bluuebunny/crossref_metadata_2025_split huggingface dataset:
The efficacy and safety of tacrolimus on top of glucocorticoids in the management of IIM-ILD: A retrospective and prospective study
Authors: Chen Yuxue , Bai Zhiqian , Zhang Ziyun , Hu Qiongjie , Zhong Jixin , Dong Lingli 
Published: September 2022

ObjectiveTo examine the efficacy of tacrolimus on top of glucocorticoids (GCs) in the management of idiopathic inflammatory myopathies-associated interstitial lung disease (IIM-ILD) and further assess the therapeutic benefit and safety of low-dose pirfenidone followed above treatments.MethodsThe retrospective study comprised 250 patients with IIM-ILD hospitalized in Tongji Hospital from 2014 to 2020. Demographic data, survival outcomes, and recurrence rates over the 1-year follow-up period were retrospectively analyzed. These patients were divided into two groups based on treatment with tacrolimus alone or other conventional immunosuppressants. Endpoints were compared by adjusted Cox regression model using inverse probability of treatment weighting to minimize treatment bias and potential confounders. For the prospective study, IIM-ILD patients treated with tacrolimus alone or tacrolimus combined with low-dose pirfenidone were enrolled from 2018 to 2020. Clinical characteristics, survival outcomes and multifarious assessment scales were followed up at baseline, 3, 6 and 12 months. The primary endpoint was 12-month survival rate and the secondary endpoints included respiratory-related events, adverse events, exacerbation in HRCT findings and laboratory parameters during therapy courses, and changes in respiratory function.ResultsFor the retrospective study, tacrolimus group (n=93) had a significantly higher survival rate (weighted HR=0.330, p=0.002) and a lower relapse rate (weighted HR=0.548, p=0.003) compared with patients treated with other types of immunosuppressant (n=157) after adjustment. The prospectively enrolled 34 IIM-ILD patients were treated with tacrolimus (n=12) or tacrolimus combined with low-dose pirfenidone (n=22). After 12 months of treatment with tacrolimus, patients in the prospective cohort showed significant improvements in cardio-pulmonary function, disease activity, muscle strength, and mental scale from baseline. Subgroup analysis indicated that patients with tacrolimus and pirfenidone combination therapy showed lower chest HRCT scores (p=0.021) and lower respiratory-related relapse rates than those in tacrolimus monotherapy group (log-rank p=0.0029). The incidence rate of drug-associated adverse events (AEs) was comparable between two groups and none of the patients discontinued the treatment due to severe AEs.ConclusionTacrolimus is well-tolerated and effective in the treatment of IIM-ILD. Furthermore, low-dose pirfenidone add-on treatment seems result in favorable improvements in pulmonary involvements for IIM-ILD patients.Clinical Trial Registrationhttp://www.chictr.org.cn, identifier ChiCTR2100043595.
Humoral antimalaria immune response in Nigerian children exposed to helminth and malaria parasites
Authors: Adukpo Selorme , Adedoja Ayodele , Esen Meral , Theisen Michael , Ntoumi Francine , Ojurongbe Olusola 
Published: September 2022

BackgroundMalaria and helminthic parasites are endemic in tropical countries, and co-infections might influence host-parasite interactions. In this community-based cross-sectional study, the effect that the presence of soil-transmitted helminths (STH) (Hookworm, Hymenolepis nana) and Schistosoma haematobium infections could have on the immunoglobulin (Ig) candidate protein of the malaria vaccine GMZ2 levels was evaluated.MethodsBlood, stool, and urine samples were collected from 5-15-year-old children to diagnose P. falciparum (Pf), STH, and Schistosoma haematobium, respectively. Identification and quantification of the parasite load of STH and S. haematobium were achieved by light microscopy. A polymerase chain reaction was carried out to detect submicroscopic infections of P. falciparum. Plasma levels of GMZ2 specific IgG and its subclasses were quantified by ELISA.ResultsThe median level of total IgG in individuals with co-infection with Pf/H. nana was significantly lower in the mono-infected group with Pf (p = 0.0121) or study participants without infection (p=0.0217). Similarly, the median level of IgG1 was statistically lower in Pf/H. nana group compared to Pf-group (p=0.0137). Equally, the Pf/H. nana infected individuals posted a lower level of IgG1 compared to Pf-group (p=0.0137) and IgG4 compared to the Pf-group (p=0.0144). Spearman rank correlation analyses indicated positive relationships between the densities of H. nana (ρ=0.25, p=0.015) and S. haematobium (ρ=0.36, p&lt;0.0001).ConclusionsHookworm and H. nana infections are associated with reduced GMZ2 specific IgG levels. This study shows the possible manipulation of immune responses by helminths for their survival and transmission, which may have serious implications for vaccine development and deployment in helminth-endemic regions.
Characterizing location of spotted lanternfly egg masses in wooded habitat during early invasion stages
Authors: Madalinska Katarzyna , McDougall Robert , Nielsen Anne L. 
Published: September 2022

The spotted lanternfly, Lycorma delicatula (Hemiptera: Fulgoridae), is an invasive planthopper from Asia that is estimated to have spread 17 km/yr since it's initial detection in Pennsylvania in 2014. Lycorma delicatula is a pest to the agricultural and forestry industries in the Mid-Atlantic region of the United States, in part due to its highly polyphagous nature. Current detection relies on visual observations, unbaited traps, or eDNA surveillance in its primary hosts, including grape and hardwoods. These approaches narrow the surveillance area by concentrating on known host plants but could be further refined to narrow the search parameters from the 100+ known host plants. Because L. delicatula appears to have a strong population buildup in wooded areas, we evaluated the relationship between egg mass presence and habitat characteristics in wooded habitats adjacent to vineyards in New Jersey at six farms within the first two years of L. delicatula detection. Habitat characteristics included distance from wood edge, and presence of a critical host plant Ailanthus altissima, and presence of Vitis spp. within 4.5 m. We identified a significant relationship between egg mass presence and Vitis spp. with an 88% probability of finding an egg mass close to a wild grapevine, dropping to 9% where grapes were absent. During the early invasion stages when this research was conducted, a two-year delay from initial detection in wooded habitats to nymphal presence in the vineyard was observed.
Frequency and gender differences in the use of professional home care in late life. Findings from three German old-age cohorts
Authors: Buczak-Stec Elżbieta W. , Hajek André , Pabst Alexander , Brettschneider Christian , van den Bussche Hendrik , Wiese Birgitt , Weyerer Siegfried , Werle Jochen , Hoell Andreas , Pentzek Michael , Fuchs Angela , Luppa Melanie , Löbner Margit , Stein Janine , Förster Franziska , Weeg Dagmar , Mösch Edelgard , Heser Kathrin , Scherer Martin , Maier Wolfgang , Angermeyer Matthias C. , Wagner Michael , Riedel-Heller Steffi G. , König Hans-Helmut 
Published: September 2022

AimThe aim of this study was to investigate the frequency of and the gender differences in the use of professional home care in Germany.MethodsWe used harmonized data from three large cohort studies from Germany (“Healthy Aging: Gender-specific trajectories into the latest life”; AgeDifferent.de Platform). Data were available for 5,393 older individuals (75 years and older). Mean age was 80.2 years (SD: 4.1 years), 66.6% were female. Professional homecare outcome variables were use of outpatient nursing care, paid household assistance, and meals on wheels' services. Logistic regression models were used, adjusting for important sociodemographic variables.ResultsAltogether 5.2% of older individuals used outpatient nursing care (6.2% women and 3.2% men; p &lt; 0.001), 24.2% used paid household assistance (26.1% women and 20.5% men; p &lt; 0.001) and 4.4% used meals on wheels' services (4.5% women and 4.0% men; p = 0.49). Regression analysis revealed that women had higher odds of using paid household assistance than men (OR = 1.48, 95% CI: [1.24–1.76]; p &lt; 0.001), whereas they had lower odds of using meals on wheels' services (OR = 0.64, 95% CI: [0.42–0.97]; p &lt; 0.05). No statistically significant differences in using outpatient nursing care between women and men were found (OR = 1.26, 95% CI: [0.87–1.81]; p = 0.225). Further, the use of home care was mainly associated with health-related variables (e.g., stroke, Parkinson's disease) and walking impairments.ConclusionsOur study showed that gender differences exist in using paid household assistance and in culinary dependency. For example, meals on wheels' services are of great importance (e.g., for individuals living alone or for individuals with low social support). Gender differences were not identified regarding outpatient nursing care. Use of professional home care services may contribute to maintaining autonomy and independence in old age.
The species-level microbiota of healthy eyes revealed by the integration of metataxonomics with culturomics and genome analysis
Authors: Dong Kui , Pu Ji , Yang Jing , Zhou Guohong , Ji Xuan , Kang Zhiming , Li Juan , Yuan Min , Ning Xiaoling , Zhang Zhaoxia , Ma XingYu , Cheng Yanpeng , Li Hong , Ma Qin , Li Hong , Zhao Lijun , Lei Wenjing , Sun Bin , Xu Jianguo 
Published: September 2022

ObjectivesTo characterize the healthy ocular surface microbiota at the species level, including cultured and uncultured taxa.MethodsWe integrated the metataxonomic method with culturomics and genome sequencing analysis of selected isolated strains to better illustrate the taxonomic structure of the ocular surface microbiota. The metataxonomics used the full-length 16S rRNA gene sequences and the operational phylogenetic unit strategy, which can precisely identify the cultured and uncultured or potentially new taxa to species level based on the phylogenetic tree constructed.ResultsWe detected 1,731 operational phylogenetic units (OPUs) in 196 healthy eyes from 128 people, affiliated to 796 cultured species, 784 potentially new species, and 151 potentially new higher taxa. The microbiota for each eye had 49.17 ± 35.66 OPUs. Of the 796 cultured species, 170 (21.36%) had previously caused clinical infections. Based on where they were initially isolated, the ocular surface microbiota mainly came from human body sites (34.55%), the environment (36.93%), plants (9.05%), animals (4.90%), and others; 428 strains were isolated from 20 eyes, affiliated to 42 species, and had come from the environment (33.33%) and the skin (16.67%). Of these, 47.62% had previously caused clinical infections. Genome analysis of 73 isolators revealed that 68.5% of them carried antibiotic resistance genes. The most frequently isolated genera, namely Staphylococcus, Streptococcus, and Moraxella, had an average of 5.30, four, and three resistance genes per strain, respectively.DiscussionThe study found that the ocular surface microbiota mainly came from the environment, plants, animals, food, and human body sites such as the skin, oral cavity, upper respiratory tract, etc. No core member of ocular surface microbiota was detected at the species level. The human eyes were invaded and colonized by bacteria from the exposed environment, some of which were capable of causing infections in humans and carried antibiotic resistance genes. Preventive measures should be developed to protect our eyes from danger.
Serum creatinine/cystatin C ratio is a systemic marker of sarcopenia in patients with gastrointestinal stromal tumours
Authors: Ding Ping’an , Guo Honghai , Sun Chenyu , Chen Shuya , Yang Peigang , Tian Yuan , Lowe Scott , Zhao Qun 
Published: September 2022

BackgroundIt is well known that sarcopenia is a common risk factor in patients with gastrointestinal tumours, which may negatively affect the clinical outcome and prognosis. Recent studies suggest that serum creatinine-cystatin C (Cr/CysC) ratio may be associated with sarcopenia, but this association lacks sufficient evidence in patients with gastrointestinal stromal tumours (GIST). Therefore, this study aimed to investigate whether the Cr/CysC ratio was associated with sarcopenia and recurrence-free survival (RFS) in patients with GIST.Materials and methodsThe study retrospectively analysed 413 patients with GIST who underwent surgical resection from January 2016 to January 2020. The serum Cr/CysC ratio was determined as a proxy for sarcopenia by comparing it with various biomarkers and Cox multifactorial analysis was used to determine the relationship between Cr/CysC ratio and prognosis.ResultsSerum Cr/CysC was positively correlated with skeletal muscle area (SMA) (r = 0.256, p &lt; 0.001), skeletal muscle index (SMI) (r = 0.300, p &lt; 0.001), and hand grip strength (HGS) (r = 0.251, p &lt; 0.001). The area under the receiver operator characteristic curve for sarcopenic subjects with serum Cr/CysC ratio was significantly greater than other biomarkers (Cr/CysC: 0.840, CysC: 0.732, Cr: 0.518). The optimal cut-off value for Cr/CysC was 0.65, and patients in the high Cr/CysC group had a higher 3-year recurrence-free survival (RFS) than those in the low Cr/CysC group (92.72 vs. 72.46%, p &lt; 0.001). Cox multifactorial analysis found that the Cr/CysC ratio was an independent risk factor for RFS in GIST patients (HR = 2.143, 95% CI: 1.431–5.459, p = 0.011).ConclusionSerum Cr/CysC ratio has satisfactory and comparable diagnostic accuracy, and prognostic value for sarcopenia in patients with GIST. Therefore, it can be a simple and practical clinical tool to screen sarcopenia in GIST patients. However, further studies are required to validate these findings.
A high preoperative serum IL-25 level is a negative prognosis predictor after liver resection for HBV-HCC
Authors: Chen Shao-hua , Wang Xu 
Published: September 2022

ObjectiveThe aim of this study was to evaluate the association between preoperative IL-25 levels and HBV-HCC patient outcomes following liver surgery.MethodsThis study enrolled consecutive HCC patients that had undergone liver surgery from 2008 to 2015. Baseline patient clinical properties were assessed to establish predictors of postoperative overall survival and recurrence-free survival (OS and RFS, respectively) following liver resection. In addition, serum IL-25 levels were assessed via ELISA.ResultsCox regression analyses revealed IL-25 levels to be independently related to the OS and RFS of 896 HBV-associated HCC patients. An optimal IL-25 cutoff level of 14.9 μg/ml was identified, with 206 patients in this cohort having IL-25 levels above this threshold. Both the OS and RFS of patients with an IL-25 level &lt;14.9 μg/ml were significantly better after liver resection as compared to those of patients with higher preoperative levels of this cytokine (p &lt; 0.05). Cox multivariate regression analyses revealed an IL-25 level ≥ 14.9 μg/L to be an independent predictor of poorer RFS and OS. A combination of IL-25 levels and tumor diameter may be an even more reliable predictor of OS.ConclusionsIL-25 levels are independent predictors of postoperative survival within HCC patients undergoing liver resection.
The epidemic of thyroid cancer in China: Current trends and future prediction
Authors: Wu Jiayuan , Zhao Xiaoyan , Sun Jianzhong , Cheng Chong , Yin Chunyu , Bai Ruhai 
Published: September 2022

BackgroundThyroid cancer (TC) is one of the most common cancers in China. The aim of this study was to identify the potential age, period, and cohort effect under the long-term trends in TC incidence and mortality, making projections up to 2030.MethodsIncidence and mortality data on TC were obtained from the Global Burden of Disease Study 2019. The population predictions were obtained from the United Nations World Population Prospects 2019. An age–period–cohort model was used for the analysis.ResultsFrom 1990 to 2019, the net drift (the overall annual percentage change of TC over time adjusted for age groups) of the TC incidence was 5.01% (95% confidence interval [CI]: 4.72%, 5.29%) for men and 1.48% (95% CI: 1.14%, 1.82%) for women. The net drift of TC mortality was 1.64% (95% CI: 1.38%, 1.91%) for men and –2.51% (95% CI: –2.77%, –2.26%) for women. Regarding the incidence of TC, both the period and the cohort relative risks (RRs) in men and women showed an overall increasing trend. As to the mortality rate of TC, both the period and cohort RRs in women showed a monotonic declining trend. The period RRs for men decreased after 2015, but the cohort RRs revealed a fluctuating upward pattern. From 2019 to 2030, the TC incidence was projected to rise by 32.4% in men and 13.1% in women, the mortality declining by 13.0% in men and 17.3% in women. The elderly was projected to have an increasing proportion of TC occurrence and deaths.ConclusionsOver the past 30 years, the incidence rate of TC in China has continually increased, and this trend was projected to continue. Although male mortality has increased in the past, it is expected to decline in the future. The proportion of older people among TC occurrence and death was projected to gradually increase, and the difficulties elderly with TC lrequire more attention.
Deep learning analysis to predict EGFR mutation status in lung adenocarcinoma manifesting as pure ground-glass opacity nodules on CT
Authors: Yoon Hyun Jung , Choi Jieun , Kim Eunjin , Um Sang-Won , Kang Noeul , Kim Wook , Kim Geena , Park Hyunjin , Lee Ho Yun 
Published: September 2022

BackgroundEpidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) showed potency as a non-invasive therapeutic approach in pure ground-glass opacity nodule (pGGN) lung adenocarcinoma. However, optimal methods of extracting information about EGFR mutation from pGGN lung adenocarcinoma images remain uncertain. We aimed to develop, validate, and evaluate the clinical utility of a deep learning model for predicting EGFR mutation status in lung adenocarcinoma manifesting as pGGN on computed tomography (CT).MethodsWe included 185 resected pGGN lung adenocarcinomas in the primary cohort. The patients were divided into training (n = 125), validation (n = 23), and test sets (n = 37). A preoperative CT-based deep learning model with clinical factors as well as clinical and radiomics models was constructed and applied to the test set. We evaluated the clinical utility of the deep learning model by applying it to 83 GGNs that received EGFR-TKI from an independent cohort (clinical validation set), and treatment response was regarded as the reference standard.ResultsThe prediction efficiencies of each model were compared in terms of area under the curve (AUC). Among the 185 pGGN lung adenocarcinomas, 122 (65.9%) were EGFR-mutant and 63 (34.1%) were EGFR-wild type. The AUC of the clinical, radiomics, and deep learning with clinical models to predict EGFR mutations were 0.50, 0.64, and 0.85, respectively, for the test set. The AUC of deep learning with the clinical model in the validation set was 0.72.ConclusionsDeep learning approach of CT images combined with clinical factors can predict EGFR mutations in patients with lung adenocarcinomas manifesting as pGGN, and its clinical utility was demonstrated in a real-world sample.
Development and validation of a nomogram for predicting pelvic lymph node metastasis and prognosis in patients with cervical cancer
Authors: Wang Mengting , Ma Min , Yang Liju , Liang Chengtong 
Published: September 2022

ObjectiveCervical cancer (CC) is one of the main causes of death among gynecological malignancies. Patients with CC with lymph node metastasis (LNM) have poor prognoses. We investigated the risk factors and prognosis of LNM in patients with CC patients using data from the SEER database.MethodsWe collected the information of cervical cancer patients registered in SEER database from 2010 to 2015. The dataset was divided into a training set and a validation set at a 7:3 ratio. LASSO regression analysis was used to evaluate risk factors for LNM in patients with CC. Using the results, we established a nomogram prediction model. C-index, ROC curves, calibration curves, decision curve analysis, and clinical impact curves were used to evaluate the prediction performance of the model.ResultsWe included 14,356 patients with CC in the analysis. Among these, 3997 patients were diagnosed with LNM. A training set (10,050 cases) and a validation set (4306 cases) were used for the following analysis. We established nomogram LNM prediction models for the patients with T1-2-stage CC. The C-indices for the internal and external validations of the prediction models were 0.758 and 0.744, respectively. In addition, we established a prognostic nomogram for all CC patients with LNM, and the internal and external validation C-indices were 0.763 and 0.737.ConclusionWe constructed a quantitative and visual predictive nomogram that predicted prognosis of patients with LNM in CC to provide clinicians with a reference for diagnosis and treatment.
A fresh “slant” on modified Mitchell bladder neck reconstruction: A contemporary single-institution experience
Authors: Bowen Diana K. , Cheng Earl Y. , Hirsch Josephine , Huang Jason , Meyer Theresa , Rosoklija Ilina , Chu David I. , Yerkes Elizabeth B. 
Published: September 2022

IntroductionPatients with neurogenic urinary incontinence due to an incompetent outlet may be offered bladder neck reconstruction, but the quest for the perfect surgical-outlet procedure continues. Our aim was to characterize continence and complications after modified Mitchell urethral lengthening/bladder neck reconstruction (MMBNR) with sling and to introduce a modification of exposure that facilitates subsequent steps of MMBNR.MethodsA single-institution, retrospective cohort study of patients who underwent primary MMBNR between May 2011 and July 2019 was performed. Data on demographics, urodynamic testing, operative details, unanticipated events, continence, bladder changes, and additional procedures were collected. A 2013 modification that permits identification of the incompetent bladder neck prior to urethral unroofing was applied to the last 17 patients. The trigone and bladder neck are exposed via an oblique low anterolateral incision on the bladder. Ureteral reimplantation is not routinely performed. Focal incision of the endopelvic fascia after posterior plate creation limits breadth of blunt dissection for sling placement. Descriptive statistics were utilized.ResultsA total of 25 patients (13 females) had MMBNR with sling at a median age of 10 years [interquartile range (IQR) 8–11]. Bladder augmentation was performed concurrently in 14/25 (56%) patients. At a median of 5.0 (IQR 3.9–7.5) years follow-up after MMBNR, 9/11 (82%) without bladder augmentation and 13/14 (93%) with bladder augmentation had no leakage per urethra during the day without further continence procedures. Of the three patients with persistent incontinence, two achieved continence with bladder wall Botox injection (overall continence 24/25, 96%). New and recurrent vesicoureteral reflux was noted in five patients and one patient, respectively. Two patients required subsequent bladder augmentation for pressures and one other will likely require it. None have required bladder neck closure or revision.ConclusionMMBNR with sling provides promising continence per urethra in neurogenic bladder with low need for secondary continence procedures. Ongoing modifications may achieve elusive total continence.