bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Osimertinib Plus Bevacizumab In Glioblastoma Patients With Simultaneous EGFR Amplification And EGFRvIII Mutation
Authors: Jaramillo-Velásquez Daniel , Cardona Andrés F. , Ruiz-Patiño Alejandro , Polo Carolina , Jiménez Enrique , Hakim Fernando , Gómez Diego F , Ramón Juan Fernando , Cifuentes Hernando , Mejía Juan Armando , Salguero Fernando , Ordoñez Camila , Muñoz Álvaro , Bermúdez Sonia , Useche Nicolas , Pineda Diego , Ricaurte Luisa , Zatarain-Barrón Zyanya Lucia , Rodríguez July , Avila Jenny , Rojas Leonardo , Jaller Elvira , Sotelo Carolina , Garcia-Robledo Juan Esteban , Santoyo Nicolas , Rolfo Christian , Rosell Rafael , Arrieta Oscar 
Published: July 2021

Abstract
Background: Amplification of EGFR and its active mutant EGFRvIII are common in glioblastoma (GB). While EGFR and EGFRvIII play critical roles in pathogenesis, targeted therapy with EGFR-tyrosine kinase inhibitors (TKIs) or antibodies has shown limited efficacy. To improve the likelihood of effectiveness, we targeted adult patients with recurrent GB enriched for simultaneous EGFR amplification and EGFRvIII mutation, with osimertinib/bevacizumab at doses described for non-small cell lung cancer (NSCLC). Methods: We retrospectively explored whether previously described EGFRvIII mutation in association with EGFR gene amplification could predict response to osimertinib/bevacizumab combination in a subset of 15 patients treated at recurrence. The resistance pattern in a subgroup of subjects is described using a commercial NGS panel in liquid biopsy.Results: There were ten males (66.7%), and the median patient’s age was 56 years (range 38-70 years). After their initial diagnosis, 12 patients underwent partial (26.7%) or total resection (53.3%). Subsequently, all cases received IMRT and concurrent and adjuvant temozolomide (TMZ; the median number of cycles 9, range 6-12). The median follow-up after recurrence was 17.1 months (95% CI 12.3-22.6). All patients received osimertinib/bevacizumab as a second-line intervention with a median progression-free survival (PFS) of 5.1 months (95% CI 2.8-7.3) and overall survival (OS) of 9.0 months (95% CI 3.9-14.0). The PFS6 was 46.7%, and the overall response rate (ORR) was 13.3%. After exposure to the osimertinib/bevacizumab combination, the main secondary alterations were MET amplification, STAT3, IGF1R, PTEN, and PDGFR.Conclusions: While the osimertinib/bevacizumab combination was marginally effective in most GB patients with simultaneous EGFR amplification plus EGFRvIII mutation, a subgroup experienced a long-lasting meaningful benefit. The findings of this brief cohort justify the continuation of the research in a clinical trial. The pattern of resistance after exposure to osimertinib/bevacizumab includes known mechanisms in the regulation of EGFR, findings that contribute to the understanding and targeting in a stepwise rational this pathway.
Assessment of Malnutrition in Emergency Laparotomy Patients. A QIP Highlights Simple Measures To Improve Early Recognition and Optimisation of High-Risk Patients.
Authors: Raslan Charef , Tomalieh Feras , Lasheen Omar , Siddique Khurram 
Published: July 2021

Abstract
Aim Early recognition of high-risk malnourished patients is important for optimisation of nutritional status leading to better outcomes. The accurate recording of malnutrition universal screening tool (MUST) results is vital in this regard. This quality improvement project (QIP) aimed to review the quality of nutritional assessment of emergency laparotomy patients against the National Institute for Health and Care Excellence (NICE) guidelines and outline area of improvement.Method The QIP was conducted at Royal Oldham Hospital in 2019-2020 over a seven-month period. Fifty random patients were included in the first audit cycle over a 4-month period, followed by implementation of recommended changes and a re-audit of 30 patients over a 2-month period. The initial MUST scores which were calculated and documented by nursing staff were identified as the nursing staff MUST score (NSMS). To assess the accuracy of NSMS, we developed a MUST rescoring method which was performed by a senior member of the medical team and was identified as the medical team MUST rescore (MTMR). Results The initial audit showed a significant difference between NSMS and MTMR scores. According to MTMR, 23 patients (46%) had an inaccurate MUST score assessment by the nursing staff. A multidisciplinary approach using a standard online calculator were recommended. The second phase of the QIP showed an obvious improvement in the accuracy of MUST assessment. Our interventions improved the accuracy rate of MUST scores significantly (27, 54% vs 29, 96.6%, P = 0.00005).Conclusion A multidisciplinary team approach and online calculator are useful in improving the accuracy of MUST assessment in emergency laparotomy patients. This helped early involvement of the dietitian leading to improvement in morbidity and mortality.
Lipid Profile, Atherogenic Index of Plasma, and Anthropometric Measurements Among Osteoporotic Postmenopausal Sudanese Women: Possible Risk for Cardiovascular Disease
Authors: Elmugadam Abdelgadir , Elfadil Ghada A. , Hamad Abdelrahman Ismail , Aledrissy Mawahib , Altayb Hisham N. , Elshikieri Ahlam Badreldin 
Published: July 2021

Abstract
Background: Osteoporosis and menopausal women’s health had paucity data from Africa, especially Sub-Saharan countries. The current study aimed to assess the relationship between lipid profile, atherogenic Index of Plasma (AIP), anthropometric measurements, and the risk of cardiovascular disease (CVD) among osteoporotic Sudanese postmenopausal women.Methods: An epidemiological, cross-sectional comparative, community-based study was conducted. Postmenopausal women (n = 300), aged 47- 90 years, with an average one year postmenopause, were recruited from various centers in Khartoum State. Dual-energy X-ray absorptiometry (DEXA) was used to assess bone density. DEXA scan was interpreted in terms of T-score as per World Health Organization guidelines. Weight, height, and waist circumference were measured twice following standard protocols. In addition, fasting blood samples (5ml) were collected for the determination of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). AIP was calculated as an indicator for CVD risk. Blood samples were assayed on the Roche/Hitachi Cobas c311 system (Roche Diagnostics GmbH, Germany). Statistical analysis was carried out using SPSS version 26. Results: The mean age of the postmenopausal women was 61.7±10.3 years, with 80 women having normal T-score and an equal number of osteoporotic and osteopenic (n = 110 each). Most women (59%) aged 47-64 years. The prevalence of osteoporosis was 36.7%. Many postmenopausal women with normal BMD suffered from general (68%) and central obesity (94%) compared with their counterparts. Hypercholesterolemia, hypertriglyceridemia, high LDL-C, hypo-HDL-C were identified among 26.4%, 31%, 16.3%, and 32.7% osteoporotic women respectively. Osteoporotic postmenopausal (36.4%) women had medium to high risk of CVD according to their AIPs. There was a significantly inverse correlation between age and HDL-C (r= -0.205; p=0.032) whereas positive association between AIP and TC (r=0.230; p=0.016), among osteoporotic women. Osteoporotic (52%) and osteopenic (42%) women had ≥2 CVD risk factors. Multiple Linear regression analysis showed T-score value decreased significantly with age and AIP and increased with BMI. Conclusion: Osteoporosis is prevalent among Sudanese postmenopausal women who are at increased risk for CVD. Necessary steps are needed for public education and wider dissemination of information about osteoporosis, CVD and their prevention.
Incidence, Aetiology and Clinical Features of Eosinophilic Pleural Effusion: A Retrospective Study
Authors: Li Minfang , Zeng Yunxiang , Li Yaqing , Jia Dan , Chen Sheng , Wang Jinlin 
Published: July 2021

Abstract
Background: Eosinophilic pleural effusion (EPE) is a distinct entity among pleural effusions, but its diagnostic and prognostic significance is still controversial. This study aimed to evaluate the incidence and aetiological distribution of EPE in our institution and to assess the relationship between EPE and malignancy and other underlying diseases and the relevance of the percentage of eosinophils and other laboratory parameters. Methods: A retrospective study was conducted by reviewing the medical records of 252 patients with PE from September 2017 to January 2021.Results: EPE was found in 34 (13.49%) out of 252 patients. There were 20 (58.82%) males and 14 (41.18%) females in the EPE group. The mean percentage of eosinophils in EPE (21.7%, range (10.0%-67.5%)) was significantly higher than the percentage of eosinophils in peripheral blood (5.65%, range (0%-34.60%); p<0.05). The most common cause of EPE was malignant disease (52.94%), followed by idiopathy (14.71%), parasites (8.82%), pneumonia (8.82%) and others (14.71%). Comparative analysis of patients with malignant versus nonmalignant EPE showed that patients with malignant EPE were significantly older, and had a lower white blood cell (WBC) count in the pleural fluid ( 1.8 vs 4.7 cells×109/L, p <0.05). However, the percentage of eosinophils in PE was not significantly different between malignant EPE and nonmalignant EPE (p=0.66). There was no correlation between the percentage of eosinophils in PE and peripheral blood (r =0.29; p =0.09).Conclusions: Malignant disease ranks as the leading cause of EPE. The presence of EPE should not be considered as a predictive factor of benign conditions. Pleural parasitic infestation (PPI) should be emphasized in areas with a high incidence of parasitic disease. Trial registration: GYFYY. Registration No: GYFYY20200301221. Registered time: 12 Mar 2020. Date of enrolment of the first participant to the trial: 22 March 2020.
The Influence of Energy Output And Substitution On The Environmental Impact of Waste-To-Energy Operation. Quantification By Means of A Case Study.
Authors: Boakes Elizabeth Zoe , De Voogd Jan-Kees , Wauters Guido , Caneghem Jo Van 
Published: July 2021

Abstract
A Life Cycle Assessment (LCA) was conducted to evaluate the total environmental impact of state-of-the-art Waste-to-Energy (WtE) in Belgium, with respect to recovered energy utilization and addition of Carbon Capture and Storage (CCS). Four energy output scenarios were modelled on Umberto LCA software using primary data of mass and energy flows surrounding the six incinerators at the considered WtE plant, and predefined processes from the Ecoinvent 3.6 database. The normalized LCA results suggest that by utilizing all the recovered energy as steam, the WtE plant can avoid an equivalent annual environmental impact value of approximately 21200, 36800, 6700, 15800, 37000 and 6900 average European citizens in the impact categories ‘climate change’, ‘freshwater and terrestrial acidification’, ‘freshwater eutrophication, ‘photochemical ozone creation’ and ‘respiratory effects, inorganics’, ‘terrestrial eutrophication’, respectively. The ‘Electricity and Steam with CCS’ scenario resulted in the most avoided environmental impact in the impact category ‘climate change’. However, in all other impact categories, it resulted in less avoided environmental impact compared to the ‘Steam’ scenario. The comparative analysis showed that 19 out of 24 of the LCA results varied by more than 50% between two energy substitution models, thus quantifying the influence of energy substitution in LCA modelling. This study exemplifies the environmental benefit WtE technology can realize by substituting conventional energy production processes that are reliant on fossil resources, whilst performing its primary function that is reducing the volume of non-recyclable waste, destroying hazardous organic components it contains and recovering useful materials from it.
Reproductive Toxicity Induced By Benzo[a]pyrene Exposure: First Exploration Highlighting The Multi-stage Molecular Mechanism In Female Scallop Chlamys Farreri
Authors: Xu Ruiyi , Pan Luqing , Zhou Yueyao , Gao Zhongyuan , Miao Jingjing , Yang Yingying , Li Dongyu 
Published: July 2021

Abstract
Reproductive toxicity induced by Benzo[a]pyrene (B[a]P) exposure have received great ecotoxicological concerns. However, huge gaps on molecular mechanism still exist in bivalves. In this study, reproduction-related indicators during reproductive periods (proliferative, growth, mature, and spawn stage) were investigated in female scallops Chlamys farreri, which under gradient concentration of B[a]P at 0, 0.04, 0.4 and 4 μg/L. To elucidate the potential molecular mechanisms of reproductive toxicology, a multi-stage ovarian transcriptome analysis under 4 μg/L B[a]P exposure was also conducted. The results indicated that life-cycle exposure to 0.4 and 4 μg/L B[a]P had significantly decreased GSI and sex steroid levels. Even 0.04 μg/L B[a]P could play the wicked role on DNA integrity at mature and spawn stages. Ovarian histological sections showed the inhibitions on oocyte maturation and ovulation of B[a]P with dose-dependent effects. Through the functional enrichment analysis of DEGs from transcriptome data, 18 genes involved in endocrine disruption effects, DNA damage and repair, and oogenesis damage were selected and further determined by qRT-PCR. The down-regulate of steroidogenic and estrogen signaling pathways genes indicated the endocrine disruption mechanisms by B[a]P, which emphasized the functions of receptor independent and dependent pathways under B[a]P exposure. The variation of DNA single strand break and repair gene expressions implied there might exist the similar toxic mechanism with that in vertebrates. Gene expression data involved in cell cycle, apoptosis and cell adhesion exhibited the possibly toxic mechanisms of oogenesis caused by B[a]P. Taken together, this study is a pioneer to take advantage of genome-wide transcriptomic analysis and its corresponding reproductive indicators to explore the toxic mechanism under B[a]P exposure in bivalves. Meanwhile, some selected genes were firstly identified in bivalves, and the expression data might be useful in establishing new hypotheses and discovering new biomarkers for marine biomonitoring.
Effect of Addition of Pomegranate Peel in the Ration with or Without Polyethylene Glycol on Productive Performance of Lactating Goats
Authors: Kholif Abd El-Kader Mahmoud , Aboulfotouh Gamal Eldeen , Hassan Ola Gamal Ahmed , El-Mola Abdelalim Mohamed Abd 
Published: July 2021

Abstract
Pomegranate juice processing industries generate enormous waste in the form of peel that has been suggested and evaluated as a supplement in animal feed but pomegranate peel have high percent of tannins, So the purpose of this paper was to estimate the effect of addition of pomegranate peel (PP), detanninated pomegranate peel (DPP) and pomegranate peel with polyethylene glycol (PEG) on nutrients digestibility, goats milk yield and its composition, feed conversion and some blood parameters. Also, simple economic evaluation of the tested rations was considered.Sixteen lactating Zaraibi goats of about 3-4 years old (in their 2nd to 4th of lactation seasons with an average body weight of about 25 + 0.5 kg were used in the present study. After 14 days of parturition was randomly assigned into four groups, four animals per each tested ration (R) for 90days, R1: Control : 50% CFM + 25% Egyptian clover and 25% wheat straw, R2: Control ration+1% PP, R3: Control ration+1% PP + 20 g (PEG) and R4:Control ration+1% DPP. The results revealed that the PP contained 90.85% DM, 4.84% CP, 15.53% CF, 87.21%OM, 4.69% EE, 62.15% NFE and 15.28% tannins. No significant differences were found between the tested rations regarding nutrients digestibility except EE digestibility. Nutritive values of R2 and R3 were slightly higher than R4 and R1, respectively. Ration three (R3) was the best ration for daily milk yield and total milk yield, where R4 showed the worst one. Also, there are no significant differences for dry matter, SV and TDN intake. While, values of DCP intake were higher significantly (P<0.05), for R3 and R2 followed by R4 then R1. Regarding feed conversion, R4 was superior to other tested rations followed by R1 then R3 followed by R2. All blood serum parameters were in the normal rang which support that the healthy effect of tested additives in goats rations. It seems that R2 and R3 could be used successfully for lactating goats, but R3 is very expensive from economical point of view, where R3 was negatively economical effect, and not recommended.
Phytohormones Regulate the Non-Redundant Response of ω-3 Fatty Acid Desaturases to Low Temperatures in Chorispora Bungeana
Authors: Shi Yulan , Yang Sizhong , Yue Xiule , Zhao Zhixing , An Lizhe 
Published: July 2021

Abstract
To explore the contribution of ω-3 fatty acid desaturases (FADs) to cold stress response in a special cryophyte, Chorispora bungeana (C. bungeana), two plastidial ω-3 FAD genes (CbFAD7 and CbFAD8) were cloned and verified in a Arabidopsis fad7fad8 mutant, before being compared with the microsomal ω-3 FAD gene (CbFAD3) on expression profile. Though these genes were expressed in all tested tissues of C. bungeana, CbFAD7 and CbFAD8 have the highest expression in leaves, while CbFAD3 was mostly expressed in non-green tissues. Low temperatures (4, 0 and -4 ℃) resulted in significant increases in trienoic fatty acids (TAs, mainly C18:3), which were consistent with the non-redundant expression of CbFAD3 and CbFAD8 in suspension-cultured cells, and the coordination of CbFAD7 and CbFAD8 in leaves. Furthermore, the contribution of CbFAD8 increased as temperature decrease in the two tissues. Our data revealed that jasmonie acid and brassinosteroids participated in the cold-responsive expression of these genes in both tissues, and the pyhtohormone regulation in leaves was more complicated with the participation of abscisic acid and gibberellin. These results point to the hormone-regulated non-redundant contribution of ω-3 CbFADs to maintain appropriate level of TAs under low temperatures, which help C. bungeana survive in cold environments.
Combination Therapy for Cerebral Ischemia: Do Progesterone and Noscapine Provide Better Neuroprotection Than Either Alone in the Treatment ?
Authors: Kawadkar Manisha , Mandloi Avinash Singh , Singh Nidhi , Mukherjee Rajesh , Dhote Vipin 
Published: July 2021

Abstract
Purpose: Ischemic stroke presents multifaceted pathological outcomes with overlapping mechanisms of cerebral injury. High mortality and disability with stroke warrant a novel multi-targeted therapeutic approach. The neuroprotection with progesterone (PG) and noscapine (NOS) on cerebral ischemia-reperfusion (I-R) injury was demonstrated individually, but the outcome of combination treatment to alleviate cerebral damage is still unexplored.Methods: Randomly divided groups of rats (n=6) were Sham-operated, I-R, PG (8mg/kg), NOS (10mg/kg), and PG+NOS (8mg/kg+10mg/kg). The rats exposed to bilateral common carotid artery occlusion, except Sham-operated to investigate the therapeutic outcome of PG and NOS alone and in combination on I-R injury. Besides the alterations in cognitive and motor abilities, we estimated infarct area, oxidative stress, blood-brain barrier (BBB) permeability, and histology after treatment. Pharmacokinetic parameters like Cmax, Tmax, half-life, and AUC0-t were estimated in biological samples to substantiate the therapeutic outcomes of the combination treatment.Results: We report PG and NOS prevent loss of motor ability and improved spatial memory after cerebral I-R injury. Combination treatment significantly reduced inflammation and restricted infarction; it attenuated oxidative stress, BBB damage, and improved grip strength. Histopathological analysis demonstrated a significant reduction in leukocyte infiltration with the most profound effect in the combination group. Simultaneous analysis of PG and NOS in plasma revealed enhanced peak drug concentration, improved AUC, and prolonged half-life; the drug levels in the brain have increased significantly for both. Conclusion: We conclude that PG and NOS have beneficial effects against brain damage and, the co-administration further reinforced neuroprotection in the cerebral ischemia-reperfusion injury.
Adaptive Traffic Routing Practice for Load Balance and Congestion Control in AdHoc Network in Cloud-MANET
Authors: Dalal Surjeet , Dahiya Neeraj , Seth Bijeta , Jaglan Vivek , Malik Meenakshi , Surbhi Surbhi , Rani Uma , Le Dac-Nhuong , Hu Yu-Chen 
Published: July 2021

Abstract
Cloud services can dramatically improve the computing proficiency of mobile devices. Mobile operators can count on the cloud to carry out thorough computing operations such as research, data mining and multimedia handling. Load balancing and network congestion are the difficult ad hoc network tasks due to its un-predictable dynamic behavior and random topology alteration of such systems. The most important reason of data loss in wireless grids is flexibility, network congestion and channel errors. The majority of the accessible directing schemes deal with the energy efficiency, congestion and balancing overload load outstandingly. Proficient routing protocol is proposed in this manuscript which will adaptively control the network congestion and achieve load balancing in Mobile Ad Hoc Networks (MANET). The proposed technique discovers multiple alternate paths between two nodes. The cost and stability of the link and traffic load is calculated depending on the available power of the participated nodes. If the traffic load on a specific link escalates beyond the threshold value, the traffic will be distributed to other alternate links. It is clear with the simulation outcomes that the projected approach enhances the network lifespan by integrating load balancing and congestion control with energy efficient algorithm. Thereby, it reduces the packet dropping probability and node to node delay in the network and improves the system lifetime.
The Evaluation of Neutrophil to Lymphocyte Ratio in Kawasaki Disease and Its Value in Predicting IVIG Therapy Resistance
Authors: Houshmand Hamidreza , Farhadi Ramin , Sedokani Amin 
Published: July 2021

Abstract
Introduction: Kawasaki disease is a common systemic vasculitis of unknown cause in children and involves various organs but the main damage of this multisystemic vasculitis is mainly in the coronary arteries. Currently, the main treatments for this disease include aspirin therapy and IVIG. In the present study, we investigated the ratio of neutrophils to lymphocytes in patients with Kawasaki disease and its relationship with IVIG resistance in Kawasaki patients.Method: First, we reviewed the clinical records of patients diagnosed with Kawasaki, who received treatment at Motahari Hospital in Urmia from 2008 to 2018 (IVIG therapy). We re-examined Kawasaki diagnostic criteria for each individual before enrolling patients. Results: In our study, initially 460 cases of patients who were admitted to Motahari Hospital in Urmia between 2009 and 2019 with an initial diagnosis of Kawasaki disease were reviewed. Among them, patients who met Kawasaki diagnostic criteria were included in the final review and the rest of the cases were excluded from the study according to the exclusion criteria. Finally, out of 460 cases, 241 patients were included in the final analysis. The results indicated high blood leukocyte count (p-value = 0.013) and low urinary leukocyte count (p-value = 0.01) were directly related to response to treatment in Kawasaki patients, but age, sex, neutrophil ratio to Lymphocytes, neutrophil count, blood lymphocytes, CRP, hypoalbuminemia, ALT levels, anemia, thrombocytosis, and the time interval between onset of symptoms and treatment response to IVIG therapy in Kawasaki patients are not significantly related.Conclusion: High blood leukocyte count and low urinary leukocyte count in patients can be good criteria for predicting the prognosis of Kawasaki patients in response to IVIG, while the ratio of neutrophils to lymphocytes is not effective in this prediction.