bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical predictive efficacy of C-reactive protein for diagnosing infectious complications after gastric surgery
Authors: Shi Jinyao , Wu Zhouqiao , Wang Qi , Zhang Yan , Shan Fei , Hou Shiyang , Ying Xiangji , Huangfu Longtao , Li Ziyu , Ji Jiafu 
Published: July 2020

Background: With the popularization of Enhanced Recovery After Surgery (ERAS), identifying patients with complications before discharging becomes important. This study aimed to explore the efficacy of C-reactive protein (CRP) in predicting infectious complications after gastrectomy. Methods: Patients with gastric cancer who underwent gastrectomy at Beijing Cancer Hospital from March 2017 to April 2018 were enrolled in the training set. Complications were prospectively registered. Receiver operating characteristic analysis was performed to assess the diagnostic accuracy of CRP via evaluating the area under the curve (AUC). Patients who had CRP tested on postoperative day (POD) 5 and accepted gastrectomy from April to December 2018 were included in the validation set to validate the cut-off value of CRP obtained from the training set. Results: A total of 350 patients were included (263 patients in the training set and 87 patients in the validation set). Out of these, 24 patients were diagnosed with infectious complications and 17 patients had anastomotic leakage in the training set. The CRP level on POD5 had superior diagnostic accuracy for infectious complications with an AUC of 0.81. The cut-off value of CRP on POD5 at 166.65 mg/L yielded 93% specificity and 97.2% negative predict value (NPV); For anastomotic leakage, the AUC of CRP on POD5 was 0.81. Using the cut-off value of CRP at 166.65 mg/L on POD5 achieved 92% specificity and 98.6% NPV. The optimal cut-off value (CRP 166.65 mg/L on POD5) was validated in the validation set. It achieved 97.5% specificity and 94.0% NPV for infectious complications, and 97.6% specificity and 96.4% NPV for anastomotic leakage. Conclusion: CRP is a reliable predictive marker for the diagnosis of inflammatory complications following gastric surgery. However, this study was based on preliminary data. The validity of this data needs confirmation by a larger number of cases.
Reverse shoulder arthroplasty glenoid lateralization influences scapular spine strains
Authors: Kerrigan Alicia M , Reeves Jake , Langohr G Daniel G , Johnson James A , Athwal George S 
Published: July 2020

Background Scapular spine insufficiency fractures following reverse shoulder arthroplasty are poorly understood. There exists limited literature regarding the role of reverse shoulder arthroplasty lateralization on scapular spine strains and fractures. The purpose of this cadaveric biomechanical simulator study was to evaluate the role of glenoid lateralization on scapular spine strain. Methods Eight cadaveric shoulders were tested using an in-vitro simulator. A custom modular reverse shoulder arthroplasty was implanted that allowed for in-situ glenoid lateralization adjustment. Scapular spine strain was measured by strain gauges placed in clinically relevant Levy zones along the scapular spine. All specimens were tested in loaded forward elevation and abduction. Results Glenoid lateralization from 0 to 5 mm caused negligible changes in scapular spine strains. Lateralization from 5 to 10 mm, however, caused significant increases in strain at 0° forward elevation in all strain gauges (p < 0.026). Strains measured in Levy zone 2 were significantly higher than all other locations (p < 0.039). Additionally, forward elevation resulted in significantly higher strain values than abduction (p = 0.001). Conclusions Glenoid lateralization is an important parameter in reverse shoulder arthroplasty; however, our results demonstrate higher degrees of lateralization may place higher strains on the scapular spine. An understanding of reverse shoulder arthroplasty lateralization and scapular spine strains is important to optimize parameters and to mitigate negative effects. Level of evidence Basic Sciences Study, Cadaveric Model, Biomechanics.
Use of patient derived orthotopic xenograft models for real-time therapy guidance in a pediatric sporadic malignant peripheral nerve sheath tumor
Authors: Fernández-Rodríguez Juana , Morales La Madrid Andrés , Gel Bernat , Castañeda Heredia Alicia , Salvador Héctor , Martínez-Iniesta María , Moutinho Catia , Morata Jordi , Heyn Holger , Blanco Ignacio , Creus-Bachiller Edgar , Capella Gabriel , Farré Lourdes , Vidal August , Soldado Francisco , Krauel Lucas , Suñol Mariona , Serra Eduard , Villanueva Alberto , Lázaro Conxi 
Published: July 2020

Background: The aim of this study was to test the feasibility and utility of developing patient-derived orthotopic xenograft (PDOX) models for patients with malignant peripheral nerve sheath tumors (MPNSTs) to aid therapeutic interventions in real time. Patient & Methods: A sporadic relapsed MPNST developed in a 14-year-old boy was engrafted in mice, generating a PDOX model for use in co-clinical trials after informed consent. SNP-array and exome sequencing was performed on the relapsed tumor. Genomics, drug availability, and published literature guided PDOX treatments. Results: A MPNST PDOX model was generated and expanded. Analysis of the patient’s relapsed tumor revealed mutations in the MAPK1, EED, and CDK2NA/B genes. First, the PDOX model was treated with the same therapeutic regimen as received by the patient (everolimus and trametinib); after observing partial response, tumors were left to regrow. Regrown tumors were treated based on mutations (palbociclib and JQ1), drug availability, and published literature (nab-paclitaxel; bevacizumab; sorafenib plus doxorubicin; and gemcitabine plus docetaxel). The patient had a lung metastatic relapse and was treated according to PDOX results, first with nab-paclitaxel, second with sorafenib plus doxorubicin after progression, although a complete response was not achieved and multiple metastasectomies were performed. The patient is currently disease free 46 months after first relapse. Conclusion: Our results indicate the feasibility of generating MPNST-PDOX and genomic characterization to guide treatment in real time. Although the treatment responses observed in our model did not fully recapitulate the patient’s response, this pilot study identify key aspects to improve our co-clinical testing approach in real time.
Procedure-specific prognostic impact of micropapillary subtype may guide resection strategy in small-sized lung adenocarcinomas: a multicenter study
Authors: Su Hang , Xie Huikang , Dai Chenyang , Zhao Shengnan , Xie Dong , She Yunlang , Ren Yijiu , Zhang Lei , Fan Ziwen , Chen Donglai , Jiang Feng , Liu Jinshi , Zhu Quan , Yao Jie , Ke Honggang , Zhang Lei , Wu Chunyan , Jiang Gening , Chen Chang 
Published: July 2020

Background: Limited resection has gradually become an acceptable treatment for lung adenocarcinomas (ADCs) presenting as ground-glass nodules (GGNs). However, its role in lung ADCs presenting as pure solid nodules (PSN) remains unclear. In this study, we aimed to identify potential candidates for limited resection in lung ADCs presenting as PSN. Methods: We retrospectively reviewed 772 patients from seven hospitals with lung ADCs ⩽2 cm, presenting as PSN on computed tomography scans, who had undergone surgery between 2009 and 2013. Histological subtypes were listed in 5% increments. To investigate the value of histological subtypes in surgical decision making, five pathologists prospectively evaluated the feasibility of identifying histological subtypes using frozen section (FS) in two cohorts. Results: The percentage of micropapillary (MIP) subtype had a striking impact on recurrence-free survival (RFS) and overall survival (OS) for lung ADCs ⩽2 cm presenting as PSNs. In multivariable Cox analysis, segmentectomy was significantly associated with worse RFS and OS in patients with MIP >5% than lobectomy, but not in those with MIP ⩽5%. With wedge resection, worse RFS and OS were observed in patients with MIP >5% and those with MIP ⩽5% than lobectomy. The sensitivity and specificity for detecting MIP by FS were 74.2% and 85.6%, respectively, with substantial inter-rater agreement. Conclusion: Segmentectomy and lobectomy had similar oncological outcomes in patients with lung ADCs ⩽2 cm presenting as PSN with MIP ⩽5%. Randomized trials are necessary to validate the feasibility of intraoperative FS to choose candidates for segmentectomy.
The role of intraoperative kidney mucosal biopsy on screening of squamous cell carcinoma of the kidney in nephrolithiasis patients with stones larger than 20 mm
Authors: Nugroho Tri Sunu Agung , Safriadi Ferry , Noegroho Bambang Sasongko 
Published: July 2020

Introduction: Renal pelvic squamous cell carcinoma is a very rare tumor, with a prevalence <1% of all urinary tract tumors, about 0.5–8% of all kidney tumors, and the average age is 50–70 years. Although the incidence of renal squamous cell carcinoma is less common than renal cell carcinoma and renal transitional cell carcinoma, due to its more aggressive nature renal squamous cell carcinoma is often found intraoperatively and is already in an advanced stage or metastasis. The relevant medical history of squamous cell carcinoma is pyelonephritis, chronic nephrolithiasis, and a history of kidney stone surgery. Data which was obtained from previous research at Hasan Sadikin Hospital, from January 2014–December 2017, found the incidence of renal squamous cell carcinoma from nephrectomy procedures was 6%. Methods: This study was a cross-sectional study with a correlative analytic study, samples were taken consecutively from biopsy of kidney mucosa intraoperatively in hospitalized patients with kidney stones with size larger than 20 mm at the Department of Urology, Hasan Sadikin Hospital Bandung, which performed open kidney surgery or percutaneous nephrolithotomy from January–May 2019. Results: The number of samples in this study were from 30 patients, consisting of 16 males and 14 females. Five patients underwent open kidney surgery and 25 patients underwent percutaneous nephrolithotomy surgery, with an average of age of 49.5±11.8 years and 63.3% of patients were aged from 40–60 years. In this study, one patient (3.3%) showed squamous cell carcinoma of the kidney, a 57-year-old male patient with a left staghorn kidney stone who underwent left percutaneous nephrolithotomy surgery. Conclusion: There is a benefit for intraoperative kidney mucosal biopsy as a screening for squamous cell carcinoma of the kidney in nephrolithiasis patients with stones larger than 20 mm. Level of evidence: 3
Evaluation of anterior inferior iliac spine impingement after hip arthroscopic osteochondroplasty using computer simulation analysis
Authors: Kobayashi Naomi , Choe Hyonmin , Ike Hiroyuki , Higashihira Shota , Kobayashi Daigo , Watanabe Shintaro , Kubota So , Inaba Yutaka 
Published: July 2020

Background: Anterior inferior iliac spine (AIIS) impingement is an important risk factor for revision hip arthroscopy. Although a morphological classification system is available, evaluating AIIS impingement with respect to joint kinematics remains a challenge. Purpose: To use computer simulation analysis to ascertain the prevalence of AIIS impingement before and after osteochondroplasty. Methods: A total of 35 joints from 30 cases (20 males and 10 females; average age: 43.3 ± 13.7 years) were analyzed. All joints had cam morphology and underwent hip arthroscopic osteochondroplasty. A three-dimensional model of each joint was constructed pre- and postoperatively. Joint kinematic simulation software (ZedHip®, Lexi, Tokyo) was used to identify the impingement point on the acetabular side and the incidence (expressed as a percentage) of AIIS impingement calculated. Radiographic and clinical evaluation was performed pre- and postoperatively. Results: AIIS impingement was observed postoperatively in six joints but preoperatively in only one joint. The rate of AIIS postoperative impingement was significantly higher than that of preoperative impingement. All impingement points were located on the inferior aspect of the AIIS apex. However, there were no significant differences between the AIIS impingement and non-impingement groups in terms of clinical outcome. Conclusion: The incidence of AIIS impingement after osteochondroplasty was 17% by computer simulation analysis. Osteochondroplasty may result in subsequent AIIS impingement.
Epidemiology, incidence, and survival of synovial sarcoma subtypes: SEER database analysis
Authors: Aytekin Mahmut Nedim , Öztürk Recep , Amer Kamil , Yapar Aliekber 
Published: July 2020

Background: Synovial sarcoma (SyS) is a rare malignancy that is typically located on the limbs and occurs predominantly in adolescents. A study in a large population for SyS comparing subtypes has not yet been reported. Methods: National Cancer Institute’s Surveillance, Epidemiology, and End Results database was queried for patients diagnosed with SyS between January 1975 and December 2016. Patients were classified demographically according to gender, age, race/ethnicity, and marital status, and they were also classified by tumors, subtypes, localization, grade, year of diagnosis, laterality, type of treatment, and follow-up results. Results: A total of 3228 patients were included, with a mean age of 39.3 ± 18.8 (range: 1–94), of which 1521 (47.1%) were females and 1707 (52.9%) were males. According to its subtypes, 47.2% were SyS not otherwise specified, 32.3% were spindle cell, 19.9% were biphasic, and 0.6% were epithelioid type. The overall survival period is 138.0 (95% confidence interval: 113.2–162.8) months. Survival duration was found to be significantly different between groups according to gender (log-rank test; p < 0.001), age groups (log-rank test; p < 0.001), race (log-rank test; p = 0.001), marital status (log-rank test; p < 0.001), tumor subtypes (log-rank test; p < 0.001), tumor location (log-rank test; p < 0.001), tumor laterality (log-rank test; p < 0.001), date of diagnosis (log-rank test; p = 0.025), tumor grade (log-rank test; p < 0.001), historic stage (log-rank test; p < 0.001), state of chemotherapy (log-rank test; p < 0.001), state of radiotherapy (log-rank test; p < 0.001), presence of metastasis (log-rank test; p < 0.001), and total number of malignant tumors (log-rank test; p < 0.001). Conclusion: Male gender, being colored individual, being over 35 years at the time of diagnosis, epithelioid type, non-head and neck region localization is associated with poor prognosis. While radiotherapy improves survival, benefit of chemotherapy is unclear. Level of Evidence: III retrospective analysis.
Investigation of Impact Strength, Water Sorption and Cytotoxicity of Denture Base Resin Reinforced with Polypropylene Fiber: In Vitro Study
Authors: Tugut Faik , Coskun Mehmet Emre , Akin Hakan , Dogan Derya Ozdemir 
Published: July 2020

Aim: Polymethyl methacrylate is the common material used as a denture base. Ease of application, stability in the oral environment are its advantages; however, its mechanical properties should be enhanced. This study aimed to evaluate the effect of different ratios of polypropylene fiber (PPF) in addition to denture base materials on impact strength, water sorption, and cytotoxicity. Materials and Methods: Heat-cure acrylic resin specimens were prepared according to the manufacturer’s instruction by adding PPFs of 6 mm length in different ratios (1, 3, 5, 10, and 20 wt%). In order to determine the impact strength, specimens were subjected to a Charpy impact test machine after being kept in distilled water at 37°C for 48 h. A span of 40 mm was adjusted and a 0.5 J pendulum was used. The fractured surface of specimens was also analyzed using a scanning electron microscope. In addition, mouse fibroblast cells and agar diffusion tests were used for cytotoxicity determination. The results were analyzed using the Kruskal–Wallis and the Mann–Whitney U tests for determining impact strength, and Kruskal–Wallis and Tukey’s range tests were performed for determining water sorption values ( P = 0.05). Results: 5 wt% PPF group exhibited the highest water sorption and impact strength values, and the difference was statistically significant ( P < .05). On the other hand, no cytotoxic effects were determined in PPF added groups. Furthermore, increased fiber concentration caused less water sorption. Conclusion: Addition of PPFs in acrylic resin increased the impact strength and decreased water sorption without any cytotoxic effects.
Evaluation of Polypropylene Fiber Reinforced Glass Ionomer Cement: A Comparative In-Vitro Study
Authors: Oznurhan Fatih , Ozturk Ceren 
Published: July 2020

Aim: To compare the surface roughness, microtensile bond strength (µTBS), and flexural strength of polypropylene (PP) fibers reinforced glass ionomer cements (GICs). Materials and Methods: A comparative in vitro study was designed to test the PP fiber reinforced GIC, which was formed when 0.5–1 mm length PP fibers were added into the powder of conventional GIC. Four groups were prepared (Group 1: control, Group 2: 1 wt% PP fiber, Group 3: 3 wt% PP fiber, and Group 4: 5 wt% PP fiber) to evaluate flexural strength, surface roughness values, and µTBS. A total of 10 samples with 25 × 2.5 × 5 mm dimensions were prepared for each group to test flexural strength. Disk-shaped specimens ( n = 10) of 2 mm thickness and 10 mm diameter were used to test surface roughness. A total of 24 human primary molar teeth were used to evaluate µTBS, and 12 sticks were obtained for each group. The fractured surface analyses of samples from µTBS was performed using scanning electron microscope. The data obtained from the experiments were recorded and analyzed with one-way analyses of variance technique, and the normality was tested using the Shapiro–Wilk technique. A significance level of .05 was used. Results: In flexural strength tests, Group 3 (3 wt% PP fiber) showed significantly increased values ( p < .05) when compared with other groups. Group 4 (5 wt% PP) showed significantly highest values in surface roughness tests ( p < .05). No significant differences were seen between the groups ( p > .05) according to µTBS results. More PP fibers were seen in fractured surfaces, when PP ratio increases. Conclusion: It was observed that increased PP fiber percentage showed increased surface roughness, and 3 wt% PP fiber gave optimal values for fracture toughness. Incorporation of PP fiber to GIC does not affect the bonding to primary tooth dentine.
EmPHasis-10 health-related quality of life score predicts outcomes in patients with idiopathic and connective tissue disease-associated pulmonary arterial hypertension: results from a UK multicentre study
Authors: Lewis Robert A. , Armstrong Iain , Bergbaum Carmel , Brewis Melanie J. , Cannon John , Charalampopoulos Athanasios , Church A. Colin , Coghlan J. Gerry , Davies Rachel J. , Dimopoulos Konstantinos , Elliot Charlie , Gibbs J. Simon R. , Gin-Sing Wendy , Haji Gulam , Hameed Abdul G. , Howard Luke S. , Johnson Martin K. , Kempny Aleksander , Kiely David G. , Lo Giudice Francesco , McCabe Colm , Peacock Andrew J. , Peleyeju Oyinkansola , Pepke-Zaba Joanna , Polwarth Gary , Price Laura , Sabroe Ian , Schreiber Benjamin E. , Sheares Karen , Taboada Dolores , Thompson A.A. Roger , Toshner Mark R. , Wanjiku Ivy , Wort S. John , Yorke Janelle , Condliffe Robin 
Published: July 2020

Health-related quality of life (HRQoL) scores assess symptom burden in pulmonary arterial hypertension (PAH) but data regarding their role in prognostication and risk stratification are limited. We assessed these relationships using the emPHasis-10 HRQoL measure.1745 patients with idiopathic PAH (IPAH), drug-induced PAH (DPAH), heritable PAH (HPAH) (collectively “(I/D/H)PAH”), or connective tissue disease-associated PAH (CTD-PAH), who had completed emPHasis-10 questionnaires at one of six UK referral centres between 2014 and 2017, were identified. Correlations with exercise capacity and World Health Organization (WHO) functional class were assessed, and exploratory risk stratification thresholds were tested.Moderate correlations were seen between emPHasis-10 scores and 6-min walk distance (r=−0.546), incremental shuttle walk distance (r=−0.504) and WHO functional class (r=0.497) (all p<0.0001). Distribution of emPHasis-10 score differed significantly between each WHO functional class (all p<0.0001). On multivariate analysis, emPHasis-10 score, but not WHO functional class, was an independent predictor of mortality. In a risk stratification approach, scores of 0–16, 17–33 and 34–50 identified incident patients with 1-year mortality of 5%, 10% and 23%, respectively. Survival of patients in WHO functional class III could be further stratified using an emPHasis-10 score ≥34 (p<0.01). At follow-up, patients with improved emPHasis-10 scores had improved exercise capacity (p<0.0001) and patients who transitioned between risk groups demonstrated similar survival to patients originally in those risk groups.The emPHasis-10 score is an independent prognostic marker in patients with (I/D/H)PAH or CTD-PAH. It has utility in risk stratification in addition to currently used parameters. Improvement in emPHasis-10 score is associated with improved exercise capacity.
Sparse reduced-rank regression for integrating omics data
Authors: Hilafu Haileab , Safo Sandra E. , Haine Lillian 
Published: July 2020

AbstractBackgroundThe problem of assessing associations between multiple omics data including genomics and metabolomics data to identify biomarkers potentially predictive of complex diseases has garnered considerable research interest nowadays. A popular epidemiology approach is to consider an association of each of the predictors with each of the response using a univariate linear regression model, and to select predictors that meet a priori specified significance level. Although this approach is simple and intuitive, it tends to require larger sample size which is costly. It also assumes variables for each data type are independent, and thus ignores correlations that exist between variables both within each data type and across the data types.ResultsWe consider a multivariate linear regression model that relates multiple predictors with multiple responses, and to identify multiple relevant predictors that are simultaneously associated with the responses. We assume the coefficient matrix of the responses on the predictors is both row-sparse and of low-rank, and propose a group Dantzig type formulation to estimate the coefficient matrix.ConclusionExtensive simulations demonstrate the competitive performance of our proposed method when compared to existing methods in terms of estimation, prediction, and variable selection. We use the proposed method to integrate genomics and metabolomics data to identify genetic variants that are potentially predictive of atherosclerosis cardiovascular disease (ASCVD) beyond well-established risk factors. Our analysis shows some genetic variants that increase prediction of ASCVD beyond some well-established factors of ASCVD, and also suggest a potential utility of the identified genetic variants in explaining possible association between certain metabolites and ASCVD.