bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of preoperative immunonutrition on outcomes of colon cancer surgery: study protocol for a randomized controlled trial
Authors: Lee Soo Young , Yeom Seung-Seop , Kim Chang Hyun , Kim Hyeong Rok 
Published: July 2020

Abstract
Background
Current guidelines recommend the prescription of immune-enriched oral nutritional supplements for malnourished patients before major gastrointestinal surgery. However, the benefit of preoperative immunonutrition is still controversial. This randomized controlled trial aims to evaluate the effect of preoperative immunonutrition on the outcomes of surgery for colon cancer.

Methods/design
Patients with primary colon cancer will be included as study participants after screening. They will be randomly assigned (in a ratio of 1:1) to receive preoperative immunonutrition added to the normal diet (experimental arm) or consume normal diet alone (control arm). Patients in the experimental arm will receive oral supplementation (400 mL/day) with arginine and ω-3 fatty acids for 7 days before elective surgery. The primary endpoint is the rate of infectious complications, while the secondary endpoints are postoperative complication rate, change in body weight, length of hospital stay, and nature of fecal microbiome. The authors hypothesize that the rate of infectious complications would be 13% in the experimental arm and 30% in the control arm. With a two-sided alpha of 0.05 and a power of 0.8, the sample size is calculated as 176 patients (88 per arm).

Discussion
Although there have been many studies demonstrating significant benefits of preoperative immunonutrition, these were limited by a small sample size and potential publication bias. Despite the recommendation of immunonutrition before surgery in nutritional guidelines, its role in reduction of rate of infectious complications is still controversial. This trial is expected to provide evidence for the benefits of administration of preoperative immunonutrition in patients with colon cancer.

Trial registration
Clinical Research Information Service KCT0003770. Registered on 15 April 2019.
The implementation and utility of patient screening logs in a multicentre randomised controlled oncology trial
Authors: Lewis Rebecca , Todd Rachel , Newton Michelle , Jones Robert J. , Wilson Caroline , Donovan Jenny L. , Bryan Richard T. , Birtle Alison , Hall Emma ,   on behalf of the POUT Trial Management Group
Published: July 2020

Abstract
Background
The utility of patient screening logs and their impact on improving trial recruitment rates are unclear. We conducted a retrospective exploratory analysis of screening data collected within a multicentre randomised controlled trial investigating chemotherapy for upper tract urothelial carcinoma.

Methods
Participating centres maintained a record of patients meeting basic screening criteria stipulated in the trial protocol, submitting logs regularly to the clinical trial coordinating centre (CTC). Sites recorded the number of patients ineligible, not approached, declined and randomised. The CTC monitored proportions of eligible patients, approach rate (proportion of eligible patients approached) and acceptance rate (proportion recruited of those approached). Data were retrospectively analysed to identify patterns of screening activity and correlation with recruitment.

Results
Data were collected between May 2012 and August 2016, during which time 71 sites were activated—a recruitment period of 2768 centre months. A total of 1138 patients were reported on screening logs, with 2300 requests for logs sent by the CTC and 47% of expected logs received. A total of 758 patients were reported as ineligible, 36 eligible patients were not approached and 207 declined trial participation. The approach rate was 91% (344/380), and the acceptance rate was 40% (137/344); these rates remained consistent throughout the data collection. The main reason patients provided for declining (99/207, 48%) was not wanting to receive chemotherapy. There was a moderately strong correlation (r = 0.47) between the number reported on screening logs and the number recruited per site. Considerable variation in data between centres was observed, and 54/191 trial participants (28%) enrolled during this period were not reported on logs.

Conclusions
Central collection of screening logs can identify reasons for patients declining trial participation and help monitor trial activity at sites; however, obtaining complete data can be challenging. There was a correlation between the number of patients reported on logs and recruitment; however, this was likely confounded by sites’ available patient population. The use of screening logs may not be appropriate for all trials, and their use should be carefully considered in relation to the associated workload. No evidence was found that central collection of screening logs improved recruitment rates in this study, and their continued use warrants further investigation.

Trial registration
ISRCTN98387754. Registered on 31 January 2012
Stability and bifurcation analysis of an amensalism system with Allee effect
Authors: Zhao Ming , Du Yunfei 
Published: July 2020

AbstractIn this work, we propose and study a new amensalism system with Allee effect on the first species. First, we investigate the existence and stability of all possible coexistence equilibrium points and boundary equilibrium points of this system. Then, applying the Sotomayor theorem, we prove that there exists a saddle-node bifurcation under some suitable parameter conditions. Finally, we provide a specific example with corresponding numerical simulations to further demonstrate our theoretical results.
Characterisation of a hand-held CZT-based gamma camera for 177Lu imaging
Authors: Roth Daniel , Larsson Erik , Sundlöv Anna , Sjögreen Gleisner Katarina 
Published: July 2020

Abstract
Background
Currently, hand-held gamma cameras are being developed for 99mTc imaging, mainly for sentinel lymph node detection. These cameras offer advantages, such as mobility and ease of access, and may be useful also for other applications such as biokinetic studies in animals or for imaging of small, superficial structures in patients. In this work, the suitability of a CZT-based hand-held camera for 177Lu imaging is investigated. The energy response of CZT-based detectors combined with the multiple photon emissions of 177Lu poses new challenges compared to 99mTc imaging, and a thorough camera characterisation is thus warranted.

Methods
Three collimators (LEHR, LEHS, and MEGP) and three energy windows (55 keV, 113 keV, and 208 keV) are investigated. Characterised camera properties include the system spatial resolution, energy resolution, sensitivity, image uniformity, septal penetration, and temperature dependence. Characterisations are made starting from NEMA guidelines when applicable, with adjustments made when required. The applicability of the camera is demonstrated by imaging of a superficially located tumour in a patient undergoing [177 Lu]Lu-DOTA-TATE therapy.

Results
Overall, the results are encouraging. Compared to a conventional gamma camera, the hand-held camera generally has a higher sensitivity for a given collimator. For source-collimator distances below 3 cm, the spatial resolution FWHM is within 6 mm for the LEHR and MEGP collimators. Before uniformity correction, the central field-of-view integral uniformity shows best results for the 113-keV window, with values obtained between 11 and 14%. The corresponding values after uniformity correction are within 3%. Effects of septal penetration are observed but are manageable with a proper combination of collimator and energy window setting. Septal penetration and collimator scatter not only affect the 208-keV window but also contribute with counts in lower windows due to energy-tailing effects. The patient study revealed non-uniform uptake patterns in a region that appeared uniform in a conventional gamma camera image.

Conclusions
The results show that the hand-held camera can be used for 177Lu imaging. A 113-keV energy window combined with LEHR or MEGP collimators provides the best image system characteristics.
Regional ethnic autonomy: thinking and actions on the reconstruction of a unified multi-ethnic country by the CPC
Authors: Chen Jianyue 
Published: July 2020

AbstractThe founding of the People’s Republic of China (PRC) established and consolidated a new type of socialist ethnic relations, and the people of all ethnic groups in China have embarked on a socialist road since then. This “had never occurred in thousands of years” in the history of China’s ethnic relations and was based on the correct path for solving ethnic issues with Chinese characteristics pioneered by the Communist Party of China (CPC), the institutional core of which is the system of regional ethnic autonomy. So to speak, the system of regional ethnic autonomy, as a fundamental political system of the country, is the reconstruction of the important content and system of ethnic relations and the reconstruction of the governance system of a unified multi-ethnic country. Around the year of 1949, the Chinese communists planned the system of regional ethnic autonomy in a systematical and comprehensive manner, and established a basic discourse guiding the ethnic work, ethnic policies and ethnic studies in the PRC. On the basis of historical literature, this paper arranges and sorts out the ethic policies and thinking context at the early stage of the governance by the CPC.
Review on the succession process of Pinus densiflora forests in South Korea: progressive and disturbance-driven succession
Authors: Choung Yeonsook , Lee Jongsung , Cho Soyeon , Noh Jaesang 
Published: July 2020

Abstract
Background
Most of the Pinus densiflora forests, occupying the largest area, have been restored in South Korea since the 1970s. As young pioneer forests, the succession process is under way. Since the forests are distributed nationwide and are vulnerable to disturbances, the process may differ depending on the geography and/or site conditions. Therefore, we reviewed the direction, the seral communities, and the late-successional species of progressive and disturbance-driven succession nationwide in the cool-temperate zone through meta-analysis and empirical observations.

Main text
As a result of a meta-analysis of the direct succession and vertical structure, we found that the P. densiflora forest is in a directionally progressive succession, changing to the broadleaved forest after forming a mixed forest with its overwhelming successor, Quercus species (particularly Q. mongolica and Q. serrata). In dry stands in a relative sense, the Quercus species was favored occupying over 80% of the abundance of the succeeding species. Therefore, in dry stands, it is presumed that Quercus-dominated stage would last for a long time due to the current dominance and long life span, and eventually, it settles as Quercus-broadleaved forest with a site change. Contrary to this, it is presumed that in mesic stands where Quercus species do not occur or have low abundance, the late-successional broadleaved species settle early to form a co-dominant forest with multiple species. Due to geographical limits, the species composition of the two late-successional forests is different. Disturbances such as insect pests and fire retrogressed vulnerable P. densiflora forest for a while. However, it was mostly restored to the Quercus forest and is expected to be incorporated in the pathway of the dry stand.

Conclusions
We revealed the succession process of P. densiflora forests according to geography and moisture and found that stand moisture had a decisive effect on the species and abundance of the successor. Although the P. densiflora forest is undergoing structural changes, the forest is still young; so within a few decades, physiognomy is not likely to change. Therefore, the decrease in the forest area may be due to other causes such as disturbances and forest conversion rather than due to succession.
The protective role of olive oil against gibberellic acid-induced embryotoxicity at prenatal stages of mice
Authors: Abu Amra El-Sabry , Lashein Fakhr El Din M. , Seleem Amin A. , Saleh Manar M. 
Published: July 2020

Abstract
Background
Gibberellic acid (GA3) is a plant growth regulator used to improve the quality of crops but its residues in food causes many hazardous effects. In contrast, olive oil has registered several health benefits including antioxidant, anti-inflammatory, and anti-cancer. Thus, the present study suggests the use of olive oil as a natural food source to counteract the GA3 toxicity during mice development. In a preliminary experiment, 18 mature females were classified into control and GA3-treated subgroups with ascending doses of GA3 (55, 110, 240, 480, 960 mg/kg B.W.) for 2 weeks. In the main experiment, 20 pregnant females at the 7th day of gestation were divided into four groups: G1 is control, G2 treated orally with GA3 (55 mg/kg), G3 treated with olive oil, and G4 treated with GA3-olive oil. The pregnant females were dissected at prenatal stages at E14 and E18 of gestation.

Results
The high doses of GA3 in the preliminary experiment showed decrease of uterine folds, reduction of carbohydrates content and TNFR2 expression of the uterine glands, degeneration of the ovarian follicles, blood vessels congestion, and altered TNFR2 expression in oocyte membrane as compared with the control. In the second experiment, GA3-treated embryo at E14 and E18 revealed histopathological changes and altered TNFR2 immunostaining in the developing liver, kidney, and skin tissues. Treatment of GA3 with olive oil improves the negative effects induced by GA3.

Conclusion
The study concluded that a supplementation rich diet with olive oil creates a protective effect against gibberellic acid-induced embryotoxicity during pregnancy.
Role of magnetic susceptibility-weighted imaging in characterization of cerebral microbleeds in acute ischemic stroke Egyptian obese patients
Authors: Abou Elmaaty Ali Ahmed , Zarad Carmen Ali 
Published: July 2020

Abstract
Objective
The study was done to investigate the role of susceptibility-weighted imaging (SWI) in characterization of cerebral microbleeds (CMBs) and incidence of CMBs in acute ischemic stroke obese patients.

Materials and methods
We recruited 120 acute ischemic stroke obese patients. All participants or their relatives gave written informed consent. MRI of the brain with SWI sequences was done for all patients.

Results
SWI showed 30% of the patients have CMBs. The total numbers of CMBs were statistically significant higher in small vessel diseases (SVDs) than large vessel diseases (LVDs) (P = 0.008). According to the severity scale, CMBs were more prominent in patients with grade 0 (70%) followed by grade III (25.8%) then grade II (4.2%). BMI was independent risk factors for developing CMBs as shown in simple regression analysis (х2 = 6.008, P = 0.002). SVDs and hypertension were statistically significant independent predictors and had higher odds to exhibit CMBs. Patients with SVDs had 5.3 times higher odds to exhibit CMBs (P = 0.002) while patients with hypertension had 3.9 times higher odds to exhibit CMBs (P = 0.032).

Conclusion
SWI is a gold standard MR imaging technique in diagnosis and characterization of CMBs with more prevalence especially in obese patients suffering from acute ischemia stroke due to SVDs. Hypertension was an independent risk factor for development of CMBs but IHD, use of antiplatelet medications, increased BMI, and dyslipidemia must be taken into consideration.
Biophilic streets: a design framework for creating multiple urban benefits
Authors: Cabanek Agata , Zingoni de Baro Maria Elena , Newman Peter 
Published: July 2020

AbstractBiophilic urbanism is bringing new perspectives to how natural systems need to be integrated into the fabric of cities. This paper shows how biophilic streets can be the front door to biophilic urbanism by integrating nature into a new street design, benefiting a range of economic, environmental and social functions. A theoretical integrated Biophilic Streets Design Framework, is outlined and evaluated through the analysis of four street revitalisation projects from Vitoria-Gasteiz, Berkeley, Portland and Melbourne. Its practical applications and multiple urban benefits will be of value to street designers globally. The Biophilic Streets Design Framework demonstrated that the four case studies meet the main design categories, which is favourable since multiple additional benefits are likely to be obtained. Future research is needed to monitor and quantify the performance of biophilic streets design to address the increasing effects of climate change, environmental degradation and biodiversity loss in a cost-effective way.
Strategic Operational Redesign for Successfully Navigating Prior Authorization Barriers at a Large-Volume Proton Therapy Center
Authors: Brooks Eric D. , Ning Matthew S. , Palmer Matthew B. , Gunn G. Brandon , Frank Steven J. , Shah Aashish K. 
Published: July 2020

PURPOSE: Prior authorization (PA) can be a resource-intensive barrier to oncologic care. To improve patient access and reduce delays at our large, academic proton therapy center, we implemented a novel payor-focused strategy to efficiently navigate the PA process while eliminating physician burden and reducing inappropriate denials. METHODS: In 2017, business operations were redesigned to better reflect the insurance process: (1) certified medical dosimetrists (CMDs), with their unique treatment expertise, replaced our historical PA team to function as an effective interface among physicians, patients, and payors; (2) a structured, tiered timeline was implemented to hold payors accountable to PA deadlines; and (3) our PA team provided administrative leadership with requisite insurance knowledge. PA outcomes were compared 6 months before and after the intervention. RESULTS: After implementation of this multifaceted strategy, the median time to successful appeal (after initial denial of coverage) decreased from 30 to 18 days ( P < .001), and the total number of overturned denials increased by 56%. Because of the efficiency of the CMDs, full-time equivalents on the PA team actually decreased by 44%, translating to a 34% reduction in team personnel expenses. Internal referrals increased by 29%, attributable to optimized communication and diminished administrative burden for providers. New treatment starts also increased, resulting in a 37% larger patient census on treatment. CONCLUSION: Incorporating payor-focused strategies can improve patient access in a cost-effective manner while decreasing time and administrative burden associated with the PA process. These operational concepts can be adapted for other oncologic practice settings facing analogous PA-related obstacles.
Towards understanding the cell surface phenotype, metabolic properties and immune functions of resident macrophages of the peritoneal cavity and splenic red pulp using high resolution quantitative proteomics
Authors: Nagala Manjula , Crocker Paul R. 
Published: July 2020

Background:Resident macrophages (Mϕs) are distributed throughout the body and are important for maintaining tissue homeostasis and for defence against infections. Tissue Mϕs are highly adapted to their microenvironment and thought to mediate tissue-specific functions involving metabolism and immune defence that are not fully elucidated. Methods:We have used high resolution quantitative proteomics to gain insights into the functions of two types of resident tissue Mϕs: peritoneal cavity Mϕs and splenic red pulp Mϕs. The cellular expression levels of many proteins were validated by flow cytometry and were consistently in agreement with the proteomics data.Results:Peritoneal and splenic red pulp macrophages displayed major differences in cell surface phenotype reflecting their adaptation to different tissue microenvironments and tissue-specific functions. Peritoneal Mϕs were shown to be enriched in a number of key enzymes and metabolic pathways normally associated with the liver, such as metabolism of fructose, detoxification, nitrogen homeostasis and the urea cycle. Supporting these observations, we show that peritoneal Mϕs are able to utilise glutamine and glutamate which are rich in peritoneum for urea generation. In comparison, splenic red pulp Mϕs were enriched in proteins important for adaptive immunity such as antigen presenting MHC molecules, in addition to proteins required for erythrocyte homeostasis and iron turnover. We also show that these tissue Mϕs may utilise carbon and nitrogen substrates for different metabolic fates to support distinct tissue-specific roles.Conclusions:This study provides new insights into the functions of tissue Mϕs in immunity and homeostasis. The comprehensive proteomics data sets are a valuable resource for biologists and immunologists.
Crescentic glomerulonephritis: what’s different in South Asia? A single center observational cohort study
Authors: Alexander Suceena , Yusuf Sabina , Rajan Gautham , Elias John Elenjickal , Roy Sanjeet , Annamalai VC , Thomas Athul , Joseph Eapen Jeethu , T Valson Anna , George David Vinoi , Varughese Santosh 
Published: July 2020

Background: The spectrum and outcomes of crescentic glomerulonephritis (Cr.GN) in South Asia is vastly different from that reported worldwide and there is a paucity of information. The aim of the study was to study the demography, clinical presentation, histology and predictors of longitudinal outcomes of Cr.GN in this population. Methods: An observational cohort study of renal biopsies was performed in the largest tertiary center in South India over a period of 10 years (January 2006 to December 2015) with ≥50% crescents on renal histology indicating Cr.GN. Results: A total of 8645 kidney biopsies were done; 200 (2.31%) were Cr.GN. Patients were categorized into three etiological groups: anti-glomerular basement membrane (type I), immune complex (type II), and pauci-immune (type III). Type II was the most common (96, 46.5%), followed by type III (73, 38%) and type I (31, 15.5%). Female preponderance was seen across all types. About half of all patients presented with recent onset hypertension. Type II had the highest median proteinuria (4.2 (2.1-6) g/day, p=0.06) and the median estimated glomerular filtration rate was lowest in type I (5 (4-8) ml/min/1.73m2, p<0.001). Among type III, anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis was seen only in ~50% of patients. Nearly one third of patients with type I were also positive for ANCA making them ‘double positive’. Acute glomerular insults like tuft necrosis and chronic changes as evidenced by moderate to severe interstitial fibrosis, was a predominant feature of type I. Conclusions: ANCA-negative pauci-immune vasculitis, as well as double positive Cr.GN, are reported for the first time in South-Asia. Renal survival was significantly worse in type I/III compared to type II. Types I/III, moderate to severe interstitial fibrosis and tubular atrophy, presence of oliguria/anuria and increasing percentage of crescents in renal biopsy were significant predictors of end stage kidney disease in our cohort.