bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrasonographic characteristics and outcome of Type III umbilical-portal-systemic venous shunt
Authors: Zhu Linlin , Wu Haifang , Cong Xiang , Ma Zhe , Tao Guowei 
Published: July 2021

Aims: According to a novel in-utero classification termed “umbilical-portal-systemic venous shunt (UPSVS)” recently proposed for an abnormal umbilical, portal and ductal venous system, the portal-systemic shunt belongs to type III UPSVS. This study was designed to examine the ultrasonographic characteristics and outcome of type III UPSVS.Material and methods: All cases of Type III UPSVS diagnosed at our department from April 2016 to December 2020 were retrospectively studied.Results: Seventeen patients with type III UPSVS including 12 type IIIa and 5 IIIb cases were identified. Sonography showed a shunt between the inferior left portal vein and the left hepatic vein in all type IIIa cases. Three cases of type IIIb had a combination of another shunt (2 with type I and one with type IIIa). Integrate intrahepatic portal vein system was not seen in those 2 cases of type IIIb combined with type I UPSVS, leading to termination of pregnancy (TOP). TOP occurred in 4 patients with type IIIa as requested by the parents. Two cases (type IIIa and type IIIb each) underwent surgical procedure for the closure of the shunt. Spontaneous complete closure in 4 type IIIa cases and partial closure in one type IIIb case occurred during a period of 3-16 months.Conclusions: The majority of patients had type IIIa UPSVS presenting a good outcome. The lack of integrate intrahepatic portal vein system was the main reason for TOP in patients with type IIIb UPSVS. These data suggest the UPSVS classification is a useful tool for a prognosis prediction of type III UPSVS.
Prospective randomised controlled trial of adults with perianal fistulising Crohn’s disease and optimised therapeutic infliximab levels: PROACTIVE trial study protocol
Authors: Gu Bonita , De Gregorio Michael , Pipicella Joseph Louis , Vande Casteele Niels , Andrews Jane M , Begun Jakob , Connell William , D’Souza Basil , Gholamrezaei Ali , Hart Ailsa , Liew Danny , Radford-Smith Graham , Rimola Jordi , Sutherland Tom , Toong Catherine , Woods Rodney , Wu Yang , Xuan Wei , Williams Astrid-Jane , Ng Watson , Ding Nik Sheng , Connor Susan 
Published: July 2021

IntroductionPerianal fistulising Crohn’s disease (pfCD) can be somewhat treatment refractory. Higher infliximab trough levels (TLIs) may improve fistula healing rates; however, it remains unclear whether escalating infliximab therapy to meet higher TLI targets using proactive, or routine, therapeutic drug monitoring (TDM) improves outcomes. This randomised controlled trial aimed to assess whether infliximab therapy targeting higher TLIs guided by proactive TDM improves outcomes compared with standard therapy.Methods and analysisPatients with active pfCD will be randomised 1:1 to either the proactive TDM arm or standard dosing arm and followed up for 54 weeks. Patients in the proactive TDM arm will have infliximab dosing optimised to target higher TLIs. The targets will be TLI ≥ 25 µg/mL at week 2, ≥ 20 µg/mL at week 6 and ≥ 10 µg/mL during maintenance therapy. The primary objective will be fistula healing at week 32. Secondary objectives will include fistula healing, fistula closure, radiological fistula healing, patient-reported outcomes and economic costs up to 54 weeks. Patients in the standard dosing arm will receive conventional infliximab dosing not guided by TLIs (5 mg/kg at weeks 0, 2 and 6, and 5 mg/kg 8 weekly thereafter). Patients aged 18–80 years with pfCD with single or multiple externally draining complex perianal fistulas who are relatively naïve to infliximab treatment will be included. Patients with diverting ileostomies or colostomies and pregnant or breast feeding will be excluded. Fifty-eight patients per arm will be required to detect a 25% difference in the primary outcome measure, with 138 patients needed to account for an estimated 6.1% primary non-response rate and 10% dropout rate.Ethics and disseminationResults will be presented in peer-reviewed journals and international conferences. Ethics approval has been granted by the South Western Sydney Local Health District Human Research Ethics Committee in Australia.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12621000023853); Pre-results.
Cross-sectional hospital-based study on the seroprevalence of hepatitis B virus markers among healthcare workers, NWR, Cameroon
Authors: W Akazong Etheline , Tume Christopher , Ayong Lawrence , Njouom Richard , Kenmoe Sebastien , Njankouo Ripa , Kuiate Jules-Roger 
Published: July 2021

BackgroundHepatitis B virus (HBV) infection is a major public health issue worldwide, with about 257 million people reported to be chronic carriers by the WHO fact sheet updated in 2018. HBV can be contracted via direct contact with infected body fluid and infection is almost always asymptomatic. Although healthcare workers (HCWs) are at high risk of HBV infection, little is known about the prevalence of the various HBV markers among HCWs in Cameroon. The present study was taken to evaluate the prevalence of different HBV serological markers among HCWs in the North-West Region of Cameroon.MethodsThis cross-sectional hospital-based study was carried out between April and September 2017 during which 395 HCWs were recruited. The serum of the HCWs were tested for the presence of HBV core antibody, hepatitis B surface antibody, hepatitis B e antibody and hepatitis B surface antigen using Monalisa ELISA kits produced by BIO-RAD laboratories. Data were analysed using SPSS V.20.0.ResultsAmong the 395 participants, 270 (68.4%) of them were females, 187 (47.3%) had been exposed to HBV, 145 (36.7%) had resolved the infection, 42 (10.6%) were current HBV carriers, 10 (2.5%) were infective, 36 (9.1%) were vaccinated and 172 (43.5%) were still susceptible. Exposure to HBV, past infection and susceptibility were significantly associated with age while the rate of vaccination was significantly associated with the job of the HCW in the health facilities.ConclusionThe prevalence of HBV exposure and infection among HCWs obtained in this study was high while the level of vaccination in this at-risk population was low. Adequate steps should be taken to sensitise this population on HBV and the vaccination procedure.
Development and evaluation of self-care intervention to improve self-care practices among people living with type 2 diabetes mellitus: a mixed-methods study protocol
Authors: Gupta Saurabh Kumar , Lakshmi P V M , Rastogi Ashu , Kaur Manmeet 
Published: July 2021

IntroductionThe management of diabetes mellitus (DM) depends on medication adherence, self-care and regular follow-up to prevent complications and premature mortality. This study aims to develop and implement the behavioural change theory and model based diabetes self-care intervention package to improve self-care practices among people living with type 2 DM.Methods and analysisAn exploratory sequential mixed-method study design wherein, quantitative follows qualitative will be used to develop, implement and evaluate the effect of diabetes self-care intervention package among people living with type 2 diabetes. The qualitative research method will be used to identify barriers and facilitators for self-care practices among people living with type 2 DM and will also provide the basis for the development of the diabetes self-care intervention package. The quasi-experimental with control study design will be used to evaluate the developed intervention package among 220 randomly selected people living with type 2 diabetes in both intervention and control arms. Baseline, follow-ups and endline data will be collected using same prevalidated and structured questionnaire for each self-care activity. Difference-in-difference analysis will be used to measure for changes in the proportion of people living with type 2 DM doing different component of self-care practices, preintervention and postintervention in both arms.Ethics and disseminationPermission for conducting the study has been taken from Institutional Ethical Committee of PGIMER, Chandigarh (Ref no. NK/4538/PhD/226, Dated 18.08.18). The findings of the trial will be disseminated through publication in peer-reviewed journals.Trial registration numberCTRI/2018/10/016108; Pre-results.
Identifying adults with acute rhinosinusitis in primary care that benefit most from antibiotics: protocol of an individual patient data meta-analysis using multivariable risk prediction modelling
Authors: Venekamp Roderick P , Hoogland Jeroen , van Smeden Maarten , Rovers Maroeska M , De Sutter An I , Merenstein Daniel , van Essen Gerrit A , Kaiser Laurent , Liira Helena , Little Paul , Bucher Heiner CC , Reitsma Johannes B 
Published: July 2021

IntroductionAcute rhinosinusitis (ARS) is a prime reason for doctor visits and among the conditions with highest antibiotic overprescribing rates in adults. To reduce inappropriate prescribing, we aim to predict the absolute benefit of antibiotic treatment for individual adult patients with ARS by applying multivariable risk prediction methods to individual patient data (IPD) of multiple randomised placebo-controlled trials.Methods and analysisThis is an update and re-analysis of a 2008 IPD meta-analysis on antibiotics for adults with clinically diagnosed ARS. First, the reference list of the 2018 Cochrane review on antibiotics for ARS will be reviewed for relevant studies published since 2008. Next, the systematic searches of CENTRAL, MEDLINE and Embase of the Cochrane review will be updated to 1 September 2020. Methodological quality of eligible studies will be assessed using the Cochrane Risk of Bias 2 tool. The primary outcome is cure at 8–15 days. Regression-based methods will be used to model the risk of being cured based on relevant predictors and treatment, while accounting for clustering. Such model allows for risk predictions as a function of treatment and individual patient characteristics and hence gives insight into individualised absolute benefit. Candidate predictors will be based on literature, clinical reasoning and availability. Calibration and discrimination will be evaluated to assess model performance. Resampling techniques will be used to assess internal validation. In addition, internal–external cross-validation procedures will be used to inform on between-study differences and estimate out-of-sample model performance. Secondarily, we will study possible heterogeneity of treatment effect as a function of outcome risk.Ethics and disseminationIn this study, no identifiable patient data will be used. As such, the Medical Research Involving Humans Subject Act (WMO) does not apply and official ethical approval is not required. Results will be submitted for publication in international peer-reviewed journals.PROSPERO registration numberCRD42020220108.
Detection of cancers and advanced adenomas in asymptomatic participants in colorectal cancer screening: a cross-sectional study
Authors: Schult Anna Lisa , Botteri Edoardo , Hoff Geir , Randel Kristin R , Dalén Eirin , Eskeland Sigrun Losada , Holme Øyvind , de Lange Thomas 
Published: July 2021

ObjectivesTo assess detection rates for colorectal cancer (CRC) and advanced adenomas in asymptomatic CRC screening participants and bowel symptoms in association with CRC and advanced adenoma.DesignCross-sectional study.SettingTwo screening centres.Participants42 554 men and women, aged 50–74 years, participating in a randomised CRC screening trial. 36 059 participants underwent a sigmoidoscopy (and follow-up colonoscopy if positive sigmoidoscopy) and 6495 underwent a colonoscopy after a positive faecal immunochemical test (FIT).Primary and secondary outcome measuresProportion of asymptomatic participants diagnosed with CRC or advanced adenomas. Prevalence of bowel symptoms (rectal bleeding, change in bowel habits, diarrhoea, constipation, bloating, alternating bowel habits, general symptoms, other bowel symptoms) recorded by the endoscopist and their association with CRC and advanced adenomas.ResultsAmong sigmoidoscopy participants, 7336 (20.3%) reported at least one symptom. 120 (60%) out of 200 individuals with screen-detected CRC and 1301 (76.5%) out of 1700 with advanced adenoma were asymptomatic. Rectal bleeding was associated with detection of CRC and advanced adenoma (OR 4.3, 95% CI 3.1 to 6.1 and 1.8, 95% CI 1.5 to 2.1, respectively), while change in bowel habits only with CRC detection (OR 3.8, 95% CI 2.4 to 6.1). Among the FIT positives, 2173 (33.5%) reported at least one symptom. Out of 299 individuals with screen-detected CRC and 1639 with advanced adenoma, 167 (55.9%) and 1 175 (71.7%) were asymptomatic, respectively. Detection of CRC was associated with rectal bleeding (OR 1.8, 95% CI 1.4 to 2.3), change in bowel habits (OR 2.2, 95% CI 1.4 to 3.5) and abdominal pain (OR 1.8, 95% CI 1.2 to 2.7).ConclusionsSome bowel symptoms increased the likelihood of being diagnosed with CRC or advanced adenoma. However, the majority of individuals with these findings were asymptomatic. Asymptomatic individuals should be encouraged to participate in CRC screening.Trial registration numberClinicaltrials.gov Identifier:NCT01538550.
An acoustic absorbing metamaterial with multi-Helmholtz resonators at low-frequency underwater
Authors: Luo Y. Q. , Lou J. J. , Zhang Y. B. 
Published: July 2021

An ultra-thin waterborne acoustic metamaterial (AM), which is made of steel and composed of multi-Helmholtz resonators (MHRs), is proposed to achieve perfect sound absorption at low frequencies, which are generated around the resonance mode. The average surface acoustic impedance of the metamaterial is almost perfectly matched with water impedance under the action of resonance among the HRs, thus the perfect sound absorption is achieved. The case of two resonators is taken as an example to verify the design idea. By adjusting HRs’ sizes in simulation, the sound absorption coefficient reaches 99.6% at low frequency of 2740 Hz with ultra-thin thickness less than [Formula: see text]. The abnormal physical properties of AMs are often accompanied by abnormal effective material parameters, which turn to be negative near the perfect sound absorption through inversion calculation. The HRs proposed are simple to fabricate, mechanically stable, and convenient to couple with other resonators to achieve low-frequency broadband sound absorption.
Trust Enforced Cloud Service Composition Based on Teaching–Learning-Based Optimization – STORM
Authors: Meena V. , Sasikaladevi N. , Praba T. Suriya , Sriram V. S. Shankar 
Published: July 2021

In the arena of Cloud Computing, the emergence of social networks and IoT increased the number of available services on the cloud platform, making service composition and optimal selection (SCOS) in Cloud Manufacturing (CMfg), NP-hard. The existing approaches for addressing SCOS often fail to offer assistance with maximized trust and satisfied QoS preferences. Hence, this research paper presents a novel TeachIng leaRning-based Optimization aLgorithm (TIROL) for achieving the optimal solution for truST enforced clOud seRvice coMposition (STORM) to assist CMfg for improving the trust value with satisfied QoS preference(s). The performance of the proposed framework has been validated using the synthetic dataset generated from different test-cases. Experimental results show that the proposed framework is reliable and outperforms the SOTA approaches in terms of trust value maximization.
Disección arterial cérvico-cefálica post trauma en pediatría
Authors: Kobus Garin Valentina , Giménez Barros Belén , Carcey Rivera Javier , Marín Medina José Ignacio 
Published: July 2021

Introducción: la disección arterial cérvico-cefálica (DACC) es una causa importante de accidente cerebrovascular (ACV) en pediatría. Dentro de los factores de riesgo más relevantes están los traumas cervicales y cefálicos, presentes en el 50% de los casos. El pronóstico es variable y depende de la magnitud de oclusión de la arteria afectada. Es importante la detección precoz de esta patología, que muchas veces se presenta con pocos síntomas en pediatría, lo que genera retraso en el diagnóstico y tratamiento. Objetivo: presentar la evidencia disponible sobre DACC incluyendo DACC post trauma para familiarizar a los médicos generales y especialistas sobre la sospecha diagnóstica, diagnóstico enfocado en neuroimágenes y posibles manejos de esta patología. Métodos: se llevó a cabo una revisión bibliográfica de la literatura científica sobre esta condición. Dentro de los criterios de selección de los estudios se consideró la fecha de publicación, el diseño y la relevancia. Conclusiones: la DACC post trauma es una causa frecuente de ACV en pediatría. Se puede presentar con escasa sintomatología, por lo que es importante mantener una alta sospecha en contexto de trauma cervical o cefálico, implementando un diagnóstico y tratamiento precoces para mejorar el pronóstico de los pacientes.
Abstract 1156: The integrated stress response (ISR) is involved in the synergistic combinatorial efficacy of ONC201 and epigenetic modulators in brain tumor cell lines
Authors: Zhang Yiqun , Zhou Lanlan , Prabhu Varun V. , Allen Joshua E. , Seyhan Attila A. , El-Deiry Wafik S. 
Published: July 2021

Abstract
First-in-class small molecule ONC201 is an anti-cancer agent that activates the TRAIL pathway through ATF4 and the integrated stress response (ISR). ONC201 demonstrated durable tumor regressions and prolonged disease stabilization in some patients with histone H3K27M-mutated diffuse midline glioma (DMG). The H3K27M-mutation reduces H3K27 methylation. EZH2 inhibitors (EZH2i) reduce global H3K27 methylation. We hypothesized that ONC201 sensitivity and tumor cell death may be enhanced by reducing H3K27 methylation with EZH2i as a mimic of the H3K27M-mutation, particularly in tumor types beyond DMG. We treated cancer cells from different tissue origins including breast cancer, pancreatic cancer, colorectal cancer, glioblastoma, and DMG with single agent ONC201, EZH2 inhibitor EPZ-6438 or PF-06821497, or the combination of ONC201 plus EPZ-6438 or ONC201 plus PF-06821497. Cell viability was determined with the Cell Titer-Glo assay. Integrated stress response (ISR) activation widely observed in ONC201-treated tumor cells was evaluated using Western blot analysis of ATF4. We determined TRAIL pathway activity by analysis of DR5, and apoptosis by analysis of PARP cleavage. The effect of EPZ-6438 or PF-06821497on the target was validated by immunoblotting of H3K27me3. We knocked down ATF4 with siRNA to evaluate the role of ISR in cell death. Our results demonstrate that ONC201 synergistically reduced cell viability in combination with EZH2i, induced integrated stress response and apoptosis in combination with EZH2i. There was greater induction of ATF4 and DR5 in combinatorial therapy-treated tumor cells versus monotherapy. Knockdown of ATF4 reduced the apoptosis induced by combination therapy. EPZ-6438 or PF-06821497 decreased H3K27 tri-methylation. Our study results unravel potent synergy between ONC201 and EZH2i, highlight the role of ISR in the synergy, and provide further insights into the role of H3K27me3 in ONC201 drug sensitivity.
Citation Format: Yiqun Zhang, Lanlan Zhou, Varun V. Prabhu, Joshua E. Allen, Attila A. Seyhan, Wafik S. El-Deiry. The integrated stress response (ISR) is involved in the synergistic combinatorial efficacy of ONC201 and epigenetic modulators in brain tumor cell lines [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1156.
Abstract 1396: Non-competitive inhibition of proteasome by kinase inhibitors
Authors: Kisselev Alexei F. , Akintola Olasubomi , Smith John 
Published: July 2021

Abstract
Inhibitors of Bruton's Tyrosine Kinase (BTK) and inhibitors of the proteasome are currently in use for treatment of hematologic malignancies. While the ubiquitin proteasome system is necessary for protein homeostasis in all mammalian cells, BTK is unique to some B cell malignancies. However, BTK inhibitors and LU-102, a specific inhibitor of the β2 site of the proteasome, have previously been shown to synergize in hematologic malignancies which do not express BTK, at a 100-fold higher concentration than is needed for complete inhibition of BTK, suggesting an off-target effect of these BTK inhibitors. Triple Negative Breast Cancer (TNBC), a cancer with poor prognosis and no current targeted therapy, also does not express BTK. We found that LU-102 and a specific BTK inhibitor, CGI-1764, are de-facto synthetically lethal to TNBC cells, and that effect of other BTK inhibitors varied from similar synergy to no synergy. This data further supports the idea that synergy is due to off-target effects of BTK inhibitors.We have now found that CGI-1764 is a non-competitive, allosteric inhibitor of all catalytic subunits of the proteasome 20S proteolytic core and exerts its effect in a unique, dose-dependent manner. RNA sequencing shows that the Unfolded Protein Response pathway is upregulated in TNBC cells response to treatment with the CGI-1746+LU-102 combination. We also found that accumulation of ubiquitin conjugates is synergistic indicating that the combination treatment has a synergistic effect on the inhibition of proteasome activity. These findings may pave the path to the development of more potent allosteric inhibitors of the proteasome and show that kinase inhibitors should be screened for inhibition of the proteasome as potential off-target effect.
Citation Format: Alexei F. Kisselev, Olasubomi Akintola, John Smith. Non-competitive inhibition of proteasome by kinase inhibitors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1396.