bluuebunny/crossref_metadata_2025_split huggingface dataset:
Super high-flux membrane dialyzers improve mortality in patients on hemodialysis: a 3-year nationwide cohort study
Authors: Abe Masanori , Masakane Ikuto , Wada Atsushi , Nakai Shigeru , Nitta Kosaku , Nakamoto Hidetomo 
Published: September 2021

ABSTRACT

Introduction
In Japan, dialyzers are classified based on β2-microglobulin clearance. Type I dialyzers are classified as low-flux dialyzers (&lt;10 mL/min clearance), type II and III as high-flux dialyzers (≥10 to &lt;30 mL/min and ≥30 to &lt;50 mL/min clearance, respectively), and type IV and V as super high-flux dialyzers (≥50 to &lt;70 mL/min and ≥70 mL/min clearance, respectively). Super high-flux dialyzers are commonly used, but their superiority over low-flux dialyzers is controversial.

Methods
In this nationwide prospective cohort study, we analyzed Japanese Society for Dialysis Therapy Renal Data Registry data collected at the end of 2008 and 2011. We enrolled 242,467 patients on maintenance hemodialysis and divided them into five groups by dialyzer type. We assessed the associations of each dialyzer type with 3-year all-cause mortality using Cox proportional hazards models and performed propensity score matching analysis, adjusting for potential confounders.

Results
By the end of 2011, 53,172 (21.9%) prevalent dialysis patients had died. Mortality significantly decreased according to dialyzer type. Hazard ratios (HRs) were significantly higher for type I, II and III compared with type IV (reference) after adjustment for basic factors and further adjustment for dialysis-related factors. HR was significantly higher for type I, but significantly lower for type V, after further adjustment for nutrition- and inflammation-related factors. These significant findings were also evident after propensity score matching.

Conclusions
Hemodialysis using super high-flux dialyzers might reduce mortality. Randomized controlled trials are warranted to clarify whether these type V dialyzers can improve prognosis.
A Novel Approach to Adaptive Resource Allocation for Energy Saving in Reconfigurable Heterogeneous Networks
Authors: Nabipour Mohammad , Momen Amir Reza 
Published: September 2021

Abstract
The dense deployment of small cell networks is a key feature of next generation mobile networks aimed at providing the necessary capacity increase. Wireless heterogeneous networks are created by combining several radio access technologies, each with its own potentials, capabilities and limitations. In these networks, providing real-time services with quality assurance is essential. For effective use of radio resources, the Radio Resource Management method was introduced which its performance and efficiency is better than the control of independent radio resources in any radio access technology. In this paper, we introduced a novel approach to select the most effective radio access technologies by taking into account some performance parameters like the type of service, users’ distribution pattern and the cost of the services. It also optimizes the handover relations between macrolayer and small cells. The proposed approach is a self-optimizing model can be employed to control resources and improve performance indices associated with mobile networks without human interference by only relying on network intelligence. In order to maximize the network performance, we applied the dynamic backhauling technique to analyze the uplink signaling data which increased the validity level of the decision-making process. Based on the extracted semantic information, the network decision-making engine is able to adjust the network parameters and efficiently allocate the resources. The numerical results exhibit considerable power saving for different traffic models in addition to reduce the rate of vertical handovers. The results also show increase the network throughput by up to 30%.
Multi-Keyword Ranked Searchable Encryption with the Wildcard Keyword for Data Sharing in Cloud Computing
Authors: Liu Jinlu , Zhao Bo , Qin Jing , Zhang Xi , Ma Jixin 
Published: September 2021

Abstract
Multi-keyword ranked searchable encryption (MRSE) supports multi-keyword contained in one query and returns the top-k search results related to the query keyword set. It realized effective search on encrypted data. Most previous works about MRSE can only make the complete keyword search and rank on the server-side. However, with more practice, users may not be able to express some keywords completely when searching. Server-side ranking increases the possibilities of the server inferring some keywords queried, leading to the leakage of the user’s sensitive information. In this paper, we propose a new MRSE system named ‘multi-keyword ranked searchable encryption with the wildcard keyword (MRSW)’. It allows the query keyword set to contain a wildcard keyword by using Bloom filter (BF). Using hierarchical clustering algorithm, a clustering Bloom filter tree (CBF-Tree) is constructed, which improves the efficiency of wildcard search. By constructing a modified inverted index (MII) table on the basis of the term frequency-inverse document frequency (TF-IDF) rule, the ranking function of MRSW is performed by the user. MRSW is proved secure under adaptive chosen-keyword attack (CKA2) model, and experiments on a real data set from the web of science indicate that MRSW is efficient and practical.
It is time to mate: population-level plasticity of wild boar reproductive timing and synchrony in a changing environment
Authors: Brogi Rudy , Merli Enrico , Grignolio Stefano , Chirichella Roberta , Bottero Elisa , Apollonio Marco 
Published: September 2021

AbstractOn a population level, individual plasticity in reproductive phenology can provoke either anticipations or delays in the average reproductive timing in response to environmental changes. However, a rigid reliance on photoperiodism can constraint such plastic responses in populations inhabiting temperate latitudes. The regulation of breeding season length may represent a further tool for populations facing changing environments. Nonetheless, this skill was reported only for equatorial, nonphotoperiodic populations. Our goal was to evaluate whether species living in temperate regions and relying on photoperiodism to trigger their reproduction may also be able to regulate breeding season length. During 10 years, we collected 2,500 female reproductive traits of a mammal model species (wild boar Sus scrofa) and applied a novel analytical approach to reproductive patterns in order to observe population-level variations of reproductive timing and synchrony under different weather and resources availability conditions. Under favorable conditions, breeding seasons were anticipated and population synchrony increased (i.e., shorter breeding seasons). Conversely, poor conditions induced delayed and less synchronous (i.e., longer) breeding seasons. The potential to regulate breeding season length depending on environmental conditions may entail a high resilience of the population reproductive patterns against environmental changes, as highlighted by the fact that almost all mature females were reproductive every year.
100 TOTAL LYMPHOCYTES COUNT (TLC) PREDICTS THE OVERALL SURVIVAL AFTER CHEMORADIOTHERAPY IN ESOPHAGEAL CARCINOMA PATIENTS
Authors: Nishida Masato , Sato Shinsuke , Higashizono Kazuya , Taki Yusuke , Nagai Erina , Wataanbe Masaya , Ohata Ko , Kanemoto Hideyuki , Oba Noriyuki 
Published: September 2021

Abstract

Lymphocytes play a critical role in the host immune system, and a decrease in number of lymphocytes, caused by malnutritional status and chemoradiotherapy (CRT) leads to immunosuppression. Immunosuppression could enhance the cancer development and progression. Previous studies demonstrated that lymphopenia was associated with worse prognosis in the pancreatic, lung, head and neck, and rectal cancer, but little is known about esophageal cancer.

Methods
There were 298 patients of esophageal malignant tumors, who had been initially treated with chemoradiotherapy (CRT) between January, 2007 and December, 2018. The total lymphocyte counts (TLC) before CRT and the nadir value during 6 weeks after CRT along with other clinical and treatment characteristics of these 298 patients, were retrospectively evaluated in relevance with the overall survival (OS) after CRT.

Results
The median TLC before and after CRT were 1469 (range 456–4710)/mm3 and 354 (range 21–1500)/mm3, respectively. When the patients were stratified with the threshold value of 1500/mm3 of pretreatment TLC, the Log-Rank test showed significant difference in OS between these 2 groups (OS 48.7% vs 36.6%, p = 0.011). In addition, the CTCAE grade of lymphopenia exceeding 3 after CRT was associated with worse OS even in the group with pretreatment TLC level more than 1500/mm3. The multivariate analysis showed that the significant prognostic factors of OS were cN, cM, additional esophagectomy and pretreatment TLC.

Conclusion
The decease of pretreatment TLC was significantly associated with worse OS when the patients of esophageal cancer were initially treated with CRT.
155 A META-ANALYSIS OF EFFICACY AND SAFETY OF ANTI-BODIES TARGETING PD-1 IN TREATMENT OF ADVANCED ESOPHAGEAL CANCER
Authors: Wang Feng , Lu Yao , Meng Xiangrui , Fan Qingxia 
Published: September 2021

Abstract

Systemic chemotherapy is the first choice for patients with advanced esophageal cancer. However, due to drug resistance and dose-limiting toxicity, a large number of patients in China have not been treated. A novel therapy based on programed death 1 (PD-1) inhibitors has been proved to be effective in advanced esophageal cancer.This article is a meta-analysis aiming to systematically evaluate the efficacy and safety of anti-PD-1 therapy in patients with esophageal cancer.

Methods
Data were collected from eligible studies searched from PubMed, Web of Science, Cochrane Library and Embase. Pooled hazard ratio (HR) for overall survival (OS) and progression-free survival (PFS) was estimated to assess the efficacy of PD-1 inhibitors versus chemotherapy, and pooled odds ratio (OR) was calculated for objective response rate (ORR). The analysis among patients tested with different PD-1 status was also performed to figure out the relationship between PD-1 status and efficacy of anti-PD-1 therapy. The OR for occurrence of treatment-related adverse effect was calculated to assess the safety of anti-PD-1 therapy.

Results
A total of 8 studies were analyzed. Compared with patients with chemotherapy, patients with anti-PD-1 therapy had a significant improvement in OS (HR = 0.80, 95% CI: 0.70–0.91, P = 0.001), but no significant relationship was observed in ORR (HR = 1.87, 95% CI: 0.82–4.25, P = 0.13) and PFS (HR = 0.94, 95% CI: 0.70–1.26, P = 0.67). A similar result was observed in esophageal squamous cell carcinoma (ESCC). The PD-L1 status has no obvious connection with the efficacy of anti-PD-1 therapy. The incidence of grade 3 to 5 treatment-related adverse effect(AE) in anti-PD-1therapy was distinctly lower than that in chemotherapy, but there is no statistical difference in all treatment-related AE.

Conclusion
Anti-PD-1 therapy significantly prolonged the OS when compared with chemotherapy, while no significantly difference in PFS and ORR for the population of esophageal cancer, ESCC， PD-L1 positive. Based on the analysis of grade 3 to 5 treatment-related adverse effect events, a lower risk was associated with the anti-PD-1 therapy versus chemotherapy.
165 CLINICAL IMPACT OF PREOPERATIVE SERUM P53 ANTIBODY TITERS IN 1,487 PATIENTS WITH ESOPHAGEAL CARCINOMA: A MULTI-INSTITUTIONAL STUDY
Authors: Suzuki Takashi , Yajima Satoshi , Okamura Akihiko , Yoshida Naoya , Taniyama Yusuke , Murakami Kentarou , Okura Yu , Nakajima Yasuaki , Yagi Kouichi , Fukuda Takashi , Ogawa Ryo , Hoshino Isamu , Tanaka Yusaku , Narumiya Kosuke , Tsubosa Yasuhiro , Soma Daisuke , Shimada Hideaki 
Published: September 2021

Abstract

Although previous reports showed clinicopathological and diagnostic significance of serum p53 antibody in esophageal squamous cell carcinoma, all those reports analyzed only 100 to 200 patients at single institute. This study was designed as a multi-institutional study promoted by the Japan Esophageal Society to elucidate the clinical significance of serum p53 antibody in esophageal cancer treatment.

Methods
A total of 1,487 patients, from 15 hospitals of Japan, with esophageal carcinoma surgically treated between 2008 and 2016 were enrolled in this retrospective study. We used 1.30 U/ml as a cutoff for classifying patients into positive and negative groups. And we attempted to analyze only positive cases. A receiver operating characteristic curve was constructed to assess serum p53 antibody cutoff levels to differentiate poor prognosis. We used 9.82 U/ml as a cutoff for classifying patients into low and high groups. Univariate and multivariate analyses were used to evaluate the clinicopathological and prognostic significance of pretreatment level of serum p53 antibody.

Results
There were significant relationships between serum p53 antibody level and tumor depth (p = 0.002), nodal status (p = 0.027) and pathological stage (p = 0.002). The positive serum p53 antibody group had a no significantly worse overall survival than that of the negative group (p = 0.699). The high serum p53 antibody group had a significantly worse overall survival than that of the low group (p = 0.024). However, the difference was not significant in the multivariate analysis (p = 0.137).

Conclusion
Although high level (&gt;9.82 U/ml) of pretreatment serum p53 antibody might be associated with poor prognosis for patients with esophageal cancer, high serum p53 antibody was not an independent risk factor.
215 LOCATION OF ANASTOMOSIS BEHIND THE STERNOCLAVICULAR JOINT INCREASES THE INCIDENCE OF ANASTOMOTIC STENOSIS IN RETROSTERNAL RECONSTRUCTION AFTER ESOPHAGECTOMY
Authors: Kurahashi Yasunori , Hojo Yudai , Nakamura Tatsuro , Kumamoto Tsutomu , Nakanishi Yasutaka , Ishida Yoshinori , Shinohara Hisashi 
Published: September 2021

Abstract

Anastomotic stenosis after esophagectomy is a major cause of long-term morbidity because it leads to poor dietary intake and malnutrition that markedly reduces quality of life. The aim of this study was to test the hypothesis that the risk of anastomotic stenosis is higher when the anastomosis is located behind the sternoclavicular joint than when it deviates from the sternoclavicular joint.

Methods
Among 226 patients who underwent esophagectomy between April 2010 and March 2019, we selected 114 patients who underwent retrosternal reconstruction using a gastric conduit for this study. They were classified into two groups according to the location of the anastomosis as determined by postoperative computed tomography scans: anastomosis located behind the sternoclavicular joint (group B; n = 71) and anastomosis deviated from the joint (group D; n = 43). The primary endpoint was the difference in the incidence of anastomotic stenosis between the two groups. Whether the occurrence of anastomotic leak affected the likelihood of anastomotic stenosis was also investigated.

Results
The incidence of anastomotic stenosis was significantly higher in group B than in group D (71.8% [n = 51] vs 18.6% [n = 8]; p &lt; 0.0001). The incidence of stenosis in patients who developed an anastomotic leak was significantly higher in group B than in group D (88.0% vs 41.7%; p = 0.0057), although the findings were similar in patients who did not develop an anastomotic leak (63.0% and 9.7%, respectively; p &lt; 0.0001).

Conclusion
There is an increased risk of anastomotic stenosis independent of anastomotic leak when the anastomosis is located behind the sternoclavicular joint in patients who undergo retrosternal reconstruction with a gastric conduit after esophagectomy.
287 OUTCOMES OF DEFINITIVE CHEMORADIOTHERAPY IN LONG SEGMENT ESOPHAGEAL CANCERS FROM A TERTIARY CANCER CENTRE IN INDIA
Authors: Agarwal Jaiprakash , Tibdewal Anil , Johnny Carlton , Chopade Pradnya , Mummudi Naveen , Mhatre Ritesh , Kinhikar Rajesh , Noronha Vanita , Prabhash Kumar 
Published: September 2021

Abstract

Definitive chemoradiotherapy (CTRT) is the standard of care for unresectable esophageal cancer. Long segment esophageal primary disease makes it challenging to deliver radiation doses needed to achieve good local control without exceeding normal tissue tolerance to the surrounding organs at risk (OAR). We report our experience and outcomes of such patients where the RT doses were reduced from our institutional standard of 63Gy to 50.4Gy.

Methods
Between Jan 2017 and Dec 2019, 30/232 consecutive esophageal cancer patients were identified with long segment disease that required dose reduction from 63 to 50.4Gy and were included in this analysis. For this study, we divided nodal regions by their location into cervical, mediastinal, and gastro-hepatic. We generated and compared dosimetric parameters of the standard dose (63Gy) plan with that of treated low-dose plan (50.4Gy) using paired t-test. We also evaluated the patterns of recurrence and have reported them as local relapse (LR), loco-regional relapse (LRR), and distant metastases (DM).

Results
The median age was 55.5 years; 16 (53.3%) were males and 28 (93.3%) had squamous carcinoma. Single nodal site was involved in 6(20%), 2 sites in 20(66.7%) and 3 sites in 4 (13.3%). Median GTV and PTV length were 7.9 cm (IQR:6.4–9.7 cm) and 18.8 cm (IQR:14.08–22.31 cm) respectively. Median OAR doses with standard Vs treated plan achieved were: Total lung V20 and V5:28 Vs 22.14% (p = 0.00), and 81 Vs 70.5% (p = 0.005) respectively, and heart V20:70.92% Vs 64.7% (p = 0.000). No patients experienced ≥grade2 lung toxicity. After a median follow up of 8.4 months, 3 patients experienced LRR and 1 developed DM.

Conclusion
Treatment of long segment esophageal cancers warrants dose reduction to avoid higher doses to OAR like lung and heart. Early loco-regional and distant failures suggest need for improved treatment strategies or dose escalation with more conformal techniques like proton therapy. Longer follow-up is necessary to assess the median LR, LRR rates and overall survival for this reduced dose group as compared to the standard dose group.
309 ASSOCIATION BETWEEN CERVICAL ANASTOMOSIS METHODS AND ANASTOMOSIS STRICTURE AFTER ESOPHAGECTOMY FOR CANCER
Authors: Suzuki Akihiro 
Published: September 2021

Abstract

Esophagectomy with three-field lymph node dissection is the most important part of advanced esophageal cancer therapy, especially for squamous cell carcinoma (SCC) patients. After esophagectomy, cervical anastomosis with gastric tube is required. However, some patients suffer anastomotic stenosis and require endoscopic balloon dilations. In this study, we investigated the relationship between cervical anastomosis methods and anastomosis stricture after esophagectomy for cancer patients.

Methods
Patients with esophageal cancer undergoing radical esophagectomy with cervical anastomosis were identified from the prospectively maintained database at our institution. From 2013 to 2019, 28 patients received esophagectomy with cervical lymph node dissection in our institution. Association between anastomotic methods, linear stapler vs circular stapler, and other factors (patient characteristics, surgical complications including anastomotic stenosis, and length of postoperative stay) were analyzed.

Results
Their average age was 63.3 years. Males and SCC cases predominated. Thirteen patients (46%) received cervical anastomosis with the circular stapler (Group C), and 11 patients (39%) received treatment with the linear stapler (Group L).
None of the following variables were significant different between the two methods: preoperative chemotherapy (53.8% in group C vs. 45.5% in group L; p = 0.58), length of hospital stay (25.8 vs. 20.7 days; p = 0.15), pulmonary complications (16.7% vs. 0.0%; p = 0.36), and anastomotic leakage (33.3% vs. 9.1%; p = 0.24). However, the rate of anastomotic stenosis without malignancies was significantly higher in group C patients (66.7% vs. 0%, p &lt; 0.01).

Conclusion
Cervical anastomosis with the linear stapler may be safer and associated with a lower stenosis rate than with the circular stapler. In future, cervical anastomosis with linear stapler after mediastinoscopic esophagectomy would be better for not only esophageal SCC patients but also esophagogastric junction adenocarcinoma patients with pulmonary complications.
351 SINGLE-PORT MINIMALLY INVASIVE ESOPHAGECTOMY TO TREAT ESOPHAGEAL CANCER: EXPERIENCE OF 144 CASES
Authors: Lee Jang-Ming , Ke-Cheng Chen , Mong-Wei Lin , Pei-Wen Yang , Pei-Ming Huang 
Published: September 2021

Abstract

Single-incision thoracoscopic and laparoscopic procedures has have been applied in treating various diseases. However, it is limited in literature for such procedures used in treating esophageal cancer.

Methods
Minimally invasive esophagectomy (MIE) with a single-incision approach in the thoracoscopic and laparoscopic procedures was attempted in 144 patients with esophageal cancer.

Results
There was 96 patients underwent a McKeown procedure and 48 an Ivor Lewis procedure repectively. The mean ventilator usage of the patients after surgery was 0.3 ± 0.6 days, the mean ICU stay was 7.42 ± 17.15 days, and the mean number of dissected lymph nodes was 43.5 ± 21.8. There 11 patients suffered from postoperative complications, including 3 pulmonary complications, 4 anastomotic leakage and 4 vocal cord palsy. There are no 30-day mortality, however, there were one patient died from ARDS 40 days after surgery.

Conclusion
Single-port MIE seems to be a feasible option for treating patients with esophageal cancer, which offers an acceptable perioperative surgical outcome. However, the long-term survival results of the patients requires to be follow-up in the future.
385 MIR-24-3P REGULATES CDX2 DURING THE PROCESS OF INTESTINALIZATION OF THE CARDIAC-TYPE EPITHELIUM IN A HUMAN MODEL OF BARRETT’S ESOPHAGUS
Authors: Pera Manuel , Garrido Marta , Gil Gabriel , Fassan Matteo , Climent Marta , Nonell Lara , Anglada Roger , Iglesias Mar , Guzzardo Vicenza , Borga Chiara , Grande Luis , Bolós Carme 
Published: September 2021

Abstract

Cardiac-type epithelium has been proposed as an intermediate stage between normal squamous epithelium and intestinal metaplasia in the development of Barrett’s esophagus. Deregulation of certain miRNAs and their effects on CDX2 expression might contribute to the intestinalization process of cardiac-type epithelium. The aim of this study was to identify miRNAs differentially expressed between CDX2 positive and negative glands of Barrett’s esophagus and to examine the function of specific miRNAs on the regulation of CDX2.

Methods
miRNA expression profiling using OpenArrayTM analysis in microdissected cardiac-type glands with and without fully CDX2 expression was performed in biopsies from patients who developed cardiac-type epithelium in the remnant esophagus after esophagectomy. Data were validated using real-time PCR in esophageal adenocarcinoma cell lines and in situ and real-time PCR miRNA/CDX2/MUC2 co-expression analysis in cardiac-type mucosa samples. The effect of miR-24-3p precursor transfection on CDX2 expression was assessed in the esophageal adenocarcinoma cell lines FLO-1 and KYAE-1.

Results
CDX2 positive glands were characterized by an unique miRNA profile with a significant downregulation of miR-24-3p, miR-520e-3p, miR-548a-1, miR-597-5p, miR-133a-3p, miR-30a-5p, miR-638, miR-625-3p, miR-1255b-1, miR-1260a and upregulation of miR-590 (Figure 1A). miRNA-24-3p was identified as potential regulator of CDX2 gene expression in three bioinformatics algorithms, and this was confirmed in esophageal adenocarcinoma cell lines (Figure 1C). Furthermore, miR-24-3p expression negatively correlates with CDX2 in cardiac-type mucosa samples with different stages of mucosal intestinalization (Figure 1B).

Conclusion
These results imply that miRNA-24-3p directly targets CDX2, and downregulation of miRNA-24-3p is associated with the acquisition of an intestinal phenotype in cardiac-type epithelium.