bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical significance of metabolic quantification for retinal nonperfusion in diabetic retinopathy
Authors: Jeong Areum , Yao Xue , Hemert Jano van , Sagong Min 
Published: March 2022

Abstract
Diabetic retinopathy (DR) is characterized by microvascular changes including ischemia. Degradation and metabolic changes of various retinal cells occur during ischemia. Ischemic region containing more cells will lead to greater metabolic impairment. We analyzed the non-perfusion region (NPR) by integrating histologic mapping with ultra-widefield fluorescein angiography (UWF FA) images. We also investigated the correlations of the weighted ischemic index (ISI) considering the regional distribution of retinal cells with cytokines, macular edema (ME), and neovascularization (NV). In this study, 32 patients with treatment-naïve DR and 21 age-matched control participants were included. The difference between the non-weighted and weighted ISI of NPR with leakage was greatest at the posterior region. The weighted ISI of NPR with leakage was correlated with MCP-1, IL-8, IL-6, PlGF, and VEGF-A levels, while the non-weighted ISI of NPR with leakage was correlated with IL-8 and IL-6 levels. The presence of baseline ME or NV in patients with DR was associated with the weighted ISI, with a stronger association when cones and rods were weighted. The weighted ISI reflecting both metabolic activity and cell distribution demonstrated a better correlation with clinical features and was more valuable in NPR with leakage than non-weighted ISI, which previous studies conventionally used.
A Novel Prognostic Prediction Model Based on Pyroptosis-related Signature for Breast Cancer
Authors: Tian Bao-Xing , Yin Kai , Qiu Xia , Sun Hai-Dong , Zhao Ji , Du Yi-Bao , Gu Yi-Fan , Wang Xing-Yun , Wang Jie 
Published: March 2022

Abstract
Background: Breast cancer (BC) is the most common cancer affecting women and the leading cause of cancer-related deaths worldwide. Compelling evidence indicates that pyroptosis, a newly discovered form of programmed cell death accompanied by inflammation and immune response, is inextricably involved in the development of cancer, and may activate tumor-specific immunity and/or enhance the effectiveness of existing therapies.Methods: We constructed a novel pyroptosis-related model, based on RNA-seq and clinical data downloaded from The Cancer Genome Atlas (TCGA). Data from a total of 1025 patients were included in this study, and the relationships among their clinicopathological features, survival, immune cell infiltration and RNA-seq expression levels were analyzed.Results: Two pyroptosis clusters were determined according to 38 pyroptosis-related genes. The proportions of tumor-infiltrating immune cells differed significantly in the two pyroptosis clusters. The GO and KEGG enrichment analysis of the differential gene expressions (DGEs) implicated that the immune-related pathways were activated. Then, a 56 pyroptosis-related genes signature, constructed by using univariate and multivariate Cox regression, was significantly associated with progression free interval (PFI), disease specific survival (DSS), and overall survival (OS) of patients with BC. Kaplan-Meier (KM) and receiver operating characteristic (ROC) analyses were conducted to confirm the clinical significance of the signature. Finally, a nomogram was constructed based on the signature to evaluate its clinical value. Cox analysis revealed that the signature was significantly associated with PFI and DSS of patients with BC. KM analysis demonstrated that the signature could efficiently distinguish high and low risk patients. Moreover, ROC analysis showed that the signature exhibited high sensitivity and specificity in predicting the prognosis of patients with BC. Patients in both gene and clinical low risk subgroup (G-C-) who received adjuvant chemotherapy had a significantly lower incidence of the clinical event than those who did not. A nomogram constructed based on the signature was effective in predicting 5- and 10-year PFI and DSS. Conclusion: This study presents a novel 56 pyroptosis-related genes signature prognostic signature significantly associated with PFI, DSS, and OS in patients with BC, and combining with TNM stage might be a potential therapeutic strategy for individualized clinical decision-making.
Immunohistochemical staining of LEF-1 is a useful marker for distinguishing WNT-activated Medulloblastomas
Authors: Wang Depeng , Gong Jie , Zhang Hui , Liu Yulu , Sun Nannan , Hao Xiaomeng , Mu Kun 
Published: March 2022

Abstract
Objectives: To investigate lymphoid enhancer factor 1 (LEF-1) protein expression in medulloblastomas (MBs) and its correlation with molecular grouping of MBs. Methods: Expressions of LEF-1 and β-catenin were detected by immunohistochemistry, and molecular grouping was performed based on the NanoString and sequencing techniques for 30 MBs. Results: By genetic defining, 3 MBs were WNT-activated , 11 were SHH-activated, 3 were in Group 3 and 13 in Group 4 respectively. Nuclear LEF-1 staining was found in 8 MBs using immunohistochemical method. Three out of 8 showed diffuse and strong nuclear LEF-1 staining which were proved to be WNT-activated genetically, while the other 5 MBs with focal staining were SHH-activated genetically. The expression of LEF-1 protein was significantly correlated with genetically defined WNT-activated MBs (P<0.0001). We also found focal nuclear β-catenin expression ( less than 1% of tumor cells）in 5 MBs. LEF-1 positivity was significantly correlated nuclear β-catenin expression (p<0.001). Conclusions: Immunohistochemical staining of LEF-1 can be used as a substitute for β-Catenin, the latter is difficult to recognize for the cytoplasm/membrane staining background. Diffuse nuclear staining of LEF-1 indicates WNT-activated MB.
A comparison of First Nations and Non-First Nations Australians’ survey responses to COVID-19 risks and impacts: Implications for health communications
Authors: Allan Julaine , Kleinschafer Jodie , Saksena Teesta , Rahman Azizur , Lawrence Jayne , Lock Mark 
Published: March 2022

Abstract
This study investigated differences between rural Australian First Nations and non-First Nations survey respondents’ perceptions of COVID-19 related risks; and analysed other variables that could predict an exacerbation of anxiety related to COVID-19 harms.
Methods
A cross-sectional online and paper survey of rural and regional residents from the western regions of NSW, Australia was conducted. Descriptive and multivariate statistical analyses were used to assess links between First Nations status and other variables.
Results
There were significant differences between First Nations (n=60) and non-First Nations (n= 639) respondents across all socio-demographic categories. The results reflect a significantly higher level of anxiety among the First Nations Australians in the sample: they felt afraid more often, felt it was highly likely they would catch the virus and if they did catch the virus perceived that it would be very harmful. Living with children under eighteen years of age and in small rural towns were key factors linked to feeling afraid of COVID-19 and First Nations status.
Conclusion
Health risk communication in pandemic response should include an equitable focus on rural areas, recognising that First Nations Australians are a significant proportion of the rural population with different risk factors and concerns than those of non-First Nations Australians. This principle of First Nations led design is critical to all health policy and planning. Governments globally should include rural areas in planning pandemic responses, recognising that First Nations populations are a significant proportion of the rural population creating syndemic conditions.
Ward Nurses’ Perception and Performance on Communication with Physician in Clinical Deterioration in Korea: A cross-sectional study
Authors: Jin Bo-Gyeong , Kang Kyoungrim , Cho Hyun-Jin 
Published: March 2022

Abstract
Background
Effective communication between nurses and physicians is necessary for prompt and accurate response in clinical deterioration.
Purpose
This study aimed to examine nurses’ perception and performance on communication with physicians in clinical deterioration situations in the ward.
Method
A descriptive research design with a survey of 250 ward nurses working in two tertiary hospitals.
Findings
: On communication with the physician, nurses’ perception was highest for the timeliness, followed by accuracy, understanding, satisfaction, and openness, and their performance was highest for preparation, followed by the situation, background, assessment, and recommendation.
Conclusions
It is suggested that proactive activities for improving openness, accuracy, satisfaction, and mutual understanding between physicians and nurses are required for patient safety. Additionally, the performance for assessment and recommendations should be improved. Education programs for nurses and physicians should be developed and applied to clinical practice to promote understanding and trust in interprofessional communication.
Psychosomatic symptoms: resilience as a protective factor in adolescents.
Authors: Fuentes-Chacón Rosa Mª , Simón-Saiz Mª José , Díaz-Valentín Mª José , Rodriguez-Sánchez Mª José , Martínez-García Rosa Mª , Garrido-Abejar Margarita 
Published: March 2022

Abstract
Background: Psychosomatic symptoms—clinical manifestations without a clear pathological origin—have a high prevalence in adolescents. However, most studies are oriented towards the search for risk factors and very few have approached the subject by examining which elements may be protective. The objective of this current work was to identify whether there is an association between the presence of psychosomatic symptoms and the capacity for resilience in adolescents. Methods: This was an observational, descriptive, cross-sectional, and multicenter study carried out at five different schools in Cuenca (Spain). The sample comprised 844 adolescents aged 15 to 18 years who were in the 3rd or 4th years of compulsory secondary education or the 1st or 2nd years of the baccalaureate. At each academic level, groups were randomly selected for administration of the Psychosomatic Problems Scale and 10-Item Connor–Davidson Resilience Scale (to determine psychosomatic symptoms and resilience, respectively); sociodemographic data were also recorded.Results: Girls overall, and adolescents aged 17–18 years, presented significantly higher psychosomatic symptoms. Being more resilient was negatively correlated with all the psychosomatic symptoms. The strongest correlation was between ‘felt sad’ and ‘concentrating difficulties’ and the multivariate analysis, which controlled for sex and age, predicted fewer psychosomatic symptoms among the most resilient individuals. Conclusions: Psychosomatic symptoms are frequently observed in the adolescent population and are often expressions that make emotional distress visible. The capacity for resilience positively affected emotional well-being and reduced the risk of presenting psychosomatic symptoms in our study population.
Bacterial coinfections are really rare in Covid-19 intensive care units?
Authors: Karaca Banu , Aksun² Murat , Karahan² Nagihan Altıncı , Girgin² Senem , Ormen¹ Bahar , Tuzen² Ahmet Salih , Demirdal Tuna , Sencan Atilla 
Published: March 2022

Abstract
Background: There are conflicting and limited data about nosocomial coinfections in COVID-19 case in the intensive care unit. This study aims to investigate coinfections in COVID-19 patients followed in a tertiary care reference university hospital intensive care unit. Methods: This study was conducted and analyzed retrospectively the data of coinfections of 351 COVID-19 patients in the period 28.02.2020–15.01.2021 in a tertiary care intensive care unit in a university hospital. Results: Bacterial coinfections were present in 216 of the 351 cases. One hundred and thirty of these cases were evaluated as nosocomial infections. Third day the Sequential Organ Failure Assessment Score, usage of invasive mechanical ventilation, and presence of septic shock were significantly higher in the coinfected group. The neutrophil/lymphocyte ratio, polymorphonuclear leukocyte count, procalcitonin, C reactive protein, ferritin, and blood urea nitrogen values were significantly higher in the coinfection group. In the multinomial regression analysis, the number of white blood cells (WBC) (HR: 1.063 [1.019–1.109], p: 0.005) and invasive mechanical ventilation use (HR: 3.336 [1.865–5.966], p < 0.001) were considered independent risk factors for coinfection. The rates of hospitalization on the day of arrival (p: 0.000) and the 21st day (p: 0.005), as well as total mortality (p: 0.004), were significantly higher in the coinfected group.Conclusions: Bacterial coinfections of COVID-19 patients in intensive care unit was not rare. Mortality in coinfected patients was higher than noninfected group. Identifying the infectious agent, classifying colonizations and infections, and using the proper treatment of antibiotics is of great importance in case management of COVID-19 patients in intensive care unit.
Prediction of the therapeutic efficacy of epirubicin combined with ifosfamide in patients with lung metastases from soft tissue sarcoma based on chest enhanced CT radiomics features
Authors: Miao Lei , Ma Shu-Tao , Jiang Xu , Zhang Huan-Huan , Wang Yan-Mei , Li Meng 
Published: March 2022

Abstract
Objective: To investigate the value of enhanced chest CT radiomics features in predicting the efficacy of epirubicin combined with ifosfamide in patients with pulmonary metastases from soft tissue sarcoma Methods: In a retrospective analysis of 51 patients with pulmonary metastases from soft tissue sarcoma, all received the chemotherapy regimen of epirubicin combined with ifosfamide, and the efficacy was evaluated by the RECIST（1.1）. Each patient selected 1 or 2 chemotherapy regimens. Lung metastases were used as target lesions (86 target lesions total), and the patients were divided into a progression group (n=29) and a nonprogressive group (n=57). The nonprogressive group included a stable group (n=34) and a partial response group (n=23). Information of lung metastases was extracted from enhanced CT images before chemotherapy, and all lesions were delineated by ITK-SNAP software manually or semiautomatically. The decision tree classifier had a better effect in all radiomics models. The receiver operating characteristic (ROC) curve was plotted to evaluate the predictive performance of the model for progression vs. non-progression.Results: In total, 851 enhanced CT radiomics features were extracted for each target lesion and finally reduced to 2 radiomics features, which were used to construct a radiomics model. The areas under the curve (AUCs) of the model for predicting the progression of lesions were 0.917 and 0.856 in the training and test groups.Conclusion: The model established based on the radiomics features of chest enhanced CT before treatment has certain predictive value for the chemotherapy efficacy of patients with soft tissue sarcoma lung metastases.
I-125 seeds brachytherapy with transcatheter arterial chemoembolization for subcapsular hepatocellular carcinoma
Authors: Gao Fu-Lei , Wang Yong , Huang Xiang-Zhong , Pan Tian-Fan , Guo Jin-He 
Published: March 2022

Abstract
Background: I-125 seeds brachytherapy (ISB) has been used to improve the clinical effectiveness of transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). We aim to appraise the safety and clinical efficacy of combined ISB and TACE for the treatment of subcapsular HCC.Materials and Methods: A retrospective investigative study extending from January 2017 to December 2020, involved individuals suffering from subcapsular HCC, who were subjected to TACE treatment with or without ISB in our center. The clinical effectiveness was compared between 2 groups.Results: Sixty-four patients, in total, with subcapsular HCC had to undergo TACE with (n = 32) or without (n = 32) ISB in our center. After CT-guided ISB, only 2 (6.3%) patients experienced a self-limited pneumothorax. Combined treatment resulted in a significantly higher complete response (56.3% vs. 18.8%, P = 0.002) and total response (90.7% vs. 59.4%, P = 0.004) rates than that of TACE alone. In comparison to the TACE alone group, the median progression-free survival was substantially longer in the combined treatment group (11 months vs. 5 months, P = 0.016). Further, 15 and 28 patients in combined and TACE alone groups respectively died within the follow-up. The median OS was comparable between combined and TACE alone groups (22 months vs. 18 months, P = 0.529). Conclusions: Combined TACE and ISB therapy is a safe treatment method for individuals suffering from subcapsular HCC. When compared, combined treatment had significantly enhanced clinical efficacy as a subcapsular HCC therapy, in comparison to TACE alone.
Effects of Long-Haul COVID on the Health-Related Quality of Life Among Recovered Hospitalized Patients
Authors: Trihandini Indang , Muhtar Manendra , Sakti Dea Allan Karunia , Erlianti Chintya Putri 
Published: March 2022

Abstract
People with long-haul COVID-19 could experience various health problems, from milder to more severe ones. This study aimed to identify the effect of long-haul COVID-19, specifically on the Quality of Life domains, experienced by COVID-19 patients who have been discharged. Data collection was carried out online, using data from DKI Jakarta hospitalized patients who have been confirmed with and recovered from SARS-CoV-2 infections. We selected patients who were at least a month away from the onset of COVID-19. Logistic regression technique was used to analyse the data. The questionnaire used in this study contained questions regarding long-haul COVID 19 symptoms and domains of Quality of Life, which were measured by WHOQOL-BREF. Prior to the data collection, we tested the questionnaire with 30 recovered patients who were hospitalized outside DKI Jakarta. Of the 172 recovered inpatients who filled out the questionnaire correctly and aged 18 years or more selected by random sampling, 30.2% had long-haul COVID 19. Respondents who only experienced one long-haul COVID-19 symptom had a proportion of 23.8 %, while those who experienced more than one long-haul COVID-19 symptom had a proportion of 6.4%. This study showed that the long-haul effects of COVID-19 affected almost all domains in Quality of Life except the environmental one. Age, gender, and marital status were covariates for the association between long-haul COVID 19 and the Quality of Life domains. In conclusion, coordination between health service providers and public health officers is essential to obtain an adequate response of post surveillance for recovered COVID-19 patients.
Clinical implications of circulating tumor DNA in predicting the outcome of first line treatment in diffuse large B-cell lymphoma (DLBCL) patients
Authors: Li Miaomiao , Mi Lan , Wang Chunyang , Wang Xiaojuan , Zhu Jianhua , Qi Fei , Yu Hui , Ye Yingying , Wang Dedao , Cao Jiaowu , Hu Dingyao , Yang Quanyu , Zhao Dandan , Ma Tonghui , Song Yuqin , Zhu Jun 
Published: March 2022

Abstract
Background: The clinical implication of circulating tumor DNA (ctDNA) as a prognostic or predictive biomarker in DLBCL patients receiving standard immunochemotherapy is uncertain. Methods: Here, using targeted next-generation sequencing, we assessed the prognostic and predictive utility of ctDNA in 73 DLBCL patients before, during and after the first line therapy Results: Pretreatment ctDNA level was an independent prognostic factor for both progression-free survival (PFS, adjusted HR 2.42; 95% CI 1.27 - 4.6; p = 0.007) and overall survival (OS, adjusted HR 2.58; 95% CI 1.204 - 5.5; p = 0.015) by multivariate analysis. Besides, we found for the first time that the phase after two cycles of therapy was also an appropriate timing to predict survival and patients with higher ctDNA levels had an inferior PFS (6.5 months vs. unreached; HR 2.604; 95% CI 0.996 - 6.807; p = 0.043) and OS (6.5 months vs. unreached; HR 2.604; 95% CI 0.996 - 6.807; p = 0.043). Furthermore, the patients classified as molecular responders who presented larger decrease in ctDNA levels after the initial two treatment cycles had more favorable PFS (unreached vs. 6.25 months; HR 5.348; 95% CI 1.698 - 16.85; p = 0.0015) and OS (unreached vs. 25.87; HR 4.0; 95% CI 1.051 - 15.22; p = 0.028) compared with non-responders. Beyond that, interim ctDNA clearance may be an alternative noninvasive method of PET-CT for predicting better PFS (HR 3.65; 95% CI 1.452 - 9.178; p = 0.0033) and OS (HR 3.536; 95% CI 1.192 - 10.49; p = 0.016). In addition, ctDNA was a potential biomarker for tracking minimal residue disease (MRD) at radiographic CR status and ctDNA-MRD identified patients at high risk of recurrence (HR 6.471; 95% CI 1.177 - 35.58; p = 0.014) after treatment. Conclusions: ctDNA was a promising noninvasive tool for prognosis prediction, response assessment, and early relapse prediction of first line treatment in DLBCL patients.
Cytomegalovirus infection may be oncoprotective against neoplasms of B-lymphocyte lineage: single-institution experience and survey of global evidence
Authors: Janković Marko , Knežević Aleksandra , Todorović Milena , Đunić Irena , Mihaljević Biljana , Soldatović Ivan , Protić Jelena , Miković Nevenka , Stoiljković Vera , Jovanović Tanja 
Published: March 2022

Abstract
Background
Although cytomegalovirus (CMV) is not considered tumorigenic, there is evidence for its oncomodulatory effects and association with hematological neoplasms. Conversely, a number of experimental and clinical studies suggest its putative anti-tumour effect. We investigated the potential connection between chronic CMV infection in patients with B-lymphocyte (B-cell) malignancies in a retrospective single-center study and extracted relevant data on CMV prevalences and the incidences of B-cell cancers the world over.
Methods
In the clinical single-center study, prevalence of chronic CMV infection was compared between patients with B-cell leukemia/lymphoma and the healthy controls. Also, global data on CMV seroprevalences and the corresponding country-specific incidences of B- lineage neoplasms worldwide were investigated for potential correlations.
Results
Significantly higher CMV seropositivity was observed in control subjects than in patients with B-cell malignancies (p = 0.035). Moreover, an unexpected seroepidemiological evidence of highly significant inverse relationship between country-specific CMV prevalence and the annual incidence of B-cell neoplasms was noted across the populations worldwide (ρ= -0.625, p < 0.001).
Conclusions
We try to draw attention to an unreported interplay between CMV infection and B-cell lymphomagenesis in adults. A large-scale survey across > 70 countries disclosed a link between CMV and B-cell neoplasms. Our evidence hints at an antagonistic effect of chronic CMV infection against B-lymphoproliferation.