bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the Role of HLA DRB1 Alleles and Oligoclonal Bands in Influencing Clinical Course of Multiple Sclerosis – A Study from the Mangalore Demyelinating Disease Registry
Authors: DCunha Anitha , Pandit Lekha , Malli Chaithra , Sudhir Akshatha 
Published: January 2021

Background:
The possible interaction between genetic and immunological factors in influencing clinical course of multiple sclerosis (MS) has not been studied previously in Indian population.

Aim:
In this study we evaluated the association of HLA alleles and OCB in affecting clinical course and disability of MS.

Methods:
Clinical and demographic features of 145 MS patients who had CSF oligoclonal bands (OCB) tested by isoelectric focussing technique were analyzed, disability status estimated, and HLA DRB1 alleles were genotyped.

Results:
OCBs were positive in 53.8% (78/145) of all MS cases. Patients with CSF OCB had more frequent relapses and an association with HLA DRB1*15. Early disease onset and a high annualized relapse rate was associated with HLA DRB1*03 allele. A relapsing remitting course for MS was seen with HLA DRB1*03 & 15 while a progressive disease was associated with DRB1*01. Presence of both OCB and HLA DRB1*13 was significantly associated with disability in this cohort.

Conclusion:
The results of our study suggest that an interaction between immunological and genetic factors may influence disease onset, course, and disability in MS.
Bracka Urethroplasty with Buccal Mucosa Graft
Authors: Shandilya Gaurav , Kureel Shiv Narain , Gupta Archika , Singh Gyan Prakash , Pandey Anand , Rawat Jiledar D. , Wakhlu Ashish 
Published: January 2021

Aims:
The aim of the study was to report a new technique of ergonomic penile skin-dartos management during buccal mucosa graft (BMG) to provide adequate penile skin-dartos for neourethral coverage at the time of second-stage tubularization.

Materials and Methods:
Ten proximal hypospadias with severe chordee underwent first-stage surgery with a new technique. An incision along the urethral plate margin and preputial edge was used to split inner prepuce off preputial dartos and penile degloving leaving inner prepuce attached to corona. Urethral plate was divided into the subfascial plane. Penile dartos was bisected in the dorsal midline. Distal half of penile skin-dartos bifurcated and joined to inner preputial edges. Mobilized and lateralized penile skin-dartos was sutured flanking edges of BMG. The second-stage tubularization after 6 months provided neourethral double dartos coverage with eccentric suture lines.

Results:
Adequate dartos for neourethral coverage during second-stage tubularization was available in all. Subcoronal urethrocutaneous fistula occurred in one that was repaired.

Conclusions:
Ergonomic management of inner-preputial skin and ventral transfer of penile skin-dartos helps in providing neourethral coverage during subsequent second-stage tubularization to minimize the occurrence of complications.
Optimism for the Single-stage Transanal Swenson in Neonates
Authors: Mohamed Wesam , Elsawaf Mohamed I. , Shalaby Aly I. , Arafat Ahmed E. , Marei Mahmoud M. , Aboulfadl Mohamed H. , Kaddah Sherif N. , El Tagy Gamal H. , Bahaaeldin Khaled H. K. 
Published: January 2021

Background:
Hirschsprung's disease (HD) has been traditionally treated from infancy onward and different techniques have been used including Swenson, Soave, and Duhamel procedures. The purpose of this study was to evaluate the transanal Swenson's procedure for classical rectosigmoid HD in neonates.

Patient and Methods:
This was a prospective study in which neonates diagnosed with HD were recruited from January 2017 to December 2018. Cases with a transition zone proximal to the midsigmoid were excluded. All patients underwent a transanal Swenson's procedure in the neonatal period using a unified protocol. Intraoperative course and postoperative outcomes such as leak, pelvic abscess, soiling, perianal excoriation, stricture, enterocolitis, and constipation were evaluated and all patients were followed for at least 6 months.

Results:
Twenty-three patients (17 males and 6 females) underwent transanal Swenson's procedure. The mean age was 22 ± 5.7 days. Follow-up ranged from 6 to 30 months. No anastomotic leak, retraction, or prolapse was reported. Mild perianal excoriations occurred early in 9 (39%) cases and all responded to medical treatment and disappeared before 2 months postoperatively. Stricture occurred in 2 (8%) patients, enterocolitis in 3 (13%), and constipation in 3 (13%).

Conclusion:
Transanal Swenson's procedure is feasible and can be performed safely in neonates with rectosigmoid HD with good short-term outcomes. Proper patient selection and standard protocol following fine procedural hall-marks and details are keys for optimal results and patient satisfaction.
Modified Epirubicin, cisplatin, and 5-FU
regimen as first-line chemotherapy in metastatic
gastric or gastroesophageal junction
adenocarcinoma: A Phase II study
Authors: Babu K. Govind , Chaudhuri Tamojit , Lakshmaiah K. C. , Dasappa Lokanatha , Jacob Linu Abraham , Suresh Babu M. C. , Rudresha A. H. , Lokesh K. N. , Rajeev L. K. 
Published: January 2021

Abstract
Background: Epirubicin, cisplatin, and
5-FU (ECF) is one of the most commonly used
first-line chemotherapy regimens in metastatic
gastric cancer. However, due to protracted
infusion schedule, need for special infusion
pumps, and catheter-related complications, the
practical utility and acceptability of standard
ECF regimen are limited, particularly in
resource-constrained settings including India.
Materials and Methods: In the present study, we
have used a more convenient modification of the
standard ECF protocol (using 5 days intravenous
infusion of 5-FU at a dose of 750 mg/m2/day, given
over 6 h through a peripheral venous line), in
Indian patients with metastatic gastric or
gastroesophageal junction (GEJ) adenocarcinoma.
The primary endpoint was overall survival (OS).
The secondary endpoints were overall response rate
(ORR), progression-free survival (PFS), and
toxicity profile. Results: Between January 2014
and December 2017, 107 patients were assigned and
treated with this modified ECF regimen. The median
age was 52 years (range, 34–62); 66.3% were males
and 36.5% of the patients had ≥ 3 metastatic
disease site involvement at baseline. Dose
reductions due to toxicity were required in 14.9%
of the patients. The ORR was 32.7%; median PFS and
OS were 5.9 months (95% confidence interval [CI]:
4.7–6.9) and 10.4 months (95% CI: 8.4–11.8),
respectively. Both the hematological and
nonhematological toxicities were manageable, and
there was no toxicity-related death. The most
frequent Grade 3–4 adverse events were neutropenia
(18.7%), febrile neutropenia (13.1%), mucositis
(5.6%), and diarrhea (5.6%). Conclusions: In the
present study, the modified ECF regimen
demonstrated significant efficacy with an
acceptable toxicity profile in Indian patients
with metastatic gastric and GEJ adenocarcinoma.
The survival outcomes of this modified schedule
were comparable with those of the standard ECF
regimen, as reported earlier. Clearly, this
modified and more convenient ECF protocol should
be explored and validated through large
prospective randomized trials.
Oral cancer incidence trends in Delhi
(1990–2014): An alarming scenario
Authors: Kumar Anshuman , Popli Gourav , Bhat Sujeet , Mohan Sumedha , Sowdepalli Avinash , Kumari Kiran 
Published: January 2021

Abstract
Background: Oral cancer ranks in the top
three of all cancers in India, which accounts for
over 30% of all cancers reported in the country,
and oral cancer control is quickly becoming a
global health priority. We have conducted an age
period analysis of oral cancer incidence trends
using the Population-Based Cancer Registry (PBCR)
data in Delhi over a 24-year period (1990–2014) to
address the trends of one of the leading cancer
sites in Delhi. Materials and Methods: The data of
oral cancer proportion and incidence for the year
1990–2014 were taken from Delhi PBCR which records
cancer cases from more than 180 government and 250
private facilities. The data were segregated by
sex, age, and anatomical site and were analyzed to
calculate age-specific incidence rates and
expressed in cases per 100,000 persons/year.
Results: The highest incidence for both genders
was seen in the age group 50–59 years and the
lowest incidence for both genders was in youngest
age group (<20 years) for all the years from
1990 to 2014. The relative proportion of oral
cancer among all types of cancer in Delhi has
shown alarming rise from the year 2003 onward.
Conclusion: Increasing relative proportion of oral
cancer can be implicated in increased consumption
of gutkha chewers in the last decade of the 20th
Century. As access to health-care services and
cancer-related awareness is highly variable in
India, more in-depth analysis of the incidence of
oral cancer in rural regions will be
required.
Predictors of adverse drug reactions in
geriatric patients: An exploratory study among
cancer patients
Authors: Sneha S. George , Simhadri Kalpana , Subeesh Viswam K. , Sneha S. Varghese 
Published: January 2021

Abstract
Objectives: The objective of this study
was to study the predictors of adverse drug
reactions (ADRs) among geriatric patients in the
Department of Medical Oncology. Methods: A
hospital-based prospective observational study was
carried out among 153 inpatients in the Department
of Medical Oncology for 6 months. Patients above
60 years of age with a confirmed history of
malignancy were included in the study. The
potential risk factors for ADR were defined in
relation to the patient and chemotherapeutic
regimen and relationship between them was assessed
by univariate and multivariate logistic regression
analysis. Results: Among 153 patients, 94 (64.43%)
experienced ADRs. The mean ADR per patient was
0.88 ± 1.2. The common ADRs found were alopecia
(30.18%) and diarrhea (28.68%). Risk estimates
revealed that there was a significant association
between smokers (odds ratio [OR] = 10.326; 95%
confidence interval [CI] 2.345–45.47, P = 0.001),
alcoholics (OR = 10.897; 95% CI 2.479–47.902, P =
0.001), increasing age (OR = 2.22; 95% CI
1.698–2.909, P = 0.001), overweight (OR = 16.68;
95% CI 2.179–127.741, P = 0.001), and male
participants (OR = 0.143; 95% CI 0.05–0.390 P =
0.001) with the development of ADRs. The risk of
carboplatin (OR = 13.359; 95% CI 3.056–58.406 P =
0.001) and 5-fluorouracil (OR = 1.938 95% CI
1.266–2.935 P = 0.001) use and occurrence of ADRs
were also found to be high. Conclusion: The study
findings showed that smoking, alcohol consumption,
age more than 70 years, and overweight had a high
risk for developing ADRs in geriatric patients who
underwent chemotherapy. The independent risk
factors identified should be targeted for
preventive measures to improve anticancer agent
prescription and reduce the risk of ADRs.
Modified Heidelberg technique of pancreatic
anastomosis postpancreaticoduodenectomy – 10 years
of experience
Authors: Chowdappa Ramachandra , Tiwari Ajeet Ramamani , Ranganath Namrata , Kumar Rekha V. 
Published: January 2021

Abstract
Context: Pancreatic fistula has forever
been a dreaded complication after pancreatic
anastomosis (PA). We present a retrospective
analysis of 10 years of experience with the
Modified Heidelberg technique (MHT) that has been
recently described. Aim: The aim of the study is
to establish postoperative pancreatic fistula
(POPF) rates after MHT. Settings and Design: This
is a retrospective observational study carried out
at a tertiary cancer center in South India in the
Department of Surgical Oncology. Subjects and
Methods: Two hundred and eight consecutive
patients who underwent pancreaticoduodenectomy
(PD) and PA with MHT for a variety of proximal
pancreatic lesions from January 2008 to February
2018 were included in this study. The incidence of
POPF was recorded by the International Study Group
on Pancreatic Fistula 2005 and 2016 definitions.
Statistical Analysis Used: Epidemiological and
clinical data are expressed in ratios and
percentage and presented in table format. Results:
Between January 2008 and March 2016, 186 patients
underwent PD, and MHT was used for PA. Five (2.7%)
patients developed Grade A POPF whereas Grades B
and C were seen in three (1.6%) patients each with
one death. Between April 2016 and February 2018,
22 patients underwent PD. Two patients (9%) had
biochemical leak whereas none of them developed
clinically relevant POPF. No deaths were recorded
in this period. Overall, Grade B and Grade C POPF
rates were 1.4% each, whereas 30-day mortality was
0.4%. Conclusions: Results of this study indicate
that MHT is a safe, reliable, easy to learn, and
adopt technique of pancreatic reconstruction after
PD.
Effectiveness and tolerability of
nimotuzumab in unresectable, locally
advanced/metastatic esophageal cancer: Indian
hospital-based retrospective evidence
Authors: Subramanian Sundaram , Sridharan Nithya , Balasundaram V. , Chaudhari Sameer 
Published: January 2021

Abstract
Context: Epidermal growth factor receptor
(EGFR) is overly expressed in esophageal squamous
cell carcinoma (ESCC) and is important prognostic
and predictive biomarker. Nimotuzumab is a
humanized anti-EGFR monoclonal antibody and has
documented promising clinical outcomes and
survival rates in various solid tumors with high
EGFR expression. Aims: Attempt to fill gap on
paucity of data in India on the efficacy of
Nimotuzumab in the treatment of locally
advanced/metastatic ESCC. Settings and Design:
Hospital records of 15 patients with unresectable,
locally advanced/metastatic esophageal cancers,
histologically confirmed squamous cell carcinoma
being treated with Nimotuzumab along with standard
treatments from October 2006 to November 2016 were
retrospectively analyzed. Subjects and Methods:
The tumor response rate and overall survival (OS)
were analyzed. All patients were assessed for
toxicity and adverse events (AEs) as per Common
Terminology Criteria for Adverse Events (CTCAE)
v4. Results: Majority had lower thoracic
esophageal cancer. Tumor response rate observed
was as follows 33% had a complete response, 67%
had a partial response, and objective response
rate was 100%. Survival rate at 1-, 3-, and 5-year
was 58.33%, 29.17%, and 29.17%, respectively.
Median OS was 26.8 months (95% confidence
interval, 2.63–not reached). No Grade III or Grade
IV AEs were observed. No added toxicity was
observed due to nimotuzumab.Conclusions:
Nimotuzumab combined with standard treatment in
locally advanced/metastatic ESCC improved the
survival rate and achieved a better tumor response
rate without accumulation of toxicity and was well
tolerated.
THE RELATIONSHIP BETWEEN FACTORS AFFECTING CUSTOMERS’ PARTICIPATION INTENTION AND CUSTOMERS’ PARTICIPATION DECISION TOWARDS LIFE-INSURANCE IN HO CHI MINH CITY
Authors: PHƯƠNG NGUYỄN NGUYÊN , QUANG HUỲNH PHƯƠNG 
Published: January 2021

As developed living conditions, people always expect to improve their quality of life, ensure safety against unforeseen risks. Life insurance (BHNT) were formed to help overcome risks and losses occurring in life. It’s truly obvious that life insurance provides individuals, families and society with a lot of benefits. Accordingly, this study was designed to propose and test the factors affecting customers’ participation intention towards life-insurance, and the effect of participation intention to participation decision. These relationships are verified through 150 customers who are holders of individual insurance policies. Cronbach’s Alpha and Confirming factor analysis (CFA) tests were applied to examine the reliability and validity of the scale. Structural Equation Modeling (SEM) was also adopted to test the hypotheses. The finding shows that the insurance agents, Brand image, Participation motivation, Social influences have positive effect on participation intention. Participation intention also positively impacts on participation decision of life insurance. As the result, some implications are discussed, and the next research direction is proposed.
Immunoscore and personification of chemotherapeutic treatment in patients with gastric cancer
Authors: Kirkilevskyi S. I. , Sulaeva O. M. , Lukyanchuk O. V. , Lurin A.G. , Mashukov A. O. , Tkachenko O. I. , Zgura O.M. , Bilenko O.A. , Maksimovskyi V. E. , Ratsiborskyi D. V. , Syrbu V. N. 
Published: January 2021

Background. There are a few indications known in the world to administer immunotherapy (IT) via immune checkpoint inhibitors (ICIs). Prescribing IT by means of ICIs in gastric cancer (GC) results from PDL1 ligand expression on tumor cells; high tumor mutation burden; GC with microsatellite instability MSI-h or DNA mismatch repair (MMR) failure; T-killer immunoscore (IS).
Purpose. To study the composition of the immunocellular phenotype of gastric malignancies.
Materials and methods. The paper presents the outcomes of a clinical study conducted at the premises of Thoracic Tumors Research Department of National Cancer Institute and Abdominal Oncosurgery Department of Municipal Non-Profit Enterprise “Odessa Regional Oncology Dispensary” of Odessa Regional Council enrolling 221 patients operated on for gastric cancer within the period from 2007 to 2013. The average age was 60.88 ± 10.5, men – 180, women – 41. A total of 143 gastrectomies and 78 distal subtotal resections were performed. The study group of patients to investigate IS consisted of 22 patients with gastric cancer. At the first stage, the density of immunocompetent TILs or TIMs were determined, where TILs quantified tumor-infiltrating lymphocytes and TIMs counted the number of tumor-infiltrating macrophages. The second step was assessing the severity of infiltration by immune cells of two compartments: the central areas of the tumor (CT) and around the edge of the tumor invasion (IM), i. e. in the peritumoral stroma.
Results and discussion. All patients included in the study were radically operated on. The tumors removed during surgery were examined by means of immunoscore. A particularly high correlation was observed between PD-L1 expression in cells and CD8 T-lymphocytes in tumor nest – 0.81. Immunoscore effect on the prognosis was 0.64. A negative high correlation was assessed between the concentration of M2 CD163 macrophages in the tumor and the metastases to regional lymph nodes – 0.65. A particularly high correlation between the concentration of CD3 and CD8 in the central areas of the tumor reaching 0.95. A particularly high correlation between PD-L1 expression in cells and CD3 cells in tumor nest – 0.84. The correlation between CD3 and CD8 in the tumor stroma was particularly high, 0.87. Conclusions. The study of immunoscore is essential both in terms of the impact on patient survival, as a prognostic factor, and with a view to more active administering and using immune-targeted drugs in the future.
Grigoriev institute for medical radiology and oncology centenary: historic events
Authors: Krasnoselskyi M.V. , Artamonova N.O. 
Published: January 2021

Background. The historical survey of the activities carried out at Grigoriev Institute for Medical Radiology and Oncology is of present interest, resulting from the need to structure the Institute development trends in terms of a centenary celebration. Providing insight to visions of the past, one can also apprehend historical events, personalities and phenomena.
Purpose – to summarize historical findings on establishing and development of SO «Grigoriev Institute for Medical Radiology and Oncology of the National Academy of Medical Sciences of Ukraine».
Materials. The study deals with analyzing historical scientific literature, manuscripts, archive paper records, data on electronic data storage devices and other carriers that reveal the historical aspects of forming X-ray Radiography, Radiology and Oncology in Ukraine, particularly in Kharkiv.
Results and discussion. For a century of the existence of the Institute, the scientists of several generations have come a long way in forming and developing X-ray Radiography, Radiation Therapy, Diagnostic Radiology, Oncology, Radiobiology, Radiation Dosimetry and others. They were the first to receive radium for the country alongside with establishing oncology dispensaries, X-ray technical school and setting up a chain of remote research and support stations (13 radiology and 26 oncology ones). These days, the team of the Institute are going out of their way to further develop science and medicine to the benefit of human health.
Conclusions. One hundred years ago, the first step in developing Oncology and Radiology initiated forming a new scientific community of experts, who contributed a lot to the formation of some frontmost medical science along with non-stop promoting efficacious scientific and theoretical evolvement of those.
Communication Strategy Use in English Conversational Discourse
Authors: Tóthné Herbst Zsuzsanna 
Published: January 2021

The ultimate goal of language learners is to communicate efficiently and fluently in the given second language, which is hard work to reach. They are learning the language for long years, and it may happen that theoretically they are familiar with all the grammar intricacies, but practically they are not able to ask for even a glass of water in real situations. The question is whether the use of communication strategies could help to cope with the difficulties by their direct teaching. A few years ago I conducted a research to find out what kind of interactive strategies the learners are using and to provide a full list of them. The publications at that time did not deal with strategies specifically in the teaching material. I used my own list. The latest books, however, put a stress on useful phrases. So the question is whether the fact that they draw attention to strategies in separate sections, will bring significant changes in the learners’ communication.
Six-minute walk distance, ECOG Performance Status, and Modified Borg Scale scores in a cohort of Pakistani men and women with noncancerous end-stage liver disease selected for liver transplant
Authors: Khaula Ashraf  , Saeed Bin Ayaz  , Rehana Yasmeen  , Bisharat Ullah Khan  , Rabia Fayyaz  , Naureen Tassadaq  , Admin  
Published: January 2021

Abstract
Objectives: To evaluate the functional status of Pakistani patients with non-cancerous end-stage liver disease selected for liver transplant, and to compare results acquired through various assessment tools.
Methods: The study was conducted at the Rehabilitation Medicine Department, Shifa International Hospital, Islamabad, Pakistan, from August 2017 to November 2019, and comprised end-stage liver disease patients of either gender who had been selected for liver transplant. Assessment tools included the Six-Minute Walk Distance, Eastern Cooperative Oncology Group Performance Status and Modified Borg Scale across age, gender, ethnicity, primary aetiology, and Model for end-stage liver disease scores. Data was analysed using SPSS 20.
Results: Of the 172 patients, 143(83%) were males; 99(58%) hailed from the Punjab province; and 118(71%) had hepatitis C as the most common aetiology. The overall mean age was 46.1±10.5 years (range: 14–70 years). The mean Six-Minute Walk Distance was 291.9±67.2m. Model for end-stage liver disease scores had a significant inverse correlation with Six-Minute Walk Distance (p<0.01) and a significant positive correlation with Modified Borg Scale (p=0.02) and Eastern Cooperative Oncology Group Performance Status scores (p<0.01). Age and ethnicity had no correlation with the variables (p>0.05).
Conclusions: The Six-Minute Walk Distance score was significantly low. The Model for end-stage liver disease scores were inversely correlated with Six-Minute Walk Distance scores, and positively correlated with Eastern Cooperative Oncology Group Performance Status and Modified Borg Scale scores. Continuous...