bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exacerbation of Autoimmune Bullous Diseases After Severe Acute Respiratory Syndrome Coronavirus 2 Vaccination: Is There Any Association?
Authors: Kianfar Nika , Dasdar Shayan , Salehi Farid Ali , Balighi Kamran , Mahmoudi Hamidreza , Daneshpazhooh Maryam 
Published: July 2022

Background and AimThere have been concerns regarding the potential exacerbation of autoimmune bullous diseases (AIBDs) following vaccination against COVID-19 during the pandemic. In the current study, vaccine safety was evaluated in patients with AIBDs.MethodsIn this study, patients with AIBDs were contacted via face-to-face visits or phone calls. Patient demographics, vaccine-related information, pre- and post-vaccine disease status, and complications were recorded. The exacerbation was considered either relapse in the remission/controlled phase of the disease or disease worsening in the active phase. The univariate and multivariate logistic regression tests were employed to determine the potential risk factors of disease exacerbation.ResultsOf the patients contacted, 446 (74.3%) reported receiving at least one dose of vaccine injection (54.7% female). Post-vaccine exacerbation occurred in 66 (14.8%) patients. Besides, there were 5 (1.1%) patients with AIBD diagnosis after vaccination. According to the analysis, for every three patients who received vaccines during the active phase of the disease one experienced disease exacerbation. The rate of disease exacerbation increased by three percent with every passing month from the last rituximab infusion. Active disease in the past year was another risk factor with a number needed to harm of 10.ConclusionRisk of AIBD exacerbation after the COVID-19 vaccine is not high enough to prevent vaccination. This unwanted side effect, can be reduced if the disease is controlled at the time of vaccination.
A Nomogram Based on Hematological Parameters and Clinicopathological Characteristics for Predicting Local–Regional Recurrence After Breast-Conserving Therapy
Authors: Sun Luhao , Zhao Wei , Wang Fukai , Song Xiang , Wang Xinzhao , Li Chao , Yu Zhiyong 
Published: July 2022

ObjectivesThe aim of this study was to identify the factors for local–regional recurrence (LRR) after breast-conserving therapy (BCT). We established a practical nomogram to predict the likelihood of LRR after BCT based on hematological parameters and clinicopathological features.MethodsA retrospective analysis was performed on 2,085 consecutive breast cancer patients who received BCT in Shandong Cancer Hospital from 2006 to 2016, including 1,460 patients in the training cohort and 625 patients in the validation cohort. Univariate and multivariate analyses were performed based on hematological parameters (fibrinogen, platelets, mean platelet volume, neutrophils, monocytes, and lymphocytes) and clinicopathological characteristics to identify the independent factors for LRR. Subsequently, a nomogram for predicting LRR was established by logistic regression analysis. The nomogram was validated in 625 patients in the validation cohort.ResultsDuring the median follow-up period of 66 months, 44 (3.01%) patients in the training cohort and 19 (3.04%) patients in the validation cohort suffered from LRR. Multivariate analysis showed six independent factors related to LRR, including molecular subtype, pathological N stage, re-resection, radiotherapy or not, platelet count*MPV*fibrinogen (PMF), and neutrophil count/lymphocyte count ratio (NLR). Six variables were entered into logistic regression to establish the nomogram for predicting LRR. The nomogram of LRR showed excellent discrimination and prediction accuracy. The area under the receiver operating characteristic curve (AUC) was 0.89 (p &lt; 0.001, 95% CI = 0.83, 0.95) in the training cohort and 0.88 (p &lt; 0.001, 95% CI = 0.8, 0.96) in the validation cohort. Calibration curves for the prediction model in the training and validation cohorts both demonstrated satisfactory consistency between the nomogram-predicted and actual LRR.ConclusionThe combination of hematological parameters and clinicopathological characteristics can predict LRR after BCT. The predictive nomogram based on preoperative and postoperative indicators of BCT might serve as a practical tool for individualized prognostication. More prospective studies should be performed to verify the model.
Image-guided interstitial brachytherapy for recurrent cervical cancer after radiotherapy: A single institution experience
Authors: Ren Xiaojun , Fu Yingli , Liu Zhongshan , Lin Xia , Qiu Ling , Li Yunfeng , Li Hanyang , Bai Yuqi , Wang Tiejun 
Published: July 2022

PurposeThe aim of this study is to evaluate the efficacy and toxicity of image-guided high-dose rate (HDR) interstitial brachytherapy (ISBT) for the reirradiation of cervical cancer within a previously irradiated area.Methods and materialsTwenty-three consecutive patients with cervical cancer were reirradiated with curative intent using brachytherapy (BT) with or without external beam irradiation. The median biologically equivalent dose in 2-Gy fractions (EQD2) for reirradiation was 64.0 Gy (range: 31.3–95.1 Gy), and the median cumulative EQD2 (for primary treatment and reirradiation) was 152.4 Gy (range: 97.8–200.9 Gy). The average clinical target volume was 82.9 cm3 (range: 26.9–208.3 cm3), and the median treatment-free interval (TFI) was 13 months (range: 3–93 months).ResultsThe median follow-up time was 19 months (range: 2–59 months). The complete response rate after reirradiation was 56.5%. The 1-, 2- 3-, and 4-year post-relapse survival (PRS) rates were 65.2%, 43.5%, 33.8%, and 27.1%, respectively. The median reirradiation EQD2 D2cc of rectum and bladder was 39.5 Gy (range = 14.6–96.2 Gy) and 52.1 Gy (range = 29.1–114.2 Gy). The median cumulative EQD2 D2cc of rectum and bladder was 115.0 Gy (range = 84.4–189.3 Gy) and 130.5 Gy (range = 95.5–173.5 Gy). During follow-up, nine (39.1%) patients had experienced grade 3 or 4 late toxicities. Grade ≥3 rectal toxicity occurred in three patients (13.0%). Grade ≥3 urinary toxicity occurred in five patients (21.7%). One patient (4.3%) had both grade ≥3 urinary and rectal toxicity. Tumor volume, TFI, tumor invasion organ number, and local control were significant prognostic factors adversely affecting OS.ConclusionsFor recurrent cervical cancer after radiotherapy, reirradiation of HDR-ISBT is feasible, even if the local tumor invasion is large, with a good chance of survival and acceptable side effects.
Nivolumab Versus Sorafenib as First-Line Therapy for Advanced Hepatocellular Carcinoma: A Cost-Effectiveness Analysis
Authors: Li Yan , Liang Xueyan , Li Huijuan , Yang Tong , Guo Sitong , Chen Xiaoyu 
Published: July 2022

Objective: Nivolumab improves overall survival (OS) and is associated with fewer adverse events than sorafenib for the treatment of advanced hepatocellular carcinoma (aHCC). However, the cost-effectiveness of nivolumab compared with sorafenib treatment for aHCC remains unclear. This study evaluated the cost-effectiveness of nivolumab and sorafenib in the treatment of aHCC.Materials and methods: A partitioned survival model that included three mutually exclusive health states was used to evaluate the cost-effectiveness of nivolumab and sorafenib for treating aHCC. The clinical characteristics and outcomes of the patients in the model were obtained from the CheckMate 459. We performed deterministic one-way sensitivity and probabilistic sensitivity analyses to evaluate the robustness of the model. Subgroup analyses were also performed. Costs, life-years, quality-adjusted life-years (QALYs), incremental cost-effectiveness ratio (ICER), incremental net health benefits (INHB), and incremental net monetary benefits (INMB) were measured.Results: The base case analysis showed that compared with sorafenib, treatment with nivolumab was associated with an increment of 0.50 (2.45 vs. 1.95) life-years and an increment of 0.32 (1.59 vs. 1.27) QALYs, as well as a $69,762 increase in cost per patient. The ICER was $220,864/QALY. The INHB and INMB were −0.15 QALYs and −$22,362 at a willingness-to-pay (WTP) threshold of $150,000/QALY, respectively. The probabilistic sensitivity analysis demonstrated that the probability of nivolumab being cost-effective was only 10.38% at a WTP threshold of $150,000/QALY. The model was most sensitive to the costs of sorafenib and nivolumab according to the one-way sensitivity analysis. When the price of sorafenib exceeded $0.93/mg or nivolumab was less than $24.23/mg, nivolumab was more cost-effective. The subgroup analysis illustrated that the probability of cost-effectiveness was &gt;50% in the Barcelona Clinic Liver Cancer Stage B subgroups for nivolumab at a WTP threshold of $150,000/QALY. This study also showed that the probability of cost-effectiveness was &lt;50% in most subgroups.Conclusion: Nivolumab was not cost-effective, although it was associated with better clinical benefit and a favorable safety profile for the treatment of aHCC compared with sorafenib from the third-party payer perspective in the United States. If the price of nivolumab is substantially reduced, favorable cost-effectiveness can be achieved among patients with aHCC.
A UPLC-Q-TOF-MS-Based Metabolomics Approach to Screen out Active Components in Prepared Rhubarb for Its Activity on Noxious Heat Blood Stasis Syndrome
Authors: Zhu Hui , Duan Yu , Qin Kunming , Jin Junjie , Liu Xiao , Cai Baochang 
Published: July 2022

Background: Prepared rhubarb was obtained by steaming raw rhubarb with wine. Different from raw rhubarb with a purgative effect, prepared rhubarb shows effects of promoting blood circulation and removing blood stasis. However, the mechanisms of its action through regulating endogenous metabolites remain unclear.Purpose: The purpose of this study was to explore active chemical components in prepared rhubarb for its activity on noxious heat blood stasis syndrome (NHBS) by comprehensive metabolomics profiling.Study design: Plant extracts usually show their activities in a synergistic way; therefore, integrated omics was developed as a rational way for a better understanding of their biological effects and potential active compounds.Methods: The activities of prepared rhubarb were evaluated by biochemical and metabolomic analysis; meanwhile, serum chemical profiles were sought using UHPLC-Q-TOF-MS. Gray correlation analysis (GCA) was used for calculating the underlying correlations between them.Results: The metabolomics profiles of rat plasma from model and control groups were significantly different, with 31 endogenous metabolites changed by NHBS. Then, after the administration of prepared rhubarb, 18 of them were regulated. Multiple metabolic pathways were disturbed after NHBS modeling and restored by prepared rhubarb, among which had a greater impact on sphingolipid metabolism. A total of 28 compounds from prepared rhubarb absorbed into the plasma were identified, including nine prototypes and 19 metabolites. Statistical results suggested that rhein and its metabolites accounted for half of the top 10 active compounds in prepared rhubarb for its biomedical activities.Conclusion: This study presented evidence for the therapeutic effects and active chemicals of prepared rhubarb on NHBS in the way of metabolomics.
The Relationship of Pyroptosis-Related Genes, Patient Outcomes, and Tumor-Infiltrating Cells in Bladder Urothelial Carcinoma (BLCA)
Authors: Xie Ruiyan , Xie Ming , Zhu Litong , Chiu Joanne W. Y. , Lam Wayne , Yap Desmond Y. H. 
Published: July 2022

Introduction: The role of pyroptosis and its effects on tumor-infiltrating cells (TICs) in the pathogenesis and treatment outcomes of patients with bladder urothelial carcinoma (BLCA) remains unclear.Methods: We conducted a bioinformatics analysis on the pyroptosis-related genes (PRGs) and TICs using data from public domains, and evaluated their impact on the pathogenesis and clinical outcomes of BLCA patients. A risk score based on PRGs and a prognostic risk model that incorporated patient demographics, tumor characteristics, and differentially expressed genes (DEGs) were developed.Results: Twenty-three DEGs of 52 PRGs were identified in BLCA and normal samples from the TCGA database. Missense mutations and single nucleotide polymorphisms in PRGs are the most common genetic abnormalities. Patients with high PRG risk scores showed an inferior survival compared to those with low risk scores. The prognostic risk model based on patient demographics, tumor characteristics, and DEGs showed good predictive values for patient survival at 1, 3, and 5 years in BLCA patients. Caspase-8 (CASP8) was the only intersection gene of the prognostic genes, DEGs, and different genes expressed in tissue. Patients with a high CASP8 expression had improved survival, and an increased CASP8 expression level was observed in activated CD4 memory T cells, follicular T helper cells, resting NK cells, M0 macrophages, and activated dendritic cells. CASP8 expression also showed a positive correlation with the IL7R expression—a key cell marker of CD4 memory T cells. CASP8 expression also showed correlations with immune checkpoints (PDCD1, CD274, and CTLA4) and response to immune checkpoint inhibitors.Conclusion: Our data suggest that PRGs, especially CASP8, showed strong associations with patient outcomes and TICs in BLCA. If validated, these results could potentially aid in the prognostication and guide treatment in BLCA patients.
Pasang Surut Politik dan Sejarah Isu Kebijakan Sawit di Riau
Authors: Anwar Khairul , Ishak Ishak , Isril Isril , Erman Erman 
Published: July 2022

Artikel ini bertujuan menemukan konteks politik sejarah pasang surut isu kebijakan sawit di Riau dengan mengambil fokus masa awal reformasi 2000-2010. Latar belakangnya pergulatan politik aktor dalam sejarah isu kebijakan sawit sejak kolonial hingga awal reformasi Indonesia termasuk di Riau. Argumentasinya adalah akumulasi pasang surut isu politik sawit, terjadi pada awal reformasi. Pertanyaannya, bagaimana pasang surut interaksi politik aktor tersebut berlangsung di Riau? Dalam menjawab pertanyaan dipakai teori dan metode analisis modern political economy Jeffry Frieden. Pasang surut politik terkait isu kebijakan sawit terjadi sejak diterapkan UU.No.32/tahun 2009 dan UU.No.25/ tahun 1999. Dalam era rezim ORBA tuntutan politik hanya dilakukan para politisi di DPRD dan Birokrasi lokal. Sepanjang tahun 2000-2010, aktor lokal yang melakukan aksi memperjuangkan isu sawit spektrumnya semakin melebar, ada banyak aktor lokal dalam batas tertentu bersifat pasif kemudian menjadi viral. Masa transisi politik ini diungkapkan melalui fakta munculnya sejumlah aktivis masyarakat sipil, teknokrat dan pemerintah. Ada aktor pemerintah bersikap setuju, menolak dan setuju dengan usulan. Para aktor memiliki strategi, taktik, dan kiat dalam berkoalisi sesuai dengan posisinya. Dalam konteks politik lokal pluralistik seperti inilah, pasang surut politik lokal isu kebijakan sawit terjadi sebagai hasil interaksi aktor lokal dan nasional.
Photon Chamber Showing Incompleteness of Wave Interpretations of Double Slit Experiments
Authors: peng hui 
Published: July 2022

<p>Young’s double slit experiments, which represent the mystery of quantum mechanics, have been described by the optic wave theory, the electromagnetic wave (EM wave) theory and pilot wave theory. Recently, the coexistence of the particle nature and the wave distribution of light in double slit experiments has been demonstrated. In this article we utilize the photon chamber to detect the traces of the light beam in the double slit experiments. The existence of the light tracks indicates the particle nature of the light beam in the wave experiments. The particle nature of the light beam is visualized by the tracks, while the wave-like distribution is visualized by the interference pattern. </p>
<p>Furthermore, we cover the two sides of the chamber by copper foil for shielding the EM wave. If the light beams were the EM waves, then the interference pattern would be disturbed. The experiments show that the light behave as particles moving through the photon chamber, while distribute as waves without being disturbed. Thus, the double slit/photon chamber experiments visually indicate that the wave interpretations of the optical wave theory and the EM wave theory of the double slit experiments are incomplete. However, the experiments support the pilot wave theory at far field. The experiments in this article confirm the conclusions of the previous modified double slit experiments. But, the experimental devices, experimental setups and experimental observations are totally different. The experiments in this article make the mystery of the double slit experiments even more mysterious. The photon chamber is inexpensive and may be used to study the nature of the light.</p>
Complications of Microvascular Decompression in patients with Trigeminal Neuralgia
Authors: Amjad Qaisarani  , Rizwan AhmedK han  , Irfan Sheikh  , Fayyaz Madiha 
Published: July 2022

Objective: To determine the frequency of complications of microvascular decompression for patients with trigeminal neuralgia undergoing surgical decompression.
Materials and Methods: A descriptive case study was carried out in the Neurosurgery Unit 1, Lahore General Hospital. The study included 80 patients who fulfilled the inclusion criteria. Informed consent was obtained and possible outcomes and complications of surgery were explained beforehand to the patients. Demographic details were noted. Surgical site infection, CSF leak, Facial numbness, Facial palsy, Hearing impairment, and Postoperative hematoma as complications were assessed. The presence of complications was recorded. Data was stratified for age and gender from. Chi-square was used as a statistical test, taking a p-value ?0.05 as the level of significance.
Results: The study included 80 patients. The mean age of the patients was 40.8 ± 11.7 years. Overall complications were reported in 21 (26.3%) patients. Distribution of complications was as follows; surgical site infection 2 (9.5%), CSF leak (19.0%), facial palsy 5 (23.8%), facial numbness 9 (42.9%), hearing impairment 2 (9.5%) and post-operative hematoma 5 (23.8%).
Conclusion: Microvascular decompression (MVD) is recommended neurosurgical procedure for medically refractory patients with trigeminal pain if there is no contraindication for surgery. Surgical complications can be minimized by meticulous surgery resulting in adequate tissue respect. Another means to get better and long-lasting results with fewer complications is by using an autologous muscle graft.
Frequency of SCF Leakage in Post-operative Patients of Tethered Spinal Cord in A Tertiary Care Hospital
Authors: Rehman Muhammad Abdur , Aziz Junaid , Asghar Inamullah , Anwar Taimoor , Wahab Anum , Hussain Muhammad Akmal 
Published: July 2022

Objective: The study aimed to report the incidence of CSF leakage in patients with a tethered spinal cord, post-operatively.
Materials and Methods: A total of 75 individuals aged more than 2 years and of either gender who were hospitalized for surgery for tethered cord syndrome were included. All patients had a preoperative MRI of the spine, and those above the age of 6 had urodynamic tests. Clinical evaluations were performed until hospital release, then again at 3, 6, and 12 months. Urodynamic tests and spine MRIs were redone one year following surgery. Under general anesthesia, all patients had microscopic untethering procedures to release tethering materials and heal the thecal sac.
Results: 52% of patients fall under TCS type ‘simple’, whereas, 48% of patients found with complex TCS. The frequency of CSF leakage in post-operative patients with a tethered spinal cord was found in 17.33%. No CSF leak was reported in the majority of patients (49%) patients in the age group 2-30 years. 52% of patients with simple TCS reported no CSF leak, whereas, only 13(18%) patients with complex TCS reported CSF leaks. 40% of patients reported no CSF leak who was diagnosed with complex TCS. There existed a significant relationship between the types of TCS (simple/complex) for CSF leak distribution.
Conclusion: This study concluded that the frequency of CSF leakage in post-operative patients with tethered spinal cord was found in 17.33% of patients.
Keywords: Tethered Spinal Cord (TCS), CSF Leakage, Lipomyelomeningocele.
Per-Operative External Ventricular Drainage Results in Children with Posterior Fossa Tumors and Hydrocephalus
Authors: Abdul Mannan Aftab  , Abdul Aziz Khan  , Khalid Zadran  , Aamir Zaman  
Published: July 2022

Objective: We determined the outcome of per operational external ventricular drainage in pediatric patients with posterior fossa tumors and hydrocephalus.
Material And Methods: 54 patients included presenting with posterior fossa tumors and mild to moderate hydrocephalous were considered for per operative external ventricular drainage. The external ventricular drain was then weaned off in one week. If it cannot be removed due to persistent hydrocephalous it was converted into a permanent ventriculoperitoneal shunt.
Results: In the study, the mean age was 7 years. Twenty-seven children had ependymoma, 19% of children had medulloblastoma, and 54% of children had pilocytic astrocytoma. Moreover, 67% of children had weaned off and 33% of children had converted to VP shunt. There existed an insignificant difference in the outcome (yes/ no) concerning age groups, gender, and tumor type.
Conclusion: Our study concludes that the outcome of per operative external ventricular drainage was weaned off (67%) and converted to VP shunt (33%) in pediatrics with posterior fossa tumors and hydrocephalous.
Multidisciplinary Management and Outcome of Intradural Extramedullary Spinal Tumors
Authors: Samra Majeed  , Fareeha Majid  , Nayyara Tahir  , Waqar Azim  , Azam Niaz  , Azam Niaz  , Anjum Habib Vohra  
Published: July 2022

Introduction/Objective: About fifteen percent of the primary CNS tumors are intraspinal. About two-thirds of tumors are intradural extramedullary (IDEM). This study was conducted to review the outcome of operative management of intradural extramedullary tumors in correlation with the factors, both clinical & histopathological, influencing the neurology of patients & prognosis.
Materials and Methods: It was a multicenter study including 42 patients conducted from December 2018 to December 2020. All patients were diagnosed by MRI with and without contrast. Patients were surgically treated & analyzed for clinical features i.e., pain by visual analog scale (VAS) & neurology by modified McCormick scale both preoperatively & post-operatively. Clinical features & outcomes were correlated with tumor size & histopathology. p-value < 0.05 was considered significant.
Results: This study included 42 cases. The most common diagnosis was schwannoma (76.19%). The average intradural space occupied at presentation was 82%. The most common location was dorsal (90.4%). The visual analog score for pain (VAS) improved in all patients post-operatively from 7 ± 1.9 to 2 ± 0.8 (p = 0.003) & modified McCormick scale from 3.0 ± 1.3 to 2.0 ± 1.0 (p = 0.005). The preoperative symptoms were correlated with the only size of the tumor occupying the intradural space (VAS p = 0.021, modified McCormick scale p = 0.018).
Conclusion: All the tumors excised showed some improvement in neurological status. Therefore, all patients diagnosed with IDEM should be operated on even if present with prolonged symptoms or severe neurological compromise.
Keywords: Intradural Extramedullary, Meningioma, Schwannoma, Intraspinal.