bluuebunny/crossref_metadata_2025_split huggingface dataset:
Environmental and economic accounting for biomass energy in Ethiopia
Authors: Yalew Amsalu Woldie 
Published: June 2022

Abstract
Background
Energy consumption is inextricably linked with the economy and the environment. The interlinkages are particularly important in low-income countries such as Ethiopia where biomass fuels account for more than 85% of the total energy consumed. This paper aims to assess the energy and economic values, and environmental emissions of solid biomass fuels in Ethiopia.

Methods
The study considered four common solid biomass fuels (firewood, charcoal, crop residues, and cattle dung) in Ethiopia. The amount of biomass fuels during the Ethiopian fiscal year 2015/2016 was compiled from various data sources. Prices, net calorific values, and emission factors per mass of fuels were then used to calculate the economic, energy, and emission values of the solid biomass fuels.

Results
The study showed that, in 2015/2016, the consumption of the four solid biomass fuels contributed between 33,327 and 44,547 ktoe to the total energy consumption with an estimated economic value of 4.4–7.7% of the GDP at current market prices. The stationary combustion of the biomass fuels could result in 165–219 Mt of CO2eq emissions, whereas the fuelwood consumption could potentially impinge on the size or quality of 730 thousand ha of forest, woodlands, and shrublands.

Conclusions
The results suggest that the country should scale-up its policy measures aimed at increasing households’ access to modern energy sources and energy-efficient cooking stoves while at the same time strengthening its afforestation and reforestation activities.
A greater modified Mediterranean diet score is associated with lower insomnia score among adolescent girls: a cross-sectional study
Authors: Yaghtin Zahra , Beigrezaei Sara , Yuzbashian Emad , Ghayour-Mobarhan Majid , Khayyatzadeh Sayyed Saeid 
Published: June 2022

Abstract
Background
Previous studies has shown that a low quality diet is related to sleep disorders. A Mediterranean diet is considered to be a high quality diet and has been shown to have beneficial effects on overall health. Thus, the aim of our study was to investigate the association between adherence to Mediterranean dietary pattern and insomnia score among adolescent girls.

Methods
The data for 733 adolescent girls between 12–18 years old was assessed in this cross-sectional study. A 147 item-food frequency questionnaire was used to assess dietary intake. A modified model of Mediterranean diet score was calculated that ranged from 0–9 points. A validated version of Insomnia Severity Index questionnaire was used to assess insomnia. To explore the association between modified Mediterranean (mMED) diet score and insomnia, linear regression was conducted in crude and adjusted models (energy intake adjustmet in Model I, further adjustments were performed for physical activity, father’s and mother’s education in Model II and full adjusted model adjusted for age, body mass index percentiles, and abdominal obesity).

Results
A significant inverse association between mMED diet score and insomnia score was observed using a crude model (β = -0.091, 95% confidence interval (CI): -0.392 to -0.046); P-value = 0.013) and also after adjustment for confounding factors in Model I (β = -0.098, CI: -0.423 to -0.045; P = 0.015), Model II (β = -0.092, CI: -0.410 to -0.029; P-value = 0.024), Model III (β = -0.082, CI: -0.385 to -0.006); P = 0.044).

Conclusion
There was an inverse relationship between adherence to the mMED diet score and insomnia level among Iranian adolescent girls. Prospective studies are needed to confirm these results and clarify whether a causal relationship exists.
A case of refractory pneumothorax and contralateral atelectasis after thoracoscopic subtotal esophagectomy treated with independent lung ventilation
Authors: Hirai Natsuko , Konda Makiko , Naito Yusuke , Tanaka Nobuhiro , Egawa Junji , Kawaguchi Masahiko 
Published: June 2022

Abstract
Background
Independent lung ventilation (ILV) allows separate positive end-expiratory pressures (PEEP) and inspiratory pressures for each lung. However, only a few articles have reported ILV management for lungs affected by different pathologies.

Case presentation
A 56-year-old man underwent video-assisted thoracic surgery for esophageal cancer. The right lung was injured during surgery, causing a bronchopleural fistula and necessitating chest drainage. On the third day in the intensive care unit, the patient’s oxygenation worsened during pressure support with continuous positive airway pressure ventilation. ILV was initiated for right-sided severe pneumothorax and left-sided atelectasis and pneumonia. ILV was continued for 2 days, and the patient’s trachea was successfully extubated the following day.

Conclusion
Applying high-level PEEP to the one lung and minimizing the airway pressure on the other lung could be achieved using ILV, which might contribute to successful tracheal extubation.
Hazard ranking of wastewater sources in a highly polluted river in northern Taiwan by using positive matrix factorization with metal elements
Authors: Hsieh Pei-Yuan , Lin Huan-Chun , Wang Gen-Shuh , Hsu Yuan-Jeng , Chen Yi-Ju , Wang Tzu-Hui , Wang Ren-De , Kuo Chun-Yu , Wang Di-Wen , Liao Ho-Tang , Wu Chang-Fu 
Published: June 2022

AbstractImproving water quality is a critical issue worldwide. However, the general parameters (i.e., temperature, pH, turbidity, total solids, fecal coliform, dissolved oxygen, biochemical oxygen demand, phosphates, and nitrates) used in water quality index estimations are unable to identify pollution from industrial wastewater. This study investigated pollution sources at a river pollution hotspot by using the positive matrix factorization (PMF) model. A two-phase sampling collection along a highly polluted river in northern Taiwan was designed. The sampling spots were distributed along the river in Phase I to monitor the spatial variation of river pollutants. A pollution hotspot was determined based on two indices, namely the summed concentrations of metal elements and a metal index (MI). In Phase II, the river water samples were collected from the hotspot twice daily over 30 consecutive days to monitor the temporal variation of river pollutants. Source profiles of metal elements were obtained during the monitoring period. The Phase II samples were then factorized using the PMF model. Factor profiles retrieved from the PMF model were further assigned to industrial categories through Pearson correlation coefficients and hierarchical classification. The results indicated that the main pollution source was bare printed circuit boards (BPCB), which contributed up to 92% of the copper in the pollution hotspot. In terms of MI apportionment of 11 metals related to health effects, BPCB contributed 91% of the MI in high pollution events. Overall, the MI apportionment provides linkages between pollution level and human health. This is an evidence for policymakers that the regulation of the effluents of BPCB is an effective means to controlling copper concentrations and thus improving water quality in the study area.
Digital spatial profiling to uncover biomarkers of immunotherapy outcomes in head and neck squamous cell carcinoma.
Authors: Gavrielatou Niki , Vathiotis Ioannis , Aung Thazin Nwe , Shafi Saba , Burela Sneha , Fernandez Aileen , Psyrri Amanda , Rimm David L. 
Published: June 2022

6050 Background: Immunotherapy (ITx) has become the standard of care in the treatment of recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC). However, response rate is limited to 13-18% of patients, underlining the need to identify mechanisms implicated in response or resistance. This study aims to uncover novel biomarkers of ITx outcomes in R/M HNSCC using digital spatial profiling (DSP) technology. Methods: Pre-treatment biopsy samples of 50 ITx-treated R/M HNSCC patients, constructed in the form of tissue microarray (YTMA496), were included in our discovery cohort. Cases underwent DSP with the Human Immuno-Oncology protein panel (NanoString Technologies), comprising 71 photocleavable oligonucleotide-labeled primary antibodies, used for target-protein quantification in 4 distinct molecularly defined compartments: tumor (CK+), leukocyte (CD45+), macrophage (CD68+) and immune stroma (CD45+/CD68+). All markers were explored for associations with progression-free (PFS) and overall survival (OS) using a univariate Cox regression model. Significant markers were validated using an alternative quantitative immunofluorescence method as well as in an independent validation cohort of 29 ITx-treated R/M HNSCC cases (YTMA523). Results: Univariate DSP data analysis revealed high beta2-microglobulin (B2M), LAG-3, CD25 and 4-1BB in tumor, high B2M, CD45 and CD4 in stroma, and low fibronectin in the macrophage compartment, as markers associated with improved PFS. Increased levels of B2M and CD25 in tumor and CD11c in stroma were also correlated with prolonged OS. Focusing on B2M, cases at the top tertile of tumor B2M expression were associated with improved PFS and OS [HR, 0.43; 95% confidence interval (CI), 0.21-0.9; p = 0.034 and HR, 0.41; 95% CI, 0.18-0.90; p = 0.047, respectively], by an orthogonal QIF method. Findings were replicated in our validation cohort for PFS [HR, 0.41; 95% CI, 0.19-0.93; p = 0.034] and showed a similar trend for OS [HR, 0.44; 95% CI, 0.19-1.0; p = 0.074]. B2M-high tumors also had significant enrichment with immune-cell markers (CD3, CD4, CD8, CD11c, CD68 and CD163) and increased immune checkpoint expression (PD-L1, ICOS, TIM-3, LAG-3, IDO1, B7-H3), predominantly in the tumor compartment. Conclusions: Our study indicates that intact, highly functional antigen presentation, sustained by high B2M expression in tumor, confers survival benefit in ITx treated R/M HNSCC patients, an effect driven by increased intra-tumoral immunogenicity.
TPF induction chemotherapy versus PF adjuvant chemotherapy plus concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma: A multicenter, randomized controlled, III trial.
Authors: Qianyong He 
Published: June 2022

6069 Background: To investigate the efficacy and safety of the two modes of concurrent chemoradiotherapy combined with induction or adjuvant chronotherapy for the treatment of locoregionally advanced nasopharyngeal carcinoma. Methods: A total of 266 patients with locoregionally advanced NPC were enrolled from May 2018 to July 2021 and randomly divided into a test (n = 133) and a control (n = 133) group. In the test group, the docetaxel and cisplatin plus fluorouracil (TPF) regimen was used to induce chronological chemotherapy for 3 cycles (docetaxel 75mg / m2, D1, cisplatin 75mg / m2, d1-d5, fluorouracil 750mg / m2 / D, d1-d5) + 3 cycles of concurrent chemoradiotherapy (cisplatin 100mg / m2; The control group was treated with three cycles of concurrent chemoradiotherapy (cisplatin 100mg / m2) + cisplatin plus fluorouracil (PF) regimen with adjuvant schedule chemotherapy for three cycles (cisplatin 80mg / m2 on days d1-d5, fluorouracil 800mg / m2 / d on days d1-d5). In both groups, intensity-modulated radiation therapy was used with a total dose of 69.96 Gy to the primary tumor at T1 and T2, 72.6 Gy to the primary tumor at T3 and T4, and 69.96 Gy to the positive lymph nodes. Acute adverse effects and survival were compared between the two groups. Results: A median follow-up of 19 months, 129 patients in the test group and 124 in the control group were evaluable for efficacy and adverse effects.Compliance was 96.99% and 90.22%, respectively. The 2-year overall survival rates were 91.7% and 90.5%, and the 2-year progression free survival rates were 92.4% and 90.4% in the test and control groups, respectively, with no significant difference ( P > 0.05). The test group had a lower incidence of radiation mucositis, dry mouth, and dysphagia than the control group ( P < 0.05), whereas the test group had a higher incidence of leukopenia, neutropenia, hemoglobin loss, vomiting ( P < 0.05), decreased radiation dermatitis, platelets There were no significant differences in the categories of creatinine elevation and transaminase elevation (P > 0.05). Conclusions: The patients' compliance was good and the toxic effects such as radiation mucositis, dry mouth and dysphagia were reduced under the treatment mode in which the TPF induced chemotherapy combined with concurrent chemoradiotherapy.Although the toxic effects such as leukopenia, neutropenia, hemoglobin reduction and vomiting were increased, the efficacy was comparable with that of the PF in which the adjuvant schedule chemotherapy combined with concurrent chemoradiotherapy. Clinical trial information: NCT-03574324.
Phase III randomized control study evaluating adjuvant metronomic chemotherapy in locally advanced head and neck cancers post-radical chemoradiation (MACE-CTRT).
Authors: Chopade Sunil Ramdhan , Patil Vijay Maruti , Noronha Vanita , Menon Nandini Sharrel , Bhattacharjee Atanu , Nawale Kavita Prakash , Banavali Shripad Dinanath , Prabhash Kumar , Mathrudev Vijayalakshmi 
Published: June 2022

6073 Background: Locally advanced head and neck cancer treated with radical chemoradiation have unsatisfactory outcomes. Oral metronomic chemotherapy improves outcomes in comparison to maximum tolerated dose chemotherapy in the palliative setting. There is also limited evidence that it may do so in an adjuvant setting. Hence this randomised study was conducted. Methods: Patients of HN cancer with primary in oropharynx, larynx or hypopharynx, with PS 0-2 post radical chemoradiation with documented complete response were 1:1 randomised to either observation or oral metronomic adjuvant chemotherapy (MAC) for 18 months. MAC consisted of weekly oral methotrexate (15 mg/m2) and celecoxib (200 mg PO BD). The primary endpoint was OS and the overall sample size was 1038. The study had 3 planned interim analyses for efficacy and futility. Results: 137 patients were recruited and an interim analysis was done. The 3 year PFS in the observation arm was 67.1% (95% CI 53.8-77.3) and the same in the MAC arm was 62.5%(95%CI 49.4-73.1). The corresponding hazard ratio was 1.402 (95% CI 0.7393-2.66, P-value = 0.3). The 3 year OS in the observation arm was 77.3% (95% CI 64.4-86) and the same in the MAC arm was 64.1% (95%CI 51-74.5). The corresponding hazard ratio was 1.588 (95% CI 0.8734-2.886, P-value = 0.1). Any grade mucositis was seen in 30 patients (45.5%) in the MAC arm and 20 patients (28.2%) in the observation arm (P-value = 0.05). The rate of grade 3 or above mucositis was 7.6%(n = 5) in the MAC arm and 1.4%(n = 1) in the observation arm (P-value = 0.106). Conclusions: Both arms had similar OS. Hence observation post complete response post radical chemoradiation remains the standard of care. Clinical trial information: CTRI/2016/09/007315.
Outcomes by tobacco history in E3311, a phase II trial of transoral surgery (TOS) followed by pathology-based adjuvant treatment in HPV-associated (HPV+) oropharynx cancer (OPC): A trial of the ECOG-ACRIN Cancer Research Group.
Authors: Mehra Ranee , Flamand Yael , Quon Harry , Garcia Joaquin J. , Weinstein Gregory S. , Duvvuri Umamaheswar , O'Malley Bert W. , Ozer Enver , Thomas Giovana R. , Koch Wayne , Gross Neil D. , Bell Richard Bryan , Saba Nabil F. , Lango Miriam , Bayon Rodrigo , Burtness Barbara , Ferris Robert L. 
Published: June 2022

6077 Background: E3311 is a phase II randomized study which showed favorable outcomes among intermediate (INT) risk HPV+ OPC patients (pts) who underwent TOS followed by pathology-guided or adapted, deintensified adjuvant treatment. Among HPV+ pts treated with definitive chemoradiation, survival outcomes are worse among those who smoked > 10 pack years (pk-yrs). Methods: We retrospectively analyzed demographics, pathologic results, and efficacy outcomes from E3311 by smoking group (current (C) vs. former (F) and > 10 vs. ≤10 pk-yrs  the latter a pre-specified stratification factor for INT patients). Binary and categorical variables were compared using a chi-square test (or Fishers exact test for small sample sizes). Ordinal variables were compared using a Wilcoxon rank sum test. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method and compared using a log-rank test. Results: Among 359 evaluable pts, performance status (PS) was significantly worse for pts with > 10 pk-yrs vs. ≤10 pk-yrs (15.4% vs. 7.9% with PS of 1, p = 0.034). Primary site, margin status, histologic grade, stage, and extranodal extension were not significantly different between the groups of > 10 vs. ≤10 pk-yrs. Smoking status (F vs. C) was available for 182 pts with a history of smoking. Slightly more C vs. F smokers had tonsil as primary site (79.5% vs. 65.0%, p = 0.09). Positive margins were significantly more frequent among C smokers (10.3% vs. 2.1%; p = 0.029). Overall, there were no significant differences in PFS (p = 0.55) or OS (p = 0.94), comparing those with > 10 vs. ≤10 pk-yrs, or comparing C vs. F smokers (p = 0.76, p = 0.82, respectively). Similarly, no significant differences were observed within the treatment arms. (Table 1) Conclusions: In this analysis of smoking status in E3311, INT risk HPV+ OPC pts who are C smokers or have a history of > 10 pk-yrs had favorable 3-yr PFS and OS rates that were not significantly worse than those with < 10 pk-yrs history. This data represents the first treatment approach for HPV+ OPC in which outcomes were not influenced by smoking status. Clinical trial information: NCT01898494. [Table: see text]
Cabozantinib versus placebo in patients (pts) with radioiodine-refractory (RAIR) differentiated thyroid cancer (DTC) who progressed after prior VEGFR-targeted therapy: Outcomes in prespecified subgroups based on histology subtypes.
Authors: Capdevila Jaume , Robinson Bruce , Sherman Steven I. , Jarząb Barbara , Lin Chia-Chi , Vaisman Fernanda , Hoff Ana , Hitre Erika , Bowles Daniel W. , Williamson Denise , Oliver Jennifer Wright , Keam Bhumsuk , Brose Marcia S. 
Published: June 2022

6081 Background: DTC comprises multiple histology subtypes, the most common being papillary and follicular. Based on results of the phase 3 COSMIC-311 trial, the multikinase inhibitor cabozantinib was recently approved by FDA for the treatment of pts with RAIR DTC who progressed after prior VEGFR-targeted therapy (Brose et al. 2021). In an extended follow-up, median (m) progression-free survival (PFS) was 11 months (mo) for cabozantinib vs 1.9 mo for placebo (HR 0.22, 96% CI 0.15–0.32, P<.0001) in the intent-to-treat (ITT) population (Capdevila et al. ESMO 2021. Abstr LBA67). Here we present outcomes for prespecified subgroups based on the baseline histology subtypes of papillary and follicular thyroid cancers. Methods: Pts were randomized 2:1 to cabozantinib (60 mg QD) or placebo. Placebo pts could cross over to open-label cabozantinib upon disease progression per blinded independent radiology committee (BIRC). Primary endpoints were PFS (ITT) and objective response rate (ORR, first 100 randomized pts), per RECIST v1.1 assessed by BIRC. Results: After a median follow-up of 10.1 mo, 258 pts (170 cabozantinib, 88 placebo) had been randomized (data cutoff 8 Feb 2021); 150 pts (96 cabozantinib, 54 placebo) had papillary thyroid cancer (PTC) and 113 pts (78 cabozantinib, 35 placebo) had follicular thyroid cancer (FTC), with the PTC and FTC subgroups each including 5 pts with both PTC and FTC. Sixty-three pts (̃56%) within the FTC subgroup had Hurthle cell and poorly differentiated variants. mPFS was 9.2 mo for cabozantinib vs 1.9 mo for placebo in the PTC subgroup (HR 0.27, 95% CI 0.17–0.43) and 11.2 mo vs 2.6 mo in the FTC subgroup (HR 0.18, 95% CI 0.10–0.31). The mPFS was 11.1 mo for cabozantinib and 1.9 mo for placebo for pts with Hurthle cell and poorly differentiated variants (HR 0.12, 95% CI 0.05–0.27). The ORR was 15% for cabozantinib vs 0% for placebo in the PTC subgroup and 8% vs 0% in the FTC subgroup. Median duration of cabozantinib exposure was 5.5 mo for the PTC subgroup and 7.3 mo for FTC. Grade 3/4 treatment-emergent adverse events (TEAE) in the cabozantinib arm occurred in 59% of pts in the PTC subgroup and 68% of pts in the FTC subgroup; discontinuations due to TEAE occurred in 17% and 15% of pts, respectively. Conclusions: In the extended follow-up, cabozantinib maintained superior efficacy vs placebo irrespective of histology subtype, including the aggressive Hurthle cell and poorly differentiated variants. The moderately higher rates of grade 3/4 TEAE in the FTC vs the PTC subgroup could be attributed to the longer median duration of exposure of cabozantinib in the FTC subgroup. Clinical trial information: NCT03690388.
The prevalence and prognostic impact of mutations promoting chromatin remodelling dysregulation in non-resectable or recurrent/metastatic adenoid cystic carcinoma.
Authors: Rack Samuel , Feeney Laura , Mistry Hitesh , Betts Guy , Harrington Kevin Joseph , Metcalf Robert 
Published: June 2022

6087 Background: Few effective drug therapies exist for patients with recurrent/metastatic (R/M) adenoid cystic carcinoma (ACC). Mutations in genes encoding chromatin remodelling proteins are described in almost 50% of ACC patients (pts). Novel drug therapies are being developed to target these pathways, and may have clinical utility in this sub-group. We sought to classify mutations in chromatin remodelling genes in ACC based on predicted pathogenicity and to determine the impact of chromatin remodelling dysregulation (CRD) on clinical outcomes. Methods: Matched clinical-genomic data from 269 pts with non-resectable or R/M ACC were included in this study. 130 pts were prospectively recruited to an ethically approved study. For these pts, DNA extracted from FFPE tissue was sequenced on a commercially available platform to detect point mutations, indels and copy number variation in 324 genes. In addition, clinical-genomic data from 139 ACC pts were collected from cBioPortal (MetTropism, Cell 2021) for analysis. Mutations were classified as pathogenic using COSMIC, ClinVar and OncoKB. Univariate survival analysis was performed to determine the impact of one or more mutations in chromatin remodelling genes on survival from first recurrence or metastasis. p values determined using Kaplan-Meier and log-rank. Results: In 269 pts with non-resectable or R/M ACC, mutations promoting CRD were identified in ARID1A (11%), CREBBP (5%), EP300 (5%), KMT2C (1%), KMT2D (5%), KDM6A (13%), and SETD2 (3%). CRD mutations were identified in 94/269 (35%) pts, with 27/269 (10%) having 2 or more CRD mutations. For patients in whom CRD mutations were present survival from recurrence was decreased (median OS 4.6 v 8.2 years, HR 1.65 (95% confidence interval (CI) 1.13-2.40), p = 0.01). Analysis of each individual CRD gene identified that association with decreased survival from recurrence was significant for mutations in KDM6A (n = 35; median OS 4.2 vs 6.5 years; HR 2.01 (95% CI 1.25-3.22); p = 0.004), CREBBP (n = 11; median OS 4.2 vs 5.9 years; HR 2.97 (95% CI 1.20-7.38); p = 0.019) and SETD2 (n = 7; median OS 3.7 vs 5.9; HR 2.47 (95% CI 1.002-6.09); p = 0.042). Previous studies have identified NOTCH pathway activation and TP53 loss-of-function as prognostic. In a secondary analysis of pts without NOTCH activation and/or TP53 mutations (n = 202), OS from recurrence was decreased in those with CRD mutations (n = 58 median OS 5.7 vs 9.2 years, HR 1.5 (CI 95% 0.95-2.55), p = 0.07). Conclusions: We have identified a novel prognostic group of ACC pts characterised by mutations promoting CRD, which may have potential therapeutic options. Alterations in EP300/CREBBP/ARID1A may provide a rationale for treatment with CREBBP/EP300 inhibitors currently in clinical development. Significant co-occurrence with NOTCH gain of function may provide a rationale for future combination studies.