bluuebunny/crossref_metadata_2025_split huggingface dataset:
The efficacy and safety of conventional transcatheter arterial chemoembolization combined with PD-1 inhibitor and anti-angiogenesis tyrosine kinase inhibitor treatment for patients with unresectable hepatocellular carcinoma: a real-world comparative study
Authors: Guo Zheng , Zhu Huabin , Zhang Xiufang , Huang Li , Wang Xiangcai , Shi Huaqiu , Yu Li , Qiu Yingwei , Tu Fuping 
Published: September 2022

AimWe sought to evaluate the efficacy and safety of conventional transcatheter arterial chemoembolization (cTACE) sequentially combined with systemic treatment by programmed cell death protein 1 (PD-1) inhibitor and anti-angiogenesis tyrosine kinase inhibitor (Anti-angiogenesis TKI) in patients with unresectable hepatocellular carcinoma (HCC).Materials and methodsOne hundred and forty-seven advanced HCC patients who received PD-1 inhibitors and TKIs as first-line systemic treatment between August 2019 and April 2021 were collected retrospectively. Fifty-four patients were finally included and divided into cTACE and no-cTACE groups, according to whether cTACE treatment was performed within 8 weeks before systemic treatment. The tumor objective response ratio (ORR), progression-free survival (PFS), overall survival (OS), and adverse events (AEs) were compared between the groups. Significant factors affecting PFS and OS were determined by Cox regression.ResultsThirty-one patients received cTACE followed by systemic treatment and 23 patients received systemic treatment only. The ORRs of the cTACE group were 48.4% (after two cycles of systemic treatment) and 51.6% (after four cycles of systemic treatment), while those of the no-cTACE group were only 17.4% and 21.7%. cTACE patients also had a longer median PFS (11.70 vs. 4.00 months, P = 0.031) and median OS (19.80 vs. 11.6 months, P = 0.006) than no-cTACE patients. Regression analyses indicated that cTACE therapy and Eastern Cooperative Oncology Group performance status were independent risk factors for PFS and OS. AEs by type were similar between the cTACE and no-cTACE groups, except for liver function injury, which was more common among cTACE patients. Fourteen patients suffered with grade 1-2 of rash in 21 patients with objective response, while only 10 patients suffered with rash in 33 patients without objective response, the adjusted hazard ratio (HR) was 4.382 (1.297–14.803).ConclusionsThe combination of cTACE and PD-1 inhibitors and anti-angiogenesis TKIs as therapy significantly improved markers of treatment efficacy, including ORR, PFS, and OS, in unresectable HCC patients, while no more serious AEs recorded in this population compared to those receiving systemic treatment alone. Skin rash might be a predict factor to the efficacy of PD-1 inhibitors and TKI treatment.
Relationship between metastasis and second primary cancers in women with breast cancer
Authors: Li Chaofan , Liu Mengjie , Li Jia , Zhao Xixi , Wang Yusheng , Chen Xi , Wang Weiwei , Sun Shiyu , Feng Cong , Cai Yifan , Wu Fei , Du Chong , Zhang Yinbin , Zhang Shuqun , Qu Jingkun 
Published: September 2022

BackgroundBreast cancer (BC) survivors have an increased risk of developing second primary cancers (SPCs); however, it is still unclear if metastasis is a risk factor for developing SPCs. Usually, long-term cancer survivors face an increased risk of developing SPCs; however, less attention has been paid to SPCs in patients with metastatic cancer as the survival outcomes of the patients are greatly reduced.MethodsA total of 17,077 American women diagnosed with breast cancer between 2010 and 2018 were identified from Surveillance, Epidemiology, and End Results (SEER) database and were included in the study. The clinical characteristics, standardized incidence ratio (SIR), standardized mortality ratio (SMR), and patterns of SPCs in BC patients with no metastasis, regional lymph node metastasis, and distant metastasis were investigated. Kaplan-Meier method was used to compare the prognosis of BC patients after developing SPCs with different metastatic status. XGBoost, a high-precision machine learning algorithm, was used to create a prediction model to estimate the prognosis of metastatic breast cancer (MBC) patients with SPCs.ResultsThe results reveal that the SIR (1.01; 95% CI, 0.99–1.03, p&gt;0.05) of SPCs in non-metastasis breast cancer (NMBC) patients was similar to the general population. Further, patients with regional lymph node metastasis showed an 8% increased risk of SPCs (SIR=1.08, 95%CI, 1.05–1.11, p&lt;0.05), and patients with distant metastasis had a 26% increased risk of SPCs (SIR=1.26, 95%CI, 1.16–1.37, p&lt;0.05). The SIR of SPCs in all patients below the age of 40 was the highest, which decreased with age. Patients with poorly differentiated cancers, large tumor size, and late N stage had an increased risk of SPCs. However, an increase in SIR of SPCs was observed in distant MBC patients, even at the early T1 (SIR=1.60, 95% CI, 1.22–1.98, p&lt;0.05) and N1 (SIR=1.27, 95% CI, 1.10–1.44, p&lt;0.05) stage. An increase in the SIR of SPCs was observed in patients with triple-negative BC, and the SIR of SPC increased with metastasis development in BC patients with luminal A subtype. The peak of SPCs risk occurrence was earlier in MBC patients (4-6 months and 10 months) compared to NMBC patients (12 months). The effect of metastasis on the prognosis of SPCs patients was dependent on the type of SPCs. Meanwhile, the XGBoost model was created to predict the 3-year (AUC=0.873) and 5-year survival (AUC=0.918) of SPCs in MBC patients.ConclusionsOur study provides novel insight into the impact of metastasis on SPCs in BC patients. Metastasis could promote the second primary tumorigenesis which further increased cancer-related deaths. Therefore, more attention should be paid to the occurrence of SPCs in MBC patients.
MiR-21 and let-7 cooperation in the regulation of lung cancer
Authors: Bai Jinquan , Shi Zhenzhou , Wang Shuting , Pan Hong , Zhang Tong 
Published: September 2022

BackgroundLung cancer occurs and develops as a result of a complicated process involving numerous genes; therefore, single-gene regulation has a limited therapeutic effect. We discovered that miR-21 expression was high in lung cancer tissues and cells, whereas let-7 expression was low, and it is unclear whether their combined regulation would be superior to therapy involving single regulation. The goal of our research was to investigate this situation and the regulatory mechanism that exists between these genes.MethodsTo regulate the levels of miR-21 and let-7 in these two types of lung cancer cells, we transfected miRNA mimics or inhibitors into A549 and H460 cells. Lung cancer cells were tested for proliferation, apoptosis, migration, and invasion. The results were verified using a Western blot and a qRT-PCR assay. Bioinformatics was used to investigate their potential regulatory pathways, and luciferase assays were used to confirm the binding sites.ResultsThe expression of miR-21 was increased and that of let-7 was decreased in lung cancer tissues and cells compared with paracancerous tissues and normal lung cells (p &lt; 0.01). Tumor cells were inhibited by downregulation of miR-21 and upregulation of let-7, and cooperative regulation showed a better effect. Upregulation of miR-21 and downregulation of let-7 promoted tumor cells, and this tumor-promoting effect was amplified by cooperative regulation. MiR-21 regulated lung cancer cells directly via the Wnt/-catenin pathway, and let-7 exerted its effects via the PLAG1/GDH1 pathway. MiR-21 and let-7 cooperated to regulate lung cancer cells via the K-ras pathway.ConclusionsThe effect of cooperative regulation of miR-21 and let-7 on lung cancer is greater than that of a single miRNA. MiR-21 and let-7 are important differentially expressed genes in lung cancer that are regulated by the K-ras pathway. As a result, for multigene lung cancer, the cooperative regulation of two miRNAs will provide a new target and direction for lung cancer treatment in the future.
The worldwide impact of COVID-19 on cancer care: A meta-analysis of surveys published after the first wave of the pandemic
Authors: Di Cosimo Serena , Susca Nicola , Apolone Giovanni , Silvestris Nicola , Racanelli Vito 
Published: September 2022

BackgroundThe rapid and global spread of COVID-19 posed a massive challenge to healthcare systems, which came across the need to provide high-intensity assistance to thousands of patients suffering from SARS-CoV-2 infection while assuring continuous care for all other diseases. This has been of particular importance in the oncology field. This study explores how oncology centers responded to the pandemic at a single center level by assessing surveys addressing different aspects of cancer care after the pandemic outbreak.MethodsWe performed a systematic review and meta-analysis of the cancer care surveys published until December 11th, 2020. Data were analyzed according to three main areas of interest, namely health care organization, including cancellation/delay and/or modification of scheduled treatments, cancellation/delay of outpatient visits, and reduction of overall cancer care activities; routine use of preventive measures, such as personal protective equipment (PPE) by both patients and health care workers, and systematic SARS-CoV-2 screening by nasopharyngeal swabs; and implementation of telemedicine through remote consultations.FindingsFifty surveys reporting data on 9150 providers from 121 countries on 5 continents were included. Cancellation/delay of treatment occurred in 58% of centers; delay of outpatient visits in 75%; changes in treatment plans in 65%; and a general reduction in clinical activity in 58%. Routine use of PPE by patients and healthcare personnel was reported by 81% and 80% of centers, respectively; systematic SARS-CoV-2 screening by nasopharyngeal swabs was reported by only 41% of centers. Virtual visits were implemented by the majority (72%) of centers.InterpretationThese results describe the negative impact of COVID-19 on cancer care, the rapid response of cancer centers in terms of preventive measures and alternative treatment approaches such as telemedicine, and confirm that surveys can provide the valuable, low-cost and immediate information that critical situations require.
Transcranial versus direct electrical stimulation for intraoperative motor-evoked potential monitoring: Prognostic value comparison in asleep brain tumor surgery
Authors: Viganò Luca , Callipo Vincenzo , Lamperti Marta , Rossi Marco , Conti Nibali Marco , Sciortino Tommaso , Gay Lorenzo , Puglisi Guglielmo , Leonetti Antonella , Cerri Gabriella , Bello Lorenzo 
Published: September 2022

ObjectiveSafe resection of gliomas involving motor pathways in asleep-anesthesia requires the combination of brain mapping, to identify and spare essential motor sites, and continuous monitoring of motor-evoked potentials (MEPs), to detect possible vascular damage to the corticospinal tract (CST). MEP monitoring, according to intraoperative neurophysiology societies, is generally recommended by transcranial electrodes (TES), and no clear indications of direct cortical stimulation (DCS) or the preferential use of one of the two techniques based on the clinical context is available. The main aim of the study was to identify the best technique(s) based on different clinical conditions, evaluating the efficacy and prognostic value of both methodologies.MethodsA retrospective series of patients with tumors involving the motor pathways who underwent surgical resection with the aid of brain mapping and combined MEP monitoring via TES and DCS was evaluated. Irreversible MEP amplitude reduction (&gt;50% compared to baseline) was used as an intraoperative warning and correlated to the postoperative motor outcome. Selectivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were computed for both techniques.ResultsFour hundred sixty-two patients were retrospectively analyzed, and only 1.9% showed a long-term motor impairment. Both TES and DCS obtained high specificity and NPV for the acute and 1-month motor deficit. Sensitivity was rather low for the acute deficit but excellent considering the 1-month follow-up for both techniques. DCS was extremely reliable in predicting a postoperative motor decline (PPV of 100% and 90% for acute and long-term deficit, respectively). Conversely, TES produced a high number of false-positive results, especially for long-term deficits (65, 87.8% of all warnings) therefore obtaining poor PPV values (18% and 12% for acute and 1-month deficits, respectively). TES false-positive results were significantly associated with parietal tumors and lateral patient positioning.ConclusionsData support the use of mapping and combined monitoring via TES and DCS. The sole TES monitoring is reliable in most procedures but not in parietal tumors or those requiring lateral positioning. Although no indications are available in international guidelines, DCS should be recommended, particularly for cases approached by a lateral position.
Supporting the diagnosis of infantile colic by a point of care measurement of fecal calprotectin
Authors: Sommermeyer Henning , Bernatek Malgorzata , Pszczola Marcin , Krauss Hanna , Piatek Jacek 
Published: September 2022

BackgroundInfantile colic (IC) is a condition characterized by extensive crying which affects about 20% of all infants during their first months of life. Most pediatricians diagnose IC only based on their clinical experience.AimInvestigating if a measurement of fecal calprotectin can support the diagnosis of IC.MethodsThe crying behavior of newborns was assessed using the Wessel's criteria. Fecal calprotectin levels were measured in non-colicky and colicky babies using a standard test that can be used at the time and place of patient care (point of care (PoC) measurement).ResultsColicky babies were found to have significantly elevated fecal calprotectin levels. Calprotectin levels were not influenced by gender, type of feeding, gestation age or birth weight. However, significantly elevated fecal calprotectin levels were found in cesarean section born babies. Fecal calprotectin ≥100 μg/g correlated with a colicky status of an infant while those &lt;100 μg/g indicated a non-colicky status the error margin was 11.2 and 13.2%, respectively. Combining data of fecal calprotectin with information about the type of delivery made it possible to determine the colicky status in vaginally-born infants with fecal calprotectin ≥100 μg/g with an accuracy of 97.8%. As elevated fecal calprotectin levels in cesarean-born infants can be caused by IC, but also by the disturbed gut microbiota commonly found in these babies, the accuracy of diagnosing the colicky status of a cesarean-born infant with calprotectin levels ≥100 μg/g was less accurate (accuracy rate of 76.5%).ConclusionData from the study suggest that measuring fecal calprotectin should be considered by pediatricians to support the diagnosis of IC.The study was registered at ClinicalTrials.gov under NCT04666324.
Pharmacists’ experiences on adverse drug reaction: 10 years later
Authors: Karuppannan Mahmathi , Mohamad Rizal Nur Azzrin Nisha , Wong Kok-Thong , Mohd. Ali Salmiah , Ting Kang-Nee , Boardman Helen 
Published: September 2022

Adverse drug reaction (ADR) is one of the leading public health concerns associated with high mortality rate. Healthcare professionals, particularly pharmacists, have a significant role in monitoring and preventing ADRs. This study was conducted on Malaysian Pharmaceutical Society (MPS) pharmacists who worked at the hospitals, health clinics, and community pharmacies to determine if pharmacists’ experiences on ADRs are still the same 10 years later. In 2010, a postal survey and in 2020, an online survey were conducted among these pharmacists. A total of 472 pharmacists and 208 participated in 2010 and 2020, respectively. About 82% and 90% of hospital/health clinic pharmacists (HCPs) observed an ADR over the last 6 months in 2010 and 2020, while 60% and 100% community pharmacists in 2010 and 2020 observed an ADR, respectively. Perindopril was the top drug (HCPs: p = 0.657; CPs: p = 0.98), and rash was the top ADR reported by the pharmacists in both years (HCPs: p &lt; 0.001; CPs: p = 0.679). The most common actions taken by HCPs in 2010 were to report the ADR (p = 0.343), while in 2020, most HCPs explained to patients regarding the reaction (p = 0.061), which was also the same in the CP group in 2020 (p = 0.958). The top factor encouraging ADR reporting in both years and both pharmacist groups was the high degree of severity of the reaction (HCPs: p &lt; 0.001; CPs: p = 0.769). While the top factors discouraging ADR reporting were a lack of information from the affected patients (HCPs: p = 0.2; CPs: p = 0.656), reaction is widely known (HCPs: p = 0.001; CPs: p = 0.144) and uncertainty of the causal relationship (HCPs: p = 0.169; CPs: p = 0.609). Majority of the pharmacists agreed that severe reactions should be reported (HCPs: p = 0.158; CPs: p = 0.501) and the main aim for reporting is to measure the incidence of ADRs (HCPs: p = 0.148; CPs: p = 0.762). Despite being able to identify ADRs during the daily practice, many pharmacists especially community pharmacists are not reporting them. There is a misconception on the purpose of reporting ADRs. An interventional program and ADR reporting training would be a useful step in improving ADR reporting practice.
Chinese herbal medicine for the treatment of chronic fatigue syndrome: A systematic review and meta-analysis
Authors: Zhang Yang , Jin Fangfang , Wei Xing , Jin Qiuyu , Xie Jingri , Pan Yujia , Shen Wenjuan 
Published: September 2022

Objectives: This meta-analysis aimed to assess the effectiveness and safety of Chinese herbal medicine (CHM) in treating chronic fatigue syndrome (CFS).Methods: Nine electronic databases were searched from inception to May 2022. Two reviewers screened studies, extracted the data, and assessed the risk of bias independently. The meta-analysis was performed using the Stata 12.0 software.Results: Eighty-four RCTs that explored the efficacy of 69 kinds of Chinese herbal formulas with various dosage forms (decoction, granule, oral liquid, pill, ointment, capsule, and herbal porridge), involving 6,944 participants were identified. This meta-analysis showed that the application of CHM for CFS can decrease Fatigue Scale scores (WMD: –1.77; 95%CI: –1.96 to –1.57; p &lt; 0.001), Fatigue Assessment Instrument scores (WMD: –15.75; 95%CI: –26.89 to –4.61; p &lt; 0.01), Self-Rating Scale of mental state scores (WMD: –9.72; 95%CI:–12.26 to –7.18; p &lt; 0.001), Self-Rating Anxiety Scale scores (WMD: –7.07; 95%CI: –9.96 to –4.19; p &lt; 0.001), Self-Rating Depression Scale scores (WMD: –5.45; 95%CI: –6.82 to –4.08; p &lt; 0.001), and clinical symptom scores (WMD: –5.37; 95%CI: –6.13 to –4.60; p &lt; 0.001) and improve IGA (WMD: 0.30; 95%CI: 0.20–0.41; p &lt; 0.001), IGG (WMD: 1.74; 95%CI: 0.87–2.62; p &lt; 0.001), IGM (WMD: 0.21; 95%CI: 0.14–0.29; p &lt; 0.001), and the effective rate (RR = 1.41; 95%CI: 1.33–1.49; p &lt; 0.001). However, natural killer cell levels did not change significantly. The included studies did not report any serious adverse events. In addition, the methodology quality of the included RCTs was generally not high.Conclusion: Our study showed that CHM seems to be effective and safe in the treatment of CFS. However, given the poor quality of reports from these studies, the results should be interpreted cautiously. More international multi-centered, double-blinded, well-designed, randomized controlled trials are needed in future research.Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022319680], identifier [CRD42022319680].
Clinical outcomes of gemcitabine-loaded callispheres drug-eluting beads for patients with advanced and inoperable lung cancer: A case series study
Authors: Bi Yonghua , Zhang Bo , Ren Jianzhuang , Han Xinwei , Wu Wenze 
Published: September 2022

Aim: Drug-eluting beads transarterial chemoembolization (DEB-TACE) has not been widely used in patients with advanced and inoperable lung cancer. We aimed to report the preliminary outcomes of DEB-TACE with gemcitabine-loaded CalliSpheres beads for patients with advanced and inoperable lung cancer.Methods: From November 2017 to October 2021, 37 patients (29 males, mean age 64.7 ± 10.3 years) with advanced and inoperable lung cancer underwent DEB-TACE with gemcitabine-loaded CalliSpheres beads. The primary endpoint was overall response rate, and the secondary endpoints were overall survival and progression-free survival.Results: A total of 54 sessions of DEB-TACE were performed in 37 patients, with a technique success rate of 100%. Fourteen patients received a second session of DEB-TACE. The mean follow-up time was 18.7 ± 11.9 months. After 1, 3, and 6 months, overall response rate and disease control rate were 27.8% and 91.7%, 25.8% and 74.2%, 32.1%, and 67.9%, respectively. The median progression-free survival was 8.8 months (95% CI 7.5, 12.5 months). The 3-, 6- and 12- month progression-free survival rates were 67.1%, 57.0%, and 30.1%, respectively. The median overall survival was 10.0 months (95% CI 4.5, 13.1 months). The 3-, 6-, and 12- month overall survival rates were 88.5%, 72.7%, and 40.9%, respectively. Minor complications were observed in 14 patients (37.8%), with no procedure-related deaths or severe adverse events.Conclusion: DEB-TACE with gemcitabine-loaded CalliSpheres beads is a safe, feasible and effective treatment strategy for patients with advanced and inoperable lung cancer.
Left atrial appendage occlusion in ventricular assist device patients to decrease thromboembolic events: A computer simulation study
Authors: Ghodrati-Misek Mojgan , Schlöglhofer Thomas , Gross Christoph , Maurer Alexander , Zimpfer Daniel , Beitzke Dietrich , Zonta Francesco , Moscato Francesco , Schima Heinrich , Aigner Philipp 
Published: September 2022

Atrial fibrillation (AF) is a common comorbidity in left ventricular assist device (LVAD) patients and has been identified as a risk factor for thromboembolic stroke. Blood stagnation within the left atrial appendage (LAA) is considered a possible major source of thrombosis and clinical studies have shown reduced thromboembolic risk after LAA occlusion (LAAO). Therefore, this study aims to investigate the effect of LAAO on thrombosis-related parameters using patient-specific simulations. Left ventricular and left atrial geometries of an LVAD patient were obtained from computed tomography and combined with hemodynamic data with either sinus rhythm (SR) or AF generated by a lumped parameter model. In four simulations applying contractile walls, stagnation volume and blood residence times were evaluated with or without AF and with or without LAAO. Reduced atrial contraction in AF resulted in unfavorable flow dynamics within the left atrium. The average atrial velocity was lower for the AF simulation when compared to SR, resulting in a 55% increase in the atrial stagnation volume (from 4.2 to 6.5 cm3). Moreover, blood remained in the LAA for more than 8 cardiac cycles. After LAAO the atrial stagnation decreased from 4.2 to 1.4 cm3 for SR and from 6.5 to 2.3 cm3 for the AF simulation. A significant stagnation volume was found in the LAA for both SR and AF, with larger values occurring with AF. These regions are known as potential sources for thrombus formation and can be diminished by LAAO. This significantly improved the thrombus-related flow parameters and may also lower the risk of thromboembolic events from the appendage.