bluuebunny/crossref_metadata_2025_split huggingface dataset:
A dosimetric study to improve the quality of nodal radiotherapy in breast cancer
Authors: Welgemoed Camarie , Coughlan Simon , McNaught Patti , Gujral Dorothy , Riddle Pippa 
Published: March 2021

Objectives: Field-based planning for regional nodal breast radiotherapy (RT) used to be standard practice. This study evaluated a field-based posterior axillary boost (PAB) and two forward-planned intensity-modulated RT (IMRT) techniques, aiming to replace the first. Methods: Supraclavicular and axillary nodes, humeral head, brachial plexus, thyroid, and oesophagus were retrospectively delineated on 12 CT scans. Three plans, prescribed to 40.05 Gy, were produced for each patient. Breast plans consisted of field-in-field IMRT tangential fields in all three techniques. Nodal plans consisted of a field-based PAB (anterior and posterior boost beam), and 2 forward-planned techniques: simple IMRT 1 (anterior and posterior beam with limited segments), and a more advanced IMRT 2 technique (anterior and fully modulated posterior beam). Results: The nodal V90% was similar between IMRT 1: mean 99.5% (SD 1.0) and IMRT 2: 99.4% (SD 0.5). Both demonstrated significantly improved results (p = 0.0001 and 0.005, respectively) compared to the field-based PAB technique. IMRT 2 lung V12Gy and humeral head V10Gy were significantly lower (p = 0.002, 0.0001, respectively) than the field-based PAB technique. IMRT 1 exhibited significantly lower brachial plexus Dmax and humeral head V5, 10, and 15Gy doses (p = 0.007, 0.013, 0.007 and 0.007, respectively) compared to the field-based PAB technique. The oesophagus and thyroid dose difference between methods was insignificant. Conclusions: Both IMRT techniques achieved the dose coverage requirements and reduced normal tissue exposure, decreasing the risk of radiation side effects. Despite the increased cost of IMRT, compared to non-IMRT techniques 1, both IMRT techniques are suitable for supraclavicular and axillary nodal RT. Advances in knowledge: Forward-planned IMRT already resulted in significant dose reduction to organs at risk and improved planning target volume coverage. 1 This new, simplified forward-planned IMRT one technique has not been published in this context and is easy to implement in routine clinical practice.
Development and validation of a new formula for sex estimation based on multislice computed tomographic measurements of maxillary and frontal sinuses among Brazilian adults
Authors: de Mendonça Diego Santiago , Kurita Lúcio Mitsuo , Carvalho Francisco Samuel Rodrigues , Tuji Fabrício Mesquita , Silva Paulo Goberlânio de Barros , Bezerra Tácio Pinheiro , de Aguiar Andréa Silvia Walter , Gurgel Costa Fábio Wildson 
Published: March 2021

Objectives:To evaluate the accuracy of the measurements of the maxillary sinus (MS) and frontal sinus (FS) in sex estimation among Brazilian adults using multislice computed tomography (MCT) and to develop and cross-validate a new formula for sex estimation.Methods:The present cross-sectional research was conducted in two phases: (1) development of a formula on the basis of the measurements of both the sinuses (50 males and 50 females); and (2) validation study (20 males and 20 females). The linear measurements (height, width and diameter) were assessed using the RadiAnt DICOM software. A new formula for sex estimation was developed (multivariate statistical approach) and validated. Receiver operating characteristic curves, area under the curve, sensitivity, specificity, positive and negative predictive values, accuracy and likelihood ratio were estimated.Results:Males displayed higher mean values (width, height and diameter) of the FS and MS (p < 0.05). The MS was a better predictor in sex estimation (males vs females), compared to the FS (accuracy between 61–74% and 58–69%, respectively). The distance between the right and left MS displayed the highest accuracy (74%). The sensitivity, specificity and accuracy of the new formula were 80%, 95.5% and 87.5%, respectively. 63.1% reduction was observed in the number of predictive values for sex estimation (individuals older than 30 years).Conclusions:The present MCT measurements showed a higher accuracy in the estimation of sex in males. The highest accuracy was associated with the distance between the right and left MS. The new formula displayed high precision for sex estimation.
Comparing the performance of QuantiFERON-TB Gold Plus with QuantiFERON-TB Gold in-tube among highly TB exposed gold miners in South Africa
Authors: Ntshiqa Thobani , Chihota Violet , Mansukhani Raoul , Nhlangulela Lindiwe , Velen Kavindhran , Charalambous Salome , Maenetje Pholo , Hawn Thomas R. , Wallis Robert , Grant Alison D. , Fielding Katherine , Churchyard Gavin 
Published: March 2021

Background: QuantiFERON-TB Gold in-tube (QFT-GIT) is an interferon-gamma release assay (IGRA) used to diagnose latent tuberculosis infection. Limited data exists on performance of QuantiFERON-TB Gold-Plus (QFT-Plus), a next generation of IGRA that includes an additional antigen tube 2 (TB2) while excluding TB7.7 from antigen tube 1 (TB1), to measure TB specific CD4+ and CD8+ T lymphocytes responses. We compared the performance of QFT-Plus with QFT-GIT among highly TB exposed goldminers in South Africa. Methods: We enrolled HIV-negative goldminers in South Africa, ≥33 years with no prior history of TB disease or evidence of silicosis. Blood samples were collected for QFT-GIT and QFT-Plus. QFT-GIT was considered positive if TB1 tested positive; while QFT-Plus was positive if both or either TB1 or TB2 tested positive, as per manufacturer's recommendations. We compared the performance of QFT-Plus with QFT-GIT using Cohen’s Kappa. To assess the specific contribution of CD8+ T-cells, we used TB2−TB1 differential values as an indirect estimate. A cut-off value was set at 0.6. Logistic regression was used to identify factors associated with having TB2-TB1>0.6 difference on QFT-Plus. Results: Of 349 enrolled participants, 304 had QFT-Plus and QFT-GIT results: 205 (68%) were positive on both assays; 83 (27%) were negative on both assays while 16 (5%) had discordant results. Overall, there was 94.7% (288/304) agreement between QFT-Plus and QFT-GIT (Kappa = 0.87). 214 had positive QFT-Plus result, of whom 202 [94.4%, median interquartile range (IQR): 3.06 (1.31, 7.00)] were positive on TB1 and 205 [95.8%, median (IQR): 3.25 (1.53, 8.02)] were positive on TB2. A TB2-TB1>0.6 difference was observed in 16.4% (35/214), with some evidence of a difference by BMI; 14.9% (7/47), 9.8% (9/92) and 25.3% (19/75) for BMI of 18.5-24.9, 18.5-25 and >30 kg/m2, respectively (P=0.03). Conclusion: In a population of HIV-negative goldminers, QFT-Plus showed a similar performance to QFT-GIT.
Portfolio Entrepreneurs’ Behavior and Performance: A Resource Redeployment Perspective
Authors: Santamaria Simone 
Published: March 2021

Prior research suggests portfolio entrepreneurs—businesspeople who run more than one firm simultaneously—launch more successful ventures than their single-business counterparts. However, their ventures are less likely to survive. In an attempt to reconcile this paradox, this paper presents a framework in which portfolio entrepreneurs’ main advantage is not a superior ability to select the best business opportunities ex ante, but rather the ability to redeploy human and capital resources across businesses ex post, which reduces the sunkenness of their investments in new projects. This redeployment option facilitates their exit from new businesses that fail initial market tests. Thus, portfolio entrepreneurs’ heterogeneous termination decisions explain a greater portion of new firm performance differential than ex ante opportunity selection. We test these ideas using a longitudinal data set of more than 5,700 entrepreneurs and find consistent evidence. Portfolio companies do not show systematically higher performance at the time of entry; a performance difference emerges only over time, as the selection effect and resource redeployment occur.This paper was accepted by Ashish Arora, entrepreneurship and innovation.
<p><strong>On the <em>Acidota</em> Stephens fauna of Russia (Staphylinidae, Omaliinae, Anthophagini)</strong></p>
Authors: SHAVRIN ALEXEY 
Published: March 2021

A faunistic review on three widespread species of the genus Acidota Stephens, 1829 of Russia is presented: A. crenata (Fabricius, 1792), A. cruentata Mannerheim, 1830, and A. quadrata (Zetterstedt, 1839). A new synonymy is proposed: A. crenata = A. crenata japonica Watanabe, 1990 syn. nov. Faunistic and bionomical data for these species are summarized, and distributional maps for the Palaearctic Region are provided. The eastern borders of the distribution range of A. cruentata are clarified and previous records east of West Siberia are not confirmed. Images of habitus and aedeagi, and a key to the Acidota species of Russia are provided. All these species of Acidota are recorded for the first time from certain area: A. crenata from Khabarovsk Territory, Armenia and Uzbekistan, A. cruentata from Novosibirsk Area, and A. quadrata from Sverdlovsk Area, Tuva, Chita Area and Khabarovsk Territory. Key words: Coleoptera, Staphylinidae, Omaliinae, Acidota, fauna, distribution, taxonomy, synonymy, Palaearctic Region, Russia
An imagined community of practice: Online discourse among wheelchair users
Authors: Cochrane Leslie E. 
Published: March 2021

People with disabilities often live in local communities primarily made up of people without disabilities: in the absence of a geographic community of people with disabilities, the internet becomes a valuable tool for connecting individuals across both local and global contexts. The power of computer-mediated communication (CMC) to allow individuals to interact both locally and globally has been well-studied in linguistics (e. g. Baron 2008; Page 2012), and this work has included the discourse of e-health (e. g. Hamilton 1998; Locher 2006, 2013) and the online discourse of people with disabilities (Al Zidjaly 2011, 2015). Less research has been done, however, on the implications of online discourse for understanding people with disabilities as a linguistic community.This paper argues that the community of people with disabilities can be viewed from a linguistic perspective as an imagined community of practice: an imagined community, because members recognize their common belonging even if they do not interact locally (Anderson 1983); a community of practice, because members use recognizable, if not identical, disability practices and engage in shared sense-making (Eckert 2006; Eckert/McConnell-Ginet 1992). This understanding of the community of people with disabilities is evidenced in online blogs by wheelchair users.A close discourse analysis of the blog posts shows shared sense-making around disability practices, even though individual bloggers’ practices may vary according to their specific strategies for accommodation. In their posts, the bloggers construct their disability identities in terms of practice and imagine themselves to belong to a community that is distinguished by disability practice. The analysis reveals shared sense-making: in particular, the way that the bloggers position themselves in opposition to the societal discourse that people with disabilities are an inspiration to people without them. In this way, the bloggers demonstrate their membership within an imagined community of practice made up of people with disabilities.
‘None of my ancestors ever discussed this disease before!’ How disease information shapes adaptive capacity of marginalised rural populations in India
Authors: Asaaga Festus A. , Rahman Mujeeb , Kalegowda Suresh D. , Mathapati Jagadeesh , Savanur Irfanahemad , Srinivas Prashanth N. , Seshadri Tanya , Narayanswamy Darshan , Kiran Shivani K. , Oommen Meera A. , Young Juliette C. , Purse Bethan V. 
Published: March 2021

Smallholder farmer and tribal communities are often characterised as marginalised and highly vulnerable to emerging zoonotic diseases due to their relatively poor access to healthcare, worse-off health outcomes, proximity to sources of disease risks, and their social and livelihood organisation. Yet, access to relevant and timely disease information that could strengthen their adaptive capacity remain challenging and poorly characterised in the empirical literature. This paper addresses this gap by exploring the role of disease information in shaping the adaptive capacity of smallholder farmer and tribal groups to Kyasanur Forest Disease (KFD), a tick-borne viral haemorrhagic fever. We carried out household surveys (n = 229) and in-depth interviews (n = 25) in two affected districts–Shimoga and Wayanad–in the Western Ghats region.
Our findings suggest that, despite the generally limited awareness about KFD, access to disease information improved households’ propensity to implement adaptation strategies relative to households that had no access to it. Of the variety of adaptation strategies implemented, vaccination, avoiding forest visits, wearing of protective clothing and footwear, application of dimethyl phthalate (DMP) oil and income diversification were identified by respondents as important adaptive measures during the outbreak seasons. Even so, we identified significant differences between individuals in exposure to disease information and its contribution to substantive adaptive action. Households reported several barriers to implement adaptation strategies including, lack of disease information, low efficacy of existing vaccine, distrust, religio-cultural sentiments, and livelihood concerns. We also found that informal information sharing presented a promising avenue from a health extension perspective albeit with trade-offs with potential distortion of the messages through misinformation and/or reporting bias. Altogether, our findings stress the importance of contextualising disease information and implementing interventions in a participatory way that sufficiently addresses the social determinants of health in order to bolster households’ adaptive capacity to KFD and other neglected endemic zoonoses.
Association between continuity of care and subsequent diagnosis of multimorbidity in Ontario, Canada from 2001–2015: A retrospective cohort study
Authors: Chau Edward , Rosella Laura C. , Mondor Luke , Wodchis Walter P. 
Published: March 2021

Background
Continuity of care is a well-recognized principle of the primary care discipline owing to its medical, interpersonal, and cost-saving benefits. Relationship continuity or the ongoing therapeutic relationship between a patient and their physician is a particularly desirable goal, but its role in preventing the accumulation of chronic conditions diagnoses in individuals is unknown. The objective of this study was to investigate the effect of continuity of care with physicians on the rate of incident multimorbidity diagnoses in patients with existing conditions.

Methods
This was a population-based, retrospective cohort study from 2001 to 2015 that focused on patients aged 18 to 105 years with at least one chronic condition (n = 166,665). Our primary exposure was relationship continuity of care with general practitioners and specialists measured using the Bice-Boxerman Continuity of Care Index (COCI). COCI was specified as a time-dependent exposure prior to the observation period. Our outcomes of interest were the time to diagnosis of a second, third, and fourth chronic condition estimated using cause-specific hazard regressions accounting for death as a competing risk.

Findings
We observed that patients with a single chronic condition and high continuity of care (>0.50) were diagnosed with a second chronic condition or multimorbidity at an 8% lower rate compared to individuals with low continuity (cause-specific hazard ratio (HR) 0.92 (95% Confidence Interval 0.90–0.93; p<0.0001) after adjusting for age, sex, income, place of residence, primary care enrolment, and the annual number of physician visits. Continuity remained protective as the degree of multimorbidity increased. Among patients with two conditions, the risk of diagnosis of a third chronic condition was also 8% lower for individuals with high continuity (HR 0.92; CI 0.90–0.94; p<0.0001). Patients with three conditions and high continuity had a 9% lower risk of diagnosis with a fourth condition (HR 0.91; CI 0.89–0.93; p<0.0001).

Conclusions
Continuity of care is a potentially modifiable health system factor that reduces the rate at which diagnoses of chronic conditions are made over time in patients with multimorbidity. Additional research is needed to explain the underlying mechanisms through which continuity is related to a protective effect and the clinical sequalae.
Tinnitus treatment by vagus nerve stimulation: A systematic review
Authors: Stegeman I. , Velde H. M. , Robe P. A. J. T. , Stokroos R. J. , Smit A. L. 
Published: March 2021

Background
Tinnitus is a phantom sensation of sound, which can have a negative impact on quality of life of those affected. No curative treatments are currently known. Neuromodulation by vagus nerve stimulation has emerged as a new treatment option for tinnitus, though till date the effectiveness remains unclear. Therefore, we aim to review the effect of vagus nerve stimulation on tinnitus distress and tinnitus symptom severity in patients with chronic tinnitus.

Methods
We searched Pubmed, Embase and the Cochrane Library systematically for RCTs, observational studies and case studies on the effect of VNS treatment for tinnitus on October 29, 2019. Studies including adult patients with subjective tinnitus, comparing transcutaneous or implantable VNS to placebo or no treatment or before and after application of VNS treatment on tinnitus distress and tinnitus symptom severity measured with a validated questionnaire were eligible. The risk of bias was assessed with the appropriate tool for each type of study.

Results
Our search identified 9 primary studies of which 2 RCTs, 5 cohort studies and 2 case series or reports. 5 studies used transcutaneous VNS treatment and 4 used implanted VNS treatment. 6 studies combined VNS treatment with sound therapy. There was a serious risk of bias in all studies, especially on confounding. Most studies reported a small decrease in tinnitus distress or tinnitus symptom severity.

Conclusion
Due to methodological limitations and low reporting quality of the included studies, the effect of VNS on tinnitus remains unclear. To draw conclusions for which patient population and to what extent (t)VNS is beneficial in the treatment of tinnitus, a randomised controlled trial should be considered.
Clinical efficacy on glycemic control and safety of mesenchymal stem cells in patients with diabetes mellitus: Systematic review and meta-analysis of RCT data
Authors: He Jingjing , Kong Desheng , Yang Zhifen , Guo Ruiyun , Amponsah Asiamah Ernest , Feng Baofeng , Zhang Xiaolin , Zhang Wei , Liu Aijing , Ma Jun , O’Brien Timothy , Cui Huixian 
Published: March 2021

Background
Diabetes mellitus as a chronic metabolic disease is threatening human health seriously. Although numerous clinical trials have been registered for the treatment of diabetes with stem cells, no articles have been published to summarize the efficacy and safety of mesenchymal stem cells (MSCs) in randomized controlled trials (RCTs).

Methods and findings
The aim of this study was to systematically review the evidence from RCTs and, where possible, conduct meta-analyses to provide a reliable numerical summary and the most comprehensive assessment of therapeutic efficacy and safety with MSCs in diabetes. PubMed, Web of Science, Ovid, the Cochrane Library and CNKI were searched. The retrieval time was from establishment of these databases to January 4, 2020. Seven RCTs were eligible for analysis, including 413 participants. Meta-analysis results showed that there were no significant differences in the reduction of fasting plasma glucose (FPG) compared to the baseline [mean difference (MD) = -1.05, 95% confidence interval (CI) (-2.26,0.16), P<0.01, I2 = 94%] and the control group [MD = -0.62, 95%CI (-1.46,0.23), P<0.01, I2 = 87%]. The MSCs treatment group showed a significant decrease in hemoglobin (Hb) A1c [random-effects, MD = -1.32, 95%CI (-2.06, -0.57), P<0.01, I2 = 90%] after treatment. Additionally, HbA1c reduced more significantly in MSC treatment group than in control group [random-effects, MD = -0.87, 95%CI (-1.53, -0.22), P<0.01, I2 = 82%] at the end of follow-up. However, as for fasting C-peptide levels, the estimated pooled MD showed that there was no significant increase [MD = -0.07, 95%CI (-0.30, 0.16), P<0.01, I2 = 94%] in MSCs treatment group compared with that in control group. Notably, there was no significant difference in the incidence of adverse events between MSCs treatment group and control group [relative risk (RR) = 0.98, 95%CI (0.72, 1.32), P = 0.02, I2 = 70%]. The most commonly observed adverse reaction in the MSC treatment group was hypoglycemia (29.95%).

Conclusions
This meta-analysis revealed MSCs therapy may be an effective and safe intervention in subjects with diabetes. However, due to the limited studies, a number of high-quality as well as large-scale RCTs should be performed to confirm these conclusions.
Identification of distinct phenotypes related to benralizumab responsiveness in patients with severe eosinophilic asthma
Authors: Yamada Hideyasu , Nakajima Masayuki , Matsuyama Masashi , Morishima Yuko , Arai Naoki , Hida Norihito , Nakaizumi Taisuke , Masuko Hironori , Yatagai Yohei , Saito Takefumi , Hizawa Nobuyuki 
Published: March 2021

Purpose
To characterize the clinical phenotypes of severe eosinophilic asthma based on early responsiveness to benralizumab in terms of forced expiratory volume in 1 second (FEV1) improvement.

Patients and methods
Sixty-four participants diagnosed with severe eosinophilic asthma and who had completed 4 months of benralizumab treatment were included in this analysis. Pre-treatment clinical factors were compared between responders and non-responders according to improvements in ACT or FEV1. Correlations between the sums of increased Type 2-related inflammatory parameters and changes of ACT or FEV1 were also evaluated before and after the 4-month treatment. A two-step cluster analysis was performed to identify distinct phenotypes related to benralizumab responsiveness in terms of FEV1.

Results
At the 4-month timepoint, all parameters, except for FeNO, were significantly improved after benralizumab treatment. FEV1 responders were associated with higher levels of Type 2-related inflammatory parameters. An improvement in FEV1 but not in ACT was clearly associated with increases in the sums of increased type 2-related inflammation parameters (p = 0.0001). The cluster analysis identified 5 distinct phenotypes of severe eosinophilic asthma according to the variable FEV1 responsiveness to benralizumab. The greatest response was found in the distinct phenotype of severe eosinophilic asthma, which was characterized by modest increase in total IgE and FeNO relative to blood eosinophils with least exposure to smoking.

Conclusion
This study, to the best of our knowledge, is the first cluster analysis to report distinct phenotypes related to clinical benralizumab response in a real-world population with severe eosinophilic asthma. These results may help to predict responsiveness to benralizumab in patients with severe eosinophilic asthma.