bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dose escalation in oropharyngeal cancer: a comparison of simultaneous integrated boost and brachytherapy boost
Authors: Embring Anna , Onjukka Eva , Mercke Claes , Lax Ingmar , Berglund Anders , Friesland Signe 
Published: April 2023

Abstract
Background
Local recurrence is the most common pattern of failure in head and neck cancer. It can therefore be hypothesised that some of these patients would benefit from an intensified local treatment, such as radiation dose escalation of the primary tumour. This study compares treatment and toxicity outcomes from two different boost modalities in oropharyngeal cancer: simultaneous integrated boost (SIB) and brachytherapy boost.

Methods
Two hundred and forty-four consecutive patients treated with > 72 Gy for oropharyngeal squamous cell carcinoma between 2011 and 2018 at our institution were retrospectively analysed. Data on side effects were collected from a local quality registry and supplemented with a review of medical records. Patients receiving a brachytherapy boost first had external beam radiotherapy consisting of 68 Gy in 2 Gy fractions to the gross tumour volume (GTV), and elective radiotherapy to the neck bilaterally. The brachytherapy boost was typically given using pulsed dose rate, 15 fractions and 0.56–0.66 Gy per fraction [total dose in EQD2 = 75.4–76.8 Gy (α/β = 10)]. The typical dose escalated radiotherapy with external beam radiotherapy only, was delivered using SIB with 74,8 Gy in 2.2 Gy fractions [EQD2 = 76.0 Gy (α/β = 10)] to the primary tumour, 68 Gy in 2 Gy fractions to GTV + 10 mm margin and elective radiotherapy to the neck bilaterally.

Results
Dose escalation by SIB was given to 111 patients and brachytherapy boost to 134 patients. The most common type of cancer was base of tongue (55%), followed by tonsillar cancer (42%). The majority of patients had T3- or T4-tumours and 84% were HPV-positive. The 5-year OS was 72,4% (95% CI 66.9–78.3) and the median follow-up was 6.1 years. Comparing the two different dose escalation modalities we found no significant differences in OS or PFS and these results remained after a propensity-score matched analysis was performed. The analysis of grade ≥ 3 side effects showed no significant differences between the two different dose escalation techniques.

Conclusions
We found no significant differences in survival or grade ≥ 3 side effects comparing simultaneous integrated boost and brachytherapy boost as alternative dose escalation modalities in the treatment of oropharyngeal cancer.
Venoarterial extracorporeal membrane oxygenation for cardiac support in human immunodeficiency virus-positive patients: a case report and review of a multicentre registry
Authors: Laraghy Matthew , McCullough James , Gerrard John , Stroebel Andrie , Winearls James 
Published: April 2023

Abstract
Background
Human immunodeficiency virus (HIV) is associated with increased risk of heart failure via multiple mechanisms both in patients with and without access to highly active antiretroviral therapy (HAART). Limited information is available on outcomes among this population supported on Venoarterial Extracorporeal Membrane Oxygenation (VA ECMO), a form of temporary mechanical circulatory support.

Methods
We aimed to assess outcomes and complications among patients with HIV supported on VA ECMO reported to a multicentre registry and present a case report of a 32 year old male requiring VA ECMO for cardiogenic shock as a consequence of his untreated HIV and acquired immune deficiency syndrome (AIDS). A retrospective analysis of the Extracorporeal Life Support Organization (ELSO) registry data from 1989 to 2019 was performed in HIV patients supported on VA ECMO.

Results
36 HIV positive patients were reported to the ELSO Database who received VA ECMO during the study period with known outcomes. 15 patients (41%) survived to discharge. No significant differences existed between survivors and non-survivors in demographic variables, duration of VA ECMO support or cardiac parameters. Inotrope and/or vasopressor requirement prior to or during VA ECMO support was associated with increased mortality. Survivors were more likely to develop circuit thrombosis. The patient presented was supported on VA ECMO for 14 days and was discharged from hospital day 85.

Conclusions
A limited number of patients with HIV have been supported with VA ECMO and more data is required to ascertain the indications for ECMO in this population. HIV should not be considered an absolute contraindication to VA ECMO as they may have comparable outcomes to other patient groups requiring VA ECMO support.
Gender differences in symptom structure of adolescent problematic internet use: A network analysis
Authors: Liu Sihan , Zhang Di , Tian Yuxin , Xu Boya , Wu Xinchun 
Published: April 2023

Abstract
Background
Gender differences in problematic Internet use (PIU) have long been discussed. However, whether and how female and male adolescents differ in central symptoms and symptom associations are not fully understood.

Methods
As a national survey in the Chinese mainland, 4884 adolescents (51.6% females; Mage = 13.83 ± 2.41) participated in the present study. This study applies network analysis to identify central symptoms of PIU networks in female and male adolescents and compares whether and how global and local connectivity of PIU networks differ by gender.

Results
Female and male network structures of PIU were different and global strength was stronger in males than females, indicating a higher risk of chronicity of PIU among male adolescents. Specifically, “Reluctant to turn off Internet” exerted the largest effect on both genders. “Increase time online to achieve satisfaction” and “Feel depressed once not online for a while” were particularly critical to female and male adolescents, respectively. Moreover, females scored higher centralities in social withdrawal symptoms and males did so in interpersonal conflicts owing to PIU.

Conclusions
These findings provide novel insights into gender differential risks and features of adolescent PIU. Differences in the core symptoms of PIU suggest that gender-specific interventions focusing on core symptoms might effectively relieve PIU and maximize treatment effects.
The Canadian Healthy Life Trajectories Initiative (HeLTI) Trial: a study protocol for monitoring fidelity of a preconception-lifestyle behaviour intervention
Authors: Dennis Cindy-Lee , Marini Flavia , Prioreschi Alessandra , Dol Justine , Birken Catherine , Bell Rhonda C. 
Published: April 2023

Abstract
Background
In evaluating technology-based behaviour change interventions, it is increasingly important to have a monitoring plan for intervention fidelity. It is important to maintain intervention fidelity to ensure that the theory-based intervention that is being tested is what causes the observed changes, particularly for eHealth behaviour change interventions. In this protocol, we outline the intervention fidelity and monitoring protocol for Healthy Life Trajectory Initiative (HeLTI) Canada, a randomized controlled trial evaluating the effect of a preconception-early childhood technology-based intervention delivered by public health nurses among pregnancy-planning women and their partners to optimize child growth and development.

Methods
The HeLTI Canada fidelity protocol is based on the National Institutes of Health Behaviour Change Consortium (NIH BCC) Treatment Fidelity Framework, outlining the following components of intervention fidelity: study design, provider training, intervention delivery, intervention receipt, and intervention enactment. The intervention fidelity components and associated monitoring strategies were developed to align with the HeLTI Canada approach. Strategies for intervention fidelity monitoring include a pre-post written evaluation of training, standardization of provider training, use and monitoring of activity logs, and intervention session checklists. Possible challenges to intervention fidelity include provider turnover due to the length of the trial and lack of ability to directly monitor participant behaviour change in real-life settings. Details about intervention fidelity monitoring are provided in detail. The study launched in January 2021 and is currently recruiting.

Discussion
Using the NIH BCC Treatment Fidelity Framework, HeLTI Canada has a robust framework for monitoring and reporting intervention fidelity to improve intervention validity, ability to assess intervention effectiveness, and transparency.

Trial registration
ISRCN ISRCTN13308752. Registered on February 29, 2019.
Ultrasonography of the multifidus muscle in student circus artists with and without low back pain: a cross-sectional study
Authors: Rossini Bianca , Anstruther Meagan , Wolfe Daniel , Fortin Maryse 
Published: April 2023

AbstractBackgroundDegenerative structural changes and functional deficits of the lumbar multifidus (LM) muscle were observed in athletes with low back pain. While spinal injuries are common in circus artists, there is no information on LM characteristics in this population. The aims of this study were to investigate LM morphology and function and explore the relationship between LM characteristics and low back pain in male and female circus artists.Methods31 college circus students were recruited. Participants completed an online survey to acquire demographic data and low back pain history. Body composition was measured using multi-frequency bio-impedance analysis. Ultrasound examinations at the fifth lumbar vertebrae in prone and standing positions were performed to assess LM cross-sectional area, echo-intensity, thickness. Independent and dependent t-test assessed the difference between sex and side, respectively. The relationships between measures were assessed with Pearson’s correlations. The LM characteristics’ difference between artists with and without low back pain (group binary variable) was assessed with Analysis of covariance using lean body mass, height and % body fat as continuous covariates.ResultsMales had significantly larger LM cross-sectional area, lower echo-intensity and greater thickness change from rest to contracted than females. LM cross-sectional area asymmetry in prone was greater in artists reporting low back pain in the previous 4-weeks (p = 0.029) and 3-months (p = 0.009). LM measures were correlated with lean body mass, height, and weight (r = 0.40–0.77, p ≤ 0.05).ConclusionThis study provided novel insights into LM characteristics in circus artists. Greater LM asymmetry was observed in artists with a history of low back pain. In accordance with previous studies in athletes, LM morphology and function were highly correlated with body composition measurements.
Impact of intrauterine exposure to maternal diabetes on preterm birth: fetal DNA methylation alteration is an important mediator
Authors: Wang Guoying , Xu Richard , Zhang Boyang , Hong Xiumei , Bartell Tami R. , Pearson Colleen , Liang Liming , Wang Xiaobin 
Published: April 2023

AbstractBackgroundIn utero exposure to diabetes has been shown to contribute to preterm birth, though the underlying biological mechanisms are yet to be fully elucidated. Fetal epigenetic variations established in utero may be a possible pathway. This study aimed to investigate whether in utero exposure to diabetes was associated with a change in newborn DNA methylation, and whether the identified CpG sites mediate the association between diabetes and preterm birth in a racially diverse birth cohort population.MethodsThis study included 954 mother–newborn pairs. Methylation levels in the cord blood were determined using the Illumina Infinium MethylationEPIC BeadChip 850 K array platform. In utero exposure to diabetes was defined by the presence of maternal pregestational or gestational diabetes. Preterm birth was defined as gestational age at birth less than 37 weeks. Linear regression analysis was employed to identify differentially methylated CpG sites. Differentially methylated regions were identified using the DMRcate Package.Results126 (13%) newborns were born to mothers with diabetes in pregnancy and 173 (18%) newborns were born preterm, while 41 newborns were born both preterm and to mothers with diabetes in pregnancy. Genomic-wide CpG analysis found that eighteen CpG sites in cord blood were differentially methylated by maternal diabetes status at an FDR threshold of 5%. These significant CpG sites were mapped to 12 known genes, one of which was annotated to gene Major Histocompatibility Complex, Class II, DM Beta (HLA-DMB). Consistently, one of the two identified significant methylated regions overlapped with HLA-DMB. The identified differentially methylated CpG sites mediated the association between diabetes in pregnancy and preterm birth by 61%.ConclusionsIn this US birth cohort, we found that maternal diabetes was associated with altered fetal DNA methylation patterns, which substantially explained the link between diabetes and preterm birth.
The activation of mGluR4 rescues parallel fiber synaptic transmission and LTP, motor learning and social behavior in a mouse model of Fragile X Syndrome
Authors: Martín Ricardo , Suárez-Pinilla Alberto Samuel , García-Font Nuria , Laguna-Luque M. Luisa , López-Ramos Juan C. , Oset-Gasque María Jesús , Gruart Agnes , Delgado-García José M. , Torres Magdalena , Sánchez-Prieto José 
Published: April 2023

Abstract
Background
Fragile X syndrome (FXS), the most common inherited intellectual disability, is caused by the loss of expression of the Fragile X Messenger Ribonucleoprotein (FMRP). FMRP is an RNA-binding protein that negatively regulates the expression of many postsynaptic as well as presynaptic proteins involved in action potential properties, calcium homeostasis and neurotransmitter release. FXS patients and mice lacking FMRP suffer from multiple behavioral alterations, including deficits in motor learning for which there is currently no specific treatment.

Methods
We performed electron microscopy, whole-cell patch-clamp electrophysiology and behavioral experiments to characterise the synaptic mechanisms underlying the motor learning deficits observed in Fmr1KO mice and the therapeutic potential of positive allosteric modulator of mGluR4.

Results
We found that enhanced synaptic vesicle docking of cerebellar parallel fiber to Purkinje cell Fmr1KO synapses was associated with enhanced asynchronous release, which not only prevents further potentiation, but it also compromises presynaptic parallel fiber long-term potentiation (PF-LTP) mediated by β adrenergic receptors. A reduction in extracellular Ca2+ concentration restored the readily releasable pool (RRP) size, basal synaptic transmission, β adrenergic receptor-mediated potentiation, and PF-LTP. Interestingly, VU 0155041, a selective positive allosteric modulator of mGluR4, also restored both the RRP size and PF-LTP in mice of either sex. Moreover, when injected into Fmr1KO male mice, VU 0155041 improved motor learning in skilled reaching, classical eyeblink conditioning and vestibuloocular reflex (VOR) tests, as well as the social behavior alterations of these mice.

Limitations
We cannot rule out that the activation of mGluR4s via systemic administration of VU0155041 can also affect other brain regions. Further studies are needed to stablish the effect of a specific activation of mGluR4 in cerebellar granule cells.

Conclusions
Our study shows that an increase in synaptic vesicles, SV, docking may cause the loss of PF-LTP and motor learning and social deficits of Fmr1KO mice and that the reversal of these changes by pharmacological activation of mGluR4 may offer therapeutic relief for motor learning and social deficits in FXS.
High-grade large cell neuroendocrine carcinoma of the esophagus: a case report and review of the literature
Authors: Awada Hussein , Hajj Ali Adel , Bakhshwin Ahmed , Daw Hamed 
Published: April 2023

Abstract
Background
Neuroendocrine carcinomas are extremely rare in the esophagus as they represent less than 0.04% of all neuroendocrine tumors. To date, only 14 cases of poorly differentiated, high-grade esophageal NEC have been described in the literature. The majority of these patients presented with typical dysphagia symptoms. Due to its rarity, no standardized guidelines have been proposed to treat esophageal neuroendocrine carcinoma, although general recommendations suggest surgery with adjuvant chemoradiotherapy as the treatment of choice.

Case presentation
A 67-year-old previously healthy White male presented with a year-long intermittent nonspecific retrosternal discomfort, with the absence of any other symptoms. Esophagogastroduodenoscopy revealed an ulcerative mass in his lower esophagus, with concern of malignancy. Endoscopic ultrasound-guided biopsy revealed poorly differentiated neuroendocrine carcinoma of the esophagus with metastasis to a diaphragmatic lymph node. He was treated with neoadjuvant chemoradiation followed by surgery, and he has been in remission for over 5 years.

Conclusion
Here, we review the literature and report a unique case of a patient with a vague presentation of esophageal neuroendocrine carcinoma as he enters his sixth year of survival following neoadjuvant chemoradiotherapy.
$(\omega ,c)$-periodic solutions for a class of fractional integrodifferential equations
Authors: Alvarez E. , Grau R. , Meriño R. 
Published: April 2023

AbstractIn this paper we investigate the following fractional order in time integrodifferential problem $$ \mathbb{D}_{t}^{\alpha}u(t)+Au(t)=f \bigl(t,u(t) \bigr)+ \int _{-\infty}^{t} k(t-s)g \bigl(s,u(s) \bigr)\,ds, \quad t \in \mathbb{R}. $$

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is the Caputo derivative. We obtain results on the existence and uniqueness of $(\omega ,c)$
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-periodic mild solutions assuming that −A generates an analytic semigroup on a Banach space X and f, g, and k satisfy suitable conditions. Finally, an interesting example that fits our framework is given.
Retiform hemangioendothelioma of the breast in a man with 18F-flurodeoxyglucose accumulation on positron emission tomography: a case report
Authors: Ogura Kaoru , Shibasaki Yoko , Honda Satoshi , Akita Hidetaka , Aoki Nobuhiko , Chong Ja-Mun , Motoi Toru 
Published: April 2023

Abstract
Background
Retiform hemangioendothelioma (RH) is a rare, intermediate-grade vascular tumor that often arises in the trunk and extremities. The clinical and radiological features of RH remain largely unknown.

Case presentation
A male patient in his 70s presented with shortness of breath on exertion, and computed tomography incidentally revealed a tumor in his right breast. Positron emission tomography (PET) revealed moderate 18F-fluorodeoxyglucose (FDG) uptake in the tumor. RH was observed in the resected specimens. Three months after surgery, the patient was free of local recurrence and distant metastasis.

Conclusions
RH was found in the male breast and was accompanied by FDG uptake on PET. PET may be useful in diagnosing RH. Although metastasis is rare in RH, local recurrence may occur, and careful follow-up is required.
Intraoperative imaging in hip arthroplasty: a meta-analysis and systematic review of randomized controlled trials and observational studies
Authors: Lecoultre Yannic , Danek Jan , Rompen Ingmar F. , van de Wall Bryan J. M. , Haefeli Pascal C. , Beeres Frank J. P. , Babst Reto , Link Björn C. 
Published: April 2023

Abstract
Background
Intraoperative fluoroscopy (IFC) is gaining popularity in total hip arthroplasty (THA), with the aim to achieve better component positioning and therefore eventually reduced revision rates. This meta-analysis investigated the benefit of IFC by comparing it to intraoperative assessment alone. The primary outcome was component positioning and the secondary outcomes included complications and revision rates.

Methods
PubMed, Embase and Cochrane Central Register of Controlled Trials were searched for both randomized clinical trials (RCT) and observational studies. Effect estimates for radiographic cup position, offset/leg length difference and outliers from a safe zone were pooled across studies using random effects models and presented as a weighted odds ratio (OR) with a corresponding 95% confidence interval (95% CI).

Results
A total of 10 observational studies involving 1,394 patients were included. No randomized trials were found. IFC showed no significant reduction in acetabular cup position (inclination and anteversion), offset, leg-length discrepancies, revision (none reported) or overall complication rates.

Conclusion
The current meta-analysis found no differences in cup positioning, offset, leg length discrepancy, the incidence of complications or revision surgery. It should be acknowledged that the included studies were generally performed by experienced surgeons. The benefit of intraoperative fluoroscopy might become more evident at an early phase of the learning curve for this procedure. Therefore, its role has yet to be defined.
A pigmented lesion of the auricle and its significance: a case report
Authors: Rajendiran Abinaya , Amalanathan Sophia , Kishore Prathiba , Sinhasan Sankappa P. , Kumar Satish , Colbert Kumaran Alias Ramesh 
Published: April 2023

Abstract

Background
A pigmented lesion that progressively increases in size anywhere in the body is a matter of concern, and when it presents in the ear, it has various differential diagnosis, one among them being a benign nevus. In this case report, we present a rare and interesting case of a pigmented lesion in the aural concha and review the literature of the same.

Case presentation
A 40-year-old male presented with pigmented right aural conchal growth with easy bruising of 1-year duration. Initial evaluation reported as a possible hemangioma, and excision biopsy revealed a compound nevus.

Conclusion
Despite its rarity, we should consider compound nevus as a differential diagnosis of pigmented external ear lesions. Histopathological examination is considered confirmatory; hence, excision biopsy is the treatment of choice.
Readymade-image-sentence: protest aesthetics in a time of democracy post-1989
Authors: McInneny Anthony 
Published: April 2023

ABSTRACTJacques Rancière perceives the image as what is sayable and visible and 20C film montage as an Image-sentence: the closest proximity of parallel realities (Rancière 2007). Prohibited from public view, Marcel Duchamp’s 1917 Readymade revolution is re-membered in a photographic image: a fountain-urinal. On the mourning after WWII, George Orwell noted readymade-sentences of what could(n’t) be said (Duchamp 1997). Captured by Rene Magritte, the treachery of a painted-word-image-thought, could have been a film about what it wasn’t (Flavia, 2014). About now, Walter Benjamin saw an optical unconscious in the photograph miraculously inverting the awe of culture and nature. (Benjamin 2004) After 1989, Bruno Latour held this modern Constitution as equally anti-modern (before ever having been modern) and postmodern, after which there would be nothing, except the digital image (Latour 1993). Before this, Situationist International and Fluxus showed life as the other side art. Keep your coins, I want change, read millennial graffiti’s signature anonymity . With no True North, this portfolio-essay presents an Image of protest aesthetics in a time of democracy post-1989. Before, from a North in the South; after from southern hemisphere parallels; in-between from a South in the North. Overarching is a Pacific mirror. Each readymade-image-sentence has four cartoons and four, 200-word max. abstract captions.Keywords – aesthetics, protest, city, North-South, East-West