bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Delta4DVH Anatomy in 3D Patient-Specific IMRT Quality Assurance
Authors: Tang Du , Yang Zhen , Dai Xunzhang , Cao Ying 
Published: July 2020

Purpose: To evaluate the performance of Delta4DVH Anatomy in patient-specific intensity-modulated radiotherapy quality assurance. Materials and Methods: Dose comparisons were performed between Anatomy doses calculated with treatment plan dose measured modification and pencil beam algorithms, treatment planning system doses, film doses, and ion chamber measured doses in homogeneous and inhomogeneous geometries. The sensitivity of Anatomy doses to machine errors and output calibration errors was also investigated. Results: For a Volumetric Modulated Arc Therapy (VMAT) plan evaluated on the Delta4 geometry, the conventional gamma passing rate was 99.6%. For a water-equivalent slab geometry, good agreements were found between dose profiles in film, treatment planning system, and Anatomy treatment plan dose measured modification and pencil beam calculations. Gamma passing rate for Anatomy treatment plan dose measured modification and pencil beam doses versus treatment planning system doses was 100%. However, gamma passing rate dropped to 97.2% and 96% for treatment plan dose measured modification and pencil beam calculations in inhomogeneous head & neck phantom, respectively. For the 10 patients’ quality assurance plans, good agreements were found between ion chamber measured doses and the planned ones (deviation: 0.09% ± 1.17%). The averaged gamma passing rate for conventional and Anatomy treatment plan dose measured modification and pencil beam gamma analyses in Delta4 geometry was 99.6% ± 0.89%, 98.54% ± 1.60%, and 98.95% ± 1.27%, respectively, higher than averaged gamma passing rate of 97.75% ± 1.23% and 93.04% ± 2.69% for treatment plan dose measured modification and pencil beam in patients’ geometries, respectively. Anatomy treatment plan dose measured modification dose profiles agreed well with those in treatment planning system for both Delta4 and patients’ geometries, while pencil beam doses demonstrated substantial disagreement in patients’ geometries when compared to treatment planning system doses. Both treatment planning system doses are sensitive to multileaf collimator and monitor unit (MU) errors for high and medium dose metrics but not sensitive to the gantry and collimator rotation error smaller than 3°. Conclusions: The new Delta4DVH Anatomy with treatment plan dose measured modification algorithm is a useful tool for the anatomy-based patient-specific quality assurance. Cautions should be taken when using pencil beam algorithm due to its limitations in handling heterogeneity and in high-dose gradient regions.
Safety and Feasibility of Transradial Access in Patients Presenting With Traumatic Injuries: A Single Urban Center Experience
Authors: Patel Aesha , Sare Antony , Shahid Muhammad U. , Kumar Abhishek , Shukla Pratik A. 
Published: July 2020

Purpose: To evaluate the efficacy, safety, and feasibility of transradial approach (TRA) for endovascular management of traumatic bleeding. Materials and Methods: A retrospective review was performed at a single level 1 trauma institution from August 2018 to July 2019. Patients presented to the interventional radiology department who were intended to be treating using TRA for the management of trauma-induced bleeding were selected. Demographics, indication for embolization, embolization site, preprocedural labs, hemodynamic stability, technical success, and complications were recorded. Results: Transradial approach was attempted in 29 (74.4%) of the 39 patients identified by operators who prefer TRA. Four patients received treatment using TRA on 2 separate occasions, for a total of 33 procedures completed with a technical success of 97% (32/33). Transradial approach was safely completed in 9 patients (27.3%) with preprocedural hemodynamically unstable status. For the 10 patients who received treatment via a transfemoral approach (TFA), traumatic disfiguration of the left upper extremity, preexisting arterial lines placed by the trauma team, and external iliac artery injuries requiring covered stent placement were the most common indications for TFA over TRA. There were no procedural or access site–related complications. Conclusion: Transradial approach for the endovascular management of bleeding in a trauma setting is safe and effective with a high technical success rate and no complications.
Safety and Efficacy of Arterial Closure Devices Following Antegrade Femoral Access: A Case–Control Study
Authors: Barrette Louis-Xavier , Vance Ansar Z. , Mantell Mark P. , Kratz Kathleen M. , Redmond Jonas W. , Clark Timothy W. I. 
Published: July 2020

Purpose: Vascular closure device (VCD) use following antegrade femoral access may present unique challenges relative to retrograde access. We retrospectively compared safety and efficacy of these devices between antegrade and retrograde patient cohorts undergoing percutaneous intervention. Materials and Methods: Over a 5-year period, a consecutive series of 107 limbs in 84 patients underwent VCD arteriotomy closure following percutaneous revascularization using an antegrade approach (VCD-A). Device deployment success rates, time to ambulation, and complication rates were compared to a contemporaneous control group of 401 limbs in 305 patients who underwent closure following retrograde access (VCD-R) during revascularization or embolization procedures. Results: Closure was attempted in VCD-A using 53 StarClose, 35 Perclose, and 19 Angio-Seal devices. Hemostasis (without supplemental manual compression) was achieved in 86/107 (80.4%) limbs. Closure was attempted in VCD-R using 215 StarClose, 119 Perclose, and 67 Angio-Seal devices with hemostasis in 357/401 (89.0%) limbs. Device deployment failure occurred in 7/107 (6.5%) of VCD-A and 20/401 (5.0%) of VCD-R ( P = .52), independent of specific device type. Femoral pseudoaneurysm developed in 1/107 and 1/401 of VCD-A and VCD-R ( P = .31), and minor hematoma developed in 3/107 and 8/401 of the VCD-A and VCD-R ( P = .61). Mean time to ambulation was 204.1 minutes in VCD-A and 204.8 minutes in VCD-R ( P = .97). Conclusion: Antegrade femoral closure was associated with high rates of technical success and low complications, similar to retrograde closure. Time to ambulation was the same in both groups despite higher heparin doses in the antegrade patients.
Life-threatening and major cardiac events during long-distance races: updates from the prospective RACE PARIS registry with a systematic review and meta-analysis
Authors: Gerardin Benoît , Guedeney Paul , Bellemain-Appaix Anne , Levasseur Thomas , Mustafic Hazrije , Benamer Hakim , Monsegu Jacques , Lamhaut Lionel , Montalescot Gilles , Aubry Pierre , Collet Jean-Philippe ,   for the Groupe de Réflexions sur la Cardiologie Interventionnelle
Published: July 2020

Abstract

Aims
Limited data exist regarding the incidence and aetiology of life-threatening events such as major cardiac events or exertional heat stroke during long-distance races. We aimed to provide an updated incidence, etiology and prognosis of life-threatening events during long-distance races.

Methods
The prospective RACE PARIS registry recorded all life-threatening events/fatal events occurring during 46 marathons, half-marathons and other long-distance races in the Paris area between 2006 and 2016, comprising 1,073,722 runners. Event characteristics were determined by review of medical records and interviews with survivors.

Results
The incidence of life-threatening events, exertional heat stroke and major cardiac events was 3.35 per 100,000, 1.02 per 100,000 and 2.33 per 100,000, respectively, including 18 sudden cardiac arrests (1.67 per 100,000). The main aetiology of sudden cardiac arrest was myocardial ischaemia (11/18), due to acute coronary thrombosis (6/11), stable atherosclerotic coronary artery disease (2/11), coronary dissection (1/11), anomalous connection (1/11) or myocardial bridging (1/11). A third of participants with ischaemia-related major cardiac events presented with pre-race clinical symptoms. Major cardiac events were more frequent in the case of a high pollution index (6.78 per 100,000 vs. 2.07 per 100,000, odds ratio 3.27, 95% confidence interval 1.12–9.54). Case fatality was low (0.19 per 100,000). Similarly, we report in a meta-analysis of eight long-distance race registries comprising 16,223,866 runners a low incidence of long-distance race-related sudden cardiac arrest (0.82 per 100,000) and fatality (0.39 per 100,000). Death following sudden cardiac arrest was strongly associated with initial asystole or pulseless rhythm.

Conclusion
Long-distance race-related life-threatening events remain rare although serious events. Better information for runners on the risk of pre-race clinical symptoms, outside air pollution and temperature may reduce their incidence.
Educating for Wholeness, but Beyond Competences: Challenges to Key-Competences-Based Education in China
Authors: Zhao Kang 
Published: July 2020

Purpose: This article aims to conduct a critical analysis of key-competences-based education in China today by revealing three main challenges that Chinese educational practitioners, researchers, and policymakers might face. Design/Approach/Methods: Against the backdrop of international and Chinese policy and the practice of key-competences-based education, this article focuses on a critical discourse analysis of this educational movement in China. Findings: China places great emphasis on the personal, cultural, and moral dimensions in generating a framework of competences, paying considerable attention to the well-being of children; hence it currently endeavors to provide a consistent educational framework to educate the young for the all-round development. However, three challenges are salient: the dilemma between Core-Suyang (Core-Competence) and the education for all-round development of the young, the limitations of design of “subject core-competences,” and a lack of consideration of subjectification as purpose of education. Originality/Value: Education which merely focuses on a list of key-competences might not only exclude non-key-competences but also exclude something unforeseen and unknown in the process of educational adventure. It is therefore suggested that a holistic education needs to be engaged in with an encompassing and dynamic view of purpose(s) of education, in which the education for subjectification is at stake in our educational endeavor.
Safety of Lumbar Interbody Fusion Procedures for Degenerative Disc Disease: A Systematic Review With Network Meta-Analysis of Prospective Studies
Authors: Chi Kuan-Yu , Cheng Shih-Hao , Kuo Yu-Kai , Lin En-Yuan , Kang Yi-No 
Published: July 2020

Study Design: A network meta-analysis. Objectives: Lumbar degenerative disc disease (LDDD) is an important issue in aging population, for which lumbar interbody fusion (LIF) is a feasible management in cases refractory to conservative therapy. There are various techniques available to perform LIF, including posterior (PLIF), transforaminal (TLIF), and anterior (ALIF) approaches. However, the comparative safety profile of these procedures remains controversial. Our study aimed to evaluate comparative adverse events of the LIF procedures in patients with LDDD. Methods: We searched 5 databases for relevant prospective cohort studies and randomized clinical trials. After quality assessments, we extracted neural, spinal, vascular, and wound events for conducting contrast-based network meta-analysis. Results were reported in risk ratio (RR), 95% confidence interval (CI), and surface under the cumulative ranking (SUCRA). Results: We identified 14 studies involving 921 participants with LDDD. Pooled result showed that open PLIF (OPLIF) leads to significantly higher overall adverse event rate than does open TLIF (OTLIF; RR = 3.43, 95% CI = 1.21-9.73). OTLIF confers the highest SUCRA in neural (78.7) and spinal (80.8) event rates. Minimally invasive TLIF has the highest SUCRA in vascular event (84.2), and minimally invasive PLIF has the highest SUCRA in wound event (88.1). No inconsistency or publication bias was detected in the results. Conclusions: Based on our results, perhaps OPLIF should be avoided in the management of LDDD due to the inferiority of overall complications. Specifically, TLIF seems to have the safest profile in terms of neural, spinal, and vascular events. Nevertheless, shared decision making is still mandatory when choosing the proper LIF procedure for patients with LDDD in clinical practice.
Extra copies of MYC, BCL2, and BCL6 and outcome in patients with diffuse large B-cell lymphoma
Authors: Sermer David , Bobillo Sabela , Dogan Ahmet , Zhang Yanming , Seshan Venkatraman , Lavery Jessica A. , Batlevi Connie , Caron Philip , Hamilton Audrey , Hamlin Paul , Horwitz Steven , Joffe Erel , Kumar Anita , Matasar Matthew , Noy Ariela , Owens Colette , Moskowitz Alison , Palomba M. Lia , Straus David , von Keudell Gottfried , Rodriguez-Rivera Ildefonso , Falchi Lorenzo , Zelenetz Andrew , Yahalom Joachim , Younes Anas 
Published: July 2020

Abstract
High-grade B-cell lymphoma (HGBL) with translocations involving MYC and BCL2 or BCL6 comprises ∼10% of cases of diffuse large B-cell lymphoma (DLBCL) and carries a poor prognosis. The incidence, prognosis, and optimal therapy for DLBCL harboring extra copies of the genes MYC, BCL2, and BCL6, rather than their genetic translocations, are unknown. In this retrospective, single-center study we identified 144 DLBCL cases including 46 patients with classic HGBL with double-hit or triple-hit chromosomal translocations (DHL), 55 with extra copies of MYC in addition to aberrations (extra copies or translocations) of BCL2 and/or BCL6 but did not meet the criteria for HGBL (EC group), and 43 without any aberrations of MYC, BCL2, or BCL6 (wild type [WT]). Unfavorable baseline characteristics had similar frequency in the EC and WT groups, but were significantly more prevalent in the DHL group. With a median follow-up of 36 months, the 2-year event-free survival (EFS) was similar between the WT and EC groups at 77% (95% confidence interval [CI], 65-90) and 82% (95% CI, 72-93), respectively. In contrast, the 2-year EFS of the DHL group was 63% (95% CI, 51-79). The 2-year overall survival in the WT, EC, and DHL groups was 86% (95% CI, 76-97), 89% (95% CI, 81-98), and 74% (95% CI, 62-88), respectively. Among patients treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone), the EC group had outcomes similar to those of the WT group. Our results indicate that patients with DLBCL with extra gene copies of MYC, BCL2, and BCL6 fare differently from those with HGBL and respond well to standard R-CHOP therapy.
A refined cell-of-origin classifier with targeted NGS and artificial intelligence shows robust predictive value in DLBCL
Authors: Xu-Monette Zijun Y. , Zhang Hongwei , Zhu Feng , Tzankov Alexandar , Bhagat Govind , Visco Carlo , Dybkaer Karen , Chiu April , Tam Wayne , Zu Youli , Hsi Eric D. , You Hua , Huh Jooryung , Ponzoni Maurilio , Ferreri Andrés J. M. , Møller Michael B. , Parsons Benjamin M. , van Krieken J. Han , Piris Miguel A. , Winter Jane N. , Hagemeister Fredrick B. , Shahbaba Babak , De Dios Ivan , Zhang Hong , Li Yong , Xu Bing , Albitar Maher , Young Ken H. 
Published: July 2020

Abstract
Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous entity of B-cell lymphoma. Cell-of-origin (COO) classification of DLBCL is required in routine practice by the World Health Organization classification for biological and therapeutic insights. Genetic subtypes uncovered recently are based on distinct genetic alterations in DLBCL, which are different from the COO subtypes defined by gene expression signatures of normal B cells retained in DLBCL. We hypothesize that classifiers incorporating both genome-wide gene-expression and pathogenetic variables can improve the therapeutic significance of DLBCL classification. To develop such refined classifiers, we performed targeted RNA sequencing (RNA-Seq) with a commercially available next-generation sequencing (NGS) platform in a large cohort of 418 DLBCLs. Genetic and transcriptional data obtained by RNA-Seq in a single run were explored by state-of-the-art artificial intelligence (AI) to develop a NGS-COO classifier for COO assignment and NGS survival models for clinical outcome prediction. The NGS-COO model built through applying AI in the training set was robust, showing high concordance with COO classification by either Affymetrix GeneChip microarray or the NanoString Lymph2Cx assay in 2 validation sets. Although the NGS-COO model was not trained for clinical outcome, the activated B-cell–like compared with the germinal-center B-cell–like subtype had significantly poorer survival. The NGS survival models stratified 30% high-risk patients in the validation set with poor survival as in the training set. These results demonstrate that targeted RNA-Seq coupled with AI deep learning techniques provides reproducible, efficient, and affordable assays for clinical application. The clinical grade assays and NGS models integrating both genetic and transcriptional factors developed in this study may eventually support precision medicine in DLBCL.
High-dose chemotherapy and autologous stem cell transplant in elderly patients with primary CNS lymphoma: a pilot study
Authors: Schorb Elisabeth , Kasenda Benjamin , Ihorst Gabriele , Scherer Florian , Wendler Julia , Isbell Lisa , Fricker Heidi , Finke Juergen , Illerhaus Gerald 
Published: July 2020

Key Points
Age-adapted high-dose chemotherapy and autologous stem cell transplantation is safe and highly effective in elderly patients with PCNSL.
Treatment-associated hemolysis in Kawasaki disease: association with blood-group antibody titers in IVIG products
Authors: Bruggeman Christine W. , Nagelkerke Sietse Q. , Lau Wendy , Manlhiot Cedric , de Haas Masja , van Bruggen Robin , McCrindle Brian W. , Yeung Rae S. M. , Kuijpers Taco W. 
Published: July 2020

AbstractHemolytic anemia resulting from IV Immunoglobulin (IVIG) treatment can be a serious complication, especially for those with underlying conditions with a high level of inflammation and after administration of high IVIG dosages, such as Kawasaki disease (KD), a multisystem vasculitis affecting young children. This hemolysis is caused by antibodies against blood groups A and B, but the precise mechanism for hemolysis is not known. We performed a single center, partly retrospective, partly prospective study of a cohort of 581 patients who received IVIG for treatment of KD from 2006 to 2013. Factors associated with hemolysis were identified through univariable and multivariable logistic regression. Six IVIG preparations were assayed for their hemolytic effect with serological and cellular assays to clarify the mechanism of red cell destruction. During the study period, a sudden increase in the incidence of hemolysis was observed, which coincided with the introduction of new IVIG preparations in North America that contained relatively high titers of anti-A and anti-B. These blood-group–specific antibodies were of the immunoglobulin G2 (IgG2) subclass and resulted in phagocytosis by monocyte-derived macrophages in an FcγRIIa-dependent manner. Phagocytosis was increased in the presence of proinflammatory mediators that mimicked the inflammatory state of KD. An increased frequency of severe hemolysis following IVIG administration was caused by ABO blood-group–specific IgG2 antibodies leading to FcγRIIa-dependent clearance of erythrocytes. This increase in adverse events necessitates a reconsideration of the criteria for maximum titer (1:64) of anti-A and anti-B in IVIG preparations.
Altered hypothalamic functional connectivity in post-traumatic headache after mild traumatic brain injury
Authors: Lu Liyan , Li Fengfang , Wang Peng , Chen Huiyou , Chen Yu-Chen , Yin Xindao 
Published: July 2020

Abstract
Background
Post-traumatic headache (PTH) is one of the most frequent symptoms following mild traumatic brain injury (mTBI). Neuroimaging studies implicate hypothalamic function connectivity (FC) disruption as an important factor in pain disorders. However, it is unknown whether there are alterations in the hypothalamus-based resting state FC within PTH following mTBI at the acute stage and its relationship with headache symptom measurement.

Methods
Forty-four mTBI patients with PTH, 27 mTBI patients without PTH and 43 healthy controls who were well matched for age, gender, and years of education were enrolled in this study. All participants underwent resting-state functional magnetic resonance imaging (fMRI) scanning as well as headache symptom measurement and cognitive assessment. Hypothalamic resting state networks were characterized by using a standard seed-based whole-brain correlation method. The bilateral hypothalamic FC was compared among the three groups. Furthermore, the correlations between hypothalamic resting state networks and headache frequency, headache intensity and MoCA scores was investigated in mTBI patients with PTH using Pearson rank correlation.

Results
Compared with mTBI patients without PTH, mTBI patients with PTH at the acute stage presented significantly decreased left hypothalamus-based FC with the right middle frontal gyrus (MFG) and right medial superior frontal gyrus (mSFG), and significantly decreased right hypothalamus-based FC with the right MFG. Decreased FC of the right MFG was significantly positively associated with headache frequency and headache intensity (r = 0.339, p = 0.024; r = 0.408, p = 0.006, respectively). Decreased FC of the right mSFG was significantly positively associated with headache frequency and headache intensity (r = 0.740, p < 0.0001; r = 0.655, p < 0.0001, respectively).

Conclusion
Our data provided evidence of disrupted hypothalamic FC in patients with acute mTBI with PTH, while abnormal FC significantly correlated with headache symptom measurement. Taken together, these changes may play an essential role in the neuropathological mechanism of mTBI patients with PTH.
A survey of RNA viruses in mosquitoes from Mozambique reveals novel genetic lineages of flaviviruses and phenuiviruses, as well as frequent flavivirus-like viral DNA forms in Mansonia
Authors: Abílio Ana Paula , Silva Manuel , Kampango Ayubo , Narciso Inácio , Gudo Eduardo Samo , das Neves Luís Carlos Bernardo , Sidat Mohsin , Fafetine José Manuel , de Almeida António Paulo Gouveia , Parreira Ricardo 
Published: July 2020

Abstract
Background
Mosquito-borne diseases involving arboviruses represent expanding threats to sub-Saharan Africa imposing as considerable burden to human and veterinary public health. In Mozambique over one hundred species of potential arbovirus mosquito vectors have been identified, although their precise role in maintaining such viruses in circulation in the country remains to be elucidated. The aim of this study was to screen for the presence of flaviviruses, alphaviruses and bunyaviruses in mosquitoes from different regions of Mozambique.

Results
Our survey analyzed 14,519 mosquitoes, and the results obtained revealed genetically distinct insect-specific flaviviruses, detected in multiple species of mosquitoes from different genera. In addition, smaller flavivirus-like NS5 sequences, frequently detected in Mansonia seemed to correspond to defective viral sequences, present as viral DNA forms. Furthermore, three lineages of putative members of the Phenuiviridae family were also detected, two of which apparently corresponding to novel viral genetic lineages.

Conclusion
This study reports for the first-time novel insect-specific flaviviruses and novel phenuiviruses, as well as frequent flavivirus-like viral DNA forms in several widely known vector species. This unique work represents recent investigation of virus screening conducted in mosquitoes from Mozambique and an important contribution to inform the establishment of a vector control program for arbovirus in the country and in the region.