bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subdivision of de novo metastatic nasopharyngeal carcinoma based on tumor burden and pretreatment Epstein-Barr virus DNA for therapeutic guidance of primary tumor radiotherapy
Authors: Yang Jin-Hao , Sun Xue-Song , Xiao Bei-Bei , Liu Li-Ting , Guo Shan-Shan , Liang Jia-dong , Jia Guo-Dong , Tang Lin-Quan , Chen Qiu-Yan , Mai Hai-Qiang 
Published: February 2021

Abstract
Purpose: To improve individualized treatment of de novo metastatic nasopharyngeal carcinoma (dmNPC) patients by investigating prognostic factors and identifying patients who achieved better survival outcomes after locoregional radiotherapy (LRRT).Materials and methods: Our study included a cohort of 498 dmNPC patients. Overall survival (OS) was the primary endpoint. We analyzed the correlation of all potential prognostic factors and survival outcomes by Kaplan-Meier survival curves using log-rank test and Cox proportional hazards regression model.Results: Multivariate analysis identified three independent prognostic factors: Epstein-Barr virus (EBV) DNA, number of metastatic lesions, and number of metastatic organs. Through these factors, we successfully divided all patients into 3 subgroups: low-risk (single metastatic organ, EBV DNA ≤ 25,000 copies/ml, and ≤ 5 metastatic lesions), intermediate-risk (single metastatic organ, EBV DNA > 25,000 copies/ml, and ≤ 5 metastatic lesions), and high-risk (multiple metastatic organs or > 5 metastatic lesions or both). By comparing LRRT and non-RT groups, we found statistical differences in OS in the low-risk and intermediate-risk subgroups (p = 0.039 and p = 0.010, respectively) but no significant difference in OS in the high-risk subgroup (p = 0.076). Further multivariate analysis of different risk stratifications revealed that LRRT was a protective factor only for the low- and intermediate-risk subgroups.Conclusions: The risk stratification of dmNPC may be used as a new prognostic factor to help clinicians organize individualized LRRT treatment to improve the survival outcomes of dmNPC patients.
Bone char from an invasive aquatic species "devilfish" as a sustainable adsorbent for the removal of fluoride in water for human consumption
Authors: Cruz-Briano Sergio Armando , Medellín-Castillo Nahum Andrés , Torres-Dosal Arturo , Leyva-Ramos Roberto , Moreno-Piraján Juan Carlos , Giraldo-Gutiérrez Liliana , Ilizaliturri-Hernández César Arturo , Díaz-Flores Paola Elizabeth , Reyes-López Simón Yobanny , Ocampo-Pérez Raúl , Rodríguez-Estupiñan Jenny Paola , Aldama-Aguilera Cristóbal 
Published: February 2021

Abstract
In this study, bone chars were obtained from an alien acuatic species “devilfish” bones by pyrolysis of 500–800°C. Bone chars were evaluated as a sustainable adsorbent of fluoride, it was found pyrolysed bone char at 500°C adsorbed the most amount of fluoride. The effect of pH indicated that the adsorption capacity increased as the pH decreased. Thermodynamic parameters of fluoride adsorption on devilfish bone chars were estimated as ΔH°= 7.213 kJ mol− 1, ΔG°= 23.61 kJ mol− 1 and ΔS° = 103.4 J mol− 1 K− 1 indicating that adsorption is endothermic, spontaneous and with great affinity of fluoride on bone char from devilfish. The fluoride desorption study showed that fluoride is desorbed from the material of 0.24 to 20.06 %, so the adsorption is considered to be partly reversible. The regeneration of the bone char at 400, 500 and 600°C was studied and it was noted that its adsorption capacity decreases slightly so it could be considered appropriate for the use in water treatment technologies. Adsorption of fluorides from drinking well water of a rural community with dental fluorosis problems and high levels of fluoride in water, revealed that by increasing the amount of the bone char of 0.05 to 0.8 g, the disposal of fluoride increases from 69.1 to 98.7 %. Lastly, it was established that the bone char synthesized from devilfish is a low-cost, viable a sustainable material to remove fluorides from water and represents an environmental management strategy of this alien species.
How Do People With Dementia Make Sense of Their Medications? An Interpretative Phenomenological Analysis Study
Authors: Lim Rosemary , Sharmeen Taniya , Donyai Parastou 
Published: February 2021

Abstract
BACKGROUND: Managing medication is complex and multifaceted for people with dementia and their family carers. Despite efforts to support medication management, medication errors and medication-related hospital admissions still occur. This study investigated how people with dementia viewed and talked about their medications and medication-taking. METHODS: An interpretative phenomenological approach (IPA) qualitative research design combining photo elicitation and in-depth interviews was used. People with a diagnosis of mild or moderate dementia confirmed with Montreal Cognitive Assessment, took photographs of anything they viewed to be related to medication, with/out the help of family carers, over any two-day period. The photographs were then used as cues for a subsequent in-depth interview. Interview data were analysed using IPA.RESULTS: Twelve people with dementia were interviewed. In-depth analysis of interviews generated four themes: 1) Medication as a lifeline, 2) Overcoming the uncertainty about the effectiveness of donepezil, 3) Managing medications dominate daily lives and plans and 4) Sense of being and being in control. People with dementia view donepezil as a lifeline but some continually struggle to know whether it helps their condition. Despite this uncertainty, people with dementia continue to take their medications. Managing medications dominates their daily lives and plans and redefines them. CONCLUSIONS: This study provided unique insights into how people with dementia make sense of their medication. Healthcare professionals can use these insights to shape their practice around medication prescribing and advice. The findings are also useful to researchers looking to develop interventions to support medication management within the home setting.
CRISPR/Cas9-mediated Base-editing Enables a Chain Reaction Through Sequential Repair of sgRNA Scaffold Mutations
Authors: Fukushima Tsuyoshi , Tanaka Yosuke , Adachi Keito , Masuyama Nanami , Asada Shuhei , Ishiguro Soh , Mori Hideto , Seki Motoaki , Yachie Nozomu , Goyama Susumu , Kitamura Toshio 
Published: February 2021

Abstract
Cellular behavior is governed by the complex gene regulatory networks. Although studies have revealed diverse roles of individual genes, it has been a challenge to record or control the sequential genetic events in living cells. In this study, we designed two cellular chain reaction systems that enable sequential sgRNA expression in mammalian cells using a nickase Cas9 tethering of a cytosine nucleotide deaminase (nCas9-CDA). In these systems, the thymidine (T)-to-cytosine (C) substitutions in the scaffold region of sgRNA or TATA box containing loxP sequence (TATAloxP) are corrected by the nCas9-CDA, which leads to expression of next sgRNA. These reactions can proceed several times, thus generating cellular chain reactions. As a proof of the concept, we established a chain reaction through the repair of sgRNA scaffold mutations in 293T cells. Importantly, the results obtained in yeast or in vitro were not consistent with those in mammalian cells, suggesting that the in vivo chain reactions need to be optimized in appropriate cellular contexts. Our system may lay the foundation for building cellular chain reaction systems that have a broad utility in the future biomedical research.
Fresh Unstable Trochanteric Fracture in Elderly Patients: Mortality, Readmission and Reoperation After Primary Hemiarthroplasty
Authors: Lin Tzu-Chieh , Wang Pin-Wen , Lin Chun-Teng , Chang Yu-Jun , Lin Ying-Ju , Liang Wen-Miin , Lin Jeff 
Published: February 2021

Abstract
Objectives: Most unstable trochanteric fractures are treated with internal fixation often with high complication rates. Hemiarthroplasty is an alternative treatment to achieve early weight-bearing, early mobilization and acceptable functional outcomes. However, few have investigated the long-term outcomes after hemiarthroplasty for unstable trochanteric fracture. We investigated patients with fresh trochanteric fracture after primary hemiarthroplasty on their long-term outcomes, including mortality, readmission and reoperation.Methods: We studied a total of 2,798 elderly adults who had received hemiarthroplasty for fresh unstable trochanteric fracture from 2000 to 2010, and followed them up until the end of 2012. Survival analysis and Cox model were used to characterize mortality. Competing risk analysis and Fine and Gray model were used to estimate the cumulative incidences of the first readmission and the first reoperation.Results: The follow-up mortality rate for 1-year was 17.94%; 2-year, 29.76%; 5-year, 56.8%; and 10-year, 83.38%. The cumulative incidence of the first readmission was 16.4% for 1-year and 22.44% for 3-year. The cumulative incidence of the first reoperation was 13.87% for 1-year, 18.11% for 2-year, 25.79% for 5-year, and 38.24% for 10-year. Male, older age, larger CCI and lower insured amount were all risk factors for the overall mortality. Older age and larger CCI were risk factors for the first readmission. Older age was a protective factor for reoperation, which is likely due to the competing death.Conclusion: Results are consistent with hemiarthroplasty being a robust alternative treatment for unstable trochanteric fracture among a heterogeneous elderly population.
Determination of CLINDAMYCIN HCl in Capsules by New, Validated, Simple and Green Kinetic Spectrometric Method
Authors: Affas Shaza , Sakur Amir Alhaj 
Published: February 2021

Abstract
Background: simple, sensitive, free of organic solvents, kinetic spectrophotometric method has been developed for the determination of Clindamycin Hydrochloride, both in pure form and Capsules. Method used is based on reaction of Clindamycin with potassium iodide and potassium iodate in aqueous medium at (25 ±2 °c) to produce yellow colored tri iodide ions (I3-). the reaction is followed spectrophotometrically by measuring the absorbance at 350 nm wavelength during 40 minutes. Results: the effects of analytical parameters on reported kinetic methods were investigated. Under the optimized conditions, the initial rate and fixed time (at 10 min) methods were used for constructing the calibration graphs. The graphs were linear in concentration ranges 1-20 μg.ml-1 with limit of detection of 0.12 and 0.22 μg ml-1for the initial rate and fixed time methods, respectively. The results were satisfactory and the analytical performance for both methods was validated. Conclusion: The proposed methods have been applied to determine the components in capsules with an average recovery of 98.25% to 102.00% and the results are in good agreement with those found by the reference method.
Reporting Violations of European Charter of Patients’ Rights: Analysis of Patient Complaints in Croatia
Authors: Karačić Jasna , Viđak Marin , Marušić Ana 
Published: February 2021

Abstract
Background

The European Charter of Patients' Rights (ECPR) presents basic patients' rights in health care. We analysed the characteristics of patients' complaints about their rights through the official system and non-governmental organizations in Croatia.
Methods

The official system for patients ’complaints in Croatia does not have a common protocol but there are different modes for addressing patient complaints. In this cross-sectional study, we analysed the reports about patients’ complaints from the regional committees sent to the Ministry of Health and mapped the complaints received by the Croatian Association for the Protection of Patient’s Rights (CAPR) to ECPR.
Results

The official data from the Ministry of Health in 2017 and 2018 included only 289 individual complaints from 10 out of 21 counties. Complaints were most frequently related to secondary and tertiary healthcare institutions and details were not provided. CAPR had 301 complaints about violations of patients ’rights. The most common complaint was the Right of Access to health care (35.3%) followed by the Right to Information (29.9%) and the Right to Safety (21.7%). The fewest complaints were about the Right to Complain (1.9%), Right to Innovation (1.4%), Right to Compensation (1.4%), and Right to Preventive Measures (1.0%).
Conclusions

Reporting and dealing with patients’ complaints about violations of their patients’ rights is not effective in systems with parallel but uncoordinated complaints pathways. Mapping patient's complaints to the ECPR is a useful tool to assess the perception of patients’ rights and to plan actions to improve the complaints system for effective health care.
Multilocus sequence based systematics of Pseudomonas sp. from supraglacial site of Sikkim Himalaya and their adaptational strategies
Authors: Mukhia Srijana , Kumar Anil , Kumari Poonam , Kumar Rakshak , Kumar Sanjay 
Published: February 2021

Abstract
Background Being one of the most complex and diverse genera, deciphering the correct taxonomy of Pseudomonas species has always been challenging. This study investigates and resolves the taxonomic ambiguity of 11 strains of Pseudomonas obtained from the supraglacial site of East Rathong glacier. Since the supraglacial region represents an extreme, stressful environment, the inhabitant microorganisms must have evolved multiple adaptive traits that define their origin. Hence, for adaptation study, we examined the survivability of the 11 strains in physical conditions of freezing and ultraviolet radiation, and their ability to produce extracellular cold-active enzymes. Results Multilocus sequence analysis (MLSA) using five housekeeping genes (1140 polymorphic sites) supported the taxonomic assignment of these strains to Pseudomonas antarctica, further supported by their lesser mean genetic distances with P. antarctica (0.73%) as compared to P. fluorescens (3.65 %). The studied strains displayed significant tolerance to freezing for 96 hours as compared to the mesophilic control strain, while except 4 strains, all strains exhibited substantial tolerance to UV-C radiations, and all strains produced cold active enzymes as well. Conclusion MLSA successfully resolved the taxonomy of these significant group of bacteria from physical extremes of temperature and radiation. The isolates ERGC3:01 and ERGC3:05, owing to their polyadaptational attributes, may be considered promising for exploitation in various industries.
Trans-obturator Cable Fixation for Disrupted Pubic Symphysis: A Reasonable Option Compared to Plating?
Authors: Jordan Martin C. , Jaeckle Veronika , Scheidt Sebastian , Gilbert Fabian , Hoelscher-Doht Stefanie , Ergün Süleyman , Meffert Rainer H. , Heintel Timo M. 
Published: February 2021

Abstract
Operative treatment of ruptured pubic symphysis by plating is often accompanied by complications. Trans-obturator cable fixation might be a more reliable technique; however, have not yet been tested for stabilization of ruptured pubic symphysis. This study compares symphyseal trans-obturator cable fixation versus plating through biomechanical testing and evaluates safety in a cadaver experiment. APC type II injuries were generated in synthetic pelvic models and subsequently separated into three different groups. The anterior pelvic ring was fixed using a four-hole steel plate in Group A, a stainless steel cable in Group B, and a titan band in Group C. Biomechanical testing was conducted by a single-leg-stance model using a material testing machine under physiological load levels. A cadaver study was carried out to analyze the trans-obturator surgical approach. Peak-to-peak displacement, total displacement, plastic deformation and stiffness revealed a tendency for higher stability for trans-obturator cable/band fixation but no statistical difference to plating was detected. The cadaver study revealed a safe zone for cable passage with sufficient distance to the obturator canal. Trans-obturator cable fixation has the potential to become an alternative for symphyseal fixation with less complications.
Proteasome Inhibitor or Immunomodulators Which is The Optimal Maintenance For Newly Diagnosed Multiple Myeloma: A 7-Year Real-World Data in China.
Authors: Han Xiaoyan , Jin Chunxiang , Zheng Gaofeng , He Donghua , Zhao Yi , Li Yi , Wu Wenjun , Zheng Weiyan , Wei Guoqing , Zhang Enfan , He Huang , He Jingsong , Cai Zhen 
Published: February 2021

Abstract
Background: According to different patients’ subgroups choose optimal maintenance therapy. Methods: 226 Newly Diagnosed Multiple Myeloma (NDMM) patients in our center were included, the patients’ characteristics, survival, response, subgroup analysis, adverse reactions were compared between the patients with or without maintenance, proteasome inhibitor (PI) or immunomodulators (IMiDs) maintenance. And the survival of different maintenance duration of bortezomib-based regimens was also analyzed.Results: The maintenance therapy not only upgraded more patients’ response (34.3 vs. 13.3%, p= 0.006), but also significantly prolonged the patients’ PFS (median PFS: 41.1 vs. 10.5 months, p < 0.001) and OS (median OS: not reached vs. 38.6 months, p < 0.001). Compared with IMiDs, the PFS (median PFS: 43.7 vs. 38.5 months, p = 0.034) and OS (median OS: not reached vs. 78.5 months, p = 0.041) can both benefit from bortezomib-based maintenance. The patients younger than 65 years old with bortezomib-based maintenance significantly prolonged the OS (p= 0.032). Patients achieving the only partial response (PR) after induction and consolidation therapy experienced a significantly longer PFS and OS with bortezomib-based maintenance compared to IMiDs (p= 0.007, 0.002). Besides, the high-risk patients (ISS 2-3, DS 2-3 and RISS 2-3) with bortezomib-based maintenance can benefit PFS (p= 0.002, 0.02, 0.06, respectively) and OS (p=0.059, 0.047, 0.044, respectively) compared with IMiDs. The OS was significantly prolonged in the patients who received ≥12 months of bortezomib-based maintenance than those with maintenance < 12 months (p< 0.001), but no difference was observed in OS between the patients who received the 12-24 or ≥ 24months of bortezomib-based maintenance (p= 0.292).Conclusion: Maintenance therapy can significantly improve the survival of NDMM patients. Bortezomib-based regimens maintenance was more superior to IMiDs in overall PFS and OS. The beneficial effect is most evident in patients achieving the only PR after induction and consolidation therapy, and the high-risk patients. Moreover, younger patients also could benefit from bortezomib-based maintenance in OS. The bortezomib-based maintenance duration lasting 12-24 months after induction and consolidation therapy can reach a satisfactory OS.
Gender-specific association between unidirectional variation of cholesterol and cognitive decline: a longitudinal study of middle-aged and elderly adults
Authors: Liu Huamin , Zhou Rui , Zheng Jiazhen , Zhang Minyi , Wu Keyi , Huang Zhiwei , Yuan Zelin , Wu Xianbo 
Published: February 2021

Abstract
Background

Higher fluctuation of cholesterol has been shown associated with cognitive decline. But the association between unidirectional variation of cholesterol and cognition remains unclear. In the present study, we examined the association between variation of cholesterol from normal to high level or from high to normal level and cognition.
Methods

A total of 4,915 participants (mean age, 57.7 years; 49.2% female) with normal cognition in baseline (2011) from the China Health and Retirement Longitudinal Study (CHARLS) were included. Plasma total cholesterol (TC), non-high-density lipoprotein cholesterol (NHDL-C), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were divided into two clusters according to cutoff in 2011 and 2015, respectively. Participants were divided into four groups: normal-normal, normal-high, high-normal and high-high. Cognitive functions were assessed by episodic memory and mental intactness. The binary logistic regression was used to analyze the association of cholesterol variation with cognitive decline.
Results

Participants with increased cholesterol were more likely had lower incidence of cognitive decline. The fluctuations of cholesterol were more likely occurred in females. The odds ratio (OR) and 95% confidence interval (CI) of global cognitive decline in normal-high compared with normal-normal group of TC was 0.61 (0.36–1.03), and significant only in females [OR and 95% CI: 0.50 (0.26–0.97)]; the risk of memory function decline in high-normal group compared with high-high group was increased both in males [OR and 95% CI: 1.98 (1.02–4.05)] and females [OR and 95% CI: 1.61 (1.01–2.74)]. The similarly results were shown in NHDL-C groups [OR and 95% CI of global cognitive decline in normal-high group: 0.50 (0.26–0.95) for overall; 0.38 (0.17–0.85) for females]; but the risk of memory function decline in high-normal group only increased in females [OR and 95% CI: 1.64 (1.02–2.25)]. The risk of mental intactness decline in males significantly decreased in high-normal group of LDL-C compared with high-high group [OR and 95% CI: 0.30 (0.13–0.67)] and increased in high-high compared with normal-normal group [OR and 95% CI: 2.27 (1.18–2.98)].
Conclusions

Longitudinal decreasing of TC or NHDL-C is detrimental to cognitive function, especially in females. But LDL-C is still a risk factor of cognitive decline in males.
Modeling and Optimization of Reactive Cotton Dyeing Using Response Surface Methodology Combined with Artificial Neural Network
Authors: Rosa Jorge Marcos , Guerhardt Flavio , Júnior Silvestre Eduardo Rocha Rocha Ribeiro , Belan Peterson Adriano , Lima Gustavo Araujo , Santana José Carlos Curvelo , Berssaneti Fernando Tobal , Tambourgi Elias Basile , Vanale Rosangela Maria , Araújo Sidnei Alves de 
Published: February 2021

Abstract
This work explores the modeling and optimization of the conditions to obtain a set of blue pigments for dyeing reactive cotton, by means of an approach that combines the techniques response surface methodology (RSM) and artificial neural network (ANN). By means of RSM technique the interactions and the effects of the main process variables (factors) on the behavior of coloristic intensity (K.S-1) were investigated. For this, a 26 central composite rotational design (CCRD) was carried out considering the factors temperature, NaCl, Na2CO3, NaOH, processing time and RB5 concentration. The results obtained show that all investigated factors have considerable effect on the behavior of K.S-1. The data produced in the dyeing experiments were used to build and train a Multilayer Perceptron ANN (MLP-ANN) to predict K.S-1, being the input layer of the MLP-ANN designed according to the results achieved by the RSM. The non-linear behavior of dyeing with RB5 was successfully modeled by a three-layer MLP-ANN comprising 6 input neurons, 15 hidden neuros, and 1 output neuron to indicate the value of K.S-1. The results achieved in the performed simulations confirmed the ANN effectiveness to predict K.S-1 values in RB5 the dyeing process, with high coefficient of determination (R2=0.942). The developed approach allowed the composition of a table containing optimized conditions to obtain a set of colors of the blue palette using RB5 dye, varying from sky blue to oxford blue, which will facilitate the assembly of the dyes. Finally, the experiments conducted in this work allowed the development of a computational tool to support the dyeing process, saving chemical inputs and time in cotton dyeing with specific dyestuff.