bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term clinical outcomes and prognostic factors of upfront surgery as a first-line therapy in biopsy-proven clinical N2 non-small cell lung cancer
Authors: Bertolaccini Luca , Prisciandaro Elena , Guarize Juliana , Girelli Lara , Sedda Giulia , Filippi Niccolò , de Marinis Filippo , Spaggiari Lorenzo 
Published: July 2022

BackgroundMultimodality therapy offers the best opportunity to improve pathological N2 non-small cell lung cancer (NSCLC) prognosis. This paper aimed to evaluate the long-term clinical outcomes and the prognostic factors of upfront surgery as first-line therapy in biopsy-proven clinical N2.MethodsRetrospective review of biopsy-proven cN2 NSCLC patients operated between 2007 and 2017. Upfront surgery was considered if the primary tumour was deemed completely resectable, with mediastinal nodal involvement confined to a single station and no preoperative evidence of extranodal tumour invasion.ResultsTwo hundred eighty-five patients who underwent radical resections were included. One hundred fifty-nine patients (55.8%) received induction chemotherapy. At follow-up completion, 127 (44.6%) patients had died. For the induction chemotherapy group, the median overall survival (OS) was 49 months [95% confidence interval (CI): 38–70 months], and the 5-year OS was 44.4%. The median and 5-year OS for the up front surgery group was 66 months (95% CI: 40–119 months) and 66.3%, respectively. There were no statistically significant differences between treatment approaches (p = 0.48). One hundred thirty-four patients (47.0%) developed recurrence. The recurrence-free survival (RFS) at 5 years was 17% (95% CI: 11–25%) for induction chemotherapy and 22% (95% CI: 9–32%) for upfront surgery; there were no statistically significant differences between groups (p = 0.93). No significant differences were observed based on the clinical N status (OS, p = 0.36; RFS, p = 0.65).ConclusionsUpfront surgery as first-line therapy for biopsy-proven cN2 NSCLC showed favourable clinical outcomes, similar to those obtained after induction chemotherapy followed by surgery. Therefore, it should be considered one of the multimodality treatment options in resectable N2 NSCLC.
Prophylactic Central Neck Dissection to Improve Disease-Free Survival in Pediatric Papillary Thyroid Cancer
Authors: Ngo Duy Quoc , Le Duong The , Le Quang 
Published: July 2022

BackgroundPediatric PTC is a rare disease. Although, the prognosis is excellent and the mortality rate is low, the role of prophylactic central neck dissection is still the subject of debate. The aim was to evaluate both the role and safety of prophylactic central neck dissection (CND) in managing pediatric papillary thyroid cancer (PTC), especially in respect of disease-free survival (DFS).Patients and MethodsIn this retrospective study, we collected 54 pediatric cN0 PTC patients (≤ 18 years of age) who were treated from January 2014 to January 2021 at a high-volume thyroid surgery center. Patients were divided into two groups based on the status of prophylactic CND. We analyzed the factors related to the clinicopathological features and recurrence of PTC in children.ResultsOf the 54 cN0 patients, 35 underwent prophylactic CND and 19 patients did not undergo prophylactic CND. The two groups were similar in clinical and pathologic features, such as age, gender, tumor size, multifocal status, and follow-up time. The average DFS was 84.4 ± 2.7 months. Log-rank tests on Kaplan-Meier curves revealed that age, gender, tumor size, multifocality, and extrathyroid extension did not relate to DFS time. Furthermore, DFS time was not affected by the extent of thyroidectomy (p=0.07) or RAI treatment (p=0.21). Prophylactic CND was found to increase DFS time for pediatric patients with cN0 PTC (p = 0.003). There was no statistically significant difference in complications such as transient hypocalcemia (p=0.15) and transient recurrent laryngeal nerve injury (p=0.37) between the prophylactic CND group and the no-prophylactic CND group.ConclusionProphylactic CND was found to be associated with increased DFS and not with increased rates of complications after surgery.
Pathological characteristics and predictive factors of prostate biopsy in patients with serum PSA levels between 0 and 4.0 ng/ml
Authors: Su Rui , Pan Jin-feng , Ren Da-wei , Jiang Jun-hui , Ma Qi 
Published: July 2022

BackgroundThis study aimed to analyze the pathological characteristics and predictive factors of prostate biopsy in men with PSA levels below 4.0 ng/ml.Patients and methodsWe retrospectively analyzed 158 patients who underwent prostate biopsy with PSA levels below 4.0 ng/ml. Pathological results were statistically analyzed. The logistic regression analysis was used to determine the predictive factors for malignant outcomes. Subgroup analysis was performed on patients who received surgery and the postoperative pathological upgrading was counted.ResultsA total of 143 patients were enrolled. The tumor detection rate was 20.3%. Among these patients, most of them (79.3%) had prostate adenocarcinoma, but rare malignant tumors also accounted for 20.7%. Logistic regression analysis indicated that the only independent predictive factor for a positive prostate biopsy was the PI-RADS score. For prostate adenocarcinoma cases, 95.7% of them were organ localized and 47.8% of cases were clinically significant. Subgroup analysis was performed on 14 patients who received surgical treatment. 28.6% of patients were upgraded to clinically significant prostate cancer, while 64.3% of patients had an upgrade in tumor stage.ConclusionOur study indicated that 20.3% of men with PSA levels between 0 and 4.0 ng/ml were diagnosed with prostate malignancies. Among these patients, most of them (79.3%) were diagnosed with prostate adenocarcinoma, and several uncommon types of malignancies were also detected in 20.7% of patients. The only risk factor for a positive biopsy in patients with a low PSA concentration was the PI-RADS score. It should be emphasized that the invasiveness of PCa patients diagnosed by biopsy may be underestimated as more than half of patients will upgrade their Gleason score or clinical stages after surgery. Thus, clinicians should pay more attention to patients with PSA levels between 0 and 4.0 ng/ml.
Local and systemic therapy may be safely de-escalated in elderly breast cancer patients in China: A retrospective cohort study
Authors: Wang Ji , Fu Hongtao , Zhong Zhaoyun , Jiang Yunshan , Pan Hong , Sun Xiaowei , Xu Weiwei , Tang Xinyu , Zhou Wenbin , Wang Shui 
Published: July 2022

BackgroundFor elderly patients with breast cancer, the treatment strategy is still controversial. In China, preoperative axillary lymph node needle biopsy is not widely used, resulting in many patients receiving axillary lymph node dissection (ALND) directly. Our study aims to determine whether local and systemic therapy can be safely de-escalated in elderly breast cancer.MethodsPatients aged ≥70 years were retrospectively enrolled from our institution’s medical records between May 2013 and July 2021. Groups were assigned according to local and systemic treatment regimens, and stratified analysis was performed by molecular subtypes. Univariate and multivariate survival analyses were used to compare the effects of different regimens on relapse-free survival (RFS).ResultsA total of 653 patients were enrolled for preliminary data analysis, and 563 patients were screened for survival analysis. The mean follow-up was 19 months (range, 1–82 months). Axillary lymph node metastases were pathologically confirmed in only 2.1% of cN0 cases and up to 97.1% of cN+ cases. In the aspect of breast surgery, RFS showed no significant difference between mastectomy and BCS group (p = 0.3078). As for axillary surgery, patients in the ALND group showed significantly better RFS than those in the sentinel lymph node biopsy (SLNB) group among pN0 patients (p = 0.0128). Among these cases, the proportion of cN+ in ALND was significantly higher than that in SLNB (6.4% vs. 0.4%, p = 0.002), which meant axillary lymph nodes (ALNs) of ALND patients were larger in imaging and more likely to be misdiagnosed as metastatic. With regard to adjuvant therapy, univariate and multivariate analyses showed that RFS in different comprehensive adjuvant regimens were similar especially among hormone receptor (HR)+/human epidermal growth factor receptor 2 (HER2)− subgroup where patients who did not receive any adjuvant therapy accounted for 15.7% (p &gt; 0.05).ConclusionsIt is feasible to reduce some unnecessary local or systemic treatments for elderly breast cancer patients, especially in HR+/HER2− subtype. Multiple patient-related factors should be considered when making treatment plans.
Necroptosis-associated long noncoding RNAs can predict prognosis and differentiate between cold and hot tumors in ovarian cancer
Authors: He Yi-bo , Fang Lu-wei , Hu Dan , Chen Shi-liang , Shen Si-yu , Chen Kai-li , Mu Jie , Li Jun-yu , Zhang Hongpan , Yong-lin Liu , Zhang Li 
Published: July 2022

ObjectiveThe mortality rate of ovarian cancer (OC) is the highest among all gynecologic cancers. To predict the prognosis and the efficacy of immunotherapy, we identified new biomarkers.MethodsThe Cancer Genome Atlas (TCGA) and the Genotype-Tissue Expression Project (GTEx) databases were used to extract ovarian cancer transcriptomes. By performing the co-expression analysis, we identified necroptosis-associated long noncoding RNAs (lncRNAs). We used the least absolute shrinkage and selection operator (LASSO) to build the risk model. The qRT-PCR assay was conducted to confirm the differential expression of lncRNAs in the ovarian cancer cell line SK-OV-3. Gene Set Enrichment Analysis, Kaplan-Meier analysis, and the nomogram were used to determine the lncRNAs model. Additionally, the risk model was estimated to evaluate the efficacy of immunotherapy and chemotherapy. We classified necroptosis-associated IncRNAs into two clusters to distinguish between cold and hot tumors.ResultsThe model was constructed using six necroptosis-associated lncRNAs. The calibration plots from the model showed good consistency with the prognostic predictions. The overall survival of one, three, and five-year areas under the ROC curve (AUC) was 0.691, 0.678, and 0.691, respectively. There were significant differences in the IC50 between the risk groups, which could serve as a guide to systemic treatment. The results of the qRT-PCR assay showed that AL928654.1, AL133371.2, AC007991.4, and LINC00996 were significantly higher in the SK-OV-3 cell line than in the Iose-80 cell line (P &lt; 0.05). The clusters could be applied to differentiate between cold and hot tumors more accurately and assist in accurate mediation. Cluster 2 was more vulnerable to immunotherapies and was identified as the hot tumor.ConclusionNecroptosis-associated lncRNAs are reliable predictors of prognosis and can provide a treatment strategy by screening for hot tumors.
The expression, clinical relevance, and prognostic significance of HJURP in cholangiocarcinoma
Authors: Yang Yang , Yuan Jinyan , Liu Zhenzhong , Cao Wenwen , Liu Pei 
Published: July 2022

BackgroundCholangiocarcinoma (CCA) is the malignancy originating from the biliary epithelium, including intrahepatic (iCCA), perihilar (pCCA), and distal (dCCA) CCA. The prognosis of CCA is very poor, and the biomarkers of different CCA subsets should be investigated separately. Holliday junction recognition protein (HJURP) is a key component of the pre-nucleosomal complex, which is responsible for normal mitosis. The ectopic expression of HJURP has been reported in several cancers, but not CCA.Materials and methodsIn our study, we investigated the expression of HJURP in 127 CCA patients which were composed of 32 iCCAs, 71 pCCAs, and 24 dCCAs with immunohistochemistry and divided these patients into subgroups with a low or high expression of HJURP. With chi-square test and univariate and multivariate analyses, we evaluated the clinical relevance and prognostic significance of HJURP in iCCAs, pCCAs, and dCCAs.ResultsHJURP was ectopically upregulated in CCAs compared with the para-tumor tissues based on TCGA and other mRNA-seq databases. A high expression of HJURP was correlated with low overall survival rates of iCCA and pCCA, but not in dCCA. Moreover, HJURP was an independent prognostic biomarker in both iCCA and pCCA. Patients with high HJURP were more likely to suffer CCA-related death after operation.ConclusionsHJURP was an independent prognostic biomarker in both iCCA and pCCA, but not in dCCA. Our results provide more evidence of the molecular features of different CCA subsets and suggest that patients with high HJURP are more high-risk, which can guide more precision follow-up and treatment of CCA.
Case report: Effectiveness of sirolimus in a de novo FAS mutation leading to autoimmune lymphoproliferative syndrome-FAS and elevated DNT/Treg ratio
Authors: Gu Hao , Chen Zhenping , Ma Jie , Ma Jingyao , Fu Lingling , Zhang Rui , Wang Tianyou , Wu Runhui 
Published: July 2022

BackgroundThe autoimmune lymphoproliferative syndrome (ALPS) is a rare disease characterized by defective function of the FAS death receptor, which results in chronic, non-malignant lymphoproliferation and autoimmunity accompanied by elevated numbers of double-negative (DN) T cells (T-cell receptor α/β + CD4–CD8–) and an increased risk of developing malignancies later in life.Case descriptionHere, we report a patient with a de novo FAS mutation with a severe phenotype of ALPS-FAS. The FAS gene identified as a novel spontaneous germline heterozygous missense mutation (c.857G &gt; A, p.G286E) in exon 9, causing an amino acid exchange and difference in hydrogen bond formation. Consequently, the treatment with sirolimus was initiated. Subsequently, the patient’s clinical condition improved rapidly. Moreover, DNT ratio continuously decreased during sirolimus application.ConclusionWe described a novel germline FAS mutation (c.857G &gt; A, p.G286E) associated with a severe clinical phenotype of ALPS-FAS. Sirolimus effectively improved the patient clinical manifestations with obvious reduction of the DNT ratio.
Clinical presentation of pediatric patients with symptomatic SARS-CoV-2 infection during the first months of the COVID-19 pandemic in a single center in Mexico City
Authors: Aragón-Nogales Ranferi , Zurita-Cruz Jessie , Vázquez-Rosales Guillermo , Arias-Flores Rafael , Gómez-González Claudia , Montaño-Luna Victoria , Sámano-Aviña Mariana , Pacheco-Rosas Daniel , Flores-Ruiz Eric , Villasís-Keever Miguel , Miranda-Novales Guadalupe 
Published: July 2022

BackgroundThe clinical spectrum of COVID-19 is broad, from asymptomatic to severe cases and death. The objective of this study is to analyze the clinical course of patients attended during the first months of the SARS-CoV-2 pandemic in a third-level pediatric hospital.MethodsDesign: prospective cohort study. Patients with viral respiratory disease or suspected cases of COVID-19 were evaluated at the Pediatric Hospital, National Medical Center XXI Century, Mexico City, from 21 March 2020 to 13 January 2021. Statistical analysis: Chi-square test and Fisher’s exact test were used for comparisons; a logistic regression model was constructed to identify clinical or laboratory characteristics associated with critical disease. A p-value &lt; 0.05 was considered statistically significant.ResultsA total of 697 patients met the operational definition of viral respiratory disease or suspected cases of COVID-19 and underwent real-time reverse transcription polymerase chain reaction (rRT-PCR) SARS-CoV-2 testing. Patients with a positive result were included. Of the 181 patients (26%), 121 (66.8%) had mild disease and were treated as outpatients and 60 (33.1%) were hospitalized. A total of six patients met the criteria for multisystem inflammatory syndrome in children (MIS-C). Of the 60 inpatients, 65% were males, and 82% had one or more comorbidities. The main comorbidities were cancer (42%) and overweight (15%). The median hospital stay was 9 days. The inpatients had a higher frequency of fever, general malaise, dyspnea, chills, polypnea, and cyanosis than the outpatients (p &lt; 0.05). Only 21.4% of the outpatients had one or more comorbidities, which were lower than in the hospitalized patients (p &lt; 0.001). Laboratory data at admission were similar between critically ill and those with moderate and severe disease. The patients who developed pneumonia were at higher risk of critical disease, while older age was associated with a better prognosis. A total of 13 of the 60 inpatients died (mortality 7.1%). All but one had one or more comorbidities: four had cancer, four congenital heart disease, one chronic kidney disease and epilepsy, one Epstein–Barr virus-induced hemophagocytic lymphohistiocytosis, one obesity, and one diabetes mellitus.ConclusionHospital mortality is high, especially in children with comorbidities. Despite 2 years having passed since the beginning of the COVID-19 pandemic, the epidemiological and clinical data on children are still helpful to improve their prognosis.
The value of interleukin-27 for differentiating tuberculous pleural effusion from Mycoplasma pneumoniae pneumonic effusion in children
Authors: Xu Hui , Yang Haiming , Liu Jinrong , Liu Hui , Tang Xiaolei , Li Huimin , Cai Siyu , Zhao Shunying 
Published: July 2022

ObjectivesThe early diagnosis of tuberculous pleural effusion (TPE) is challenging due to the difficulty of isolatingMycobacterium tuberculosis, and pleural biomarkers are an optional choice. Recent studies showed that interleukin-27 (IL-27) appears to be a new accurate biomarker for TPE in adults and no related studies were reported in children. In this study, we aimed to evaluate the potential value of IL-27 in pediatric tuberculous pleurisy by detecting its levels in pleural fluid and serum.MethodsA total of 48 children with TPE and 64 children with severeMycoplasma pneumoniae(MP) pneumonic effusion (SMPPE) were enrolled in this study. IL-27 concentrations were measured in serum and pleural fluid. The diagnostic yield of IL-27 was evaluated using receiver operating characteristic (ROC) curves.ResultsThe level of p-IL-27 in TPE showed statistically no significant difference when compared with SMPPE (p&gt; 0.05). However, pleural fluid IL-27 (p-IL-27) / serum IL-27 (s-IL-27) ratio in TPE were significantly much higher than those in SMPPE (p&lt; 0.05). By the analysis of the ROC curves, the diagnostic sensitivity and specificity of the p-IL-27/s-IL-27 ratio were 100% and 48.44%, respectively (cutoff value of 1.0280). The area under the ROC curve for p-IL-27/s-IL-27 was 0.7295.ConclusionPleural fluid IL-27 alone was not accurate in distinguishing pediatric TPE from SMPPE, which was different from the diagnostic value of IL-27 in adult studies due to the different disease spectra between children and adults. Our results implied that the p-IL-27/s-IL-27 ratio had a potential value in distinguishing TPE from SMPPE. However, the specificity of IL-27 was relatively lower and it is necessary to find a more specific marker in tuberculous pleurisy of children.
A Positive Versus Negative Interaction Memory Affects Parole Officers’ Implicit Associations Between the Self-Concept and the Group Parolees
Authors: Saad Marina K. , Rivera Luis M. , Veysey Bonita M. 
Published: July 2022

BackgroundParole officers are one of many actors in the legal system charged with interpreting and enforcing the law. Officers not only assure that parolees under their supervision comply with the terms of their release, but also monitor and control parolees’ criminal behavior. They conduct their jobs through their understanding of their official mandate and make considered and deliberate choices while executing that mandate. However, their experiences as legal actors may impact their implicit cognitions about parolees. This experiment is the first of its kind to examine implicit (i.e., automatic) associations between the self and parolees among actors of the legal system.ObjectiveThe present study examines the implicit cognitive consequences of the quality of the parole officer-parolee relationship from the perspective of the parole officer; specifically, whether parole officers who are reminded of positive experiences with parolees implicitly associate more with the group parolees than those reminded of a negative experience. In addition, we explore the moderating effects of parole officers’ subjective professional orientation and identification.MethodEighty-four New Jersey parole officers participated in the study. First, an experimental manipulation of either a past positive or negative experience was administered via a writing task. Participants then completed an Implicit Association Test (IAT) to measure associations between the self-concept of parole officers with parolees who are part of the group criminal, followed by measures of professional orientation and identification.ResultsParticipants who were reminded of a positive experience with a parolee exhibited stronger associations between self and the group parolee when compared to those who were reminded of a negative experience. Neither professional orientation nor parole officer group identification were related to implicit associations and did not moderate the effect of the past experience reminder on implicit associations.Conclusion and ImplicationsImplicit cognitions of parole officers may influence their behaviors and interactions with those whom they supervise. Positive reminders affect implicit self-associations with parolees presumably via empathy, which is known to affect the quality of therapeutic and supervision relationships; thus, theoretically, leading to improved outcomes for both officers and parolees.