bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case Report: Molecular Profiling Assists in the Diagnosis and Treatment of Cancer of Unknown Primary
Authors: Yu Bo , Wang Qifeng , Liu Xin , Hu Silong , Zhou Liangping , Xu Qinghua , Sun Yifeng , Hu Xichun , Luo Zhiguo , Zhang Xiaowei 
Published: March 2022

BackgroundFor cancer of unknown primary (CUP), non-selective empiric chemotherapy is usually used. However, patients suffering from CUP are generally assumed to have a dismal prognosis with median overall survival of less than 1 year. Therefore, clinicians eagerly await the establishment of effective strategies for diagnosis and treatment. In recent years, the remarkable advances in next-generation sequencing (NGS) technology have enabled the wide usage of DNA/RNA sequencing to comprehensively analyze the molecular information of individual tumors and identify potential targets for patients’ diagnosis and treatment. Here, we describe a patient of CUP who was successfully diagnosed and treated with targeted therapy directed by comprehensive molecular profiling.Case PresentationA 61-year-old Asian woman with a painless, slow-growing mass lesion in the mesosternum underwent fluorodeoxyglucose-positron emission tomography/computed tomography and was found to have malignant metastatic tumors in the mesosternum. Conventional pathological examination of metastatic lesions could not conclude the primary origin of the tumors. The patient was diagnosed with CUP at first. Then, comprehensive molecular profiling was employed to identify the tumor origin and genetic alterations. A gene expression-based tissue origin assay was performed using a tissue biopsy sample. The test result suggested that the lesion tumors might be breast cancer metastasis. Furthermore, liquid biopsy-based circulating tumor DNA profiling detected an ERBB2 copy number amplification. Subsequent surgery and additional postoperative pathology analysis confirmed that the primary tumor site was indeed located in the right outer upper quadrant of the breast. After local surgical resection, the patient received 8 cycles of Docetaxel + Carboplatin + Trastuzumab + Pertuzumab (TCbHP) chemotherapy with subsequent human epidermal growth factor receptor 2 (HER2)-targeted maintenance therapy. Currently, the patient is on regular follow-up and has achieved disease control for up to 6 months.ConclusionOur findings suggest that molecular identification of the tumor origin and the detection of actionable molecular alterations may offer promise for improved diagnostic accuracy and important therapeutic implications for patients with the CUP syndrome.
Risk Factor Assessment of Lymph Node Metastasis in Patients With FIGO Stage IB1 Cervical Cancer
Authors: Xu Mu , Xie Xiaoyan , Cai Liangzhi , Xie Yongjin , Gao Qiao , Sun Pengming 
Published: March 2022

ObjectivesTo assess the risk factors of lymph node metastasis (LNM) in patients with FIGO stage (2009) IB1 cervical cancer (CC).MethodsPatients with FIGO stage IB1 CC who underwent radical resection between 2012 and 2018 were recruited. The risk factors for LNM were analysed. A recursive partitioning analysis (RPA) was used to divide the patients into risk groups and assess their risk of LNM.ResultsThe 5-year overall survival rate was 91.72%, while 80.0% and 93.5% for patients with or without LNM (P&lt;0.05). Multivariable logistic regression analysis showed that lymphovascular invasion (LVI), depth of invasion (DI), tumour size (TS), squamous cell carcinoma (SCC) antigen level were independent risk factors (all P&lt;0.05). Patients were divided into low-risk (no LVI, DI &lt;1/2, TS &lt;2 cm), intermediate-risk (no LVI, DI &lt;1/2, TS ≥2 cm; no LVI, DI ≥1/2, normal SCC level; LVI, DI &lt;1/2, TS &lt;2 cm), and high-risk (no LVI, DI ≥1/2, SCC level ≥1.5 ng/ml; LVI, TS &lt;2 cm, DI ≥1/2; LVI, TS ≥2 cm) groups by RPA according to these four factors. The incidence of LNM among the three groups was 0.00%, 4.40%, and 24.10%, respectively (all P&lt;0.001). The 5-year overall survival rates differed among the groups (98.2%, 92.7%, 83.0%, respectively, P=0.001).ConclusionsLNM affects the prognosis of patients with FIGO stage IB1 CC. Lymphadenectomy may be avoided for patients in the low-risk group and recommended for those in the high-risk group. Whether dissection is performed in the intermediate-risk group depends on the lymph node biopsy results.
Prognostic Value of Lymph Node Evaluation in Stage II Small Bowel Adenocarcinoma: An Updated Analysis of Surveillance, Epidemiology, and End Results Database
Authors: Liu Zhen , Liu Kun , Gao Jiale , Jing Chao , Ma Yanhong , Zheng Shu , Shan Jianzhen 
Published: March 2022

BackgroundDue to the lack of large-scale clinical trials, the treatment strategies of small bowel adenocarcinoma (SBA) are controversial, especially for stage II patients. According to the National Comprehensive Cancer Network (NCCN) guideline, few lymph nodes (LNs) examined (&lt;5 for duodenum or &lt;8 for jejunal/ileal primary location) are one of the high-risk features for stage II patients, for whom adjuvant chemotherapy is recommended. This consensus is originally drawn from data in the Surveillance, Epidemiology, and End Results Database (SEER) between 1988 and 2010. However, the surgical modalities and chemotherapy strategies changed a lot after 2004 for SBA patients. The previous data may not represent a true picture of current therapeutics. Thus, we reanalyzed the SEER database and updated the cutoff point of LN numbers resected with respect to cancer-specific survival (CSS) using the latest SEER information.MethodsPatients diagnosed with stage II SBA and who underwent curative surgery between 2004 and 2018 were extracted from the SEER database. CSS was calculated using the Kaplan–Meier method and compared by log-rank test. Maximum survival differences based on total LNs examined for duodenal and jejunoileal tumors were determined separately with the cut-point analysis and maximum log-rank χ2 statistic. A nomogram model was constructed based on the multivariate Cox analysis to predict 5‐ and 10‐year CSS and was then validated with an internal cohort.ResultsA total of 935 stage II SBA patients met the inclusion criteria. The greatest difference in survival was found in patients who had removal of at least 5 LNs for duodenal and 12 LNs for jejunoileal tumors. Multivariate Cox analysis showed that age, T stage, histology grade, primary site, and LN numbers were independent prognostic factors for survival. The C index of nomogram model was 0.701 (95% CI, 0.661–0.741, p &lt; 0.001).ConclusionsThe number of LNs harvested is an important prognostic factor for survival in stage II SBA patients. LN number examined &lt;5 remains a high-risk factor for duodenum, but the cutoff point for jejunal/ileal tumors should rise from 8 to 12. Appropriate radical lymphadenectomy should be performed in stage II SBA surgery.
Transient Elastography in the Diagnosis of Pediatric Non-alcoholic Fatty Liver Disease and Its Subtypes
Authors: Yang Lin , Zhu Yafei , Zhou Lu , Yin Huimei , Lin Yan , Wu Guangsheng 
Published: March 2022

ObjectiveTo study the diagnosis efficacy of controlled attenuation parameters (CAP) and liver stiffness measurement (LSM) in the transient elastography of non-alcoholic fatty liver disease (NAFLD) and its subtypes in children with obesity.MethodsRetrospectively analyze children with obesity in the Childhood Obesity Clinic of the Affiliated Hospital of Hangzhou Normal University from July 2020 to March 2021. The correlation between clinical data and NAFLD subtypes was analyzed, and included the relevant clinical data into the receiver operating characteristic curve for diagnosis and prediction.Results120 children aged between 6.1 and 17.8 years, with 70 males (58.33%), 50 females (41.67%), and a ratio of 1.4:1, were enrolled in the study. CAP and LSM correlated in all subtypes of NAFLD. The correlation was significant for diagnosing NAFLD in children with obesity when CAP &gt; 258.00 dB/m and LSM &gt; 4.65 kPa. It was also significant for NASH diagnosis when CAP &gt; 276.00 dB/m and LSM &gt; 5.15 kPa, while it was less significant for diagnosing NAFLD in children with obesity.ConclusionsCAP and LSM have diagnostic efficacy for NAFLD and its subtypes in children with obesity, with optimal predictive values of CAP &gt; 258.00 dB/m and LSM &gt; 4.65 kPa for NAFLD in children with obesity, and CAP &gt; 276.00 dB/m and LSM &gt; 5.15 kPa for NASH in children with obesity.
A New Birthweight Reference by Gestational Age: A Population Study Based on the Generalized Additive Model for Location, Scale, and Shape Method
Authors: Wu Qiong , Zhang Hui-Yun , Zhang Li , Xu Yue-Qin , Sun Jin , Gao Nan-Nan , Qiao Xiu-Yun , Li Yan 
Published: March 2022

BackgroundIt is important to choose a suitable birthweight reference to assess newborns, especially those that are small for gestational age (SGA). Currently, there is no regional standard reference for the north of China or for Shandong province.MethodsA total of 130,911 data records of singleton, live neonates born at 24–42 weeks of gestation were collected from 2016 to 2018 in Shandong province. A new birthweight-for-gestational age percentile reference was constructed based on the Generalized Additive Model for Location, Scale and Shape (GAMLSS) package in R version 3.5. The established gestational age weight curve was compared separately with the Fenton curve, INTERGROWTH−21st curve, and the Chinese Neonatal Network Standard curve of 2015.ResultsWe established the reference values of birthweight by gestational age at the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles. Newborns had much heavier birthweights than those in the INTERGROWTH-21st and Fenton curves at most gestational ages. Although the newborns' birthweight references were closer to the Chinese Neonatal Network Standard except a few for gestational age, this study and INTERGROWTH-21st had similar birthweight curve shapes.ConclusionsThere are obvious differences among the criteria for newborn birthweights. Therefore, it is more accurate to assess newborns using the local birthweight reference.
Implementation of a Children's Safe Asthma Discharge Care Pathway Reduces the Risk of Future Asthma Attacks in Children–A Retrospective Quality Improvement Report
Authors: Kennedy Lesley , Gallagher Gillian , Maxwell Barbara , Bartholme Brigitte , Fitzsimons Andrew , Russell Catherine , Mallon Orla , Hughes Jenny L. , Beattie Susan , Vasi Veena , O'Donoghue Dara Bartholomew , Shields Michael David 
Published: March 2022

BackgroundMany children attend Emergency Departments (ED) and Out of Hours (OoH) frequently for acute asthma. Follow up care is often suboptimal leaving these children at risk of a future attacks. We report on the development, implementation and evaluation of a safe asthma discharge care pathway (SADCP).MethodsThis is a retrospective report on the development, implementation and evaluation of outcomes of a SADCP. The pathway was based on the Teach-to-goal educational methodology that supported the mastery correct inhaler technique and ability to action the personalized asthma action plan (PAAP). Children with frequent asthma attacks were entered as they were discharged from the Emergency Department or ward. The first training session occurred within 1–3 weeks of the index asthma attack with 2 further sessions in the following 8 weeks. Children exiting the pathway were discharged either back to primary care or to a hospital clinic.Results81 children entered the pathway (median age 5 years) with 72 discharged from the ED and 9 from the medical wards of the Royal Belfast Hospital for Sick Children. At pathway entry 13% had correct inhaler technique, 10% had a Personalized Asthma Action Plan (PAAP), and 5% had &gt;80% (45% &gt;50%) repeat refill evidence of adherence to inhaled corticosteroid over the previous 12 months. On pathway exit all children demonstrated correct inhaler technique and were able to action their PAAP. One year later 51% and 95% had refill evidence of &gt;80% and &gt;50% adherence. Comparisons of the 12 months before and 12 months after exit from the pathway the median number of emergency ED or OoH asthma attendances and courses of oral corticosteroids reduced to zero with &gt;75% having no attacks requiring this level of attention. Similar findings resulted when the SADCP was implemented in a district general hospital pediatric unit.ConclusionImplementing an asthma care pathway, using Teach-to-Goal skill training methods and frequent early reviews after an index asthma attack can reduce the future risk of asthma attacks in the next 6 to 12 months.
The Efficacy and Safety of Sodium Bicarbonate Ringer’s Solution in Critically Ill Patients: A Retrospective Cohort Study
Authors: Bian Yi , Xu Tingting , Le Yue , Li Shusheng 
Published: March 2022

Background: Sodium bicarbonate Ringer’s solution has been widely used in clinical practice in recent years. There are few clinical studies on the efficacy and safety of this fluid among critically ill patients until now.Method: This retrospective cohort study included critically ill adult patients in the intensive care unit (ICU) of Tongji Hospital from 1 January 2019 to 31 December 2020. By reviewing exclusively the use of either sodium bicarbonate Ringer’s solution or saline for resuscitation or maintenance, the patients were included into two groups, respectively. The primary outcome was the major adverse kidney event within 30 days (MAKE30), including death, new receipt of renal replacement therapy, or persistent renal dysfunction. Safety outcomes were focused on arterial blood gas and plasma biochemical alterations, which might potentially be induced by the administration of bicarbonate Ringer’s solution.Result: A total of 662 patients were included in the cohort. Compared to the saline group, the bicarbonate Ringer’s group had a significantly lower rate of the new receipt of renal replacement therapy [adjusted odds ratio (OR) = 0.591, 95% confidence interval (CI), 0.406 to 0.861; p = 0.006]. There was no significant difference between the two groups in 30-day mortality, final creatinine level ≥200% of baseline, and major adverse kidney event within 30 days. In subgroup analysis, the incidence of MAKE30 was higher in the bicarbonate Ringer’s group than that of the saline group among patients with cardiovascular disease. The patients in the bicarbonate Ringer’s group had a longer length of intensive care unit stay than patients in the saline group, but their new renal replacement therapy days were shorter. No major alterations were found in arterial blood gas and plasma biochemical during the follow-up period.Conclusion: Compared to saline, sodium bicarbonate Ringer’s solution exhibited a potential renal function protective effect while causing no major alterations in arterial blood gas and plasma biochemistry. However, the application in patients with cardiovascular disease diagnosis at ICU admission should be cautious.
The Effects of Prenatal Diagnosis on the Interaction of the Mother–Infant Dyad: A Longitudinal Study of Prenatal Care in the First Year of Life
Authors: de Souza Vera Cristina Alexandre , Parlato-Oliveira Erika , Anchieta Lêni Márcia , Machado Alexei Manso Correa , Savelon Sylvie Viaux 
Published: March 2022

IntroductionMother–child interactions during the first years of life have a significant impact on the emotional and cognitive development of the child. In this work, we study how a prenatal diagnosis of malformation may affect maternal representations and the quality of these early interactions. To this end, we conducted a longitudinal observational study of mother–child interactions from the gestational stage until the baby completed 12 months of age.Participants and MethodsWe recruited 250 pregnant women from a local university hospital. Among them, 50 mother–infant dyads participated in all stages of the study. The study group consisted of 25 pregnant women with fetuses with some structural alteration and the control group consisted of 25 pregnant women with fetuses without structural anomalies. We collected obstetric and socio demographic data and pregnancy outcomes. Anxiety and depressive state data were collected using the COVI and Raskin Scales. We video-recorded the mother–infant interactions during several stages, including when the child was a newborn and when the child was 2, 4, 6, 9, and 12 months of age. The quality of the mother infant interactions were measured using the Coding Interactive Behavior (CIB). The interactive moments recorded on video was composed of three different activities, each one lasting appoximately 3 min, which included (1) Free Interaction, where the mother was instructed to interact “as usual” without any toy, (2) Toy Interaction, where the mother and baby played with a puppv, and (3) Song Interaction, where the mother and baby interacted while the mother sang the “Happy Birthday” song.ResultsIn the gestational phase, there was a significant difference between the groups with respect to anxiety and depression scores, which were significantly higher for the study group. In the postnatal phase, we found significant differences between the groups with respect to CIB scales after the child completed 6 months of age: the study group presented significantly higher values of Maternal Sensitivity at 6 months of age, of Baby Involvement at 9 and 12 months of age, and of Dyadic Reciprocity at 6, 9, and 12 months of age, while the control group presented significantly higher values of Withdrawal of the Baby at 6 months of age, and of Dyadic Negative States at 6 and 9 months of age.ConclusionThe support offered by the study favored the mother–infant bond and had a positive effect on the quality of interaction during the first year of life, despite the presence of prenatal diagnosis.
Influencing Factors of Dyadic Coping Among Infertile Women: A Path Analysis
Authors: Tang Nan , Jia Yingying , Zhao Qing , Liu Huihui , Li Junzheng , Zhang Hongchen , Han Lin , Huangfu Chaoji 
Published: March 2022

BackgroundThe infertility prevalence of married couples in China is increasing gradually. The dyadic coping level and its influencing factors of infertile women in China are poorly reported. The relationship between dyadic coping and the family cohesion and adaptability in infertile women was investigated.MethodsA total of 482 infertile women in the reproductive clinics of three affiliated hospitals of the Lanzhou University were selected by the convenience sampling method. The self-made general information questionnaire, family adaptability and cohesion evaluation scale, and dyadic coping questionnaire were used in this study.ResultsThe average age of infertile women was 31.73 ± 4.57 years, the duration of infertility was 28.66 ± 27.99 months, the total score of dyadic coping was 132.66 ± 25.49, the total score of family cohesion and adaptability was 101.48 ± 20.96. A significant positive correlation between dyadic coping and family cohesion and adaptability was observed (r = 0.74, p &lt; 0.01). The multiple linear regression analysis showed that religious belief, number of miscarriages, relationship between family members, family intimacy, and adaptability were the influencing factors of dyadic coping level in the family of infertile women (R2 = 0.566, p &lt; 0.01).ConclusionsThe dyadic coping level of infertile women is in the medium level, which is significantly positively correlated with family intimacy and adaptability. In clinical nursing, nurses try to improve the family relationship of patients to increase the level of dyadic coping of infertile women.
Stress Experience of COVID-19 Patients as Reported by Psychological Supporters in South Korea: A Qualitative Study
Authors: Park Hyein , Lee Nabin , Lee Jung Hyun , Lee Dayoung , Kim Kyoung Ae , Kim Hyun-Seung , Oh Eunhye , Ha Ji Hyun , Hyun So Yoen , Lee Juyeon , Kim Jiae , Jeon Kyoungsun , Kim Hyeong Taek , Sim Minyoung 
Published: March 2022

Background:COVID-19 patients experience various stressors during the quarantine period and after release from quarantine. However, stressors experienced during each period remain unclear.MethodsA total of 15 mental health experts from the integrated psychological support group for COVID-19participated in this study. Psychological support was provided for the total 932 confirmed COVID-19 patients and their families. Qualitative data were collected using Focus Group Interview (FGI). The participants were divided into two groups and semi-structured questions were used to allow participants to speak their minds.ResultsDuring the quarantine period, difficulties of being diagnosed with COVID-19, concerns about recovery from COVID-19, stress related to quarantine, issues related to the treatment environment, and limited information about COVID-19 and communication were frequently reported. After release from quarantine, the reported main stressors include reinfection or reactivation, concerns about complications, and financial difficulties. Confusion as vectors and victims, stigma and discrimination, and conflicts within a family were observed during both periods.ConclusionsCOVID-19 patients suffered various stressors during the quarantine period and after release from quarantine. Moreover, returning to their daily life required timely psychosocial support, intervention, and treatment for COVID-19 infection.
Association Between Unequal Division of Caregiving Work and South Korean Married Women's Depressive Symptoms
Authors: Park Minah , Jang Jieun , Joo Hye Jin , Kim Gyu Ri , Park Eun-Cheol 
Published: March 2022

Background:A disproportionate amount of family caregiving can negatively impact married women's mental health. This study aims to examine the relationship between depressive symptoms in South Korean women and the satisfaction with their husband's participation in family caregiving.MethodsRaw data from 1,515 of the participants in the 2014, 2016, and 2018 Korean Longitudinal Survey of Women and Families were analyzed. Satisfaction with husbands' participation in family caregiving was classified as satisfied, less satisfied, and not satisfied. The survey used the Center for Epidemiologic Studies Depression Scale to measure depressive symptoms. The association was examined using a generalized estimating equations model.ResultsResults indicated 22.2% of the participating women reported depressive symptoms. Women who reported dissatisfaction with their husband's participation in caregiving were 2.54 times more likely to report depressive symptoms than the women who were satisfied. Subgroup analysis indicated that women with higher levels of education, were more likely to have depressive symptoms when they were not satisfied with their husbands' participation in caregiving.ConclusionMarried women who reported being dissatisfied with their husbands' participation in caregiving were more likely to report depressive symptoms. These results suggest the need to create environments with fair distribution of caregiving duties to minimize depressive symptoms in women.