bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimal dose-fractionation schedule of palliative radiotherapy for patients with bone metastases: a protocol for systematic review and network meta-analysis
Authors: Tang Xiaofang , Hu Qiancheng , Chen Ye , Wang Xin , Li Xiaofen , Cheng Ke , Cao Dan 
Published: January 2020

IntroductionThe optimal dose-fractionation schedule of palliative radiotherapy has been debated in patients with bone metastases. Our objective is to comprehensively compare multiple fraction schedules with single fraction radiotherapy in terms of efficacy and toxicities by performing a systematic review and network meta-analysis.Methods and analysisElectronic searches of titles/abstracts of palliative radiotherapy for bone metastases will be performed, using PubMed, Cochrane Library, Embase,clinical trials, American Society for Therapeutic Radiology and Oncology and European Society of Radiotherapy and Oncology. The primary outcome of interest is the incidence of skeletal-related event following palliative radiotherapy for bone metastases in prospective studies. The risk of bias and quality of evidence will be evaluated based on Cochrane Collaboration’s tool and Grades of Recommendation, Assessment, Development and Evaluation in the network meta-analysis. We will conduct subgroup analysis and sensitivity analysis regardless of heterogeneity estimates.Ethics and disseminationThis study will synthesise the evidence regarding dose-fractionation schedule of palliative radiotherapy in patients with bone metastases. We hope the findings from this study will help clinicians and patients select optimum palliative radiotherapy by identifying the optimal dose-fractionation schedule of palliative radiotherapy with the most value in terms of patient-important outcomes. The evidence obtained from network meta-analysis will help to guide head-to-head research in the future. The results will be disseminated through international conference reports and peer-reviewed manuscripts. Ethics review board is not required for this network meta-analysis.PROSPERO registration numberCRD42019135195.
Effects of tai chi on postural control during dual-task stair negotiation in knee osteoarthritis: a randomised controlled trial protocol
Authors: Wang Xiangbin , Hou Meijin , Chen Shaoqing , Yu Jiao , Qi Dalu , Zhang Yanxin , Chen Bo , Xiong Feng , Fu Shengxing , Li Zhenhui , Yang Fengjiao , Chang Alison , Liu Anmin , Xie Xuerong 
Published: January 2020

IntroductionStair ascent and descent require complex integration between sensory and motor systems; individuals with knee osteoarthritis (KOA) have an elevated risk for falls and fall injuries, which may be in part due to poor dynamic postural control during locomotion. Tai chi exercise has been shown to reduce fall risks in the ageing population and is recommended as one of the non-pharmocological therapies for people with KOA. However, neuromuscular mechanisms underlying the benefits of tai chi for persons with KOA are not clearly understood. Postural control deficits in performing a primary motor task may be more pronounced when required to simultaneously attend to a cognitive task. This single-blind, parallel design randomised controlled trial (RCT) aims to evaluate the effects of a 12-week tai chi programme versus balance and postural control training on neuromechanical characteristics during dual-task stair negotiation.Methods and analysisSixty-six participants with KOA will be randomised into either tai chi or balance and postural control training, each at 60 min per session, twice weekly for 12 weeks. Assessed at baseline and 12 weeks (ie, postintervention), the primary outcomes are attention cost and dynamic postural stability during dual-task stair negotiation. Secondary outcomes include balance and proprioception, foot clearances, self-reported symptoms and function. A telephone follow-up to assess symptoms and function will be conducted at 20 weeks. The findings will help determine whether tai chi is beneficial on dynamic stability and in reducing fall risks in older adults with KOA patients in community.Ethics and disseminationEthics approval was obtained from the Ethics Committee of the Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine (#2018KY-006–1). Study findings will be disseminated through presentations at scientific conferences or publications in peer-reviewed journals.Trial registration numberChiCTR1800018028.
Core competencies in neurocritical care training in China: consensus developed by a national Delphi consensus survey combined with nominal group technique
Authors: Cui Zhen , Gao Liang , Huang Qi Bing , Li Li Hong , Qiu Bing Hui , Shi Guang Zhi , Yu Xiang You , Wang Yan , Zhang Li , Wang Yumei , Zhang Linlin , Zhou Jian-Xin 
Published: January 2020

ObjectivesTo define the core competencies essential for specialist training in neurocritical care in China.DesignModified Delphi method and nominal group (NG) technique.SettingNational.ParticipantsA total of 1094 respondents from 33 provinces in China participated in the online survey. A NG of 11 members was organised by the Neuro-Critical Care Committee affiliated with the Chinese Association of Critical Care Physicians and the National Center for Healthcare Quality Management in Neurological Diseases.Results1094 respondents from 33 provinces in China participated in the online survey. A formal list containing 329 statements was generated for the rating by a NG. After five rounds of NG meetings and one round of comments and iterative review, 198 core competencies (54 on neurological diseases, 64 on general medical diseases, 42 on monitoring of practical procedures, 20 on professionalism and system management, five on ethical and legal aspects, three on the principles of research and certification and 10 on scoring systems) formed the final list.ConclusionBy using consensus techniques, we have developed a list of core competencies for neurocritical care training, which may serve as a reference for future specialist training programmes in China.
How French general practitioners adapt their care to patients with social difficulties?
Authors: De Oliveira Annie , Chavannes Barbara , Steinecker Magali , Denantes Mady , Chastang Julie , Ibanez Gladys 
Published: January 2020

ObjectiveSeveral studies have shown the role of the primary care system in access to care and in reducing social inequalities in health. The objective of this study was to describe the practices of general practitioners (GPs) in taking into account the social environment of their patient, and the ways they adapted to social difficulties.DesignQualitative study comprising interviews and focus groups.SettingFrench primary care settings.ParticipantsTwenty semistructured interviews and two focus groups were conducted with 33 GPs. Sessions were audio recorded, transcribed verbatim and analysed using thematic analysis. The reporting of findings was guided by consolidated criteria for reporting qualitative research.ResultThis study identified adaptations at three levels: in the individual management of patients (alert system, full involvement in prevention, better communication, prioritised additional examinations, financial facilities, help in administrative tasks), in the collective management of patients in an office (consultation without appointment, pay-for-performance indicators, medical staffs, multidisciplinary protocols, medical practice in group, medical student), and in the community management (patients description, cooperation with associations, public health sector and politics).ConclusionIn France, GPs can take into account the social determinants of health in practice through simple or more complex actions.
Identification of novel pheno-groups in heart failure with preserved ejection fraction using machine learning
Authors: Hedman Åsa K , Hage Camilla , Sharma Anil , Brosnan Mary Julia , Buckbinder Leonard , Gan Li-Ming , Shah Sanjiv J , Linde Cecilia M , Donal Erwan , Daubert Jean-Claude , Mälarstig Anders , Ziemek Daniel , Lund Lars 
Published: January 2020

ObjectiveHeart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome. We aimed to derive HFpEF phenotype-based groups ('phenogroups') based on clinical and echocardiogram data using machine learning, and to compare clinical characteristics, proteomics and outcomes across the phenogroups.MethodsWe applied model-based clustering to 32 echocardiogram and 11 clinical and laboratory variables collected in stable condition from 320 HFpEF outpatients in the Karolinska-Rennes cohort study (56% female, median 78 years (IQR: 71–83)). Baseline proteomics and the composite end point of all-cause mortality or heart failure (HF) hospitalisation were used in secondary analyses.ResultsWe identified six phenogroups, for which significant differences in the prevalence of concomitant atrial fibrillation (AF), anaemia and kidney disease were observed (p<0.05). Fifteen out of 86 plasma proteins differed between phenogroups (false discovery rate, FDR<0.05), including biomarkers of HF, AF and kidney function. The composite end point was significantly different between phenogroups (log-rank p<0.001), at short-term (100 days), mid-term (18 months) and longer-term follow-up (1000 days). Phenogroup 2 was older, with poorer diastolic and right ventricular function and higher burden of risk factors as AF (85%), hypertension (83%) and chronic obstructive pulmonary disease (30%). In this group a third experienced the primary outcome to 100 days, and two-thirds to 18 months (HR (95% CI) versus phenogroups 1, 3, 4, 5, 6: 1.5 (0.8–2.9); 5.7 (2.6–12.8); 2.9 (1.5–5.6); 2.7 (1.6–4.6); 2.1 (1.2–3.9)).ConclusionsUsing machine learning we identified distinct HFpEF phenogroups with differential characteristics and outcomes, as well as differential levels of inflammatory and cardiovascular proteins.
Mechanism of action of the erector spinae plane block: distribution of dye in a porcine model
Authors: Otero Pablo E , Fuensalida Santiago E , Russo Pedro C , Verdier Natali , Blanco Carlos , Portela Diego A 
Published: January 2020

This study aimed to describe the anatomical distribution of dye injected in the erector spinae plane (ESP) in a porcine living model, which could aid to reveal factors potentially relevant to the unexplained clinical effects of the ESP block. Six pigs received 0.6 mL/kg of 0.25% new methylene blue at the level of the sixth thoracic vertebra through either a cranial-to-caudal or a caudal-to-cranial in-plane ultrasound-guided bilateral ESP injection 20 min before euthanasia.Spread of dye evaluated through transverse cryosections (four injections) extended from T5 to T10 and from T5 to T8 when a cranial-to-caudal direction of injection was used, and from T5 to T9 and from T5 to T8 when the opposite direction of injection was used. A median of 4.5 medial and lateral branches of the dorsal rami was observed stained through anatomical dissection (eight injections), regardless of the direction of injection. No evidence of dye was found in the thoracic paravertebral or epidural spaces, where the dorsal root ganglia, ventral rami and rami communicantes are located. In all the cases, dye solution was found in the prevertebral thoracic lymph nodes.In this study, ESP injection resulted in a median spread over five spinal segments (12 injections), staining the lateral and medial branches of the dorsal rami of the spinal nerves, regardless of the direction of the needle used.
Enhancing scientific and societal understanding of geohazards in Sri Lanka
Authors: Weththasinghe D. S. M. , Ratnayake N. P. , Hemalal P. V. A. , Dushyantha N. P. 
Published: January 2020

Abstract
After the Indian Ocean tsunami in 2004, the possibility of the occurrence of catastrophic disasters was realized, although Sri Lanka is not close to a plate boundary. This catastrophic event has emphasized that Sri Lanka as a country may not be able to cope with these major natural disasters, in addition to localized and frequently occurring disasters such as landslides and floods, without a proper disaster management plan (DMP). In the aftermath of the 2004 tsunami, the Government of Sri Lanka developed a comprehensive DMP with the consultation of international expertise. This study reviews the DMP in Sri Lanka and examines the effectiveness of the existing management structure by revisiting the affected areas and communities in selected case studies of a tsunami-struck coastal strip in 2004 and a recent catastrophic landslide. Questionnaire surveys and field observations were used to collect data on preparedness, the availability of evacuation plans and pre-disaster warning systems. The results show the necessity for further improvements in the management of geohazards.
The Immunosuppressive Microenvironment in BRCA1-IRIS–Overexpressing TNBC Tumors Is Induced by Bidirectional Interaction with Tumor-Associated Macrophages
Authors: Sami Eman , Paul Bibbin T. , Koziol James A. , ElShamy Wael M. 
Published: January 2020

AbstractTumor-associated macrophages (TAM) promote triple-negative breast cancer (TNBC) progression. Here, we report BRCA1-IRIS–overexpressing (IRISOE) TNBC cells secrete high levels of GM-CSF in a hypoxia-inducible factor-1α (HIF1α)- and a NF-κB–dependent manner to recruit macrophages to IRISOE cells and polarize them to protumor M2 TAMs. GM-CSF triggered TGFβ1 expression by M2 TAMs by activating STAT5, NF-κB, and/or ERK signaling. Despite expressing high levels of TGFβ1 receptors on their surface, IRISOE TNBC cells channeled TGFβ1/TβRI/II signaling toward AKT, not SMAD, which activated stemness/EMT phenotypes. In orthotopic and syngeneic mouse models, silencing or inactivating IRIS in TNBC cells lowered the levels of circulating GM-CSF, suppressed TAM recruitment, and decreased the levels of circulating TGFβ1. Coinjecting macrophages with IRISOE TNBC cells induced earlier metastasis in athymic mice accompanied by high levels of circulating GM-CSF and TGFβ1. IRISOE TNBC cells expressed low levels of calreticulin (the “eat me” signal for macrophages) and high levels of CD47 (the “do not eat me” signal for macrophages) and PD-L1 (a T-cell inactivator) on their surface. Accordingly, IRISOE TNBC tumors had significantly few CD8+/PD-1+ cytotoxic T cells and more CD25+/FOXP3+ regulatory T cells. These data show that the bidirectional interaction between IRISOE cells and macrophages triggers an immunosuppressive microenvironment within TNBC tumors that is favorable for the generation of immune-evading/stem-like/IRISOE TNBC metastatic precursors. Inhibiting this interaction may inhibit disease progression and enhance patients' overall survival.Significance:The BRCA1-IRIS oncogene promotes breast cancer aggressiveness by recruiting macrophages and promoting their M2 polarization.
Regulatory T-cell Depletion Alters the Tumor Microenvironment and Accelerates Pancreatic Carcinogenesis
Authors: Zhang Yaqing , Lazarus Jenny , Steele Nina G. , Yan Wei , Lee Ho-Joon , Nwosu Zeribe C. , Halbrook Christopher J. , Menjivar Rosa E. , Kemp Samantha B. , Sirihorachai Veerin R. , Velez-Delgado Ashley , Donahue Katelyn , Carpenter Eileen S. , Brown Kristee L. , Irizarry-Negron Valerie , Nevison Anna C. , Vinta Alekya , Anderson Michelle A. , Crawford Howard C. , Lyssiotis Costas A. , Frankel Timothy L. , Bednar Filip , Pasca di Magliano Marina 
Published: January 2020

Abstract

Regulatory T cells (Treg) are abundant in human and mouse pancreatic cancer. To understand the contribution to the immunosuppressive microenvironment, we depleted Tregs in a mouse model of pancreatic cancer. Contrary to our expectations, Treg depletion failed to relieve immunosuppression and led to accelerated tumor progression. We show that Tregs are a key source of TGFβ ligands and, accordingly, their depletion reprogramed the fibroblast population, with loss of tumor-restraining, smooth muscle actin–expressing fibroblasts. Conversely, we observed an increase in chemokines Ccl3, Ccl6, and Ccl8 leading to increased myeloid cell recruitment, restoration of immune suppression, and promotion of carcinogenesis, an effect that was inhibited by blockade of the common CCL3/6/8 receptor CCR1. Further, Treg depletion unleashed pathologic CD4+ T-cell responses. Our data point to new mechanisms regulating fibroblast differentiation in pancreatic cancer and support the notion that fibroblasts are a heterogeneous population with different and opposing functions in pancreatic carcinogenesis.

Significance:
Here, we describe an unexpected cross-talk between Tregs and fibroblasts in pancreatic cancer. Treg depletion resulted in differentiation of inflammatory fibroblast subsets, in turn driving infiltration of myeloid cells through CCR1, thus uncovering a potentially new therapeutic approach to relieve immunosuppression in pancreatic cancer.
See related commentary by Aykut et al., p. 345.
This article is highlighted in the In This Issue feature, p. 327
Detecting Hand Posture in Piano Playing Using Depth Data
Authors: Johnson David , Damian Daniela , Tzanetakis George 
Published: January 2020

AbstractWe present research for automatic assessment of pianist hand posture that is intended to help beginning piano students improve their piano-playing technique during practice sessions. To automatically assess a student's hand posture, we propose a system that is able to recognize three categories of postures from a single depth map containing a pianist's hands during performance. This is achieved through a computer vision pipeline that uses machine learning on the depth maps for both hand segmentation and detection of hand posture. First, we segment the left and right hands from the scene captured in the depth map using per-pixel classification. To train the hand-segmentation models, we experiment with two feature descriptors, depth image features and depth context features, that describe the context of individual pixels' neighborhoods. After the hands have been segmented from the depth map, a posture-detection model classifies each hand as one of three possible posture categories: correct posture, low wrists, or flat hands. Two methods are tested for extracting descriptors from the segmented hands, histograms of oriented gradients and histograms of normal vectors. To account for variation in hand size and practice space, detection models are individually built for each student using support vector machines with the extracted descriptors. We validate this approach using a data set that was collected by recording four beginning piano students while performing standard practice exercises. The results presented in this article show the effectiveness of this approach, with depth context features and histograms of normal vectors performing the best.
What People Know about the Weather
Authors: Nunley Christopher , Sherman-Morris Kathleen 
Published: January 2020

AbstractRecent social science research has provided a better understanding of risk communication and decision-making. However, less is understood about the public’s actual weather knowledge, how they assess their weather knowledge, and how knowledge may relate to weather forecast information use. The objective of this study was to gain a better understanding of self-perceived and assessed weather knowledge of participants. Psychology literature indicates some people are prone to overestimating their knowledge, which is known as the Dunning–Kruger effect (DKE), but this has yet to be studied in a meteorological context. This study compared participants’ assessed weather knowledge with their self-perceived weather knowledge, and results indicate participants with the lowest assessed weather knowledge do overestimate their weather knowledge, a result consistent with previous psychological studies. Participants who obtained a weather forecast more frequently exhibited higher perceived and assessed weather knowledge. Higher perceived and assessed weather knowledge was also observed among users of a specialty weather website compared to a more general audience. The study raises interesting questions about how users of different weather sources acquire or (add to) their weather knowledge and is the first study to explore DKE in the context of weather communication.
Oceanic Mixing over the Northern Arabian Sea in a Warming Scenario: Tug of War between Wind and Buoyancy Forces
Authors: Praveen V. , Valsala V. , Ajayamohan R. S. , Balasubramanian Sridhar 
Published: January 2020

AbstractA consensus of the twenty-first-century climate change in the ocean is surface warming, stratification due to extreme freshening and subsequent weakening of mixing, overturning circulation, and biological production. Counterintuitively, certain parts of the tropical ocean may develop a resistance to changes in mixing, where the climate change impacts of atmosphere and ocean are complementary to each other. Under the poleward shift of monsoon low-level jet (LLJ) in the twenty-first century, a part of the northern Arabian Sea has a tendency to maintain the mixed layer depth intact. The process is studied using a set of high-resolution regional ocean model downscaling experiments for the present and future climate. It is found that the wind intensification caused by the shift in LLJ tends to counteract the stratification gained by surface ocean warming and maintains the mixing process in a warming scenario. The mixing energetics shed light on the way in which this is achieved. Intensified winds promote shear production and surface ocean warming demotes buoyancy production of turbulent kinetic energy (TKE), with a net effect of an increase in TKE. However, TKE appears to be dissipating quickly because of the presence of a larger number of small-scale eddies. This causes the mixing length and mixed layer depth to remain intact. Therefore, the interpretations of impacts of future climate change in ocean mixing should be viewed with caution, at least regionally, by focusing on the detailed changes of the governing mechanisms.
Clinical value of CTLA4-associated microRNAs combined with inflammatory factors in the diagnosis of non-small cell lung cancer
Authors: Liu Xiaohong , Tang Chunlian , Song Xianda , Cheng Lanfang , Liu Ying , Ding Fan , Xia Chun , Xue Lian , Xiao Jun , Huang Baorong 
Published: January 2020

Background The current study aimed to explore the value of cytotoxic T-lymphocyte-associated protein 4 (CTLA4)-associated microRNAs combined with inflammatory factors in the differential diagnosis of non-small cell lung cancer (NSCLC). Methods A retrospective study including 245 NSCLC patients and 245 healthy controls was conducted on a testing group. A regression formula for NSCLC prediction was established based on the testing group. Two validation groups from two centres were used to assess the novel logistic regression model including 144 NSCLC patients and 144 healthy controls recruited from the Wuchang Hospital Affiliated to Wuhan University of Science and Technology, and 128 NSCLC patients and 128 healthy controls recruited from the Zhongnan Hospital of Wuhan University. Results Predictive software and dual-luciferase reporter assays showed that miR-155-5p and miR-630 could target CTLA4 expression. The miR-155-5p and miR-630 concentrations in the NSCLC patients were significantly lower, and the neutrophil to lymphocyte ratio, hypersensitive C-reactive protein (hs-CRP), interleukin 6, cytokeratin-19-fragment (CYFRA21-1), squamous cell carcinoma antigen (SCCA) concentrations and the smoking rate were significantly higher than that in healthy controls ( P <  0.05). A logistic regression model that included smoking, neutrophil to lymphocyte ratio, hs-CRP, interleukin 6, CYFRA21-1, SCCA, miR-155-5p and miR-630 was performed. This model presented a high discriminating value (AUC: 0.830, sensitivity/specificity: 74.6%/89.7%) than any single indicator. In the validation groups, this model still showed a high discriminating value (AUC = 0.838 with the internal validation group; AUC = 0.851 with the external validation group). Conclusion The current model has potential significance for the non-invasive diagnosis for NSCLC.