bluuebunny/crossref_metadata_2025_split huggingface dataset:
A retrospective analysis based on multiple machine learning models to predict lymph node metastasis in early gastric cancer
Authors: Yang Tao , Martinez-Useros Javier , Liu JingWen , Alarcón Isaias , Li Chao , Li WeiYao , Xiao Yuanxun , Ji Xiang , Zhao YanDong , Wang Lei , Morales-Conde Salvador , Yang Zuli 
Published: December 2022

BackgroundEndoscopic submucosal dissection has become the primary option of treatment for early gastric cancer. However, lymph node metastasis may lead to poor prognosis. We analyzed factors related to lymph node metastasis in EGC patients, and we developed a construction prediction model with machine learning using data from a retrospective series.MethodsTwo independent cohorts’ series were evaluated including 305 patients with EGC from China as cohort I and 35 patients from Spain as cohort II. Five classifiers obtained from machine learning were selected to establish a robust prediction model for lymph node metastasis in EGC.ResultsThe clinical variables such as invasion depth, histologic type, ulceration, tumor location, tumor size, Lauren classification, and age were selected to establish the five prediction models: linear support vector classifier (Linear SVC), logistic regression model, extreme gradient boosting model (XGBoost), light gradient boosting machine model (LightGBM), and Gaussian process classification model. Interestingly, all prediction models of cohort I showed accuracy between 70 and 81%. Furthermore, the prediction models of the cohort II exhibited accuracy between 48 and 82%. The areas under curve (AUC) of the five models between cohort I and cohort II were between 0.736 and 0.830.ConclusionsOur results support that the machine learning method could be used to predict lymph node metastasis in early gastric cancer and perhaps provide another evaluation method to choose the suited treatment for patients.
The lowest level of tumor involvement is a significant prognostic factor for upper tract urothelial carcinoma after radical nephroureterectomy: A large retrospective cohort study
Authors: Huang Ying-Che , Wang Hung-Jen , Sung Min-Tse , Chuang Yao-Chi , Chen Yen-Ta , Cheng Yuan-Tso , Kang Chih-Hsiung , Liu Hui-Ying , Chang Yin-Lun , Chiang Po-Hui , Luo Hao-Lun 
Published: December 2022

PurposeTo evaluate the prognostic impact of the lowest level of tumor location for upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU).Materials and methodsData were collected from patients with UTUC treated with RNU (01/2005- 06/2020) at a single center in Taiwan. Patients were stratified by the lowest level of tumor location into three groups: renal pelvis only (RPO), above upper ureter (AUU), and below upper ureter (BUU). We compared characteristics between groups and examined the association of the lowest level of tumor involvement with intravesical recurrence (IVR), systemic metastasis (SM), and cancer-specific mortality (CSM).ResultsOverall, 1239 patients (542 RPO, 260 AUU, 437 BUU) were enrolled. Concurrent bladder cancer, multifocality, tumor architecture, lymphovascular invasion, carcinoma in situ, and variant histology were significantly different across different tumor locations. BUU had worse five-year intravesical recurrence (IVR), systemic metastasis (SM) and cancer-specific mortality (CSM) (p &lt; 0.001, p = 0.056 and p = 0.13, respectively). In multivariable models, the lowest level of tumor involvement was an independent predictor of IVR (AUU hazard ratio (HR) = 1.52, p = 0.007; BUU HR = 1.75, p &lt; 0.001), but only BUU was an independent predictor of SM (HR = 1.61, p = &lt; 0.001) and CSM (HR = 1.51, p = 0.008).ConclusionThe lowest level of tumor involvement in UTUC, especially BUU, was associated with a higher risk of IVR, SM and CSM. Assessment of the lowest level of tumor involvement after RNU may help identify patients who require more intensive follow-up.
A mitochondria-related signature for predicting immune microenvironment and therapeutic response in osteosarcoma
Authors: Zhang Lina , Wu Song , Huang Junjie , Shi Yanbin , Yin Yuesong , Cao Xu 
Published: December 2022

BackgroundOsteosarcoma remains to be the most devastating malignant tumor in children and teenagers. Mitochondria have also been proven to play critical roles in osteosarcoma. However, a mitochondria-related signature has been established in osteosarcoma to comprehensively evaluate the pathogenic roles and regulatory roles of mitochondria in osteosarcoma.MethodsIn this study, osteosarcoma samples' transcriptome data and clinical information were collected from Therapeutically Applicable Research to Generate Effective Treatments (TARGET) and Gene Expression Omnibus (GEO) databases. A comprehensive bioinformatics analysis was performed on the samples at the bulk RNA sequencing level and single-cell RNA sequencing (scRNA-seq) level. EdU, Transwell, and immunohistochemistry (IHC) were performed on PCCB.ResultsA mitochondria-related signature was constructed in osteosarcoma patients. The prognostic value of the mitochondria-related signature was explored. The predictive value of the mitochondria-related signature in the immune microenvironment and chemotherapy agents was explored. The association between mitochondria and immunity in the tumor microenvironment of osteosarcoma at the scRNA-seq level was investigated. The tumorigenic role of the critical mitochondria-related gene, PCCB, was verified by in vitro validation.ConclusionIn conclusion, a mitochondria-related signature was developed in osteosarcoma with solid predictive values in the immune microenvironment, chemotherapy agents, and prognosis.
Prevalence and predictors of medication non-adherence in children with inflammatory bowel disease in China: A cross-sectional study
Authors: Wu Yuanyuan , Huang Lingfei , Sun Jin , Wang Huijuan , Fang Luo , Miao Jing 
Published: December 2022

Background: Non-adherence to physician-prescribed medications, especially oral medications, is common in children with inflammatory bowel disease (IBD), and medication non-adherence is associated with poorer outcomes in IBD. Therefore, understanding and improving medication adherence in children with IBD is critical for optimizing treatment and improving treatment outcomes. Despite the relatively high prevalence of IBD in children in China, to date, very little is known about medication adherence in these patients.Objective: The aim of this study was to investigate the prevalence of medication non-adherence and its risk factors in children with IBD in China to provide a basis for developing adherence improvement strategies.Methods: A cross-sectional design was employed. Children (aged &lt;18 years) with IBD who visited the Children’s Hospital, Zhejiang University School of Medicine, from September 2020 to December 2021 were included. Data were collected by a general information questionnaire, the 4-item Medication Adherence Report Scale (MARS-4) and Crohn’s and Colitis Knowledge (CCKNOW) questionnaire. Subsequently, forward stepwise binary logistic regression analysis was performed to determine independent predictors of medication non-adherence.Results: A total of 119children were included in this study. The results showed that 33 (27.73%) and 86 (72.27%) children had poor and good medication adherence, respectively. Of these, 83 (69.75%) had forgotten to take their medications sometimes, often, or always. On binary logistic regression, we found that the incidence of medication non-adherence in children with IBD course of 3 years and above [OR 4.82 (95%CI: 1.47-15.88); p = 0.01] was significantly higher than that in children with course of 3 months to 1 year, whereas children with higher parental CCKNOW scores [OR 0.77 (95%CI: 0.67-0.88); p = 0.00] had significantly lower incidence of medication non-adherence than those with lower parental CCKNOW scores, and the results of the correlation between parental knowledge scores of the four categories and children’s medication adherence showed that drug knowledge scores (r = 0.36, p &lt; 0.00) and complication knowledge scores (r = 0.24, p = 0.01) were positively correlated with medication adherence.Conclusion: Poor medication adherence in children with IBD in China was common, and forgetting to take medication was the main barrier. Longer disease duration (3 years and above) in children could act as a risk factor for medication adherence, whereas higher level of parental knowledge about IBD could act as a protective factor, and one interesting novel finding was that the level of parental knowledge about drug and complication were significantly correlated with medication adherence in children with IBD. Our results may inform on the design and implementation of medication adherence interventions for children with IBD.
Pharmacological inhibition of protein tyrosine kinases axl and fyn reduces TNF-α-induced endothelial inflammatory activation in vitro
Authors: Ellermann Sophie F. , Jongman Rianne M. , Luxen Matthijs , Kuiper Timara , Plantinga Josee , Moser Jill , Scheeren Thomas W. L. , Theilmeier Gregor , Molema Grietje , Van Meurs Matijs 
Published: December 2022

Major surgery induces systemic inflammation leading to pro-inflammatory activation of endothelial cells. Endothelial inflammation is one of the drivers of postoperative organ damage, including acute kidney injury Tumour Necrosis Factor alpha (TNF-α) is an important component of surgery-induced pro-inflammatory activation of endothelial cells. Kinases, the backbone of signalling cascades, can be targeted by pharmacological inhibition. This is a promising treatment option to interfere with excessive endothelial inflammation. In this study, we identified activated kinases as potential therapeutic targets. These targets were pharmacologically inhibited to reduce TNF-α-induced pro-inflammatory signalling in endothelial cells. Kinome profiling using PamChip arrays identified 64 protein tyrosine kinases and 88 serine-threonine kinases, the activity of which was determined at various timepoints (5–240 min) following stimulation with 10 ng/ml TNF-α in Human umbilical vein endothelial cells in vitro. The PTKs Axl and Fyn were selected based on high kinase activity profiles. Co-localisation experiments with the endothelial-specific protein CD31 showed Axl expression in endothelial cells of glomeruli and Fyn in arterioles and glomeruli of both control and TNF-α-exposed mice. Pharmacological inhibition with Axl inhibitor BMS-777607 and Fyn inhibitor PP2 significantly reduced TNF-α-induced pro-inflammatory activation of E-selectin, VCAM-1, ICAM-1, IL-6 and IL-8 at mRNA and VCAM-1, ICAM-1, and IL-6 at protein level in HUVEC in vitro. Upon pharmacological inhibition with each inhibitor, leukocyte adhesion to HUVEC was also significantly reduced, however to a minor extent. In conclusion, pre-treatment of endothelial cells with kinase inhibitors BMS-777607 and PP2 reduces TNF-α-induced endothelial inflammation in vitro.
The distinction between state and trait anxiety levels in patients with BPPV in comparison with healthy controls
Authors: Kalderon Liran , Chaimoff Moshe , Katz-Leurer Michal 
Published: December 2022

IntroductionAn association exists between vestibular dysfunction and anxiety, yet a distinction between state and trait anxiety in patients with Benign Paroxysmal Positional Vertigo (BPPV) in comparison with healthy subjects has not been well established. The aim of this study is to assess both state and trait anxiety levels in patients with BPPV in comparison with healthy controls, and their relations with cardiac autonomic parameters.Materials and methodsA case–control study, that included patients with BPPV (N = 18) referred to vestibular physiotherapy and gender and age matched healthy controls (N = 18). All participants completed the State–Trait Anxiety Inventory (STAI) questionnaire, while heart-rate (HR) and heart-rate variability (HRV) measures were recorded.ResultsPatients with BPPV (age range 32–66 years; 12 women and 6 men) showed a higher state anxiety level (10 points median difference, p = 0.001) in comparison with healthy controls (age range 34–66 years; 12 women and 6 men), yet no differences were found in trait anxiety score or total STAI score. Only among patients with BPPV, a positive-moderate correlation was found between state anxiety and HR (r = 0.53, p &lt; 0.05), and a negative moderate-strong correlation was found between state anxiety and HRV (r = −0.67, p &lt; 0.01).DiscussionPatients with BPPV do not differ from healthy subjects in terms of predisposition to feel anxious, and only their temporary state anxiety levels are higher in comparison with healthy controls. We recommend researchers and clinicians who assess anxiety levels in patients with BPPV to distinguish between anxiety as a temporary state (state anxiety) and anxiety as a personality trait (trait anxiety).
Patients with affective disorders profit most from telemedical treatment: Evidence from a naturalistic patient cohort during the COVID-19 pandemic
Authors: Rohrmann Tobias , Praus Peter , Proctor Tanja , Benedyk Anastasia , Tost Heike , Hennig Oliver , Meyer-Lindenberg Andreas , Wahl Anna-Sophia 
Published: December 2022

BackgroundDuring the COVID-19 pandemic telemedicine became essential in maintaining diagnostic procedures and treatment in psychiatry. However, it is still an open question if telemedicine is a feasible treatment option for all groups of psychiatric patients alike. This prospective monocentric observational trial was conducted to assess the general applicability of telemedical treatment in a naturalistic psychiatric outpatient cohort and to identify groups of disorders and clusters of psychopathology that respond particularly well to telemedical treatment considering sociodemographic characteristics and patients' perspectives.MethodsPatients were recruited April 2020–April 2021 and asked to fill out the WHO-5 and the SCL-90R at baseline, after 4–6 and 8–12 weeks and a feedback-survey. Additionally, medical records, psychopathology, psychosocial functioning, and socio-demographic data were analyzed. Primary outcomes were well-being, psychopathology and functioning during treatment. Secondly, diagnostic groups and psychopathology linked to a superior treatment-response were determined with respect to patients' subjective experiences.ResultsOut of 1.385 patients, 254—mostly with hyperkinetic (35.3%) and depressive disorders (24.6%)—took part. Well-being and SCL-90R total scores improved substantially (both p &lt; 0.001). CGI and GAF scores were worse in depressed subjects (both p &lt; 0.05). Improvement was mainly seen in depressed patients; chronic disorders experienced a decline in well-being. Sociodemographic characteristics could not explain this difference. Particularly female (r = 0.413) patients found telepsychiatry equivalent to conventional treatment. The more virtual sessions participants attended the more likely they were to find telepsychiatry equal to conventional treatment (r = 0.231).ConclusionTelemedicine is an effective treatment for patients with depression under naturalistic conditions. Telemedical consultations are a simple and reliable way of monitoring symptom severity and directing treatment choices during the treatment of depressive disorders. Patients with depression benefited more from telemedical treatment compared to participants with chronic non-episodic psychiatric disorders. Future research needs to concentrate on improving telemedical treatment options suited for the latter conditions. Psychiatric telemedicine yielded overall high degrees of satisfaction among users.
Improving occupational health for health workers in a pilot hospital by application of the HealthWISE international tool: An interview and observation study in China
Authors: Zhang Min , Huang Yiming , Wu Fengyao , Liu Dongmei , Wei Caiyun , Qin Yaqin 
Published: December 2022

ObjectiveFor a safe and healthy workplace in the health sector, the International Labor Organization (ILO) and the World Health Organization (WHO) jointly developed HealthWISE, an international technical tool that helps health workers (HWs) to identify workplace hazards and apply low-cost solutions. This study sought to gather experiences and lessons from a Chinese pilot hospital for the scale-up application of HealthWISE.MethodsA qualitative study was undertaken at a Chinese public hospital with a ≥5-year application of HealthWISE through in-depth interviews with targeted HWs who participated in the Training-of-Trainer (TOT) workshops, and observations were gathered using evidence from photos and publications, then, thematic analysis was formulated.ResultsDriven by motivation, the participants learned from the HealthWISE TOT workshop alongside the favorite and worst parts of it. Positive changes and results of occupational health for HWs occurred after the workshop, the participants trained others and planned to implement HealthWISE within their responsibility. During the COVID-19 Pandemic, the Hospital acted the approaches of protecting the health, safety and well-being of HWs with significant results. Further suggestions on workshop and HealthWISE implementing as well as the national policies were collected. The study indicated the Hospital's experience of leadership and participation, supporting and facilitating, system establishment, and culture creation. The suggestion included keeping staff engaged under a positive safety and health culture, promoting recognition of HealthWISE among public health institutions nationwide, developing online courses for medical colleges, focusing on the alignment among various law systems, and adopting measures under the principle of the hierarchy of occupational hazards controls.ConclusionThis study has demonstrated the systematic improvement of occupational health for HWs by HealthWISE implementation in the Chinese hospital. The valuable experiences and lessons derived here can be shared with other hospitals in China and beyond, especially under the unprecedented challenges of the COVID-19 pandemic, to achieve the goals of safety, health, and well-being for HWs by building a resilient health system.
The impact of nurses' sense of security on turnover intention during the normalization of COVID-19 epidemic: The mediating role of work engagement
Authors: Tang Yao , Dias Martins Luís M. , Wang Shi-bin , He Qing-xia , Huang Hui-gen 
Published: December 2022

BackgroundCOVID-19 pandemic has entered a normal stage in China. During this phase, nurses have an increased workload and mental health issues that threaten the sense of security. Poor sense of security may have a considerable impact on turnover intention through low work engagement. It was challenging to maintain the nurse workforce. Fewer studies have been conducted on the effect of nurses' sense of security on their turnover intention in that phase. This study aimed to investigate the interrelationship between nurses' sense of security, work engagement, and turnover intention during the normalization phase of the epidemic in China and to explore the impact of sense of security on turnover intention.MethodsA cross-sectional survey was conducted from September 2020 to May 2021 in Guangdong Province, China. Data were collected online using Sense of Security Scale for Medical Staff (SSS-MS), Utrecht Work Engagement Scale (UWES), and Turnover Intention Scale. Pearson's correlation analysis was used to assess the correlation between sense of security, work engagement, and turnover intention. The hypothesis model used multiple linear regression models and the bootstrapping procedure to analyze the relationship between these variables.ResultsData were collected from 2,480 nurses who met the inclusion criteria. Over half(64.5%) of nurses had a high and very high turnover intention. After controlling the demographic and working variables, sense of security (β = 0.291, P &lt; 0.001) had a direct positive effect on work engagement. Sense of security (β = −0.447, P &lt; 0.001) and work engagement (β = −0.484, P &lt; 0.001) had a direct negative effect on turnover intention. Sense of security and all of its components were associated with turnover intention through the partially mediating effects of work engagement.ConclusionsNurses' turnover intention was at a high level during the normalization phase of the epidemic. Sense of security and its components act as positive resources to reduce turnover intention by improving work engagement. Policy makers and managers may pay attention to the needs of nurses' sense of security, which may be a new perspective to help managers reduce their turnover intention and stabilize the nurse team.
The design and implementation of natural population cohort study Biobank: A multiple-center project cooperation with medical consortia in Southwest China
Authors: Fan Ping , Zhang Shu , Wang Weiya , Yang Zongze , Tan Weiwei , Li Shujun , Zhu Chenxing , Hu Dan , Zhou Xinran , Tian Zixuan , Wang Yaxi , Liu Fang , Huang Wei , Chen Lei 
Published: December 2022

ObjectiveThe West China Hospital of Sichuan University collaborated with regional medical consortia in Sichuan Province to launch a natural population cohort study (NPCS) to investigate the health status of residents and collect public health data in southwest China.MethodsUp to 80,000 participants will be enrolled by the NPCS from 11 regional medical consortia over five years. Individuals are invited to visit one of 11 participating medical consortia to fill out questionnaires, receive a free health exam, and donate biospecimens upon enrolment. All participating medical facilities adhered to standard operating procedures for collecting and processing biospecimens to ensure uniformity (serum, lithium heparinized plasma, ethylene diamine tetraacetie acid plasma, and buffy coat). The Electronic Data Capture System, Picture Archiving and Communication System, Laboratory Information Management System, Biospecimen Quality Control System, Biobank Information Management System, and will be used to sort and classify clinical indices, imaging data, laboratory parameters, pre-analytical variables, and biospecimen information, respectively. All quality assurance and quality control procedures in the NPCS biobank adhered to the “DAIDS Guidelines for Good Clinical Laboratory Practice Standards”. This project will integrate high-dimensional multi-omics data, laboratory data, clinical data, questionnaire data, and environmental risk factors.ResultsAn estimated 2,240,000 aliquots of the sample will be stored by the end of the study. These samples are linked with comprehensively collected clinical indices, imaging data, and laboratory parameters. Big data analysis can be implemented to create predictive algorithms, explore pathogenesis mechanisms, uncover potential biomarkers, and provide information on public health.ConclusionsNPCS will provide an integrative approach to research risk factors and pathogenesis of major chronic or endemic diseases in Sichuan Province and provide key scientific evidence to support the formulation of health management policies in China.