bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ex Vivo Near-Infrared Molecular Imaging of Human Upper Urinary Tract Urothelial Carcinoma With a CD47-Based Targeted Tracer
Authors: Yan Pengyu , Chen Dan , Yan Xutao , Yan Xiaoting , Wang Yingpeng , Liu Chao , Yang Xiaofeng 
Published: February 2022

ObjectiveThe low detection rate of early and small tumors remains a clinical problem that urgently needs to be solved in the accurate diagnosis and treatment of upper urinary tract urothelial carcinoma (UTUC). The objective of this study is to evaluate the feasibility of CD47 as a target for optical molecular imaging of human UTUC and conduct preliminary ex vivo imaging experiments.MethodsWe firstly analyzed the genome-wide mRNA expression data from Gene Expression Omnibus (GEO). Paraffin-embedded tissue specimens comprising UTUC and normal urothelium were collected. All tissue specimens were used for immunohistochemistry to compare CD47 protein expression in normal and cancer tissue. Meanwhile, 12 patients undergoing radical nephroureterectomy were prospectively included in ex vivo imaging experiments. Freshly isolated upper urinary tract specimens were incubated with anti-CD47-Alexa Fluor 790 and then imaged under white light and near-infrared (NIR) light. Standard histopathologic evaluation was performed, and findings were correlated with CD47-targeted NIR molecular imaging.ResultsThe GEO data revealed that CD47 mRNA expression was higher in UTUC specimens than that in paracancer normal tissue. In immunohistochemical analysis, the CD47 protein expression level was higher in both non-muscle-invasive and muscle-invasive (stage ≥T2) UTUCs than that in normal uroepithelium, and the localization of CD47 protein was the tumor cell membrane. In the ex vivo imaging experiments, all patients were pathologically diagnosed with UTUC, and no adverse effects of anti-CD47-Alexa Fluor 790 on the histological structure of the tumor and normal uroepithelium were observed. In the NIR grayscale images, the mean fluorescence intensity of the tumor tissue was significantly higher than that of the adjacent normal background tissue, which greatly improved the visualization of the tumor.ConclusionsCD47-targeted NIR molecular imaging could be a feasible and powerful strategy for the accurate diagnosis of UTUC. Larger-scale randomized trials are needed.
Value of 18F-FDG PET/MRI in the Preoperative Assessment of Resectable Esophageal Squamous Cell Carcinoma: A Comparison With 18F-FDG PET/CT, MRI, and Contrast-Enhanced CT
Authors: Wang Fei , Guo Rui , Zhang Yan , Yu Boqi , Meng Xiangxi , Kong Hanjing , Yang Yang , Yang Zhi , Li Nan 
Published: February 2022

ObjectivesTo investigate the value of 18F-FDG PET/MRI in the preoperative assessment of esophageal squamous cell carcinoma (ESCC) and compare it with 18F-FDG PET/CT, MRI, and CECT.MethodsThirty-five patients with resectable ESCC were prospectively enrolled and underwent PET/MRI, PET/CT, and CECT before surgery. The primary tumor and regional lymph nodes were assessed by PET/MRI, PET/CT, MRI, and CECT, respectively, and the diagnostic efficiencies were determined with postoperative pathology as a reference standard. The predictive role of imaging and clinical parameters on pathological staging was analyzed.ResultsFor primary tumor staging, the accuracy of PET/MRI, MRI, and CECT was 85.7%, 77.1%, and 51.4%, respectively. For lymph node assessment, the accuracy of PET/MRI, PET/CT, MRI, and CECT was 96.2%, 92.0%, 86.8%, and 86.3%, respectively, and the AUCs were 0.883, 0.745, 0.697, and 0.580, respectively. PET/MRI diagnosed 13, 7, and 6 more stations of lymph node metastases than CECT, MRI, and PET/CT, respectively. There was a significant difference in SUVmax, TLG, and tumor wall thickness between T1-2 and T3 tumors (p = 0.004, 0.024, and &lt; 0.001, respectively). Multivariate analysis showed that thicker tumor wall thickness was a predictor of a higher T stage (p = 0.040, OR = 1.6).Conclusions18F-FDG PET/MRI has advantages over 18F-FDG PET/CT, MRI, and CECT in the preoperative assessment of primary tumors and regional lymph nodes of ESCC. 18F-FDG PET/MRI may be a potential supplement or alternative imaging method for preoperative staging of ESCC.
Quality of Life in Chinese Patients With Large Congenital Melanocytic Nevi
Authors: Wang Huijing , Yu Qingxiong , Li Qingfeng , Wang Zhichao 
Published: February 2022

BackgroundLarge congenital melanocytic nevus (LCMN) is a rare skin disease that deeply affects an individual's appearance, may influence patients' self-evaluation and social relationships, and further affects their quality of life (QoL). The Skindex-29 and 36-Item Short Form Survey (SF-36) are valid instruments used to evaluate QoL specifically. It is necessary to assess the QoL of patients with LCMN and summarize potentially impactful factors to help people understand LCMN patients and assist doctors in offering professional advice.MethodsTwenty-five patients were recruited from Shanghai Ninth People's Hospital from July 1st, 2019, to March 31st, 2021. Both males and females were included, and the age groups were divided into infants (0–6 y), children (7–12 y), teenagers (13–17 y) and youths (18–45 y). The Skindex-29 and SF-36 were applied as questionnaires for the assessment of QoL. Clinical information was acquired by physical examination.ResultsQoL in patients with LCMN was diminished, especially in the emotional aspect. However, different genders, ages and distribution patterns of LCMN did not significantly influence QoL, but the patterns of “Bonce” and “Body” affected QoL the most and the severest. The results of Skindex-29 and SF-36 were consistent in that LCMN mainly reduced QoL from an emotional perspective.ConclusionsThis research shows that LCMN has the strongest impact on patients' emotional wellbeing but weakly influences the whole fettle of QoL. The gender, age and distribution patterns of lesions all have no direct effect on QoL, although a larger proportion of LCMNs probably insinuates worse QoL. Even though patients with LCMN show better QoL than those with other visible skin conditions, their general mental health still requires ample attention from surroundings and professional doctors.
Esophageal Diameter as a Function of Weight in Neonates, Children and Adolescents: Reference Values for Dilatation of Esophageal Stenoses
Authors: Loff Steffan , Diez Oliver , Ho Wei , Kalle Thekla v. , Hetjens Svetlana , Boettcher Michael 
Published: February 2022

IntroductionEsophageal stenoses are frequent complications after esophageal atresia surgery as well as after acid, alkali and battery ingestion. Worldwide, repeated balloon dilatations are the most frequently performed procedures for these stenoses. In most cases the stenoses can be dilated sufficiently to allow adequate enteral nutrition. Until recently, age dependent esophageal lumen size has not been established; which was aim of the current study.MethodsAll children in whom an esophageal contrast imaging was performed between 1/2011 and 5/2021 were included. The width was measured by two investigators at two measuring points in two planes, the diameter was calculated and plotted against the respective weight of the child. Bland-Altmann plots have confirmed the validity of the measurements of both investigators.ResultsEsophagus diameter was measured in more than 100 children. The resulting curves show a very good correlation with weight (upper measuring point: r = 0.86743, p &lt; 0.0001; lower measuring point: r = 0.80593, p &lt; 0.0001).ConclusionThese results are the first to define the esophageal diameter in children. The results of this study may guide physicians performing esophageal interventions including dilatations in future.
Patients' Perception of the Use of the EasyPod™ Growth Hormone Injector Device and Impact on Injection Adherence: A Multi-Center Regional Study
Authors: Deeb Asma , Al Yaarubi Saif , Abbas Bassam Bin , Al Jubeh Jamal , Chaturvedi Deepti , Al Hassani Noura , Mutair Angham , Al Masri Neamat , Al Sanad Yazan , Al Shidhani Azza , Mahmoud Noha Samir , Alherbish Abdullah , Savage Martin O. 
Published: February 2022

ObjectiveThis study aimed to assess patient perceptions of the use of the EasyPod™ growth hormone delivery device and its association with compliance.MethodsThis cross-sectional, multicenter study was conducted in six centers from three countries (United Arab Emirates, Oman, and Saudi Arabia,) between March 2020 and June 2020. Children and adolescents aged 3–18 years, diagnosed with growth disorders and receiving rhGH through the EasyPod™ device were enrolled. Patients and caregivers were given a pre-set questionnaire that evaluated patient satisfaction, preference for technical and personalized features, and device drawbacks. The results were analyzed using independent measures of analysis of variance to evaluate the association of higher satisfaction with device features and better compliance.ResultsA total of 186 patients were enrolled in the study. Of these, 45.7% had GH deficiency. The mean age (±SD) of patients was 11.8 (±2.76) years; 117 (62.90%) were males. Average compliance was 87%. One hundred patients (53.76%) had injection compliance of ≥90%. Amongst these patients, 74%, 68%, and 77% top-scored (5/5) the technical features of hidden needle, skin sensor, and pre-set dosing, respectively, compared to top scores by 39%, 34%, and 51% patients in the &lt;90% compliance group (p-value &lt;0.05). Similarly, a statistically significant difference was observed between the groups (p-value &lt;0.05) in the perception of the usefulness of the tracking features such as display of history of injected doses (78% vs. 47.7%), a reminder for medicine remaining (46% vs. 23.3%) and battery power indicator (48% vs. 20.9%). Personal screen messages were associated with higher compliance while the requirement to keep the device in the fridge was reported as the most inconvenient feature by 56% of patients in the higher compliance group as against 39.5% in the lower compliance group (p-value &lt;0.05). There was no statistically significant difference in the intensity of pain reported in the two compliance groups.ConclusionOur study showed that there is a statistically significant association between better perception of device features and higher compliance.
β-Sitosterol Inhibits Rheumatoid Synovial Angiogenesis Through Suppressing VEGF Signaling Pathway
Authors: Qian Kai , Zheng Xue-Xia , Wang Chen , Huang Wen-Guang , Liu Xiao-Bao , Xu Shu-Di , Liu Dan-Kai , Liu Min-Ying , Lin Chang-Song 
Published: February 2022

Background: Rheumatoid arthritis (RA) is a chronic disabling inflammatory disease that causes synovial angiogenesis in an invasive manner and leads to joint destruction. Currently available pharmacotherapy for RA has unwanted side effects and limitations. Although anti-angiogenic therapy is regarded as a new potential treatment for RA, only a few anti-angiogenic drugs are available. An increasing number of studies have shown that β-sitosterol (BSS) may exert inhibitory effects against angiogenesis. However, the mechanisms involved are still unclear.Methods: Based on the results of the gene set enrichment analysis (GSEA) of the transcriptome data of endothelial cells from RA patients, we evaluated the pharmacological effects of BSS on the tube formation, cell proliferation, and migration of human umbilical vein endothelial cells (HUVECs). Furthermore, the effects of BSS treatment on vascular endothelial growth factor receptor 2 (VEGFR2) were determined using molecular docking and Western blotting. Additionally, in the presence or absence of BSS, synovial angiogenesis and joint destruction of the ankle were investigated in collagen-induced arthritis (CIA) mice. The effect of BSS treatment on VEGFR2/p-VEGFR2 expression was verified through immunohistochemical staining.Results: The immunohistochemistry results revealed that BSS treatment inhibited angiogenesis both in vitro and in vivo. In addition, the results of 5-ethynyl-2′-deoxyuridine and cell cycle analysis showed that BSS treatment suppressed the proliferation of HUVECs, while the Transwell migration and stress fiber assays demonstrated that BSS treatment inhibited the migration of HUVECs. Notably, the inhibitory effect of BSS treatment on VEGFR2/p-VEGFR2 was similar to that of axitinib. In CIA mice, BSS also exerted therapeutic effects on the ankles by reducing the degree of swelling, ameliorating bone and cartilage damage, preventing synovial angiogenesis, and inhibiting VEGFR2 and p-VEGFR2 expression.Conclusion: Therefore, our findings demonstrate that BSS exerts an inhibitory effect on synovial angiogenesis by suppressing the proliferation and migration of endothelial cells, thereby alleviating joint swelling and bone destruction in CIA mice. Furthermore, the underlying therapeutic mechanisms may involve the inhibition of VEGF signaling pathway activation.
A Broadband Low-RCS Circularly Polarized Meta-Antenna
Authors: Zhou Hongkun , Wang Yuchao , Liu Chengguo , Zhang Cheng 
Published: February 2022

A low-profile circularly polarized (CP) meta-antenna with a broadband low-RCS feature is proposed in this article. Our design is the combination of a CP antenna with a chessboard polarization conversion metasurface (CPCM) for balancing the radiation property and stealth feature. To relieve the adverse effect of the CPCM on the entire radiation performance, several redundant meta-atoms with the opposite phase state were removed to enhance the realized gain within the operation bandwidth (8.0–9.0 GHz). The proposed meta-antenna showed excellent radiation performance: −10 dB impedance relative bandwidth was 26.48% (6.78–8.85 GHz), and 3-dB axial ratio relative bandwidth was 22.03% (7.27–9.07 GHz). In addition, RCS reduction over 5 dB was achieved via our design from 8.5 to 21.5 GHz (86.67%) with the help of the deliberately designed CPCM. The final measured results demonstrate great consistency with the simulated ones.
CCAAT/Enhancer-Binding Protein Alpha Is a Novel Regulator of Vascular Smooth Muscle Cell Osteochondrogenic Transition and Vascular Calcification
Authors: Chen Pengyuan , Hong Wanzi , Chen Ziying , Gordillo-Martinez Flora , Wang Siying , Fan Hualin , Liu Yuanhui , Dai Yining , Wang Bo , Jiang Lei , Yu Hongjiao , He PengCheng 
Published: February 2022

AimsVascular calcification is a common clinical complication of chronic kidney disease (CKD), atherosclerosis (AS), and diabetes, which is associated with increased cardiovascular morbidity and mortality in patients. The transdifferentiation of vascular smooth muscle cells (VSMCs) to an osteochondrogenic phenotype is a crucial step during vascular calcification. The transcription factor CCAAT/enhancer-binding protein alpha (C/EBPα) plays an important role in regulating cell proliferation and differentiation, but whether it regulates the calcification of arteries and VSMCs remains unclear. Therefore, this study aims to understand the role of C/EBPα in the regulation of vascular calcification.Methods and ResultsBoth mRNA and protein expression levels of C/EBPα were significantly increased in calcified arteries from mice treated with a high dose of vitamin D3 (vD3). Upregulation of C/EBPα was also observed in the high phosphate- and calcium-induced VSMC calcification process. The siRNA-mediated knockdown of C/EBPα significantly attenuated VSMC calcification in vitro. Moreover, C/EBPα depletion in VSMCs significantly reduced the mRNA expression of the osteochondrogenic genes, e.g., sex-determining region Y-box 9 (Sox9). C/EBPα overexpression can induce SOX9 overexpression. Similar changes in the protein expression of SOX9 were also observed in VSMCs after C/EBPα depletion or overexpression. In addition, silencing of Sox9 expression significantly inhibited the phosphate- and calcium-induced VSMC calcification in vitro.ConclusionFindings in this study indicate that C/EBPα is a key regulator of the osteochondrogenic transdifferentiation of VSMCs and vascular calcification, which may represent a novel therapeutic target for vascular calcification.
Parent–Child Relationship Quality and Internet Use in a Developing Country: Adolescents’ Perspectives
Authors: Nguyen Thao Thi Phuong , Nguyen Tham Thi , Do Ha Ngoc , Vu Thao Bich Thi , Vu Khanh Long , Do Hoang Minh , Nguyen Nga Thu Thi , Doan Linh Phuong , Vu Giang Thu , Do Hoa Thi , Nguyen Son Hoang , Latkin Carl A. , Ho Cyrus S. H. , Ho Roger C. M. 
Published: February 2022

ObjectiveThe goal of the study was to explore the relationship between parent–children relationships related to using the internet among kids and potentially associated factors.Materials and MethodsA sample of 1.216 Vietnamese students between the ages of 12 and 18 agreed to participate in the cross-sectional online survey. Data collected included socioeconomic characteristics and internet use status of participants, their perceived changes in relationship and communication between parents and children since using the internet, and parental control toward the child’s internet use. An Ordered Logistic Regression was carried out to determine factors associated with parent–children relationship since using the internet.ResultsThe characteristics of the relationship between children and their parents since using the Internet were divided into three levels: deterioration (7.0%), stability (78.2%), and improvement (14.8%). The topics that children most often communicate with their parents include learning, housework, and future directions. Two-way interactive activities, such as supporting parents to use the Internet, have a positive impact on the parent–child relationship. Stubborn parental control, such as establishing rules about contact or allowing Internet access and setting up global positioning system (GPS) to track negatively affecting parent–child relationships.ConclusionFindings indicated that changes in the quality of the parent–child relationship were self-assessed by participants regard to kids’ internet use, especially in the COVID-19 epidemic context. Educational campaigns and programs to raise awareness of parents as to the dangers and negative influences that their children may encounter online, psychology of children’s behaviors and effects of different responding strategies are recommended.
Concerns of Parental Substance Abuse and Mental Health Problems Reported to Child Welfare Services—Testing a Moderated Mediation Model for Paths From Reports to Substantiated Concern and Service Provision
Authors: Vis Svein Arild , Lauritzen Camilla , Havnen Karen J. S. , Reedtz Charlotte , Handegård Bjørn Helge 
Published: February 2022

BackgroundParental mental health and substance abuse problems are found in reports of concern to child protection and welfare services. The aim of this study was first to investigate what characterized these reports and how they differed from reports with other types of concerns. Two hypotheses were tested. The first hypothesis was (i) if a report contains concerns about mental health and substance abuse problems, the likelihood of service provision was mediated by substantiation status. The second hypothesis was (ii) that the threshold for substantiation of such problems differed depending on child age, single parent status, and the presence of other child and parent related problems.MethodThe study was designed as a case file study which was carried out retrospectively (N = 883). A conceptual model was tested in two steps. First a mediation model with direct and indirect paths from reports of concerns through substantiation decision to service provision was tested. Then a second model was expanded to also include moderators for the indirect effects of reported concerns on substantiation decisions.ResultsA total of 33.1% of reports about substance abuse and 41.7% of reports about parental mental illness concerns were provided services. The first hypothesis was confirmed. There is a negative direct effect and a positive mediated effect of reported concern on service provision. The second hypothesis was not confirmed. We failed to identify any significant moderating effect of child age, single caregiver status, or number of child problems, upon the threshold for substantiation of mental health and drug abuse problems.ConclusionsThe total effect of reports about mental illness and substance abuse upon service provision was low. Service provision in cases with suspected substance abuse and/or mental illness is highly dependent upon substantiation of that specific problem. Substantiation threshold is not impacted by other case characteristics. This is surprising because there are good theoretical reasons to assume that parental drug abuse and or mental illness are potentially more detrimental to child health, development and safety if the child is younger, if the parent is a single caregiver, and there are many other parallel concerns.
Harmful Alcohol Use Among Healthcare Workers at the Beginning of the COVID-19 Pandemic in Kenya
Authors: Jaguga Florence , Kwobah Edith Kamaru , Mwangi Ann , Patel Kirtika , Mwogi Thomas , Kiptoo Robert , Atwoli Lukoye 
Published: February 2022

BackgroundHealthcare workers play a key role in responding to pandemics like the on-going COVID-19 one. Harmful alcohol use among them could result in inefficiencies in health service delivery. This is particularly concerning in sub-Saharan Africa where the health workforce is already constrained. The aim of this study is to document the burden and correlates of harmful alcohol use among healthcare workers at the beginning of the COVID-19 pandemic in Kenya with the aim of informing policy and practice.MethodsThis study was a cross-sectional analysis of data obtained from a parent online survey that investigated the burden and factors associated with mental disorders among healthcare workers during the COVID-19 pandemic in Kenya. We analyzed data obtained from a sub-population of 887 participants who completed the Alcohol Use Disorder Identification Test questionnaire. We used descriptive statistics to summarize the socio-demographic characteristics of the participants and multivariate analysis to determine the factors associated with harmful alcohol use.ResultsThree hundred and eighty nine (43.9%) participants reported harmful alcohol use. The factors significantly associated with increased odds of endorsing harmful alcohol use were: being male (AOR = 1.56; 95% CI = 1.14, 2.14; p = 0.006), being unmarried (AOR = 2.06; 95% CI = 1.48, 2.89; p &lt; 0.001), having 11-20 years of experience as compared to having 20+ years of experience (AOR = 1.91; 95% CI = 1.18, 3.12; p = 0.009), and being a specialist (AOR = 2.78; CI = 1.64, 4.78; p = &lt; 0.001) or doctor (AOR = 2.82; 95% CI = 1.74, 4.63; p &lt; 0.001) as compared to being a nurse.ConclusionsA high proportion of healthcare workers reported harmful alcohol use at the beginning of the COVID-19 pandemic in Kenya. Males, the unmarried, those with 11–20 years of experience in the health field, doctors and specialists, were more likely to report harmful alcohol use. These findings highlight the need to institute interventions for harmful alcohol use targeting these groups of healthcare workers in Kenya during the COVID-19 pandemic in order to optimize functioning of the available workforce.