bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ethnobotany, ethnopharmacology, and phytochemistry of traditional medicinal plants used in the management of symptoms of tuberculosis in East Africa: a systematic review
Authors: Obakiro Samuel Baker , Kiprop Ambrose , Kowino Isaac , Kigondu Elizabeth , Odero Mark Peter , Omara Timothy , Bunalema Lydia 
Published: August 2020

AbstractObjectiveMany studies on the treatment of tuberculosis (TB) using herbal medicines have been undertaken in recent decades in East Africa. The details, however, are highly fragmented. The purpose of this study was to provide a comprehensive overview of the reported medicinal plants used to manage TB symptoms, and to analyze scientific reports on their effectiveness and safety.MethodA comprehensive literature search was performed in the major electronic databases regarding medicinal plants used in the management of TB in East Africa. A total of 44 reports were retrieved, and data were collected on various aspects of the medicinal plants such as botanical name, family, local names, part(s) used, method of preparation, efficacy, toxicity, and phytochemistry. The data were summarized into percentages and frequencies which were presented as tables and graphs.ResultsA total of 195 species of plants belonging to 68 families and 144 genera were identified. Most encountered species were from Fabaceae (42.6%), Lamiaceae (19.1%), Asteraceae (16.2%), and Euphorbiaceae (14.7%) families. Only 36 medicinal plants (18.5%) have been screened for antimycobacterial activity. Out of these, 31 (86.1%) were reported to be bioactive with minimum inhibitory concentrations ranging from 47 to 12,500 μg/ml. Most tested plant extracts were found to have acceptable acute toxicity profiles with cytotoxic concentrations on normal mammalian cells greater than 200 μg/ml. The most commonly reported phytochemicals were flavonoids, terpenoids, alkaloids, saponins, cardiac glycosides, and phenols. OnlyTetradenia riparia,Warburgia ugandensis, andZanthoxylum leprieuriihave further undergone isolation and characterization of the pure bioactive compounds.ConclusionEast Africa has a rich diversity of medicinal plants that have been reported to be effective in the management of symptoms of TB. More validation studies are required to promote the discovery of antimycobacterial drugs and to provide evidence for standardization of herbal medicine use.
Retinal nerve fiber layer and ganglion cell layer changes using optical coherence tomography in patients with chronic migraine: a case-control study
Authors: Labib Dalia M. , Hegazy Montaser , Esmat Soheir Mohamed , Ali Enas Abdel Hamid , Talaat Foraysa 
Published: August 2020

Abstract
Background
Migraine is a prevalent, chronic, and multifactorial neurovascular disease.

Objectives
Our work aimed to investigate if the retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness are affected in patients with chronic migraine to improve the understanding of the etiology and pathophysiology of migraine.

Subjects and methods
A case-control study conducted on 30 patients with chronic migraine and 30 aged and sex-matched healthy controls. Subjects underwent full neurological and ophthalmological history, ophthalmological examination, and measuring RNFL and GCL thickness using the spectral domain-optical coherence tomography (SD-OCT).

Results
RNFL thinning (average, superior, inferior, nasal, and temporal) was significantly more in patients with chronic migraine than healthy control (P = 0.001, 0.022, 0.045, 0.034, and 0.001, respectively). No statistically significant difference was found between chronic migraine patients and healthy controls regarding GCL thickness (average, superior, and inferior) (P value ˃ 0.05).
The average RNFL thickness was significantly thinner in migraine with aura (MwA) than migraine without aura (MwoA) (P = 0.006). The average GCL thickness was thinner in MwA than MwoA (P = 0.039). No statistically significant difference was found between the eyes on the side of the headache and the eyes of the contralateral side regarding RNFL and GCL thickness (P value ˃ 0.05). Age at onset, disease duration, headache frequency, and headache intensity showed an insignificant correlation with OCT parameters.

Conclusion
Retinal changes could be an association with chronic migraine that may be used as a biomarker.
A novel feature extraction methodology using Siamese convolutional neural networks for intrusion detection
Authors: Moustakidis Serafeim , Karlsson Patrik 
Published: August 2020

AbstractIntrusion detection systems (IDS) can play a significant role in detecting security threats or malicious attacks that aim to steal information and/or corrupt network protocols. To deal with the dynamic and complex nature of cyber-attacks, advanced intelligent tools have been applied resulting into powerful and automated IDS that rely on the latest advances of machine learning (ML) and deep learning (DL). Most of the reported effort has been devoted on building complex ML/DL architectures adopting a brute force approach towards the maximization of their detection capacity. However, just a limited number of studies have focused on the identification or extraction of user-friendly risk indicators that could be easily used by security experts. Many papers have explored various dimensionality reduction algorithms, however a large number of selected features is still required to detect the attacks successfully, which humans cannot intuitively or immediately understand. To enhance user’s trust and understanding on data without sacrificing on accuracy, this paper contributes to the transformation of the available data collected by IDS into a single actionable and easy-to-understand risk indicator. To achieve this, a novel feature extraction pipeline was implemented consisting of the following components: (i) a fuzzy allocation scheme that transforms raw data to fuzzy class memberships, (ii) a novel modality transformation mechanism for converting feature vectors to images (Vec2im) and (iii) a dimensionality reduction module that makes use of Siamese convolutional neural networks that finally reduces the input data dimensionality into a 1-d feature space. The performance of the proposed methodology was validated with respect to detection accuracy, dimensionality reduction performance and execution time on the NSL-KDD dataset via a thorough comparative analysis that demonstrated its effectiveness (86.64% testing accuracy using only one feature) over a number of well-known feature selection (FS) and extraction techniques. The output of the proposed feature extraction pipeline could be potentially used by security experts as an indicator of malicious activity, whereas the generated images could be further utilized and/or integrated as a visual analytics tool in existing IDS.
Perceived benefits and barriers towards exercise among healthcare providers in Ain Shams University Hospitals, Egypt
Authors: Gabal Hebat-Allah M. S. , Wahdan Maha M. , Eldin Waleed Salah 
Published: August 2020

Abstract
Background
Physical inactivity is considered a problem with great impact on morbidity and mortality. There is a necessity to combat this behavior through an assessment of barriers and benefits perceived by subjects.

Objectives
The current study aimed to measure exercise intention, in addition to identifying physical exercise predictors, including perceived barriers and benefits among healthcare providers (HCPs) in Ain Shams University Hospitals.

Methods
A cross-sectional study was performed on a sample (n = 327) of healthcare providers (physicians and nurses) in Ain Shams University Hospitals in Cairo, Egypt, using anonymous self-administrated questionnaires and relevant scales.

Results
Out of 327 healthcare providers approached, 52.6% of them were males and the mean age of participants was (29.34 ± 7.84 years). Physical exercise was reported by 44.6% of participants. The most significant factors associated with physical exercise engagement were male gender, participants with lower body mass index (BMI), and those with higher perceived “life enhancement subscale” benefit score and lower perceived exercise milieu and physical exertion barriers subscale scores. Exercisers showed significantly higher total overall (benefits and barriers) score compared to non-exercisers. Physicians showed a significantly higher total score compared to nurses.

Conclusion and recommendations
The prevalence of regular exercise is low and inversely related to the female gender, BMI, Exercise milieu, and Physical exertion barriers subscale scores, and directly related to life enhancement benefit subscale score. Health education program about the benefits and barriers of exercise is recommended to encourage healthcare personnel to follow a healthy lifestyle as a role model to their patients and to act as health promoters to them.
Performance of bone mineral density and trabecular bone score in assessment of bone quality in Egyptian male patients with ankylosing spondylitis
Authors: Adel Yasmin , El Adalany Mohamed Ali , Bassiouni Sherine Abdel Rahman Abdel Karim 
Published: August 2020

Abstract
Background
Osteoporosis is a common complication of ankylosing spondylitis (AS) even in the early stages of disease; however, previously published studies have demonstrated large discrepancies in the reported incidence of osteoporosis, based on measurement of bone mineral density (BMD). The aim of the present study was to compare bone quality using trabecular bone score (TBS) between AS patients and healthy controls and to evaluate factors associated with TBS in patients with AS.

Results
Ankylosing spondylitis patients had significantly lower BMD and T score at the neck of femur and lower total hip BMD than controls (BMD p = 0.010 and 0.032 respectively), (T score p = 0.006 and p = 0.025 respectively). The mean TBS was significantly lower in AS patients than in controls (p < 0.001). Lumbar spine TBS was directly correlated with BMI (p = 0.029) and BMD at the neck of femur (p = 0.016) and BMD of total hip (p = 0.007) while inversely correlated with the Bath AS Metrology Index (BASMI) (p = 0.026), the modified Stoke AS Spinal Score (mSASS) (p = 0.029), ESR (p = 0.031), and CRP (p = 0.033).

Conclusion
TBS evaluation detected lower bone quality in the lumbar spine in patients with AS when compared with matched controls, while lumbar BMD failed to identify it. These findings encourage the use of TBS as a beneficial tool to recognize the risk of axial osteoporosis as early as possible in AS patients. Also, we recommend its use for regular follow up of drug treatment for those patients.
Effects of genomic copy number variants penetrant for schizophrenia on cortical thickness and surface area in healthy individuals: analysis of the UK Biobank
Authors: Caseras Xavier , Kirov George , Kendall Kimberley M. , Rees Elliott , Legge Sophie E. , Bracher-Smith Matthew , Escott-Price Valentina , Murphy Kevin 
Published: August 2020

BackgroundSchizophrenia is a highly heritable disorder with undetermined neurobiological causes. Understanding the impact on brain anatomy of carrying genetic risk for the disorder will contribute to uncovering its neurobiological underpinnings.AimsTo examine the effect of rare copy number variants (CNVs) associated with schizophrenia on brain cortical anatomy in a sample of unaffected participants from the UK Biobank.MethodWe used regression analyses to compare cortical thickness and surface area (total and across gyri) between 120 unaffected carriers of rare CNVs associated with schizophrenia and 16 670 participants without any pathogenic CNV. A measure of cortical thickness and surface area covariance across gyri was also compared between groups.ResultsCarrier status was associated with reduced surface area (β = −0.020 mm2,P< 0.001) and less robustly with increased cortical thickness (β = 0.015 mm,P= 0.035), and with increased covariance in thickness (carriersz= 0.31v.non-carriersz= 0.22,P< 0.0005). Associations were mainly present in frontal and parietal areas and driven by a limited number of rare risk alleles included in our analyses (mainly 15q11.2 deletion for surface area and 16p13.11 duplication for thickness covariance).ConclusionsResults for surface area conformed with previous clinical findings, supporting surface area reductions as an indicator of genetic liability for schizophrenia. Results for cortical thickness, though, argued against its validity as a potential risk marker. Increased structural thickness covariance across gyri also appears related to risk for schizophrenia. The heterogeneity found across the effects of rare risk alleles suggests potential different neurobiological gateways into schizophrenia's phenotype.
Exploration of PCORnet Data Resources for Assessing Use of Molecular-Guided Cancer Treatment
Authors: Carnahan Ryan M. , Waitman Lemuel R. , Charlton Mary E. , Schroeder Mary C. , Bossler Aaron D. , Campbell W. Scott , Campbell James R. , McDowell Bradley D. , Smith Nicholas C. , Gryzlak Brian M. , Chrischilles Elizabeth A. 
Published: August 2020

PURPOSE Examine the ability of PCORnet data resources to investigate molecular-guided cancer treatment. PATIENTS AND METHODS Patients (N = 86,154) had single primary solid tumors (diagnosed 2013-2017) from hospital oncology registries linked to the PCORnet Common Data Model (CDM) at 11 medical institutions. Molecular and anatomic test procedures and oral and infused therapies were identified with Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes, RxNorm Concept Unique Identifier, and National Drug Codes from CDM tables. Chart review (2 institutions, n = 213) for advanced colorectal cancer and Medicare claims linkages (7 institutions, n = 1,731) for breast cancer explored options for increasing electronic data capture. RESULTS Molecular testing prevalence detected via analyte-specific molecular CPT/HCPCS codes was 5.5% (n = 4,784); for the nonspecific anatomic pathology codes, for which only some testing is performed to guide therapy selection, it was an additional 44.8% (n = 38,610). Molecular-guided therapy prevalence was 5% (n = 4,289). Testing and treatment were most common with stage IV disease and varied across cancer types and study institutions (testing, 0%-10.4%; treatment, 0.8%-8.4%). Therapy-concordant test results were found in charts for all 36 treated patients with colorectal cancer at the 2 institutions, 3 (8.3%) of whom received treatment outside the institution. Breast cancer Medicare claims linkage increased rates of identified testing from 62.7%-98.9% and treatment from 3.9%-8.2%. CONCLUSION Although a minority of patients received molecular-guided therapies, the majority had testing that could guide cancer treatment. Claims data extended electronic data capture for therapies and test orders but often was uninformative for types of test ordered. Test results continue to require text data curation from narrative pathology reports.
Chemotherapy Treatment Modifications During the COVID-19 Outbreak at a Community Cancer Center in New York City
Authors: Lin Dong D. , Meghal Trishala , Murthy Pooja , Mo Lan , D’Silva Ashley , Huang Yiwu , Xu Yiqing 
Published: August 2020

PURPOSE As a result of their immunocompromised status associated with disease and treatment, patients with cancer face a profound threat for higher rates of complications and mortality if they contract the coronavirus disease 2019 infection. Medical oncology communities have developed treatment modifications to balance the risk of contracting the virus with the benefit of improving cancer-related outcomes. METHODS We systemically examined our community cancer center database to display patterns of change and to unveil factors that have been considered with each decision. We studied a cohort of 282 patients receiving treatment and found that 159 patients (56.4%) had treatment modifications. RESULTS The incidence of treatment modification was observed in patients undergoing adjuvant and neoadjuvant (41.4%), palliative (62.9%), or injectable endocrine or bone-modulating only (76.0%) treatments. Modifications were applied to regimens with myelosuppressive (56.5%), immunosuppressive (69.2%), and immunomodulating (61.5%) potentials. These modifications also affected intravenous (54.9%) and subcutaneous injectable treatments (62.5%) more than oral treatments (15.8%). Treatment modifications in 112 patients (70.4%) were recommended by providers, and 47 (29.6%) were initiated by patients. The most common strategy of modification was to skip or postpone a scheduled treatment (49%). Among treatment with no modifications, treatment regimens were maintained in patients who tolerated treatment well (37.0%), in treatments with curative intent (22%), and in symptomatic patients who required treatment (14%). CONCLUSION Our observation and analysis suggested that the primary goal of treatment modification was to decrease potential exposure. The pattern also reflected the negative impact of the pandemic on health care providers who initiated these changes. Providers have to consider individualized recommendations incorporating multiple factors, such as tolerance, potential toxicity, treatment nature and route, and disease severity.
Social Media Perceptions of Surgical Cancer Care in the Era of COVID-19: A Global Cross-Sectional Study
Authors: Keil Evan J. , Navarro Sergio M. , Shaikh Hashim , Yao Lilian E. , Tuttle Todd M. 
Published: August 2020

PURPOSEThe rapid dissemination of information through social media renders a profound lens to evaluate perceptions of emerging topics, especially in the context of a global pandemic. The primary objective of this cross-sectional study was to elucidate trends on social media in the setting of surgical cancer care affected by the COVID-19 pandemic across the globe.METHODSA public search of Twitter from April 1 to 30, 2020, was conducted, which yielded 996 posts related to COVID-19 and cancer. Two authors (E.J.K. and H.S.) individually reviewed all posts and recorded the post category, engagement, author category, and geographic location. Data were then analyzed through descriptive analyses. Only English-language posts were included, and any noncancer- or non-COVID–related posts were excluded from the analysis.RESULTSA total of 734 unique authors from 26 different countries wrote 996 relevant posts that averaged 12.0 likes, 4.7 retweets, and 0.5 hashtags per post. Only 2.3% (23 of 996) of posts included a video. Authors of the included tweets most frequently were friends and families of patients (183; 18.4%), academic institutions or organizations (182; 18.3%), and physicians (138; 13.9%). Topics of importance were cancellations of surgeries (299; 40.1%), COVID-19 education (211; 121.2%), and research studies (93; 9.3%). The United Kingdom and the United States made up 81.5% of the cohort, followed by Canada (6.6%) and India (2.4%). Of posts where a specific type of surgery was identified (196), the most common type mentioned was breast cancer (50; 25.5%), followed by lung cancer (37; 18.9%) and urologic cancer (22; 11.2%).CONCLUSIONThis analysis provides insight into the resulting impacts of COVID-19 on the global discussion of surgical cancer care.
Cost-Effectiveness of the International Late Effects of Childhood Cancer Guideline Harmonization Group Screening Guidelines to Prevent Heart Failure in Survivors of Childhood Cancer
Authors: Ehrhardt Matthew J. , Ward Zachary J. , Liu Qi , Chaudhry Aeysha , Nohria Anju , Border William , Fulbright Joy M. , Mulrooney Daniel A. , Oeffinger Kevin C. , Nathan Paul C. , Leisenring Wendy M. , Constine Louis S. , Gibson Todd M. , Chow Eric J. , Howell Rebecca M. , Robison Leslie L. , Armstrong Gregory T. , Hudson Melissa M. , Diller Lisa , Yasui Yutaka , Armenian Saro H. , Yeh Jennifer M. 
Published: August 2020

PURPOSE Survivors of childhood cancer treated with anthracyclines and/or chest-directed radiation are at increased risk for heart failure (HF). The International Late Effects of Childhood Cancer Guideline Harmonization Group (IGHG) recommends risk-based screening echocardiograms, but evidence supporting its frequency and cost-effectiveness is limited. PATIENTS AND METHODS Using the Childhood Cancer Survivor Study and St Jude Lifetime Cohort, we developed a microsimulation model of the clinical course of HF. We estimated long-term health outcomes and economic impact of screening according to IGHG-defined risk groups (low [doxorubicin-equivalent anthracycline dose of 1-99 mg/m2 and/or radiotherapy < 15 Gy], moderate [100 to < 250 mg/m2 or 15 to < 35 Gy], or high [≥ 250 mg/m2 or ≥ 35 Gy or both ≥ 100 mg/m2 and ≥ 15 Gy]). We compared 1-, 2-, 5-, and 10-year interval-based screening with no screening. Screening performance and treatment effectiveness were estimated based on published studies. Costs and quality-of-life weights were based on national averages and published reports. Outcomes included lifetime HF risk, quality-adjusted life-years (QALYs), lifetime costs, and incremental cost-effectiveness ratios (ICERs). Strategies with ICERs < $100,000 per QALY gained were considered cost-effective. RESULTS Among the IGHG risk groups, cumulative lifetime risks of HF without screening were 36.7% (high risk), 24.7% (moderate risk), and 16.9% (low risk). Routine screening reduced this risk by 4% to 11%, depending on frequency. Screening every 2, 5, and 10 years was cost-effective for high-risk survivors, and every 5 and 10 years for moderate-risk survivors. In contrast, ICERs were > $175,000 per QALY gained for all strategies for low-risk survivors, representing approximately 40% of those for whom screening is currently recommended. CONCLUSION Our findings suggest that refinement of recommended screening strategies for IGHG high- and low-risk survivors is needed, including careful reconsideration of discontinuing asymptomatic left ventricular dysfunction and HF screening in low-risk survivors.
Phase II Study of Combination Obinutuzumab, Ibrutinib, and Venetoclax in Treatment-Naïve and Relapsed or Refractory Chronic Lymphocytic Leukemia
Authors: Rogers Kerry A. , Huang Ying , Ruppert Amy S. , Abruzzo Lynne V. , Andersen Barbara L. , Awan Farrukh T. , Bhat Seema A. , Dean Allison , Lucas Margaret , Banks Christin , Grantier Cara , Heerema Nyla A. , Lozanski Gerard , Maddocks Kami J. , Valentine Thomas R. , Weiss David M. , Jones Jeffrey A. , Woyach Jennifer A. , Byrd John C. 
Published: August 2020

PURPOSE The development of highly effective targeted agents for chronic lymphocytic leukemia offers the potential for fixed-duration combinations that achieve deep remissions without cytotoxic chemotherapy. PATIENTS AND METHODS This phase II study tested a combination regimen of obinutuzumab, ibrutinib, and venetoclax for a total of 14 cycles in both patients with treatment-naïve (n = 25) and relapsed or refractory (n = 25) chronic lymphocytic leukemia to determine the response to therapy and safety. RESULTS The primary end point was the rate of complete remission with undetectable minimal residual disease by flow cytometry in both the blood and bone marrow 2 months after completion of treatment, which was 28% in both groups. The overall response rate at that time was 84% in treatment-naïve patients and 88% in relapsed or refractory patients. At that time, 67% of treatment-naïve patients and 50% of relapsed or refractory patients had undetectable minimal residual disease in both the blood and marrow. At a median follow-up of 24.2 months in treatment-naïve patients and 21.5 months in relapsed or refractory patients, the median progression-free and overall survival times were not yet reached, with only 1 patient experiencing progression and 1 death. Neutropenia and thrombocytopenia were the most frequent adverse events, followed by hypertension. Grade 3 or 4 neutropenia was experienced by 66% of patients, with more events in the relapsed or refractory cohort. There was only 1 episode of neutropenic fever. A favorable impact on both perceived and objective cognitive performance during treatment was observed. CONCLUSION The combination regimen of obinutuzumab, ibrutinib, and venetoclax offers time-limited treatment that results in deep remissions and is now being studied in phase III cooperative group trials.