bluuebunny/crossref_metadata_2025_split huggingface dataset:
Updated Survival Data for a Phase I/II Study of Carboplatin plus Nab-Paclitaxel and Concurrent Radiotherapy in Patients with Locally Advanced Non-Small Cell Lung Cancer
Authors: Tsuchiya-Kawano Yuko , Sasaki Tomonari , Yamaguchi Hiroyuki , Hirano Katsuya , Horiike Atsushi , Satouchi Miyako , Hosokawa Shinobu , Morinaga Ryotaro , Komiya Kazutoshi , Inoue Koji , Fujita Yuka , Toyozawa Ryo , Kimura Tomoki , Takahashi Kosuke , Nishikawa Kazuo , Kishimoto Junji , Nakanishi Yoichi , Okamoto Isamu 
Published: October 2019

Abstract

Lessons Learned
Updated survival data for a phase I/II study of carboplatin plus nab-paclitaxel and concurrent radiotherapy were collected. In the group of 58 patients who were enrolled at 14 institutions in Japan, the median overall survival was not reached and the 2-year overall survival rate was 66.1% (95% confidence interval, 52.1%–76.8%). Results reveal encouraging feasibility and activity for this regimen.

Background
We report the updated survival data for a phase I/II study of carboplatin plus nab-paclitaxel (nab-P/C) and concurrent radiotherapy (CRT) in patients with locally advanced non-small cell lung cancer (NSCLC).

Methods
Individuals between 20 and 74 years of age with unresectable NSCLC of stage IIIA or IIIB and a performance status of 0 or 1 were eligible for the study. Patients received weekly nab-paclitaxel at 50 mg/m2 for 6 weeks together with weekly carboplatin at an area under the curve (AUC) of 2 mg/ml/min and concurrent radiotherapy with 60 Gy in 30 fractions. This concurrent phase was followed by a consolidation phase consisting of two 3-week cycles of nab-paclitaxel (100 mg/m2 on days 1, 8, and 15) plus carboplatin (AUC of 6 on day 1). After the treatment, patients were observed off therapy. The primary endpoint of the phase II part of the study was progression-free survival (PFS).

Results
Between October 2014 and November 2016, 58 patients were enrolled at 14 institutions in Japan, with 56 of these individuals being evaluable for treatment efficacy and safety. At the median follow-up time of 26.0 months (range, 4.0–49.6 months), the median overall survival (OS) was not reached (95% confidence interval [CI], 25.3 months to not reached) and the 2-year OS rate was 66.1% (95% CI, 52.1%–76.8%). The median PFS was 11.8 months (95% CI, 8.2–21.0 months), and the 2-year PFS rate was 35.9% (95% CI, 23.1%–48.9%). Subgroup analysis according to tumor histology or patient age revealed no differences in median PFS or OS. Long-term follow-up of toxicities did not identify new safety signals, and no treatment-related deaths occurred during the study period.

Conclusion
Concurrent chemoradiation with nab-P/C was safe and provided a long-term survival benefit for patients with locally advanced NSCLC.
İçme suyu havzası koruma sınırlarının belirlenmesine yeni yöntem önerisi: Kırklareli barajı içme suyu havzası örneği
Authors: KURU Azem , TEZER Azime 
Published: October 2019

Günümüzde nüfus artışıyla birlikte insan
faaliyetlerinin artması çevresel kaynakların sürdürülebilirliğinin
sağlanmasında yoğun baskılar ve olumsuz etkiler oluşturmaktadır. Ekonomik
kalkınma amaçlı gerçekleştirilen arazi kullanım değişiklikleri, özellikle
hassas ekosistemler üzerindeki baskıları arttırmaktadır. Bununla birlikte doğal
eşiklerin yeteri kadar dikkate alınamadığı idari sınırlar içerisinde
gerçekleştirilen planlama faaliyetleri ise hassas ekosistemlerin koruma -
kullanma dengesini sağlayamamaktadır. İçme suyu havzaları, yüksek nüfuslu
kentsel yerleşimler için vazgeçilmez ekolojik birimlerdendir. Türkiye’de havza
yönetimi yapısında koruma esasları kuş uçuşu mesafeler dikkate alınarak
gerçekleştirilmekte ve her bir havzanın kendine özgü durumu
değerlendirilmemektedir. Bu konuda her bir havzaya özgü gerçekleştirilen koruma
planları ve özel hükümlerde havzalara özgü ekolojik niteliklere yönelik kapsam
günümüzdeki uygulamalarda yeni yeni ele alınmaktadır. Bu çalışma kapsamında öncelikle; Kırklareli
kentinin içme suyunun tamamını sağlayan Kırklareli Barajı su toplama havzasının
arazi kullanım değişiklikleri 1990, 2000 ve 2012 dönemlerine ait CORINE arazi
kullanımı/arazi örtüsü verileri esas alınarak değerlendirilmiştir. İkinci
aşamada kirletici unsurların olumsuz etkilerinin yüzey suyuna ulaşma durumunu
etkileyen veri seti derlenmiş ve mesafeye dayalı yaklaşıma alternatif alana
özgü su kalitesi mekânsal kontrol yaklaşımı sunulmaya çalışılmıştır. Bununla
birlikte havza planlama çalışmalarında havzanın sahip olduğu diğer ekolojik
değerlerin de dikkate alınması zorunluluğu bulunmaktadır. Bu amaçla ekosistem
servisleri yaklaşımı da, bu çalışmaya dahil edilmiştir. Bu çalışma ile mesafeye
dayalı havza koruma alanlarının belirlenmesi yaklaşımı yerine; havzanın
morfolojik özelliklerine ve ekosistem servisleri potansiyeline dayalı
bütünleşik havza alt-koruma alanları belirleme yaklaşımı Kırklareli Barajı
Havzası için oluşturulmuştur.
Levonorgesterel releasing intra uterine system in the control of heavy menstrual bleeding. Is it an alternative to hysterectomy?
Authors: Nair Sobha S. , Nayar Jayashree , Kurien Ann John , Seth Isha 
Published: October 2019

Background: Heavy menstrual bleeding (HMB) affects 10 to 35% of women. Studies indicate LNG-IUS which releases controlled amounts of levonorgestrel (LNG) is effective in non- surgical treatment for HMB and has fewer side effects when compared to the conventional pharmacological agents. It also improves the quality of life. Levonorgesterel releasing intra uterine system can be an alternative to hysterectomy in the control of HMB.Methods: Retrospective study of 2 years in a tertiary care centre, Kochi. 170 women with abnormal uterine bleeding were enrolled in the study. Clinical examination, routine investigations and imaging was done. Endometrial sampling done and followed with HPE reports in indicated cases.Results: Mean age was 41 years. 30.6% had menorrhagia. Adenomyosis in 44% and endometrial hyperplasia in 19. 4%. Lost follow up in 12.9% cases and expulsion in 3.6%. 4.1% were unsatisfied and had hysterectomy. The uterine width in adenomyosis was significantly reduced p <0.012. The mean ET in endometrial hyperplasia cases also significantly reduced with p <0.01. Satisfaction rate was 97%.Conclusions: LNG-IUS is having a high success rate in controlling menstrual symptoms, thereby improving the quality of life and avoiding hysterectomy in women with abnormal uterine bleeding. It is highly efficient in symptomatic relief of adenomyosis and reduction in the uterine volume (width). Endometrial hyperplasia showed complete regression with LNG-IUS.
Psycho-social factors affecting antenatal care services utilization at the Ministry of Health’s primary health care centers in Jeddah, Kingdom of Saudi Arabia, 2017-2018: an analytical cross-sectional study
Authors: Al Daajani Manal M. , Gosadi Ibrahim M. , Milaat Waleed A. , Osman Ahmed A. 
Published: October 2019

Background: This study aimed to explore the psychosocial factors affecting the utilization of antenatal care (ANC) services.Methods: This was an analytical cross-sectional study carried-out in the 4 main MOH maternity hospitals in Jeddah. The study sample included 2 groups: 80 women with inadequate ANC attendance and 159 with adequate ANC attendance. We applied probability proportional to size sampling technique. The outcome of this study was ANC attendance (adequate or inadequate). Independent variables included: age, nationality, educational level, occupation, monthly income, the dependent variables included: the number of ANC visits.Results: The utilization findings of this study revealed that 88 women out of 239 women had not fully used the health services provided to them (underutilization) and the utilization rate was 66.5%. Approximately one-half of the women with inadequate ANC had birth intervals of less than 2 years. Three-quarters of them reported that they did not plan their current pregnancies, and nearly two-thirds of them had high levels of stress. Logistic regression analysis indicated that inadequate ANC attendance was predicted by past negative experiences related to ANC attendance (p=0.001) (OR=0.183 CI=0.065-0.513).Conclusions: The most significant identified barriers to utilization of ANC services were high stress, previous negative ANC experience, unplanned pregnancy, and short birth intervals. Furthermore, women who had adequate ANC visits were more likely to have planned pregnancies and be aware of available ANC services.
Graft uptake and post-operative hearing outcome with type-I tympanoplasty in dry versus wet ear: a comparative study
Authors: Sandhu Kulwinder Singh , Kaur Puneet , Singh Jagdeepak , Arya Sania 
Published: October 2019

<p class="abstract"><strong>Background:</strong> The discharging ear presents the otologist with the dilemma of operating on it or not. This study is being undertaken to study and compare the results of type I tympanoplasty in dry ear (no ear discharge at the time of surgery) and wet ear (culture negative consistent ear discharge at the time of surgery).</p><p class="abstract"><strong>Methods:</strong> 50 patients of either sex aged between 18 to 50 years undergoing type-I tympanoplasty were included in the study on the basis of pre-determined clinical criteria. Type I tympanoplasty was performed using temporalis fascia graft by underlay technique. Post-operative data regarding graft uptake and hearing improvement was recorded in the follow up period of three months. </p><p class="abstract"><strong>Results:</strong> The complete graft uptake was there in 88% of the patients in group 1 and 84% patients in group 2. The difference in the two groups was statistically insignificant (p&gt;0.05). The mean pre-operative pure tone average in group 1 was 30.57±7.80 dB while post-operative pure tone average was 20.68±8.22 dB with a mean hearing gain of 9.89 dB. The mean pre-operative pure tone average in group 2 was 35.21±5.98 dB while the post-operative pure tone average was 27.07±9.25 dB with a mean hearing gain of 8.12 dB. There was marked hearing improvement in both the groups post operatively (p&lt;0.001 i.e., highly significant). When hearing improvement was compared between two groups there was no significant statistical difference (p&gt;0.05).</p><p class="abstract"><strong>Conclusions:</strong> The outcome is equally good for type 1 tympanoplasty in dry and wet ear in safe (mucosal) type of chronic suppurative otitis media with respect to graft uptake and hearing improvement.</p>
Effect of interlay tympanoplasty on anterior tympanomeatal angle and pure tone audiometry at one month, six month and one year follow up
Authors: Khan Abdul Rehman , Siddiqui Farzana 
Published: October 2019

<p class="abstract"><strong>Background:</strong> The aim of the study was to determine the effect of interlay tympanoplasty on anterior tympanomeatal angle and on puretone average at 1 month, 6 month and 1 year follow up.</p><p class="abstract"><strong>Methods:</strong> This study was done at department of Otorhinolaryngology, RMRI, Bareilly, India, a tertiary-care Teaching hospital. A total number of 187 patients (86 females, 101 males) were included in this study from April 2014 to March 2018. Age range of selected patients was 15 years to 62 years, 133 patients were having subtotal perforation and remaining having perforation in the anterior half extending upto the annulus. </p><p class="abstract"><strong>Results:</strong> The anterior tympanomeatal angle blunting and pure tone audiometry (PTA) at the due follow up time was assessed and results were analyzed in terms of angle of blunting and hearing loss detected by PTA. Anterior tympanomeatal angle (ATA) blunting was categorized in three groups as follows &lt;90<sup>o</sup>,90-120<sup>o </sup>and &gt;120<sup>o</sup>. Only 3 patients were having &gt;120<sup>o </sup>ATA after one year and mean hearing loss (air bone gap) was significantly less after 1 year follow up. There were only 3 patients with remnant perforation, after 1 year of surgery out of 187 cases, with 98.4% success rate.</p><p class="p1"><strong>Conclusions:</strong> Interlay tympanoplasty was significantly effective in repairing anterior and subtotal tympanic membrane perforations with avoidance of blunting at the anterior tympanomeatal angle and achieved good functional results. </p>
Malaria induced sudden sensorineural hearing loss: a rare presentation
Authors: Agbaakin Adewale D. , Akinola Ayodele M. , Adeyeye Adetola Rachael , Nkemjika Chinonso B. 
Published: October 2019

<p>Sudden Hearing loss has been rarely reported as a presenting symptom of malaria fever. It’s even more rare to have a bilateral profound sudden sensorineural hearing loss. A 19 years old female student presented with fever, body weakness, hearing loss with tinnitus. Laboratory investigations done were essentially normal except blood film for malaria parasite which showed a high concentration of the parasite in blood on both occasions. Otoacoustics emission test was passed bilaterally while auditory steady state response showed profound hearing loss bilaterally. Normal hearing was restored within 48 hrs of commencement of anti-malaria drugs and low dose steroids. </p>
Pedagogía del diseño: el proyecto del proyecto.
Authors: Caram Carlos 
Published: October 2019

Reflexionar sobre cómo se enseña y se aprende el diseño debería ser imprescindible para todos los sujetos protagonistas de estos procesos. La pedagogía del diseño es un proyecto, un proceso hipotético - iterativo, una actividad planificada que sin embargo no debería perder la espontaneidad del momento de la clase.El proyecto de pedagogía no debería ser neutro, el docente posee conceptos acerca de qué es el diseño, cómo se aprende, qué es la teoría, la práctica y cuáles son sus límites. Asimismo se aborda el proyecto con un concepto ideológico sobre el estudiante, el profesor, el contenido y la evaluación. El presente ensayo intenta generar preguntas, diálogos y cuestionamientos sobre la práctica y la reflexión pedagógica, entendiendo al conocimiento como socialmente construido, provisorio e inacabado y a la práctica pedagógica como asimétrica, deliberada, intencionaday descontextualizada.
Dysplasia Epiphysealis Hemimelica/Trevor Disease: Report of a Lesion Solely Involving the Lunate Bone
Authors: Ali Malik I. , Padhye Kedar P. , Flood Meghan , Schollenberg Erica , Logan Karl J. 
Published: October 2019

Case:
We describe the case of a dysplasia epiphysealis hemimelica (DEH) lesion affecting uniquely the lunate bone in a 16-year-old boy causing pain, stiffness, and decreased range of motion. Surgical excision was performed, leading to resolution of primary symptoms with residual limitations in terminal wrist extension.

Conclusions:
From our review of the literature, we believe this case to be the first report of a DEH lesion affecting solely the lunate bone. Although conservative and surgical management have both been described with DEH cases, we report a positive outcome following the excision of a symptomatic lesion.
The precursor for nerve growth factor (proNGF) is not a serum or biopsy-rinse biomarker for thyroid cancer diagnosis
Authors: Rowe Christopher W , Faulkner Sam , Paul Jonathan W , Tolosa Jorge M , Gedye Craig , Bendinelli Cino , Wynne Katie , McGrath Shaun , Attia John , Smith Roger , Hondermarck Hubert 
Published: October 2019

Abstract
Background: Nerves and neurotrophic growth factors are emerging promoters of cancer growth. The precursor for Nerve Growth Factor (proNGF) is overexpressed in thyroid cancer, but its potential role as a clinical biomarker has not been reported. Here we have examined the value of proNGF as a serum and biopsy-rinse biomarker for thyroid cancer diagnosis. Methods: Patients presenting for thyroid surgery or biopsy were enrolled in separate cohorts examining serum (n=204, including 46 cases of thyroid cancer) and biopsy-rinse specimens (n=188, including 26 cases of thyroid cancer). ProNGF levels in clinical samples were analysed by ELISA. Multivariate statistical analyses testing for potential confounders were used to compare proNGF levels with clinicopathological parameters. Results: ProNGF was not detected in the majority of serum samples 176/204 (86%) and the detection of proNGF was not associated with thyroid cancer diagnosis. In the few cases where proNGF was detected in the serum, thyroidectomy did not affect proNGF concentration, demonstrating that the thyroid was not the source of serum proNGF. Intringuingly, an association between hyperthyroidism and serum proNGF was observed (OR 3.3, 95%CI 1.6-8.7 p=0.02). In biopsy-rinse, proNGF was detected in 73/188 (39%) cases, with no association between proNGF and thyroid cancer. However, a significant positive association between follicular lesions and biopsy-rinse proNGF was found (OR 3.3, 95% CI 1.2-8.7, p=0.02). Conclusions: ProNGF levels in serum and biopsy-rinse are not increased in thyroid cancer and therefore proNGF is not a clinical biomarker for this condition.
The dishwasher rubber seal acts as a reservoir of bacteria in the home environment
Authors: Zupančič Jerneja , Turk Martina , Črnigoj Miha , Avguštin Jerneja Ambrožič , Gunde-Cimerman Nina 
Published: October 2019

Abstract
Bacteria that colonise the extreme environment of household dishwasher rubber seals were investigated using cultivation-dependent and metagenomic approaches. All 30 dishwashers investigated were colonised by various bacteria. Cultivation approaches resulted in 632 bacterial isolates in total, belonging to four phyla, eight classes, 40 genera and 74 species. The majority were Gram-positive, as solely Firmicutes (dominated by the Bacillus cereus group) and Actinobacteria. Gammaproteobacteria were primarily represented by Stenotrophomonas maltophilia, Pseudomonas aeruginosa and Escherichia coli. All isolates were tested for resistance to seven selected antibiotics. Metagenomic assessment of the bacterial biodiversity of the dishwasher rubber seals confirmed the predominance of Gram-positive bacteria, as primarily Actinobacteria, followed by Proteobacteria dominated by Gammaproteobacteria, and by pathogenic species such as Escherichia sp., Acinetobacter baumannii, Pseudomonas sp., Stenotrophomonas maltophilia, and Enterobacter sp.. Metagenomic assessment of bacterial biodiversity in the tap water connected to dishwashers revealed predominance of Gram-negative bacteria, in particular Proteobacteria, mainly represented by Tepidimonas sp.. Actinobacteria showed low numbers while no Firmicutes were detected in the tap water. The bacterial diversity of tap water was also lower, 23 genera compared to 39 genera on dishwasher rubber seals. Only 13 out of 49 genera identified by metagenomics approach was found in both environments, of those Gordonia was enriched while half of 13 genera were depleted in dishwashers compared to tap water. These data indicate that colonisation of dishwasher rubber seals probably depends primarily on the bacterial input from the dirty vessels, and much less on the bacteria in the tap water. Based on the antibiotic resistance data, the dishwasher rubber seal bacterial isolates do not represent a serious threat for the spread of antibiotic resistance into the household environment. Nevertheless dishwashers cannot be ignored as potential sources of human infections, in particular for immuno-compromised individuals.
Efficacy of urination in alleviating man’s urethral pain associated with flexible cystoscopy : a single-center randomized trial
Authors: Xie Yingwei , Wang Wei , Yan Wei , Liu Dan , Liu Yuexin 
Published: October 2019

Abstract
Objective: This study aimed to assess whether urethral pain can be alleviated by urination in male patients undergoing flexible cystoscopy. Patient and Methods: Ninety-six male outpatients undergoing flexible cystoscopy were randomly divided into two groups. Patients in the test group urinated during flexible cystoscopy, whilst patients in the control group received no instructions to do so. All patients received 10mL of 2% lidocaine gel prior to assessment. Using 0 (no-pain) to 10 (unbearable severe pain) pain scores (VAS), we assessed patient discomfort prior to anesthesia gel perfusion (baseline), during gel perfusion, during cystoscope insertion through the urethra, and 15minutes post-examination analysis. The entire protocol was completed by a single doctor in our Department of Urology. Results: The groups showed no statistical differences regarding age or examination time. During cystoscope insertion, the test group recorded significantly lower pain scores 2 (IQR 1-3) - compared to the control group 3 (IQR 2-3) , (P = 0.001). No significant differences between other evaluation points were observed between groups. Conclusion: Urethral pain can be significantly alleviated by urination in male patients undergoing flexible cystoscopy through the urethra.
Fibular strut allograft influences reduction and outcomes after locking plate fixation of comminuted proximal humeral fractures in elderly patients: a retrospective study
Authors: Cui Xueliang , chen Hui , Ma Binbin , Fan Wenbin , Li He 
Published: October 2019

Abstract
Background: Proximal humeral fractures (PHFs) are the third most commonly occurring fractures in elderly patients. Most of these fractures can be treated with conservative methods, but the optimal surgical treatment strategy for unstable fractures in elderly patients remains controversial. This study aimed to compare the radiological and clinical outcomes between locking compression plate (LCP) fixation and LCP fixation with fibular allograft implantation for the treatment of comminuted PHFs.
Methods: We retrospectively reviewed 60 patients (mean age, 72.75 years) with closed 3- or 4-part fractures, and a minimum of 2 years of follow-up. Fracture reduction was quantitatively determined by humeral head height (HHH) and neck-shaft angle (NSA). The clinical outcome was evaluated by Constant-Murley score (CMS) and American Shoulder and Elbow Surgeons (ASES) score.
Result: The average radiological changes were higher in the LCP group than in the locking plate with fibular allograft group (HHH of 4.16 mm vs 1.18 mm [p<0.001] and NSA of 9.94° versus 3.12° [p<0.001 ]). The final average outcome scores were lower in the LCP group than in the FA group (CMS of 73.00 vs 78.96 [p=0.024] and ASES score of 72.80 vs 78.64 [p=0.022]). The FA group showed better forward elevation (p=0.010) and abduction (p=0.002); however, no significant differences were observed for shoulder external rotation or internal rotation. The number of complications was higher in the LCP group (28.57%) than in the FA group (1.2%) (p<0.001).
Conclusion: For comminuted PHFs in elderly patients, LCP fixation combined with a fibular allograft is reasonable option to ensure satisfactory radiological and clinical outcomes.
Trial registration: ZDYJLY(2018)New-9.
Name of registry: IEC for clinical Research of Zhongda Hospital, Affiliated to Southeast University.
URL of registry: http://www.njzdyy.com. Date of registration: 2018-05-17
Key words: proximal humeral fracture; fibular allograft; locking plate; elderly patients