bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pretherapeutic Assessment of Pancreatic Cancer: Comparison of FDG PET/CT Plus Delayed PET/MR and Contrast-Enhanced CT/MR
Authors: Zhang Zaizhu , Zhou Nina , Guo Xiaoyi , Li Nan , Zhu Hua , Yang Zhi 
Published: January 2022

PurposeThis study aims to determine the diagnostic performance of whole-body FDG PET/CT plus delayed abdomen PET/MR imaging in the pretherapeutic assessment of pancreatic cancer in comparison with that of contrast-enhanced (CE)-CT/MR imaging.Materials and MethodsForty patients with pancreatic cancer underwent nonenhanced whole-body FDG PET/CT, delayed abdomen PET/MR imaging, and CE-CT/MR imaging. Two nuclear medicine physicians independently reviewed these images and discussed to reach a consensus, determining tumor resectability according to a 5-point scale, N stage (N0 or N positive), and M stage (M0 or M1). With use of clinical-surgical-pathologic findings as the reference standard, diagnostic performances of the two imaging sets were compared by using the McNemar test.ResultsThe diagnostic performance of FDG PET/CT plus delayed PET/MR imaging was not significantly different from that of CE-CT/MR imaging in the assessment of tumor resectability [area under the receiver operating characteristic curve: 0.927 vs. 0.925 (p = 0.975)], N stage (accuracy: 80% (16 of 20 patients) vs. 55% (11 of 20 patients), p = 0.125), and M stage (accuracy: 100% (40 of 40 patients) vs. 93% (37 of 40 patients), p = 0.250). Moreover, 14 of 40 patients had liver metastases. The number of liver metastases detected by CE-CT/MR imaging, PET/CT, and PET/MR imaging were 33, 18, and 61, respectively. Compared with CE-CT/MR imaging, PET/MR imaging resulted in additional findings of more liver metastases in 9/14 patients, of which 3 patients were upstaged. Compared with PET/CT, PET/MR imaging resulted in additional findings of more liver metastases in 12/14 patients, of which 6 patients were upstaged.ConclusionsAlthough FDG PET/CT plus delayed PET/MR imaging showed a diagnostic performance similar to that of CE-CT/MR imaging in the pretherapeutic assessment of the resectability and staging of pancreatic tumors, it still has potential as the more efficient and reasonable work-up approach for the additional value of metastatic information provided by delayed PET/MR imaging.
Apparent Diffusion Coefficient-Based Convolutional Neural Network Model Can Be Better Than Sole Diffusion-Weighted Magnetic Resonance Imaging to Improve the Differentiation of Invasive Breast Cancer From Breast Ductal Carcinoma In Situ
Authors: Yin Haolin , Jiang Yu , Xu Zihan , Huang Wenjun , Chen Tianwu , Lin Guangwu 
Published: January 2022

Background and PurposeBreast ductal carcinoma in situ (DCIS) has no metastatic potential, and has better clinical outcomes compared with invasive breast cancer (IBC). Convolutional neural networks (CNNs) can adaptively extract features and may achieve higher efficiency in apparent diffusion coefficient (ADC)-based tumor invasion assessment. This study aimed to determine the feasibility of constructing an ADC-based CNN model to discriminate DCIS from IBC.MethodsThe study retrospectively enrolled 700 patients with primary breast cancer between March 2006 and June 2019 from our hospital, and randomly selected 560 patients as the training and validation sets (ratio of 3 to 1), and 140 patients as the internal test set. An independent external test set of 102 patients during July 2019 and May 2021 from a different scanner of our hospital was selected as the primary cohort using the same criteria. In each set, the status of tumor invasion was confirmed by pathologic examination. The CNN model was constructed to discriminate DCIS from IBC using the training and validation sets. The CNN model was evaluated using the internal and external tests, and compared with the discriminating performance using the mean ADC. The area under the curve (AUC), sensitivity, specificity, and accuracy were calculated to evaluate the performance of the previous model.ResultsThe AUCs of the ADC-based CNN model using the internal and external test sets were larger than those of the mean ADC (AUC: 0.977 vs. 0.866, P = 0.001; and 0.926 vs. 0.845, P = 0.096, respectively). Regarding the internal test set and external test set, the ADC-based CNN model yielded sensitivities of 0.893 and 0.873, specificities of 0.929 and 0.894, and accuracies of 0.907 and 0.902, respectively. Regarding the two test sets, the mean ADC showed sensitivities of 0.845 and 0.818, specificities of 0.821 and 0.829, and accuracies of 0.836 and 0.824, respectively. Using the ADC-based CNN model, the prediction only takes approximately one second for a single lesion.ConclusionThe ADC-based CNN model can improve the differentiation of IBC from DCIS with higher accuracy and less time.
Cardiopulmonary Function Assessment in Children With Pulmonary Valve Stenosis
Authors: Teng Li Yun , Tsai Sen Wei , Hsiao Chun Yuan , Sung Wei Hung , Lin Ko Long 
Published: January 2022

ObjectivePulmonary valve (PV) stenosis affects cardiac pulmonary function and exercise performance. A cardiopulmonary exercise test (CPET) combined with a transthoracic echocardiogram (TTE) can measure exercise performance, disease progression, and treatment effects. We assessed the exercise capacity in children with PV stenosis by conducting CPET and TTE.MethodsFrom 2005 to 2021, 84 patients with PV stenosis aged 6–18 years were enrolled; 43 were treated with balloon pulmonary valvuloplasty (BPV) (Group A), and 41 received follow-up care (Group B), and their CPET and pulmonary function test results were compared with 84 healthy, matched individuals (Control). We also conducted TTE to compare the peak pulmonary artery pulse wave velocity and pulmonary valve (PV) area before and after catheterization and follow-up care.ResultsThere were no significant differences among the CPET parameters of the patient groups and controls in anaerobic metabolic equivalent (MET) (group A: 6.44 ± 0.58; group B: 6.28 ± 0.47, control: 6.92 ± 0.39, p = 0.110), peak MET (group A: 9.32 ± 0.74; group B: 9.13 ± 0.63; control: 9.80 ± 0.52, p = 0.263), and heart rate recovery (group A: 28.04 ± 4.70; group B: 26.44 ± 3.43, control:26.10 ± 2.42, p = 0.718). No significant differences were found in the pulmonary functions between the three groups. The pulmonary artery pulse wave velocity significantly decreased after catheterization (3.97 ± 1.50 vs. 1.95 ± 0.94, p &lt; 0.0001), but not after follow-up care (1.67 ± 0.77 vs. 1.75 ± 0.66, p = 0.129). The pulmonary vale area significantly improved in group A (0.89 ± 0.71 vs. 1.16 ± 0.58, p &lt; 0.0001), whereas only insignificant progression of PV stenosis was observed in group B (1.60 ± 0.64 vs. 1.57 ± 0.65, p = 0.110).ConclusionsPatients treated with BPV had a similar exercise capacity with that of patients under follow-up care and the healthy controls. Larger or multi-center studies should be conducted to confirm the physical fitness of pediatric patients with PV stenosis after management.
Neuroprotective Effect of Daidzein Extracted From Pueraria lobate Radix in a Stroke Model Via the Akt/mTOR/BDNF Channel
Authors: Zheng Meizhu , Zhou Mi , Chen Minghui , Lu Yao , Shi Dongfang , Wang Jing , Liu Chunming 
Published: January 2022

Daidzein is a plant isoflavonoid primarily isolated from Pueraria lobate Radix as the dry root of P. lobata (Wild.) Ohwi, have long been used as nutraceutical and medicinal herb in China. Despite the report that daidzein can prevent neuronal damage and improve outcome in experimental stroke, the mechanisms of this neuroprotective action have been not fully elucidated. The aim of this study was to determine whether the daidzein elicits beneficial actions in a stroke model, namely, cerebral ischemia/reperfusion (I/R) injury, and to reveal the underlying neuroprotective mechanisms associated with the regulation of Akt/mTOR/BDNF signal pathway. The results showed that I/R, daidzein treatment significantly improved neurological deficits, infarct volume, and brain edema at 20 and 30 mg/kg, respectively. Meanwhile, it was found out that the pretreatment with daidzein at 20 and 30 mg/kg evidently improved striatal dopamine and its metabolite levels. In addition, daidzein treatment reduced the cleaved Caspase-3 level but enhanced the phosphorylation of Akt, BAD and mTOR. Moreover, daidzein at 30 mg/kg treatment enhanced the expression of BDNF and CREB significantly. This protective effect of daidzein was ameliorated by inhibiting the PI3K/Akt/mTOR signaling pathway using LY294002. To sum up, our results demonstrated that daidzein could protect animals against ischemic damage through the regulation of the Akt/mTOR/BDNF channel, and the present study may facilitate the therapeutic research of stroke.
Data Sources for Drug Utilization Research in Brazil—DUR-BRA Study
Authors: Leal Lisiane Freitas , Osorio-de-Castro Claudia Garcia Serpa , Souza Luiz Júpiter Carneiro de , Ferre Felipe , Mota Daniel Marques , Ito Marcia , Elseviers Monique , Lima Elisangela da Costa , Zimmernan Ivan Ricardo , Fulone Izabela , Carvalho-Soares Monica Da Luz , Lopes Luciane Cruz 
Published: January 2022

Background: In Brazil, studies that map electronic healthcare databases in order to assess their suitability for use in pharmacoepidemiologic research are lacking. We aimed to identify, catalogue, and characterize Brazilian data sources for Drug Utilization Research (DUR).Methods: The present study is part of the project entitled, “Publicly Available Data Sources for Drug Utilization Research in Latin American (LatAm) Countries.” A network of Brazilian health experts was assembled to map secondary administrative data from healthcare organizations that might provide information related to medication use. A multi-phase approach including internet search of institutional government websites, traditional bibliographic databases, and experts’ input was used for mapping the data sources. The reviewers searched, screened and selected the data sources independently; disagreements were resolved by consensus. Data sources were grouped into the following categories: 1) automated databases; 2) Electronic Medical Records (EMR); 3) national surveys or datasets; 4) adverse event reporting systems; and 5) others. Each data source was characterized by accessibility, geographic granularity, setting, type of data (aggregate or individual-level), and years of coverage. We also searched for publications related to each data source.Results: A total of 62 data sources were identified and screened; 38 met the eligibility criteria for inclusion and were fully characterized. We grouped 23 (60%) as automated databases, four (11%) as adverse event reporting systems, four (11%) as EMRs, three (8%) as national surveys or datasets, and four (11%) as other types. Eighteen (47%) were classified as publicly and conveniently accessible online; providing information at national level. Most of them offered more than 5 years of comprehensive data coverage, and presented data at both the individual and aggregated levels. No information about population coverage was found. Drug coding is not uniform; each data source has its own coding system, depending on the purpose of the data. At least one scientific publication was found for each publicly available data source.Conclusions: There are several types of data sources for DUR in Brazil, but a uniform system for drug classification and data quality evaluation does not exist. The extent of population covered by year is unknown. Our comprehensive and structured inventory reveals a need for full characterization of these data sources.
Effects of the COVID-19 Pandemic on the Mental Health of Healthcare Providers: A Comparison of a Psychiatric Hospital and a General Hospital
Authors: Anzola Daniel , Limoges Jacqueline , McLean Jesse , Kolla Nathan J. 
Published: January 2022

Background:Before the COVID-19 pandemic, healthcare providers (HCPs) were already experiencing a higher prevalence of mental health disorders compared with non-healthcare professionals. Here, we report on the psychosocial functioning and stress resilience of HCPs who worked during the COVID-19 pandemic in a large-sized psychiatric facility and a large acute care hospital, both located in central Ontario, Canada.Methods:Participants completed five validated psychometric instruments assessing depression, anxiety, and stress (The Depression, Anxiety, and Stress Scale-21, DASS-21); work-related quality of life (Work-Related Quality of Life Scale, WRQoL); resilience (Connor-Davidson Resilience Scale, CD-RISC); anxiety about the novel coronavirus (Coronavirus Anxiety Scale, CAS); and loneliness (UCLA Loneliness Scale, ULS). Participants from the psychiatric hospital (n = 94) were sampled during the easing of restrictions after the first wave in Ontario, and participants from the acute care hospital (n = 146) were sampled during the height of the second wave in Ontario.Results:Data showed that HCPs from the acute care hospital and psychiatric hospital reported similar scores on the psychometric scales. There were also no significant differences in psychometric scale scores between medical disciplines at the acute care hospital. Among all HCPs, being a nurse predicted better quality of life (p = 0.01) and greater stress resilience (p = 0.031).Conclusion:These results suggest that HCPs' psychological symptoms are similar across the hospital settings sampled. Compared to other HCPs, nurses may show a unique resiliency to the pandemic. We suggest that emergencies such as the COVID-19 pandemic have a pervasive effect on HCPs. It is important to address HCPs' mental health needs in terms of crisis management and improve resilience among all HCPs during the inter-crisis period before a new challenge arrives.
Digital Media Exposure and Predictors for Screen Time in 12-Month-Old Children: A Cross-Sectional Analysis of Data From a German Birth Cohort
Authors: Durham Kira , Wethmar David , Brandstetter Susanne , Seelbach-Göbel Birgit , Apfelbacher Christian , Melter Michael , Kabesch Michael , Kerzel Sebastian ,   The KUNO Kids Study Group
Published: January 2022

Background: Early exposure to digital media may affect the physical and cognitive development in young children. The American Academy of Pediatrics and national guidelines recommend no digital media use at all under the age of 18 months. The aim of our study was to determine the actual exposure to digital media in 12-month-old infants and to reveal potential risk factors for screen time.Methods: In this prospective cross-sectional survey, data was collected from the KUNO Kids birth cohort study using parent-report questionnaires regarding the media exposure of the study child. We determined age at first contact with different digital media, mean screen time on an average weekday, and the influence of major demographic and socioeconomic factors.Results: Data for screen time analysis was available for 630 children. In summary, 45% of children had already been exposed to digital media by their first birthday. The most frequent first digital media exposure was the TV (33.0%) followed by smartphones (16.9%), both most commonly exposed to around the age of 8 months. On a regular weekday, 20% of the children spent 0.5–1 h in front of a TV and 9% were exposed to a smartphone for the same time frame, compared to 31% of joint parent-child media use. Predictors for screen time were having one sibling, less living space per person, and excessive TV use in the household, the latter of which doubled the chance of the child being exposed to digital media.Conclusion: A proportion of 10% of 1-year-old children were already regularly exposed to digital media. The TV remains the most predominant device but new media, particularly smartphones, might be catching up. Our study provides further support that family TV time is a major predictor of infant screen time. Pediatric recommendations should be re-evaluated in the light of the actual exposure to digital media already in infancy and parents should be proactively counseled regarding possible effects on child development.
Socioeconomic and Environmental Factors Associated With Increased Alcohol Purchase and Consumption in 38 Countries During the Covid-19 Pandemic
Authors: Kyaw Hla Zaheer , Ramalho Rodrigo , Teunissen Lauranna , Cuykx Isabelle , Decorte Paulien , Pabian Sara , Van Royen Kathleen , De Backer Charlotte , Gerritsen Sarah 
Published: January 2022

AimsTo explore changes in alcohol purchase and consumption during the first few months of the Covid-19 pandemic, and assess associations between increased alcohol purchase/use and socioeconomic and environmental factors.DesignSecondary data from a cross-sectional online survey conducted from 17 April to 25 June 2020.SettingThirty-eight countries from all continents of the world.ParticipantsA total of 37,206 adults (mean age:36.7, SD:14.8, 77% female) reporting alcohol purchasing and drinking habit before and during the pandemic.MeasurementsChanges in alcohol stock-up and frequency of alcohol use during the pandemic and increased alcohol stock-up and use were stratified by gender, age, education, household structure, working status, income loss, psychological distress, and country based on alcohol consumption per capita. The associations between increased alcohol stock-up/use and living with children, working from home, income loss and distress were examined using multivariate logistic regression, controlling for demographic factors.FindingsThe majority of respondents reported no change in their alcohol purchasing and drinking habits during the early pandemic period. Increased drinking was reported by 20.2% of respondents, while 17.6% reported decreased alcohol use. More than half (53.3%) of respondents experienced psychological distress, with one in five (20.7%) having severe distress. Female gender, being aged under 50, higher educational attainment, living with children, working from home, and psychological distress were all independently associated with increased alcohol drinking during lockdown. Limitations of the study were the non-representative sample, the data collection early in the pandemic, and the non-standard measurement of alcohol consumption.ConclusionIncreased psychological distress among people during the early pandemic period, resulted in increased alcohol consumption, especially among women with children working from home during lockdown.
Serial-Multiple Mediation of Job Burnout and Fatigue in the Relationship Between Sickness Presenteeism and Productivity Loss in Nurses: A Multicenter Cross-Sectional Study
Authors: Li Yuxin , Guo Bingmei , Wang Yongchao , Lv Xiaoyan , Li Rong , Guan Xiangyun , Li Li , Li Junli , Cao Yingjuan 
Published: January 2022

Background:In China, sickness presenteeism, job burnout, and fatigue are common among nurses during the COVID-19 pandemic. We propose the prevalence of sickness presenteeism can adversely affect nurses' physical and mental health, negatively impact their work productivity and quality, and pose a threat to patients' safety. Therefore, this study examines the mechanism of productivity loss caused by sickness presenteeism, fatigue, and job burnout.Objectives:To investigate the serial-multiple mediating effect of job burnout and fatigue in the relationship between sickness presenteeism and productivity loss among nurses.Methods:A multicenter cross-sectional survey was undertaken by administering an online questionnaire from December 2020 to May 2021. Stratified cluster sampling was used to include 3,491 nurses from 14 hospitals in Shandong Province, China. Variables were measured using the Sickness Presenteeism Questionnaire, Stanford Presenteeism Scale, Chalder Fatigue Scale, and Maslach Burnout Inventory. Data analyses were carried out using descriptive statistics, one-way analysis of variance, independent-samples t-test, Pearson correlation analysis, hierarchical regression, and bootstrapping method.Results:From the 3,491 nurses who volunteered in this online survey, only 2,968 valid questionnaires were returned. Sickness presenteeism exhibited a prevalence of 70.6% during the COVID-19 pandemic. The average score of health-related productivity loss was 15.05 ± 4.52, fatigue was 8.48 ± 3.40, and job burnout was 39.14 ± 19.64. Sickness presenteeism was positively associated with fatigue and job burnout while job burnout was positively associated with nurse fatigue. Sickness presenteeism, fatigue, and job burnout were also positively correlated with health-related productivity loss. Statistically significant paths via the single mediation of fatigue and job burnout were established. A statistically significant serial-multiple mediating effect of fatigue and job burnout on the association between sickness presenteeism and productivity loss accounted for 35.12% of the total effect size.Conclusions:There was a high incidence of sickness presenteeism and job burnout among Chinese nurses. High-frequency sickness presenteeism may result in increased productivity loss through the two mediating effects of fatigue and job burnout. Sickness presenteeism may increase fatigue, promote job burnout, and result in increased productivity loss among Chinese nurses during the COVID-19 pandemic.
Combined Anterior and Posterior Decompression With Fusion for Cervical Ossification of the Posterior Longitudinal Ligament
Authors: Kuo Chao-Hung , Kuo Yi-Hsuan , Chang Chih-Chang , Chang Hsuan-Kan , Fay Li-Yu , Wu Jau-Ching , Huang Wen-Cheng , Cheng Henrich , Tu Tsung-Hsi 
Published: January 2022

Objective:Cervical myelopathy caused by ossification of the posterior longitudinal ligament (OPLL) is not uncommon among Asian ethnic groups. Despite reports comparing the pros and cons of anterior- and posterior-only approaches, the optimal management remains debatable. This study aimed to evaluate the outcomes of patients who underwent a combined anterior and posterior approach, simultaneous circumferential decompression and fixation, for cervical OPLL.Method:The study retrospectively reviewed patients with OPLL and who underwent circumferential decompression and fixation, combined anterior corpectomy and posterior laminectomy. The clinical outcomes were evaluated by the Visual Analog Scale of neck and arm pain, the Japanese Orthopedic Association scores, Neck Disability Index, and Nurick scores at each time-point of evaluation. Radiological evaluations included plain and dynamic radiographs and computed tomography for every patient within 2 years post-operation. Subgroup analyses were further performed between the groups, with and without intra-operative cerebrospinal fluid (CSF) leakage.Results:A total of 41 patients completed the follow-up for more than 2 years (mean = 39.8 months) and were analyzed. Continuous-type OPLL was the most common (44%), followed by segmental (27%), mixed (22%), and localized types (7%) in the cohort. Myelopathy and all other functional outcomes improved significantly at 2 years post-operation (all p &lt; 0.05). There were 13 (32%) patients who had intra-operative CSF leakage. At 2 years post-operation, there were no differences in the demographics, functional outcomes, and complication rates between the CSF-leakage and no-leakage groups. The CSF-leakage group had more patients with continuous-type OPLL than the no-leakage group (77 vs. 29%, p = 0.004 &lt; 0.05). During the follow-up, there was no secondary or revision surgery for pseudomeningocele, pseudarthrosis, or other surgery-related complications.Conclusions:Simultaneous circumferential decompression and fixation combine the surgical benefits of sufficient decompression by the posterior approach and direct decompression of OPLL by the anterior approach. It is an effective surgical option for patients with cervical myelopathy caused by OPLL, given that myelopathy unanimously improved without neurological complications in this study. The fusion rates were high, and reoperation rates were low. Despite higher rates of CSF leakage, there were no related long-term sequelae, and minimal wound complications.