bluuebunny/crossref_metadata_2025_split huggingface dataset:
When Synchronous Mucinous Metaplasia and Neoplasia of the Female Genital Tract and Peutz-Jeghers Syndrome Meet: A Case Report and Literature Reviews
Authors: Zhou Yue , Wang Xinyi , Li Yang , Zhang Weiru , Xu Xiaoxuan , Pang Yingxin , Liu peishu 
Published: February 2024

Abstract
Background: Peutz-Jeghers syndrome (PJS) is characterized by hamartomatous polyps in the gastrointestinal tract and mucocutaneous pigmentation on the lips, oral mucosa, nose, fingers, and toes. Synchronous Mucinous Metaplasia and Neoplasia of the Female Genital Tract (SMMN-FGT) refers to the occurrence of multifocal mucinous lesions in at least 2 sites of the female genital tract, including the cervix, uterus, fallopian tubes, and ovaries. SMMN-FGT and PJS are both rare diseases with very low incidence especially occur at the same time.
Case presentation: We report a case in which a woman with a huge mass on the left ovary received a gynecological surgery and diagnosed with cervical gastric-type adenocarcinoma and mucinous lesions in endometrium, bilateral fallopian tubes, and ovary, i.e., SMMN-FGT by postoperative paraffin pathology. The female seek doctors for help because of abdominal distension and enlargement, gynecological ultrasound revealed a multi-room cystic mass in the pelvis while serum tumor markers are normal with CA 199、CA125 elevated mildly, and cervical thin-prep cytology test was negative. The female had a PJS family history and was diagnosed with PJS since the age of 8 with black spots on her skin and mucous membranes, her gene testing shows STK11 germline mutation heterozygous type. She underwent left adnexectomy and hysterectomy surgery etc. and received adjuvant chemotherapy for a total of 6 courses, there were no signs of recurrence during the 15-month follow-up period after treatment.
Conclusions: Gynecologists should pay attention to vaginal discharge symptoms although the TCT result is negative. Gynecologists, gastroenterologists, dermatologists, and even urologists need to be vigilant when patient had black spots on her skin and mucous membranes. The patient's PJS symptoms can provide evidence for clinical doctors to be alert to the occurrence of malignant tumors, which can lead to early detection, diagnosis, and treatment of malignant tumors. Gynecologists, gastroenterologists, dermatologists, and even urologists need to be vigilant in clinical practice. In addition, patient education is particularly important, including genetic counseling, regular follow-up, and early screening and predictive diagnosis for their direct relatives.
Exploring the Link between Metformin Use and Adhesive Capsulitis of the Shoulder: a retrospective cohort study in Taiwan
Authors: Lin Bing-Sian , Chien Wu-Chien , Lu Chieh-Hua , Chung Chi-Hsiang , Tsao Chang-Huei , Weng Zi-Xeng 
Published: February 2024

Abstract

Objective The risk of adhesive capsulitis of shoulder in diabetic patients taking metformin has not been evaluated. We aimed for evaluating the relative risk of adhesive capsulitis of shoulder in diabetic patients taking metformin at the level of the whole country population. Methods We conducted a retrospective cohort study using a national health insurance database in Taiwan from 2000 to 2013. We used International Classification of Diseases, Ninth Revision, to categorise the medical condition for study group and comparison group. We used Cox proportional hazard regression analyses to determined adjusted hazard ratios (aHRs) of adhesive capsulitis of shoulder between study and comparison group after adjusting for sex, age and comorbidities. Results Among 13863 diabetic patients using metformin, 1294 patients were diagnosis with adhesive capsulitis of shoulder during follow up. Of the 55452 patients without the use of metformin, 5227 patients developed adhesive capsulitis of shoulder. Adhesive capsulitis of shoulder risk was elevated in patients taking metformin than in non-metformin group (adjusted hazard ratio [HR] 1.064, 95% confidence interval [95% CI] 1.000 to 1.321; p = 0.048). Conclusions Risk of adhesive capsulitis of shoulder among the diabetic patients taking metformin was higher than those did not taking metformin. It indicated that metformin may cause fibrosis in joint capsule.
Deep Learning Models for Predicting the Survival of Patients with Hepatocellular Carcinoma Based on a Surveillance, Epidemiology, and End Results (SEER) Database Analysis
Authors: Wang Shoucheng , Shao Mingyi , Fu Yu , Zhao Ruixia , Xing Yunfei , Zhang Liujie , Xu Yang 
Published: February 2024

Abstract

Background
This study aims to develop and validate a predictive model for Hepatocellular Carcinoma (HCC) patients using deep learning algorithms and to explore its clinical applicability.
Methods
HCC patients pathologically diagnosed between January 2011 and December 2015 in the SEER (Surveillance, Epidemiology, and End Results) database of the National Cancer Institute of the United States were selected as study subjects. We utilized two deep learning-based algorithms (DeepSurv and Neural Multi-Task Logistic Regression [NMTLR]) and a machine learning-based algorithm (Random Survival Forest [RSF]) for model training. A multivariable Cox Proportional Hazards (CoxPH) model was also constructed for comparison. The dataset was randomly divided into a training set and a test set in a 7:3 ratio. The training dataset underwent hyperparameter tuning through 1000 iterations of random search and 5-fold cross-validation. Model performance was assessed using the concordance index (C-index), Brier score, and Integrated Brier Score (IBS). The accuracy of predicting 1-year, 3-year, and 5-year survival rates was evaluated using Receiver Operating Characteristic (ROC) curves, calibration plots, and Area Under the Curve (AUC). The primary outcomes were the 1-year, 3-year, and 5-year overall survival rates. Models were developed using DeepSurv, NMTLR, RSF, and Cox Proportional Hazards regression. Model differentiation was evaluated using the C-index, calibration with concordance plots, and risk stratification capability with the log-rank test.
Results
The study included 2,197 HCC patients, randomly divided into a training cohort (70%, n = 1,537) and a testing cohort (30%, n = 660). Clinical characteristics between the two cohorts showed no significant statistical difference (p > 0.05). The deep learning models outperformed both RSF and CoxPH models, with C-indices of 0.735 (NMTLR) and 0.731 (DeepSurv) in the test dataset. The NMTLR model provided more accurate and better-calibrated survival estimates for predicting 1-year, 3-year, and 5-year survival rates (AUC: 0.803–0.824). We deployed the NMTLR model as a web application for clinical practice.
Conclusion
The predictive model developed using the deep learning algorithm NMTLR demonstrated excellent performance in prognostication for Primary Hepatocellular Carcinoma.
Cloud Elasticity: VM vs container: A Survey
Authors: Fourati Mohamed Hedi , Marzouk Soumaya , Jmaiel Mohamed 
Published: February 2024

Abstract
Microservices is an architectural style of development consisting of a collection of small independent and loosely coupled components. Microservices-based applications are deployed in form of many containers deployed in a pool of virtual machines (VMs). When there is a rise on the workload, microservice resources are overloaded and then it should have additional resources. One of the most important issues in cloud environment is to minimize computing resources so as to reduce the deployment cost of the application. We can resolve this issue and optimize computing resources using autoscaling techniques. An autoscaler automatically provisions essential resources at real time. Existing autoscalers have many issues which reduce their efficiency. The first issue is that existing autoscalers suppose that threshold exceeding is always caused by the rise of the workload. However, exceeding thresholds may not be caused by the increase in the workload, but may be caused by other problems such as specific requests, VM or container issues. The second issue is that in resource provisioning, many autoscalers do not select the appropriate microservices for scaling resources. The third issue is that existing autoscalers do not calculate needed resources to be allocated for each microservice
Study on the mechanism of Euscaphic acid in the treatment of non-Hodgkin lymphoma based on network pharmacology and molecular docking
Authors: li guangru , Liang Chunyuan , Liu Yan , Pan Yueyuan , Li Zhiyuan , Wu Guocai , wen Ruiting , Yang Zhigang 
Published: February 2024

Abstract
Non-Hodgkin's lymphoma (NHL) is a highly heterogenous disease. 5-year survival duration after diagnosis is poor among patients with aggressive/relapsing form of NHL. Our previous research found for the first time that Euscaphic acid (EA) has anti-tumor effects in NHL. However, the underlying mechanism by which EA plays a role in NHL remains unclear. In this study, we used network pharmacology and molecular docking to investigate the target and mechanism of the pharmacological action of EA on NHL. The EA-related targets and NHL-related targets were collected from the public database and overlapped to obtain the potential targets of EA-related anti-NHL. Target interaction was analyzed using STRING database, and 10 core target genes (TNF, PPARG, MMP9, HSP90AA1, PTGS2, IGF1R, AR, ESR2, NR3C1, MMP2) was screened by Cytoscape software. In the GO enrichment analysis and KEGG pathway analysis, TNF, PTGS2, PPARG and MMP9 are mainly enriched in the IL-17 signaling pathway, PPAR signaling pathway. The molecular docking results show there was strong interaction between the top 10 core targets and the EA. In addition, we found that EA inhibited the proliferation of RAJI NHL cells and induced cell apoptosis. These results suggested that EA may act on TNF, PTGS2, PPARG, and MMP9 through the IL-17 and PPAR signaling pathways, thereby exerting anti-NHL effects.
MC1R regulates T regulatory cells differentiation through metabolic reprogramming to promote colon cancer
Authors: Zhu Shaoliang , Zou Mengjie , Li Chunxing , Tang Yuntian , Dong Xiaofeng , Luo Honglin 
Published: February 2024

Abstract

Background
By 2021, colon cancer was a leading global cancer, with early detection improving outcomes but advanced cases still having poor prognosis. Therefore, understanding its molecular mechanisms is crucial for developing new preventive and therapeutic strategies.
Methods
In our study, we leveraged the TCGA database to assess MC1R expression in colon cancer and its link with patient prognosis. Further, employing mouse models and diverse experimental techniques, we investigated MC1R's impact on colon cancer progression and elucidated its underlying mechanism.
Results
In a follow-up study of clinical patients, MC1R was identified as having an important role in the development of colon cancer. First, it was found that MC1R was more highly expressed in colon tumor tissues than in adjacent tissues. In addition, we found that MC1R was associated with the prognosis of colon cancer, and higher expression of MC1R tended to predict a worse prognosis. To verify the reliability of this conclusion, we obtained MC1R−/− mice, which showed a greater ability to resist tumor growth than wild-type mice, as expected. To further explore the mechanism, we conducted a series of experiments. Further investigation revealed that the portion of Tregs in MC1R−/− mice changed significantly, while the portion of CD4 + and CD8 + T cells remained unchanged. The in vitro experiments also found that the MC1R−/− T cells had a weaker ability to differentiate into Tregs. Previous studies have found that the functional integrity of Tregs is interwoven with cellular metabolism. Therefore, we deduced that MC1R regulated the differentiation of Tregs by reprogramming metabolism. As expected, MC1R−/− T cells showed weaker mitochondrial function and a lower aerobic oxidation capacity. At the same time, the MC1R−/− T cells obtained stronger limiting effects on colon cancer cells. According to these experimental results, the inhibitor of MC1R came to our sight as a potential therapeutic agent to suppress colon cancer. The results showed that when we suppressed MC1R, the tumors in the mice developed more slowly, and the mice survived longer, which may provide a novel strategy for treating clinical colon cancer in the future.
Conclusion
By regulating the differentiation of Tregs, MC1R overexpression in colon cancer correlates with poor prognosis, and MC1R inhibition shows potential as a therapeutic strategy to slow tumor growth and enhance survival.
Testing and diagnosis of Clostridioides difficile infection in special scenarios: A systematic review
Authors: Singh Karan Bir , Khouri Anas , Singh Deepak , Prieto Jose , Dutta Priyata , Nnadozie Maduka , Clanton Clista , Morrison Esther , Sonnier William 
Published: February 2024

Abstract

Aim
To evaluate Clostridioides difficile testing and diagnosis in specific patient populations.
Background
Clostridioides difficile infection (CDI) is a biochemical and clinical diagnosis. Certain patient populations are at higher risk and testing must be interpreted correctly to avoid overdiagnosis and overtreatment. Consequently, we need to understand the limitations of the tests used to avoid increase morbidity and mortality due to false negative test results. Diagnostic assays should be ordered in a step wise approach in specific patient populations to confirm CDI.
Methods
Manuscripts were extracted from three different databases based on keywords. Data were extracted based on the PRISMA 2020 guidelines. Each manuscript was analyzed using appropriate critical appraisal tools.
Results
A total of 70 reports were evaluated. 18 review articles, 4 retrospective cohorts, 3 guidelines, 1 experimental, and 1 cross sectional study were eligible for inclusion. A total of 27 reports were included.
Discussion
CDI should be considered in all patients with traditional risk factors. Increased clinical suspicion of CDI is required in special populations such as hypogammaglobulinemia, transplant recipients, surgery, and inflammatory bowel disease. Testing should be limited to patients with the clinical manifestations of CDI to ensure a high pre-test probability for test interpretation. Diagnostic assays should follow a sequential, stepwise approach to accurately categorize the toxin expression status of the bacteria.
Effectiveness of Silver Ion Controlled Release Antimicrobial Compound in Reducing Multi-Drug Resistant Microorganism Contamination in an Intensive Care Unit: A Prospective Observational Study
Authors: Ramirez Paula , Forteza Maria , Benamu Esther , Frasquet Juan , Fernandez Sergio , Sanchez Trinidad , Arrando Hugo , Gonzalez Eva , Castellanos Alvaro 
Published: February 2024

Abstract
Purpose
This study aims to evaluate the efficacy of a silver ion controlled release antimicrobial compound (AgG-CRC) applied to surfaces in preventing surface colonization by multi-drug resistant microorganisms (MDRM) and reducing MDRM colonization and infection rates among patients admitted to an intensive care unit (ICU).
Methods
We conducted a five-month prospective study in a 24-bed mixed ICU divided into two identical subunits (12 bed-boxes each). AgG-CRC was applied in one subunit (Intervention Unit: IU), while the other followed standard disinfection protocols were maintained (Control Unit: CU). We compared the rates of MDRM surface contamination, MDRM patient colonization, and MDRM nosocomial infections between the two subunits.
Results
A total of 519 surface samples were collected during 22-point prevalent day samplings; with 236 from the IU and 283 from the CU. MDRM were detected in 22 (4.23%) surface samples: 5 from IU (2.1%) and 17 from CU (6%); p = 0.028. Patient MDRM colonization rates in the IU and CU were 4.1% and 9.9%, respectively; p = 0.048. The incidence of nosocomial infections was similar in both subunits. Two outbreaks occurred in the CU during the study (MDR Acinetobacter baumannii (3 patients) and an MDR Candida auris (4 patients), while no outbreaks were detected in the IU.
Conclusions
Application of AgG-CRC on ICU surfaces led to a significant reduction in MDRM surface colonization and accompanied a decrease in MDRM transmission to patients, indicating its utility in MDRM control.
Lower Bounds on Mutual Information of QPSK and BPSK in General Memoryless channels
Authors: Ezri Sagi , Bergel Itsik 
Published: February 2024

Abstract
We derive novel lower bounds on the mutual information in general memoryless channels with quadrature-phase-shift-keying (QPSK) or binary-phase-shift-keying (BPSK) modulation. These novel bounds are very easy to evaluate and result in closed-form expressions. The bounds' derivation is based on the mean squared error (MSE) of the channel input given the channel output. To emphasize the usefulness of these bounds, we evaluate the bounds for two cases of interest. We consider a general additive white noise channel, and derive simple bounds on the mutual information that depend solely on the noise variance (and not on its distribution). In addition, we derive a closed-form lower bound for QPSK modulation over a Rician fading channel with 1-bit analog to digital converter (ADC) at the receiver. The bound characterizes the achievable performance as function of the SNR and the ADC phase offset. The bound is shown to be tight in the absence of phase offset, and at most 25% from the actual mutual information at any phase offset.
Analysis of Subtypes of Urinary Incontinence in a Geriatric Outpatient Assessment of Older Women With Hip Fracture
Authors: Hellman-Bronstein Aino Tuulikki , Luukkaala Tiina H. , Ala-Nissilä Seija S. , Nuotio Maria S. 
Published: February 2024

Abstract
Purpose
Urinary incontinence (UI) is known to be prevalent among older female hip fracture patients. Little is known about different subgroups of UI (stress, SUI; urgency, UUI; mixed, MUI) among these patients. Our aim was to identify factors associated with subtypes of UI.
Methods
1,675 female patients aged ≥ 65 and treated for their first hip fracture in Seinäjoki Central Hospital, Finland, during 2007–2019, were included in a prospective cohort study. Of these women, 1,106 underwent comprehensive geriatric assessment (CGA), including questions on continence, at our geriatric outpatient clinic six-months post-fracture. A multivariable-adjusted multinomial logistic regression model was used.
Results
Of the 779 patients included in the present study, 360 (46%) were continent and 419 (54%) had UI six-months post-fracture. Of the women with UI, 117 (28%) had SUI, 183 (44%) had UUI, and 119 (28%) had MUI, respectively. Mean age of the patients was 82 ± 6,91. In multivariable analysis, depressive mood and poor mobility and functional ability were independently associated with SUI. Fecal incontinence (FI) and Body Mass Index (BMI) over 28 were independently associated with UUI. MUI shared the aforementioned factors with SUI and UUI and was independently associated with constipation.
Conclusion
MUI was associated with most factors, of which depressive mood and impaired mobility and poor functional ability were shared with SUI, and FI and higher BMI with UUI. MUI represents the most severe UI type in this patient population. CGA is key in managing and preventing UI in these vulnerable patients, regardless of UI subtype.
Health-Related Quality of Life and its Determinants in Patients with Malignant Brain Tumors: A prospective longitudinal study
Authors: Xiao Zhiyuan , Yang Tianrui , Chen Wenlin , Guo Xiaopeng , Cao Yaning , Xia Yu , Li Junlin , Wu Jiaming , Zhang Xin , Wang Yaning , Zhang Yi , Wang Yu , Ma Wenbin 
Published: February 2024

Abstract
Purpose: The aim of this study was to evaluate the health-related quality of life (HRQoL) of malignant brain tumor (MBT) patients before surgery and to determine the change in HRQoL after surgery. Also, the prediction of independent factors associated with HRQoL after surgery was conducted.
Methods: Patients diagnosed with BMT and admitted to Peking Union Medical College Hospital for surgery from May 2018 to August 2020 were included. Self-reported HRQoL questionnaires (EORTC QLQ-C30 and QLQ-BN20) were obtained before surgery and at seven days, one month, and three months after surgery. The Karnofsky Performance Scale (KPS) was assessed at the same time period. An online database was used to collect sociodemographic, oncologic history, and surgical information.
Results: 140 patients were enrolled, while 98 patients were diagnosed with glioma and 42 patients were diagnosed with brain metastases (BM). 91.4% of patients (n=128) completed the 7-day postoperative assessment, 47.1% (n=66) completed the 1-month assessment, and 32.9% (n=46) completed the 3-month assessment. At the 7-day postoperative assessment, quality of life (QoL) had worsened significantly (P < 0.05) in terms of global health status, physical function, role function, fatigue, pain, and leg weakness, but remained stable at 1 month in patients with glioma. Seizure status improved significantly after surgery and was statistically significantly improved at 1 month compared to baseline (P < 0.05). Constipation and bladder control worsened after surgery. Skin pruritus worsened at 3 months postoperatively compared to preoperatively (P < 0.05). QoL of patients with BM was worse than baseline at 7 days after surgery for physical, role, and social function (P < 0.05). Fatigue, diarrhea, and leg weakness were worse than baseline at 7 days after surgery and recovered at 1 month (P < 0.05). One month after surgery, there were significant improvements in cognitive function, future uncertainty, and headache (P <0.05). The results of the multivariable linear regression showed that available sociodemographic, oncologic history, and surgical factors were important prognostic factors for different domains of QoL at different time periods.
Conclusions: Patients with BMT who undergo surgery experience fluctuations in various dimensions of QoL in the early postoperative period, and one month after surgery is a key time point that can generally improve gradually. The tumor is located on the left side of the brain and the communication deficit is worse than on the right side. HRQoL can be identified through assessment, identification of QoL determinants, and consideration of interventions to improve patient QoL.