bluuebunny/crossref_metadata_2025_split huggingface dataset:
The synergistic anticancer effects of apatinib combined with PD-L1 inhibitor on breast cancer
Authors: Han Danyang , Hu Hongxia , Li Jing , Liu Zhiwei , Li Xinyang , Wang Ziming , Chang Yongchao , Wang Xinshuai 
Published: March 2022

Abstract
Purpose: Apatinib have potential anti-angiogenic and anti-tumor activities in breast cancer. PD-L1 inhibitor also has a good effect on breast cancer . In this study we aimed to discuss the synergistic effect of apatinib combined with PD-L1 inhibitor and explore its mechanisms in breast cancer. Method: We investigated the synergistic effects of apatinib and PD-L1 inhibitor on breast cancer in vitro and in vivo. MTT assay, Wound-healing, and transwell invasion assays were used to determine the effects of apatinib and PD-L1 inhibitor on cell proliferation, migration, and invasion of MCF-7 and MDA-MB-231 cells in vitro. Western blotting was performed to assess the expression of Erk, p-Erk, NF-κB and slug. In vivo, xenograft model were established to test the effect of single drug or the combined therapy in the nude mice.Results: The results indicated that apatinib and PD-L1 inhibitor significantly inhibit proliferation, migration and invasion of MCF-7 and MDA-MB-231 cells. The combined treatment showed synergistic anticancer activities. Moreover, apatinib and PD-L1 inhibitor significantly downregulated the expression of p-Erk, NF-κB and slug in breast cancer cells. Conclusion: Apatinib and PD-L1 inhibitor show synergistic effects both in vitro and in vivo,which may provide a more effective treatment option for breast cancer patients.
Disparities in Place of Death for Patients with Primary Brain Tumors and Brain Metastases in the United States
Authors: Shenker Rachel , McLaughlin Mary Elizabeth , Chino Fumiko , Chino Junzo 
Published: March 2022

Abstract
Purpose
Patients with primary or metastatic brain tumors often require intensive end-of-life care, for which place of death may serve as a quality metric. Death at home or hospice are considered a more ‘ideal’ location. Comprehensive information on place of death of people with brain tumors is lacking.
Methods
Using CDC Wonder Database data, those who died in the U.S. from a solid cancer from 2003 to 2016 were included and place of death for those with primary brain, brain metastases, and solid non-brain tumors were compared. Multivariate logistic regression tested for disparities in place of death.
Results
By 2016, 51.1% of patients with primary brain tumors and 45.2% with brain metastases died at home. 15.9% of patients with primary brain tumors and 23.6% with brain metastases died in the hospital. Black patients were least likely to die at home or hospice. For patients with primary brain tumors, being married (OR = 2.25 (95%CI 2.16–2.34), p < 0.01) and having an advanced degree (OR = 1.204 (95%CI 1.15–1.26), p < 0.01) increased odds of home/hospice death; older age (OR = 0.50 (95%CI 0.46–0.54), p < 0.01) decreased odds for home/hospice death. For patients with brain metastases, being married (OR = 2.19 (95%CI 2.11–2.26), p < 0.01) increased odds of home/hospice death and male sex (OR = 0.87 (095%CI .85–0.89), p < 0.01) and older age (OR = 0.59 (95%CI 0.47–0.75), p < 0.01) decreased odds of home/hospice death.
Conclusion
Although the trends are improving, disparities exist in place of death in the brain tumor population. Focused interventions are indicated to increase the utilization of hospice in those with metastatic cancer, under-represented minority groups, and the elderly population.
Comparison of the accuracy of three methods measured the length of the right main stem bronchus by chest computed tomography as a guide to the use of right sided double-lumen tube
Authors: Liu Meiqi , Ma Zhongfeng , Zhao Li , Qi Xiaohang , yu Yang , Liang Shujuan , Yang Xiaochun , Liu Zhuo 
Published: March 2022

Abstract
Background
The variation of right main stem bronchus leads to the orifice of the right upper lobe bronchus may be obstructed or increase the incidence of malposition intraoperatively when the right sided double-lumen tube is used. Therefore, the aim of this study was to compare the accuracy of three methods measured the length of the right main stem bronchus via chest computed tomography as a guide to the use of right sided double-lumen tube.
Methods
In this study, 168 adult patients undergoing left sided thoracic surgery were included. All these patients were allocated to carina-proximal (C-P) group, carina-distal (C-D) group and carina-carina (C-C) group. The position of endobronchial cuff observed via Fiberoptic bronchoscopy after successful initial placement and after turning the patients to the lateral decubitus position, as well as the incidence of malposition of right sided double-lumen tube intraoperative were recorded to assess the accuracy of three methods in predicting the position of right sided double-lumen tube.
Results
The distance between the carina to the proximal margin of the right upper lobe orifice, carina to the distal margin of the right upper lobe orifice and carina to the first right interlobar carina of the right upper lobe orifice were 17.2 ± 2.3mm, 25.4 ± 3.7mm and 28.5 ± 3.1mm (P < 0.05). In the C-D group, the number of endobronchial cuffs seen to be herniating out of the carina, the number of bronchoscopies during initial placement and on the lateral position, the number of total malposition intraoperative and the number of reposition manoeuvres intraoperative were significantly less than the C-P group or the C-C group (P < 0.05)
Conclusions
The length of the right main stem bronchus measured by the carina to distal margin of right upper lobe orifice method was more accurate than the other two methods in guiding the use of right sided double-lumen tube.
Clinical trials registration number:
Clinical Trials. gov. no. NCT04127903. Registered at https://register.clinicaltrials.gov on 16/10/2019.
Higher leukocyte count is associated with lower presence of carotid lipid-rich necrotic core: a sub-study in the Plaque At RISK (PARISK) study
Authors: Velzen Twan J. van , Stolp Jeffrey , Dam-Nolen Dianne H.K. van , Kassem Mohamed , Hendrikse Jeroen , Kooi Eline (M. E.) , Bos Daniel , Nederkoorn Paul J. 
Published: March 2022

Abstract
Background Increasing evidence suggests that inflammation inside the vessel wall has a prominent role in atherosclerosis. In particular in carotid atherosclerosis, vulnerable plaque characteristics are strongly linked to an increased stroke risk. An association between leukocytes and plaque characteristics has not been investigated before and could help with gaining knowledge of inflammation in plaque vulnerability, which could contribute to a new target for intervention. In this study, we investigated the association of leukocyte count with carotid vulnerable plaque characteristics.Methods All patients from the Plaque At RISK (PARISK) study whom had complete data on leukocyte count and CTA- and MRI-based vulnerable plaque characteristics, were included. Univariable logistic regression was used to detect associations of leukocyte count with the separate vulnerable plaque characteristics (intra-plaque haemorrhage (IPH), lipid-rich-necrotic core (LRNC), thin or ruptured fibrous cap (TRFC, plaque ulceration and plaque calcifications). Subsequently, other known risk factors for stroke were included as covariates in a multivariable logistic regression model. Results 161 patients were eligible for inclusion in this study. Forty six (28.6%) of these patients were female with a mean age of 70 [IQR 64-74]. An association was found between higher leukocyte count and lower prevalence of LRNC (OR 0.818 (95% CI 0.687-0.975), while adjusting for covariates. No associations were found between leucocyte count and presence of IPH, TRFC, plaque ulceration or calcifications. Conclusions Leukocyte count is inversely associated with presence of LRNC in the atherosclerotic carotid plaque in patients with a recently symptomatic carotid stenosis. The exact role of leukocytes and inflammation in plaque vulnerability deserves further attention.
Intronic NEFH variant is associated with reduced risk for sporadic ALS and later age of disease onset
Authors: Theunissen Frances , Anderton Ryan S , Mastaglia Frank L , James Ian , Bedlack Richard , Akkari P. Anthony 
Published: March 2022

Abstract
Neurofilament heavy (NEFH) is one of the critical proteins required for the formation of the neuronal cytoskeleton and polymorphisms in NEFH are reported as a rare cause of sporadic ALS (sALS). In the current study, a candidate tetranucleotide (TTTA) repeat variant in NEFH was selected using an in-silico SSV evaluation algorithm and investigated in two cohorts of North American sALS patients, both separately and combined (Duke cohort n = 138, Coriell cohort n = 333; combined cohort n = 471), compared to a group of healthy controls from the Coriell Institute biobank (n = 496). Stratification according to site of disease onset revealed that the 9 TTTA allele was associated with a 2x reduced risk specifically confined to spinal-onset sALS patients in the Duke cohort (p = 0.001). Furthermore, carriage of the 10 TTTA allele was associated with a 2.7 year later age of disease onset in the larger combined sALS cohort (p = 0.02). These results suggest that the 9 and 10 TTTA motif length may have a protective advantage for potentially lowering the risk of sALS and delaying the age of disease onset, however these results need to be replicated in larger multicenter and multi-ethnic cohorts.
Comparison of Botulinum Toxin (BoNT) Injection and Lateral Internal Sphincterotomy (redo-LIS) for Recurrent Anal Fissure Treatment
Authors: Alyanak Ahmet , Gülen Merter , Ege Bahadır 
Published: March 2022

Abstract
Today’s gold standard for treating chronic anal fissure is the Lateral Internal Sphincterotomy (LIS). Botulinum Toxin (BoNT) injection is, on the other hand, an alternative treatment for patients who do not want to have surgical treatment, patients undergoing chemotherapy, patients of high risk for surgery, and those who have the risk of anal incontinence (e.g. elderly, past anorectal surgery, vaginal multiple births, etc.). The objective of this work is to compare the effectiveness of BoNT and redo-LIS for treatment of post-LIS recurrent chronic anal fissure, and reveal differences if any.PURPOSE : This study aims to compare the success rates of redo-LIS and BoNT injection for treating post-LIS recurrent anal fissure.METHODS :Prospectively prepared standard forms were evaluated retrospectively. Nineteen patients who received LIS treatment and then redo-LIS or BoNT injection due to recurrence in the follow-up were included in this study as they met the criteria for doing so. And their data were reviewed retrospectively. Their data on age, sex, healing duration, and anal incontinence scores and pain (VAS score) score as well. RESULTS : During the 6-month post-surgery follow-up period, there was statistically significant difference (p<0.01) between groups by pain. No deterioration in the incontinence scores of patients in the group during the 6-month post-surgery period.CONCLUSION :This study demonstrates that redo lateral internal sphincterotomy (LIS) is a reliable method for patients who received LIS but developed recurrent chronic anal fissure, and achieves successful results in terms of recurrence and relief of pain.
Multielectrode Balloon-type Dielectric Elastomer Actuator for 3-Degrees-of-Freedom Lens Actuation
Authors: Yoshimoto Shunsuke , Mitsubayashi Hiroki , Ikeda Sei , Yamamoto Akio 
Published: March 2022

Abstract
The use of dielectric elastomer actuators (DEA) in the development of compact and flexible tunable lens systems for microscopic imaging applications is appealing. However, there are still challenges with imaging system functionality and fabrication process easiness. In this paper, we proposed a multielectrode balloon-type DEA which is capable of tuning both the focus and optical axis of a lens system using 3-degrees-of-freedom movement of the DEA. We first investigated the DEA’s fundamental characteristics and found that effective microscale tangential and axial displacements were obtained up to approximately 10 Hz, and the displacements increased with applied voltage and air pressure. Assuming microscopic imaging application scenarios, we then conducted two-dimensional tracking and focus adjustment tests with a DEA-driven lens system. The result suggested that the position of the optical axis was successfully controlled using the captured image, and target images at different distances were successfully focused and defocused by the axial movement of the DEA.
Real-World experience of interictal burden and treatment in migraine: a qualitative interview study
Authors: Lo Siu Hing , Gallop Katy , Smith Timothy , Powell Lauren , Johnston Karissa , Hubig Lena Teresa , Williams Emma , Coric Vladimir , Harris Linda , L'Italien Gilbert , Lloyd Andrew J. 
Published: March 2022

Abstract
Background: The debilitating nature of migraine attacks is widely established; however, less is known about how the interictal burden (i.e., how patients are affected in-between migraine episodes) of migraine impacts on patients’ health-related quality of life (HRQL). Acute and preventive treatments may lift the burden of the disease, but they often have unwanted side effects and limited effectiveness. The objective of this study was to understand the interictal burden of migraines, from the patient perspective, and to explore patient experience with migraine treatments. Methods: Participants (n=35) with a self-reported diagnosis of migraine were recruited in the US, UK and Canada, including a subgroup of patients who had taken calcitonin gene-related peptide monoclonal antibody (CGRP mAb) treatment for ≥3 months. Participants completed a background questionnaire, followed by a semi-structured interview via telephone or video call. The interviews explored patients’ migraine symptoms, perception of interictal burden and treatment experience. The interview transcripts were analysed using thematic analysis.Results: The most reported migraine symptom was migraine pain, followed by aura, sensory sensitivity and nausea. Most participants reported interictal impact on HRQL, lifestyle changes they made to avoid triggers or in anticipation of an attack, impacts on work, career, daily activities and relationships. Emotional impacts were reported by all participants, including anger, depression, anxiety and hopelessness. Many participants who took preventive treatments reported improvements in HRQL and functioning but still experienced breakthrough attacks. Among patients who took CGRP mAbs, participants noted varying consistency of treatment effectiveness between treatment administrations.Conclusion: This study detailed the additional HRQL impact of migraine in-between migraine attacks and described the unmet need for effective treatment options to prevent and mitigate migraine attacks.Trial registration: Not applicable
The relationship between pan-immune-inflammation value and survival outcomes in patients with metastatic renal cell carcinoma treated with nivolumab in the second line and beyond: A Turkish Oncology Group Kidney Cancer Consortium (TKCC) study
Authors: Ürün Yüksel , Yekedüz Emre , Tural Deniz , Ertürk İsmail , Karakaya Serdar , Erol Cihan , Ercelep Özlem , Arslan Çağatay , Sever Özlem Nuray , Kılıçkap Saadettin , Öztaş Nihan Şentürk , Küçükarda Ahmet , Can Orçun , Öksüzoğlu Berna , Şendur Mehmet Ali , Karadurmuş Nuri 
Published: March 2022

Abstract
Background
Pan-immune-inflammation value (PIV) is an easily accessible immune marker based on peripheral blood to estimate prognosis in patients with cancer. This study evaluates the prognostic value of PIV in patients with metastatic renal cell carcinoma (mRCC) treated with nivolumab.
Methods
In this retrospective cohort study, patients with mRCC treated with nivolumab in the second line and beyond were selected from the Turkish Oncology Group Kidney Cancer Consortium (TKCC) database. PIV was calculated by using the following formula: neutrophil (103/mm3) x monocyte (103/mm3) x platelet (103/mm3) / lymphocyte (103/mm3).
Results
A total of 152 patients with mRCC were included in this study. According to cut-off value for PIV, 77 (50.7%) and 75 (49.3%) patients fell into PIV-low (\(\le\)372) and PIV-high (>372) groups, respectively. In multivariate analysis, PIV-high (HR:1.64, 95% CI: 1.04–2.58, p = 0.033 for overall survival (OS); HR:1.55, 95% CI: 1.02–2.38, p = 0.042 for progression-free survival (PFS)) was independent risk factor for OS and PFS after adjusting for confounding variables such as performance score, the International mRCC Database Consortium (IMDC) risk score, and liver metastasis.
Conclusion
This study established that pre-treatment PIV might be a prognostic biomarker in patients with mRCC treated with nivolumab in the second line and beyond.
Delayed acute onset of widespread macular lesions following COVID-19 booster vaccine case report
Authors: Kaszycki Margaret , Kaszycki Grazyna , Notaro William 
Published: March 2022

Abstract
Cutaneous reactions in response to the COVID-19 vaccination have even deemed the term “COVID-arm” which is described as a local localized erythematous rash surrounding the COVID-19 injection site within 72 hours. Other less common cutaneous reactions to the COVID-19 vaccinations include morbilliform, erythema multiforme, leukocytoclastic vasculitis, lupus and immune thrombocytopenic reactions are more rarely reported. In this report we discuss a case report of a man in his 50’s who experienced an acute onset of pruritic macular lesions four weeks post Pfizer’s COVID-19 booster vaccine. Patient denied fevers, chills, malaise, or anorexia. Patients past medical history is non-contributory apart from seasonal allergic rhinitis treated with nasal steroids. No new medications or treatments were started within the past three years. Patient also denies any immediate cutaneous reactions following the first two doses of the Pfizer COVID-19 vaccine. This patient has no prior history of hypersensitivity reactions to other vaccines or medications. Physical examination demonstrated well demarcated circinate erythematous lesions scattered on the trunk and extremities ranging in size from 1 – 5cm. The patient was treated with topical triamcinolone cream 0.5% twice daily and oral antihistamine. Significant improvement of the rash was observed within three days with complete resolution seen in one month. Over the past year, there has been growing collections of evidence depicting cutaneous reactions in response to not only COVID-19 but also the COVID-19 vaccine. However it is important to recognize that various cutaneous reactions can occur from the COVID-19 vaccine, at various time periods, and it is not a contraindication for further vaccinations as many rashes resolve with no long-lasting effects.
Trends in Hysteroscopic Endometrial Sampling in Women 70 Years and Older
Authors: Bar-On Shikma , Solomon Neta , Rattan Gilad , Ben-David Alon , Grisaru Dan 
Published: March 2022

Abstract
Background: Women 70 years of age or older with suspected endometrial pathologies would especially benefit from office hysteroscopy due to the risks of anesthesia and high rates of clinically significant findings in this age group. However, performing office hysteroscopy in those older patients can be technically challenging, and patient cooperation, which is essential for the success of the office procedure, may be compromised in this age group. The objective of the present study was to characterize the clinical and procedural features of office and operating-room hysteroscopy in women 70 years of age or older.Methods: This was a retrospective chart analysis of all women aged 70 years and older who underwent a hysteroscopy procedure in a single tertiary-care medical center between March 2011 and August 2018. We compared the clinical and procedural characteristics of patients who underwent hysteroscopy in our outpatient clinic to those who underwent hysteroscopy under anesthesia in the operating room. Primary outcomes included procedure success and histopathological findings. Secondary outcomes included short-term complications of the procedure. Results: The data of 577 patients were analyzed. The median age at the time of the procedure was 76 years. 225 office hysteroscopy procedures and 405 operating room procedures were included. Of the 236 patients with postmenopausal bleeding (PMB), 73 (30.9%) were diagnosed with having malignancy compared to 25/341 (7.3%) patients with no PMB (p < .001, odds ratio (OR) = 5.66; confidence interval (CI) 3.46-9.26). The office procedure was successful in 194 (87%) patients. Fifty-three patients required a second hysteroscopy, which revealed 12 cases of premalignant or malignant lesions. The volume of procedures in the office increased 16 times during the study period, and the diagnostic yield of new abnormal findings by means of the procedure in the office setting has increased over time. Operating room hysteroscopy had a higher rate of complications compared to office hysteroscopy, including mortalities related to the procedure.Conclusions: Office hysteroscopy for women over the age of 70 is safe, feasible, and reliable for diagnosis of endometrial malignancy. Failed hysteroscopy and a moderate-to-high index of suspicion for malignancy indicates the need for a repeat hysteroscopy.
Clinicohistopathological Correlation in Leprosy Lesions: Study in a Tertiary Care Institute in Chhattisgarh
Authors: Dambhare Poonam Tulshiram , Gupta Ashish Kumar , Hussain Nighat , Ganguly Satyaki 
Published: March 2022

Background: Leprosy is a chronic granulomatous infectious disease, caused by Mycobacterium leprae. Early diagnosis is important to prevent morbidity caused by leprosy. However, accurate clinical or histopathological diagnosis is challenging especially in early skin lesions and in mid-borderline leprosy which shows overlapping features. Hence clinicohistopathological correlation is of utmost importance for accurate diagnosis. This study was conducted to evaluate the predominant subtype of leprosy in patients visiting for treatment in a tertiary care hospital, Chhattisgarh during the post-elimination phase in India.
Methods: A retrospective study of 49 skin biopsies received from June 2019 to October 2020 was conducted in the Department of Pathology and Lab Medicine, AIIMS Raipur. Clinically suspected cases, outside diagnosed cases, and new lesions in treated cases of leprosy were included in this study. Clinical diagnosis was correlated with histopathological examination.
Results: Among 49 skin biopsies, 34 cases were diagnosed as leprosy on histopathological examination. There was no evidence of leprosy in the remaining 15 cases. The most common type was borderline tuberculoid (35.3%), followed by Erythema nodosum leprosum (20.6%). Three cases were associated with type 1 lepra reaction. Among 34 confirmed cases of leprosy, 17(50.0%) cases were positive for acid-fast bacilli by Fite Faraco stain on histological sections. Maximum cases belonged to the age group of 31-40 years and the male to female ratio was 5.8:1.
Conclusion: Histopathological examination of skin lesion along with Fite Faraco stain and clinical correlation is equally efficient for categorization and adequate treatment to achieve leprosy free world.