bluuebunny/crossref_metadata_2025_split huggingface dataset:
The lifestyle factors of physical activity and diet balance associated with HPV infection in China: The cross-sectional study
Authors: Li Yantao , Liu Mengping , Huang Peng , Wang Wenxiang , Jiang Yuxin , Yang Zhongzhou , Wang Anli 
Published: December 2022

BackgroundHuman wellbeing has been linked with lifestyle factors such as physical activity, diet balance, sleep quality, depression, and anxiety. However, few studies illustrate the relationship between such lifestyle factors and HPV infection. In this study, we investigated the association between lifestyle factors, age, disease status and HPV infection.Participants and methodsParticipants were recruited through a digital eHealth platform in Shenzhen, Mainland China. Both lifestyle factors and cervicovaginal mucus (CVM) samples to test for HPV outcomes were collected from each participant as a cross-sectional study. In addition, the eHealth platform recorded age and current or history diseases, which were adjusted to apply for both univariable and multivariable logistic regression. Furthermore, lifestyle factors were categorized as different levels to conduct stratification analysis.ResultsWe recruited 149 HPV positive and 346 HPV negative participants through HPV detection. Physical activity and diet balance were significantly associated with HPV infection in lifestyle factors (P values &lt; 0.001) after adjusting for age and current or history diseases. However, stratified analysis showed three factors were insignificant for HPV infection – namely, sleep quality, depression, and anxiety. Most HPV infections involved a sole HPV serotype (83%), and diet balance was the most significant difference between sole and multiple HPV infections.ConclusionsAmong lifestyle factors, physical inactivity or diet imbalance can significantly increase HPV infection risk. In particular, diet balance might be related to the number of HPV serotypes. Our results suggest that exercising and regulating diet may reduce the risk of HPV infection.
Preoperative prediction of lymphovascular invasion in patients with T1 breast invasive ductal carcinoma based on radiomics nomogram using grayscale ultrasound
Authors: Xu Mao-Lin , Zeng Shu-E , Li Fang , Cui Xin-Wu , Liu Gui-Feng 
Published: December 2022

PurposeThe aim of this study was to develop a radiomics nomogram based on grayscale ultrasound (US) for preoperatively predicting Lymphovascular invasion (LVI) in patients with pathologically confirmed T1 (pT1) breast invasive ductal carcinoma (IDC).MethodsOne hundred and ninety-two patients with pT1 IDC between September 2020 and August 2022 were analyzed retrospectively. Study population was randomly divided in a 7: 3 ratio into a training dataset of 134 patients (37 patients with LVI-positive) and a validation dataset of 58 patients (19 patients with LVI-positive). Clinical information and conventional US (CUS) features (called clinic_CUS features) were recorded and evaluated to predict LVI. In the training dataset, independent predictors of clinic_CUS features were obtained by univariate and multivariate logistic regression analyses and incorporated into a clinic_CUS prediction model. In addition, radiomics features were extracted from the grayscale US images, and the radiomics score (Radscore) was constructed after radiomics feature selection. Subsequent multivariate logistic regression analysis was also performed for Radscore and the independent predictors of clinic_CUS features, and a radiomics nomogram was developed. The performance of the nomogram model was evaluated via its discrimination, calibration, and clinical usefulness.ResultsThe US reported axillary lymph node metastasis (LNM) (US_LNM) status and tumor margin were determined as independent risk factors, which were combined for the construction of clinic_CUS prediction model for LVI in pT1 IDC. Moreover, tumor margin, US_LNM status and Radscore were independent predictors, incorporated as the radiomics nomogram model, which achieved a superior discrimination to the clinic_CUS model in the training dataset (AUC: 0.849 vs. 0.747; P &lt; 0.001) and validation dataset (AUC: 0.854 vs. 0.713; P = 0.001). Calibration curve for the radiomic nomogram showed good concordance between predicted and actual probability. Furthermore, decision curve analysis (DCA) confirmed that the radiomics nomogram had higher clinical net benefit than the clinic_CUS model.ConclusionThe US-based radiomics nomogram, incorporating tumor margin, US_LNM status and Radscore, showed a satisfactory preoperative prediction of LVI in pT1 IDC patients.
Minimally invasive management of a giant paratubal cyst in an adolescent female: Case report and review of the literature in the pediatric population
Authors: Romeo Paola , Loria Giada , Martinelli Canio , Ercoli Alfredo , Romeo Carmelo 
Published: December 2022

IntroductionParaovarian or paratubal cysts both define cysts located between the ovary and the fallopian tube. They are usually benign and frequently occur in the third and fourth decade of life. Paratubal cysts are defined as giant when they exceed the threshold of 150 mm.MethodsWe report the case of a 15-year-old girl who complained about diffuse abdominal pain since 2 years that was diagnosed with a 196 mm × 90 mm × 267 mm giant paratubal cyst. We furthermore reviewed all the data published on 13 articles, published between 2006 and 2021, concerning giant paraovarian cyst (POC) in pediatric patients.ResultsThe giant mass of our 15-year-old patient was removed through a fertility-sparing laparoscopic surgery. Histopathological diagnosis of cystadenofibroma was made up, with no cytologic report of neoplastic cells. The incidence of POC in the pediatric and adolescent population attests around 4%. However, only 12.96% of them are defined giant (larger than 15 cm). Indeed, to the best of our knowledge, only 13 cases of giant paratubal cysts have been reported in adolescents. To accomplish diagnosis and differential diagnosis, accurate history and physical examination are mandatory. In all cases reported in the literature, further instrumental analyses were performed, including ultrasound, CT, and/or MRI scan. International Ovarian Tumor Analysis (IOTA) rules have not yet been validated in the pediatric population. Because of the advantages of the laparoscopic procedures, it is often preferred in pediatric population, also to help preserve as much ovarian parenchyma and salpinx if thought possible. The incidence of malignant adnexal masses in the pediatric population is reported to range from 4% to 9%, accounting for 1% of all pediatric cancers.ConclusionGiant paratubal cysts in adolescent females are extremely rare and usually benign. A fertility-sparing laparoscopic surgery should be the preferable option whenever possible. Considering the rarity of these conditions, further investigations are needed to exclude the possibility of a malignant evolution.
Intravitreal vascular endothelial growth factor inhibitors did not increase the risk of end-stage renal disease in patients with biopsy-proven diabetic kidney disease based on matched study
Authors: Xiao Xiang , Zhang Junlin , Ji Shuming , Zou Yutong , Wu Yucheng , Qin Chunmei , Yang Jia , Zhao Yuancheng , Yang Qin , Liu Fang 
Published: December 2022

Purpose: This study aimed to investigate the effects of intravitreal (IVT) VEGFi on long-term renal outcomes in patients with biopsy-proven diabetic kidney disease (DKD).Patients and methods: Patients prescribed IVT VEGFi (VEGFi group) were enrolled from a retrospective cohort with biopsy-proven DKD, and those not prescribed VEGFi (non-VEGFi group) were enrolled by 1:3 propensity score matching, adjusted for clinical and pathological baseline indicators. The primary endpoint is defined as end-stage renal disease (ESRD) and the secondary endpoint is defined as all-cause mortality.Results: Compared with patients in non-VEGFi group, patients with VEGFi had a higher proportion of diabetic retinopathy (DR) (50.9% vs 100%, p &lt; 0.001) before matching. Standardized mean difference (SMD) of age, DR, duration of diabetes, the proportion of hypertension, eGFR, initial proteinuria, serum albumin, hemoglobin, the proportion of RAAS inhibitor and interstitial fibrosis and tubular atrophy (IFTA) were &gt;10%. After matching, there was no significant difference in clinical pathology between the two groups. Except for the proportion of hypertension, the SMD of other indicators was &lt;10%. Endpoints such as ESRD (Log-Rank p = 0.772) and all-cause mortality (Log-Rank p = 0.834) were not significantly different between the two groups.Conclusion: Our data suggested that IVT VEGFi did not increase the incidence of ESRD and all-cause mortality in patients with DKD.
First-line sintilimab plus chemotherapy in locally advanced or metastatic esophageal squamous cell carcinoma: A cost-effectiveness analysis from China
Authors: Shen Jian , Du Yi , Shao Rong , Jiang Rong 
Published: December 2022

Objective: The study aimed to assess the cost-effectiveness of sintilimab combined with cisplatin plus paclitaxel versus chemotherapy alone as first-line treatment in patients with advanced or metastatic esophageal squamous cell carcinoma from the Chinese healthcare system.Materials and methods: A partitioned survival model was developed based on the ORIENT-15 clinical trial. Drug costs and health state utility were obtained from the literature. Outcomes included the health outcomes in life-years, quality-adjusted life-years (QALYs), and the incremental cost-effectiveness ratio. One-way and probabilistic sensitivity analyses were performed to evaluate the model uncertainty.Result: In overall population, patients given sintilimab plus chemotherapy gained more health benefits (0.90 QALYs vs. 0.61 QALYs), and the cost was more (15,399.21 US$ VS. 7475.58 US$) than that for patients in the chemotherapy group. In the subgroup, patients given sintilimab plus chemotherapy gained more health benefits (0.89 QALYs vs. 0.68 QALYs), and the cost was more (15,656.19 US$ vs. 9,162.77 US$) than that for patients in the chemotherapy group. Compared with chemotherapy, patients receiving sintilimab plus chemotherapy had ICERs of $26,773.68/QALY in the overall population and $30,065.50/QALY in the subgroup, which was above the threshold of WTP.Conclusion: Sintilimab plus chemotherapy was more cost-effective than chemotherapy alone for patients with advanced esophageal cancer from the perspective of the Chinese healthcare system.
Internal translation of Gja1 (Connexin43) to produce GJA1-20k: Implications for arrhythmia and ischemic-preconditioning
Authors: Whisenant Claire C. , Shaw Robin M. 
Published: December 2022

Internal translation is a form of post-translation modification as it produces different proteins from one mRNA molecule by beginning translation at a methionine coding triplet downstream of the first methionine. Internal translation can eliminate domains of proteins that otherwise restrict movement or activity, thereby creating profound functional diversity. Connexin43 (Cx43), encoded by the gene Gja1, is the main gap junction protein necessary for propagating action potentials between adjacent cardiomyocytes. Gja1 can be internally translated to produce a peptide 20 kD in length named GJA1-20k. This review focuses on the role of GJA1-20k in maintaining cardiac electrical rhythm as well as in ischemic preconditioning (IPC). Connexin43 is the only ion channel we are aware that has been reported to be subject to internal translation. We expect many other ion channels also undergo internal translation. The exploration of post-translational modification of ion channels, and in particular of internal translation, has the potential to greatly increase our understanding of both canonical and non-canonical ion channel biology.
Identification of cassava germplasms resistant to two-spotted spider mite in China: From greenhouse large-scale screening to field validation
Authors: Liang Xiao , Chen Qing , Liu Ying , Wu Chunling , Li Kaimian , Wu Mufeng , Yao Xiaowen , Qiao Yang , Zhang Yao , Geng Yue 
Published: December 2022

IntroductionUtilization of resistant germplasm is considered as an effective, economical and eco-friendly strategy for cassava pest management. Tetranychus urticae, known as the two-spotted spider mite (TSSM), is a devastating pest in Asian cassava planting countries as well as in China. However, the resistant levels of abundant cassava germplasms to TSSM remains largely unknown.MethodsTo fill this knowledge gap, we conducted screening of 202 cassava germplasm for resistance to TSSM in China based on the classification of mite damage phenotype, under both greenhouse and field conditions.ResultsThe three rounds of large-scale greenhouse experiments had identified two highly resistant (HR) varieties (C1115 and MIANDIAN), five resistant (R) varieties (SC5, SC9, SC15, COLUMBIA-4D and LIMIN) and five highly susceptible (HS) varieties (KU50, BREAD, SC205, TMS60444 and BRA900), besides, these ‘HR’ and ‘R’ varieties would significantly repress the normal development and reproduction of TSSM. In addition, the 12 cassava varieties selected from the greenhouse screening were further subjected to consecutive five years of field validation at Danzhou, Wuming and Baoshan. The seven resistant varieties not only exhibited stable TSSM-resistance performance across the three field environments, but also possessed the same resistant levels as the greenhouse identification, while the resistant varieties SC5 was an exception, which was identified as moderate resistant in Baoshan, indicating the variety-environment interaction may affect its resistance. Furthermore, regional yield estimation suggested that the higher the resistance level was, the better capacity in reducing the yield losses.DiscussionThis study demonstrated that the TSSM-resistant varieties could be considered as ideal materials in mite control or in future breeding programme of mite-resistant cassava plant.
Hand hygiene compliance and associated factor among nurses working in public hospitals of Hararghe zones, Oromia region, eastern Ethiopia
Authors: Umar Hamza , Geremew Abraham , Worku Kassie Teshager , Dirirsa Gebisa , Bayu Kefelegn , Mengistu Dechasa Adare , Berhanu Ashenafi , Mulat Salie 
Published: December 2022

BackgroundHealthcare workers are in constant contact with a wide variety of materials and surfaces, including waste, body fluids, mucous membranes, food, their own bodies, and the skin of patients. As a result, their hands are colonized by different groups of pathogens. Hand hygiene of healthcare workers is recognized to be the main factor in reducing healthcare-associated infections. Therefore, this study aimed to assess hand hygiene adherence and related factors among nurses working in public hospitals in eastern Ethiopia.MethodsAn institutional based cross-sectional study was conducted in Hospital, Hararghe zone, Eastern Ethiopia from July 1 to 30, 2021. A total of 451 study participants were randomly selected, after the proportional allocation of study participants to each selected hospital. The data was collected using self-administered questionnaire and observation checklist. SPSS version 26 was used to analyze the data. Bivariable and multivariable analysis were employed to assess the association between outcome and independent variables. Finally, a p-value of &lt; 0.05 was used as a cutoff point for statistical significance.ResultsOut of 436 eligible nurses, the overall hand hygiene compliance was 37.4% [95% CI (0.33, 0.42)]. The overall compliance among those working in medical, surgical, OR ward, OPD, Gynecology/obstetrics, emergency ward, Intensive care units, Pediatrics, and other wards/departments was 46.8, 44.8, 35.7, 28.2, 20.7, 45.1, 23.1, 40.5, and 29.4%, respectively. The mean knowledge score was 21.6% (SD: 2.08). Furthermore, there was a statistically significant association between hand hygiene compliance and gender, work experience, training in hand hygiene, availability of running water, and knowledge of hand hygiene.ConclusionThe current study found overall compliance with hand hygiene accounted for 34.7%. Therefore, an exemplary worker may initiate others to do so, and strong managerial and leadership commitment may also help the workers stick to the rules and regulations to follow the multimodal hand hygiene practice as per WHO recommendation.
Interpretable machine learning for predicting pathologic complete response in patients treated with chemoradiation therapy for rectal adenocarcinoma
Authors: Wang Du , Lee Sang Ho , Geng Huaizhi , Zhong Haoyu , Plastaras John , Wojcieszynski Andrzej , Caruana Richard , Xiao Ying 
Published: December 2022

PurposePathologic complete response (pCR) is a critical factor in determining whether patients with rectal cancer (RC) should have surgery after neoadjuvant chemoradiotherapy (nCRT). Currently, a pathologist's histological analysis of surgical specimens is necessary for a reliable assessment of pCR. Machine learning (ML) algorithms have the potential to be a non-invasive way for identifying appropriate candidates for non-operative therapy. However, these ML models' interpretability remains challenging. We propose using explainable boosting machine (EBM) to predict the pCR of RC patients following nCRT.MethodsA total of 296 features were extracted, including clinical parameters (CPs), dose-volume histogram (DVH) parameters from gross tumor volume (GTV) and organs-at-risk, and radiomics (R) and dosiomics (D) features from GTV. R and D features were subcategorized into shape (S), first-order (L1), second-order (L2), and higher-order (L3) local texture features. Multi-view analysis was employed to determine the best set of input feature categories. Boruta was used to select all-relevant features for each input dataset. ML models were trained on 180 cases from our institution, with 37 cases from RTOG 0822 clinical trial serving as the independent dataset for model validation. The performance of EBM in predicting pCR on the test dataset was evaluated using ROC AUC and compared with that of three state-of-the-art black-box models: extreme gradient boosting (XGB), random forest (RF) and support vector machine (SVM). The predictions of all black-box models were interpreted using Shapley additive explanations.ResultsThe best input feature categories were CP+DVH+S+R_L1+R_L2 for all models, from which Boruta-selected features enabled the EBM, XGB, RF, and SVM models to attain the AUCs of 0.820, 0.828, 0.828, and 0.774, respectively. Although EBM did not achieve the best performance, it provided the best capability for identifying critical turning points in response scores at distinct feature values, revealing that the bladder with maximum dose &gt;50 Gy, and the tumor with maximum2DDiameterColumn &gt;80 mm, elongation &lt;0.55, leastAxisLength &gt;50 mm and lower variance of CT intensities were associated with unfavorable outcomes.ConclusionsEBM has the potential to enhance the physician's ability to evaluate an ML-based prediction of pCR and has implications for selecting patients for a “watchful waiting” strategy to RC therapy.
Changing the organizational culture to transform the economy: The case of Greece
Authors: Boufounou Paraskevi , Argyrou Maria Despoina 
Published: December 2022

IntroductionOrganizational culture determines the ability of companies to adapt, transform, and innovate, thereby directly affecting their profitability and competitiveness. However, the same applies to the public sector since, now more than ever, it has to be agile in order to shield its society and economy against modern challenges (such as COVID-19, climate change, and digitalization). This article uses the case of Greece as an example to present the need for change in organizational culture to unlock its development and growth potential through transformation, adaptation, and innovation. To support our argument, we combine the findings of the international literature regarding the relationship between organizational culture and the aforementioned elements, as well as empirical evidence from Greece.MethodsIn particular, we assess organizational culture pertaining to the major sector reforms that took place in Greece, as a result of the recent economic and financial crisis, by presenting and evaluating comparative empirical findings on the characteristics of the prevailing and desired future organizational culture.Results and discussionExamining and comparing the results of previous studies in Greece that used the Organizational Culture Assessment Instrument (OCAI) questionnaire survey in both private (such as banking and telecoms) and public sectors (such as social security, public revenues authority, and hospitals), two interesting results arise: (i) there is a clear distinction between the public sector and the private sector, with the former being mainly characterized by “hierarchy culture,” while the latter by “market culture” and (ii) in both sectors and all industries/services, the desire to prevail in future organizational culture is the “clan culture.” These findings are of immense importance as organizational culture issues play a key role in formulating future strategic plans, enabling the development of key sectors of the Greek economy and enhancing effective governance and social services. Concisely, our results draw useful conclusions for policy implications and academics, implying that there is an emergent need for organizational transformation in both private and public sectors in Greece, which can be achieved through new innovative methods of organization and operation, creating a new more agile, adaptive, and innovative culture.
Interplay of temperature and calcium content in beta-casein solutions: From controlled self-aggregation of micelles in bulk to the design of stable foams
Authors: Fameau Anne-Laure , Houinsou Houssou Bérénice , Riaublanc Alain , Cousin Fabrice 
Published: December 2022

We describe in this study the aggregation behaviour of β-casein micelles from milk in bulk aqueous solution as function of both temperature and calcium content, and its influence on the foaming properties, in order to test if the different aggregation states of β-casein makes possible the design of proteins-based thermoresponsive foams. First, we characterized the morphology of the self-assembled β-casein molecules in solution by coupling turbidity measurements, Dynamic Light Scattering and Small Angle Neutron Scattering. They self-organize into individual micelles at low temperature (20°C) whatever the calcium content, and transit in a reversible way into aggregates of micelles at large temperature in presence of calcium, with a threshold transition that depend both on temperature and calcium content. The micelles aggregation is driven by the calcium through association with serine phosphate groups localized on the hydrophilic part of the β-casein. In the micelles regime, we demonstrated that the addition of calcium tunes the aggregation number of unimers per micelle in the same way than an increase of temperature through a change of hydrophobic interactions. The hydrophilic chains of the corona are however in a good solvent and interact through excluded volume interactions, even when the β-casein micelles aggregates themselves. The internal molecular structure of the micelles is thus not modified by calcium bridges, which explains the complete reversibility of the aggregation process over temperature cycling. Second, we studied the foam stability versus time as a function of the temperature and calcium content by measuring the kinetic evolution of both the foam volume and the liquid fraction. Foams produced by solutions containing only β-casein micelles were stable in terms of foam volume on a timescale of 1 h at 20°C but drained quickly. However, foams become unstable when the temperature was increased above 20°C. In presence of calcium, the aggregation of β-casein micelles inside the foam liquid channels enabled to increase foam stability at larger temperature by acting as a cork, which slows down the drainage. The increase of foam stability by such aggregates is however not sufficient on the long term to allow the design of thermoresponsive foams.