bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retrospective survival analysis of stage II–III rectal cancer: tumour regression grade, grading and lymphovascular invasion are the only predictors
Authors: Morini Andrea , Annicchiarico Alfredo , Romboli Andrea , Ricco' Matteo , Crafa Pellegrino , Montali Filippo , Dell'Abate Paolo , Costi Renato 
Published: December 2020

AbstractBackgroundTumour regression grade is gaining interest as a prognostic factor of patients undergoing neoadjuvant chemoradiotherapy and surgery for locally advanced rectal cancer.MethodsA series of 68 consecutive patients with locally advanced rectal cancer treated by neoadjuvant chemoradiotherapy and surgery between 2010 and 2016 was retrospectively studied. The impact on disease‐free survival (DFS) and overall survival (OS) of several criteria was analysed. Univariate analysis was performed through Kaplan–Meier statistics. Multivariate analysis was performed through Cox regression model. Using criteria found to be related to long‐term outcomes, a predictive model of patient's OS was calculated.ResultsPoor tumour regression grade – TRG3 (P = 0.010), poor grading – G3 (P = 0.001) and lymphovascular invasion (LVI; P = 0.030) were associated with short OS at univariate analysis. OS was associated with TRG3 and G3 at multivariate analysis (P = 0.016 and P = 0.027, respectively). DFS was associated with LVI (P = 0.001), G3 tumours (P = 0.046) and TRG3 (P = 0.045) at univariate analysis. At multivariate analysis, only LVI was associated with DFS (P = 0.041). A score, pondering the impact of three parameters (2 points for TRG3, 2 for G3 and 1 for LVI), was created and resulted to predict patient OS (P = 0.008), ranging from 94.5 months (score = 0–1) to 32 months (score = 3–5).ConclusionTRG3 and G3 were associated with poor OS, and LVI was the most significant predictor of DFS. An easy‐to‐use score may allow for a more accurate prediction of OS.
Thyroid gland metastasis from renal cell carcinoma: a case series and literature review
Authors: Tjahjono Richard , Phung Daniel , Gurney Howard , Gupta Ruta , Riffat Faruque , Palme Carsten E. 
Published: December 2020

AbstractBackgroundRenal cell carcinoma (RCC) is the most common malignancy that metastasises to the thyroid. This study aims to better understand the clinical characteristics of patients with thyroid metastasis from RCC.MethodsA retrospective case series of patients with thyroid metastasis from RCC between 2008 and 2020 from two tertiary centres were examined. MEDLINE and PubMed database searches were performed to retrieve the relevant literature.ResultsFifteen patients (eight males) were identified, with a median age of 57.0 (interquartile range (IQR) 51.0–63.0) at time of RCC diagnosis. Median time to thyroid metastasis was 92.0 months (IQR 40.0–156.0), with 12 (80.0%) patients undergoing thyroidectomy within 2 months of diagnosis. No patients developed post‐operative complications or local thyroid recurrence. The two most common non‐thyroid metastatic sites in this case series are lungs and bone (five patients, respectively; 33.3%) and pancreas (four patients; 26.7%). Ten (66.6%) patients underwent systemic chemotherapy, and five (33.4%) patients underwent radiotherapy for other sites of metastasis. Median survival following thyroid metastasis was 54.0 months (IQR 15.0–100.0). The literature review was conducted through MEDLINE and PubMed database searches, and 30 papers were considered relevant to this review. Results from our study are comparable to those reported in the literature.ConclusionThyroid metastases can occur long after nephrectomy and portends a better prognosis. To prevent development of central neck disease, thyroidectomy should be considered.
Management of Boerhaave syndrome in Australasia: a retrospective case series and systematic review of the Australasian literature
Authors: Allaway Matthew G. R. , Morris Paul D. , B. Sinclair Jane‐Louise , Richardson Arthur J. , Johnston Emma S. , Hollands Michael J. 
Published: December 2020

AbstractBackgroundBoerhaave syndrome is a rare and life‐threatening condition characterized by a spontaneous transmural tear of the oesophagus. There remains wide variation in the condition's management with non‐operative management (NOM) and surgery being the two main treatment strategies. The aim was to review the presentation, management and outcomes for patients treated for Boerhaave syndrome at our institution and to compare these data with that previously reported within the Australasian literature.MethodsA retrospective case series was performed for consecutive patients diagnosed with Boerhaave syndrome at our institution between January 2000 and January 2020. A systematic review of the Australasian literature was also performed.ResultsIn case series, 15 patients were included (n = 2 NOM, n = 13 operative). The most common operative technique was primary repair with intercostal drainage via thoracotomy. Major complications occurred in 11 (73%) patients. Median Comprehensive Complication Index was 53.4 (interquartile range: 50). There was a significantly lower Comprehensive Complication Index associated with primary repair when compared to oesophageal resection (P = 0.01). There was one death, in the operative management group. Median length of hospital stay was 33 days (interquartile range: 58). In systematic review, 11 articles were included; four case series and seven case reports. From these, 23 patients met inclusion criteria. The majority of patients (83%) were managed operatively, with only four undergoing NOM. Seven patients died, representing an overall mortality rate of 30%.ConclusionsWe provide an updated overview of the management of Boerhaave syndrome within Australasia. Aggressive operative management is associated with reasonable outcomes.
Transabdominal and transperineal ultrasound vs routine care before instrumental vaginal delivery – A randomized controlled trial
Authors: Barros Joana G. , Afonso Maria , Martins Ana T. , Carita Ana I. , Clode Nuno , Ayres‐de‐Campos Diogo , Graça Luís M. 
Published: December 2020

AbstractIntroductionThe role of intrapartum ultrasound as an ancillary method to instrumental vaginal delivery is yet to be determined. This study aimed to compare the use of transabdominal and transperineal ultrasound with routine clinical care before performing an instrumental vaginal delivery, regarding the incidence of adverse maternal and neonatal outcomes.Material and MethodsA randomized controlled trial was conducted between October 2016 and March 2019 in two tertiary care maternity hospitals in Lisbon, Portugal. Women at term, with full cervical dilatation, singleton fetuses in cephalic presentation, and with an established indication for instrumental vaginal delivery, were approached for enrollment. After informed consent was obtained, randomization into one of two groups was carried out. In the experimental arm, women underwent transabdominal ultrasound for determination of the fetal head position and transperineal ultrasound for evaluation of the angle of progression, before instrumental vaginal delivery. In the control arm, no ultrasound was carried out before instrumental vaginal delivery. Primary outcomes were composite measures of maternal and neonatal morbidity. Composite maternal morbidity consisted of severe postpartum hemorrhage, perineal trauma, and prolonged hospital stay. Composite neonatal morbidity consisted of low 5‐minute Apgar score, umbilical artery metabolic acidosis, birth trauma, and neonatal intensive care unit admission.ResultsA total of 222 women were enrolled (113 in the experimental arm and 109 in the control arm). No significant differences between the two arms were found in composite measures of maternal (23.9% in the experimental group vs 22.9% in the control group, odds ratio 1.055, 95% CI 0.567‐1.964) or neonatal morbidity (9.7% in the experimental group vs 6.4% in the control group, odds ratio 1.571, 95% CI 0.586‐4.215), nor in any of the individual outcomes.ConclusionsIn this small randomized controlled trial that was stopped for futility before reaching the required sample size, transabdominal and transperineal ultrasound performed just before instrumental vaginal delivery did not reduce the incidence of adverse maternal and neonatal outcomes, when compared with routine clinical care.
Measuring Multi‐Dimensional Labour Law Violation with an Application to South Africa
Authors: Bhorat Haroon , Kanbur Ravi , Stanwix Benjamin , Thornton Amy 
Published: December 2020

AbstractThe rights of workers contained in labour law are multi‐dimensional, and where workers face violations in more than one dimension, this compounds worker vulnerability. Yet, past analysis has tended to concentrate on compliance one dimension at a time — often with an almost exclusive focus on minimum wages. How can we conceptualize and measure compliance with labour laws more comprehensively? This article draws on the multi‐dimensional poverty literature to set up an index that measures the extent of labour law violation along different dimensions. This index is then applied to South Africa to illustrate its application, and examine the insights such an index can provide on the nature and granular structure of compliance and levels of worker vulnerability. A quantile regression approach reveals how correlates of compliance vary substantially across the distribution of violation, highlighting that the probability of violation at the individual level is not linear but multiplicative in nature. As in the field of poverty studies, the development of multi‐dimensional measures for labour violation can offer a broader understanding of the impact of overlapping vulnerabilities.
p62 is a useful predictive marker for tumour regression after chemoradiation therapy in patients with advanced rectal cancer: an immunohistochemical study
Authors: Kobayashi Toshinori , Ishida Mitsuaki , Miki Hisanori , Matsumi Yuki , Fukui Toshiro , Hamada Madoka , Tsuta Koji , Sekimoto Mitsugu 
Published: December 2020

AbstractAimThis study aimed to evaluate the relationship between p62 expression status and tumour regression grade in advanced rectal cancer.MethodsWe enrolled 47 consecutive patients with advanced rectal cancer who underwent chemoradiation therapy (CRT) before surgery. p62 expression in the biopsy specimens was immunohistochemically evaluated, and p62 expression score (staining intensity × positive tumour cells, %) was calculated (range 0–300). The relationship between p62 expression score and CRT effect was analysed.ResultsThe staining intensity was +2 and +3 in 29 and 18 patients, respectively. The median proportion of positive neoplastic cells was 87.8%, and that of the p62 expression score was 200. Stronger staining intensity and a higher proportion of p62‐positive neoplastic cells were significantly associated with CRT non‐effectiveness (P = 0.0002 and P = 0.0116, respectively), and a higher p62 expression score was significantly associated with CRT non‐effectiveness (P < 0.0001). The optimal cut‐off value for predicting the CRT effect was 240.ConclusionsA higher p62 expression score was significantly associated with less CRT effectiveness in patients with advanced rectal cancer. Analysis of p62 expression score using biopsy specimens is a useful and easily assessable prediction marker for CRT effect and might help select patients who can undergo a ‘watch‐and‐wait’ strategy after CRT.
N‐Sulphonatoalkyl indophenine derivatives: Design, synthesis and dyeing properties on wool, silk and nylon fabrics
Authors: Cai Jinfang , Jiang Hua , Cui Zhihua , Chen Weiguo 
Published: December 2020

AbstractThe importance of quinonoidal planarity in improving the wet fastness of acid dyes was studied in a new series of N‐sulphonatoalkyl‐substituted indophenine derivatives. These derivatives were synthesised via the sulphonatoalkylation reaction of isatins with alkanesultone or sodium bromoalkanesulphonate followed by the indophenine reaction. The effects of the position of sulphonic acid groups, length of the alkyl chain, and electron‐donating/withdrawing groups on geometry, electronic structure, solubility, and absorption properties were systematically examined and correlated with the performances of the dyes on wool, silk and nylon fabrics. The N‐sulphonatoalkyl indophenine dyes could exhibit a blue colour in N,N‐dimethylformamide (DMF) and on silk or nylon fabric but a purplish colour in water and on wool fabric. Methoxy groups had a negative impact on the molar extinction coefficient and dye exhaustion, leading to relatively poor dyeing performance. In comparison, fluorine or chlorine atoms were less influential. The introduction of nitro groups could induce a yellowness to the dyed fabrics caused by the strengthened absorption at the region of 360 to 420 nm and reduce the dyeing rate and wet fastness level due to the low dye–fibre affinity. In general, the N‐sulphonatoalkyl indophenine dyes exhibited satisfactory washing and rubbing fastness, especially on dyed nylon fabric. This study provides insight into the structure–property relationship of indophenine dyes and demonstrates that sulphonatoalkylation is an efficient methodology for designing high‐performance textile dyestuffs based on quinonoidal heterocyclic structures.
Relation of sputum neutrophilia to the development of chronic lung allograft dysfunction after lung transplantation
Authors: Sikkeland Liv Ingunn Bjoner , Durheim Michael Thomas , Riste Tonje Bøyum , Kongerud Johny , Alexis Neil E. , Holm Are Martin 
Published: December 2020

AbstractChronic lung allograft dysfunction (CLAD) is a serious complication after lung transplantation (LuTx) and is associated with elevated proportions of neutrophils in bronchoalveolar lavage (BAL). Induced sputum is a less‐invasive sampling method than BAL and assesses markers of inflammation on the surfaces of large central airways. We wanted to examine whether % neutrophil levels in induced sputum were elevated prior to CLAD diagnosis among LuTx recipients, and whether sputum markers of inflammation can be used as a tool for predicting the development of CLAD. Induced sputum samples were collected at 1, 3, 6, 12, and 24 months post‐LuTx in 36 patients with a history of COPD or pulmonary fibrosis, and of these, 16 developed CLAD either during or after the sputum surveillance period. At 2 years, median (IQR) % neutrophils in induced sputum were significantly higher among patients with CLAD compared with those without CLAD [73 (52‐80) % vs 59 (41‐76) %, p = .01]. Interestingly, we found a significant increase in the rate of change in % neutrophils beginning at 90 days preceding the diagnosis of CLAD. This suggests using sputum neutrophil percentage as a surveillance modality for monitoring lung allograft function after LuTx.
Cervical dysplasia in a patient with inherited epidermodysplasia verruciformis—A mere coincidence?
Authors: Singh Amrit P. , Jeffus Susanne K. , Shalin Sara C. 
Published: December 2020

AbstractEpidermodysplasia verruciformis (EV) is a rare inherited or acquired genodermatosis caused by increased susceptibility to infection by the beta subtypes of human papillomavirus (HPV). The co‐occurrence of EV with high‐risk (HR) HPV infection leading to cervical dysplasia is unreported in the literature to date. We report a patient with inherited EV who developed extensive anogenital and cervical dysplasia linked to concurrent HR‐HPV infection. Literature review suggests that there is a negative correlation of cervical dysplasia and cervical cancer with EV, which suggests that this patient's presentation and course are exceptional.
Alcohol retail privatisation in Canadian provinces between 2012 and 2017. Is decision making oriented to harm reduction?
Authors: Giesbrecht Norman , Wettlaufer Ashley , Stockwell Tim , Vallance Kate , Chow Clifton , April Nicole , Asbridge Mark , Callaghan Russell , Cukier Samantha , Hynes Geoff , Mann Robert E. , Solomon Robert , Thomas Gerald , Thompson Kara 
Published: December 2020

AbstractIntroductionPolicy changes may contribute to increased alcohol‐related risks to populations. These include privatisation of alcohol retailing, which influences density of alcohol outlets, location of outlets, hours of sale and prevention of alcohol sales to minors or intoxicated customers. Meta‐analyses, reviews and original research indicate enhanced access to alcohol is associated with elevated risk of and actual harm. We assess the 10 Canadian provinces on two alcohol policy domains—type of alcohol control system and physical availability of alcohol—in order to track changes over time, and document shifting changes in alcohol policy.MethodsOur information was based on government documents and websites, archival statistics and key informant interviews. Policy domains were selected and weighted for their degree of effectiveness and population reach based on systematic reviews and epidemiological evidence. Government representatives were asked to validate all the information for their jurisdiction.ResultsThe province‐specific reports based on the 2012 results showed that 9 of 10 provinces had mixed retail systems—a combination of government‐run and privately owned alcohol outlets. Recommendations in each provincial report were to not increase privatisation. However, by 2017 the percentage of off‐premise private outlets had increased in four of these nine provinces, with new private outlet systems introduced in several.Discussion and ConclusionsDecision‐making protocols are oriented to commercial interests and perceived consumer convenience. If public health and safety considerations are not meaningfully included in decision‐making protocols on alcohol policy, then it will be challenging to curtail or reduce harms.
Effects of dapagliflozin on prevention of major clinical events and recovery in patients with respiratory failure because of COVID‐19: Design and rationale for the DARE‐19 study
Authors: Kosiborod Mikhail , Berwanger Otavio , Koch Gary G. , Martinez Felipe , Mukhtar Omar , Verma Subodh , Chopra Vijay , Javaheri Ali , Ambery Philip , Gasparyan Samvel B. , Buenconsejo Joan , Sjöström C. David , Langkilde Anna Maria , Oscarsson Jan , Esterline Russell 
Published: December 2020

AbstractAimsCoronavirus disease 2019 (COVID‐19) is caused by a novel severe acute respiratory syndrome coronavirus 2. It can lead to multiorgan failure, including respiratory and cardiovascular decompensation, and kidney injury, with significant associated morbidity and mortality, particularly in patients with underlying metabolic, cardiovascular, respiratory or kidney disease. Dapagliflozin, a sodium‐glucose cotransporter‐2 inhibitor, has shown significant cardio‐ and renoprotective benefits in patients with type 2 diabetes (with and without atherosclerotic cardiovascular disease), heart failure and chronic kidney disease, and may provide similar organ protection in high‐risk patients with COVID‐19.Materials and methodsDARE‐19 (NCT04350593) is an investigator‐initiated, collaborative, international, multicentre, randomized, double‐blind, placebo‐controlled study testing the dual hypotheses that dapagliflozin can reduce the incidence of cardiovascular, kidney and/or respiratory complications or all‐cause mortality, or improve clinical recovery, in adult patients hospitalized with COVID‐19 but not critically ill on admission. Eligible patients will have ≥1 cardiometabolic risk factor for COVID‐19 complications. Patients will be randomized 1:1 to dapagliflozin 10 mg or placebo. Primary efficacy endpoints are time to development of new or worsened organ dysfunction during index hospitalization, or all‐cause mortality, and the hierarchical composite endpoint of change in clinical status through day 30 of treatment. Safety of dapagliflozin in individuals with COVID‐19 will be assessed.ConclusionsDARE‐19 will evaluate whether dapagliflozin can prevent COVID‐19‐related complications and all‐cause mortality, or improve clinical recovery, and assess the safety profile of dapagliflozin in this patient population. Currently, DARE‐19 is the first large randomized controlled trial investigating use of sodium‐glucose cotransporter 2 inhibitors in patients with COVID‐19.
Gene expression analysis in epileptic hippocampi reveals a promoter haplotype conferring reduced aldehyde dehydrogenase 5a1 expression and responsiveness
Authors: Tsortouktzidis Despina , Schulz Herbert , Hamed Motaz , Vatter Hartmut , Surges Rainer , Schoch Susanne , Sander Thomas , Becker Albert J. , van Loo Karen M. J. 
Published: December 2020

AbstractIncreasing evidence indicates the pathogenetic relevance of regulatory genomic motifs for variability in the manifestation of brain disorders. In this context, cis‐regulatory effects of single nucleotide polymorphisms (SNPs) on gene expression can contribute to changing transcript levels of excitability‐relevant molecules and episodic seizure manifestation in epilepsy. Biopsy specimens of patients undergoing epilepsy surgery for seizure relief provide unique insights into the impact of promoter SNPs on corresponding mRNA expression. Here, we have scrutinized whether two linked regulatory SNPs (rs2744575; 4779C > G and rs4646830; 4854C > G) located in the aldehyde dehydrogenase 5a1 (succinic semialdehyde dehydrogenase; ALDH5A1) gene promoter are associated with expression of corresponding mRNAs in epileptic hippocampi (n = 43). The minor ALDH5A1‐GG haplotype associates with significantly lower ALDH5A1 transcript abundance. Complementary in vitro analyses in neural cell cultures confirm this difference and further reveal a significantly constricted range for the minor ALDH5A1 haplotype of promoter activity regulation through the key epileptogenesis transcription factor Egr1 (early growth response 1). The present data suggest systematic analyses in human hippocampal tissue as a useful approach to unravel the impact of epilepsy candidate SNPs on associated gene expression. Aberrant ALDH5A1 promoter regulation in functional terms can contribute to impaired γ‐aminobutyric acid homeostasis and thereby network excitability and seizure propensity.
High‐resolution single‐cell transcriptomics reveals heterogeneity of self‐renewing hair follicle stem cells
Authors: Chovatiya Gopal , Ghuwalewala Sangeeta , Walter Lauren D. , Cosgrove Benjamin D. , Tumbar Tudorita 
Published: December 2020

AbstractMultipotent bulge stem cells (SCs) fuel the hair follicle (HF) cyclic growth during adult skin homeostasis, but their intrinsic molecular heterogeneity is not well understood. These hair follicle stem cells (HFSCs) engage in bouts of self‐renewal, migration and differentiation during the hair cycle. Here, we perform high‐resolution single‐cell RNA sequencing (scRNA‐seq) of HFSCs sorted as CD34+/K14‐H2BGFP+ from mouse skin at mid‐anagen, the self‐renewal stage. We dissect the transcriptomic profiles and unravel population‐specific transcriptional heterogeneity. Unsupervised clustering reveals five major HFSC populations, which distinguished by known markers associated with both the bulge and the outer root sheath (ORS) underneath. These populations include quiescent bulge, ORS cellular states and proliferative cells. Lineage trajectory analysis predicted the prospective differentiation path of these cellular states and their corresponding self‐renewing subpopulations. The bulge population itself can be further sub‐divided into distinct subpopulations that can be mapped to the upper, mid and lower bulge regions, and present a decreasing quiescence score. Gene set enrichment analysis (GSEA) revealed new markers and suggested potentially distinct functions of the ORS and bulge subpopulations. This included communications between the upper bulge subpopulation and sensory nerves and between the upper ORS and skin vasculature, as well as enrichment of a bulge subset in cell migratory functions. The lower ORS enriched genes may potentially enable nutrients passing from the surrounding fat and vasculature cells towards the proliferating hair matrix cells. Thus, we provide a comprehensive account of HFSC molecular heterogeneity during their self‐renewing stage, which enables future HF functional studies.