bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and Validation of a Nomogram to Predict Overall Survival for Patients with Metastatic Renal Cell Carcinoma
Authors: Zheng Wenwen , Zhu Weiwei , Yu Shengqiang , Li Kangqi , Ding Yuexia , Wu Qingna , Tang Qiling , Zhao Quan , Lu Congxiao , Guo Chenyu 
Published: May 2020

Abstract
Background: The prognosis of metastatic renal cell carcinoma (RCC) patients vary widely because of clinical and pathological heterogeneity.We aimed to develop a novel nomogram to predict overall survival (OS) for this population.Methods: Metastatic RCC patients were selected from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2016. These patients wererandomly assignedto a training set and a validation set at a ratio of 1:1. Significant prognostic factors of survival were identified through Cox regression models and then integrated to form a nomogram to predict 1-, 3- and 5-year OS. The nomogram was subsequently subjected to validationsvia the training and the validation sets. The performance of this model was evaluated by using Harrell’s concordance index (C-index), calibration curve, integrated discrimination improvement (IDI), net reclassification improvement (NRI), and decision curve analysis (DCA). Results: Overall, 2315 eligible metastatic RCC patients were enrolled from the SEER database. A nomogram of survival prediction for patients of newly diagnosed with metastatic RCC was established, in which eight clinical factors significantly associated with OS were involved, including Fuhrman grade, lymph node status, sarcomatoid feature, cancer-directed surgery, bone metastasis, brain metastasis, liver metastasis, and lung metastasis.The new model presented better discrimination power than the American Joint Committee on Cancer (AJCC) staging system (7th edition) in the training set (C-indexes, 0.701 vs. 0.612, P<0.001) and the validation set (C-indexes, 0.675 vs. 0.600, P<0.001). The calibration plots of the nomogram exhibited optimal agreement between the predicted values and the observed values.The results of NRI and IDI also indicated the superior predictive capability of the nomogram relative to the AJCC staging system. The DCA plots revealed higher clinical use of our model in survival prediction.Conclusions: We developed and validated an effective nomogram to provide individual OS prediction for metastatic RCC patients, which would be beneficial to clinical trial design, patient counseling, and therapeutic modality selection.
CHI3L1 Expression is a Prognostic Marker for Patients with Diagnosed Solid Tumors: Evidence from a Systematic Review and Meta-Analysis
Authors: pan jianyuan , Wu Liping , Yin Shiwu , Tang Yongqin , Zhang Jing , Feng Jun , Chen Zhenfei , Mossel Marije 
Published: May 2020

Abstract
Background: Accumulating studies have demonstrated YKL-40 associated with the prognosis of several cancers and contributed to the tumor progression through promoting tumor angiogenesis, migration, invasion and metastasis. The objective of this meta-analysis was to investigatethe relationship between YKL-40 and prognosis inpatients with solid tumors and seek for a new prognostic biomarker.Method: Relevant studies were searched in the Medline (PubMed), Web of science, and Embase. Pooled HR of overall survival and disease-free survival (DFS) were calculated to evaluate the strengthof the association between YKL-40 and cancer prognosis by using Stata software 14.0.Results: In total, 30 studies comprising 5160 patients were considered eligible and enrolled into the final meta-analysis. According to the meta-analysis results, higher expression of YKL-40 predicted poorer OS (pooled HR=1.85 CI%=1.58-2.18；P<0.001) and DFS (pooled HR =3.63 95% CI =2.63-5.01; P<0.001).Conclusion: The current evidence suggests that YKL-40 has a predictive effect onsurvival of cancer patients as indexed by DFS and OS. YKL-40 tissue expression is a valuable prognostic biomarker and may be a promising therapeutic target for solid tumors.
Utilization of Long-Lasting Insecticide Treated Net and Associated Factors Among Pregnant Women in Malarious Kebeles in Awabel District, North-West Ethiopia, 2017
Authors: Tariku Mengistie Kassahun , Dagnew Zewdu , Misikir Sewnet Wongiel , Belete Abebe Habtamu 
Published: May 2020

Abstract
Background: Utilization of long-lasting insecticide treated net (LLITN) is one of the main vector control activities. It has a killing, repellent and physical barrier effects against mosquito. Even if priority is given for pregnant women, not all nets owned by household have been utilized by pregnant women. The objective of the study was to assess utilization of Long-lasting insecticidal net and associated factors among pregnant women in malarious kebeles, Awabel woreda, North-West Ethiopia. Methods: A community-based cross-sectional study was conducted from May 1 to June 30, 2017. A systematic random sampling was used to select 422 households. Two days training was given for data collectors and supervisors. Collected data were coded and entered using epi-data version 3.1, then it was exported to Statistical Package for Social Science (SPSS) version 20. After bivariate logistic regression analysis, all variables with a p-value less than or equal to 0.25was entered into multivariable logistic regression and p value < 0.05 considered as significantly associated with the outcome variable. Results: Utilization of LLITN was 33.6%. Factors such as attending antenatal care [adjusted odd ratio (AOR) =1.89; 95% CI; 1.04-3.44], traveling <1 hour to reach health facility AOR=4.41; 95% CI; 2.06-9.43], age [AOR= 3.67; 95% CI; 1.36-9.95], knowledge[AOR=11.68; 95% CI; 5.96-22.89] and having positive attitude [AOR=3.12; 95 CI; 1.66-5.88] were significantly associated with utilization of LLITN. Conclusion: This study showed that low utilization of LLITN. Attending antenatal care (ANC), traveling <1 hour to reach health facility, age , knowledge and attitude had positive association with LLITN utilization. Every concerned body should focus on reducing distance barrier by giving outreach services and increasing ANC, the attitude and knowledge of pregnant women toward malaria and LLITN which increase utilization of LLITN. Key words : LLITN utilization, pregnant women, malarious kebeles, Awable, Ethiopia
Fully automatic three-dimensional MRI analysis for the cartilage and meniscus of the knee: Kanagawa Knee Study
Authors: Aoki Hayato , Ozeki Nobutake , Katano Hisako , Hyodo Akinobu , Matsuda Junpei , Takanashi Kimiko , Suzuki Kenji , Masumoto Jun , Okanouchi Noriya , Fujiwara Takeo , Sekiya Ichiro 
Published: May 2020

Abstract
Objective We have developed a fully automatic three-dimensional MRI analysis software that measures the projected cartilage area ratio (PCAR) to allow for the quantification of the cartilage in the knee. Our objectives for this cross-sectional study were to verify our software’s accuracy and to quantify cartilage and meniscus extrusion. We also examined which cartilage quantification was most affected by age and analyzed the relationship between PCAR and meniscus extrusion. Methods 108 subjects were selected for training, and Dice similarity coefficients were determined from 5 other subjects. This study included 561 subjects between 30–70 years of age. From their knee MRI data, we quantified cartilage thickness, cartilage volume, and PCAR (0.0–1.5 mm) in four regions, including the medial tibial (MT) cartilage. Furthermore, each region was divided into nine subregions. The medial central (mc) subregion was also analyzed. As a quantification for meniscus extrusion, the medial meniscus coverage ratio (MMCR) was also investigated. Results Dice similarity coefficients were 0.911 and 0.892 for the femoral and tibial cartilage and 0.916 and 0.891 for the medial and lateral meniscus. Among 48 cartilage quantifications, the highest absolute value of the correlation coefficient with age was mcMT PCAR 1.0 mm in females and mcMT cartilage thickness in males. In females, mcMT PCAR 1.0 mm was correlated with MMCR, although MMCR was not correlated with age. In males, mcMT PCAR 0.0 mm was correlated with MMCR. Conclusions Our software showed high segmentation accuracy and provided numerous quantifications of cartilage related to age and meniscus extrusion.
Elevated serum levels of checkpoint molecules in patients with adult Still’s disease
Authors: Fujita Yuya , Asano Tomoyuki , Matsumoto Haruki , Matsuoka Naoki , Temmoku Jumpei , Sato Shuzo , Furuya Makiko Yashiro , Suzuki Eiji , Watanabe Hiroshi , Koga Tomohiro , Kawakami Atsushi , Migita Kiyoshi 
Published: May 2020

Abstract
Background: The interaction between galectin-9 (Gal-9) and its ligand, T cell immunoglobulin and mucin-containing-molecule-3 (TIM-3), one of the coinhibitory receptors, transduce the inhibitory signaling to regulate immune responses. The dysregulated expression of checkpoint molecules has been reported under various inflammatory or autoimmune conditions. The aim of this study is to investigate the levels of these checkpoint molecules and their associations between proinflammatory markers in patients with adult Still’s disease (ASD). Methods: Serum samples were collected from 47 patients with active ASD, 116 patients with rheumatoid arthritis (RA), and 29 healthy controls (HCs). Serum levels of Gal-9, soluble TIM-3 (sTIM-3), and IL-18 were determined using enzyme-linked immunosorbent assay (ELISA). Results were compared with clinical features of ASD. Results: Serum Gal-9 levels in patients with ASD (median: 21.57 ng/ml, interquartile range IQR [11.41–39.72]) were significantly higher compared to those in patients with RA (7.58 ng/ml, IQR [5.57–10.20] p < 0.001) as well as those in HCs (4.74 ng/ml, [IQR; 4.27–5.63], p < 0.001). Similarly, serum sTIM-3 levels in patients with ASD were significantly higher than those in patients with RA and HCs. Serum levels of Gal-9 or sTIM-3 showed positive correlations with IL-18 levels (Gal-9; r = 0.90, p< 0.001, sTIM-3; r = 0.78, p< 0.001) in patients with ASD. Serum levels of Gal-9 or sTIM-3 correlated with serum ferritin (Gal-9; r = 0.77, p< 0.001, sTIM-3; r = 0.71, p< 0.001) and ASD disease activity score (Pouchot’s score, Gal-9; r = 0.66, p< 0.001, sTIM-3; r = 0.67, p< 0.001). Whereas there was no significant correlation between serum Gal-9 or sTIM-3 and CRP. ASD patients with chronic arthritis phenotype had a significantly higher Gal-9/ferritin and sTIM-3/ferritin ratio than those without this phenotype. After immunosuppressive treatment, Gal-9 and sTIM-3 levels showed a significant decline in parallel to the disease activity scores. Conclusions: Serum levels of the coinhibitory checkpoint molecules were elevated and correlated with disease activity in patients with ASD. These coinhibitory checkpoint molecule may be implicated in the autoinflammatory process seen in ASD.
Single-Nucleotide Polymorphisms in One-Carbon Metabolism Genes, Mediterranean Diet and the Risk of Pre- and Postmenopausal Breast Cancer
Authors: Cao Shang , Zhu Zheng , Zhou Jinyi , Li Wei , Dong Yunqiu , Qian Yun , Wei Pingmin , Wu Ming 
Published: May 2020

Abstract
Background: One-carbon metabolism pathway could interfere with the carcinogenesis of breast cancer (BC). Dietary pattern plays an important role in one-carbon metabolism linking the combination of dietary micronutrients. Methods: We assessed associations between single-nucleotide polymorphisms (SNPs) of one-carbon metabolism, adherence to Mediterranean dietary pattern (MDP) and BC risk from a case-control study (818 cases, 935 controls) among Chinese female population. The genotyping of 15 SNPs in eleven one-carbon metabolism-related genes (MTHFD1, MTRR, MAT1A, MAT2B, FOLR1, CBS, GLS, DNMT3B, UNG2, ADA, CDO1) were performed. Dietary measurements were assessed by a validated food-frequency questionnaire. Gene-diet interactions were analyzed. Results: No evidence demonstrated SNPs of one-carbon metabolism or their haplotypes were associated with BC risk. The associations between high adherence to the MDP and risk reduction of BC were influenced by the SNPs genotype, with the increasing number of variant allele in MTHFD1 (rs11627387), MTHFD1 (rs2281603), MTRR (rs16879334), MTRR (rs2287780), MAT2B (rs4869087), FOLR1 (rs10501409), UNG2 (rs231622) and ADA (rs244072), the protective effect against BC risk from high adherence to the MDP was gradually weakened and disappeared, while for MTHFD1 (rs8003567) and CDO1 (rs34869) genotypes, women who take homozygous allele were less affected by adherence to the MDP than to women who take heterozygotes allele. Significant gene-diet interactions were observed between MTHFD1 (rs8003567) polymorphism and MDP on BC risk. Conclusions: SNPs of one-carbon metabolism genes modify the effect of high adherence to MDP against BC risk in Chinese women, as potential effect modifiers. Genetic variants may influence the association between diet and BC risk.
The Survival Effect of Ovary Preservation in Early Stage Endometrial Cancer: A Single Institution Retrospective Analysis
Authors: Shin Wonkyo , Park Sang-Yoon , Kang Sokbom , Lim Myong Cheol , Seo Sang-Soo 
Published: May 2020

Abstract
Purpose: We investigated the effect of ovary preserving surgery in early International Federation of Obstetrics and Gynecology (FIGO) stage endometrial cancer patients.Methods: Medical records were retrospectively reviewed for 539 patients who were diagnosed with early stage endometrial cancer between Jan 2006 and Dec 2017. Patients were categorized into ovary preservation and ovary removal groups. Demographics, recurrence free survival (RFS), and five-year overall survival (OS) rate were compared, and the clinical factors affecting survival were evaluated by univariate and multivariate analysis.Results: The median follow-up period was 85 months (range, 6-142 months), and the median age was 52.7 years. The mean age was higher in the ovary removal group than in the ovary preservation group (54.4 vs 40.94 years; P < 0.001). The ovary preservation group showed an earlier FIGO stage than the ovary removal group. (P = 0.0264). There was a greater incidence of adjuvant chemotherapy administration in the removal group. There were no statistical differences in other baseline characteristics.When comparing the RFS and OS rates, there were no statistical differences between the preservation and removal groups. (recurrence free rate 98.5% vs 92.7%, p = 0.4360, and 5-year survival rate 98.6% vs 93.0%, p = 0.0892, respectively). Endometrioid histology (p=0.006) and post-operative adjuvant chemotherapy (p=0.0062) were related to OS, and adjuvant chemotherapy (p<0.001) and radiotherapy (p=0.005) were related to RFSConclusions: Ovary preservation in early stage endometrial cancer is worth considering, as it does not affect survival in early stage endometrial cancer patients
A novel comprehensive immune-related gene signature as a promising survival predictor for head and neck squamous cell carcinoma
Authors: Fang Ruihua , Chen Lin , Liao Jing , Luo Jierong , Zhang Chenchen , Wei Fanqin , Zhang Zhiyu , Wen Weiping , Sun Wei 
Published: May 2020

Abstract
Background: Head and neck squamous cell carcinoma (HNSCC), the most frequent subtype of head and neck cancer, continues to have a poor prognosis with no improvement. Growing evidence has demonstrated that the immune system plays a crucial role in the development and progression of HNSCC. The goal of our study was to develop an immune-related signature for accurately predicting the survival of HNSCC patients. Methods: Gene expression profiles were established from a total of 546 HNSCC and normal tissues to establish a training set and 83 HNSCC tissues for a validation set. Differentially expressed prognostic immune genes were identified by univariate Cox regression analysis and a corresponding network of differentially expressed transcription factors (TFs) were identified using Cytoscape. The immune-related gene signature was established and validated by univariate Cox regression analysis, least absolute shrinkage and selector operation (LASSO), and multivariate Cox regression analyses. In addition, the prognostic value of the immune-related signature was analyzed by survival and Cox regression analysis. Finally, the correlation between the immune-related signature and the immune microenvironment was established.Results: In this study, the TF-mediated network revealed that Foxp3 plays a central role in the regulatory mechanism of most immune genes. A prognostic signature based on 10 immune-related genes, which divided patients into high and low risk groups, was developed and successfully validated using two independent databases. Our prognostic signature was significantly related to worse survival and predicted prognosis in patients with different clinicopathological factors. A nomogram including clinical characteristics was also constructed for accurate prediction. Furthermore, it was determined that our prognostic signature may act as an independent factor for predicting the survival of HNSCC patients. ROC analysis also revealed that our signature had superior predictive value compared with TNM stage. As for the immune microenvironment, our signature showed a positive correlation with activated mast cells and M0 macrophages, a negative correlation with Tregs, and immune checkpoint molecules PD-1 and CLTA-4. Conclusions: Our study established an immune-related gene signature, which not only provides a promising biomarker for survival prediction, but may be evaluated as an indicator for personalized immunotherapy in patients with HNSCC.
Sex-dependent dysregulation of human neutrophils responses​ by bisphenol A
Authors: Ratajczak-Wrona Wioletta , Garley Marzena , Rusak Malgorzata , Nowak Karolina , Czerniecki Jan , Wolosewicz Katarzyna , Dabrowska Milena , Wolczynski Slawomir , Radziwon Piotr , Jablonska Ewa 
Published: May 2020

Abstract
Background: The study objective was to assess the impact of a xenoestrogen—bisphenol A (BPA) (at the environmental concentration and 100-fold increased dose)—on selected functions of neutrophils, as well as to compare the effect of this compound and 17-β-estradiol (E2) (at the physiological concentration) on the studied functions of these cells in women and men.Methods and Results: Analysis of the results obtained for both sexes demonstrated a reduction in the chemotactic potential of neutrophils after exposure to BPA. In the presence of BPA, the phagocytic activity, as measured via the SCORE index, was found to be elevated in the neutrophils from women and reduced in those isolated for men. Exposure to BPA resulted in an increased percentage of neutrophils expressing CD14 and CD284 (TLR4), as well as an increased percentage of NET-forming cells, in the case of both sexes. In addition, a reduced capacity to release NETs was observed in cells that were preincubated with xenoestrogen and then stimulated with LPS. The stimulating role of BPA and 17-β-estradiol in the activation of NADPH oxidase, evaluated using NBT stimulation test, was evident only in the neutrophils from women. No influence of E2 could be observed on the expression of CD14 and CD284 by neutrophils, their chemotactic potential and phagocytic activity, and the amount of NETs for both sexes. The study further showed that BPA intensified the NO production and iNOS expression in the neutrophils from both sexes. In addition, an increase in expression was found for all the tested proteins of the PI3K/AKT pathway for men.Conclusions: The conducted study demonstrated that BPA influenced the functions of neutrophils associated with locomotion and pathogen elimination, which may disturb the response of these cells in both women and men. Furthermore, neutrophils isolated from women were found to be more susceptible to the effect of BPA in terms of oxygen-dependent killing, compared to those obtained from men. The variable results of the tests conducted in the presence of BPA indicated the stronger effect of xenoestrogen on human neutrophils compared to that of 17-β-estradiol.
Association Between Obstructive Sleep Apnea-Hypopnea Syndrome and Outcomes in Patients with Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease
Authors: He Chaojie , Cao Linfeng , Zhu Chunyan , Zhu Yujuan , Wang Shijun , Zhai Changlin , Hu Hui-lin 
Published: May 2020

Abstract
Background: Myocardial infarction in the absence of obstructive coronary artery disease (MINOCA) occurs in 5% to 10% of all patients with acute myocardial infarction. Obstructive sleep apnea-hypopnea syndrome (OSAHS) is linked to increased cardiovascular morbidity and mortality, but the relationship of OSAHS and outcomes in patients with MINOCA remains unknown. Objectives: We aimed to evaluate the association between OSAHS and clinical outcomes in patients with MINOCA.Methods and Results: Between January 2015 and December 2016, we carried out a prospective and consecutive cohort study of 583 patients with MINOCA and followed them up for three years. An apnea-hypopnea index of ≥15 events per hour recorded by polysomnography was defined as the diagnostic criterion for OSAHS. The primary end point was all-cause mortality, and the second end point was major adverse cardiovascular or cerebrovascular events (MACCE), a composite of cardiac death, nonfatal myocardial infarction, heart failure, cardiovascular-related rehospitalization, and stroke. All-cause mortality happened in 69 patients and MACCE occurred in 113 patients during the three-year follow-up. Kaplan–Meier survival curves indicated the significant relationship of OSAHS with all-cause mortality (log-rank P = 0.012) and MACCE (log-rank P = 0.002). Multivariate Cox regression analysis indicated OSAHS as an independent predictor of all-cause mortality and MACCE (adjusted hazard ratio: 1.714; 95% confidence interval (CI): 1.203–2.168; P = 0.013; and adjusted hazard ratio: 1.787; 95% CI: 1.249–2.236; P = 0.004; respectively), independent of age, sex, cardiovascular risk factors and discharge medications.Conclusions: OSAHS is independently associated with increased risk of all-cause mortality and MACCE in patients with MINOCA. Intervention and treatment should be considered to alleviate OSAHS-associated risk.
Clinical characteristics of imported and second-generation COVID-19 cases outside Wuhan, China: A multicenter retrospective study
Authors: Shi Puyu , Ren Guoxia , Yang Jun , Li Zhiqiang , Deng Shujiao , Li Miao , Wang Shasha , Xu Xiaofeng , Chen Fuping , Li Yuanjun , Li Chunyan , Yang Xiaohua , Xie Zhaofeng , Wu Zhengxia , Mingwei Chen 
Published: May 2020

Abstract
Background: The mortality of COVID-19 differs between countries and regions. By now, reports on COVID-19 are largely focused on first-generation cases. This study aimed to clarify the clinical characteristics of imported and second-generation cases. Methods : This retrospective, multicenter cohort study included 134 confirmed COVID-19 cases from 9 cities outside Wuhan. Epidemiological, clinical and outcome data were extracted from medical records and were compared between severe and non-severe cases. We further profiled the dynamic laboratory findings of some patients. Results : 34.3% of the 134 patients were severe cases, and 11.2% had complications. As of March 7, 2020, 91.8% patients were discharged and one patient (0.7%) died. Age, lymphocyte count, C-reactive protein, erythrocytes edimentation rate, direct bilirubin, lactate dehydrogenase, hydroxybutyrate dehydrogenase showed difference between severe and no-severe cases (all P<0.05). Baseline lymphocyte count was higher in the survived patients than in the non-survivor case, and it increased as the condition improved, but declined sharply when death occurred. The interleukin-6 level displayed a downtrend in survivors, but rose very high in the death case. Pulmonary fibrosis was found on later chest CT images in 51.5% of the pneumonia cases. Conclusion : Imported and second-generation cases outside Wuhan had a better prognosis than initial cases in Wuhan. Lymphocyte count and IL-6 level could be used for evaluating prognosis. Pulmonary fibrosis as the sequelae of COVID-19 should be taken into account.