1.02–1.65), and had high academic performance (OR = 1.85, 95% CI: 1.34–2.57) were more likely to report higher NL levels than did other students. The ORs for NL (OR = 1.60, 95% CI: 1.06–2.41), nutrition knowledge (OR = 1.51, 95% CI: 1.00–2.26), obtaining skills (OR = 1.76, 95% CI: 1.16–2.65), and critical skills (OR = 1.59, 95% CI: 1.05–2.39) were higher for medical students who had received nutrition education than for other students. The ORs for NL (OR = 2.42, 95% CI: 1.21–4.84), nutrition understanding (OR = 2.59, 95% CI: 1.28–5.25), and interactive skills (OR = 2.06, 95% CI: 1.04–4.08) were higher for only-child students and those with a monthly expenditure of &gt;¥1500.ConclusionsNL of university students differed in terms of place of origin, living arrangement, nutrition education, academic performance, and household income, and the findings imply that universities should have all students take a basic nutrition course to improve their NL.
Epidemiological status and associated factors of frailty and pre-frailty in older adults with asthma in China: A national cross-sectional study
Authors: Zeng Xue-zhai , Meng Ling-bing , Jia Na , Shi Jing , Zhang Chi , Li Ying-ying , Hu Xing , Hu Jia-bin , Li Jian-yi , Wu Di-shan , Li Hui , Qi Xin , Wang Hua , Zhang Qiu-xia , Li Juan , Liu De-ping 
Published: March 2023

ObjectiveThere are few studies on the prevalence and factors associated with frailty and pre-frailty in older adults with asthma worldwide. The aim of this study was to examine the epidemiological status and factors associated with frailty and pre-frailty in older adults with asthma in China.Research design and methodsData were obtained from the Sample Survey of Aged Population in Urban and Rural China in 2015, a nationwide cross-sectional survey covering 224,142 older people aged 60 years or older in 31 provinces/autonomous regions/municipalities in mainland China. We performed frailty and pre-frailty assessments using the frailty index, and the diagnosis of asthma in the older adults was self-reported based on the history of the physician's diagnosis.ResultsNine thousand four hundred sixteen older adults with asthma were included in the study. The age-sex standardized prevalence of frailty and pre-frailty in Chinese older adults with asthma was 35.8% (95% CI 34.8%−36.7%) and 54.5% (95% CI 53.5%−55.5%). Multinomial logistic regression analysis showed that increased age, female, illiteracy, living alone, poor economic status, ADL disability, comorbid chronic diseases, previous hospitalization in the past year, and residence in northern China were associated with frailty and pre-frailty in older adults with asthma.ConclusionThe prevalence of frailty and pre-frailty in Chinese older adults with asthma is very high, and assessment of frailty should become routine in the management of older adults with asthma. Appropriate public health prevention strategies based on identified risk factors for frailty in older adults with asthma should be developed to reduce the burden of frailty in Chinese older adults with asthma.