bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐term remission in an adult heart transplant recipient with advanced Burkitt’s lymphoma post‐transplant lymphoproliferative disorder after anthracycline‐free chemotherapy: A case report and literature review
Authors: AbdelHameid Duaa , Felice Anthony , Cooper Lauren B. , Katugaha Shalika B. 
Published: February 2020

AbstractIncidence of Burkitt's lymphoma post‐transplant lymphoproliferative disorder (BL‐PTLD) in solid organ transplant (SOT) recipients in 1.4%‐1.6% with unknown cure rate. We report a case of Epstein‐Barr virus (EBV) positive, late‐onset BL‐PTLD in a 24‐year‐old EBV donor positive/recipient negative female. This is the first reported case of advanced BL‐PTLD post‐heart transplant in an adult. This is also the first reported case of treatment of advanced BL‐PTLD in a heart transplant recipient with a combined chemotherapy regimen without anthracyclines to avoid cardiotoxicity. The patient received 6 cycles of R‐COEP (rituximab with cyclophosphamide, vincristine, etoposide, prednisone) over 6 months and subsequently 3 cycles of high‐dose methotrexate (MTX) over 3 months for CNS prophylaxis. She remains without evidence of disease at 19 months post‐treatment. This case demonstrates that an anthracycline‐free regimen can be the therapy option for patients with BL‐PTLD after heart transplantation.
Dimensional Optimization for Minimally Invasive Surgery Robot Based on Double Space and Kinematic Accuracy Reliability Index
Authors: Jing Yang , Lingyan Jin , Xinge Shi , Deming Zhao , Ming Hu 
Published: February 2020

Abstract
To improve the kinematic performance of the remote center mechanism for surgical robot, a double space index and kinematic accuracy reliability index are proposed to optimize the dimensional sizes of mechanism. First, the influence of the angular error on the position error and the operability of the remote center in the workspace are analyzed. The position error space and operability space index are weighted to establish the double space index. Second, a kinematic accuracy reliability index is established based on the influence of joint clearance on output position accuracy. Finally, the dimensional sizes of remote center adjustment mechanism and double parallelogram mechanism are optimized based on proposed optimization indices. Multipopulation genetic algorithm is used to obtain the optimal size parameters under the corresponding index. The optimized double space index is 56.7%, which is 56.5% higher than before optimization. The optimized kinematic accuracy reliability is 0.91, which is 22.9% higher than before optimization. The kinematic performance of remote center mechanism has been significantly improved after optimization.
Analysis and Assessment of Tower Solar Collector Driven Trigeneration System
Authors: Khaliq Abdul , Alharthi Mathkar A. , Alqaed Saeed , Mokheimer Esmail M. A. , Kumar Rajesh 
Published: February 2020

Abstract
This paper describes the development and performance assessment of a tower solar collector driven integrated system operating in trigeneration mode to generate electricity, heating, and cooling, in a carbon-free manner. The proposed system applies a heliostat-based central receiver unit as a base of solar energy input to drive the steam Rankine cycle which is combined with the process heater and the lithium bromide-water operated absorption chiller. An analysis is performed to monitor the behavior of energy and exergy efficiency at various operating conditions of the proposed trigeneration system. The computed results are authenticated with the reported literature. A comparison is made between the present findings and reported results in the form of exergy efficiency, total exergy destroyed, and energy efficiency. Consideration of process heat and cold along with electricity provides a promising increase in energy efficiency from 15.8% to 64.1% while the exergy efficiency is enhanced from 16.9% to 24.4%. Variation in direct normal irradiations from 600 W/m2 to 1000 W/m2 results in the significant rise of energetic and exergetic outcomes of the proposed trigeneration system. Out of 100% solar exergy supplied to the proposed trigeneration, 24% is generated as the exergetic output, 1.6% is lost to ambient, and the remaining 74.4% is the exergy destroyed in the system components.
Measuring multimorbidity beyond counting diseases: systematic review of community and population studies and guide to index choice
Authors: Stirland Lucy E , González-Saavedra Laura , Mullin Donncha S , Ritchie Craig W , Muniz-Terrera Graciela , Russ Tom C 
Published: February 2020

AbstractObjectivesTo identify and summarise existing indices for measuring multimorbidity beyond disease counts, to establish which indices include mental health comorbidities or outcomes, and to develop recommendations based on applicability, performance, and usage.DesignSystematic review.Data sourcesSeven medical research databases (Medline, Web of Science Core Collection, Cochrane Library, Embase, PsycINFO, Scopus, and CINAHL Plus) from inception to October 2018 and bibliographies and citations of relevant papers. Searches were limited to English language publications.Eligibility criteria for study selectionOriginal articles describing a new multimorbidity index including more information than disease counts and not focusing on comorbidity associated with one specific disease. Studies were of adults based in the community or at population level.ResultsAmong 7128 search results, 5560 unique titles were identified. After screening against eligibility criteria the review finally included 35 papers. As index components, 25 indices used conditions (weighted or in combination with other parameters), five used diagnostic categories, four used drug use, and one used physiological measures. Predicted outcomes included mortality (18 indices), healthcare use or costs (13), hospital admission (13), and health related quality of life (7). 29 indices considered some aspect of mental health, with most including it as a comorbidity. 12 indices are recommended for use.Conclusions35 multimorbidity indices are available, with differing components and outcomes. Researchers and clinicians should examine existing indices for suitability before creating new ones.Systematic review registrationPROSPERO CRD42017074211.
Relationship between a uterine fibroid diagnosis and the risk of adverse obstetrical outcomes: a cohort study
Authors: karlsen kamilla , Schiøler Kesmodel Ulrik , Mogensen Ole , Humaidan Peter , Ravn Pernille 
Published: February 2020

ObjectiveThe aim was to investigate the association between clinically significant uterine fibroids and preterm birth, caesarean section (CS), postpartum haemorrhage (PPH), placental abruption, intrauterine growth restriction (IUGR) and uterine rupture.Methods, participants and settingA historical cohort study based on data from the Danish National Birth Cohort, the Danish National Patient Registry and the Danish National Birth Registry (DNBR). The final study population consisted of 92 696 pregnancies and was divided into four groups for comparison. Group 1: pregnancies of women without a fibroid diagnosis code or fibroid operation code; group 2: pregnancies of women with a fibroid diagnosis code before pregnancy, during pregnancy or up to 1 year after delivery, and no fibroid operation code before pregnancy; group 3: pregnancies of women with a fibroid diagnosis code given more than 1 year after delivery; and group 4: pregnancies of women with a fibroid operation code given before pregnancy.ResultsA diagnosis of fibroids before pregnancy yielded an increased risk of preterm birth (gestational age (GA) ≤37 weeks) (OR 2.27 (1.30─3.96)) and extreme preterm birth (GA 22+0─27+6 weeks, OR 20.09 (8.04─50.22)). The risk of CS was increased (OR 1.83 (1.23─2.72)) for women with a fibroid diagnosis code given before pregnancy; significantly increased risk of elective CS (OR 1.92 (1.11─3.32)), but not acute CS (OR 1.54 (0.94─2.52)). The risks of PPH, placental abruption or IUGR were not increased in any of the groups.ConclusionWe found a strong association between clinically significant uterine fibroids and preterm birth, and an association between clinically significant uterine fibroids and CS. In contrast, no association between clinically significant uterine fibroids and PPH, placental abruption or IUGR was seen.
Effect of salt reduction interventions in lowering blood pressure in Chinese populations: a systematic review and meta-analysis of randomised controlled trials
Authors: Jin Aoming , Xie Wuxiang , Wu Yangfeng 
Published: February 2020

Rationale and objectiveSalt reduction remains a global challenge and different salt reduction strategies have been studied in China. This study is to systematically evaluate evidence from randomised controlled trials (RCT) in China and inform the effective salt reduction strategies.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, Embase, Cochrane Central Register of Controlled Trials, Wanfang Data and the China National Knowledge Infrastructure databases through October 2019.Eligibility criteriaRCTs conducted in China with at least 4 weeks’ duration of study and blood pressure (BP) reported.Data extraction and synthesisData were screened, extracted and appraised by two independent reviewers. The quality of study was assessed using a modified Cochrane Collaboration’s risk of bias tool. The primary outcome was the difference in BP change from baseline to the end of study between interventions and control. The effects were pooled using a random effects model and associated factors were explored by a meta-regression.ResultsWe identified 24 studies involving 10 448 participants, including 8 studies on health education (4583 participants), 2 studies on salt restriction diet (162 participants), 1 study on salt restriction spoon (50 participants) and 13 studies on salt substitute (5653 participants). Six studies on salt substitute and three studies on health education were identified with high quality. Pooled results from the six studies showed that salt substitutes significantly reduced systolic BP (−5.7 mm Hg; 95% CI −8.5 to −2.8) and diastolic BP (−2.0 mm Hg; 95% CI −3.5 to −0.4). The School-EduSalt study showed that the school-based health education significantly reduced systolic BP among parents (−2.3 mm Hg; 95% CI −4.5 to −0.04).ConclusionsAmong four salt reduction strategies studied in China with RCT design, only salt substitute was proved effective in lowering BP by the pooled effect from multiple studies with high quality. More well-designed studies are warranted for other strategies.
Malnutrition and morbidity trends in Somalia between 2007 and 2016: results from 291 cross-sectional surveys
Authors: Martin-Canavate Rocio , Custodio Estefania , Yusuf Abukar , Molla Daniel , Fasbender Dominique , Kayitakire Francois 
Published: February 2020

BackgroundMore than two decades of conflict and natural disasters in Somalia have resulted in one of the longest running humanitarian crises in the world. Nutrition data have been collected over the years despite challenges to inform programmatic action. This paper explores malnutrition and morbidity trends in Somalia during the last decade, disaggregated by geographical zone and livelihood system.MethodsWe used data from 291 cross-sectional surveys conducted in children aged 6–59 months between 2007 and 2016 in Somalia. Wasting, morbidity and stunting prevalences over time were analysed by geographic area, livelihood system and season. Logistic regressions were used to test trends.ResultsThe wasting trends show a striking peak in 2011, more marked in southern and central Somalia and coinciding with the famine declaration. The trend declines slightly thereafter although not consistently across all zones and livelihoods, and it raises again in 2016 especially among internally displaced persons (IDPs). Stunting declined for all groups and in all zones but with more consistent patterns in northern Somalia.Morbidity also showed a declining trend, although with multiple peaks depicting disease outbreaks.Pastoralist showed the lowest stunting estimates overall, while agrarian populations showed the lowest prevalence of wasting and morbidity. IDPs were the most affected by all outcomes. Seasonality affected the three outcomes differently by livelihood system. Stunting rates increased after the 2011 famine for all age groups within children under 5 years.ConclusionsDespite the continuous complex situation in Somalia, there has been a sustained decline in stunting and morbidity in the last decade. Wasting trends have remained at very high levels especially in north-east and the south zones of Somalia. The findings support the importance of performing trend analyses disaggregated by zone and livelihood groups within countries to better identify priorities for programme intervention.
Stimulation of the tibial nerve: a protocol for a multicentred randomised controlled trial for urinary problems associated with Parkinson’s disease—STARTUP
Authors: McClurg Doreen , Panicker Jalesh , Walker Richard W , Cunnington AnneLouise , Deane Katherine H O , Harari Danielle , Elders Andrew , Booth Jo , Hagen Suzanne , Mason Helen , Stratton Susan 
Published: February 2020

IntroductionParkinson’s disease is the second most common chronic neurodegenerative condition with bladder dysfunction affecting up to 71%. Symptoms affect quality of life and include urgency, frequency, hesitancy, nocturia and incontinence. Addressing urinary dysfunction is one of the top 10 priority research areas identified by the James Lind Alliance and Parkinson’s UK.ObjectivesConduct a randomised controlled trial (RCT) targeting people with Parkinson’s disease (PwP) who have self-reported problematic lower urinary tract symptoms, investigating the effectiveness of transcutaneous tibial nerve stimulation (TTNS) compared with sham TTNS. Implement a standardised training approach and package for the correct application of TTNS. Conduct a cost-effectiveness analysis of TTNS compared with sham TTNS.Methods and analysisAn RCT of 6 weeks with twice weekly TTNS or sham TTNS. Participants will be recruited in 12 National Health Service neurology/movement disorder services, using a web-based randomisation system, and will be shown how to apply TTNS or sham TTNS. Participants will receive a weekly telephone call from the researchers during the intervention period. The trial has two coprimary outcome measures: International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form and the International Prostate Symptom Score. Secondary outcomes include a 3-day bladder diary, quality of life, acceptability and fidelity and health economic evaluation. Outcomes will be measured at 0, 6 and 12 weeks.A sample size of 208 randomised in equal numbers to the two arms will provide 90% power to detect a clinically important difference of 2.52 points on the Internatioanl Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) and of 3 points in the International Prostate Symptom Score total score at 12 weeks at 5% significance level, based on an SD of 4.7 in each arm and 20% attrition at 6 weeks. Analysis will be by intention to treat and pre defined in a statistical analysis planEthics and disseminationEast of Scotland Research Ethics Service (EoSRES), 18/ES00042, obtained on 10 May 2018. The trial will allow us to determine effectiveness, safety, cost and acceptability of TTNS for bladder dysfunction in PWP. Results will be published in open access journals; lay reports will be posted to all participants and presented at conferences.Trial registration numberISRCTN12437878; Pre-results.
Challenges for funders in monitoring compliance with policies on clinical trials registration and reporting: analysis of funding and registry data in the UK
Authors: Knowles Rachel L , Ha Kam Pou , Mueller Julia , Rawle Frances , Parker Rosa 
Published: February 2020

ObjectivesTo evaluate compliance by researchers with funder requirements on clinical trial transparency, including identifying key areas for improvement; to assess the completeness, accuracy and suitability for annual compliance monitoring of the data routinely collected by a research funding body.DesignDescriptive analysis of clinical trials funded between February 2011 and January 2017 against funder policy requirements.SettingPublic medical research funding body in the UK.Data sourcesRelevant clinical trials were identified from grant application details, post-award grant monitoring systems and the International Standard Randomised Controlled Trial Number (ISRCTN) registry.Main outcome measureThe proportion of all Medical Research Council (MRC)-funded clinical trials that were (a) registered in a clinical trial registry and (b) publicly reported summary results within 2 years of completion.ResultsThere were 175 grants awarded that included a clinical trial and all trials were registered in a public trials registry. Of 62 trials completed for over 24 months, 42 (68%) had publicly reported the main findings by 24 months after trial completion; 18 of these achieved this within 12 months of completion. 11 (18%) trials took >24 months to report and 9 (15%) completed trials had not yet reported findings. Five datasets were shared with other researchers.ConclusionsCompliance with the funder policy requirements on trial registration was excellent. Reporting of the main findings was achieved for most trials within 24 months of completion; however, the number of unreported trials remains a concern and should be a focus for future funder policy initiatives. Identifying trials from grant management and grant monitoring systems was challenging therefore funders should ensure investigators reliably provide trial registries with information and regularly update entries with details of trial publications and protocols.
Detection of Molecular Signatures of Homologous Recombination Deficiency in Prostate Cancer with or without BRCA1/2 Mutations
Authors: Sztupinszki Zsofia , Diossy Miklos , Krzystanek Marcin , Borcsok Judit , Pomerantz Mark M. , Tisza Viktoria , Spisak Sandor , Rusz Orsolya , Csabai István , Freedman Matthew L. , Szallasi Zoltan 
Published: February 2020

Abstract

Purpose:
Prostate cancers with mutations in genes involved in homologous recombination (HR), most commonly BRCA2, respond favorably to PARP inhibition and platinum-based chemotherapy. We investigated whether other prostate tumors that do not harbor deleterious mutations in these particular genes can similarly be deficient in HR, likely rendering those sensitive to HR-directed therapies.

Experimental Design:
Homologous recombination deficiency (HRD) levels can be estimated using various mutational signatures derived from next-generation sequencing data. We used this approach on whole-genome sequencing (WGS; n = 311) and whole-exome sequencing (WES) data (n = 498) of both primary and metastatic prostate adenocarcinomas to determine whether prostate cancer cases display clear signs of HRD in somatic tumor biopsies.

Results:
Known BRCA-deficient samples showed all previously described HRD-associated mutational signatures in the WGS data. HRD-associated mutational signatures were also detected in a subset of patients who did not harbor germline or somatic mutations in BRCA1/2 or other HR-related genes. Similar results, albeit with lower sensitivity and accuracy, were also obtained from WES data.

Conclusions:
These findings may expand the number of cases likely to respond to PARP inhibitor treatment. On the basis of the HR-associated mutational signatures, 5% to 8% of localized prostate cancer cases may be good candidates for PARP-inhibitor treatment (including those with BRCA1/2 mutations).
Intratumoral Immunotherapy for Early-stage Solid Tumors
Authors: Hong Wan Xing , Haebe Sarah , Lee Andrew S. , Westphalen C. Benedikt , Norton Jeffrey A. , Jiang Wen , Levy Ronald 
Published: February 2020

Abstract
The unprecedented benefits of immunotherapy in advanced malignancies have resulted in increased interests in exploiting immune stimulatory agents in earlier-stage solid tumors in the neoadjuvant setting. However, systemic delivery of immunotherapies may cause severe immune-related side-effects and hamper the development of combination treatments. Intratumoral delivery of neoadjuvant immunotherapy provides a promising strategy in harnessing the power of immunotherapy while minimizing off-target toxicities. The direct injection of immune stimulating agents into the tumor primes the local tumor-specific immunity to generate a systemic, durable clinical response. Intratumoral immunotherapy is a highly active area of investigation resulting in a plethora of agents, for example, immune receptor agonists, non-oncolytic and oncolytic viral therapies, being tested in preclinical and clinical settings. Currently, more than 20 neoadjuvant clinical trials exploring distinct intratumoral immune stimulatory agents and their combinations are ongoing. Practical considerations, including appropriate timing and optimal local delivery of immune stimulatory agents play an important role in safety and efficacy of this approach. Here, we discuss promising approaches in drug delivery technologies and opportunity for combining intratumoral immunotherapy with other cancer treatments and summarize the recent preclinical and clinical evidences that highlighted its promise as a part of routine oncologic care.
Galgos and Podencos in Spain: A Rescue’s Perspective
Authors: Robinson Lisa , Watkinson Julie 
Published: February 2020

Abstract
This article introduces readers to the status of sighthounds in Spain, the abuse they endure at the hands of humans, and the work being carried out to help them by Galgos Del Sol, a local rescue with international partners. This paper is not based on empirical data or on scientific methods; it is, however, sourced directly from the experiences of an established Spanish sighthound rescue organisation, and affords the reader a unique and informed insight into this area.
Implications of Tumor Size, Subsite, and Adjuvant Therapy on Outcomes in pT4aN0 Oral Cavity Carcinoma
Authors: Namin Arya W. , Bollig Craig A. , Harding Brette C. , Dooley Laura M. 
Published: February 2020

ObjectiveTo determine if tumor size, subsite, and adjuvant radiation therapy (AXRT) are associated with overall survival (OS) in patients with pT4aN0 oral cavity squamous cell carcinoma (OSCC) who underwent mandibulectomy with negative surgical margins (NSMs).Study DesignRetrospective cohort study.SettingNational Cancer Database (NCDB).Subjects and MethodsRetrospective analysis of the NCDB that included patients diagnosed with pT4aN0 OSCC who underwent mandibulectomy with NSMs between 2004 and 2015. The association of age, Charlson‐Deyo score (CDS), tumor size, subsite, and AXRT with OS was analyzed. The cases were divided into 3 subgroups based on maximal tumor dimension for subgroup analysis; tumors ≤2.0 cm, tumors 2.1 to 4.0 cm, and tumors >4.0 cm.ResultsFor the entire cohort; age (P <. 001; hazard ratio [HR], 1.03; 95% confidence interval [CI], 1.02‐1.03), CDS (P =. 013; HR, 0.57; 95% CI, 0.37‐0.89), tongue subsite (P =. 003; HR, 2.01; 95% CI, 1.27‐3.40), floor of mouth subsite (P =. 001; HR, 1.76; 95% CI, 1.28‐2.42), tumor size (P <. 001; HR, 0.57; 95% CI, 0.45‐0.72), and AXRT (P <. 001; HR, 1.46; 95% CI, 1.24‐1.72) were associated with OS on multivariate analysis. On subgroup analysis, AXRT not significantly associated with OS in patients with gingival, hard palate, retromolar trigone, and not specified tumors ≤2.0 cm (P =. 323; HR, 1.29; 95% CI, 0.78‐2.15).ConclusionsIn patients with pT4aN0 OSCC who underwent mandibulectomy with NSMs, age, CDS, tongue subsite, floor of mouth subsite, tumor size, and AXRT are associated with OS. AXRT was not significantly associated with overall survival in patients with gingival, hard palate, retromolar trigone, and not specified tumors ≤2.0 cm.