bluuebunny/crossref_metadata_2025_split huggingface dataset:
Corneal Perforation Caused by Eyelid Margin Trichilemmal Carcinoma: A Case Report and Review of Literature
Authors: Zhang Liying , Lin Zhirong , Wu Huping , Ou Shangkun 
Published: May 2022

BackgroundTrichilemmal carcinoma (TLC) is a rare malignant adnexal tumor most commonly found in the elderly, usually affecting the scalp, eyelids, neck and face. Here, we first reported a rare case of corneal perforation caused by eyelid margin TLC.Case PresentationA 68-year-old female presented with 2 months history of unprovoked redness, pain and blurred vision in the left eye. On slit-lamp examination, a 1 × 2 mm sized aseptic corneal perforation embedded by iris prolapsed was noted. Upon detailed case investigation, we speculated that the severe meibomian gland dysfunction (MGD) and subsequent Blepharokeratoconjunctivitis (BKC) could have led to corneal perforation. The patient underwent penetrating keratoplasty to prevent ulcer enlargement and infection. However, several tiny nodules gradually developed on the eyelid margin postoperatively, accompaniedby with bleeding, burst and madarosis postoperatiely. Subsequently, biopsy revealed the growth of TLC on the eyelid margin, and lesionectomy was immediately conducted During the 1-year follow-up period, no local recurrence or metastasis was observed.ConclusionsTo date, there has not been any report of corneal perforation caused by eyelid margin TLC. Consideration of the clinical presentation, feature and histopathologist will be benefit for the dignoses and treatment of TLC. Ensuring a smooth eyelid margin by total excision of TLC and consistent followup of patient will avoid recurrence.
Immune-Related RNA-Binding Protein-Based Signature With Predictive and Prognostic Implications in Patients With Lung Adenocarcinoma
Authors: Xu Lei , Li Wanru , Yang Ting , Hu Siqi , Zou Qiong , Jiao Ju , Jiang Ningyi , Zhang Yong 
Published: May 2022

Background: Dysregulation of RNA-binding proteins (RBPs) in cancers is associated with immune and cancer development. Here, we aimed to profile immune-related RBPs in lung adenocarcinoma (LUAD) and construct an immune-related RBP signature (IRBPS) to predict the survival and response to immunotherapy.Methods: A correlation analysis was performed to establish a co-expression network of RBPs and immune-related genes (IRGs) to characterize immune-related RBPs in the TCGA–LUAD cohort (n = 497 cases). Then, a combination of the Random survival forest (RSF) and Cox regression analysis was performed to screen the RBPs and establish IRBPS. This was followed by independent validation of IRBPS in GSE72094 (n = 398 cases), GSE31210, (n = 226 cases), and GSE26939 (n = 114 cases). Differences between the low- and high-risk groups were compared in terms of gene mutations, tumor mutation burden, tumor-infiltrating lymphocytes, and biomarkers responsive to immunotherapy.Results: DDX56, CTSL, ZC3H12D, and PSMC5 were selected and used to construct IRBPS. The high-risk scores of patients had a significantly worse prognosis in both training and testing cohorts (p &lt; 0.0001 and p &lt; 0.05, respectively), and they tended to be older and have an advanced TNM stage. Furthermore, IRBPS was a prognostic factor independent of age, gender, smoking history, TNM stage, and EGFR mutation status (p = 0.002). In addition, high-risk scores of IRBPS were significantly correlated with tumor-infiltrating lymphocytes (p &lt; 0.05). They also had a high level of PD-L1 protein expression (p &lt; 0.01), number of neoantigens (p &lt; 0.001), and TMB (p &lt; 0.001), implying the possible prediction of IRBPS in the immunotherapy of LUAD.Conclusion: The currently established IRBPS encompassing immune-related RBPs might serve as a promising tool to predict survival, reflect the immune microenvironment, and predict the efficacy of immunotherapy among LUAD patients.
Erenumab Impact on Sleep Assessed With Questionnaires and Home-Polysomnography in Patients With Migraine: The ERESON Study
Authors: Pellitteri Gaia , Pez Sara , Nilo Annacarmen , Surcinelli Andrea , Gigli Gian Luigi , Lettieri Christian , Valente Mariarosaria 
Published: May 2022

IntroductionMigraine and sleep share a complex and unclear relationship. Poor sleep may trigger migraine attacks; migraine, in turn, is frequently associated with sleep disorders. Few previous studies used questionnaires to assess sleep changes in patients who were treated with migraine-preventive medications (MPMs). More extensive polysomnography (PSG)-based studies for this purpose were not available.ObjectiveTo investigate possible sleep changes in patients with migraine treated with erenumab, using validated sleep questionnaires and home-PSG.MethodsThis observational, prospective, open-label pilot study was conducted at the Clinical Neurology Unit Headache Center of Udine University Hospital from 2020 to 2021. Patients were treated with erenumab as monotherapy or add-on treatment for migraine prevention. Sleep changes were evaluated with questionnaires and polysomnographic recordings at baseline, after 3 and 12 months of treatment. Erenumab efficacy and safety in migraine prophylaxis were also investigated.ResultsTwenty-nine patients completed 3 months of follow-up, whereas 15 patients completed 12 months. We found a weak trend of improvement in daytime somnolence after 3 months of treatment, with stronger results after 12 months (median Epworth Sleepiness Scale (ESS) score from 6.0 to 4.0, p = 0.015); a significant improvement in subjective sleep quality (median Pittsburgh Sleep Quality Index (PSQI) total score from 7 to 5; p = 0.001) was also observed. Home-PSG showed a significant increase in objective sleep efficiency (SE), both after 3 (from 88.1 to 91.0, p = 0.006) and 12 months (from 87.1 to 91.0, p = 0.006) of treatment. In addition, our data confirmed erenumab effectiveness and safety in migraine prevention.ConclusionOur study demonstrated an improvement in both subjective and objective sleep quality in patients treated with a migraine-preventive therapy. Erenumab, in particular, does not cross the blood-brain barrier (BBB), thus a direct effect on sleep is unlikely. Future studies are needed to better understand the mutual influence between migraine and sleep disorders.
Evaluation of a Fully Automatic Deep Learning-Based Method for the Measurement of Psoas Muscle Area
Authors: Van Erck Dennis , Moeskops Pim , Schoufour Josje D. , Weijs Peter J. M. , Scholte Op Reimer Wilma J. M. , Van Mourik Martijn S. , Janmaat Yvonne C. , Planken R. Nils , Vis Marije , Baan Jan , Hemke Robert , Išgum Ivana , Henriques José P. , De Vos Bob D. , Delewi Ronak 
Published: May 2022

BackgroundManual muscle mass assessment based on Computed Tomography (CT) scans is recognized as a good marker for malnutrition, sarcopenia, and adverse outcomes. However, manual muscle mass analysis is cumbersome and time consuming. An accurate fully automated method is needed. In this study, we evaluate if manual psoas annotation can be substituted by a fully automatic deep learning-based method.MethodsThis study included a cohort of 583 patients with severe aortic valve stenosis planned to undergo Transcatheter Aortic Valve Replacement (TAVR). Psoas muscle area was annotated manually on the CT scan at the height of lumbar vertebra 3 (L3). The deep learning-based method mimics this approach by first determining the L3 level and subsequently segmenting the psoas at that level. The fully automatic approach was evaluated as well as segmentation and slice selection, using average bias 95% limits of agreement, Intraclass Correlation Coefficient (ICC) and within-subject Coefficient of Variation (CV). To evaluate performance of the slice selection visual inspection was performed. To evaluate segmentation Dice index was computed between the manual and automatic segmentations (0 = no overlap, 1 = perfect overlap).ResultsIncluded patients had a mean age of 81 ± 6 and 45% was female. The fully automatic method showed a bias and limits of agreement of −0.69 [−6.60 to 5.23] cm2, an ICC of 0.78 [95% CI: 0.74–0.82] and a within-subject CV of 11.2% [95% CI: 10.2–12.2]. For slice selection, 84% of the selections were on the same vertebra between methods, bias and limits of agreement was 3.4 [−24.5 to 31.4] mm. The Dice index for segmentation was 0.93 ± 0.04, bias and limits of agreement was −0.55 [1.71–2.80] cm2.ConclusionFully automatic assessment of psoas muscle area demonstrates accurate performance at the L3 level in CT images. It is a reliable tool that offers great opportunities for analysis in large scale studies and in clinical applications.
Exosomal Circsafb2 Reshaping Tumor Environment to Promote Renal Cell Carcinoma Progression by Mediating M2 Macrophage Polarization
Authors: Huang Xin , Wang Jingyu , Guan Jibin , Zheng Zhong , Hao JunFeng , Sheng Zitong , Wang Menghua , Xu Tianhua , Guo Guangying , Yao Li 
Published: May 2022

BackgroundMacrophages are the most abundant infiltrating immune-related stromal cells present in and around tumors, showing different phenotypes and functions. M2 macrophages mainly exert immunosuppressive functions and promote tumor growth. Exosomes are emerging as important mediators of cross-talk between tumor cells and the microenvironment. CircRNAs are novel members of non-coding RNAs that regulate cancer proliferation and progression. However, the mechanism by which exosomal circRNA regulates macrophage polarization in renal cell carcinoma (RCC) is still largely unknown.MethodsRCC-derived exosomes were characterized using transmission electron microscopy and nanoparticle tracking analysis (NTA). CCK-8, wound healing, and Transwell assays were performed to assess whether exosomes would affect the proliferation, migration, and invasion of RCC. Furthermore, we performed a bioinformatics analysis to identify circRNAs in RCC serum-derived exosomes from the GEO database. The fluorescence in situ hybridization (FISH) assay was used to detect the cellular distribution of circSAFB2. Bioinformatics analyses (StarBase 2.0) were used to pool the miRNA targets of circSAFB2. Luciferase assays were performed to verify the direct interactions. Western blotting was used to detect markers of macrophage M2 polarization. Lastly, mouse xenograft and bioluminescence imaging were used to examine the clinical relevance of exosomal circSAFB2 in vivo.ResultsWe report the circRNA derived from SAFB2 and evaluate its biological function in promoting the immune escape of RCC. We found that circSAFB2 was highly expressed in RCC tissues and RCC-derived exosomes. Furthermore, we demonstrated that exosomal circSAFB2 mediates the polarization of M2 macrophages through the miR-620/JAK1/STAT3 axis to promote RCC metastasis.ConclusionsOur data first demonstrated that circSAFB2 leads to immune escape from RCC by mediating M2 macrophage polarization via the miR-620/JAK1/STAT3 axis. These findings indicate a novel molecular mechanism of exosomal circSAFB2 in the progression of RCC and implicate circSAFB2 as a target for exosome-mediated tumor immune evasion.
Systematic Review and Meta-Analysis of Prevalence of Depression Among Caregivers of Cancer Patients
Authors: Pan Yuan-Chien , Lin Yaw-Sheng 
Published: May 2022

BackgroundCaregivers of cancer patients commonly experience depressive symptoms due to the heavy burden of caregiving responsibility.ObjectiveThis meta-analysis examined the prevalence of depression among caregivers of cancer patients.MethodsWe included 85 studies covering 23,317 participants published between 2001 and 2021 (25 countries) that reported the prevalence of depression among caregivers of cancer patients. We examined the pooled prevalence of depression and hypothesized moderators, including year, age, sex, geographic regions, percentage of spousal caregivers, depression measures, and cancer stage.ResultsAll 85 effect sizes included 6,077 caregivers of patients with depression. The weighted average prevalence of depression was 25.14% (95% CI, 21.42–29.27%) among caregivers. The prevalence rates were moderated by geographic region, patients' cancer stage, and measures for depression. The prevalence rates also varied among the different measures assessing depression. The prevalence rate decreased with the mean age of the caregivers and the percentage of spousal caregivers.ConclusionsThis study revealed a high prevalence of depression among caregivers of cancer patients. The prevalence rates also varied with the study design, demographics of caregivers, and patients' medical information. These findings highlight that psychological support and intervention may be crucial for patients and their caregivers in clinical practice.
Inverse Association Between Resting-State Putamen Activity and Iowa Gambling Task Performance in Patients With Obsessive-Compulsive Disorder and Control Subjects
Authors: Hasuzawa Suguru , Tomiyama Hirofumi , Murayama Keitaro , Ohno Aikana , Kang Mingi , Mizobe Taro , Kato Kenta , Matsuo Akira , Kikuchi Kazufumi , Togao Osamu , Nakao Tomohiro 
Published: May 2022

BackgroundSymptoms of obsessive-compulsive disorder (OCD) have been conceptualized as manifestations of decision-making deficits. Patients with OCD exhibit impairment during the decision-making process, as assessed by the Iowa Gambling Task (IGT). This impairment is independent of clinical severity and disease progression. However, the association between the decision-making deficit and resting-state brain activity of patients with OCD has not been examined.MethodsFifty unmedicated patients with OCD and 55 matched control subjects completed IGT. Resting-state brain activity was examined using the fractional amplitude of low-frequency fluctuations (fALFFs). fALFF analysis focused on the slow-4 and 5 bands. Group comparisons were performed to determine the association between IGT performance and fALFFs.ResultsThere was a significant group difference in the association between the IGT total net score and slow-4 fALFFs in the left putamen (voxel height threshold of p &lt; 0.001; cluster size threshold of p &lt; 0.05; family wise error-corrected). Higher putamen slow-4 fALFFs were correlated with lower IGT scores for OCD patients (r = −0.485; p &lt; 0.0005) and higher IGT scores for control subjects (r = 0.402; p &lt; 0.005). There was no group difference in the association between the IGT total net score and slow-5 fALFFs.ConclusionsThese findings in unmedicated patients demonstrate the importance of resting-state putamen activity for decision-making deficit associated with OCD, as measured by IGT. The inverse correlation may be explained by the hypersensitive response of the putamen in patients with OCD.
Comparison of Hypomanic Symptoms Between Bipolar I and Bipolar II Disorders: A Network Perspective
Authors: Bai Wei , Feng Yuan , Sha Sha , Zhang Qinge , Cheung Teris , Zhang Dexing , Su Zhaohui , Ng Chee H. , Xiang Yu-Tao 
Published: May 2022

BackgroundHypomanic symptoms between bipolar-I disorder (BD-I) and bipolar-II disorder (BD-II) are often indistinguishable in clinical practice. This study compared the network structure of hypomanic symptoms between patients with BD-I and BD-II.MethodsThe 32-item Hypomania Checklist (HCL-32) was used to assess hypomanic symptoms. Network model was generated in BD-I and BD-II patients. Centrality index of strength was used to quantify the importance of each symptom in the network. The Network Comparison Test (NCT) was used to assess the differences in hypomanic symptoms between BD-I and BD-II patients.ResultsAltogether, 423 patients with BD (BD-I: 191 and BD-II: 232) were included. The most central symptom was HCL17 “I am more flirtatious and/or am more sexually active” (strength BD–I = 5.21) and HCL12 “I have more ideas, I am more creative” (strength BD–II = 6.84) in BD-I and BD-II samples, respectively. The results of NCT showed that four nodes (HCL12 “I have more ideas, I am more creative,” HCL17 “I am more flirtatious and/or am more sexually active,” HCL23 “My thoughts jump from topic to topic,” and HCL31 “I drink more alcohol”) were significantly different between the BD-I and BD-II samples. Two edges (HCL3 “I am more self-confident”–HCL17 “I am more flirtatious and/or am more sexually active,” and HCL10 “I am physically more active (sport, etc.)”–HCL24 “I do things more quickly and/or more easily”) were significantly stronger in BD-I compared to BD-II patients.ConclusionThe network structure of hypomanic symptoms is different between BD-I and BD-II patients. Interventions targeting the respective central symptoms and edges should be developed for BD-I and BD-II separately.
A Prospective Comparative Study of Health Inequalities and the Epidemiology of Stroke in French Guiana and Dijon, France
Authors: Rochemont Devi Rita , Mimeau Emmanuelle , Misslin Caroline , Papaix-Puech Martine , de Toffol Bertrand , Sabbah Nadia , Delmas Emmanuel , Bejot Yannick , Fournel Isabelle , Nacher Mathieu 
Published: May 2022

BackgroundIn French Guiana poverty is widespread and specialized care is lacking. We aimed to compare strokes between precarious and non-precarious patients within French Guiana and to compare the epidemiology of ischemic strokes and their outcomes between French Guiana and mainland France.MethodsA multicenter prospective cohort examined the influence of social inequalities on stroke characteristics. Consecutive patients aged &gt; 18 years admitted for an acute ischemic stroke, confirmed by neuroimaging were eligible. Exclusion criteria were a history of symptomatic stroke, presence of other short-term life-threatening diseases and inability to contact patients by telephone during follow-up. Social deprivation was measured using the EPICES score, which is based on a multidimensional questionnaire.ResultsOverall, 652 patients with ischemic stroke were included. The patients in French Guiana were 7 years younger, were more frequently male, of sub-Saharan ancestry, they had a low level of education, and were more often precarious (67.7%) than the patients included in Dijon (39.2%). The origin of the ischemic stroke was predominantly lacunar for patients included in French Guiana and cardioembolic for patients included in Dijon, with greater severity for patients included in Dijon. The proportion of patients with known pre-stroke hypertension, diabetes, or a history of Transient Ischemic Accident was greater in French Guiana than in Dijon. In contrast, hypercholesterolemia, atrial fibrillation, and history of Myocardial Infarction were more frequently found in patients included in Dijon than in patients included in French Guiana. Fibrinolysis was less frequent in French Guiana than in Dijon, 24% of patients arriving early enough receiving thrombolysis in French Guiana vs. 45% in Dijon, P &lt; 0.0001. However, after adjustment for patient characteristics, the effect of the center on the use of fibrinolysis disappeared. When comparing precarious and non-precarious patients within French Guiana, the main difference was the younger age and the lower mortality of precarious patients—notably immigrants.ConclusionPrecariousness was widespread in French Guiana. Within French Guiana, despite a younger age among foreigners than French patients, the risk factors, mechanisms, and outcomes were homogenous across socioeconomic strata. The observed differences between the two contrasted French territories suggested that, beyond health inequalities, the epidemiology of cardiovascular risk factors may differ between French Guiana and mainland France.
Undiagnosed Diabetes Mellitus and Its Predictors Among Socially Marginalized Menja Communities in Southwest Ethiopia
Authors: Assefa Ashenafi , Shifera Nigusie 
Published: May 2022

Background:Diabetes mellitus (DM) is a metabolic disorder marked by a persistently high blood glucose level over a prolonged period of time linked to either defects in insulin secretion, insulin action, or both. It is responsible for 537 million adult cases and 6.7 million deaths in 2021. However, about half of the people with diabetes go undiagnosed. Low-income and socially disadvantaged communities are the most vulnerable to the disease. Despite this fact, nothing has been done among these communities, so this study aimed to assess the extent of undiagnosed diabetes and its predictors among the socially marginalized Menja communities of Southwest Ethiopia, 2021.MethodsA community-based cross-sectional study was done in the Menja communities from April 21/2021 to June 30/2021. The required sample size was calculated using the single population proportion formula and systematic sampling techniques were employed to select the households. Data were collected through face-to-face interviews utilizing an interviewer-administered questionnaire to collect socio-demographic and behavioral characteristics, and anthropometric measurements were taken from each participant. Diabetes was defined as participants who had an FBG ≥ 126 mg/dL or RBG &gt; 200 mg/dL. The multivariate logistic regression model was used to identify the predictors of diabetes; adjusted OR with a 95% CI was computed to assess the strength of associations.ResultsThe prevalence of undiagnosed DM among the socially marginalized Menja communities was 14.7% [95% CI: (11.1–18.3)], and sex-specific prevalence was 16.8%, and 11.1% for men and women respectively. Factors like alcohol consumption (AOR = 3.0, 95% CI 1.49 to 6.05), family history of DM 4.4 (AOR = 4.37, 95% CI 2.04 to 9.35), lower vegetable consumption 3.5 (1.19–10.31) (AOR = 3.5, 95% CI 1.19 to 10.31), and less physical exercise 3.3 (AOR = 3.34, 95% CI 1.61 to 6.90) were the independent predictors that increase the risk of diabetes among Menja communities.Conclusion and RecommendationsUndiagnosed diabetes was high as compared to other settings. Alcohol use, family history of diabetes, vegetable consumption, and physical exercise were predictors of diabetes. Hence, the study suggests frequent screening and treatment for high-risk groups. Minimizing alcohol drinking, frequent vegetable consumption, and physical exercises were recommended measures for the prevention and control of DM among the population of Ethiopia.
Factors Associated With Coverage of Health Insurance Among Women in Malawi
Authors: Chauluka Margaret , Uzochukwu Benjamin S. C. , Chinkhumba Jobiba 
Published: May 2022

IntroductionAccess to healthcare for the vulnerable groups including women has long been a theme encouraged worldwide from the first general assembly on health to the current sustainable development goals. Despite many countries having a free public healthcare system, there are inequalities in access to care and significant out-of-pocket spending, pushing most women into poverty against the principles of universal health coverage. Coverage of Malawian women with health insurance is poor; thus, there is limited cushioning and high risk of poverty, as women bear costs of care as primary caregivers. There is need to explore determinants of coverage of health insurance among women in Malawi to inform health policy.MethodologyThis study was quantitative in nature, using cross-sectional secondary data from the 2015 to 2016 Malawi Demographic and Health Survey involving women aged between 15 and 49 years. We assessed factors associated with insurance coverage by comparing women with and without insurance schemes using binary logistic regression. Analysis was done using STATA statistical package version 13.ResultsThe analysis included a total of 24,562 women with a mean age of 28 SD (9.3). Of these cases, 1.5% had health insurance. High education attainment, occupation, and wealth were significantly associated with health insurance ownership, with all having p-values of &lt; 0.01. On the other hand, a woman's residence, marital status, and who heads a household were not associated with ownership of health insurance significantly.ConclusionEducation, occupation, and wealth have a key role in influencing a woman's choice in owning health insurance. This informs policymakers and health insurance providers on how best to approach women's health financing and factors to target in social security programs and health insurance products that speak to women's needs and capacity.