bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radical Prostatectomy in High-Risk Prostate Cancer: Incidence of Specimen-Confined Disease (pT2-pT3a N0R0) and Outcomes
Authors: Mearini Luigi , Nunzi Elisabetta , Bini Vittorio , Lepri Luca , Bruno Raffaella , Porena Massimo 
Published: May 2014

Introduction Radical prostatectomy (RP) in patients with high-risk prostate cancer (PC) [prostate specific antigen (PSA) ≥20 ng/mL, and/or Gleason score ≥8, and/or cT3a disease] is considered an optional therapy, usually as a part of multimodal approach. Aim of the study is to evaluate the outcome of radical prostatectomy in case of specimen-confined (SC) disease and to compare it with patients with pathological locally-advanced disease. Materials and Methods Data from 176 consecutive patients with high-risk prostate cancer who underwent RP as initial therapy were analyzed, identifying subjects with specimen-confined disease (i.e. negative margins and negative lymph-nodes) in which RP was considered as monotherapy, and comparing oncological outcomes to patients with pathological non-SC disease, in which RP was considered as the first step of a multimodal approach. Results In high-risk prostate cancer, pathological report showed the presence of specimen-confined disease in 28.3% of cases. At univariate analysis, age and PSA correlate with the presence of SC disease at radical prostatectomy, while at multivariate analysis only PSA was a significant predictor of SC disease. At 5 years, Kaplan-Meier estimation of biochemical-free and cancer-specific survival was 56.2% and 97.7% vs 40.8% and 92.8% in specimen-confined disease and non-specimen-confined disease, respectively. Conclusions High-risk prostate cancer presents challenges for uro-oncologists since standard treatment is still under debate. One third of patients will present with specimen-confined disease, for which radical prostatectomy represents the sole, initial curative therapy; RP as multimodal therapy in patients without SC disease permits excellent long-term oncological outcomes.
The Cancelling of Elective Surgical Operations Causes Emotional Trauma and a Lack of Confidence: Study from a Urological Department
Authors: Dell'Atti Lucio 
Published: May 2014

Objectives Cancellation of elective surgical procedures is inconvenient and stressful on patients, causing loss of working days and disruption of daily life. Furthermore, it causes significant emotional trauma to the patients and their families. The purpose of this study was to analyze the number of elective surgery cancellations, as well as to identify and compare potential emotional trauma and satisfaction between older (≥65 years) and younger (<65 years) patients. Methods 157 patients whose surgeries were scheduled and then cancelled were divided in two groups: Group A (62 younger patients, age <65) and Group B (95 older patients, age ≥65). The Hospital Anxiety and Depression Scale (HADS) was used to assess depression and anxiety. Patient satisfaction was collected from the Healthcare Providers and Systems Survey (HCAHPS). Results All groups with higher HADS score demonstrated markedly reduced satisfaction scores (with a mean score of 38%, p<0.001). In fact, patient satisfaction scores varied widely across the surveyed groups. Patient overall satisfaction scores after surgery ranged from 39% to 82%, with a mean of 68.5%, and from 28% to 73%, with a mean of 47.3% in Group A and B, respectively. These results point out a significantly lower satisfaction in elderly patients with depression (p<0.001) and with anxiety than in younger patients (p<0.002). Conclusions The study goal was to point out the importance of satisfying patients’ expectations to offer a better assistance, in order to ensure a comforting and friendly experience, especially when the patients are weak and not young anymore.
Role of PSA-Related Variables in Improving Positive Ratio of Biopsy of Prostate Cancer within Serum PSA Gray Zone
Authors: liu Bo , pan Tie jun 
Published: May 2014

Prostate neoplasms and benign prostatic hyperplasia Objective The aim of this study was to assess the validity of predictors of prostate biopsy outcome in order to improve their positive predictive value (PPV). The related variables of PSA such as free/total PSA ratio (F/T), complexed/total PSA ratio (C/T), density of PSA (PSAD) were studied to improve early diagnosis for early PCa within serum PSA gray zone. Methods Samples of venous blood were collected early in the morning from 459 patients, aged 50 to 88 years (average 70.5 years old), whose serum T-PSA was between 4 to 10 ng/mL (153 cases of Pca, 306 cases of BPH). Serum T-PSA, F-PSA and C-PSA were determined by ELISA method; prostate volume was measured by transrectal ultrasound, then prostate biopsy was taken for all patients. Results Out of f 459 patients, 153 cases of Pca and 306 of BPH were diagnosed by prostate biopsy, whose mean values of T-PSA were 7.2 ± 1.25 ng/mL and 6.8 ± 0.96 ng/mL, respectively (P<0.05), of F/T were 0.117 ± 0.018 and 0.196 ± 0.021 (P<0.01), and of C/T they were 0.890 ± 0.023 and 0.754 ± 0.015 (P<0.01), of PSAD were 0.197 ± 0.023 and 0.106 ± 0.019 (P<0.01). The threshold of F/T > 0.16 diagnosed 91 cases of cancer (59.5%), of C/T>0.84 88 cases (57.5%), of PSAD > 0.15 94 cases (61.4%), and especially, of F/T > 0.16 combined PSAD > 0.15 80 cases whose sensitivity, specificity, accuracy, positive predictive values were 52.3%, 76.1%, 68.2%, 52.3%, respectively (P<0.05). Conclusion There are some defects only in taking T-PSA as a biomarker for the diagnosis of PCa within serum PSA gray zone, and the threshold of F/T > 0.16 combined PSAD > 0.15 may be a new and significant indicator to provide a better basis for the diagnosis of early PCa.
Vesicoureteral Reflux in Pediatric Age: Where are we Today?
Authors: Altobelli Emanuela , Nappo Simona Gerocarni , Guidotti Michele , Caione Paolo 
Published: May 2014

Although the diagnosis of vesicoureteral reflux and of reflux nephropathy is a well-established and shared procedure, its treatment nowadays is still very controversial. New developments on the knowledge of pathophysiology of renal damage associated to reflux opened the way towards a different diagnostic work-up and different therapeutic approaches. Recently, the “top-down” diagnostic approach has gained wider interest, versus the “down-top” protocol. The attention has recently focused on the renal parenchyma damage and less interest has been given to the presence and the radiological degree of vesicoureteral reflux. The review criteria were based on an in-depth search of references conducted on PubMed, using the terms “vesicoureteral reflux”, “children”, “incidence”, “etiology”, “diagnosis”, “treatment” and “outcomes”. The selection of the papers cited in this review was influenced by the content and the relevance to the points focused in the article. Conservative approaches include no treatment option with watchful waiting, long-term antibiotic prophylaxis and bladder rehabilitation. The operative treatment consists of endoscopic, open, laparoscopic and robotic procedures to stop the refluxing ureter. No final consensus has been achieved in literature yet, and further studies are necessary in order to better define the subset of children at risk of developing progression of renal damage. This review aims to clarify the diagnostic management and the urological-nephrological treatment of reflux in pediatric age, on the basis of a review of the best-published evidence.
Balloon cell melanoma: a case report with polarized and non-polarized dermatoscopy and dermatopathology
Authors: Maher James , Cameron Alan , Wallace Sharon , Acosta-Rojas Rafael , Weedon David , Rosendahl Cliff 
Published: May 2014

Balloon cell melanoma is a rare melanoma subtype, with only one previous case with dermatoscopy published. It is often non-pigmented, leading to diagnostic difficulty, and there is a tendency for lesions to be thick at diagnosis.
We report a case of balloon cell melanoma on the forearm of a 61-year-old man with both polarized and non-polarized dermatoscopy and dermatopathology. It presented as a firm pale nodule with focal eccentric pigmentation. The clinical images evoke a differential diagnosis of dermatofibroma, dermal nevus, Spitz nevus and basal cell carcinoma as well as melanoma. This melanoma was partially pigmented due to a small, pigmented superficial spreading component on the edge of the non-pigmented balloon cell nodule, prompting further evaluation. In retrospect there was the clue to malignancy of polarizing-specific white lines (chrysalis structures) and polymorphous vessels, including a pattern of dot vessels. The reticular lines exclude basal cell carcinoma, polarizing-specific white lines are inconsistent with the diagnosis of dermal nevus and their eccentric location is inconsistent with both Spitz nevus and dermatofibroma. Excision biopsy was performed, revealing a superficial spreading melanoma with two distinct invasive components, one of atypical non-mature epithelioid cells and the other an amelanotic nodular component, comprising more than 50% of the lesion, characterized by markedly distended epithelioid melanocytes showing pseudo-xanthomatous cytoplasmic balloon cell morphology. A diagnosis of balloon cell melanoma, Breslow thickness 1.9 mm, mitotic rate 3 per square millimeter was rendered. Wide local excision was performed, as was sentinel lymph node biopsy, which was negative.
Vanadium: Possible Use in Cancer Chemoprevention and Therapy
Authors: Ladislav Novotny  , Samuel B. Kombian  
Published: May 2014

Vanadium belongs among the microelements and plays a role in human nutrition. However, it is not regarded as an essential micronutrient. Vanadium affects various biochemical processes and when present in the body, it is capable of interacting with a notable number of enzymes e.g. protein kinases, phosphatases, ATPases, peroxidases, ribonucleases, oxidoreductases and others. It is documented in scientific literature that vanadium takes part in biochemical processes in mammals. Vanadium is not carcinogenic but its presence in cancer cells and its interactions with many key enzymatic processes results in modified expression of p53 and Bax and in down regulation of Bcl2 proteins and in antiproliferative activity. Anti-carcinogenic and anticancer effects of vanadium in various forms have been demonstrated using in vitro and in vivo experiments. Presently, epidemiologic and clinical studies are necessary for developing a clinically useful, vanadium-based anticancer agent/drug for chemoprevention of cancer. This review summarizes recent scientific information on the role and potential use of vanadium in cancer chemoprevention and cancer therapy.
Crystalline Metabolites of the Tinder Polypore (Fomes fomentarius)
Authors: Wasko Samuel J. , Brenner Mark V. , Cartier Stephen F. 
Published: May 2014

Abstract
In 2005, author Paul Stamets detailed a novel fungal antimicrobial mechanism in his book “Mycelium Running.” According to Stamets' observations, microscopic octahedral crystals produced by Fomes fomentarius “stunned” surrounding E. coli bacteria. In light of the lack of published peer-reviewed evidence, the present study was conducted to evaluate Stamets' claims. Specifically, the claim that large “secondary” crystals only occur in the presence of E. coli was addressed. Fruiting bodies of F. fomentarius were collected from the Montreat Wilderness Area (Buncombe County, North Carolina) and tissue culture techniques were used to cultivate mycelia on malt-agar plates. Successful cultures were randomly assigned to two treatment groups: F. fomentarius grown in isolation (n  =  6) and F. fomentarius grown in the presence of E. coli (n  =  6). After 28 days of growth and 10 days of E. coli exposure, the periphery of each mycelium was observed using 400–1,000× Differential Interference Contrast (DIC) microscopy. None of the interspecies frontiers and one of the isolated F. fomentarius cultures contained “secondary” crystals. Samples were then selected from the center of each dish, where hyphae had been established between 28 and 58 days. High magnification microscopy (400–1,000× DIC) revealed that five out of six interspecies dishes and six out of six isolated F. fomentarius dishes contained “secondary” crystals. While these observations do confirm the presence of secondary crystals documented by Stamets, they do not support his hypothesis that they occur only in the presence of E. coli. In light of this new evidence, Stamets' proposed antibacterial mechanism is improbable. It is suggested that future chemical tests evaluate whether or not F. fomentarius crystals are composed of calcium oxalate (an unlikely antibacterial agent).
Improving criteria for dissemination in space in multiple sclerosis by including additional regions
Authors: Foster Michael A. , Pontillo Giuseppe , Davagnanam Indran , Collorone Sara , Prados Ferran , Kanber Baris , Yiannakas Marios C. , Ogunbowale Lola , Burke Ailbhe , Gandini Wheeler‐Kingshott Claudia A. M. , Ciccarelli Olga , Brownlee Wallace , Barkhof Frederik , Toosy Ahmed T. 
Published: July 2024

AbstractObjectiveWe investigated the effects of adding regions to current dissemination in space (DIS) criteria for multiple sclerosis (MS).MethodsParticipants underwent brain, optic nerve, and spinal cord MRI. Baseline DIS was assessed by 2017 McDonald criteria and versions including optic nerve, temporal lobe, or corpus callosum as a fifth region (requiring 2/5), a version with all regions (requiring 3/7) and optic nerve variations requiring 3/5 and 4/5 regions. Performance was evaluated against MS diagnosis (2017 McDonald criteria) during follow‐up.ResultsEighty‐four participants were recruited (53F, 32.8 ± 7.1 years). 2017 McDonald DIS criteria were 87% sensitive (95% CI: 76–94), 73% specific (50–89), and 83% accurate (74–91) in identifying MS. Modified criteria with optic nerve improved sensitivity to 98% (91–100), with specificity 33% (13–59) and accuracy 84% (74–91). Criteria including temporal lobe showed sensitivity 94% (84–98), specificity 50% (28–72), and accuracy 82% (72–90); criteria including corpus callosum showed sensitivity 90% (80–96), specificity 68% (45–86), and accuracy 85% (75–91). Criteria adding all three regions (3/7 required) had sensitivity 95% (87–99), specificity 55% (32–76), and accuracy 85% (75–91). When requiring 3/5 regions (optic nerve as the fifth), sensitivity was 82% (70–91), specificity 77% (55–92), and accuracy 81% (71–89); with 4/5 regions, sensitivity was 56% (43–69), specificity 95% (77–100), and accuracy 67% (56–77).InterpretationOptic nerve inclusion increased sensitivity while lowering specificity. Increasing required regions in optic nerve criteria increased specificity and decreased sensitivity. Results suggest considering the optic nerve for DIS. An option of 3/5 or 4/5 regions preserved specificity, and criteria adding all three regions had highest accuracy.
Treatment of Antineutrophil Cytoplasmic Antibody–Associated Vasculitis With Diffuse Alveolar Hemorrhage With Avacopan
Authors: Falde Sam D. , Lal Amos , Cartin‐Ceba Rodrigo , Mertz Lester E. , Fervenza Fernando C. , Zand Ladan , Koster Matthew J. , Warrington Kenneth J. , Lee Augustine S. , Aslam Nabeel , Abril Andy , Specks Ulrich 
Published: July 2024

ObjectiveAvacopan, an activated complement factor 5 receptor antagonist, has been approved as adjunct therapy for severe active antineutrophil cytoplasmic antibody–associated vasculitis (AAV). Current evidence supports the management of AAV presenting with diffuse alveolar hemorrhage (DAH) by administering glucocorticoids combined with either rituximab or cyclophosphamide in addition to supportive care. The role of avacopan in patients with DAH as a primary severe disease manifestation of AAV has not been well established. Furthermore, concerns remain regarding timely access to avacopan, the best glucocorticoid tapering regimen, and long‐term efficacy and safety of the drug. We sought to identify clinical features and outcomes of patients presenting with DAH secondary to AAV who received avacopan in addition to glucocorticoids and rituximab or cyclophosphamide.MethodsWe performed a retrospective cohort study of all consecutive patients presenting with DAH as part of active severe granulomatosis with polyangiitis or microscopic polyangiitis. Demographic and clinical characteristics were collected at presentation and follow‐up.ResultsFifteen patients met inclusion criteria and were observed for a median time of 17 weeks (interquartile range [IQR] 6–37 weeks) after initiation of avacopan. Patients were predominantly female and White, had never smoked, and were a median age of 66 years (IQR 52–72 years) at diagnosis. The majority had newly diagnosed severe AAV with renal involvement. Three patients progressed to respiratory failure. The timing of avacopan introduction and patterns of glucocorticoid tapers varied widely in this cohort. Two serious adverse events related to infection were observed, including one opportunistic infection leading to the patient's death, although neither was directly attributed to avacopan administration.ConclusionWe describe the clinical course of patients who presented with the severe AAV disease manifestation of DAH and received avacopan as adjunct therapy. Most patients achieved remission during follow‐up, and adverse events, including infection, were observed.
Efficacy and Safety of Bimekizumab in Patients With Psoriatic Arthritis With or Without Methotrexate: 52‐Week Results From Two Phase 3 Studies
Authors: McInnes Iain B. , Mease Philip J. , Tanaka Yoshiya , Gossec Laure , Husni M. Elaine , Kristensen Lars Erik , Warren Richard B. , Ink Barbara , Bajracharya Rajan , Coarse Jason , Gottlieb Alice B. 
Published: July 2024

ObjectiveThe objective of this study was to assess 52‐week efficacy and safety of bimekizumab in patients with active psoriatic arthritis (PsA) with or without concomitant methotrexate (+/−MTX) treatment at baseline.MethodsWe conducted a post hoc analysis of patients in BE OPTIMAL (NCT03895203; biologic disease‐modifying antirheumatic drug [bDMARD]‐naïve), BE COMPLETE (NCT03896581; prior inadequate response or intolerance to tumor necrosis factor inhibitors [TNFi‐IR]), and the BE VITAL open‐label extension (NCT04009499) study. Patients were randomized to one of the following treatment groups: bimekizumab 160 mg every four weeks, placebo, or a reference drug (adalimumab 40 mg every two weeks; BE OPTIMAL only). From Week 16, placebo‐randomized patients received bimekizumab. Missing data were imputed using non‐responder imputation, multiple imputation, or worst‐category imputation.ResultsThrough Week 52, similar proportions of bimekizumab‐treated patients achieved American College of Rheumatology 50% (ACR50) response criteria for both +MTX and −MTX (BE OPTIMAL: 54.4% +MTX, 54.7% −MTX; BE COMPLETE: 56.3% +MTX, 48.0% −MTX). Similar proportions of bimekizumab‐treated patients achieved complete skin clearance (Psoriasis Area and Severity Index 100% [PASI100] response) and minimal disease activity in both +MTX and −MTX groups. Similar trends were seen in placebo/bimekizumab‐treated patients. Through Week 52, the proportion of bimekizumab‐treated patients with ≥1 treatment‐emergent adverse event were similar between the +MTX and −MTX groups (BE OPTIMAL 325 of 410 [79.3%] vs 230 of 292 [78.8%], BE COMPLETE 105 of 168 [62.5%] vs 138 of 220 [62.7%]). The safety profile was comparable between subgroups and consistent with the prior safety profile of bimekizumab.ConclusionTreatment with bimekizumab demonstrated consistent, sustained efficacy to 52 weeks in bDMARD‐naïve and TNFi‐IR patients with PsA and was well tolerated, irrespective of concomitant MTX.image
Consensus of multi‐agent system with reaction‐diffusion terms and time delays via output‐feedback adaptive boundary control
Authors: Wan Xinglong , Yan Xu , Li Zhenxing , Qiu Jianlong , Yang Chengdong 
Published: July 2024

SummaryMulti‐agent systems (MASs) are widely used in many necessary fields such as cybersecurity, precision agriculture, satellites, and smart grids. In many practical processes, a proportion of states cannot be obtained directly. Therefore, it is desired to design an observer. This article explores the utilization of output‐feedback adaptive control techniques to achieve consensus in MASs based on partial differential equations (PDEs) with reaction‐diffusion terms and time delays. First, in dealing with time‐invariant delays, an observer according to the Luenberger method is proposed to assess the state of agents. Convergence conditions of the estimated states are obtained by employing Lyapunov functions and Wirtinger inequality. Using the obtained estimated states, a boundary adaptive control strategy is proposed to make the error system consensus. The merit of this control method lies in the fact that communication between agents only occurs at the spatial boundary position, not throughout the entire spatial domain, and the parameters of the system can be constantly changed. Consensus criteria of MASs with time‐invariant delays are obtained by using the output‐feedback adaptive control, and the results are further generalized to the model with time‐varying delays. Lastly, two experimental scenarios are provided to show the practicality of the proposed theories.
IRF4 Suppresses Osteogenic Differentiation of Periodontal Ligament Stem Cells by Activating IL‐18 Signaling Pathway in Periodontitis
Authors: Hu Zhenyu , Luo Yongjie , Lin Wei , Wu Xiaolian 
Published: July 2024

AbstractThe present study aims to investigate the role of interferon regulatory factor 4 (IRF4) in osteogenic differentiation of periodontal ligament stem cells (PDLSCs) and analyze the underlying signaling of these processes. In this study, IRF4 is upregulated in periodontitis periodontal ligament tissues, as compared to healthy periodontal ligament tissues. IRF4 knockdown increases cell proliferation, decreases levels of tumor necrosis factor‐alpha, interleukin‐6, and interleukin‐8, enhances osteogenic activity, and increases the expression of RUNX family transcription factor 2, Collagen I, and Osteocalcin in PDLSCs. The opposite results are observed in IRF4 overexpressed PDLSCs. Additionally, GSEA shows that IRF4 activates the interleukin‐18 (IL‐18) signaling pathway. The expressions of IL‐18, B‐cell translocation gene 2, interleukin‐1beta, and caspase‐3 are decreased by IRF4 knockdown, while increased by IRF4 overexpression. IL‐18 overexpression eliminates the promoting effect of IRF4 knockdown on osteogenic differentiation of PDLSCs. In conclusion, IRF4 suppresses osteogenic differentiation of PDLSCs by activating the IL‐18 signaling pathway.