bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance of the IMPACT and Helsinki models for predicting 6-month outcomes in a cohort of patients with traumatic brain injury undergoing cranial surgery
Authors: Chen Lei , Xu Haiting , He Jianqing , Zhang Chunlei , Maas Andrew I. R. , Nieboer Daan , Raj Rahul , Sun Hong , Wang Yuhai 
Published: October 2022

Background and aimPrediction models for patients with traumatic brain injury (TBI) require generalizability and should apply to different settings. We aimed to validate the IMPACT and Helsinki prognostic models in patients with TBI who underwent cranial surgery in a Chinese center.MethodsThis validation study included 607 surgical patients with moderate to severe TBI (Glasgow Coma Scale [GCS] score ≤12) who were consecutively admitted to the Neurotrauma Center of People's Liberation Army (PLANC), China, between 2009 and 2021. The IMPACT models (core, extended and lab) and the Helsinki CT clinical model were used to estimate 6-month mortality and unfavorable outcomes. To assess performance, we studied discrimination and calibration.ResultsIn the PLANC database, the observed 6-month mortality rate was 28%, and the 6-month unfavorable outcome was 52%. Significant differences in case mix existed between the PLANC cohort and the development populations for the IMPACT and, to a lesser extent, for the Helsinki models. Discrimination of the IMPACT and Helsinki models was excellent, with most AUC values ≥0.80. The highest values were found for the IMPACT lab model (AUC 0.87) and the Helsinki CT clinical model (AUC 0.86) for the prediction of unfavorable outcomes. Overestimation was found for all models, but the degree of miscalibration was lower in the Helsinki CT clinical model.ConclusionIn our population of surgical TBI patients, the IMPACT and Helsinki CT clinical models demonstrated good performance, with excellent discrimination but suboptimal calibration. The good discrimination confirms the validity of the predictors, but the poorer calibration suggests a need to recalibrate the models to specific settings.
Bibliometric analysis of research on gene expression in spinal cord injury
Authors: Wang Siqiao , Qian Weijin , Chen Shaofeng , Xian Shuyuan , Jin Minghao , Liu Yifan , Zhang Hao , Qin Hengwei , Zhang Xinkun , Zhu Jiwen , Yue Xi , Shi Chaofeng , Yan Penghui , Huang Runzhi , Huang Zongqiang 
Published: October 2022

BackgroundSpinal cord injury (SCI) is a severe disease with motor and sensory function being destroyed, which leads to a poor prognosis and a serious financial burden. It is urgent to figure out the molecular and pathological mechanisms of SCI to develop feasible therapeutic strategies. This article aims to review documents focused on gene expression in SCI and summarize research hotspots and the development process in this field.MethodsPublications of SCI-related studies from 2000 to 2022 were retrieved from the Web of Science Core Collection database. Biblioshiny was used to evaluate the research performance, core authors, journals and contributed countries, together with trend topics, hotspots in the field, and keyword co-occurrence analysis. Visualized images were obtained to help comprehension.ResultsAmong 351 documents, it was found that the number of annual publications increased in general. The most productive country was China, followed by the United States with the highest influence and the most international cooperation.Plos Onewas the journal of the maximum publications, whileJournal of Neurosciencewas the most influential one. According to keyword co-occurrence and trend topics analysis, these articles mainly focused on molecular and pathological mechanisms as well as novel therapies for SCI. Neuropathic pain, axonal regeneration and messenger RNA are significant and promising research areas.ConclusionAs the first bibliometric study focused on gene expression in SCI, we demonstrated the evolution of the field and provided future research directions like mechanisms and treatments of SCI with great innovativeness and clinical value. Further studies are recommended to develop more viable therapeutic methods for SCI.
Every fifth patient suffered a high nutritional risk—Results of a prospective patient survey in an oncological outpatient center
Authors: Jendretzki Julia , Henniger Dorothea , Schiffmann Lisa , Wolz Constanze , Kollikowski Anne , Meining Alexander , Einsele Hermann , Winkler Marcela , Löffler Claudia 
Published: October 2022

IntroductionMalnutrition in cancer patients often remains undetected and underestimated in clinical practice despite studies revealing prevalences from 20 to 70%. Therefore, this study aimed to identify patient groups exposed to an increased nutritional risk in a university oncological outpatient center.MethodsBetween May 2017 and January 2018 we screened oncological patients there using the malnutrition universal screening tool (MUST). Qualitative data were collected by a questionnaire to learn about patients’ individual information needs and changes in patients’ diets and stressful personal nutrition restrictions.ResultsWe included 311 patients with various cancers. 20.3% (n = 63) were found to be at high risk of malnutrition, 16.4% (n = 51) at moderate risk despite a mean body mass index (BMI) of 26.5 ± 4.7 kg/m2. The average age was 62.7 (± 11.8) with equal gender distribution (52% women, n = 162). In 94.8% (n = 295) unintended weight loss led to MUST scoring. Patients with gastrointestinal tumors (25%, n = 78) and patients &gt;65 years (22%, n = 68) were at higher risk. Furthermore, there was a significant association between surgery or chemotherapy within six months before survey and a MUST score ≥2 (OR = 3.6). Taste changes, dysphagia, and appetite loss were also particular risk factors (OR = 2.3–3.2). Young, female and normal-weight patients showed most interest in nutrition in cancer. However, only 38% (n = 118) had a nutritional counseling.ConclusionThis study confirms that using the MUST score is a valid screening procedure to identify outpatients at risk of developing malnutrition. Here one in five was at high risk, but only 1% would have been detected by BMI alone. Therefore, an ongoing screening procedure with meaningful parameters should be urgently implemented into the clinical routine of cancer outpatients as recommended in international guidelines.
The characteristics of postprandial glycemic response patterns to white rice and glucose in healthy adults: Identifying subgroups by clustering analysis
Authors: Liu An-shu , Fan Zhi-hong , Lu Xue-jiao , Wu Yi-xue , Zhao Wen-qi , Lou Xin-ling , Hu Jia-hui , Peng Xi-yi-he 
Published: October 2022

ObjectivesLarge interpersonal variability in postprandial glycemic response (PGR) to white rice has been reported, and differences in the PGR patterns during the oral glucose tolerance test (OGTT) have been documented. However, there is scant study on the PGR patterns of white rice. We examined the typical PGR patterns of white rice and glucose and the association between them.Materials and methodsWe analyzed the data of 3-h PGRs to white rice (WR) and glucose (G) of 114 normoglycemic female subjects of similar age, weight status, and same ethnic group. Diverse glycemic parameters, based on the discrete blood glucose values, were calculated over 120 and 180 min. K-means clustering based on glycemic parameters calculated over 180 min was applied to identify subgroups and representative PGR patterns. Principal factor analysis based on the parameters used in the cluster analysis was applied to characterize PGR patterns. Simple correspondence analysis was performed on the clustering categories of WR and G.ResultsMore distinct differences were found in glycemic parameters calculated over 180 min compared with that calculated over 120 min, especially in the negative area under the curve and Nadir. We identified four distinct PGR patterns to WR (WR1, WR2, WR3, and WR4) and G (G1, G2, G3, and G4), respectively. There were significant differences among the patterns regard to postprandial hyperglycemia, hypoglycemic, and glycemic variability. The WR1 clusters had significantly lower glycemic index (59 ± 19), while no difference was found among the glycemic index based on the other three clusters. Each given G subgroup presented multiple patterns of PGR to WR, especially in the largest G subgroup (G1), and in subgroup with the greatest glycemic variability (G3).ConclusionMultiple subgroups could be classified based on the PGR patterns to white rice and glucose even in seemingly homogeneous subjects. Extending the monitoring time to 180 min was conducive to more effective discrimination of PGR patterns. It may not be reliable to extrapolate the patterns of PGR to rice from that to glucose, suggesting a need of combining OGTT and meal tolerance test for individualized glycemic management.
Prognostic nomogram that predicts progression-free survival and overall survival of patients with ovarian clear cell carcinoma
Authors: Li Jiayi , Cao Dongyan 
Published: October 2022

ObjectivesWe aims to develop nomograms to predict progression-free survival (PFS) and overall survival (OS) in patients with ovarian clear cell carcinoma (OCCC) after primary treatment and compare the predictive accuracy with the currently used International Federation of Gynecology and Obstetrics (FIGO) system.MethodsWe collected data from 358 Chinese patients diagnosed with OCCC and who underwent standard treatment at our hospital. Patients diagnosed from 1982-9 to 2011-12 were classified as the training group and patients diagnosed from 2012-1 to 2016-11 were classified as the validation group. Nomograms were developed based on the training group and was validated in the validation group. The predictive performance was determined by concordance index and calibration curve.ResultsThe most predictive nomogram for PFS was constructed using variables: thrombosis, the FIGO staging, residual of the tumor and distant metastasis, with a concordance index of 0.738. While the nomogram for OS consisted of thrombosis, lymph node metastasis, residual of the tumor, malignant ascites/washing, and platinum resistance, with a concordance index of 0.835. The nomograms were internally validated by concordance indexes of 0.775 and 0.807 for predicting PFS and OS, respectively. In comparison, the concordance statistics for OS based on the FIGO staging was significantly lower (P&lt;0.05).ConclusionWe have established two prognostic nomograms for recurrence and long-term survival in patients with OCCC after primary treatment in a large Chinese center and validated them in patients from the same center. This tool used variables specifically related to OCCC and was more accurate than the FIGO system. It is relatively easy to use in clinic for patient counseling, postoperative management, and follow-up for individual patients.
Impact of frailty on survival and readmission in patients with gastric cancer undergoing gastrectomy: A meta-analysis
Authors: Wang Xiaoyan , Sun Yimeng , Wang Pei , Jie Yu , Liu Guodong , Gong Dandan , Fan Yu 
Published: October 2022

BackgroundFrailty as a common geriatric syndrome can affect the clinical outcomes in patients with gastric cancer. However, the impact of frailty on survival and readmission patients with gastric cancer has not been well-characterised.ObjectivesTo investigate the impact of frailty on survival and readmission in patients with gastric cancer undergoing gastrectomy by conducting a meta-analysis.MethodsEligible studies were identified by searching the PubMed, Web of Science, Cochrane Library, and Embase databases until 2 September 2022. Observational studies that evaluated the value of frailty in predicting adverse outcomes in gastric cancer patients undergoing gastrectomy were included. The outcomes of interest were overall survival, disease-specific survival (death from gastric cancer), and readmission. Adjusted hazard ratios (HR) with 95% confidence intervals (CI) were pooled to calculate the association of frailty with adverse outcomes.ResultsEight studies reported on nine articles with 2,792 patients with gastric cancer were included. A fixed-effect meta-analysis indicated that frailty was associated with a reduced in-hospital overall survival (HR 2.08; 95% CI 1.46–2.95), long-term overall survival (HR 1.84; 95% CI 1.37–2.47), and disease-specific survival (HR 1.94; 95% CI 1.34–2.83). In addition, frailty was associated with increased risk of readmission within 1 year (HR 3.63; 95% CI 1.87–7.06).ConclusionsFrailty was associated with a reduced overall survival and disease-specific survival and an increased risk of readmission in patients with gastric cancer undergoing gastrectomy. Frail status may play an important role in the risk stratification of gastric cancer after gastrectomy.
Esophageal low-grade intraepithelial neoplasia overlying multiple leiomyomas: A case report and review of the literature
Authors: Pan Wen , Wu Junchao , Liu Chao , He Yanjun , Yang Jinlin 
Published: October 2022

BackgroundEsophageal leiomyoma is the most common benign submucosal mesenchymal tumor. Esophageal intraepithelial neoplasia includes low-grade and high-grade intraepithelial neoplasia. The coexistence of epithelial lesions and the subepithelial lesion is rare. We recorded a case of esophageal low-grade intraepithelial neoplasia (LGIN) overlying multiple esophageal leiomyomas and followed with a review of the literature.Case presentationA 49-year-old female patient came for the treatment of esophageal lesions. The submucosal eminences were observed in the right posterior wall and the left anterior wall of the esophagus by Esophagogastroduodenoscopy (EGD). Additionally, we noticed the mucosa of the right wall with brown background color and the dilated, tortuous vessels by narrow-band imaging (NBI). Then we ensured that the submucosal lesions originated from the esophageal mucosal muscle by endoscopic ultrasonography (EUS) and enhanced CT. Subsequently, the submucosal eminence of the right posterior wall and the overlying mucosal lesion were removed together by endoscopic submucosal dissection (ESD). Postoperative pathological diagnosed esophageal submucosal leiomyoma with focal LGIN. Review EGD showed white scars on the right wall of the upper esophagus three months later, while pathological biopsy showed slight squamous epithelial hyperplasia in the left wall. We decided that the left submucosal lesion can be resected at a selective-time operation, and we continue to follow up as planned.ConclusionsThe case of intraepithelial neoplasia overlying the submucosal tumor is rare. Either missed diagnosis or overdiagnosis should be avoided through EGD and pathological biopsy.
Thoracoscopic surgery for congenital diaphragmatic hernia in neonates: Should it be the first choice?
Authors: Liu Rui , Zheng Zebing , Tang Chengyan , Zhang Kaizhi , Du Qing , Gong Yuan , Zhu Daiwei , Xia Xingrong , Zhou Wankang , Huang Lu , Liu Yuanmei , Jin Zhu 
Published: October 2022

ObjectiveCongenital diaphragmatic hernia (CDH) is an uncommon but potentially life-threatening surgical condition in neonates. Surgery can be performed by either open or thoracoscopic techniques. In this study, we compared the clinical efficacy, safety, and effectiveness of thoracoscopic and open CDH repair.MethodsA retrospective review of neonates with CDH who underwent operations at our hospital from 2013 to 2021 was performed. The various perioperative parameters were compared between neonates undergoing thoracoscopic and open surgery.ResultsThere were 50 neonates in this study (37 in the thoracoscopic group and 13 in the open group). Thoracoscopic surgery was associated with significantly shorter hospital stay (13.32 vs. 18.77 days, p &lt; 0.001); shorter duration of postoperative mechanical ventilation (3.70 vs. 5.98 days, p &lt; 0.001); early feeding (4.34 vs. 7.46 days, p &lt; 0.001); and shorter time to reach optimal feeding (8.21 vs. 13.38 days, p &lt; 0.001). There was one postoperative death in the open group and no death in the thoracoscopic group. The median follow-up time of the two groups was 23.8 months (20.5 months in open group and 25.0 months in thoracoscopic group). Thoracoscopic surgery was associated with lower recurrence rates, but the difference was not statistically significant (2.7% vs. 7.7%, p = 0.456).ConclusionThoracoscopy CDH repair, a safe and effective surgical technique for neonates, has better cosmesis, faster postoperative recovery, and a lower recurrence rate than other procedures. It can be considered the first choice for CDH treatment for neonates among experienced surgeons.
Proximal interruption of the pulmonary artery: A review of radiological findings
Authors: Zhang Ming-Jie , Cao Ya-Xian , Zhou Ning , Wang Rui , Wu Hui-Ying , Zhang Xiao-Chun 
Published: October 2022

ObjectivesProximal interruption of the pulmonary artery (PIPA) has various clinical manifestations. This review focused on and summarized the clinical and radiological features of PIPA, based on relevant literature studies.MethodsThe study included a total of 25 PIPA cases in the Guangzhou Women and Children's Medical Center between January 2015 and December 2021. Conventional chest photographs and chest computed tomography angiography (CCTA) of patients with PIPA were analyzed and summarized.ResultsThe radiological results showed that 17 cases were right-sided and 8 cases were left-sided PIPA. Additionally, the percentage of pulmonary hypoplasia on the affected side was 44%, 36% for pulmonary hypertension, 28% for the mosaic sign, 20% for subpleural cystic lucency shadow, 20% for subpleural serrated shadow, 20% for collateral vessel thickening, 16% for subpleural band-like parenchyma, 12% for pneumonia, and 56% for patent ductus arteriosus.ConclusionThe clinical manifestations of PIPA are non-specific. Awareness of this anomaly, based on radiological manifestations, particularly those observed on CCTA images, is important for ruling out alternative diagnoses and implementing appropriate management.
Bariatric surgery for diabetic comorbidities: A focus on hepatic, cardiac and renal fibrosis
Authors: Ding Huanxin , Zhang Yun , Ma Xiaomin , Zhang Zhongwen , Xu Qian , Liu Chuxuan , Li Bingjun , Dong Shuohui , Li Linchuan , Zhu Jiankang , Zhong Mingwei , Zhang Guangyong 
Published: October 2022

Graphical AbstractPharmacological treatment and mechanisms of bariatric surgery for diabetic comorbidities.
Prevalence of syphilis and chlamydia trachomatis infection among female sex workers in Jiangsu, China: Results from a multicenter cross-sectional and venue-based study
Authors: Shi Lingen , Luo Jun , Chen Yuheng , Chen Liping , Hu Haiyang , Qiu Tao , Liu Xiaoyan , Xu Xiaoqin , Chen Yunting , Zhang Zhi , Zhou Ying , Lu Jing , Fu Gengfeng 
Published: October 2022

BackgroundFemale sex workers (FSWs) are considered highly vulnerable to sexually transmitted infections (STIs), but available data on the prevalence of STIs among FSWs in China is limited at a provincial level. This study aimed to evaluate the prevalence of STIs and risk factors among FSWs in Jiangsu, China.MethodsWe conducted a multicenter cross-sectional study in seven cities of Jiangsu to investigate the prevalence and risk factors associated with HIV and other STIs. Blood and urine were collected to test for HIV, syphilis, Hepatitis C (HCV), Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) infections.ResultsWe enrolled 3,580 FSWs. The overall prevalence of bacterial STIs was 6.2% (5.4%−7.0%). The prevalence of HIV, syphilis infection, HCV, NG and CT were 0.1% (95%CI, 0.0–0.2), 1.8% (95%CI, 1.4–2.3), 0.3% (95%CI, 0.1–0.5), 0.3% (95%CI, 0.2–0.5) and 4.3% (95%CI, 3.6–5.0), respectively. Most FSWs (85.6%) reported consistent condom use with clients in the past month. Only 10.6% of FSWs reported group sex, and 68.3% self–reported HIV testing in the previous year. According to the multivariable model, having group sex in the past year (aOR, 2.521, 95%CI: 1.366–4.651) and HIV infection (aOR, 26.260, 95%CI: 2.432–283.563) were associated with a higher risk of syphilis infection. Migrants (aOR, 1.669, 95%CI: 1.163–2.395), having a history of STIs in the past year (aOR, 4.601, 95%CI: 1.003–21.118), and NG infection (aOR, 38.549, 95%CI: 11.214–132.514) were associated with a higher risk of CT infection. On the contrary, FSWs aged older than 25 were associated with lower risk of syphilis infection (25–34: aOR, 0.339, 95%CI: 0.151–0.763) and CT infection (25–34: aOR, 0.503, 95%CI: 0.316–0.802; ≥35: aOR, 0.578, 95%CI: 0.362–0.925).ConclusionThis study's prevalence rates of syphilis and CT infections show the need to promote comprehensive STIs control and prevention strategies, including behavioral intervention and STIs screening, especially in younger high–risk populations. With the increasing coverage of HIV testing, integrating other STIs screening with HIV testing may be a reasonable way to implement comprehensive STIs control and prevention.
Neuro-emotions based on electroencephalograph response to different color Ardisia mamillata Hance plants in elderly people with and without cognitive impairment
Authors: Du Juan , Chen Xiaomei , Li Xi , Pan Yuanzhi , Fu Erkang , Huang Yumei , Zhu Chunyan , Jiang Mingyan , Hassan Ahmad , Wu Dingru , Ma Jun , Yuan Guangsheng 
Published: October 2022

BackgroundGiven the aging population, the quality of mental health of elderly people deserves special attention. The aims of this study were (1) to assess the difference of neuro-emotion based on EEG from the cognitively impaired elderly (CNE) and the cognitively normal elderly (CIE) participants viewing different color Ardisia mamillata Hance and (2) to determine which color Ardisia mamillata Hance has greater benefits for boosting their neuro-emotions.MethodsThe cognitive function of the participants was judged by using the revised Chinese version of the Mini-Mental State Examination (MMSE) scale combined with the daily cognitive performance of the participants, and the participants were divided into the cognitive normal elderly (CNE) and the cognitive impairment elderly (CIE). A total of 10 CNE volunteers and 10 CIE volunteers were recruited as participants for this study. For this study, two varieties of Ardisia mamillata Hance, green tiger tongue (GTT) with green leaves and red tiger tongue (RTT) with reddish brown leaves, were observed as plant materials. In total, six emotional indexes, including stress, engagement, interest, excitement, focus, and relaxation, were then measured by electroencephalography (EEG).ResultsRTT had the most positive effect on EEG neuro-emotion in the CNE group, with significant reductions in stress, engagement, and focus in the RTT test, while the combination of GTT+RTT had a positive effect on EEG neuro-emotions in the CIE group, with significant reductions in engagement and focus in the GTT+RTT test. No statistically significant differences were found for the interest, excitement, and relaxation index in the CNE and CIE participants in all tests.ConclusionSignificant reductions were observed in stress, engagement, and focus values of the CIE participants in the RTT test, which indicated that the CNE participants were more relaxed. RTT is a reddish brown and warm color plant, so the CNE individuals should always have the warm color plants indoors or outdoors, which could help boost their neuro-emotions. Significant reductions were observed in engagement and focus values of the CIE participants in the GTT+RTT test, which indicated that the CIE participants were more relaxed. The combination of GTT+RTT test shows the combination cold and warm color plants; therefore, the CIE individuals should always have a combination of cool and warm color plants indoors or outdoors, which could help boost their EEG neuro-emotions.