bluuebunny/crossref_metadata_2025 huggingface dataset:
SIP SMART: A parallel group randomised feasibility trial of a tailored pre-treatment swallowing Intervention package compared with usual care for patients with head and neck cancer
Authors: Govender Roganie , Smith Christina H , Barratt Helen , Gardner Benjamin , Taylor Stuart
Published: April 2020

Background: Dysphagia or difficulty in swallowing affects quality of life for most patients with head and neck cancer. SIP SMART – [Swallowing Intervention Package: Self-Monitoring, Assessment, Rehabilitation Training] aims to improve post-treatment swallowing outcomes through a targeted and tailored pre-treatment intervention. This feasibility study assessed 1) recruitment and retention, 2) patient acceptability of randomisation and participation, 3) patient adherence, and 4) sought to identify a suitable primary outcome for a definitive trial, including sample size estimation. Methods: This two-arm parallel group non-blinded randomised feasibility trial took place within a head and neck centre at a teaching hospital in London, UK. Patients newly diagnosed with stage III/IV head and neck cancer were recruited and underwent 6-month follow-up. Patients were randomised to SIP-SMART or usual care via an online web-based system. SIP SMART comprised two 45-minute consultations including a baseline clinical and instrumental swallowing assessment, relevant educational information, targeted swallowing exercises, and specific behaviour change strategies to increase exercise adherence. Usual care comprised a single session including a baseline clinical assessment and generic information about the likely impact of treatment on swallowing. Results: A total of 106 patients were identified at pre-screening, 70 were assessed for eligibility. Twenty-six patients did not meet eligibility criteria [0.37, 95% CI 0.27 to 0.49]. Five of 44 [0.11, 95% CI 0.05 to 0.24] eligible patients were not approached by researchers during clinic. Seven [0.18, 95% CI 0.08 to 0.33] of the 39 approached declined participation. Target recruitment (32 consented patients) was achieved within the timeframe. At 6-months 29/32 [0.91, 95% CI 0.76 to 0.97] patients remained in the trial. Acceptability of randomisation and participation in the intervention was favourable, and adherence to the exercises exceeded the pre-defined 35% minimum criterion. The MD Anderson Dysphagia Inventory swallow related quality of life measure was selected as the most suitable primary outcome for sample size estimation. No adverse effects arose from the intervention, or study participation. Conclusions: A definitive trial of the SIP SMART intervention compared to usual care is feasible and can be undertaken with patients with head and neck cancer treated within the NHS.Trial Registration: ISRCTN40215425, registered retrospectively http://www.isrctn.com/ISRCTN40215425
Barriers and facilitators to retaining a cohort of street-based cisgender female sex workers recruited in Baltimore, Maryland, USA: Results from the SAPPHIRE study
Authors: Silberzahn Bradley , Morris Miles B. , Riegger Katelyn E. , White Rebecca H. , Tomko Catherine A. , Park Ju N. , Footer Katherine H.A. , Huettner Steven S. , Sherman Susan G.
Published: April 2020

Background: Despite experiencing HIV/STIs, violence, and other morbidities at higher rates than the general public, street-based female sex workers are often absent from public health research and surveillance due to the difficulty and high costs associated with engagement and retention. The current study builds on existing literature by examining barriers and facilitators of retaining a street-based cohort of cisgender female sex workers recruited in a mobile setting in Baltimore, Maryland who participated in the SAPPHIRE study. Participants completed interviews and sexual health testing at baseline, 3-, 6-, 9-, and 12-months.Methods: Retention strategies are described and discussed in light of their benefits and challenges. Strategies included collecting several forms of participant contact information, maintaining an extensive field presence by data collectors, conducting social media outreach and public record searches, and providing cash and non-cash incentives. We also calculated raw and adjusted retention proportions at each follow-up period. Lastly, baseline sample characteristics were compared by number of completed visits across demographic, structural vulnerabilities, work environment, and substance use variables using F-tests and Pearson’s chi-square tests. Results: Although there were drawbacks to each retention strategy, each method was useful in tandem in achieving a successful follow-up rate. While direct forms of contact such as phone calls, social media outreach, and email were useful for retaining more stable participants, less stable participants required extensive field-based efforts such as home and site visits that increase the likelihood of random encounters. Overall, adjusted retention exceeded 70% for the duration of the 12-month study. Participants who were younger, recently experienced homelessness, and injected drugs daily were less likely to have completed all or most follow-up visits.Conclusion: Retention of street-based female sex workers required the simultaneous use of diverse retention strategies that were tailored to participant characteristics. With familiarity of the dynamic nature of the study population characteristics, resources can be appropriately allocated to the most likely method(s) of successful retention.
DNA methylation regulates glioma cell cycle through down-regulating MiR-133a-5p expression
Authors: Liu Liang , Zhu Zhengquan , Li Xu , Zheng Yong
Published: April 2020

Background: MiRNAs plays a key role in regulating gene expression networks of various biological processes in many cancers. Results: Here, we analyzed miRNA expression profiles by miRNA microarray and verified by RT-PCR. It was shown that the expression difference of miR-133a-5p was most significantly and consistently downregulated. The proliferative capacity and cell cycle profile of cells transfected with miR-133a-5p mimic were assessed by colony forming assay and PI staining, respectively. The target gene of miR-133a-5p was predicted using TargetScan and verified by dual luciferase gene reporter assay. Western blotting and RT-PCR were used to analyze the expression levels of relevant factors. Methylation-specific quantitative PCR (MSP) was used to detect miR-133a-5p methylation levels. Epigenetic regulation of miR-133a-5p was assessed by treating the cells with the DNA methyltransferase inhibitor AZA or the histone deacetylase inhibitor TSA. We found that overexpression of miR-133a-5p inhibited cell proliferation, induced a cell cycle arrest and downregulated the expression of Cyclin D1, Cyclin D2, and cyclin dependent kinase 4 (CdK4). Peroxisome proliferator-activated receptor γ coactivator 1 alpha (PPARGC1A or PGC-1α) was verified as a target gene of miR-133a-5p. PGC-1α protein levels were significantly decreased in glioma cells following miR-133a-5p overexpression. Furthermore, forced expression of PGC-1α partly abrogated the anti-proliferative effects of miR-133a-5p. miR-133a-5p was hypermethylated in glioma cells, and AZA treatment significantly up-regulated its levels. Conclusions: MiR-133a-5p is downregulated in glioma cells through promoter hypermethylation, and its forced expression inhibits glioma cell proliferation and induces G1 phase arrest by targeting PGC-1α.
Evaluating capacity at three government referral hospital emergency units in the Kingdom of Eswatini using the WHO Hospital Emergency Unit Assessment Tool
Authors: Pigoga Jennifer , Joiner Anjni Patel , Chowa Phindile , Luong Jennifer , Mhlanga Masitsela , Reynolds Teri , Wallis Lee
Published: April 2020

Background: The Kingdom of Eswatini, a lower-middle income nation of 1.45 million in southern Africa, has recently identified emergency care as a key strategy to respond to the national disease burden. We aimed to evaluate the current capacity of hospital emergency care areas using the WHO Hospital Emergency Unit Assessment Tool (HEAT) at government referral hospitals in Eswatini. Methods: We conducted a cross-sectional study of three government referral hospital emergency care areas using HEAT in May 2018. This standardised tool assists healthcare facilities to assess the emergency care delivery capacity in facilities and support in identifying gaps and targeting interventions to strengthen care delivery within emergency care areas. Senior-level emergency care area employees, including senior medical officers and nurse matrons, were interviewed using the HEAT. Results: All sites provided some level of emergency care 24 hours a day, seven days a week, though most had multiple entry points for emergency care. Only one facility had a dedicated area for receiving emergencies and a dedicated resuscitation area; two had triage areas. Facilities had limited capacity to perform signal functions (life-saving procedures that require both skills and resources). Commonly reported barriers included training deficits and lack of access to supplies, medications, and equipment. Sites also lacked formal clinical management and process protocols (such as triage and clinical protocols). Conclusions: The HEAT highlighted strengths and weaknesses of emergency care delivery within hospitals in Eswatini and identified specific causes of these system and service gaps. In order to improve emergency care outcomes, multiple interventions are needed, including training opportunities, improvement in supply chains, and implementation of clinical and process protocols for emergency care areas. We hope that these findings will allow hospital administrators and planners to develop effective change management plans.
Mutation analysis of 419 family and prenatal diagnosis of 339 cases of spinal muscular atrophy in China
Authors: Sun Yingjie , Kong Xiangdong , Zhao Zhenhua , Zhao Xuechao
Published: April 2020

Background Spinal muscular atrophy (SMA) is a common and lethal autosomal recessive neurodegenerative disease caused by mutations in the survival motor neuron 1 (SMN1) gene. At present, gene therapy medicine for SMA, i.e., Spinraza (Nusinersen), has been approved by the FDA, bringing hope to SMA patients and families. Accurate diagnosis is essential for treatment. Our goal was to detect genetic mutations in SMA patients in China and to show the results of the prenatal diagnosis of SMA.Methods In this study, we examined 419 patients in our hospital from January 2010 to September 2019. Multiplex ligation-dependent probe amplification analysis was used to determine the copy numbers of SMN1 and SMN2. Long-range PCR combined with nested PCR was used to detect point mutations in SMN1. In addition to the above detection methods, we also used QF-PCR in prenatal diagnosis to reduce the impact of maternal contamination. We conducted a total of 339 prenatal diagnoses from January 2010 to September 2019.Results Homozygous deletion of SMN1 exon 7 was detected in 96.40% (404/419) of patients. Homozygous deletion of SMN1 exon 7 alone was detected in 15 patients (3.60%). In total, 10 point mutations were detected in the 15 pedigrees. Most patients with SMA Type I have 1~2 copies of the SMN2 gene. Patients with SMA Type II have 2 or 3 copies of the SMN2 gene. The results of prenatal diagnoses showed that 118 fetuses were normal, 149 fetuses were carriers of heterozygous variants, and the remaining 72 fetuses harbored compound heterozygous variants or homozygous variants. Conclusions Our study found that the most common mutation in SMA was homozygous deletion of SMN1 exon 7 in our study. We suggest that detecting only the deletion of exon 7 of SMN1 can meet most of the screening needs. We also believe that SMN2 copy numbers can help infer the disease classification and provide some reference for future treatment options.
Molecular epidemiology of carbapenem resistant Enterobacteriaceae in Sri Lanka: First report of KPC-producing Klebsiella pneumoniae
Authors: Kumudunie Wirittamulla Gamage Maheshika , Wijesooriya Wijesooriya Rathnayaka Pathirennehalage Lakmini Inoka , Namalie Kalubowilage Dhananja , Sunil-Chandra Narapity Pathirannehalage , Wijayasinghe Yasanandana Supunsiri
Published: April 2020

The authors have withdrawn this preprint due to author disagreement.
HIV understanding, experiences and perceptions of HIV-positive men who have sex with men in Amazonian Peru: A qualitative study.
Authors: Tattsbridge Jasmine , Wiskin Connie , De Wildt Gilles , Llavall Anna Clavé , Ramal-Asayag César
Published: April 2020

Background HIV-related incidence and mortality is increasing across Peru, with highest mortality rates recorded in Amazonian region of Loreto. This epidemic is concentrated in men who have sex with men, a population with 14% HIV treatment adherence despite free national provision. This study investigates barriers and facilitators to following healthcare advice through experiences and perceptions of HIV-positive men who have sex with men and healthcare professionals in Loreto. Methods Twenty qualitative interviews with HIV-positive men who have sex with men and one focus group with HIV-specialist healthcare professionals were conducted in Loreto, January-February 2019. Interviews were transcribed per verbatim. Thematic content analysis and deviant case analysis were used. Results A culture of isolation and discrimination was identified, propagated by poor public knowledge surrounding HIV transmission and treatment. Employment potential was hampered and 7/20 patients had suicidal thoughts post-diagnosis. Barriers to care included: shame, depression, travel cost/times, a preference for traditional plant-based medicine and side-effects of antiretroviral therapy. Facilitators included: education, family and clinic support, disease acceptance and lifestyle changes. Conclusion More effective, focussed community education and workplace discrimination investigations are recommended to reduce stigma and increase adherence to treatment in this population.
Facile method for the selective recover of Gd and Pr from LCD screen wastes using ultrasound-assisted leaching
Authors: Pérez Astrid D. Toache , Miró Ana M. Bolarín , De Jesús Félix Sánchez , Lavine Gretchen T. Lapidus
Published: April 2020

Rare earth elements (REE) are essential for the production of technological devices. However, their high demand and low availability, together with an increase in electronic waste generation, compel the development of efficient, economic and green methods for recovering these elements from electronic waste. In this work, a facile method for selective recovering of REE from Liquid Crystal Display (LCD) screen wastes, employing ultrasound assisted leaching is presented. The screen wastes were milled and sieved to pass through − 325 mesh sieve. The milled powder was summited to ultrasound-assisted leaching in aqueous medium, at room temperature (25 °C) and pH 6 for 60 minutes. Subsequently, a magnetic separation was applied into the leach residue. ICP was employed to quantitatively analyze the composition of the LCD powders and the effectiveness of the extraction process. SEM-EDS allowed qualitatively analyzing the chemical composition of the solid materials. The results shown that the LCD screen wastes are formed, mainly, by amorphous oxides of Si, Fe, In, Sn and REE. The amount of Gd and Pr in the wastes were 93 mg/kg and 24 mg/kg, respectively; It represents enough reason to recover it. X-ray diffraction analysis of the magnetic portion of the leaching residue, confirmed the presence of an amorphous phase together with crystalline metallic iron alloy. The magnetic behavior, obtained by Vibration Sample Magnetometry, helped to understand the nature of the residues. The formation of this metallic alloy is attributed to the effect of high power ultrasonic during the leaching. It was confirmed that the magnetic residues concentrates and recovers 87 wt. % of Gd and 85 wt. % of Pr of the total content of these REE in the magnetic residue. Therefore, ultrasound-assisted leaching is a selective and facile method for recovering Gd and Pr from a screen wastes.
Plant Community Analysis along Environmental Gradients in Moist Afromontane Forest of Gerba Dima, South-western Ethiopia
Authors: Hundie Abyot Dibaba , Urgessa Teshome Soromessa , Dullo Bikila Warkineh
Published: April 2020

Background
This study was carried out in Gerba Dima Forest, South-Western Ethiopia, to determine the floristic composition, species diversity and community types along environmental gradients. Ninety sample plots having a size of 25 × 25 m (625 m2) were laid by employing stratified random sampling. Nested plots were used to sample plants of different sizes and different environmental variables. All woody plant species with Diameter at breast height (DBH) ≥ 2.5 cm and height ≥ 1.5 m were recorded in 25 m X 25 m plots. Within the major plots, five 3 m x 3 m subplots (9 m2) was used to collect shrubs with dbh < 2.5 cm and > 1.5 m height. Within each 9 m2subplots, two 1 m2 subplots were used to collect data on the species and abundance of herbaceous plants. Hierarchical (agglomerative) cluster analysis was performed using the free statistical software R version 3.6.1 using package cluster to classify the vegetation into plant community types. Redundancy Analysis (RDA) ordination was used in describing the pattern of plant communities along an environmental gradient.
Result
One hundred and eighty plant species belonging to 145 genera, 69 families and comprising of 15 endemic species were recorded. Cluster analysis resulted in five different plant communities and this result was supported by the ordination result. RDA result showed altitude was the main environmental variable in determining the plant communities. The ANOVA test indicated that the five community types differ significantly from each other with regard to EC and K.
Conclusions
The studied forest can play a significant role in biodiversity conservation since it harbours high species diversity and richness. Thus, all Stakeholders including Oromia Forest and wildlife enterprise (OFWE) and the regional government should work to designate the forest as a biosphere reserve and being registered under UNESCO.
The psychometric properties of the Bergen–Yale Sex Addiction Scale for the Iranian population
Authors: Youseflu Samaneh , Kraus Shane W. , Razavinia Fatemeh , Afrashteh Majid Yousefi , niroomand soudabeh
Published: April 2020

Background: The assessment of sex addiction among different populations requires a valid and reliable tool. Since the Bergen–Yale Sex Addiction Scale (BYSAS) was not available in Iran, this study aimed to evaluate the validity and reliability of the Persian version of BYSAS. Method: After translation/back-translation procedure, a total of 756 Iranian men and women completed the BYSAS. The structural validity of this tool was evaluated by exploratory and confirmatory factor analysis. An expert panel review also examined content validity of the items. Psychometric properties of the scale including validity, reliability (internal consistency [Cronbach’s alpha]) and test-retest) and factor structure were assessed. Results: Content Validity Index (CVI) and Content Validity Ratio (CVR) scores for BYSAS were 0.75 and 0.62, respectively. Data analysis demonstrated satisfactory internal consistency (Cronbach’s alpha ranging from 0.88 to 0.89). Discussion: Study findings suggest that the BYSAS is a valid and reliable instrument for assessing sex addiction among Persian speaking adults. Replication of research findings is needed to expand the BYSAS for clinical and non-clinical Iranian populations.
Cumulative live birth rates over multiple complete cycles of in vitro fertilisation cycles: ten-year cohort study of 20687 women following freeze-all strategy
Authors: Zhu Qianqian , Wang Bian , Lin Jiaying , Yin Mingru , Wang yun , Guo Haiyan , kuang yanping
Published: April 2020

Background

For patients embarking on in vitro fertilization (IVF) or Intracytoplasmic sperm injection (ICSI), one of the most concerned problems is their chance of a live-birth. The cumulative live birth rate (CLBR) after IVF has been reported in recent years; however these studies were all about conventional IVF strategy, the CLBRs following freeze-all strategy has not been reported.
Methods

This was a retrospective cohort study. A total of 20687 women undergoing their first and following IVF cycles during the period from January 1, 2007 through March 31, 2016 were included in this study. The primary Outcomes of the present study were presented in three types: the live birth rate per complete cycle, the conservative CLBR and the optimal CLBR.
Results

The CLBR increased from 50.74% for the first complete cycle to 64.41% after seven complete cycles,and varied by age category. The CLBR after five complete cycles declined from 77.11% for women younger than 31 years, to 8.63% for women older than 40 years. The predictors of live birth over multiple complete cycles for patients embarking on IVF following freeze-all strategy were women’s age and causes of infertility. In the model constructed for patients finishing the first complete cycle, the number of oocyte retrieved at complete cycle one also played an important predictive role.
Conclusions

Among women undergoing IVF following freeze-all strategy, the CLBR after seven complete IVF cycles was 84.77% if there were no barriers to continue the IVF treatment, with variation by age. Two prediction models were developed to estimate their probability of having a baby over multiple complete IVF cycles with freeze-all strategy among patients before starting IVF and patients after the first complete cycle, which is critical for patients to make treatment decisions and preparations physically, emotionally and financially.
Is the tuberculosis knowledge awareness obstructing tuberculosis infection in rural areas of Anqing, China?
Authors: Wen Yufeng , Zou Yunfei , Zhang Zhiping , Wu Huan , Wang Ximei , Wang Chenxu , Xue Hui
Published: April 2020

Background

Health education on tuberculosis is considered as one of the major measures for prevention of tuberculosis disease epidemic. This study is to assess the effects of tuberculosis awareness on tuberculosis infection in rural areas in China.
Methods

This study was conducted in rural areas of Anhui province, China. There 1118 newly diagnosed TB patients were selected as case group while 384 participants with no TB disease enrolled in control group. Univariate analysis and Multivariable logistic regression model were carried out to assess the effect of TB awareness on TB infection.
Results

The univariate analysis showed that four core knowledge items of TB, sex, age, education, domicile, smoking, drinking, income, contacting with TB patients, vaccination of bacillus calmette guerin and living area on TB were significantly different between the case and control groups (P < 0.05). The multivariate logistic regression analysis revealed that education (OR = 0.242, P = 0.001), income (OR = 0.555, P = 0.016) were protective factors and domicile (OR = 0.073, P = 0.026), contacting with TB patients (OR = 3.020, P = 0.017) were risk factors for TB infection. However, the awareness or any item of knowledge of TB were not found to be related to TB infection.
Conclusions

The awareness of TB is not the main influencing factor for TB infection in rural areas, the contents or forms of health education towards TB maybe modified in rural areas.
LRIG1 regulates invasion and migration of human gliomas through SNAI2 and E-cadherin
Authors: Tao Xiang , Zhang Wenfei , Liu Junhui , Zhu Xiaonan , Ji Baowei , Xu Haitao , Chen Zhibiao
Published: April 2020

The particular molecular mechanisms that activates invasion and migration of human gliomas remains obscure. Our previous study has indicated the function of leucine-rich repeats and immunoglobulin-like domains 1(LRIG1) in the inhibition of the cell invasion and downstream genes snail homolog 2(SNAI2) and E-cadherin were involved in this process. In this study we give an insight into the role SNAI2 and E-cadherin played in this process and the relationship between them in glioma tissue specimen. We employed a full length expression plasmid to overexpress LRIG1 in the malignant glioma cell line U251. Introduction of exogenous LRIG1 into U251 significantly inhibited cell invasion and metastasis detected by transwell assay and scratch test, respectively. On the other hand, LRIG1 overexpression leads to reduced SNAI2 expression and elevated E-cadherin expression, manifested by qRT-PCR and western blot, which was consistent with the results in glioma tissue specimens. Further research revealed that 4-chloro-DL-phenylalanine (PCPA), a small molecule inhibitor of SNAI2, can significantly promote the inhibitory effect of cell invasion and migration caused by overexpressed LRIG1. Our data suggested that LRIG1 as a tumor suppressor restricted glioma invasion and migration by regulating SNAI2 and E-cadherin axis and low expression of LRIG1 is associated with poor prognosis in glioma. In conclusion, restoration of LRIG1 in glioma cells could be a novel therapeutic strategy.
Tissue Mechanics and Expression of TROP2 in Oral Squamous Cell Carcinoma with Varying Differentiation
Authors: Zhang Baoping , Gao Shuting , Li Yiting , Li Ruiping , Cao Rui , Cheng Jingyang , Guo Yumeng , Wang Errui , Huang Ying , Zhang Kailiang
Published: April 2020

Background Trophoblast cell surface antigen 2 (TROP2) is overexpressed in many squamous cell carcinomas and contributes to tumor development and invasion. The correlation between the expression of TROP2 and occurrence and development of oral squamous cell carcinoma (OSCC) remains to be understood.Methods We have investigated the role of the specific marker TROP2 in OSCC patients using a combination of biophysics approaches. Analyzed 108 OSCC patient specimens with varying degrees of differentiation using hematoxylin and eosin staining and immunohistochemistry for TROP2 expression, along with Kaplan-Meier survival curve analysis and atomic force microscopy, to understand the morphology and mechanical properties of OSCC tissues.Results In total, 34% poor differentiation underwent high TROP expression. TROP2 as risk factor about patient age (OR = 0.437, P = 0.039), tumor size (OR = 13.148, P = 0.000), TNM stage (OR = 0.141, P = 0.000) during low survival rate. Average surface roughness of low, medium, and highly differentiated OSCC tissues were 448.9 ± 54.8, 792.7 ± 83.6, and 993.0 ± 104.3 nm, respectively. The Pearson coefficient revealed a negative correlation between stiffness and TROP2 expression (r=-0.84, P < 0.01).Conclusion TROP2 expression increased with the decrease in survival rate and negatively correlated with the various degrees of differentiation and tissue mechanics. Taken together, our findings demonstrate that TROP2 may be an indicator of OSCC differentiation that leads to the altered mechanical properties (e.g., stiffness) of OSCC tissues.
Phase II study of sequential S-1 and cyclophosphamide therapy in patients with metastatic breast cancer
Authors: Yanai Keiko , Fujii Takaaki , Horiguchi Jun , Nakazawa Yuko , Kurozumi Sasagu , Obayashi Sayaka , Yajima Reina , Shirabe Ken
Published: April 2020

Purpose: S-1 and cyclophosphamide (CPA) can be given orally, and their combination may have great potential for treating metastatic breast cancer (MBC). A phase I study of sequential S-1 and CPA therapy was conducted in patients with MBC; the recommended doses that were determined for this regimen were 80 mg/m 2 /day for S-1 and 100 mg/m 2 /day for CPA. We then conducted a phase II study of this oral S-1 and CPA regimen. Patients and Methods: This was a single-arm, open-label, single-center prospective phase II study to evaluate the efficacy of a sequential S-1 and CPA regimen for MBC. S-1 was administered orally 2´/day for 14 consecutive days, and then CPA was administered orally 1´/day for 14 consecutive days in a repeating 4-week cycle (S-1 for 2 weeks, CPA for 2 weeks). The primary endpoint was the overall response rate (ORR). Secondary endpoints included the overall survival (OS), progression-free survival (PFS), clinical benefit rate (CBR) and safety. Results: Thirty-six patients were enrolled in this study. The overall response was complete response in 0 (0%), partial response in 12 (33.3%), stable disease in 12 (33.3%), and progressive disease in 11 (30.1%) patients. The ORR was 33.3% (12/36). The CBR was 66.7% (24/36). The mean PFS was 9.5 months (95%CI: 7.1–11.9 months). The OS was 20.2 months (95%CI: 15.0–25.6 months) Grade 3/4 adverse events included neutropenia in seven patients (19.4%). Dose reductions because of adverse events occurred in 12 patients (33.3%). There was no treatment-related mortality. Conclusion: The combination of sequential therapy with S-1 and CPA was tolerable and had efficacy with good disease control. Sequential therapy with S-1 and CPA is a feasible new treatment option for patients with MBC.
Clinical features of gingivostomatitis due to primary infection of Herpes simplex virus in children
Authors: Huang Chen-Wei , Hsieh Chi-Hsien , Lin Ming-Ru , Huang Yhu-Chering
Published: April 2020

Background:
Primary herpetic gingivostomatitis (PHGS) in children, though usually self-limited, might mimic bacterial and enteroviral pharyngitis clinically. We conducted a study to define the clinical features of PHGS in children.
Methods:
Between January 2012 to December 2016, 282 inpatients aged less than 19 years with culture-confirmed herpes simplex virus (HSV) infection in a medical center were identified. Clinical data were retrospectively collected.
Results:
Among the 282 inpatients, 185 cases were considered as PHGS and included for analysis. 99.5% had fever. The mean duration of fever was 5.11 days (± 2.24) with the longest being 17 days. The common oral manifestations included oral ulcers (84.3%), which equally resided in the anterior and posterior part of the oral cavity (65.4% vs. 63.2%), gum swelling and/or bleeding (67.6%), and exudate coated tonsils (16.8%). Leukocytosis (WBC count > 15,000/uL3) was noted in 52 patients (28.1%) and a serum C-reactive protein level > 40 mg/L in 55 patients (29.7%). 65 patients (35%) were diagnosed as PHGS on admission and were significantly more likely to have ulcers over the anterior oral cavity (76.1% vs. 26.7%) and gum swelling/bleeding (76.2% vs. 7.5%, p all < 0.001) on admission and were significantly less likely to receive antibiotic treatment (16.9 vs. 36.7%, p < 0.01) than others. 46 patients (25%) undiagnosed as PHGS on discharge were significantly more likely to have exudate coated on tonsils, receive antibiotic treatment and significantly less likely to have gum swelling/bleeding and oral ulcers (all p values < 0.01).
Conclusion:
Meticulously identifying specific oral manifestations of gum swelling/bleeding and/or ulcers over the anterior oral cavity in children can differentiate PHGS from both bacterial and enteroviral pharyngitis and subsequently reduce unnecessary prescription of antibiotics and medical cost.
Recognition of pathological voices by Human Factor Cepstral Coefficients (HFCC)
Authors: Hamdi Rabeh , HAJJI Salah , Cherif Adnene
Published: April 2020

Several tools have been introduced to achieve early detection of voice disorders. Among these tools are the human factor cepstral coefficients HFCC combined with prosodic parameters, the noise-harmonic ratio (NHR), the harmonic-noise ratio (HNR), analysis of trend fluctuations (DFA) and fundamental frequency (F0). These parameters are introduced and calculated in every frame. In this work, we used a variation of HFCC called equivalent rectangular bandwidth (ERB) to study the effects of HFCC on the classification of pathological voices. Using the HTK classifiers, the classification is carried out on two pathological databases, Massachusetts Eye and Ear Infirmary (MEEI) and Saarbruecken Voice Database (SVD). To assess the performance of the system, we used sensitivity and specificity.
Pushing occupational rehabilitation – Implementation of a therapy diary in the outpatient aftercare of psychosomatic rehabilitation may promote the occupational reintegration process: A survey of therapists and patients.
Authors: Thiel Carolin , Richter Cynthia , Samos Franziska-Antonia Zora , Heise Marcus , Frese Thomas , Fankhänel Thomas
Published: April 2020

Background Treatment results achieved after completion of inpatient psychosomatic rehabilitation are often not permanent. Further participation in an outpatient rehabilitation aftercare may reduce the risk of recurrent disorders and support a successful return to working life. A therapy diary, should accompany the aftercare and bring about the self-reflection process of psychosomatic rehabilitants, could reduce recurrent disease progressions and support the recovery process as a whole. The study focuses on the assessment of the effectiveness and implementation possibilities of a therapy diary in outpatient rehabilitation aftercare. Methods Seven group leaders in Central Germany and eleven psychiatric rehabilitants were interviewed in a qualitative study using partially standardized, guideline-based expert interviews. The data evaluation is based on the Qualitative Content Analysis according to Mayring. Results The results indicate that the accompanying use of a therapy diary within the outpatient rehabilitation aftercare, the rehabilitated by writing down thoughts, emotions, dysfunctional behaviours in problematic situations and thereby experienced successes, allows an intense engagement with their own thoughts and feelings. Through this initiated self-reflection process, the rehabilitant gains a better understanding of one's own behaviour in dealing with oneself and the environment and thereby learns to generate new ways of acting if necessary. Conclusions The use of the therapy diary on a voluntary basis in the outpatient rehabilitation aftercare could support the therapy process and thus the recovery of the rehabilitants and also increase the chance of a successful occupational rehabilitation.
SIX1/EYA1 are novel liver damage biomarkers in chronic hepatitis B and other liver diseases
Authors: Xu Baoyan , Zhang Zhiqiao , Zheng Chong , Tang Yingzi , Tan Zhaoxia , Fu Haiyan , Peng Jing , Xiang Xiaomei , Gan Linlin , Deng Guohong , Mao Qing , Xu Pin-Xian , Ding Jianqiang
Published: April 2020

Background: The aim of this study was to investigate the clinicopathological significance of SIX1/ EYA1 in chronic hepatitis B (CHB) and other liver diseases. Materials and methods: Both SIX1 and EYA1 levels were detected in human serum and liver tissues by enzyme linked immunosorbent assay (ELISA) and immunofluorescent staining, respectively. Results: Serum SIX1 and EYA1 levels were 7.24±0.11 ng/ml and 25.21±0.51 ng/ml, respectively, in 313 CHB patients, and these values were significantly higher than those in 33 healthy controls (2.84±0.15ng/ml and 13.11±1.01ng/ml, respectively; P < 0.05). Serum SIX1 and EYA1 were also significantly increased in patients with many other liver diseases including liver fibrosis, hepatocellular carcinoma, fatty liver disease, alcoholic liver disease, fulminant hepatic failure, autoimmune liver disease, and hepatitis C relative to healthy controls ( P < 0.05). Dynamic observation of these proteins over time in 35 selected CHB patients revealed that SIX1 and EYA1 serum levels increased over an interval. Immunofluorescent staining revealed that both SIX1 and EYA1 were only expressed in hepatic stellate cells (HSCs), and their increased expression was evident in CHB liver tissue. Conclusion: Both SIX1 and EYA1 are novel biomarkers of liver damage in CHB and other liver diseases, with potential clinical utility.
Perioperative circulating tumor cells (CTCs) and CTC-white blood cells detected by a size-based platform predict worse prognosis in renal cell cancer patients
Authors: Wang Zhen-Long , Zhang Peng , Chong Yue , Xue Yu-Quan , Yang Xiao-Jie , Li He-Cheng , Zhang Ya-Ping , Li Zhao-Lun , Xue Li , Li Hong-Liang , Chen Qi , Chong Tie
Published: April 2020

Purpose To explore the clinical significance of perioperative CTCs counts, EMT-CTCs and CTC- white blood cells (WBCs) in renal cancer patients.Materials and Methods A total of 131 patients with renal cancer who underwent operation from the Second Affiliated Hospital of Xi’an Jiaotong University were enrolled. 20 patients with benign renal diseases were used as control. 5 mL Peripheral blood was extracted from 131 patients with renal cancer before operation and about 3 months after operation. Control patients took blood at the corresponding time. CanPatrol CTC detection technique was used to enrich and identify CTCs, EMT-CTCs and CTC-WBCs simultaneously.Results All patients enrolled were T1-3N0M0. 52 renal cancer patients received radical resection, while other 79 patients underwent nephron-sparing surgery. The positive rate of CTC, mesenchymal CTCs (MCTC) and CTC-WBC before surgery were 95.4% (125/131), 61.1% (80/131) and 11.5% (15/131), respectively. Preoperative total CTCs, mesenchymal CTCs or CTC-WBCs were poorly correlated with patients’ parameters. Preoperative CTC, MCTC or CTC-WBC showed little association with progression-free survival (PFS), while post-operation total CTC (≥ 6), positive mesenchymal CTCs and positive CTC-WBC significantly correlated with early recurrence and metastasis, and remained independent indicators for worse PFS. In addition, the elevation of CTC and MCTC after operation were also correlated with unfavourable PFS.Conclusions With the detection of CTCs in peripheral blood, better risk stratification of renal cancer patients might therefore help to identify a subset of patients that might have higher recurrent risk than the overall population of patients.
The efficacy of single-segment anterior decompression, fixation and fusion in the treatment of traumatic spondylolisthesis of the axis
Authors: Zhang Dan , Luo Jing , Zhou Yongchun
Published: April 2020

Background

This study evaluated the clinical efficacy of single-segment anterior decompression, fixation and fusion in patients with traumatic spondylolisthesis of the axis.
Methods

From January 2008 to January 2017, 49 patients with traumatic spondylolisthesis of the axis were treated in our centre using single-segment anterior decompression, fixation and fusion. Clinical and radiographic results were analysed. Clinical efficacy was evaluated according to the operative time and blood loss. The Frankel scale was used to evaluate neurological function. A visual analogue scale was used to assess neck pain. Bone graft fusion, instrumentation failure and cervical curvature were monitored via radiography.
Results

The operative time and intraoperative blood loss of the 49 patients averaged 90.5 ± 4.6 min and 118.5 ± 38.12 ml, respectively. Intervertebral bone grafts were fused in patients with an average fusion time of 6.7 ± 1.0 months (range, 5–8). Cervical curvature was significantly higher at 3 months and 1 year after surgery than before surgery, and the American Spinal Cord Injury Association score at 12 months after surgery was significantly higher than that before surgery.
Conclusion

Single-segment anterior decompression, fixation and fusion can achieve remarkable curative effects in patients with traumatic spondylolisthesis of the axis including satisfactory anatomical reduction, and this strategy promotes the recovery of spinal cord nerve function.
Mapping Evidence on Management of Cervical Cancer in Sub-Saharan Africa: Scoping Review Protocol
Authors: Zibako Petmore , Hlongwa Mbuzeleni , Tsikai Nomsa , Manyame Sarah , Ginindza Themba G
Published: April 2020

BackgroundCancer is a non-communicable disease, and is the number two leading cause of death globally. Among all cancers, cervical cancer is the number one killer of women in Low-Income countries (LICs). Cervical cancer is a well understood preventable cancer. The rates of cervical cancer are very varied and inversely proportional to effectiveness of disease management policies. Management of cervical cancer includes: prevention, screening, diagnosis and treatment. The main objective of this scoping review is to map evidence on cervical cancer management in sub-Saharan Africa (SSA) to understand the coverage of cervical cancer prevention and treatment services and provide an opportunity to generate knowledge on risk factors, attitudes and practices extendable globally.Methods and analysisThis review will be guided by Arksey and O’Malley’s framework recommended for conducting scoping review studies. The Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews (PRISMA-Scr) checklist will also be completed to ensure that the review adheres to sound methodological rigour acceptable for scoping review studies. The following electronic databases will be search for potentially eligible articles: PubMed, Ebsco Host, Scopus and Cochrane Database of Systematic Reviews. Study screening procedures recommended by Higgins and Deeks will be followed.DiscussionCervical cancer can become a disease of the past with a proper control strategy in place. It is therefore imperative to map available evidence on management of cervical cancer to inform policy and advocacy action. More knowledge on the status quo will guide policy makers in ensuring cancer management guiding policies are formulated/updated/ revised accordingly.Scoping review registration: Not registered with PROSPERO (not needed).Protocol and registration: This scoping review was not registered.
Remark on the Swarm data residual distribution
Authors: Khokhlov Andrey
Published: April 2020

The behavior of data in space and time is usually based on a preliminary model of variability. Deviations observed from the model characterize both the model itself and possible data errors. Gaussian error theory is usually used to characterize the distribution of deviations, but very often non-gaussian nature of these deviations is visually obvious. We may see this on the semi-logarithmic chart of the corresponding histogram. Therefore, the percentage of large deviations may be significantly larger than that predicted with the help of the Gaussian error theory: a different method of processing the residuals is necessary for real data. If we assume that the variability itself depends on space and time (in the language of probability theory this behavior is characterized as a mixture of Gaussian distributions), then the non-gaussian shapes of histograms can be explained. For practical purposes, an explicit characterization of the mixing law is of interest, since the share of significant deviations is determined by this very law. The article substantiates the explicit description of the mixing law and shows how to calculate its parameters from the data using the example of magnetic data. Such an approach is also applicable in more general situations.
Survival Benefit of Post-Operative Radiotherapy in Patients with Resectable Pancreatic Head Adenocarcinoma
Authors: gan yu , song su , bo li , fan cheng
Published: April 2020

Background Controversy still exis ts with regard to the beneficial effects of adjuvant radiotherapy (RT) on patients with resectable pancreatic head adenocarcinoma. The aim was to investigate the role of post-operative RT in resectable pancreatic head adenocarcinoma.Methods A total of 2092 patients with resectable pancreatic head adenocarcinoma were enrolled from 2004 to 2016. The data of these patients were obtained from the Surveillance, Epidemiology and End Results (SEER) database of the National Cancer Institute. The propensity score matching method was used to avoid selection bias of the treatment. A multivariable Cox proportional hazards model was used in analyzing the survival benefit from the utilization of post-operative RT.Results In total, 186 patients received post-operative RT after pancreatic head adenocarcinoma resection. Compared with patients who only underwent surgery (n = 1906), the subjects who had postoperative RT were younger (P = 0.000) and had a greater TNM stage (P = 0.00). The baseline characteristics of the two groups were well matched, and more notable in the clinicopathologic and demographic aspects. Before and after matching, the patients who received post-operative RT after pancreatic head adenocarcinoma resection had a higher survival rate than those who underwent only resection (P = 0.00). Subgroups analyses revealed that this benefit was restricted to patients with Lymph node invasion (P = 0.00).Conclusions Pancreatic head adenocarcinoma resection followed by post-operative RT demonstrated considerable survival benefit in relation to surgery alone.
A nomogram prediction model for lymph node metastasis in endometrial cancer patients
Authors: Wang Zhiling , Zhang Shuo , Ma Yifei , Li Wenhui , Tian Jiguang , Liu Ting
Published: April 2020

Background: The determination of lymph node(LN) status is critical for evaluating prognosis and identifying the necessity of adjuvant therapy of endometrial cancer(EC) patients. However, the significance of systematic lymphadenectomy remains controversial. This study aimed to explore the risk factors for lymph node metastasis(LNM) in patients with EC and develop a clinically useful nomogram based on clinicopathological parameters to predict it.Methods: A total of 1517 consecutive patients who underwent staging surgery for EC were abstracted from Qilu Hospital of Shandong University. Parameters including patient-related, tumor-related, and preoperative hematologic examination-related were analyzed by univariate and multivariate logistic regression to determine the correlation with LNM. Based on the multivariate results, a nomogram was constructed and underwent further validation to predict the probability of LNM.Results: The nomogram was constructed and incorporated valuable parameters from the final multivariate model including histological type, histological grade, depth of myometrial invasion, LVSI, cervical involvement, parametrial involvement, and HGB levels. The nomogram was cross-validated internally by the 200 bootstrap sample and showed good discrimination accuracy with an AUC of 0.899.Conclusions: We developed and validated a 7-variable nomogram with a high concordance probability to predict the risk of LNM in patients with EC.
Household Wealth Inequalities in High Body Mass Index among Women of Childbearing Age: Evidence from the Ghana Demographic and Health Survey
Authors: Dankwah Emmanuel , Koduah-Benewaa Priscilla
Published: April 2020

Background

Ghana is currently experiencing higher body mass index (BMI), that is overweight and obesity, among reproductive-aged women. However, understanding the role of socioeconomic status in the high BMI among this cohort has not been studied extensively in Ghana and the few existing studies in the country have generated mixed results. This study aims to examine household wealth inequalities in high BMI among Ghanaian women of childbearing age.
Methods

The 2014 Ghana Demography and Health Survey (GDHS) dataset was analyzed. A univariable and multivariable regression model with a logit link function was specified to ascertain the effect of household wealth inequalities in high BMI among Ghanaian women. Furthermore, concentration index and curve were used to measure the degree of household wealth inequalities in high BMI among reproductive aged women.
Results

This study found high BMI prevalence of 35.9 percent with significant household wealth-related inequalities (Concentration index = 0.24, 95%CI (confidence interval): 0.22–0.26). The analysis revealed that high BMI is concentrated among wealthier women. Compared to poorest women, poorer (AOR (Adjusted odds ratio) = 2.18, 95%CI: 1.66–2.85), middle-class (AOR = 4.44, 95%CI: 3.24–6.09), richer (AOR = 7.75, 95%CI: 5.53–10.86) and richest (AOR = 11.03, 95%CI: 8.07–15.06) women were more likely to have high BMI. On top of that, socioeconomic characteristics including age, marital status, and education of reproductive-aged women were significantly associated with high BMI.
Conclusions

The research revealed that a woman from a wealthier household had higher likelihood of having high BMI relative to those from a less wealthy household. Also, women who were educated and cohabiting, formerly or currently married had an increased risk of having high BMI. This observation suggests targeted policy interventions and programs that promote healthy body weight to reduce the high BMI prevalence among women of childbearing age in Ghana.