bluuebunny/crossref_metadata_2025_split huggingface dataset:
MRI-based radiomics: promise for locally advanced cervical cancer treated with a tailored integrated therapeutic approach
Authors: Laliscia Concetta , Gadducci Angiolo , Mattioni Roberto , Orlandi Francesca , Giusti Sabina , Barcellini Amelia , Gabelloni Michela , Morganti Riccardo , Neri Emanuele , Paiar Fabiola 
Published: July 2021

Objective: To assess prognostic factors by analyzing clinical and radiomic data of patients with locally advanced cervical cancer (LACC) treated with definitive concurrent cisplatin-based chemoradiotherapy (CCRT) using magnetic resonance imaging (MRI). Methods: We analyzed radiomic features from MRI in 60 women with FIGO (International Federation of Gynecology and Obstetrics) stage IB2–IVA cervical cancer who underwent definitive CCRT 45–50.4 Gy (in 25–28 fractions). Thirty-nine (65.0%) received EBRT sequential boost (4–20 Gy) on primary tumor site and 56 (93.3%) received high-dose-rate brachytherapy boost (6–28 Gy) (daily fractions of 5–7 Gy). Moreover, 71.7% of patients received dose-dense neoadjuvant chemotherapy for 6 cycles. The gross tumor volume was defined on T2-weighted sequences and 29 features were extracted from each MRI performed before and after CCRT, using dedicated software, and their prognostic value was correlated with clinical information. Results: In univariate analysis, age ⩾60 years and FIGO stage IB2–IIB had significantly better progression-free survival (PFS) ( p = 0.022 and p = 0.009, respectively). There was a trend for significance for worse overall survival (OS) in patients with positive nodes ( p = 0.062). In multivariate analysis, only age ⩾60 years and FIGO stage IB2–IIB reached significantly better PFS ( p = 0.020 and p = 0.053, respectively). In radiomic dataset, in multivariate analysis, pregray level p75 was significantly associated with PFS ( p = 0.047), pre-D3D value with OS ( p = 0.049), and preinformation measure of correlation value with local control ( p = 0.031). Conclusion: The combination of clinical and radiomics features can provide information to predict behavior and prognosis of LACC and to make more accurate treatment decisions.
Clinical-Grade MRI-Based Methods to Identify Combined Anatomic Factors That Predict ACL Injury Risk in Male and Female Athletes
Authors: Beaulieu Mélanie L. , Nowak Emma K. , Beynnon Bruce D. , Ashton-Miller James A. , Sturnick Daniel R. , Wojtys Edward M. 
Published: July 2021

Background: Recently developed multivariate sex-specific statistical models can predict anterior cruciate ligament (ACL) injury risk using various knee anatomic factors. However, screening tools able to identify individuals at an increased injury risk are unlikely to be developed based on these models, given that sophisticated and time-consuming methods were used to measure those factors on research-grade resolution magnetic resonance images (MRIs). Purpose: To determine whether simpler methods, amenable to using clinical-grade resolution MRIs, can identify the same knee anatomic factors previously found to contribute to ACL injury risk using sophisticated methods and research-grade resolution images. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: High-resolution 3-dimensional MRIs previously acquired from 87 patients with primary, noncontact, grade III ACL injury and 87 uninjured matched control participants for a series of published studies were downgraded to clinical-grade resolution images. The 4 knee anatomic factors found to contribute to ACL injury risk in women and in men in these published studies—femoral intercondylar notch width at the anterior outlet of the ACL (NW_O), posterior-inferior directed slope of the middle region articular cartilage surface of the tibial plateau’s lateral compartment (LatTibMCS), ACL volume, and tibial plateau’s lateral compartment posterior meniscus to subchondral bone wedge angle (LatTibMBA)—were measured using clinical-grade resolution MRI-based methods. Stepwise multivariate conditional logistic regressions were used to identify the combinations of factors most highly associated with an ACL injury risk in women and men separately. Results: The multivariate model that best predicted ACL injury risk in the female participants included the LatTibMCS and the NW_O. For the male participants, this model included the ACL volume and the LatTibMBA. These results corroborate the previously published results that reported models with the same knee anatomic factors to best predict injury risk in this group of young women and men. Conclusion: Simpler methods using MRIs downgraded to a clinical-grade resolution can identify the same knee anatomic factors previously found to significantly contribute to ACL injury risk using sophisticated methods and research-grade resolution MRIs.
Effectiveness of School-Based Child Sexual Abuse Prevention Programs in China: A Meta-Analysis
Authors: Zhang Huiping , Shi Rui , Li Yali , Wang Yang 
Published: July 2021

Purpose: Although the number of school-based education programs for child sexual abuse (CSA) prevention has recently increased in China, little is known about their effectiveness. This meta-analysis aimed to examine the effectiveness of school-based CSA prevention programs on improving children’s knowledge and skills, which can prevent them from being sexually abused. Method: Systematic searches were conducted based on five English-language databases (PubMed, Web of Science, ScienceDirect, MEDLINE, and PsycINFO) and three Chinese databases (CNKI, Wan Fang Data, and CQVIP). Seven studies with 2,593 participants finally met the quality criteria of this review, and the meta-analysis was conducted using a random effect model. Results: The overall effect sizes of school-based CSA prevention education showed a significant improvement in children’s knowledge ( d = 2.53, 95% CI [2.03, 3.04]) and skills ( d = 2.00, 95% CI [1.39, 2.60]). Programs instructed by researchers were more effective than those instructed by teachers, and preschoolers had a larger increase in both knowledge and skills than elementary and middle school students. Discussion: This study provides empirical evidence for further implementation of school-based CSA prevention programs, especially under the guidance of experienced researchers and conducted for students at an early age.
Assessing Adherence to Audiologic Parameters of Care for Children With Cleft Palate: A Quality Improvement Initiative
Authors: Findlen Ursula M. , Grischkan Jonathan , Alston Sandra , Durinka Lauren , Baylis Adriane 
Published: July 2021

Objective: To evaluate and increase adherence to an evidence-based audiologic management protocol for children with cleft palate. Design: Prospective, multidisciplinary quality improvement initiative. Setting: Tertiary pediatric hospital. Patients, Participants: Children with cleft palate (with or without cleft lip) between the ages of 0 and 5 years (n = 205). Interventions: A multidisciplinary team identified key drivers for nonadherence to recommended audiological follow-up and implemented interventions to improve adherence. Key drivers included provider practices and preferences, clinic logistics and flow, and patient/family awareness and education. Several interventions were implemented between 2016 and 2020, including developing an evidence-based audiologic protocol, maximizing access to audiologic clinic visits across multiple departments, cleft team education, and improved team communication. Main Outcome Measure(s): Completion of recommended audiologic assessment at 5 separate care milestones. Results: After implementation of interventions between 2016 and 2020, adherence to recommended audiologic follow-up increased from 59% to 84%. Analysis of individual care milestones revealed that increased access to audiologic testing during team clinics resulted in the largest increase in adherence to recommended follow-up. Additionally, cause-effect analysis revealed that nonadherence due to provider-related causes decreased over the project period to a greater extent than patient/family-related causes. Conclusions: Implementation of an evidence-based audiologic care protocol and improvements in access to early hearing care are feasible in a high-volume multidisciplinary cleft clinic. Adherence to recommended audiologic management can be improved by establishing strategies to improve access to care, team member and family education, and enhanced team communication.
Spine eburnation in a metastatic lung cancer patient treated with immunotherapy and radiotherapy. The first case report of bystander effect on bone
Authors: Parisi Silvana , Napoli Ilenia , Lillo Sara , Cacciola Alberto , Ferini Gianluca , Iatì Giuseppe , Pontoriero Antonio , Tamburella Consuelo , Davì Valerio , Pergolizzi Stefano 
Published: July 2021

Introduction Metastatic non-small cell lung cancer (NSCLC) is nowadays treated with a multimodal therapeutic approach including immunotherapy, targeted therapy and radiotherapy. Radiation therapy, in addition to immune checkpoint inhibitors, gives rise to a particular radiobiological effect known as “bystander effect” consisting of the radiation-induced damage in nearby unirradiated cells. Case report We report a case of a 79-year-old female patient with stage IV NSCLC treated with concomitant immuno-radiotherapy who showed a bystander effect on bone. Management and outcome: Primary tumour biopsy revealed an adenocarcinoma with a PDL1 expression >50%, while staging exams showed a right pulmonary lesion with a partial involvement of the contiguous rib and a single brain metastasis. The patient refused chemotherapy, so that Pembrolizumab 2 mg/Kg was administered every 3 weeks. After two administrations, the single brain metastasis was treated using stereotactic radiosurgery while the site of primitive lung cancer received an 8 Gy-single fraction 3 D-conformal radiotherapy. Three months after irradiation a chest CT showed a radiological remission of about 10% of the GTV and a partial eburnation of the vertebra located nearby the target volume. The CT images of a PET/CT at six months showed a complete vertebral eburnation. At the last follow-up, the patient was free of disease (brain MRI, spinal MRI and PET/CT). Discussion The present case alerts for unusual side effects provoked by bystander phenomenon in patients treated with a combination of immunotherapy and irradiation. Immune activation exacerbates the bystander effect causing normal tissues toxicities beyond what immunotherapies are causing by themselves.
A case of palmar hypopigmentation induced by capecitabine in a gastrointestinal cancer patient
Authors: Gratiaux Julian , Gossery Chloé , Rezzag-Mahcene Chirine , Botsen Damien , Visseaux Laetitia , Slimano Florian , Bouche Olivier 
Published: July 2021

Introduction Capecitabine is an antimetabolite antineoplastic agent widely used in the treatment gastrointestinal cancers. The common frequently reported cutaneous adverse drug reaction associated with capecitabin are a palmar-plantar erythrodysesthesia syndrome, rash and hyperpigmentation. This case reports a capecitabine-induced palmar hypopigmentation. Case report We report the case of a 74-years old patient with jejunum adenocarcinoma treated by capecitabine. The patient developed a pseudo-vitiligo after 2 cycles capecitabine and without history of cutaneous disorders. The skin lesions were characterized with skin hypopigmentation on both hands. Management and outcome: The hypopigmentation slowly recovered after capecitabine discontinuation. Conclusion This is the first described case of pseudo-vitiligo induced by capecitabine. This impressive but non-severe adverse effect should be known by oncologists and oncology pharmacists to reassure the patients in particular about the possible recovery after discontinuation of capecitabine.
Partial laryngectomy for the management of laryngeal masses in six cats
Authors: Moser Jasmine , Haimel Georg , Tichy Alexander , Findji Laurent 
Published: July 2021

Objectives Partial laryngectomy is an organ-sparing surgical procedure for the removal of laryngeal masses which has not been described in cats. The aim of this study was to report on the surgical procedure and the short- and long-term clinical outcomes of cats that underwent partial laryngectomy. Methods Medical records were retrospectively collected over a 4-year period in two institutions. The following data were retrieved: signalment, history, clinical signs, diagnostic test results, surgical procedure, postoperative management, complications and outcome. Results Six cats underwent partial laryngectomy. The most common clinical signs in cats with laryngeal masses were stridor (n = 4) and dyspnoea (n = 4). In all cats, a full-thickness portion of one or several laryngeal cartilages was resected, including thyroid cartilage alone (n = 2), thyroid cartilage and arytenoid (n = 2), and arytenoid cartilage and epiglottis (n = 2). The resected laryngeal masses were reported to be lymphoma (n = 3), carcinoma (n = 1), laryngeal cyst (n = 1) and inflammatory laryngeal disease (n = 1). All cats survived the surgical intervention of partial laryngectomy. Four cats showed varying degrees of respiratory distress in the short-term postoperative period. A temporary tracheostomy tube was placed in two cats. No other postoperative complications were noted in the short- or long-term. Four cats were still alive at the time of writing. These cats survived at least 252 days. Conclusions and relevance In a small number of cases, our results show that successful long-term outcomes after partial laryngectomy are achievable, with longer survival times than previously reported. Therefore, partial laryngectomy should be considered as a viable treatment option in cats with laryngeal masses.
Salivary Heme Oxygenase-1: A Potential Biomarker for Central Neurodegeneration
Authors: Galindez Julia M , Juwara Lamin , Cressatti Marisa , Gornitsky Mervyn , Velly Ana M , Schipper Hyman M 
Published: July 2021

Background: Parkinson disease (PD) is the second most common neurodegenerative disease, affecting 2% of the population over 65 years of age. PD diagnosis is based on clinical examination and can only be confirmed during autopsy. In 2018, we reported that heme oxygenase-1 (HO-1), an inducible stress response protein important for heme catabolism and implicated in PD pathology, was higher in PD saliva relative to healthy controls, suggesting that salivary HO-1 may serve as a potential biomarker of PD. Objectives: To ascertain whether HO-1 protein levels are elevated in PD saliva relative to degenerative neurological, non-degenerative neurological and healthy controls. Methodology: The study included 307 participants comprising 75 participants with idiopathic PD and 3 control groups: 162 non-neurological, 37 non-PD degenerative neurological, and 33 non-degenerative neurological participants. Salivary HO-1 and total protein concentrations were measured using ELISA and BCA assay, respectively. Receiver operating characteristic (ROC) curves were used to estimate model discrimination. Analyses were adjusted by age, sex, total protein, and relevant comorbidities. Results: Elevated HO-1 concentrations were observed in the PD group and other neurodegenerative conditions compared to subjects with no neurological or non-degenerative neurological conditions. ROC curves using HO-1 levels and covariates yielded areas under the curve above 85% in models for PD or neurodegenerative conditions versus controls. Conclusions: Salivary HO-1 concentrations in combination with covariates may provide a biomarker signature that distinguishes patients with neurodegenerative conditions from persons without. Classification of evidence: This study provides Class III evidence that salivary HO-1 multivariable models can distinguish neurodegenerative conditions.
Getting the whole story: Integrating patient complaints and staff reports of unsafe care
Authors: Van Dael Jackie , Gillespie Alex , Reader Tom , Smalley Katelyn , Papadimitriou Dimitri , Glampson Ben , Marshall Daniel , Mayer Erik 
Published: July 2021

Objective It is increasingly recognized that patient safety requires heterogeneous insights from a range of stakeholders, yet incident reporting systems in health care still primarily rely on staff perspectives. This paper examines the potential of combining insights from patient complaints and staff incident reports for a more comprehensive understanding of the causes and severity of harm. Methods Using five years of patient complaints and staff incident reporting data at a large multi-site hospital in London (in the United Kingdom), this study conducted retrospective patient-level data linkage to identify overlapping reports. Using a combination of quantitative coding and in-depth qualitative analysis, we then compared level of harm reported, identified descriptions of adjacent events missed by the other party and examined combined narratives of mutually identified events. Results Incidents where complaints and incident reports overlapped (n = 446, reported in 7.6%’ of all complaints and 0.6% of all incident reports) represented a small but critical area of investigation, with significantly higher rates of Serious Incidents and severe harm. Linked complaints described greater harm from safety incidents in 60% of cases, reported many surrounding safety events missed by staff (n = 582), and provided contesting stories of why problems occurred in 46% cases, and complementary accounts in 26% cases. Conclusions This study demonstrates the value of using patient complaints to supplement, test, and challenge staff reports, including to provide greater insight on the many potential factors that may give rise to unsafe care. Accordingly, we propose that a more holistic analysis of critical safety incidents can be achieved through combining heterogeneous data from different viewpoints, such as through the integration of patient complaints and staff incident reporting data.
The effectiveness of telehealth for a caregiver wellness program
Authors: Serwe Katrina M , Walmsley Angela LE 
Published: July 2021

Introduction This study compared outcomes of a telehealth and in-person delivered caregiver wellness program called Powerful Tools for Caregivers (PTC). Methods A total of 11 pairs of PTC class leaders delivered in-person and telehealth PTC classes. Caregiver participants completed a health-related questionnaire one week before, one week after, and six months after completing the program. A split-plot, mixed-design analysis of variance (ANOVA) and t tests were used to examine attendance and health-related outcome measures: depression as measured by the Center for Epidemiological Studies Depression Scale-Revised (CESD-R), caregiver experience as measured by the Bakas Caregiving Outcomes scale (BCOS), caregiver self-efficacy, and number of negative self-care behaviors. Results A total of 72 caregivers attended PTC in-person and 42 attended via telehealth. Mean attendance was 4.97 ± 1.21 for the in-person group and 5.21 ± 0.071 for the telehealth group, with no significant difference between delivery formats t(112) = 1.074, p = 0.285; 23 caregivers completed all three assessment periods for ANOVA. Interaction of group and time was non-significant for all outcome measures and the main effect of group was only significant for CESD-R scores at pre-PTC assessment, indicating that there were no differences between the two delivery formats for outcomes at post test or six months. The effect of time was significant for all outcome measures, indicating both in-person and telehealth participants improved on health-related outcomes over time. Discussion Telehealth is an effective delivery format for PTC – a traditionally in-person caregiver wellness program. This trial was registered [ClinicalTrials.gov identifier: NCT03800238].
Literacy instruction for autistic children who speak languages other than English
Authors: Bailey Benjamin , Arciuli Joanne 
Published: July 2021

Much of what is known about autism and literacy instruction is derived from studies including monolingual English-speaking children. Yet, less than one-fifth of the world’s population are English speakers. This review examines the research on literacy instruction for children with autism learning to read and write in languages other than English. A systematic search of the literature identified potentially relevant publications, a relatively small number of these met inclusion criteria. The included studies investigated instruction methods targeted at word reading and spelling, reading comprehension, and written expression for autistic children learning to use alphabetic, syllabary or logosyllabary writing systems. Autistic children benefitted from literacy instruction methods designed for typically developing children. However, some studies showed that additional skills and supports may be required. The included studies also highlight some potential differences in effective instruction practices used when working with autistic children learning alphabetic, syllabary and logosyllabary writing systems. Studies tended to include small samples. We hope this review will bring increased awareness and research efforts in the area of autism and global literacy. Lay abstract Many autistic children across the globe speak languages other than English. However, much of the research about teaching children with autism to read and write is derived from studies including people who speak English and no other languages. Here, we review the research on teaching children with autism to read and write in languages other than English. We did this because the world’s languages, and the ways they are represented in written form, vary greatly. A broader overview that encompasses languages other than English can help us better understand how learning to read and write can be supported for autistic children around the world. The studies included in our review highlight some potential differences in effective literacy teaching for autistic children learning to read and write using different writing systems. The studies we reviewed tended to include relatively small samples of autistic children, among other limitations. We hope that our review will increase awareness and research efforts in the area of autism and global literacy.
Coil-In-Plug Technique Using the Amplatzer Vascular Plug II to Occlude a Portosystemic Shunt
Authors: Nagatomi Satoru , Ichihashi Shigeo , Yamamoto Hiroshi , Bolstad Francesco , Kichikawa Kimihiko 
Published: July 2021

Introduction The family of Amplatzer Vascular Plugs (AVPs) is characterized by their precise deployment and high resistance to migration. However, a risk of recanalization of the embolized vessels has been reported. To augment the effectiveness of embolization, the coil-in-plug (CIP) technique was developed, exclusively using AVP I or IV. However, these plugs cannot be used for large vessels like portovenous shunt because of the size limitation. AVP II has a larger-sized model up to 22 mm. This article reports two cases of embolizing high-flow and large-caliber portosystemic shunts where the CIP technique with multilayer AVP II was effectively employed. Materials and methods The CIP technique using AVP II was utilized for one case with a portocaval shunt and another with a splenorenal shunt. CIP was established with wire penetration through the multilayer meshes, followed by a microcatheter insertion. After the microcatheter was positioned in the central lobe, the internal space was embolized tightly using pushable or detachable coils. Results A use of guidewire with a high tip load enabled an establishment of CIP and complete occlusion of the target vessels immediately without migration of the embolic devices in both cases. The symptom of encephalopathy improved after the procedure in both the case of the portocaval and the splenorenal shunt. Conclusion The CIP technique with the AVP II was safe and effective to achieve complete occlusion of the large-caliber portosystemic shunts.