bluuebunny/crossref_metadata_2025_split huggingface dataset:
Circulating tumor cell associated white blood cell cluster as a biomarker for metastasis and recurrence in hepatocellular carcinoma
Authors: Chen Jing , Luo Yuhong , Xi Xiaoxue , Li Haixia , Li Shufen , Zheng Lei , Yang Dinghua , Cai Zhen 
Published: November 2022

BackgroundRecently, an in vivo study demonstrated that circulating tumor cell-associated white blood cell (CTC-WBC) cluster possess much greater potential than single CTCs. We aim to explore the correlation between the CTC-WBC cluster and the clinicopathological characteristics of hepatocellular carcinoma (HCC) patients to seek novel biomarkers for HCC metastasis and recurrence.MethodsWe retrospectively analyzed 136 HCC patients from October 2014 to March 2020 who received CTC tests using the CanPatrol CTC enrichment technique. The correlation between the clinical features and total CTCs, EMT-CTCs, and CTC-WBC cluster were analyzed by a chi-square test. The ROC curves were simulated for evaluating the diagnostic performance of CTC parameters in HCC metastasis. Patients were followed up from February 2015 to November 2021, and the relapse-free survival (RFS) was analyzed using the Kaplan–Meier curve.ResultsA total of 93.4% (127/136) and 31.6% (43/136) of HCC patients had detectable CTCs and CTC-WBC clusters. Baseline CTC-WBC cluster was closely correlated with microvascular invasion, portal vein tumor thrombus, and extrahepatic metastasis in pre-treatment HCC patients (P &lt;0.05). The simulated ROC curves presented an AUC of 0.821 for the CTC-WBC cluster (sensitivity of 90.0% and specificity of 93.7%) in discriminating metastasis from non-metastatic HCC, which was higher than that for total CTCs (0.718) and EMT-CTCs (0.716). Further follow-up analysis showed that compared to the CTC-WBC cluster negative group (&lt;1/5 ml), patients in the CTC-WBC cluster positive group (≥1/5 ml) presented an increased relapse ratio (60.0% versus 17.9%) and shorter RFS (22.9 versus 53.8 months). Dynamic analysis of CTCs parameters showed that total CTC level, EMT-CTCs proportion, and CTC-WBC cluster were decreased after microwave ablation treatment, while CTC-WBC cluster increased on average 10 months in advance of imaging (MRI) diagnosed recurrence.ConclusionThe CTC-WBC cluster is a promising biomarker for the metastasis diagnosis and prognosis of HCC metastasis. Dynamic monitoring of the CTC-WBC cluster is an effective method for early detection and intervention of HCC recurrence and metastasis.
Ultrasound to guided epicutaneo-caval catheter insertion in newborn infants
Authors: Ren Xiao-Ling , Wang Man , Wei Yu-Ru , Liu Jing 
Published: November 2022

ObjectiveRecently, ultrasound (US) has been increasingly used for epicutaneo-caval catheter (ECC) tip positioning; however, the selection of blood vessels for ECC still depends on the operator’s subjective judgment. This study aimed to explore the value of US in decision-making regarding the great saphenous vein (GSV), tip navigation, and tip location of ECC.MethodsCatheterization through the GSV of the lower extremity was selected. The running condition of the GSV was assessed by using US, and the angle between the GSV and the femoral vein was observed and measured. We selected the GSV with a smaller angle to the femoral vein for ECC catheterization.ResultsECC catheterization under ultrasound guidance increased the success rate at the time of catheterization from 82.5% to 100% (increased by 17.5%) and shortened the catheterization time from 56.1 ± 5.30 min to 31.5 ± 2.58 min on average (shortened by 44%). The incidence rate of catheter-related complications decreased by 58.2% catheter days from 6.80/1,000 to 2.84/1,000.ConclusionECC insertion under the guidance of US has numerous advantages, including significantly improving the success rate of one-time catheterization, shortening the time of catheterization, and reducing catheter-related complications.
Tailoring second-line or above therapy for patients with advanced or metastatic gastric cancer: A multicenter real-world study
Authors: Nie Caiyun , Xu Weifeng , Lv Huifang , Gao Xiaohui , Li Guofeng , Chen Beibei , Wang Jianzheng , Liu Yingjun , Zhao Jing , He Yunduan , Wang Saiqi , Chen Xiaobing 
Published: November 2022

Background: There is currently still a lack of effective therapeutic manner after the failure of first-line therapy for patients with advanced or metastatic gastric cancer. The present study aimed to evaluate the clinical efficacy and safety of different treatment strategies as second-line or above therapy for patients with advanced or metastatic gastric cancer.Methods: This was an observational multicenter real-world study. From January 2018 to December 2020, advanced or metastatic gastric cancer patients who have failed prior therapy were enrolled and treated with chemotherapy, anti-angiogenic TKIs (tyrosine kinase inhibitors) + chemotherapy or TKIs + ICIs (immune checkpoint inhibitors). In this study, progression free survival (PFS) was the primary end-point. Other evaluation indicators were objective response rate (ORR), disease control rate (DCR), overall survival (OS) and drug toxicities.Results: 162 patients were enrolled, of which 61 patients received chemotherapy, 47 patients received TKIs plus chemotherapy, and 54 patients received TKIs + ICIs. No statistically significant difference existed in ORR among groups (16.4% vs. 19.1% vs. 18.5%, p = 0.924). Patients who received TKIs plus chemotherapy obtained better DCR compared with the chemotherapy group (78.7% vs. 54.1%, p = 0.008), and simultaneously, the median PFS (3.3 m vs. 2.8 m, p = 0.001) and OS (8.0 m vs. 5.8 m, p = 0.005) in TKIs plus chemotherapy group were superior to chemotherapy group. Consistent results were observed in subgroup analysis, including sex, age, ECOG, number of metastatic sites and treatment line. No statistically differences were found between TKIs + ICIs and the chemotherapy group concerning DCR (63.0% vs. 54.1%, p = 0.336), median PFS (3.0 m vs. 2.8 m, p = 0.051) and OS (5.2 m vs. 5.8 m, p = 0.260). Different treatment manner present a special spectrum of adverse events (AEs), and the incidence of Grade 3–4 AEs were 31.1%, 38.3% and 18.5%, respectively.Conclusion: Compared with chemotherapy, anti-angiogenic TKIs plus chemotherapy demonstrated superior second-line or above therapeutic efficacy for advanced or metastatic gastric cancer with well tolerated toxicity. However, TKIs + ICIs failed to demonstrate a clinical advantage over chemotherapy.
Identification of SNPs associated with methotrexate treatment outcomes in patients with early rheumatoid arthritis
Authors: Kolan Shrikant S. , Li Gaoyang , Grimolizzi Franco , Sexton Joe , Goll Guro , Kvien Tore K. , Sundlisæter Nina Paulshus , Zucknick Manuela , Lillegraven Siri , Haavardsholm Espen A. , Skålhegg Bjørn Steen 
Published: November 2022

Methotrexate is one of the cornerstones of rheumatoid arthritis (RA) therapy. Genetic factors or single nucleotide polymorphisms (SNPs) are responsible for 15%–30% of the variation in drug response. Identification of clinically effective SNP biomarkers for predicting methotrexate (MTX) sensitivity has been a challenge. The aim of this study was to explore the association between the disease related outcome of MTX treatment and 23 SNPs in 8 genes of the MTX pathway, as well as one pro-inflammatory related gene in RA patients naïve to MTX. Categorical outcomes such as Disease Activity Score (DAS)-based European Alliance of Associations for Rheumatology (EULAR) non-response at 4 months, The American College of Rheumatology and EULAR (ACR/EULAR) non-remission at 6 months, and failure to sustain MTX monotherapy from 12 to 24 months were assessed, together with continuous outcomes of disease activity, joint pain and fatigue. We found that the SNPs rs1801394 in the MTRR gene, rs408626 in DHFR gene, and rs2259571 in AIF-1 gene were significantly associated with disease activity relevant continuous outcomes. Additionally, SNP rs1801133 in the MTHFR gene was identified to be associated with improved fatigue. Moreover, associations with p values at uncorrected significance level were found in SNPs and different categorical outcomes: 1) rs1476413 in the MTHFR gene and rs3784864 in ABCC1 gene are associated with ACR/EULAR non-remission; 2) rs1801133 in the MTHFR gene is associated with EULAR response; 3) rs246240 in the ABCC1 gene, rs2259571 in the AIF-1 gene, rs2274808 in the SLC19A1 gene and rs1476413 in the MTHFR gene are associated with failure to MTX monotherapy after 12–24 months. The results suggest that SNPs in genes associated with MTX activity may be used to predict MTX relevant-clinical outcomes in patients with RA.
Case report: Personalized adapted motor activity in a COVID-19 patient complicated by critical illness polyneuropathy and myopathy
Authors: Crisafulli Oscar , Baroscelli Marta , Grattarola Luca , Tansini Giuseppe , Zampella Cristian , D’Antona Giuseppe 
Published: November 2022

Background: COVID-19 may require hospitalization in an intensive care unit (ICU) and is often associated with the onset of critical illness polyneuropathy (CIP) and critical illness myopathy (CIM). Due to the spread of the disease around the world, the identification of new rehabilitation strategies for patients facing this sequence of events is of increasing importance.Case presentation: We report the clinical presentation and the beneficial effects of a prolonged, supervised adapted motor activity (AMA) program in a highly deconditioned 61-year-old male COVID-19 patient discharged from the ICU and complicated by residual CIP and CIM. The program included aerobic, strength, gait, and balance training (1 h, 2 sessions per week).Measures: Pulmonary (spirometry), metabolic (indirect calorimetry and bioimpedance), and neuromuscular functions (electromyography) were evaluated at baseline and after 1 year of training.Results: Relative to baseline, an amelioration of several spirometric parameters such as vital capacity (VC, +40%), total lung capacity (TLC, +25%), and forced expiratory volume in 1 s (FEV1, +28%) was appreciable. Metabolic parameters such as body water (60%–46%), phase angle (3.6°–5.9°), and respiratory quotient (0.92–0.8) returned to the physiological range. Electromyographic parameters were substantially unchanged. The overall amelioration in clinical parameters resulted in a significant improvement of patient autonomy and the quality of life.Conclusion: Our results highlight the importance of AMA for counteracting respiratory, metabolic, and functional but not neuromuscular impairments in COVID-19 patients with residual CIM and CIP.
Cluster analysis for symptomatic management of Neisseria gonorrhoea and Chlamydia trachomatis in sexually transmitted infections related clinics in China
Authors: Ning Ning , Weng Rongxing , Zhang Chunlai , Wen Lizhang , Wang Honglin , Ye Jianbin , Li Jing , Chen Xiangsheng , Cai Yumao 
Published: November 2022

ObjectiveThis study aimed to perform a cluster analysis of symptoms linked with Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) and to identify which cluster of symptoms was associated with a higher risk of NG and CT.Study designFrom 15 April to 16 May 2018, a cross-sectional study was conducted, and patients attending sexually transmitted infections (STI) related clinics were recruited from 22 medical institutions in six districts of Shenzhen city.MethodsA structured questionnaire was used to collect social-demographic information as well as STI symptoms, and urine samples were collected for nucleic acid detection. Cluster analysis and logistic regression were applied.ResultsAmong 8,207 participants, the prevalence of CT and NG infection was 9.04% (742/8,207) and 2.36% (194/8,207), respectively. Among male outpatients, four clusters with distinct symptomatic patterns were identified. Unmarried, having casual sexual partners in the past 6 months, cluster 2 (OR = 6.70, 95% CI = 3.36–13.35) and cluster 4 (OR = 24.53, 95% CI = 12.96–46.44) were risk factors associated with NG infection. Unmarried, cluster 2 (OR = 2.54, 95% CI = 1.83–3.53) and cluster 4 (OR = 3.31, 95% CI = 2.37–4.61) were risk factors associated with CT infection. Among female outpatients, five clusters with distinct symptomatic patterns were identified. Aged 24 years or below and cluster 3 (OR = 3.68, 95% CI = 1.61–8.39) were risk factors associated with NG infection. Aged 24 years or below, unmarried, having a high school/secondary technical school education, and having junior high school or below education were risk factors associated with CT infection.ConclusionThe cluster of symptoms integrated into risk assessment for CT and NG infections suggests a new strategy of symptomatic management. Healthcare providers in STI clinics and resource-limited places may use this strategy to identify more potential patients and deliver adequate, acceptable, and equitable STI care for outpatients with a high risk of STI.
Relationship between family functioning and self-transcendence in patients with breast cancer: A network analysis
Authors: He Chunyan , Yang Tianqi , He Yang , Guo Sijin , Lin Yawei , Wu Chao , Gao Li , Liu Xufeng , Wu Shengjun , Cao Baohua 
Published: November 2022

BackgroundFor patients with breast cancer, family functioning is an important factor affecting self-transcendence, which is a key source of happiness. However, network analysis studies of family functioning and self-transcendence are lacking, particularly among patients with breast cancer.PurposeThe present study investigated the network structure of family functioning and self-transcendence in patients with breast cancer and aimed to identify bridge items to provide some theoretical support for the improvement and intervention of self-transcendence in patients with breast cancer.MethodsA total of 294 patients with breast cancer were enrolled in our study. Self-transcendence was evaluated with the Self-Transcendence Scale. Family functioning was evaluated with the Family Adaptation, Participation, Growth, Affection, Resolution (APGAR) Scale. Network analyses were used for the statistical analysis.ResultsIn the network of family functioning and self-transcendence in patients with breast cancer, there were 22 edges across communities, of which the 5 strongest edges connected to the 5 dimensions of family functioning are “Adaptation” with “Enjoyment of hobbies”, “Participation” with “Life enjoyment”, “Growth” with “Acceptance of bodily changes”, “Affection” with “Life enjoyment”, “Resolution” with “Help acceptance”. “Adaptation” had the highest bridge expected influence value (0.30) in the family functioning community, while “Life enjoyment” had the highest bridge expected influence value (0.27) in the self-transcendence community.ConclusionComplex patterns of associations existed in the fine-grained relationship between family functioning and self-transcendence in patients with breast cancer. From the perspective of network analysis, the “Adaptation” aspect of family functioning and the “Life enjoyment” aspect of self-transcendence may be the best targets for improving self-transcendence. These results have important implications to clinical practice, which provided potential targets for interventions to improve self-transcendence from the perspective of family functioning.
Three leading suicide methods in the United States, 2017–2019: Associations with decedents' demographic and clinical characteristics
Authors: Choi Namkee G. , Marti C. Nathan , Choi Bryan Y. 
Published: November 2022

Background and aimsThe U.S. suicide data show that use of lethal methods, specifically firearms and hanging/suffocation, has been increasing among young and middle-aged adults of both sexes over the past decades. In this study, we examined demographic and clinical correlates of use of firearms, hanging/suffocation, and poisoning as suicide methods among suicide decedents age 18+.MethodsData came from the 2017-2019 National Violent Death Reporting System (NVDRS; N = 94,454, age ≥ 18 at the time of suicide; 74,042 men and 20,412 women). We fit generalized linear models (GLMs) for a Poisson distribution with a log link to examine (1) changes in four suicide methods (firearms, hanging/suffocation, poisoning, and other) during the study period, controlling for sex and age group; and (2) correlates of firearms, hanging/suffocation, and poisoning use.ResultsIn all age groups, 55% of men and 30% of women used firearms; 28% of men and 29% of women hanging/suffocation; 9% of men and 32% of women poisoning, and 8% of men and 9% of women “other” methods. Men age &lt; 45 had higher likelihood of firearm and/or hanging/suffocation use than those age 45–64. Women age&lt;45 also had higher likelihood of hanging/suffocation than those age 45–64. Prior suicide attempt history was associated with higher likelihood of poisoning in both sexes and hanging/suffocation in men; mental disorders/SUD were associated with higher likelihood of hanging/suffocation and poisoning in both sexes; physical health problems were associated with higher likelihood poisoning in both sexes and firearm use in men; relationship problems were associated with higher likelihood of firearm use; legal problems and job/financial/housing problems were associated with higher likelihood of hanging/suffocation in both sexes; and more crises were associated with higher likelihood of firearm use in both sexes.ImplicationsThe findings call for the following suicide prevention strategies: (1) restricted access to firearms; (2) improved access to mental health/substance use treatment; (3) improved long-term and palliative care services for those (mostly older adults) with physical health problems; (4) financial/housing support policies to mitigate economic hardship; and (5) more research to identify effective strategies to curtail the increasing use of firearm and hanging/suffocation among young and middle-aged adults.
Psychological Distress, Anxiety, Depression, and Associated Factors Among Nigerian Healthcare Workers During COVID-19 Pandemic: A Cross-Sectional Study
Authors: Ibigbami Olanrewaju Ibikunle , Akinsulore Adesanmi , Opakunle Tolu , Seun-Fadipe Champion , Oginni Olakunle Ayokunmi , Okorie Victor Ogbonnaya , Oloniniyi Ibidunni , Olibamoyo Olushola , Aloba Olutayo Olubunmi , Mapayi Boladale , Adewuya Abiodun 
Published: November 2022

Objectives: We determined the prevalence of psychological distress, and the associations between sociodemographic factors, anxiety, depression, COVID-19-related experiences, and psychological distress, among nurses and doctors in Nigeria.Methods: The study was a cross-sectional descriptive study, conducted over a month (1st of July–31st of July 2021) among 434 Health Care Workers (HCWs) [225 (51.8%) nurses and 209 (48.2%) doctors] from two tertiary health facilities in southwestern Nigeria. Binary logistic regression was carried out to determine the factors associated with psychological distress (dependent variable), while the independent variables were anxiety, depression, and COVID-19 experience-related factors.Results: The prevalence of moderate and severe psychological distress was 49.1% and 5.8%, respectively. Individuals who had the first degree had significantly lower odds (AOR: 0.43; p = 0.037) of experiencing psychological distress while being a nurse (AOR: 2.03; p = 0.014), higher levels of anxiety (1.28; p &lt; 0.001), and depression (AOR: 1.17; p = 0.005) were associated with significantly higher odds of experiencing moderate to severe levels of psychological distress.Conclusion: There is a high level of psychological distress experienced by these health workers. Hence, they will benefit from strategies to reduce their distress.
EDUKASI TENTANG KEKERASAN PADA ANAK MASA PANDEMI COVID -19 DI KELURAHAN METESEH KEC. TEMBALANG SEMARANG
Authors: Anggarawati Tuti , Astuti Yuni 
Published: November 2022

Tren penularan virus Covid-19 terus mengintai anak-anak di luar rumah. Selain Covid-19, kekerasan pun juga turut menyerang kesehatan mental anak-anak selama pandemi berlangsung. Selama pembelajaran online mulai dari prasekolah sampai perguruan tinggi, banyak orang tua mau menjadi orang tua yang bagus, tapi lepas kendali dalam memecahkan perilaku sang anak. Terutama jika mereka masih usia pra-sekolah dasar dan sekolah dasar. Agar anak terhindar dari kekerasan maka perlu upaya dari pemberdayaan masyarakat untuk terlibat secara aktif menurunkan angka kejadian kekerasan saat pandemic covid. Penguatan kapasitas keluarga menjadi suatu keniscayaan untuk diperhatikan utamanya fungsi keluarga dalam memberikan pendampingan terhadap anak selama pandemi. PKK sebagai garda depan dalam mengatasi berbagai persoalan yang terjadi di tengah masyarakat dan sebagai motor penggerak utama dalam mewujudkan keluarga yang bahagia, sejahtera, serta mandiri diberikan pendampingan melalui edukasi tentang kekerasan pada anak. Metode pendampingan ini dilakukan dengan ceramah dan diskusi dengn tetap memperhatikan protocol Kesehatan. Pendampingan ini dapat meningkatkan pengetahuan dan pemahaman keluarga sehingga keluarga mampu berfungsi dengan baik dan mampu menciptakan keluarga yang sejahtera. Sehingga harapannya, berbagai kasus kekerasan anak yang melibatkan orangtua akibat pandemi ini dapat diminimalisasi pada titik terendah. Kata Kunci : edukasi; kekerasan pada anak; pandemic EDUCATION REGARDING VIOLENCE AGAINST CHILDREN DURING THE COVID-19 PANDEMICIN METESEH SUB DISTRIC- TEMBALANG SEMARANG Abstract The trend of transmission of the Covid-19 virus continues to lurk children outside the home. Apart from Covid-19, violence has also affected children's mental health during the pandemic. During online learning from preschool to college, many parents want to be good parents, but lose control of their child's behavior. Especially if they are still of pre-primary and elementary school age. In order for children to avoid violence, efforts are needed from community empowerment to be actively involved in reducing the incidence of violence during the covid pandemic. Strengthening family capacity is a necessity to pay attention to, especially the function of the family in providing assistance to children during the pandemic. Family Welfare Develompemnt Program as the vanguard in overcoming various problems that occur in the community and as the main driving force in creating a happy, prosperous, and independent family is provided with assistance through education about violence against children. This mentoring method was carried out through lectures and discussions while still paying attention to the Health protocol. This assistance can increase the knowledge and understanding of the family to create a prosperous family. So it is hoped that various cases of child violence involving parents due to this pandemic can be minimized to the lowest point. Keywords: education; violence against children; pandemic