bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cancer of Unknown Primary Presenting as Bone-Predominant or Lymph Node-Only Disease: A Clinicopathologic Portrait
Authors: Huey Ryan W. , Smaglo Brandon G. , Estrella Jeannelyn S. , Matamoros Aurelio , Overman Michael J. , Varadhachary Gauri R. , Raghav Kanwal P.S. 
Published: February 2021

Abstract

Background
Cancer of unknown primary (CUP) presenting as bone-predominant (BCUP) or lymph node-only disease (LNCUP) represents two clinically distinct subsets of nonvisceral CUP. These present a diagnostic challenge with a large differential of putative primary cancers and defy the “one-treatment-fits-all” approach.

Materials and Methods
We identified patients with BCUP (n = 29) and LNCUP (n = 63) using a prospectively collected CUP database and tumor registry of patients seen at MD Anderson Cancer Center between 2001 to 2017. Clinicopathological characteristics, treatments, and outcomes were abstracted. A control group of non-BCUP/LNCUP cases (n = 443) from the database was used for comparison. Kaplan-Meier method was used to estimate overall survival and compared using log-rank test.

Results
In this cohort, 64% and 60% patients had disseminated disease at diagnosis and 39% and 23% had Culine poor-risk disease in BCUP and LNCUP, respectively. Median overall survival (OS) for BCUP was 14.5 months and for LNCUP was 32.6 months. For BCUP, gemcitabine plus platinum was the most common initial chemotherapy (54%). For LNCUP, carboplatin plus paclitaxel was the most common initial chemotherapy (38%). Radiation was given to 74% of patients with BCUP and 37% of those with LNCUP. On multivariate analysis, poor-risk Culine group (hazard ratio [HR], 1.76; p &lt; .001) and high neutrophil-to-lymphocyte ratio (HR, 2.38, p &lt; .001) were associated with worse OS.

Conclusion
BCUP and LNCUP are rare subsets within CUP with varying prognosis. Poor-risk Culine group and high neutrophil-to-lymphocyte ratio are associated with poor survival. Select patients with limited metastases can have long-term survival with aggressive multimodality treatment. Careful clinicopathological review can facilitate chances of site-directed therapy.

Implications for Practice
Cancer of unknown primary (CUP) rarely presents as bone-predominant (BCUP) or lymph node-only (LNCUP) disease. This article describes a cohort of each and compares with a larger CUP cohort. Patients with BCUP have unique issues with fractures and pain, often receiving radiation. Overall survival of 14.5 months was similar to a larger CUP comparison cohort. Patients with LNCUP had improved overall survival at 32.6 months, with longer survival in patients without disseminated disease. Culine poor-risk group and neutrophil-to-lymphocyte ratio were associated with worse overall survival. Tips regarding diagnosis and management of these rare malignant subsets are provided.
DNA meta‐barcoding using rbcL based mini‐barcode revealed presence of unspecified plant species in Ayurvedic polyherbal formulations
Authors: Pandit Ramesh , Travadi Tasnim , Sharma Sonal , Joshi Chaitanya , Joshi Madhvi 
Published: February 2021

AbstractIntroductionAyurveda takes advantage of the beneficial properties of medicinal plants. High demands in combination with inadequate availability of botanicals and a lack of knowledge with respect to their precise identification lead to adulterations in herbal products. Identification becomes more difficult in complex herbal formulations. Four different polyherbal formulations have been analyzed for the present paper. The targeted plants have different pharmacological properties for various ailments.ObjectiveWe aimed to examine the rbcL gene based plant DNA mini‐barcode to identify target and non‐target plants in polyherbal formulations by using high‐throughput next generation sequencing.MethodsDegenerate primers of the selected mini‐barcode region have been identified from the literature. A blend of 30 authentic medicinal plant species was used to examine the species resolution capacity of the mini‐barcode. DNA was isolated from herbal formulations, an amplicon library was prepared, and sequencing was performed on an IonS5 system. Data were analyzed using various bioinformatics tools.ResultsAnalysis of control pooled samples revealed the optimum resolving power of the DNA mini‐barcode. Data analysis of the commercial samples revealed that only one herbal formulation contained all plants and matched with listed contents. In two formulations, only 10 out of 21 and 11 out of 20 plants were detected, respectively. Additionally, several non‐listed plants were also detected in these formulations. Two formulations contained >20% reads assigned to non‐target plants. Overall, 21.98% of the reads were assigned to non‐target plants.ConclusionThe present study clearly demonstrated the successful application and potential of meta‐barcoding in the quality control of complex herbal matrices. The results strongly suggest that this approach can be used in pharmacovigilance of processed herbal products.
Willpower beliefs and diabetes distress: a preliminary cross‐sectional study
Authors: Skinner Timothy C , Skinner Isabelle K 
Published: February 2021

AbstractThis study aimed to explore whether beliefs about willpower are associated with emotional well‐being.A cross‐sectional study of 323 people with type 2 diabetes completed a short form of the Problem Areas In Diabetes Scale and the World Health Organisation five‐item well‐being scale, the Brief Illness Perceptions Questionnaire for diabetes (BIPQ) and the Implicit Willpower Beliefs to Resist Temptations (IWB‐RT).A total of 332 individuals responded. They were a mean of 61.3 (SD 11.8) years of age, 68% were from the UK, 41% were female, and 30% had completed secondary education. They had diabetes for a mean of 10.0 years (SD 8.6), with 78% taking oral antidiabetes medication, 26% taking insulin, 71% taking medication for their blood pressure and 71% taking medication for their cholesterol. After controlling for demographics, treatment characteristics and illness beliefs, holding a resource limited belief about the nature of willpower was associated with reporting higher levels of diabetes distress.These results indicate that holding a resource limited belief about the nature of willpower may be a predisposing factor contributing to the development of diabetes distress. Longitudinal and experimental studies are required to confirm this possible causative role for willpower beliefs in the aetiology of diabetes distress. Copyright © 2021 John Wiley & Sons.
Cannabinoid hyperemesis syndrome as a cause of recurrent vomiting in type 1 diabetes
Authors: Aung Ei Thuzar , Balafshan Tala , Wace Perseus , Weston Philip J 
Published: February 2021

AbstractAbdominal pain and vomiting are common presentations to the emergency medical ward. Management of recurrent abdominal pain and vomiting can be difficult, especially in patients who have diabetes. People with diabetes can present with vomiting and abdominal pain that can cause a diagnostic dilemma. Are the symptoms due to an acute or chronic complication of their diabetes or to other causes? In patients with diabetes who also use cannabis, further diagnostic challenges can arise as recurrent vomiting and abdominal pain due to diabetic gastroparesis and cannabinoid hyperemesis syndrome (CHS) can present in similar ways. We present a case series of four patients with type 1 diabetes who had multiple admissions with abdominal pain and vomiting mimicking diabetic gastroparesis, all of whom were eventually diagnosed with CHS. Copyright © 2021 John Wiley & Sons.
Triple jeopardy: old age, frailty and diabetes in COVID‐19
Authors: Fox Charles , Kilvert Anne 
Published: February 2021

AbstractThe COVID‐19 pandemic has turned the lives of people throughout the world upside down and the virus has hit the older population hardest of all. The term ‘triple jeopardy’ has been coined to identify that older people with frailty and diabetes are at particular risk from the virus.Government figures for non‐COVID deaths from March to May 2020 show a 20–50% increase in those >70 years but lack of testing capacity may have led to under‐reporting of the virus. There has undoubtedly been a catastrophe in care homes, with 40% of total COVID‐19 deaths occurring in this setting. Whether frailty poses a greater risk than age alone is uncertain, with observational studies producing conflicting results. NICE guidance to include assessment of frailty in clinical decision making may have introduced study bias.Diabetes adds additional risk, with 33% of all hospital deaths occurring in people with diabetes: hazard ratio 3.51 for type 1 diabetes and 2.03 for type 2. The majority of those who died were >70 years (60.9% type 1 and 79.2% type 2). Poor glycaemic control is associated with increased risk.A 19th century definition of triple jeopardy defined gender, race and poverty as the dominant factors and these remain just as relevant in the COVID‐19 era. The arrival of a second wave highlights the need to introduce measures to protect people with diabetes and those marginalised by society. This includes older people and their carers. Copyright © 2021 John Wiley & Sons.
Screening for pancreatic ductal adenocarcinoma in the population with diabetes
Authors: Sharp Patrick , Brown Beata , Price Hermione 
Published: February 2021

AbstractPancreatic ductal adenocarcinoma (PDAC) is an uncommon condition with an incidence of about 8–12 cases per 100,000 of the population per year. Presentation is often late, treatment outcomes poor and the mortality rate is high. There is no screening strategy for the condition at present. However, it is recognised that PDAC is associated with a rise in blood glucose in the months prior to diagnosis. Current NICE guidance recommends that imaging is considered in individuals over the age of 60 years who present with new onset diabetes. In this brief review we consider the background to this recommendation and how it might be incorporated into practice for diabetes health care professionals. The key point is to keep aware of the fact that a few of our patients with diabetes may have a background diagnosis of pancreatic cancer and to be vigilant for any possible red flag signs. Copyright © 2021 John Wiley & Sons.
Effects of an acute care brain injury medicine continuity consultation service on health care utilization and rehabilitation outcomes
Authors: Weppner Justin L. , Linsenmeyer Mark A. , Wagner Amy K. 
Published: February 2021

AbstractIntroductionAlthough general physiatry acute‐care consultation services are commonplace and improve length of stay (LOS), the benefits of a subspecialty physiatric continuity consultation service targeting patients with severe brain injury have not been reported.ObjectivesOur primary objective was to characterize patient care recommendations from a Brain Injury Medicine (BIM) Continuity Consult Service, and to investigate the effects on acute‐care LOS relative to brain injury patients receiving General Physical Medicine & Rehabilitation (PM&R) Consult Services. Our secondary objectives were to examine inpatient rehabilitation (IPR) health care utilization metrics and costs between groups and evaluate clinical improvements during IPR and discharge disposition.DesignRetrospective cohort comparison study.SettingAcademic medical center with level 1 trauma center.ParticipantsAdults with severe brain injury admitted to a single‐site acute‐care facility and subsequently admitted to a single inpatient brain injury rehabilitation unit over the same time period.Physiatric Care ModelsBIM Continuity Consult Service versus General PM&R Consult Service.Main Outcome MeasuresAcute‐care LOS; unplanned discharges to acute‐care.ResultsDespite no major demographic or clinical group differences, the BIM Consult Service had more patient comorbidities than General PM&R Consult Service (17.5±5.3 versus 16±5.1;P = .04). BIM Consult Service patients spent fewer days in acute care (30±11.8 versus 36±22.8; P = .008), and early BIM consult (≤7 days after admission) was associated with shorter acute‐care LOS (P < .002). IPR LOS was similar between groups when considering unplanned transfers. Unplanned transfers among General PM&R Consult Service patients occurred twice as frequently as in BIM Consult Service patients; average readmission costs were $2778 per patient on the BIM Consult Service and $6702 per patient on the General PM&R Consult Service. More BIM Consult Service (85.7%) than General PM&R Consult Service (27.3%) patients emerged from disorders of consciousness during IPR (P = .02).ConclusionsBIM Continuity Consultation Services were associated with shorter acute‐care LOS, fewer unplanned acute‐care transfers, and an increased likelihood of emerging from a minimally conscious state during IPR.
Men in rural Nigeria have a poor perception of prostate cancer risk; Hence they seldom seek screening
Authors: Adedeji Isaac A. , Lawal Saheed A. , Aluko‐Arowolo Sola , Oduwole Ebun O. 
Published: February 2021

AbstractObjectivesThe study aimed to investigate the behavioral and social factors that underlie the risk perception and screening behavior of prostate cancer (PCa) among rural men in Southwest Nigeria.MethodsThe study adopted a descriptive cross‐sectional design. To investigate the behavioral and social factors associated with men's screening behavior in rural communities, the study utilized an interviewer‐administered questionnaire. A sample of 384 men who lived in six rural communities across Southwest Nigeria participated in the study. Constructs of the Health Belief Model provided theoretical framing. Key variables were the demographics, screening behavior, knowledge of PCa, and perception of PCa risk. Data analysis tools were descriptive (simple percentages) and multiple regression at p < 0.05.ResultsAbout 49.7% were age 31–40, most of the men in the rural communities (64.1%) did not have more than secondary school education, and about 48.7% owned their businesses. Exactly 56% earned less than 18,000 per month; 65.6% were Christians, and the majority (90.6%) were married, with most (60.2%) not having more than four children (≤4 children). Knowledge of PCa has a significant but weak relationship with PCa screening behavior (p = 0.02). Age (β = 0.014), religion (β = 0.052), and income (β = 0.010)/(β = 0.011) had predicted risk perception. Only income (β = 0.038) significantly influenced screening behavior.ConclusionThere is a need to improve PCa awareness and knowledge to address risk perception fears and encourage increased screening behavior among men in rural areas.
Tracheostomy trends in preterm infants with bronchopulmonary dysplasia in the United States: 2008–2017
Authors: Donda Keyur , Agyemang Christfelly O. , Adjetey Naa A. , Agyekum Afua , Princewill Nimitariye , Ayensu Marian , Bray Leonita , Yagnik Priyank J. , Bhatt Parth , Dapaah‐Siakwan Fredrick 
Published: February 2021

AbstractObjectiveTo determine the trends in tracheostomy placement and resource use in preterm infants less than or equal to 30 weeks gestational age (GA) with bronchopulmonary dysplasia (BPD) in the United States from 2008 to 2017.Study designThis was a retrospective, serial cross‐sectional study using data from the NIS. Inclusion criteria were: GA less than or equal to 30 weeks, hospitalization at less than or equal to 28 days of age, assignment of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD9‐CM) or ICD10‐CM codes for BPD and tracheostomy. Trends in tracheostomy and resource utilization were assessed using Jonckheere–Terpstra test. p‐value < .05 was considered significant.ResultsOverall, 987 out of 68,953 (1.4%) hospitalizations with BPD had tracheostomy. Characteristics of the study population: 60.8% were male, 68.4% less than or equal to 26 weeks GA, 43.8% White, 60.5% with Medicaid or self‐pay, 65.2% in the Midwest and South census regions of the United States, and 45.7% had gastrostomy tube placement. Tracheostomy placement (expressed as per 100,000 live births) decreased from 2.7 in 2008 to 1.9 in 2011. Thereafter, it increased from 1.9 in 2011 to 3.5 in 2017 (p < .001). GA less than or equal to 24 weeks was significantly associated with increased odds of tracheostomy placement. Median length of stay increased significantly from 170 to 231 days while median inflation adjusted hospital cost increased significantly from $323,091 in 2008–2009 to $687,141 between 2008–2009 and 2016–2017.ConclusionAlthough tracheostomy placement among preterm hospitalizations with BPD was rare, the frequency of its placement and its associated resource utilization significantly increased during the study period. Future studies should probe the reasons and factors behind these trends.
Role of ATP5B in colorectal cancer
Authors: Zhu Yue , Wei Wei , Zhang Yuan , Wu Jianzhong , Ma Rong , Feng Jifeng 
Published: February 2021

AbstractObjectiveTo explore the role and possible regulatory mechanisms of ATP5B in colorectal cancer.MethodsOnline databases were used to analyze expression of ATP5B and prognosis in patients with l colorectal cancer. The data of TCGA database were analyzed by Gene Set Enrichment Analysis. Co‐expression network analysis of ATP5B was analyzed by coexpedia. Colorectal cancer cell (SW480 and DLD1) were transfected with small interfering RNA and validated by real‐time fluorescence quantitative PCR. Cell proliferation ability was detected by CCK8 experiment, cell migration and invasion ability were detected by scratch experiment and Transwell experiment.ResultsATP5B is highly expressed in colorectal cancer tissue. Up‐regulation of ATP5B is associated with poor prognosis of colorectal cancer patients. ATP5B may regulate the cell junction pathway and the PI3K‐AKT‐mTOR signaling pathway. ATP5B expression is positively correlated with the proliferation, migration, and invasion of colorectal cancer cells.ConclusionsATP5B plays an important role in the tumorigenesis and metastasis of colorectal cancer.
Two carboxylesterase genes in Plutella xylostella associated with sex pheromones and plant volatiles degradation
Authors: Wang Mei‐Mei , Long Gui‐Jun , Guo Huan , Liu Xuan‐Zheng , Wang Hong , Dewer Youssef , Li Zhao‐Qun , Liu Kun , Zhang Qiu‐Liang , Ma Yun‐Feng , He Peng , He Ming 
Published: February 2021

AbstractBACKGROUNDCarboxyl/cholinesterases (CCEs) are thought to play a pivotal role in the degradation of sex pheromones and plant‐derived odorants in insects, but their exact biochemistry and physiological functions remain unclear.RESULTSIn this study, two paralogous antennae‐enriched CCEs from Plutella xylostella (PxylCCE16a and 16c) were identified and functionally characterized. High‐purity protein preparations of active recombinant PxylCCE16a and 16c have been obtained from Sf9 insect cells by Ni2+ affinity purification. Our results revealed that the purified recombinant PxylCCE016c is able to degrade two sex pheromone components Z9‐14:Ac and Z11‐16:Ac at 27.64 ± 0.79% and 24.40 ± 3.07%, respectively, while PxylCCE016a presented relatively lower activity. Additionally, a similar difference in activity was measured in plant‐derived odorants. Furthermore, both CCEs displayed obvious preferences for the two sex pheromone components, especially on Z11‐16:Ac (Km values are in the range 7.82–45.06 μmol L–1) which much lower than plant odorants (Km values are in the range 1290–4030 μmol L–1). Furthermore, the activity of the two newly identified CCEs is pH‐dependent. The activity at pH 6.5 is obviously higher than that at pH 5.0. Interestingly, only PxylCCE016c can be inhibited by a common esterase inhibitor triphenyl phosphate (TPP) with LC50 of 1570 ± 520 μmol L–1.CONCLUSIONPxylCCE16c plays a more essential role in odorant degradation than PxylCCE16a. Moreover, the current study provides novel potential pesticide targets for the notorious moth Plutella xylostella.© 2021 Society of Chemical Industry
First principles study of electronic, elastic, optical and magnetic properties of Rh2MnX (X = Ti, Hf, Sc, Zr, Zn) Heusler alloys
Authors: Güler Emre , Güler Melek , Uğur Şule , Uğur Gökay 
Published: February 2021

AbstractWe report the electronic, elastic, mechanical, optical, and magnetic properties of Rh2MnX (X = Ti, Hf, Sc, Zr, Zn) Heusler alloys performed within density functional theory. The generalized gradient approximation was used for calculations in the context of the Perdew–Burke–Ernzerhof exchange‐correlation energy treatment. The computed elastic constants and elastic moduli show that all investigated alloys are mechanically stable and ductile. It has been found that the magnitudes of the theoretical Vickers hardness values of these alloys are in the range of Ti > Sc > Zr > Hf > Zn. Also, a typical metallic behavior is obtained for all alloys after agreement of mechanical, electronic and optical data. On the other side, all alloys show strong ferromagnetic ordering following the magnetic moment (μB) rank of Ti > Zr > Hf > Sc > Zn. Our calculated μB data also agree well with the former theoretical results of Rh2MnX (X = Ti, Hf, Sc, Zr, Zn) Heusler alloys.
Digital for real: A multicase study on the digital transformation of companies in the embedded systems domain
Authors: Bosch Jan , Olsson Helena H. 
Published: February 2021

AbstractWith digitalization and with technologies such as software, data, and artificial intelligence, companies in the embedded systems domain are experiencing a rapid transformation of their conventional businesses. While the physical products and associated product sales provide the core revenue, these are increasingly being complemented with service offerings, new data‐driven services, and digital products that allow for continuous value creation and delivery to customers. However, although there is significant research on digitalization and digital transformation, few studies highlight the specific needs of embedded systems companies and what it takes to transform from a traditional towards a digital company within business domains characterized by high complexity, hardware dependencies, and safety‐critical system functionality. In this paper, we capture the difference between what constitutes a traditional and a digital company and we detail the typical evolution path embedded systems companies take when transitioning towards becoming digital companies.