bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Natural History of Patients with Prostate Specific Antigen Elevation Receiving Holmium Laser Enucleation of the Prostate: Prospective Cohort Study
Authors: Lee Hahn-Ey , Yoon Hyun Sik , Kim ByungWon , Suh Jungyo , Oh Seung-June 
Published: August 2021

Abstract
Objectives

To understand the natural history of patients with prostate specific antigen (PSA) elevation receiving Holmium Laser Enucleation of the Prostate (HoLEP) for benign prostatic hyperplasia (BPH), and to understand clinical factors correlated with PSA elevation.
Subjects and Methods:

Patients in the prospective database registry from our institution who underwent HoLEP between January 2010 and May 2020 were analyzed. The patients were classified into low (< 3.0ng/mL) and high ( > = 3.0ng/mL) PSA groups at baseline. Intraoperative and early postoperative outcomes were evaluated. Postoperative evaluation was performed, with PSA being evaluated at the postoperative sixth month. Factors showing correlation with PSA elevation were analyzed.
Results

A total of 1297 patients with a mean age of 69.7 (± 6.8 SD) years were analyzed. The baseline PSA was 4.0 (± 4.2) ng/mL, with 713 (55.0%) patients in the low PSA group (1.6 (± 0.8) ng/mL), and 584 (45.0%) patients in the high PSA group (6.9 (± 4.7) ng/mL). The PSA level decreased postoperatively by 66.6 (± 23.6)% in all patients, and 54.3 (± 23.9)% in the low PSA group, and 79.6 (± 14.7)% in the high PSA group.
Conclusions

In patients with LUTS and elevated PSA, significant PSA reduction and symptom improvement was observed after HoLEP.
Single HER2-Positive Tumor Cells are Detected in Initially HER2-Negative Breast Carcinomas using the DEPArray™–HER2-FISH Workflow
Authors: Grüntkemeier Lisa , Khurana Aditi , Bischoff Farideh Zamaniyan , Hoffmann Oliver , Kimmig Rainer , Moore Mathew , Cotter Philip , Kasimir-Bauer Sabine 
Published: August 2021

Abstract
Background: In breast cancer (BC), overexpression of HER2 on the primary tumor (PT) is determined by immunohistochemistry (IHC) or fluorescence in situ hybridization (FISH) to stratify samples as negative, equivocal and positive to identify patients (pts) for anti-HER2 therapy. CAP/ASCO guidelines recommend FISH for analyzing HER2/neu ( ERBB2 ) gene amplification and for resolving equivocal HER2 IHC results. However, pre-analytical and analytical aspects are often confounded by sample related limitations and tumor heterogeneity and HER2 expression may differ between the PT and circulating tumor cells (CTCs), the precursors of metastasis. We used a validation cohort of BC pts to establish a new DEPArray™-PT-HER2-FISH workflow for further application in a development cohort, characterized as PT-HER2-negative but CTC-HER2/ neu -positive, to identify pts with PT-HER2 amplified cells not detected by routine pathology. Methods: 50 µm FFPE tumor curls from the validation cohort (n=49) and the development cohort (n=25) underwent cutting, deparaffinization and antigen retrieval followed by dissociation into a single cell suspension. After staining for cytokeratin, vimentin, DAPI and separation via DEPArray™, single cells were processed for HER2-FISH analysis to assess the number of chromosome 17 and HER2 loci signals for comparison, either with available IHC or conventional tissue section FISH. CTC-HER2/ neu status was determined using the AdnaTest BreastCancer (QIAGEN, Hilden, Germany). Results: Applying CAP/ASCO guidelines for HER2 evaluation of single PT cells, the comparison of routine pathology and DEPArray™-HER2-FISH analysis resulted in a concordance rate of 81.6% (40/49 pts) in the validation cohort and 84% (21/25 pts) in the development cohort, respectively. In the latter one, 4/25 pts had single HER2-positive tumor cells with 2/25 BC pts proven to be HER2-positive, despite being HER2-negative in routine pathology. The two other pts showed an equivocal HER2 status in the DEPArray™-HER2-FISH workflow but a negative result in routine pathology. Pts with discordant HER2 results had already died, the others are still alive. Conclusions: The DEPArray™ system allows pure tumor cell recovery for subsequent HER2/neu FISH analysis and is highly concordant with conventional pathology. For PT-HER2-negative pts, harboring HER2/ neu- positive CTCs, this approach might allow caregivers to more effectively offer anti-HER2 treatment.
Investigative Study On The AC And DC Breakdown Voltage of Nanofluid From Jatropha –Neem Oils Mixture For Use In Oil-Filled Power Equipment.
Authors: Tambuwal Faruk Riskuwa , Oparanti Samson Okikiola , Abdulkadir Ibrahim , Sadiq Umar , Abdelmalik A. A. 
Published: August 2021

Abstract
This paper investigated the feasibility of developing alternative insulating nanofluid from a mixture of Jatropha and Neem oils into which compositions of 0.2wt% to 1.0wt% of titanium oxide nanoparticles were dispersed. FTIR, SEM-EDX and XRD analysis of Titanium oxide nanoparticles were carried out. The DC and AC breakdown voltages were measured and analysed using Weibull statistical tool. In the Weibull statistical analysis, it was observed that the characteristic breakdown field strength of PJO is higher relative to PNO and has slight differences compared to the PJNO sample. With the dispersion of TiO2 nanoparticles, the characteristic breakdown strength improved as compared with the base oil. Furthermore, the developed Jatropha-Neem mixture nanofluid recorded characteristic breakdown field strength that is much higher compared to that of the mineral oil sample. The JNNF sample possessed the highest characteristic breakdown strength among prepared nanofluids which indicates that the characteristic breakdown strength of the oil samples has been improved considerably with the dispersion of TiO2 nanoparticles. The results have shown the viability of Jatropha-Neem nanofluid as insulating oil for use in oil-filled power equipment.
Cross-Cultural Adaptation of The Spanish MINICHAL Instrument Into English For Use In The United Kingdom
Authors: Jordan Andrew , Anning Christine , Wilkes Lindsay , Ball Claire , Pamphilon Nicola , Clark Christopher E , Bellenger Nicholas G , Shore Angela C , Sharp Andrew SP , Valderas Jose M 
Published: August 2021

Abstract
Background: Hypertension is a highly prevalent condition, with optimal treatment to BP targets conferring significant gains in terms of cardiovascular outcomes. Understanding why some patients do not achieve BP targets would be enhanced through greater understanding of their health-related quality of life (HRQoL). However, the only English language disease-specific instruments for measurement of HRQoL in hypertension have not been validated in accordance with accepted standards. It is proposed that the Spanish MINICHAL instrument for the assessment of HRQoL in hypertension could be translated, adapted and validated for use in the United Kingdom. The aim of the study was therefore to complete this process, using a cohort of patients enrolled in an 18-week programme for the treatment of grade II-III hypertension. Methods: The MINICHAL authors were contacted and the original instrument obtained. This was then translated into English by two independent English-speakers, with these versions then reconciled, before back-translation and subsequent production of a 2nd reconciled version. Thereafter, a final version was produced after cognitive debriefing, for administration and psychometric analysis in the target population. Results: The final version of the instrument was administered to 30 individuals with grade II/III hypertension before and after 18 weeks’ intensive treatment. Psychometric analysis demonstrated a floor effect, though no ceiling effect. Internal consistency for both state of mind (StM) and somatic manifestations (SM) dimensions of the instrument were acceptable (Cronbach’s alpha = 0.81 and 0.75), as was test-retest reliability (ICC=0.717 and 0.961) and construct validity, which was measured through co-administration with the EQ5d5L and Bulpitt-Fletcher instruments. No significant associations were found between scores and patient characteristics known to affect HRQoL. The EQ5D5L instrument found an improvement in HRQoL following treatment, with the StM and SM dimensions of the English language MINICHAL trending to support this (d=0.32 and 0.02 respectively). Conclusions: The present study details the successful English translation and validation of the MINICHAL instrument for use in individuals with hypertension. The data reported also supports an improvement in HRQoL with rapid treatment of grade II/III hypertension, a strategy which has been recommended by contemporaneous European guidelines. Trial registration: ISRCTN registry number: 57475376 (assigned 25/06/2015).
Airborne toxic exposure and pulmonary outcomes among petrochemical complex workers
Authors: Jalilian Hamed , Mirzaei Ahmad , khojasteh Soroush , jafarpour Elias , Rajabi Fazel , Mirzaei Rasoul , Stenehjem Jo S , Rueegg Corina Silvia 
Published: August 2021

Abstract
Background

Petrochemical workers are exposed to a variety of airborne toxic compounds which have been associated with increased risk for respiratory outcomes. However, long-term exposure to SO2, NO2, O3, H2S and NH3 in relation to spirometric parameters and self-reported respiratory problems is largely unknown.
Methods

Airborne concentration levels of SO2, NO2, O3, H2S and NH3 were collected from two fixed stations over a 3-year period in a petrochemical complex. We assessed spirometric parameters and respiratory symptoms in the petrochemical workers (n = 200) and in an unexposed group (n = 200). We calculated β-coefficients (β) and odds ratios (ORs) with 95% confidence intervals (CIs) before and after adjustment for covariates.
Results

The mean airborne pollution levels were 159 µg/m3 for SO2, 43 µg/m3 for NO2, 66 µg/m3 for O3, 6 µg/m3 for H2S, and 24 µg/m3 for NH3. We found a significant reduction in spirometric parameters among petrochemical workers compared to the unexposed: FEV1 (forced expiratory volume in 1s) (adjusted β -12; 95%CI -16, -7.64), FEV1/ FVC (forced vital capacity) (β -7.26; 95%CI -9.23, -5.28), and PEF (peak expiratory flow) (β -6.61; 95%CI -12, -0.76). Additionally, we observed higher adjusted risks for any respiratory symptom (OR 4.69; 95%CI 1.76, 12), mucus (OR 4.36; 95%CI 1.70, 11) and shortness of breath (OR 15; 4.95, 46) among petrochemical workers compared to the unexposed group.
Conclusions

Most measured airborne pollution levels were within the ambient recommendation levels. Still, long-term exposure to low level airborne pollutants, reduced FEV1, FEV1/FVC and PEF, and increased respiratory symptoms in Iranian petrochemical workers compared to unexposed controls.
Patient-Reported Outcomes in RA Patients Treated With Tofacitinib or bDMARDs in Real-life Conditions in Two Latin American Countries
Authors: Reyes JM , Gutierrez MV , Madariaga H , Otero W , Guzman R , Izquierdo J , Abello M , Velez P , Castillo D , de Leon Dario Ponce , Lukic T , Amador L 
Published: August 2021

Abstract

Objective: To describe the efficacy, safety and patient-reported outcomes (PROs) in patients with rheumatoid arthritis (RA) with an inadequate response to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) treated with tofacitinib or biological DMARDs (bDMARDs) in real-life conditions.Methods: A noninterventional study was performed between March 2017 and September 2019 at 13 sites in Colombia and Peru. Demographic and clinical information was collected. Outcomes measured at baseline and at the 6-month follow-up were disease activity (RAPID3 [Routine Assessment of Patients Index Data] score), functional status (HAQ-DI [Health Assessment Questionnaire] score), and quality of life (EQ-5D-3L [EuroQol Questionnaire]). The Disease Activity Score-28 (DAS28-ESR) and frequency of adverse events (AEs) were also reported. Unadjusted and adjusted differences from baseline were estimated and expressed as the least squares mean difference (LMDs).Results: Data from 100 patients treated with tofacitinib and 70 patients with bDMARDs were collected. At baseline, the patients’ mean age was 53.53 years (SD 13.77), the mean disease duration was 6.31 years (SD 7.01) and the mean DAS28-ESR was 5.48 (SD 2.97). The change from baseline at month 6 was not statistically significant different in the adjusted LMD [SE] for tofacitinib vs. bDMARDs for RAPID3 score (-0.20 [0.69] vs. -0.32 [0.71]), HAQ-DI score (-0.56 [0.07] vs. -0.50 [0.08]), EQ-5D-3L score (0.23 [0.06] vs. 0.29 [0.06]) and DAS28-ESR (-3.86 [0.59] vs. -4.23 [0.61]). Patients from both groups presented similar proportions of nonserious and serious AEs. No deaths were reported. These results have noninterventional-study-specific limitations.Conclusion: Changes from baseline were not statistically significant different between tofacitinib and bDMARDs in terms of RAPID3 scores and the secondary outcomes (HAQ-DI score, EQ-5D-3L score and DAS28-ESR). Patients from both groups presented similar proportions of nonserious and serious AEs.Clinical trial number: NCT03073109
Clinical Characteristics and Prognostic Factors of HIV-Positive Patients With Lymphoma in the Poverty Region of China: A Real-World Multicenter Analysis
Authors: Zhang Jinxin , Xie Zhiman , Qin Shanfang , Ruan Guangjing , Cai Shaohang , Lu Aili , Wu Yihua , Chen Juanjuan , Peng Jie 
Published: August 2021

Abstract
Background: People living with HIV (PLWHIV) are at increased risk of Hodgkin and non-Hodgkin lymphoma compared with HIV-negative individuals. However, high-quality epidemiological data for lymphoma among PLWHIV from low-income and middle-income countries are scarce, especially in South China. This retrospective study aimed to better define the clinical characteristics, outcomes, and prognostic factors of HIV-associated lymphoma patients in Guangxi and Guangdong provinces of China in the highly active antiretroviral therapy (HAART) era. Methods: We performed a pooled analysis from existing databases of 143 patients with HIV-positive lymphoma between January 2013 and June 2020 from three hospitals in South China. Survival curves were estimated using the Kaplan–Meier method and compared using the log-rank test. Univariable and multivariable Cox proportional hazard models were performed to identify the association of patient-, lymphoma- and HIV-specific variables with the outcomes progression-free survival (PFS) and overall survival (OS). Results: Of all 143 HIV-positive lymphoma patients, diffuse large B cell lymphoma (DLBCL) was the most common subtype identified (81.8%). The median age was 49 years (IQR 18–79), and 118 patients (82.5%) were male. The mean CD4 T-cell count was 185.5 cells/µL (IQR 3–1089), and 86 (60.1%) patients were receiving HAART at enrollment. Opportunistic infections (OIs) were reported in 40 (28.0%) patients. Seventy-seven (53.8%) patients had stage I/II lymphoma, and the Eastern Cooperative Oncology Group performance status was 0 or 1 in 87 (60.8%) patients. Information on elevated lactate dehydrogenase (LDH) and positive CD20 was available for 72% (103/143) and 96.0% (48/50), respectively. A total of 65.8% (77/117) of DLBCL patients received EPOCH- (dose-adjusted etoposide, vincristine, cyclophosphamide, prednisone, and doxorubicin) or CHOP-based (cyclophosphamide, doxorubicin, vincristine, and prednisone) regimens. The 1-year PFS and 1-year OS were 32.98% and 43.62% in non-Hodgkin's lymphoma (NHL) patients and 32.18% and 41.40% in DLBCL patients, respectively. Advanced age and elevated LDH were significant predictors of the outcome in both HIV-associated NHL and DLBCL, and the influence of other factors waxed and waned. A lower CD4/CD8 ratio was an independent poor predictor for 1-year OS in HIV-associated NHL but not for DLBCL. Conclusions: In our population, HIV-positive patients with lymphoma presented aggressive characteristics and exhibited poor survival outcomes, even in the modern HAART era. Effective HIV-directed therapies reduced the impact of HIV-associated prognostic factors on outcomes; however, lymphoma-related factors, such as age and LDH, were found to be key independent predictors for HIV-associated lymphoma.
Global, Regional, and National Burden of Urinary Tract Infections from 1990-2019: an Analysis of the Global Burden of Disease Study 2019
Authors: Zeng Zhilin , Zhan Juan , Zhang Kaimin , Chen Huilong , Cheng Sheng 
Published: August 2021

Abstract
Objective
We aimed to estimate the burden of UTIs by age, sex, and socioeconomic status in 204 countries and territories from 1990–2019.
Method
We used data from GBD 2019 to analyse the incidence, mortality, and disability-adjusted life-years (DALYs) due to UTIs at the global, regional, and national levels. Estimates are presented as numbers and age-standardised or age-specific rates per 100000 population, with 95% uncertainty intervals (UIs). We further explored the associations between the incidence, mortality, DALYs, and socio-demographic index (SDI) as a proxy for the development status of regions and countries.
Results
In 2019, more than 404.6 million (95% UI 359.4-446.5) individuals had UTIs globally and nearly 236 786 people (198 433 − 259 034) died of UTIs, contributing to 5.2 million (4.5–5.7) DALYs. The age-standardised incidence rate increased from 4 715.0 (4 174.2-5 220.6) per 100 000 population in 1990 to 5 229.3 (4 645.3-5 771.2) per 100 000 population in 2019. At the GBD regional level, the highest age-standardised incidence rate in 2019 occurred in Tropical Latin America (13 852.9 [12 135.6–15 480.3] per 100 000 population). At the national level, Ecuador had the highest age-standardised incidence rate (15 511.3 [13 685.0–17 375.6] per 100 000 population). The age-standardised death rates were highest in Barbados (19.5 [13.7–23.5] per 100 000 population). In addition, age-standardised incidence, death, and DALY rates generally increased across the SDI.
Conclusions
Our study results suggest a globally rising trend of UTI burden between 1990 and 2019. The results of this study could be useful in policy-making, priority setting, and resource allocation in UTI prevention and treatment.
Adverse Cardiovascular Complications Following Prescription of Programmed Cell Death 1 (PD-1) and Programmed Cell Death Ligand 1 (PD-L1) Inhibitors: A Propensity-Score Matched Cohort Study With Competing Risk Analysis
Authors: Zhou Jiandong , Lee Sharen , Lakhani Ishan , Yang Lei , Liu Tong , Zhang Yuhui , Xia Yunlong , Chan Esther W , Wong Ian Chi Kei , Tse Gary , Zhang Qingpeng 
Published: August 2021

Abstract
Background: Programmed death-1 (PD-1) and programmed death- ligand 1 (PD-L1) inhibitors, such as pembrolizumab, nivolumab and atezolizumab, are major classes of immune checkpoint inhibitors that are increasingly used for cancer treatment. However, their use is associated with adverse cardiovascular events. We examined the incidence of new-onset cardiac complications in patients receiving PD-1 or PD-L1 inhibitors.Methods: Patients receiving PD-1 or PD-L1 inhibitors since their launch up to 31st December 2019 at the Hospital Authority of Hong Kong, without pre-existing cardiac complications were included. The primary outcome was a composite of incident heart failure, acute myocardial infarction, atrial fibrillation or atrial flutter with the last follow-up date of 31st December 2020. Propensity score matching between PD-L1 inhibitor use and PD-1 inhibitor use with a 1:2 ratio for patient demographics, past comorbidities and non-PD-1/PD-L1 medications was performed.Results: A total of 1959 patients were included. Over a median follow-up of 247 days (interquartile range [IQR]: 72-506), 320 (incidence rate [IR]: 16.31%) patients met the primary outcome after PD-1/PD-L1 treatment: 244 (IR: 12.57%) with heart failure, 38 (IR: 1.93%) with acute myocardial infarction, 54 (IR: 2.75%) with atrial fibrillation, 6 (IR: 0.31%) with atrial flutter. Compared with PD-1 inhibitor treatment, PD-L1 inhibitor treatment was significantly associated with a lower risk of composite outcome both before (hazard ratio [HR]: 0.32, 95% CI: [0.18-0.59], P value=0.0002) and after matching (HR: 0.34, 95% CI: [0.18-0.65], P value=0.001), and lower all-cause mortality risk before matching (HR: 0.77, 95% CI: [0.64-0.93], P value=0.0078) and after matching (HR: 0.80, 95% CI: [0.65-1.00], P value=0.0463). Patients who developed cardiac complications had shorter average readmission intervals and a higher number of hospitalizations after treatment with PD-1/PD-L1 inhibitors both before and after matching (P value<0.0001). Competing risk analysis with cause-specific hazard and subdistribution hazard models, and multiple approaches based on the propensity score all confirmed these observations. Conclusions: Compared with PD-1 treatment, PD-L1 treatment was significantly associated with lower risk of new onset cardiac composite outcome and all-cause mortality both before and after propensity score matching.
Topological phase singularities in atomically thin high-refractive-index materials
Authors: Ermolaev Georgy , Voronin Kirill , Baranov Denis , Kravets Vasyl , Tselikov G. , Stebunov Yury , Yakubovsky Dmitry , Novikov Sergey , Vyshnevyy Andrey , Mazitov Arslan , Kruglov Ivan , Zhukov Sergey , Romanov Roman , Markeev Andrey , Arsenin Aleksey , Novoselov Konstantin , Grigorenko Alexander , Volkov Valentyn 
Published: August 2021

Abstract
Atomically thin transition metal dichalcogenides (TMDCs) present a promising platform for numerous photonic applications due to excitonic spectral features, possibility to tune their constants by external gating, doping, or light, and mechanical stability. Utilization of such materials for sensing or optical modulation purposes would require a clever optical design, as by itself the 2D materials can offer only a small optical phase delay – consequence of the atomic thickness. To address this issue, we combine films of 2D semiconductors which exhibit excitonic lines with the Fabry-Perot resonators of the standard commercial SiO2/Si substrate, in order to realize topological phase singularities in reflection. Around these singularities, reflection spectra demonstrate rapid phase changes while the structure behaves as a perfect absorber. Furthermore, we demonstrate that such topological phase singularities are ubiquitous for the entire class of atomically thin TMDCs and other high-refractive-index materials, making it a powerful tool for phase engineering in flat optics. As a practical demonstration, we employ PdSe2 topological phase singularities for a refractive index sensor and demonstrate its superior phase sensitivity compared to typical surface plasmon resonance sensors.