bluuebunny/crossref_metadata_2025 huggingface dataset:
Greek New Comic Fragments
Authors: Nervegna Sebastiana
Published: September 2020

The expression “Greek New Comedy” traditionally indicates a specific phase of Attic Comedy dated to the late 4th and 3rd centuries bce, although New Comedies continued to be written well into the Imperial period. New Comedies bring onto the stage fictional characters, domestic situations, and love-stories, and their plots tend to repeat common elements. Ancient sources identify over sixty New Comedy poets and consistently name three dramatists as the main representatives of this genre: Menander, Diphilus, and Philemon. Menander was born in 342/1 and died around 290 bce; the biographies of his two rivals are largely obscure but Philemon was reportedly older than Menander while Diphilus was one of Menander’s contemporaries. Unlike Menander, they were both born outside Athens. Two or three more authors were added to the list of the best New Comedy poets: Philippides, Apollodorus of Carystus, and Posidippus. New Comedy poets were generally more prolific than their 5th-century colleagues, but their plays are largely lost. Menander is the only author whose comedies survive thanks to a series of lucky papyrus findings in the 20th century: we have one complete comedy, Dyskolos, and substantial portions of several more. The dramas written by other New Comedy poets survive only in short fragments preserved by a few papyri and, most often, by ancient authors largely interested in linguistic peculiarities or moralizing excerpts. The standard collection of the fragments (F) of Greek Comedy and the testimonia (T) for Greek comic poets is Kassel and Austin 1983–2001 (Poetae Comici Graeci, cited under Editions and Translations), which is generally abbreviated as “K-A.” While surviving fragments are typically not very informative, an important source for our knowledge of Greek New Comedies is Roman Comedy. Roman poets adapted select plays into Latin, often disclosing the titles, the authors, and other details of their Greek models. Roman comedies give us indirect access to their now lost Greek originals.
Death and Burial in the Roman Age
Authors: Pearce John
Published: September 2020

Evidence for death and burial in the Roman age extends across all materials surviving from Antiquity, literary texts, the remnants of memorials to the dead, inscriptions, images, and burials themselves, both the remains of the dead and the objects used in the rituals for burying them. This diversity of source material and the relevance of funerary evidence to so many aspects of ancient life continue to fragment scholarship. The allocation of epitaphs, architecture, images, artifacts, and the remains of the dead to separate disciplines has compounded their decontextualization from funerary ensembles. The subject area has also been divided by different approaches depending on the region and period concerned: the dominant interests in late Roman burials, for example, have been the investigation of Christian conversion or migration into the Roman world. However, some unifying trends can be observed. In recent decades attention has shifted to exploring the mass of burial evidence for what it reveals of Roman society, its social structures, demographic characteristics, and so on. This has been given extra impetus by the results of archaeological fieldwork, creating a sample of well-excavated burials and human skeletal remains which now rivals the numbers of inscribed memorials. The optimism of reading off social structures or demographic characteristics from funerary evidence has been replaced with an emphasis on exploring how groups and individuals negotiated their relationships to their communities through rituals and monuments. This essay presents Roman behavior in relation to death, bereavement, and commemoration, mainly using material evidence in its broadest sense. It is necessarily selective, giving examples of key syntheses and datasets and of developing approaches. In some cases (especially monuments) it gives some greater weighting to English language publications, especially where they provide gateways to non-Anglophone scholarship. After opening sections on general works on death and burial and on the Roman funeral and mourning, the essay discusses in turn monuments, funerary rituals as reconstructed from archaeological evidence, and late Roman burial practice, including its relationship to conversion to Christianity. It concludes with case studies where different forms of evidence, architectural, artistic, artifactual, osteological, etc. combine to produce a richer view of monuments and processes, in specific cultural and social contexts across the empire. Study of human remains from a demographic or paleopathological perspective is outside the scope of this essay, though some bibliographic pointers are given in the first section (Overviews of Death and Burial). Recent work on osteological and biomolecular characteristics of the skeleton is however noted where its integration with the evidence for rituals has significantly enriched the study of identities in death.
Aram
Authors: Sader Hélène
Published: September 2020

The first genuine reference to Aram is in a 14th-century bce text of Amenhotep III and attests to a region located in north-central Syria. In the 11th-century bce Middle Assyrian texts, Aram appears in connection with Ahlamû (i.e., nomadic) groups and refers to the area between the Khabur and the Euphrates and even beyond, since these Ahlamû of the Land Aram or “Aramaeans” seem to move freely also west of the Euphrates as far as Jebel Bishri, Palmyra, and Mount Lebanon. In the 8th-century bce Aramaic inscription of Sfire there is mention of “All” and “Upper and Lower Aram.” These terms refer most probably to a geographical area that seems to cover roughly the boundaries of modern Syria. In the 8th-century bce Aramaic inscriptions of Breij and Afis, Aram is the name of a south Syrian kingdom the capital of which was Damascus. This latter use of Aram is attested to in the Old Testament, where the term appears associated also with specific geopolitical entities such as the chiefdoms of Aram-Ṣobah and Aram Beth–Rehob. In short, the available written sources indicate that Aram is a geographical term that refers at times to a specific polity, and, at others, to a wider geographical area located within the territory of present-day Syria. Modern scholarship designates as “Aramaean” any of the Iron Age polities of Syria that bore the characteristic appellation Bīt-PN, and/or whose rulers bore Aramaic names and left inscriptions in the West Semitic dialect known as Aramaic. The inhabitants of these states are referred to as Aramaeans. Regarding the etymology of the name “Aram,” there is no scholarly consensus on the origin and meaning of the word. Among the most commonly accepted suggestions is an etymology derived from a Semitic root rwm (“to be high”). Another suggestion interprets the name as a broken plural meaning “white antelopes” or “wild bulls.”
Women and the Reformation
Authors: Helfferich Tryntje
Published: September 2020

The historiography of the Reformation era, roughly 1517–1650, was long dominated by scholarship that focused on theological developments, religious debates, and major reformers, such as Martin Luther, John Calvin, and Ignatius Loyola. The late 20th century, however, saw an expansion in areas of scholarly inquiry, with many new works on the period’s extraordinary cultural, social, economic, and political transformations and conflicts. Scholars increasingly argued, moreover, that the era had weathered not a single, traumatic “Reformation,” but multiple and diverse “Reformations,” whose impacts had rippled throughout early modern society in a variety of ways. Part of this historiographical shift involved the exploration of new perspectives and voices, which included a growing interest in the role of women as active participants in and contributors to historical change. Scholars thus began to investigate the ways in which women had experienced the Reformation, perhaps differently from men, and how the Reformation had influenced women’s social roles, marriages, family lives, faith and religious expressions, and all other aspects of their everyday lives. In the process, there emerged what became a long-running controversy, often with confessional overtones, over whether the Reformation was “good” or “bad” for women. This has thankfully now died down, since partisans on both sides have mainly accepted that the question was not only overly simplistic, but also tended to lump together all women as an undifferentiated mass. Nevertheless, readers cannot fail to find signs of the old battle everywhere they look. To explain it briefly, therefore, the argument on the one side was that Protestants, and particularly radical reformers, had benefited women by elevating them as equal to men in spiritual worth, introducing a more egalitarian form of marriage, which they had praised as a noble institution, and freeing from their bondage the nuns previously forced into involuntary celibacy and enclosure. The argument on the other side, however, was that Protestants had, on the contrary, harmed women by toppling the Virgin Mary from her seat as Queen of Heaven and frowning on her veneration, and by discouraging women from turning to Mary or the female saints as intercessors and models of strong and influential women. By closing the monasteries and emphasizing marriage and motherhood as women’s highest calling, moreover, Protestants had limited the independence and freedom formerly enjoyed by women religious, ended the political and social power of abbesses, and removed women’s ability to choose the unmarried life.
Benito Arias Montano
Authors: Kallendorf Hilaire
Published: September 2020

Benito Arias Montano (b. c. 1525/27–d. 1598) was a Spanish humanist, censor, polymath, and chaplain to King Philip II, as well as librarian for the royal library at El Escorial. He is best known for having produced the Polyglot Bible—also known as the Biblia Regia (Royal Bible)—printed by Christopher Plantin in Antwerp, a monumental undertaking for which it was necessary to move physically to the Netherlands for an extended period of seven years. There he became an agent of international book culture by virtue of his work on the Inquisitorial Index of prohibited and expurgated books, as well as an acquisitions broker for the Spanish royal library and a circle of prominent Spanish intellectuals including Fernando de Herrera and Francisco Pacheco. In addition to printing the Royal Bible, Plantin also received a contract from the Spanish Crown to print other devotional literature (prayer books, breviaries, missals, books of hours, etc.). Arias Montano supervised this publishing program too. The “Rey Prudente” trusted his judgement enough to request his input on important political decisions after he distinguished himself as part of the Spanish delegation to the Council of Trent, the multi-year gathering which launched the Counter-Reformation. Educated in theology at the Universities of Seville and Alcalá, he also became a Knight of the Order of Santiago. He wrote poetry and prose in both Latin and Spanish on a wide range of topics including medicine, geology, physics, architecture, botany, and even painting. His epistolary correspondence with a transnational network of merchants, diplomats and intellectuals is voluminous. In addition to the above-mentioned languages, he was also fluent in Greek, Hebrew, Italian, and French. His probable converso origins might explain some of his activities as a Hebraist, mostly focused around providing a more literal translation of the Bible than the outdated, but still standard, Vulgate.
History of Technology Integration in Education
Authors: Heath Marie , Parrish Andrea H.
Published: September 2020

This entry identifies key works which both summarize the history of educational technology in the 20th and 21st centuries and identify major influences in the field. Educational technology as a field is influenced by educational psychology and instructional design, and follows a similar epistemological and ontological trajectory as these fields. Thus the history of the field can be understood chronologically and thematically. This entry identifies works that provide both types of overviews of the history of educational technology. It furthermore includes works that are often considered foundational to the field, including historical debates which continue to influence policy, practice, and research.
Leadership in Early Childhood Education
Authors: Thornton Kate
Published: September 2020

Leadership in early childhood education is a relatively young but expanding field of scholarship reflected in the early 21st-century nature of the literature in this entry. In many cases, the literature draws on existing leadership theories and relates it to the early childhood education context. Common theories of leadership such as transactional or transformational leadership have been rejected by those in the sector as these approaches do not reflect the collaborative nature of leadership in the early years sector. Conversely, broader leadership approaches commonly referred to in the wider education sector, such as pedagogical and distributed leadership, are seen as relevant to the early childhood education sector and sections of this entry are devoted to literature on these. Literature on Distributed Leadership and teacher leadership focuses on the practice of leadership rather than those in leadership roles and literature on the link between leadership practice and quality in early childhood is also included. Leadership is acknowledged to be contextual and this is particularly the case in the early childhood education sector where the status of the profession, the structure, and the terminology used varies widely across countries. Much of the writing in the field has come from countries such as Australia, New Zealand, England, and Nordic countries, where teachers and leaders are more highly qualified and where there is a greater level of recognition for the sector and the importance of leadership. In contrast some of the literature from North America reveals a sector in which the importance of leadership struggles to be acknowledged or respected. While there is a separate section on Leadership in Different Contexts, context is of relevance in the majority of literature included. Reasons for the lack of recognition for leadership in the sector include the lack of support for leadership development highlighted in the selection of articles focused on this entry. Tensions in the field are highlighted in a section on Challenges and Debates. The predominance of women in the sector appears to be another factor in the lack of recognition and this is reflected in the authorship of the literature with the majority of articles being written by women. While most of the literature referred to takes the form of articles, some books are included. These are mainly Texts and Guides for practitioners however some include theorization on the nature of leadership in the field.
RADON IN MINES OF KRYVYI RIH IRON ORE BASIN IN UKRAINE
Authors: Molchanov O , Podrezov A , Brechko K , Soroka Y , Ishchenko L
Published: September 2020

The first studies of radiation exposure in old mines of Kryvyi Rih Iron Ore Basin (Kryvbas) began relatively recently, about 20 years ago. The results of these studies have shown that the problem of radon is present in the major part of the Basin mines. In 6 of 8 mines tested, an excess of radiation safety standards for the equilibrium equivalent decay products concentration (EEC) of Radon-222 was observed. According to the sum of the main measured parameters of radiation situation, a preliminary assessment of doses to underground workers was made and a classification of the Basin mines according to radiation danger was developed. Results of the recent radiation surveys of these mines are shown in this article. Data on the incidence of lung cancer among the miners are presented and classified into age groups. Measures to improve the radiation situation in the mines of Kryvbas are considered.
‘Key selection criteria’ as administrative devices: An investigation of academic bureaucratization at Australian universities
Authors: Woelert Peter
Published: September 2020

Over recent decades, tensions arising from the ways universities operate have become increasingly apparent. While there have been ongoing ambitions to reduce traditional bureaucratic mechanisms and ‘red tape’ within universities, there has been mounting concern internationally that the administrative dimensions of academic work are becoming increasingly burdensome (a phenomenon also referred to as ‘academic bureaucratization’). This article explores how a specific administrative device used at Australian universities—the ‘key selection criteria’ (KSC) that applicants have to address in writing when applying for academic positions—manifests academic bureaucratization. The analyses of the size, composition, and content of 273 sets of KSC conducted for this article suggest that academic bureaucratization at Australian universities is well entrenched, fueled by the sedimentation of and redundancy in formal elements, and is further reinforced by vacuously-worded requirements reflecting attitudes of indifference, complacency, or cynicism if considering the prospective informational value of applicants’ response.
Genome Sequence of Verticillium dahliae Race 1 Isolate VdLs.16 From Lettuce
Authors: Chen Jie-Yin , Zhang Dan-Dan , Huang Jin-Qun , Wang Dan , Hao Shi-Jun , Li Ran , Puri Krishna D. , Yang Lin , Tong Bang-Zhuo , Xiong Ke-Xu , Simko Ivan , Klosterman Steven J. , Subbarao Krishna V. , Dai Xiao-Feng
Published: September 2020

Verticillium dahliae is a widespread fungal pathogen that causes Verticillium wilt on many economically important crops and ornamentals worldwide. Populations of V. dahliae have been divided into two distinct races based upon differential host responses in tomato and lettuce. Recently, the contemporary race 2 isolates were further divided into an additional race in tomato. Herein, we provide a high-quality reference genome for the race 1 strain VdLs.16 isolated from lettuce in California, U.S.A. This resource will contribute to ongoing research that aims to elucidate the genetic basis of V. dahliae pathogenicity and population genomic diversity.
No Time for Silence
Authors: Kennedy Maureen Shawn
Published: September 2020

This presidential election may be the most important of modern times.
Improving Access to Preventive Care for HIV
Authors: Adri Avishay
Published: September 2020

Strong measures are needed to increase access to and education about PrEP.
Interventions for Drug-Using Offenders with Mental Health Problems
Authors: Atkinson Debbi
Published: September 2020

Editor's note: The mission of Cochrane Nursing is to provide an international evidence base for nurses involved in delivering, leading, or researching nursing care. Cochrane Corner provides summaries of recent systematic reviews from the Cochrane Library. For more information, see https://nursing.cochrane.org.
Minimizing Opioid Overdose Deaths
Authors: Aschenbrenner Diane S.
Published: September 2020

To help decrease deaths from opioid overdose, the Food and Drug Administration (FDA) is urging health care professionals to discuss naloxone use with patients whenever opioids are prescribed.

The FDA is also revising the labeling of all opioid and opioid use disorder medications to include language that encourages coprescription of naloxone.
Is that Hand Sanitizer Safe?
Authors: Aschenbrenner Diane S.
Published: September 2020

The Food and Drug Administration warns of ineffective and dangerous products sold as hand sanitizers.
Learning to Spot False or Misleading Prescription Drug Promotion
Authors: Aschenbrenner Diane S.
Published: September 2020

A free online course, eligible for continuing education credits, is available to help health care providers recognize potentially false or misleading prescription drug promotion and report it to the Food and Drug Administration.
Common Environmental Exposures Linked to Adverse Pregnancy Outcomes
Authors: Rosenberg Karen
Published: September 2020

According to this study:

Increasingly common environmental exposures exacerbated by climate change are significantly associated with adverse pregnancy outcomes in the United States.
Meeting Ms. Ada
Authors: Grogan Kara Caparulo
Published: September 2020

An encounter dreaded by a new nurse becomes a cherished memory.
Cataract surgery contributes to ocular axis growth of aphakic eyes in infants with complex microphthalmos
Authors: Sun Jinfeng , Zhang Jing , Dai Yunhai , Wan Xiaomei , Xie Lixin
Published: September 2020

To observe the ocular axis, visual acuity and intraocular pressure (IOP) of aphakic eye in infants with congenital cataract and complex microphthalmos after first-stage cataract surgery.

This retrospective study included infants with congenital cataract and operated at the Qingdao Eye Hospital between January 2010 and December 2014. The infants were divided into 2 groups: preoperative axial length <18 mm (microphthalmos) or ≥18 mm (controls). Follow-up lasted 24 months; visual acuity, axial length, and IOP were evaluated.

There were 28 infants (55 eyes) in the microphthalmos group and 35 (61 eyes) in the control group. The preoperative visual acuity was negative for optokinetic nystagmus, while the postoperative visual acuity was positive for optokinetic nystagmus in both groups. The growth rate was higher in the microphthalmos group (1.4 ± 0.8 vs 0.8 ± 0.4 mm/yr, P < .001 vs controls). The axial length was smaller in the microphthalmos group at all time points compared with the control group (all P < .001). There was no changes in IOP in the microphthalmos group from baseline to 24 months (P = .147), but the IOP was slightly decreased in the control group (P = .015).

Cataract surgery may contribute to ocular axis growth in infants with complex microphthalmos.
Effectiveness of psychological interventions for treating chronic prostatitis/chronic pelvic pain syndrome
Authors: Xu Yuanjie , Zhang Ling , Shen Yifeng , Yao Hangyu , Yong Shanshan , You Yaodong
Published: September 2020

Introduction:

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is one of the most common diseases in urology, which 50% of men are infected at some point in their lives. Type III CP/CPPS is the most complex and controversial of all types of prostatitis, the highest incidence rate, uncertain efficacy, the long-term treatment that affects the patient's psychopathic symptoms, increases the psychological burden of patients. Psychological intervention for patients with CP/CPPS, which is difficult to treat with drugs and physics, can effectively improve clinical efficacy and improve the psychological condition. The researchers found a high prevalence of psychosocial problems and catastrophic distress in CP/CPPS patients, such as serious mental disorders, especially depression, anxiety and stress, and the high incidence of pain-devastating illness. In this study, we will evaluate psychological interventions as an effective way to relieve chronic prostatitis.

Methods and analysis:

The databases of English databases (PubMed, MEDLINE, EMBASE, Web of Science, Cochrane Library) and Chinese databases (China National Knowledge Infrastructure, China Biology Medicine Database, Wanfang Database, VIP Database) will be retrieved. The search strategy that will be run in the PubMed and tailored to the other database when necessary is presented in this article. RevMan 5.3 and Stata 11.0 will be used for Systematic Review and Meta-analysis. This protocol reported under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and we will report the systematic review by following the PRISMA statement.

Results:

The study is a protocol for systematic review and meta-analysis without results, and data analysis will be carried out after the protocol. We will share our findings in the third quarter of 2021.

Conclusion:

This systematic review will provide more evidence to assess whether psychological is an effective intervention for patients with chronic prostatitis/chronic pelvic pain syndrome. Besides, the results will be published in a public issue journal and offer the urologists help to make clinical decisions.

Ethics and dissemination:

Formal ethical approval is not required in this protocol. We will collect and analyze data based on published research. Since this research does not involve patients, personal privacy will not be affected. The results of this review will be distributed to peer-reviewed journals or submitted to relevant conferences.

Protocol registration number:

INPLASY202080021
Psychological effect of comprehensive nursing intervention in elderly patients with perforated peptic ulcer
Authors: Chen Bing , Liu Xiu-Yu , Zhang Hong-Mei , Zhang Bai-Jun , Wang Ying-Ting
Published: September 2020

Background:

This study aims to assess the psychological effect of comprehensive nursing intervention (CNI) in elderly patients with perforated peptic ulcer (PPU).

Methods:

This protocol will search all potential studies from inception to the present in electronic database sources (Cochrane Library, PUBMED, EMBASE, PsycINFO, WANGFANG, CBM, and CNKI), and other sources (such as clinical trial registry, and conference proceedings). We will not apply limitations to language and publication status. Two independent authors will scan literature, extract data, and appraise study quality. A third author will be invited to solve any disagreements between 2 authors. We will utilize RevMan 5.3 software for statistical analysis. If necessary, we will also carry out subgroup group, sensitivity analysis, and reporting bias.

Results:

This protocol will summarize high quality evidence to evaluate the psychological effect of CNI in elderly patients with PPU.

Conclusion:

The results of this study may provide evidence to determine whether CNI is effective or not on psychological effect in elderly patients with PPU.

Study registration:

INPLASY202080069.
Association between phonation and the vowel quadrilateral in patients with stroke
Authors: Park Eo Jin , Kim Jae Hoon , Choi Young Hwa , Son Jung Eun , Lee Seung Ah , Yoo Seung Don
Published: September 2020

Articulation disorder is associated with impaired control of respiration and speech organ movement. There are many cases of dysarthria and dysphonia in stroke patients. Dysphonia adversely affects communication and social activities, and it can interfere with everyday life. The purpose of this study is to assess the association between phonation abilities and the vowel quadrilateral in stroke patients.

The subjects were stroke patients with pronunciation and phonation disorders. The resonance frequency was measured for the 4 corner vowels to measure the vowel space area (VSA) and formant centralization ratio (FCR). Phonation ability was evaluated by the Dysphonia Severity Index (DSI) and maximal phonation time (MPT) through acoustic evaluation for each vowel. Pearsons correlation analysis was performed to confirm the association, and multiple linear regression analysis was performed between variables.

The correlation coefficients of VSA and MPT/u/ were 0.420, VSA and MPT/i/ were 0.536, VSA and DSI/u/ were 0.392, VSA and DSI /i/ were 0.364, and FCR and DSI /i/ were −0.448. Multiple linear regression analysis showed that VSA was a factor significantly influencing MPT/u/ (β = 0.420, P = .021, R
2 = 0.147), MPT/i/ (β = 0.536, P = .002, R
2 = 0.262), DSI/u/ (β = 0.564, P = .045, R
2 = 0.256), and DSI/i/ (β = 0.600, P = .03, R
2 = 0.302).

The vowel quadrilateral can be a useful tool for evaluating the phonation function of stroke patients.
Comparative effectiveness of different therapies for treating striae distensae
Authors: Lu Haishan , Guo Jian , Hong Xudong , Chen Aifen , Zhang Xudong , Shen Shengxian
Published: September 2020

Background:

Striae distensae (SD) are common and aesthetically undesirable dermal lesions. The aim of this study is to comprehensively evaluate the effectiveness of different therapies in treating striae distensae using network meta-analysis.

Methods:

A systematic search of electronic databases up to December 1, 2019 was conducted. Randomized controlled trails (RCTs) examining the effectiveness of different methods in treating striae distensae were included. The primary outcomes are clinical effective rate and patient's satisfaction degree. Risk of bias was assessed by the Cochrane risk of bias tool. Network meta-analysis was based on Bayesian framework.

Results:

Fourteen trails that met the criteria with 651 subjects were included. The results of the network meta-analysis show that topical tretinoin combined bipolar radiofrequency showed the highest probability of being the best method to improve the clinical effectiveness and patient satisfaction rate of treating SD (84.5% and 95.7% respectively), closely followed by bipolar radiofrequency (75.3% and 84.3% respectively). Among laser treatment, CO2 fractional laser is superior to other lasers in the clinical effectiveness and patient satisfaction (72.0% and 58.1% respectively). Statistics showed the topical tretinoin was the worst-performing option in improving the clinical effectiveness and patient satisfaction rate of SD treatment (5.4% and 5.1% respectively).

Conclusion:

Based on the results of network meta-analysis, we recommend treating striae distensae with bipolar radio frequency combined topical tretinoin. The commonly used CO2 fractional laser can be considered as alternative treatment candidate. Additional large-scale RCTs are necessary to obtain more precise estimates of their relative efficacy.
Osimertinib induced cardiomyopathy
Authors: Shinomiya Shun , Kaira Kyoichi , Yamaguchi Ou , Ishikawa Keitaro , Kagamu Hiroshi
Published: September 2020

Rationale:

Cardiotoxicity related to osimertinib, including cardiac failure, QT prolongation, and atrial fibrillation, has been reported as an extremely rare incidence in patients with advanced non-small cell lung cancer (NSCLC). However, little is known about the occurrence of osimertinib-induced cardiomyopathy.

Patient concerns:

A 76-year old woman was treated with afatinib (40 mg/day) as the 1st line treatment due to recurrence after surgical resection for pulmonary adenocarcinoma. However, she experienced recurrence with positive T790 M, and osimertinib (80 mg/day) was administered as the 2nd line therapy.

Diagnosis:

Four months after osimertinib initiation, she complained of fever and progressive dyspnea, and a diagnostic endomyocardial biopsy confirmed non-specific cardiomyopathy, indicating osimertinib-induced cardiomyopathy.

Interventions and outcomes:

She was treated with furosemide, carvedilol, and enalapril, and her cardiac function, her symptoms, and condition improved 3 weeks after the withdrawal of osimertinib.

Lessons:

Physicians should be alert of the cardiomyopathy-causing potential of osimertinib in advanced NSCLC patients.
First case of bronchiolar adenoma lined purely by mucinous luminal cells with molecular analysis
Authors: Liu Shuli , Liu Nan , Xiao Mingming , Wang Liang , Wang En-Hua
Published: September 2020

Rationale:

Bronchiolar adenoma (BA) is a newly designated rare entity of the lung, including both the currently designated ciliated muconodular papillary tumor (CMPT) and so-called non-classic CMPT. The most prominent histological feature of BAs is the bilayered cell structures composed of the continuous basal cell layer and the luminal layer which consists of different proportion of mucinous cells, ciliated cells, Clara cells and/or type II pneumocytes. BA purely covered by mucinous cells without other components in the luminal layer has never been reported.

Patient concerns:

An 82-year-old female patient was detected a 0.8 cm ground glass nodule in the left lower lobe of the lung.

Diagnoses:

The serum levels of tumor markers were normal.

Interventions:

The patient underwent a segmentectomy of the left lower lobe.

Outcomes:

The postoperative pathological diagnosis was BA. Molecular analysis revealed that the tumor harbored ALK rearrangement and BRAF mutations simultaneously. There was no recurrence in 17 months of follow-up.

Lessons:

BA can be lined only by mucinous cells, without any cuboidal and/or ciliated cells in the surface layer. This sets a dangerous pitfall in differentiation diagnosis with invasive mucinous adenocarcinoma especially during intraoperative frozen pathological diagnosis.
A novel FGFR2 (S137W) mutation resulting in Apert syndrome
Authors: Shi Qingyang , Dai Rulin , Wang Ruixue , Jing Jili , Yu Xiaowei , Liu Ruizhi , Liu Yanhong
Published: September 2020

Rationale:

Apert syndrome (AS) is an autosomal dominant inheritance pattern of the most severe craniosynostosis syndrome. AS is characterized by synostosis of cranial sutures and acrocephaly, including brachycephaly, midfacial hypoplasia, and syndactyly of the hands and feet. Patients with AS often present with craniosynostosis, severe syndactyly, and skin, skeletal, brain, and visceral abnormalities.

Patient concerns:

A pregnant Chinese woman presented with a fetus at 23 + 5 weeks of gestation with suspected AS in a prenatal ultrasound examination. Following ultrasound, the pregnancy underwent spontaneous abortion. Gene sequencing was performed on the back skin of the dead fetus.

Diagnosis:

The diagnosis of AS was confirmed on the basis of clinical manifestations of the fetus, and a de novo mutation in the fibroblast growth factor receptor 2 (FGFR2) gene was identified.

Interventions:

The couple finally chose to terminate the pregnancy based on the ultrasonic malformations and the risk of the parents having a neonate with AS in the future is small. However, any future pregnancy must be assessed by prenatal diagnosis.

Outcomes:

The dead fetus presented with bilateral skull deformation. Additionally, there were bilateral changes to the temporal bone caused by inwards movement leading to concave morphology, a “clover” sign, and syndactyly from the index finger/second toe to the little finger/little toe. AS was diagnosed by genetic testing, which showed a p.S137W (c.410C>G, chr10:123279677) mutation in the FGFR2 gene.

Lessons:

Clinicians should be aware that there are a variety of ultrasound findings for AS. Therefore, genetic testing should be used when appropriate to confirm diagnosis of AS.
Antiretroviral treatment and its impact on oral health outcomes in 5 to 7 year old Ugandan children
Authors: Birungi Nancy , Fadnes Lars T. , Engebretsen Ingunn M.S. , Tumwine James K. , Åstrøm Anne Nordrehaug
Published: September 2020

Background:

Antiretroviral therapy for HIV in sub-Saharan Africa has transformed the highly infectious virus to a stable chronic condition, with the advent of Highly active antiretroviral therapy (HAART). The longterm effects of HAART on the oral health of children are understudied.

Objective:

To compare the effect of lopinavir-ritonavir and lamivudine on oral health indicators (dental caries, gingivitis, tooth eruption, and oral health related quality of life) in 5 to 7 year old HIV-1 exposed uninfected children from the ANRS 12174 trial.

Methods:

This study used data collected in 2017 among children aged 5 to 7 years from the Ugandan site of the ANRS 12174 randomized trial (ClinicalTrials.gov no: NCT00640263) implemented between 2009 and 2012 in Mbale district, Eastern Uganda. The intervention was lopinavir-ritonavir or lamuvudine treatment to prevent vertical HIV-1 transmission. One hundred thirty-seven and 139 children were randomized to receive lopinavir-ritonavir or lamivudine treatment at day 7 postpartum to compare efficacy of prevention of vertical HIV-1 transmission. At follow up, the children underwent oral examination using the World Health Organization methods for field conditions. The oral health related quality of life was assessed using the early childhood oral health impact scale. Negative binomial and logistic regression were used for the analysis of data.

Main outcome measures:

Dental caries, gingivitis, tooth eruption, and oral health related quality of life) in 5 to 7 year old HIV-1 exposed uninfected children.

Results:

The prevalence of dental caries was 48% in the study sample: 49% in the lopinavir-ritonavir arm and 48% in the lamivudine treatment group. The corresponding mean decayed missing filled teeth and standard deviation was 1.7 (2.4) and 2.3 (3.7) The mean number (standard deviation) of erupted permanent teeth was 3.8 (3.7) and 4.6 (3.9) teeth in the lopinavir- and lamivudine group, respectively. The prevalence of reported impacts on oral health was 7% in the lopinavir-ritonavir and 18% in the lamivudine group. Gingivitis had a prevalence of 7% in the lopinavir-ritonavir and 14% lamivudine treatment group. The regression analysis revealed 70% less reported impacts on oral health in lopinavir-ritonavir group than the lamivudine treatment group with an incidence rate ratio of 0.3 (95% confidence interval: 0.1–0.9).

Conclusions:

HIV exposed uninfected infants in the lopinavir-ritonavir group reported less impacts on oral health than the lamivudine treatment group. Dental caries, gingivitis, and tooth eruption were not significantly affected by the treatment lopinavir-ritonavir or lamivudine.

Trial Registration ClinicalTrials.gov identifier:

NCT00640263.
Efficacy and safety of Kanglaite injection combined with chemotherapy for colorectal cancer
Authors: Mao Weili , Fan Yihua , Cheng Chao , Yuan Xingyu , Lan Tian , Mao Kaili , Wang Jun
Published: September 2020

Background:

The incidence and mortality of colorectal cancer are high. Chemotherapy is currently the commonly used therapeutic scheme, but there are drug resistance and toxic and side effects. Kanglaite (KLT) injection is a broad-spectrum anticancer drug extracted from Semen Coicis (Yi Yi Ren), which has been widely used in the treatment of colorectal cancer. Clinical practice shows that KLT injection combined with chemotherapy has certain therapeutic advantages, but there is a lacking of evidence of evidence-based medicine. The purpose of this study is to systematically investigate the efficacy and safety of KLT injection combined with chemotherapy in the treatment of colorectal cancer.

Methods:

Randomized controlled trials of KLT injection combined with chemotherapy in the treatment of colorectal cancer were retrieved from English databases (PubMed, Embase, Web of Science, the Cochrane Library) and Chinese databases (China National Knowledge Infrastructure, Wanfang, Chongqing VIP Chinese Science and Technology Periodical Database, Chinese Biological and Medical database), as well as searching Baidu academic and Google academic manually, and the retrieval time was from their establishment to August 2020. Two researchers independently conducted data extraction and literature quality evaluation on the quality of the included literatures, and meta-analysis was conducted on the included literatures using RevMan 5.3 (developed by the UK's International Cochrane Collaboration).

Results:

This study assessed the efficacy and safety of KLT injection combined with chemotherapy in the treatment of colorectal cancer by effective rate, Karnofsky Performance Status, Carcinoemybryonic Angtigen remission rate, pain remission rate, and incidence of adverse reactions etc.

Conclusions:

This study will provide reliable evidence-based evidence for the clinical application of KLT injection combined with chemotherapy in the treatment of colorectal cancer.

Ethics and dissemination:

The private information from individuals will not be published. This systematic review also will not involve endangering participant rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.

OSF Registration number:

DOI 10.17605/OSF.IO/EKVAF
Herbal medicine Siho-sogan-san for functional dyspepsia
Authors: Ha Na-Yeon , Jeong Hae-in , Lee Ha-nul , Ko Seok-Jae , Park Jae-Woo , Kim Jinsung
Published: September 2020

Background:

Functional dyspepsia (FD) is characterized by persistent and recurrent dyspeptic symptoms, such as postprandial fullness and epigastric pain. Although it is rarely severe or life-threatening, it can degrade the quality of life and cause social and economic issues. As symptoms often persist despite the treatment with conventional Western medicine, herbal medicine can be considered as an alternative for treating FD. Siho-sogan-san (SHS) is a traditional herbal formula prescribed for dyspepsia for hundreds of years. This protocol for a systematic review was designed to evaluate the safety and efficacy of SHS for the treatment of FD through a meta-analysis.

Methods:

Studies will be searched from the following electronic databases up to March 2020: Embase, MEDLINE (via PubMED), Cochrane Central Register of Controlled Trials, Allied and Complementary Medicine Database, Korean Medical Database, KoreaMed, Korean Studies Information Service System, National Digital Science Library, Oriental Medicine Advanced Searching Integrated System, China National Knowledge Infrastructure Database, and Citation Information by Nii. Randomized controlled trials of SHS and herb-added SHS for treating FD will be selected in this review. The control groups of no-treatment, placebo, and conventional Western medicine will be compared with SHS for its efficacy. The synergetic effect of SHS with Western medicine will also be analyzed in comparison with conventional Western medicine alone. Two independent reviewers will collect the data and assess the risk of bias in individual studies. The total clinical effectiveness rate will be synthesized and evaluated as primary outcome.

Results:

This systematic review will present an adequate clinical evidence of SHS for the treatment of FD based on specific parameters, including dyspepsia-related symptoms, gastric emptying, and adverse events.

Conclusion:

This study will provide evidence for the safety and efficacy of SHS for the treatment of patients with FD.

Review Registry Unique Identifying Number:

reviewregistry952.
Acupuncture for mild cognitive impairment in elderly people
Authors: Li Weitong , Wang Qing , Du Shizheng , Pu Yalou , Xu Guihua
Published: September 2020

Background:

Acupuncture has an unique role in preventing and managing mild cognitive impairment (MCI) in nonpharmaceutical therapies because of its small wound, mild pain, and high security for many years. However, there is no systematic review evaluating safety and efficacy of acupuncture for MCI in elderly people. Therefore, this study will provide a protocol to explore the effectiveness and safety of acupuncture for MCI in the elderly.

Methods:

Retrieval from 8 electronic databases was conducted to determine eligible trials published until May, 2019. Homogeneity qualified studies were included for data were extracted such as study country location, demographic characteristics, and measure outcomes, and were analyzed by a random effect model and sensitivity analyses to identify heterogeneity. Review Manager (Revman Version 5.3) software will be used for data synthesis, sensitivity analysis, meta regression, subgroup analysis, and risk of bias assessment. A funnel plot will be developed to evaluate reporting bias.

Results:

A total of 15 randomized control trials involving 1051 subjects were included. The results were as follows: Compared with the control group, the clinical efficacy rates of acupuncture was better, odds ratio = 2.52, 95% confidence interval (CI) (1.86, 3.42), P < .00001, mini-mental state examination scores (mean difference [MD] = 1.53, 95% CI [1.04, 2.01], P < .00001), Montreal cognitive assessment scores (MD = 2.05, 95% CI [1.17, 1.92], P < .00001), activity of daily living scale (MD = 1.71, 95% CI [–1.38, 4.79], P > .05), and clock drawing task scores (MD = 1.91, 95% CI [1.74, 2.08], P < .00001).

Conclusion:

This study shows that acupuncture is beneficial for improving aspects of cognitive function in elderly people with MCI, which suggests that acupuncture may be an effective alternative and complementary approach to existing therapies for elderly people. More rigorous experimental studies and longer follow-up studies should be conducted in the future.
Relationship between hand and wrist bone age assessment methods
Authors: Bian Zhen , Guo Yuan , Lyu XueMin , Yang Zheng , Cheung Jason Pui Yin
Published: September 2020

Assessment of skeletal maturity is crucial for managing growth related problems. Tanner and Whitehouse (TW) hand and wrist bone age assessment is an accurate method; however, it is complex and labor-intensive. Several simplified methods derived from the TW method were proposed, and each had its own character. The purpose of this study is to explore the relationship between these methods for accurate usage.

Between 2018 and 2019, a cross-sectional study was performed with consecutive left hand and wrist x-rays obtained from a pediatric orthopedic clinic. Bone age assessments included the distal radius and ulna (DRU) classification, Sanders staging (S), thumb ossification composite index (T), and TW method. Somers delta correlation was conducted to determine the interchangeability of these stages. The mean bone age and standard deviation (SD) of each subgrade were compared and analyzed.

Totally 103 films (92 girls) were analyzed with mean age of 12.1 years (range: 8.0–17.9 years). The radius (R) stages had good correlation with S, T, and U stages with a very high Somers delta correlation (P < .05). R5 had relatively large SD (1.5) and referred to T2 and T3; R6 and R7 had the smallest SD (0.3) with reference to T4 or S2; R8 referred to T5 or S3, S4, S5; R9 referred to S6 and S7.

The internal relationship between the DRU and digital stages system was well proven. We also provided a simple and accurate way to assess the bone age by combination of some subgrades with smaller SD: 10y-proximal thumb covered without sesamoid (T2); 10.5y-sesamoid just appearing (T3); 11y-distal radial physis just covered (medial double joint line, R6); 11.5y-medial capping of distal radial physis (R7); 12y-bilateral capping of distal radial physis (R8) / phalangeal capping without fusion (S3); 12.5y-distal phalangeal physes start to fuse (S4); 13y-distal phalangeal physes fused (S5); 13.5y-proximal phalangeal physes start to fuse (S6); 14.5y-proximal phalangeal physes fused (S7); 15y-distal radial physis almost fused (R10).

Level of Evidence: Diagnostic study, level III.