bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of elderly patients following thoracoscopic esophagectomy for esophageal cancer
Authors: Kuwabara Shirou , Kobayashi Kazuaki , Sudo Natsuru 
Published: May 2022

Abstract
Purpose: Thoracoscopic esophagectomy (TE) is widely used for esophageal cancer treatment. However, the short- and long-term outcomes of TE in older patients remain unknown. Thus, we investigated those outcomes as well as the effectivity of TE in this patient cohort.Methods: A total of 228 consecutive patients who underwent TE for esophageal cancer from 2002 to 2015 were included in the study and divided into the elderly (≥75 years) and non-elderly (<75 years) groups. The background was adjusted by propensity score matching. The short- and long-term outcomes were then compared between the two groups.Results: There was no difference in the short-term outcomes between the two groups. The elderly group had significantly lower overall survival (OS) and relapse-free survival (RFS) than the non-elderly group. When pulmonary complications occurred, the OS and RFS were significantly decreased in the elderly group but not in the non-elderly group. Without pulmonary complications, the OS and RFS in the elderly group did not differ from those in the non-elderly group. The multivariate analysis showed that pulmonary complications were independent poor prognostic factors for OS and RFS in the elderly group but not in the non-elderly group.Conclusion: Minimally invasive esophagectomy is safe and feasible for older patients. However, the OS and RFS of the elderly group were significantly worse than those of the non-elderly group, especially when pulmonary complications occurred. Therefore, perioperative management to prevent pulmonary complications is essential to improve the long-term outcomes of older patients receiving TE.
Generalised flat morphology, II: more properties and hybrid operators
Authors: ICube Christian RONSE 
Published: May 2022

Abstract
In a previous paper, we gave a new general theory of the construction of flat operators on grey-level or multivalued images from operators on binary images. While the traditional approach was based on threshold superposition, we rely instead on threshold summation, and this allows a correct formulation for non-increasing flat operators, and also for operators with non-binary outputs. We obtained then some basic properties of flat operators, valid for both increasing and non-increasing operators. Here we pursue this work by investigating further properties of flat operators, which differ in the increasing and non-increasing cases, in particular the composition, join and meet of operators, and the commutation with contrast mappings. We study dual-ity under inversion and characterise discrete linear convolution operators as flat operators. This allows to integrate various hybrid morphological operators into our framework.
Elasti̇ci̇ty of Leg Muscles and Ri̇sk of Falls İn Older Adults: a Prospecti̇ve Cohort Analysi̇s
Authors: Cavusoglu Cagatay , Sendur Halit Nahit , Cerit Mahi Nur , Candemir Burcu , Ileri Ibrahim , Borazan Funda Yildirim , Dogrul Rana Tuna , Goker Berna 
Published: May 2022

Abstract
Background: Aging impacts muscle strength and elasticity, which in turn influence dynamic balance, walking speed, and physical performance. We aimed to evaluate the relationship between the elasticity of leg muscles and the incidence of falls in older adults.Methods: We conducted a prospective cohort analysis with outpatients from a geriatric clinic. Participants underwent comprehensive geriatric assessments and timed up and go tests. Any history of fall in the past year was recorded. Elasticities of the gastrocnemius medialis and rectus femoris muscles were evaluated using shear wave elastography. All patients were asked to record their falls in a diary and additional phone calls were made each month. A regression analysis was performed to identify parameters associated with fall incidence during the follow-up period.Results: The median age of the included patients (n = 55) was 75 years (66–89); 72 % were women. The gastrocnemius muscle showed significantly lower elasticity in patients with a history of fall in the past year than in those without (8.08 kpa [3.90–16.17] vs. 9.70 kpa [4.99–20.95]; p = 0.028). A similar negative correlation between gastrocnemius elasticity and fall incidence was noted among those with additional falls during the follow-up period (6.96 kpa [3.90–12.41] vs. 9.13 kpa [4.99–20.95]; p = 0019). Gastrocnemius muscle elasticity was significantly correlated with the timed up and go test score (r = -0.612, p < 0.001), handgrip strength (r = 0.384, p = 0.015), and muscle thickness (r = 0,232, p = 0.049). No such associations were observed for the rectus femoris muscles.Conclusions:Gastrocnemius muscle elasticity is associated with alterations in muscle structure that may lead to falls in older adults; therefore, muscle elasticity may be a fall predictor in older adults.
Safety and efficacy of retrograde intrarenal surgery for urolithiasis in octogenarians
Authors: Koterazawa Shigeki , Kanno Toru , Takahashi Toshifumi , Somiya Shinya , Ito Katsuhiro , Haitani Takao , Arakaki Ryuichiro , Kawase Norio , Higashi Yoshihito , Yamada Hitoshi 
Published: May 2022

Abstract
Kidney stone disease is a common urological disorder worldwide. However, little evidence is reported to support retrograde intrarenal surgery (RIRS) for urolithiasis in octogenarians. Therefore, this study aimed to examine the safety and efficacy of RIRS for urolithiasis in octogenarians. A total of 1,207 patients were analyzed, 166 in the octogenarian patient group and 1041 in the younger patient group. The proportion of female patients (p < 0.001), American Society of Anesthesiologists (ASA) score (p < 0.001), rate of preoperative pyelonephritis (p < 0.001), and diabetes mellitus (p = 0.003) were higher in the octogenarian group than in the younger group. No statistically significant differences were found between the two groups in terms of stone size, location, operative time, and intraoperative complications. Postoperative complications, which reached a significant difference, were observed in 34 (20.5%) octogenarians and 117 (11.2%) younger patients (p = 0.002). However, age itself was not significantly associated with the occurrence of complications in multivariate analysis. Female sex (p < 0.001), ASA score of ≥ 3 (p = 0.045), history of diabetes mellitus (p = 0.029), and prolonged operative time (≥ 120 min) (p = 0.043) were the significant predictors of complications. The stone-free rate in the octogenarian group was superior to that in the younger patient group (80.1% vs. 68.2%, respectively; p = 0.014), indicating that RIRS in the octogenarians was an effective treatment with a high success rate. In conclusion, our results suggest that RIRS for urolithiasis can be safely and effectively applied to octogenarians in selected cases.
Intra-Carpal Injection of Ketorolac Compared with Triamcinolone for Carpal Tunnel Syndrome; A Randomized Controlled Trial
Authors: Karimzadeh Afshin , Esmaily Hadi , Esmaelzade Maryam , Aghamiri Seyed Hossein , Bolandnazar Najmeh 
Published: May 2022

Abstract
Introduction: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity that can be treated with surgical and non-surgical methods. Ketorolac, a nonsteroidal anti-inflammatory drug, is commonly used for musculoskeletal disorders, but its intra-carpal injection has not been studied. Therefore, we conducted a controlled trial to compare ketorolac with triamcinolone in CTS.Methods: In this blinded, randomized, controlled trial, patients with mild to moderate CTS were randomly allocated to two treatment groups to receive either a local injection of 30 mg ketorolac or 40 mg triamcinolone. Patients were evaluated based on the Boston Carpal Tunnel Questionnaire, electrodiagnostic findings, patient satisfaction, and any injection site reactions. Results: Finally 43 patients were completed the study according to the protocol. Both groups showed significant improvement in the visual analog scale (VAS) and Boston Questionnaire Symptom Severity Scale (BQ-SS), Boston Questionnaire Functional Status Scale (BQ-FS), and electrodiagnostic scores at 3 months were compared with the baseline (P < 0.001). Comparison of the groups showed significant differences with respect to VAS, BQ-FS, and BQ-SS, with the observed improvement being significantly higher in the triamcinolone group. There was no difference between the two groups regarding electrodiagnostic results, patient satisfaction, and injection complications.Conclusions: This study shows that injection of triamcinolone or ketorolac in patients with mild to moderate CTS resulted in improvement of pain, function, and electrodiagnostic findings; it also revealed that triamcinolone was superior to ketorolac in providing better analgesic effect and resulted in greater improvement in symptom severity and function.
Signature Construction and Molecular Subtype Identification Based on Immune-Related Genes for Better Prediction of Prognosis in Hepatocellular Carcinoma
Authors: Sun Liang , Wu Zhengyi , Dong Cairong , Huang He , Chen Zhendong , Wu Zhipeng , Yin Xiangbao , Yu Shian 
Published: May 2022

Abstract
Objective: Hepatocellular carcinoma (HCC) immunotherapy is a focus of current research. We established a model that can effectively predict the prognosis and efficacy of HCC immunotherapy by analyzing the immune genes of HCC.Methods: Through the data mining of hepatocellular carcinoma in The Cancer Genome Atlas (TCGA), the immune genes with differences in tumor and normal tissues are screened, and then the univariate regression analysis is carried out to screen the immune genes with differences related to prognosis. The prognosis model of immune related genes is constructed by using the minimum absolute contraction and selection operator (lasso) Cox regression model in the TCGA training set data, The risk score of each sample was calculated, and the survival was compared with the Kaplan Meier curve and the receiver operating characteristic (ROC) curve to evaluate the predictive ability. Data sets from ICGC and TCGA were used to verify the reliability of signatures. The correlation between clinicopathological features, immune infiltration, immune escape and risk score was analyzed.Results: Seven immune genes were finally determined as the prognostic model of liver cancer. According to these 7 genes, the samples were divided into the high and low risk groups, and the results suggested that the high-risk group had a poorer prognosis, lower risk of immune escape, and better immunotherapy effect. In addition, the expression of TP53 and MSI was positively correlated in the high-risk group. Consensus clustering was performed to identify two main molecular subtypes (named clusters 1 and 2) based on the signature. It was found that compared with cluster 1, better survival outcomes was observed in cluster 2.Conclusion: signature construction and molecular subtype identification of immune-related genes could be used to predict the prognosis of HCC, which may provide a specific reference for the development of novel biomarkers for HCC immunotherapy.
Clinical Findings in Patients with Nervous System Involvement Hospitalized at the COVID-19 Isolation Hospital in Alexandria University, Egypt: A Case Control Study
Authors: Abdelaziz Osama S. , Waffa Zuraiha , Abdelsalam Wael N. , Helmy Tamer A. , Nosseir Ayman A. 
Published: May 2022

Abstract
Background Global studies have exemplified that COVID-19 has neurological manifestations. This study gives an insight to the impact of COVID-19 on the nervous system in Alexandria, Egypt and identifies predictors of severity and mortality. MethodsThis single centre, case-control study was conducted from August 1st, 2020 to January 31st, 2021, on patients admitted at the COVID-19 Isolation Hospital in Alexandria University, Egypt. A Neuro-COVID patient was defined as confirmed COVID-19 case presenting with one or more new onset nervous system finding. ResultsOut of 1073 in-patients, 352 were Neuro-COVID patients (183 [52%] females and 169 [48%] males). The mean age was 36.64 ± 18.97 years and 161 (45.7%) had comorbidities. Most common involvement was neuromusculoskeletal system (240 [68.2%]), followed by central nervous system (164 [46.6%]) and peripheral nervous system (125 [35.5%]), whereas, psychiatric disorders (4 [1.1%]) were the least common. Myalgia (215 [61.1%]); anosmia (118 [33.5%]); headache (100 [28.4%]); ageusia (80 [22.7%]); altered level of consciousness (56 [15.9%]); arthralgia (43 [12.2%]) and dizziness (12 [3.4%]) were predominant presentations. Female Neuro-COVID patients were twice as more likely to be critical than moderate (P =0.030). Critical cases with nervous system presentations manifested 12 times higher risk of death when compared to severe cases (P <0.001). Conclusions Nervous system involvement was predominant and clinically significant in COVID-19. Disease severity was identified as an independent predictor of mortality in Neuro-COVID patients.
Psychometric Evaluation of a Korean Version of the Sexual Risk Behavior Beliefs and Self-efficacy Scale among Female College Students
Authors: Lee Jungmin , James Montegrico 
Published: May 2022

Abstract
Purpose: While the sexual activity of college students is more prevalent during this life stage, to the best of our knowledge, a value system capable of properly controlling and judging sexual impulses and behaviors has not been fully established. This study examined the psychometric properties of the Korean version of the sexual risk behavior beliefs and self-efficacy (KR-SRBBS) to assess the sexual behavior and self-efficacy of college students. Participants and methods: Convenience sampling was conducted using Social Network Services. The participants were 169 female college students aged 18-25 years. The validity and reliability were examined using item analysis, factor analysis, and Cronbach’s alpha. A total of 17 items were selected for the analysis. Results: Four factors were extracted through factor analysis, explaining 63.797% of the variance. After two modifications, it showed a good model fit for the KR-SRBBS. Cronbach’s alpha was 0.77. Conclusion: Our findings indicate that the KR-SRBBS may be a suitable instrument for measuring risky sexual behavior and self-efficacy in condom use among female college students.
Warthin-like mucoepidermoid carcinoma of the parotid gland: case report
Authors: Yan Limin , Xu Jinheng , Liu Liyun , Li Xin 
Published: May 2022

Abstract
Warthin tumor (WT)-like mucoepidermoid carcinoma (WT MEC) resembles the histologic pattern of WT, and pathologists unaware of this possibility may misdiagnose it as squamous and mucoepithelial WT or WT malignant transfer into MEC (MEC ex WT). Here, we report a case of a 41-year-old Chinese woman with a solitary mass in the left parotid gland. In this case, microscopic observation revealed prominent lymph node stroma and multiple cystic structures similar to those seen in WT. It lacked the two layers of oncocytic epithelial tissue characteristic of WT. Considering the histological findings, we diagnosed this case as WT MEC. This case provides pathological and clinical features to differentiate from MEC ex-WT and WT with squamous and mucous epithelium. In conclusion, further observations and case reports will clearly define this tumor.
Hypoxia-inducible Factor-1α protects against Intervertebral Disc Degeneration through Antagonizing Mitochondrial Oxidative Stress.
Authors: Yang Wen , Jia Chunwang , Liu Long , Fu Yu , Wu Yawei , Liu Zhicheng , Yu Ruixuan , Ma Xiaojie , Gong Ao , Liu Fangming , Xia Yanni , Hou Yong , Li Yuhua , Zhang Lei 
Published: May 2022

Abstract
Intervertebral disc degeneration (IVDD) demonstrates a gradually increased incidence and has developed into a major health problem worldwide. Nucleus pulposus is characterized by the hypoxic and avascular environment, in which hypoxia inducible factor1α (HIF-1α) has an important role through its participation in extracellular matrix synthesis, energy metabolism, cellular adaptation to stresses and genesis. In this study, the effects of HIF-1α on mouse primary nucleus pulposus cells (MNPCs) exposed to TNF-α were observed and the potential mechanism was explored, and a rabbit IVDD model was established to verify the protective role of HIF-1α on IVDD. In vitro results demonstrated that HIF-1α could attenuate the inflammation, apoptosis and mitochondrial dysfunction induced by TNF-α in MNPCs, and promote cellular anabolism, and inhibit cellular catabolism. In vivo results demonstrated that after establishment of IVDD model in rabbit, disc height and IVD extracellular matrix were decreased in a time-dependent manner, and MRI analysis showed a tendency for decreased T2 values in a time-dependent manner, and supplementation of HIF-1α improved histological and imaginative IVDD while down-regulation of HIF-1α exacerbated this degeneration. In summary, HIF-1α protected against IVDD, possibly through reducing ROS production in mitochondria and consequent inhibition of inflammation, metabolism disorders and apoptosis of MNPCs, which provided a potential therapeutic instrument for treatment of IVDD diseases.
Identification of a novel immune checkpoint molecule V‐set immunoglobulin domain‐containing 4 that leads to impaired immunity infiltration in pancreatic ductal adenocarcinoma
Authors: Jiang Yongsheng , Han Lijie , Yang Jian , Yang Minwei , Zhang Jian , Xue Meilin , Zhu Youwei , Xiong Cheng , Shi Minmin , Zhao Shiwei , Shen Baiyong , Xu Zhiwei , Jiang Lingxi , Chen Hao 
Published: May 2022

Abstract
Background
Checkpoint-based immunotherapy has failed to elicit responses in the majority of patients with pancreatic cancer. In our study, we aimed to identify the role of a novel immune checkpoint molecule V-set Ig domain-containing 4 (VSIG4) in pancreatic ductal adenocarcinoma (PDAC).
Methods
Online datasets and tissue microarray (TMA) were utilized to analyze the expression level of VSIG4 and its correlation with clinical parameters in PDAC. CCK8, transwell assay and wound healing assay were applied to explore the function of VSIG4 in vitro. Subcutaneous, orthotopic xenograft and liver metastasis model were established to explore the function of VSIG4 in vivo. TMA analysis and chemotaxis assay were conducted to uncover the effect of VSIG4 on immune infiltration. Histone acetyltransferase (HAT) inhibitors and si-RNA were applied to investigate factors that regulate the expression of VSIG4.
Results
Both mRNA and protein levels of VSIG4 were higher in PDAC than normal pancreas in TCGA, GEO, HPA datasets and our TMA. VSIG4 showed positive correlations with tumor size, T classification and liver metastasis. Patients with higher VSIG4 expression were related to poorer prognosis. VSIG4 knockdown impaired the proliferation, migration ability of pancreatic cancer cells both in vitro and in vivo. Bioinformatics study showed positive correlation between VSIG4 and infiltration of neutrophil and tumor-associated macrophages (TAMs) in PDAC and it inhibited the secretion of cytokines. According to our TMA panel, High expression of VSIG4 was correlated with fewer infiltration of CD8+ T cells. Chemotaxis assay also showed knockdown of VSIG4 increased the recruitment of total T cells and CD8+ T cells. HAT inhibitors and knockdown of STAT1 leaded to decreased expression of VSIG4.
Conclusions
Our data indicates that VSIG4 contribute to cell proliferation, migration and resistance to immune attack, thus identified as a promising target for PDAC treatment with good prognostic value.
Iodine metabolism and thyroid function during the perinatal period: Maternal-neonatal correlation and effects of topical povidone-iodine skin disinfectants
Authors: Fuse Yozen , Ogawa Hiroyasu , Tsukahara Mutsu , Fuse Yoji , Ito Yoshiya , Shishiba Yoshimasa , Irie Minoru 
Published: May 2022

Abstract
An adequate maternal iodine intake during pregnancy and lactation is essential for growth and mental development in fetuses and newborns. Both deficient and excess iodine may disrupt normal thyroid function. There are limited data on perinatal iodine metabolism in mothers and infants, as well as the effect of povidone-iodine (PVP–I) antiseptics used in Cesarean delivery. The urinary iodine concentration (UIC), serum iodine, thyrotropin (TSH), free thyroxine (FT4) and breast milk iodine concentration (BMIC) were measured consecutively in a total of 327 mothers and 249 term-infants in two prospective studies. The maternal median UIC was 164 µg/L in the third trimester, increased to 256 µg/L on postpartum day 2, then decreased to 116 µg/L one month later. The BMIC on postpartum days 2 and 30 was 17.6 and 13.5 µg/100g, respectively. In neonatal infants born to the mothers unexposed to PVP-I, the median UIC was 131 µg/L in the first voiding urine and increased to 272 µg/L on day 4, then slightly decreased to 265 µg/L on day 28 suggesting sufficient iodine reserve at birth. PVP-I antiseptics containing 1g of iodine for skin preparation at Cesarean delivery transiently increase maternal serum iodine concentration, UIC and BMIC, however, it has little effect on maternal TSH, FT4 and neonatal UIC, TSH, or FT4. The iodine status of pregnant women and their infants was adequate in this population; however, the UIC in lactating mothers at one postnatal month was low enough to suggest iodine deficiency or near iodine deficiency. Further studies are necessary. This study was not registered to any clinical trials registry (CTR).
Identification of a ubiquitination-based classification system and a gene signature for predicting prognosis and immunotherapy response for sarcoma
Authors: Zhang Lin , Lin Weihao , Cao Zheng , Feng Xiaoli , Gao Yibo , He Jie 
Published: May 2022

Abstract
Background: Sarcomas are heterogeneous tumors deriving from the mesenchyme and have a poor response to systemic therapies. Ubiquitination is a post-translational modification that is involved in various physiological processes and cancer growth.Methods: We integrated the transcriptome data of 256 sarcoma patients from The Cancer Genome Atlas (TCGA) to analyze the expression of the predefined ubiquitin-related genes and identified two ubiquitin-related clusters based on that. Patients’ survival, enrichment analysis, and tumor microenvironment analyses were conducted. Further, a ubiquitin-related gene signature was built to predict prognoses. The prognostic value of the signature was also validated in public datasets. Pathway analysis, and tumor microenvironment characterization were conducted between different risk groups. The prognostic values of the signature were partly verified using immunohistochemistry assay in an independent cohort from our center.Results: The two clusters were characterized by different survival outcomes, enriched pathways, and characteristics of the tumor microenvironment. The signature could effectively predict patient prognoses across TCGA sarcoma cohort, and another two public sarcoma cohorts. Different risk groups were also characterized by distinct enriched pathways and characteristics of the tumor microenvironment. Histochemistry score analyses revealed that patients with a higher TRIM21 expression had a significantly better prognosis, and higher TRIM21 combined with higher CD8 was also significantly associated with better overall survival. Conclusions: This study provided novel classification for sarcoma patients based on expressions of ubiquitin-related genes. The classification and the constructed gene signature may facilitate the understanding of sarcoma pathogenesis, prediction of prognosis and immunotherapy response for sarcoma patients.