bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impaired fasting glucose levels among perinatally HIV-infected adolescents and youths in Dar es Salaam, Tanzania
Authors: Nkinda Lilian , Buberwa Eliud , Memiah Peter , Ntagalinda Alieth , George Martin , Msafiri Frank , Joachim Agricola , Majigo Mtebe , Ramaiya Kaushik , Sunguya Bruno 
Published: December 2022

ObjectiveThis study assessed impaired fasting glucose and associated factors among perinatally HIV-infected adolescents and youths in Dar es salaam Tanzania.BackgroundImpaired fasting glucose is a marker of heightened risk for developing type 2 diabetes among perinatally HIV-infected individuals. Therefore, identifying individuals at this stage is crucial to enable early intervention. Therefore, we assessed impaired fasting glucose (IFG) and associated factors among perinatally HIV-infected population in Dar es salaam Tanzania. MethodsA cross-sectional study was conducted among 152 adolescents and youth attending HIV clinic at Muhimbili National Hospital and Infectious Disease Centre from July to August 2020. Fasting blood glucose (&gt;8 hours) was measured using one-touch selects LifeScan, CA, USA. We also examined C-Reactive Protein and interleukin-6 inflammatory biomarkers in relation to impaired fasting glucose (IFG). Associations between categorical variables were explored using Chi-square, and poison regression with robust variance was used to calculate the prevalence ratios.ResultsOf the 152 participants, the majority were male (n=83[54.6%]), and the median age was 15(14-18) years. Overweight or obesity was prevalent in 16.4%, while more than one in ten (13.2%) had high blood pressure (≥149/90mmHg). All participants were on antiretroviral therapy (ART); 46% had used medication for over ten years, and about one in three had poor medication adherence. Among the recruited participants, 29% had impaired fasting glucose. The odds of IFG were two times higher in males compared to females (PR, 2.07, 95% CI 1.19 -3.59 p=0.001). Moreover, we found with every increase of Interleukin 6 biomarker there was a 1.01 probability increase of impaired fasting glucose (PR, 1.01, 95% CI 1.00 – 1.02 p=0.003).ConclusionAbout one in three perinatally HIV-infected youths had impaired fasting glucose in Dar es Salaam, Tanzania, with males bearing the biggest brunt. Moreover, with every increase of 1.101 of the probability of having IFG increased. This calls for urgent measures to interrupt the progression to diabetes disease and prevent the dual burden of disease for this uniquely challenged population.
Physical activity and risk of gallstone disease: A Mendelian randomization study
Authors: Qian Qilin , Jiang Han , Cai Bingyue , Chen Dingwan , Jiang Minmin 
Published: December 2022

Objective: Given the association between physical activity and the reduced risk of gallstone disease as suggested in observational studies, a Mendelian randomization study was conducted to evaluate the causal nature of this association in genetic epidemiology.Study: Including self-reported and accelerometer-based physical activity traits, the independent genetic variants associated with physical activity were selected from the corresponding genome-wide association studies as instrumental variables. The summary-level data for gallstone disease were sourced from the UK Biobank (7,682 cases and 455,251 non-cases) and FinnGen consortium (23,089 cases and 231,644 non-cases). Then, two-sample Mendelian randomization analysis was conducted. Inverse-variance weight (IVW), weighted median, and Mendelian randomization–Egger regression were determined through Mendelian randomization analyses. To ensure the robustness of the results, sensitivity analyses were also carried out in the study.Results: The negative causality between the genetically predicted accelerometer-based “average acceleration” physical activity and the risk of gallstone disease was suggested in the UK Biobank study (p = 0.023, OR = 0.93, 95% CI: 0.87–0.99), and accelerometer-based “overall activity” physical activity and the risk of gallstone disease in the UK Biobank study (p = 0.017, OR = 0.38, 95% CI: 0.17–0.84). With accelerometer-based “average acceleration” physical activity negatively correlated with gallstone disease in the FinnGen consortium data (p = 0.001, OR = 0.94, 95% CI: 0.90–0.97). As for self-reported moderate-to-vigorous physical activity, however, there was no causality observed in both pieces of data.Conclusion: Our studies provide the evidence suggesting a casual association between physical activities and gallstone disease through analysis of genetic data. As indicated by the research results, there is a possibility that a higher level of physical activities could mitigate the risk of gallstone disease.
Anti-PD-1 antibodies, a novel treatment option for advanced chemoresistant pulmonary lymphoepithelioma carcinoma
Authors: Zhou Na , Tang Hui , Yu Shuangni , Lin Yi , Wang Yingyi , Wang Yuzhou 
Published: December 2022

BackgroundPulmonary lymphoepithelioma-like carcinoma (LELC) exhibits a unique immune microenvironment, including high PD-L1 expression and abundant infiltrating-immune cells. However, the availability of PD-1/PD-L1 inhibitors in patients with LELC is still not determined.MethodsA total of 36 cases of pulmonary LELC treated with PD-1/PD-L1 inhibitors were reviewed, including 10 cases from our institute and 26 cases included from the literature. The Kaplan-Meier method and log-rank test were utilized to analyze the survival outcomes of LELC patients receiving immunotherapy, and the factors related to immunotherapy response were further examined.ResultsOf the 10 patients from our institute, the median age was 53.5 years, adrenal glands and distant lymph nodes were the most common metastatic sites, and 4 of 8 (50%) patients had a PD-L1 TPS ≥50%. The median progression-free survival and overall survival in patients from our institute and from the literature were 11.6 and 27.3 months, 17.2 months and not reached, respectively. In all 36 patients, the objective response rate was as high as 57.6%. Patients with higher PD-L1 expression were more likely to have a tumor response, but the association of PD-L1 expression with survival time remains to be determined.ConclusionsPD-1/PD-L1 inhibitors in patients with pulmonary LELC demonstrated a promising efficacy in retrospective cohorts, and deserve further validation in prospective studies administrating in front-line setting.
Frailty index based on laboratory tests improves prediction of short-and long-term mortality in patients with critical acute myocardial infarction
Authors: Bai Weimin , Hao Benchuan , Xu Lijun , Qin Ji , Xu Weihao , Qin Lijie 
Published: December 2022

BackgroundPrevious studies have shown that the frailty index based on laboratory tests (FI-Lab) can identify older adults at increased risk of adverse health outcomes. This study aimed to determine whether the FI-Lab is associated with mortality risk and can provide incremental improvements in risk stratification of patients with critical acute myocardial infarction (AMI).Materials and methodsWe conducted a secondary analysis of data from the Medical Information Mart for Intensive Care (MIMIC)-IV database. A 33-item FI-Lab was constructed. Outcomes of interest were in-hospital and 1-year mortality. Logistic regression models were used to investigate the association between the FI-Lab and outcomes. For the assessment of the incremental predictive value, the FI-Lab was added to several risk stratification scoring systems for critically ill patients, and the following indices were calculated: Δ C-statistic, integrated discrimination improvement (IDI), and net reclassification improvement (NRI).ResultsOut of 2,159 patients, 477 died in hospital (22.1%), and 898 died during the 1-year follow-up period. After adjustment for confounders, the FI-Lab was associated with increased in-hospital mortality [odds ratio (OR) = 1.06, 95% confidence interval (CI): 1.05–1.07] and 1-year mortality (OR = 1.05, 95% CI: 1.04–1.06) when assessed as a continuous variable (per 0.01-score increase). When assessed as a categorical variable, the FI-Lab was associated with in-hospital mortality (2nd Quartile: OR = 1.89, 95% CI: 1.18–3.03; 3rd Quartile: OR = 3.46, 95% CI: 2.20–5.46; and 4th Quartile: OR = 5.79, 95% CI: 3.61–9.28 compared to 1st Quartile) as well as 1-year mortality (2nd Quartile: OR = 1.66, 95% CI: 1.23–2.24; 3rd Quartile: OR = 2.40, 95% CI: 1.76–3.26; and 4th Quartile: OR = 3.76, 95% CI: 2.66–5.30 compared to 1st Quartile) after adjustment for confounders. The addition of the FI-Lab to all disease severity scores improved discrimination and significantly reclassified in-hospital and 1-year mortality risk.ConclusionThe FI-Lab was a strong predictor of short- and long-term mortality in patients with critical AMI. The FI-Lab improved the ability to predict mortality in patients with critical AMI and therefore might be useful in the clinical decision-making process.
Characterizing bacterial communities in Phragmites australis rhizosphere and non-rhizosphere sediments under pressure of antibiotics in a shallow lake
Authors: Zhang Ling , Bai Junhong , Zhang Kegang , Wei Zhuoqun , Wang Yaqi , Liu Haizhu , Xiao Rong , Jorquera Milko A. 
Published: December 2022

IntroductionAntibiotics are ubiquitous pollutants and widely found in aquatic ecosystems, which of rhizosphere sediment and rhizosphere bacterial communities had certain correlation. However, the response of bacterial communities in Phragmites australis rhizosphere and non-rhizosphere sediments to antibiotics stress is still poorly understood.MethodsTo address this knowledge gap, the samples of rhizosphere (R) and non-rhizosphere (NR) sediments of P. australis were collected to investigate the differences of bacterial communities under the influence of antibiotics and key bacterial species and dominate environmental factors in Baiyangdian (BYD) Lake.ResultsThe results showed that the contents of norfloxacin (NOR), ciprofloxacin (CIP) and total antibiotics in rhizosphere sediments were significantly higher than that in non-rhizosphere sediments, meanwhile, bacterial communities in non-rhizosphere sediments had significantly higher diversity (Sobs, Shannon, Simpsoneven and PD) than those in rhizosphere sediments. Furthermore, total antibiotics and CIP were found to be the most important factors in bacterial diversity. The majority of the phyla in rhizosphere sediments were Firmicutes, Proteobacteria and Campilobacterota, while Proteobacteria, Chloroflexi was the most abundant phyla followed by Bacteroidota, Actinobacteriota in non-rhizosphere sediments. The dominate factors of shaping the bacterial communities in rhizosphere were total antibiotics, pH, sediment organic matter (SOM), and NH4-N, while dissolved organic carbon (DOC), NO3-N, pH, and water contents (WC) in non-rhizosphere sediments.DiscussionIt is suggested that antibiotics may have a substantial effect on bacterial communities in P. australis rhizosphere sediment, which showed potential risk for ARGs selection pressure and dissemination in shallow lake ecosystems.
A predictive model using risk factor categories for hospital-acquired pneumonia in patients with aneurysmal subarachnoid hemorrhage
Authors: Hu Sheng-Qi , Hu Jian-Nan , Chen Ru-Dong , Yu Jia-Sheng 
Published: December 2022

ObjectivesTo identify risk factors for hospital-acquired pneumonia (HAP) in patients with aneurysmal subarachnoid hemorrhage (aSAH) and establish a predictive model to aid evaluation.MethodsThe cohorts of 253 aSAH patients were divided into the HAP group (n = 64) and the non-HAP group (n = 189). Univariate and multivariate logistic regression were performed to identify risk factors. A logistic model (Model-Logit) was established based on the independent risk factors. We used risk factor categories to develop a model (Model-Cat). Receiver operating characteristic curves were generated to determine the cutoff values. Areas under the curves (AUCs) were calculated to assess the accuracy of models and single factors. The Delong test was performed to compare the AUCs.ResultsThe multivariate logistic analysis showed that the age [p = 0.012, odds ratio (OR) = 1.059, confidence interval (CI) = 1.013–1.107], blood glucose (BG; &gt;7.22 mmol/L; p = 0.011, OR = 2.781, CI = 1.263–6.119), red blood distribution width standard deviation (RDW-SD; p = 0.024, OR = 1.118, CI = 1.015–1.231), and Glasgow coma scale (GCS; p &lt; 0.001, OR = 0.710, CI = 0.633–0.798) were independent risk factors. The Model-Logit was as follows: Logit(P) = −5.467 + 0.057 * Age + 1.023 * BG (&gt;7.22 mmol/L, yes = 1, no = 0) + 0.111 * RDW-SD−0.342 * GCS. The AUCs values of the Model-Logit, GCS, age, BG (&gt;7.22 mmol/L), and RDW-SD were 0.865, 0.819, 0.634, 0.698, and 0.625, respectively. For clinical use, the Model-Cat was established. In the Model-Cat, the AUCs for GCS, age, BG, and RDW-SD were 0.850, 0.760, 0.700, 0.641, and 0.564, respectively. The AUCs of the Model-Logit were insignificantly higher than the Model-Cat (Delong test, p = 0.157). The total points from −3 to 4 and 5 to 14 were classified as low- and high-risk levels, respectively.ConclusionsAge, BG (&gt; 7.22 mmol/L), GCS, and RDW-SD were independent risk factors for HAP in aSAH patients. The Model-Cat was convenient for practical evaluation. The aSAH patients with total points from 5 to 14 had a high risk for HAP, suggesting the need for more attention during treatment.
RETRACTED: A study on expression level and nutritional status of IGFBP-2 after left neck anastomosis combined with placement of feeding nutritional applicators carrying ^(125)I particles in the treatment of esophageal cancer
Authors: Zhan Zhiqiang , Mei Jiaqi , Zhou Xiangwu , Jiang Sicong , Li Daojing , Wang Xuefeng 
Published: December 2022

BackgroundTo explore the changes and significance of the expression level and nutritional status of human insulin-like growth factor binding protein-2 (IGFBP2) after the treatment of esophageal cancer with left neck anastomosis combined with placement of feeding nutritional applicators carrying ^(125)I particles.MethodsA total of 110 patients with esophageal cancer (observation group: left neck anastomosis combined with placement of feeding nutritional applicators carrying ^(125)I particles) and 100 healthy people (control group) were enrolled at the same period. Then enzyme-linked immunosorbent assay (ELISA) was carried out to detect level of IGFBP-2. Lymphocyte count and serum albumin were measured by immune analyzer and automatic protein analyzer to evaluate nutritional status. Logistic regression analysis was used to analyze the relationship between serum IGFBP-2, nutritional status and prognosis of esophageal cancer after combined treatment.ResultsThe albumin, lymphocyte absolute value and PNI detection value of the control group were lower than those of the observation group 1 month after treatment, and the difference was statistically significant compared with the control group. The detection value of IGFBP-2 in early patients before and after treatment was lower than that in middle and late patients, and the detection values of albumin, lymphocyte absolute value and PNI were higher than those in middle and late patients, the differences were statistically significant. Serum IGFBP-2 level was negatively correlated with PNI, and albumin and lymphocyte absolute value were positively correlated with PNI. The detection value of IGFBP-2 in patients with good prognosis was significantly lower than that in patients with poor prognosis, and the detection values of albumin, lymphocyte absolute value and PNI were significantly higher than those in patients with poor prognosis. The AUC (0.887,95% CI: 0.799-0.975) of IGFBP-2, albumin, lymphocyte absolute value and PNI in predicting poor prognosis of esophageal cancer was the largest, and the sensitivity and specificity were 94.12% and 92.47%, respectively.ConclusionsLeft neck anastomosis combined with ^(125)I particle application nutritional tube is helpful for the decrease of serum IGFBP-2 and the increase of various nutritional status indicators, which is beneficial for the improvement of the patient’s condition.
Communication and access to healthcare: Experiences of Aboriginal and Torres Strait Islander people managing pain in Queensland, Australia
Authors: Bernardes Christina Maresch , Houkamau Kushla , Lin Ivan , Taylor Marayah , Birch Stephen , Claus Andrew , Bryant Matthew , Meuter Renata , Isua Jermaine , Gray Paul , Kluver Joseph P , Jones Corey , Ekberg Stuart , Pratt Gregory 
Published: December 2022

BackgroundPain management requires a multidisciplinary approach and a collaborative relationship between patient-provider in which communication is crucial. This study examines the communication experiences of Aboriginal and Torres Strait Islander patients and Aboriginal and Torres Strait Islander Hospital Liaison Officers (ATSIHLOs), to improve understanding of how pain is managed in and through patient-health professional communication.MethodsThis qualitative study involved a purposive sample of patients attending three persistent pain clinics and ATSIHLOs working in two hospitals in Queensland, Australia. Focus groups and in-depth interviews explored the communication experiences of patients managing pain and ATSIHLOs supporting patients with pain. This study adopted a descriptive phenomenological methodology, as described by Colaizzi (1978). Relevant statements (patient and ATSIHLOs quotes) about the phenomenon were extracted from the transcripts to formulate meanings. The formulated meanings were subsequently sorted into thematic clusters and then integrated into themes. The themes were then incorporated into a concise description of the phenomenon of communication within pain management. Findings were validated by participants.ResultsA total of 21 Aboriginal and Torres Strait Islander participants were involved in this study. Exploration of the communication experiences of patients and ATSIHLOs revealed overlapping themes of important barriers to and enablers of communication that affected access to care while managing pain. Acknowledging historical and cultural factors were particularly important to build trust between patients and health professionals. Some patients reported feeling stigmatized for identifying as Aboriginal and Torres Strait Islander, while others were reluctant to disclose their background for fear of not having the same opportunity for treatment. Differences in the expression of pain and the difficulty to use standard pain measurement scales were identified. Communication was described as more than the content delivered, it is visual and emotional expressed through body language, voice intonation, language and the speed of the conversation.ConclusionCommunication can significantly affect access to pain management services. Aboriginal and Torres Strait Islander patients highlighted the burden of emotional pain caused by historical factors, negative stereotypes and the fear of discrimination. Pain management services and their health professionals need to acknowledge how these factors impact patients trust and care.
Establishment of a cell senescence related prognostic model for predicting prognosis in glioblastoma
Authors: Li Hongbin , Wang Zhuozhou , Sun Chengde , Li Shuangjia 
Published: December 2022

Background: Glioblastoma (GBM) is highly malignant and has a worse prognosis with age, and next-generation sequencing (NGS) provides us with a huge amount of information about GBM.Materials and Methods: Through the enrichment scores of cell senescence-related pathways, we constructed a consensus matrix and mined molecular subtypes and explored the differences in pathological, immune/pathway and prognostic. Also we identified key genes related to cell senescence characteristics using least absolute shrinkage and selection operator (Lasso) regression and univariate COX regression analysis models. The use of risk factor formats to construct clinical prognostic models also explored the differences in immunotherapy/chemotherapy within the senescence-related signatures score (SRS.score) subgroups. Decision trees built with machine learning to identify the main factors affecting prognosis have further improved the prognosis model and survival prediction.Results: We obtained seven prognostic-related pathways related to cell senescence. We constructed four different molecular subtypes and found patients with subtype C1 had the worst prognosis. C4 had the highest proportion of patients with IDH mutations. 1005 differentially expressed genes (DEGs) were analyzed, and finally 194 Risk genes and 38 Protective genes were obtained. Eight key genes responsible for cell senescence were finally identified. The clinical prognosis model was established based on SRS.score, and the prognosis of patients with high SRS.score was worse. SRS.score and age were the vital risk factors for GBM patients through decision tree model mining.Conclusion: We constructed a clinical prognosis model that could provide high prediction accuracy and survival prediction ability for adjuvant treatment of patients with GBM.
The application of the nnU-Net-based automatic segmentation model in assisting carotid artery stenosis and carotid atherosclerotic plaque evaluation
Authors: Zhu Ying , Chen Liwei , Lu Wenjie , Gong Yongjun , Wang Ximing 
Published: December 2022

Objective: No new U-net (nnU-Net) is a newly-developed deep learning neural network, whose advantages in medical image segmentation have been noticed recently. This study aimed to investigate the value of the nnU-Net-based model for computed tomography angiography (CTA) imaging in assisting the evaluation of carotid artery stenosis (CAS) and atherosclerotic plaque.Methods: This study retrospectively enrolled 93 CAS-suspected patients who underwent head and neck CTA examination, then randomly divided them into the training set (N = 70) and the validation set (N = 23) in a 3:1 ratio. The radiologist-marked images in the training set were used for the development of the nnU-Net model, which was subsequently tested in the validation set.Results: In the training set, the nnU-Net had already displayed a good performance for CAS diagnosis and atherosclerotic plaque segmentation. Then, its utility was further confirmed in the validation set: the Dice similarity coefficient value of the nnU-Net model in segmenting background, blood vessels, calcification plaques, and dark spots reached 0.975, 0.974 0.795, and 0.498, accordingly. Besides, the nnU-Net model displayed a good consistency with physicians in assessing CAS (Kappa = 0.893), stenosis degree (Kappa = 0.930), the number of calcification plaque (Kappa = 0.922), non-calcification (Kappa = 0.768) and mixed plaque (Kappa = 0.793), as well as the max thickness of calcification plaque (intraclass correlation coefficient = 0.972). Additionally, the evaluation time of the nnU-Net model was shortened compared with the physicians (27.3 ± 4.4 s vs. 296.8 ± 81.1 s, p &lt; 0.001).Conclusion: The automatic segmentation model based on nnU-Net shows good accuracy, reliability, and efficiency in assisting CTA to evaluate CAS and carotid atherosclerotic plaques.