bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance of tumor testing for Lynch syndrome identification in patients with colorectal cancer: A retrospective single-center study
Authors: Signoroni Stefano , Tibiletti Maria Grazia , Ricci Maria Teresa , Milione Massimo , Perrone Federica , Pensotti Valeria , Chiaravalli Anna Maria , Carnevali Ileana , Morabito Alberto , Bertario Lucio , Vitellaro Marco 
Published: August 2018

Objective: To investigate the performance of tumor testing approaches in the identification of Lynch syndrome (LS) in a single-center cohort of people with colorectal cancer (CRC). Methods: A retrospective analysis of data stored in a dedicated database was carried out to identify patients with CRC suspected for LS who were referred to Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, between 1999 and 2014. The sensitivity and specificity of immunohistochemistry (IHC) for mismatch repair (MMR) proteins and microsatellite instability (MSI) analysis (alone or combined) were calculated with respect to the presence of causative MMR germline variants. Results: A total of 683 patients with CRC suspected for LS were identified. IHC results of MMR protein analysis and MSI were assessed in 593 and 525 CRCs, respectively, while germline analysis was performed in 418 patients based on the IHC or MSI test result and/or clinical features. Univariate and multivariate analysis revealed a significant correlation of pathogenic MMR germline variants with all clinicopathologic features including Amsterdam criteria, presence of endometrial cancer, CRC site, age at onset, stage, and grade. The highest odds ratio values were observed for IHC and MSI (17.1 and 8.8, respectively). The receiver operating characteristic curve and area under the curve values demonstrated that IHC alone or combined with other clinicopathologic parameters was an excellent test for LS identification. Conclusions: This study confirms the effectiveness of tumor testing to identify LS among patients with CRC. Although IHC and MSI analysis were similarly effective, IHC could be a better strategy for LS identification as it is less expensive and more feasible.
Cytokine Measurements for Diagnosing and Characterizing Leukemoid Reactions and Immunohistochemical Validation of a Granulocyte Colony-Stimulating Factor and CXCL8-Producing Renal Cell Carcinoma
Authors: Åström Maria , Tajeddinn Walid , Karlsson Mats G , Linder Olle , Palmblad Jan , Lindblad Per 
Published: August 2018

Background: Various paraneoplastic syndromes are encountered in renal cell carcinomas. This case report illustrates that a paraneoplastic leukemoid reaction may precede the diagnosis of renal cell carcinoma and be explained by cytokine production from the cancer cells. Case presentations: A 64-year-old man was referred for hematology workup due to pronounced leukocytosis. While being evaluated for a possible hematologic malignancy as the cause, he was found to have a metastasized renal cell carcinoma, and hyperleukocytosis was classified as a leukemoid reaction. A multiplex panel for measurement of 25 serum cytokines/chemokines showed highly elevated levels of granulocyte colony-stimulating factor (G-CSF) and CXCL8 (C-X-C-motif chemokine ligand 8, previously known as interleukin [IL]-8). By immunohistochemistry it was shown that the renal carcinoma cells expressed both these cytokines. Two additional, consecutive patients with renal cell carcinoma with paraneoplastic leukocytosis also showed elevated serum levels of CXCL8, but not of G-CSF. Nonparametric statistical evaluation showed significantly higher serum concentrations of CXCL8, IL-6, IL-10, monocyte chemoattractant protein 1 (MCP-1), and tumor necrosis factor, but lower interferon gamma (IFN-γ) and IL-1α, for the 3 renal cell carcinoma cases compared with healthy blood donors. Conclusions: In suspected paraneoplastic leukocytosis, multiplex serum cytokine analyses may facilitate diagnosis and provide an understanding of the mechanisms for the reaction. In the index patient, combined G-CSF and CXCL8 protein expression by renal carcinoma cells was uniquely documented. A rapidly fatal course was detected in all 3 cases, congruent with the concept that autocrine/paracrine growth signaling in renal carcinoma cells may induce an aggressive tumor phenotype. Immune profiling studies could improve our understanding for possible targets when choosing therapies for patients with metastatic renal cell carcinoma.
Navigation of a 6-French guiding sheath into the common carotid artery using a tri-axial catheter system in transbrachial carotid artery stenting
Authors: Sakamoto Shigeyuki , Matsushige Toshinori , Abiko Masaru , Shimonaga Koji , Hosogai Masahiro , Okazaki Takahito , Ishii Daizo , Oshita Jumpei , Kurisu Kaoru 
Published: August 2018

Background and purpose Placement of a large-bore guiding sheath or catheter into the common carotid artery (CCA) is crucial in transbrachial carotid artery stenting (CAS). Herein, we describe technical tips for the navigation of a 6-French guiding sheath into the CCA using a tri-axial catheter system in transbrachial CAS. Materials and methods A total of 27 patients underwent transbrachial CAS. For the right side, a 6-French straight guiding sheath was navigated directly into the CCA using a tri-axial catheter system, with a 4-French Simmons catheter placed through a 6-French straight guiding catheter. For the left side, a 6-French Simmons guiding sheath was navigated into the CCA using a tri-axial catheter system, with a 4-French Simmons catheter placed through a 6-French Simmons guiding catheter. After the placement of a 6-French guiding sheath into the CCA, CAS was performed under distal filter or balloon protection. Results Fifteen patients had a right carotid stenosis and 12 patients had a left carotid stenosis. The 6-French guiding sheath was safely placed with ease and provided adequate stabilization for CAS. All procedures were successfully performed without any complications. Conclusion The use of a tri-axial catheter system for the navigation of a 6-French guiding sheath into the CCA appears safe and efficient, allowing transbrachial CAS, with 6-French guiding sheath stabilization, to be performed without any complication.
Perspectives on cervical cancer screening and prevention: challenges faced by providers and patients along the Texas–Mexico border
Authors: Boom K , Lopez M , Daheri M , Gowen R , Milbourne A , Toscano P , Carey C , Guerra L , Carvajal JM , Marin E , Baker E , Fisher-Hoch S , Rodriguez AM , Burkalter N , Cavazos B , Gasca M , Cuellar MM , Robles E , Lopez E , Schmeler K 
Published: August 2018

Background: The Rio Grande Valley (RGV) and Laredo regions located along the Texas–Mexico border consist of seven counties with a population of approximately 1.5 million people and a high uninsured rate (33.5%). Cervical cancer mortality in these border counties is approximately 30% higher than the rest of Texas. The RGV and Laredo areas were studied to better understand the state of access to cervical cancer prevention services along the Texas–Mexico border. Methods: Data on the population served and the services provided were analyzed to determine the gap between cervical cancer screenings recommended versus those received. Through interviews, we gathered the perspectives of 16 local stakeholders regarding cervical cancer screening for underserved individuals in the region. Findings: It is estimated that 69,139 uninsured women aged 21–64 years in the RGV/Laredo per year are recommended to undergo cervical cancer screening with Papanicolaou (Pap) and/or human papillomavirus (HPV) testing, but only 8941 (12.9%) Pap tests are being performed by the Federally Qualified Health Center (FQHC) serving uninsured women in these regions. Systemic barriers identified include insufficient provider clinical capacity, the high cost of healthcare, and uncertainty about government funding sources. Patient barriers identified include inadequate knowledge on navigating the local healthcare system, low health literacy, lack of money and childcare, an inability to miss work, limited transportation, and fear of deportation. Conclusion: Decreasing the disparity between cervical cancer screening services provided and those recommended requires addressing the barriers, identified by local experts, which prevent uninsured women from accessing care. These challenges are being addressed through ongoing programs and collaborations.
Comparison of Best Versus Worst Clinical Outcomes for Adult Cervical Deformity Surgery
Authors: Smith Justin S. , Shaffrey Christopher I. , Kim Han Jo , Passias Peter , Protopsaltis Themistocles , Lafage Renaud , Mundis Gregory M. , Klineberg Eric , Lafage Virginie , Schwab Frank J. , Scheer Justin K. , Kelly Michael , Hamilton D. Kojo , Gupta Munish , Deviren Vedat , Hostin Richard , Albert Todd , Riew K. Daniel , Hart Robert , Burton Doug , Bess Shay , Ames Christopher P. 
Published: August 2018

Study Design: Retrospective cohort study. Objective: Factors that predict outcomes for adult cervical spine deformity (ACSD) have not been well defined. To compare ACSD patients with best versus worst outcomes. Methods: This study was based on a prospective, multicenter observational ACSD cohort. Best versus worst outcomes were compared based on Neck Disability Index (NDI), Neck Pain Numeric Rating Scale (NP-NRS), and modified Japanese Orthopaedic Association (mJOA) scores. Results: Of 111 patients, 80 (72%) had minimum 1-year follow-up. For NDI, compared with best outcome patients (n = 28), worst outcome patients (n = 32) were more likely to have had a major complication ( P = .004) and to have undergone a posterior-only procedure ( P = .039), had greater Charlson Comorbidity Index ( P = .009), and had worse postoperative C7-S1 sagittal vertical axis (SVA; P = .027). For NP-NRS, compared with best outcome patients (n = 26), worst outcome patients (n = 18) were younger ( P = .045), had worse baseline NP-NRS ( P = .034), and were more likely to have had a minor complication ( P = .030). For the mJOA, compared with best outcome patients (n = 16), worst outcome patients (n = 18) were more likely to have had a major complication ( P = .007) and to have a better baseline mJOA ( P = .030). Multivariate models for NDI included posterior-only surgery ( P = .006), major complication ( P = .002), and postoperative C7-S1 SVA ( P = .012); models for NP-NRS included baseline NP-NRS ( P = .009), age ( P = .017), and posterior-only surgery ( P = .038); and models for mJOA included major complication ( P = .008). Conclusions: Factors distinguishing best and worst ACSD surgery outcomes included patient, surgical, and radiographic factors. These findings suggest areas that may warrant greater awareness to optimize patient counseling and outcomes.
What Are the Important Predictors of Postoperative Functional Recovery in Patients With Cervical OPLL? Results of a Multivariate Analysis
Authors: Nakashima Hiroaki , Kanemura Tokumi , Kanbara Shunsuke , Satake Kotaro , Ito Keigo , Ishiguro Naoki , Kato Fumihiko , Imagama Shiro 
Published: August 2018

Study Design: A retrospective cohort study. Objective: The objective of this study was to identify important predictors of poor functional recovery in patients undergoing surgery for cervical ossification of the posterior longitudinal ligament (OPLL). Methods: This was a retrospective cohort study of 142 OPLL patients with laminoplasty; 135 had complete radiographical data and were followed up for ≥2 years. The following OPLL characteristics were compared between patients with “good” and “poor” outcomes (Japanese Orthopedic Association [JOA] recovery rate ≥50% and <50%, respectively): number of ossified levels, OPLL classification, ossification shape, K-line, canal-occupying ratio, and increased magnetic resonance imaging (MRI) signal intensity. Predictors of functional recovery were identified. Results: Pre- and postoperative (2 years following surgery) JOA scores were 10.6 ± 2.9 and 14.1 ± 2.2, respectively, indicating significant improvement following laminoplasty ( P < .001). The average JOA recovery rate was 53.4% ± 34.7%, with 81 (60.0%) and 54 (40.0%) patients in the better and poorer neurological outcome groups, respectively. The canal occupation ratio of OPLL ≤60%/>60% were 117 (86.7%) and 18 (13.3%) patients, respectively. In the stepwise logistic regression analysis, an occupation ratio greater than 60% was identified as a significant factor for poor postoperative neurological outcome (relative risk, 4.82; 95% confidential interval, 1.61-14.46, P = .005). Conclusions: This multivariate analysis demonstrated a large size OPLL (occupying ratio >60%) was associated with a risk of poor neurological recovery roughly 5 times greater, and therefore other types of surgery are recommended in cases with such a ratio.
A percutaneous, minimally invasive annulus fibrosus needle puncture model of intervertebral disc degeneration in rabbits
Authors: Luo T David , Marquez-Lara Alejandro , Zabarsky Zachary K , Vines Jeremy B , Mowry Katie C , Jinnah Alexander H , Ma Xue , Berwick Benjamin W , Willey Jeffrey S , Li Zhongyu , Smith Thomas L , O’Gara Tadhg J 
Published: August 2018

Purpose: Various animal models have been proposed to mimic the pathophysiologic process of intervertebral disc degeneration, a leading cause of back pain. The purpose of this study is to describe a minimally invasive technique via percutaneous needle puncture of the annulus fibrosus in New Zealand white rabbits. Methods: Under fluoroscopic guidance, an 18-gauge spinal needle was inserted 2 cm lateral to the midline spinous process. The needle was slowly advanced at approximately 45° angle until it was adjacent to the L5/L6 disc space. Lateral and anteroposterior views were used to verify correct needle position before advancing into the nucleus pulposus. The rabbits underwent weekly X-rays for 4 weeks to assess disc height index. MRI T2 relaxation was evaluated at week four to assess morphological changes. Discs were histologically graded on a 12-point scale to assess degeneration and compared to discs obtained from uninjured rabbits. Results: There were no complications associated with the percutaneous needle puncture procedure. All animals survived the duration of the experiment. Four weeks after injury, the disc height had progressively narrowed to approximately 50% of baseline. MRI assessment at the 4-week time point demonstrated a mean T2 relaxation time at the L5/L6 level that was 20.9% of the T2 relaxation time at the uninjured L4/L5 disc level ( p < 0.001). Histological analysis demonstrated lamellar disorganization of the annulus and decreased cellularity and proteoglycan content within the injured nucleus compared to uninjured control discs. Conclusion: The present study demonstrated a reliable technique of inducing an annular tear via a percutaneous needle puncture. Compared to open surgical approaches, the percutaneous model produces similar progressive disc degeneration while minimizing harm to the animal subjects. Clinical Relevance: The present study establishes a technique for the introduction of novel therapeutic agents to treat disc degeneration that may translate to future clinical trials.
Return to Play After PRP and Rehabilitation of 3 Elite Ice Hockey Players With Ulnar Collateral Ligament Injuries of the Elbow
Authors: McCrum Christopher L. , Costello Joanna , Onishi Kentaro , Stewart Chris , Vyas Dharmesh 
Published: August 2018

Background: Ulnar collateral ligament (UCL) injury is a well-described etiology of pain and decreased performance for the overhead athlete. Despite a growing volume of literature regarding the treatment of these injuries for overhead athletes, there is a paucity of such data regarding stickhandling collision sport athletes, such as ice hockey players. Purpose/Hypothesis: The purpose of this study was to characterize this injury among 3 elite ice hockey players and to describe the ability of these athletes to return to play, as well as to review the unique sport-specific implications of this injury, evaluation, nonsurgical management, and considerations for return to play. The authors hypothesized that elite ice hockey players will be able to return to play at the same level following nonoperative treatment of UCL injury. Study Design: Case series; Level of evidence, 4. Methods: Data from 3 elite professional ice hockey players who sustained a high-grade injury to the UCL were retrospectively reviewed. All athletes underwent 2 autologous conditioned plasma injections as part of their treatment and were evaluated with ultrasonography and magnetic resonance imaging. Results: Three consecutive elite ice hockey players were included in this study, and no patients were excluded. Players were cleared to full return to play at a mean 36 days postinjury. Follow-up examination at this time point demonstrated full range of motion of the elbow for all athletes, without tenderness to palpation over the UCL, including no tenderness over the humeral insertion site. Stability examination improved as well, demonstrating a soft to moderate endpoint with valgus stress, although this was not symmetric to the contralateral side. All athletes were able to continue to play at the same level of competition as before the injury occurred, without any complaints. No players had repeat injury during the same or following seasons. Conclusion: The authors present 3 elite-level ice hockey players who sustained a high-grade injury to the UCL. Successful return to play was possible after nonoperative treatment with injection of autologous conditioned plasma at a mean 36 days following injury. Athletes who injure either the top or bottom hand can return to play at the same elite level following this injury.
IL-33 facilitates proliferation of colorectal cancer dependent on COX2/PGE2
Authors: Li Yongkui , Shi Jie , Qi Shanshan , Zhang Jian , Peng Dong , Chen Zhenzhen , Wang Guobin , Wang Zheng , Wang Lin 
Published: August 2018

Abstract
Background
Interleukin-33 (IL-33) participates in various types of diseases including cancers. Previous studies of this cytokine in cancers mainly focused on its regulation on immune responses by which IL-33 modulated cancer progression. The IL-33 triggered signals in cancer cells remain unclear.

Methods
We analyzed IL-33 gene expression in human colorectal cancer (CRC) tissues and carried out gene enrichment analysis with TCGA Data Portal. We studied CRC proliferation in vivo by inoculating MC38 tumors in IL-33 transgenic mice. We investigated the cell proliferation in vitro with primary CRC cells isolated from fresh human CRC tissues, human CRC cell line HT-29 and mouse CRC cell line MC38. To evaluate the proliferation modulating effects of recombinant IL-33 incubation and other administrated factors, we measured tumor growth, colony formation, cell viability, and the expression of Ki67 and proliferating cell nuclear antigen (PCNA). We used several inhibitors, prostaglandin E2 (PGE2) neutralizing antibody, ST2 blocking antibody and specific shRNA expressing plasmid to study the pathway mediating IL-33-induced CRC proliferation. The IL-33 receptor ST2 in human CRC tissues was detected by immunohistochemistry staining and western blotting. The ST2-positive or negative subsets of primary CRC cells were acquired by flow cytometry sorting.

Results
We found that IL-33 expression was correlated with the gene signature of cell proliferation in 394 human CRC samples. The MC38 tumors grew more rapidly and the tumor Ki67 and PCNA were expressed at higher levels in IL-33 transgenic mice than in wild-type mice. IL-33 promoted cell growth, colony formation and expression of Ki67 and PCNA in primary CRC cells as well as CRC cell lines. IL-33 activated cycloxygenase-2 (COX2) expression and increased PGE2 production, whereas the COX2 selective inhibitor and PGE2 neutralizing antibody abolished the proliferation promoting effect of IL-33. ST2 blockade, ST2-negative sorting, NF-κB specific inhibitor and NF-κB specific shRNA (shP65) abrogated the COX2 induction caused by IL-33.

Conclusion
IL-33 facilitates proliferation of colorectal cancer dependent on COX2/PGE2. IL-33 functions via its receptor ST2 and upregulates COX2 expression through NF-κB signaling. Understanding the IL-33 signal transduction in CRC cells provides potential therapeutic targets for clinical treatment.
Improving clustering performance using independent component analysis and unsupervised feature learning
Authors: Gultepe Eren , Makrehchi Masoud 
Published: August 2018

AbstractObjectiveTo provide a parsimonious clustering pipeline that provides comparable performance to deep learning-based clustering methods, but without using deep learning algorithms, such as autoencoders.Materials and methodsClustering was performed on six benchmark datasets, consisting of five image datasets used in object, face, digit recognition tasks (COIL20, COIL100, CMU-PIE, USPS, and MNIST) and one text document dataset (REUTERS-10K) used in topic recognition. K-means, spectral clustering, Graph Regularized Non-negative Matrix Factorization, and K-means with principal components analysis algorithms were used for clustering. For each clustering algorithm, blind source separation (BSS) using Independent Component Analysis (ICA) was applied. Unsupervised feature learning (UFL) using reconstruction cost ICA (RICA) and sparse filtering (SFT) was also performed for feature extraction prior to the cluster algorithms. Clustering performance was assessed using the normalized mutual information and unsupervised clustering accuracy metrics.ResultsPerforming, ICA BSS after the initial matrix factorization step provided the maximum clustering performance in four out of six datasets (COIL100, CMU-PIE, MNIST, and REUTERS-10K). Applying UFL as an initial processing component helped to provide the maximum performance in three out of six datasets (USPS, COIL20, and COIL100). Compared to state-of-the-art non-deep learning clustering methods, ICA BSS and/or UFL with graph-based clustering algorithms outperformed all other methods. With respect to deep learning-based clustering algorithms, the new methodology presented here obtained the following rankings: COIL20, 2nd out of 5; COIL100, 2nd out of 5; CMU-PIE, 2nd out of 5; USPS, 3rd out of 9; MNIST, 8th out of 15; and REUTERS-10K, 4th out of 5.DiscussionBy using only ICA BSS and UFL using RICA and SFT, clustering accuracy that is better or on par with many deep learning-based clustering algorithms was achieved. For instance, by applying ICA BSS to spectral clustering on the MNIST dataset, we obtained an accuracy of 0.882. This is better than the well-known Deep Embedded Clustering algorithm that had obtained an accuracy of 0.818 using stacked denoising autoencoders in its model.ConclusionUsing the new clustering pipeline presented here, effective clustering performance can be obtained without employing deep clustering algorithms and their accompanying hyper-parameter tuning procedure.