bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum vascular endothelial growth factor as a significant marker of treatment response in Hodgkin disease
Authors: Weyl Ben Arush M. , Ben Barak A. , Shenzer P. , Maurice S. , Livne E. 
Published: March 2020

9033 Background: The aim of this pilot study was to determine VEGF serum levels (S-VEGF) at diagnosis and at restaging in children diagnosed with Hodgkin’s disease, and to investigate whether this parameter provides prognostic information for remission after 2 courses of chemotherapy Methods: S-VEGF levels of 9 consecutive pediatric patients (pts) with Hodgkin’s disease were assayed at diagnosis and at restaging. Levels of VEGF were determined using a commercially available ELISA anti-human VEGF immunoassay kit. PET-CT fusion was performed for each child at diagnosis and after 2 courses of chemotherapy in order to assess response to treatment. Results: 8 children went into complete remission or very good partial response after 2 courses of chemotherapy according to the protocol, one child developed tumor progression and respond to second line chemotherapy. At diagnosis average S-VEGF level was 655.7pg/ml (range, 1078.7–29.22 pg/ml) and at restaging decreased to 237.6 pg/ml (range, 0–453 pg/ml). (p=0.0039). One child with Hodgkin’s disease who had a higher level at first restaging and developed progressive disease responded to reinduction therapy and had a significantly lower level at the second restaging. The comparison between the levels of S-VEGF at diagnosis and at restaging showed a significant difference for the pts who responded to treatment with decreased S-VEGF and the pt who developed tumor progression with increased S-VEGF. Conclusions: Changes in S-VEGF levels correlated with response to treatment for most of the children diagnosed with Hodgkin’s disease. This provides a rationale for exploring clinical interest in S-VEGF measurements of a larger group of children with Hodgkin, and using the test for clinical trials of antiangiogenic therapies. No significant financial relationships to disclose.
Risk factors associated to invasive infection in children and adolescents with cancer during febrile neutropenia episodes
Authors: Carlesse F. A. , Petrilli A. , Weckx L. Y. , Cypriano M. S. , Pereira C. A. 
Published: March 2020

9046 Background: Febrile neutropenia (FN) after chemotherapy requires prompt introduction of empiric antimicrobial therapy. It has been demonstrated that FN patients do not represent a homogeneous group, and the stratification of infectious risk leads to changes in therapy. Our objectives were to evaluated the efficacy of the antimicrobial regimens used according to the FN institutional protocol and to identify risk factors related to invasive infection in children and adolescents during episodes of FN. Methods: We conducted a prospective study in the Pediatric Oncology Institute (IOP-GRAACC-UNIFESP/SP-Brazil) from March/2003 to June/2004. We analyzed 448 FN episodes in 200 patients, they were classified in high and low risk of invasive infection according to the underling disease and comorbities. Low risk patients (solid tumors, ALL and lymphomas in remission, without comorbities) were treated with oral gatifloxacin as outpatient; whereas high risk (AML, solid tumors, Lymphomas and ALL with comorbities or activity) were treated with cefepime as inpatient. Invasive infection was considered when a culture obtained from a sterile site resulted positive for bacterial and/or fungus or there were clinical and laboratory findings that strongly suggest sepsis. Results: Of 204 (45.5%) episodes treated with gatifloxacin, 72.1% obtained success without modification. Of 206 (46.0%) episodes treated with cefepime, 34.5% obtained success without modification, 38 (8.5%) patients were treated with distinct antibiotic regimen. Invasive infection was observed in 133 episodes (29.6%); 16 (3.6%) deaths occurred, all of them in the high risk group and the overall success was 84.3%. In the logistic regression analysis remained as independent risk factors: age ≤3 ys (OR: 2.3), temperature ≥38.5ºC (OR:1.6), central venous catheter (OR:1.7), underlying active disease (OR:1.6), mucositis (OR:2.4) and diarrhea (OR:2.4). Conclusions: Applying a institutional protocol, it is possible to predict the infectious risk and treat the patients individually .The observed overall success (84.3%), confirms that the therapy based in the protocol was adequate. There was no toxicity associated with gatifloxacin in this study, and no deaths in the low risk group. No significant financial relationships to disclose.
Expression of erythropoietin and its receptor in neuroblastomas
Authors: Sartelet H. , Fabre M. , Castaing M. , Bosq J. , Racu I. , Lagonotte E. , Scott V. , Michiels S. , Patte C. , Vassal G. 
Published: March 2020

9054 Background: Children with neuroblastomas (NB) may potentially benefit from treatment with recombinant human erythropoietin (Epo). Epo is a specific stimulator of erythropoiesis, acting via its specific receptor (EpoR). The aim of this study was to evaluate the expression of Epo and EpoR in NB and in normal tissues and their action in the proliferation of tumor cells. Methods: A tissue microarrays study was performed on 101 patients with NB from 3 hospitals (16 stage I; 7, II; 22, III; 48, IV and 8, IVS). Four blocks were constructed and contained 101 primary tumors, 39 paired metastases (35 lymph nodes), 56 paired control normal tissues and 6 cell lines of NB. Immunohistochemical staining was performed on sections using antibodies against Epo and EpoR. Immunostaining intensity was evaluated by a semi-quantitative score based on the percentage of positive cells. The wilcoxon signed rank test was applied for the comparison of paired data. For overall survival analysis, the expression was dichotomized at the median value and cox regression models were used stratified by hospital. An in vitro study of cell proliferation in presence of recombinant Epo was carried out with two of the 6 cell lines, one expressing EpoR, the other not. Results: Median follow-up was 64 months. The expression of EpoR was significantly higher in tumors than in paired control tissues (p<0.0001) but not for Epo (p=0.06). When restricted to the lymph nodes metastases, the level of expression of EpoR was significantly more expressed in the metastases than in primary tumors (p=0.02), contrary to Epo (p=0.99). Survival analysis showed that patients who expressed more EpoR had a statistically significant better overall survival than those who did not (p=0.03). Furthermore, the expression of EpoR was an independent prognostic factor from induction chemotherapy, tumor stage and age (p=0.02). No significant differences were found in Epo analyses. EpoR was expressed in only three cell lines and Epo not in any of them. In the in vitro study, recombinant Epo did not modify the proliferation of both cell lines. Conclusions: Epo and EpoR were expressed in NB but did not modify cells proliferation. The use of Epo in children with NB could be proposed but its benefit should be confirmed in a clinical trials. No significant financial relationships to disclose.
Non cutaneous AIDS-associated Kaposi’s sarcoma
Authors: Stebbing J. , Mazhar D. , Palmieri C. , Thirlwell C. , Powles T. , Nelson M. , Gazzard B. , Bower M. 
Published: March 2020

9555 Background: Acquired immune deficiency syndrome related Kaposi’s sarcoma (AIDS-KS) remains a significant cause of morbidity and mortality. We describe for the first time a proportion of patients with AIDS-KS who presented with no evidence of cutaneous disease. Methods: From our cohort of 5,932 individuals infected with the human immunodeficiency virus (HIV-1) treated in the HAART era, 319 were identified with KS. Of these, 11 patients (5.4%) were diagnosed with KS without the presence of any cutaneous disease. We compared their survival, clinical, immunologic and virologic characteristics to other individuals with KS. Results: There were no statistically significant differences in survival, CD4 count or HIV viral load at KS presentation. We observed that tumour-associated edema (p=0.046) and non-oral gastro-intestinal KS (p=0.042) were significantly more common in patients with non-cutaneous KS. Only 1 case of non-cutaneous KS was observed prior to the era of highly active anti-retroviral therapy (HAART). Conclusions: Non-cutaneous KS is a recognisable condition; patients should be treated with the standard of care as their prognosis is not inferior. This is likely to reflect a strong immune response, in the era of HAART. No significant financial relationships to disclose.
Indication for neoadjuvant chemotherapy in adult patients with high-risk soft-tissue sarcomas
Authors: Kasper B. , Kuehl E. , Wuchter P. , Bernd L. , Ho A. D. , Egerer G. 
Published: March 2020

9578 Background: To determine the efficacy and safety of neoadjuvant chemotherapy for local tumour control and overall survival in patients with high-risk soft-tissue sarcomas (tumour size ≥ 5 cm, G II/III, extracompartimental and deep localisation) we have analyzed the clinical outcome in 25 patients. Methods: Patients with high-risk soft-tissue sarcomas were treated with four cycles of etoposide 125 mg/m2/day 1+4, ifosfamide 1500 mg/m2/day 1–4 and doxorubicin 50 mg/m2/day 1 (EIA regimen) followed by definitive surgery with or without postoperative radiotherapy and adjuvant chemotherapy. 21 patients received chemotherapy in a combined neoadjuvant/adjuvant clinical setting; eighteen of them completed adjuvant chemotherapy. Four patients received chemotherapy in an adjuvant setting only. Results: The objective response rate of neoadjuvant chemotherapy assessable in 21 patients was 43%. Including NED (n = 7) and partial remissions (n = 3), the radiographic response rate was 47.6% with additional 42.9% stable diseases (n = 9). Surgery was performed in two patients before completing the four neoadjuvant chemotherapy cycles because of disease progression. Median overall survival for all patients from the time of first diagnosis was 21.6+ months [range: 8 - 50] and from the start of treatment 20.5+ months [range: 8 - 49]; median progression-free survival after start of treatment was 18.6+ months [range: 1 - 49]. After completion of chemotherapy, R0-resection could be performed in 13 of 21 patients (60%). At completion of entire treatment, 21 of 25 patients (84%) had NED after R0- and R1-resection. Two patients showed no disease progression after R2-resection and are alive with disease (AWD) 21 and 18 months after start of treatment. Two patients died of disease (DOD) ten and eight months after first diagnosis due to metastases. Conclusions: The high proportion of R0-resections supports the idea of a tumour downstaging after neoadjuvant treatment. Our data support the hypothesis that neoadjuvant chemotherapy might be beneficial as an integral part in the treatment strategy of high-risk soft-tissue sarcoma patients. No significant financial relationships to disclose.
The study of tamoxifen and raloxifene (STAR): First report of patient-reported outcomes (PROs) from the NSABP P-2 Breast Cancer Prevention Study
Authors: Ganz P. A. , Land S. R. , Wickerham D. L. , Lee M. , Ritter M. , Vogel V. , Pajon E. , Wade J. L. , Costantino J. P. , Wolmark N. 
Published: March 2020

LBA561 Background: STAR is a double-blind, randomized phase III prevention trial designed to evaluate the relative efficacy of raloxifene (R) compared to tamoxifen (T) in reducing the incidence of invasive breast cancer in high-risk postmenopausal women. In addition to standard safety monitoring, PROs were measured for quality of life (QOL) and symptoms (SXs). Methods: QOL was measured with the MOS SF-36, the CES-D, and the MOS Sexual Activity Questionnaire. SXs were measured using a modified checklist (SCL) from the NSABP P-1 BCPT. Primary endpoints were the SF-36 physical (PCS) and mental (MCS) component scales. A sample size of 1,670 provided statistical power of at least 0.8 (two-tailed test, alpha = .05). The QOL study was open to accrual at selected sites between 1/4/2000 and 5/31/2001, with questionnaires administered at baseline (pre-treatment), q 6 mos until 60 mos, and at 72 mos. SCL data were collected on all STAR participants. Longitudinal analyses used mixed effects modeling for the PCS, MCS, CES-D, and regression analyses were used to compare the average severity of SCL scores between T and R. Results: 19,747 participants enrolled in STAR and were eligible for the SCL assessment, with median follow-up time (mFU) 4.6 yrs. The QOL study enrolled 1,983 participants, 973 assigned to T and 1,010 assigned to R, mFU 5.4 yrs. QOL participants were comparable to women accrued concurrently at non-participating institutions. SCL and QOL forms compliance was high (with a low of 75% at 4.5 yrs for SCL and 74% for QOL). Mean PCS and MCS scores declined modestly over the 60 mos on study, with no significant difference between T and R. Mean CES-D scores worsened slightly on study, but with no significant difference between T and R. However, statistically significant differences (all p’s < .002) were noted between the T and R for severity of SXs, with R women reporting greater musculoskeletal problems, dyspareunia and weight gain and T women reporting greater vasomotor symptoms, leg cramps, bladder and gynecological problems. Conclusions: There were no significant differences between T and R in PROs for physical & mental health or depresson. While SX severity was generally low in this postmenopausal sample, the pattern of SXs differed between T and R. [Table: see text]
Imaging of the immune system – towards a subcellular and molecular understanding
Authors: Wen Lai , Fan Zhichao , Mikulski Zbigniew , Ley Klaus 
Published: March 2020

ABSTRACT
Immune responses involve many types of leukocytes that traffic to the site of injury, recognize the insult and respond appropriately. Imaging of the immune system involves a set of methods and analytical tools that are used to visualize immune responses at the cellular and molecular level as they occur in real time. We will review recent and emerging technological advances in optical imaging, and their application to understanding the molecular and cellular responses of neutrophils, macrophages and lymphocytes. Optical live-cell imaging provides deep mechanistic insights at the molecular, cellular, tissue and organism levels. Live-cell imaging can capture quantitative information in real time at subcellular resolution with minimal phototoxicity and repeatedly in the same living cells or in accessible tissues of the living organism. Advanced FRET probes allow tracking signaling events in live cells. Light-sheet microscopy allows for deeper tissue penetration in optically clear samples, enriching our understanding of the higher-level organization of the immune response. Super-resolution microscopy offers insights into compartmentalized signaling at a resolution beyond the diffraction limit, approaching single-molecule resolution. This Review provides a current perspective on live-cell imaging in vitro and in vivo with a focus on the assessment of the immune system.
Dietary considerations in the evaluation and management of nocturia
Authors: Alwis Upeksha S , Monaghan Thomas F , Haddad Rebecca , Weiss Jeffrey P , Roggeman Saskia , Van Laecke Erik , Vande Walle Johan , Wein Alan J , Everaert Karel 
Published: March 2020

Aim: This narrative review investigates the effect of dietary intake on nocturnal voiding severity. The primary aims of this review are to provide a framework for future research and ultimately contribute to more comprehensive, lifestyle-centered guidelines for the management of nocturia. Methods: A literature search was conducted in Web of Science, PubMed, and Google Scholar databases using the keywords “nocturia”, “diuresis”, “natriuresis”, “food”, “diet”, and “nutrients”. Results: High fruit and vegetable consumption was negatively associated with nocturia. High intake of tea and dietary sodium showed a positive association with nocturia. Several foods have also been directly linked to changes in diuresis rate, glycemic control, and endogenous serum melatonin concentration, offering potential mechanisms for this observed effect. Overall quality of the evidence was low. Conclusion: At present, there is limited evidence to suggest that certain foods, electrolytes, and specific compounds may contribute to the pathogenesis of nocturia. A greater understanding of the impact of food and nutrients on body fluid metabolism is needed to further refine the evaluation and treatment of nocturia.
Comparison of the Informed Health Choices Key Concepts Framework to other frameworks relevant to teaching and learning how to think critically about health claims and choices: a systematic review
Authors: Oxman Andrew D. , García Laura Martínez 
Published: March 2020

Background:The Informed Health Choices (IHC) Key Concepts are principles for evaluating the trustworthiness of claims about treatment effects. The Key Concepts provide a framework for developing learning-resources to help people use the concepts when treatment claims are made, and when they make health choices.Objective:To compare the framework provided by the IHC Key Concepts to other frameworks intended to promote critical thinking about treatment (intervention) claims and choices.Methods:We identified relevant frameworks from reviews of frameworks, searching Google Scholar, citation searches, and contact with key informants. We included frameworks intended to provide a structure for teaching or learning to think critically about the basis for claims, evidence used to support claims, or informed choices. For a framework to be included, there had to be a description of its purpose; a list of concepts, competences, or dispositions; and definitions of key terms. We made independent assessments of framework eligibility and extracted data for each included framework using standardised forms.Results:Twenty-two frameworks met our inclusion criteria. The purpose of the IHC Framework is similar to that of two frameworks for critical thinking and somewhat similar to that of a framework for evidence-based practice. Those frameworks have broader scopes than the IHC Framework. An important limitation of broad frameworks is that they do not provide an adequate basis (concepts) for deciding which claims to believe and what to do. There was at most some overlap between the concepts, competences, and dispositions in each of the 22 included frameworks and those in the IHC Framework.Conclusions:The IHC Key Concepts Framework appears to be unique. Our review has shown how it and other frameworks can be improved by taking account of the ways in which other related frameworks have been developed, evaluated, and made useful.
Is there a place for servant leadership in nursing?
Authors: Best Catherine 
Published: March 2020

With nursing in the spotlight in 2020, Catherine Best explores the role servant leadership can play in strengthening the profession As 2020 is the International Year of the Nurse and Midwife, nursing is in the spotlight. Nurses are well-placed to help achieve the United Nations Sustainable Development Goals which aim to improve health globally. However, in order to do so, high-quality healthcare leadership is needed. Disengaged leaders, high turnover, poor organisational culture and dysfunctional external relations can affect nurses' capacity to deliver optimum care. This article considers the role of the servant leader in bringing together nurses from all nations to speak with one voice in order to positively influence global health.
Use of Polyacrylamide Superabsorbent Polymers and Plantain Peel Biochar to Reduce Heavy Metal Mobility and Uptake by Wastewater-Irrigated Potato Plants
Authors: Dhiman Jaskaran , Prasher Shiv O. , ElSayed Eman , Patel Ramanbhai , Nzediegwu Christopher , Mawof Ali 
Published: March 2020

HighlightsAmending soil with SAP+BC and SAP reduced Cd, Cu, and Zn uptake into potato tubers.SAP+BC treatment led to greater Cd and Zn retention in topsoil.Acrylamide monomers were not detected in potatoes grown in SAP-amended soil.Potato peels accumulated higher concentrations of heavy metals than tuber flesh.Abstract. Agriculture is the largest consumer of freshwater; therefore, use of alternate sources for irrigation, such as wastewater, could alleviate increasing stress on freshwater resources. However, wastewater may contain contaminants such as heavy metals (Cd, Cr, Cu, Fe, Pb, and Zn), which could be taken up by food crops and/or contaminate groundwater. To reduce the mobility of heavy metals in soil and deter their uptake by potatoes ( L.) irrigated with synthetic wastewater, polyacrylamide superabsorbent polymer (SAP) and a mixture of SAP and plantain peel biochar (SAP+BC) were tested as soil amendments. The experiment was performed in field lysimeters packed with sandy soil. SAP was incorporated into the soil layer from 0.15 to 0.25 m below the surface and BC was mixed into the top 0.10 m of soil, both at an application rate of 1% (w/w). Leachate and composite soil samples from different depths, collected after each irrigation event, were analyzed for heavy metals. Upon harvest, different plant parts were subjected to heavy metal analysis. Compared to the untreated control, the SAP+BC treatment led to significantly greater (p &lt; 0.05) retention of Cd and Zn in the topsoil while significantly reducing (p &lt; 0.05) Cd, Cu, and Zn uptake into potato tuber flesh tissue and Cd uptake into tuber peels. The SAP treatment also significantly reduced (p &lt; 0.05) Cd uptake in the tuber as compared to the control. Acrylamide monomers were not detected in tuber flesh and peel samples for all treatments, indicating possible safe use of SAP and BC in soils to reduce heavy metal leaching and uptake by plants. Keywords: Biochar, Heavy metals, Hydrogels, Lysimeter, Plant uptake, Superabsorbent polymers, Wastewater.