bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expression of PD-1/PD-L1 in head and neck squamous cell carcinoma and its clinical significance
Authors: Chen Shu-Wei , Li Si-Hao , Shi Ding-Bo , Jiang Wen-Mei , Song Ming , Yang An-Kui , Li Yu-Dong , Bei Jin-Xin , Chen Wen-Kuan , Zhang Quan 
Published: November 2019

Objective: To investigate the role of programmed death-1 (PD-1), programmed death-ligand 1 (PD-L1), and P16 in patients with head and neck squamous cell carcinoma (HNSCC). Methods: A total of 95 paraffin-embedded samples of tumorous tissue of HNSCC were collected. Expression levels of PD-1, PD-L1, and P16 were determined by immunohistochemistry. Results: A significantly higher proportion of PD-1 among patients infected with the human papillomavirus was found. PD-L1 expression is closely associated with the primary site of the tumor, postoperative recurrence, survival, PD-1 expression and P16 expression. Univariable analysis indicated that T stage, N stage, tumor node metastasis stage, tumor differentiation, and PD-L1 expression were all shown to be prognostic variables for overall survival in patients with HNSCC. In the multivariate analysis, only N stage ( P = 0.010) and PD-L1 expression ( P = 0.001) were found to be independent prognostic variables for overall survival. In addition, for disease recurrence, multivariate analysis showed that only PD-L1 expression was the associated independent risk factor. For the patients with negative PD-L1 expression, Kaplan-Meier analysis revealed that they had significantly worse outcomes in terms of overall survival ( P = 0.001). Similarly, compared with the patients with positive PD-L1 expression, those with negative PD-L1 expression had a higher probability of recurrence ( P = 0.026). Conclusions: The expression of PD-L1, PD-1, and P16 in HNSCC is significantly correlated. Human papillomavirus infection (P16 positive) is negatively related to postoperative recurrence. HNSCC patients with positive PD-L1/PD-1 expression tend to have better overall survival outcomes and lower probability of recurrence, providing more evidence for the PD-l-targeted immunotherapy of HNSCC.
Clinical Efficacy and Safety of Omalizumab in the Treatment of Allergic Rhinitis: A Systematic Review and Meta-analysis of Randomized Clinical Trials
Authors: Yu Chenjie , Wang Kaijian , Cui Xinyan , Lu Ling , Dong Jianfei , Wang Maohua , Gao Xia 
Published: November 2019

Background Patients with moderate to severe allergic rhinitis (AR) who are treated according to the current rhinitis management guidelines may be inadequately controlled. These patients are at risk of serious comorbidities, such as asthma and chronic sinusitis. These symptoms, sneezing and an itchy, runny, stuffy nose, may have a negative impact on patients’ daily functioning. Omalizumab is being developed as a new choice for the treatment of AR. We therefore undertook a meta-analysis to assess the efficacy and safety of omalizumab in the treatment of AR. Methods We systematically searched PubMed, Cochrane Library, and MEDLINE databases for randomized controlled studies on the treatment of AR with omalizumab. Our evaluation outcomes were symptom scores, medication efficacy, combined symptom and medication scores, and adverse events. We descriptively summarized and quantitatively synthesized original data to evaluate the efficacy and safety of omalizumab in the treatment of AR by using Stata12.0 software for meta-analyses. Results The results of our meta-analysis showed that there were statistically significant differences between the omalizumab group and the control group in the following aspects: daily nasal symptom score (standardized mean difference [SMD] = –0.443, 95% confidence interval [CI]: –0.538 to –0.347, P < .001); daily ocular symptom score (SMD = –0.385, 95% CI: –0.5 to –0.269, P < .001); daily nasal medication symptom scores (SMD = –0.421, 95% CI: –0.591 to –0.251, P < .001); proportion of days of emergency drug use (risk ratio [RR] = 0.488, 95% CI: 0.307 to 0.788, P < .005); rhinoconjunctivitis-specific quality of life questionnaire (SMD = –0.286, 95% CI: –0.418 to –0.154, P < .001); and overall evaluation (RR = 1.435, 95% CI: 1.303–1.582, P < .001). There was no statistically significant difference in safety indicator: adverse events (RR = 1.026, 95% CI: 0.916–1.150, P = .655). Conclusion Omalizumab is effective and relatively safe in patients with AR; omalizumab used in conjunction with special immunotherapy has shown promising results, especially in reducing adverse events.
A pilot study of diffusion tensor imaging metrics and cognitive performance pre and post repetitive, intentional sub-concussive heading in soccer practice
Authors: Kenny Rebecca A , Mayo Chantel D , Kennedy Samantha , Varga Aaron A , Stuart-Hill Lynneth , Garcia-Barrera Mauricio A , McQuarrie Amanda , Christie Brian R , Gawryluk Jodie R 
Published: November 2019

Background Although soccer players routinely head the ball in practice and games, recent research has suggested that cumulative effects of repetitive heading may cause sub-concussive injury with accompanying effects on brain and behavior. The current study aimed to prospectively investigate the effects of repetitive, intentional heading in soccer practice on brain structure and cognitive function, using a within-subjects design. Methods Participants included 10 soccer players (mean age 20.09 years ± 2.88) who were examined immediately pre- and post-heading practice. An accelerometer was used to measure the force of the impact during soccer heading. Magnetic resonance imaging data were acquired on a 3 T GE Scanner with diffusion tensor imaging. Diffusion tensor imaging analyses were completed using functional magnetic resonance imaging of the brain software library’s Tract-Based Spatial Statistics to examine changes in both fractional anisotropy and mean diffusivity due to heading the soccer ball. Behavioral measures were also completed pre- and post-soccer heading and included the Sport Concussion Assessment Tool and three short-computerized executive function tasks; R studio was used to compare behavioral data within subjects. Results Accelerometer data revealed that none of the heading impacts were >10 g. At this level of impact, there were no significant pre–post heading differences in either fractional anisotropy or mean diffusivity. Additionally, aside from minimal practice effects, there were no significant differences in Sport Concussion Assessment Tool scores and no significant differences in the performance of the three executive function tasks pre–post heading. Conclusions The results provide initial evidence that repetitive heading in soccer practice, at a g force of 10, does not cause changes in brain structure or executive function. Future research should investigate heading in the context of games and with a greater sample size that would allow for sex-based comparisons.
A Quasi-Experimental Study Examining the Impact and Challenges of Implementing a Fitness-Based Health Risk Assessment and a Physical Activity Counseling Intervention in the Workplace Setting
Authors: Hamm Naomi C. , Kehler D. Scott , Hay Jacqueline L. , Stammers Andrew N. , Strachan Shaelyn M. , Bouchard Danielle R. , Duhamel Todd A. 
Published: November 2019

Objectives: Few adults participate in enough physical activity for health benefits. The workplace provides a unique environment to deliver heath interventions and can be beneficial to the employee and the employer. The purpose of the study was to explore the use of a physical activity counseling (PAC) program and a fitness-based health risk assessment (fHRA) in the hospital workplace. Methods: A workplace-based intervention was developed utilizing a PAC program and an fHRA to improve physical activity levels of employees. Hospital employees were enrolled in a 4-month PAC program and given the option to also enroll in an fHRA program (PAC + fHRA). Physical activity was assessed by accelerometry and measured at baseline, 2 months, and 4 months. Changes in musculoskeletal fitness for those in the fHRA program were assessed at baseline and 2 months. Results: For both groups (PAC n = 22; PAC + fHRA n = 16), total and moderate to vigorous physical activity in bouts of 10 minutes or more increased significantly by 18.8 ( P = .004) and 10.2 ( P = .048) minutes per week at each data collection point, respectively. Only participants with gym memberships demonstrated increases in light physical activity over time. Those in the fHRA group significantly increased their overall musculoskeletal fitness levels from baseline levels (18.2 vs 21.7, P < .001). There was no difference in the change in physical activity levels between the groups. Conclusions: A PAC program in the workplace may increase physical activity levels within 4 months. The addition of an fHRA does not appear to further increase physical activity levels; however, it may improve overall employee musculoskeletal fitness levels.
Does ophthalmic-grade silicone oil possess antimicrobial properties?
Authors: Dave Vivek Pravin , Joseph Joveeta , Jayabhasker Priyanka , Pappuru Rajeev Reddy , Pathengay Avinash , Das Taraprasad 
Published: November 2019

Abstract

Purpose
To test the antimicrobial properties of silicon oil (Aurosil 1000 cSt, Aurosil Plus 5000 cSt) on in vitro growth of common microorganisms causing endophthalmitis.

Materials and methods
Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, multi-drug resistant (MDR) strain of Klebsiella pneumoniae, Escherichia coli, Candida albicans, and Aspergillus flavus were prepared to 0.5 McFarland turbidity. The bacteria and fungi were inoculated into the silicone oils, brain heart infusion (BHI) broth for bacteria and Sabouraud dextrose agar (SDA) broth for fungi, respectively, and cultured aerobically for 30 days. From each sample, 10 μl was plated onto nutrient agar and potato dextrose agar (PDA) for testing growth of bacteria and fungi respectively. Cultures from specimens, overnight incubation, and CFU counting were repeated on days 1, 3, 5, 7, 14, 21, 24, and 30. Negative controls were brain heart infusion and physiologic saline as well as silicone oils without any inoculations.

Results
All bacteria showed a decrease in CFUs by the fifth day and eliminated between 21 and 30 days in silicone oil. The silicon oil, irrespective of its viscosity, had only fungistatic effect up to 30 days. Colony-forming units of microorganisms remained stable in physiologic saline during the study. In BHI and Sabouraud broth, both bacteria and fungi showed a growth pattern that was compatible with the growth curve of microorganisms.

Conclusion
Medical-grade silicone oil used in ophthalmology exhibited in vitro bactericidal and fungistatic activity over 30 days. Insertion of silicone oil in vitrectomy for endophthalmitis, when required, could supplement the antimicrobial activities of intravitreal antibiotics in management of endophthalmitis.
E-learning as valuable caregivers’ support for people with dementia – A systematic review
Authors: Klimova Blanka , Valis Martin , Kuca Kamil , Masopust Jiri 
Published: November 2019

AbstractBackgroundPresent demographic trends show a considerable rise in elderly populations with aging disorders, such as dementia. The current article focused on the exploitation of e-learning as an informal support for caregivers of people with dementia and considered its benefits and limitations to provide proper and relevant care for this target group of people as well as maintain the quality of life of their caregivers.MethodsThe methodology of this study is based on a literature review of accessible peer-review articles from three recognized databases: Web of Science, Scopus, and PubMed. The findings of the selected studies were compared and evaluated.ResultsThe findings showed that e-learning educational programs/courses helped caregivers feel more confident about dementia care, reduced their perceived stress and enhanced their feelings of empathy, understanding and concern.ConclusionsThe findings of this study reveal that the exploitation of e-learning as a support tool, especially for informal caregivers, in the management of dementia may be a promising method, but its implementation requires professional training of informal caregivers in the use of this technology. More evidence-based studies are needed on this topic.
Optimising the performance of frontline implementers engaged in the NTD programme in Nigeria: lessons for strengthening community health systems for universal health coverage
Authors: Oluwole Akinola , Dean Laura , Lar Luret , Salami Kabiru , Okoko Okefu , Isiyaku Sunday , Dixon Ruth , Elhassan Elizabeth , Schmidt Elena , Thomson Rachael , Theobald Sally , Ozano Kim 
Published: November 2019

Abstract

Background
The control and elimination of Neglected Tropical Diseases (NTDs) is dependent on mass administration of medicines (MAM) in communities and schools by community drug distributers (CDDs) who are supported and supervised by health facility staff (FLHF) and teachers. Understanding how to motivate, retain and optimise their performance is essential to ensure communities accept medicines. This study aimed to capture and translate knowledge, problems and solutions, identified by implementers, to enhance NTD programme delivery at the community level in Nigeria.

Methods
Qualitative data was collected through participatory stakeholder workshops organised around two themes: (i) identification of problems and (ii) finding solutions. Eighteen problem-focused workshops and 20 solution-focussed workshops were held with FLHF, CDDs and teachers in 12 purposively selected local government areas (LGA) across two states in Nigeria, Ogun and Kaduna States.

Result
The problems and solutions identified by frontline implementers were organised into three broad themes: technical support, social support and incentives. Areas identified for technical support included training, supervision, human resource management and workload, equipment and resources and timing of MAM implementation. Social support needs were for more equitable drug distributor selection processes, effective community sensitisation mechanisms and being associated with the health system. Incentives identified were both non-financial and financial including receiving positive community feedback and recognition and monetary remuneration. The results led to the development of the ‘NTD frontline implementer’s framework’ which was adapted from the Community Health Worker (CHW) Generic Logic Model by Naimoli et al. (Hum Resour Health 12:56, 2014).

Conclusion
Maximising performance of frontline implementers is key to successful attainment of NTD goals and other health interventions. As NTDs are viewed as a ‘litmus test’ for universal health coverage, the lessons shared here could cut across programmes aiming to achieve equitable coverage. It is critical to strengthen the collaboration between health systems and communities so that together they can jointly provide the necessary support for frontline implementers to deliver health for all. This research presents additional evidence that involving frontline implementers in the planning and implementation of health interventions through regular feedback before, during and after implementation has the potential to strengthen health outcomes.
Community-based maternal and child health project on 4+ antenatal care in the Democratic Republic of Congo: a difference-in-differences analysis
Authors: Lee Hocheol , Park Sung Jong , Ndombi Grace O. , Nam Eun Woo 
Published: November 2019

AbstractBackgroundDespite efforts to achieve the Millennium Development Goals, the maternal mortality ratio in the Democratic Republic of Congo was 693 per 100,000 in 2015—the 6th highest in the world and higher than the average (547 per 100,000) in sub-Saharan Africa. Antenatal care (ANC) service is a cost-effective intervention for reducing the maternal mortality ratio in low-income countries. This study aimed to identify the intervention effect of the maternal and child health care (MCH) project on the use of four or more (4+) ANC services.MethodsThe MCH project was implemented using the three delays model in Kenge city by the Ministry of Public Health (MoPH) of the DRC with technical assistance from Korea International Cooperation Agency (KOICA) and the Yonsei Global Health Center from 2014 to 2017. Furthermore, Boko city was selected as the control group. A baseline and an endline survey were conducted in order to evaluate the effectiveness of this project. We interviewed 602 and 719 participants in Kenge, and 150 and 614 participants in Boko in the baseline and endline surveys, respectively. We interviewed married reproductive-aged women (19–45 years old) in both cities annually. The study instruments were developed based on the UNICEF Multiple Indicator Cluster Surveys. This study used the homogeneity test and the binary logistic regression difference-in-differences method of analysis.ResultsThe odds of reproductive-aged women’s 4+ ANC service utilization at the intervention site increased 2.280 times from the baseline (OR: 2.280, 95% CI: 1.332–3.902,p = .003) as compared to the control site.ConclusionsThis study showed that the KOICA MCH project effectively increased the 4+ANC utilization by reproductive-aged women in Kenge. As the 4+ ANC services are expected to reduce maternal deaths, this project might have contributed to reducing maternal mortality in Kenge. In the future, we expect these findings to inform MCH policies of the MoPH in the DRC.
Individual variation of the masticatory system dominates 3D skull shape in the herbivory-adapted marsupial wombats
Authors: Weisbecker Vera , Guillerme Thomas , Speck Cruise , Sherratt Emma , Abraha Hyab Mehari , Sharp Alana C. , Terhune Claire E. , Collins Simon , Johnston Stephen , Panagiotopoulou Olga 
Published: November 2019

AbstractBackgroundWithin-species skull shape variation of marsupial mammals is widely considered low and strongly size-dependent (allometric), possibly due to developmental constraints arising from the altricial birth of marsupials. However, species whose skulls are impacted by strong muscular stresses – particularly those produced through mastication of tough food items – may not display such intrinsic patterns very clearly because of the known plastic response of bone to muscle activity of the individual. In such cases, allometry may not dominate within-species shape variation, even if it is a driver of evolutionary shape divergence; ordination of shape in a geometric morphometric context through principal component analysis (PCA) should reveal main variation in areas under masticatory stress (incisor region/zygomatic arches/mandibular ramus); but this main variation should emerge from high individual variability and thus have low eigenvalues.ResultsWe assessed the evidence for high individual variation through 3D geometric morphometric shape analysis of crania and mandibles of three species of grazing-specialized wombats, whose diet of tough grasses puts considerable strain on their masticatory system. As expected, we found little allometry and low Principal Component 1 (PC1) eigenvalues within crania and mandibles of all three species. Also as expected, the main variation was in the muzzle, zygomatic arches, and masticatory muscle attachments of the mandibular ramus. We then implemented a new test to ask if the landmark variation reflected on PC1 was reflected in individuals with opposite PC1 scores and with opposite shapes in Procrustes space. This showed that correspondence between individual and ordinated shape variation was limited, indicating high levels of individual variability in the masticatory apparatus.DiscussionOur results are inconsistent with hypotheses that skull shape variation within marsupial species reflects a constraint pattern. Rather, they support suggestions that individual plasticity can be an important determinant of within-species shape variation in marsupials (and possibly other mammals) with high masticatory stresses, making it difficult to understand the degree to which intrinsic constraints act on shape variation at the within-species level. We conclude that studies that link micro- and macroevolutionary patterns of shape variation might benefit from a focus on species with low-impact mastication, such as carnivorous or frugivorous species.
Adaptive radiotherapy for head and neck cancer reduces the requirement for rescans during treatment due to spinal cord dose
Authors: Belshaw Louise , Agnew Christina E. , Irvine Denise M. , Rooney Keith P. , McGarry Conor K. 
Published: November 2019

Abstract

Background
Patients treated with radiotherapy for head and neck (H&N) cancer often experience anatomical changes. The potential compromises to Planning Target Volume (PTV) coverage or Organ at Risk (OAR) sparing has prompted the use of adaptive radiotherapy (ART) for these patients. However, implementation of ART is time and resource intensive. This study seeks to define a clinical trigger for H&N re-plans based on spinal cord safety using kV Cone-Beam Computed Tomography (CBCT) verification imaging, in order to best balance clinical benefit with additional workload.

Methods
Thirty-one H&N patients treated with Volumetric Modulated Arc Therapy (VMAT) who had a rescan CT (rCT) during treatment were included in this study. Contour volume changes between the planning CT (pCT) and rCT were determined. The original treatment plan was calculated on the pCT, CBCT prior to the rCT, pCT deformed to the anatomy of the CBCT (dCT), and rCT (considered the gold standard). The dose to 0.1 cc (D0.1cc) spinal cord was evaluated from the Dose Volume Histograms (DVHs).

Results
The median dose increase to D0.1cc between the pCT and rCT was 0.7 Gy (inter-quartile range 0.2–1.9 Gy, p < 0.05). No correlation was found between contour volume changes and the spinal cord dose increase. Three patients exhibited an increase of 7.0–7.2 Gy to D0.1cc, resulting in a re-plan; these patients were correctly identified using calculations on the CBCT/dCT.

Conclusions
An adaptive re-plan can be triggered using spinal cord doses calculated on the CBCT/dCT. Implementing this trigger can reduce patient appointments and radiation dose by eliminating up to 90% of additional un-necessary CT scans, reducing the workload for radiographers, physicists, dosimetrists, and clinicians.