bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neutrophil to lymphocyte ratio predicting poor outcome after aneurysmal subarachnoid hemorrhage: A retrospective study and updated meta-analysis
Authors: Guo Yinghan , Liu Jiang , Zeng Hanhai , Cai Lingxin , Wang Tingting , Wu Xinyan , Yu Kaibo , Zheng Yonghe , Chen Huaijun , Peng Yucong , Yu Xiaobo , Yan Feng , Cao Shenglong , Chen Gao 
Published: August 2022

BackgroundThe relationship between neutrophil to lymphocyte ratio (NLR) and poor outcome of aneurysmal subarachnoid hemorrhage (aSAH) is controversial. We aim to evaluate the relationship between NLR on admission and the poor outcome after aSAH.MethodPart I: Retrospective analysis of aSAH patients in our center. Baseline characteristics of patients were collected and compared. Multivariate analysis was used to evaluate parameters independently related to poor outcome. Receiver operating characteristic (ROC) curve analysis was used to determine the best cut-off value of NLR. Part II: Systematic review and meta-analysis of relevant literature. Related literature was selected through the database. The pooled odds ratio (OR) and corresponding 95% confidence interval (CI) were calculated to evaluate the correlation between NLR and outcome measures.ResultsPart I: A total of 240 patients with aSAH were enrolled, and 52 patients had a poor outcome. Patients with poor outcome at 3 months had a higher admission NLR, Hunt &amp; Hess score, Barrow Neurological Institute (BNI) scale score, Subarachnoid Hemorrhage Early Brain Edema Score (SEBES), and proportion of hypertension history. After adjustment, NLR at admission remained an independent predictor of poor outcome in aSAH patients (OR 0.76, 95% CI 0.69-0.83; P &lt; 0.001). The best cut-off value of NLR in ROC analysis is 12.03 (area under the curve 0.805, 95% CI 0.735 - 0.875; P &lt; 0.001). Part II: A total of 16 literature were included. Pooled results showed that elevated NLR was significantly associated with poor outcome (OR 1.31, 95% CI 1.14-1.49; P &lt; 0.0001) and delayed cerebral ischemia (DCI) occurrence (OR 1.32, 95% CI 1.11-1.56; P = 0.002). The results are more reliable in large sample sizes, low NLR cut-off value, multicenter, or prospective studies.ConclusionElevated NLR is an independent predictor of poor outcome and DCI occurrence in aSAH.
Dexmedetomidine to reduce vasopressor resistance in refractory septic shock: Protocol for a double-blind randomized controlled pilot trial (ADRESS Pilot study)
Authors: Dargent Auguste , Bourredjem Abderrahmane , Argaud Laurent , Levy Bruno , Fournel Isabelle , Cransac Amélie , Badie Julio , Quintin Luc , Quenot Jean-Pierre 
Published: August 2022

IntroductionRefractory septic shock (RSS) is characterized by high vasopressor requirements, as a consequence of vasopressor resistance, which may be caused or enhanced by sympathetic hyperactivation. Experimental models and clinical trials show a reduction in vasopressor requirements and improved microcirculation compared to conventional sedation. Dexmedetomidine did not reduce mortality in clinical trials, but few septic shock patients were enrolled. This pilot trial aims to evaluate vasopressor re-sensitization with dexmedetomidine and assess the effect size, in order to design a larger trial.MethodsThis is an investigator-initiated, multicenter, randomized, double-blind, placebo-controlled trial, comparing dexmedetomidine versus placebo in RSS patients with norepinephrine dose ≥0.5μg/kg/min. The primary outcome is blood pressure response to phenylephrine challenge, 6 hours after completion of a first challenge, after study treatment initiation. Secondary outcomes include feasibility and safety outcomes (bradycardia), mortality, vasopressor requirements, heart rate variability, plasma and urine catecholamines levels. The sample size is estimated at 32 patients to show a 20% improvement in blood pressure response to phenylephrine. Randomization (1:1) will be stratified by center, sedation type and presence of liver cirrhosis. Blood pressure and ECG will be continuously recorded for the first 24 h, enabling high-quality data collection for the primary and secondary endpoints. The study was approved by the ethics committee “Sud-Est VI” (2019-000726-22) and patients will be included after informed consent.DiscussionThe present study will be the first randomized trial to specifically address the hemodynamic effects of dexmedetomidine in patients with septic shock. We implement a high-quality process for data acquisition and recording in the first 24 h, ensuring maximal quality for the evaluation of both efficacy and safety outcomes, as well as transparency of results. The results of the study will be used to elaborate a full-scale randomized controlled trial with mortality as primary outcome in RSS patients.Trial registrationRegistered with ClinicalTrials.gov (NCT03953677). Registered 16 May 2019, https://clinicaltrials.gov/ct2/show/NCT03953677.
Dynamicity and persistence of severe acute respiratory syndrome coronavirus-2 antibody response after double dose and the third dose with BBV-152 and AZD1222 vaccines: A prospective, longitudinal cohort study
Authors: Parai Debaprasad , Choudhary Hari Ram , Dash Girish Chandra , Behera Susmita , Mishra Narayan , Pattnaik Dipti , Raghav Sunil Kumar , Mishra Sanjeeb Kumar , Sahoo Subrat Kumar , Swain Aparajita , Mohapatra Ira , Pattnaik Matrujyoti , Moharana Aparnamayee , Jena Sandhya Rani , Praharaj Ira , Subhadra Subhra , Kanungo Srikanta , Bhattacharya Debdutta , Pati Sanghamitra 
Published: August 2022

IntroductionVaccines are available worldwide to combat coronavirus disease-19 (COVID-19). However, the long-term kinetics of the vaccine-induced antibodies against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) have not been sufficiently evaluated. This study was performed to investigate the persistence and dynamicity of BBV-152 (Covaxin)- and AZD1222 (Covishield)-induced immunoglobulin-G (IgG) antibodies over the year and neutralizing antibodies’ status after 1-month of booster dose.Materials and methodsThis 52-week longitudinal cohort study documented antibody persistence and neutralizing antibodies status among 304 healthcare workers (HCWs) from six hospitals and research facilities in Odisha, enrolled during January 2021 and continued till March 2022. IgG antibodies against spike receptor-binding domain (RBD) of SARS-CoV-2 were quantified in an automated chemiluminescence immune assay-based (CLIA) platform and a surrogate virus neutralization test (sVNT) was performed by enzyme-linked immunosorbent assay (ELISA).ResultsAmong these 304 HCWs vaccinated with double doses, 154 HCWs (50.66%) were Covaxin recipients and the remaining 150 (49.34%) were Covishield recipients. During the follow-ups for seven times, a total of 114 participants were identified as vaccine breakthrough cases. In 190 non-infected HCWs, the median antibody titer was significantly waned from DD2 to DD10, both for Covaxin (231.8 vs. 42.7 AU/ml) and Covishield (1,884.6 vs. 369.2 AU/ml). No statistically significant differences in antibody titers were observed based on age, gender, comorbidities, and blood groups. The median inhibition activity of sVNT increased from 23.8 to 91.3% for Covaxin booster recipients and from 41.2 to 96.0% for Covishield booster recipients. Among 146 booster dose recipients, 48 were breakthrough cases after booster and all were contracted by the omicron variant.ConclusionThis year-long follow-up study found a 7- and 5-fold antibody waning in Covaxin and Covishield recipients, respectively, without any breakthrough infection history. However, individuals with booster breakthrough had mild symptoms and did not require hospital admission. The data also indicate the possible escape of omicron variants despite the presence of vaccine-induced neutralizing antibodies.
Effect of rearfoot valgus on biomechanics during barbell squatting: A study based on OpenSim musculoskeletal modeling
Authors: Lu Zhenghui , Li Xin , Rong Ming , Baker Julien S. , Gu Yaodong 
Published: August 2022

BackgroundBarbell squats are commonly used in daily training and rehabilitation. Injuries are not common when the posture is standard, but the wrong posture can lead to injuries. Rearfoot valgus is a common foot abnormality that may increase the risk of injury during sports. The purpose of this study was to compare the biomechanics of lower limbs in normal foot and valgus patients during barbell squat.MethodsIn this study, 10 participants with normal foot shape and 10 participants with rearfoot valgus were enrolled. The joint angle, joint moment, and range of motion of hip, knee, and ankle joints were collected under 0, 30, and 70% one-repetition maximum (RM) load, where discrete data are statistically analyzed using the independent sample t-test, and continuous data are statistically analyzed using one-dimensional parameter statistical mapping.ResultsIn barbell squats, the range of motion and the joint moment of the hip, knee, and ankle in the rearfoot valgus participants were significantly larger than those in normal foot participants (p &lt; 0.05). The participants with rearfoot valgus had a more significant knee valgus angle when squatting to the deepest (p &lt; 0.05). In addition, with the increase in load, the participants with rearfoot valgus showed greater standardized medial knee contact force (p &lt; 0.05). In the process of barbell squats, the participants with rearfoot valgus showed no significant difference in the foot valgus angle when compared with the normal foot shape (p &gt; 0.05).ConclusionsThe valgus population showed a greater range of joint motion when performing barbell squats and showed genu valgus and greater medial knee contact force, which may increase the risk of musculoskeletal and soft tissue damage such as meniscus wear. In addition, there was no significant difference in the rearfoot valgus angle between people with rearfoot valgus and people with normal foot shape during squatting, so barbell squatting may correct valgus to a certain extent.
Intrinsic brain abnormalities in female major depressive disorder patients with childhood trauma: A resting-state functional magnetic resonance imaging study
Authors: Chen Juran , Luo Qianyi , Li Yuhong , Wu Zhiyao , Lin Xinyi , Yao Jiazheng , Yu Huiwen , Nie Huiqin , Du Yingying , Peng Hongjun , Wu Huawang 
Published: August 2022

ObjectiveChildhood trauma is a strong predictor of major depressive disorder (MDD). Women are more likely to develop MDD than men. However, the neural basis of female MDD patients with childhood trauma remains unclear. We aimed to identify the specific brain regions that are associated with female MDD patients with childhood trauma.MethodsWe recruited 16 female MDD patients with childhood trauma, 16 female MDD patients without childhood trauma, and 20 age- and education level-matched healthy controls. All participants underwent resting-state functional magnetic resonance imaging (MRI). Regional brain activity was evaluated as the amplitude of low-frequency fluctuation (ALFF). Furthermore, functional connectivity (FC) analyses were performed on areas with altered ALFF to explore alterations in FC patterns.ResultsThere was increased ALFF in the left middle frontal gyrus (MFG) and the right postcentral gyrus (PoCG) in MDD with childhood trauma compared with MDD without childhood trauma. The areas with significant ALFF discrepancies were selected as seeds for the FC analyses. There was increased FC between the left MFG and the bilateral putamen gyrus. Moreover, ALFF values were correlated with childhood trauma severity.ConclusionOur findings revealed abnormal intrinsic brain activity and FC patterns in female MDD patients with childhood trauma, which provides new possibilities for exploring the pathophysiology of this disorder in women.
Long-term oncological outcomes of oncoplastic breast-conserving surgery after a 10-year follow-up – a single center experience and systematic literature review
Authors: Hing Jun Xian , Kang Byeong Ju , Keum Hee Jung , Lee Jeeyeon , Jung Jin Hyang , Kim Wan Wook , Yang Jung Dug , Lee Joon Seok , Park Ho Yong 
Published: August 2022

AimWhile many studies reported the oncological outcomes of oncoplastic breast-conserving surgery (OBCS), there were inherent differences in the study population, surgeons’ expertise, and classifications of techniques used. There were also limited studies with long term follow up oncological outcomes beyond 5 years. This current study aimed to compare long-term oncological outcomes of ipsilateral breast tumor recurrence (IBTR) disease-free survival (DFS) and overall survival (OS) following conventional and oncoplastic breast-conserving surgery using volume displacement and replacement techniques.MethodsBetween 2009 and 2013, 539 consecutive patients who underwent breast conservation surgery including 174 oncoplastic and 376 conventional procedures were analysed. A systematic review of studies with at least five years of median follow up were performed to compare long term oncological outcomes.ResultsAt a median follow-up of 82.4 months, there were 23 (4.2%) locoregional recurrences, 17 (3.2%) metachronous contralateral breast cancer, 26 (4.8%) distant metastases, and 13 (2.4%) deaths. The hazard ratio of OBCS for IBTR, DFS and OS were 0.78 (95% confidence interval [CI] 0.21–2.94, p=0.78), 1.59 (95% CI, 0.88 to 2.87, p=0.12), and 2.1 (95% CI, 0.72 to 5.9, p=0.17) respectively. The 10-year IBTR-free, DFS and OS rate were 97.8%, 86.2%, and 95.7% respectively.ConclusionThere remained a dearth in well-balanced comparative studies with sufficient long-term follow-up, and our study reported long-term oncological outcomes for OBCS which were favourable of either VD or replacement techniques.
Exploring the pharmacological mechanism of compound kushen injection in the treatment of breast cancer using in vitro experiments: Coupling network pharmacology with GEO database
Authors: Ye Yong , Zhang Bo , Liang Qiuyun , Wang Dandan , Bai Facheng , Li Yuanhong , Wei Lizhi , Li Lilan , Huang Huixue , Tang Yunxia 
Published: August 2022

BackgroundBreast cancer (BC) is one of the most common malignant tumors in women and poses a serious threat to their health. Compound Kushen injection (CKI) has shown therapeutic effects on a variety of cancers, including BC, and it can significantly improve the lives of patients. However, the underlying mechanism remains unclear and needs to be fully elucidated.MethodsThe active constituents of CKI were identified through a literature review, and the anti-BC targets of CKI were determined using multiple databases and a ChIP data analysis. Subsequently, the target was analyzed on the DAVID database through GO and KEGG to identify the key pathway that CKI affects to exhibit anti-BC activity. In addition, MCF-7 and MDA-MB-231 cells were treated with CKI for 24 and 48 hours at five concentrations, and the effects of CKI on cell proliferation and apoptosis were measured using MTT and annexin V/propidium iodide staining assays, respectively. The genes and protein identified to be involved in this pathway were verified using real-time quantitative PCR (qPCR) and western blot(WB) in BC cells.ResultsTwelve CKI anti-BC targets were obtained by a comprehensive analysis of the targets collected in the databases and results from the ChIP analysis. Bioinformatics analysis was performed for 12 targets. KEGG analysis showed that the 12 targets were mainly related to the VEGF, ErbB, and TNF signaling pathways. We focused our study on the VEGF signaling pathway as the p-value for the VEGF signaling pathway was the lowest among the three pathways. In vitro experiments showed that CKI significantly inhibited the proliferation of BC cells and induced apoptosis. Furthermore, qPCR and WB experiments showed that the expression of VEGF signaling pathway genes PIK3CA and NOS3 were significantly increased meanwhile SRC was significantly decreased after CKI intervention.ConclusionCKI significantly inhibited the proliferation of BC cells and induced apoptosis. The main mechanism for the anti-BC effect of CKI may be that it regulates the VEGF signaling pathway by increasing the expression of PIK3CA, SRC, and NOS3. Macrozamin and lamprolobine may be the main active components of CKI against BC.
Association between microRNA 671 polymorphisms and the susceptibility to soft tissue sarcomas in a Chinese population
Authors: Zhang Peng , Li Xinling , Huang Lingling , Hu Fulan , Niu Xiaoying , Sun Yang , Yao Weitao 
Published: August 2022

This study evaluated the association between the microRNA (miRNA) gene polymorphisms and the susceptibility to soft tissue sarcomas (STSs). In this case–control study, DNA was extracted from leukocytes in peripheral blood, which was collected from 169 STSs patients and 170 healthy controls. Three SNPs for miR-210, five SNPs for miR-206, two SNPs for miR-485, two SNPs for miR-34b, two SNPs for miR-671, and three SNPs for miR-381 were investigated and genotyped using a Sequenom Mass ARRAY matrix-assisted laser desorption/ionization-time of flight mass spectrometry platform. Unconditional logistic regression analysis was used to analyze the association between miRNA gene polymorphisms and the susceptibility to STSs. The results showed that miR-671 rs1870238 GC + CC (OR = 1.963, 95% CI = 1.258–3.064, P = 0.003) and miR-671 rs2446065 CG + GG (OR =1.838, 95% CI = 1.178–2.868, P = 0.007) may be genetic risk factors for STSs after adjustment for age and smoking. Therefore, this study suggests that individuals carrying the GC + CC genotype for miR-671 rs1870238 or the CG + GG genotype for miR-671 rs2446065 are susceptible to STSs.
Radiomics based on pretreatment MRI for predicting distant metastasis of nasopharyngeal carcinoma: A preliminary study
Authors: Jiang Tingting , Tan Yalan , Nan Shuaimin , Wang Fang , Chen Wujie , Wei Yuguo , Liu Tongxin , Qin Weifeng , Lu Fangxiao , Jiang Feng , Jiang Haitao 
Published: August 2022

ObjectiveTo explore the feasibility of predicting distant metastasis (DM) of nasopharyngeal carcinoma (NPC) patients based on MRI radiomics model.MethodsA total of 146 patients with NPC pathologically confirmed, who did not exhibit DM before treatment, were retrospectively reviewed and followed up for at least one year to analyze the DM risk of the disease. The MRI images of these patients including T2WI and CE-T1WI sequences were extracted. The cases were randomly divided into training group (n=116) and validation group (n=30). The images were filtered before radiomics feature extraction. The least absolute shrinkage and selection operator (LASSO) regression was used to develop the dimension of texture parameters and the logistic regression was used to construct the prediction model. The ROC curve and calibration curve were used to evaluate the predictive performance of the model, and the area under curve (AUC), accuracy, sensitivity, and specificity were calculated.Results72 patients had DM and 74 patients had no DM. The AUC, accuracy, sensitivity and specificity of the model were 0. 80 (95% CI: 0.72~0. 88), 75.0%, 76.8%, 73.3%. and0.70 (95% CI: 0.51~0.90), 66.7%, 72.7%, 63.2% in training group and validation group, respectively.ConclusionThe radiomics model based on logistic regression algorithm has application potential for evaluating the DM risk of patients with NPC.
Apraclonidine—An eye opener
Authors: Fierz Fabienne C. , Disse Leah R. , Bockisch Christopher J. , Weber Konrad P. 
Published: August 2022

Pharmacological testing with apraclonidine eye drops induces a typical reversal of anisocoria in patients with Horner’s syndrome. Moreover, apraclonidine was observed to have an elevating effect on the upper eyelid in Horner’s syndrome as well as in healthy subjects, which is thought to be mediated by alpha-1 adrenergic receptors present in the Muller’s muscle. We aim to quantitatively investigate the effect of apraclonidine on eyelid position in patients with Horner’s syndrome compared to physiological anisocoria based on infrared video recordings from pupillometry. We included 36 patients for analysis who underwent binocular pupillometry before and after apraclonidine 1% testing for the evaluation of anisocoria. Vertical eyelid measurements were taken from infrared videos and averaged from multiple pupillometry cycles. Receiver operating characteristic curves were calculated to determine the optimal cutoff value for change in eyelid aperture pre- and post-apraclonidine. A decrease of inter-eye difference in the aperture of &gt;0.42 mm was discriminative of Horner’s syndrome compared to physiological anisocoria with a sensitivity of 80% and a specificity of 75%. Our data confirm an eyelid- elevating effect of the apraclonidine test, more pronounced in eyes with a sympathetic denervation deficit. Measuring eyelid aperture on pupillometry recordings may improve the diagnostic accuracy of apraclonidine testing in Horner’s syndrome.
Incidence and predictors of pericardial effusion following surgical closure of atrial septal defect in children: A single center experience
Authors: Campisano Martina , Celani Camilla , Franceschini Alessio , Pires Marafon Denise , Federici Silvia , Brancaccio Gianluca , Galletti Lorenzo , De Benedetti Fabrizio , Chinali Marcello , Insalaco Antonella 
Published: August 2022

ObjectivesTo evaluate the incidence of pericardial effusion (PE) after surgical atrial septal defect (ASD) closure and to investigate the presence of predictive risk factors for its development.MethodsWe collected data from 203 patients followed at Bambino Gesù Children’s Hospital of Rome who underwent cardiac surgery for ASD repair between January 2015 and September 2019.ResultsA total of 200/203 patients with different types of ASD were included. Patients were divided into two groups: Group 1) 38 (19%) who developed PE and Group 2) 162 (81%) without PE. No differences were noted between the two groups with regard to gender or age at the surgery. Fever in the 48 h after surgery was significantly more frequent in group 1 than in group 2 (23.7 vs. 2.5%; p &lt; 0.0001). ECG at discharge showed significant ST-segment elevation in children who developed PE, 24.3 vs. 2.0% in those who did not (p &lt; 0.0001). Group 1 patients were divided into two subgroups on the basis of the severity of PE, namely, 31 (81.6%) with mild and 7 (18.4%) with moderate/severe PE. Patients with moderate/severe PE had a significantly higher BMI value (median 19.1 Kg/m2) (range 15.9–23.4, p = 0.004).ConclusionThe presence of fever and ST-segment elevation after surgery predicts subsequent development of PE suggesting a closer follow-up for these categories of patients. A higher BMI appears to be associated with a higher risk of moderate/severe PE.