bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Computed Tomography Angiography (CTA): Based score (SGPGI score) to predict level of difficulty, operative, and postoperative outcomes for right-sided radical nephrectomy
Authors: Singh Uday P , Madhavan Kumar , Yadav Priyank , Soni Rahul , Lal Hira , Sureka Sanjoy K , Kapoor Rakesh , Srivastava Aneesh 
Published: July 2021

Objective: With the advent of laparoscopic approach for the large (T1b–T3a ± N1) right renal masses, higher rates of complications and conversion to open surgery are being reported. The role of preoperative angioembolization (PAE), which has increased cost and inherent morbidity but may help in select circumstances has also not been clearly defined in the literature. We therefore devised a scoring system (SGPGI score) based on pre-operative Computed Tomography Angiography (CTA) to predict the level of difficulty of radical nephrectomy and enhance its safety and efficacy which could also be used for the judicious use of PAE in selected cases. Methods: In a prospective observational study on 52 patients with right renal masses from January 2014 to July 2018, we calculated a score based on CTA parameters. The patients were stratified for type and duration of surgery, blood loss, postoperative stay, and Clavien-Dindo grade of postoperative complications. Results: Patients were classified into three groups based on our scoring system. Progressively groups with higher score had higher blood loss, operating time, complications and hospital stay, and were more likely to have undergone conversion to open surgery (Area under curve 0.8625 for a cut off score of 10). Intraclass Correlation Coefficient (ICC) was 0.678–1 for the different components of our score. Conclusion: The pre-operative CTA based SGPGI score evaluates right renal masses and is able to predict intra-operative difficulties effectively, leading to enhancement of surgery safety and efficacy. It also helps judiciously use PAE.
Profile, Treatment, and Survival of Palliative Cancer Patients in a Middle Income Country’s Cancer Center
Authors: Allende-Perez Silvia Rosa , Peña-Nieves Adriana , Gómez Miguel Ángel Herrera , Nicolau Estefania de la Paz , Verástegui-Avilés Emma 
Published: July 2021

Background: Data describing the characteristics, treatment, and survival of oncological patients referred to PCS remains scarce. Aim: To establish the characteristics of oncological patients referred to PCS, including their profile, treatment, and survival within a 7-year period. Design: Retrospective review of medical records. Clinical variables such as treatment and dates were included. Ji2 or Wilcoxon tests were used accordingly; Kaplan-Meier and log rank test were used to estimate survival. Setting/Participants: Consecutive oncological patients diagnosed between 2012 and 2018 sent to PCS were included. Results: We studied 5,631 patients, 58% female and 59% at advanced stage. Median age was 59 years, with 6 years or less of formal education and low monthly income ($152.4 USD). Neoplasms included breast (12%), stomach (12%), colorectal (10%) and cervical cancer (9%). Median referral time was 5.1 months; pain was the main reason for referral. Morphine was the most prescribed opioid with 47%. Median overall survival was 3.1 months. Conclusions: Morphine remains the paradigm of treatment making necessary to emphasize information on its optimal use. Additional measures such as education for cancer prevention and early referral to PCS are vital to improve survival and quality of life.
Current status of biosimilars in Turkey: A survey among medical oncologists
Authors: Gürler Fatih , Kasım Demet Döndü , Kurt İnci Bediz , Sütçüoğlu Osman , Ünsal Oktay , Aslan Volkan , Tahtacı Gözde , Özdemir Nuriye , Üner Aytuğ , Günel Nazan , Özet Ahmet , Yazıcı Ozan 
Published: July 2021

Introduction To evaluate biosimilar understanding and preference trends of medical oncologists in Turkey. Methods A survey consisting of 24 multiple-choice questions with checkbox answers was conducted among medical oncologists. The questionnaire was divided into five parts to some intentions: demographic characteristics, general knowledge about biosimilars, knowledge about local approval and reimbursement issues, individual preference trends, and ranking the knowledge of their own. All answers were analyzed as whole cohort, specialists and fellows. Results Fellows (n = 47) consisted 42%, and academic clinicians (n = 37) consisted 35% of the participants. In the whole cohort, the overall rate of correct answers was 55.1% in the general knowledge about the biosimilars part, and 26.7% in the local approval and reimbursement issues part. At all, 57.7% of the participants declared that they object to switch from a reference product to a biosimilar product. The rate of those who defined themselves as extremely knowledgeable decreased from 8.1% to 2.7% in the whole cohort at the end of the survey. Conclusion The need for more accurate and clarified local regulations and education emerging in the biotechnology era must be met.
Pleiotropy of a Stickler syndrome genotype
Authors: Baiyasi Ahmad , Barbosa Joshua , Parendo Anthony , Lin Xihui 
Published: July 2021

Purpose: To report a case of pleiotropy in the COL2A1 gene typically associated with Stickler Syndrome Type 1. Observations: A patient with a confirmed mutation of the COL2A1 gene presented with an isolated retinitis pigmentosa phenotype. Conclusions: The mutated COL2A1 gene in Stickler Syndrome Type 1 represents a site of pleiotropy, highlighting a change in phenotype across the same genotype potentially due to tissue alternative splicing.
An Extract of Taro (Colocasia esculenta) Mediates Potent Inhibitory Actions on Metastatic and Cancer Stem Cells by Tumor Cell-Autonomous and Immune-Dependent Mechanisms
Authors: Kundu Namita , Ma Xinrong , Hoag Stephen , Wang Fang , Ibrahim Ahmed , Godoy-Ruiz Raquel , Weber David J , Fulton Amy M 
Published: July 2021

The taro plant, Colocasia esculenta, contains bioactive proteins with potential as cancer therapeutics. Several groups have reported anti-cancer activity in vitro and in vivo of taro-derived extracts (TEs). We reported that TE inhibits metastasis in a syngeneic murine model of Triple-Negative Breast Cancer (TNBC). Purpose: We sought to confirm our earlier studies in additional models and to identify novel mechanisms by which efficacy is achieved. Methods: We employed a panel of murine and human breast and ovarian cancer cell lines to determine the effect of TE on tumor cell viability, migration, and the ability to support cancer stem cells. Two syngeneic models of TNBC were employed to confirm our earlier report that TE potently inhibits metastasis. Cancer stem cell assays were employed to determine the ability of TE to inhibit tumorsphere-forming ability and to inhibit aldehyde dehydrogenase activity. To determine if host immunity contributes to the mechanism of metastasis inhibition, efficacy was assessed in immune-compromised mice. Results: We demonstrate that viability of some, but not all cell lines is inhibited by TE. Likewise, tumor cell migration is inhibited by TE. Using 2 immune competent, syngeneic models of TNBC, we confirm our earlier findings that tumor metastasis is potently inhibited by TE. We also demonstrate, for the first time, that TE directly inhibits breast cancer stem cells. Administration of TE to mice elicits expansion of several spleen cell populations but it was not known if host immune cells contribute to the mechanism by which TE inhibits tumor cell dissemination. In novel findings, we now show that the ability of TE to inhibit metastasis relies on immune T-cell-dependent, but not B cell or Natural Killer (NK)-cell-dependent mechanisms. Thus, both tumor cell-autonomous and host immune factors contribute to the mechanisms underlying TE efficacy. Our long-term goal is to evaluate TE efficacy in clinical trials. Most of our past studies as well as many of the results reported in this report were carried out using an isolation protocol described earlier (TE). In preparation for a near future clinical trial, we have now developed a strategy to isolate an enriched taro fraction, TE-method 2, (TE-M2) as well as a more purified subfraction (TE-M2F1) which can be scaled up under Good Manufacturing Practice (GMP) conditions for evaluation in human subjects. We demonstrate that TE-M2 and TE-M2F1 retain the anti-metastatic properties of TE. Conclusions: These studies provide further support for the continued examination of biologically active components of Colocasia esculenta as potential new therapeutic entities and identify a method to isolate sufficient quantities under GMP conditions to conduct early phase clinical studies.
COVID-19 vaccine hesitancy in multiple sclerosis: A cross-sectional survey
Authors: Uhr Lauren , Mateen Farrah J 
Published: July 2021

Background: Vaccine willingness among people living with multiple sclerosis (PwMS) requires assessment following the approval of the first COVID-19 vaccines, since there remains uncertainty on multiple aspects of COVID-19 vaccination in immunosuppressed patients. Objective: To understand COVID-19 and influenza vaccine willingness and its associations among PwMS, following the approval of the first two mRNA COVID-19 vaccines. Methods: A survey was distributed to PwMS via an online platform from December 2020 to February 2021. Logistic regression models were constructed to determine the relationship between (1) COVID-19 and (2) influenza vaccination willingness with demographic and clinical characteristics. Results: Of 701 responding PwMS, 76.6% were COVID-19 vaccine willing. COVID-19 vaccine willingness was significantly associated with influenza vaccine willingness ( p < 0.001). In multivariable models, older age increased the odds of COVID-19 and influenza vaccine willingness (odds ratios (ORs) > 1) and other race decreased the odds of COVID-19 and influenza vaccine willingness (ORs < 1); higher functional disability decreased the odds of COVID-19 vaccine willingness (OR = 0.88, 95% confidence interval = 0.80–0.96). Prevalent vaccine-related concerns include safety ( n = 244) and efficacy ( n = 122). Conclusion: Our findings identify demographic and clinical factors as well as concerns influencing vaccine hesitancy in PwMS. These results may inform effective public health interventions to improve vaccine acceptability in this at-risk group.
Examining the Associations Between Childhood Trauma, Resilience, and Depression: A Multivariate Meta-Analysis
Authors: Watters Elizabeth R. , Aloe Ariel M. , Wojciak Armeda S. 
Published: July 2021

Topic of review: Childhood trauma has been associated with increased depression; however, resilience has been found to reduce this association. Method of review: Present analyses were based on multivariate meta-analytical techniques, an extension of univariate meta-analysis. All computations were performed using the metafor package and the metaRmat package from R. Bivariate associations ( r) between trauma, resilience, and depression were utilized as the pooled effect sizes. Criteria for inclusion: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, articles were coded based on the following inclusion criteria: (a) sample participants had a history of childhood trauma; (b) studies included one of the four instruments of trait resilience; (c) studies included measures of individual outcomes of depression; (d) studies were published in peer-reviewed journals, dissertations, book chapters since 2009, or provided by leading scholars who had yet to publish their data; (e) all manuscripts were written in English; and (f) studies included the Pearson Product Moment Correlation Coefficient ( r) for the effect size. Criteria for review: We systematically coded for the following items for each study: year of publication, type of report, peer-reviewed, funding, sampling strategy, sample size, gender, mean age, country of study, measure of resilience, measure depression, and measure of childhood trauma. Major findings: The pooled correlations indicate that trauma, resilience, and depression are significantly associated. There were no significant differences in symptoms of depression for high versus low reports of resilience for individuals with a history of trauma. Year of publication was a significant moderator for the associations between trauma, resilience, and depression. Resilience significantly mediated the association between trauma and depression.
The Role of Androgen Receptor Splicing Variant 7 in Predicting the Prognosis of Metastatic Castration-Resistant Prostate Cancer: Systematic Review and Meta-Analysis
Authors: Liu Rui-Ji , Hu Qiang , Li Shu-Ying , Mao Wei-Pu , Xu Bin , Chen Ming 
Published: July 2021

Objective: The purpose of this meta-analysis was to study the prognostic effects of androgen receptor splicing variant 7 (AR-V7) on metastatic castration-resistant prostate cancer (mCRPC) under different treatment options (chemotherapy, hormone therapy). Methods: We conducted a systematic search of PubMed, EMBASE and Cochrane databases for clinical studies up to June 4, 2021, and used prostate-specific antigen (PSA) progression free-survival (PSA-PFS), radiologic PFS (r-PFS), overall survival (OS) and PSA response rate (PSA RR) as the main endpoints. Subgroup analyses were conducted based on the source of the specimens. STATA v.15 software was used for data analysis. Results: Twenty-one studies were included in this meta-analysis, with a total of 1578 samples. In the abiraterone (AA)/enzalutamide (E) treatment group, AR-V7 positive patients had worse PSA-PFS (hazard ratio [HR] = 3.40; 95% confidence interval [95%CI] 2.56-4.51; P < 0.05) and worse r-PFS (HR = 2.69; 95%CI 1.70-4.24; P < 0.05) and OS (HR = 3.02; 95%CI 1.73-5.30; P < 0.05). Multivariate Cox regression results showed that AR-V7 positive status was an independent risk factor for OS in the AA/E treatment group. In the taxane treatment group, AR-V7-positive and negative patients had similar PSA-PFS (HR = 0.87; 95%CI 0.46-1.63; P = 0.657), r-PFS (HR = 1.01; 95%CI 0.53-1.96; P = 0.965) and OS (HR = 1.50; 95%CI 0.89-2.52; P = 0.127). For AR-V7-positive patients, the difference in OS between taxane and AA/E treatment was not statistically significant (HR = 1.03; 95%CI 0.52-2.06; P = 0.930). However, multivariate Cox regression results suggested that for AR-V7-positive patients, taxane therapy was a protective factor for OS (HR = 0.35; 95%CI 0.20-0.60; P < 0.05). Conclusion: The expression of AR-V7 indicates a poor prognosis and is an independent risk factor for OS in AA/E-treated mCRPC patients. However, AR-V7 positive status does not play the same role in taxane-treated patients. In addition, compared to AA/E, taxane treatment is a protective factor for OS in AR-V7-positive patients. AR-V7 may thus be an effective biomarker for treatment prognosis in patients with mCRPC.
A comparative study of 6-week and 12-week Radiographic Union Scores for HUmeral fractures (RUSHU) as a predictor of humeral shaft non-union
Authors: Guevel Borna , Gokaraju Kishan , Mohamed Foad , Sorensen Frederik , Gillott Elizabeth , Domos Peter 
Published: July 2021

Background Non-union in non-operatively managed humeral shaft fractures are associated with significant morbidity. Hence, developing a robust system that could help with early diagnosis is important. We aimed to evaluate the validity of the Radiographic Union Score for HUmeral fractures (RUSHU) at 6 weeks (RUSHU-6) and test whether a RUSHU at 12 weeks (RUSHU-12) would be a better predictor of non-union. Methods We retrospectively reviewed all non-operatively managed humeral diaphyseal fractures from 2012 to 2018. Statistical analysis was used to determine the cut-off RUSHU-12 and evaluate the effect of RUSHU-6 and RUSHU-12 on non-union prediction. Results In sum, 32 patients had radiographs at 6 weeks post-injury, 27 of which also had radiographs at 12 weeks. A RUSHU cut-off of 9 was the best predictor of non-union at 12 weeks. Only RUSHU-12 had a statistically significant influence predicting non-union (P = 0.011) and there was a significant correlation (P = 0.003) between score progression from RUSHU-6 to RUSHU-12 and the development of non-union. Discussion A RUSHU-12 of <9 and a low score progression between 6 and 12 weeks suggest superior predictive value in determining the likelihood of non-union. Further validation in the form of a large multicentred study is however required.
The Psychological Supportive Design Features in Hospitals: Case of a Public Jordanian Hospital in Amman
Authors: Al-Bqour Nadine , Rababeh Shaher , Al-Rabady Rama 
Published: July 2021

Purpose: The purpose of this study is to develop a practical framework that combines the psychological supportive design features in hospitals’ healing environments, also, to examine the implementation of these features in a Jordanian public hospital. Background: Positive psychological feelings are the hidden powerful treatment in hospitals. Although that Jordan represents a third-world country, it is counted as one of the most sought-after healthcare locations in the Middle East for its distinguished healthcare serveries (Private Hospitals Association, 2019). Nevertheless, the architectural and interior design of the healthcare facilities in Jordan usually ignores the inpatients’ psychological needs. Also, there is an absence of practicing a set of psychological supportive design features to guide the hospitals’ design in Jordan. Method: Design features are obtained from the main theories in the field of supportive healing environments. A large Jordanian public hospital was selected to be assessed in terms of these features within the developed practical framework. This study adopts a mixed methodology; data are collected using different methods, mainly literature review, site inventory, and inpatients’ questionnaire. Results: The studied hospital remains moderately considerable in terms of the psychologically supportive design features. However, the nature connectivity aspect is not satisfactorily considered in the studied hospital design. Conclusion: This study suggests a responsive design that fosters interaction and integration with surrounding nature in order to increase levels of connectivity with nature. The studied design features in this study could work as guiding principles for Jordanian hospitals’ designers.
Brain structural differences in temporal lobe and frontal lobe epilepsy patients: A voxel-based morphometry and vertex-based surface analysis
Authors: Lu Chun-Qiang , Gosden Grant P , Okromelidze Lela , Jain Ayushi , Gupta Vivek , Grewal Sanjeet S , Lin Chen , Tatum William O , Messina Steven A , Quiñones-Hinojosa Alfredo , Ju Shenghong , Middlebrooks Erik H 
Published: July 2021

Purpose Exploration of the effect of chronic recurrent seizures in focal epilepsy on brain volumes has produced many conflicting reports. To determine differences in brain structure in temporal lobe epilepsy (TLE) and extratemporal epilepsy (using frontal lobe epilepsy (FLE) a surrogate) further, we performed a retrospective analysis of a large cohort of patients with seizure-onset zone proven by intracranial monitoring. Methods A total of 120 TLE patients, 86 FLE patients, and 54 healthy controls were enrolled in this study. An analysis of variance of voxel-based morphometry (VBM) was used to seek morphometric brain differences among TLE patients, FLE patients, and healthy controls. Additionally, a vertex-based surface analysis was utilized to analyze the hippocampus and thalamus. Significant side-specific differences in hippocampal gray matter volume were present between the left TLE (LTLE), right TLE RTLE (RTLE), and control groups ( p<0.05, family-wise error (FWE) corrected). Results Vertex analyses revealed significant volume reduction in inferior parts of the left hippocampus in the LTLE group and lateral parts of the right hippocampus in the RTLE group compared to controls ( p<0.05, FWE corrected). Significant differences were also detected between the LTLE and control group in the bilateral medial and inferior thalamus ( p<0.05, FWE corrected). FLE patients did not exhibit focal atrophy of gray matter across the brain. Conclusion Our results highlight the variation in morphometric lateralized changes in the brain between different epilepsy onset zones, providing critical insight into the natural history of people with drug-resistant focal epilepsies.
Economic Impacts of the US–China Trade War on the Asian Economy: An Applied Analysis of IDE-GSM
Authors: Kumagai Satoru , Gokan Toshitaka , Tsubota Kenmei , Isono Ikumo , Hayakawa Kazunobu 
Published: July 2021

In this article, we attempt to estimate the economic impacts of the US–China trade war that began in 2018. We used IDE-GSM, a computational general equilibrium simulation model, to estimate the economic impacts of a ‘full-confrontation’ scenario wherein both countries impose 25% additional tariffs on all goods imported from each other for 3 years 2019 onwards. In our calculation, the economic impact for the United States is −0.4% and −0.5% for China. Some Asian countries benefit from the trade war. As far as it remains bilateral, the trade war is only an issue for the concerned parties. We also ran the US–world trade war scenario, wherein the United States and all other countries impose a 25% additional tariff on all goods. The negative impact on the global economy is –0.8%, much more significant than the 0.1% impact from the US–China trade war. Thus, it is clear that the world cannot afford to engage in a multilateral trade war. JEL Codes: C68, F13
Patellar Tendon Allograft Reconstruction
Authors: Spivey Matthew G. , Campbell Michael P. , Gammon Lee G. , Vap Alexander R. 
Published: July 2021

Background: Chronic patellar tendon injuries can cause significant functional deficits due to anterior knee pain, extension weakness, and extensor lag. With chronic injuries, the tissue is inadequate and of poor quality. Chronic injuries require autograft or allograft for augmentation or reconstruction. We present reconstruction of a chronic patellar tendon injury with Achilles tendon allograft. Indications: Chronic patellar tendon injuries causing functional deficits, including knee extension weakness, extensor lag, and anterior knee pain. Technique Description: A longitudinal incision is made over the patellar tendon, and the patellar tendon is excised. Two guide pins are drilled in a retrograde fashion through the patella and are overdrilled with a reamer. A trough is made at the tibial tubercle using an oscillating saw. The Achilles allograft calcaneal bone block is contoured to the appropriate size, and then press fit into the trough. Two 4.0-mm fully threaded cannulated screws with washers are used to secure the bone block. The fresh frozen Achilles allograft is doubled over, and a double Krackow running locking suture is placed. A V-Y advancement of the quadriceps tendon is performed to ensure adequate advancement of the patella. The limbs of the Krackow suture are pulled through the patella drill holes and tied with knee in full extension. Results: At 1 year, patients can expect near full range of motion with minimal extensor lag. Reconstruction results in improved pain and function as compared with preoperatively, as well as return to activities. Conclusion: Achilles tendon allograft is a good option for reconstructing chronic patellar tendon injuries. Advantages of the Achilles allograft include the bone-to-bone healing at the tibia, lack of donor site morbidity, and the large amount of tissue available for reconstruction.