bluuebunny/crossref_metadata_2025_split huggingface dataset:
A critical role of AREG for bleomycin-induced skin fibrosis
Authors: zhang Mary Yinghua , Fang Shuyi , Gao Hongyu , zhang xiaoli , Gu Dongsheng , Liu Yunlong , Wan Jun , Xie jingwu 
Published: January 2021

Abstract
We report our discovery of an important player in the development of skin fibrosis, a hallmark of scleroderma. Scleroderma is a fibrotic disease, affecting 70,000 to 150,000 Americans. Fibrosis is a pathological wound healing process that produces an excessive extracellular matrix to interfere with normal organ function. Fibrosis contributes to nearly half of human mortality. Scleroderma has heterogeneous phenotypes, unpredictable outcomes, no validated biomarkers, and no effective treatment. Thus, strategies to slow down scleroderma progression represent an urgent medical need. While a pathological wound healing process like fibrosis leaves scars and weakens organ function, oral mucosa wound healing is a scarless process. After re-analyses of gene expression datasets from oral mucosa wound healing and skin fibrosis, we discovered that several pathways constitutively activated in skin fibrosis are transiently induced during oral mucosa wound healing process, particularly the amphiregulin (Areg) gene. Areg expression is upregulated ~ 10 folds 24hrs after oral mucosa wound but reduced to the basal level 3 days later. During bleomycin-induced skin fibrosis, a commonly used mouse model for skin fibrosis, Areg is up-regulated throughout the fibrogenesis and is associated with elevated cell proliferation in the dermis. To demonstrate the role of Areg for skin fibrosis, we used mice with Areg knockout, and found that Areg deficiency essentially prevents bleomycin-induced skin fibrosis. We further determined that bleomycin-induced cell proliferation in the dermis was not observed in the Areg null mice. Furthermore, we found that inhibiting MEK, a downstream signaling effector of Areg, by selumetinib also effectively blocked bleomycin-based skin fibrosis model. Based on these results, we concluded that the Areg-EGFR-MEK signaling axis is critical for skin fibrosis development. Blocking this signaling axis may be effective in treating scleroderma.
Association between somatic RET mutations and clinical and genetic characteristics in patients with metastatic colorectal cancer
Authors: Yang Yuan-Zhong , Hu Wan-Ming , Xia Liang-Ping , He wen-zhuo 
Published: January 2021

Abstract
Background
Rearranged during transfection (RET) is a targetable oncogene. RET fusions have been reported in patients with metastatic colorectal cancer (mCRC). However, RET mutations in mCRC are less studied. Here, we aimed to characterize the clinical, pathological, and molecular landscape of RET-mutated mCRC.
Methods
Five hundred and eighty-two patients were included in this study. Next-generation sequencing was performed to detect RET mutations and calculate tumor mutation burden (TMB). We compared the clinical, pathological, and molecular characteristics of mCRC cases with tumors that harbored somatic RET mutations (N = 16, 2.7%) or had wild-type RET (N = 566, 97.3%).
Results
Males comprised the absolute majority of cases with RET mutations (15/16 [93.8%]) compared to their fraction among cases with wild-type RET (339/566 [59.9%]). Furthermore, all patients with RET mutations were younger than 60 years (16/16 [100%]), whereas such patients were less predominant in the group with wild-type RET (379/566 [67.0%]). Individuals with tumors positive for RET mutations more frequently exhibited mucinous histology (5/16 [31.2%] versus 55/566 [9.7%]), exhibited a lower incidence of liver metastasis (4/16 [25.0%] versus 335/566 [59.2%]) and higher incidence of peritoneal metastasis (9/16 [56.2%] versus 161/566 [28.4%]), expressed wild-type TP53 (8/16 [50.0%] versus 120/566 [21.2%]), and showed an increased frequency of MSI-high (6/16 [37.5%] versus 18/566 [3.2%]). In those with microsatellite-stable mCRC, patients with RET mutations had a higher median TMB than patients with wild-type RET (9.4 versus 6.7 mutations/Mb, respectively, P = 0.001). The median progression-free survival was similar in individuals with mutated and wild-type RET on the oxaliplatin-based regimen (7.1 versus 8.7 months, P = 0.516).
Conclusions
Our study suggests that cases with RET mutations represent a separate mCRC subtype. Further studies are needed to evaluate the efficacy of RET inhibitors in mCRC patients with RET mutations.
Predictive Model and Feature Importance for Early Detection of Type II Diabetes Mellitus
Authors: Adua Eric , Kolog Emmanuel Awuni , Afrifa-Yamoah Ebenezer , Amankwah Bright , Obirikorang Christian , Anto Enoch Odame , Acheampong Emmanuel , Wang Wei , Tetteh Antonia Yarney 
Published: January 2021

Abstract
Background

Accurate prediction and early recognition of type II diabetes (T2DM) will lead to timely and meaningful interventions, while preventing T2DM associated complications. In this context, machine learning (ML) is promising, as it can transform vast amount of T2DM data into clinically relevant information. This study compares multiple ML techniques for predictive modelling based on different T2DM associated variables in an African population, Ghana.
Methods

The study involves 219 T2DM patients and 219 healthy individuals who were recruited from the hospital and the local community, respectively. Anthropometric and biochemical information including glycated haemoglobin (HbA1c), body mass index (BMI), blood pressure, fasting blood sugar (FBS), serum lipids [(total cholesterol (TC), triglycerides (TG), high and low-density lipoprotein cholesterol (HDL-c and LDL-c)] were collected. From this data, four ML classification algorithms including Naïve-Bayes (NB), K-Nearest Neighbor (KNN), Support Vector Machines (SVM) and Decision Tree (DT) were used to predict T2DM. Precision, Recall, F1-Scores, Receiver Operating Characteristics (ROC) scores and the confusion matrix were computed to determine the performance of the various algorithms while the importance of the feature attributes was determined by recursive feature elimination technique.
Results

All the classifiers performed beyond the acceptable threshold of 70% for the Precision, Recall, F-score and Accuracy. After building the predictive model, 82% of diabetic test data was detected by the NB classifier, of which 93% were accurately predicted. The SVM classifier was the second-best performing classifier which yielded an overall accuracy of 84%. The non-T2DM test data yielded an accurate prediction score of 75% from the 98% of the proportion of the non-T2DM test data. KNN and DT yielded accuracies of 83% and 81%, respectively. NB has the best performance (AUC = 0.87) followed by SVM (AUC = 0.84), KNN (AUC = 0.85) and DT (AUC = 0.81). The best three feature attributes, in order of importance, are HbA1c, TC and BMI whereas the least three importance of the features are Age, HDL-c and LDL-c.
Conclusion

Based on the predictive performance and high accuracy, the study has shown the potential of ML as a robust forecasting tool for T2DM. Our results can be a benchmark for guiding policy decisions in T2DM surveillance in resource and medical expertise limited countries such as Ghana.
Case report: narcolepsy type 2 due to the optic nerve infection of Herpes zoster virus
Authors: Yu Zhenghe , Han Li , Ren Lishan , Xu You , Liu Wenjuan , Ma Lisha , Wei Youdan , WANG Shengdong 
Published: January 2021

Abstract
Rationale: Despite the acknowledged importance of environmental risk factors in the etiology of narcolepsy, there is little research on this topic. The optic nerve infection of Herpes zoster virus as a trigger for narcolepsy has not been investigated.Patient concerns: A 63-year-old male carpenter complained of excessive daytime sleepiness (EDS) over the past 3 years.Interventions: Treated with duloxetine hydrochloride enteric dissolution capsule (Cymbalta) 120mg after breakfast and clonazepam tablets 0.5mg before sleep.Outcomes: General examination showed no abnormalities of his heart, lungs, or abdomen. Neurological examination showed no positive sign. The blood routine and biochemical examination were normal. Denied having been vaccinated against the flu or having been infected with the flu virus. He scored 17 on the Pittsburg sleep quality index, 22 on the Epworth sleepiness scale, 40 on the self-rating anxiety scale, and 69 on the self-rating depression scale. The multiple sleep latency test data showed 2 periods of sleep-onset rapid eyes movement period across 4 successive tests; the average sleep latency was 7.9 minutes, and the rapid eyes movement latency was 1.2 minutes. Treated with duloxetine hydrochloride enteric dissolution capsule (Cymbalta) 120mg after breakfast and clonazepam tablets 0.5mg before sleep, the patient’s EDS symptoms disappeared immediately. He scored 6 on the Epworth sleepiness scale. During our follow-up three months later, he remained well with no complications.Diagnosis: We diagnosed the patient with narcolepsy type 2 according to the 3rd Edition of International Classification of Sleep Disorders (ICSD-3).Conclusion: The patient suffered from EDS and was diagnosed with narcolepsy type 2. The narcolepsy type 2 was linked to viral infection of the optic nerve. Optic nerve virus infection may affect the sleep-pondering pathway.
Clinical Results Following Colonic Resection for Ulcerative Colitis in Elderly Individuals ( Elderly-onset Versus Nonelderly Onset)
Authors: Kuwahara Ryuichi , Ikeuchi Hiroki , Bando Toshihiro , Goto Yoshiko , Horio Yuki , Minagawa Tomohiro , Uchino Motoi 
Published: January 2021

Abstract
BackgroundThe incidence of ulcerative colitis (UC) is increasing, but there are few reports comparing elderly UC patients undergoing colectomy for elderly-onset UC (EOUC) and nonelderly-onset UC (NEOUC). The aim of this study was to analyze the differences between EOUC and NEOUC patients who underwent UC-related surgery.MethodsWe identified 1973 patients with UC who underwent colectomy at Hyogo College of Medicine between January 1, 1984, and December 31, 2018. Only patients aged 65 years old and older who underwent colectomy were enrolled in this study (n=221, 11.2%), and their clinical records were retrospectively reviewed. Patients were divided into two groups according to their age at disease onset: those with onset at younger than 60 years old (NEOUC) and at 60 years old or older (EOUC).ResultsIn the 221 UC patients who underwent colectomy at 65 years old or older, there were 155 cases of EOUC and 66 cases of NEOUC. The main surgical indication in NEOUC patients was colitis-associated cancer/dysplasia (32/66, 47%). In contrast, refractory to medical treatment was the leading cause of surgery in EOUC patients (80/155, 52%). The distributions of surgical indications were different between the two groups (p<0.01).The preoperative daily dose of steroids was significantly higher in the EOUC group than in the NEOUC group (0 mg vs 10 mg, p<0.01). The rates of immunosuppressant, infliximab (IFX) and adalimumab use did not differ significantly between the groups. Significantly more patients underwent emergency surgery in the EOUC group than in the NEOUC group (14% vs 35%, p<0.01).The proportions of patients with postoperative morbidity (Clavien-Dindo grade III or higher) were 17.4% (27/155) in the EOUC group and 13.6% (9/66) in the NEOUC group. There was no significant difference between the two groups (p=0.48). The prognosis of the EOUC patients who underwent UC-related emergency surgery was worse than that of the NEOUC patients (p<0.01). In the EOUC group, 8 (14.8 %) of 54 patients died within 30 postoperative days, while there were no deaths in the NEOUC group.Conclusion Among elderly UC patients undergoing UC-related surgery, EOUC patients undergoing emergency surgery had very poor outcomes, and the mortality rate was 14.8%. In such cases, it is important for physicians and surgeons to begin communication at an early stage so that the optimal surgical timeframe is not missed.
Effects of Irrigation Fluid Temperature During Flexible Ureteroscopic Holmium Laser Lithotripsy on Postoperative Fever and Shivering: A Randomized Controlled Trial
Authors: He Yue , Feng Yougang , He Jun , Liang Bo , Jiang Mindong , Liu Jun , Kang Yongming , Ma Liping , Zhang Qin , Peng Qijia , Yang Tao , Liu Yao , Luo Li , Zhang Min 
Published: January 2021

Abstract
Background. Flexible ureteroscopic holmium laser lithotripsy is used to treat urinary tract calculi, but postoperative complications include shivering, fever and infection. To investigate the effects of irrigation fluid temperature on postoperative complications. Methods. This randomized controlled trial included 120 consecutive patients undergoing flexible ureteroscopic holmium laser lithotripsy at the Urology Department, Suining Central Hospital, Sichuan, China between January 2017 and July 2019. Patients were randomized 1:1:1 into three groups (17°C, 27°C or 37°C). Primary outcome was fever incidence (body temperature >37.5°C) within 48 hours after surgery. Secondary outcomes included shivering incidence during recovery from anesthesia, white blood cell count (WBC), serum procalcitonin (PCT) and incidence of suspected infection (temperature >38.5°C and PCT >0.5 µg/L). Results. There were 108 patients, (17°C group, n=36; 27°C group, n=35; 37°C group, n=37), received flexible ureteroscopic holmium laser lithotripsy and analyzed. Age, gender distribution, body mass index, ASA grade, stone burden, preoperative creatinine, preoperative core temperature and irrigation fluid volume did not differ significantly between groups. 17°C, 27°C and 37°C groups exhibited significant differences in the incidences of postoperative fever (38.9% vs. 17.1% vs. 13.5%) and shivering (22.2% vs. 5.7% vs. 2.7%) (p<0.05 for all pairwise comparisons). There was no significant difference of WBC, PCT and incidence of suspected infection in 37°C or 27°C group compared with 17°C group. One case each of flash pulmonary edema and bleeding occurred in 37°C group. Conclusion. Warming the irrigation fluid can reduce the incidence of postoperative fever and shivering, but further studies are needed to determine the optimal temperature.
The Effect of Intraoperative Neuromonitoring on Damage to the Laryngeal Nerves in Patients Undergoing Total Thyroidectomy.
Authors: Bryk Piotr , Głuszek Stanisław 
Published: January 2021

Abstract
Background: Assessment of intraoperative neuromonitoring in the prevention of damage to the recurrent laryngeal nerve during total thyroidectomy.Material and methods: A group of 367 patients qualified for the study, including 312 women (85.01%) and 55 (14.99%) men, aged 18-79, having undergone total thyroidectomy due to a neutral nodular goiter. The patients were operated on by one surgeon. The study group consisted of 205 patients, including 173 (84.39%) women and 32 (15.61%) men, aged 19-79, who were operated on with the use of intraoperative neuromonitoring. The control group consisted of 162 patients, including 139 (85.80%) women and 23 (14.20%) men, aged 18-77 years, who had undergone surgery only with macroscopic visualization of the recurrent laryngeal nerve without the application of intraoperative neuromonitoring. Then, in the period from 2 to 10 years after the surgery, follow-up examinations were performed, which included 153 patients from the control group (74.6% [153/205]) and 122 patients from the study group (75.3% [122 / 162] Results: The frequency of vocal fold palsy did not differ significantly statistically in the study group and the control group (study group: 4.9% [10/205], control group: 4.9% [8/162]; p = 0.979). In the follow-up study, the incidence of laryngeal fold palsy did not show statistically significant differences between the study and control groups. Most of the damage to the recurrent laryngeal nerves was persistent.Conclusions: Neuromonitoring did not reduce the number of recurrent laryngeal nerve injuries in relation to the nerve visualization alone in noncapsular total thyroidectomy for benign nodular goiter, performed by the same experienced surgeon.
Surface Environment of Phobos and Phobos Simulant UTPS
Authors: Miyamoto Hideaki , Niihara Takafumi , Wada Koji , Ogawa Kazunori , Senshu Hiroki , Michel Patrick , Kikuchi Hiroshi , Hemmi Ryodo , Nakamura Tomoki , Nakamura Akiko M , Hirata Naoyuki , Sasaki Sho , Asphaug Erik , Britt Dan T. , Abell Paul A. , Ballouz Ronald-Louis , Barnouin Olivier S. , Barsei Nicola , Barucci Maria A. , Biele Jens , Grott Matthias , Hino Hideitsu , Hong Peng K. , Imada Takane , Kameda Shingo , Kobayashi Makito , Libourel Guy , Mogi Katsuro , Murdoch Naomi , Nishio Yuki , Okamoto Shogo , Ota Yuichiro , Otsuki Masatsugu , Otto Katharina A. , Sakaani Naoya , Shimizu Yuta , Takemura Tomohiro , Terada Naoki , Tsukamoto Masafumi , Usui Tomohiro , Willner Konrad 
Published: January 2021

Abstract
The Martian Moons eXploration (MMX) mission will study the Martian moons Phobos and Deimos, Mars, and their environments. The mission scenario includes both landing on the surface of Phobos to collect samples and deploying a small rover for in-situ observations. Engineering safeties and scientific planning for these operations require appropriate evaluations of the surface environment of Phobos. Thus, the mission team organized the Landing Operation Working Team (LOWT) and Surface Science and Geology Sub-Science Team (SSG-SST), whose view of the Phobos environment is summarized in this paper. While orbital and large-scale characteristics of Phobos are relatively well known, characteristics of the surface regolith, including the particle size-distributions, the packing density, and the mechanical properties, are difficult to constrain. Therefore, we developed several types of simulated soil materials (simulant), such as UTPS-TB (University of Tokyo Phobos Simulant, Tagish-lake based), UTPS-IB (Impact-hypothesis based), and UTPS-S (Simpler version) for engineering and scientific evaluation experiments.
Distribution of sources of household air pollution: a cross-sectional study in Cameroon
Authors: Baame Esong Miranda , Goura André Pascal , Mbatchou Bertrand Hugo Ngahane , Walage Berenice , Simo Herman Styve Yomi , Medjou Romarique Mboumo , Sonkoue Martial Pianta , Djouda Cyrielle Douanla , Ngnewa Rose Suzie Fowoh , Guiagain Milaine Sandra Teugueu , Agokeng Brice-Donald Kemnang , Homla Olivia Tania Megaptche , Pope Dan , Ateudjieu Jerome 
Published: January 2021

Abstract
Background: Household air pollution (HAP) is a recognised risk factor for many diseases, including respiratory diseases, cardiovascular/circulatory disorders, adverse pregnancy outcomes and cataracts. Population exposure to biomass fuels, including wood, varies among countries and from one fuel source to the other. This study aimed to investigate the different sources of HAP in peri-urban and rural communities in Cameroon. Methods: A cross-sectional survey was conducted in a representative sample of households from the Dschang Health District (DHD) region. This included 848 homes in which a range of fuels for cooking including biomass (firewood, charcoal, sawdust), kerosene and liquefied petroleum gas (LPG) were used both indoors and outdoors. Results: Of the study households, 651 (77%) reported exclusive use of firewood and 141 (17%) reported using more than one source of fuel. Exclusive use of firewood was greater in rural communities (94%) than in peri-urban communities (38%). In peri-urban communites, use of multiple fuels including LPG, wood, sawdust and kerosene, was more common (44.75%). A total of 25.03% of households in both peri-urban and rural communities reported using bottled gas (or liquified petroleum gas (LPG) for cooking. Motivations for choice of fuel included, price, availability (easy access), rapidity, tradition or culture related factorsConclusion: Wood is the main cooking fuel in both peri-urban and rural communities in the Dschang Health District. Work to help households (especially those who are resource poor) to adopt LPG equipment for cooking, and use in a more exclusive way is required.
The Role of Patient Education in Total Knee Arthroplasty: a new methodology for developing countries: a randomized controlled trial
Authors: Andrade Marco Antonio Percope de , Silva Guilherme Moreira Abreu e , Campos Tulio Vinicius Oliveira , Barbosa David Guen Kasuya , Leite Danilo Silva , Rezende Marcus Vinicius Teodoro , Magalhães Tauam Filipe Galo , Santos Felipe Maciel 
Published: January 2021

Abstract
Background: The illiteracy index is high in public hospitals of developing countries,. We established a method in which patients are instructed before total knee arthroplasty (TKA) in a differentiated way without the necessity of reading any self-orientation. Methods: We developed a multidisciplinary approach to improve patient education in TKA comprising of a differentiated orientation conducted by an orthopedic surgeon, a nurse and a physiotherapist. It consists of standardized lectures regarding on pre, intra and post-operative issues in a randomized controlled trial of 79 consecutive patients undergoing primary TKA. Thirty-four patients received the standard education (control group) and 45 patients received the differentiated education (intervention group). The patients were evaluated during at least six months. Results: After a 6-month follow-up period, the Short Form Health Survey (SF-36), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the visual analogue pain scale (VAS) and knee range-of-motion (ROM) improved significantly in both groups. Range-of-motion was better in the intervention group (mean and SD - 106.9 ± 5.7 versus 92.5 ± 12.1 degrees, p = 0.02). Moreover, walk ability (more than 400 meters) was better in the intervention group compared with the control group (97.4% versus 72.4%, p = 0.003). In the intervention and control groups, respectively, 10.5% and 31% of patients reported the need for some walking devices (p = 0.03). Conclusions: A differentiated educational program with a multidisciplinary team had a positive impact on functional outcomes, improving ROM and walk ability of patients undergoing TKA in a short-term evaluation.