bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recurrent Brain Metastases: The Role of Resection of in the Era of Molecular Medicine
Authors: Hessler Nadine , Jünger Stephanie T , Meissner Anna-Katharina , kocher Martin , Goldbrunner Roland H , Grau Stefan Josef 
Published: February 2021

Abstract
Purpose

To evaluate the efficacy of surgical resection for pretreated, recurrent brain metastases (BM) in the era of molecular oncologic medicine.
Patients and Methods:

In a retrospective single center study, patients were analyzed who had undergone surgical resection of recurrent BM between 2007 and 2019. Intracranial event-free survival (EFS) and overall survival (OS) were evaluated by Kaplan-Maier and Cox regression analysis.
Results

In total, 107 patients with different primary tumor entities and individual previous treatment for BM were included. Primary tumors comprised non-small cell lung cancer (NSCLC) (37.4%), breast cancer (19.6%), melanoma (13.1%), gastro-intestinal cancer (10.3%) and other, rare entities (19.6%). The number of previous treatments of BM ranged from one to four; these comprised: resection only, focal or whole brain radiotherapy, brachytherapy and radiosurgery. BM-related symptoms were present in 73.8% of the patients. Median pre-operative Karnofsky Performance Score (KPS) was 70% (range 40–100) which was improved to 80% (range 0-100) after surgery. The complication rate was 26.2% and two patients died during the perioperative period. Postoperative local radio-oncologic and/or systemic therapy regimens were applied in 67 (62.6%) patients. Median postoperative EFS and OS were 7.1 (95%CI 5.8–8.2) and 11.1 (95%CI 8.4–13.6) months, respectively. The clinical status (postoperative KPS ≥ 70 (HR 0.27 95%CI 0.16–0.46; p < 0.001) remained the only independent factor for survival in multivariate analysis.
Conclusion

Surgical resection of recurrent BM may improve the clinical status and thus OS, but is associated with a high complication rate; thus, careful patient selection is crucial.
Haploidentical Hematopoietic Stem Cell Transplantation for Malignant Infantile Osteopetrosis and Intermediate Osteopetrosis:A Retrospective Analysis of a Single-Center
Authors: Zhu Guanghua , Wei Ang , Wang Bin , Yang Jun , Yan Yan , Wang Kai , Jia Chenguang , Luo Yanhui , Li Sidan , Zhou Xuan , Wang Tianyou , Zheng Huyong , Qin Maoquan 
Published: February 2021

Abstract
ObjectiveTo evaluate the clinical efficacy of haploidentical hematopoietic stem cell transplantation (haplo-HSCT) for treatment of malignant infantile osteopetrosis (MIOP) and intermediate osteopetrosis.MethodsChildren with MIOP and IOP who underwent haplo-HSCT in Beijing Children’s Hospital, Capital Medical University, from January 2010 to May 2018 were retrospectively analyzed. Data relating to the clinical manifestations, engraftment, and prognosis of the children were extracted from medical records. ResultsTwenty-seven patients, including 18 males and 9 females, with an onset age of 12 (0.04-72) months, were enrolled in this study. The median time from diagnosis to transplantation was 4 (1-23) months. All patients received haplo-HSCT with myeloablative conditioning regimen (including fludarabine, busulfan, and cyclophosphamide). The graft versus host disease (GVHD) prophylaxis was based on anti-human T lymphocyte porcine immunoglobulin /anti-human thymus globulin, methotrexate, and mycophenolate mofetil. The median observation time was 55.2 (0.3-126.2) months. By the end of follow-up, twenty patients survived and seven patients died. The five years overall survival rate was 73.9%. Acute GVHD degree I-II was observed in 20 patients, degree III in 1 patient and without degree IV. Chronic GVHD was observed in 11 patients (40.7%). It was controlled by anti-GVHD therapy.Conclusion﻿Haplo-HSCT was effective for MIOP and IOP, with high survival rate and significantly improved of clinical symptoms. For the patients with vision impairment before HSCT, the improvement was slow after transplantation. The incidence of GVHD was high but mild, and could be effectively controlled after appropriate treatment. These data provided that haplo-HSCT was feasible in the treatment of MIOP and IOP.
Humidifier Disinfectant, Sodium Dichloroisocyanurate (NaDCC): Assessment of Respiratory Effects to Protect Workers’ Health
Authors: Seo Dong Seok , Jo JiMin 
Published: February 2021

Abstract
Background: Biocides are used to control and remove all harmful organisms. In South Korea, they are used in humidifier disinfectants and have been found to cause lung disease in users. Hence, efforts have been focused on studying the toxicity of biocides in workers who handle them. The purpose of this study was to evaluate the effects of inhalation exposure to sodium dichloroisocyanurate (NaDCC) to protect the health of workers handling NaDCC.Methods: F344 rats were exposed to 0.8-, 4-, and 20-mg/m3 of NaDCC for 6 h a day, 5 days a week for 14 days; the post-exposure recovery period was 14 days.Results: In the 20-mg/m3-exposure group, we observed a decrease in food intake in females, a weight loss in males, and a decrease in partially active thromboplastin time in males and females 2 weeks after exposure. We noted a decrease in white blood cells in males in the 4- and 20-mg/m3-exposed groups. Both males and animals in the 20-mg/m3 group and males in the 4-mg/m3 group showed irritation in the larynx related to test substance exposure. However, these findings were not observed in the recovery group.Conclusion: The main target organs affected by repeated 2-week inhalation exposure to NaDCC were the nasal cavity and larynx in the upper respiratory tract. The No Observed Adverse Effect Level (NOAEL) was considered to be 0.8 mg/m3 because the effects related to exposure of NaDCC were observed even at of 4 mg/m3. In addition, these effects were found to be reversible.
The Construction and Analysis of a Novel Four-Long Non-Coding&nbsp;RNA Signature Predicting Survival of Breast Cancer Patients
Authors: Qin Chengdong , Feng Weiliang , Yu Xingfei , Liang Chenlu , Ding Yuqin , Xuan Haojun , Hu Jiejie , Hongjian Yang , Yu Yang 
Published: February 2021

Abstract
Background

As the critical regulators for tumorigenesis and progression, long-noncoding RNAs (lncRNAs) are becoming novel prognostic biomarkers for tumor patients. By the levels of lncRNAs expression, the patients with breast carcinoma may be divided into subgroups with different risk scores. Nevertheless, there is limited evidence to evaluate the role of lncRNAs in the prognosis of breast carcinoma. The present study aimed to construct lncRNA signatures for prognostic analysis and assist clinicians in choosing optimal therapies.
Methods

Abnormal expression profiles of breast cancer-associated lncRNAs were analyzed based on the TCGA datasets. Univariate and multivariate Cox regression analysis was used to build a prognostic risk signature according to the lncRNAs expression. The prognostic ability of this signature was verified in various subgroups. Functional enrichment analysis was employed to reveal the potential roles of these predictive lncRNAs in cancer-related biological processes and pathways.
Results

Compared with normal breast tissues, the differential analysis demonstrated that 286 lncRNAs were abnormally expressed in breast carcinoma. A four-lncRNA signature (RP1-193H18.2, AL022341.3, WDR86-AS1, LINC00511) was found to be closely related to the prognosis of breast carcinoma. The four-lncRNA signature could also qualify the magnitude of treatment benefits for different breast cancer subtypes. Additionally, it was an independent risk factor out of other clinicopathological parameters based on the multivariate Cox analysis. We also uncovered that the four predictive lncRNAs are involved in multiple cellular progression and pathways of breast cancer.
Conclusions

The four-lncRNA signature could be an essential reference for prognostic prediction and making therapeutic strategies.
Synchronous Brain Metastases as a Poor Prognosis Factor in Clear Cell Renal Carcinoma: A Strong Argument for Systematic Brain Screening
Authors: Ruste Valentine , Sunyach Marie-Pierre , Tanguy Ronan , Jouanneau Emmanuel , Schiffler Camille , Carbonnaux Mélodie , Moriceau Guillaume , Neidhardt Eve-Marie , Boyle Helen , Robin Sophie , Négrier Sylvie , Fléchon Aude 
Published: February 2021

Abstract
PurposeBrain metastases (BM) usually represent a poor prognostic factor in solid tumors. About 10% of patients with renal cancer (RCC) will present BM. Local therapies such as stereotactic radiotherapy (SRT), whole brain radiotherapy (WBRT), and surgery are used to achieve brain control. We compared survival between patients with synchronous BM (SynBM group) and metachronous BM (MetaBM group). MethodsIt is a retrospective study of patients with clear cell renal cell carcinoma (ccRCC) and BM treated with TKI between 2005 and 2019 at the Centre Léon Bérard in Lyon. We collected prognostic factors: The International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk score, the TNM stage, the histological subtypes and the Fuhrman grade. Overall survival (OS) was defined from diagnosis of metastatic ccRCC to death. Brain progression-free survival (B-PFS) was defined from focal brain therapy to brain progression or death.Results99 patients were analyzed, 44 in the SynBM group and 55 in the MetaBM group. OS in the MetaBM group was 49.4 months versus 19.6 months in the SynBM group, p=0.0002. The median time from diagnosis of metastasic disease to apparition of BM in the MetaBM group was 22.9 months (4.3; 125.7). SRT was used for 101 lesions (66.4%), WBRT for 25 patients (16.4%), surgery for 21 lesions (13.8%), surgery followed by radiation for 5 lesions (3.3%). B-PFS for all patients was 7 months (IC95% [5.0-10.5]). Conclusions﻿Survival of patients with synchronous BM is inferior to that of patients with metachronous BM. Outcome is poor in both cases after diagnosis of BM. Brain screening should be encouraged at time of diagnosis of metastatis in ccRCC.
Evaluating the Effect of Statins on Prognosis in Patients Undergoing Liver Transplantation for Hepatocellular Carcinoma
Authors: Lee Hae Lim , Lee Sung Won , Jang Jeong Won , Bae Si Hyun , Choi Jong Young , Han Nam Ik , Yoon Seung Kew , Choi Ho Joong , Na Gun Hyung , You Young Kyoung , Park Il Young , Kim Dong Goo 
Published: February 2021

Abstract
IntroductionThe anti-cancer effect of statins is drawing attention. However, it is unclear whether statin use reduces the risk of hepatocellular carcinoma (HCC) recurrence in patients who undergo liver transplantation (LT) for HCC.MethodsConsecutive patients who underwent LT for HCC between 1995 and 2019 were enrolled. The effect of statins were compared between statin non-user and statin user groups. The primary endpoint was HCC recurrence. All-cause and HCC-related mortality were also evaluated. We also performed multivariable-stratified and sensitivity analyses for HCC recurrence. ResultsA total of 430 patients was enrolled, among whom 323 (75.1%) were statin non-users and 107 (24.9%) were statin users. During a median of 64.9 months (IQR, 26.1–122.6) of follow-up, 79 patients (18.4%) had HCC recurrence and 111 (25.8%) died. Among those who died, 53 (47.7%) were identified as HCC-related mortalities. Statin use was associated with a significantly lower risk of HCC recurrence (adjusted HR = 0.26, 95% CI, 0.11–0.60; P = 0.002) compared to that in statin non-users. Statin users also had significantly lower all-cause and HCC-related mortality than did statin non-users (P < 0.001 & P = 0.040, respectively). There was a dose-dependent relationship between statin use and HCC recurrence. The anti-cancer effect of statins on HCC recurrence was consistently significant across multivariable-stratified and sensitivity analyses. ConclusionsStatin use significantly reduced the risk of HCC recurrence and improved the survival of patients who underwent LT for HCC.
Cartilage Increases Swimming Efficiency of Underwater Robots
Authors: Yurugi Masaki , Nagai Toshiaki , Shintake Jun , Ikemoto Yusuke 
Published: February 2021

Abstract
Underwater robots are useful for exploring valuable resources and marine life. Traditional underwater robots use screw propellers, which may be harmful to marine life. In contrast, robots that incorporate the swimming principles, morphologies, and softness of aquatic animals are expected to be more adaptable to the surrounding environment. Rajiform is one of the swimming forms observed in nature, which swims by generating the traveling waves on flat large pectoral fins. From an anatomical point of view, Rajiform fins consist of cartilages encapsulated in soft tissue, thereby realizing anisotropic stiffness. We hypothesized that such anisotropy is responsible for the generation of traveling waves that enable a highly efficient swimming. We validate our hypothesis through the development of a stingray robot made of silicone-based cartilages and soft tissue. For comparison, we fabricate a robot without cartilages, as well as the one combining soft tissue and cartilage materials. The fabricated robots are tested to clarify their stiffness and swimming performance. The results show that inclusion of cartilages in the robot fins increases the swimming efficiency. It is suggested that arrangement and distribution of soft and hard areas inside the body structure is a key factor to realize high-performance soft underwater robots.
Strain patterns in normal anterior talofibular and calcaneofibular ligaments and after anatomical reconstruction using gracilis tendon grafts: A cadaver study
Authors: Takao Masato , Lowe Danielle , Ozeki Satoru , Oliva Xavier M , Inokuchi Ryota , Yamazaki Takayuki , Takeuchi Yoshitaka , Kubo Maya , Matsui Kentaro , Katakura Mai , Glazebrook Mark 
Published: February 2021

Abstract
BackgroundInversion sprains of the lateral ankle ligaments often result in symptomatic lateral ankle instability, and some patients need lateral reconstruction surgeries to reduce pain, improve function, and prevent subsequent injuries. Although anatomically reconstructed ligaments should behave in a biomechanically normal manner, previous studies have not measured the strain patterns of the anterior talofibular (ATFL) and calcaneofibular ligaments (CFL) after anatomical reconstruction. This study aimed to measure the strain patterns of normal and reconstructed ATFL and CFLs using a miniaturization ligament performance probe (MLPP) system.MethodsThe MLPP was sutured into the ligamentous bands of the ATFLs and CTLs of three fresh-frozen, lower extremity, cadaveric specimens. Each ankle was manually moved from 15° dorsiflexion to 30° plantar flexion, and a 1.2-N m force was applied to the ankle and subtalar joint complex.ResultsThe normal and reconstructed ATFLs exhibited maximal strain (100) during supination in three-dimensional motion. Although the normal ATFLs were not strained during pronation, the reconstructed ATFLs demonstrated relative strain values of 16–36. During axial motion, the normal ATFLs began to gradually tense at 0° plantarflexion, with the strain increasing, as the plantarflexion angle increased, to a maximal value (100) at 30° plantarflexion; the reconstructed ATFLs showed similar strain patterns. The normal CFLs exhibited maximum strain (100) during plantarflexion-abduction and relative strain measurements of 30–52 during dorsiflexion in three-dimensional motion. The reconstructed CFLs exhibited the most strain during dorsiflexion-adduction and demonstrated relative strain measurements of 29–62 during plantarflexion-abduction. During axial motion, the normal CFLs began to gradually tense at 20° plantarflexion and 5° dorsiflexion.ConclusionOur results showed that the strain patterns of reconstructed ATFLs and CFLs are not exactly the same as those in the normal ligaments.
Field investigation and analysis of rockburst and spalling in a deep hard-rock mine
Authors: Peng Xiao , Guoyan Zhao , Huanxin Liu 
Published: February 2021

Abstract
In order to investigate the ground pressure disasters in deep hard-rock mines, field investigation and theoretical analysis were carried out in a deep hard-rock mine. It is found that the degree and number of ground pressure disasters in the mine have increased significantly with depth. When the maximum tangential stress between 0.4-0.6 times the uniaxial compressive strength of surrounding rock, surrounding rock is prone to local spalling. When maximum tangential stress is greater than 0.6 times uniaxial compressive strength, serious failure is easy to occur, such as rockbursts and large-area collapses. After excavation, the rebound strain and displacement of surrounding rock increases linearly with buried depth, and the strain energy released of surrounding rock increases rapidly with the second power of buried depth. The rapidly increasing strain energy is main reason why deep ground pressure disasters in the mine are becoming more and more serious. In terms of surrounding rock support, energy-absorbing materials such as energy-absorbing bolts can well absorb strain energy released by surrounding rock. The energy-absorbing bolts are used for design of roadway support in the mine.
Integrated Study on Pulse Diagnosis of TCM and Cardiology by Analyzing the Distribution Characteristics of Atherosclerosis Parameters at Six Positions of Cunkou
Authors: Tang Qingfeng , Chen Yankun , Ye Peihan , Liu Qi , Xie Mengzhou , Wang Nanyue , Chen Meiling , Su Benyue , Liu Kui , Pan Zhigeng , Qu Haoyu 
Published: February 2021

Abstract
The authors have requested that this preprint be removed from Research Square.
Investigating Novel and Conventional Biomarkers for Post-resuscitation Prognosis: The Role of Cytokeratin-18, Neuron-specific Enolase, and Lactate
Authors: Csiszar Beata , Nemeth Almos , Marton Zsolt , Riba Janos , Csecsei Peter , Molnar Tihamer , Halmosi Robert , Deres Laszlo , Koszegi Tamas , Sandor Barbara , Toth Kalman , Kenyeres Peter 
Published: February 2021

Abstract
Introduction: We investigated the associations of cell death-related release of cytokeratin-18 (CK-18) and its caspase-cleaved form (CCCK-18) with outcomes, clinical parameters, and neuron-specific enolase (NSE) among cardiac arrest (CA) victims.Methods: We determined CK-18, CCCK-18, and NSE plasma concentrations within 6, at 24, and 72 post-CA hours of 54 successfully resuscitated patients. Baseline characteristics, laboratory, vital parameters, prognostic scores were recorded. The follow-up was 30 days.Results: Neither the absolute values of CK-18, CCCK-18, CCCK-18/CK-18 ratio, or NSE, nor their kinetics showed significant difference according to survival and neurological outcome. CK-18 decreased in good renal function in contrast to renal failure. Lactate levels were increased in non-survivors and poor neurological outcomes. In receiver operator characteristic (ROC) analyses lactate was comparable with prognostic scores in predicting 30-day mortality and neurological outcome. The ROC curve of initial lactate indicated a cut-off as 4.90 mmol/L to predict 30-day mortality (specificity=80%; sensitivity=74%) and 6.00 mmol/L (specificity=80%; sensitivity=84%) for poor neurological outcome.Conclusion: This study was the first to investigate the post-resuscitation prognostic value of CK-18 and CCCK-18 with NSE. Although we could not prove their prognostic value, we confirmed the role of initial lactate in predicting mortality and neurological outcome in unselected resuscitated patients.
Extent of Cardiac Damage and Mortality in Patients Undergoing Transcatheter Aortic Valve Implantation
Authors: Avvedimento Marisa , Franzone Anna , Leone Attilio , Piccolo Raffaele , Castiello Domenico Simone , Mariani Andrea , Ilardi Federica , Esposito Roberta , Iapicca Cristina , Angellotti Domenico , Scalamogna Maria , Santoro Ciro , Cirillo Plinio , Esposito Giovanni 
Published: February 2021

Abstract

PurposeWe sought to assess the prognostic role of the extent of cardiac damage among real-world patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI).MethodsA staging classification was applied to 262 patients from the EffecTAVI Registry at baseline and re-assessed within 30-day after TAVI. All-cause mortality at 1-year was the primary endpoint of the study. Cerebrovascular accident, myocardial infarction, permanent pacemaker implantation, endocarditis and re-hospitalization for all caused were included as secondary endpoints. ResultsAt baseline, 23 (8.7%) patients were in Stage 0/1 (no cardiac damage/left ventricular damage), 106 (40.4%) in Stage 2 (left atrial or mitral valve damage), 59 (22.5%) in Stage 3 (pulmonary vasculature or tricuspid valve damage) and 74 (28.3%) in Stage 4 (right ventricular damage). At 30-day after TAVI, a lower prevalence of advanced stages of cardiac damage than baseline, mainly driven by a significant improvement in left ventricular diastolic parameters and right ventricular function, was reported. At 1-year, a stepwise increase in mortality rates was observed according to staging at baseline: 4.3% in Stage 0/1, 6.6% in Stage 2, 18.6% in Stage 3 and 21.6% in Stage 4 (p= 0.08). No differences were found in secondary endpoints. ConclusionsAlthough TAVI might be associated with an amelioration of the left ventricular diastolic and right ventricular function, patients with a greater extent of cardiac damage at baseline are at higher risk of mortality at 1-year after the procedure.
Electronic prescribing systems as tools to improve patient care: A learning health systems approach to increase guideline concordant prescribing for venous thromboembolism prevention.
Authors: Gallier Suzy , Topham Alexander , Nightingale Peter , Garrick Mark , Woolhouse Ian , Berry Michael. A. , Pankhurst Tanya , Sapey Elizabeth , Ball Simon 
Published: February 2021

Abstract
BackgroundVenous thromboembolism (VTE) causes significant mortality and morbidity in hospitalised patients. Risk factors for VTE are well known and there are validated risk assessment tools to support the use of prophylactic therapies. In England, reporting the percentage of patients with a completed VTE risk assessment is mandated, but this does not include whether that risk assessment resulted in appropriate prescribing. Full guideline compliance, defined as an assessment which led to an appropriate action - here prescribing prophylactic low molecular weight heparin where indicated, is rarely reported. Education, audit and feedback enhance guideline compliance but electronic prescribing systems(EPS) can mandate guideline-compliant actions. We hypothesised that a systems-based EPS intervention (prescribing rules which mandate approval or rejection of a proposed prescription of prophylactic low molecular weight heparin based on the mandated VTE assessment) would increase full VTE guideline compliance more than interventions which focused on targeting individuals. MethodsAll admitted patients within University Hospitals Birmingham NHS Foundation Trust were included for analysis between 2011-2020. The proportion of patients who received a fully compliant risk assessment and action was assessed over time. Interventions included teaching sessions and face-to-face feedback based on measured performance (an individual approach) and mandatory risk assessment and prescribing rules into an EPS (a systems approach).RESULTSData from all 235,005 admissions and all 5503 prescribers were included in the analysis. Risk assessments were completed in >90-95% of patients at all times, but full guideline compliance was lower (70% at the start of this study). Face-to-face feedback improved full VTE guideline compliance from 70% to 77% (p=<0.001). Changes to the EPS to mandate assessment with prescribing rules increased full VTE compliance to 95% (p=<0.001). Further amendments to the EPS system to reduce erroneous VTE assessments slightly reduced full compliance to 92% (p<0.001), but this was then maintained including during changes to the low molecular weight heparin used for VTE prophylaxis. DISCUSSION/ ConclusionAn EPS-systems approach was more effective in improving sustained guideline-compliant VTE prevention over time. Non-compliance remained at 8 – 5% despite this mandated system. Further research is needed to assess the potential reasons for this.