bluuebunny/crossref_metadata_2025_split huggingface dataset:
Margin Matters: Analyzing the Impact of Circumferential Margin Involvement on Survival and Recurrence After Incomplete Total Mesorectal Excision for Rectal Cancer
Authors: Alipouriani Ali , Almadi Faris , Rosen David R. , Liska David , Kanters Arielle E. , Ban Kristen , Gorgun Emre , Steele Scott R. 
Published: August 2024

Abstract

Backgorund:
Incomplete mesorectal excision during rectal cancer surgery often leads to positive circumferential margins, with uncertain prognostic impacts. This study examines whether negative margins can mitigate the poorer prognosis typically associated with incomplete TME in rectal cancer surgery, thus potentially challenging the prevailing emphasis on complete mesorectal excision.
Methods
A retrospective analysis was conducted on patients who underwent proctectomy for rectal adenocarcinoma with incomplete TME at a single center from 2010–2022.Patients were stratified by margin status as determined by pathologic analysis into three groups: involved,not involved with closest margin distance ≤ 2mm,and not involved with closest margin distance > 2mm. Outcomes included recurrence and survival. Effects of neoadjuvant therapy protocols on margin status was also assessed.
Results
From 2010 to 2022, 7,941 patients underwent proctectomy for rectal cancer, with 236 (3%) having incomplete TME. The median age of these patients was 64 years,and 63% were male.Overall, margin involvement was observed in 54 (23%) patients. The median tumor size was 3.05 (IQR: 2–6) cm for the whole group. Involved margins (23.2%) had reduced overall survival (60.5 vs 87.3 months, p < 0.001), increased local recurrence (20.4% vs 9.4%, p = 0.024),and lower disease-free survival (45.2 vs 58.9 months, p = 0.006) versus uninvolved margins. Margin involvement was prognostic for decreased survival even after adjusting for confounders (p < 0.05). Among uninvolved margins,distance (> 2mm vs ≤ 2mm) did not affect outcomes. Total neoadjuvant therapy (vs standard chemoradiation)was associated with lower involved margins (p = 0.007).
Conclusions
Positive margins retain negative prognostic impact with incomplete TME. Optimization of surgical resection remains vital. Total neoadjuvant therapy may decrease risk of incomplete TME.
Leveraging Explainable AI and Large-Scale Datasets for Comprehensive Classification of Renal Histologic Types
Authors: Moon Seung Wan , Kim Jisup , Kim Young Jae , Kim Sung Hyun , An Chi Sung , Kim Kwang Gi , Jung Chan Kwon 
Published: August 2024

Abstract

Recently, as the number of cancer patients has increased, much research is being conducted for efficient treatment, including the use of artificial intelligence in renal pathology. Recent research has focused largely on the classification of renal cell carcinoma subtypes. Nonetheless, the broader categorization of renal tissue into non-neoplastic normal tissue, benign tumor and malignant tumor remains understudied. This gap in research can primarily be attributed to the limited availability of extensive datasets including benign tumor and normal tissue in addition to specific type of renal cell carcinoma, which hampers the ability to conduct comprehensive studies in these broader categories. This research introduces a model aimed at classifying renal tissue into three primary categories: normal (non-neoplastic), benign tumor, and malignant tumor. Utilizing digital pathology while slide images (WSIs) from nephrectomy specimens of 2,535 patients from multiple institutions, the model provides a foundational approach for distinguishing these key tissue types. The study utilized a dataset of 12,223 WSIs comprising 1,300 WSIs of normal tissue, 700 WSIs of benign tumors, and 10,223 WSIs of malignant tumors. Employing the ResNet-18 architecture and a Multiple Instance Learning approach, the model demonstrated high accuracy, with F1-scores of 0.934 (CI: 0.933–0.934) for normal tissue, 0.684 (CI: 0.682–0.687) for benign tumors, and 0.878 (CI: 0.877–0.879) for malignant tumors. The overall performance was also notable, achieving a weighted average F1-score of 0.879 (CI: 0.879–0.880) and a weighted average area under the receiver operating characteristic curve of 0.969 (CI: 0.969–0.969). This model significantly aids in the swift and accurate diagnosis of renal tissue, encompassing non-neoplastic normal tissue, benign tumor, and malignant tumor.
Association of oxidative balance scores with all-cause and cardiovascular mortality in individuals with prediabetes and the mediating role of oxidative stress and systemic inflammation: Evidence from NHANES 1999-2018
Authors: Guo Hong-peng , Liu Jia-song , Liu Man , Li You , Sun Cheng-lin , Guo Shi , Bai Hai-tao , Pan Xing-he 
Published: August 2024

Abstract

Background
Oxidative stress may be relevant in the progression and cardiovascular complications of prediabetes. The oxidative balance score (OBS) is an emerging metric for assessing dietary and lifestyle oxidative stress exposure. The objective of this prospective cohort study from NHANES 1999–2018 was to explore the association of OBS with all-cause and cardiovascular disease (CVD) mortality in people with prediabetes.
Methods
OBS was composed of 16 dietary components and 4 lifestyle components based on previous research. Prediabetes was diagnosed based on self-reported history or laboratory criteria. Multivariate Cox proportional hazards regression analyses were used to explore these associations and calculate hazard ratios [HR] and 95% confidence intervals [CI].
Results
A total of 8256 adult participants with prediabetes were included. Kaplan-Meier survival analysis showed significantly higher all-cause and CVD-related survival in people with prediabetes at higher OBS. After adjusting for all confounders, OBS, dietary OBS, and lifestyle OBS were all inversely associated with all-cause mortality in people with prediabetes (HR and 95% CI 0.959 (0.946,0.973), 0.965 (0.950,0.980), and 0.847 (0.798,0.899), respectively; all p < 0.0001). Higher OBS was associated with significantly lower all-cause mortality (p for trend all < 0.0001). Similar results were observed for CVD mortality. Most associations were linear, whereas the associations of OBS and dietary OBS with CVD mortality were nonlinear. Mediation analyses suggested that several oxidative stress and systemic inflammatory markers mediated these associations. Stratified and sensitivity analyses demonstrated the stability of the findings.
Conclusions
Adherence to antioxidant dietary and lifestyle patterns assessed by OBS may help prevent excess mortality in population with prediabetes. These effects may be achieved indirectly by influencing oxidative stress and systemic inflammatory markers.
Age Influence on the Prognosis and Management of Non-Functional Pancreatic Neuroendocrine Tumors in the Elderly
Authors: Wang Zhengqiang , Huang Chaoqun 
Published: August 2024

Abstract

Introduction
Pancreatic neuroendocrine tumors (PanNETs) account for about 7% of pancreatic tumors and are increasing in incidence. Non-functional PanNETs in the elderly often present asymptomatically, leading to more conservative treatment due to age bias. The impact of age on prognosis and management needs further clarification.
Methods
Clinical data for patients over 65 with non-functional PanNETs were collected from the SEER database. Kaplan-Meier curves analyzed overall survival between younger elderly (age 65–75 years) and older elderly (age ≥ 75 years) groups. Competing risk models assessed cancer-specific mortality, and Cox regression models identified independent survival risk factors. A prognostic model was constructed and evaluated for performance.
Results
Among 2,157 patients, older elderly patients (n = 695) had larger tumors, poorer differentiation, worse M stage, and lower surgery rates compared to younger elderly patients (n = 1,462). Younger elderly had better overall survival (p < 0.0001) and lower cancer-specific mortality. Surgery improved survival in younger elderly (p < 0.0001), with no age group survival difference in non-surgical patients. Cox regression identified age > 75, male, higher grades, advanced TNM stage, N1 stage, and lack of surgery as significant risk factors. A predictive model with a C-index of 0.77 was developed.
Conclusion
Age is an independent prognostic factor for elderly patients with non-functional PanNETs. Younger elderly patients benefit more from surgical treatment.
Biomechanical Analysis of Customized 3D-Printed Microporous Titanium Prostheses for Large Segmental Bone Defects in the Distal Femur
Authors: Zhang Xiaoyan , Xu Yongqing , Wang Yi , Huang Yuanning 
Published: August 2024

Abstract

Background
Large segmental bone defects in the distal femur, caused by high-energy trauma, tumor resection, and debridement of osteomyelitis, pose significant clinical challenges. The advent of 3D-printed microporous titanium prostheses offers new solutions for these complex reconstructions.
Objective
To investigate the biomechanical distribution and stability of three different 3D-printed microporous titanium prosthesis designs and fixation methods for reconstructing large segmental bone defects in the distal femur.
Methods
Three prosthesis models were developed: single-steel plate, double-steel plate, and intramedullary nail groups. Finite element analysis (FEA) was performed to simulate stress distribution and displacement understanding (0°), semi-squatting (90°), and squatting (150°) postures. The biomechanical properties, including maximum stress and displacement, were analyzed to evaluate the stability and safety of each prosthesis design.
Results
The single-steel-plate group showed higher maximum stress and displacement, particularly under semi-squatting and squatting postures, indicating potential instability. The double-steel-plate group exhibited lower stress and displacement, providing better stability than the single-steel-plate group. The intramedullary nail group demonstrated the most favorable biomechanical performance, with the lowest maximum stress and even stress distribution, enhancing mechanical stability and reducing stress shielding.
Conclusion
For large segmental defects in the distal femur, intramedullary nail fixation is recommended for superior stability and biomechanical performance. Single—or double-steel-plate prostheses are suggested for patients with severe osteoporosis or narrow medullary cavities. These findings provide valuable insights into selecting appropriate fixation methods based on individual patient conditions to achieve optimal biomechanical outcomes.
Classic Divided Sigmoidostomy Vs Loop Sigmoidostomy in Anorectal Malformations: Time for Change?
Authors: Ramirez-Amoros Carla , Carvalho Catarina , Basilio María San , Martinez Leopoldo , Encinas Jose Luis , Vilanova-Sanchez Alejandra 
Published: August 2024

Abstract

Purpose
Divided sigmoidostomy (DS) is the classic stoma for patients with anorectal malformations (ARM). Loop sigmoidostomies (LS) in ARM are associated with higher risk of stoma prolapse and urinary tract infections (UTI). This is not clearly supported by literature. We compared our experience with both techniques.
Methods
Retrospective study of ARM patients who underwent DS or LS between 2013–2023. We analysed demographics, associated malformations, intraoperative variables, oral intake and stoma functioning times, hospital stay, complications, prolapses, and UTI.
Results
Of 40 patients, 29 underwent open DS and 11 laparoscopic LS. Demographics, malformation type, associated anomalies, surgical time, intraoperative and anaesthetic complications were comparable. Postoperative complications were higher in DS than LS [14(48.3%) vs 1(9.1%), (p = 0.02)], mostly due to wound complications [12(41.3%) vs 0(0%), (p = 0.01)]; with 3 dehiscenses and 3 strictures reintervened. The hours to oral intake and stoma functioning were higher for DS [48(39–90) and 48(24–48) vs 24(24–48) and 24(24–24), (p < 0.05)], with more days of hospital stay [36(19–60) vs 8(5–10), (p = 0.001)]. Prolapses [1(3.4%) vs 1(9.1%)] and UTIs [3(10.3%) vs 1(9.1%) (p > 0.05)] were comparable.
Conclusion
LS in ARM patients have no higher risk of prolapse or UTI than DS. DS had more complications, mostly wound infections, strictures and dehiscenses.
Acute skin temperature responses to the 30-15 intermittent fitness test in professional male soccer players
Authors: Alvurdu Sümer , Arslan Yasin , Keskin Kadir , Oliveira Rafael , Nobari Hadi 
Published: August 2024

Abstract

Background
Infrared thermography has emerged as a powerful non-invasive tool with significant applications in the realm of sports science and medicine. This thermal imaging technology provides detailed insights into the skin temperature patterns and asymmetries of athletes, offering valuable data to enhance performance, assess the effectiveness of rehabilitation, monitor fatigue, and prevent injuries.
Methods
The aim of this study was to assess acute skin temperature (Tsk) responses before and after the 30 − 15 Intermittent Fitness Test (IFT) in professional male soccer players. Twenty-one professional soccer players performed a 30 − 15 IFT, and the running time, peak velocity, and true velocity (VIFT) were calculated. Thermal images of the players were acquired using an infrared thermal camera before and immediately after the 30 − 15 IFT, and Tsk measurements were analyzed from the anterior thigh, anterior leg, posterior thigh, and posterior leg.
Results
The Tsk asymmetries differed significantly between all regions of interest, with the greatest difference in the anterior and posterior thighs. Pearson correlation analysis revealed that the 30 − 15 IFT parameters were not correlated with the posttest Tsk asymmetry for any of the ROIs. However, there were significant negative correlations between pretest Tsk asymmetry in the posterior leg region and all 30 − 15 IFT parameters for running time (r = 0.30; p < .05), peak velocity (r = 0.3; p < .05), and VIFT (r = 0.25; p < .05). Finally, athletes with lower baseline Tsk asymmetries in the posterior leg region have better 30 − 15 IFT performance.
Conclusion
Thermal imaging can be used to assess muscular asymmetries following specific endurance tests or conditioning training, and this information can provide valuable information for optimizing performance and injury prevention.
The association between mitral regurgitation and long-term outcomes in acute myocardial infarction undergoing percutaneous coronary intervention: A retrospective large sample cohort study
Authors: Ning Yan , Wu Peng , Wang Fang , Wang Mohan , Ma Juan , Zhu Baozhen , Ma Xueping 
Published: August 2024

Abstract

Background
The relationship between mitral regurgitation (MR) and long-term outcomes in Chinese patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) remains scarce. This study aims to elucidate the connection between MR and long-term clinical outcomes following AMI treated with PCI.
Design and methods:
In this retrospective study 6940 patients who were diagnosed with AMI were consecutively enrolled from General Hospital of Ningxia Medical University(2014–2019). The included AMI patients were divided into no MR, mild MR and moderate/serve MR according to whether MR occurred. All patients were clinically followed for 3-years to collect major adverse cardiac and cerebrovascular events (MACCEs), which included all-cause death, nonfatal myocardial infarction (MI), rehospitalization for angina, rehospitalization for heart failure (RHF) and stroke. After controlling for different confounding factors, Cox regression models were used to investigate the relationship between MR and 3-years clinical outcomes.
Results
In 6940 analyzed patients, mild MR was identified in 3681 patients (53.04%), and moderate/severe MR in 388 patients (5.59%), whereas 2871 patients (41.35%) did not have MR. The cumulative 3 -year incidence of MACCEs was 19.21% in overall patients,15.26% in none MR,20.37% in mild MR, and 37.37% in moderate/severe MR (log-rank p < 0.001). Kaplan–Meier survival curves of MR with all-cause death and RHF were also plotted (log-rank p < 0.001). After controlling confounding variables completely, we found that moderate/severe MR compare to none MR was found to be significantly associated with 3-year MACCEs [hazard ratio (HR) = 1.34; 95% confidence interval (CI) = 1.07–1.69; p=0.0122] ,all-cause mortality (HR = 1.80; 95% CI = 1.33–2.44; P༝0.001) and RHF ( HR = 1.70; 95% CI = 1.33–2.17; P < 0.0001) through Cox proportional hazards regression models.
Conclusion
MR was significantly and positively associated with 3-years clinical outcomes in patients with AMI undergoing PCI. In the clinical practice, physicians should pay more attention to the MR in patients with AMI.
Differential Expression and Prognostic Significance of CDK1 and CDK6 in Breast Cancer: A Multi-Omics Approach
Authors: Islam Md. Wahidul , Fariha Fatema Tuj Johora , Ahmed Md. Zabir , Ferdous Jannatul , Lota Hafeza Bhuiyan , Hossain Md. Jubayer , Kundu Pritom , Shahjahan Muhibullah , Hossain Md. Shohel 
Published: August 2024

Abstract

Breast cancer, a heterogeneous disease with diverse molecular subtypes, poses significant challenges for diagnosis and treatment. Cyclin-dependent kinases (CDKs) play pivotal roles in the regulation of cell cycle progression and have emerged as potential therapeutic targets. However, studies on CDK1 and CDK6 are limited. This study comprehensively investigated the gene expression, genetic alterations, DNA methylation, and prognostic significance of CDK1 and CDK6 using the TIMER 2.0, UALCAN, HPA, cBioPortal, Enrichr, and Kaplan-Meier Plotter databases. The results indicated CDK1 upregulation and CDK6 downregulation compared to normal tissues. Elevated CDK1 levels are correlated with a higher survival rate, whereas increased CDK6 levels are associated with adverse outcomes. The analysis revealed diverse alterations, emphasizing their oncogenic potential. CDK6 methylation varies with the disease stage and ethnicity, suggesting a regulatory role. Immune cell infiltration correlates with CDK expression, indicating its impact on disease progression. Co-expression analysis identifies related genes, elucidating molecular interactions. Functional analysis revealed the pathways involving CDK1 and CDK6 as potential therapeutic targets. In consolidation, the clinical relevance of CDK1 and CDK6 as prognostic determinants and therapeutic targets in breast cancer management is discussed. This multi-omics approach provides a comprehensive framework for understanding breast cancer pathogenesis and advancing precision medical strategies to improve patient outcomes.
Impact of Insulin-like Growth Factor System on the Progression and Survival of Gastric Adenocarcinoma
Authors: Tsai Kun-Feng , Shun Chia-Tung , Fang Yu-Jen , Hong Tzu-Chan , Chen Chieh-Chang , Chen Chih-Cheng , Wu Yi-Ling , Lin Jaw-Town , Lai I-Rue , Wu Ming-Shiang , Liou JyhMing 
Published: August 2024

Abstract

Background
A comprehensive study on the impact of the insulin-like growth (IGF) signaling system in the progression of gastric cancer is lacking. Therefore, we conducted a hospital-based cohort study to comprehensively assess the influence of the IGF family, including IGF1, IGF2, and IGF binding proteins 1, 2, and 3, on gastric cancer (GC).
Method
Expression levels of IGF1, IGF2, IGF IR, IIR, and IGFBP1-3 in GC were determined by immunohistochemistry staining in 28 patients. Plasma levels of IGF1, IGF2, and IGFBP1-3 were measured using immunoradiometric assay or ELISA in the training cohort. Plasma IGFBP2 levels were determined in the validation cohort, consisting of 255 GC patients. Expression of IGFBP2 in gastric cancer tissues was assessed in 484 GC patients. Overall survival (OS) and relapse-free survival (RFS) based on plasma levels of IGF proteins and expression of IGFBP2 in GC tissues were analyzed.
Result
IGFBP2 was expressed in tumors (92.8%, 26/28) and non-tumor tissues (85.7%, 24/28) of GC patients, with low expression rates for other biomarkers. Higher plasma IGFBP2 levels in the training cohort (N = 142) were associated with worse OS (p = 0.0009) and RFS (p = 0.0001). Cox regression analysis confirmed that higher plasma IGFBP2 levels predicted a worse prognosis (HR: 1.51; 95% CI: 1.19–1.92; p = 0.001), whereas IGF1, IGF2, IGFBP1, and IGFBP3 did not. In the validation cohort (N = 255), higher plasma IGFBP2 levels again correlated with worse OS (p = 0.00001) and RFS (p = 0.0001).
Conclusion
IGFBP2, but not other members of the IGF system, correlated with the disease progression and survival of gastric cancer.
Investigation of the relationship between nasal cavity variations and pathological conditions of maxillary sinuses in Cone Beam Computed Tomography
Authors: Alizadeh Fatemeh , Jamalpour Mohammadreza , Shokri Abbas , Ebrahimi Asal , Irani Amin Dousti 
Published: August 2024

Abstract

Objective: Anatomical changes of the nasal cavities play an important role in ostiomeatal complex obstruction and can increase the risk of sinus diseases. It is important to know the prevalence of these anatomical changes and their effect on the occurrence of pathological conditions of the sinuses. The aim of this study was to determine the relationship between anatomical variations of the nasal cavity and pathological conditions of the maxillary sinus.
Methods: This descriptive-analytical study was performed on Cone Beam Computed Tomography (CBCT) scans of the nasal cavity and maxillary sinuses taken from the archives of the Department of Radiology of Hamadan Dental School between 2015 and 2021. Frequency of pathological conditions of the maxillary sinus as well as anatomical variations of nasal cavity such as septal deviation, agger nasi cells, concha bullosa, paradoxical middle concha, Haller cells,enlargement of uncinate process, supraorbital ethmoidal cell, diameter of maxillary ostium and height of infundibulum were evaluated. Finally, the data were analyzed by Stata 14.2 software at a significance level of 0.05.
Results: In this study, 280 CBCT images were collected and examined. Patients with maxillary sinus thickening have the highest frequency (42.86%) of pathological conditions. Also, among the anatomical variations, the size of unciate process on the right (80.36%) and left (86.43%) had the highest frequency. In addition, a significant correlation was observed between maxillary sinus mucosal thickening and paradoxical concha (P˂0.05). However, no association was found between nasal septal deviation, concha bullosa, unciate process size, diameter of maxillary sinus ostium and infundibulum height with maxillary sinus pathological conditions (P˃0.05).
Conclusion: The CBCT imaging is a reliable method in evaluation of anatomical variations and pathological conditions of the paranasal sinus. According to this study, paradoxical concha is associated with mucosal thickening of the maxillary sinus., Basic knowledge of anatomical variations and their relationship to the maxillary mucosa is essential for sinus surgery as well as dental implants.