bluuebunny/crossref_metadata_2025_split huggingface dataset:
Photoscreener
Authors: Sabherwal Shalinder , Sharma Manasvini , Majumdar Atanu , Singh Birendra Pratap , Siddiqui Zeeshan , Sood Ishaana , Tibrewal Shailja , Ganesh Suma 
Published: February 2023

Background:
Although studies compare the accuracy of spot photoscreeners, few evaluate photoscreeners in community settings. To our knowledge, all studies from India have been purely hospital based, particularly in children under 5 years.

Aim:
The aim was to evaluate the effectiveness of using a commercially available photoscreener for pediatric vision screening in a community setting.

Settings and Design:
This cross-sectional comparative study was conducted from December 2018 to February 2019 in a north-eastern district of Delhi.

Methods:
The automated Spot™ Vision Screener was used to screen the vision of preschoolers. A result displayed as “complete eye exam recommended” on the photoscreener was considered as screening positive and the child was referred to the pediatric ophthalmology unit of a tertiary eyecare institution, as per predefined international guidelines.

Statistical Analysis:
Referral rate and positive predictive value (PPV) of using the photoscreener were considered as primary outcome measures.

Results:
A total of 1205 children were screened using a photo-screener. Almost 16.4% of them were identified and referred a significantly higher referral rate than that in the historic control (2.7%, P < 0.001). Nearly 51.5% of the referred children reported to the unit. The PPV of pediatric eye screening done in a community setting by the photoscreener for refractive error (RE) was 81.4%. Fifty-nine percent of the children detected with REs were found to be at risk of amblyopia. Mean spherical equivalent, sphere, and cylinder of final glass prescription were significantly different from that of photoscreener refraction.

Conclusion:
Photoscreener improves the referral rate and has a high PPV. It could be a standard tool to screen preschoolers in community settings.
Surgical resection of chemotherapy-insensitive pulmonary metastases in children with hepatoblastoma in China
Authors: Xie Huawei , Liu Gang , Shen Zhou , Xing Guodong , Xia Qiao , Wang Xianqiang , Huang Liuming 
Published: February 2023

Objective:
The objective of this study is to investigate the operation timing, methods, and outcome of pulmonary metastases of hepatoblastoma (HB) in children.

Methods:
The clinical and follow-up data of 53 children with pulmonary metastases of HB that were admitted to our hospital from January 2012 to December 2018 were retrospectively analyzed. The pediatric patients, 36 male and 17 female, aged 13–124 months with the median age of 41 months, and all underwent routine thoracotomy.

Results:
In the 53 cases, 77 lung metastatic tumors were resected. Further, 37 patients received only one operation, 10 received two operations, 4 received 3 operations, and 2 received 4 operations. Based on Kaplan–Meier analysis, the accumulative overall survival (OS) rates at 1, 3, and 5 years were 86.8%, 69.0%, and 57.0%, respectively (median OS time: 60 months; 95% CI: 50.675–69.709 months), and accumulative EFS (vent-free survival) rates at 1, 3, and 5 years were 86.8%, 67.0%, and 55.4%, respectively (median EFS time: 59 months; 95% CI: 49.519–68.578 months). According to univariate analysis, OS was significantly altered for patients with no more than 5 nodules (p = 0.023), lung metastases without extrapulmonary metastases (p = 0.000), and laterality (p = 0.029). Gender and age (less than three years) were not significantly related to survival. According to univariate analysis, lung metastases with extrapulmonary metastases could be considered as individual factor contributing to poorer prognosis.

Conclusion:
In this pediatric group, patients with residual nodules after chemotherapy of HB could benefit from surgical treatment, but the appropriate surgical indication of metastasectomy needs to be further investigated.
Bronchial artery chemoembolization with apatinib for treatment of central lung squamous cell carcinoma
Authors: Zhu Jun , Xu Xiaoqian , Chen Yaoyong , Wang Qiang , Yue Quanji , Lei Kaijian , Jia Yuming , Xiao Guo , Xu Guohui 
Published: February 2023

Objective:
To evaluation the clinical efficacy and safety of bronchial artery chemoembolization (BACE) combined with apatinib for treatment of advanced central lung squamous cell carcinoma (LSCC).

Methods:
Forty-seven patients with pathologically diagnosed stage IIIB or IV central LSCC that was not resectable were selected among hospital patients presenting after November 2016. Twenty-one patients were treated with BACE combined with apatinib; the remaining patients served as a control group treated with BACE alone. Objective response rate (ORR) and disease control rate (DCR) were evaluated with postoperative contrast-enhanced CT scans at 3, 6, and 12 months. Progression-free survival (PFS) curves were used to evaluate curative effects. Adverse events were recorded to assess safety.

Results:
BACE operations were successfully completed in all 47 patients. Significant differences were found at six and 12 months (P < 0.05). Median PFS was 322 days in the observation group and 209 days in the control group: a statistically significant difference (P = 0.042). One-year survival rates were 76.19% and 46.15% for observation and control patients, respectively; this difference was also significant (P = 0.037). Three patients in the observation group received emergency interventional embolization for hemoptysis, and patients with grade III or greater adverse reaction events (AE) accounted for 19.05% of patients (4/21); these subjects improved or were controlled after active treatment.

Conclusion:
BACE combined with apatinib is effective for treatment of advanced central LSCC, with definite short-term efficacy, controllable risk, and high safety. Investigation with a larger sample size is warranted to confirm study results.
Tumor regression during radiotherapy as a predictor of response in locally advanced nonsmall cell carcinoma
Authors: Thimmarayappa Arun , Ashok Nidhun V. , Pandey Rambha , Mohan Anant , Sharma Seema , Pandey Shivam 
Published: February 2023

Aims:
To compare the predicted response with observed response to treatment by measuring gross tumor volume-primary (GTVp) using onboard kilovoltage (kV) cone-beam computed tomography (CBCT), to analyze the serial tumor volumes during radiotherapy (RT) with serial tumor volumes during follow-up, and to identify the variables associated with survival outcomes.

Materials and Methods:
Between June 2017 and December 2019, 23 patients of histologically proven locally advanced nonsmall cell lung cancer (LA-NSCLC) received definitive chemoradiation. Serial kV-CBCT images X-ray volume imaging (XVI) were generated weekly for image guidance and were used to generate serial GTVp. Posttreatment follow-up images were used to generate follow-up GTVp. Relative volume regression (VR) during RT and relative response assessment (RA) during follow-up were defined from Avg Vol, of planning CT. The predicted progression model was generated from VR and analyzed against observed progression events. Regression–response model was generated to analyze VR against RA.

Results:
The median XVI vol1, XVI vol2, and XVI vol3 were 78.123, 56.571, and 48.513 cc during the 2nd, 4th, and 6th weeks of RT, respectively. The median VR0 was 11.777% in the 2nd-week, VR1 was 20.959% in the 4th week, and 33.661% in the 6th week. The predicted responders and progression using the VR were similar to the observed response during the follow-up. The prediction of both RA0 and RA1 obtained from VR2 was statistically significant. Predication of RA0 from VR1 tended towards significant (P=0.084). VR2 was statistically significant in predicting RA2 (P = 0.04). The median progression-free survival (PFS) was not reached and the median overall survival (OS) was 24.2 months (95% confidence interval, 20.3–28.2 months). There was no statistically significant difference in PFS and OS between Avg Vol ≤ 99.5 cc and > 99.5 cc or other clinical parameters.

Conclusions:
Tumor regression during RT is a potential predictor of response in LA-NSCLC. kV-CBCT is a strong tool in assessing tumor regression during RT.
The feasibility of dose escalation using intensity-modulated radiotherapy (IMRT) and intensity-modulated proton therapy (IMPT) with FDG PET/CT guided in esophageal cancer
Authors: Zhang Yiyuan , Fan Bingjie , Sun Tao , Xu Jin , Yin Yong , Chen Zhaoqiu , Zhu Jian , Yu Jinming , Hu Man 
Published: February 2023

Context:
Previous studies show that dose escalation for gross tumor volume (GTV) improves local control of esophageal cancer (EC). However, optimal boosting remains uncertain. Recently, functional imaging guidance to achieve dose escalation in high-risk areas of tumors has been proposed.

Aims:
This study evaluated the feasibility of dose escalation in tumor regions with high fluorodeoxyglucose (FDG) uptake using intensity-modulated radiotherapy (IMRT) and intensity-modulated proton therapy (IMPT).

Settings and Design:
GTVPET was defined as a high FDG uptake region with 50% SUVmax threshold for dose escalation. IMRT and IMPT plans were generated for three boosting modes: plan 50.4 (50.4 Gy in clinical target volume, CTV), plan 63 (50.4 Gy in CTV, 63 Gy in GTV), plan 70 (50.4 Gy in CTV, 63 Gy in GTV, and 70 Gy in GTVPET).

Methods and Material:
Eleven patients with squamous cell carcinoma were evaluated. Dose parameters for heart, lung, and spinal cord were compared based on the dose-volume histogram (DVH).

Statistical Analysis Used:
Paired t-test was performed on the doses to organs-at-risk (OARs) among plan 50.4, plan 63, and plan 70 for IMRT and IMPT.

Results:
Dosimetric parameters for IMRT for heart, lung, and spinal cord increased significantly for plan 63 and some parameters even exceeded dose limits for OARs. Further dose escalation in GTV-PET did not increase dosimetric parameters significantly. Most dosimetric parameters of OARs in IMPT exhibited no statistical change compared with plan 50.4, and doses to OARs were far less than dose constraints.

Conclusions:
Dose escalation by IMRT may lead to increased risk of radiation-related injury. Further dose escalation in high FDG uptake regions did not increase doses to OARs. This dose escalation is ideal for achieving better outcomes for EC treatment.
A mathematical model to predict the different isodose volumes using TRAK value in HDR intracavitary brachytherapy for revised Manchester and ICRU-89 based Point A plans using computer tomography images
Authors: Mourya Ankur , Choudhary Sunil , Sharma Neeraj , Shahi Uday Pratap , Singh Gaganpreet , Pradhan Satyajit , Aggarwal Lalit Mohan 
Published: February 2023

Purpose:
To find out the simple relationship between Total Reference Air Kerma (TRAK) and various isodose volumes. Calculated isodose volumes were compared with experimental data for revised Manchester and International Commission on Radiation Units and measurements (ICRU)-89 Point A-based treatment plans. The accuracy of the formula was compared with the results of other relationships available in the literature.

Materials and Methods:
Dosimetric data from 62 intracavitary brachytherapy (ICBT) treatment plans of 31 patients with cervical cancer were studied. Each patient had treatment plans normalized to revised Manchester and ICRU-89 Points A (Aflange and Aicru89). For each treatment plan, TRAK values, V350, V700, V1050, and V1400 were obtained. The modeling curve was plotted between Isodose volume (Vd) and the ratio of d/TRAK obtained from Aflange plans to get a mathematical relation. The results of this formula were compared with the experimental data and outcomes of other formulas available in the literature. A paired-sample t-test was performed to assess the statistical significance.

Results:
In the case of revised Manchester-based Aflange normalization plans, the mean isodose volume of V350, V700, V1050, and V1400 were 285.98 ± 32.3 cm3, 101.96 ± 10.63 cm3, 52.71 ± 4.72 cm3, and 31.44 ± 2.33 cm3 respectively. Likewise, for ICRU-89 based Aicru89 normalization plans, the mean isodose volumes of V350, V700, V1050, and V1400 were 304.11 ± 26.17 cm3, 108.88 ± 8.29 cm3, 56.62 ± 3.69 cm3 and 34 ± 2.23 cm3 respectively. The mean difference was significant. The Mathematical relationship developed was [INLINE:1]. No correlation was found between TRAK and D0.1cm
3,D2cm
3 for organs at risk.

Conclusions:
The developed formula calculated isodose volumes within the accuracy of ± 3% in ICBT plans.
Clinical impact of extended field radiation therapy in Stage III carcinoma cervix versus conventional field techniques
Authors: Daga Prateek , Kumar H. S. , Sharma Neeti , Jakhar Shankar Lal , Harsh Kamlesh Kumar , Dhaka Saroj 
Published: February 2023

Aim:
The aim of the study was to examine tumor control and clinical outcomes of extended field irradiation and compare it with those treated with conventional field in same disease profile and also to determine toxicities associated with radiation treatment.

Methods:
This study included 50 biopsy-proven and registered International Federation of Gynecology and Obstetrics Stage III cases of carcinoma cervix treated with concurrent computed tomography (injection cisplatin 40 mg/m2 weekly) + external beam radiotherapy (EBRT) upto 50 Gy + high-dose-rate intracavitary brachytherapy (ICBT) (22.5 Gy). Twenty-five patients were randomized to each arm. Arm A: Conventional field EBRT 50 Gy with concurrent weekly chemotherapy followed by ICBT. Arm B: Extended field EBRT 50 Gy with concurrent weekly chemotherapy followed by ICBT.

Results:
At 12-month follow-up, 43 patients (86%) had attained CR. Overall, seven patients (14%) were in noncomplete response (CR) group (non-CR = patients with partial response, stable disease, or progressive disease). The non-CR rate was 16% for Arm A and 20% for Arm B. Among seven patients of non-CR group, six had local disease and one had failure at distant site. Five (10%) patients died in this study, 2 (8%) in Arm A and 3 (12%) patients in Arm B. Residual disease was seen in 2 (4%) patients. Grade III diarrhea was seen in eight patients (16%), 3 in Arm A (12%) and 5 in Arm B (20%). Fifteen patients (30%) developed Grade III skin toxicity. Seven patients in Arm A (28%) and 8 patients (32%) in Arm B developed Grade III toxicity. Twenty-five (50%) cases presented with varying stages of vaginal adhesions and stenosis.

Conclusion:
Majority of patients achieved CR with minimal acute and late toxicities with similar results in both arms. No patient had pelvic or para-aortic metastasis until recent follow-up.
Efficacy, safety, and prognostic factors of anlotinib treatment in advanced non-small cell lung cancer patients
Authors: Huang Aimi , Wang Weimin , Qin Ruoyan , Chen Guojie , Gu Aiqin , Han Baohui 
Published: February 2023

Objective:
This study aimed to evaluate the treatment response, survival profiles, prognostic factors and adverse events of anlotinib in treating advanced non-small cell lung cancer (NSCLC) patients.

Materials and Methods:
Totally, 158 advanced NSCLC patients were included in this retrospective study. All patients received anlotinib treatment until disease progression or intolerance: Administrated orally 12 mg/d for 2 weeks then discontinued for 1 week (3 weeks as a treatment cycle). Furthermore, treatment response, adverse events, and survivals were evaluated.

Results:
After 2 treatment cycles, no (0%) patients achieved complete response (CR), 7 (5.0%) patients achieved partial response (PR), 112 (80.0%) patients achieved standard deviation (SD), and 21 (15.0%) patients achieved progressive disease (PD), resulting in objective response rate (ORR) of 5.0% and disease control rate (DCR) of 85.0%. After 4 treatment cycles, no (0%) patients achieved CR, 3 (4.3%) patients achieved PR, 51 (74.0%) patients achieved SD, and 15 (21.7%) patients achieved PD, resulting in ORR of 4.3% and DCR of 78.3%. For survivals, the median progression-free (PFS) was 3.7 months (95% confidence interval [CI]: 2.7–4.7 months), and the median overall survival (OS) was 12.4 months (95% CI: 9.4–15.3 months). Subsequently, multivariate Cox's regression analyses illuminate that histological type (adenosquamous carcinoma vs. adenocarcinoma) and other mutation apart from epidermal growth factor receptor independently predicted shorter PFS; meanwhile, history of smoke and brain metastases independently predicted decreased OS. Regarding safety, most of the adverse events were at mild grade.

Conclusion:
Anlotinib displays good efficacy and well-tolerant safety profiles in the treatment of advanced NSCLC patients.
Camel-Related Head Injury in a High-Income Developing Country
Authors: Hefny Ashraf F. , Hefny Mohamed A. , Al-Ali Mohamed A. , Mousa Hussam M. 
Published: February 2023

Introduction:
Injury caused by large animals varies according to the regional distribution of the animals and their relationship to humans. Camels are usually friendly to humans; however, occasionally they become very hostile, especially in rutting season. Most in-hospital trauma deaths are related to head injury. Very few studies in the literature have discussed camel-related head injuries. We aimed to study the incidence, mechanism of injury, types, and outcome of camel-related head injury in a high-income developing country to give recommendations on preventive measures.

Methods:
We retrospectively collected data from all patients who were admitted to Al Ain Hospital with a camel-related head injury from January 1, 2015, to January 1, 2021. Data collected included demography, mechanism of injury, anatomical location, severity of the injury, associated injuries, and management. The patients were followed up during their hospital stay to record the length of hospital stay, complications, and outcome.

Results:
During the study period, 98 patients were admitted to Al Ain Hospital with camel-related injury. Thirty-nine (39.8%) of the admitted patients with a camel-related injury sustained a head injury; a camel-related head injury was more common during August (23.1%). Thirty-four (87.2%) patients were camel caregivers. Thirty-three patients (84.6%) were injured on farms. Seven patients suffered an intracranial hemorrhage, and six (85.7%) of them had a history of fall from a camel. Glasgow Coma Score was significantly correlated to the severity of head injury measured by Abbreviated Injury Severity of the head (P = 0.006, Spearman’s correlation). One patient died during the study period after having decompressive craniectomy for subdural hemorrhage (overall mortality 2.6%).

Conclusions:
The majority of camel-related head injury occurred in camel caregivers at camel farms and can be considered a work-related injury. Careful handling of camels, especially during the summertime can reduce the toll of camel-related head injury and its serious consequences. None of the injured patients was wearing a helmet at the time of injury. Legislation for compulsory helmet usage by camel caregivers at farms may decrease the incidence of head injuries in those patients.
Acute Oral Toxicity Evaluation of Andrographolide Self-Nanoemulsifying Drug Delivery System (SNEDDS) Formulation
Authors: Ramadani Arba Pramundita , Syukri Yandi , Hasanah Elma , Syahyeri Afrizal Wahyu 
Published: February 2023

Context:
Andrographolide (AND) is an active compound of well-known medicinal plant Andrographis paniculata. It has been widely published for various activities. AND is difficult to develop into dosage form due to its poor solubility and bioavailability. This problem could be solved by using self-nanoemulsifying drug delivery system (SNEDDS) for its formulation. However, the increase of bioavailability might result in potential toxicity as a large amount of drug is absorbed.

Aims:
The aim of this study is to evaluate the acute potential toxicity using Organization for Economic Cooperation and Development (OECD) test: 401 methods.

Subjects and Methods:
The OECD 401 method employs groups of animals treated by a single dose or repeated dose (<24 h) of the drug with three variances of doses. In this study, thirty male Wistar rats were divided into five groups which consisted two groups of control and three groups of AND SNEDDS formulation (500, 700, and 900 mg/kg body weight [BW], respectively). Intensive observation of toxicity symptom was performed during the first 30 minutes followed by periodic observation for 14 days. Posttermination, histopathological examination of the liver and kidney was conducted to confirm the toxicity symptoms. To determine the level of toxicity, the lethal dose 50 (LD50) value was calculated at the end of the study.

Results:
The result showed that all groups presented similar toxicological symptoms such as salivation, lethargy, and cornea reflex. However, based on histopathological examination, there were abnormalities, but still in an early stage. The toxicological symptom that emerged seems related to the SNEDDS formulation with lipophilic properties. Furthermore, the value of LD50 was 832.6 mg/kg BW (po).

Conclusions:
The AND SNEDDS formulation was slightly toxic in male Wistar rats po.
Evaluation of Community Pharmacists’ Professional Practice and Management of Patient's Respiratory Conditions
Authors: Al-Qudah Raja’a A. , Abu Farha Rana , Al Ali Maram M. , Jaradaneh Nour S. , Mohamed Ibrahim Mohamed Izham 
Published: February 2023

Objectives:
We assessed the extent of community pharmacists managing respiratory conditions and their ability to make differential diagnoses between the common cold and allergic rhinitis.

Methods:
A simulated patient technique was used to achieve the study objectives. Thirty community pharmacies were randomized to be visited by a patient with allergic rhinitis symptoms, followed by a patient with common cold symptoms, and vice versa. One simulated patient visited the 15 pharmacies assigned to allergic rhinitis. Then, after 3–4 days, the pharmacies were revisited by a second simulated patient using the same symptoms; likewise, a simulated patient visited the other 15 pharmacies with common cold symptoms. Then, these pharmacies were revisited by the other simulated patient with the common cold symptoms. Descriptive statistics and correlation analyses were carried out using SPSS at alpha 0.05.

Results:
Fifteen pharmacies were used for the common cold scenario and 15 for the allergic rhinitis scenario (a total of 30 visits per scenario). Pharmacists showed overall poor skills in asking questions for differential diagnosis between the two conditions. No significant difference was found in the overall differential diagnosis score between the two groups (P = 0.744). The overall adherence to the labeling standard score was low, with an average of 2.38 (standard deviation [SD] = 2.50) out of 11, with no significant difference between the two scenarios (P = 0.332). The overall adherence score to the counseling standard was low, with an average of 2.93 (SD = 3.74) out of 15, with no significant difference between the two scenarios (P = 0.586).

Conclusion:
The simulated patient technique approach revealed a lack of ability of pharmacists in Amman, Jordan, to make differential diagnoses between the common cold and allergic rhinitis. In addition, pharmacists lacked the ability to carry out their role with respect to the management of the common cold and allergic rhinitis, including treatment recommendations, adherence to medicine labeling standards, and adherence to the counseling standard.