bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge, Perceptions and Attitudes Toward HPV Vaccination: A Survey on Parents of Girls Aged 11–18 Years Old in Greece
Authors: Naoum Panagiota , Athanasakis Kostas , Zavras Dimitris , Kyriopoulos John , Pavi Elpida 
Published: June 2022

ObjectiveTo investigate knowledge, perceptions and practices of parents of girls aged 11–18 years old in Greece toward HPV vaccination, and determine which factors are associated with parents' decision to vaccinate their daughters.MethodsA close-end questionnaire was constructed and telephone interviews were conducted upon informed consent. The sample was random, national, stratified by geographic region and representative of the general population of parents of girls aged 11–18. The data collected include: general knowledge, attitudes and perceptions concerning HPV and HPV vaccine, information regarding their daughters' HPV vaccination, and sociodemographic characteristics. Statistical analysis included descriptives and a logistic regression model to investigate which factors are associated with HPV vaccination.ResultsOverall, 1,000 parents participated in the study, 99.4% of which knew what HPV is and 98.8% knew there is a vaccine available against HPV. Furthermore, 47% of the parents stated that their daughters had been vaccinated against HPV, while further analysis revealed that only 35% had received all the recommended doses. In the logistic regression analysis, the following variables had a statistically significant association with HPV vaccination: perceived ease of contracting HPV (OR = 1.105), level of trust in medical profession regarding information on prevention (OR = 1.205), overall perception regarding importance of children's vaccination (OR = 0.618), internet/social media as a source of parent information regarding HPV (OR = 0.886), participant (parent) age (OR = 1.125), and daughter's treating physician's recommendation for HPV vaccination (OR = 7.319).ConclusionsHPV vaccination coverage is still suboptimal. Comprehension of the obstacles toward this goal is important and the role of healthcare professionals is crucial to increase acceptance.
In Vitro and In Vivo Antigen Presentation and Diagnosis Development of Recombinant Overlapping Peptides Corresponding to Mtb ESAT-6/CFP-10
Authors: Zhang Qing , Lu Xiong , Gao Liang , Tao Siyu , Ge Yinghua , Cui Daocheng , Zhu Renying , Lu Wenshu , Wang Jian , Jiang Shisong 
Published: June 2022

Cellular immunity in Mycobacteria tuberculosis (Mtb) infection is important for the pathogenesis and final clearance of intracellular Mtb infection. In addition, it is valuable for the diagnosis of tuberculosis. In this pioneering work, we tested in vitro and in vivo antigen presentation and diagnostic application of a recombinant overlapping peptide-protein derived from two Mtb RD1 antigens ESAT-6 and CFP-10 (ROP-TB). The overlapping peptide sequence of ROP-TB is cleaved by the cathepsin S enzyme and covers the entire length of the two proteins. ROP-TB can be expressed and purified from E. coli. Once taken in by antigen-presenting cells, ROP-TB can be cleaved into a peptide pool by cathepsin S within the cells. We found that in dendritic cells, ROP-TB can be processed in 6 hours of co-culture, while the ESAT-6/CFP-10 fusion protein remained in the endosomal compartment. In Mtb-infected mice, ROP-TB stimulated stronger specific T cell responses than pooled synthetic peptides derived from ESAT-6 and CFP-10. With regard to the presentation of in vivo antigens, in a guinea pig model infected with Mtb, ROP-TB induced delayed type hypersensitivity (DTH) responses comparable to those of the tuberculin purified protein derivative (PPD) and ESAT-6/CFP-10 fusion protein. In Mycobacterium bovis (Bovine TB)-infected cattle, ROP-TB elicited DTH responses. Finally, in Mtb infected patients, ROP-TB stimulated cellular immune responses in majority of patients (16/18) of different HLA phenotypes while a single peptide derived from the same proteins did not elicit the immune responses in all patients. In summary, in vitro and in vivo data suggest that ROP-TB stimulates a strong cellular immune response irrespective of HLA phenotypes and is therefore suitable for use in vitro and in vivo diagnostics.
A Prediction Model of Significant Wave Height in the South China Sea Based on Attention Mechanism
Authors: Hao Peng , Li Shuang , Yu Chengcheng , Wu Gengkun 
Published: June 2022

Significant wave height (SWH) prediction plays an important role in marine engineering fields such as fishery, exploration, power generation, and ocean transportation. Traditional SWH prediction methods based on numerical models cannot achieve high accuracy. In addition, the current SWH prediction methods are largely limited to single-point SWH prediction, without considering regional SWH prediction. In order to explore a new SWH prediction method, this paper proposes a deep neural network model for regional SWH prediction based on the attention mechanism, namely CBA-Net. In this study, the wind and wave height of the ERA5 data set in the South China Sea from 2011 to 2018 were used as input features to train the model to evaluate the SWH prediction performance at 1 h, 12 h, and 24 h. The results show that the single use of a convolutional neural network cannot accurately predict SWH. After adding the Bi-LSTM layer and attention mechanism, the prediction of SWH is greatly improved. In the 1 h SWH prediction using CBA-Net, SARMSE, SAMAPE, SACC are 0.299, 0.136, 0.971 respectively. Compared with the CNN + Bi-LSTM method that does not use the attention mechanism, SARMSE and SAMAPE are reduced by 43.4% and 48.7%, respectively, while SACC is increased by 5%. In the 12 h SWH prediction, SARMSE, SAMAPE, and SACC of CBA-Net are 0.379, 0.177, 0.954 respectively. In the 24 h SWH prediction, SARMSE, SAMAPE, and SACC of CBA-Net are 0.500, 0.236, 0.912 respectively. Although with the increase of prediction time, the performance is slightly lower than that of 12 h, the prediction error is still maintained at a small level, which is still better than other methods.
Case Report: Alzheimer's Dementia Associated With Cerebrospinal Fluid Neurochondrin Autoantibodies
Authors: Hansen Niels , Malchow Berend , Teegen Bianca , Wiltfang Jens , Bartels Claudia 
Published: June 2022

BackgroundNeurochondrin autoimmunity is a rare disorder mainly associated with cerebellar and vestibular syndromes. Our report aims to enlarge its phenotypic spectrum to encompass major cognitive disorder with very late onset never before reported in conjunction with neurochondrin antibodies.MethodsWe describe the case of an 85-year-old woman who presented in our memory clinic. Retrospective analysis of patient records included cerebrospinal fluid (CSF) analysis, magnetic resonance imaging (MRI), and neuropsychological testing using the CERAD-plus.ResultsBecause of her unknown onset of progressive cognitive dysfunction in conjunction with speech and language problems, we decided to take an extensive differential diagnostic approach including a search for neural autoantibodies potentially involved in cognitive impairment. Our patient presented serum and CSF neurochondrin autoantibodies. Further CSF analysis revealed elevated tau and ptau 181 protein as well as a reduced Aß42/40 ratio in CSF, thus matching a biomarker profile of Alzheimer's disease (AD). Neuropsychological tests revealed predominant and severe deficits in verbal and visual memory. Her MRI showed reduced parietal and cerebellar brain volume.DiscussionTaken together, this case reveals the novelty of a patient with a CSF-based and typical clinical and imaging profile of AD. She is also likely to have neurochondrin autoimmunity, as we detected neurochondrin autoantibodies in her CSF; we therefore diagnosed AD dementia associated with neurochondrin antibodies. Our case expands the spectrum of neurochondrin autoimmunity to disorders involving major cognitive disorder such as AD dementia. Furthermore, we speculate that neurochondrin autoimmunity might have triggered an acceleration of AD symptoms as its onset was reported only after a short 6-month interval via a synergistic or negatively additive hybrid mechanism of action between neurodegeneration and autoimmunity.
Study Design and Protocol of a Randomized Controlled Trial of the Efficacy of a Smartphone-Based Therapy of Migraine (SMARTGEM)
Authors: Oliveira Gonçalves Ana Sofia , Laumeier Inga , Hofacker Maxi Dana , Raffaelli Bianca , Burow Philipp , Dahlem Markus A. , Heintz Simon , Jürgens Tim Patrick , Naegel Steffen , Rimmele Florian , Scholler Simon , Kurth Tobias , Reuter Uwe , Neeb Lars 
Published: June 2022

BackgroundDigitalization and electronic health (eHealth) offer new treatment approaches for patients with migraine. Current smartphone applications (apps) for migraine patients include a wide spectrum of functions ranging from digital headache diaries to app-based headache treatment by, among others, analysis of the possible triggers, behavioral therapy approaches and prophylactic non-drug treatment methods with relaxation therapy or endurance sport. Additional possibilities arise through the use of modern, location-independent communication methods, such as online consultations. However, there is currently insufficient evidence regarding the benefits and/or risks of these electronic tools for patients. To date, only few randomized controlled trials have assessed eHealth applications.MethodsSMARTGEM is a randomized controlled trial assessing whether the provision of a new digital integrated form of care consisting of the migraine app M-sense in combination with a communication platform (with online consultations and medically moderated patient forum) leads to a reduction in headache frequency in migraine patients, improving quality of life, reducing medical costs and work absenteeism (DRKS-ID: DRKS00016328).DiscussionSMARTGEM constitutes a new integrated approach for migraine treatment, which aims to offer an effective, location-independent, time-saving and cost-saving treatment. The design of the study is an example of how to gather high quality evidence in eHealth. Results are expected to provide insightful information on the efficacy of the use of electronic health technology in improving the quality of life in patients suffering from migraine and reducing resource consumption.
The Recognition of Facial Expressions Under Surgical Masks: The Primacy of Anger
Authors: Proverbio Alice M. , Cerri Alice 
Published: June 2022

BackgroundThe need to wear surgical masks in everyday life has drawn the attention of psychologists to the negative effects of face covering on social processing. A recent but not homogeneous literature has highlighted large costs in the ability to recognize emotions.MethodsHere it was investigated how mask covering impaired the recognition of facial mimicry in a large group of 220 undergraduate students. Sex differences in emotion recognition were also analyzed in two subgroups of 94 age-matched participants. Subjects were presented with 112 pictures displaying the faces of eight actors (4 women and 4 men) wearing or not wearing real facemasks, and expressing seven emotional states (neutrality, surprise, happiness, sadness, disgust, anger and fear). The task consisted in categorizing facial expressions while indicating the emotion recognizability with a 3-point Likert scale. Scores underwent repeated measures ANOVAs.ResultsOverall, face masking reduced emotion recognition by 31%. All emotions were affected by mask covering except for anger. Face covering was most detrimental to sadness and disgust, both relying on mouth and nose expressiveness. Women showed a better performance for subtle expressions such as surprise and sadness, both in masked and natural conditions, and men for fear recognition (in natural but especially masked conditions).ConclusionAnger display was unaffected by masking, also because corrugated forehead and frowning eyebrows were clearly exposed. Overall, facial masking seems to polarize non-verbal communication toward the happiness/anger dimension, while minimizing emotions that stimulate an empathic response in the observer.
Eating Hubs in Multiple Sclerosis: Exploring the Relationship Between Mediterranean Diet and Disability Status in Italy
Authors: Felicetti Federica , Tommasin Silvia , Petracca Maria , De Giglio Laura , Gurreri Flavia , Ianniello Antonio , Nistri Riccardo , Pozzilli Carlo , Ruggieri Serena 
Published: June 2022

BackgroundMultiple Sclerosis (MS) is a complex disease in which multiple factors contribute to disability accrual. Mediterranean Diet (MeDi) has shown beneficial effects across neurodegenerative diseases. We hypothesize that specific food habits, rather than global adherence to MeDi, might impact on MS. We aimed to (i) evaluate differences in adherence to MeDi between people living with MS (PwMS) and healthy controls (HC); (ii) characterize eating patterns in PwMS and HC, identifying the most influential MeDi items for each group by the use of network analysis; (iii) explore the relationship between patients' eating habits and disability.Materials and MethodsIn this cross-sectional study, we consecutively recruited 424 PwMS and 165 matched HC. Data were obtained through the administration of self-reported questionnaires. Expanded Disability Status Scale (EDSS) and Fatigue Severity Scale (FSS) were evaluated in the MS population. We performed between-groups comparisons via unpaired two-sample t-test and X2 test as appropriate. We calculated food networks in both MS cases and HC using and tested the association between hub nodes and disability. Finally, we conducted a post-hoc analysis, investigating the relationship between food items, lifestyle factors (smoking, exercise) and clinical outcomes.ResultsMost participants adhered sufficiently to MeDi. Exploring each group separately, fruit, vegetables, cereal, and fish were identified as hubs in PwMS, while meat and alcohol were identified as hubs in HC. Hubs were all inter-correlated, indicating that eating habits of PwMS include a large intake of all the foods identified as hubs. EDSS was predicted by the intake of vegetables (beta = −0.36, p &lt; 0.03) and fish (beta = −0.34, p &lt; 0.02). The model including smoking pack/year, International Physical Activity Questionnaire (IPAQ) score and intake of “negative foods” predicted 6% of the variance in EDSS (p &lt; 0.001), while the model including smoking pack/year and IPAQ score predicted 4% of the variance in FSS (p &lt; 0.001).ConclusionsWe identified a sufficient adherence to MeDi in our population. PwMS showed overall a healthier dietary pattern than HC. Vegetables and fish intake were associated with disability outcomes. Future longitudinal studies applying integrated approaches are needed to understand lifestyle added value to the use of standard pharmacological therapies.
Local Ablative Treatment Improves Survival in ESCC Patients With Specific Metastases, 2010–2016: A Population-Based SEER Analysis
Authors: Yang Hui , Wang Kunlun , Li Yan , Li Shenglei , Yuan Ling , Ge Hong 
Published: June 2022

BackgroundWe aimed to explore the role of local ablative treatment (LAT) in metastatic esophageal squamous cell cancer (ESCC) patients who received chemotherapy and identify patients who will most likely benefit.MethodsWe analyzed data of metastatic ESCC patients from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2016. The chi-square test was used to evaluate the unadjusted clinicopathological categorical variables between the two groups. Univariate and multivariate Cox regression analyses were conducted to identify independent prognostic factors of overall survival. Propensity score matching (PSM) was used to adjust the differences between the two groups.ResultsOverall, 720 metastatic ESCC patients treated with chemotherapy were analyzed in this study; 63.2% of patients (n = 455) received LAT, including radiotherapy (n = 444), primary site surgery (n = 12), or lymph node dissection (n = 27). Gender (HR = 1.220, 95% CI: 1.024–1.453, p = 0.026), bone metastases (HR = 1.559, 95% CI: 1.292–1.882, p &lt; 0.001), and liver metastases (HR = 1.457, 95% CI: 1.237–1.716, p &lt; 0.001) were independent prognostic factors in the entire population. However, LAT was not an independent prognostic factor. Further subgroup analyses showed that LAT improved OS from 8.0 months to 10.0 months in patients with metastases other than bone/liver (HR = 0.759, 95% CI: 0.600–0.961, p = 0.022). LAT was not a prognostic factor in patients with bone/liver metastases (HR = 0.995, 95% CI: 0.799–1.239, p = 0.961). After PSM, the median OS was 8.0 months (95% CI: 7.2–8.8 months) and patients who received LAT had a better OS than patients without LAT (HR = 0.796, 95% CI: 0.653–0.968, p = 0.023). Patients with metastases other than bone/liver could benefit from LAT compared with those with bone/liver metastases.ConclusionsOur study indicated that metastatic ESCC patients with metastases other than bone/liver could derive additional benefit from LAT with systemic chemotherapy.
The Value of Lymph Node Dissection in Patients With Node-Positive Upper Urinary Tract Urothelial Cancer: A Retrospective Cohort Study
Authors: Xia Hao-ran , Li Shu-guang , Zhai Xing-quan , Liu Min , Guo Xiao-xiao , Wang Jian-ye 
Published: June 2022

PurposeThe value of lymphadenectomy during radical nephroureterectomy (RNU) remains unclear. This study aimed to determine the effects of the removed lymph node (RLN) counts, positive lymph node (pLN) counts, and pLN density (pLND) on survival outcomes in patients with node-positive upper urinary tract urothelial cancer (UTUC).MethodsA total of 306 patients with node-positive UTUC in the Surveillance, Epidemiology, and End Results database between 2004 and 2016 were identified. Multivariable Cox regression analyses were used to evaluate the effect of RLN counts, pLN counts, and pLND on survival outcomes. The maximally selected rank statistics were used to determine the most informative cutoff value for pLND on survival outcomes.ResultsThe RLN counts or pLN counts were not associated with survival outcomes, whereas higher pLND was associated with lower cancer-specific survival (CSS) and overall survival (OS) [hazard ratio (HR) 1.75, P = 0.014 and HR 1.62, P = 0.036, respectively]. The most informative cutoff value for pLND in relation to survival was 27%. Patients with pLND ≥27% had worse 5-year survival rates than those with pLND &lt;27% (52.9% vs. 75.9% for CSS and 18.7% vs. 34.2% for OS, each P &lt; 0.05). Furthermore, the multivariable Cox regression model with pLND could predict 5-year CSS (AUC 0.732 vs. 0.647) or OS (AUC 0.704 vs. 0.621) more accurately than the model without pLND.ConclusionsFor patients with node-positive UTUC, more lymph nodes removed do not offer a better therapeutic effect. However, pLND provides additional prognostic value.
Clinicopathological Characteristics and Prognosis of HER2-Low Early-Stage Breast Cancer: A Single-Institution Experience
Authors: Xu Hangcheng , Han Yiqun , Wu Yun , Wang Yan , Li Qing , Zhang Pin , Yuan Peng , Luo Yang , Fan Ying , Chen Shanshan , Cai Ruigang , Li Qiao , Ma Fei , Xu Binghe , Wang Jiayu 
Published: June 2022

BackgroundHuman epidermal growth factor 2 (HER2)-low breast cancer, which is defined as HER2 1+ or 2+ in immunohistochemistry without gene amplification, accounts for a considerable part of all breast cancers. However, it remains controversial whether HER2-low breast cancer is a distinct entity. Our aim was to compare the clinicopathological features and survival outcomes between HER2-zero and HER2-low early breast cancer.MethodsThe study was a retrospective analysis that enrolled 1,039 patients with available HER2 expression data in a single institute from 2013 to 2014, of whom 262 HER2-positive patients were excluded from the subsequent analysis. The remaining patients were divided into HER2-zero and HER2-low groups. Each group was further categorized into a hormone receptor (HR)-positive and an HR-negative subgroup. Clinicopathological characteristics were collected and compared between HER2-zero and HER2-low groups. The primary endpoint was disease-free survival (DFS) and overall survival (OS), which were analyzed using the Kaplan–Meier method with log-rank test, landmark analysis, and Cox proportional hazards model.ResultsA total of 777 non-HER2-positive patients were included in this analysis, of whom 126, 552, 53, and 46 patients were HR-positive/HER2-zero, HR-positive/HER2-low, HR-negative/HER2-zero, and HR-negative/HER2-low, respectively. No significant difference in DFS and OS was detected between the HER2-zero group and the HER2-low group when paired by HR status. Landmark analysis with a time point set at 5 years indicated that HR-positive/HER2-low patients had a better DFS compared with HR-positive/HER2-zero patients after 5 years (p = 0.0047). HER2-low status was an independent prognostic factor for DFS after 5 years [hazard ratio (HR) 0.31, 95% confidence interval (CI) 0.13–0.75, p = 0.01].ConclusionThe clinicopathological characteristics and prognosis of HER2-zero and HER2-low breast cancer were similar regardless of HR status. Patients with HR-positive/HER2-low tumors tended to have a better DFS than their HR-positive/HER2-zero counterparts after 5 years.
Technical and Diagnostic Issues in Whole Slide Imaging Published Validation Studies
Authors: Rizzo Paola Chiara , Girolami Ilaria , Marletta Stefano , Pantanowitz Liron , Antonini Pietro , Brunelli Matteo , Santonicco Nicola , Vacca Paola , Tumino Nicola , Moretta Lorenzo , Parwani Anil , Satturwar Swati , Eccher Albino , Munari Enrico 
Published: June 2022

ObjectiveDigital pathology with whole-slide imaging (WSI) has many potential clinical and non-clinical applications. In the past two decades, despite significant advances in WSI technology adoption remains slow for primary diagnosis. The aim of this study was to identify common pitfalls of WSI reported in validation studies and offer measures to overcome these challenges.MethodsA systematic search was conducted in the electronic databases Pubmed-MEDLINE and Embase. Inclusion criteria were all validation studies designed to evaluate the feasibility of WSI for diagnostic clinical use in pathology. Technical and diagnostic problems encountered with WSI in these studies were recorded.ResultsA total of 45 studies were identified in which technical issues were reported in 15 (33%), diagnostic issues in 8 (18%), and 22 (49%) reported both. Key technical problems encompassed slide scan failure, prolonged time for pathologists to review cases, and a need for higher image resolution. Diagnostic challenges encountered were concerned with grading dysplasia, reliable assessment of mitoses, identification of microorganisms, and clearly defining the invasive front of tumors.ConclusionDespite technical advances with WSI technology, some critical concerns remain that need to be addressed to ensure trustworthy clinical diagnostic use. More focus on the quality of the pre-scanning phase and training of pathologists could help reduce the negative impact of WSI technical difficulties. WSI also seems to exacerbate specific diagnostic tasks that are already challenging among pathologists even when examining glass slides with conventional light microscopy.