bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vitamin D and Calcium Supplementation Reverses Tenofovir-Caused Bone Mineral Density Loss in People Taking ART or PrEP: A Systematic Review and Meta-Analysis
Authors: Bi Xiaoyan , Liu Fan , Zhang Xiangjun , Wang Hongyi , Ye Zehao , Yun Ke , Huang Xiaojie , Ding Haibo , Geng Wenqing , Xu Junjie 
Published: March 2022

BackgroundThe decrease of bone mineral density (BMD) after the intake of Tenofovir disoproxil fumarate (TDF)-based drugs in people living with HIV/AIDS (PLWHA) and HIV-negative key populations under pre-exposure prophylaxis (PrEP) regimen raised concerns. Previous findings on the effects of vitamin D (VD) and calcium supplements and the recovery of BMD loss were inconclusive. The optimal doses of VD and calcium and its supplementary duration remained unknown. Therefore, we conducted a systematic review and meta-analysis to synthesize current evidence on VD and calcium supplements to inform clinical practice.MethodsWe searched PubMed, Web of Science, Cochrane library, and EMBASE databases for all placebo-controlled trials and prospective cohort studies published before March 5, 2021 that investigated VD and calcium supplements in participants taking TDF-based drugs. The keywords calcium, vitamin D, Tenofovir, and BMD were used for the searches. The primary outcome was changes of spine and hip BMD. A subgroup analysis was performed to determine the factors that were related to the effects of VD supplements on BMD. Locally weighted regression (loess) was used to determine the relationships of VD supplements, supplementary duration, and changes of BMD. This study was registered at PROSPERO (No. 42021231000).FindingsSeven eligible studies including 703 participants were included in the analyses. The meta-analysis found that VD and calcium supplementation was related to a significant increase of BMD in the spine and hip [standardized mean difference (SMD) 0.43; 95% CI, 0.25 to 0.61, p = 0.009]. Moreover, positive dose-response relationships were demonstrated between doses of VD and calcium supplements, supplementary duration, and BMD recovery. Patients who took VD with the dose level of 4,000 IU/D obtained the highest BMD improvement (SMD 0.59, 95% CI, 0.43 to 0.74). No side effects were reported on VD and calcium supplementation.InterpretationWe found the VD and calcium supplementation was associated with increases of BMD in participants taking TDF-based drugs. An optimal supplementary dose of 4,000 IU/D for VD was suggested for clinicians. The findings could be used in clinical practice to improve the BMD outcomes in people who were taking TDF-based drugs.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/.
Association Between Endometriosis and Prognosis of Ovarian Cancer: An Updated Meta-Analysis
Authors: Chen Peng , Zhang Chi-Yuan 
Published: March 2022

ObjectiveIncreased risk of ovarian cancer (OC) among endometriosis patients has been proposed. However, the association between endometriosis and prognosis of OC remains controversial. This study evaluated whether endometriosis had influence on the survival outcomes of OC through a meta-analysis.MethodsRelevant studies were retrieved from PubMed, Embase, and Web of Science databases and were evaluated using the Newcastle-Ottawa Quality Assessment Scale. Effect size was presented as hazard ratio (HR) and 95% confidence interval (CI). Heterogeneity test evaluation was performed using Cochran’s Q test and I2 statistics. Publication bias was determined using Egger’s test. Statistical analysis was performed using Stata 12.0 software.ResultsTwenty-one studies involving 38641 patients were included. For the total OC, there were significant differences in overall survival (OS) [HR (95% CI)=0.67 (0.55, 0.80), P&lt;0.001] and progression-free survival (PFS) [HR (95% CI)=0.58 (0.42, 0.81), P=0.001] between endometriosis-associated ovarian cancer (EAOC) and non-EAOC patients in the random-effects models (P&lt;0.05). For ovarian clear cell cancer, there were significant differences in terms of OS [HR (95% CI)=0.63 (0.48, 0.83), P=0.001] and PFS [HR (95% CI)=0.67 (0.52, 0.87), P=0.002] between EAOC and non-EAOC patients in the fixed-effects models (P&gt;0.05). Subgroup analysis suggested no significant differences between EAOC and non-EAOC in OS and PFS in the univariate analysis per subgroup, and PFS in the American subgroup (P&gt;0.05).ConclusionEAOC patients tended to have better OS and PFS than non-EAOC patients. Conducting higher quality prospective cohort studies with large sample sizes is recommended to confirm the authenticity of the current study’s results.Systematic Review Registrationhttps://inplasy.com/inplasy-2022-3-0109/.
Evaluation Exploration of Atlas-Based and Deep Learning-Based Automatic Contouring for Nasopharyngeal Carcinoma
Authors: Wang Jinyuan , Chen Zhaocai , Yang Cungeng , Qu Baolin , Ma Lin , Fan Wenjun , Zhou Qichao , Zheng Qingzeng , Xu Shouping 
Published: March 2022

PurposeThe purpose of this study was to evaluate and explore the difference between an atlas-based and deep learning (DL)-based auto-segmentation scheme for organs at risk (OARs) of nasopharyngeal carcinoma cases to provide valuable help for clinical practice.Methods120 nasopharyngeal carcinoma cases were established in the MIM Maestro (atlas) database and trained by a DL-based model (AccuContour®), and another 20 nasopharyngeal carcinoma cases were randomly selected outside the atlas database. The experienced physicians contoured 14 OARs from 20 patients based on the published consensus guidelines, and these were defined as the reference volumes (Vref). Meanwhile, these OARs were auto-contoured using an atlas-based model, a pre-built DL-based model, and an on-site trained DL-based model. These volumes were named Vatlas, VDL-pre-built, and VDL-trained, respectively. The similarities between Vatlas, VDL-pre-built, VDL-trained, and Vref were assessed using the Dice similarity coefficient (DSC), Jaccard coefficient (JAC), maximum Hausdorff distance (HDmax), and deviation of centroid (DC) methods. A one-way ANOVA test was carried out to show the differences (between each two of them).ResultsThe results of the three methods were almost similar for the brainstem and eyes. For inner ears and temporomandibular joints, the results of the pre-built DL-based model are the worst, as well as the results of atlas-based auto-segmentation for the lens. For the segmentation of optic nerves, the trained DL-based model shows the best performance (p &lt; 0.05). For the contouring of the oral cavity, the DSC value of VDL-pre-built is the smallest, and VDL-trained is the most significant (p &lt; 0.05). For the parotid glands, the DSC of Vatlas is the minimum (about 0.80 or so), and VDL-pre-built and VDL-trained are slightly larger (about 0.82 or so). In addition to the oral cavity, parotid glands, and the brainstem, the maximum Hausdorff distances of the other organs are below 0.5 cm using the trained DL-based segmentation model. The trained DL-based segmentation method behaves well in the contouring of all the organs that the maximum average deviation of the centroid is no more than 0.3 cm.ConclusionThe trained DL-based segmentation performs significantly better than atlas-based segmentation for nasopharyngeal carcinoma, especially for the OARs with small volumes. Although some delineation results still need further modification, auto-segmentation methods improve the work efficiency and provide a level of help for clinical work.
Preoperative Clinical Characteristics Predict Recurrent Laryngeal Nerve Lymph Node Metastasis and Overall Survival in Esophageal Squamous Cell Carcinoma: A Retrospective Study With External Validation
Authors: Yan Hao-Ji , Mao Wen-Jun , Yu Rui-Xuan , Jiang Kai-Yuan , Huang Heng , Zong Zheng-Dong , Qian Qin-Chun , Guo Xiao-Guang , Wen Hong-Ying , Tian Dong 
Published: March 2022

BackgroundRecurrent laryngeal nerve (RLN) lymph node metastasis (LNM) is not rare in patients with esophageal squamous cell carcinoma (ESCC). We aimed to develop and externally validate a preoperative nomogram using clinical characteristics to predict RLN LNM in patients with ESCC and evaluate its prognostic value.MethodsA total of 430 patients with ESCC who underwent esophagectomy with lymphadenectomy of RLN LNs at two centers between May 2015 and June 2019 were reviewed and divided into training (center 1, n = 283) and external validation cohorts (center 2, n = 147). Independent risk factors for RLN LNM were determined by multivariate logistic regression, and a nomogram was developed. The performance of the nomogram was assessed in terms of discrimination, calibration, clinical usefulness, and prognostic value. The nomogram was internally validated by the bootstrap method and externally validated by the external validation cohort.ResultsMultivariate analysis indicated that clinical T stage (P &lt;0.001), endoscopic tumor length (P = 0.003), bioptic tumor differentiation (P = 0.004), and preoperative carcinoembryonic antigen level (P = 0.001) were significantly associated with RLN LNM. The nomogram had good discrimination with the area under the curve of 0.770 and 0.832 after internal and external validations. The calibration curves and decision curve analysis confirmed the good calibration and clinical usefulness of this model. High-risk of RLN LNM predicted by the nomogram was associated with worse overall survival in the external validation cohort (P &lt;0.001).ConclusionA nomogram developed by preoperative clinical characteristics demonstrated a good performance to predict RLN LNM and prognosis for patients with ESCC.
Anti-Epileptic Effect of Crocin on Experimental Temporal Lobe Epilepsy in Mice
Authors: Zhong Kai , Qian Chengyu , Lyu Rui , Wang Xinyi , Hu Zhe , Yu Jie , Ma Jing , Ye Yilu 
Published: March 2022

Temporal lobe epilepsy (TLE) is a common kind of refractory epilepsy. More than 30% TLE patients were multi-drug resistant. Some patients may even develop into status epilepticus (SE) because of failing to control seizures. Thus, one of the avid goals for anti-epileptic drug development is to discover novel potential compounds to treat TLE or even SE. Crocin, an effective component of Crocus sativus L., has been applied in several epileptogenic models to test its anti-epileptic effect. However, it is still controversial and its effect on TLE remains unclear. Therefore, we investigated the effects of crocin on epileptogenesis, generalized seizures (GS) in hippocampal rapid electrical kindling model as well as SE and spotaneous recurrent seizure (SRS) in pilocarpine-induced TLE model in ICR mice in this study. The results showed that seizure stages and cumulative afterdischarge duration were significantly depressed by crocin (20 and 50 mg/kg) during hippocampal rapid kindling acquisition. And crocin (100 mg/kg) significantly reduced the incidence of GS and average seizure stages in fully kindled animals. In pilocarpine-induced TLE model, the latency of SE was significantly prolonged and the mortality of SE was significantly decreased by crocin (100 mg/kg), which can also significantly suppress the number of SRS. The underlying mechanism of crocin may be involved in the protection of neurons, the decrease of tumor necrosis factor-α in the hippocampus and the increase of brain derived neurotrophic factor in the cortex. In conclusion, crocin may be a potential and promising anti-epileptic compound for treatment of TLE.
Protocatechualdehyde Rescues Oxygen-Glucose Deprivation/Reoxygenation-Induced Endothelial Cells Injury by Inducing Autophagy and Inhibiting Apoptosis via Regulation of SIRT1
Authors: Cao Shidong , Chen Senmiao , Qiao Xilin , Guo Yan , Liu Fang , Ding Zhishan , Jin Bo 
Published: March 2022

Background: Oxidative stress-induced endothelial cell death, such as apoptosis and autophagy, plays a critical role in ischemia-reperfusion injury. Protocatechualdehyde (PCA) is a major bioactive component of the traditional Chinese medicine Salvia miltiorrhiza Bunge (Lamiaceae), and it has been proved to be effective in the prevention and treatment of ischemic cardiovascular and cerebrovascular diseases. However, its role in oxidative stress-induced endothelial cell death and its underlying mechanisms remains unclear. This study aims to investigate the effects and mechanisms of PCA on endothelial cell apoptosis and autophagy induced by oxygen-glucose deprivation/reoxygenation (OGD/R) injury.Methods: After OGD/R induction, human umbilical vein endothelial cells (HUVECs) were treated with different concentrations of PCA. Cell viability, apoptosis, and autophagy were detected by Cell Counting Kit-8 assay, flow cytometry, and monodansylcadaverine assay, respectively. Western blot was applied to explore the effects of PCA on the expression levels of relevant protein factors.Results: The results show that PCA significantly promoted cell survival rate and cell proliferation and enhanced the antioxidant activity in OGD/R-induced HUVECs. PCA inhibited HUVECs apoptosis, as evidenced by decreased expression of cleaved-caspase-3, Bcl2-associated X (BAX), and increased expression of Bcl-2. PCA induced autophagy by reducing the expression of P62 while increasing the expression of Beclin-1 and LC3 II/I. Meanwhile, PCA enhanced the expression of Sirtuin 1 (SIRT1) and suppressed the expression of P53. When SIRT1 was inhibited by selisistat or SIRT1 small-interfering RNA, the anti-apoptotic and pro-autophagy abilities of PCA were attenuated.Conclusion: These results demonstrated that PCA rescued HUVECs from OGD/R-induced injury by promoting autophagy and inhibiting apoptosis through SIRT1 and could be developed as a potential therapeutic agent against ischemic diseases.
Circumference-Based Predictions of Body Fat Revisited: Preliminary Results From a US Marine Corps Body Composition Survey
Authors: Potter Adam W. , Tharion William J. , Holden Lucas D. , Pazmino Angie , Looney David P. , Friedl Karl E. 
Published: March 2022

Purpose: Body composition assessment methods are dependent on their underlying principles, and assumptions of each method may be affected by age and sex. This study compared an abdominal circumference-focused method of percent body fat estimation (AC %BF) to a criterion method of dual-energy x-ray absorptiometry (DXA), and a comparative assessment with bioelectrical impedance (BIA), in younger (≤30 years) and older (&gt;age 30 years) physically fit (meeting/exceeding annual US Marine Corps fitness testing requirements) men and women.Methods: Fit healthy US Marines (430 men, 179 women; 18–57 years) were assessed for body composition by DXA (iDXA, GE Lunar), anthropometry, and BIA (Quantum IV, RJL Systems).Results: Compared to DXA %BF, male AC %BF underestimated for both ≤30 and &gt;30 years age groups (bias, -2.6 ± 3.7 and -2.5 ± 3.7%); while female AC %BF overestimated for both ≤30 and &gt;30 years age groups (2.3 ± 4.3 and 1.3 ± 4.8%). On an individual basis, lean men and women were overestimated and higher %BF individuals were underestimated. Predictions from BIA were more accurate and reflected less relationship to adiposity for each age and sex group (males: ≤30, 0.4 ± 3.2, &gt;30 years, -0.5 ± 3.5; women: ≤30, 1.4 ± 3.1, &gt;30 years, 0.0 ± 3.3). Total body water (hydration) and bone mineral content (BMC) as a proportion of fat-free mass (FFM) remained consistent across the age range; however, women had a higher proportion of %BMC/FFM than men. Older men and women (&gt;age 30 years) were larger and carried more fat but had similar FFM compared to younger men and women.Conclusion: The AC %BF provides a field expedient method for the US Marine Corps to classify individuals for obesity prevention, but does not provide research-grade quantitative body composition data.
The Impact of Sleep Quality on Subjective Wellbeing Among Older Adults With Multimorbidity: A Moderated Mediation Model
Authors: Zhang Chichen , Dong Fang , Zheng Xiao , Xue Yaqing , Xiao Shujuan , Shi Lei , Xue Benli , Zhang Jiachi , Ou Weiyan 
Published: March 2022

BackgroundStudies have found that poor sleep quality is negatively associated with subjective wellbeing in older adults, but the mechanisms underlying are unclear. In this study, we aimed to examine the mediating role of negative emotions and the moderating role of perceived social support in the relationship between sleep quality and subjective wellbeing in older adults with multimorbidity.MethodsA multi-stage random sampling method was used to select a sample of 3,266 older adults aged 60 years and older. The Memorial University of Newfoundland Scale of Happiness (MUNSH), Pittsburgh Sleep Quality Index (PSQI), Depression Anxiety Stress Scales-21 (DASS-21), and Perceived Social Support Scale (PSSS) were used to assess subjective wellbeing, sleep quality, negative emotional states, and perceived social support, respectively. The moderated mediation models were examined using SPSS PROCESS Version 3.3 software.ResultsSleep quality had a significant direct effect on subjective wellbeing in older adults (β = −0.997, t = −11.783, p &lt; 0.001). Negative emotions partially mediated the effect of sleep quality on subjective wellbeing (ab = −0.608, 95%CI: −0.728, −0.497). The indirect effect was moderated by perceived social support (β = −0.038, 95%CI: −0.062, −0.014, p &lt; 0.001; β = −0.002, 95%CI: −0.004, −0.01, p = 0.008).ConclusionNegative emotions increased the negative association between sleep quality and the subjective wellbeing of older adults with multimorbidity, and perceived social support played a moderating role. Psychological and behavioral interventions should be implemented as early as possible to promote mental health and enhance social support level of older adults with multimorbidity, and ultimately improve the subjective wellbeing of older adults.
A Normative Feedback Intervention on Gambling Behavior—A Longitudinal Study of Post-Intervention Gambling Practices in At-Risk Gamblers
Authors: Berge Jonas , Abrahamsson Tove , Lyckberg Axel , Franklin Katja , Håkansson Anders 
Published: March 2022

BackgroundIn problem gambling, normative personalized feedback interventions have demonstrated promising effects. Given the widespread increase in online gambling in recent years, internet-delivered normative feedback may serve as a promising intervention. This study aimed to examine whether such an intervention, delivered by a gambling operator and aiming to help problem gamblers decrease their gambling, may in fact be associated with lower gambling practices post-intervention.MethodsOnline questions on norms and beliefs about one's own and peers' gambling habits, derived from the Gambling Quantity and Perceived Norms Scale, were followed by personalized feedback, delivered online by the Swedish state-owned gambling operator. A total of 1,453 gamblers consented to participate in a pre-post measure of wagering levels.ResultsWagering decreased significantly post-intervention (28 days) compared to pre-intervention (28 days prior). The decrease was significantly more pronounced in younger and online casino gamblers. In an 84-day follow-up, the decrease remained significant, although less pronounced.ConclusionsAn online normative intervention delivered by a state-owned gambling operator, addressing norms and beliefs about gambling levels, may lower risky gambling in the short term. Implications and further research needs are discussed.
Unraveling the Complexity of Cardiac Distress: A Study of Prevalence and Severity
Authors: Jackson Alun C. , Rogerson Michelle C. , Amerena John , Smith Julian , Hoover Valerie , Alvarenga Marlies E. , Higgins Rosemary O. , Grande Michael R. Le , Ski Chantal F. , Thompson David R. , Murphy Barbara M. 
Published: March 2022

IntroductionWhile much research attention has been paid to anxiety and depression in people who have had a recent cardiac event, relatively little has focused on the broader concept of cardiac distress. Cardiac distress is a multidimensional construct that incorporates but extends beyond common mood disorders such as anxiety and depression. In the present study we assessed the prevalence, severity and predictors of a broad range of physical, affective, cognitive, behavioral and social symptoms of cardiac distress. This is the first study to investigate cardiac distress in this comprehensive way.MethodA sample of 194 patients was recruited from two hospitals in Australia. Eligible participants were those who had recently been hospitalized for an acute cardiac event. Data were collected at patients' outpatient clinic appointment ~8 weeks after their hospital discharge. Using a questionnaire developed through a protocol-driven 3-step process, participants reported on whether they had experienced each of 74 issues and concerns in the past 4 weeks, and the associated level of distress. They also provided sociodemographic and medical information. Regression analyses were used to identify risk factors for elevated distress.ResultsAcross the 74 issues and concerns, prevalence ratings ranged from a high of 66% to a low of 6%. The most commonly endorsed items were within the domains of dealing with symptoms, fear of the future, negative affect, and social isolation. Common experiences were “being physically restricted” (66%), “lacking energy” (60%), “being short of breath” (60%), “thinking I will never be the same again” (57%), and “not sleeping well” (51%). While less prevalent, “not having access to the health care I need,” “being concerned about my capacity for sexual activity,” and “being unsupported by family and friends” were reported as highly distressing (74, 64, and 62%) for those experiencing these issues. Having a mental health history and current financial strain were key risk factors for elevated distress.Conclusion and ImplicationsSpecific experiences of distress appear to be highly prevalent in people who have had a recent cardiac event. Understanding these specific fears, worries and stressors has important implications for the identification and management of post-event mental health and, in turn, for supporting patients in their post-event cardiac recovery.
The Cost Effectiveness of Donafenib Compared With Sorafenib for the First-Line Treatment of Unresectable or Metastatic Hepatocellular Carcinoma in China
Authors: Meng Rui , Cao Yingdan , Zhou Ting , Hu Hongfei , Qiu Yijin 
Published: March 2022

BackgroundRecent clinical trials have demonstrated that donafenib has superior efficacy and safety compared with sorafenib in Chinese patients with unresectable or metastatic hepatocellular carcinoma (HCC). The objective of this study was to assess the cost effectiveness of donafenib compared with sorafenib for the treatment of patients with unresectable or metastatic HCC in China.MethodsA three-state partitioned survival model was developed to perform a cost-effectiveness analysis comparing donafenib and sorafenib from a Chinese healthcare payer's perspective. The model adopted a lifetime horizon and a 4-week cycle length. Survival data were derived from the ZGDH3 study and fitted with standard parametric functions for extrapolation beyond the trial period. Cost data were obtained from the mean price of publicly listed online bids in 2021 and medical service prices across provinces in China. Utility data were obtained from previous literature. The cost and health outcomes were discounted at an annual rate of 5%. Deterministic and probabilistic sensitivity analyses (PSAs) were carried out to verify the robustness of the model.ResultsCompared with sorafenib, donafenib incurred a higher cost (US$22,330.23 vs. US$14,775.92) but yielded more quality-adjusted life years (1.045 vs. 0.861 QALYs). The incremental cost-effectiveness ratio (ICER) for donafenib was US$41,081.52 per QALY gained (ICER = US$13,439.10/QALY). The PSA results indicated that at a willingness-to-pay threshold of 3 times the GDP in China, the probability of donafenib being cost effective was 16.9%. The ICER (US$13,439.10/QALY) decreased when the branded price of sorafenib was used in the model.ConclusionsDonafenib is unlikely to be cost effective compared with sorafenib for the first-line treatment of unresectable or metastatic HCC in China. Reducing the price of donafenib can increase the possibility of it being cost effective in the future.