bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mismatch Between Pelvic Incidence and Lumbar Lordosis is the Key Sagittal Plane Determinant of Patient Outcome at Minimum 40 Years After Instrumented Fusion for Adolescent Idiopathic Scoliosis
Authors: Rubery Paul T. , Lander Sarah T. , Mesfin Addisu , Sanders James O. , Thirukumaran Caroline P. 
Published: November 2021

Study Design.
Retrospective review

Objective.
Assess measures of spinal-pelvic balance in predicting functional outcome in patients who underwent posterior spinal fusion for adolescent idiopathic scoliosis (AIS) at minimum 40-year follow-up.

Summary of Background Data.
Back pain and long-term function are considered when choosing levels for surgery in AIS patients. Three hundred and fourteen patients underwent fusion for AIS between 1961 and 1977. One hundred and thirty-four patients were located for potential long-term follow-up.

Methods.
With Institutional Review Board approval, medical records and public resources were used to locate patients. Patients completed health-related quality of life (HRQoL) instruments, and returned for assessment including full radiographs. Radiographs were analyzed for scoliosis measures, and recognized spinal-pelvic measures including the lumbar lordosis, sagittal vertical axis (SVA), pelvic incidence, and pelvic tilt (PT). Bivariate and multivariable analyses were performed to assess the association between spinal-pelvic measures and patient-reported outcomes.

Results.
Thirty-five of 134 patients agreed to return for complete HRQoL and radiographic follow-up. There were no differences at baseline between those agreeing and declining participation. The cohort was 94% female, had an average age of 60.5 years, and average follow-up of 46 years. In bivariate analysis, pelvic incidence and lumbar lordosis difference (PI-LL) was the only spinal-pelvic parameter which statistically discriminated between patients doing well and not, as assessed by the Oswestry Disability Index and the Patient-reported Outcomes Measurement Information System (PROMIS) Pain Interference and Fatigue instruments. In multivariable analysis, (PI-LL > 9°) was associated with worse scores in PROMIS-Pain Interference, Physical Function, Depression, Fatigue, Social Function and the total Oswestry score. An SVA > 50 mm was associated with worse scores in the Scoliosis Research Society-7.

Conclusion.
In a cohort of 35 patients with average follow-up of 46 years after posterior spinal instrumentation with Harrington rods (PSIF) for AIS, spinal-pelvic mismatch as identified by (PI-LL > 9°) was associated with inferior HRQoL outcomes. Other spinal-pelvic measures (SVA and PT) were not reliably associated with inferior HRQoL.

Level of Evidence: 4
Managing job stress among teachers of children with autism spectrum disorders
Authors: Akanaeme Immaculata N. , Ekwealor Felicia Ngozi , Ifeluni Clara N. , Onyishi Charity N. , Obikwelu Chizoba L. , Ohia Nkiru Christiana , Obayi Loveline N. , Nwaoga Chinyere Theresa , Okafor Agnes E. , Victor-Aigbodion Vera , Ejiofor Toochukwu E. , Afiaenyi Ifeoma C. , Ekomaru Chinyere I. , Dike Ibiwari Caroline 
Published: November 2021

Abstract

Background:
Job-related stress undermines occupational, personal, and organizational outcomes. Stress symptoms are common among teachers of children with autism spectrum disorders and affect the academic progress of the children. This study investigated the effectiveness of yoga-based cognitive behavioral therapy in reducing occupational stress among teachers of children with autism in Lagos states, Nigeria.

Methods:
The current study adopted a group-randomized waitlist control (WLC) trial design with pre-test, posttest, and follow-up assessments. Participants included 58 teachers of children with autism in public and private special schools in Lagos state. Participants were randomly assigned to combined cognitive behavioral therapy and yoga (Y-CBT) (N = 29) and WLC (N = 29) groups. The Y-CBT group participated in a 2 hours Y-CBT program weekly for 12 weeks. Three instruments – Demographic Questionnaire, Single-Item Stress Questionnaire, and Teachers’ Stress Inventory (TSI) were used to collect data. Data were collected at baseline; posttest and follow-up evaluations. Data were analyzed using means, standard deviations, t test statistics, repeated measures analysis of variance, and bar charts.

Results:
Results revealed that all dimensions of job stress (perception of stress sources, stress manifestation, and total TSI scores) reduced significantly at posttest and follow up assessments among the Y-CBT group, compared to the WLC.

Conclusion:
It was concluded that Y-CBT modalities could help to minimize the perception of stress sources and stress manifestation as well as total TSI scores among teachers of children with autism spectrum disorders.
Synchronous double primary hepatocellular carcinoma and intrahepatic cholangiocarcinoma
Authors: Qu Meng-Meng , Zhu Yuan-Hui , Li Yi-Xiang , Li Zhi-Fan , Li Jin-Kui , Xu Yong-Sheng , Shrestha Manishkumar , Lei Jun-Qiang 
Published: November 2021

Abstract

Rationale:
Presence of synchronous double hepatocelluar carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) (sdpHCC-ICC) located separately within a single liver is extremely rare. The purpose of this study is to investigate the clinical, imaging, pathological characteristics, and prognosis of patients with sdpHCC-ICC, in order to enhance our understanding of the disease and improve diagnostic and therapeutic effect.

Patient concerns:
A 49-year-old, female with the diagnosis of hepatitis B virus with obvious liver cirrhosis, was admitted to our hospital. On admission, the levels of α-fetoprotein and carbohydrate antigen 19-9 were found to be elevated. Abdominal ultrasonography and enhanced computed tomography revealed 2 solid masses located in segments (S) 4 and 6 of the liver, with malignant behaviors.

Diagnoses:
In the light of above investigations, preoperative diagnosis of multiple primary hepatocellular carcinomas was made.

Intervention:
Hepatic resection of both segments was done. The resected specimens revealed the presence of well-defined tumors in segments 4 and 6 measuring 5.0 cm and 2.5 cm respectively.

Outcomes:
Histopathological examination confirmed the tumor of the 4th segment to be moderately and poorly differentiated ICC, and the tumor of the 6th segment to be poorly differentiated HCC. Immunohistochemically, the ICC in S4 was positive for CK19 and negative for Heppar-1, whereas the HCC in S6 was positive for Heppar-1 and negative for CK19. Unfortunately, metastasis to multiple organs and lymph nodes were observed 3 months later. The patient died of liver failure 16 months after surgery.

Lessons:
The clinical characteristics of sdpHCC-ICC are usually atypical and nonspecific making its preoperative diagnosis quite difficult. Hepatitis B virus and hepatitis C virus infection were both the independent risk factor for the development of sdpHCC-ICC. In patients with chronic liver disease, careful observation with imaging is of utmost necessity. Tumor markers may also play a valuable role in the diagnosis. The definite diagnosis depends on pathological examination. Hepatic resection is considered the most effective mode of treatment. The prognosis of synchronous occurrence of double hepatic cancers is worse than either HCC or ICC, and the origin of the disease needs further study.
Nomogram to predict contralateral breast cancer risk in breast cancer survivors
Authors: Tong Jiaci , Tan Dewei , Ma Jing , Hu Ye , Li Man 
Published: November 2021

Abstract
The main purpose of this study was to build a prediction model for patients with contralateral breast cancer (CBC) using competing risks methodology. The aim is to help clinicians predict the probability of CBC in breast cancer (BC) survivors.
We reviewed data from the Surveillance, Epidemiology, and End Results database of 434,065 patients with BC. Eligible patients were used to quantify the association between the development of CBC and multiple characteristics of BC patients using competing risk models. A nomogram was also created to facilitate clinical visualization and analysis. Finally, the stability of the model was verified using concordance index and calibration plots, and decision curve analysis was used to evaluate the clinical utility of the model by calculating the net benefit.
Four hundred thirty-four thousand sixty-five patients were identified, of whom 6944 (1.6%) developed CBC in the 10 years follow-up. The 10-year cumulative risk of developing CBC was 2.69%. According to a multivariate competing risk model, older patients with invasive lobular carcinoma who had undergone unilateral BC surgery, and whose tumor was better differentiated, of smaller size and ER-negative/PR-positive, had a higher risk of CBC. The calibration plots illustrated an acceptable correlation between the prediction by nomogram and actual observation, as the calibration curve was closed to the 45° diagonal line. The concordance index for the nomogram was 0.65, which indicated it was well calibrated for individual risk of CBC. Decision curve analysis produced a wide range of risk thresholds under which the model we built would yield a net benefit.
BC survivors remain at high risk of developing CBC. Patients with CBC have a worse clinical prognosis compared to those with unilateral BC. We built a predictive model for the risk of developing CBC based on a large data cohort to help clinicians identify patients at high risk, which can then help them plan individualized surveillance and treatment.
HIST3H2A is a potential biomarker for pancreatic cancer
Authors: Zhao Mengyu , Dai Rongyang 
Published: November 2021

Abstract
The family of histone H2A proved that there are a lot of variants associated with cancer development. The link between HIST3H2A and pancreatic cancer has never been noted before. Our research suggests that HIST3H2A affects pancreatic tumor immune process and prognosis of patients, through the JAK STAT pathway, so it is expected to become the biomarker of pancreatic cancer.
Gene expression profiles and clinical data of pancreatic cancer patients were downloaded from The Cancer Genome Atlas database (TCGA) and The Genotype Tissue Expression (GETx) project. R software (Rx64 3.6.0) was utilized to analyze. Gene set enrichment analysis (GSEA) was used to analyze HIST3H2A related signaling pathways in pancreatic cancer. CIBERSORT is applied to estimate the compositional patterns of the 22 types of immune cell fraction based on bulk expression data.
HIST3H2A was expressed at higher in pancreatic cancer tissues than normal pancreatic tissues. Kaplan–Meier survival analysis suggested that the level of HIST3H2A expression affect prognosis of pancreatic cancer patients. Univariate Cox analysis and Multivariate Cox analysis suggested that HIST3H2A expression is a prognostic factor of pancreatic cancer. Cor expression analysis indicated that the genes positively correlated with HIST3H2A expression trend were DCST1-AS1, HIST1H2BD, SLC12A9-AS1. GSEA showed that the JAK-STAT signaling pathway was enriched in the HIST3H2A high expression phenotype, whereas intestinal network for IgA production, Asthma and Chemokine signaling pathway were enriched in the HIST3H2A low expression phenotype. In additional, results showed that CD8 T cells (P = .007), activated CD4 memory T cells (P = .001), and monocytes (P = .002) were more abundant in lower HIST3H2A expression groups.
HIST3H2A is a promising biomarker for predicting prognosis of pancreatic cancer, and it could be a potential therapeutic target. HIST3H2A might regulate the progression of tumor immune in pancreatic cancer through modulating the JAK-STAT pathway. In addition, the role HIST3H2A in pancreatic cancer may be related to DCST1-AS1, HIST1H2B, SLC12A9-AS1. However, more research is necessary to validate findings.
Endoscopic removal of accidental aspirated and ingested dental foreign bodies
Authors: Hayashi Hiroki , Abe Atsushi , Ota Mitsuhiko , Momokita Moeko , Ishihama Takanori , Furuta Hiroshi , Taniguchi Toru , Takeuchi Kazuo 
Published: November 2021

Abstract
The incidence of accidental ingestion and aspiration of foreign body (FB) is likely to occur. Many FBs are discharged spontaneously, but many dental FBs are often sharp and may remain in the pharynx, esophagus, and stomach, causing serious complications such as hemorrhage, asphyxia, perforation of the digestive tract, mediastinal emphysema, peritonitis, and ileus. We aimed to examine which type of dental foreign bodies can be removed by endoscope.
In this study, we enrolled 32 patients who were evaluated at the Emergency and Critical Center between January 2014 and December 2019 and who accidentally ingested or aspirated dental FBs. Medical records were reviewed to determine the patients’ sex, age, medical history, time from accidental ingestion of a FB to consultation, cause, location, occurrence status, nature of the FB, location of retained FB, treatment, complications, and outcome.
We enrolled 32 patients (14 men, 18 women), with a mean age of 74.5 ± 12.8 years. Accidental ingestion at treatment was common. The most frequent site where the FB was retained was upper gastrointestinal tract (26 cases, 81.3%). In this study, endoscopic removal was indicated for dentures under the size of 43.3 mm, for dental FB (except dentures) more than 13.6 mm. In dentures, between the number of missing teeth, clasp, type, and endoscopic removal was not statistically significant.
Dentures under the size of 43.3 mm was likely to be removed by endoscope. Dental FB (except dentures) more than the size of 13.6 mm was likely to be removed by endoscope. There were no indications for endoscopic removal except for size.
Evaluation of the cross-sectional area of small pulmonary vessels in the diagnosis of chronic obstructive pulmonary disease by quantitative computed tomography
Authors: Wang Yifan , Su Tong , Feng Shaotong , Chen Juan , Tian Xingcang , Zhu Li 
Published: November 2021

Abstract
Patients with chronic obstructive pulmonary disease (COPD) have a reduced cross-sectional area (CSA) of small pulmonary vessels and decreased pulmonary function test (PFT) indexes. This study investigated the value of small pulmonary vessel CSA in diagnosing and evaluating the severity of COPD and its correlation with PFT.
This retrospective case-control study included patients with COPD who underwent multi-slice spiral computed tomography (CT) between March 2015 and December 2018. COPD severity was graded. Patients with normal CT results were included as controls. The CSA of small pulmonary vessels at the sub-segmental (5–10 mm2) and sub-sub-segmental (<5 mm2) levels was measured. Receiver operating characteristic (ROC) curves were used to evaluate the effect of CSA for COPD risk prediction. The correlation between CSA% and PFT indexes was evaluated.
There were 124 and 106 patients in the COPD and control groups, respectively. The %CSA <5 and %CSA5–10 were smaller in the COPD group than in controls (P
< .05). The %CSA <5 in each subgroup stratified by COPD severity was smaller than in controls (P
< .05). The % CSA5–10 was significantly smaller in the moderate and severe groups than in controls (P
< .05). At 0.655%CSA <5 cut-off, the ROC area under the curve (AUC) was 0.765. For %CSA5–10, a 0.565 cut-off led to an AUC of 0.752. Both %CSA <5 and %CSA5–10 were positively correlated with all PFT indexes (r = 0.180–0.462, all P
< .05).
CSA was positively correlated with PFT. Analysis of small pulmonary vessel CSA based on CT images contributes to diagnosing and assessing the severity of COPD.
Association between APE1 rs1760944 and rs1130409 polymorphism with prostate cancer risk
Authors: Liu Jinnian , Zheng Jian , Guo Yu , Sheng Xia , Yin Yongjian , Qian Shengqiang , Xu Bin , Xiong Wei , Yin Xiangrui 
Published: November 2021

Abstract

Background:
Recently, some studies have suggested that the association of apurinic/apyrimidinic endonuclease 1 (APE1) gene polymorphism with prostate cancer (PCa) risk, but there are still some controversies. Hence, we elaborated the relationship between APE1 rs1760944 and rs1130409 gene and PCa risk through systematic literature review and meta-analysis.

Methods:
As of March 2020, EMBASE, PubMed, the Cochrane Library, Science Direct/Elsevier, MEDLINE and CNKI were used for systematic literature retrieval to investigate the correlation between APE1 rs1760944 and rs1130409 gene polymorphism with PCa risk. Meta-analysis was performed using Review Manager and Stata software.

Results:
Seven studies were distinguished, consists of 1769 cases of PCa patients and 2237 normal controls. Our results illustrated that there are significant correlation between the APE1 rs1760944 gene polymorphism and PCa in all genetic models (P < .05). The combined odds ratios and 95% confidence intervals were as follows: Additive model (ORs 0.62, 95%, CI [0.39, 0.97]); Codominant model (ORs 0.74, 95% CI [0.58, 0.95]); Dominant model (ORs 0.75, 95%, CI [0.59, 0.95]); Recessive model (ORs 0.63, 95% CI [0.41, 0.96]); Allele model (ORs 0.78, 95% CI [0.65, 0.94]). There also have significant associations between APE1 rs1130409 polymorphisms and PCa in all genetic models (P < .05). The combined odds ratios and 95% confidence intervals were as follows: Additive model (ORs 1.37, 95%, CI [1.01, 1.85]); Codominant model (ORs 1.21, 95% CI [1.01, 1.44]); Dominant model (ORs 1.33, 95%, CI [1.02, 1.73]); Recessive model (ORs 1.74, 95% CI [1.06, 2.85]); Allele model (ORs 1.14, 95% CI [1.00, 1.29]).

Conclusion:
This study suggests that APE1 rs1760944 polymorphisms might be a protective factor of PCa, and APE1 rs1130409 is suggested to be a risk factor of PCa. APE1 rs1760944 and rs1130409 polymorphisms may be used in the risk assessment of PCa.
DDX10 and BYSL as the potential targets of chondrosarcoma and glioma
Authors: Quan Xuemin , Zhao Changsong , Gao Zhengrong , Zhang Yao , Zhao Rugang , Wang Jingjing , Zhang Qiang 
Published: November 2021

Abstract
To provide reliable molecular markers and effective therapeutic targets for chondrosarcoma and glioma.
Gene Set Enrichment (GSE) 29745 and GSE48420 were downloaded from the Gene Expression Omnibus (GEO) database. Differently expressed genes (DEGs) were identified by the GEO2R. We annotated the function of common DEGs through Digital Audio/Video Interactive Decoder (DAVID) and Metascape. Protein–protein interaction network construction was performed through STRING. Hub genes were identified by the two different algorithms (MCC, EPC). DDX10 and BYSL were key factors in embryo implantation and development, and plays a role in a variety of cancers. The role of the DDX10 and BYSL on the glioma derived from the chondrosarcoma would be explored by the clinical samples.
A total of 1442 DEGs were identified. The variations in DEGs were mainly enriched in vasculature development, cell motion, blood vessel development, cell migration, regulation of cell proliferation, regulation of cell proliferation, wound healing, biological adhesion, growth factor binding, identical pathways in cancer, and p53 signaling pathway. Dead-box helicase 10 (DDX10), Bystin-like (BYSL), and WD repeat domain 12 (WDR12) were identified as the hub genes, and the three hub genes were up-regulated in the chondrosarcoma. Chondrosarcoma patients with high expression levels of DDX10 (Logrank P = .0052; HR (high) = 1.8; n (high) = 131, 50%), and BYSL (P = 6.5e-05; HR (high) = 2.3; n (high) = 131, 50%) had poorer overall survival times than those with low expression levels.
DDX10 and BYSL genes may provide reliable molecular markers and effective therapeutic targets for chondrosarcoma and glioma.
Prediction of liver stiffness by serum indexes in HCV-infected patients with or without HIV coinfection
Authors: Merchante Nicolás , Mena Álvaro , Pascasio Juan-Manuel , Marco Andrés , Rodriguez Manuel , Hernandez-Guerra Manuel , Simón Miguel-Angel 
Published: November 2021

Abstract
Identification of advanced fibrosis/cirrhosis in hepatitis C virus (HCV)-infected patients should be a mainstay before starting treatment; however, the limited access of many centres to transient elastography (TE) is often a barrier for early assessments. We aimed to investigate the diagnostic accuracy of serum indexes for predicting liver stiffness.
Retrospective analysis of HCV patients (with or without HIV coinfection) routinely assessed in 7 centres in Spain. The diagnostic accuracy of aspartate aminotransferase-to-platelet ratio index (APRI), fibrosis-4 (FIB-4), and their combinations was evaluated using a recent TE examination as a reference test (liver stiffness ≥ 9.5 kPa and ≥12.5 kPa for advanced fibrosis and cirrhosis, respectively). In addition to area under the receiving operating characteristic curves, sensitivity, specificity, and negative predictive value (NPV) and positive predictive value were estimated.
The analysis included 1391 patients: 346 (25%) HIV-positive, 732 (53%) people who inject drugs, and 178 (13%) incarcerated. Advanced fibrosis and cirrhosis were found in 557 (40%) and 351 (25%) patients, respectively. APRI < 0.5 (n = 595; 43%) had an NPV of 95% for excluding cirrhosis. Combined FIB-4 < 1.45 with APRI < 0.5 (n = 467; 34%) had an NPV of 87% for excluding advanced fibrosis. Combined APRI > 2 and FIB-4 > 3.25 (n = 134; 10%) had a positive predictive value of 89% for advanced fibrosis. Globally, this approach would avoid the need for TE in 53% of patients. HIV coinfection did not influence diagnostic accuracy.
Inexpensive and simple serum indexes confidently allowed identifying the absence of cirrhosis and the presence of advanced fibrosis in 53% of a heterogeneous series of real-world HCV patients with or without HIV infection.
Single institute experience of intraoperative radiation therapy in early-stage breast cancer
Authors: Chi Mau-Shin , Ko Hui-Ling , Chen Chang-Cheng , Hsu Chung-Hsien , Chen Liang-Kuang , Cheng Fiona Tsui-Fen 
Published: November 2021

Abstract
Intraoperative radiation therapy (IORT) is an alternative to whole breast irradiation in selected early-stage breast cancer patients. In this single institute analysis, we report the preliminary results of IORT given by Axxent Electronic Brachytherapy (eBT) system.
Patients treated with lumpectomy and eBT within a minimum follow-up period of 12 months were analyzed. Eligible criteria include being over the age of 45, having unifocal invasive ductal carcinoma (IDC) or ductal carcinoma in situ <3 cm in diameter, not exhibiting lymph node involvement on preoperative images, and negative sentinel lymph node biopsy. The eBT was given by preloaded radiation plans to deliver a single fraction of 20 Gray (Gy) right after lumpectomy.
From January 2016 to April 2019, a total of 103 patients were collected. There were 78 patients with IDC and 25 with ductal carcinoma in situ. At a mean follow-up time of 31.1 months (range, 14.5–54.0 months), the local control rate was 98.1%. Two IDC patients had tumor recurrences (1 local and 1 regional failure). Post-IORT radiotherapy was given to 4 patients. There were no cancer related deaths, no distant metastases, and treatment side effects greater than grade 3 documented.
We report the largest single institute analysis using the eBT system in Taiwan. The low recurrence and complication rates at a 31.1 month follow-up time support the use of the eBT system in selected early-stage breast cancer patients.