bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary malignant melanoma of the esophagus successfully treated with camrelizumab: A case report and literature review*
Authors: Lin Gaoyang , Zheng Xin , Wang Fuman , Xing Daijun , Cao Yufeng 
Published: June 2023

Abstract
An 83-year-old Chinese woman presented with a 3-month history of dysphagia. She also had a history of hypertension, type 2 diabetes, fundus hemorrhage, and cataract but no history of cutaneous, ocular, or other-site melanomas. Upper gastrointestinal tract angiography revealed gastritis and duodenal diverticulum; thus, an endoscopic review was recommended. Enhanced computed tomography of the chest and upper abdomen revealed the following: (1) Esophageal space-occupying lesions and mediastinal lymph node enlargement (considering the high possibility of esophageal cancer, further endoscopy was recommended) and (2) A small amount of right pleural effusion, with no significant lymph node infiltration or distant metastasis. Esophagoscopy identified a bulge mass blocking the esophagus from 23 to 30 cm from the incisors. The upper mass had a spherical clustering, while the lower mass significantly festered. Pathological biopsy samples were obtained from the esophagus 23 and 28 cm from the incisors. Tissue biopsy showed proliferation of large round tumor cells and melanocytes. Immunohistochemistry showed positive findings for HMB45 and MelanA; partially positive findings for S100, CK7, CK5/6, CAM5.2, LCA, P63, and TTF-1; and negative findings for Syn. The Ki-67 positivity index was approximately 60%. Based on these findings, the patient was diagnosed with malignant esophageal melanoma with enlarged mediastinal lymph nodes. She was then treated with five cycles of camrelizumab therapy combined with chemotherapy from October 18, 2019, to May 5, 2020. Gastroscopy review following two courses of combination therapy revealed that the esophagus was 23-25 cm away from the incisors, and there were two continuous uplifted and beaded masses that had a smooth and black surface, with each of them having a length and diameter of approximately 1 cm. Melanosis of the mucosa around the lumen was observed at 40 cm from the incisors to the cardia; the dentate margin was clear; and the cardia had no stenosis. The patient then received five courses of combination therapy and became consistently stable after partial remission. No severe adverse events related to the immunotherapy were recorded. Camrelizumab may be a viable treatment option for patients with PMME. Additional evidence from future clinical trials and research is necessary to fully validate our findings.
The interaction between end-metabolites and immune escape
Authors: Zhu Tong , Wang Guihua 
Published: June 2023

Abstract
Emerging data from metabolites-relating trails in cancers demonstrate that a common mechanism of resistance to many novel classes of immune therapeutics is the emergence of immune escape due to the reprogramming of cellular metabolism. Among them, current work about end-metabolites mostly focuses on the intersection between lactate acid, adenosine, reactive oxygen species (ROS), and tumour immune escape. In this article, we aim to review the evidence to date for the dynamic interplay between the three end-metabolites and tumour immune escape for potential approaches to overcome obstacles in the efficacy and durability of immune cancer therapies. We have organized known end-metabolites-associated immune escape mechanisms into three hallmarks: (1) decreased immunogenicity of cancer cells which constitutes defective antigen presentation and the attenuated expression of costimulatory molecules on tumour cells, (2) immunosuppressive microenvironment with aberrant angiogenesis inhibits the differentiation, maturation, and immune deviation of immune cells while drives the activation of immunosuppressive cells by immune-suppressive mediators (cytokines and other factors), (3) immune tolerance retained by inhibitory molecules and depletion of immune cells.
Construction and validation of a prognostic risk model for uterine corpus endometrial carcinoma based on alternative splicing events*
Authors: Cheng Yi , Li Long , Gong Chen , Qin Kai 
Published: June 2023

Abstract

Objective
To establish a prognostic risk model for uterine corpus endometrial carcinoma (UCEC) based on alternative splicing (AS) event data from The Cancer Genome Atlas (TCGA) and assess the accuracy of the model.

Methods
TCGA and SpliceSeq databases were used to acquire a summary of AS events and clinical data related to UCEC. Bioinformatic analysis was performed to identify differentially expressed AS events in UCEC. Least absolute shrinkage and selection operator (LASSO) regression and multivariate Cox regression analyses were used for constructing a prognostic risk model. Next, using the receiver operating characteristic (ROC) curve, Kaplan-Meier survival analysis, and independent prognostic analysis, we assessed the accuracy of the model. In addition, a splicing network was established based on the association between potential splicing factors and AS events.

Results
We downloaded clinical data and AS events of 527 UCEC cases from TCGA and SpliceSeq databases, respectively. We obtained 18,779 survival-associated AS events in UCEC using univariate Cox regression analysis and 487 AS events using LASSO regression analysis. Multivariate Cox regression analysis established a prognostic risk model for UCEC based on the percentage splicing value of 13 AS events. Independent prognostic effect on UCEC risk was then assessed using multivariate and univariate Cox regression analyses (P < 0.001). The area under the curve was 0.827. The pathological stage and risk score were independent prognostic factors for UCEC. Herein, we established a regulatory network between alternative endometrial cancer-related splicing events and splicing factors.

Conclusion
We constructed a prognostic model of UCEC based on 13 AS events by analyzing datasets from TCGA and SpliceSeq databases with medium accuracy. The pathological stage and risk score were independent prognostic factors in the prognostic risk model.
Development of a redox-related prognostic signature for predicting biochemical-recurrence-free survival of prostate cancer*
Authors: Hu Peng , Song Guoda , Chen Bingliang , Miao Jianping 
Published: June 2023

Abstract

Objective
Prostate cancer (PCa) is one of the most common malignancies among elderly males. However, effective prognostic biomarkers are currently lacking. Bioinformatic analysis was used to identify patients at high risk of biochemical recurrence (BCR).

Methods
In our study, RNA sequencing and clinical data were downloaded from The Cancer Genome Atlas (TCGA) dataset to serve as the training and internal validation sets. The GSE84042 dataset was used as the external validation set. Batch effects were removed and normalized for the two datasets using “sva” package. Univariate Cox, least absolute shrinkage and selection operator (LASSO) Cox, and multivariate Cox regression analyses were successively performed to identify the redox-related gene (RRG) signature. After performing univariate Cox, LASSO Cox, and multivariate Cox regression analyses, a signature consisting of seven RRGs was established to predict BCR of patients with PCa, which included TP53, ADH5, SRRT, SLC24A2, COL1A1, CSF3R, and TEX19. Kaplan-Meier and receiver operating characteristic curve analyses showed good performance for the prognostic signature in the training and validation datasets.

Results
Univariate and multivariate Cox analyses showed that the RRG signature was an independent prognostic factor for BCR of patients with PCa. Thereafter, the nomogram results revealed that it was able to predict BCR of patients with PCa with high efficiency.

Conclusion
This study identified an independent prognostic signature and established a nomogram to predict BCR in PCa. This signature can be used to identify patients with PCa with a high risk of BCR, and personalized treatment can be applied.
Advances in pharmacotherapies in cancer-related cachexia*
Authors: Ouyang Ze , Tao Weili , Yu Shiying , Zou Man 
Published: June 2023

Abstract
Cancer-related cachexia is highly prevalent in patients with advanced cancer, affecting approximately 50%-80% of patients and seriously interfering with active therapy, quality of life, and survival time. There are currently no effective treatments for cachexia. Therefore, new therapeutic strategies are required. In recent years, advances in understanding the mechanisms underlying cachexia have been made, and new drugs have been developed to combat cachexia muscle wasting and weight loss due to cancer. In this systematic review, we discuss these novel targets and drug treatments.
Morphological plasticity of six tree species with different light demands growing in multi-layered deciduous forests in Central Europe
Authors: Bartkowicz Leszek , Paluch Jarosław 
Published: June 2023

AbstractTree allometry is a plastic feature, and scaling parameters can vary considerably depending on phylogeny, life strategies, growth conditions and ontogeny. We hypothesized that in multi-layered forests growing on rich sites and driven by stand dynamics without stand-replacing disturbances, light is a primary driver of allometric relationships and that the morphological plasticity of tree species is closely associated with their shade tolerance. We quantified and compared the morphological properties of six species that form a shade tolerance gradient: Alnus glutinosa (L.) Gaertner, Quercus robur L., Fraxinus excelsior L., Ulmus laevis Pall., Tilia cordata Miller and Carpinus betulus L. The relationships between tree height and local stand density as predictors and dbh, crown width, crown length and crown volume as response variables were characterized. We found that in the lower stand layer the values of crown parameters increased with tree height at a lower rate in light-adapted than in shade-tolerant species. Conversely, the response of morphological traits on competition was stronger in light-adapted species than in shade-tolerant species. The ratio of crown width-to-crown length was not associated with light demand. Apart from ash, which demonstrated a different allocation pattern, between-species differences in the slenderness ratio were insignificant. Allometry and sensitivity to competition varied in trees growing in the upper and lower stand layers. Our results indicate that the dichotomy of basic growth strategies of stress tolerance versus stress avoidance is overly simplistic and fails to consider social status and species-specific features such as apical control.
European forest sinks and climate targets: past trends, main drivers, and future forecasts
Authors: Hyyrynen Matti , Ollikainen Markku , Seppälä Jyri 
Published: June 2023

AbstractWe examine the evolution of European net sinks towards 2030 and the European Union’s (EU) climate neutrality target by 2050. The EU’s current land use policy for 2021–2030 is divided into two periods: 2021–2025 and 2026–2030. The national inventory data from several databases and statistical analyses are used to examine the trends and drivers and to forecast future forest sinks and the net sinks of the land use, land use change and forestry (LULUCF) sector. Our forecasts suggest that national forest sinks will be short of the agreed forest reference levels in most member states in 2021–2025, with a total of 128 MtCO2eq. For 2026–2030, the net sink for the whole EU LULUCF sector will be short of the EU target by 298 MtCO2eq. Thus, most member states must design more efficient LULUCF policies to fulfil their national targets. Furthermore, the decreasing trends in the LULUCF sinks also emphasize the need to reduce emissions and to increase the sinks in most member states so that the EU can achieve its climate neutrality goal by 2050.
Impact of smartphone use at bedtime on sleep quality and academic activities among medical students at Al -Azhar University at Cairo
Authors: Elsheikh Asmaa Abdelghany , Elsharkawy Safaa Abdelfattah , Ahmed Doaa Sadek 
Published: June 2023

Abstract
Aim
Smartphone use has become prevalent and rapidly expanding. Therefore, it is essential to determine the potential adverse effects. This study aims to assess the prevalence of smartphone use at bedtime and its association with sleep quality and educational-related activities among medical students.

Subject and methods
The current cross-sectional study included 1184 male and female undergraduate medical students at Al-Azhar University in Cairo. We used a self-administered questionnaire to collect data on personal characteristics, smartphone use, and academic activities. The Pittsburgh sleep quality index ((PSQI) was used for the assessment of sleep quality.

Results
The result revealed that bedtime smartphone use was highly prevalent (96.5 %), with nearly half (46.9%) of studied medical students using them for more than 2 hours. Social media was at the top of the usage list (74.2%), followed by communication (48.8%). Smartphone users at bedtime had a significantly higher prevalence of poor sleep quality, increased sleep latency, difficulty in maintaining sleep, and shorter sleep duration compared to non-user (p-value<0.05). The probability of poor sleep quality is significantly increased by bedtime smartphone use, regular coffee drinking, hostel residence, and proximity of the phone during sleep, whereas the likelihood of poor sleep quality is significantly decreased by physical activity. A significant association between poor sleep quality and academic performance was also reported.

Conclusion
This study emphasizes the negative impact of smartphone use at bedtime on sleep quality and quantity, which in turn has a negative effect on academic performance. Therefore, medical students are strongly encouraged to limit their smartphone use before bedtime for better sleep and academic performance.
4MIDable: Flexible Network Offloading For Security VNFs
Authors: Lewis Benjamin , Broadbent Matthew , Rotsos Charalampos , Race Nicholas 
Published: June 2023

AbstractThe ever-growing volume of network traffic and widening adoption of Internet protocols to underpin common communication processes augments the importance of network security. In order to enforce network security policies, network managers adopt a widening set of middleboxes and network appliances to improve traffic monitoring and processing capabilities. The resource requirements to support network security appliances are constantly increasing, making efficiency of these systems an essential aspect. The move toward Software-Defined Networking and programmable data planes offers a mean to offload traffic processing functionalities to within the network itself. To this end, we present the 4MIDable framework: a platform that facilitates the integration of existing middleboxes and monitoring appliances with an SDN (P4) network infrastructure. We also present P4Protect, a 4MIDable agent that protects the network from control plane DoS attacks with negligible impact on control plane latency, and P4ID (P4-Enhanced Intrusion Detection), a 4MIDable agent that offers stateful processing and feedback to unmodified Intrusion Detection System middleboxes and reduces traffic processing by over 80% without affecting threat detection rates.
Applicability of leadership modes outside the negotiation framework: insights from China
Authors: Hurri Karoliina , Kopra Sanna 
Published: June 2023

AbstractDrawing insights from a qualitative content analysis of China’s national climate reports between 2016 and 2019, this article examines the extent to which classical leadership typologies introduced by Oran Young, Arild Underdal, and Raino Malnes in the early 1990s have explanatory power outside of international climate negotiation frameworks. Mode by mode, we assess the strengths and weaknesses of four classical leadership modes—directional, ideational, instrumental, and structural—to grasp the manifestation of international climate leadership in a domestic context. While the analysis points out some substantial weaknesses in classical leadership modes, it indicates that China has taken consistent efforts to offer climate leadership in a domestic context. Given the huge gap between the leadership literature and the planetary reality; however, the article concludes that the key shortcoming of the leadership literature is that it tends to focus exclusively on the negotiation phase of international climate politics. Therefore, prospective studies on climate leadership have to pay more attention to the locus of leadership.
Steady-State Transitions in Ordered Porous Media
Authors: Forslund T. O. M. , Larsson I. A. S. , Hellström J. G. I. , Lundström T. S. 
Published: June 2023

AbstractPreviously performed experiments on flow through an ordered porous media cell with tomographic particle image velocimetry reveal a complex three-dimensional steady-state flow pattern. This flow pattern emerge in the region where inertial structures have been previously reported for a wide range of packings. The onset of these steady-state inertial flow structures is here scrutinized for three different types of packing using a finite difference method. It is concluded that the onset of the flow structure coincides with a symmetry break in the flow field and discontinuities in the pressure drop, volume averaged body forces and heat transfer. A quantity for identifying the transition is proposed, namely the pressure integral across the solid surfaces. It is also shown that the transition can both increase and decrease the heat transfer dependent on the actual geometry of the porous medium.
Mechanical Characterisation and Simulation of the Tensile Behaviour of Polymeric Additively Manufactured Lattice Structures
Authors: Bruson D. , Galati M. , Calignano F. , Iuliano L. 
Published: June 2023

Abstract
Background
The mechanical properties of lattice structures have been primarily investigated using uniaxial compression loads. Particularly for polymers, tensile properties are rarely considered because of the difficulties of defining a suitable specimen design in which the fracture occurs within the gauge length.

Objective
This work proposes a novel formulation to obtain a specimen for the tensile test with a gradation of the lattice density at the interface with the bulk portion, which realises a uniform stress distribution. The aim is to combine a localisation of the fracture in the gauge length with a specimen geometry accomplishing the EN ISO 527 standard and analyse the correlation between the mechanical performance and the defects induced by the process on such thin structures.

Methods
The formulation is experimentally and numerically (FEM) tested by designed specimens with different cell topology, cell size, strut diameter, and number of cells in the sample thickness. Also, results from uniaxial compression tests are used to validate the tensile properties. The specimens are manufactured in different orientations in the building volume by laser powder bed fusion with Polyamide 12. The effects of the pores morphology, distribution, and inherent anisotropy are investigated using X-ray computed tomography analysis. This data is also used to tune a numerical model.

Results
The numerical analysis showed a uniform stress distribution; experimentally, the fracture is localised inside the gauge length in respect of the ISO standard. Remarkably, among the different strut-based architectures, the elongation at break is, in the best case, 50% of the corresponding bulk material, while the tensile strengths are comparable. Vertical printed specimens exhibited a slight decrease in tensile strength, and the elongation at break was lower than 50% compared to the counterparts built along the horizontal orientation. Modifying the numerical model according to process-related dimensional deviations between the actual and the nominal structures significantly improved the numerical results. The remaining deviation highlighted the incorrectness of modelling the lattice material from the bulk properties.

Conclusion
Density gradation is a reliable approach for describing the tensile behaviour of polymeric lattice structures. However, the lower amount of porosity and the different shape in the lattice led to a different material mechanical performance with respect to the corresponding bulk counterpart. Therefore, for polymeric lattice structures, the relationship between process-design-material appears crucial for correctly representing the structure behaviour.
Prediction of quality-adjusted life years (QALYs) after bariatric surgery using regularized linear regression models: results from a Swedish nationwide quality register
Authors: Sun Sun , Stenberg Erik , Lindholm Lars , Salén Klas-Göran , Franklin Karl A. , Luo Nan , Cao Yang 
Published: June 2023

Abstract
Purpose
To investigate whether the quality-adjusted life years (QALYs) of the patients who underwent bariatric surgery could be predicted using their baseline information.

Materials and Methods
All patients who received bariatric surgery in Sweden between January 1, 2011 and March 31, 2019 were obtained from the Scandinavian Obesity Surgery Registry (SOReg). Baseline information included patients’ sociodemographic characteristics, details regarding the procedure, and postsurgical conditions. QALYs were assessed by the SF-6D at follow-up years 1 and 2. The general and regularized linear regression models were used to predict postoperative QALYs.

Results
All regression models demonstrated satisfactory and comparable performance in predicting QALYs at follow-up year 1, with R2 and relative root mean squared error (RRMSE) values of about 0.57 and 9.6%, respectively. The performance of the general linear regression model increased with the number of variables; however, the improvement was ignorable when the number of variables was more than 30 and 50 for follow-up years 1 and 2, respectively. Although minor L1 and L2 regularization provided better prediction ability, the improvement was negligible when the number of variables was more than 20. All the models showed poorer performance for predicting QALYs at follow-up year 2.

Conclusions
Patient characteristics before bariatric surgery including health related quality of life, age, sex, BMI, postoperative complications within six weeks, and smoking status, may be adequate in predicting their postoperative QALYs after one year. Understanding these factors can help identify individuals who require more personalized and intensive support before, during, and after surgery.

Graphical Abstract
Self-reported symptoms after COVID-19 vaccination. Distinct sex, age, and geographical outcomes in Lebanese and Italian cohorts
Authors: Khalil Mohamad , Bonfrate Leonilde , Di Ciaula Agostino , Portincasa Piero ,   The LEITvax Group^, Abdallah Hala , Capurso Michela , Galerati Ilaria , Hayek Soukayna , Khalifeh Hala , Mastandrea Edoardo , Noto Antonino 
Published: June 2023

AbstractFollowing the COVID-19 discovery in December 2019, different vaccines were authorized in 2021 in Italy and Lebanon, but side effects and the impact of sex and age remained partly explored. We designed a web-based “Google Form” questionnaire to record self-reported systemic and local side effects up to 7 days after 1st and 2nd dose of the vaccine in two distinct Italian and Lebanese cohorts. Twenty-one questions in Italian and Arabic languages explored the prevalence and severity of 13 symptoms. Results were compared with respect to living country, timing, sex, and age classes. A total of 1,975 Italian subjects (age 42.9 ± SD16.8 years; 64.5% females) and 822 Lebanese subjects (age 32.5 ± SD15.9 years; 48.8% females) joined the study. The most common symptoms in both groups were injection site pain, weakness, and headache after the 1st and 2nd doses. The rate of post-vaccinal symptoms and the severity score were significantly higher in females than in males and progressively decreased with increasing age following both doses. We find that among two populations from the Mediterranean basin, the anti-COVID-19 vaccine generates mild age and sex-dependent adverse effects, with ethnic differences and prevalent symptoms rate and severity in females.