bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is hypofractionated whole pelvis radiotherapy (WPRT) as well tolerated as conventionally fractionated WPRT in prostate cancer patients? The HOPE trial
Authors: Mendez Lucas C. , Arifin Andrew J. , Bauman Glenn S. , Velker Vikram M. , Ahmad Belal , Lock Michael , Venkatesan Varagur M. , Sexton Tracy L. , Rodrigues George B. , Chen Jeff , Schaly Bryan , Warner Andrew , D’Souza David P. 
Published: October 2020

Abstract
Background
Patients with high-risk prostate cancer are at increased risk of lymph node metastasis and are thought to benefit from whole pelvis radiotherapy (WPRT). There has been recent interest in the use of hypofractionated radiotherapy in treating prostate cancer. However, toxicity and cancer outcomes associated with hypofractionated WPRT are unclear at this time. This phase II study aims to investigate the impact in quality of life associated with hypofractionated WPRT compared to conventionally fractionated WPRT.

Methods
Fifty-eight patients with unfavourable intermediate-, high- or very high-risk prostate cancer will be randomized in a 1:1 ratio between high-dose-rate brachytherapy (HDR-BT) + conventionally fractionated (45 Gy in 25 fractions) WPRT vs. HDR-BT + hypofractionated (25 Gy in 5 fractions) WPRT. Randomization will be performed with a permuted block design without stratification. The primary endpoint is late bowel toxicity and the secondary endpoints include acute and late urinary and sexual toxicity, acute bowel toxicity, biochemical failure-, androgen deprivation therapy-, metastasis- and prostate cancer-free survival of the hypofractionated arm compared to the conventionally fractionated arm.

Discussion
To our knowledge, this is the first study to compare hypofractionated WPRT to conventionally fractionated WPRT with HDR-BT boost. Hypofractionated WPRT is a more attractive and convenient treatment approach, and may become the new standard of care if demonstrated to be well-tolerated and effective.

Trial registration
This trial was prospectively registered in ClinicalTrials.gov as NCT04197141 on December 12, 2019.
Integrated analysis of serum lipid profile for predicting clinical outcomes of patients with malignant biliary tumor
Authors: Sun Lejia , Ji Xin , Wang Dongyue , Guan Ai , Xiao Yao , Xu Haifeng , Du Shunda , Xu Yiyao , Zhao Haitao , Lu Xin , Sang Xinting , Zhong Shouxian , Yang Huayu , Mao Yilei 
Published: October 2020

Abstract
Background
Serum lipids were reported to be the prognostic factors of various cancers, but their prognostic value in malignant biliary tumor (MBT) patients remains unclear. Thus we aim to assess and compare prognosis values of different serum lipids, and construct a novel prognostic nomogram based on serum lipids.

Methods
Patients with a confirmed diagnosis of MBT at our institute from 2003 to 2017 were retrospectively reviewed. Prognosis-related factors were identified via univariate and multivariate Cox regression analyses. Then the novel prognostic nomogram and a 3-tier staging system were constructed based on these factors and further compared to the TNM staging system.

Results
A total of 368 patients were included in this study. Seven optimal survival-related factors—TC/HDL >  10.08, apolipoprotein B >  0.9 g/L, lipoprotein> 72 mg/L, lymph node metastasis, radical cure, CA199 > 37 U/mL, and tumor differentiation —were included to construct the prognostic nomogram. The C-indexes in training and validation sets were 0.738 and 0.721, respectively. Besides, ROC curves, calibration plots, and decision curve analysis all suggested favorable discrimination and predictive ability. The nomogram also performed better predictive ability than the TNM system and nomogram without lipid parameters. And the staging system based on nomogram also presented better discriminative ability than TNM system (P < 0.001).

Conclusions
The promising prognostic nomogram based on lipid parameters provided an intuitive method for performing survival prediction and facilitating individualized treatment and was a great complement to the TNM staging system in predicting overall survival.
Epidemiology of the extent of recreational noise exposure and hearing protection use: cross-sectional survey in a nationally representative UK adult population sample
Authors: Armitage Christopher J. , Loughran Michael T. , Munro Kevin J. 
Published: October 2020

Abstract
Background
Hearing loss is prevalent and disabling, yet little is known about the extent of recreational noise exposure and hearing protection use. The aim of the present research was to estimate the extent of recreational noise exposure and hearing protection use in a sample representative of the UK adult population.

Methods
We conducted a cross-sectional survey of 10,401 UK adults who were representative of the population.

Results
More than 7000 people (n = 7590, 73.0%) reported exposure to recreational noise excluding headphone and earphone use in the last 12 months. Just 158 people (2.1%) reported wearing hearing protection for every noisy recreational activity. Age (younger people) and beliefs of a behavioral (as opposed to genetic) cause of hearing loss were predictive of both higher recreational noise exposure and greater hearing protection use. Men were more exposed to recreational noise but women were less likely to use hearing protection.

Conclusions
For the first time, the present research quantifies the recreational noise exposure and low levels of hearing protection use in a representative sample of the UK population. The biggest public health gains are likely to be achieved through interventions targeted at younger people and in explaining behavioral (as opposed to genetic) causes of hearing loss.
Predictors of undesirable treatment outcomes of severe acute malnutrition among inpatient children in Addis Ababa, Ethiopia: a retrospective cohort study
Authors: Negussie Absalat Serawit , Tadesse Amare Worku 
Published: October 2020

Abstract
Background
In 2018, malnutrition contributed to 45% of all global cause of child death. These early child deaths were due to conditions that could either be prevented or treated with basic interventions. Hence, this study intended to provide a quantitative estimate of factors associated with undesirable treatment outcomes of severe acute malnutrition (SAM).

Methods
We studied a retrospective cohort of 304 children aged 6–59 months with complicated SAM admitted to Yekatit 12 Hospital Medical College from 2013 to 2016. We extracted data from hospital records on nutritional status, socio-demographic factors and medical conditions during admission. The analysis was carried out using SPSS version 20. The Kaplan-Meier estimator was employed to analyze the recovery rate of the children treated for SAM and multivariable Cox regression was used to determine factors that predict inpatient undesirable treatment outcomes.

Result
From a total of 304 children 6–59 months with SAM, 133 (51.4%) were boys. Marasmus was the most common type (132 (51%)) of severe acute malnutrition. The recovery, death and defaulter rate were 70.4, 12.2 and 8.2% respectively. The main predictors of undesirable treatment outcomes were found to be the presence of HIV antibody (AHR = 3.208; 95% CI: [1.045–9.846]) and sepsis (AHR = 7.677, 95% CI: [2.320–25.404]).

Conclusion
The study revealed that the overall treatment outcomes were below the SPHERE standard recommendation. The main predictors of undesirable treatment outcomes among inpatient children treated for SAM were HIV and sepsis. Intervention to reduce undesirable treatment outcomes should focus on comorbidities, especially HIV and sepsis.
How to interact with medical terminologies? Formative usability evaluations comparing three approaches for supporting the use of MedDRA by pharmacovigilance specialists
Authors: Marcilly Romaric , Douze Laura , Ferré Sébastien , Audeh Bissan , Bobed Carlos , Lillo-Le Louët Agnès , Lamy Jean-Baptiste , Bousquet Cédric 
Published: October 2020

Abstract
Background
Medical terminologies are commonly used in medicine. For instance, to answer a pharmacovigilance question, pharmacovigilance specialists (PVS) search in a pharmacovigilance database for reports in relation to a given drug. To do that, they first need to identify all MedDRA terms that might have been used to code an adverse reaction in the database, but terms may be numerous and difficult to select as they may belong to different parts of the hierarchy. In previous studies, three tools have been developed to help PVS identify and group all relevant MedDRA terms using three different approaches: forms, structured query-builder, and icons. Yet, a poor usability of the tools may increase PVS’ workload and reduce their performance. This study aims to evaluate, compare and improve the three tools during two rounds of formative usability evaluation.

Methods
First, a cognitive walkthrough was performed. Based on the design recommendations obtained from this evaluation, designers made modifications to their tools to improve usability. Once this re-engineering phase completed, six PVS took part in a usability test: difficulties, errors and verbalizations during their interaction with the three tools were collected. Their satisfaction was measured through the System Usability Scale. The design recommendations issued from the tests were used to adapt the tools.

Results
All tools had usability problems related to the lack of guidance in the graphical user interface (e.g., unintuitive labels). In two tools, the use of the SNOMED CT to find MedDRA terms hampered their use because French PVS were not used to it. For the most obvious and common terms, the icons-based interface would appear to be more useful. For the less frequently used MedDRA terms or those distributed in different parts of the hierarchy, the structured query-builder would be preferable thanks to its great power and flexibility. The form-based tool seems to be a compromise.

Conclusion
These evaluations made it possible to identify the strengths of each tool but also their weaknesses to address them before further evaluation. Next step is to assess the acceptability of tools and the expressiveness of their results to help identify and group MedDRA terms.
Functional analysis and evaluation of respiratory cilia in healthy Chinese children
Authors: Lee So-Lun , O’Callaghan Christopher , Lau Yu-Lung , Lee Chun-Wai Davy 
Published: October 2020

Abstract
Background
To aid in the diagnosis of Primary Ciliary Dyskinesia (PCD) and to evaluate the respiratory epithelium in respiratory disease, normal age-related reference ranges are needed for ciliary beat frequency (CBF), beat pattern and ultrastructure. Our aim was to establish reference ranges for healthy Chinese children.

Methods
Ciliated epithelial samples were obtained from 135 healthy Chinese children aged below 18 years by brushing the inferior nasal turbinate. CBF and beat pattern were analysed from high speed video recordings. Epithelial integrity and ciliary ultrastructure were assessed using transmission electronic microscopy.

Results
The mean CBF from 135 children studied was 10.1 Hz (95% CI 9.8 to 10.4). Approximately 20% (ranged 18.0–24.2%) of ciliated epithelial edges were found to have areas of dyskinetically beating cilia. Normal beat pattern was observed in ciliated epithelium from all subjects. We did not find any effect of exposure to second hand smoke on CBF in our subjects. Microtubular defects were found in 9.3% of all of the cilia counted in these children, while other ciliary ultrastructural defects were found in less than 3%.

Conclusions
We established the reference range for CBF, beat pattern and ultrastructure in healthy Chinese children. Using similar methodology, we found a lower overall mean CBF than previously obtained European values. This study highlights the need to establish normative data for ciliary function in different populations.
T-cell lymphoma with a granulomatous lesion of the lungs after autologous hematopoietic stem cell transplantation for Epstein–Barr virus-positive diffuse large B-cell lymphoma: a unique rare case of metachronous B-cell and T-cell lymphoma
Authors: Kajimoto Yusuke , Terasaki Yasuhiro , Terasaki Mika , Kunugi Shinobu , Okabe Yugo , Wakita Satoshi , Inokuchi Koiti , Shimizu Akira 
Published: October 2020

Abstract
Background
Epstein–Barr virus (EBV) is associated with the pathogenesis of a variety of malignancies, most notably lymphomas. Especially in the background of immunodeficiency, such as primary immunodeficiency disorder (PID) and post-transplant lymphoproliferative disorder (PTLD), the role of EBV might be crucial. PIDs are rare heterogeneous diseases affecting the development and/or the function of the innate and adaptive immune system. Malignancy is the second-highest cause of death after infection, and lymphoma accounts for about half of malignancies. The most frequently reported lymphoma type is diffuse large B-cell lymphoma (DLBCL) and the incidence of T-cell lymphoma is rare. PTLDs are also rare serious lymphoid and/or plasmacytic proliferative disorders that occur after undergoing solid organ or hematopoietic stem cell transplantation (HSCT). In the context of HSCT, most reported PTLDs have occurred in patients who received allogenic HSCT, but only a few cases have been reported in autologous HSCT (AutoHSCT) recipients.

Case presentation
A 53-year-old female patient initially presented with enlargement of the left cervical lymph nodes and was diagnosed with EBV-positive DLBCL. She was treated with R-CHOP, R-ACES, and AutoHSCT and went into remission. Four years later, computed tomography results revealed multiple lung nodules and abnormal infiltration, and sustained and progressing hypogammaglobulinemia was observed. The pathological specimen of video-assisted thoracoscopic surgical lung biopsy demonstrated extensive invasion of lymphocytes with notable granuloma findings. Flow cytometric immunophenotyping analysis showed that lymphocytes were positive for CD3 and CD5; especially, CD3 was expressed in the cytoplasm. Southern blot analysis revealed rearrangements of the T-cell receptor Cβ1 gene. She was diagnosed with peripheral T-cell lymphoma, not otherwise specified, accompanied by notable granulomatous lesions.

Conclusion
Here, as a unique case of metachronous B-cell and T-cell lymphoma, we report a rare case of T-cell lymphoma that mainly affected the lungs with the presentation of notable granulomatous findings following AutoHSCT for EBV-positive DLBCL at the age of 53 years. These lung lesions of granulomatous T-cell lymphoma could be related to the underlying primary immunodeficiency background associated with sustained hypogammaglobulinemia.
Wild edible plants collected and consumed by the locals in Daqinggou, Inner Mongolia, China
Authors: Sachula  , Geilebagan  , Zhang Yan-ying , Zhao Hui , Khasbagan  
Published: October 2020

Abstract
Background
Knowledge of wild edible plants is an important part of traditional knowledge. It is closely related to traditional human agriculture, as well as biodiversity. This study aimed to conduct a detailed investigation and evaluation of wild edible plants that are collected and consumed by the Mongolian and Han locals in Daqinggou and to provide valuable data for the development and utilization of plant resources.

Methods
In the 9 site visits to the area of Daqinggou during the period of 2017–2019, the authors used key informant interviews, semistructured interviews, and questionnaires to collect utilization information regarding precollected species of local wild edible plants. By combining the data obtained from 101 key informants, the authors used the Cultural Food Significance Index (CFSI), a quantitative index to evaluate the relative importance of the wild edible plants that were discussed in the aforementioned interviews.

Results
The investigation results show that the Mongolian people provided 67 folk names, corresponding to 57 wild plants, and the Han Chinese provided 58 folk names, corresponding to 49 wild plants. A total of 61 edible wild plant species belonging to 29 families and 52 genera were recorded as edible resources for the locals in Daqinggou. The uses include grains, oil and fat resources, vegetables, fruits, beverages, condiments, and snacks. The most commonly reported purpose of wild edible plants is using them as vegetables, followed by using them as beverages and fruits. The most widely used edible parts are fruits, leaves, and other aerial parts. Eating raw and cooked plants are the usual methods of consuming wild edible plants according to the locals. In addition, the CFSI of 61 wild edible plant species shows that 27 species have characteristics of medical food.

Conclusions
The knowledge and experience of naming and consuming wild plants by the Mongolian people and Han Chinese in Daqinggou are an important manifestation of the direct interaction between locals and plants. The CSFI evaluation of the wild edible plants consumed by the locals in Daqinggou establishes the utilization of some wild plants as part of the traditional knowledge of medical food.
The effects of exergaming on pain, postural control, technology acceptance and flow experience in older people with chronic musculoskeletal pain: a randomised controlled trial
Authors: Ditchburn Jae-Llane , van Schaik Paul , Dixon John , MacSween Alasdair , Martin Denis 
Published: October 2020

AbstractBackgroundOlder people with chronic musculoskeletal pain are at risk of falls. This study aimed to investigate the effects of exergaming on pain and postural control in older people with chronic musculoskeletal pain. Secondary outcomes were technology acceptance, flow experience, perceived physical exertion, expended mental effort and heart rate.MethodsFifty four older adults (age: 71 ± 5 years) with chronic musculoskeletal pain were randomised into 2 groups. Group 1 received exergaming training using the Interactive Rehabilitation and Exercise System (IREX®). Group 2 undertook traditional gym-based exercise (TGB). Both groups completed twice weekly 40-min exercise sessions for 6 weeks. Perceived pain was measured using a numeric pain rating scale and the Multidimensional Affect and Pain Survey questionnaire. Postural control was measured as sway using a Kistler™ force platform. Technology acceptance was measured with the Unified Theory of Acceptance and Use of Technology questionnaire and flow experience with the Flow State Scale. Physiological measures of perceived physical exertion, expended mental effort and heart rate were recorded during all sessions.ResultsThe exergaming group demonstrated significant reductions in pain intensity and thermal pain including a near significant approach in physical engagement in comparison to TGB group. Although no intervention effects on postural control were found, the exergaming group showed significant improvements in three sway measures (AP SD, ML SD and AP range) over time whereas significant improvements in ML range were found in the TGB group. Relating to technology acceptance, significant intervention effects on social influence and behavioural intention were found in the TGB group instead, although both groups demonstrated increases of acceptance over time. Regarding flow experience, concentration at task was significantly influenced in the TGB group and significant increases in flow variables over time were observed in both groups. Significant increases over time in perceived physical exertion and expended mental effort were found in both groups.ConclusionOur findings support the potential of exergaming to alleviate pain and improve balance in older people with chronic musculoskeletal pain. Both forms of exercise are acceptable, intrinsically motivating and show evidence of benefit to older people with chronic musculoskeletal pain.Trial registrationClinicalTrials.gov Identifier:NCT04029285(retrospectively registered, July 23, 2019)
Evaluation of a genetic risk score for severity of COVID-19 using human chromosomal-scale length variation
Authors: Toh Christopher , Brody James P. 
Published: October 2020

AbstractIntroductionThe course of COVID-19 varies from asymptomatic to severe in patients. The basis for this range in symptoms is unknown. One possibility is that genetic variation is partly responsible for the highly variable response. We evaluated how well a genetic risk score based on chromosomal-scale length variation and machine learning classification algorithms could predict severity of response to SARS-CoV-2 infection.MethodsWe compared 981 patients from the UK Biobank dataset who had a severe reaction to SARS-CoV-2 infection before 27 April 2020 to a similar number of age-matched patients drawn for the general UK Biobank population. For each patient, we built a profile of 88 numbers characterizing the chromosomal-scale length variability of their germ line DNA. Each number represented one quarter of the 22 autosomes. We used the machine learning algorithm XGBoost to build a classifier that could predict whether a person would have a severe reaction to COVID-19 based only on their 88-number classification.ResultsWe found that the XGBoost classifier could differentiate between the two classes at a significant level (p = 2 · 10−11) as measured against a randomized control and (p = 3 · 10−14) as measured against the expected value of a random guessing algorithm (AUC = 0.5). However, we found that the AUC of the classifier was only 0.51, too low for a clinically useful test.ConclusionGenetics play a role in the severity of COVID-19, but we cannot yet develop a useful genetic test to predict severity.
An ontology based modeling framework for design of educational technologies
Authors: Chimalakonda Sridhar , Nori Kesav V. 
Published: October 2020

AbstractDespite rapid progress, most of the educational technologies today lack a strong instructional design knowledge basis leading to questionable quality of instruction. In addition, a major challenge is to customize these educational technologies for a wide range of customizable instructional designs. Ontologies are one of the pertinent mechanisms to represent instructional design in the literature. However, existing approaches do not support modeling of flexible instructional designs. To address this problem, in this paper, we propose an ontology based framework for systematic modeling of different aspects of instructional design knowledge based on domain patterns. As part of the framework, we present ontologies for modeling goals, instructional processes and instructional material. We demonstrate the ontology framework by presenting instances of the ontology for the large scale case study of adult literacy in India (287 million learners spread across 22 Indian Languages), which requires creation of hundreds of similar but varied eLearning Systems based on flexible instructional designs. The implemented framework is available at http://rice.iiit.ac.in and is transferred to National Literacy Mission Authority of Government of India. The proposed framework could be potentially used for modeling instructional design knowledge for school education, vocational skills and beyond.