bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of Adjuvant Radiotherapy Timing on Survival Outcomes in High-Risk Patients Receiving Neoadjuvant Treatments
Authors: Cao Lu , Xu Cheng , Wang Meng-Di , Qi Wei-Xiang , Cai Gang , Cai Rong , Wang Shu-Bei , Ou Dan , Li Min , Shen Kun-Wei , Chen Jia-Yi 
Published: July 2022

PurposeTo determine the relationship between time to radiotherapy (TTR) and survival outcomes in breast cancer (BC) patients treated with neoadjuvant treatments (NATs).MethodsContinuous non-metastatic BC patients receiving NAT and adjuvant radiotherapy (RT) from 2009 to 2016 were retrospectively reviewed. A multivariable Cox model with restricted cubic splines (RCSs) was used to determine the panoramic relationship between TTR and survival outcomes. Multivariable analysis was used to control for confounding factors between the groups of TTR.ResultsA total of 315 patients were included. The RCS modeling demonstrated a non-linear relationship between TTR and survival outcomes. The lowest risk for distant metastasis-free survival (DMFS) and recurrence-free survival (RFS) was observed at the TTR of 12 weeks, and the lowest risk of BC-specific survival (BCSS) at 10 weeks. TTR was accordingly transformed into categorical variables as ≤10, 11–20, and &gt;20 weeks. Multivariable analysis revealed that the TTR of ≤10 weeks was an independent prognostic factor for worse DMFS (HR = 2.294, 95% CI 1.079–4.881) and RFS (HR = 2.126, 95% CI 1.038–4.356) compared with the TTR of 10–20 weeks, while the is no difference in DMFS, RFS, and BCSS between TTR &gt;20 weeks and TTR of 10–20 weeks.ConclusionThere exists a non-linear relationship between TTR after surgery and survival outcomes in patients treated with NAT. Early initiation of RT following surgery does not seem to be associated with a better therapeutic outcome. A relatively flexible recommendation of TTR could be adopted in clinical practice.
Prediction of clinically significant prostate cancer with a multimodal MRI-based radiomics nomogram
Authors: Jing Guodong , Xing Pengyi , Li Zhihui , Ma Xiaolu , Lu Haidi , Shao Chengwei , Lu Yong , Lu Jianping , Shen Fu 
Published: July 2022

ObjectiveTo develop and validate a multimodal MRI-based radiomics nomogram for predicting clinically significant prostate cancer (CS-PCa).MethodsPatients who underwent radical prostatectomy with pre-biopsy prostate MRI in three different centers were assessed retrospectively. Totally 141 and 60 cases were included in the training and test sets in cohort 1, respectively. Then, 66 and 122 cases were enrolled in cohorts 2 and 3, as external validation sets 1 and 2, respectively. Two different manual segmentation methods were established, including lesion segmentation and whole prostate segmentation on T2WI and DWI scans, respectively. Radiomics features were obtained from the different segmentation methods and selected to construct a radiomics signature. The final nomogram was employed for assessing CS-PCa, combining radiomics signature and PI-RADS. Diagnostic performance was determined by receiver operating characteristic (ROC) curve analysis, net reclassification improvement (NRI) and decision curve analysis (DCA).ResultsTen features associated with CS-PCa were selected from the model integrating whole prostate (T2WI) + lesion (DWI) for radiomics signature development. The nomogram that combined the radiomics signature with PI-RADS outperformed the subjective evaluation alone according to ROC analysis in all datasets (all p&lt;0.05). NRI and DCA confirmed that the developed nomogram had an improved performance in predicting CS-PCa.ConclusionsThe established nomogram combining a biparametric MRI-based radiomics signature and PI-RADS could be utilized for noninvasive and accurate prediction of CS-PCa.
Immune Checkpoint Inhibitors in the Treatment of Patients With Cancer and Preexisting Psoriasis: A Systematic Review and Meta-Analysis of Observational Studies
Authors: Yu Yixuan , Zhou Yang , Zhang Xu , Tan Kexin , Zheng Jiabin , Li Jia , Cui Huijuan 
Published: July 2022

BackgroundImmunotherapies represented by immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment. A large part of the population has both cancer and psoriasis but is usually excluded from ICI clinical trials because of the dysregulated activation of the immune system. This is the first study to evaluate the safety and efficacy of ICI therapy in patients with cancer and preexisting psoriasis.MethodsPubMed, EMBASE, Cochrane, and MEDLINE databases were searched from inception through February 2022. Observational studies on patients with cancer and confirmed psoriasis before ICI initiation were included. Outcomes included the incidence of psoriasis flares, de novo immune-related adverse events (irAEs), discontinuation rate due to flare/de novo irAEs, and efficacy of ICI therapy. Clinical manifestations, management, and outcomes for adverse events (AEs) were systematically reviewed. All pooled analyses were based on a random-effects model using Stata software. Meta-regression and subgroup analyses were performed to identify sources of heterogeneity.ResultsTwelve studies involving 191 patients were included. The pooled incidence of psoriasis flares was 45.0% (95% CI: 31.1%-58.9%, I2 = 71.7%) and 44.9% (95% CI: 29.0%–60.7%, I2 = 71.8%) for de novo irAEs. The tumor type, psoriasis subtype, ICI class, and country were the main sources of heterogeneity. Grade 3–4 flares occurred in 10.8% (95% CI: 5.3%–16.3%) of patients, and about 16.6% (95% CI: 10.7%–22.5%) of patients experienced grade 3–4 de novo irAEs. The estimated incidence of ICI discontinuation due to AE was 18.5% (95% CI: 6.1%–30.8%, I2 = 68.7%). The median times to develop flare and de novo irAEs were 44 and 63 days, respectively. Endocrinopathies and colitis were the most common de novo irAEs. Conventional therapy is effective for most AEs. The estimated objective response rate (ORR) of ICIs was 38.1% (95% CI: 11.8%–64.3%, I2 = 81.7%), and the disease control rate (DCR) was 64.5% (95% CI: 55.3%–73.8%, I2 = 0).ConclusionsThe flare of patients with cancer and preexisting psoriasis treated with ICI therapy is frequent, but the incidence of de novo irAEs and the efficacy of ICI therapy are comparable to those of the general population. Most AEs are mild and manageable with conventional therapy, which required discontinuation of ICI therapy in 18.5%.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022320646
Photodynamic Effects of Thuja occidentalis on Lung Cancer Cells
Authors: Loonat Ayesha , Chandran Rahul , Pellow Janice , Abrahamse Heidi 
Published: July 2022

The global incidence and mortality rates resulting from lung cancer encapsulate a need to identify more effective treatment protocols. Photodynamic therapy (PDT) and homeopathy offer possible anticancer therapies as part of a multi-disciplinary approach. Studies have identified the anticancer effects of Thuja occidentalis L. plant extracts. The aim of this study was to investigate the effects of Thuja occidentalis (TO) homeopathic mother tincture and TO mediated PDT (TO-PDT) on A549 lung cancer cells. Commercially available A549 cells were pre-treated with TO, or laser irradiation at 660 nm, or the combined treatment (TO-PDT). Cells were analyzed morphologically by inverted light microscopy and Hoechst stain; and biochemically by lactate dehydrogenase (LDH), adenosine triphosphate (ATP), and trypan blue assays. Cells treated with TO and TO-PDT demonstrated morphological changes in the cell and cell nuclei indicative of cell death. These groups exhibited a dose dependent increase in LDH release and a decrease in ATP levels and cell viability indicating its cytotoxic and antiproliferative potential. Furthermore, at the same doses, TO when photoactivated in PDT induced enhanced anticancer responses thereby surpassing the effects of treatment with the tincture alone. Results demonstrate how the direct cytotoxic effects of TO can be improved when administered as a photosensitizer in PDT to promote cancer cell death.
Study on Proteomics-Based Aortic Dissection Molecular Markers Using iTRAQ Combined With Label Free Techniques
Authors: Deng Ting , Liu Yongguang , Gael Akindavyi , Fu Xiaohua , Deng Xiaofang , Liu Yunfeng , Wu Yizhang , Wu Yingzhi , Wang Huimin , Deng Yuying , Lai Jun , Fu Qiang 
Published: July 2022

Background: Aortic dissection refers to the separation of aortic media and extension along the long axis to form the true and false chambers of the aortic wall. 65–70% of the patients died of cardiac tamponade, arrhythmia, dissection rupture, etc. At present, echocardiography, computed tomography angiography (CTA), etc. are the main diagnosis tools for aortic dissection. To date, there is no rapid serum molecular marker that can be used for differential diagnosis and risk assessment.Objectives: To screen serum molecular markers systematically amid aortic dissection and acute coronary syndrome and to preliminarily identify the pathogenesis of acute aortic dissection.Methods: Related disputes cases of all hospitals were statistically analyzed for the AAD medical disputes ratio, early death ratio and misdiagnosis ratio from the database of Guangdong Province Medical Disputes Coordination Committee from 2013 to 2017. Serum and Aortic tissues samples were respectively quantified by iTRAQ and label-free analysis, further validated by ELISA and protein verified by immunofluorescence and Western blot from AAD and control patients enrolled from the Zhujiang Hospital of Southern Medical University and Guangdong Province people's Hospital from 2016 to 2018.Results: AAD cases ratio accounted for 15.29% in all 150 cardiovascular disputes, 59.26% in all cardiovascular death less than 24 h, and 88.89% in the patients who remained undiagnosed at the time of death, 84 proteins (66 and 18 upregulated and downregulated, respectively) were identified by iTRAQ and 16 proteins (9 and 7 upregulated and downregulated, respectively) by Label-free. Nine proteins (Lumican, FGL1, PI16, MMP9, FBN1, MMP2, VWF, MMRN1, and PF4) related to the pathogenesis of aortic dissection were identified by David /Ease and String techniques as candidate biomarkers for verification test. Four proteins (Lumican, FGL1, PI16, and MMP9) were found to be statistically different after ELISA verification. The expression of FGL1, PI16, and MMP9 proteins was pathologically significantly increased except for Lumican. Histologically, TGF-β1, α-SMA, and Collagen1 were also significantly higher in the aortic group.Conclusion: Lumican, FGL1, PI16, and MMP9 may be potential biomarkers in AAD patients, and the Lumican-mediated TGF-β1 pathway is likely to be involved in the pathogenesis of aortic dissection.
Self-organized criticality as a framework for consciousness: A review study
Authors: Walter Nike , Hinterberger Thilo 
Published: July 2022

ObjectiveNo current model of consciousness is univocally accepted on either theoretical or empirical grounds, and the need for a solid unifying framework is evident. Special attention has been given to the premise that self-organized criticality (SOC) is a fundamental property of neural system. SOC provides a competitive model to describe the physical mechanisms underlying spontaneous brain activity, and thus, critical dynamics were proposed as general gauges of information processing representing a strong candidate for a surrogate measure of consciousness. As SOC could be a neurodynamical framework, which may be able to bring together existing theories and experimental evidence, the purpose of this work was to provide a comprehensive overview of progress of research on SOC in association with consciousness.MethodsA comprehensive search of publications on consciousness and SOC published between 1998 and 2021 was conducted. The Web of Science database was searched, and annual number of publications and citations, type of articles, and applied methods were determined.ResultsA total of 71 publications were identified. The annual number of citations steadily increased over the years. Original articles comprised 50.7% and reviews/theoretical articles 43.6%. Sixteen studies reported on human data and in seven studies data were recorded in animals. Computational models were utilized inn = 12 studies. EcoG data were assessed inn = 4 articles, fMRI inn = 4 studies, and EEG/MEG inn = 10 studies. Notably, different analytical tools were applied in the EEG/MEG studies to assess a surrogate measure of criticality such as the detrended fluctuation analysis, the pair correlation function, parameters from the neuronal avalanche analysis and the spectral exponent.ConclusionRecent studies pointed out agreements of critical dynamics with the current most influencing theories in the field of consciousness research, the global workspace theory and the integrated information theory. Thus, the framework of SOC as a neurodynamical parameter for consciousness seems promising. However, identified experimental work was small in numbers, and a heterogeneity of applied analytical tools as a surrogate measure of criticality was observable, which limits the generalizability of findings.
Addressing Filicide in Ghana: Linking Cultural Understanding With the Law Against Filicide. Does the Law Work?
Authors: Abdullah Alhassan , Frederico Margarita , Mensah Felix , Bentum Hajara , Wang Yihang , Asare Jennifer Litela 
Published: July 2022

IntroductionConsistent with international promulgation on the criminalization of filicide, Ghana’s Children’s Act 1998 (560) and the Criminal Justice Act criminalizes any form of torture against children. Yet, perpetrators of filicide in Ghana may go unpunished due to the beliefs in cultural norms that justify filicide acts. The cultural narratives of filicide can impede on the application and effectiveness of the laws of filicide.MethodThe study employed a vignette approach to explore the views of 19 adults, who were parents between 69 years of age and 30 years of age, in rural and urban Ghana on the laws of filicide in Ghana and filicide intervention measures. The interviewees were provided with narratives on two different vignettes (developed based on real life cases), followed by semi-structured questions to probe the narratives. The interviews were analyzed following Fraser’s narrative thematic analysis procedure.ResultsThe study identifies the association between cultural beliefs and the communities’ understanding of the concept of filicide. Though community members are aware of the criminalization of filicide acts, the majority of them were not informed about the laws against filicide in Ghana. Addressing filicide cases within the community was the most preferred option for the participants, as they believe that some children, termed “spirit children” (SC), deserve to be killed. Resorting to spiritual intervention from concoction men emerged as the normative pathway to obtain community approval for filicide. Police interventions were considered necessary in non-spiritual related filicides. Community members were only prepared to cooperate with the law in filicide cases if the filicide act has no connection with spirituality.ConclusionThe study adds to understanding of the concept of filicide outside western societies. The importance of intensive community campaigns against filicide acts, and norms that support filicide acts, has relevance for all counties.
The Working Alliance Inventory's Measurement Properties: A Systematic Review
Authors: Paap Davy , Karel Yasmaine H. J. M. , Verhagen Arianne P. , Dijkstra Pieter U. , Geertzen Jan H. B. , Pool Grieteke 
Published: July 2022

Measurement properties of the Working Alliance Inventory (WAI) and its various translations and adaptations for specific target groups have been investigated for over 30 years. No systematic review analyzing studies on measurement properties of the WAI has been conducted to date. COnsensus-based Standards for the selection of health Measurements INstruments (COSMIN) were developed for conducting high-quality systematic reviews on measurement properties in a transparent and standardized way. Aim of this study was to systematically review studies on measurement properties of the WAI, and its adapted versions, within psychotherapy, and other healthcare contexts using COSMIN criteria. PsycINFO, Medline, and EMBASE were searched (1989–2021). In all phases of the review procedure, study selection, data extraction, risk of bias assessment, rating of the quality of measurement properties, and rating of the quality of evidence for measurement properties, disagreement between reviewers was resolved by discussion. Results on validity, internal structure, reliability, construct validity, and responsiveness were analyzed. In total 66 studies were included. In most studies, evidence for measurement properties was according to COSMIN criteria, insufficient, lacking, or conflicting. Content validity was rated insufficient because neither patients nor healthcare professionals were involved in the development and validation process. Hence evidence for content validity of the WAI is unknown. Conflicting evidence was found for structural validity. Evidence for internal consistency could not be established. Limited evidence was found for inter-rater reliability and convergent validity. Conflicting evidence was also found for test-retest reliability and divergent validity. COSMIN criteria exposed persistent problems in validation studies of the WAI. These findings may indicate that measurement properties of the WAI are not up to current standards, or that COSMIN criteria may be less appropriate for assessing measurement properties of the WAI, or it could indicate both. The results of this systematic review suggest that WAI outcomes should be interpreted with caution and further research is needed regarding the content validity and hypotheses development. For the future, the theoretical framework underlying the measurement of the working alliance needs to be studied in psychotherapy and other health contexts, and tested in methodologically sound studies.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42019051428.
The role of leptin in indirectly mediating “somatic anxiety” symptoms in major depressive disorder
Authors: Zhu Yue , Wei Yange , Duan Jia , Li Jianing , Zhang Ran , Sun Jiaze , Wang Pengshuo , Liu Zhuang , Lv Jing , Wei Shengnan , Jiang Xiaowei , Wang Fei , Tang Yanqing 
Published: July 2022

BackgroundLeptin is a multifunctional hormone secreted from adipose tissue, which plays a core role in regulating energy intake and expenditure. Evidence has demonstrated that leptin receptors are located in brain areas involved in emotional processing, and major depressive disorder (MDD) is characterized by dysfunction of emotional processing. Taken together, these features suggest that leptin may play a potential role in the pathophysiology of MDD. However, the precise roles of leptin in modulating depressive symptoms in MDD remain unclear.MethodsParticipants [18 drug-naïve MDD patients, 15 unaffected first-degree relatives of MDD patients (FDR-MDD), and 40 healthy controls] completed clinical assessments and provided blood samples for measurement of leptin levels. We evaluated the effect of leptin on clinical status (MDD or FDR-MDD) and symptomatic dimensionalities of MDD using mediation analysis.ResultsWe found that leptin was increased in MDD patients and this only predicted “somatic anxiety” symptoms. Furthermore, leptin was a significant and indirect mediator of the association between clinical status (MDD or FDR-MDD) and “somatic anxiety” symptoms.ConclusionOur finding that leptin was a significant and indirect mediator of clinical status (MDD or FDR-MDD) and “somatic anxiety” symptoms suggests that leptin may indirectly affect somatic depressive symptoms in MDD. Our findings may provide a theoretical basis for novel clinical interventions in MDD.
Personality traits influence the effectiveness of hypomania checklist-32 in screening for bipolar disorder
Authors: Wang Qiang , Sui Aiping , Gong Lin , Chattun Mohammad Ridwan , Han Ruichen , Cao Qiuyun , Shen Diwen , Zhang Yuzhe , Zhao Peng 
Published: July 2022

BackgroundIt is clinically challenging to distinguish bipolar disorder (BD) from major depressive disorder (MDD) in the early stages. While the hypomania checklist-32 (HCL-32) is a proper auxiliary tool that is useful to differentiate between BD and MDD, there is currently no standard cut-off value. The variations in HCL-32 cut-off values could potentially be influenced by personality traits. Therefore, the aim of this study is to explore the effect of personality traits on the screening performance of HCL-32.MethodsIn this retrospective cross-sectional study, 168 patients with BD or MDD were evaluated with the Eysenck Personality Questionnaire (EPQ) and HCL-32. The associations between demographic data, diagnosis and clinical rating scales were analyzed.ResultsDiagnosis was not associated with extraversion but was related to neuroticism. HCL-32 scores in typical extraverted patients were higher in contrast to atypical extraverted patients. The best cut-off value for BD recognition of typical and atypical extraversion groups were 15 and 12.5, respectively. In patients with MDD, HCL-32 score of typical neuroticism was higher than the atypical type, but there was no difference in patients with BD. In typical neuroticism, there was no difference in HCL-32 scores between patients with MDD and BD. But among atypical neurotic patients, HCL-32 scores of BD were higher compared to MDD, with a cut-off value of 14.5.LimitationsThis study had a small sample size.ConclusionHCL-32 scores were affected by personality traits, with higher scores for typical extraversion and neuroticism. Clinicians should also consider the patients’ personality traits when referring to HCL-32 scores, so as to increase the recognition rate of BD and eliminate false positives.
Determinants of Double Burden of Malnutrition Among School Children and Adolescents in Urban Dhaka: A Multi-Level Analyses
Authors: Tariqujjaman Md. , Sheikh Sifat Parveen , Smith George , Hasan A. M. Rumayan , Khatun Fatema , Kabir Ashraful , Rashid Md. Harunor , Rasheed Sabrina 
Published: July 2022

BackgroundBangladesh faces a double burden of malnutrition, with a rising prevalence of overweight and obesity among children and adolescents parallel to existing undernutrition.ObjectiveThe current study was designed to assess the determinants of double burden of malnutrition among urban school children and adolescents from Dhaka, Bangladesh.MethodsA cross-sectional survey was conducted among 2,690 students from 14 schools in Dhaka city from January to June 2018. Anthropometric measurements were taken during school hours, and self-administered questionnaires were sent to the parents. We performed multi-level multiple logistic regression analyses to assess the determinants of underweight, overweight, and obesity.FindingsThe prevalence of overweight (33%) and obesity (23%) was highest among children and adolescents from high tuition schools but the prevalence of underweight (4%) was lowest compared to those from low (underweight 19%, overweight 17%, and obesity 6%) and medium (underweight 18%, overweight 15%, and obesity 6%) tuition schools. Children and adolescents from high-tuition schools had higher odds of being overweight/ obese (AOR: 2.92; 95% CI: 1.90, 4.49). Parental NCDs and overweight were negatively associated with underweight but positively associated with overweight and obesity among children and adolescents. Lack of physical activity inside schools was positively associated (AOR: 1.26; 95% CI: 1.02, 1.55) with overweight and obesity among school children and adolescents.ConclusionOur results point to opportunities in and outside schools to address the rising prevalence of underweight, overweight, and obesity among urban school children and adolescents.