bluuebunny/crossref_metadata_2025_split huggingface dataset:
The use of hyperbaric oxygen to treat actinic rectal fistula after SpaceOAR use and radiotherapy for prostate cancer: a case report
Authors: Kashihara Tairo , Inaba Koji , Komiyama Motokiyo , Nakayama Hiroki , Iijima Kotaro , Nishioka Shie , Okamoto Hiroyuki , Kikkawa Nao , Kubo Yuko , Shima Satoshi , Nakamura Satoshi , Takahashi Ayaka , Takahashi Kana , Okuma Kae , Murakami Naoya , Igaki Hiroshi , Nakayama Yuko , Fukunaga Arinobu , Matsui Yoshiyuki , Fujimoto Hiroyuki , Itami Jun 
Published: December 2020

Abstract
Background
In definitive radiation therapy for prostate cancer, the SpaceOAR® System, a hydrogel spacer, is widely used to decrease the irradiated dose and toxicity of rectum. On the other hand, periprostatic abscesses formation and rectal perforation are known as rare adverse effects of SpaceOAR. Nevertheless, there is a lack of reports clarifying the association between aggravation of abscesses and radiation therapy, and hyperbaric oxygen therapy (HBOT) is effective for a peri-SpaceOAR abscess and rectal perforation.

Case presentation
We report a case of a 78-year-old high-risk prostate cancer patient. After SpaceOAR insertion into the correct space, he started to receive external beam radiation therapy (EBRT). He developed a fever, perineal pain and frequent urination after the completion of EBRT, and the magnetic resonance imaging (MRI) revealed a peri-SpaceOAR abscess. Scheduled brachytherapy was postponed, administration of antibiotics and opioid via intravenous drip was commenced, and transperineal drainage was performed. After the alleviation of the abscess, additional EBRT instead of brachytherapy was performed with MRI-guided radiation therapy (MRgRT). On the last day of the MRgRT, perineal pain reoccurred, and MRI and colonoscopy detected the rectal perforation. He received an intravenous antibiotics drip and HBOT, and fully recovered from the rectal perforation.

Conclusions
Our report indicates that EBRT can lead to a severe rectum complication by causing inflammation for patients with a peri-SpaceOAR abscess. Furthermore, HBOT was effective for the peri-SpaceOAR abscess and rectal perforation associated with EBRT.
How does cognitive function measured by the reaction time and critical flicker fusion frequency correlate with the academic performance of students?
Authors: Prabu Kumar Archana , Omprakash Abirami , Kuppusamy Maheshkumar , K.N. Maruthy , B.W.C. Sathiyasekaran , P.V. Vijayaraghavan , Ramaswamy Padmavathi 
Published: December 2020

AbstractBackgroundThe reaction time (RT) is “the time taken for the appearance of rapid voluntary reaction by an individual following a stimulus, either auditory or visual” and the Critical Flickering Fusion Frequency (CFFF) is “the rate at which successively presented light stimuli appear to be steady and continuous”. RT and CFFF are commonly used for the assessment of cognitive functions that are known to influence academic performance. However, data about the exact correlation between these are scarce, particularly in India. This research aimed to study the association between visual RT (VRT), auditory RT (ART) and CFFF and their impact on the academic performance of undergraduate students.MethodsThis cross-sectional study was conducted on 700 students of Faculty of Medicine and Dentistry at a private medical university in South India, during the period from 2015 to 2017. The VRT, ART and CFFF were evaluated, and the best out of three subsequent attempts was recorded. The mean score (in percentage) of the three best marks out of the five internal assessments for the course during each academic year was considered for analysis. The association between the different cognitive tests and the average academic performance was analysed.ResultsFemale students had faster VRT (n = 345, mean = 243.97, SD = 83.87) than male students (n = 273, mean = 274.86, SD = 96.97) (p = 0.001). VRT and ART had a moderate negative correlation with academic performance (for ART,r = − 0.42,p < 0.001; for VRT;r = − 0.40,p < 0.001). CFFF had a very weak positive correlation with academic performance (r = 0.19,p = 0.01). The only independent predictors of academic performance were RT and gender (Adjusted R2 = 0.11).ConclusionAlthough there is a correlation between CFFF and cognitive function, our study showed only a weak correlation between CFFF and academic performance. Female students had faster RTs, and gender was an independent predictor of academic performance. Rather, students with faster RTs appear to have an advantage in academic performance.
Prediction of in-hospital mortality in patients on mechanical ventilation post traumatic brain injury: machine learning approach
Authors: Abujaber Ahmad , Fadlalla Adam , Gammoh Diala , Abdelrahman Husham , Mollazehi Monira , El-Menyar Ayman 
Published: December 2020

Abstract
Background
The study aimed to introduce a machine learning model that predicts in-hospital mortality in patients on mechanical ventilation (MV) following moderate to severe traumatic brain injury (TBI).

Methods
A retrospective analysis was conducted for all adult patients who sustained TBI and were hospitalized at the trauma center from January 2014 to February 2019 with an abbreviated injury severity score for head region (HAIS) ≥ 3. We used the demographic characteristics, injuries and CT findings as predictors. Logistic regression (LR) and Artificial neural networks (ANN) were used to predict the in-hospital mortality. Accuracy, area under the receiver operating characteristics curve (AUROC), precision, negative predictive value (NPV), sensitivity, specificity and F-score were used to compare the models` performance.

Results
Across the study duration; 785 patients met the inclusion criteria (581 survived and 204 deceased). The two models (LR and ANN) achieved good performance with an accuracy over 80% and AUROC over 87%. However, when taking the other performance measures into account, LR achieved higher overall performance than the ANN with an accuracy and AUROC of 87% and 90.5%, respectively compared to 80.9% and 87.5%, respectively. Venous thromboembolism prophylaxis, severity of TBI as measured by abbreviated injury score, TBI diagnosis, the need for blood transfusion, heart rate upon admission to the emergency room and patient age were found to be the significant predictors of in-hospital mortality for TBI patients on MV.

Conclusions
Machine learning based LR achieved good predictive performance for the prognosis in mechanically ventilated TBI patients. This study presents an opportunity to integrate machine learning methods in the trauma registry to provide instant clinical decision-making support.
Risk-adapted treatment reduced chemotherapy exposure for clinical stage I pediatric testicular cancer
Authors: Ye Yun-lin , Chen Zhuang-fei , Bian Jun , Liang Hai-tao , Qin Zi-ke 
Published: December 2020

Abstract
Background
Different from adult clinical stage I (CS1) testicular cancer, surveillance has been recommended for CS1 pediatric testicular cancer. However, among high-risk children, more than 50% suffer a relapse and progression during surveillance, and adjuvant chemotherapy needs to be administered. Risk-adapted treatment might reduce chemotherapy exposure among these children.

Methods
A decision model was designed and calculated using TreeAge Pro 2011 software. Clinical utilities such as the relapse rates of different groups during surveillance or after chemotherapy were collected from the literature. A survey of urologists was conducted to evaluate the toxicity of first-line and second-line chemotherapy. Using the decision analysis model, chemotherapy exposure of the risk-adapted treatment and surveillance strategies were compared based on this series of clinical utilities. One-way and two-way tests were applied to check the feasibility.

Results
In the base case decision analysis of CS1 pediatric testicular cancer, risk-adapted treatment resulted in a lower exposure to chemotherapy than surveillance (average: 0.7965 cycles verse 1.3419 cycles). The sensitivity analysis demonstrated that when the relapse rate after primary chemotherapy was ≤ 0.10 and the relapse rate of the high-risk group was ≥ 0.40, risk-adapted treatment would result in a lower exposure to chemotherapy, without any association with the proportion of low-risk patients, the relapse rate of the low-risk group, the relapse rate after salvage chemotherapy or the toxicity utility of second-line chemotherapy compared to first-line chemotherapy.

Conclusions
Based on the decision analysis, risk-adapted treatment might decrease chemotherapy exposure for these high-risk patients, and an evaluation after orchiectomy was critical to this process. Additional clinical studies are needed to validate this statement.
Early marriage and women’s empowerment: the case of child-brides in Amhara National Regional State, Ethiopia
Authors: Abera Mikyas , Nega Ansha , Tefera Yifokire , Gelagay Abebaw Addis 
Published: December 2020

AbstractBackgroundWomen, especially those who marry as children, experience various forms and degrees of exclusion and discrimination. Early marriage is a harmful traditional practice that continues to affect millions around the world. Though it has declined over the years, it is still pervasive in developing countries. In Ethiopia, Amhara National Regional State (or alternatively Amhara region) hosts the largest share of child-brides in the country. This study aimed at assessing the effects of early marriage on its survivors’ life conditions – specifically, empowerment and household decision-making – in western Amhara.MethodsThis study employed community-based cross-sectional study design. It adopted mixed method approach – survey, in-depth interview and focus group discussion (FGD) – to collect, analyse and interpret data on early marriage and its effects on household decision-making processes. The survey covered 1278 randomly selected respondents, and 14FGDs and 6 in-depth interviews were conducted. Statistical procedures – frequency distribution, Chi-square, logistic regression – were used to test, compare and establish associations between survey results on women empowerment for two groups of married women based on age at first marriage i.e., below 18 and at/after 18. Narratives and analytical descriptions were integrated to substantiate and/or explain observed quantitative results, or generate contextual themes.ResultsThis study reported that women married at/after 18 were more involved in household decision-making processes than child-brides. Child-brides were more likely to experience various forms of spousal abuse and violence in married life. The study results illustrated how individual-level changes, mainly driven by age at first marriage, interplay with structural factors to define the changing status and roles of married women in the household and community.ConclusionAge at first marriage significantly affected empowerment at household level, and women benefited significantly from delaying marriage. Increase in age did not automatically and unilaterally empowered women in marriage, however, since age entails a cultural definition of one’s position in society and its institutions. We recommend further research to focus on the nexus between the household and the social-structural forms that manifest at individual and community levels, and draw insights to promote women’s wellbeing and emancipation.
Reduced oxidized LDL in T2D plaques is associated with a greater statin usage but not with future cardiovascular events
Authors: Singh Pratibha , Goncalves Isabel , Tengryd Christoffer , Nitulescu Mihaela , Persson Ana F. , To Fong , Bengtsson Eva , Volkov Petr , Orho-Melander Marju , Nilsson Jan , Edsfeldt Andreas 
Published: December 2020

Abstract
Background
Type 2 diabetes (T2D) patients are at a greater risk of cardiovascular events due to aggravated atherosclerosis. Oxidized LDL (oxLDL) has been shown to be increased in T2D plaques and suggested to contribute to plaque ruptures. Despite intensified statin treatment during the last decade the higher risk for events remains. Here, we explored if intensified statin treatment was associated with reduced oxLDL in T2D plaques and if oxLDL predicts cardiovascular events, to elucidate whether further plaque oxLDL reduction would be a promising therapeutic target.

Methods
Carotid plaque OxLDL levels and plasma lipoproteins were assessed in 200 patients. Plaque oxLDL was located by immunohistochemistry. Plaque cytokines, cells and scavenger receptor gene expression were quantified by Luminex, immunohistochemistry and RNA sequencing, respectively. Clinical information and events during follow-up were obtained from national registers.

Results
Plaque oxLDL levels correlated with markers of inflammatory activity, endothelial activation and plasma LDL cholesterol (r = 0.22-0.32 and p ≤ 0.01 for all). T2D individuals exhibited lower plaque levels of oxLDL, sLOX-1(a marker of endothelial activation) and plasma LDL cholesterol (p = 0.001, p = 0.006 and p = 0.009). No increased gene expression of scavenger receptors was identified in T2D plaques. The lower oxLDL content in T2D plaques was associated with a greater statin usage (p = 0.026). Supporting this, a linear regression model showed that statin treatment was the factor with the strongest association to plaque oxLDL and plasma LDL cholesterol (p < 0.001 for both). However, patients with T2D more frequently suffered from symptoms and yet plaque levels of oxLDL did not predict cardiovascular events in T2D (findings are summarized in Fig. 1a).

Conclusions
This study points out the importance of statin treatment in affecting plaque biology in T2D. It also implies that other biological components, beyond oxLDL, need to be identified and targeted to further reduce the risk of events among T2D patients receiving statin treatment.
Use of long-lasting insecticidal nets among women attending antenatal clinic at a tertiary hospital in Bayelsa State, Nigeria 2019
Authors: Ibegu Maria Imaobong , Hamza Khadeejah Liman , Umeokonkwo Chukwuma David , Numbere Tamuno-Wari , Ndoreraho Adolphe , Dahiru Tukur 
Published: December 2020

Abstract
Background
Malaria in pregnancy remains a major contributor to maternal and infant morbidity and mortality despite scale up in interventions. Its prevention is one of the major interventions in reducing maternal and infant morbidity and mortality. The ownership, utilization and predictors of use of long-lasting insecticide-treated nets (LLINs) for malaria prevention among women attending antenatal clinic (ANC) at a tertiary hospital in Bayelsa State Nigeria was assessed.

Methods
A cross-sectional study of 297 women recruited through systematic sampling was carried out. Information on sociodemographic characteristics, ownership, source and utilization of LLINs, were collected with a pre-tested structured interviewer-administered questionnaire. The relationship between use of LLIN and sociodemographic characteristics was examined using chi square and logistic regression at 5% level of significance.

Results
The mean age of respondents was 28.8 ± 2.6 years. Most (59.2%) had tertiary education and were mainly (88.2%) urban dwellers. Two hundred and fifty (84.2%) owned LLINs, and 196 (78%) used LLIN the night prior to the interview. Almost half of the respondents purchased their LLINs. Those who purchased LLINs were 3 times more likely to have used it (OR: 3.13, 95% CI 1.62–6.04) compared to those that got it free. Those who were gainfully employed (OR: 3.16, 95% CI 1.59–6.29) and those who earned above the minimum wage (OR: 2.88, 95% CI 1.45–5.72) were 3 times more likely to have used LLIN in their index pregnancy.

Conclusion
The use of LLIN as a preventive measure against malaria was relatively high among the participants in this study, though still below national target. The major factors determining the use of LLIN among these women were purchase of LLINs and being gainfully employed. It was recommended that efforts should be made to enforce the policy of free LLINs at ANC registration at the tertiary hospitals, as this would further drive up ownership and utilization rates.
Unplanned hospitalizations in patients with locoregionally advanced head and neck cancer treated with (chemo)radiotherapy with and without prophylactic percutaneous endoscopic gastrostomy
Authors: Bojaxhiu Beat , Shrestha Binaya K. , Luterbacher Pascal , Elicin Olgun , Shelan Mohamed , Macpherson Andrew J. S. , Heimgartner Benjamin , Giger Roland , Aebersold Daniel M. , Zaugg Kathrin 
Published: December 2020

Abstract
Background
Current studies about percutaneous endoscopic gastrostomy (PEG) tube placement report equivalent patient outcomes with prophylactic PEG tubes (pPEGs) versus common nutritional support. Unreported was if omitting a pPEG is associated with an increased risk of complications leading to a treatment-related unplanned hospitalization (TRUH).

Methods
TRUHs were retrospectively analyzed in patients with advanced head and neck squamous cell carcinoma (n = 310) undergoing (chemo)radiotherapy with (pPEG) or without PEG (nPEG).

Results
In 88 patients (28%), TRUH was reported. One of the leading causes of TRUH in nPEG patients was inadequate oral intake (n = 16, 13%), and in pPEG patients, complications after PEG tube insertion (n = 12, 10%). Risk factors for TRUH were poor performance status, tobacco use, and surgical procedures.

Conclusions
Omitting pPEG tube placement without increasing the risk of an unplanned hospitalization due to dysphagia, dehydration or malnutrition, is an option in patients being carefully monitored. Patients aged > 60 years with hypopharyngeal carcinoma, tobacco consumption, and poor performance status appear at risk of PEG tube-related complications leading to an unplanned hospitalization.
RarERN Path: a methodology towards the optimisation of patients’ care pathways in rare and complex diseases developed within the European Reference Networks
Authors: Talarico Rosaria , Cannizzo Sara , Lorenzoni Valentina , Marinello Diana , Palla Ilaria , Pirri Salvatore , Ticciati Simone , Trieste Leopoldo , Triulzi Isotta , Terol Enrique , Bucher Anna , Turchetti Giuseppe 
Published: December 2020

AbstractBackgroundIn 2017, the European Commission has launched the European Reference Networks (ERNs), virtual networks involving healthcare providers across Europe. The aim of the ERNs is to tackle complex and rare diseases and conditions that require highly specialized treatment and a concentration of knowledge and resources. The ERN on rare and complex connective tissue and musculoskeletal diseases (ERN ReCONNET) is one of the 24 ERNs approved that aims to improve the management of Rare and Complex Connective Tissue and Musculoskeletal Diseases.ObjectiveThe RarERN Path methodology aims to create a single reference organisational model for patients’ care pathways which, if applied in different contexts, helps to ensure an improved, cost-effective and patient-centred equal care to rare and complex diseases.MethodsStarting from existing standard methods for the creation and elaboration of patients’ care pathways, a specific methodology was created in order to take advantage of the distinctive and peculiar characteristics of the ERNs. Specifically, the development of the RarERN Path methodology involved different stakeholders: health economists, clinicians and researchers expert in rare and complex diseases, communication experts, experts in patients’ involvement and narrative medicine and policy-makers.ResultsThe RarERN Path methodology foresees six consecutive phases, each with different and specific aims. Specifically, the six phases are represented by: Phase 1—mapping of existing patients’ care pathways and patients’ stories; Phase 2—design of an optimised common patients’ care pathway; Phase 3—consensus on an optimised common patients’ care pathway; Phase 4—key performance indicators definition; Phase 5—refinement; Phase 6—pilot phase (optional).ConclusionThe application of RarERN Path to the different disease-specific and geographical contexts would help to ensure an improved, cost-effective and patient-centred equal care to rare and complex diseases across Europe as well as a possible tangible action towards the integration of ERNs into the different European healthcare systems.
Altered cleavage plane orientation with increased genomic aneuploidy produced by receptor-mediated lysophosphatidic acid (LPA) signaling in mouse cerebral cortical neural progenitor cells
Authors: McDonald Whitney S. , Miyamoto Kyoko , Rivera Richard , Kennedy Grace , Almeida Beatriz S. V. , Kingsbury Marcy A. , Chun Jerold 
Published: December 2020

AbstractThe brain is composed of cells having distinct genomic DNA sequences that arise post-zygotically, known as somatic genomic mosaicism (SGM). One form of SGM is aneuploidy—the gain and/or loss of chromosomes—which is associated with mitotic spindle defects. The mitotic spindle orientation determines cleavage plane positioning and, therefore, neural progenitor cell (NPC) fate during cerebral cortical development. Here we report receptor-mediated signaling by lysophosphatidic acid (LPA) as a novel extracellular signal that influences cleavage plane orientation and produces alterations in SGM by inducing aneuploidy during murine cortical neurogenesis. LPA is a bioactive lipid whose actions are mediated by six G protein-coupled receptors, LPA1–LPA6. RNAscope and qPCR assessment of all six LPA receptor genes, and exogenous LPA exposure in LPA receptor (Lpar)-null mice, revealed involvement ofLpar1andLpar2in the orientation of the mitotic spindle.Lpar1signaling increased non-vertical cleavage in vivo by disrupting cell–cell adhesion, leading to breakdown of the ependymal cell layer. In addition, genomic alterations were significantly increased after LPA exposure, through production of chromosomal aneuploidy in NPCs. These results identify LPA as a receptor-mediated signal that alters both NPC fate and genomes during cortical neurogenesis, thus representing an extracellular signaling mechanism that can produce stable genomic changes in NPCs and their progeny. Normal LPA signaling in early life could therefore influence both the developing and adult brain, whereas its pathological disruption could contribute to a range of neurological and psychiatric diseases, via long-lasting somatic genomic alterations.