bluuebunny/crossref_metadata_2025_split huggingface dataset:
Appendiceal Neuroendocrine Tumor Is a Rare Cause of Ectopic Adrenocorticotropic Hormone Syndrome With Cyclic Hypercortisolism: A Case Report and Literature Review
Authors: Zhao Yu Xing , Ma Wan Lu , Jiang Yan , Zhang Guan Nan , Wang Lin Jie , Gong Feng Ying , Zhu Hui Juan , Lu Lin 
Published: February 2022

ObjectiveEctopic adrenocorticotropic hormone (ACTH) syndrome (EAS) is a condition of hypercortisolism caused by non-pituitary tumors secreting ACTH. Appendiceal neuroendocrine tumor as a rare cause of ectopic ACTH syndrome was reported scarcely. We aimed to report a patient diagnosed with EAS caused by an appendiceal neuroendocrine tumor and summarized characteristics of these similar cases reported before.Case Report and Literature ReviewWe reported a case with Cushing’s syndrome who was misdiagnosed as pituitary ACTH adenoma at first and accepted sella exploration. Serum and urinary cortisol decreased, and symptoms were relieved in the following 4 months after surgery but recurred 6 months after surgery. The abnormal rhythm of plasma cortisol and ACTH presented periodic secretion and seemingly rose significantly after food intake. EAS was diagnosed according to inferior petrosal sinus sampling (IPSS). Appendiceal mass was identified by 68Ga-DOTA-Tyr3-octreotate (DOTATATE)-PET-CT and removed. The pathological result was consistent with appendiceal neuroendocrine tumor with ACTH (+). The literature review demonstrated 7 cases diagnosed with EAS caused by appendiceal neuroendocrine tumor with similarities and differences.ConclusionThe diagnosis of an ectopic ACTH-producing tumor caused by the appendiceal neuroendocrine tumor can be a challenging procedure. Periodic ACTH and cortisol secretion may lead to missed diagnosis and misdiagnosis. IPSS is crucial in the diagnosis of EAS and 68Ga-DOTATATE-PET-CT plays an important role in the identification of lesions.
Smoking Status and Type 2 Diabetes, and Cardiovascular Disease: A Comprehensive Analysis of Shared Genetic Etiology and Causal Relationship
Authors: Chi Yanna , Wang Xinpei , Jia Jinzhu , Huang Tao 
Published: February 2022

ObjectiveThis study aimed to explore shared genetic etiology and the causality between smoking status and type 2 diabetes (T2D), cardiovascular diseases (CVDs), and related metabolic traits.MethodsUsing summary statistics from publicly available genome-wide association studies (GWASs), we estimated genetic correlations between smoking status and T2D, 6 major CVDs, and 8 related metabolic traits with linkage disequilibrium score regression (LDSC) analysis; identified shared genetic loci with large-scale genome-wide cross-trait meta-analysis; explored potential shared biological mechanisms with a series of post-GWAS analyses; and determined causality with Mendelian randomization (MR).ResultsWe found significant positive genetic associations with smoking status for T2D (Rg = 0.170, p = 9.39 × 10−22), coronary artery disease (CAD) (Rg = 0.234, p = 1.96 × 10−27), myocardial infarction (MI) (Rg = 0.226, p = 1.08 × 10−17), and heart failure (HF) (Rg = 0.276, p = 8.43 × 10−20). Cross-trait meta-analysis and transcriptome-wide association analysis of smoking status identified 210 loci (32 novel loci) and 354 gene–tissue pairs jointly associated with T2D, 63 loci (12 novel loci) and 37 gene–tissue pairs with CAD, 38 loci (6 novel loci) and 17 gene–tissue pairs with MI, and 28 loci (3 novel loci) and one gene–tissue pair with HF. The shared loci were enriched in the exo-/endocrine, cardiovascular, nervous, digestive, and genital systems. Furthermore, we observed that smoking status was causally related to a higher risk of T2D (β = 0.385, p = 3.31 × 10−3), CAD (β = 0.670, p = 7.86 × 10−11), MI (β = 0.725, p = 2.32 × 10−9), and HF (β = 0.520, p = 1.53 × 10−6).ConclusionsOur findings provide strong evidence on shared genetic etiology and causal associations between smoking status and T2D, CAD, MI, and HF, underscoring the potential shared biological mechanisms underlying the link between smoking and T2D and CVDs. This work opens up a new way of more effective and timely prevention of smoking-related T2D and CVDs.
Prevalence and Characteristics of Erectile Dysfunction in Obstructive Sleep Apnea Patients
Authors: Feng Chen , Yang Yan , Chen Lixiao , Guo Ruixiang , Liu Huayang , Li Chaojie , Wang Yan , Dong Pin , Li Yanzhong 
Published: February 2022

BackgroundObstructive sleep apnea (OSA) is a common and severe social problem. Erectile dysfunction (ED) is an important health concern. The prevalence of OSA with ED is increasing, which significantly affects the quality of life and work efficiency of patients. However, the mechanism underlying the comorbidity of these two diseases remains unclear.Objectives(1) Investigate the prevalence of OSA with ED; (2) analyze the correlation between OSA and ED; and (3) explore the treatment response to and possible mechanism of uvulapalatopharyngoplasty (UPPP) in patients with OSA and ED. This study aims to provide a theoretical basis for the clinical diagnosis and comprehensive treatment of OSA with ED and improve prevention and treatment strategies.Materials and MethodsIn total, 135 subjects were enrolled in the study. Clinical data, polysomnography, the ESS score, Beck anxiety score, Beck depression score, IIEF-5 score and ASEX score were recorded before UPPP and 6 months after UPPP. Sex hormones were measured for all subjects using a Roche electrochemiluminescence analyzer.ResultThe prevalence of OSA with ED was 64.52%, and the prevalence of severe OSA with ED was 73.02%. The prevalence of OSA with ED increased with age, BMI and apnea-hypopnea index (AHI) value. Among polysomnography indicators, minimum oxygen saturation and average oxygen saturation may predict the occurrence of OSA with ED. Improving the patient’s anxiety and depression is very important for treating OSA with ED. Sex hormone levels were not significantly correlated with the occurrence of OSA with ED.ConclusionED is a common symptom of OSA patients. This study showed that sex hormone levels in OSA patients with ED were not significantly correlated with the condition, but further investigation of this relationship is worthwhile. It is recommended that the free and combined types of sex hormones be further distinguished during testing because the free type is the active form. UPPP surgical treatment is effective for OSA with ED, and its possible mechanism is protection of the peripheral nerves of the sex organs by improving nighttime hypoxia and arousal.
Identification of the Chinese Population That Can Benefit Most From Postprandial Lipid Testing: Validation of the Use of Oral Fat Tolerance Testing in Clinical Practice
Authors: Hou Xiaoyu , Song An , Guan Yunpeng , Tian Peipei , Ren Luping , Tang Yong , Wang Chao , Gao Ling , Song Guangyao , Xing Xiaoping 
Published: February 2022

BackgroundDyslipidemia has become increasingly prevalent in recent decades. Blood lipid concentrations are significantly influenced by diet; however, postprandial triglyceride concentration (PTG) is not often measured. PTG can reflect the risks of diabetes and cardiovascular disease, but not all individuals would benefit from PTG testing.ObjectiveThe aim of the present study was to determine the PTG response in a Chinese cohort and identify who would benefit from diagnostic PTG measurement.MethodsA total of 400 Chinese adults were enrolled and underwent oral fat tolerance test (OFTT), which was well tolerated. The participants were assigned to groups according to their fasting triglyceride concentration to evaluate the usefulness of PTG testing. A PTG concentration &gt; 2.5 mmol/L was defined as high (HPTG).ResultsOf the 400 participants, 78.9% showed an undesirable PTG response. Those with FTG ≥1.0 mmol/L had a delayed PTG peak and higher peak values. Seventy-five percent of those with 1.0 mmol/L ≤FTG &lt;1.7 mmol/L had HPTG, of whom 18.6% had impaired glucose tolerance.ConclusionsThe present data confirm the previously reported predictive value of PTG testing. Moreover, the findings indicate that Chinese people with FTGs of 1.0 -1.7 mmol/L may benefit most from the identification of postprandial hyperlipidemia through OFTT because more than half of them have occult HPTG, which may require treatment. Thus, the detection of HPTG using an OFTT represents a useful means of identifying dyslipidemia and abnormal glucose metabolism early.Clinical Trial Registration[http://www.chictr.org.cn/index.aspx], identifier ChiCTR1800019514.
Prevalent Morphometrically Assessed Vertebral Fractures in Individuals With Type 2 Diabetes, Prediabetes and Normal Glucose Metabolism: The Maastricht Study
Authors: van Hulten Veerle , Sarodnik Cindy , Driessen Johanna H. M. , Schaper Nicolaas C. , Geusens Piet P. M. M. , Webers Carol A. B. , Dinant Geert-Jan , Ottenheijm Ramon P. G. , Rasmussen Nicklas H. , Viggers Rikke , Stehouwer Coen D. A. , van der Kallen Carla J. H. , Schram Miranda T. , Bours Sandrine P. G. , Dagnelie Pieter C. , van den Bergh Joop P. 
Published: February 2022

BackgroundType 2 diabetes (T2D) is frequently reported to be associated with an increased fracture risk. Epidemiological data on prevalent morphometric vertebral fractures (VFs) in T2D are sparse and even less is known in the prediabetic state.PurposeTo determine the association between prevalence and severity of morphometric VFs and glucose metabolism state: normal glucose metabolism (NGM), impaired glucose metabolism (prediabetes) or T2D.MethodsThis study included cross-sectional data from 3625 participants of the Maastricht Study who had a vertebral fracture assessment on lateral Dual Energy X-Ray Absorptiometry images. VFs were classified based on morphometric assessment into mild, moderate and severe VFs (respectively 20–24%, 25–39% or ≥40% reduction in expected vertebral body height). Logistic regression models were used to investigate the association between glucose metabolism status and the prevalence and severity of VFs. Analyses were adjusted for subject characteristics and life-style factors.ResultsT2D individuals were older (62.8 ± 7.5 years old) and less often female (30.5%) compared to the NGM group (57.7 ± 8.5 years old, and 58.8% female, respectively). At least one mild, moderate or severe prevalent VF was found in 8.6% of the men and 2.2% of the women in the T2D group, in 9.4% and 8.4% in the prediabetes group and in 9.1% and 4.8% in the NGM group, respectively. After adjustment T2D in women was associated with a lower probability of having a prevalent VF compared to NGM [adjusted OR 0.25 (95% CI 0.09-0.65)], while this was not the case for prediabetes. Furthermore, women with T2D had a significantly lower probability of a prevalent moderate or severe VF [adjusted OR 0.32 (95% CI 0.11-0.96)]. In men there was no significant association between T2D or prediabetes and prevalent VFs.ConclusionWomen with T2D had a lower probability of prevalent VFs compared to women with a normal glucose metabolism, while this was not the case for men with T2D and participants with prediabetes.
Comparative Efficacy of Xianling Gubao Capsules in Improving Bone Mineral Density in Postmenopausal Osteoporosis: A Network Meta-Analysis
Authors: Luo Ming-hui , Zhao Jin-long , Xu Nan-jun , Xiao Xiao , Feng Wen-xuan , Li Zi-ping , Zeng Ling-feng 
Published: February 2022

ObjectiveThe clinical efficacy of Xianling Gubao capsule (XLGB) and its combination therapy in the treatment of postmenopausal osteoporosis (PMOP) was systematically evaluated by frequency-based network meta-analysis.MethodsWe searched the China National Knowledge Infrastructure (CNKI), Wanfang, SinoMed, PubMed, Embase and Cochrane Library databases to identify clinical trials of XLGB for the treatment of PMOP from the establishment of each database to November 22, 2021. The quality of the included studies was evaluated by using the risk of bias assessment tool version 2.0 (Rob 2.0) recommended by Cochrane. Stata 14.0 was applied for statistical analysis of the data, and the surface under the cumulative ranking curve (SUCRA) was used to rank the intervention measures of each outcome index.ResultsThis study included 22 clinical trials (including 19 RCTs and 3 non-RCTs) involving 12 drug therapies. According to the results of the network meta-analysis and SUCRA, the best three interventions for improving lumbar bone mineral density (BMD) are XLGB+BP+calcium (83.7%), XLGB+BP (68.5.7%) and XLGB+VD (67.1%). XLGB+calcium was the best combination regimen for improving femoral neck BMD and increasing bone Gla protein (BGP) and alkaline phosphatase (ALP) contents in serum. The SUCRA values of XLGB+calcium for improving the three outcome indicators were 68.0%, 59.5% and 82.1%, respectively.ConclusionsThe results of this network meta-analysis show that combined application of XLGB can effectively improve BMD and serum BGP and ALP compared to calcium alone, VD or BP. In the future, multicenter, large-sample and double-blind clinical RCTs should be carried out to supplement and verify the results of this study.
Numerical Simulations of Carbon Dioxide Storage in Selected Geological Structures in North-Western Poland
Authors: Urych Tomasz , Chećko Jarosław , Magdziarczyk Małgorzata , Smoliński Adam 
Published: February 2022

In this study, dynamic simulation models of CO2 injection into saline aquifers of the Choszczno-Suliszewo structure located in north-western Poland were constructed for two scenarios with different injection rates. The injection rates of 1 Mt CO2/year and 2 Mt CO2/year were analysed for each of the injection wells. Changes in pressures, characteristic for the sequestration process, were analysed; in addition, the spatial distribution of free CO2 saturation in the structure and carbon dioxide dissolved in brine were presented in a graphical form. The observation time of changes occurring in the rock mass in the interval of up to 1,000 years after the completion of injection was assumed. During the modelling of CO2 sequestration in Lower Jurassic aquifers in the Suliszewo model, the previously assumed CO2 injection rates were achieved for both injection scenarios. The observed pressure increase does not pose any threat to the Suliszewo structure tightness. The sequestration process was found to be highly effective due to the phenomenon of the dissolution of CO2 in brine and the resulting convection motion of brine enriched with carbon dioxide. Consequently, there is an increase in CO2 storage capacity and permanent long-term trapping of the injected carbon dioxide. The process of the displacement of injected CO2 from the collector layers to the layers constituting the reservoir sealing was observed. This phenomenon takes place in the upper parts of the Choszczno structure and is caused mainly by the locally occurring worse technical parameters of seal layers in this area.
Knowledge Co-creation and Sustainable Education in the Labor Market-Driven University–Business Environment
Authors: Pocol Cristina Bianca , Stanca Liana , Dabija Dan-Cristian , Pop Ioana Delia , Mișcoiu Sergiu 
Published: February 2022

Objective: The university-business partnership plays a particularly important role in society, allowing a symbiosis between socio-economic stakeholders and the university. This symbiosis is based on co-creating and sharing knowledge, creating collaborative projects, valorizing research, implementing SD principles, and on good governance. The aim of this research is to identify groups of francophone socio-economic organizations willing to engage in co-creating knowledge with universities to adapt the academic curriculum to the dynamic requirements of the labor market, supporting entrepreneurship, whilst implementing SDG principles, and ensuring sustainable education. We base our approach on the two-step cluster analysis, data being collected via questionnaires among representatives of francophone organizations in an emerging market. This allows the identification of two clusters of francophone organizations according to the extent to which they contribute to strengthening their relationship with the university by co-creating knowledge, implementing SDG principles, and supporting sustainable education.Findings: The first cluster is represented by francophone organizations reluctant to co-create knowledge and innovate with universities. These organizations have a rather unclear long-term vision and are not actively involved in supporting SDG education or understanding the universities’ training needs. The second cluster is represented by francophone organizations willing to strengthen the relationship with universities and to co-create value, developing students’ entrepreneurial skills and cooperating on the adaptation of the academic curriculum to labor market requirements.Originality/Implications: The originality of this paper consists in conducting exhaustive research among francophone organizations in Romania, with significant practical and social implications for strengthening the strategic university-business environment partnership and identifying solutions to improve knowledge co-creation and sustainable education within a proper university governance.
Increasing but Variable Trend of Surface Ozone in the Yangtze River Delta Region of China
Authors: Tang Keqin , Zhang Haoran , Feng Weihang , Liao Hong , Hu Jianlin , Li Nan 
Published: February 2022

Surface ozone (O3) increased by ∼20% in the Yangtze River Delta (YRD) region of China during 2014–2020, but the aggravating trend is highly variable on interannual time and city-level space scales. Here, we employed multiple air quality observations and numerical simulation to describe the increasing but variable trend of O3 and to reveal the main driving factors behind it. In 2014–2017, the governmental air pollution control action plan was mostly against PM2.5 (mainly to control the emissions of SO2, NOx, and primary PM2.5) and effectively reduced the PM2.5 concentration by 18%–45%. However, O3 pollution worsened in the same period with an increasing rate of 4.9 μg m−3 yr−1, especially in the Anhui province, where the growth rate even reached 14.7 μg m−3 yr−1. After 2018, owing to the coordinated prevention and control of both PM2.5 and O3, volatile organic compound (VOC) emissions in the YRD region has also been controlled with a great concern, and the O3 aggravating trend in the same period has been obviously alleviated (1.1 μg m−3 yr−1). We further combined the precursor concentration and the corresponding O3 formation regime to explain the observed trend of O3 in 2014–2020. The leading O3 formation regime in 2014–2017 is diagnosed as VOC-limited (21%) or mix-limited (58%), with the help of a simulated indicator HCHO/NOy. Under such condition, the decreasing NO2 (2.8% yr−1) and increasing VOCs (3.6% yr−1) in 2014–2017 led to a rapid increment of O3. With the continuous reduction in NOx emission and further in ambient NOx/VOCs, the O3 production regime along the Yangtze River has been shifting from VOC-limited to mix-limited, and after 2018, the mix-limited regime has become the dominant O3 formation regime for 55% of the YRD cities. Consequently, the decreases of both NOx (3.3% yr−1) and VOCs (7.7% yr−1) in 2018–2020 obviously slowed down the aggravating trend of O3. Our study argues that with the implementation of coordinated regional reduction of NOx and VOCs, an effective O3 control is emerging in the YRD region.
Predicting EGFR and PD-L1 Status in NSCLC Patients Using Multitask AI System Based on CT Images
Authors: Wang Chengdi , Ma Jiechao , Shao Jun , Zhang Shu , Liu Zhongnan , Yu Yizhou , Li Weimin 
Published: February 2022

BackgroundEpidermal growth factor receptor (EGFR) genotyping and programmed death ligand-1 (PD-L1) expressions are of paramount importance for treatment guidelines such as the use of tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) in lung cancer. Conventional identification of EGFR or PD-L1 status requires surgical or biopsied tumor specimens, which are obtained through invasive procedures associated with risk of morbidities and may be unavailable to access tissue samples. Here, we developed an artificial intelligence (AI) system that can predict EGFR and PD-L1 status in using non-invasive computed tomography (CT) images.MethodsA multitask AI system including deep learning (DL) module, radiomics (RA) module, and joint (JO) module combining the DL, RA, and clinical features was developed, trained, and optimized with CT images to predict the EGFR and PD-L1 status. We used feature selectors and feature fusion methods to find the best model among combinations of module types. The models were evaluated using the areas under the receiver operating characteristic curves (AUCs).ResultsOur multitask AI system yielded promising performance for gene expression status, subtype classification, and joint prediction. The AUCs of DL module achieved 0.842 (95% CI, 0.825–0.855) in the EGFR mutated status and 0.805 (95% CI, 0.779–0.829) in the mutated-EGFR subtypes discrimination (19Del, L858R, other mutations). DL module also demonstrated the AUCs of 0.799 (95% CI, 0.762–0.854) in the PD-L1 expression status and 0.837 (95% CI, 0.775–0.911) in the positive-PD-L1 subtypes (PD-L1 tumor proportion score, 1%–49% and ≥50%). Furthermore, the JO module of our AI system performed well in the EGFR and PD-L1 joint cohort, with an AUC of 0.928 (95% CI, 0.909–0.946) for distinguishing EGFR mutated status and 0.905 (95% CI, 0.886–0.930) for discriminating PD-L1 expression status.ConclusionOur AI system has demonstrated the encouraging results for identifying gene status and further assessing the genotypes. Both clinical indicators and radiomics features showed a complementary role in prediction and provided accurate estimates to predict EGFR and PD-L1 status. Furthermore, this non-invasive, high-throughput, and interpretable AI system can be used as an assistive tool in conjunction with or in lieu of ancillary tests and extensive diagnostic workups to facilitate early intervention.
CD71+ Erythroid Cell Expansion in Adult Sepsis: Potential Causes and Role in Prognosis and Nosocomial Infection Prediction
Authors: Zhao Guang-ju , Jiang Dan-wei , Cai Wen-chao , Chen Xiao-Yan , Dong Wei , Chen Long-wang , Hong Guang-liang , Wu Bin , Yao Yong-ming , Lu Zhong-qiu 
Published: February 2022

BackgroundImmune suppression contributes to nosocomial infections (NIs) and poor prognosis in sepsis. Recent studies revealed that CD71+ erythroid cells had unappreciated immunosuppressive functions. This study aimed to investigate the values of CD71+ erythroid cells (CECs) in predicting NIs and prognosis among adult septic patients. The potential factors associated with the expansion of CECs were also explored.MethodsIn total, 112 septic patients and 32 critically ill controls were enrolled. The frequencies of CD71+ cells, CD71+CD235a+ cells, and CD45+ CECs were measured by flow cytometry. The associations between CECs and NIs and 30-day mortality were assessed by ROC curve analysis and Cox and competing-risk regression models. Factors associated with the frequency of CECs were identified by linear regression analysis.ResultsThe percentage of CD71+ cells, CECs, and CD45+ CECs were higher in septic patients than critically ill controls. In septic patients, the percentages of CD71+ cells, CECs, and CD45+ CECs were associated with NI development, while CD71+ cells and CECs were independently associated with 30-day mortality. Linear regression analysis showed that the levels of interleukin (IL)-6 and interferon (IFN)-γ were positively associated with the frequencies of CD71+ cells, CECs, and CD45+ CECs, while IL-10 was negatively associated with them. Additionally, the levels of red blood cells (RBCs) were negatively associated with the percentage of CD45+ CECs.ConclusionsCECs were expanded in sepsis and can serve as independent predictors of the development of NI and 30-day mortality. Low levels of RBCs and high levels of IL-6 and IFN-γ may contribute to the expansion of CECs in sepsis.Trial RegistrationChiCTR, ChiCTR1900024887. Registered 2 August 2019, http://www.chictr.org.cn/showproj.aspx?proj=38645