bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical relevance of tertiary lymphoid structures in esophageal squamous cell carcinoma
Authors: Deguchi Sota , Tanaka Hiroaki , Suzuki Shugo , Natsuki Seji , Mori Takuya , Miki Yuichiro , Yoshii Mami , Tamura Tatsuro , Toyokawa Takahiro , Lee Shigeru , Muguruma Kazuya , Wanibuchi Hideki , Ohira Masaichi 
Published: June 2022

Abstract
Background
Tertiary lymphoid structures (TLSs) have been reported to be involved in immune responses in many carcinomas. This study investigated the significance of TLSs in esophageal squamous cell carcinoma, focusing on TLS maturation.

Methods
The relationships of TLSs with clinicopathological features of 236 patients who underwent curative surgery for stage 0-IV esophageal squamous cell carcinoma were investigated. Mature TLSs, in which the germinal center formation was rich in CD23+ cells, were classified as TLSs containing a germinal center (GC-TLSs). GC-TLS densities were measured, and CD8+ cells were counted. The prognostic impact of GC-TLSs was assessed by Kaplan–Meier plots using the log-rank test for the relapse-free survival. A comparative study of GC-TLSs was performed using the Wilcoxon rank sum test. The relationship between GC-TLSs and CD8+ cells was examined by Spearman’s rank correlation coefficient test.

Results
TLSs were located mainly at the invasive margin of the tumor in cases with esophageal squamous cell carcinoma. Among the patients treated with neoadjuvant chemotherapy, those with advanced disease had a better prognosis in the GC-TLS high-density group than did those in the GC-TLS low-density group. Patients in whom neoadjuvant chemotherapy was effective had more GC-TLSs than those in whom it was less effective. The density of GC-TLSs and the number of tumor-infiltrating CD8+ cells were higher in patients treated with neoadjuvant chemotherapy than in those without chemotherapy, and a weak correlation between the density of GC-TLSs and the number of tumor-infiltrating CD8+ cells was observed. Moreover, co-culturing of PBMCs with an anticancer drug-treated esophageal squamous cell carcinoma cell line increased the CD20 and CD23 expression in PBMCs in vitro.

Conclusion
TLS maturation may be important for evaluating the local tumor immune response in patients treated with neoadjuvant chemotherapy for esophageal squamous cell carcinoma. The present results suggest that TLS maturation may be a useful target for predicting the efficacy of immunotherapy, including immune checkpoint inhibitor treatment for esophageal squamous cell carcinoma.
Evaluating the impacts of school garden-based programmes on diet and nutrition-related knowledge, attitudes and practices among the school children: a systematic review
Authors: Chan Chong Ling , Tan Pui Yee , Gong Yun Yun 
Published: June 2022

Abstract
Background
Previous evidence suggests that school garden-based programmes (SGBP) may be a promising yet cost-effective intervention to improve children’s knowledge, attitudes and practices (KAP) on healthy eating. This review aimed to summarise and evaluate the evidence available on the impacts of SGBP in addressing diet and nutrition-related KAP among school-aged children.

Methods
Five databases including PubMed, Embase, Cochrane, Web of Science and Scopus were searched until February 2021. Randomised, non-randomised controlled and pre-post intervention studies investigating the impacts of SGBP on at least one of the outcomes of interest including diet and nutrition-related knowledge, attitudes towards fruits and vegetables (F&V), food diversity and dietary practice among school-aged children were included. Study selection and data extraction were performed by one reviewer and checked for accuracy by the other two reviewers in accordance with PRISMA guideline. Quality appraisal for studies included was assessed using American Dietetic Association Quality Criteria Checklist.

Results
A total of 10,836 records were identified, and 35 studies that met the inclusion and exclusion criteria were included. This includes 25,726 students from 341 schools and 8 nurseries from 12 countries. Intervention duration ranged from 6 weeks to 4 years with 18 studies involving a varied degree of parental participation. SGBP, which majorly includes school gardening activities, cooking lessons and nutrition education, demonstrated beneficial effects on children’s nutritional knowledge, their attitudes and acceptability towards fruits and vegetables and children’s dietary practices including the actual F&V consumption and dietary diversity. However, the impacts of SGBP on such outcomes were highly influenced by various social and environmental factors including the activities/components and duration of the intervention, parental involvement, sample size, and the age of children when interventions were first introduced.

Conclusion
These findings suggest that SGBP may be effective in promoting children’s nutritional knowledge, attitudes and acceptability towards vegetables, however, the impacts may vary by the type, the extent, and the length of the programmes, and other factors such as parent involvement. Future SGBP is suggested to implement using a combined multidisciplinary approach targeting the children, parents, and community to effectively promote healthy eating among the children and prevent childhood obesity.
Effects of food nutrition labels on the health awareness of school-age children
Authors: Wang Ching-Yi , Hsu Chung-Jia , Cai Dengchuan 
Published: June 2022

Abstract
Background
Overweight and obesity have been described as a global epidemic that seriously affects the health of adults and children. Front of Package (FOP) Nutrition Labeling can increase consumers’ awareness of unhealthy foods. The purpose of this study is to find effective deterrence and improve children’s health awareness via the FOP.

Methods
This study examined children’s health awareness of snack packaging using the four labels: guideline daily amounts (GDA), traffic light system (TLS), Apple label (designed in this study), and Warning label. This study recruited 343 children in the sixth grade, including 223 children living in cities and 120 children living in rural areas. First, 30 children in grades 3 to 6 selected 8 snacks that they often buy. Then, each snack was synthesized into these four labels according to their nutritional content for a total of 32 samples. Finally, a questionnaire was used to evaluate the health of snack packaging and the visibility of nutrition labels.

Results
Four results can be drawn: (1) GDA, Apple label and TLS can help children determine healthier snack choices, (2) black Warning label cannot induce children to make healthier choices, (3) children who often buy snacks have low health awareness, and (4) rural children have weak health awareness of snack packaging.

Conclusions
These results can provide a packaging label design, which can effectively improve children’s health awareness.
Clinical significance of cyclin-dependent kinase inhibitor 2C expression in cancers: from small cell lung carcinoma to pan-cancers
Authors: Li Guo-Sheng , Chen Gang , Liu Jun , Tang Deng , Zheng Jin-Hua , Luo Jing , Jin Mei-Hua , Lu Hua-Song , Bao Chong-Xi , Tian Jia , Deng Wu-Sheng , Fu Jing-Wei , Feng Yue , Zeng Neng-Yong , Zhou Hua-Fu , Kong Jin-Liang 
Published: June 2022

AbstractBackgroundCyclin-dependent kinase inhibitor 2C (CDKN2C) was identified to participate in the occurrence and development of multiple cancers; however, its roles in small cell lung carcinoma (SCLC) remain unclear.MethodsDifferential expression analysis of CDKN2C between SCLC and non-SCLC were performed based on 937 samples from multiple centers. The prognosis effects ofCDKN2Cin patients with SCLC were detected using both Kaplan–Meier curves and log-rank tests. Using receiver-operating characteristic curves, whetherCDKN2Cexpression made it feasible to distinguish SCLC was determined. The potential mechanisms ofCDKN2Cin SCLC were investigated by gene ontology terms and signaling pathways (Kyoto Encyclopedia of Genes and Genomes). Based on 10,080 samples, a pan-cancer analysis was also performed to determine the roles ofCDKN2Cin multiple cancers.ResultsFor the first time, upregulated CDKN2C expression was detected in SCLC samples at both the mRNA and protein levels (pof Wilcoxon rank-sum test < 0.05; standardized mean difference = 2.86 [95% CI 2.20–3.52]). Transcription factor FOXA1 expression may positively regulateCDKN2Cexpression levels in SCLC. HighCDKN2Cexpression levels were related to the poor prognosis of patients with SCLC (hazard ratio > 1,p < 0.05) and showed pronounced effects for distinguishing SCLC from non-SCLC (sensitivity, specificity, and area under the curve ≥ 0.95).CDKN2Cexpression may play a role in the development of SCLC by affecting the cell cycle. Furthermore, the first pan-cancer analysis revealed the differential expression ofCDKN2Cin 16 cancers (breast invasive carcinoma, etc.) and its independent prognostic significance in nine cancers (e.g., adrenocortical carcinoma).CDKN2Cexpression was related to the immune microenvironment, suggesting its potential usefulness as a prognostic marker in immunotherapy.ConclusionsThis study identified upregulated CDKN2C expression and its clinical significance in SCLC and other multiple cancers, suggesting its potential usefulness as a biomarker in treating and differentiating cancers.
Paraspinal Muscle Health is Related to Fibrogenic, Adipogenic, and Myogenic Gene Expression in Patients with Lumbar Spine Pathology
Authors: Anderson Brad , Ordaz Angel , Zlomislic Vinko , Allen R. Todd , Garfin Steven R. , Schuepbach Regula , Farshad Mazda , Schenk Simon , Ward Samuel R. , Shahidi Bahar 
Published: June 2022

Abstract
Background
Lumbar spine pathology is a common feature of lower back and/or lower extremity pain and is associated with observable degenerative changes in the lumbar paraspinal muscles that are associated with poor clinical prognosis. Despite the commonly observed phenotype of muscle degeneration in this patient population, its underlying molecular mechanisms are not well understood. The aim of this study was to investigate the relationships between groups of genes within the atrophic, myogenic, fibrogenic, adipogenic, and inflammatory pathways and multifidus muscle health in individuals undergoing surgery for lumbar spine pathology.

Methods
Multifidus muscle biopsies were obtained from patients (n = 59) undergoing surgery for lumbar spine pathology to analyze 42 genes from relevant adipogenic/metabolic, atrophic, fibrogenic, inflammatory, and myogenic gene pathways using quantitative polymerase chain reaction. Multifidus muscle morphology was examined preoperatively in these patients at the level and side of biopsy using T2-weighted magnetic resonance imaging to determine whole muscle compartment area, lean muscle area, fat cross-sectional areas, and proportion of fat within the muscle compartment. These measures were used to investigate the relationships between gene expression patterns and muscle size and quality.

Results
Relationships between gene expression and imaging revealed significant associations between decreased expression of adipogenic/metabolic gene (PPARD), increased expression of fibrogenic gene (COL3A1), and lower fat fraction on MRI (r = -0.346, p = 0.018, and r = 0.386, p = 0.047 respectively). Decreased expression of myogenic gene (mTOR) was related to greater lean muscle cross-sectional area (r = 0.388, p = 0.045).

Conclusion
Fibrogenic and adipogenic/metabolic genes were related to pre-operative muscle quality, and myogenic genes were related to pre-operative muscle size. These findings provide insight into molecular pathways associated with muscle health in the presence of lumbar spine pathology, establishing a foundation for future research that addresses how these changes impact outcomes in this patient population.
Physician decision-making process about withholding/withdrawing life-sustaining treatments in paediatric patients: a systematic review of qualitative evidence
Authors: Zhong Yajing , Cavolo Alice , Labarque Veerle , Gastmans Chris 
Published: June 2022

AbstractBackgroundWith paediatric patients, deciding whether to withhold/withdraw life-sustaining treatments (LST) at the end of life is difficult and ethically sensitive. Little is understood about how and why physicians decide on withholding/withdrawing LST at the end of life in paediatric patients. In this study, we aimed to synthesise results from the literature on physicians’ perceptions about decision-making when dealing with withholding/withdrawing life-sustaining treatments in paediatric patients.MethodsWe conducted a systematic review of empirical qualitative studies. Five electronic databases (Pubmed, Cinahl®, Embase®, Scopus®, Web of Science™) were exhaustively searched in order to identify articles published in English from inception through March 17, 2021. Analysis and synthesis were guided by the Qualitative Analysis Guide of Leuven.ResultsThirty publications met our criteria and were included for analysis. Overall, we found that physicians agreed to involve parents, and to a lesser extent, children in the decision-making process about withholding/withdrawing LST. Our analysis to identify conceptual schemes revealed that physicians divided their decision-making into three stages: (1) early preparation via advance care planning, (2) information giving and receiving, and (3) arriving at the final decision. Physicians considered advocating for the best interests of the child and of the parents as their major focus. We also identified moderating factors of decision-making, such as facilitators and barriers, specifically those related to physicians and parents that influenced physicians’ decision-making.ConclusionsBy focusing on stakeholders, structure of the decision-making process, ethical values, and influencing factors, our analysis showed that physicians generally agreed to share the decision-making with parents and the child, especially for adolescents. Further research is required to better understand how to minimise the negative impact of barriers on the decision-making process (e.g., difficult involvement of children, lack of paediatric palliative care expertise, conflict with parents).
Colleague appraisal of Australian general practitioners in training: an analysis of multisource feedback data
Authors: Vayro Caitlin , Narayanan Ajit , Greco Michael , Spike Neil , Hanson Jan , Mitchell Ben , Hanson Dale , Stewart Rebecca 
Published: June 2022

Abstract
Background
Multisource feedback is an evidence-based and validated tool used to provide clinicians, including those in training, feedback on their professional and interpersonal skills. Multisource feedback is mandatory for participants in the Royal Australian College of General Practitioners Practice Experience Program and for some Australian General Practice Training Registrars. Given the recency of the Practice Experience Program, there are currently no benchmarks available for comparison within the program and to other comparable cohorts including doctors in the Australian General Practice Training program. The aim of this study is to evaluate and compare colleague feedback within and across General Practice trainee cohorts.

Methods
Colleague feedback, from multisource feedback of Practice Experience Program participants and Australian General Practice Training Registrars, collected between January 2018 and April 2020, was compared to identify similarities and differences. Analyses entailed descriptive statistics, between and within groups rater consistency and agreement measures, principal component analysis, t-tests, analysis of variance, and psychometric network analysis.

Results
Colleague ratings of Practice Experience Program participants (overall average 88.58%) were lower than for Registrars (89.08%), although this difference was not significant. ‘Communication with patients’ was rated significantly lower for Practice Experience Program participants (2.13%) while this group was rated significantly better for their ‘Ability to say no’ (1.78%). Psychometric network analyses showed stronger linkages between items making up the behavioural component (compared to the items of the performance and self-management components, as found by principal component analysis) for Practice Experience Program participants as compared to Registrars. Practice Experience Program participants were stronger in clinical knowledge and skills as well as confidentiality, while Registrars were stronger in communicating with patients, managing their own stress, and in their management and leadership skills.

Conclusions
The multisource feedback scores of doctors undertaking the Practice Experience Program suggests that, while all mean values are ‘very good’ to ‘excellent’, there are areas for improvement. The linkages between skills suggests that Practice Experience Program doctors’ skills are somewhat isolated and have yet to fully synthesise. We now have a better understanding of how different groups of General Practitioners in training compare with respect to professional and interpersonal skills. Based on the demonstrated differences, the Practice Experience Program might benefit from the addition of educational activities to target the less developed skills.
The impact of EMTALA on medical malpractice framework models: a review
Authors: Shenoy Amrita , Shenoy Gopinath N. , Shenoy Gayatri G. 
Published: June 2022

AbstractThe Emergency Medical Treatment & Active Labor Act (EMTALA) is a healthcare law specific to screening, stabilizing, and transferring (or accepting) patients with emergency medical conditions and active labor. This law, contextual to Medicare-participating hospitals, ensures public access to emergency medical services, regardless of the individual’s ability to pay. The Defensive Medicine (DM) model and Physician Responsiveness to Standard-of-care Reforms (PRSRs) model are two medical malpractice frameworks leveraged in this paper. The nodes of these frameworks comprise of the treatment-versus-no-treatment dynamics and cutoff thresholds. Cutoff thresholds are specific to health risks and treatment price rates. Health risks stem from those with treating or not treating a patient as well as those inherent from the patient’s ailment. Treatment price rates are subcategorized into customary and efficient price rates. Given the above nodes of these frameworks, this paper examines how the above medical malpractice models synchronize and sequentially align with the legal obligations of this law. This paper, furthermore, contemplatively describes how the incentivize/penalize dynamics interrelate to the push/pull dynamics of the PRSRs malpractice model. Thereafter, this paper applies the above push/pull dynamics contextual to the three specific obligations of this law, essentially, screening, stabilizing, and transferring (or accepting) emergency care patients. Conclusively, this paper illustrates the above network in a cascading algorithm that ligates the nodes of these frameworks to EMTALA's obligations.
Total cost of ownership in shipping: a framework for sustainability
Authors: Stavroulakis Peter J. , Papadimitriou Stratos 
Published: June 2022

Abstract
Purpose
Shipping is pivotal for global commerce, yet its externalities are not yet fully set into context, especially with reference to environmental impact. Shipping is a practise developed from the dawn of history. Its manifestation requires the introduction of relevant supporting industries as well, such as port, cargo, and logistics operations. The holistic shipping system has been growing with its main parameter pertaining to accounting cost minimisation. Yet, the shipping ecosystem has been able to exacerbate environmental, social, and health costs that in the end may prove that shipping, in the way that it is conducted, may not be as profitable as it may seem.

Method
This paper introduces a framework for the total cost of ownership in shipping, which includes a holistic approach as to the true costs associated with shipping practises. Through a structured literature review the relevant costs are identified and assessed, providing a complete framework as to the actual cost of shipping.

Findings
Shipping may appear to be profitable in some cases, but the bulk of its profit is based on practises that incur a plethora of costs that are externalised. This paper provides a clearer understanding of the total cost of shipping and the subsequent need of a paradigm shift, so that shipping may be able to portray its potential with reference to societal and environmental benefits.

Conclusion
Through frameworks such as the one presented in this work, activities and practises may be assessed as to their true impact and footprint and claim sustainability through a solid prism of holistic analysis and true profit for humanity, rather than focusing on accounting cost and turning a blind eye at other social, environmental, and health costs.
Role of 3D-CT gastric volumetric study in post-sleeve gastrectomy
Authors: Moursi Dina Mohsen Abd-Elfattah , Allam Khaled Essmat , Hetta Waleed , Elsalam Ahmed Mohammed Abd , Hussein Rasha S. 
Published: June 2022

Abstract
Background
Gastric pouch volumetry after sleeve gastrectomy reflects successful surgery. We aimed to assess the impact of gastric pouch volume after sleeve gastrectomy on weight loss.

Method
The study was performed for 30 patients (22 females and 8 males) who underwent sleeve gastrectomy. Their ages ranged from 18 to 47 years. All patients underwent (multi-slice CT) MSCT examination at 12 months after surgery with oral administration of effervescent emulsion. Post-processing in multi-planar reconstruction and 3D reconstruction was performed to all cases. Gastric pouch volume was measured and correlated with body weight, body mass index (BMI), % reduction in excess body weight and ∆weight at 1 year.

Results
A significant positive association was found among gastric volume pouch and weight loss (P = 0.04), BMI reduction (P value < 0.0001) and ∆weight (P value = 0.013). A significant inverse association was found among gastric pouch volume and % reduction in excess body weight (P value = 0.013).

Conclusion
MSCT gastric volumetry is the gold standard imaging method for assessment of the gastric pouch volume after sleeve gastrectomy. Significant positive association was found among gastric volume pouch and weight loss, BMI reduction and ∆weight at 1 year, i.e., in spite of large gastric pouch volume at 1 year, there is adequate weight loss, BMI reduction and ∆weight. Yet, significant inverse association was found among gastric pouch volume and % reduction in excess body weight.
Molecularly Imprinted Polymers with Visualized Adsorption and Antibacterial Activity for the Separation of BSA
Authors: Chen Peng , Wang Chaoli , Qiao Youbei , Teng Yonggang , Wang Jingwei , Yu Zhe , Wu Danfeng , Wang Jian , Liu Bangfu 
Published: June 2022

Abstract
The adsorption process of MIPs to template molecules, and biomacromolecule MIPs being easily contaminated with bacteria have become key factors restricting MIP applications. In this work, novel BSA-MIPs with visualized adsorption efficiency and antibacterial ability were prepared by ATRP. The results showed that the BSA-MIPs could adsorb BSA specifically through homogeneous imprinted holes and had excellent antibacterial properties in the process of separation of BSA from blood plasma.