bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility study for utilization of solar energy in the arctic areas
Authors: Tamrakar S , Mustafa M , Riise R 
Published: November 2019

Abstract
This research investigates a solar thermal system and a solar photovoltaic system which produces local energy, by incoming solar radiation, to meet the energy consumption demand of a residential building in the arctic region. The study on the use of the solar systems in the arctic areas is rare and often doubted. So, to analyze the potential of solar energy, a study case of an existing building block in Narvik, Norway was selected. The performance and function of both the systems were studied and achieved by calculation and simulation models of the thermal system and the PV system separately. The solar systems met the energy demand of DHW and space heating during summer due to the availability of the sun for long hours. However, in winter, especially in December and January, the energy production was zero due to snow accumulation and minimum sunlight. The results showed that the solar thermal collector produced about 14315 kWh throughout a year, whereas, the PV system generated an annual energy output of 18640 kWh. Thus, the results suggest considerable potential for solar utilization, however in the current context cost can be a limitation.
The future incidence, prevalence and costs of stroke in the UK
Authors: King Derek , Wittenberg Raphael , Patel Anita , Quayyum Zahid , Berdunov Vladislav , Knapp Martin 
Published: November 2019

Abstract

Background
we project incidence and prevalence of stroke in the UK and associated costs to society to 2035. We include future costs of health care, social care, unpaid care and lost productivity, drawing on recent estimates that there are almost 1 million people living with stroke and the current cost of their care is £26 billion.

Methods
we developed a model to produce projections, building on earlier work to estimate the costs of stroke care by age, gender and other characteristics. Our cell-based simulation model uses the 2014-based Office for National Statistics population projections; future trends in incidence and prevalence rates of stroke derived from an expert consultation exercise; and data from the Office for Budget Responsibility on expected future changes in productivity and average earnings.

Results
between 2015 and 2035, the number of strokes in the UK per year is projected to increase by 60% and the number of stroke survivors is projected to more than double. Under current patterns of care, the societal cost is projected to almost treble in constant prices over the period. The greatest increase is projected to be in social care costs—both public and private—which we anticipate will rise by as much as 250% between 2015 and 2035.

Conclusion
the costs of stroke care in the UK are expected to rise rapidly over the next two decades unless measures to prevent strokes and to reduce the disabling effects of strokes can be successfully developed and implemented.
Exposure to Organophosphate Pesticides and Menstrual Cycle Characteristics in Chinese Preconceptional Women
Authors: Zhang Yan , Ji Lin , Hu Yi , Tse Lap Ah , Wang Yiwen , Qin Kaili , Ding Guodong , Zhou Yijun , Yu Xiaodan , Ouyang Fengxiu , Zhang Jun , Gao Yu , Tian Ying ,   for the Shanghai Birth Cohort Study
Published: November 2019

Abstract
Organophosphates (OPs) are the most heavily used pesticides in China. The Chinese population, including preconceptional women, is highly exposed, yet little is known regarding the associations between OP exposure and menstruation in humans. We conducted a cross-sectional analysis in women preparing for pregnancy to investigate the relationship between biomarkers of OP exposure and menstrual cycle characteristics. From 2013 to 2015, 627 women visiting free preconception-care clinics at 2 maternity hospitals in Shanghai, China, were included. Information on menstrual cycle characteristics was obtained through questionnaires. OP exposure was assessed by measuring urine concentrations of 6 dialkylphosphate metabolites (dimethylphosphate, dimethylthiophosphate, dimethyldithiophosphate, diethylphosphate, diethylthiophosphate, and diethyldithiophosphate). The relationship between concentrations of dialkylphosphate metabolites and menstrual cycle characteristics was analyzed using multiple linear regression models and logistic regression models. Log-transformed levels of diethyl phosphate metabolites (the sum of diethylphosphate and diethylthiophosphate levels) were related to a higher risk of irregularity of menstrual cycles (adjusted odds ratio = 2.36, 95% confidence interval: 1.28, 4.34). Subjects with a higher concentration of diethyl phosphate metabolites (log-transformed) had a shorter duration of menstrual bleeding (adjusted β = −0.33, 95% confidence interval: −0.64, −0.02). The findings suggest that OP exposure may be associated with alterations in menstrual function in preconceptional women.
Bedtimes and Blood Pressure: A Prospective Cohort Study of Mexican Adolescents
Authors: Jansen Erica C , Dunietz Galit Levi , Matos-Moreno Amilcar , Solano Maritsa , Lazcano-Ponce Eduardo , Sánchez-Zamorano Luisa María 
Published: November 2019

Abstract

INTRODUCTION
Hypertension affects up to 5% of children worldwide and predicts later cardiovascular morbidity. Associations of short sleep and hypertension have been frequently reported in adults but less consistently in children. This study aims to examine the role of late bedtimes, a marker of short sleep duration, and potentially misaligned circadian rhythms, on incident elevated blood pressure (BP) in a large cohort of Mexican children.

METHODS
Participants included 2,033 adolescents recruited from public schools in Morelos, Mexico, free from elevated BP (&lt;90th sex, age, and height-standardized percentile). Fourteen months later, all adolescents had a second BP assessment. We abstracted baseline habitual bedtimes from questionnaires to evaluate the association between bedtime and elevated BP incidence (≥90th percentile). Risk ratios and 95% confidence intervals were estimated with discrete-time mixed survival models, adjusting for potential confounders and accounting for clustering by school.

RESULTS
Participants were 12.5 (SD = 0.6) years old at baseline. At the follow-up visit 10% of adolescents had developed elevated BP. Compared to participants with a habitual weekday bedtime between 9 and 10 pm, those with a weekday bedtime 11 pm or later had a 1.87 times higher risk of developing elevated BP over the follow-up period (95% CI = 1.09, 2.21), after accounting for confounders. Participants with earlier weekday bedtimes also had a higher risk of elevated BP (RR = 1.96; 95% CI = 1.27, 3.01). The associations persisted after accounting for wake time.

CONCLUSION
These data showed a U-shaped association between weekday bedtime and elevated/high BP risk among Mexican adolescents.
Individual signatures outweigh social group identity in contact calls of a communally nesting parrot
Authors: Smith-Vidaurre Grace , Araya-Salas Marcelo , Wright Timothy F 
Published: November 2019

Abstract
Despite longstanding interest in the evolutionary origins and maintenance of vocal learning, we know relatively little about how social dynamics influence vocal learning processes in natural populations. The “signaling group membership” hypothesis proposes that socially learned calls evolved and are maintained as signals of group membership. However, in fission–fusion societies, individuals can interact in social groups across various social scales. For learned calls to signal group membership over multiple social scales, they must contain information about group membership over each of these scales, a concept termed “hierarchical mapping.” Monk parakeets (Myiopsitta monachus), small parrots native to South America, exhibit vocal mimicry in captivity and fission–fusion social dynamics in the wild. We examined patterns of contact call acoustic similarity in Uruguay to test the hierarchical mapping assumption of the signaling group membership hypothesis. We also asked whether geographic variation patterns matched regional dialects or geographic clines that have been documented in other vocal learning species. We used visual inspection, spectrographic cross-correlation and random forests, a machine learning approach, to evaluate contact call similarity. We compared acoustic similarity across social scales and geographic distance using Mantel tests and spatial autocorrelation. We found high similarity within individuals, and low, albeit significant, similarity within groups at the pair, flock and site social scales. Patterns of acoustic similarity over geographic distance did not match mosaic or graded patterns expected in dialectal or clinal variation. Our findings suggest that monk parakeet social interactions rely more heavily upon individual recognition than group membership at higher social scales.
Hippocampal vascular reserve associated with cognitive performance and hippocampal volume
Authors: Perosa Valentina , Priester Anastasia , Ziegler Gabriel , Cardenas-Blanco Arturo , Dobisch Laura , Spallazzi Marco , Assmann Anne , Maass Anne , Speck Oliver , Oltmer Jan , Heinze Hans-Jochen , Schreiber Stefanie , Düzel Emrah 
Published: November 2019

AbstractMedial temporal lobe dependent cognitive functions are highly vulnerable to hypoxia in the hippocampal region, yet little is known about the relationship between the richness of hippocampal vascular supply and cognition. Hippocampal vascularization patterns have been categorized into a mixed supply from both the posterior cerebral artery and the anterior choroidal artery or a single supply by the posterior cerebral artery only. Hippocampal arteries are small and affected by pathological changes when cerebral small vessel disease is present. We hypothesized, that hippocampal vascularization patterns may be important trait markers for vascular reserve and modulate (i) cognitive performance; (ii) structural hippocampal integrity; and (iii) the effect of cerebral small vessel disease on cognition. Using high-resolution 7 T time-of-flight angiography we manually classified hippocampal vascularization patterns in older adults with and without cerebral small vessel disease in vivo. The presence of a mixed supplied hippocampus was an advantage in several cognitive domains, including verbal list learning and global cognition. A mixed supplied hippocampus also was an advantage for verbal memory performance in cerebral small vessel disease. Voxel-based morphometry showed higher anterior hippocampal grey matter volume in mixed, compared to single supply. We discuss that a mixed hippocampal supply, as opposed to a single one, may increase the reliability of hippocampal blood supply and thereby provide a hippocampal vascular reserve that protects against cognitive impairment.
Safety and Efficacy of Fidaxomicin and Vancomycin in Children and Adolescents with Clostridioides (Clostridium) difficile Infection: A Phase 3, Multicenter, Randomized, Single-blind Clinical Trial (SUNSHINE)
Authors: Wolf Joshua , Kalocsai Krisztina , Fortuny Claudia , Lazar Stefan , Bosis Samantha , Korczowski Bartosz , Petit Arnaud , Bradford Daniel , Croos-Dabrera Rodney , Incera Elodie , Melis Joost , van Maanen Rob 
Published: November 2019

Abstract

Background
Fidaxomicin, a narrow-spectrum antibiotic approved for Clostridioides (Clostridium) difficile infection (CDI) in adults, is associated with lower rates of recurrence than vancomycin; however, pediatric data are limited. This multicenter, investigator-blind, phase 3, parallel-group trial assessed the safety and efficacy of fidaxomicin in children.

Methods
Patients aged &lt;18 years with confirmed CDI were randomized 2:1 to 10 days of treatment with fidaxomicin (suspension or tablets, twice daily) or vancomycin (suspension or tablets, 4 times daily). Safety assessments included treatment-emergent adverse events. The primary efficacy end point was confirmed clinical response (CCR), 2 days after the end of treatment (EOT). Secondary end points included global cure (GC; CCR without CDI recurrence) 30 days after EOT (end of study; EOS). Plasma and stool concentrations of fidaxomicin and its active metabolite OP-1118 were measured.

Results
Of 148 patients randomized, 142 were treated (30 &lt;2 years old). The proportion of participants with treatment-emergent adverse events was similar with fidaxomicin (73.5%) and vancomycin (75.0%). Of 3 deaths in the fidaxomicin arm during the study, none were CDI or treatment related. The rate of CCR at 2 days after EOT was 77.6% (76 of 98 patients) with fidaxomicin and 70.5% (31 of 44) with vancomycin, whereas the rate of GC at EOS was significantly higher in participants receiving fidaxomicin (68.4% vs 50.0%; adjusted treatment difference, 18.8%; 95% confidence interval, 1.5%–35.3%). Systemic absorption of fidaxomicin and OP-1118 was minimal, and stool concentrations were high.

Conclusions
Compared with vancomycin, fidaxomicin was well tolerated and demonstrated significantly higher rates of GC in children and adolescents with CDI.

Clinical Trials Registration
NCT02218372
P11 KRT17 PROMOTES PROLIFERATION AND METASTASIS OF ESOPHAGEAL SQUAMOUS CELL CARCINOMA LEADING TO POOR PROGNOSIS
Authors: Zhun Liu , Zhimin Shen , Peipei Zhang , Shaobin Yu , Lei Gao , Sui Chen , Mingqiang Kang 
Published: November 2019

Abstract

Background
Keratin17(KRT17), as a multifunction cytoskeletal protein, associated with a multitudinous of biological processes, including cell proliferation, migration, and invasion. Previously, we have found overexpression of KRT17 genes in ESCC tissues. Currently, published kinds of researches claimed KRT17 is engaged in the tumorigenesis and progression of multiple cancers. However, the prognostic significance of KRT17 in ESCC patients and its effects in ESCC progression remain indistinct.

Methods
We verified the expression of KRT17 in ESCC tissues by Western blotting and q-PCR. And then the immunochemistry was performed to investigate the KRT17 expression in 64 ESCC tissue specimens. KRT17 upregulated, and knockdown EC9706 and Eca109 cells were constructed by Lentivirus overexpression and CRISPR-Cas9. The function of KRT17 in ESCC proliferation and metastasis were studied by CCK-8 assays, plate colony formation assays, trans-well and wound healing in vitro.

Results
overexpression of KRT17 was verified in 12 pairs of fresh ESCC tissues. We found that the expression of KRT17 was remarkably positively correlated with the depth of invasion (T) (P<0.05), lymph node metastasis (N) (P<0.05), tumor node metastasis (TNM) stage (P<0.0001). High expression of KRT17 predicted a lower 5-year survival rate(P<0.001) of ESCC patients. We verified the KRT17 malignant behavior of ESCC in vitro. We conformed proliferation and migration capacity of ESCC were significantly enhanced by overexpression of KRT17 but compromised when KRT17 was knocked down. Collectively, it supported that the increased expression of KRT17 promoted proliferation and migratory phenotype of ESCC.

Conclusion
The breakthrough indicated that the upregulation of KRT17 in ESCC is closely related to malignant progression, our findings revealed that KRT17 plays a vital role in facilitating proliferation and metastasis, and could be used as a novel predictive biomarker, thus providing a novel diagnosis and therapeutic target for ESCC patients.
Keywords: Molecular target ESCC Keratin17 Therapeutic target
P110 MANAGEMENT OF LIVER OLIGOMETASTATIC ESOPHAGEAL CANCER: REVIEW OF THE CURRENT INDICATIONS AND PROPOSAL FOR A MULTIMODALITY STRATEGY
Authors: Fabio Procopio , Salvatore Marano , Damiano Gentile , Anna Da Roit , Silvia Basato , Pietro Riva , Guido Torzilli , Carlo Castoro 
Published: November 2019

Abstract

Aim
Esophageal cancer (EC) is an aggressive disease associated with poor prognosis due to its metastatic spread. Surgery associated with chemotherapy (CHT)/chemo-radiotherapy represents the only curative treatment, however metastatic EC has not been treated with curative intent until now. Oligometastatic disease is defined as a relatively favorable clinical state, with a concentration metastasis to a single organ. Liver is one of the most common sites of metastasis, however treatment for liver oligometastatic EC (OEC) is still debated and its prognosis remains obscure. The aim of this review is to provide an overview of different treatments for liver OEC with a proposal of a multimodality strategy.

Methods
Literature search was conducted using PubMed, Embase and Cochrane to identify articles evaluating different treatment strategies for liver OEC.

Results
Liver OEC has been treated with either palliative therapy or multimodal approach (CHT+surgery/loco-regional therapies). Some small trials reported the benefits of hepatectomy in combination with CHT when applied to patients with low tumor burden (<3 lesions), therefore liver OEC patients should not be necessarily excluded from surgery. An alternative to surgery is represented by loco-regional therapies, including radiofrequency ablation (RFA), microwave ablation (MWA) and stereotactic body radiation therapy (SBRT). These treatments could be proposed to patients with small or non-resectable lesions. However, at present, there are no trials comparing these different treatment modalities.

Conclusion
In conclusion, we highlighted the need of a definition of treatment protocols and we propose our treatment flow-chart. However, prospective trials are needed to define universally accepted inclusion criteria, outcomes and timing for treatments.
O114 TUMOR VOLUME REGRESSION DURING NEOADJUVANT CHEMORADIOTHERAPY FOR ESOPHAGEAL CANCER: A PROSPECTIVE STUDY WITH WEEKLY MRI
Authors: Defize Ingmar L , Boekhoff Mick R , Borggreve Alicia S , Takahashi Noriyoshi , Ruurda Jelle P , van Hillegersberg Richard , Mook Stella , Meijer Gert J 
Published: November 2019

Abstract

Aim
To assess changes in tumor volume during neoadjuvant chemoradiotherapy (nCRT) for esophageal cancer with weekly MRI.

Background & Methods
Neoadjuvant chemoradiotherapy (nCRT) for esophageal cancer can cause tumor regression, however data on the magnitude of the volumetric changes during nCRT are scarce. Tumor regression can induce changes in the thoracic anatomy, with smaller target volumes and displacement of organs at risk (OARs) in close proximity to the tumor target as a result. Adaptation of the radiotherapy treatment plan according to volumetric changes during treatment might reduce dose to the OARs while maintaining adequate target coverage. In the current study patients with histologically proven esophageal cancer undergoing nCRT for esophageal cancer underwent 6 MRI scans: 1 scan prior to nCRT and 5 weekly scans during treatment. Tumors were delineated on T2 weighted images by two gastrointestinal radiation oncologists and volumetric changes were assessed.

Results
A total of 164 MRI scans of 28 patients were included. The mean tumor volume at baseline was 45ml (SD ± 23ml). Tumor volume regression started after the first week of nCRT and appeared to be a linear process with significant declines in tumor volume every subsequent week (p-values <0.05). The mean relative volume regression was 25% (SD ±15) between baseline and the fifth week of treatment (Figure 1.)

Conclusion
This study shows a significant linear decrease in tumor volume after the first week of nCRT for esophageal cancer on weekly MRI. These findings suggest the possible benefit of radiotherapy plan adaptations during nCRT.
P124 LOCALIZED ESOPHAGEAL NEUROENDOCRINE TUMORS. REPORT ON CLINICAL AND TREATMENT PARAMETERS FROM A TERTIARY HOSPITAL
Authors: Anna Koumarianou , Jose Duran Moreno , Katerina Kampoli , Aliki Liakea , Konstantinos Kostopanagiotou , Andromachi Kougioumtzopoulou , Gregory Kaltsas , Erasmia Vlachou , Maria Theochari , Periklis Tomos , Periklis Foukas 
Published: November 2019

Abstract

Aim
We retrospectively analyzed the medical files of patients treated with neuroendocrine neoplasms (NENs) of the esophagus in our unit.

Background & Methods
Esophageal NENs are rare and lacking functional symptoms. This results in a delay of diagnosis that may compromise patient survival. Numerous single cases are reported in literature, without a consensus on their management. The true incidence of esophageal NETs is unknown but evidence indicated geographic variability while smoking and alcohol abuse are the major risk factors. Men (60-70 years) are most commonly afflicted and usual symptoms include dysphagia and loss of appetite with consequent weight loss. The histologic subtypes reported in the literature include high or low-grade NETs and mixed neuroendocrine neoplasms (MINENs). Central pathology assessment significantly contributes to the accurate diagnosis and management. Personalised treatment depends on the grade, involved anatomic region and stage of disease and most commonly comprises combination chemotherapy and radiotherapy and rarely surgery.

Results
We report on three cases with localized esophageal NET diagnosed with endoscopic biopsies and staged with FDG or Gallium-PET CT scan. The mean age was 56, two were men and histologies included 1 MINEN (lower thoracic esophagus), 1 NET G3 (upper thoracic esophagus) and 1 NET G2 (middle thoracic esophagus). The patient with MINEN was stage 1b and was treated with complete esophagectomy and lymph nodal dissection without any further adjuvant therapy. Two patients with upper and middle thoracic esophagus were treated with combination chemotherapy and definitive IMRT radiotherapy. All patients remain disease free at 12 months follow up.

Conclusion
Localized esophageal NET are often diagnosed following endoscopic investigation. Long-term survival may be achieved with excellent quality of life after careful evaluation of the clinicopathologic characteristics by a dedicated multidisciplinary group.
P172 ESOPHAGEAL SUBMUCOSAL LIPOMA AND CONCOMITANT INEFFECTIVE MOTILITY: LAPAROSCOPIC TRANSHIATAL ENUCLEATION
Authors: Daniele Bernardi , Matteo Porta , Emanuele Asti , Stefano Siboni , Veronica Lazzari , Luigi Bonavina 
Published: November 2019

Abstract

Aim
To describe an unusual case of benign esophageal submucosal tumor.

Background
Esophageal lipomas account for less than 1% of benign tumors of the esophagus, which represent less than 1% of all esophageal neoplasms. The presence of a concomitant esophageal motility disorder may be underestimated in patients with benign esophageal submucosal tumors.

Case report
A 77-year-old man was referred for a 12-year history of daily heartburn, occasional dysphagia progressively worsening during the last few months, and more recent onset of epigastric pain, regurgitation, and weight loss. Empirical therapy with proton-pump inhibitors was ineffective. The GERD-HRQL score was 22. Physical examination was unremarkable. Upper gastrointestinal endoscopy showed a soft submucosal mass in the posterior wall of the lower third of the esophagus, 3 cm above the esophago-gastric junction. The endoscopic finding was confirmed by a chest CT scan that documented a submucosal esophageal lesion with luminal narrowing. High resolution manometry did not reveal EGJ obstruction but showed a pan-esophageal pressurization in 100% of the swallows. The patient underwent laparoscopic transhiatal enucleation of a 11x4 cm mass, suture repair of the esophageal muscle layer, posterior cruroplasty, and 270° Toupet fundoplication. The postoperative course was uneventful. A gastrographin swallow study on day 1 showed the normal esophagogastric transit and the absence of leaks. The patient was discharged on postoperative day 2. Pathology confirmed the clinical suspicion of esophageal lipoma. At 3-month follow-up visit the GERD-HRQL score was 7 and the patient was very pleased with the results of the operation.

Conclusion
Esophageal lipoma is very rare. Laparoscopic transhiatal enucleation was feasible and safe in our experience. The choice of a Toupet fundoplication was justified by the finding of ineffective esophageal motility on high-resolution manometry.