bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adjuvant therapy for HER2 positive pT1a-b pN0 breast cancer
Authors: Yang Xuan , Qu Chong Xiao 
Published: June 2022

Abstract
Deciding if patients with small (≤1 cm), node-negative, human epidermal growth factor receptor 2 (HER2) positive breast cancer should receive adjuvant systemic therapy remains a challenge. No randomized clinical trials have examined the efficacy of trastuzumab in this setting. This prospective observational study aimed to investigate the choice of adjuvant systemic therapy in clinical practice in China.
We prospectively collected data from patients with HER-2 positive breast cancer (less than 1 cm and node negative) patients who underwent breast cancer surgery at Shanxi Provincial People's Hospital Breast Center from January 1, 2017 to December 31, 2019, and retrospectively investigated the association between baseline clinicopathological features and treatment strategy, cardiotoxicity, and disease outcome.
Of 168 eligible patients, 102 (60.7%) received adjuvant systemic therapy with trastuzumab (AST+T), 47 (28%) received adjuvant systemic therapy without trastuzumab (AST) and 19 (11.3%) did not receive adjuvant systemic therapy. Multivariate logistic regression analysis demonstrated that age, tumor size and hormone receptor status were significantly associated with treatment choice. Three-year invasive disease-free survival probability was 100%, 97.9% and 89.5% with AST+T, AST, and no therapy, respectively (P < .001).
The majority of patients (60.7%) with pT1a-b pN0 HER2 positive breast cancer received adjuvant systemic therapy with trastuzumab, whereas only 11.3% did not receive any adjuvant systemic therapy. Tumor size, age and hormone receptor status influenced treatment choice. The 3-year invasive disease-free survival probability was significantly higher for patients who received adjuvant systemic therapy with trastuzumab compared with those who did not receive adjuvant systemic therapy. Cardiac adverse events were rare.
Associations of health-related quality of life with depression and stigma in MERS-CoV survivors during the recovery period
Authors: Ahn So-Hyun , Kim Jeong Lan , Lee So Hee , Park Hye Yoon , Lee Jung Jae , Lee Haewoo 
Published: June 2022

Abstract
We explored factors related to health-related quality of life (HRQOL), including psychiatric symptoms and stigma related to Middle East respiratory syndrome coronavirus (MERS-CoV) infection, among MERS-CoV survivors during the recovery period.
Sixty-three MERS-COV survivors were recruited from five hospitals for a cohort study, one year after their infection in 2015. The subjects’ demographic information and medical conditions associated with MERS-CoV were recorded. HRQOL was evaluated using the Short Form-8 Health Survey (SF-8). Depression, post-traumatic stress symptoms, chronic fatigue, and perceived stigma were assessed using several questionnaires
The mean physical component summary (PCS) and mean mental component summary (MCS) of the SF-8 score were below 50 T (43.47 ± 9.60, 45.74 ± 10.18). Depression, chronic fatigue, posttraumatic stress symptoms and stigma were negatively correlated with the SF-8 PCS and MCS. Multivariate logistic regression analysis showed that the PCS was associated with stigma (OR 8.66, 95% CI 1.96–38.23), whereas MCS was associated with depression (OR 26.62, 95% CI 3.56–198.85).
The estimated HRQOL of MERS-CoV survivors during recovery was poor and appeared to be associated with depression and MERS-related stigma.
Physiological exophoria did not increase the incidence of myopia in rural school children in Taiwan
Authors: Hsu Jui-Hung , Lai Li-Ju , Tung Tao-Hsin , Hsu Wei-Hsiu 
Published: June 2022

Abstract
This study evaluated the incidence rate and risk factors for developing myopia in elementary school students in Chiayi, Taiwan. This prospective cohort study comprised 1816 students without myopia (grades 1 to 5 in Chiayi County). The students underwent a noncycloplegic ocular alignment examinations using an autorefractometer and completed a questionnaires at baseline and at a 1-year follow-up. A univariate logistic regression was used to assess the effects of the categorical variables on new cases of myopia. A multinomial logistic regression was then conducted. A chi-squared test was used to compare new cases of myopia in terms of ocular alignment. A Cox hazard ratio model was then used to validate factors associated with changes in ocular alignment. A P value of <.05 was considered significant. In 370 participants with new cases of myopia out of 1816 participants, a spherical error of −1.51 ± 0.6 diopters was noted at follow-up. The baseline ocular alignment was not a significant risk factor for developing myopia (exophoria vs orthophoria: OR 1.26, 95% CI 0.97–1.62; other vs. orthophoria: OR 1.15, 95% CI 0.73–1.82). However, new cases of myopia (HR 1.36, 95% CI 1.14–1.61), and baseline ocular alignment (exophoria vs orthophoria: HR 3.76, 95% CI 3.20–4.42; other vs orthophoria: HR 3.02, 95% CI 2.05–4.45) were associated with exophoria at follow-up. This study provided epidemiological data on the incidence of myopia in elementary school students in Chiayi, Taiwan. It also demonstrated that physiological exophoria does not predispose patients to developing myopia.
Clinical significance of HEp-2 cell cytoplasmic patterns in anti-neutrophil cytoplasmic antibody associated vasculitis
Authors: Zhang Naidan , Ji Chaixia , Bao Xiao , Yuan Chengliang 
Published: June 2022

Abstract
The study was to investigate the clinical characteristics and significance of antinuclear antibody (ANA) cytoplasmic patterns in ANCA-associated vasculitis (AAV) from Southwest China.
A retrospective study including 232 AAV patients from Peoples Hospital of Deyang City was performed. These included 115 patients with ANA cytoplasmic pattern as observation group and 117 patients without ANA cytoplasmic pattern as control group.
Chest involvement (60.00 vs 46.15, P = .035), cardiovascular involvement (5.21 vs 29.91, P < .001), and renal involvement (37.39 vs 77.78, P = .001) were different between groups.
Total protein (69.55 vs 64.01, P < .001), triglyceride (1.41 vs 1.18, P = .023), mean cell volume (89.76 vs 87.59, P = .040), and estimated glomerular filtration rate (76.67 vs 50.87, P = .035) were higher in ANA cytoplasmic patterns group. Creatinine (73.00 vs 117.50, P = .011), white blood cell (6.93 vs 8.86, P = .001), platelet (196.0 vs 239.0, P = .017), anti-myeloperoxidase (2.44 vs 3.42, P = .042), and anti-proteinase 3 (1.00 vs 4.93, P = .007) were lower in this group. In multivariate analysis, creatinine (odds ratio [OR] = 1.21, 95% confidence interval [CI]: 1.06–1.38), triglyceride (OR = 1.97, 95% CI: 1.10–3.48), and anti-myeloperoxidase (OR = 1.64, 95% CI: 1.37–1.95) were independent risk factors of AAV renal involvement. Total protein (OR = .95, 95% CI: 0.91–0.99) was an independent protective factor of AAV renal involvement. Chi-square test showed that speckled pattern was different among anti-neutrophil cytoplasmic antibody patterns (χ
2 = 18.526, P < .001).
In summary, HEp-2 cell cytoplasmic patterns have certain clinical significance in AAV, which is a new exploration of the clinical value of ANA.
Retrospective analysis of hepatic perivascular epithelioid cell tumour (PEComa) in a single centre for clinical diagnosis and treatment clinical diagnosis and treatment of hepatic PEComa
Authors: Yang Xiao , Wang Qingyuan , Zhou Xiao , Zhou Haoming , Jia Wenbo , Hu Chunyang , Chu Jian , Kong Lianbao 
Published: June 2022

Abstract
Our primary objective was to investigate the clinical features, diagnosis, treatment and prognosis of hepatic perivascular epithelioid cell tumour (PEComa).
Thirty-five cases of pathologically proven hepatic PEComa that were treated in the Department of Hepatobiliary Centre of the First Affiliated Hospital of Nanjing Medical University from January 2008 to February 2019 were retrospectively analysed, and the literature was also reviewed.
Twenty-nine females and 6 males were included in this study. The mean age of these patients was 48.0 years (range, 21–75 years). Thirteen patients complained of upper abdominal pain or discomfort, while others were accidentally discovered by imaging examination. Hepatic PEComas tended to occur in the right lobe of the liver (20 cases in the right lobe, 13 in the left lobe and 2 in the caudate lobe). Two cases were characterized by multiple tumours, and the remaining cases were single lesions (range, 1.2–12 cm). Only 8 cases were correctly diagnosed by the preoperative imaging examination, and the correct diagnosis rate was only 22.9%. The postoperative immunohistochemistry analysis showed that hepatic PEComas are positive for human melanoma black 45, Melan-A and smooth muscle actin, with the exception of 1 case that was negative for Melan-A. All patients undergoing an operation accepted regular follow-up, and the average time was 66.5 months (range, 3–132 months). Two patients who experienced tumour recurrence and 1 patient who died of cardiovascular disease, but the remaining patients showed no evidence of tumour recurrence or metastasis during the follow-up period.
Hepatic PEComas are a rare type of tumours that mainly occur in young and middle-aged women. The lack of clinical manifestations and imaging findings increases the difficulty of determining a preoperative diagnosis, which mainly depends on the results of pathological examinations. Surgery is currently the only effective treatment, and long-term clinical follow-up is necessary due to the aggressive behaviour and relapse of hepatic PEComa in some patients.
Segmented linear correlations between bone scan index and prostate cancer biomarkers, alkaline phosphatase, and prostate specific antigen in patients with a Gleason score ≥7
Authors: Ebrahim Tasmeera , Hadebe Bawinile , Aldous Colleen , Tinarwo Partson , Nyakale Nozipho 
Published: June 2022

Abstract
Technetium-99m methyl diphosphonate bone scintigraphy is relatively easily accessible for detecting bone metastases in prostate cancer patients. However, it is subjective and can be challenging to compare images taken at different time points. The bone scan index (BSI) is a more objective evaluation and allows for better comparison of images. Its correlation with other biomarkers of prostate cancer metastases such as prostate specific antigen (PSA) and alkaline phosphatase (ALP) is not clearly understood. This study thus aimed to compare the BSI correlation to PSA against that of BSI to ALP levels in patients with a Gleason score ≥7.
A retrospective analysis of the medical records of 50 prostate cancer patients with a Gleason score of ≥7 referred for a bone scan between January 1, 2015 and December 31, 2018 was undertaken. Bone scans were interpreted visually, and using a semi-automated computer programme to quantify the BSI and its relation to PSA and ALP measurements.
For the metastasis positive measurements, there was a statistically significant moderate positive overall linear correlation between BSI and PSA. For ALP and BSI, there were 2 segmented strong positive linear relationships between them. The first segment consisted of ALP < 375 IU/L and BSI >10%, where ALP and BSI were strongly and positively correlated. The other segment tended to have generally low BSI measurements (<10%) and also had a strong and positive correlation.
The BSI was found to be better linearly correlated with ALP than PSA.
Long-term outcomes after different treatments for gastric cancer with synchronous liver metastasis
Authors: Li Minghui , Yang Bin 
Published: June 2022

Abstract

Background:
The treatment of gastric cancer (GC) with synchronous liver metastasis is still controversial. This systematic review and network meta-analysis was designed to evaluate the long-term outcomes after different treatments of GC with synchronous liver metastasis.

Methods:
Several electronic databases were searched to identify eligible studies updated on May 1, 2021. Studies assessing the overall survival (OS) after different treatments (including chemotherapy, interventional therapy, surgical therapy alone and adjunctive therapy after surgery) of GC with synchronous liver metastasis were included. Odds ratios with 95% confidence interval (CI) were calculated for survival variables.

Results:
A total of 15 studies including 4312 patients were included in this network meta-analysis. Adjunctive therapy after surgery performed better than surgery therapy alone (hazard ratio [HR] = 1.23, 95% credible interval [CrI]: 0.69–2.17), chemotherapy (HR = 1.18, 95%CrI: 0.71–1.95), and interventional therapy in terms of 1-year OS (HR = 2.03, 95%CrI: 1.22–3.37). In terms of 3-OS, adjunctive therapy after surgery showed better efficacy than surgery therapy alone (HR = 1.48, 95%CrI: 0.40–5.47), chemotherapy (HR = 1.27, 95%CrI: 0.37–4.35), and interventional therapy (HR = 3.16, 95%CrI: 0.73–13.63). For 5-OS, adjunctive therapy after surgery was superior to surgery therapy alone (HR = 1.74, 95%CrI: 0.08–37.76), chemotherapy (HR = 1.44, 95%CrI: 0.66–3.14), and interventional therapy (HR = 1.46, 95%CrI: 0.06–34.36). There were no statistical inconsistency and small-study effect existed in our network meta-analysis for 1-year, 3-year, or 5-year OS. Cluster ranking analysis performed with surface under the cumulative ranking showed adjuvant therapies after surgery (99.9, 96.7, 90.2) ranking higher than surgery therapy alone, chemotherapy, and interventional therapy for 1-year, 3-year, 5-year OS.

Conclusion:
The OS of adjuvant therapy after surgery was better than that of surgery therapy alone, chemotherapy, and interventional therapy. Adjuvant therapy after surgery is the most recommended therapy for people with GC with synchronous liver metastasis.
ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease
Authors: Mearin Maria Luisa , Agardh Daniel , Antunes Henedina , Al-toma Abdul , Auricchio Renata , Castillejo Gemma , Catassi Carlo , Ciacci Carolina , Discepolo Valentina , Dolinsek Jernej , Donat Ester , Gillett Peter , Guandalini Steffano , Husby, MD, DMSc Steffen , Koletzko, MD Sibylle , Koltai Tunde , Korponay-Szabó Ilma Rita , Kurppa Kalle , Lionetti Elena , Mårild Karl , Martinez Ojinaga Eva , Meijer Caroline , Monachesi Chiara , Polanco Isabel , Popp Alina , Roca Maria , Rodriguez-Herrera Alfonso , Shamir Raanan , Stordal Ketil , Troncone Riccardo , Valitutti Francesco , Vreugdenhil Anita , Wessels Margreet , Whiting Penny ,   on behalf of the ESPGHAN Special Interest Group on Celiac Disease
Published: June 2022

There is a need for consensus on the recommendations for follow-up of children and adolescents with celiac disease.

Objectives:
To gather the current evidence and to offer recommendations for follow-up and management.

Methods:
The Special Interest Group on Celiac Diseases of the European Society of Paediatric Gastroenterology Hepatology and Nutrition formulated ten questions considered to be essential for follow-up care. A literature search (January 2010–March 2020) was performed in PubMed or Medline. Relevant publications were identified and potentially eligible studies were assessed. Statements and recommendations were developed and discussed by all coauthors. Recommendations were voted upon: joint agreement was set as at least 85%.

Results:
Publications (n = 2775) were identified and 164 were included. Using evidence or expert opinion, 37 recommendations were formulated on: The need to perform follow-up, its frequency and what should be assessed, how to assess adherence to the gluten-free diet, when to expect catch-up growth, how to treat anemia, how to approach persistent high serum levels of antibodies against tissue-transglutaminase, the indication to perform biopsies, assessment of quality of life, management of children with unclear diagnosis for which a gluten-challenge is indicated, children with associated type 1 diabetes or IgA deficiency, cases of potential celiac disease, which professionals should perform follow-up, how to improve the communication to patients and their parents/caregivers and transition from pediatric to adult health care.

Conclusions:
We offer recommendations to improve follow-up of children and adolescents with celiac disease and highlight gaps that should be investigated to further improve management.
SARS-CoV-2 Infection in Pediatric Solid Organ Transplant Recipients: A Single Center Observation
Authors: Paul Saikat , Royal Scott , Lee Margaret , Shin Stephanie , Chahine Joeffrey , Rozeboom Aaron , Ahn Jaeil , Dhani Harmeet , Yazigi Nada , Kaufman Stuart , Khan Khalid , Matsumoto Cal , Kroemer Alexander , Fishbein Thomas , Ekong Udeme D. 
Published: June 2022

Objectives:
This is a descriptive study to characterize rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pediatric solid organ transplant (SOT) recipients during the early days of the pandemic. We hypothesized that asymptomatic infection may represent a large proportion of SARS-CoV-2 infection in pediatric SOT recipients.

Methods:
We queried Organ Transplant Tracking Record (OTTR) for all pediatric SOT recipients followed at our center and reviewed medical records to identify patients tested for SARS-CoV-2 between March 15, 2020 and June 30, 2021. Patients were tested by polymerase chain reaction (PCR): prior to planned procedures or because of symptoms; OR: tested by measurement of IgG to spike protein with their routine labs q 2-monthly. A positive PCR was called acute infection. A positive IgG with negative PCR was called convalescence. For immunologic studies, blood was obtained when the PCR or IgG was positive. Statistical comparisons were made between (1) acute infection versus convalescence; (2) acute infection versus SOT recipients without infection (called healthy controls); (3) liver transplant (LT) versus small bowel (SB)/multivisceral transplant (MVT); (4) positive versus negative test result.

Results:
Of 257 LT recipients, 99 were tested: 6 were PCR positive, 13 were antibody positive. Of 150 SB/MVT recipients, 55 were tested: 4 were PCR positive, 6 were antibody positive. Of 8 simultaneous liver, kidney transplant recipients, 3 were tested: 1 was PCR positive. Symptoms when present were mostly mild. Patients with a positive test result were younger (6.3 vs 10.0 years; P = 0.017). We observed a rapid decline in viral load within 96 hours without a change in immunosuppression. Antibody lasted >8 months beyond the time it was monitored. Acute infection was associated with increased CD4 and CD8 TEM cell frequency (P = 0.04, P = 0.03, respectively), decreased interferon (IFN)-γ production from T-cells (2.8% vs 11.3%; P = 0.006), and decreased CD8 TEMRA frequency (4.56% vs 11.70%; P = 0.006).

Conclusions:
Early in the pandemic, COVID-19 disease was mostly mild in pediatric SOT recipients with no rejection, patient death, or graft loss observed.
Adipose-derived stem cell-enriched lipotransfer reverses skin sclerosis by suppressing dermal inflammation
Authors: Jiang Wenqing , Wang Jing , Lin Jiayan , Jiang Shenglu , Quan Yuping , Liao Yunjun , Gao Jianhua , Cai Junrong 
Published: June 2022

Background:
Scleroderma is a chronic autoimmune disease with an incidence of 2.7 per 100,000 people. Traditional lipotransfer has been used to treat atrophic sclerotic skin. Enzymatically processed cell-assisted lipotransfer (CAL) and mechanically processed stromal vascular fraction gel (SVF-gel) are fat products with abundant adipose-derived stem cells (ASCs). The present study aimed to assess whether ASC-enriched lipotransfer elicits superior therapeutic effects on scleroderma.

Methods:
Scleroderma was induced in nude mice by injections of bleomycin for 4 weeks. Human-derived Coleman fat (CF), CAL, or SVF-gel (0.1 mL) was injected into sclerotic lesions. Histologic examinations, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL), and expression analyses of inflammatory factors in skin lesions and transferred fat were performed at 4 weeks post-implantation.

Results:
Dermal thickness was lower in the CF- (339.0 ± 19.66 µm), CAL- (271.0 ± 16.15 µm), and SVF-gel- (197.8 ± 12.99 µm) injected groups than in the phosphate-buffered saline-injected group (493.3 ± 28.13 µm) (P<0.05). The numbers of TUNEL+ and Mac2+ cells in fat tissue were significantly higher in the CF-injected group than in the SVF-gel- and CAL-injected groups. Expression of monocyte chemotactic protein-1 and interleukin-6 was significantly lower in the ASC-enriched groups than in the CF group. Histologic analysis showed there were far fewer macrophages and myofibroblasts in skin lesions in the ASC-enriched groups than in the CF group.

Conclusion:
Transplantation of SVF-gel and CAL, which contain abundant ASCs, reduces the levels of apoptotic cells and inflammation, significantly reverses skin sclerosis, and elicits superior anti-inflammatory and anti-fibrotic effects on scleroderma.
Malignant Gastrointestinal Neuroectodermal Tumor: A New Kid on the Block?
Authors: Morani Ajaykumar C. , Ramani Nisha S. , Yedururi Sireesha , Prasad Srinivasa R. 
Published: June 2022

Abstract
Also referred to as “osteoclast-rich, clear cell sarcoma–like tumor of the gastrointestinal tract (CCSLGT),” malignant gastrointestinal neuroectodermal tumor is a newly described, rare, aggressive sarcoma that commonly arises in the small bowel, stomach, and colon. Histogenesis is likely from an autonomous nervous system–related primitive cell of neural crest origin. The hallmark genetic finding of EWS-CREB1 or EWS-ATF1 fusion transcripts clinches the diagnosis. Annular constrictive lesions tend to be smaller, show homogenous contrast enhancement on computed tomography, and may present with bowel obstruction. Larger, expansile masses tend to be exophytic and show heterogeneous contrast enhancement. Surgical resection is the mainstay of treatment. Frequent recurrences, metastases, and death from disease in 75% of patients portend a poor prognosis. Targeted chemotherapy based on specific tumor pathways is being developed.
Frontofacial Reconstruction Technique Modification With Preservation of Blood Supply to the Monobloc Segment
Authors: King Brody , Veith Jacob , Kim Erinn , Kestle John , Siddiqi Faizi , Gociman Barbu 
Published: June 2022

Abstract:
Craniosynostosis syndromes, including Apert Syndrome, Pfeiffer Syndrome, and Crouzon Syndrome, share similar phenotypes, including bicoronal craniosynostosis, midface hypoplasia, hypertelorism, and exorbitism. The standard surgical treatment for these craniofacial abnormalities is monobloc osteotomy with distraction osteogenesis. Complications of this technique include the failure of osteogenesis or resorption of the frontal bone. The authors propose an alternative surgical technique with a frontal arch in continuity with the midface segment to ensure vascularization to anterior and posterior borders of distraction. A case report of an 8-year-old female patient with Apert Syndrome is reported using our technique. Our frontal arch monobloc distraction procedure preserves blood supply to a cranial component of the monobloc segment site that becomes the anterior portion of distraction rather than with the traditional devascularized frontal bone flap. This technique modification should improve osteogenesis outcomes by preventing resorption or failure of bone formation.