bluuebunny/crossref_metadata_2025_split huggingface dataset:
A phase I dose escalation trial using intensity-modulated radiotherapy with simultaneous integrated boost in pelvic chemoradiotherapy for metastatic rectal cancer
Authors: Lizée Thibaut , Seegers Valérie , Blanchecotte Julien , Rio Emmanuel , Capitain Olivier , Véronique Guerin-Meyer , Legouté Florence , Autret Damien , Mahé Marc-Andre , Paumier Amaury 
Published: December 2020

Abstract
BackgroundIn unresectable metastatic rectal cancers, the surgery of the primitive tumor remains highly debated. Chemoradiotherapy (CRT) of the primitive could allow sufficient local control in order to avoid major and sometimes mutilating surgery. Dose escalation during CRT could increase this local control. The aim of this study was to evaluate the feasibility and tolerance of a CRT with radiation dose escalation delivered in intensity modulated radiotherapy (IMRT) with simultaneous integrated boost (SIB), in metastatic low and middle rectal cancers.MethodsThis multicenter phase I study included six patients treated for unresectable synchronous metastatic low and middle rectal adenocarcinoma in two dose levels. Radiotherapy was delivered using IMRT with SIB. The dose escalation was 52.5 Gy (level 1) and 56.25 Gy (level 2) in the primary tumor, in 25 fractions of 2.1 Gy and 2.25 Gy, respectively. High-risk clinical target volume (CTV) and low-risk CTV received respectively 50 Gy and 45 Gy in 25 fractions in the two levels. Concomitant chemotherapy was oral capecitabine and CRT was performed after four cycles of mFOLOX6 chemotherapy. The dose-limiting toxicity (DLT) was defined by a toxicity requiring the interruption of radiotherapy for more than five consecutive fractions.ResultsAll six patients received the full course of treatment at scheduled doses. No patients had acute toxicity requiring interruption of radiotherapy therefore no DLT has been reported. No patients had acute toxicity ≥ 3. Concerning late toxicity, three patients experienced grade 3. After CRT, four patients had a partial response and one patient had a complete clinical response. Two patients were considered in local progression at 9.4 months and 20.4 months of inclusion.ConclusionsDose escalation at 56.25 Gy in the tumor lesion was possible with good acute tolerance. It needs to be evaluated in a larger study. It could allow sufficient local control in order to avoid mutilating surgery in these metastatic patients.Trial registrationNCT03634202. Registered 16 August 2018 – retrospectively registered, https://www.clinicaltrials.gov/ct2/show/NCT03634202
Effect of perfluorosulfonic acid side chains on oxygen permeation in hydrated ionomers of PEMFCs: Molecular dynamics simulation approach
Authors: Kwon Sung Hyun , Kang Haisu , Sohn Young-Jun , Lee Jinhee , Shim Sunbo , Lee Seung Geol 
Published: December 2020

Abstract
We prepared two types of perfluorosulfonic acid (PFSA) ionomers with Aquivion (short side chain) and Nafion (long side chain) on a Pt surface and varied their water contents (2.92 ≤ λ ≤ 13.83) to calculate the solubility and permeability of O2 in hydrated PFSA ionomers on a Pt surface using full atomistic molecular dynamics (MD) simulations. The solubility and permeability of O2 molecules in hydrated Nafion ionomers were greater than those of O2 molecules in hydrated Aquivion ionomers at the same water content, indicating that the permeation of O2 molecules in the ionomers is affected not only by the diffusion coefficient of O2 but also by the solubility of O2. Notably, O2 molecules are more densely distributed in regions where water and hydronium ions have a lower density in hydrated Pt/PFSA ionomers. Radial distribution function (RDF) analysis was performed to investigate where O2 molecules preferentially dissolve in PFSA ionomers on a Pt surface. The results showed that O2 molecules preferentially dissolved between hydrophilic and hydrophobic regions in a hydrated ionomer. The RDF analysis was performed to provide details of the O2 location in hydrated PFSA ionomers on a Pt surface to evaluate the influence of O2 solubility in ionomers with side chains of different lengths. The coordination number of C(center)–O(O2) and O(side chain)–O(O2) pairs in hydrated Nafion ionomers was higher than that of the same pairs in hydrated Aquivion ionomers with the same water content. Our investigation provides detailed information about the properties of O2 molecules in different PFSA ionomers on a Pt surface and with various water contents, potentially enabling the design of better-performing PFSA ionomers for use in polymer electrolyte membrane fuel cells.
Dynamic QTL analysis for developmental behavior of cell wall components and forage digestibility in maize (Zea mays L.)
Authors: Li Kun , Yang Xue , Liu Xiaogang , Hu Xiaojiao , Wu Yujin , Wang Qi , Ma Feiqian , Li Shuqiang , Wang Hongwu , Liu Zhifang , Huang Changling 
Published: December 2020

Abstract
Background

Cell wall architecture plays a key role in stalk strength and forage digestibility. Lignin, cellulose and hemicellulose are the three main components of the plant cell wall and can impact stalk quality by affecting cell wall structure and strength. To explore cell wall development during secondary cell wall lignification in maize stalks, conventional and conditional genetic mappings was used to identify the dynamic quantitative trait locus (QTL) for cell wall components and digestibility traits in five growth stages after silking.
Results

Acid detergent lignin (ADL), cellulose (CEL), Acid detergent fiber (ADF), neutral detergent fiber (NDF), and in vitro dry matter digestibility (IVDMD) of stalk were evaluated in a maize recombinant inbred line (RIL) population. The cell wall components gradually increased in the 10–40 days after silking (DAS), reached a maximum at 30–40 DAS, and then steadily decreased. IVDMD decreased over the initial 40 DAS and then increased slightly. Seventy-two QTL were identified for five traits and each accounted for 3.48–24.04% of the phenotypic resistance variation. Twenty-six conditional QTL were detected using conditional QTL mapping. 22 out of 24 conditional QTL were found for stages III|II and V|IV. Six QTL hotspots were found localized in bins 1.08, 2.04, 2.07, 7.03, 8.05, and 9.03 in the maize genome.
Conclusion

The unconditional pleiotropic QTL in bins 1.08 and 8.05 were also associated with stalk strength. Furthermore, several pleiotropic QTL for cell wall and digestibility were found not associated with stalk strength. A simultaneous improvement in forage digestibility and lodging resistance can be achieved by pyramiding multiple effective QTL identified in the present study.
Super Bolus – A Remedy for A High Glycemic Index Meal in Children With Type 1 Diabetes on Insulin Pump Therapy?:&nbsp;Study&nbsp;Protocol for a Randomised Controlled Trial.
Authors: Kowalczyk Emilia , Dżygało Katarzyna , Szypowska Agnieszka 
Published: December 2020

Abstract
Background: Postprandial hyperglycemia (PPH) is common clinical problem among patients with type 1 diabetes (T1D), especially in relation to high glycemic index (h-GI) meals. The main problem are high, sharp glycemic spikes with following hypoglycemia after h-GI meal consumption. There is lack of effective and satisfactory solutions concerning insulin dose adjustment to cover the h-GI meal. The goal of this research is to find out whether a Super Bolus is an effective strategy to prevent postprandial hyperglycemia and late hypoglycemia after h-GI meal in comparison to the normal bolus.Methods: A total of 72 children aged 10-18 years with T1D for at least 1 year, treated with continuous subcutaneous insulin infusion for more than 3 months will be enrolled in a double-blind, randomized, cross-over clinical trial. Participants will receive the prandial insulin bolus for h-GI breakfast in the form of Super Bolus and as Normal Bolus another day. The primary outcome measure will be the glucose level 90 minutes after administration the prandial bolus. The secondary endpoints will refer to glucose level 30, 60, 120, 150, 180 minutes postprandially; the area under the blood glucose curve within 180 min postprandially; the peak glucose and time to peak glucose level; the glycemic rise, mean amplitude of glycemic excursion, time in postprandial glucose range and the number of hypoglycemia episodes.Discussion: There is a lack of clinical studies concerning this kind of bolus. Available literature refers only to in-silico studies and case reports. The Super Bolus was defined as a prandial insulin dose increased by 50% in comparison to the dose calculated based on individualized patient’s Insulin-Carbohydrate Ratio (ICR) and simultaneous suspension of the basal insulin for 2 hours. The comprehensive and effective solution to this frequent clinical difficulty of PPH after h-GI meals has not been found yet. The problem is known and important but the presented solution innovatory and easy to apply in every-day life.Trial registration: The trial was registered at the ClinicalTrials.gov prior to the inclusion of the first patient, 15 July 2019 on registration number: NCT04019821.
Crystal and Electronic Structure Engineering of Tin Monoxide by External Pressure
Authors: Li Kun , Wang Junjie , Blatov Vladislav A. , Gong Yutong , Umezawa Naoto , Tada Tomofumi , Hosono Hideo , Oganov Artem R. 
Published: December 2020

Abstract
Although tin monoxide (SnO) is an interesting compound due to its p-type conductivity, a widespread application of SnO has been limited by its narrow band gap of 0.7 eV. In this work, we theoretically investigate the structural and electronic properties of several SnO phases under high pressure through employing van der Waals (vdW) functionals. Our calculations reveal that a metastable SnO (A-SnO), which possesses space group P21/c and a wide band gap of 1.9 eV, is more stable than l-SnO at pressures higher than 80 GPa. Moreover, a stable (space group P2/c) and a metastable (space group Pnma) phases of SnO appear at pressures higher than 120 GPa. Energy and topological analyses show that P2/c-SnO has a high possibility to directly transform to t-SnO at around 120 GPa. Our work also reveals that h-SnO is a necessary intermediate state between high-pressure phase Pnma-SnO and low-pressure phase o-SnO for the phase transition path Pnma-SnO ®u-SnO ® g-SnO. Two phase transition analyses indicate that there is a high possibility to synthesize h-SnO under high-pressure conditions and have it remain stable under normal pressure. Finally, our study reveals that the conductive property of -SnO can be engineered in a low-pressure range (0-9 GPa) through a semiconductor-to-metal transition, while maintaining transparency in the visible light range.
The Effectiveness and Safety of Heat Sensitive Moxibustion for Anaphylactic Rhinitis: A PRISMA&nbsp;Compliance Systematic Review and Meta-Analysis of Randomized Clinical Trials
Authors: Yang Jun , Xiong Jun , Yuan Ting , Wang Xue , Yunfeng Yun Feng , Zhou Xiao hong , Kai Liao , Xu Ling Ling 
Published: December 2020

Abstract
BackgroundAnaphylactic rhinitis (AR) is an IgE antibody-mediated, inflammatory disorder. Heat- sensitive moxibustion (HSM) has been accepted for AR in clinically. Our study was conducted to evaluate the effectiveness and safety of HSM for AR. MethodsWe conducted a comprehensive literature review of the PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Science and Technology Periodical Database (VIP) and Chinese Biomedical Literature Database (CBM) from their inception to April 2020 for RCTs that compared HSM with other active intervention for AR. The primary outcome measure was the total nasal symptom and sign score, and secondary outcomes include total effective rate, Rhinoconjunctivitis quality of life questionnaire (RQLQ) and adverse events. More than two authors independently conducted the process of data collection and analysis by Review Manager (Version 5.3). ResultsA total of 15 RCTs of 1087 participants were included in our study. The overall meta-analysis demonstrated that HSM were superior in relieving the symptoms and signs of AR in treatment (SMD = -1.46, 95%CI (-1.81, -1.10); P < 0.00001) or during the follow-up period (SMD = -2.87, 95%CI (-5.11, -0.63); P < 0.0001). The results also applied to the total effective rate (OR = 2.96, 95%CI (2.19, 4.00); P < 0.00001) and RQLQ (SMD = -7.80, 95%CI (-13.92, -1.68); P < 0.00001) in treatment. Subgroup analysis indicated that there was a significant difference between the HSM group and control group. There were two studies referred to the adverse effects. The overall level of evidence was low with low methodology quality. ConclusionThis meta-analysis suggests that the effectiveness of HSM on AR were statistically significant in treatment or during the follow-up period. However, the included studies have relatively poor quality; further high-quality trials should be conducted to confirm our finding.Systematic review registrationPROSPERO CRD42019140723
The Effect of An mLearning Application on Nurses’ and Midwives’ Knowledge and Skills for The Management of Postpartum Hemorrhage and Neonatal Resuscitation: Quasi-Experimental Study.
Authors: Nishimwe Aurore , Ibisomi Latifat , Nyssen Marc , Conco Daphney Nozizwe 
Published: December 2020

Abstract
Background: Globally, mobile learning (mLearning) tools have attracted considerable attention as a means of continuous training for healthcare workers. Rwanda like other low-resource settings with scarce in-service training opportunities requires innovative approaches that adapt technology to context to improve healthcare workers’ knowledge and skills. One such innovation is the safe delivery application (SDA), a smartphone mLearning application for Basic Emergency Obstetric and Neonatal Care (BEmONC) content. This study assessed the effect of the SDA intervention on nurses’ and midwives’ knowledge and skills for the management of postpartum hemorrhage (PPH) and neonatal resuscitation (NR).Methods: The study used a pre-post, quasi-experimental design to compare knowledge and skills of nurses and midwives in the management of PPH and NR at two measurement points: immediately prior SDA intervention and after 6 months SDA intervention. The intervention took place in two district hospitals in Rwanda and included 54 participants. A paired-sample t-test was used to measure the pre-post intervention, mean knowledge and skills scores differences. Confidence intervals (CIs) and effect size were calculated. A t-test and a one-way Anova was used to test for potential confounders. Results: The analysis included 54 participants. Knowledge scores and skills scores on PPH management and NR increased significantly from baseline to endline measurements. The mean difference for PPH knowledge is 17.1 out of 100; 95% CI = 14.69 to 19.49 and 2.6% for PPH skills; 95% CI = 1.01 to 4.25. The mean difference for NR knowledge is 19.1 out of 100; 95% CI = 16.31 to 21,76 and 5.5% for NR skills; 95% CI = 3.66 to 7.41. Increases were unaffected by participants’ attendance to in-service training six months prior and during SDA intervention and previous smartphone use. However, pre- and post-intervention skills scores were significantly different by years of experience in obstetric care.Conclusion: The SDA intervention improved the knowledge and skills of nurses and midwives on the management of PPH and NR as long as 6 months after SDA introduction. The results are highly relevant in low-income countries like Rwanda, where quality of delivery care is challenged by a lack of in-service continuous training for healthcare providers.
Clinical Outcomes of Severe Sepsis and Septic Shock Patients with Left Ventricular Dysfunction Undergoing Continuous Renal Replacement Therapy: A Multicenter Retrospective Study
Authors: Yu Guangwei , Cheng Kun , Liu Qing , Zhu Zhenhao , Lin Fenghui , Lin Xiaohong , Wu Wenwei 
Published: December 2020

Abstract
Background: Baseline left ventricular (LV) dysfunction is associated with subsequent risks of acute kidney injury (AKI) and mortality in patients with sepsis. This study investigated the therapeutic effects of continuous renal replacement therapy (CRRT) in hemodynamically unstable patients with severe sepsis and septic shock combined with LV dysfunction.Methods: In this multicenter retrospective study, severe sepsis and septic shock patients with LV dysfunction were classified into one of two groups according to the timing of CRRT: the early group (before AKI was detected) or the control group (patients with AKI). All-cause intensive care unit (ICU) mortality and ICU stay were compared between the groups. Patients were weighted by stabilized inverse probability of treatment weights (sIPTW) to overcome differences in baseline characteristics.Results: After sIPTW analysis, the ICU mortality was significantly lower in the early group than the control group (25.9% vs 59.0%, p < 0.001). Weighted multivariable analysis showed that early CRRT initiation was a protective factor for the risk of ICU mortality. Early CRRT initiation significantly improved the ICU mortality compared to the control group (OR, 0.322; 95% CI, 0.125-0.834; p = 0.020).Conclusions: Early CRRT in the absence of AKI is suggested for hemodynamically unstable patients with severe sepsis and septic shock combined with LV dysfunction since it benefits survival outcomes.Trial registration: The study was preregistered in the Chinese Clinical Trial Registry (number, ChiCTR2000033083).
A Novel Longshi Scale Measured Activity of Daily Living Disability in Elderly Patients Affected by Neurological Diseases: a Multi-center Cohort Study in China
Authors: Zhao Jingpu , Wan Li , Gao Yan , Huang Meiling , Liu Xiangxiang , Zha Fubing , Long Jianjun , Li Dongxia , Wang Yulong 
Published: December 2020

Abstract
Background: The activity of daily life (ADL) ability is often impaired in the elderly patients with neurological diseases. Barthel index (BI) is a global disability scale which can assess the performance of ADL for old people. The Longshi scale is a novel pictorial-based scale for evaluating a patient’s disability, but few studies assess the elderly patients. Hence, the aim of this study was to determine whether Longshi scale can distinguish the ADL level of the elderly people and investigate the relationship between the Longshi scale and BI in measuring ADL among the elderly disabled. Methods: This was a multi-center cross-sectional study of elderly disabled patients (more than 65 years old). The ADL levels of all patients were evaluated by both Longshi scale and BI. Patients were divided into three groups (Bedridden group, Domestic group, Community group) based on the Longshi scale, while there were four groups (slight dependence, moderate dependence, severe dependence, total dependence) according to different BI scores. The relationship between the scores of Longshi scale and BI at different level were analysed. Results: A total of 2438 consecutive patients were recruited into the study from 9 centers during a period of 6 months (from 1 Oct 2019 to 1 April 2020). There was a significant difference of the total BI scores between the three groups of Longshi scale (p<0.001). Moreover, the Longshi scale scores showed significant differences between the four BI groups in the bedridden group, domestic group and community group of Longshi scale (p<0.001), respectively. Furthermore, the Spearman correlation coefficients between the LS scores of three groups (bedridden, domestic and community group) and BI scores were 0.869, 0.848 and 0.828 (P<0.001, respectively). Conclusions: Longshi scale can efficiently distinguish the degree of ability of daily living activities among the elderly disabled and has positive correlations with the BI.
Performance comparison of public hospitals between 2014 and 2018 in different regions of Guangdong province, China, following 2017 medical service price reforms
Authors: Weng Kaiyuan , Xia Feng , Wang Yibao 
Published: December 2020

Abstract
BackgroundThis study analyzed performance of public hospitals and regional differences in performance following reform of medical service prices in Guangdong province, China. From three cities in four regions, we randomly selected a total of 12 traditional Chinese medicine hospitals and 12 general tertiary hospitals.MethodsSix questionnaires were completed by the hospitals, using 2014–2018 internal data. Principal components analysis was used to compare performances of the hospitals and regions following price reform. The extent to which medical service prices were adjusted varied considerable for different procedures in the same region and for the same category of procedures among regions.ResultsAfter reform, compensation for medical services in public hospitals reached the target of 80%, except in the Western region. However, annual growth of costs to patients was generally above 4%; the burden on patients was not alleviated by fee control. Reforms were more effective for comprehensive than Chinese traditional medicine hospitals. Performance scores of general hospitals in the Pearl River Delta, Eastern, Western, and Northern regions were 1.24, 1.16, -0.22, and -1.01, respectively. This is consistent with ranking by level of economic development of each region.ConclusionsThe government should implement a regional medical service pricing mechanism. Additionally, comprehensive and traditional Chinese medicine hospitals should each have appropriate pricing policies. Future policies should focus on controlling costs incurred by patients.
Impact of the HLA-DRB1 shared epitope on responses to treatment with tofacitinib or abatacept in patients with rheumatoid arthritis
Authors: Hirose Wataru , Harigai Masayoshi , Amano Koichi , Hidaka Toshihiko , Itoh Kenji , Aoki Kazutoshi , Nakashima Masahiro , Nagasawa Hayato , Komano Yukiko , Nanki Toshihiro 
Published: December 2020

Abstract
Objectives The aim of this study was to compare the clinical effectiveness of tofacitinib and abatacept and clarify the impact of the HLA-DRB1 shared epitope (SE) on responses to these treatments in patients with rheumatoid arthritis (RA).MethodsAfter adjustments by propensity score matching, 70 out of 161 patients receiving tofacitinib and 70 out of 131 patients receiving abatacept were extracted. The clinical effectiveness of both drugs over 24 weeks and the impact of the copy numbers of SE on effectiveness outcomes were investigated.ResultsThe percentage of patients in remission in the 28-joint count disease activity score using the erythrocyte sedimentation rate (DAS28-ESR) did not significantly differ between patients receiving tofacitinib and abatacept at week 24 (32% vs 37%, p=0.359). The mean change at week 4 in DAS28-ESR from baseline was significantly greater in patients receiving tofacitinib than in those receiving abatacept (-1.516 vs -0.827, p=0.0003). The percentage of patients in remission at week 4 was 30% with tofacitinib and 15% with abatacept (p=0.016). When patients were stratified by the copy numbers of SE alleles, differences in these numbers did not affect DAS28-ESR scores of patients receiving tofacitinib. However, among patients receiving abatacept, DAS28-ESR scores were significantly lower in patients carrying 2 copies of SE alleles than in those carrying 0 copies at each time point throughout the 24-week period. Furthermore, the percentage of patients in remission with DAS28-ESR at week 24 was not affected by the copy numbers of SE alleles in patients receiving tofacitinib (p=0.947), whereas it significantly increased as the copy numbers became higher in patients receiving abatacept (p=0.00309). Multivariable logistic regression analyses showed a correlation between the presence SE and DAS28-ESR remission in patients receiving abatacept (OR=25.881, 95%CI=3.140−213.351, p=0.0025), but not in those receiving tofacitinib (OR=1.473, 95%CI=0.291−7.446, p=0.639).ConclusionsAlthough the clinical effectiveness of tofacitinib and abatacept was similar at week 24, tofacitinib was superior to abatacept for changes from baseline in DAS28-ESR and the achievement of remission at week 4. SE positivity was associated with the achievement of DAS28-ESR remission by week 24 in patients receiving abatacept, but not in those receiving tofacitinib.