bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification of prognostic factors for predicting survival of patients with malignant adrenal tumors: A population-based study
Authors: Wang Keyi , Zhang Tao , Ni Jinliang , Chen Jianghong , Zhang Houliang , Wang Guangchun , Gu Yongzhe , Peng Bo , Mao Weipu , Wu Jianping 
Published: October 2022

BackgroundThis study aimed to identify the prognostic factors for overall survival (OS) and cancer-specific survival (CSS) in patients with malignant adrenal tumors and establish a predictive nomogram for patient survival.MethodsThe clinical characteristics of patients diagnosed with malignant adrenal tumors between 1988 and 2015 were retrieved from the Surveillance, Epidemiology and End Results (SEER) database. As the external validation set, we included 110 real-world patients from our medical centers. Univariate and multivariate Cox regressions were implemented to determine the prognostic factors of patients. The results from Cox regression were applied to establish the nomogram.ResultsA total of 2,206 eligible patients were included in our study. Patients were randomly assigned to the training set (1,544; 70%) and the validation set (662; 30%). It was determined that gender, age, marital status, histological type, tumor size, SEER stage, surgery, and chemotherapy were prognostic factors that affected patient survival. The OS prediction nomogram contained all the risk factors, while gender was excluded in the CSS prediction nomogram. The receiver operating characteristic (ROC) curve and decision curve analysis (DCA) indicated that the nomogram had a better predictive performance than SEER stage. Moreover, the clinical impact curve (CIC) showed that the nomograms functioned as effective predictive models in clinical application. The C-index of nomogram for OS and CSS prediction was 0.773 (95% confidence interval [CI]: 0.761–0.785) and 0.689 (95% CI: 0.675–0.703) in the training set. The calibration curves exhibited significant agreement between the nomogram and actual observation. Additionally, the results from the external validation set also presented that established nomograms functioned well in predicting the survival of patients with malignant adrenal tumors.ConclusionsThe following clinical variables were identified as prognostic factors: age, marital status, histological type, tumor size, SEER stage, surgery, and chemotherapy. The nomogram for patients with malignant adrenal tumors contained the accurate predictive performance of OS and CSS, contributing to optimizing individualized clinical treatments.
Patient initiated follow-up in cancer patients: A systematic review
Authors: Newton Claire , Beaver Kinta , Clegg Andrew 
Published: October 2022

BackgroundPatient-initiated follow-up (PIFU) is increasingly being implemented for oncology patients, particularly during the COVID-19 pandemic, given the necessary reduction in face-to-face hospital outpatient appointments. We do not know if PIFU has a positive (or negative) impact on overall, or progression free, survival.ObjectivesTo investigate the impact of PIFU on overall survival, progression free survival, patient satisfaction, psychological morbidity, specifically quality of life (QoL) and economic costs compared to hospital follow up (HFU), for any type of cancer.MethodsWe carried out a systematic review using five electronic databases: MEDLINE, CINAHL, EMBASE, PsycInfo and Cochrane Central Register of Controlled Trials. Studies were eligible if they were controlled clinical trials comparing PIFU with another form of active follow-up. Effectiveness was assessed using the primary outcome of overall survival and secondary outcomes of progression free survival, patient satisfaction, psychological morbidity, QoL and cost effectiveness.ResultsEight studies met the inclusion criteria and were included. Only one study included survival as a primary outcome and indicated no significant differences between hospital-based follow-up and PIFU, although not adequately powered to detect a difference in survival. For secondary outcomes, few differences were found between PIFU and other forms of active follow-up. One study reported significant differences in fear of cancer recurrence between PIFU and HFU although did not reach the limit of clinical significance; in the short term, fear decreased significantly more in hospital based follow-up.ConclusionWe do not have evidence to support the impact of PIFU on survival or progression free survival. Fully powered randomized controlled trials are required to determine the full impact of PIFU in the longer term.
Combined contact force and local impedance dynamics during repeat atrial fibrillation catheter ablation
Authors: Alken Fares-Alexander , Scherschel Katharina , Kahle Ann-Kathrin , Masjedi Mustafa , Meyer Christian 
Published: October 2022

Background: Optimal lesion formation during catheter-based radiofrequency current (RFC) ablation depends on electro-mechanical tip-tissue coupling measurable via contact force (CF) and local impedance (LI) monitoring. We aimed to investigate CF and LI dynamics in patients with previous atrial fibrillation (AF) ablation who frequently present with heterogenous arrhythmia substrate.Methods: Data from consecutive patients presenting for repeat AF or atrial tachycardia ablation using a novel open-irrigated single-tip ablation catheter were studied. RFC applications were investigated regarding CF, LI and the maximum LI drop (∆LI) for evaluation of ablation efficacy. ∆LI &gt; 20 Ω was defined as a successful RFC application.Results: A total of 730 RFC applications in 20 patients were analyzed. Baseline CF was not associated with baseline LI (R = 0.06, p = 0.17). A mean CF &lt; 8 g during ablation resulted in lower ∆LI (&lt;8 g: 13 Ω vs. ≥ 8 g: 16 Ω, p &lt; 0.001). Baseline LI showed a better correlation with ∆LI (R = 0.35, p &lt; 0.001) compared to mean CF (R = 0.17, p &lt; 0.001). Mean CF correlated better with ∆LI in regions of low (R = 0.31, p &lt; 0.001) compared to high (R = 0.21, p = 0.02) and intermediate voltage (R = 0.17, p = 0.004). Combined CF and baseline LI predicted ∆LI &gt; 20 Ω (area under the receiver operating characteristic curve (AUC) 0.75) better compared to baseline LI (AUC 0.72), mean CF (AUC 0.60), force-time integral (AUC 0.59) and local bipolar voltage (0.55).Conclusion: Combination of CF and LI may aid monitoring real-time catheter-tissue electro-mechanical coupling and lesion formation within heterogenous atrial arrhythmia substrate in patients with repeat AF or atrial tachycardia ablation.
Neuroscience on breaking bad news: Effects of physicians’ response on patient emotion and trust
Authors: Song Yan , Xiu Yifan , Li Wei , Wang Fang 
Published: October 2022

BackgroundThe outbreak of COVID-19, due to restrictions on patients’ access to hospitals, makes patient mental health a severe problem to solve, especially for cancer patients. Delivering bad news has become one of the abilities that physicians need to improve. Former research has proposed communication strategies like SPIKES to respond to patients’ emotions. However, existing strategies lack systematic and structural responses to different cues and concerns of patients.ObjectiveThis study aims to investigate whether and how the response styles of information delivery, empathy, and authority affect patient emotions and trust in order to present a structural response system. Furthermore, we explore the correlation between strategies and EEG markers to moderate emotions and trust.MethodsThis research selects different scenarios and strategies in the context of breast cancer and performs two experiments. First, we performed a behavioral experiment with 93 medical students and 15 breast cancer patients. Moreover, an EEG experiment with 53 students via video stimuli was conducted to explore the moderate function between strategies and emotions/trust. We use time-frequency analysis and the repeated measure ANOVA method to explore the association between strategy and EEG components. Furthermore, we perform a GLM method to investigate the relationship between EEG components and patient emotion and trust.ResultsFor the first time, this study proposes the strategy matrix. The response strategies NPIm and NRIa play important roles in this system. In behavioral experiments, information delivery, empathy, and authority strategy significantly affect emotions and trust. The scenario is significant as a moderator. In the EEG experiment, strategy NPIm has more correlation with parietal alpha power than other strategies, and parietal alpha power has a significant effect on emotions, which verifies that empathy-related cerebral activities affect emotions and trust.ConclusionAccording to the strategy matrix, physicians could apply strategy ERIa in most scenarios, and strategy NRIa in many scenarios, which means information provision is significant when it comes to responding to patients’ cues and concerns. The most important strategy that physicians need to avoid is the authority strategy. Refusing to respond to patients’ cues and concerns may cause their dislike. Moreover, through the EEG experiment, we verify that empathy affects emotions and trust from a neuroscience perspective and propose parietal alpha and frontal alpha as neuro-markers to moderate emotions and trust. Physicians could adjust strategies through these EEG markers.
Association of BDNF and MMP-9 single-nucleotide polymorphisms with the clinical phenotype of schizophrenia
Authors: Pan Lihong , Cao Zhonghai , Chen Lianghu , Qian Min , Yan Yuzhong 
Published: October 2022

ObjectiveSchizophrenia is a highly polygenic psychiatric disorder; however, the complex genetic architecture underlying the pathogenesis remains elusive. Brain-derived neurotrophic factor (BDNF), a neurotrophin, and matrix metalloproteinase 9 (MMP-9), a gelatinase B, are the promising candidate genes for schizophrenia. To shed new light on the relationship between the single-nucleotide polymorphisms (SNPs) of BDNF and MMP-9 and the clinical variability of schizophrenia phenotype, this study aims to evaluate the relationship, and provide more definitive evidence for the relationship with various clinical features of schizophrenia.MethodsA case-control association study was performed, and one hundred and five subjects of Chinese Han population were enrolled, including 55 schizophrenia patients (SP) and 50 healthy controls (HC). The BDNF rs6265 196 G &gt; A and MMP-9 rs3918242 −1562C &gt; T SNPs were genotyped using PCR-RFLP assay. The Positive and Negative Syndrome Scale (PANSS) was used to assess the clinical symptoms of patients with schizophrenia.ResultsCompared with HC, the frequency of SP carrying BDNF rs6265 GG/GA genotype was significantly higher than HC, and the frequency of SP carrying BDNF rs6265 AA genotype was significantly lower than HC (p &lt; 0.01). With regards to MMP-9 rs3918242 −1562C &gt; T SNP, no significant difference was observed between the control and SP. BDNF GG genotype showed significantly higher PANSS and positive symptoms score than GA and AA genotypes (P &lt; 0.01). MMP-9 CC genotype showed significantly higher PANSS and general score than CT and TT genotypes (P &lt; 0.05).ConclusionBDNF rs6265 196 G &gt; A and MMP-9 rs3918242–1562C &gt; T SNPs are related to the clinical features of schizophrenia and could be a useful biomarker for the changes, remission or deterioration of clinical status of schizophrenia.
Heavy metal contamination assessment and probabilistic health risks in soil and maize near coal mines
Authors: Yang Xiujuan , Cheng Bijun , Gao Yi , Zhang Hongmei , Liu Liangpo 
Published: October 2022

ObjectiveCoal mining activities have continuously introduced heavy metals into the soil–crop system, causing increasing damage to crops. This study integrated the analysis of the heavy metal contamination status and human health risk in soil and maize near coal mines to help formulate control strategies for soil quality, maize production, and safe consumption.MethodThis study was carried out on maize agricultural land near a coal mining plant. Heavy metal contamination was assessed by the geo-accumulation index (Igeo), enrichment factor (EF), and bioaccumulation factor (BCF). The Monte Carlo simulation was used to estimate the probabilistic health risk of heavy metals exposure in soil and maize. The relationship between the concentration of heavy metal in the soil and that in maize was further visualized by correlation analysis and random forest analysis.ResultsThe results revealed that the mean concentrations of soil Ni, Cu, As, Cd, Sn, Zn, Pb, and Hg were all above the local background level. Ni was the most severely polluted heavy metal in maize and had a concentration higher than the risk control standard for corn in China (NY 861-2004). The Igeo values of all heavy metals were low, and EF values showed enrichment in V, Cr, Ti, Ni, and As. The assessment of probabilistic health risk exposed by heavy metals in soil and maize indicated that 1.16 and 1.46% of residents exceeded the carcinogenic risk level due to heavy metal exposure from soil and maize, respectively. Children were the most sensitive to maize and soil heavy metal exposure in the contaminated area. Ingestion of heavy metals was associated with the highest health risk to residents, followed by dermal contact and inhalation. As and Cr in soil and Cr and Ni in maize had the greatest impact on human health risk. Furthermore, maize heavy metals were affected the most by soil Cr, Cd, and V.ConclusionThese results may provide useful information for human carcinogenic risk associated with soil and maize heavy metal exposure due to coal mining activities.
Patient attitude and determinants toward chronic diseases control: A cross-sectional survey in rural China
Authors: Lu Yuanyuan , Zhao Yuhang , Shangguan Xiaofang , Lv Benyan , Huang Rui 
Published: October 2022

ObjectivesThe patients' attitude is critical in disease control. This study aims to explore the determinants of patients' attitude and satisfaction.MethodsA total of 844 patients in the rural areas of Shandong, Henan, and Sichuan provinces with hypertension or diabetes were randomly selected for investigation. The outcome variables were the patients' attitude and satisfaction toward chronic disease control, which were measured through patient self-reported. Binary logistic regression models were used to explore the determinants of patients' attitude and satisfaction.ResultsTeachers were more likely to regard that chronic disease management was helpful in their chronic disease control than that in farmers (OR = 3.994, 95% confidence interval (CI) = 1.309–12.188). Moreover, the probability of health institutions recording chronic diseases changes and guiding rehabilitation for patients regularly is considered helpful 2.688 times more than those that are not. In addition, receiving chronic disease management services can make patients repute that chronic disease management services are helpful in controlling chronic diseases more capably (OR = 1.582, 95% CI = 2.198–10.771). In terms of satisfaction, patients who do not know regular follow-up tend to be dissatisfied with chronic diseases control result (OR = 0.376, 95% CI = 0.192–0.737; OR = 0.592, 95%CI = 0.417–0.841).ConclusionThe government increases the promotion of chronic disease management in rural areas to improve patients' awareness. Health institutions also can provide diversified services to meet the needs of more people. At last, paying more attention to the timeliness of health services need to be considered to develop a health plan.
Clinical and sociodemographic profile of acute intoxications in an emergency department: A retrospective cross-sectional study
Authors: Aguilón-Leiva Juan José , Tejada-Garrido Clara Isabel , Echániz-Serrano Emmanuel , Mir-Ramos Eduardo , Torres-Pérez Antonio Manuel , Lafuente-Jiménez Alberto , Martínez-Soriano María , Santolalla-Arnedo Iván , Czapla Michal , Smereka Jacek , Juárez-Vela Raúl , Satústegui-Dordá Pedro José 
Published: October 2022

BackgroundEpidemiological studies about acute poisoning are useful for developing clinical toxicology, especially those carried out in hospital emergency departments. We aimed to evaluate acute intoxication clinical and sociodemographic profile in South Aragon Hospital, Spain.MethodsWe carried out a retrospective cross-sectional study. We included 442 patients treated for acute poisoning in the emergency department during the 3 years 2015–2018. In the inferential analysis, the Chi-square test was used to compare proportions, and the Mann-Whitney U-test was used to compare ranges. A confidence level of 95 per cent was considered in all tests.ResultsThe mean age was 44.1 years. 57.2% were men. Drugs of abuse were present in 243 patients (55%), drugs in 172 (38.9%), chemicals in 57 (12.9%) and three patients (0.7%) were poisoned by mushrooms. Nine different drugs of abuse, 73 drugs, 15 chemical compounds and 2 varieties of mushrooms were registered. Of the intoxicated patients, 92.3% had symptoms, 84.2% received treatment and 78.7% were discharged from the emergency department.ConclusionsWe obtain a clear clinical and sociodemographic profile of intoxicated patients who come to the emergency department; the five toxins that cause most acute poisoning are: alcohol, benzodiazepines, antiarrhythmics, cannabis and carbon monoxide.
On the green isolated proton auroras during Canada thanksgiving geomagnetic storm
Authors: Liang Jun , Gillies D. , Donovan E. , Parry H. , Mann I. , Connors M. , Spanswick E. 
Published: October 2022

The existence of detached/isolated auroral structures in the subauroral ionosphere has been recognized and studied for decades. One major subset of such detached auroras is the so-called “isolated proton aurora” (IPA). IPA is characterized by substantial hydrogen emissions and thus inferred to be proton aurora, but is also accompanied by other emission lines. In particular, IPA is usually dominated by 557.7 nm green-line emissions in optical luminosity. To date, there is still a lack of dedicated spectrographic study and detailed comparison among structures in different emission lines of IPA. The intensity ratios between the 557.7 nm and hydrogen emissions in IPA have not been well established from concurrent observations or theoretical models. In this study, we report an IPA event during ∼0245–0345 UT on 12 October 2021, the Canada Thanksgiving storm night. Using multi-station, multi-wavelength optical instruments, including the Transition Region Explorer (TREx) spectrograph, we investigate the evolution and spectrographic properties of the IPA. In-situ and ground magnetometer data show evidence of electromagnetic ion cyclotron (EMIC) waves associated with the passage of IPA, supporting a causal link between the EMIC wave and the proton precipitation. The precipitating proton energies are estimated to range between a few keV and a few tens of keV according to the IPA emission heights inferred from triangulation analyses. Via careful examination of the spectral intensities and the elevation-angle profiles of the 557.7, 427.8, and 486.1 nm emissions based on the spectrograph data, we conclude that the 557.7 nm emissions contained in the IPA were unlikely to owe their source to energetic electron precipitation from the magnetosphere, but were the byproduct of the proton precipitation. The intensity ratio between the 557.7 nm (427.8 nm) and the 486.1 nm emissions of the IPA are confined within a relatively narrow range around ∼26 (∼4), which may serve as validation tests for existing and developing proton transport models.
Safety and efficacy of tirofiban after early neurological deterioration in patients with branch atheromatous disease receiving alteplase
Authors: Zhong Xuemin , Zhao Meng , Xu Ronghua , Wang Jian , Du Jiaxiu 
Published: October 2022

ObjectivesNo standard treatment exists for branch atheromatous disease (BAD), and patients' conditions often worsen after thrombolytic therapy. We evaluated the safety and effectiveness of tirofiban after early neurological deterioration (END) development in patients receiving intravenous alteplase.Materials and methodsBleeding incidence, National Institute of Health Stroke Scale (NIHSS) score, and modified Rankin scale (mRS) score were assessed for patients with BAD receiving alteplase within 4.5 h of stroke onset.ResultsAmong 193 patients, 119 (61.64%) did not experience exacerbation after thrombolytic treatment, 74 (38.34%) had END, 34 were treated with tirofiban after END, and 40 received standard treatment. On day 7 or at discharge, no cases of symptomatic cerebral hemorrhage were noted, and no patient died during the 90-day follow-up. Fifty-two of 74 patients (70.27%) had a good mRS score at 90 days. Among patients with END who received tirofiban, 27 (79.41%) had a good mRS score at 90 days, which was significantly better than that of the 18 cases that did not receive tirofiban after exacerbation (45%; P &lt; 0.001). NIHSS scores were significantly lower 24 h, 48 h, and 7 days after tirofiban treatment in patients with exacerbation after thrombolytic therapy than in those without tirofiban treatment.ConclusionsPatients with BAD have elevated risks of END after thrombolytic therapy. Compared with conventional oral antiplatelet aggregation drugs, tirofiban rescue therapy resulted in significantly better NIHSS and mRS scores without increased symptomatic cerebral hemorrhage rates.
Effect of n-6/n-3 PUFA ratio on body fat deposition, tissues fatty acid composition and key genes expression of liver lipid metabolism in silver foxes (Vulpes vulpes fulva) during the winter fur-growth period
Authors: Zhong Wei , Luo Guoliang , Luo Jing , Guo Li 
Published: October 2022

ObjectiveThe proportion of n-6/n-3 polyunsaturated fatty acid (PUFA) plays an important role in regulating lipid metabolism. This study aimed to investigate the effects of dietary n-6/n-3 PUFA ratios on body fat deposition, tissues fatty acid composition, and gene expression of liver lipid metabolism of silver foxes during the winter fur growth period.MethodsForty-eight age-matched male silver foxes with similar body weights were randomly divided into four dietary groups for 47 days, which were fed n-6/n-3 PUFA ratio with 3, 18, 41, and 136 experimental diets, respectively.ResultsDietary n-6/n-3 PUFA ratio did not significantly influence fat deposition parameters except for hepatic fat content. The variation trend of the fatty acid composition of liver, intramuscular fat, and subcutaneous fat in silver fox was directly related to dietary fatty acid content (p &lt; 0.05). With the dietary n-6/n-3 PUFA ratio increasing, the expression of liver fatty acid synthase (FAS) mRNA and peroxisome proliferator-activated receptor (PPAR) mRNA exhibited the trend of first decreasing and then increasing (p &lt; 0.05), whereas L-fatty acid binding protein (L-FABP) mRNA expression showed a gradual increasing trend (p &lt; 0.05).ConclusionIn summary, silver foxes fed an n-6/n-3 PUFA ratio 18:1 diet (supplementing with 9.38% corn oil and 4.62% soybean oil) was more conducive to lipid decomposition, PUFA transport, and utilization of tissues, thereby meeting it for supplying energy and withstanding the cold.