bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary extra-gastrointestinal stromal tumor of retroperitoneum: Clinicopathologic characteristics and prognosis of six cases
Authors: Lin Jiaxin , Liao Weilin , Wang Jiahao , Li Wenjuan , Tang Xin , Li Hongming , Yi Xiaojiang , Lu Xinquan , Chen Zhaoyu , Zhu Bosen , Feng Xiaochuang , Diao Dechang 
Published: February 2023

AimThis study investigates the clinicopathological features and prognostic genic biomarker factors of primary retroperitoneal extra-gastrointestinal stromal tumors (EGISTs).MethodsThe clinicopathological data of six patients with primary retroperitoneal EGIST were analyzed, including cell type (epithelioid or spindle), mitoses, and the presence of intratumoral necrosis and hemorrhage. Mitoses were counted and summed from 50 high power fields (HPFs). Mutations of exons 9, 10, 11, 13, 14, and 17 of the C-kit genes and those of exons 12 and 18 of the PDGFRA gene were examined. Follow-up was performed via telephone, and all outpatient records were reviewed. The last follow-up date was February 2022, the median follow-up was 27.5m and the postoperative status, medication, and survival of the patients were recorded.ResultThe patients were treated with radical intent. Four cases (patients 3, 4, 5, and 6) underwent multivisceral resection for encroachment on the adjacent viscera. The postoperative pathological results demonstrated that all biopsy specimens were negative for S-100 and desmin, and positive for DOG1 and CD117. Additionally, four patients (case 1, 2, 4, and 5) were positive for CD34, four (case 1, 3, 5, and 6) were positive for SMA, four (case 1, 4, 5, and 6) had &gt;5/50 HPFs, and three (case 1, 4, and 5) had Ki67 &gt;5%. According to the modified National Institutes of Health (NIH) guidelines, all patients were graded as high-risk cases. By exome sequencing, exon11 mutations were detected in the six patients, while exon10 mutations were detected in two cases (patients 4 and 5). The median follow-up time was 30.5 (11–109) months, with only one fatality at 11 months.ConclusionRetroperitoneal EGIST is a rare mesenchymal tumor that is difficult to distinguish from other retroperitoneal tumors. To diagnose this highly malignant tumor, low-threshold suspicion is necessary, and Kit and PDGFRA gene mutations should be routinely tested to confirm the diagnosis and guide subsequent treatment.
Angiogenesis regulators S100A4, SPARC and SPP1 correlate with macrophage infiltration and are prognostic biomarkers in colon and rectal cancers
Authors: Kazakova Elena , Rakina Militsa , Sudarskikh Tatiana , Iamshchikov Pavel , Tarasova Anna , Tashireva Liubov , Afanasiev Sergei , Dobrodeev Alexei , Zhuikova Lilia , Cherdyntseva Nadezhda , Kzhyshkowska Julia , Larionova Irina 
Published: February 2023

IntroductionIncreasing evidence suggests that it is necessary to find effective and robust clinically validated prognostic biomarkers that can identify “high-risk” colorectal cancer (CRC) patients. Currently, available prognostic factors largely include clinical-pathological parameters and focus on the cancer stage at the time of diagnosis. Among cells of tumor microenvironment (TME) only Immunoscore classifier based on T lymphocytes showed high predictive value.MethodsIn the present study, we performed the complex analysis of mRNA and protein expression of crucial regulators of tumor angiogenesis and tumor progression, expressed by tumor-associated macrophages (TAMs): S100A4, SPP1 and SPARC. Colon and rectal cancer patients were investigated independently and in a combined cohort (CRC). For mRNA expression, we analyzed RNA sequencing data obtained from TCGA (N=417) and GEO (N=92) cohorts of colorectal cancer patients. For protein expression, we performed IHC digital quantification of tumor tissues obtained from 197 patients with CRC treated in the Department of abdominal oncology in Clinics of Tomsk NRMC.ResultsHigh S100A4 mRNA expression accurately predicted poor survival for patients with CRC independently of cancer type. SPARC mRNA level was independent prognostic factors for survival in colon but not in rectal cancer. SPP1 mRNA level had significant predictive value for survival in both rectal and colon cancers. Analysis of human CRC tissues revealed that S100A4, SPP1 and SPARC are expressed by stromal compartments, in particular by TAMs, and have a strong correlation with macrophage infiltration. Finally, our results indicate that chemotherapy-based treatment can change the predictive direction of S100A4 for rectal cancer patients. We found that S100A4 stromal levels were higher in patients with better response to neoadjuvant chemotherapy/chemoradiotherapy, and S100A4 mRNA levels predicted better DFS among non-responders.DiscussionThese findings can help improve the prognosis of patients with CRC based on S100A4, SPP1 and SPARC expression levels.
Multiparametric magnetic resonance imaging-based radiomics nomogram for predicting tumor grade in endometrial cancer
Authors: Yue Xiaoning , He Xiaoyu , He Shuaijie , Wu Jingjing , Fan Wei , Zhang Haijun , Wang Chengwei 
Published: February 2023

BackgroundTumor grade is associated with the treatment and prognosis of endometrial cancer (EC). The accurate preoperative prediction of the tumor grade is essential for EC risk stratification. Herein, we aimed to assess the performance of a multiparametric magnetic resonance imaging (MRI)-based radiomics nomogram for predicting high-grade EC.MethodsOne hundred and forty-three patients with EC who had undergone preoperative pelvic MRI were retrospectively enrolled and divided into a training set (n =100) and a validation set (n =43). Radiomic features were extracted based on T2-weighted, diffusion-weighted, and dynamic contrast-enhanced T1-weighted images. The minimum absolute contraction selection operator (LASSO) was implemented to obtain optimal radiomics features and build the rad-score. Multivariate logistic regression analysis was used to determine the clinical MRI features and build a clinical model. We developed a radiomics nomogram by combining important clinical MRI features and rad-score. A receiver operating characteristic (ROC) curve was used to evaluate the performance of the three models. The clinical net benefit of the nomogram was assessed using decision curve analysis (DCA), net reclassification index (NRI), and integrated discrimination index (IDI).ResultsIn total, 35/143 patients had high-grade EC and 108 had low-grade EC. The areas under the ROC curves of the clinical model, rad-score, and radiomics nomogram were 0.837 (95% confidence interval [CI]: 0.754–0.920), 0.875 (95% CI: 0.797–0.952), and 0.923 (95% CI: 0.869–0.977) for the training set; 0.857 (95% CI: 0.741–0.973), 0.785 (95% CI: 0.592–0.979), and 0.914 (95% CI: 0.827–0.996) for the validation set, respectively. The radiomics nomogram showed a good net benefit according to the DCA. NRIs were 0.637 (0.214–1.061) and 0.657 (0.079–1.394), and IDIs were 0.115 (0.077–0.306) and 0.053 (0.027–0.357) in the training set and validation set, respectively.ConclusionThe radiomics nomogram based on multiparametric MRI can predict the tumor grade of EC before surgery and yield a higher performance than that of dilation and curettage.
Efficacy of third-line anti-EGFR-based treatment versus regorafenib or trifluridine/tipiracil according to primary tumor site in RAS/BRAF wild-type metastatic colorectal cancer patients
Authors: Salvatore Lisa , Bensi Maria , Vivolo Raffaella , Zurlo Ina Valeria , Dell’Aquila Emanuela , Grande Roberta , Anghelone Annunziato , Emiliani Alessandra , Citarella Fabrizio , Calegari Maria Alessandra , Ribelli Marta , Basso Michele , Pozzo Carmelo , Tortora Giampaolo 
Published: February 2023

BackgroundRight- (R) and left-sided (L) metastatic colorectal cancer (mCRC) exhibit different clinical and molecular features. Several retrospective analyses showed that survival benefit of anti-EGFR-based therapy is limited to RAS/BRAF wt L-sided mCRC patients. Few data are available about third-line anti-EGFR efficacy according to primary tumor site.MethodsRAS/BRAF wt patients mCRC treated with third-line anti-EGFR-based therapy versus regorafenib or trifluridine/tipiracil (R/T) were retrospectively collected. The objective of the analysis was to compare treatment efficacy according to tumor site. The primary endpoint was progression-free survival (PFS); secondary endpoints were overall survival (OS), response rate (RR) and toxicity.ResultsA total of 76 RAS/BRAF wt mCRC patients, treated with third-line anti-EGFR-based therapy or R/T, were enrolled. Of those, 19 (25%) patients had a R-sided tumor (9 patients received anti-EGFR treatment and 10 patients R/T) and 57 (75%) patients had a L-sided tumor (30 patients received anti-EGFR treatment and 27 patients R/T). A significant PFS [7.2 vs 3.6 months, HR 0.43 (95% CI 0.2-0.76), p= 0.004] and OS benefit [14.9 vs 10.9 months, HR 0.52 (95% CI 0.28-0.98), p= 0.045] in favor of anti-EGFR therapy vs R/T was observed in the L-sided tumor group. No difference in PFS and OS was observed in the R-sided tumor group. A significant interaction according to primary tumor site and third-line regimen was observed for PFS (p= 0.05). RR was significantly higher in L-sided patients treated with anti-EGFR vs R/T (43% vs. 0%; p &lt;0.0001), no difference was observed in R-sided patients. At the multivariate analysis, third-line regimen was independently associated with PFS in L-sided patients.ConclusionsOur results demonstrated a different benefit from third-line anti-EGFR-based therapy according to primary tumor site, confirming the role of L-sided tumor in predicting benefit from third-line anti-EGFR vs R/T. At the same time, no difference was observed in R-sided tumor.
MEK inhibition causes BIM stabilization and increased sensitivity to BCL-2 family member inhibitors in RAS-MAPK-mutated neuroblastoma
Authors: Eleveld Thomas F. , Vernooij Lindy , Schild Linda , Koopmans Bianca , Alles Lindy K. , Ebus Marli E. , Dandis Rana , van Tinteren Harm , Caron Huib N. , Koster Jan , van Noesel Max M. , Tytgat Godelieve A. M. , Eising Selma , Versteeg Rogier , Dolman M. Emmy M. , Molenaar Jan J. 
Published: February 2023

IntroductionMutations affecting the RAS-MAPK pathway occur frequently in relapsed neuroblastoma tumors and are associated with response to MEK inhibition in vitro. However, these inhibitors alone do not lead to tumor regression in vivo, indicating the need for combination therapy.Methods and resultsVia high-throughput combination screening, we identified that the MEK inhibitor trametinib can be combined with BCL-2 family member inhibitors, to efficiently inhibit growth of neuroblastoma cell lines with RAS-MAPK mutations. Suppressing the RAS-MAPK pathway with trametinib led to an increase in pro-apoptotic BIM, resulting in more BIM binding to anti-apoptotic BCL-2 family members. By favoring the formation of these complexes, trametinib treatment enhances sensitivity to compounds targeting anti-apoptotic BCL-2 family members. In vitro validation studies confirmed that this sensitizing effect is dependent on an active RAS-MAPK pathway. In vivo combination of trametinib with BCL-2 inhibitors led to tumor inhibition in NRAS-mutant and NF1-deleted xenografts.ConclusionTogether, these results show that combining MEK inhibition with BCL-2 family member inhibition could potentially improve therapeutic outcomes for RAS-MAPK-mutated neuroblastoma patients.
Single-site laparoscopic ligation of the hernia sac in infants with congenital Morgagni hernia
Authors: Wang Cao , Liu Xiang , Shu Zhen , Yin Jia , Luo Zheng , Zhou Guangxu , Liu Bin 
Published: February 2023

BackgroundCongenital Morgagni hernia (CMH) is a rare midline defect involving herniation of abdominal viscera into the thoracic cavity through triangular parasternal gaps in the diaphragm.MethodsThe medical records of three patients with CMH admitted to the Department of Pediatric Surgery at the Affiliated Hospital of Zunyi Medical University between 2018 and 2022 were retrospectively reviewed. Pre-operative diagnosis was based on chest x-ray, chest computerized tomography, and barium enema. All patients were treated with single-site laparoscopic ligation of the hernia sac.ResultsHernia repair was successful in all patients (males; age: 14 months, 30 months, 48 months). The average operative time for repair of a unilateral hernia was 20 ± 5 min. Volume of surgical blood loss was 2–3 ml. There was no damage to organs such as the liver or intestines, or to tissues such as the pericardium or the phrenic nerve. Patients were allowed a fluid diet 6–8 h after surgery, and remained on bed rest until 16 h after surgery. No postoperative complications occurred, and patients were discharged on postoperative Day 2 or 3. No symptoms or complications were noted during the 1–48 months of follow-up. Aesthetic outcomes were satisfactory.ConclusionsSingle-site laparoscopic ligation of the hernia sac provides pediatric surgeons a safe and effective technique for repair of CMH in infants and children. The procedure is straightforward, operative time and surgical blood loss are minimal, recurrence is unlikely, and aesthetic outcomes are satisfactory.
A precision refractometer using strict dual-mode elliptical multilayer-core fibers with temperature and strain decoupled
Authors: Liang Xiao , Zuo Binzhou 
Published: February 2023

To accurately measure the surrounding refractive index (SRI), an all-fiber microstructure multi-parameters optical sensor based on Mach–Zehnder interferometer (MZI) has been designed. A homemade elliptical multilayer-core fiber (EMCF), in which only two modes could be propagated, is used in this sensor. This sensor has a sandwich structure of EMCF-SMF-EMCF (ESE). The sensitivities of RI, temperature, and strain are analyzed practically, and different from each other which would provide a basis for restraining cross-sensitivity of sensor and improving measuring precision. According to the numerical simulation, the relationship between the guided mode and relevant excitation coefficient is shown, and the sensing characteristic of the interference spectrum is well expatiated. Maximum sensitivities of ∼31.83 nm per refractive index unit (RIU), ∼69 pm/°C, and ∼2.06 pm/µε have been experimentally achieved. The monitoring system is promoted by the fact that the resonance dips have their individual sensitivities, and the standard matrix inversion method is used for simultaneous three parameters determination. Consequently, this fiber sensor could ensure the completion of accurate SRI measurements with temperature and strain decoupled.
Performance of an ultra-pure NaI(Tl) detector produced by an indigenously-developed purification method and crystal growth for the COSINE-200 experiment
Authors: Lee H. , Park B. J. , Choi J. J. , Gileva O. , Ha C. , Iltis A. , Jeon E. J. , Kim D. Y. , Kim K. W. , Kim S. H. , Kim S. K. , Kim Y. D. , Ko Y. J. , Lee C. H. , Lee H. S. , Lee I. S. , Lee M. H. , Ra S. J. , Son J. K. , Shin K. A. 
Published: February 2023

The COSINE-100 experiment has been operating with 106 kg of low-background NaI(Tl) detectors to test the results from the DAMA/LIBRA experiment, which claims to have observed dark matter. However, since the background of the NaI(Tl) crystals used in the COSINE-100 experiment is 2–3 times higher than that in the DAMA detectors, no conclusion regarding the claimed observation from the DAMA/LIBRA experiment could be reached. Therefore, we plan to upgrade the current COSINE-100 experiment to the next phase, COSINE-200, by using ultra-low background NaI(Tl) detectors. The basic principle was already proved with the commercially available Astro-grade NaI powder from Sigma-Aldrich (now Merck) company. However, we have developed a mass production process of ultra-pure NaI powder at the Center for Underground Physics (CUP) of the Institute for Basic Science (IBS), Korea, using the direct purification of the raw NaI powder. We plan to produce more than 1,000 kg of ultra-pure powder for the COSINE-200 experiment. With our crystal grower installed at CUP, we have successfully grown a low-background crystal using our purification technique for the NaI powder. We have assembled a low-background NaI(Tl) detector. In this article, we report the performance of this ultra-pure NaI(Tl) crystal detector produced at IBS, Korea.
Delay in seeking health care from community residents during a time with low prevalence of COVID-19: A cross-sectional national survey in China
Authors: Wang Ziyu , Tang Yurong , Cui Yu , Guan Hanwen , Cui Xiaoqian , Liu Yuan , Liu Yanni , Kang Zheng , Wu Qunhong , Hao Yanhua , Liu Chaojie 
Published: February 2023

BackgroundThe pandemic of COVID-19 has significant implications on health resources allocation and health care delivery. Patients with non-COVID illness may have to change their care seeking behaviors to mitigate the risk of infections. The research aimed to investigate potential delay of community residents in seeking health care at a time with an overall low prevalence of COVID-19 in China.MethodsAn online survey was conducted in March 2021 on a random sample drawn from the registered survey participants of the survey platform Wenjuanxing. The respondents who reported a need for health care over the past month (n = 1,317) were asked to report their health care experiences and concerns. Logistic regression models were established to identify predictors of the delay in seeking health care. The selection of independent variables was guided by the Andersen's service utilization model. All data analyses were performed using SPSS 23.0. A two-sided p value of &lt;0.05 was considered as statistically significant.Key resultsAbout 31.4% of respondents reported delay in seeking health care, with fear of infection (53.5%) as a top reason. Middle (31–59 years) age (AOR = 1.535; 95% CI, 1.132 to 2.246), lower levels of perceived controllability of COVID-19 (AOR = 1.591; 95% CI 1.187 to 2.131), living with chronic conditions (AOR = 2.008; 95% CI 1.544 to 2.611), pregnancy or co-habiting with a pregnant woman (AOR = 2.115; 95% CI 1.154 to 3.874), access to Internet-based medical care (AOR = 2.529; 95% CI 1.960 to 3.265), and higher risk level of the region (AOR = 1.736; 95% CI 1.307 to 2.334) were significant predictors of the delay in seeking health care after adjustment for variations of other variables. Medical consultations (38.7%), emergency treatment (18.2%), and obtainment of medicines (16.5%) were the top three types of delayed care, while eye, nose, and throat diseases (23.2%) and cardiovascular and cerebrovascular diseases (20.8%) were the top two conditions relating to the delayed care. Self-treatment at home was the most likely coping strategy (34.9%), followed by Internet-based medical care (29.2%) and family/friend help (24.0%).ConclusionsDelay in seeking health care remained at a relatively high level when the number of new COVID-19 cases was low, which may present a serious health risk to the patients, in particular those living with chronic conditions who need continuous medical care. Fear of infection is the top reason for the delay. The delay is also associated with access to Internet-based medical care, living in a high risk region, and perceived low controllability of COVID-19.
A typology of integrated care policies in the care home sector: A policy document analysis
Authors: Simpson Glenn , Entwistle Charlotte , Short Andrea D. , Morciano Marcello , Stokes Jonathan 
Published: February 2023

BackgroundHealth and social care systems in many countries have begun to trial and adopt “integrated” approaches. Yet, the significant role care homes play within the health and social care system is often understated. A key first step to identifying the care home integration interventions that are most (cost-)effective is the ability to precisely identify and record what has been implemented, where, and when—a “policy map.”MethodsTo address gaps relating to the identification and recording of (cost-)effective integrated care home interventions, we developed a new typology tool. We conducted a policy mapping exercise in a devolved region of England—Greater Manchester (GM). Specifically, we carried out systematic policy documentary searches and extracted a range of qualitative data relating to integrated health and social care initiatives in the GM region for care homes. The data were then classified according to existing national ambitions for England as well as a generic health systems framework to illustrate gaps in existing recording tools and to iteratively develop a novel approach.ResultsA combined total of 124 policy documents were identified and screened, in which 131 specific care home integration initiatives were identified. Current initiatives emphasized monitoring quality in care homes, workforce training, and service delivery changes (such as multi-disciplinary teams). There was comparatively little emphasis on financing or other incentive changes to stimulate provider behavior for the care home setting. We present a novel typology for capturing and comparing care home integration policy initiatives, largely conceptualizing which part of the system or specific transition point the care home integration is targeting, or whether there is a broader cross-cutting system intervention being enacted, such as digital or financial interventions.ConclusionsOur typology builds on the gaps in current frameworks, including previous lack of specificity to care homes and lack of adaptability to new and evolving initiatives internationally. It could provide a useful tool for policymakers to identify gaps in the implementation of initiatives within their own areas, while also allowing researchers to evaluate what works most effectively and efficiently in future research based on a comprehensive policy map.