bluuebunny/crossref_metadata_2025_split huggingface dataset:
Liver resection versus liver transplantation for hepatocellular carcinoma within the Milan criteria based on estimated microvascular invasion risks
Authors: Yang Pinghua , Teng Fei , Bai Shilei , Xia Yong , Xie Zhihao , Cheng Zhangjun , Li Jun , Lei Zhengqing , Wang Kui , Zhang Baohua , Yang Tian , Wan Xuying , Yin Hao , Shen Hao , Pawlik Timothy M , Lau Wan Yee , Fu Zhiren , Shen Feng 
Published: June 2023

Abstract

Background
Preoperative prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) may optimize individualized treatment decision-making. This study aimed to investigate the prognostic differences between HCC patients undergoing liver resection (LR) and liver transplantation (LT) based on predicted MVI risks.

Methods
We analysed 905 patients who underwent LR, including 524 who underwent anatomical resection (AR) and 117 who underwent LT for HCC within the Milan criteria using propensity score matching. A nomogram model was used to predict preoperative MVI risk.

Results
The concordance indices of the nomogram for predicting MVI were 0.809 and 0.838 in patients undergoing LR and LT, respectively. Based on an optimal cut-off value of 200 points, the nomogram defined patients as high- or low-risk MVI groups. LT resulted in a lower 5-year recurrence rate and higher 5-year overall survival (OS) rate than LR among the high-risk patients (23.6% vs 73.2%, P &lt; 0.001; 87.8% vs 48.1%, P &lt; 0.001) and low-risk patients (19.0% vs 45.7%, P &lt; 0.001; 86.5% vs 70.0%, P = 0.002). The hazard ratios (HRs) of LT vs LR for recurrence and OS were 0.18 (95% confidence interval [CI], 0.09–0.37) and 0.12 (95% CI, 0.04–0.37) among the high-risk patients and 0.37 (95% CI, 0.21–0.66) and 0.36 (95% CI, 0.17–0.78) among the low-risk patients. LT also provided a lower 5-year recurrence rate and higher 5-year OS rate than AR among the high-risk patients (24.8% vs 63.5%, P = 0.001; 86.7% vs 65.7%, P = 0.004), with HRs of LT vs AR for recurrence and OS being 0.24 (95% CI, 0.11–0.53) and 0.17 (95% CI, 0.06–0.52), respectively. The 5-year recurrence and OS rates between patients undergoing LT and AR were not significantly different in the low-risk patients (19.4% vs 28.3%, P = 0.129; 85.7% vs 77.8%, P = 0.161).

Conclusions
LT was superior to LR for patients with HCC within the Milan criteria with a predicted high or low risk of MVI. No significant differences in prognosis were found between LT and AR in patients with a low risk of MVI.
Quantifying Healthy Aging in Older Veterans Using Computational Audio Analysis
Authors: Yin Yunting , Hanes Douglas William , Skiena Steven , Clouston Sean A P 
Published: June 2023

Abstract

Background
Researchers are increasingly interested in better methods for assessing the pace of aging in older adults, including vocal analysis. The present study sought to determine whether paralinguistic vocal attributes improve estimates of the age and risk of mortality in older adults.

Methods
To measure vocal age, we curated interviews provided by male U.S. World War II Veterans in the Library of Congress collection. We used diarization to identify speakers and measure vocal features and matched recording data to mortality information. Veterans (N = 2 447) were randomly split into testing (n = 1 467) and validation (n = 980) subsets to generate estimations of vocal age and years of life remaining. Results were replicated to examine out-of-sample utility using Korean War Veterans (N = 352).

Results
World War II Veterans’ average age was 86.08 at the time of recording and 91.28 at the time of death. Overall, 7.4% were prisoners of war, 43.3% were Army Veterans, and 29.3% were drafted. Vocal age estimates (mean absolute error = 3.255) were within 5 years of chronological age, 78.5% of the time. With chronological age held constant, older vocal age estimation was correlated with shorter life expectancy (aHR = 1.10; 95% confidence interval: 1.06–1.15; p &lt; .001), even when adjusting for age at vocal assessment.

Conclusions
Computational analyses reduced estimation error by 71.94% (approximately 8 years) and produced vocal age estimates that were correlated with both age and predicted time until death when age was held constant. Paralinguistic analyses augment other assessments for individuals when oral patient histories are recorded.
Exponential Riesz Bases in L2 on Two Intervals
Authors: Belov Yurii , Mironov Mikhail 
Published: June 2023

Abstract
We give sufficient conditions for an exponential system to be a Riesz basis in $L^{2}(E)$, where $E$ is a union of two intervals. We show that these conditions are close to be necessary. In addition, we demonstrate “extra point effect” for such systems, that is, it may happen that a Riesz basis in $L^{2}(E)$ differs by one point from a Riesz basis on an interval.
Experience of stigma among persons with type 2 diabetes in Africa: a systematic review
Authors: Akyirem Samuel , Ekpor Emmanuel 
Published: June 2023

Abstract
Diabetes stigma is a pervasive social phenomenon with significant impacts on individuals living with type 2 diabetes mellitus (T2DM). Despite the negative health impact of diabetes stigma, little is known about the experience of this phenomenon in Africa. This review aimed to synthesize existing quantitative and qualitative studies that examine the experiences and outcomes of T2DM stigma in Africa. A mixed studies review methodology was utilized to conduct this research. Relevant articles were identified by searching the Cumulative Index to Nursing and Allied Health Literature, PubMed, MEDLINE and PsycINFO databases. The mixed method appraisal tool was used to assess the quality of included studies. Of 2626 records identified, 10 articles met the inclusion criteria. The prevalence of diabetes stigma was as high as 70%. The results of the review indicate that individuals with T2DM in Africa are labelled as ‘having HIV’, ‘nearing their death’ and ‘wasting resources’. These experiences were associated with low quality of life, disease concealment and avoidance of self-management behaviours. The findings highlight the urgent need for further stigma-centric studies to fully understand how T2DM stigma is experienced in Africa. The evidence from such studies would inform the development and evaluation of effective interventions to address this social consequence of T2DM.
Favorable prognostic impact of phosphatase and tensin homolog alterations in wild-type isocitrate dehydrogenase and telomerase reverse transcriptase promoter glioblastoma
Authors: Higa Nayuta , Akahane Toshiaki , Yokoyama Seiya , Makino Ryutaro , Yonezawa Hajime , Uchida Hiroyuki , Takajo Tomoko , Kirishima Mari , Hamada Taiji , Noguchi Naoki , Otsuji Ryosuke , Kuga Daisuke , Nagasaka Shohei , Yamahata Hitoshi , Yamamoto Junkoh , Yoshimoto Koji , Tanimoto Akihide , Hanaya Ryosuke 
Published: June 2023

Abstract

Background
Telomerase reverse transcriptase promoter (TERTp) mutations are a biological marker of glioblastoma; however, the prognostic significance of TERTp mutational status is controversial. We evaluated this impact by retrospectively analyzing the outcomes of patients with isocitrate dehydrogenase (IDH)- and TERTp-wild-type glioblastomas.

Methods
Using custom next-generation sequencing, we analyzed 208 glioblastoma samples harboring wild-type IDH.

Results
TERTp mutations were detected in 143 samples (68.8%). The remaining 65 (31.2%) were TERTp-wild-type. Among the TERTp-wild-type glioblastoma samples, we observed a significant difference in median progression-free survival (18.6 and 11.4 months, respectively) and overall survival (not reached and 15.7 months, respectively) in patients with and without phosphatase and tensin homolog (PTEN) loss and/or mutation. Patients with TERTp-wild-type glioblastomas with PTEN loss and/or mutation were younger and had higher Karnofsky Performance Status scores than those without PTEN loss and/or mutation. We divided the patients with TERTp-wild-type into 3 clusters using unsupervised hierarchical clustering: Good (PTEN and TP53 alterations; lack of CDKN2A/B homozygous deletion and platelet-derived growth factor receptor alpha (PDGFRA) alterations), intermediate (PTEN alterations, CDKN2A/B homozygous deletion, lack of PDGFRA, and TP53 alterations), and poor (PDGFRA and TP53 alterations, CDKN2A/B homozygous deletion, and lack of PTEN alterations) outcomes. Kaplan–Meier survival analysis indicated that these clusters significantly correlated with the overall survival of TERTp-wild-type glioblastoma patients.

Conclusions
Here, we report that PTEN loss and/or mutation is the most useful marker for predicting favorable outcomes in patients with IDH- and TERTp-wild-type glioblastomas. The combination of 4 genes, PTEN, TP53, CDKN2A/B, and PDGFRA, is important for the molecular classification and individual prognosis of patients with IDH- and TERTp-wild-type glioblastomas.
Case-Control Study to Estimate the Association Between Tdap Vaccination During Pregnancy and Reduced Risk of Pertussis in Newborn Infants in Peru, 2019–2021
Authors: Juscamayta-López Eduardo , Valdivia Faviola , Soto María Pía , Horna Helen , Pajuelo Mónica 
Published: June 2023

Abstract

Background
Despite widespread vaccination, pertussis has re-emerged as a serious public health concern worldwide. Since 2017, Peru has experienced an increase in pertussis cases exhibiting a higher risk of severity and death in young infants. Thus, a dose of the tetanus, diphtheria, and acellular pertussis (Tdap) vaccine is recommended for pregnant women in the third trimester. Although evidence suggests the maternal Tdap vaccine is safe and effective, its association with a reduced risk of pertussis in developing countries remains poorly investigated.

Methods
We conducted a case-control study to evaluate the association between Tdap vaccination during pregnancy and reduction in the risk of pertussis among infants aged &lt;2 months in Peru. Pertussis cases and controls treated in healthcare facilities nationwide between 2019 and 2021 and confirmed by real-time polymerase chain reaction were included. The controls were randomly selected from test-negative patients. Odds ratios (ORs) and vaccine effectiveness (VE) were calculated using a multiple logistic regression model and 1 − (OR) × 100%, respectively.

Results
Fifty cases and 150 controls were included in the analysis. The mothers of 4% of cases and 16.7% of controls received Tdap vaccination during pregnancy, resulting in an OR of 0.19 (95% confidence interval [CI], .04–.86) and VE of 81% (95% CI, 14%–96%) for preventing pertussis in infants.

Conclusions
Peruvian infants &lt;2 months old whose mothers received the Tdap vaccine in the third trimester of pregnancy had a significantly lower risk of pertussis. The Tdap vaccination is thus an effective intervention to reduce the burden of pertussis in at-risk populations.
Insights into vascular physiology from sleep photoplethysmography
Authors: Yilmaz Gizem , Ong Ju Lynn , Ling Lieng-Hsi , Chee Michael W L 
Published: June 2023

Abstract

Study Objectives
Photoplethysmography (PPG) in consumer sleep trackers is now widely available and used to assess heart rate variability (HRV) for sleep staging. However, PPG waveform changes during sleep can also inform about vascular elasticity in healthy persons who constitute a majority of users. To assess its potential value, we traced the evolution of PPG pulse waveform during sleep alongside measurements of HRV and blood pressure (BP).

Methods
Seventy-eight healthy adults (50% male, median [IQR range] age: 29.5 [23.0, 43.8]) underwent overnight polysomnography (PSG) with fingertip PPG, ambulatory blood pressure monitoring, and electrocardiography (ECG). Selected PPG features that reflect arterial stiffness: systolic to diastolic distance (∆T_norm), normalized rising slope (Rslope) and normalized reflection index (RI) were derived using a custom-built algorithm. Pulse arrival time (PAT) was calculated using ECG and PPG signals. The effect of sleep stage on these measures of arterial elasticity and how this pattern of sleep stage evolution differed with participant age were investigated.

Results
BP, heart rate (HR) and PAT were reduced with deeper non-REM sleep but these changes were unaffected by the age range tested. After adjusting for lowered HR, ∆T_norm, Rslope, and RI showed significant effects of sleep stage, whereby deeper sleep was associated with lower arterial stiffness. Age was significantly correlated with the amount of sleep-related change in ∆T_norm, Rslope, and RI, and remained a significant predictor of RI after adjustment for sex, body mass index, office BP, and sleep efficiency.

Conclusions
The current findings indicate that the magnitude of sleep-related change in PPG waveform can provide useful information about vascular elasticity and age effects on this in healthy adults.
Cytotoxicity screening ofThymus vulgarisL. in breast cancer: in vitro study
Authors: Bıtgen Nazmiye , Onder Gozde Ozge , Baran Munevver , Yay Arzu 
Published: June 2023

AbstractBreast cancer is one of the leading causes of cancer-related deaths due to its aggressive course. There is an increasing need for alternative therapy strategies, including herbal medications, to treat the disease because of its high incidence. Medicinal plants, such as Thymus vulgaris L. (T. vulgaris), have recently attracted great interest due to the antitumor properties of their extracts. The purpose of this investigation was to ascertain whether T. vulgaris had any cytotoxic effects on two different breast cancer cell lines. MTT test was applied to evaluate the effect of T. vulgaris on cell viability. TUNEL method was used to determine its apoptotic effect. LC3 and Beclin-1 expression levels were determined by immunofluorescence staining method and its autophagic effect was evaluated. Our findings demonstrate that T. vulgaris greately lowers proliferation, both in terms of concentration and duration. Consistent with decreased proliferation, an increase in apoptotic and autophagic cell death were also observed. The migration capacity of MCF-7 and MDA-MB-231 breast cancer cells was greatly suppressed by T. vulgaris, while significantly reducing colony formation. This study is the first to look into how T. vulgaris methanol extract affects breast cancer cells. All of these findings demonstrate that T. vulgaris prevents breast cancer cells from developing a malignant phenotype. It is possible to say that the methanol extract of T. vulgaris is suitable for the treatment of breast cancer, including aggressive types. However, in vivo research should support these results.
Cognitive assessment in primary care
Authors: Clevenger Carolyn K. , Schlenger Alison , Gunter Debbie , Glasgow Glenna Brewster 
Published: June 2023

Abstract:
Primary care clinicians play a critical role in both the identification and management of cognitive impairment due to common diseases. Primary care practices should incorporate feasible, reliable, and helpful tools into existing workflow to recognize and support people living with dementia and their care partners.
The Statistical Fragility of Trials Comparing Cervical Disc Arthroplasty and Anterior Cervical Discectomy and Fusion
Authors: Ortiz-Babilonia Carlos D. , Gupta Arjun , Cartagena-Reyes Miguel A. , Xu Amy L. , Raad Micheal , Durand Wesley M. , Skolasky Richard L. , Jain Amit 
Published: June 2023

Study Design.
Meta-analysis

Objective.
Assess the robustness of randomized controlled trials (RCTs) that compared cervical disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) for the treatment of symptomatic degenerative cervical pathology by using fragility indices.

Summary of Background Data.
RCTs comparing these surgical approaches have shown that CDA may be equivalent or even superior to ACDF due to better preservation of normal spinal kinematics.

Methods.
RCTs reporting clinical outcomes after CDA versus ACDF for degenerative cervical disc disease were evaluated. Data for outcome measures were classified as continuous or dichotomous. Continuous outcomes included: Neck Disability Index (NDI), overall pain, neck pain, radicular arm pain, and modified Japanese Orthopaedic Association (mJOA) scores. Dichotomous outcomes included: any adjacent segment disease (ASD), superior-level ASD, and inferior-level ASD. The fragility index (FI) and continuous FI (CFI) were determined for dichotomous and continuous outcomes, respectively. The corresponding fragility quotient (FQ) and continuous FQ (CFQ) were calculated by dividing FI/CFI by sample size.

Results.
Twenty-five studies (78 outcome events) were included. Thirteen dichotomous events had a median FI of 7 (IQR: 3–10) and the median FQ was 0.043 (IQR: 0.035–0.066). Sixty-five continuous events had a median CFI of 14 (IQR: 9–22) and median CFQ of 0.145 (IQR: 0.074–0.188). This indicates that, on average, altering the outcome of 4.3 patients out of 100 for the dichotomous outcomes, and 14.5 out of 100 for continuous outcomes, would reverse trial significance. Of the 13 dichotomous events that included lost to follow-up data, 8 (61.5%) represented ≥7 patients lost. Of the 65 continuous events reporting lost to follow-up data, 22 (33.8%) represented ≥14 patients lost.

Conclusion.
RCTs comparing ACDF and CDA have fair to moderate statistical robustness and do not suffer from statistical fragility.
Preoperative Symptom Duration Influences Neurological Recovery and Patient　Reported Outcome Measures After Surgical Treatment of Cervical Ossification of the Posterior Longitudinal Ligament
Authors: Matsukura Yu , Egawa Satoru , Inose Hiroyuki , Sakai Kenichiro , Kusano Kazuo , Tsutsui Shunji , Hirai Takashi , Matsukura Yu , Wada Kanichiro , Katsumi Keiichi , Koda Masao , Kimura Atsushi , Furuya Takeo , Maki Satoshi , Nagoshi Narihito , Nishida Norihiro , Nagamoto Yukitaka , Oshima Yasushi , Ando Kei , Nakashima Hiroaki , Takahata Masahiko , Mori Kanji , Nakajima Hideaki , Murata Kazuma , Miyagi Masayuki , Kaito Takashi , Yamada Kei , Banno Tomohiro , Kato Satoshi , Ohba Tetsuro , Moridaira Hiroshi , Fujibayashi Shunsuke , Katoh Hiroyuki , Kanno Haruo , Taneichi Hiroshi , Imagama Shiro , Kawaguchi Yoshiharu , Takeshita Katsushi , Nakamura Masaya , Matsumoto Morio , Yamazaki Masashi , Okawa Atsushi , Yoshii Toshitaka 
Published: June 2023

Study Design:
A prospective multicenter study.

Objective:
To investigate the effect of preoperative symptom duration on neurological recovery for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL).

Summary of Background Data:
The optimal timing to perform surgery in the setting of cervical OPLL remains unknown. It is important to know the influence of symptom duration on postoperative outcomes to facilitate discussions regarding the timing of surgery.

Methods:
The study included 395 patients (291 men and 104 women, mean age 63.7±11.4 y): 204 treated with laminoplasty, 90 with posterior decompression and fusion, 85 with anterior decompression and fusion, and 16 with other procedures. The Japanese Orthopedic Association (JOA) score and patient reported outcomes of JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) were used to assess clinical outcomes preoperatively and two years following surgery. Logistic regression analysis was used to identify factors associated with achievement of MCID following surgery.

Results:
The recovery rate was significantly lower in the group with symptom duration of ≥5 years compared to the groups with durations of <0.5 years, 0.5–1 year, and 1-2 years. Improvement of JOACMEQ in the upper extremity function score (P<0.001), lower extremity function (P=0.039), quality of life (P=0.053) and bladder function (P=0.034) were all decreased when the symptom duration exceeded 2 years. Duration of symptoms (P=0.001), age (P<0.001), and BMI (P<0.001) were significantly associated with the achievement of MCID. The cutoff value we established for symptom duration was 23 months (AUC 0.616, sensitivity 67.4%; specificity 53.5%).

Conclusions:
Symptom duration had a significant impact on neurological recovery and patient reported outcome measures in this series of patients undergoing surgery for cervical OPLL. Patients with symptom duration exceeding 23 months may be at greater risk of failing to achieve MCID after surgery.

Level of Evidence:
3.
Does the 2017 global initiative for chronic obstructive lung disease revision really improve the assessment of Chinese chronic obstructive pulmonary disease patients? A multicenter prospective study for more than 5 years
Authors: Cui Yanan , Ma Yiming , Dai Zhongshang , Long Yingjiao , Chen Yan 
Published: June 2023

Abstract

Background:
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 proposed a new classification that reclassified many chronic obstructive pulmonary disease (COPD) patients from group D to B. However, there is a paucity of data related to the comparison between reclassified and non-reclassified COPD patients in terms of long-term prognosis. This study aimed to investigate long-term outcomes of them and determine whether the GOLD 2017 revision improved the assessment of COPD patients.

Methods:
This observational, multicenter, prospective study recruited outpatients at 12 tertiary hospitals in China from November 2016 to February 2018 and followed them up until February 2022. All enrolled patients were classified into groups A to D based on GOLD 2017, and the subjects in group B included patients reclassified from group D to B (group DB) and those remaining in group B (group BB). Incidence rates and hazard ratios (HRs) were calculated for the exacerbation of COPD and hospitalization in each group.

Results:
We included and followed up 845 patients. During the first year of follow-up, the GOLD 2017 classification had a better discrimination ability for different risks of COPD exacerbation and hospitalization than GOLD 2013. Group DB was associated with a higher risk of moderate-to-severe exacerbation (HR = 1.88, 95% confidence interval [CI] = 1.37–2.59, P < 0.001) and hospitalization for COPD exacerbation (HR = 2.23, 95% CI = 1.29–3.85, P = 0.004) than group BB. However, during the last year of follow-up, the differences in the risks of frequent exacerbations and hospitalizations between group DB and BB were not statistically significant (frequent exacerbations: HR = 1.02, 95% CI = 0.51–2.03, P = 0.955; frequent hospitalizations: HR = 1.66, 95% CI = 0.58–4.78, P = 0.348). The mortality rates of the two groups were both approximately 9.0% during the entire follow-up period.

Conclusions:
The long-term prognosis of patients reclassified into group B and of those remaining in group B was similar, although patients reclassified from group D to group B had worse short-term outcomes. The GOLD 2017 revision could improve the assessment of Chinese COPD patients in terms of long-term prognosis.