bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Estrogen Receptor Beta in Patients with Triple Negative Breast Cancer
Authors: Mubisi HS , Farouk MM , Zaki II , El Fayoiem TA , Ismail AA 
Published: June 2020

Introduction: Triple negative breast cancer (TNBC), defined as lacking the expression of estrogen receptor alpha (ERα), progesterone receptor and human epidermal growth factor receptor is an aggressive breast cancer subtype for which there is a need to identify new therapeutic targets. About 50-80% of TNBC express Estrogen Receptor Beta (ERβ). Given its slight differences from ERα in terms of structure, signaling and its anti-proliferative effects on breast cancer cells, ERβ may be a possible therapeutic target. This study sought to assess the presence of ERβ and its correlation with the clinico-pathological features among the Egyptian females with TNBC. Material and Methods: The study was a retrospective analysis. The following data was retrieved from patient’s files and recorded: age, tumor size, lymph nodes metastasis, and stage. Paraffin blocks for patients confirmed by IHC to be TNBC were subjected to immunohistochemical staining for ERβ, CK5/6, and Ki 67. Results: ERβ was positive in 80% of cases (n=32/40). ERβ significantly correlated with Age (rs = -0.473, P = 0.002, n = 40), Tumor size (rs = -0.471, P = 0.007, n = 40), Lymph nodes (rs = -0.365, P = 0.021, n =40), and Stage (rs = -0.468, P = 0.002, n = 40). There was no correlation between ERβ with Ki-67 and CK5/6 a marker of the basal phenotype. All 8 patients without ERβ had an aggressive disease. 4 received neoadjuvant chemotherapy with minimum or no pathologic complete response in the axillary lymph nodes, 2 presented with upfront metastatic disease while the other 2 were cases of local recurrence with a change in the molecular phenotype of the tumor from luminal subtype to TNBC. Conclusion: This study shows ERβ expression occurs in TNBC. It may have the potential to become a therapeutic target for TNBC.
Outcome of patients with colorectal cancer undergoing lung metastases resection: a single-institution retrospective analysis
Authors: Mammana Marco , Bergamo Francesca , Procaccio Letizia , Schiavon Marco , Loupakis Fotios , Lonardi Sara , Manai Chiara , Schirripa Marta , Fassan Matteo , Dei Tos Angelo Paolo , Calabrese Fiorella , Rea Federico , Zagonel Vittorina 
Published: June 2020

Introduction: This study was undertaken to review a single-institution cohort of patients with metastatic colorectal cancer undergoing lung resection after a multidisciplinary evaluation and to investigate the main prognostic factors for survival. Methods: Medical records of 129 patients undergoing lung metastasectomy for colorectal cancer with curative intent from 2001 to 2017 were reviewed. Tissue samples from the primary tumor were analyzed with a multiplex genotyping system for the detection of mutations in RAS and BRAF genes. Survival analyses were carried out by the Kaplan-Meier method. Univariate and multivariable analyses were performed using the log-rank test and the Cox regression model. Results: Postoperative morbidity and mortality were 13.2% and 0%, respectively. At a median follow-up time of 62.5 months, median overall survival was 90.5 months and median relapse-free survival was 42.8 months. Multivariable analysis for overall survival identified synchronous versus metachronous metastatic presentation as the only prognostic factor, whereas relapse-free survival was independently associated with synchronous versus metachronous metastatic presentation, number of metastases, and postoperative chemotherapy. Conclusions: This study shows particularly favorable survival outcomes for patients undergoing lung metastasectomy. The validity of some of the main prognostic factors was confirmed and a positive effect of postoperative chemotherapy on relapse-free survival was shown. Contrary to other reports, the presence of KRAS mutations was not associated with significant survival differences. Further studies are needed in order to clarify the interactions between molecular, clinical, and pathologic characteristics and treatment-related factors.
The Decline of College Textbook Publishing: Cengage Learning and McGraw-Hill
Authors: Carbaugh Bob 
Published: June 2020

America’s college textbook publishers historically had a business model based on continuing profits and growth led by high prices. However, that model eroded as competition from the used-book market and rental textbooks resulted in falling textbook sales and losses for publishers. Textbook publishers are currently revising their business model so as to move away from printed textbooks to digital (online) educational materials. Also, publishers are downsizing their operations and undergoing mergers with each other to survive in the marketplace. The 2019 merger proposal of McGraw-Hill and Cengage Learning reflects the current problems of college textbook publishing: The merger would be between two financially weak companies that are attempting to reduce overhead and production costs and create additional revenue streams. However, the U.S. Department of Justice’s concerns about the harmful effects on competition led to the companies’ agreement to abandon their plans to merge in May 2020. JEL Classification: A00, K21, L22, L41
Principals’ Self- and Interpersonal Leadership Amid Work Intensification
Authors: Wang Fei 
Published: June 2020

Objectives: Despite all the attention given in recent years to work intensification among school principals, little research has explored the practices and strategies that principals employ to meet their job expectations and demands and how they adapt to the increasingly uncertain and complex school reality. This qualitative study identifies practices and strategies that principals employ to meet their job expectations and adapt to their intensified work condition in Vancouver, British Columbia, Canada. Framework: The study integrates self- and interpersonal leadership into a composite framework to guide the inquiry. Methods: Eighteen school principals in Metro Vancouver participated in one-hour semi-structured interviews and shared their comments on the changing nature of their work and strategies they use to go about doing their work amid work intensification. Results: The findings capture principals’ skills and competencies that pertain to their personal and social competencies, including self awareness, self direction, social awareness, and relationship management. The findings also identify knowledge and skills that are necessary to prepare principals for their work and highlight strategies they use to gain a sense of being in control at work in a complex and changing work environment.
Efficacy of Brodalumab for Moderate to Severe Plaque Psoriasis: A Canadian Network Meta-Analysis
Authors: Xue Weiguang , Saharia Paranjoy , Gray Emma , Khoudigian-Sinani Shoghag , Gaudet Véronique , Barbeau Martin , Papp Kim 
Published: June 2020

Background Several treatments for plaque psoriasis are available, but it remains challenging for physicians to make informed treatment decisions due to a lack of head-to-head trials. Objectives This network meta-analysis (NMA) compares the efficacy of brodalumab to other biologic agents in Canada for moderate-to-severe plaque psoriasis. Methods A systematic literature review of randomized controlled trials (RCTs) published before October 2017 was conducted to populate the NMA. Comparators included etanercept, infliximab, adalimumab, ustekinumab, secukinumab, ixekizumab, guselkumab, and placebo. The primary outcome was the psoriasis area and severity index (PASI) response at the end of induction phase. A random effects Bayesian multinomial likelihood and probit link model analyzed PASI 75, 90, and 100 responses. Inconsistency and heterogeneity were assessed. Sensitivity analyses were conducted to explore potential effect modifiers like baseline PASI score, age, and weight. Results A total of 43 RCTs were included. Brodalumab 210 mg had significantly better PASI response than etanercept, ustekinumab, adalimumab, secukinumab, and guselkumab and comparable responses to infliximab and ixekizumab. Relative risk of PASI 90 response for brodalumab varied from 2.84 (95% credible interval [CrI]: 2.35-3.52, P < .05) to 0.99 (95% CrI: 0.88-1.11, ns) compared to etanercept and ixekizumab. This was similar across PASI 75 responses, but a larger relative risk between brodalumab and all comparators except ixekizumab was observed for PASI 100. No significant heterogeneity or inconsistencies were identified. The results were consistent across sensitivity analyses, indicating robustness of the results. Conclusion Brodalumab 210 mg has efficacy superior to most biologic agents for moderate-to-severe plaque psoriasis in Canada.
The Prevalence of Sex Trafficking of Children and Adolescents in the United States: A Scoping Review
Authors: Franchino-Olsen Hannabeth , Chesworth Brittney R. , Boyle Colleen , Rizo Cynthia Fraga , Martin Sandra L. , Jordan Brooke , Macy Rebecca J. , Stevens Lily 
Published: June 2020

Topic: This scoping review investigated research regarding the magnitude of minor sex trafficking (domestic minor sex trafficking and/or commercial sexual exploitation of children) in the United States, summarizing estimates, methodologies, and strengths and weaknesses of the studies. Method: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, peer-reviewed articles and the gray literature were accessed via databases searches, reference harvesting, and expert advice. Articles were included if they provided a count or prevalence proportion estimate of trafficked or at-risk minors across or within a region of the United States. Six empirical studies, published from 1999 to 2017, were included in the review. Results: Included studies produced count estimates ( n = 3) or prevalence proportion estimates ( n = 3) for youth at risk of minor sex trafficking ( n = 2) or reporting victimization ( n = 5). Studies examined sex trafficking risk and victimization in different geographical areas, including across the United States ( n = 2), in New York City ( n = 1), and in Ohio ( n = 1). Further, several studies focused on particular populations, such as street and shelter youths ( n = 1) and adjudicated males ( n = 1). Sampling methodologies of reviewed estimates included traditional random sampling ( n = 1), nationally representative sampling ( n = 2), convenience sampling ( n = 1), respondent-driven sampling ( n = 1), purposive sampling ( n = 1), and use of census data ( n = 2). Conclusion: Little research has estimated the prevalence of minor sex trafficking in the United States. The existing studies examine different areas and populations and use different categories to estimate the problem. The estimates reviewed here should be cited cautiously. Future research is needed on this important topic, including methodologies to produce more representative estimates of this hard-to-reach population.
Comparison of Current Staging Systems for Sinonasal Inverted Papilloma
Authors: Nakayama Tsuguhisa , Tsunemi Yasuhiro , Kashiwagi Takashi , Kuboki Akihito , Yamakawa Shuchi , Konno Wataru , Mori Aya , Iimura Jiro , Tsukidate Toshiharu , Tanaka Yasuhiro , Haruna Shin-ichi 
Published: June 2020

Background A staging system is essential for determining the optimal surgical approach and predicting postoperative outcomes for inverted papilloma (IP). Although staging systems based on the extent to which the location is occupied by an IP have been widely used, an origin site-based classification of IP using unsupervised machine learning algorithms has recently been reported. Objective To determine the most appropriate of five staging systems for sinonasal IP by comparing recurrence rates for each stage according to each of those systems. Methods Eighty-seven patients with sinonasal IP were enrolled in the study. Their tumors were retrospectively categorized according to the Krouse, Oikawa, Cannady, and Han staging systems, which are based on the extent of IP, and the Meng system, which is based on the site of origin. The rates of recurrence for each stage of the five systems were compared. Results Seven of the 87 patients (8.0%) had recurrences during an average 45.5 months (12–138 months) of follow-up. There were significant differences in disease-free survival between the stages specified by Han and Meng (p = 0.027 and p < 0.001, respectively), but not between the stages specified by Krouse, Oikawa, and Cannady (p = 0.236, 0.062, and 0.130, respectively). Cox proportional hazard models revealed that Meng system (adjusted hazard ratio [aHR] 4.32, 95% confidence interval [CI] 1.10–17.04) and presence of dysplasia (aHR 7.42, 95% CI 1.15–47.85) were significantly associated with recurrence. Conclusion The staging systems proposed by Han and Meng were found to be accurate in terms of tumor recurrence. We recommend use of the Han staging system before surgery and the Meng system after intraoperative identification of the origin of the tumor.
Comparative efficacy and safety of lactulose plus paraffin vs polyethylene glycol in functional constipation: a randomised clinical study
Authors: Piche T , Dapoigny M 
Published: June 2020

BackgroundFew head‐to‐head comparisons of the different classes of laxatives have been conducted.ObjectiveThe objective of this work is to compare the efficacy of lactulose plus paraffin vs polyethylene glycol in the treatment of functional constipation (non‐inferiority study).MethodsThis randomised, parallel‐group, multicentre phase 4 study recruited patients with functional constipation diagnosed according to Rome III criteria. Patients received lactulose plus paraffin or polyethylene glycol for 28 days. The primary end point was the change from baseline in the Patient Assessment of Constipation–Symptoms (PAC‐SYM) score.ResultsA total of 363 patients were randomised to lactulose plus paraffin (n  = 179) or polyethylene glycol (n  = 184). On day 28, the mean PAC‐SYM score decreased significantly vs baseline with both treatments (p  < 0.001). The lower boundary of the 95% CI exceeded the pre‐specified limit of −0.25, therefore establishing non‐inferiority of lactulose plus paraffin vs polyethylene glycol. At least one adverse event occurred in 20 patients (11.2%) in the lactulose plus paraffin group and in 26 patients (14.2%) in the polyethylene glycol group, most of which were of mild or moderate severity and unrelated to study drugs.ConclusionLactulose plus paraffin may be used interchangeably with polyethylene glycol for the pharmacological treatment of functional constipation.Trial registration: EudraCT number 2015‐003021‐34
The use of botulinum toxin in keloid scar management: a literature review
Authors: Sohrabi Catrin , Goutos Ioannis 
Published: June 2020

Introduction: Administration of botulinum toxin is an increasingly popular procedure in the medical and aesthetic field. There is emerging evidence that it can influence fibroblast activity and minimise tension around the scar by virtue of muscular chemoimmobilisation. This review aims to explore the current evidence base behind the treatment of keloid scars with botulinum toxin. [Formula: see text] Methods: A detailed literature review was conducted using PubMed Medline, Embase and Web of Science databases. Manuscripts were appraised and classified in accordance with the Joanna Briggs Institute Levels of Evidence by an independent consultant in evidence synthesis. The results of this search are presented in descending order of evidence for botulinum toxin as a primary management agent as well as a secondary adjunct following extralesional keloid excision. Discussion: On the basis of level 1 evidence, botulinum toxin appears to be equivalent to triamcinolone in producing a short-term reduction in keloidal volume, height and vascularity. A number of level 1 and 2 studies also suggest that botulinum toxin may be particularly helpful in alleviating symptoms of keloid associated pain and itch. There are currently limited studies appraising the value of botulinum toxin in the postoperative management of keloid scars. Conclusion: Botulinum toxin may represent a promising agent in the management of keloid scars. However, further research involving large-scale studies with comparative designs and long-term follow-up is warranted to delineate the value of this therapeutic modality in scar management protocols.
Similar early functional recovery after total knee replacement comparing single shot versus continuous saphenous nerve block: A randomised, double-blind trial
Authors: Lam Ho Yee Joyce , Tang Yan Ho Bruce , Wong Hok Leung , Yang Isaac Bruce 
Published: June 2020

Purpose: Total knee replacement (TKR) is associated with post-operative pain. Femoral nerve block can relieve the pain but also affects the post-operative mobility. Saphenous nerve block (SNB) can improve analgesia without interfering mobilisation. However, there is no consensus on the ideal mode of administration of SNB. We aim to compare the effects of single shot versus continuous SNB on patients undergoing TKR. Methods: Patients were randomised into two groups: single shot and continuous SNB groups. Post-operative rehabilitation and mobilisation were assessed by blinded physiotherapists, and preoperative and post-operative American knee scores were recorded by blinded specialised nurse. Post-operative analgesics usage was recorded by blinded pain nurses and anaesthetists. Results: Sixty-four patients were recruited; 6 patients withdrew with 29 patients in each group. There is no significant difference in early mobilisation and rehabilitation comparing both groups. The mean of the range gained on day 2 when compared to day 1 in single-shot SNB group was 17.41 ± 19.67° versus continuous SNB group was 23.45 ± 19.18° ( p = 0.149). The mean of the range gained on day 3 when compared to day 1 in single-shot group was 27.24 ± 22.66° versus continuous SNB group was 29.31 ± 21.57° ( p = 0.6). The mean of maximum flexion achieved by day 3 in single-shot SNB group was 92.41 ± 9.6° versus continuous SNB was 91.90 ± 7.95° ( p = 0.84). The day of reaching maximum flexion and the goal of 40 m showed no significant difference. Length of stay (LOS), difference in post-operative American Knee Society knee score at 3 months and analgesics usage showed no significant difference. Conclusion: There is no significant difference in comparing the effect on mobilisation, LOS, early clinical outcome, analgesics usage in the single-shot group and the continuous SNB group.
Clinician Barriers and Facilitators to Routine HIV Testing: A Systematic Review of the Literature
Authors: Bagchi Ann Dalton , Davis Tracy 
Published: June 2020

Background: Routine HIV screening rates are suboptimal. Objectives: This systematic review identified barriers to/facilitators of routine HIV testing, categorized them using the socioecological model (SEM), and provided recommendations for interventions to increase screening. Data Sources: Included articles were indexed in PubMed, EBSCO CINAHL, Scopus, Web of Science, and the Cochrane Library between 2006 and October 2018. Eligibility Criteria: Included studies were published in English or Spanish and directly assessed providers’ barriers/facilitators to routine screening. Data Extraction: We used a standardized Excel template to extract barriers/facilitators and identify levels in the SEM. Data Synthesis: Intrapersonal factors predominated as barriers, while facilitators were directed at the institutional level. Limitations: Policy barriers are not universal across countries. Meta-analysis was not possible. We could not quantify frequency of any given barrier/facilitator. Conclusions: Increasing reimbursement and adding screening as a quality measure may incentivize HIV testing; however, many interventions would require little resource investment.
Gene Expression in Torn Rotator Cuff Tendons Determined by RNA Sequencing
Authors: Tashjian Robert Z. , Lock Ian , Granger Erin K. , Wang Yangliang , Lee Younghee , Chalmers Peter N. , Jones Kevin B. 
Published: June 2020

Background: Although the cause of rotator cuff tearing is likely multifactorial and a genetic predisposition has been proposed, the biochemical basis remains unknown. Purpose: To determine gene expression profiles in torn rotator cuff tendon tissue through use of RNA sequencing. Study Design: Controlled laboratory study. Methods: The supraspinatus tendon edge was biopsied in 24 patients undergoing arthroscopic rotator cuff repair for full-thickness supraspinatus rotator cuff tears. The supraspinatus tendon was also biopsied in 9 patients undergoing open reduction and internal fixation for a proximal humeral fracture (controls). Total RNA was extracted and sequenced. Differential gene expression was analyzed between the tear and control groups, and a secondary analysis was conducted between groups defined by an unbiased clustering. Results: Tear and control transcriptomes demonstrated significant differential expression in more than 3000 genes. The identified differential genes were highlighted in pathways involved in inflammation in control patients and extracellular matrix generation in patients with tears. Secondary analysis using unsupervised and thus unbiased hierarchical clustering revealed 2 clusters (c2 and c3). Cluster c3 contained smaller ( P < .001) and less retracted ( P = .018) tears (ie, tears earlier in the progression of rotator cuff disease) with increased expression of hypoxia target genes. Cluster c2 contained larger, more retracted tears (ie, tears further in the progression of rotator cuff disease) with increased expression of endothelial cell markers and chronic inflammation target genes. Tears in c2 had significantly worse healing rates compared with tears in c3 (0% vs 89%; P = .007). Conclusion: Smaller, less retracted tears had increased expression of hypoxia target genes and improved healing, whereas larger, more retracted tears were associated with endothelial cell markers and worse healing. Thus, hypoxia may be the inciting event for tear development, whereas with tear enlargement, a chronic, inflammatory, angiogenic process may predominate. Clinical Relevance: Identification of differential gene expression in rotator cuff tears may be a reliable tool to predict repair healing in the future.