bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient Age Associates With Tumor-Infiltrating Lymphocytes Density In Breast Cancer
Authors: Takada Koji , Kashiwagi Shinichiro , Asano Yuka , Goto Wataru , Ishihara Sae , Morisaki Tamami , Shibutani Masatsune , Tanaka Hiroaki , Hirakawa Kosei , Ohira Masaichi 
Published: May 2021

Abstract
Purpose: Lymphocytes surrounding the cancer participate in tumor-related immune responses, and are called tumor-infiltrating lymphocytes (TILs). Several recent reports suggest TILs to index the tumor-microenvironment (TME), and predict the therapeutic effect of chemotherapy. However, only few studies have studied the relationship between age and TILs. Aging reduces host immunity, and we predict that it may also affect TILs. Thus, we hypothesized that older breast cancer (BC) patients may have low TILs density than younger BC patients. Here, we retrospectively analyzed the differences in TILs by age and the therapeutic effects of pre-operative chemotherapy (POC) in BC patients aged less than 45 years and more than 60 years.Methods: POC was administered to 356 patients. We confirmed and compared TILs density and therapeutic effects in patients aged < 45 years (n=75) and those aged >61 years (n=116). TIL density was evaluated using pre-treatment needle biopsy specimens. Definition and evaluation of TILs was based on the International TILs Working Group 2014.Results: Based on subtype, younger patients showed significantly higher pathological complete response rates than older patients with hormone receptor (HR)+ human epidermal growth factor receptor 2 (HER2)+ and HER2-enriched BC. In HR+HER2+BC, the objective response rate was significantly high in younger than in older patients. Further, a significant difference was observed for overall survival between these patients with triple-negative BC.Conclusions: Our study suggests that younger BC patients possess significantly high TILs density than older patients. These differences may influence the therapeutic efficacy in highly immunogenic subtypes.
Is Totally Laparoscopic Total Gastrectomy Better Than Laparoscopy- Assisted Total Gastrectomy For Clinical Stage I Gastric Cancer? A Propensity-Score Matched Analysis
Authors: Park Shin-Hoo , Suh Yun-Suhk , Kim Tae-Han , Choi Yoon-Hee , Choi Jong-Ho , Kong Seong-Ho , Park Do Joong , Lee Hyuk-Joon , Yang Han-Kwang 
Published: May 2021

Abstract
Background: This study aimed to evaluate the surgical outcome and quality of life (QoL) of totally laparoscopic total gastrectomy (TLTG) compared with laparoscopy-assisted total gastrectomy (LATG) in patients with clinical stage I gastric cancer.Methods: From 2012 to 2018, EGC patients who underwent TLTG (n=223), including the first case with intracorporeal hemi-double stapling, were matched to those who underwent LATG (n=114) with extracorporeal circular stapling, using 2:1 propensity score matching (PSM). Prospectively collected morbidity was compared between the TLTG and LATG groups in conjunction with the learning curve. The European Organization for Research and Treatment of Cancer (EORTC) QoL questionnaires QLQ-C30, STO22, and OG25 were prospectively surveyed during postoperative 1 year for patient subgroups.Results: After PSM, grade I pulmonary complication rate was lower in the TLTG group (n=213) than in the LATG group (n=111) (0.5% vs. 5.4%, P=0.007). Other complications were not different between the groups. The learning curve of TLTG was overcome at the 26th case in terms of the comprehensive complication index. The TLTG group after learning curve showed lower grade I pulmonary complication rate than the matched LATG group (0.5% vs. 4.7%, P=0.024). Regarding postoperative QoL, the TLTG group (n=63) revealed less dysphagia (P=0.028), pain (P=0.028), eating restriction (P=0.006), eating (P=0.004), odynophagia (P=0.023) than the LATG group (n=21). Multivariate analyses for each QoL item demonstrated that TLTG was the only common independent factor for better QoL.Conclusions: TLTG reduced pulmonary complications and provided better QoL in dysphagia, pain, eating, odynophagia than LATG for patients with clinical stage I gastric cancer.
Heterogeneous Health Classes for Older Adults in China: Based on Multidimensional Health
Authors: Hu Yi , Wang Zhenyu , Liu Zhihan , Li Bei 
Published: May 2021

Abstract
Background

The concept of health is multidimensional, so the evaluation of the health status of the elderly and the analysis of the influencing factors should also be multidimensional. This study aims to identify the heterogeneity of the health status of Chinese older adults.
Methods

Data were derived from the China Health and Retirement Longitudinal Study (CHARLS) 2015 (n = 4190). Latent class analysis was performed based on 6 health indicators, including self-reported health status, the number of chronic diseases, activity of daily living (ADL), depressive symptoms, cognitive ability, and social activities participation. Logistic regression was used to analyze the predictive effect of demographic characteristics variables on different health classes of older adults.
Results

Three health latent classes were identified and labeled as Relatively Healthy Group (n = 1003, 23.94%), Multiple Chronic Conditions with High Social Participation Group (n = 1744, 41.62%), and Frail Group (n = 1443, 34.44%). The health status of Chinese older adults is not optimistic. In particular, our study found that older adults with multiple chronic diseases had the highest social participation frequency among the three classes. When Frail Group was the reference, the logistic regression results showed that older-aged adults, those without spouses, those with low educational level, and those with agricultural household registration were more likely to be Frail Group.
Conclusion

There is heterogeneity in the health status of older adults, and identifying the health status of older adults from a multidimensional health perspective can help provide better health services to them based on health latent classes.
Image-based Tool Condition Monitoring Based on Convolution Neural Network in Turning Process
Authors: Kou Rui , Lian Shiwei , Xie Nan , Lu Beier , Liu Xuemei 
Published: May 2021

Abstract
Tool wear condition (TCM) has a significant impact on machining quality, efficiency and cost, so it is vitally important in manufacturing systems. The current work of TCM mainly process the time series signals from multisensory by intelligent algorithm. However, the limited of these method is; 1) the image information are not integrated into the time series signals, 2) the traditional methods are facing the problems of poor generalization and fast convergence. Thus, a novel integrated model based on the multisensory feature fusion and neural network is presented. After the PAA pre-processed, the developed model recodes the sensor data into images using GAF and inputs to CNN model with the tool infrared images, then realizes the output of flank wear value. Compared with other algorithms, the results show that the algorithm has better classification ability.
Development and validation of a prognostic nomogram in lung cancer with obstructive sleep apnea syndrome
Authors: hu ke , Liu Wei , wu xiaofeng , zhou ling 
Published: May 2021

Abstract
Background

To analyze the prognostic factors and survival rate of lung cancer patients with OSA by nomogram.
Methods

We developed and validated a nomogram to help improve prediction of overall survival in Lung cancer patients with OSA. The nomogram was established by a development cohort (n = 90), and the validation cohort included 38 patients. Factors in the nomogram were identified by Cox hazard analysis. We tested the accuracy of the nomograms by discrimination and calibration, and plotted decision curves to assess the benefits of nomogram-assisted decisions. At last we evaluated the risk in the two cohort.
Results

There were significant difference in sex, AHI, TNM stage, coronary heart disease, LSpO2, T90%, TS90% and ODI4 between lung cancer subgroup and lung cancer with OSA subgroup (P < 0.05). Lung cancer patients with OSA age(P = 0.021), AHI(P = 0.006), TNM stage(P = 0.005), cancer types(P = 0.038), BMI(P = 0.007) and were independent prognostic factor. Based on these six factors, a nomogram model was established. The c-index of internal verification was 0.802 (95% CI 0.767–0.885)。The ROC curve analysis for the nomogram show 1-year survival (AUC = 0.827), 3-year survival (AUC = 0.867), 5-year survival (AUC = 0.801) in the development cohort and 3-year survival(AUC = 0.863) in the validation cohort is with good accuracy. The calibration curve shows that the survival probability of this prediction model is in good agreement with the actual situation at 1, 3 and 5 years with good consistency. decision curve analysis(DCA)suggests that the net benefit of decision-making with this nomogram is higher, especially in the probability interval of < 20% threshold.
Conclusions

Age, AHI,TNM stage, cancer types, BMI and ODI4 are independent risk factors for prognosis of lung cancer patients with OSAS༌the nomogram can predict the prognosis of patients and guide individualized treatment.
Impact of Serum Lipoprotein (A) Level on Coronary Artery Calcification: An Intravascular Ultrasound Study
Authors: Sheng Zhe , Wu Xi , Liu Jun , Chen Chen-yang , Pan Bao-ping , Chen Ye , Huang Wei , Cao Yu 
Published: May 2021

Abstract
Background

Plasma lipoprotein(a) [Lp(a)] participates in the development of coronary heart disease (CAD). However, the relationship between Lp(a) level and the characteristic of coronary artery calcification has not been investigated.
Methods

A total of 123 patients with CAD who underwent percutaneous coronary intervention(PCI) were analyzed.Calcification burden of coronary culprit plaque was measured by the angle and thickness with intravascular ultrasound imaging(IVUS). Patients were divided into 2 groups: low Lp(a) group, < 150mg/L; high Lp(a) group, ≥ 150mg/L.
Results

Mean patient age was 62.6 ± 10.1years, and 75.6% were men. Among 139 lesions, compared with the high Lp(a) group, the low Lp(a) group had significantly greater median maximum calcification angle (166.4°[102.1, 260.5] vs 118.4° [83.4,169.7], P = 0.007) and thick calcification(40.7% vs 21.2%, P = 0.013).Plaques with a maximum calcification angle of ≥ 180° were more frequently observed in the low Lp(a) group (42.6% vs 18.8%, P = 0.002).The calcification lesions of maximum arc ≥ 180° +thick calcification were larger in the low Lp(a) group (35.2% vs 11.8%, P = 0.001). Multivariate logistic regression analysis showed that low Lp(a) level was a independent predictor of a greater calcification burden: calcification arc ≥ 180°(OR 4.43, 95%CI1.93-10.13;P < 0.001),and thick calcification + maximum calcification arch ≥ 180°(OR 5.92, 95% CI 2.36–14.82; P < 0.001).
Conclusion

In patients with CAD, Low Lp(a) level was associated with high burden of coronary artery calcification. Our findings might provide a new perspective of Lp(a) level on plaque-stabilizing effects in coronary atherosclerotic plaque.
Stress analysis of double-walled pipes undergone mechanical drawing process
Authors: Zhang Ruogu , Wang Yu , Zhu Yinbo , Jin JiDong , Wu HengAn , Gu Ping , Zhao Yang 
Published: May 2021

Abstract
Double-walled metal pipes are important components for heat exchange and liquid transportation. They can be manufactured by mechanical drawing of two concentric pipes. In this work, a mechanical model is developed to analyze the stress state evolution during the manufacturing process, and the criterion for forming the double-walled pipe was given under the ideal elastoplastic and thick-wall assumptions. The model also encompasses the results deduced under the thin-wall assumption. Numerical simulations confirmed that the accuracy of the analytical model was within 5%. The application on actual steel materials with various parameters varied, including the wall thickness and initial gap, was analyzed. This work can provide theoretical support to industrial manufacturing procedures and help to reduce costs by eliminating required test procedures.
Introducing MyPlate in the Curriculum of Nutrition Teaching for Undergraduate Medical and Health Allied Professions of Palestinian Students
Authors: Natour Nihal , Al-Tell Mariam 
Published: May 2021

Abstract
Introduction: MyPlate is an American educational tool that was introduced by United States Department of Agriculture (USDA) as replacement for MyPyramid. It provides the American public with key messages on healthy diet, but was not studied in other populations.Aims: we aimed to study the acceptance and utility of MyPlate among Palestinian medical and allied health students by introducing the application in the nutrition course which is part of curriculum.Methods: Electronic survey was distributed on social media and university platforms to Palestinian students at schools of medicine, nursing and pharmacy at Najah University. The survey collected data on demographic variable, obesity, nutritional deficiencies, nutritional problems and use of MyPlate. In addition vegetables use, physical activity information. Data was analyzed using IBM SPSS 21 software.Results: We included 106 students in the study. 68% of our study group were females, 58.% medical students, 44% were nursing students, and the rest were pharmacy students. 89% of our students reported using knowing MyPlate, 61% reported using MyPlate and 79% reported that they found the use of application easy. The reason for using the application were mainly related to calculating the needed calories and plan a healthy diet. However, our students reported low ability to change their lifestyle accordingly. There was no age difference between users and non-users (19.4 y ± 0.8 y versus 19.8 y ± 0.8 y) or BMI ((20.0±4.6) Kg/m2 versus (21.3±5.8) Kg/m2). MyPlate users were more physically active, but there was no difference in physical activity.Conclusion: MyPlate was very well accepted among our students but they need follow up to improve adherence to healthy lifestyle
Numerical Simulation of The Top Side-Pouring Twin-Roll Casting of 6.5 wt.% Si Steel Process
Authors: Xuan Dongpo , zhou cheng , Zhou You , Jiang Tianliang , Zhu Biji , Fan Wenhao , Jia Yangguang 
Published: May 2021

Abstract
Using the commercial finite element software ProCAST to predict the temperature field, the flow field, the turbulent kinetic energy, and melt-pool outlet temperature of the top side-pouring twin-roll casting (TSTRC) of 6.5 wt.% Si steel process, and the cellular automaton–finite element (CA-FE) method was used to simulate the melt-pool outlet microstructure. The effect of different process conditions on the TSTRC process was investigated through numerical simulation and a processing technic appropriate for the production of 6.5 wt.% Si steel was obtained. Meanwhile, the influence of violent stirring in the melt-pool on the microstructure under different process conditions was evaluated. It was found that vigorous stirring in the melt-pool was conducive to formate the equiaxed crystal structure. Not only realized the near-final shape of the metal sheet, but also realized the near-final shape of the microstructure. Chose the proper process to experiment, and from comparing the simulation and the experiment, the simulation and experimental results were in good agreement, which verified the simulation's feasibility and accuracy.
Porous, Multi-layered Piezoelectric Composites Based on Highly Oriented Pzt/pvdf Electrospinning Fibers for High-performance Piezoelectric Nanogenerators
Authors: Du Xiangxin , Zhou Zheng , Zhang Zhao , Yao Liqin , Zhang Qilong , Yang Hui 
Published: May 2021

Abstract
Piezoelectric nanogenerators (PENGs) that can harvest mechanical energy from ambient environment have broad prospects for multi-functional applications. Here, multi-layered piezoelectric composites with a porous structure based on highly oriented PZT/PVDF electrospinning fibers are prepared via a laminating method to construct high-performance PENGs. PZT particles as piezoelectric reinforcing phases are embedded in PVDF fibers and facilitate the formation of polar β phase in PVDF. The multi-layered, porous structure effectively promotes the overall polarization and surface bound charge density, resulting in highly efficient electromechanical conversion. The PENG based on 10 wt.% PZT/PVDF composite fibers with a 220 µm film thickness output an optimal voltage of 62.0 V and a power of 136.9 μW, which is 3.4 and 6.5 times the voltage and power of 10wt.% PZT/PVDF casting film-based PENG, respectively. Importantly, the PENG shows a high sensitivity of 12.4 VN-1, presenting a significant advantage in comparison to PENGs with other porous structures. In addition, the composites show excellent flexibility with a Young’s modulus of 227.2 MPa and an elongation of 262.3%. This work shows great potential application of piezoelectric fiber composites in flexible energy harvesting devices.
Behavioral and Psychiatric Health Problems in Iranian Students During the COVID-19 Pandemic
Authors: Sany Seyedeh Belin Tavakoly , Kiani Mohammad Ali , Talebi Mahdi , Layeghi Darab , Ghasemi Mehri , Taheri Maryam , Taheri Ahmad reza , peyman Nooshin 
Published: May 2021

Abstract
Background
the study of behavioral and psychiatric health problems in space and time, can help to improve health services for adolescents and children by increasing understanding of causes, development, and course of psychiatric disorders.
Methods
This cross-sectional study has been carried out through cluster sampling design on 322 normal students aged 12–18 attending in public high and elementary school in Esfahan, Iran. They completed study instrument that included the 110-item The Child Symptom Inventory-4 (CSI-4) and those inquiring the students’ demographic information.
Results
Findings showed that 58% students met criteria for all psychiatric symptoms except of the autism and Asperger’s disorders, and 39.5% suffered from more than one comorbid categories of psychiatric disorders. The most common psychiatric disorders in boys and girls were ADHD (18.5%), ODD (15%), ADHD-C (13.5%), GAD (12.8%), ADHD: HI (11.5), and MDD (10.8%).
Conclusion
Most of students suffered from more than one co-morbid category of psychiatric disorders. It is better to develop effective strategies and interventions, train students about self-protection, and establish a psychological crisis intervention team to minimize the psychological impact of the COVID-19 pandemic.
Urea to Albumin Ratio Is an Independent Predictor of In-Hospital Mortality in Patients With Severe Pneumonia: A Retrospective Cohort Study
Authors: Tian Yu , Li Yihao , Chen Jieru , Jiang Zixin 
Published: May 2021

Abstract
Background: Severe pneumonia (SP) is a major complication of respiratory system disease that is associated with high mortality and morbidity. Our objective was to identify risk factors predictive of SP patients and its mortality in intensive care unit (ICU).Methods: We conducted a single-center retrospective observational study involving 212 patients with SP in ICU from June 1st, 2016 to June 1st, 2020. The receiver operating characteristic (ROC) curve was constructed to assess the predictive significance of urea to albumin ratio (U/A). Kaplan-Meier survival curves were plotted with log-rank tests to compare survival of patients with different value of U/A. Multivariate COX regression models were used to calculate the adjusted hazard ratios (HR). Additionally, interaction analysis showed the association between U/A and in-hospital mortality was influenced by sex. Primary outcome was in-hospital mortality.Results: A total of 212 patients were enrolled in the analysis. In the hospital, 101 (47.6%) patients had died. ROC analysis showed that the current cut-off of 0.2555 had a sensitivity of84.2% for in-hospital mortality (AUC = 0.63, 95%CI: 0.55-0.70,P = 0.001). The multivariate COX analysis showed that the incidence of death was higher with the higher U/A group than the lower group (HR: 2.234, 95%CI: 1.146-4.356, P = 0.018).Besides, this pattern persisted in subgroup analyses considering sex. (HR: 9.380, 95%CI: 2.248-39.138, P = 0.002)Conclusions: A high level of U/A is an independent risk factor for in-hospital mortality in patients with SP.
Clinical Evidence of Initiating a Very Low Dose of Sacubitril/Valsartan; Beyond the PARADIGM-HF and PIONEER-HF: A Prospective Observational Analysis
Authors: Kim Hyoeun , Oh Jaewon , Lee Sanghyup , Ha Jaehyung , Yoon Minjae , Chun Kyeong-hyeon , Lee Chan Joo , Park Sungha , Lee Sang-Hak , Kang Seok-Min 
Published: May 2021

Abstract
AimsSacubitril/valsartan is superior to enalapril in reducing the risks of cardiovascular death and preventing hospitalization in patients with heart failure and reduced ejection fraction (HFrEF). However, patients often do not receive sacubitril/valsartan because of concerns about hypotension. We examined the feasibility of initiating sacubitril/valsartan at a very low dose (VLD) in potentially intolerant patients with HFrEF and subsequent dose up-titration, treatment persistence and outcomes.Methods and ResultsWe analyzed 206 patients with HFrEF grouped according to starting sacubitril/valsartan dose. The VLD group (n=106) commenced 25 mg twice daily, and the standard-dose (SD) group (n=100) started on ≥50 mg twice daily. Baseline systolic blood pressure was 103±12 mmHg vs. 119±14 mmHg in the SD group (P<0.001). The maximal target dose achievement rate was higher in the SD group (27.0% vs 9.4%, p=0.001) and the VLD group experienced more dose up-titrations and fewer down-titrations than the SD group. The VLD group had a decrease in N-terminal prohormone of brain natriuretic peptide (NT-proBNP) similar to the SD group and a similar increase in left ventricular ejection fraction. There were no significant differences in symptomatic hypotension, worsening renal function, hyperkalemia, cardiovascular mortality, and rehospitalization due to HF between the two groups during follow-up period.ConclusionsIn patients considered by the treating physician likely to be intolerant of sacubitril/valsartan, initiation with 25 mg twice daily was generally possible and patients remained in therapy, with similar decreases in NT-proBNP and increases in left ventricular ejection fraction to those observed in patients receiving SD sacubitril/valsartan.