bluuebunny/crossref_metadata_2025_split huggingface dataset:
The difference in red blood cell distribution width from before to after thrombolysis as a prognostic factor in acute ischemic stroke patients: A 2-year follow-up
Authors: Jiang Yanyan , Ren Chuancheng , Alimujiang Aydos , Wu Yuncheng , Huang Dongya , Yang Weiting 
Published: October 2022

PurposeThe aim of our study was to determine whether delta red blood cell distribution (ΔRDW) improves neurological outcomes in acute ischemic stroke (AIS) patients 2 years after intravenous thrombolysis (IVT) therapy.MethodsAIS patients who received IVT between January 2013 and December 2019 were retrospectively analyzed. In accordance with their mRS scores, the patients were divided into two groups. A binary logistic regression analysis was conducted to determine the influencing factors of adverse functional outcomes. It was decided to evaluate the variables' the predictive ability by using the area under the receiver operating characteristic. For the poor neurological recovery risk model, features were selected using the LASSO regression model. We also developed a predictive model based on logistic regression analysis, which combined the features selected in the minimum absolute contraction and selection operator regression models. An evaluation of the discrimination, calibration, and clinical applicability of the predictive model was conducted using the C index, calibration chart, and decision curve analysis. Internal validation was evaluated via bootstrapping.ResultsBinary logistic regression analysis showed that ΔRDW was an independent influencing factor for poor neurofunctional outcomes. The most appropriate ΔRDW cut-off value for predicting the recovery of poor neurological outcomes was 18.9% (sensitivity: 89.9%, specificity: 78.6%, p &lt; 0.001). The predictive factors included in the nomogram were age, the occurrence of CHD, stroke, AF, ΔRDW, NIHSS score at onset, interval time from onset to IVT, and whether there were indwelling urine catheters and gastric tubes. The model has not only a good discrimination ability, which was indicated by an overall C index of 0.891 (95% confidence interval: 0.829–0.953), but also a considerable calibration ability. Decision curve analysis showed that the nomogram of adverse neurological outcomes recovery was useful in the clinical practice when intervention was implemented above the threshold of 1% possibility of adverse neurological outcomes recovery.ConclusionIn patients with AIS after thrombolysis, the ΔRDW is a potential influencing factor that can be readily used to predict the likelihood of poor neurological function recovery.
Folate receptor-positive circulating tumor cells predict survival and recurrence patterns in patients undergoing resection for pancreatic cancer
Authors: Cheng Hao , Yang Jun , Fu Xu , Mao Liang , Chu Xuehui , Lu Chenglin , Li Gang , Qiu Yudong , He Wei 
Published: October 2022

ObjectiveTo evaluate the prognostic impact of folate receptor (FR)-positive circulating tumor cells (FR+ CTCs) for patients with pancreatic cancer (PC).BackgroundRisk stratification before surgery for PC patients remains challenging as there are no reliable prognostic markers currently. FR+ CTCs, detected by ligand-targeted polymerase chain reaction (LT-PCR), have shown excellent diagnostic value for PC in our previous study and prognostic value in a variety of cancer types.MethodsPeripheral blood samples from 44 consecutive patients diagnosed with PC were analyzed for FR+ CTCs. 25 patients underwent tumor resection and were assigned to the surgical group. 19 patients failed to undergo radical resection because of local advance or distant metastasis and were assigned to the non-surgical group. The impact of CTCs on relapse and survival were explored.ResultsFor the prognostic stratification, the optimal cut-off value of CTCs analyzed by receiver operating characteristic (ROC) curve was 14.49 folate units (FU)/3 ml. High CTC levels (&gt; 14.49 FU/3 ml) were detected in 52.0% (13/25) of the patients in the surgical group and 63.2% (12/19) in the non-surgical group. In the surgical group, median disease-free survival (DFS) for patients with high CTC levels versus low CTC levels (&lt; 14.49 FU/3 ml) was 8.0 versus 26.0 months (P = 0.008). In multivariable analysis, CTCs were an independent risk factor for DFS (HR: 4.589, P = 0.012). Concerning the recurrence patterns, patients with high CTC levels showed a significantly frequent rate of distant and early recurrence (P = 0.017 and P = 0.011). CTC levels remained an independent predictor for both distant (OR: 8.375, P = 0.014) and early recurrence (OR: 8.412, P = 0.013) confirmed by multivariable logistic regression. However, CTCs did not predict survival in the non-surgical group (P = 0.220).ConclusionFR+ CTCs in resected PC patients could predict impaired survival and recurrence patterns after surgery. Preoperative CTC levels detected by LT-PCR may help guide treatment strategies and further studies in a larger cohort are warranted.
Cerebral glucose changes after chemotherapy and their relation to long-term cognitive complaints and fatigue
Authors: Schroyen Gwen , Schramm Georg , Van Weehaeghe Donatienne , Leenaerts Nicolas , Vande Casteele Thomas , Blommaert Jeroen , Koole Michel , Smeets Ann , Van Laere Koen , Sunaert Stefan , Deprez Sabine 
Published: October 2022

PurposeTo investigate the short-term cerebral metabolic effects of intravenous chemotherapy and their association with long-term fatigue/cognitive complaints.Experimental designUsing [18F]-FDG-PET/CT whole-body scans, we retrospectively quantified relative cerebral glucose metabolism before and after neoadjuvant chemotherapy in a cohort of patients treated for non-metastatic breast cancer (2009-2019). Self-report of cognitive complaints and fatigue were prospectively assessed 7 ± 3 years after therapy. Metabolic changes were estimated with i) robust mixed-effects modelling in regions-of-interest (frontal, parietal, temporal, occipital, and insular cortex) and ii) general-linear modelling of whole-brain voxel-wise outcomes. iii) The association between metabolic changes and self-reported outcomes was evaluated using linear regression-analysis.ResultsOf the 667 screened patients, 263 underwent PET/CT before and after chemotherapy and 183 (48 ± 9 years) met the inclusion criteria. After chemotherapy, decreased frontal and increased parietal and insular metabolism were observed (|ß|&gt;0.273, pFDR&lt;0.008). Separately, additional increased occipital metabolism after epiribucin+ cyclophosphamide (EC) and temporal metabolism after EC+ fluorouracil chemotherapy were observed (ß&gt;0.244, pFDR≤0.048). Voxel-based analysis (pcluster-FWE&lt;0.001) showed decreased metabolism in the paracingulate gyrus (-3.2 ± 3.9%) and putamen (3.1 ± 4.1%) and increased metabolism in the lateral cortex (L=2.9 ± 3.1%) and pericentral gyri (3.0 ± 4.4%). Except for the central sulcus, the same regions showed changes in EC, but not in FEC patients. Of the 97 self-reported responders, 23% and 27% experienced extreme fatigue and long-term cognitive complaints, respectively, which were not associated with metabolic changes.ConclusionBoth hyper- and hypometabolism were observed after chemotherapy for breast cancer. Combined with earlier findings, this study could support inflammatory mechanisms resulting in relative hypermetabolism, mainly in the parietal/occipital cortices. As early metabolic changes did not precede long-term complaints, further research is necessary to identify vulnerable patients.
18F-DCFPyL PET/CT in advanced high-grade epithelial ovarian cancer: A prospective pilot study
Authors: Metser Ur , Kulanthaivelu Roshini , Chawla Tanya , Johnson Sarah , Avery Lisa , Hussey Douglas , Veit-Haibach Patrick , Bernardini Marcus , Hogen Liat 
Published: October 2022

ObjectivesGlutamate carboxypeptidase-II (GCP-II), a zinc metalloenzyme that resides in cell membrane, has been reported as overexpressed in the neovasculature of ovarian cancers. The study objective was to determine whether GCP-II targeted imaging with 18F-DCFPyL PET/CT can detect disease sites in women with advanced high-grade serous ovarian cancer (HGSOC).Materials and methodsTwenty treatment-naïve women with advanced HGSOC were recruited (median age 60 years). Prior to commencing therapy (primary cytoreductive surgery [n=9] or neoadjuvant chemotherapy [n=11]), subjects underwent routine staging with contrast-enhanced abdominopelvic CT (=CT), followed by 18F-DCFPyL PET/CT (=PET). CT and PET were reported independently using a standardized reporting template assessing 25 sites. The performance of PET was compared to CT in all subjects and to surgery and surgical histopathology in 9 patients who underwent primary cytoreductive surgery.ResultsOf the 25 sites assessed in 20 patients, CT detected disease in 292/500 (58.4%) locations and PET detected disease in 171/500 (34.2%). Compared to CT the sensitivity (95% CI) of PET to detect disease in the upper abdomen, the gastrointestinal tract or the peritoneum was 0.29 (0.20,0.40), 0.21 (0.11,0.33) and 0.74 (0.64,0.82), respectively. In the surgical cohort, 220 sites in 9 patients were evaluated. The sensitivity and specificity of CT and PET were 0.85 versus 0.54 (p&lt;0.001) and 0.73 versus 0.93 (p&lt;0.001), respectively.ConclusionAlthough 18F-DCFPyL has higher specificity than CT in detecting advanced HGSOC tumor sites, it detects less disease sites than CT, especially in the upper abdomen and along the gastrointestinal tract, likely limiting its clinical utility.Clinical trial registrationClinicalTrials.gov, NCT03811899.
The prognostic role of circulating tumor cells in gastric cancer: A meta-analysis
Authors: Li Zuxi , Song Meijuan , Han Shangjun , Jin Chuanwei , Yang Jing 
Published: October 2022

ObjectiveWe conducted a meta-analysis to evaluate the relationship between circulating tumor cells (CTC) and the prognosis of patients with gastric cancer.Materials and methodsThe cohort studies reporting on the relationship between CTC and prognosis of gastric cancer were collected from Pubmed, Cochrane, Embase, CNKI, WanFang Data, and VIP databases. The two researchers independently screened the literature, extracted the data, and evaluated the bias risk of the included literature. The data were analyzed by Revman software (Review Manager version 5.4).ResultA total of 14 retrospective cohort studies with 1053 patients were included. The results showed that the overall survival time (OS) and progression-free survival time (PFS) of CTC-positive patients were shorter compared to CTC-negative patients. Taking into consideration the critical value of CTC positive patients, country of origin, sample size, treatment mode, and study time, the subgroup analysis showed that CTC-positive was related to the shortening of OS in patients with gastric cancer. Based on the subgroup analysis of the factors such as CTC positive critical value &lt; 2.8, sample size ≥ 75, mixed therapy, longer study duration, country, and immunofluorescence detection of CTC, it was found that OS in CTC positive group was shorter than that in CTC-negative group (all P&lt;0.05), while the critical value of positive CTC ≥ 2.8, sample size ≥ 75, choice of treatment only for operation or non-operation, short study time and molecular detection of CTC were not associated with OS (all P&gt;0.05). In addition, CTC-positive patients had a more advanced TNM staging, poorer tumor differentiation, and earlier distant metastasis.ConclusionCTC can be used as a prognostic indicator of gastric cancer. Gastric cancer patients with positive CTC may have a poorer prognosis compared to those with CTC-negative tumors.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022323155.
Comparing outcomes between culture-positive and culture-negative septic shock in a PICU: A retrospective cohort study
Authors: Huang Haixin , Chen Jian , Dang Hongxing , Liu Chengjun , Fu Yue-qiang 
Published: October 2022

BackgroundWe assessed the outcomes and characteristics of culture-negative septic shock (CNSS) and culture-positive septic shock (CPSS) in pediatric intensive care unit (PICU).MethodsWe performed a retrospective study on the data of children admitted to the PICU due to septic shock between January 2018 and December 2021. The primary outcome was in-hospital mortality. The secondary outcomes were the length of stay (LOS) of hospital, the need for mechanical ventilation (MV) and continue renal replacement therapy (CRRT).ResultsOverall, 238 patients were enrolled. 114 patients (47.9%) had positive cultures (60 blood samples, 41 sputum samples, 17 pus samples, and 19 others), 18 of whom were cultured positive at two sites, 1 at three sites, and 3 had two different types of bacteria at same site. The in-hospital mortality was 47.1%. There were no significant differences in the in-hospital mortality (47.6% vs. 46.5%, P = 0.866), PRISM-III score (10 vs. 12, P = 0.409), PIM-3 score (0.08 vs. 0.07, P = 0.845), pSOFA score (10 vs. 10, P = 0.677) or the need for MV (64.5% vs. 68.4%, P = 0.524) and CRRT (29.8% vs. 34.2%, P = 0.470) between the CNSS group and the CPSS group. The Procalcitonin (8.89 ng/ml vs. 28.39 ng/ml, P = 0.001) and C-reactive protein (28 mg/L vs. 58 mg/L, P = 0.001) levels were significantly lower in the CNSS group than in the CPSS group, while WBC count (9.03 × 109/L vs. 5.02 × 109/L, P = 0.002) and serum sodium (137 mmol/L vs. 132 mmol/L, P = 0.001) was significantly higher in CNSS. The LOS of hospital was significantly longer (16 days vs. 11 days, P = 0.011) in the CPSS group than in the CNSS group, while the LOS of PICU (5 days vs. 4 days, P = 0.094) stay was not significantly different.ConclusionCompared with children with CNSS, children with CPSS had higher PCT and CRP levels, but lower WBC count. Children with CPSS had longer LOS of hospital. However, positive or negative culture results were not associated with in-hospital mortality, the LOS of PICU, the need for MV or CRRT in children with septic shock.
Efficacy and determinants of vacuum bell treatment in preschool children with pectus excavatum
Authors: Luo Dengke , Cheng Kaisheng , Yuan Miao , Xu Chang , He Taozhen 
Published: October 2022

ObjectiveThe outcome of vacuum bell (VB) treatment for preschool patients with pectus excavatum (PE) is poorly understood. We aim to investigate the short-term treatment effect of VB with a three-dimensional scanner and assess the clinical and demographic factors that might influence treatment outcomes.MethodsWe conducted a chart review study to review the records of preschool patients with PE who received VB treatment in a tertiary hospital from January 1, 2021, through January 1, 2022. Demographic data and chest wall deformity assessments were recorded at follow-up, including the anterior chest wall depths and depth ratio (DR). The demographic and clinical factors influencing treatment outcomes were tested using a logistic regression model.Results139 patients who accepted vacuum bell treatment were included in the final study analysis, with a mean age of 4.6 years and a BMI of 14.9. Forty-three patients (30.9%) with a depth of less than 3 mm met the termination criteria and showed cosmetic results. The changes in depths (P &lt; 0.001) and DR (P &lt; 0.001) were statistically significant in 55 patients with three or four follow-ups. Multifactor logistic regression analysis showed that initial depth (OR 0.69, 95% CI 0.58–0.84, P &lt; 0.001) and treatment period (OR 1.58, 95% CI 1.23–2.04, P &lt; 0.001) were independent predictors of achieving complete correction.ConclusionVB is an effective treatment modality in preschool patients in the short-term follow-up, which is influenced by the depth of depression and the duration of treatment. However, further prospective studies are needed to confirm these results.
Developmental defects of enamel in children born preterm
Authors: Halperson Elinor , Shafir Salome , Fux-Noy Avia , Ram Diana , Eventov-Friedman Smadar 
Published: October 2022

IntroductionTo investigate manifestations of developmental defects of enamel (DDE) in children born preterm (PT), and to explore possible neonatal morbidities related to DDE manifestation and severity.MethodsA cohort study of 52 children born before gestational week 32 and treated in the neonatal intensive care unit; and 55 children born at full term (FT) as a control group. All the children had a dental examination at age 1–4 years by a professional pediatric dentist. DDE was defined as an alteration in the enamel surface.ResultsDDE were observed in 23 (44%) and 6 (11%) children, in the PT and FT groups, respectively, odds ratio (OR) = 6.47. The OR for damaged anterior teeth was 12.87 times higher in the PT group. DDE of molars was diagnosed in 19% and 11% of the respective groups. In the PT group, the OR of DDE was 4.1 higher among those with than without respiratory distress. The risk for DDE was 5.7 higher in those who received surfactant than in those who did not. Ventilation length, both invasive and non-invasive, was significantly related to DEE.ConclusionsDDE was higher in children born PT than FT. The DDE rate was lower than expected based on current literature, and considering the overall increase in survival; this suggests improvement in treatments affecting DEE. Respiratory distress syndrome, surfactant administration reflecting the need for intubation, longer ventilation and local oral trauma were risk factors for DDE. We recommend routine dental examinations in follow up of children born PT, particularly those exposed to assisted ventilation.
Risk factors and prediction score model for unplanned readmission among neonates with NRDS under one year of age: A retrospective cohort study
Authors: Yue Weihong , Wei Hong , Chen Feng , Chen Xinhong , Xu Zhen-E , Hu Ya 
Published: October 2022

ObjectiveThis study aimed to analyze the risk factors and establish a prediction score model for unplanned readmission among neonates with neonatal respiratory distress syndrome (NRDS) for respiratory problems under one year of age.MethodsThis retrospective cohort study enrolled 230 neonates with NRDS who were admitted between January 2020 and December 2020. The infants were classified into two subgroups based on whether they were readmitted for respiratory problems under one year of age: readmit group and non-readmit group. Readmission risk factors for NRDS were analyzed by logistic regression and a prediction score model was generated.ResultsAmong the 230 enrolled infants, 51 (22%) were readmitted, and 179 (78%) were not readmitted. In univariate analysis, compared with non-readmit group infants, readmit group infants had a significantly younger birth gestational age (31.9 ± 2.3 vs. 32.8 ± 2.5 weeks, p = 0.012), lower birth weight (1,713.7 ± 501.3 g vs. 1,946.8 ± 634.4 g, p = 0.007), older age at discharge (41.7 vs. 31.7 days, p = 0.012), higher proportion of necrotizing enterocolitis (NEC) (31% vs. 16%, p = 0.016), higher rate of blood transfusion (39% vs. 25%, p = 0.049), higher rate of postnatal dexamethasone (DEX) administration (28% vs. 9.5%, p = 0.001), and higher rate of home oxygen therapy (HOT) (57% vs. 34%, p = 0.003). Moreover, readmit group infants had significantly longer antibiotic days usage (12.0 vs. 10.0 days, p = 0.026) and a longer duration of hospital stay (41.0 vs. 31.0 days, p = 0.012) than non-readmit group infants. The multivariate logistic regression analysis showed that taking readmission as a target variable, postnatal DEX administration (OR: 2.689, 95% CI: 1.168–6.189, p = 0.020), HOT (OR: 2.071, 95% CI: 1.060–4.046, p = 0.033), and NEC (OR: 2.088, 95% CI: 0.995–4.380, p = 0.051) could be regarded as risk factors for readmission. A scoring model predicting readmission was administered with a positive predictive value of 0.651 (95% CI: 0.557–0.745, p = 0.002), with a sensitivity of 0.412 and a specificity of 0.888 at a cut-off of 3.5 points, which were evaluated on the receiver operating characteristic curve.ConclusionsPostnatal DEX administration, HOT, and NEC were risk factors for readmission of NRDS. NRDS infants with a predictive score of 3.5 points or more were at high risk for unplanned readmission.
Applicability of the hour of life approach in hyperbilirubinemia among Filipino term infants
Authors: Villanueva-Uy Maria Esterlita T. , G. Uy Herbert , Amarillo Maria Lourdes E. 
Published: October 2022

BackgroundHyperbilirubinemia remains a common morbidity among infants. Additional research on bilirubin kinetics and associated risk factors will contribute to providing a more targeted management approach for the Filipino infant.ObjectiveTo develop a Filipino bilirubin nomogram by studying bilirubin patterns during the first 5 days of life.MethodologyThis prospective study recruited 1,412 stable, full-term infants (≥37 weeks age of gestation) born at the Philippine General Hospital (PGH). Using the Dräger-Minolta JM-103 jaundice meter, transcutaneous bilirubin (TcB) levels were determined at the 3rd, 6th, 12th, 24th, 36th, 48th, 72nd, 96th, and 120th hour of life (HOL). A bilirubin nomogram was created using the averages of 3 TcB forehead and sternal measurements at each time epoch. Simultaneous measurement of TcB and total serum bilirubin (TsB) on a subset of 106 infants was done to determine correlation.ResultsCorrelation coefficients were high between TsB and forehead TcB (r2 = 0.88), and between TsB and sternal TcB (r2 = 0.91). The Filipino bilirubin nomogram reflected a steep rise until the 48th hour, followed by plateauing of values. Inadequate nursing and bilirubin levels at 12th and 48th HOL were risk factors for developing significant hyperbilirubinemia at 72nd HOL.ConclusionTcB is a reliable, non-invasive bilirubin screening tool. Among healthy, full-term, Filipino infants, their nomogram features a sudden increase in bilirubin values during the first 48 h, followed by a plateau. To aid in identification of infants at risk for significant hyperbilirubinemia, healthcare providers can assess breastfeeding adequacy and perform bilirubin screening at the 24th−48th HOL. Registration No. (RGAO-2016-0686).