bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical characteristics and prognosis of patient with leptospirosis: A multicenter retrospective analysis in south of China
Authors: Li Dianwu , Liang Huaying , Yi Rong , Xiao Qian , Zhu Yiqun , Chang Qinyu , Zhou Lihua , Liu Bin , He Junjun , Liu Tianxing , Fan Zhijun , Cheng Wei , Wang Weizhong , Zhang Yan , Pan Pinhua 
Published: October 2022

PurposeLeptospirosis is a zoonotic disease caused by pathogenic spirochetes of the genus Leptospira. However, there is currently no consensual definition or diagnostic criteria for severe and different forms of leptospirosis. Therefore, more insight on clinical manifestations, risk factors, and outcomes of leptospirosis is warranted. The identification of leptospirosis with distinct clinical manifestations and prognosis in our population.MethodsMultiple correspondence analysis and hierarchical classification on principal components were presented to identify different clinical types of leptospirosis. The outcomes were clinical phenotypes, laboratory and imaging findings, and prognosis.ResultsThe 95 enrolled patients had median values of 54.0 years (39.0-65.0) for age, 9.0 (7.0-14.0) for total hospital stay lengths, of whom 86.3% was male and 40.0% was transferred to ICU. Three clinical types were distinguished: mild leptospirosis (n=43, 45.3%) with less organ dysfunction and shorter hospital stays; respiratory leptospirosis (n=28, 29.5%) with hemoptysis, and respiratory and circulatory failure; and hepato-renal leptospirosis (n=24, 25.3%) with worst liver and kidney dysfunction. Total hospital mortality was 15.8% and was associated with dyspnea and high levels of neutrophil counts.ConclusionsThe identification of leptospirosis with distinct clinical manifestations and prognosis in our population may assist clinicians to distinguish leptospirosis-like disease. Moreover, dyspnea and neutrophil count were found to be independent risk factors for severe leptospirosis progression.
Influence of hypertension duration and blood pressure levels on cardiovascular disease and all-cause mortality: A large prospective cohort study
Authors: Zheng Yan , Gao Xiang , Jia Hai-Yi , Li Fu-Rong , Ye Hui 
Published: October 2022

Background and objectsA longer duration of hypertension (HTN) has been suggested to be associated with a greater risk of cardiovascular disease (CVD). Whether such an association is similar for mortality risk, and whether HTN duration is associated with CVD/mortality beyond blood pressure (BP) control levels are yet to be assessed. We aimed to examine the associations of HTN duration and the combination of HTN duration and systolic blood pressure (SBP)/diastolic blood pressure (DBP) with risks of CVD and all-cause mortality.MethodsWe used data on ∼450,000 UK residents. Participants were categorized by HTN status and HTN duration. The primary outcome was a composite of non-fatal myocardial infarction, non-fatal stroke and CVD death. We also explored the results for the above-mentioned CVD outcomes separately. All-cause mortality was also used as a secondary outcome. The age at HTN diagnosis was obtained by self-report. HTN duration was calculated as baseline age minus age at diagnosis.ResultsAmong all participants, compared with non-hypertensive participants, those with a longer HTN duration had increased risks of CVD and all-cause mortality. These associations persisted among hypertensive patients. Specifically, compared with patients with HTN durations of &lt; 5 y, patients with a HTN duration of 5 to &lt; 10 y, 10 to &lt; 15 y, and ≥ 15 y had adjusted HRs (95% CI) of 1.09 (1.03, 1.17), 1.21 (1.13, 1.31), and 1.38 (1.29, 1.48) for composite CVD (P-trend &lt; 0.001); and 1.03 (0.97, 1.08), 1.09 (1.02, 1.16), and 1.17 (1.11, 1.24) for all-cause mortality (P-trend &lt; 0.001). When compared with hypertensive patients with BP &lt; 140/90 mmHg and a HTN duration of &lt; 5 y, adjusted HRs of CVD and all-cause mortality were 1.35 (1.15, 1.57) and 1.26 (1.11, 1.42) for those with BP &lt; 140/90 mmHg and a duration of ≥ 15 y, and 1.43 (1.26, 1.60) and 1.13 (1.03, 1.25) for those with BP ≥ 140/90 mmHg and durations of ≥ 15 y, respectively.ConclusionA longer HTN duration was associated with increased risks of CVD and overall death in a linear fashion, and these associations were independent of BP control levels.
Right atrial appendage firing in atrial fibrillation
Authors: Baptiste Florian , Kalifa Jérôme , Durand Cyril , Gitenay Edouard , Bremondy Michel , Ayari Anis , Maillot Nicolas , Taormina Antonio , Fofana Aicha , Penaranda Guillaume , Siame Sabrina , Bars Clément , Seitz Julien 
Published: October 2022

BackgroundThe role of atrial fibrillation (AF) drivers located at the left atrium, superior vena cava, crista terminalis and coronary sinus (CS) is well established. While these regions are classically targeted during catheter ablation, the role of right atrial appendage (RAA) drivers has been incompletely investigated.ObjectiveTo determine the prevalence and electrophysiological characteristics of AF driver’s arising from the RAA.Materials and methodsWe conducted a retrospective analysis of clinical and procedural data of 317 consecutive patients who underwent an AF ablation procedure after bi-atrial mapping (multipolar catheter). We selected patients who presented with a per-procedural RAA firing (RAAF). RAAF was defined as the recording of a sustained RAA EGM with a cycle length shorter than 120 ms or 120 &lt; RAAF CL ≤ 130 ms and ratio RAA CL/CS CL ≤ 0.75.ResultsRight atrial/atrium appendage firing was found in 22 patients. The prevalence was estimated at 7% (95% CI, 4–10). These patients were mostly men (72%), median age: 66 yo ± 8 without structural heart disease (77%). RAAFs were predominantly found in paroxysmal AF patients (63%, 32%, and 5% for paroxysmal, short standing and long-standing AF, respectively, p &gt; 0.05). RAAF median cycle length was 117 ms ± 7 while CS cycle length was 180 ms ± 10 (p &lt; 0.01).ConclusionIn 317 consecutive AF ablation patients (22 patients, 7%) the presence of a high-voltage short-cycle-length right atrial appendage driver (RAAF) may conclusively be associated with AF termination. This case series exemplifies the not-so-uncommon role of the RAA in the perpetuation of AF.
Comparing the effects of endometrial injury in the luteal phase and follicular phase on in vitro fertilization treatment outcomes
Authors: Wang Yang , Bu Zhiqin , Hu Linli 
Published: October 2022

BackgroundSeveral studies have shown that endometrial injury improves clinical pregnancy outcomes in patients undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment with a history of implantation failure. However, endometrial injury can be performed in the follicular phase (FP) followed by embryo transfer in the same menstrual cycle or in the luteal phase (LP) before the embryo transfer cycle.MethodThis prospective cohort study was conducted from January 2015 to September 2021, and a total of 487 patients were included. All included patients had a history of a failed implantation cycle. They were divided into two groups: the FP group (N = 330), in which endometrial injury was performed on menstrual day 3-5, and the LP group (N = 157), in which endometrial injury was performed in the cycle preceding embryo transfer 7 days after ovulation.ResultsFirst, in unselected patients, the implantation rate and clinical pregnancy rate were comparable between the LP and FP groups. However, in patients with a history of ≥ 2 failed transfer cycles, the implantation rate was significantly higher in the LP group than in FP group (43.09% versus 33.33%, P = 0.03). Moreover, the clinical pregnancy rate was also significantly higher in patients in the LP group than in patients in the FP group (60.17% versus 46.15%, P=0.02). In addition, logistic regression analysis showed that endometrial injury in the LP group was an independent factor affecting clinical pregnancy outcome in patients with a history of ≥ 2 failed transfer cycles (aOR = 2.05, 90% CI:1.22-3.47, P=0.01).ConclusionEndometrial injury improves pregnancy outcomes when performed in the luteal phase compared with the follicular phase in patients with a history of ≥ 2 failed transfer cycles but not in unselected patients.
Risk factors, survival analysis, and nomograms for distant metastasis in patients with primary pulmonary large cell neuroendocrine carcinoma: A population-based study
Authors: Song Zhuo , Zou Lijuan 
Published: October 2022

IntroductionPulmonary large cell neuroendocrine carcinoma (LCNEC) is a rapidly progressive and easily metastatic high-grade lung cancer, with a poor prognosis when distant metastasis (DM) occurs. The aim of our study was to explore risk factors associated with DM in LCNEC patients and to perform survival analysis and to develop a novel nomogram-based predictive model for screening risk populations in clinical practice.MethodsThe study cohort was derived from the Surveillance, Epidemiology, and End Results database, from which we selected patients with LCNEC between 2004 to 2015 and formed a diagnostic cohort (n = 959) and a prognostic cohort (n = 272). The risk and prognostic factors of DM were screened by univariate and multivariate analyses using logistic and Cox regressions, respectively. Then, we established diagnostic and prognostic nomograms using the data in the training group and validated the accuracy of the nomograms in the validation group. The diagnostic nomogram was evaluated using receiver operating characteristic curves, decision curve analysis curves, and the GiViTI calibration belt. The prognostic nomogram was evaluated using receiver operating characteristic curves, the concordance index, the calibration curve, and decision curve analysis curves. In addition, high- and low-risk groups were classified according to the prognostic monogram formula, and Kaplan–Meier survival analysis was performed.ResultsIn the diagnostic cohort, LCNEC close to bronchus, with higher tumor size, and with higher N stage indicated higher likelihood of DM. In the prognostic cohort (patients with LCNEC and DM), men with higher N stage, no surgery, and no chemotherapy had poorer overall survival. Patients in the high-risk group had significantly lower median overall survival than the low-risk group.ConclusionTwo novel established nomograms performed well in predicting DM in patients with LCNEC and in evaluating their prognosis. These nomograms could be used in clinical practice for screening of risk populations and treatment planning.
Malaria and anemia in children under 7 years of age in the western region of Côte d’Ivoire
Authors: Ehouman Mocket Adolphe , N’Goran Kouakou Eliezer , Coulibaly Gaoussou 
Published: October 2022

BackgroundAnemia is a major public health problem, affecting nearly one-quarter of the world’s population. It is defined as a reduction in the hemoglobin level in the peripheral blood to below the normal threshold set for a particular population. Very often in the subtropics, helminths or malaria co-infect an individual, causing morbidities that vary by age and region. This study aims to characterize the type of anemia observed in children under 7 years of age infected with malaria in the western region of Côte d’Ivoire, to recommend a better strategy of care.MethodsThe study was carried out from March 2020 to May 2021 in 22 villages in Man, Tonkpi Region, with a cohort of 451 children, both male and female, aged from 3 months to 6 years. The children provided venous blood samples for the diagnosis and characterization of anemia (full blood count), and Giemsa staining (GS) (thick and thin smears) and rapid diagnostic tests (RDTs) were used for the diagnosis of malaria. Risk factors and morbidity profiles were assessed using a questionnaire. Logistic regressions models were employed to identify independent risk factors and morbidity patterns associated with Plasmodium falciparum mono-infection and co-infections.ResultsOf the 451 children who completed the study, 221 (49.0%) were female and 230 (51.0%) were male. The prevalence of anemia was 55.0%, distributed as 30.7% mild, 66.1% moderate, and 3.2% severe anemia. The characterization of anemia revealed that hypochromic microcytic anemia (HMA) was the predominant type, being found in 195 (78.63%) children. It was followed by normochromic microcytic anemia (29 children, 11.69%), normochromic normocytic anemia (14 children, 5.65%), and, finally, hypochromic normocytic anemia (10 children, 4.03%). The prevalence of malaria was 66.7% and 78.3% based on GS and RDTs, respectively. The closed association between malaria (Plasmodium) and anemia led to P. falciparum alone causing 56.7% of mild, 51.3% of moderate, and 37.5% of severe anemia in children.ConclusionMalaria infection was highly prevalent among children aged ≤ 7 years in both sex and in different age groups, although the number of Plasmodium parasites present during infections was greatest in younger children. Similarly, the prevalence of anemia was high, with moderate anemia and HMA being more prevalent in children ≤ 7 years of age in the western region of Côte d’Ivoire.
Hydroxyapatite-collagen- carboxylic carbon quantum dot composite loaded with chrysin supported the proliferation and differentiation of human bone marrow derived mesenchymal stem cells
Authors: Zhou Ao , Chen Sinan , Mickymaray Suresh , Alqurashi Yaser E. , Jeraud Mathew , Chen Biao , Hu Yunjiu 
Published: October 2022

Developing a bioactive scaffold with biocompatible material is a substantial approach to bone regeneration and functional healing. Hydroxyapatite (HAP) is the main component in bone formation as an inorganic component and regeneration due to its osteoconductive properties. In this study, we prepared a scaffold material composed of HAP and collagen (COL) cross-linked via carboxylic carbon quantum dots (CCQD) with a chrysin (CRN) molecule. CRN is a flavonoid that has been shown to encourage the bone development of bone marrow-derived mesenchymal stem cells. It is loaded for enhancing bone regeneration and HAP’s growth ability. XRD, FT-IR, SEM, and TEM analysis have characterized the prepared composites for their crystalline nature, functional behavior, and morphological evaluations. The HAP has retained its original crystalline lattice confirmed from XRD analysis in the prepared composites. The addition of CRN molecule has decreased the length of HAP rods from ∼932 nm to ∼459 nm, as confirmed by TEM images. The increased particle sizes have been observed for the prepared composites. It reaches the maximum at 938.0 nm for the final HAP/COL/CCQD/CRN composite, which was confirmed by particle size analysis. The in-vitro CRN release behavior shows that the CRN molecule has controlled release up to 23% for 48 h. The biocompatibility of prepared material was investigated and confirmed on human bone marrow-derived mesenchymal stem cells (hBMSCs). This examination has proven that the prepared material is good for bone cell regeneration. The material may apply for bone regeneration applications after in-vivo and clinical investigations.
Complete remission of Hodgkin’s lymphoma in a pediatric patient with TTN gene mutation treated with brentuximab vedotin combined chemotherapy without anthracyclines: A case report
Authors: Li Ying , Liu Ligang , Sun Hao , Li Nan , Huang Shuang , Olinger Alexander , Xu Xiaolin , Wang Xiaoling , Duan Yanlong 
Published: October 2022

IntroductionThere is no guideline for the treatment of Hodgkin’s lymphoma (HL) in pediatric patients with titin (TTN) gene mutation and heart failure. We explored the feasibility of using brentuximab vedotin (BV) plus chemotherapy without anthracyclines to treat one pediatric HL patient with TTN mutation.Case presentationA 5-year and 7-month male patient was admitted to the hospital due to high fever and shortness of breath. He was diagnosed with stage IV IVB high-risk Hodgkin’s lymphoma (lymphocyte-depleted type) at admission. Echocardiography showed that the left ventricular ejection fraction (LVEF) was 27%. The gene sequencing revealed a pathogenic variant in the TTN gene. Due to the risk of cardiotoxicity of anthracycline, he received 6 cycles of chemotherapy (no anthracyclines), 4 cycles of them plus BV with dosing 1.8 mg/kg, q3w. The tumor was reduced by 77% after 2 cycles of BV and 4 cycles of chemotherapy. At the end of 4 cycles of BV and six courses of chemotherapy, with complete remission achieved, the tumor was reduced by 85%. After 11 months of follow-up, the patient was still in complete remission with no adverse events reported, and his LVEF improved to 62%.ConclusionThe combination of BV with chemotherapy is effective and well-tolerated for pediatric HL patients with TTN gene mutation.
Association between nutritional status, physical fitness and executive functions in preadolescents: A person-centered approach
Authors: Zhu Yuxin , Sun Fenghua , Tao Sisi , Cooper Simon B. , Gao Tian-Yu 
Published: October 2022

ObjectiveIn the current study, a person-centered approach was adopted to investigate the relationship between nutritional status and physical fitness profiles and executive functions (EF) in preadolescents.MethodsParticipants (Mage = 10.8 years; Male = 50.8%) were recruited from two primary schools in Hong Kong. Nutritional status [body mass index (BMI)], physical fitness including cardiorespiratory fitness (CRF, predicted VO2max, multi-stage fitness test) and speed-agility (20-m sprint) were measured on school days. EF performance was measured using the Flanker task (inhibition) and the Sternberg task (working memory).ResultsData from 120 preadolescents were considered valid. Three distinct profiles were identified by a person-centered approach. Profile 1 was featured by high BMI (21.61 ± 3.38 kg/m2), poor VO2max (33.29 ± 23.96 ml/kg/min), and slow 20-m sprint (4.51 ± 0.13 s). Profile 2 was featured by low BMI (15.99 ± 3.38), fair VO2max (44.98 ± 23.96) and fast 20-m sprint (3.97 ± 0.13). Profile 3 was featured by low BMI (15.63 ± 3.38), poor VO2max (32.37 ± 23.96), and slow 20-m sprint (4.48 ± 0.13). Wald chi-square test revealed preadolescents in profile 1 and profile 2 performed better than profile 3 in accuracy of Flanker task (1 vs. 3: χ2 = 12.23, P &lt; 0.001; 2 vs. 3: χ2 = 10.86, P = 0.001). That is, for normal weight preadolescents with poor CRF and speed-agility, those with superior nutritional status performed better in inhibition. For normal weight preadolescents with poor nutritional status, those with superior CRF and speed-agility had better inhibitory capacity.ConclusionCompared to the commonly used variable-centered approach, this person-centered approach is a valuable addition that expands the understanding of the association between nutritional status, physical fitness and EF in preadolescents. Results are discussed with regards to maximizing health behaviors and implications for educational policy.
Knowledge, practice and attitude toward anabolic hormones and nutritional supplements among people practicing sports in the MENA region before and during COVID-19 lockdown
Authors: Eltewacy Nael Kamel , Nabil Soha , Sweedy Rahma , Marzo Roy Rillera , Hamza Nouran ,   The EARG Group
Published: October 2022

IntroductionDuring the COVID-19 lockdown, people's lifestyles have changed including their habits and physical activities. There has been an increase in anabolic hormones and nutritional supplement use among people who regularly do exercise in the MENA region. This study aims to assess knowledge, practice, and attitude toward the use of anabolic hormones and nutritional supplements among people who regularly exercise in the Middle East and North Africa (MENA) region and to compare their exercise habits and hormones and supplements usage between before and during COVID-19 lockdown.MethodsA self-administrated online Google form survey was carried out between February 2021 and April 2021. Five thousand eight hundred forty-five participants who regularly exercise and aged ≥18 years responded to the questionnaire. The questionnaire was distributed through social media platforms and included five sections: demographic, training characters, knowledge, practice, and attitude.ResultsThe participants mean age was 27.4 ± 8.6 years. Males represented 58.2 % of participants. 75.3% of the study participants had not used either hormones or supplements, and about 19% used supplements only. The mean percent score for knowledge, practice, and attitude were 39.3 ± 30.5, 1.1 ± 9.5, and 21.3 ± 23.8, respectively. Level of knowledge was higher among participants who worked in the medical field or as sports coaches. The practice was higher among male participants. The most commonly used anabolic hormones and nutritional supplements were steroids and proteins with bodybuilding being the most common purpose. Internet was the main source of information and pharmacy was the main source for procuring these substances. There was a significant decrease in proteins, carbohydrates, and sports drinks used during the COVID-19 lockdown compared to before the COVID-19 lockdown, while a statistically significant increase in vitamins used during the COVID-19 lockdown compared to before COVID-19 lockdown.DiscussionIn the MENA region, there has been an increase in the use of anabolic hormones and nutritional supplements. Most of the population has low knowledge of the harmful effect of uncontrolled, uninformed and unmonitored use of these substances Therefore, increasing the awareness level of participants and sports coaches should be a priority to limit the unsupervised use of hormones and supplements.
Develop and validate nomogram to predict cancer-specific survival for patients with testicular yolk sac tumors
Authors: Li Maoxian , Wang Jinkui , Li Jinfeng , Zhang Yongbo , Zhao Xing , Lin Yang , Deng Changkai , Li Fulin , Peng Qiang 
Published: October 2022

PurposeTesticular yolk sac tumor (TYST) is a rare malignant germ cell tumor that mainly occurs in young men. Due to the low incidence of yolk sac tumors, there is a lack of prospective cohort studies with large samples. We aimed to develop a nomogram to predict cancer-specific survival (CSS) in patients with TYST.Materials and methodsPatient information was downloaded from the Surveillance, Epidemiology and End Results (SEER) database. We enrolled all patients with TYST from 2000 to 2018, and all patients were randomly divided into a training set and a validation set. Univariate and multivariate Cox proportional hazards regression models were used to identify independent risk factors for patients. We constructed a nomogram based on the multivariate Cox regression model to predict 1-, 3-, and 5-year CSS in patients with TYST. We used a series of validation methods to test the accuracy and reliability of the model, including the concordance index (C-index), calibration curve and the area under the receiver operating characteristic curve (AUC).Results619 patients with TYST were enrolled in the study. Univariate and multivariate Cox regression analysis showed that age, T stage, M stage and chemotherapy were independent risk factors for CSS. A nomogram was constructed to predict the patient's CSS. The C-index of the training set and the validation set were 0.901 (95%CI: 0.859–0.847) and 0.855 (95%CI: 0.865–0.845), respectively, indicating that the model had excellent discrimination. The AUC showed the same results. The calibration curve also indicated that the model had good accuracy.ConclusionsIn this study, we constructed the nomogram for the first time to predict the CSS of patients with TYST, which has good accuracy and reliability and can help doctors and patients make clinical decisions.