bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chemoradiotherapy in geriatric patients with squamous cell carcinoma of the esophagus: Multi-center analysis on the value of standard treatment in the elderly
Authors: Bostel Tilman , Akbaba Sati , Wollschläger Daniel , Mayer Arnulf , Nikolaidou Eirini , Murnik Markus , Kirste Simon , Rühle Alexander , Grosu Anca-Ligia , Debus Jürgen , Fottner Christian , Moehler Markus , Grimminger Peter , Schmidberger Heinz , Nicolay Nils Henrik 
Published: March 2023

Background and purposeTo evaluate the tolerability and outcomes of chemoradiation in elderly patients with locally advanced esophageal squamous cell carcinoma (ESCC).Materials and methodsThis multi-center retrospective analysis included 161 patients with SCC of the esophagus with a median age of 73 years (range 65-89 years) treated with definitive or neoadjuvant (chemo)radiotherapy between 2010 and 2019 at 3 large comprehensive cancer centers in Germany. Locoregional control (LRC), progression-free survival (PFS), distant metastasis-free survival (DMFS), overall survival (OS), and treatment-associated toxicities were analyzed, and parameters determining patient outcomes and treatment tolerance were assessed.ResultsThe delivery of radiotherapy without dose reduction was possible in 149 patients (93%). In 134 patients (83%), concomitant chemotherapy was initially prescribed; however, during the course of therapy, 41% of these patients (n = 55) required chemotherapy de-escalation due to treatment-related toxicities. Fifty-two patients (32%) experienced higher-grade acute toxicities, and 22 patients (14%) higher-grade late toxicities. The 2-year LRC, DMFS, PFS, and OS rates amounted to 67.5%, 33.8%, 31.4%, and 40.4%, respectively. Upon multivariate analysis, full-dose concomitant chemotherapy (vs. no or modified chemotherapy) was associated with significantly better DMFS (p=0.005), PFS (p=0.005) and OS (p=0.001). Furthermore, neoadjuvant chemoradiotherapy followed by tumor resection (vs. definitive chemoradiotherapy or definitive radiotherapy alone) significantly improved PFS (p=0.043) and OS (p=0.049). We could not identify any clinico-pathological factor that was significantly associated with LRC. Furthermore, definitive (chemo)radiotherapy, brachytherapy boost and stent implantation were significantly associated with higher-grade acute toxicities (p&lt;0.001, p=0.002 and p=0.04, respectively). The incidence of higher-grade late toxicities was also significantly associated with the choice of therapy, with a higher risk for late toxicities when treatment was switched from neoadjuvant to definitive (chemo)radiotherapy compared to primary definitive (chemo)radiotherapy (p&lt;0.001).ConclusionsChemoradiation with full-dose and unmodified concurrent chemotherapy has a favorable prognostic impact in elderly ESCC patients; however, about half of the analyzed patients required omission or adjustment of chemotherapy due to comorbidities or toxicities. Therefore, the identification of potential predictive factors for safe administration of concurrent chemotherapy in elderly ESCC patients requires further exploration to optimize treatment in this vulnerable patient cohort.
Survival analyses of different treatment modalities and clinical stage for hypopharyngeal carcinoma
Authors: Lin Tian-Yun , Lee Tsung-Lun , Hsu Yen-Bin , Tai Shyh-Kuan , Wang Ling-Wei , Yang Muh-Hwa , Chu Pen-Yuan 
Published: March 2023

ObjectiveWe investigated the effects of different treatment modalities and clinical stage for hypopharyngeal carcinoma (HPC) patients.MethodsBetween February 2004 and December 2012, 167 HPC patients were reviewed. We calculated overall survival (OS), progression-free survival (PFS), local failure-free survival (LFFS), regional failure-free survival (RFFS), and distant metastasis failure-free survival (DMFFS) using the Kaplan–Meier method and compared various survival outcomes between definitive chemoradiotherapy (CRT) and surgery-based therapy (SBT).ResultsThere were no significant differences in baseline characteristics between SBT (n = 102) and definitive CRT (n = 65) groups. The 5-year rates of OS (59.7% vs. 24.0%, p &lt; 0.0001) and PFS (49.9% vs. 22.6%, p = 0.0002) were significantly better in patients who received SBT than in those who received definitive CRT. The SBT group also obtained better LFFS (p &lt; 0.0001), RFFS (p = 0.0479), and DMFFS (p = 0.0110). We did similar analyses by different T-classification (T1–2, T3, and T4) and found that SBT had better OS (p &lt; 0.0001 and p = 0.0020), PFS (p &lt; 0.0001 and p = 0.0513), LFFS (p = 0.0002 and p = 0.0075), RFFS (p = 0.1949 and p = 0.0826), and DMFFS (p = 0.0248 and p = 0.0436) in the T4 and T1–2 subgroups but similar OS (p = 0.9598), PFS (p = 0.5052), RFFS (p = 0.9648), and DMFFS (p = 0.8239) in T3 patients. Analyses by different overall stages revealed no differences between definitive CRT and SBT for stage III patients but significantly better results for stage IV patients who received SBT.ConclusionsSBT can obtain significant survival benefits when compared with definitive CRT for the whole cohort of patients. Definitive CRT has similar survival outcomes compared with SBT only for T3 tumors or overall stage III disease.
FBXO43 increases CCND1 stability to promote hepatocellular carcinoma cell proliferation and migration
Authors: Li Chun-Ming , Zhang Jie , Wu Wu , Zhu Zhu , Li Feng , Wu Di , Wang Xiao-Jun , Xie Chuan-Ming , Gong Jian-Ping 
Published: March 2023

Background and AimsAbnormal expression of E3 ubiquitin ligase plays an important role in the development and progression of hepatocellular carcinoma (HCC), although the mechanism has remained elusive. This study aimed to investigate the biological function and potential mechanism of FBXO43 in HCC.MethodsFBXO43 expression in tissues and cells were detected by quantitative real-time PCR (qRT−PCR), Western blot, and immunohistochemistry (IHC). The Kaplan-Meier method and Cox regression analysis were used to explore the correlation between the expression level of FBXO43 and the clinical survival. MTT assay, EdU incorporation, colony formation, Transwell, and wound healing assays were performed to evaluate the function of FBXO43 in cell proliferation and migration in vitro. The interaction between FBXO43 and cyclin D1 (CCND1) was assessed by co-immunoprecipitation (Co-IP) assay and in vivo ubiquitination assay.ResultsWe found that FBXO43 was upregulated in HCC patient tissues and positively associated with poor clinicopathological features. Meanwhile, HCC patients with high expression of FBXO43 had shorter overall survival (OS) and disease-free survival (DFS). Furthermore, knockdown of FBXO43 inhibited HCC cell proliferation, migration and epithelial-mesenchymal transition (EMT) in HCC cells. Mechanistically, FBXO43 interacted with CCND1 and promoted its stability by polyubiquitination, leading to HCC cell proliferation, migration and EMT. Functional rescue experiments demonstrated that knockdown of CCND1 blocks FBXO43-mediated cell proliferation and metastasis.ConclusionsFBXO43, as an independent prognostic biomarker, promotes HCC cell proliferation, metastasis and EMT by stability of CCND1, which provides a new potential strategy for HCC treatment by targeting FBXO43-CCND1 axis.
SeDeM expert system with I-optimal mixture design for oral multiparticulate drug delivery: An encapsulated floating minitablets of loxoprofen Na and its in silico physiologically based pharmacokinetic modeling
Authors: Rauf-ur-Rehman  , Shoaib Muhammad Harris , Ahmed Farrukh Rafiq , Yousuf Rabia Ismail , Siddiqui Fahad , Saleem Muhammad Talha , Qazi Faaiza , Khan Momina Zarish , Irshad Asma , Bashir Lubna , Naz Shazia , Farooq Muhammad , Mahmood Zafar Alam 
Published: March 2023

Introduction: A SeDeM expert tool-driven I-optimal mixture design has been used to develop a directly compressible multiparticulate based extended release minitablets for gastro-retentive drug delivery systems using loxoprofen sodium as a model drug.Methods: Powder blends were subjected to stress drug-excipient compatibility studies using FTIR, thermogravimetric analysis, and DSC. SeDeM diagram expert tool was utilized to assess the suitability of the drug and excipients for direct compression. The formulations were designed using an I-optimal mixture design with proportions of methocel K100M, ethocel 10P and NaHCO3 as variables. Powder was compressed into minitablets and encapsulated. After physicochemical evaluation lag-time, floating time, and drug release were studied. Heckel analysis for yield pressure and accelerated stability studies were performed as per ICH guidelines. The in silico PBPK Advanced Compartmental and Transit model of GastroPlus™ was used for predicting in vivo pharmacokinetic parameters.Results: Drug release follows first-order kinetics with fickian diffusion as the main mechanism for most of the formulations; however, a few formulations followed anomalous transport as the mechanism of drug release. The in-silico-based pharmacokinetic revealed relative bioavailability of 97.0%.Discussion: SeDeM expert system effectively used in QbD based development of encapsulated multiparticulates for once daily administration of loxoprofen sodium having predictable in-vivo bioavailability.
Gel growth and characterization of Cs3Bi2Br9 perovskite single crystals for radiation detection
Authors: Alshogeathri Saqr , Cao Da , Kim Doup , Yang Ge 
Published: March 2023

Metal halide perovskites have been sought for ionizing radiation detection due to their tunable bandgap, high quantum yield, high absorption coefficient, excellent charge transport properties, flexible chemistry synthesis and cost-effective manufacturing. Among the family of perovskites, bismuth-based halide perovskites have attracted a rapidly growing interest as possible alternatives to lead-based halide perovskites in the development of nontoxic perovskites for opto-electronic devices. Herein, bismuth-based inorganic perovskite Cs3Bi2Br9 single crystals were successfully grown using an innovative dual-diffusion gel growth technique for the first time. Silica gel has been developed as an enabling medium for gel growth of single crystals due to its transparency and easy control of nucleation sites. The UV-vis transmission spectrum was recorded using a light source of deuterium and halogen lamps and a Tauc plot was obtained, which gave an estimate of the bandgap energy, 2.54 eV. Silver electrodes were used on the top surface and the bottom surface of Cs3Bi2Br9 single crystals for material characterization and detector tests. Current-voltage (I-V) measurements gave a room-temperature resistivity of 1.79×1011 Ω•cm. The Cs3Bi2Br9 single crystals were then tested for X-ray response using ON\OFF testing which revealed attractive responsiveness for X-ray photons (rise and fall time: ≈0.3 s ). Using the net current (IXray−Idark), which can be extracted from the X-ray response measurements at varied applied voltages, a modified Hecht fitting was applied to estimate the mobility-lifetime product of electrons, μτ=5.12×10−4 ±6.70×10−5 cm2/V for a Ag/Cs3Bi2Br9/Ag device. This study shows that our innovative crystal growth method, enabled by the unique gel growth process, can be used as an appealing technique to grow functional crystals for opto-electronic devices. Meanwhile, Cs3Bi2Br9 has shown great potential as a promising candidate for X-ray detection applications. The efforts in this work will serve as a metric for growing halide perovskites in the gel for opto-electronic devices.
Methods: Aortic wall deformation assessment by ultrafast ultrasound imaging: Application to bicuspid aortic valve associated aortopathy
Authors: Goudot Guillaume , Cheng Charles , Guédon Alexis F. , Mirault Tristan , Pedreira Olivier , Dahan Alexandre , Wang Louise Z. , Pernot Mathieu , Messas Emmanuel 
Published: March 2023

Purpose: Aortic maximal rate of systolic distention (MRSD) is a prognosis factor of ascending aorta dilatation with magnetic resonance imaging. Its calculation requires precise continuous tracking of the aortic diameter over the cardiac cycle, which is not feasible by focused ultrasound. We aimed to develop an automatic aortic acquisition using ultrafast ultrasound imaging (UUI) to provide access to the aortic MRSD.Methods: A phased array probe and developed sequences at 2000 frames/s were used. A created interface automatically tracked the anterior and posterior aortic walls over the cardiac cycle. Tissue Doppler allowed a precise estimation of the walls’ movements. MRSD was the maximum derivative of the aortic diameter curve over time. To assess its feasibility, 34 patients with bicuspid aortic valve (BAV) and 31 controls were consecutively included to evaluate the BAV-associated aortopathy at the sinus of Valsalva, the tubular ascending aorta, and the aortic arch.Results: UUI acquisitions and the dedicated interface allow tracking of the aortic diameter and calculating the MRSD for the BAV patients and controls (mean age of 34 vs. 43 years, p = 0.120). A trend toward lower deformation in the different aortic segments was observed, as expected. Still, only the MRSD with UUI was significantly different at the sinus of Valsalva in this small series: (0.61 .103.s–1 [0.37–0.72] for BAV patients vs. 0.92 .103.s–1 [0.72–1.02] for controls, p = 0.025).Conclusion: Aortic deformation evaluated with UUI deserves attention with a simple and automated measurement technique that could assess the segmental aortic injury associated with BAV.
Nurses' knowledge, barriers and practice in the care of patients with delirium in the intensive care unit in Poland—A cross-sectional study
Authors: Lange Sandra , Mȩdrzycka-Da̧browska Wioletta , Tomaszek Lucyna , Wujtewicz Magdalena , Krupa Sabina 
Published: March 2023

BackgroundDelirium is a cognitive disorder that occurs with high frequency in patients in intensive care units and affects patient outcomes. Despite recommendations for monitoring and assessing delirium in the ICU, studies show that it is still not routinely assessed and often remains undiagnosed or misinterpreted as dementia or depression.AimThe aim of this study was (1) to assess nurses' knowledge and clinical practices regarding delirium, (2) to identify the factors associated with nurses' knowledge, and (3) to define barriers to effective control of delirium.MethodsA cross-sectional study was conducted among 371 ICU nurses in Poland.Results53.1% of nurses had never been educated on delirium control resulting in a deficit in knowledge of delirium symptoms, risk factors and complications associated with delirium in ICU patients. Master's degree in nursing (vs. Registered nurses + Bachelor's), female gender, and working in university hospital (vs. other) were positively correlated with nurse's knowledge, while age had a negative impact on knowledge. Delirium is a marginalized state in ICU patients, only 16.4% of nurses assessed delirium routinely and 35.8% assessed delirium occasionally, rarely using validated scales. Barriers to effective delirium control were primarily the lack of a requirement to assess delirium, the difficulty of assessing delirium in intubated patients and nurses' lack of confidence in their ability to use delirium assessment tools.ConclusionsThere is an urgent need to educate nurses about delirium and to make delirium assessment obligatory in clinical practice. The area of change should also include a hospital policy on delirium monitoring and management. The study was registered on ClinicalTrials.gov (NCT05384964).
Household polluting cooking fuels and adverse birth outcomes: An updated systematic review and meta-analysis
Authors: Luo Mengrui , Liu Tiancong , Ma Changcheng , Fang Jianwei , Zhao Zhiying , Wen Yu , Xia Yang , Zhao Yuhong , Ji Chao 
Published: March 2023

Background and aimThe current study aimed to clarify the association between household polluting cooking fuels and adverse birth outcomes using previously published articles.MethodsIn this systematic review and meta-analysis, a systematic literature search in PubMed, Embase, Web of Science, and Scopus databases were undertaken for relevant studies that had been published from inception to 16 January 2023. We calculated the overall odds ratio (OR) and 95% confidence interval (CI) for adverse birth outcomes [low birth weight (LBW), small for gestational age (SGA), stillbirth, and preterm birth (PTB)] associated with polluting cooking fuels (biomass, coal, and kerosene). Subgroup analysis and meta-regression were also conducted.ResultsWe included 16 cross-sectional, five case–control, and 11 cohort studies in the review. Polluting cooking fuels were found to be associated with LBW (OR: 1.37, 95% CI: 1.24, 1.52), SGA (OR: 1.48, 95% CI: 1.13, 1.94), stillbirth (OR: 1.38, 95% CI: 1.23, 1.55), and PTB (OR: 1.27, 95% CI: 1.19, 1.36). The results of most of the subgroup analyses were consistent with the main results. In the meta-regression of LBW, study design (cohort study: P &lt; 0.01; cross-sectional study: P &lt; 0.01) and sample size (≥ 1000: P &lt; 0.01) were the covariates associated with heterogeneity. Cooking fuel types (mixed fuel: P &lt; 0.05) were the potentially heterogeneous source in the SGA analysis.ConclusionThe use of household polluting cooking fuels could be associated with LBW, SGA, stillbirth, and PTB. The limited literature, observational study design, exposure and outcome assessment, and residual confounding suggest that further strong epidemiological evidence with improved and standardized data was required to assess health risks from particular fuels and technologies utilized.
Risky sexual behaviors and their associated factors within high school students from Collège Saint André in Kigali, Rwanda: An institution-based cross-sectional study
Authors: Ndagijimana Emmanuel , Biracyaza Emmanuel , Nzayirambaho Manasse 
Published: March 2023

BackgroundRisky sexual behaviors (RSBs) remain public health concerns in adolescents from sub-Saharan Africa (SSA), and these practices may increase vulnerability to reproductive health problems if no early healthcare strategies are implemented. While previous studies reported that adolescents are engaged in these RSBs due to diverse influences such as the teenage stage, urbanization, and change in the environment they experience, there is a shortage of studies on RSB among adolescents in SSA. This study assessed the magnitude of RSBs and the RSB-associated factors among in-school adolescents.MethodsSchool-based cross-sectional study was conducted among 263 Saint Andre school students in Kigali, Rwanda, from July 3, 2020, to September 30, 2020. Systematic random sampling techniques were employed. All data were entered into Epi-Data and analyzed using SPSS version 25. Chi-square tests and multivariable logistic regression analyses were applied to determine factors associated with risky sexual behaviors. Confidence intervals (CIs) of 95% and 5% for statistical significance were maintained.ResultsOf 263 participants, 109 (41%) experienced RSB in their lifetime. Among them, 66 respondents (60.55%) utilized contraceptive methods to prevent sexual and reproductive problems that can be caused by unprotected sexual intercourse. The students who experienced domestic violence had increased odds of experiencing RSB [odds ratio (OR) = 4.22; 95% CI: 1.6–11.23] than their counterparts. Those in grade 11 (OR = 2.68; 95% CI: 1.06–6.78) and grade 12 (OR = 4.39; 95% CI: 1.82–10.56) were more likely to practice RSB than those in grade 10. Alcohol users were almost more likely to experience RSB (OR = 3.9; 95% CI: 1.97–5.5) than their counterparts. Those who lived away from their biological parents had higher likelihood of experiencing RSB (OR = 2.5; 95% CI: 1.14–4.42) than those who lived with one or both parents. Students who experienced peer pressure were more likely to engage in RSB (OR = 3.9; 95% CI: 2.01–7.51) than their counterparts.ConclusionPromoting specific intervention programs built upon the factors associated with RSB among high school students needs to be prioritized.
Application of Clavien–Dindo classfication-grade in evaluating overall efficacy of laparoscopic pancreaticoduodenectomy
Authors: Song Xiangyang , Ma Yu , Shi Hongyun , Liu Yahui 
Published: March 2023

BackgroundThe Clavien–Dindo classification (CDC) has been widely accepted and applied in clinical practice. We investigated its effectiveness in prediction of major complications (LPPC) after laparoscopic pancreaticoduodenectomy (LPD) and associated risk factors.MethodsA retrospective analysis was conducted covering clinical data of 793 patients undergoing LPD from April 2015 to November 2021. CDC was utilized to grade postoperative complications and analyze the differences. Risk factors of LPPC were identified according to univariate and multivariate analyses.ReslutsFor the 793 patients undergoing laparoscopic pancreaticoduodenectomy in the northeast of China, LPPC was reported in 260 (32.8%) patients, pancreatic fistula in 169 (21.3%), biliary fistula in 44 (5.5%), delayed gastric emptying in 17(2.1%), post pancreatectomy hemorrhage in 55 (6.9%), intestinal fistula in 7 (0.8%), abdominal infections in 59 (7.4%) and pulmonary complication in 28 (3.5%). All complications were classified into five levels with the C–D classification (Grade I–V), with 83 (31.9%) patients as grade I, 91 (35.0%) as grade II, 38 (14.6%) as grade IIIa, 24 (9.2%) as grade IIIb, 9 (3.5%) as grade IV and 15 (5.8%) as grade V. 86 (10.8%) patients experienced major complications (grade III–V).The results of univariate and multivariate analysis revealed the independent risk factors for laparoscopic pancreaticoduodenectomy complications to be preoperative total bilirubin (P = 0.029, OR = 1.523), soft pancreas texture (P &lt; 0.001, OR = 1.399), male (P = 0.038, OR = 1.396) and intraoperative transfusion (P = 0.033, OR = 1.517). Preoperative total bilirubin (P = 0.036, OR = 1.906) and intraoperative transfusions (P = 0.004, OR = 2.123) were independently associated with major postoperative complications. The influence of different bilirubin levels on C–D grade of complications was statistically significant (P = 0.036, OR = 1.906).ConclusionsThe Clavien–Dindo classification (CDC) may serve as a valid tool to predict major postoperative complications and contribute to perioperative management and comparison of surgical techniques in different medical centers.