bluuebunny/crossref_metadata_2025_split huggingface dataset:
Apatinib Plus Camrelizumab With/Without Chemoembolization for Hepatocellular Carcinoma: A Real-World Experience of a Single Center
Authors: Ju Shuguang , Zhou Chen , Yang Chongtu , Wang Chaoyang , Liu Jiacheng , Wang Yingliang , Huang Songjiang , Li Tongqiang , Chen Yang , Bai Yaowei , Yao Wei , Xiong Bin 
Published: January 2022

ObjectiveThis study was conducted in order to compare the efficacy and safety of transarterial chemoembolization (TACE) plus apatinib plus camrelizumab (TACE+AC) and apatinib plus camrelizumab (AC) in the treatment of unresectable hepatocellular carcinoma (HCC) in a real-world setting.MethodsIn this single-center retrospective study, the data of patients with unresectable HCC who had received TACE+AC or AC treatment during March 2017 to May 2021 were assessed. Patients in the AC group received intravenous administration of camrelizumab 200 mg every 3 weeks and oral apatinib 250 mg/day treatment. Patients in the TACE+AC group received the same dose of camrelizumab and apatinib 1 week after TACE. The primary endpoint of the study was overall survival (OS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs) as the secondary endpoints.ResultsA total of 108 patients were enrolled in the study. There were 52 patients in the AC group and 56 patients in TACE+AC group. Median OS was significantly longer in the TACE+AC group than in the AC group (24.8 vs. 13.1 months; P = 0.005). Patients in the TACE+AC group achieved a higher ORR [24 (42.9%) vs. 9 (17.3%), P = 0.004] than those in the AC group. Patients in the TACE+AC group also achieved a higher disease control rate (DCR) [48 (85.7%) vs. 30 (57.7%), P = 0.001] than patients in the AC group. There was no significant difference in the incidence of AEs related to apatinib and camrelizumab between the two groups, except for gastrointestinal reaction (P &gt; 0.05, all; P &lt; 0.05, gastrointestinal reaction).ConclusionTACE plus apatinib plus camrelizumab significantly improved OS, ORR, and DCR over apatinib plus camrelizumab in patients with unresectable HCC. AEs were tolerable and manageable.
Analysis on the MRI and BAEP Results of Neonatal Brain With Different Levels of Bilirubin
Authors: Lu Zhongxing , Ding Shouling , Wang Fen , Lv Haitao 
Published: January 2022

BackgroundTo explore whether there is abnormality of neonatal brains' MRI and BAEP with different bilirubin levels, and to provide an objective basis for early diagnosis on the bilirubin induced subclinical damage on brains.MethodsTo retrospectively analyze the clinical data of 103 neonatal patients, to conduct routine brain MRI examination and BAEP testing, and to analyze BAEP and MRI image results of the neonatal patients, who were divided into three groups based on the levels of total serum bilirubin concentration (TSB): 16 cases in mild group (TSB: 0.0–229.0 ěmol/L), 49 cases in moderate group (TSB: 229.0–342.0 ěmol/L), and 38 cases in severe group (TSB ≥ 342.0 ěmol/L).ResultsWe found the following: A. Comparison of the bilirubin value of the different group: The bilirubin value of the mild group is 171.99 ± 33.50 ěmol/L, the moderate group is 293.98 ± 32.09 ěmol/L, and the severe group is 375.59 ± 34.25 ěmol/L. The comparison of bilirubin values of the three groups of neonates (p &lt; 0.01) indicates the difference is statistically significant (p &lt; 0.01). B. The weight value of the &lt;2,500 g group is 2.04 ± 0.21 and the ≥2,500 g group is 3.39 ± 0.46; the weight comparison of the two groups indicates that the difference is statistically significant (p &lt; 0.01). C. Comparison of the abnormal MRI of the different groups: The brain MRI result's abnormal ratio of the mild group is 31.25%, the moderate group is 16.33%, and the severe group is 21.05%, but the comparison of brain MRI results of the three neonates groups indicates that the difference is not statistically significant (p &gt; 0.05). D. Comparison of abnormal MRI signal values of globus pallidus on T1WI in different groups: 1. The comparison of normal group signal values with that of mild group (p &lt; 0.05), with that of moderate group, and with that of severe group (p &lt; 0.01) indicates that the difference is statistically significant.ConclusionAt low level of bilirubin, central nervous system damage may also occur and can be detected as abnormality by MRI and BAEP. Meanwhile, MRI and BAEP can also provide early abnormal information for the judgment of central nervous system damage of the children with NHB who have no acute bilirubin encephalopathy (ABE) clinical features, and provide clues for early treatment and early intervention.
CB2R Deficiency Exacerbates Imiquimod-Induced Psoriasiform Dermatitis and Itch Through the Neuro-Immune Pathway
Authors: Li Li , Liu Xin , Ge Wenqiang , Chen Chao , Huang Yuqiong , Jin Zilin , Zhan Muouyang , Duan Xiaoru , Liu Xinxin , Kong Yi , Jiang Jian , Li Xuemei , Zeng Xin , Li Fei , Xu Shibin , Li Man , Chen Hongxiang 
Published: January 2022

Background: Cannabinoid receptor 2 (CB2R) is a potential target for anti-inflammatory and pain therapeutics given its significant immunomodulatory and analgesic effects. However, the role of CB2R in imiquimod (IMQ)-induced psoriasiform dermatitis (PsD) and itch is poorly understood.Objective: To investigate the function and mechanism of CB2R in PsD and itch in mice.Methods: Following daily treatment with topical IMQ cream for 5-7 consecutive days in C56BL/6 wild-type (WT) and CB2R gene knockout (KO) mice, we assessed the Psoriasis Area and Severity Index (PASI) scores and the scratch bouts every day, and hematoxylin and eosin (H&amp;E) staining, toluidine blue staining were used to observe the histological changes. mRNA levels were analyzed by quantitative real-time polymerase chain reaction (qRT-PCR). Protein levels were detected by western blotting (WB), immunohistochemistry (IHC), immunofluorescence (IF) and cytometric bead array (CBA). Flow cytometry (FCM) was used to examine the proportion of Th17/Treg cells.Results: We found that CB2R expression levels were increased in mice with psoriasis. Compared with WT mice, CB2R deficiency exacerbated IMQ-induced PsD and scratching bouts and upregulated the expression of proinflammatory cytokines by increasing the infiltration of CD4+ T cells and the Th17/Treg ratio. Obvious proliferation and prolongation of nerve fibers and high expression of nerve growth factor (NGF) were observed in PsD and CB2R KO mice. Pretreatment with the CB2R agonist, JWH-133 significantly reversed inflammation and scratching bouts. CB2R didn't participate in the induction of itch in psoriasis by regulating the expression of IL-31, thymic stromal lymphopoietin (TSLP) and mast cells in mouse skins.Conclusion: Our results demonstrate that CB2R plays a pivotal role in the pathophysiology of psoriasis, providing a new potential target for anti-inflammatory and antipruritic drugs.
Predictive Model Construction for Social–Emotional Competence of Toddlers in Shanghai, China: A Population-Based Study
Authors: Chen Deng , Huang Yilu , Chen Sikun , Huang Yunzhe , Swain Andrew , Yu Jinming 
Published: January 2022

ObjectiveTo construct a simple model containing predictors derived from Chinese Learning Accomplishment Profile (C-LAP) to better the evaluation of the social–emotional development of toddlers aged 24–36 months.MethodThe test results by C-LAP system and demographic information of toddlers aged 24–36 months were collected between 2013 and 2019 in Shanghai, China, whose guardians were voluntary to accept the investigation. We developed a norm with the dataset based on the study population. With the norm, stepwise regression and best subset analysis were applied to select predictors.ResultsRelying on the norm established and stepwise regression and also the best subset analysis, an optimal model containing only 6 indicators was finally determined and the nomogram of the model was constructed. In the training and validation dataset, the AUCs of the optimal model were 0.95 (95% CI: 0.94–0.96) and 0.88 (95% CI: 0.85–0.90), respectively. When the cutoff point of the model was set at 0.04, its sensitivity in training and validation dataset was 0.969 and 0.949, respectively, and the specificity in training and validation dataset is 0.802 and 0.736, respectively.ConclusionA simplified predictive model which includes only 6 items derived from C-LAP is developed to evaluate the probabilities of being at risk of developmental problem in social–emotional development for toddlers aged 24–36 months. Meanwhile, specificity and sensitivity of the model may be high enough for future fast screening.
The Prevalence of Burnout and Its Associated Factors Among Surgical Specialists in Kuwait Ministry of Health Hospitals
Authors: Akl Amr , Mohiyaldeen Idrees , Alshatti Rashed , Alenezi Omer , Dougherty Ryan , Al-Raihan Abdullah , Alotaibi Salman , Tadros Nardine , Longenecker Joseph C. 
Published: January 2022

BackgroundWorkplace burnout is a state of emotional exhaustion (EE), depersonalization of others (DP), and low personal accomplishment (PA) owing to workplace stressors. This study aimed to assess the prevalence of burnout and its associated factors among surgical specialists in Kuwait.MethodsThis cross-sectional study assessed the prevalence of burnout among 489 surgeons in practice at Kuwait Ministry of Health (MOH). Data were collected using a self-administered questionnaire. Burnout was assessed using the Maslach Burnout Inventory, which defines burnout as having a high score of EE or DP, or a low score of PA; with severe burnout involving all. The associations between burnout or severe burnout with sociodemographic and occupational characteristics were assessed using multivariate binary logistic regression to adjust for potential confounders.ResultsPrevalence estimates for burnout and severe burnout were 76.9% (95% Confidence Interval = 72.9–80.7%) and 14.0% (11.0–17.5%), respectively. The prevalence estimates for high EE, high DP, and low PA scores were 44.7, 43.1, and 47.2%, respectively. The prevalence of burnout and severe burnout was highest among neurosurgeons. Burnout was lowest among otolaryngology surgeons and severe burnout was lowest among cardiothoracic surgeons. After adjustment, burnout was associated with younger age, lower income, and more on-calls per month. The four most common sources of stress included less family time, verbal assault, case overload, and highly complicated cases.ConclusionThe prevalence of burnout among surgeons in Kuwait MOH hospitals is high. Occupational health programs should use these findings to design and implement interventions that can treat and prevent burnout in this population.
Health Effects of Metabolic Risks in the United States From 1990 to 2019
Authors: Chen Ruifang , Safiri Saeid , Behzadifar Masoud , Kong Jude Dzevela , Zguira Mohamed Sami , Bragazzi Nicola Luigi , Zhong Wen , Zhang Weiru 
Published: January 2022

IntroductionMetabolic risks including high body mass index, high fasting plasma glucose, high low-density lipoprotein cholesterol, high systolic blood pressure, kidney dysfunction and low bone mineral density, contribute heavy burden to the US health systems. We aimed to investigate the burden attributable to metabolic risks in the US from 1990 to 2019.MethodsUsing methodology of Global Burden of Disease Study, the deaths and DALYs attributable to metabolic risks were analyzed by age, gender, states, Socio-demographic Index (SDI) and diseases from 1990 to 2019 in the US.ResultsIn 2019, the age-standardized death and DALY rates attributable to metabolic risks were 174.9 and 4738.7 per 100,000 people, accounting for 33.1% and 18.2% of death and DALY rates from all causes in the US, and there was a decrease by −32.5% and −21.2% in age-standardized death and DALY rates since 1990. The burden attributable to metabolic risks increased with age, and was higher in males than females. In addition, the burden varied widely across the states, generally in inverse proportion to the SDI levels, and the heaviest burden was observed in East and West South-Central of the US. Cardiovascular diseases carried heavy burden attributable to metabolic risks.ConclusionThe burden attributable to metabolic risks remained major public health concerns in the US. Prevention of metabolic risks should be a high priority in the US.
Heterogeneity of Urban and Rural Areas in Association of Fringe Benefits and Depression: A Cross-Sectional Study
Authors: Luo Tianwen , Yan Chaoyang , Zhang Xiang 
Published: January 2022

BackgroundFringe benefits are an important social support in the work scenario, but empirical research on their effect on the mental health of employees is lacking. This study aims to analyse the relationship between different fringe benefits and depression in urban and rural areas.MethodsChi-square analysis was used to describe the distribution differences of individual characteristics between urban and rural areas in depression groups. Logistic regression was used to further estimate the relationship between fringe benefits and depression between urban and rural areas.ResultsPeople with free lunch in urban areas are less likely to suffer from depression. People with food subsidies in rural areas are also less likely to suffer from depression. The abnormal result is people with housing subsidies in rural areas are more likely to be depressed. The effects of job type and contract on depression were different between urban and rural areas.ConclusionsEmployers in urban areas should focus on providing free lunch and the quality of lunch, whereas in rural areas, catering subsidies may be a more appropriate way to improve the mental health of employees. The psychological status of rural workers who receive housing subsidies and have contracts also needs attention.
Irrigating Solutions and Activation Methods Used in Clinical Endodontics: A Systematic Review
Authors: Tonini Riccardo , Salvadori Matteo , Audino Elisabetta , Sauro Salvatore , Garo Maria Luisa , Salgarello Stefano 
Published: January 2022

BackgroundEx vivo and in vitro studies have demonstrated the effectiveness of some irrigation protocols in reducing the bacterial load in the root canal system. However, standardized protocols have not yet been defined for the real clinical context due to many irrigation procedures available.ObjectiveTo evaluate the clinical endodontic protocols and limitations of irrigating solutions in the disinfection of the root canal system in patients with apical periodontitis.MethodsPubMed, Scopus, Embase, Web of Science, and Cochrane databases were searched for randomized controlled trials (RCT) published until January 2021. Hand searching was also performed. Studies focused on evaluating the effectiveness of irrigating solutions and/or irrigation activation methods in reducing the bacterial load in the root canal system were considered. The Cochrane risk-of-bias tool for randomized trials (RoB2) was used to assess the quality of the studies.ResultsFour hundred and twenty eight published articles were identified. After removing the duplicate studies and analyzing full texts, seven RCTs were selected. Two studies compared pure NaOCl with some combination of NaOCl with HEDP and MTAD. Two studies analyzed the antibacterial efficacy of NaOCl and chlorhexidine (CHX). Three studies compared conventional needle irrigation with different irrigation activation methods (PUI, XP-endo finisher, F-file activator, EndoVac activator). The review attained a satisfactory methodology. The main results of each included study were described.DiscussionActivation methods provide significantly higher biofilm reduction than conventional needle irrigation methods. Combinations of NaOCl with different chelating agents were ineffective in terms of antimicrobial, but it could potentially increase the risk of irrigant extrusion. However, the irrigating protocols were not carefully detailed, especially those regarding the irrigants application time or total volume. The existing literature lacks high-quality studies. The level of evidence is moderate.ConclusionsThe available data is too heterogeneous to compare and identify the superiority of specific valuable irrigation protocols in each clinical context. Application time, volume, and activation methods should be standardized to determine the optimal irrigating procedures to reduce the bacterial load and ensure higher predictability of the endodontic treatment.Systematic Review Registration(https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=218555), PROSPERO registration: CRD42020218555.
Performance Characterization of Dosimeters Based on Radiation-Hard Silicon Diodes in Gamma Radiation Processing
Authors: Bueno C. C. , Camargo F. , Gonçalves J. A. C. , Pascoalino K. , Mangiarotti A. , Tuominen E. , Härkönen J. 
Published: January 2022

The dosimetric response of silicon diodes produced with distinct engineering technologies, Magnetic Czochralski (MCz), and standard Float Zone (Fz), has been investigated, aiming at their use for online dosimeters in gamma radiation processing applications. The p+-n-n+ junction diodes, 300 µm thick with an active area of 25 mm2, are operated as online radiation dosimeters in the short-circuit current mode. In this case, the key dosimetric quantity is the dose rate, which is correlated with the output current from the diode subjected to radiation. Thus, the dose is obtained offline by the integration of the corresponding current signal. The irradiations are performed with an industrial Gammacell 60Co facility at 2.3–2.44 kGy/h covering doses up to 275 kGy. Under continuous irradiation, both diodes delivered current signals whose intensities decreased with accumulated doses. Mitigation of this decay has been accomplished by pre-irradiating the devices to 700 kGy. Polynomial functions best represent the dose responses for either pristine or preirradiated diodes. The relevant dosimetric parameters as response stability, charge sensitivity, and repeatability of current signals (&lt;5%) reveal the better performance of the MCz diode. It is important to note that the whole dataset fully complies with the international standard protocols for routine dosimeters in radiation processing dosimetry. Regarding radiation damage, which in unbiased diodes manifests primarily in the decay of current sensitivity, the results also showed greater tolerance of the MCz diode. Based on these studies, large availability, and better cost-effectiveness, it is possible to endorse the potential use of MCz devices as online routine dosimeters in radiation processing applications. However, the data reproducibility with the accumulated dose, the dose lifespan, and the effect of the irradiation conditions (e.g., temperature, relative humidity, and dose fractionating) remain to be investigated. Works in this direction are currently in progress.
Serum Lactate Level in Early Stage Is Associated With Acute Kidney Injury in Traumatic Brain Injury Patients
Authors: Wang Ruoran , Wang Shaobo , Zhang Jing , He Min , Xu Jianguo 
Published: January 2022

BackgroundAcute kidney injury (AKI) is a common complication in the clinical practice of managing patients with traumatic brain injury (TBI). Avoiding the development of AKI is beneficial for the prognosis of patients with TBI. We designed this study to testify whether serum lactate could be used as a predictive marker of AKI in patients with TBI.Materials and MethodsIn total, 243 patients with TBI admitted to our hospital were included in this study. Univariate and multivariate logistic regression analyses were utilized to analyze the association between lactate and AKI. The receiver operating characteristic (ROC) curves were drawn to verify the predictive value of lactate and the logistic model.ResultsAcute kidney injury group had higher age (p = 0.016), serum creatinine (p &lt; 0.001), lactate (p &lt; 0.001), and lower Glasgow Coma Scale (GCS; p = 0.021) than non-AKI group. Multivariate logistic regression showed that age [odds ratio (OR) = 1.026, p = 0.022], serum creatinine (OR = 1.020, p = 0.010), lactate (OR = 1.227, p = 0.031), fresh frozen plasma (FFP) transfusion (OR = 2.421, p = 0.045), and platelet transfusion (OR = 5.502, p = 0.044) were risk factors of AKI in patients with TBI. The area under the ROC curve (AUC) values of single lactate and predictive model were 0.740 and 0.807, respectively.ConclusionSerum lactate level in the early phase is associated with AKI in patients with TBI. Lactate is valuable for clinicians to evaluate the probability of AKI in patients with TBI.
Solar Radiation Components on a Horizontal Surface in a Tropical Coastal City of Salvador
Authors: Gomes Leonardo Rafael Teixeira Cotrim , Marques Filho Edson Pereira , Pepe Iuri Muniz , Mascarenhas Bruno Severino , de Oliveira Amauri Pereira , de A. França José Ricardo 
Published: January 2022

Renewable energy must be prioritized by humankind, mainly if there is an expected increase of 50% in energy consumption by 2030 and climate change scenarios are also confirmed. Urban areas consume 70% of the available energy on the planet. Brazil, the largest country in South America, concentrates more than 85% of its population in urban areas, facing a challenge to increase the renewable power plants in its energy matrix. This work presents the solar radiation components behavior for the city of Salvador to contribute with initiatives for the use of solar energy resource. Firstly, a radiometric platform was implemented to obtain direct measurements of global (EG) and diffuse (EDF) components of incoming solar radiation at the surface. The knowledge of EDF is an important requirement to support photovoltaic system projects, and there is no information on direct measurements of this component in the State of Bahia. The diffuse radiation measurement device (DRMD) was designed and built for this purpose. The measurements of solar radiation components performed in this research were submitted to a specific quality control, statistically analyzed and used to evaluate the performance of different empirical models to represent the behavior of EDF in the tropical coastal city. The results demonstrate the potential to explore solar energy in the city of Salvador, with annual values of sunshine higher than 2200 h year−1 and average daily intensities of EG and EDF equal to 18.7 MJm−2day−1 and 7.35 MJm−2day−1, respectively. The analysis of the diurnal cycle shows that EG in summer reaches a maximum of 4.2 MJm−2h−1 and in the rainy season it reaches a minimum of 3.7 MJm−2h−1, both at noon, and in summer the EDFh is 35% of the EGh and it is 46% in the rainy season.