bluuebunny/crossref_metadata_2025 huggingface dataset:
Health-related quality of life in adolescents with persistent pain and the mediating role of self-efficacy: a cross-sectional study
Authors: Grasaas Erik , Helseth Sølvi , Fegran Liv , Stinson Jennifer , Småstuen Milada , Haraldstad Kristin
Published: January 2020

Background

Persistent pain has a high prevalence among adolescents. Pain has been shown to reduce all aspects of the adolescent’s health-related quality of life (HRQOL). In adult patients with pain, self-efficacy has been shown to mediate the relationship between pain intensity, disability and depression. However, little is known about whether self-efficacy acts as a mediating variable in the relationship between persistent pain and HRQOL sub-scale scores in a school-based population of adolescents.

Objectives

To describe the experience of pain, HRQOL and self-efficacy, and to explore the association between pain intensity, general self-efficacy and HRQOL in adolescents with persistent pain by testing self-efficacy as a possible mediator.

Methods

The study participants were 78 adolescents with persistent pain, aged 16–19 years, who were recruited from five high schools in southern Norway. All participants completed an electronic survey consisting of the Lubeck Pain Questionnaire, which included a visual analogue scale (VAS) measuring pain intensity, the General Self-Efficacy Scale (GSE) and the KIDSCREEN-52 Questionnaire measuring HRQOL. Statistical analyses were conducted using the PROCESS macro for SPSS developed by Andrew Hayes.

Results

All participants reported pain in multiple locations, of which the head was most common (88.5%). Mean (SD) pain intensity score of the participants was 5.4 (1.8). The study sample had poor HRQOL, with mean (SD) scores for several sub-scales ranging from 45.2 (21.0) to 91.0 (13.3) on a 0–100 scale. The associations between pain intensity and the HRQOL sub-scales of physical well-being, psychological well-being, mood, self-perception, autonomy and school environment were mediated by self-efficacy. The highest degree of mediation and, thus, the largest indirect effect was estimated for the HRQOL sub-scale physical well-being (67.2%).

Conclusions

This school-based sample of adolescents with persistent pain had impaired HRQOL. Up to 67% of the reduction in the HRQOL sub-scale scores for physical well-being, psychological well-being, mood, self-perception, autonomy and school environment could be explained by the mediating variable self-efficacy. Thus, future pain-management interventions that aim to increase HRQOL in school-based populations of adolescents with persistent pain should consider promoting self-efficacy and providing more targeted interventions.

Trial registration

ClinicalTrials.gov ID NCT03551977.
The quality of life of the patients with diabetes type 2 using EQ-5D-5 L in Birjand
Authors: Abedini Mohammad Reza , Bijari Bita , Miri Zahra , Shakhs Emampour Fatemeh , Abbasi Ali
Published: January 2020

Background

Due to high prevalence of diabetes and its complications, evaluating of the patients’ quality of life is critical. EQ-5D-5 L is a valid tool for assessing the quality of life in chronic diseases including diabetes. The present study conducted to illustrate the quality of life for the patients who referred to the Diabetes clinic and determine its relationship with their demographic and clinical characteristics in Birjand in 2017.

Methods

In this cross-sectional study, 300 patients with type 2 diabetes were selected through a systematic sampling in 2017. Data were collected using a checklist including patients’ demographic, clinical and laboratory information and the EQ-5D-5 L. Data were entered the SPSS (22) software, analyzed by independent sample T-test, ANOVA, Chi-Square and logistic regression tests. Statistical significance was inferred at α = 0.05.

Results

Mean age for the participants was 58.1 ± 9.6 years. The mean score for the quality of life based on the EQ-5D-5 L and VAS scale were 0.89 ± 0.13 and 65.22 ± 9.32, respectively. Moderate and severe problems were found in the anxiety/depression dimensions in 12% of the patients, while these numbers for the presence of pain/discomfort and mobility were slightly higher (13.7 and 13.6%, respectively). The mean scores for quality of life and VAS were significantly higher in the men, employed and patients < 50 years age.

Conclusion

The quality of life for the type 2 diabetes patients is affected by numerous factors including sex, occupation, duration of the disease and the presence of complications such as neuropathy and nephropathy.
Prognostic value of pre-treatment Naples prognostic score (NPS) in patients with osteosarcoma
Authors: Yang Qiankun , Chen Tong , Yao Zhongxiang , Zhang Xiaojing
Published: January 2020

Background

This study aimed to evaluate the clinical significance of pre-treatment Naples prognostic score (NPS) in patients with osteosarcoma.

Methods

The clinical data of 133 osteosarcoma patients between January 2011 and February 2018 in our hospital was retrospectively collected and analyzed. NPS was calculated from four parameters, including serum albumin level, serum total cholesterol (TC), lymphocyte-to-monocyte ratio (LMR), and neutrophil-to-lymphocyte ratio (NLR). Patients were divided into three groups (group 1-3) based on NPS. The relationships between NPS and clinical features, overall survival (OS), and progression-free survival (PFS) were analyzed. Two prediction models based on NPS and clinical parameters were developed: clinical parameters model (model A), and the combined model of NPS and clinical parameters (model B). Their predictive performances were further evaluated and compared.

Results

The median follow-up time of this cohort was 46.0 (range, 5–75) months, while the median OS and PFS was 40 (range, 5–75) months and 36 (range, 5–71) months, respectively. NPS was significantly correlated with gender, tumor location, Enneking stage, pathological fracture, local recurrence, and metastasis (allP< 0.05). Variables of NPS, Enneking stage, local recurrence, metastasis, and NLR were confirmed as independent prognostic factors for OS and PFS by univariate and multivariate Cox analysis. Prediction model B obtained larger AUCs for OS and PFS and showed better consistency between nomogram-predicted and actual survival than that of model A at the follow-up time of 1-, 3-, and 5-year.

Conclusions

NPS was a novel, reliable, and multidimensional prognostic scoring system with favorable predictive performance for patients with osteosarcoma.
A clinical-radiomics nomogram for the preoperative prediction of lymph node metastasis in colorectal cancer
Authors: Li Menglei , Zhang Jing , Dan Yibo , Yao Yefeng , Dai Weixing , Cai Guoxiang , Yang Guang , Tong Tong
Published: January 2020

Background

Accurate lymph node metastasis (LNM) prediction in colorectal cancer (CRC) patients is of great significance for treatment decision making and prognostic evaluation. We aimed to develop and validate a clinical-radiomics nomogram for the individual preoperative prediction of LNM in CRC patients.

Methods

We enrolled 766 patients (458 in the training set and 308 in the validation set) with clinicopathologically confirmed CRC. We included nine significant clinical risk factors (age, sex, preoperative carbohydrate antigen 19-9 (CA19-9) level, preoperative carcinoembryonic antigen (CEA) level, tumor size, tumor location, histotype, differentiation and M stage) to build the clinical model. We used analysis of variance (ANOVA), relief and recursive feature elimination (RFE) for feature selection (including clinical risk factors and the imaging features of primary lesions and peripheral lymph nodes), established classification models with logistic regression analysis and selected the respective candidate models by fivefold cross-validation. Then, we combined the clinical risk factors, primary lesion radiomics features and peripheral lymph node radiomics features of the candidate models to establish combined predictive models. Model performance was assessed by the area under the receiver operating characteristic (ROC) curve (AUC). Finally, decision curve analysis (DCA) and a nomogram were used to evaluate the clinical usefulness of the model.

Results

The clinical-primary lesion radiomics-peripheral lymph node radiomics model, with the highest AUC value (0.7606), was regarded as the candidate model and had good discrimination and calibration in both the training and validation sets. DCA demonstrated that the clinical-radiomics nomogram was useful for preoperative prediction in the clinical environment.

Conclusion

The present study proposed a clinical-radiomics nomogram with a combination of clinical risk factors and radiomics features that can potentially be applied in the individualized preoperative prediction of LNM in CRC patients.
Oligohydramnios: a prospective study of fetal, neonatal and maternal outcomes in low-middle income countries
Authors: Figueroa Lester , McClure Elizabeth M. , Swanson Jonathan , Nathan Robert , Garces Ana L. , Moore Janet L. , Krebs Nancy F. , Hambidge K. Michael , Bauserman Melissa , Lokangaka Adrien , Tshefu Antoinette , Mirza Waseem , Saleem Sarah , Naqvi Farnaz , Carlo Waldemar A. , Chomba Elwyn , Liechty Edward A. , Esamai Fabian , Swanson David , Bose Carl L. , Goldenberg Robert L.
Published: January 2020

Background

Oligohydramnios is a condition of abnormally low amniotic fluid volume that has been associated with poor pregnancy outcomes. To date, the prevalence of this condition and its outcomes has not been well described in low and low-middle income countries (LMIC) where ultrasound use to diagnose this condition in pregnancy is limited. As part of a prospective trial of ultrasound at antenatal care in LMICs, we sought to evaluate the incidence of and the adverse maternal, fetal and neonatal outcomes associated with oligohydramnios.

Methods

We included data in this report from all pregnant women in community settings in Guatemala, Pakistan, Zambia and the Democratic Republic of Congo (DRC) who received a third trimester ultrasound as part of the First Look Study, a randomized trial to assess the value of ultrasound at antenatal care. Using these data, we conducted a planned secondary analysis to compare pregnancy outcomes of women with to those without oligohydramnios. Oligohydramnios was defined as measurement of an Amniotic Fluid Index less than 5 cm in at least one ultrasound in the third trimester. The outcomes assessed included maternal morbidity and fetal and neonatal mortality, preterm birth and low-birthweight. We used pairwise site comparisons with Tukey-Kramer adjustment and multivariable logistic models using general estimating equations to account for the correlation of outcomes within cluster.

Results

Of 12,940 women enrolled in the clusters in Guatemala, Pakistan, Zambia and the DRC in the First Look Study who had a third trimester ultrasound examination, 87 women were diagnosed with oligohydramnios, equivalent to 0.7% of those studied. Prevalence of detected oligohydramnios varied among study sites; from the lowest of 0.2% in Zambia and the DRC to the highest of 1.5% in Pakistan. Women diagnosed with oligohydramnios had higher rates of hemorrhage, fetal malposition, and cesarean delivery than women without oligohydramnios. We also found unfavorable fetal and neonatal outcomes associated with oligohydramnios including stillbirths (OR 5.16, 95%CI 2.07, 12.85), neonatal deaths < 28 days (OR 3.18, 95% CI 1.18, 8.57), low birth weight (OR 2.10, 95% CI 1.44, 3.07) and preterm births (OR 2.73, 95%CI 1.76, 4.23). The mean birth weight was 162 g less (95% CI -288.6, − 35.9) with oligohydramnios.

Conclusions

Oligohydramnos was associated with worse neonatal, fetal and maternal outcomes in LMIC. Further research is needed to assess effective interventions to diagnose and ultimately to reduce poor outcomes in these settings.

Trial registration

NCT01990625.
Developing of a new guideline for improving birth experiences among Iranian women: a mixed method study protocol
Authors: Ghanbari-Homayi Solmaz , Fardiazar Zahra , Mohammad-Alizadeh-Charandabi Sakineh , Asghari Jafarabadi Mohammad , Mohamadi Eesa , Meedya Shahla , Mirghafourvand Mojgan
Published: January 2020

Background

The childbirth experience has significant effects on the life of the mother and family. However, there are no Iranian studies which evaluate and measure women’s childbirth experiences to provide accurate data on this important matter. The aim of this study is to develop a new guideline to improve women’s childbirth experiences by meeting their needs and expectations.

Methods/design

The present study will use the mixed method with the explanatory sequential approach. Phase one is a cross-sectional survey with random cluster sampling of the health centers in Tabriz. Eight hundred primiparous women will be selected to measure their childbirth experiences and predictors factors. Phase two is a qualitative study to explore women’s perceptions of the aspects and determinants of the childbirth experience. Phase two participants will be selected using purposive sampling from the women who participated in phase one. Phase three involves developing a new guideline to improve women’s childbirth experiences. The new guideline will be developed based on the following elements: a) the results of the qualitative and quantitative data from phase one and two, b) a review of the related literature, and c) expert opinions that have been collected using the Delphi technique.

Discussion

By exploring women’s childbirth experiences and the influencing factors, a culturally sensitive evidence-based guideline can be developed. The provision of the evidence-based guideline resulting from this study might be effective in improving the quality care of the services for pregnant women.

Ethical code

IR.TBZMED.REC.1396.786.
QuitSMART Utah: an implementation study protocol for a cluster-randomized, multi-level Sequential Multiple Assignment Randomized Trial to increase Reach and Impact of tobacco cessation treatment in Community Health Centers
Authors: Fernandez Maria E. , Schlechter Chelsey R. , Del Fiol Guilherme , Gibson Bryan , Kawamoto Kensaku , Siaperas Tracey , Pruhs Alan , Greene Tom , Nahum-Shani Inbal , Schulthies Sandra , Nelson Marci , Bohner Claudia , Kramer Heidi , Borbolla Damian , Austin Sharon , Weir Charlene , Walker Timothy W. , Lam Cho Y. , Wetter David W.
Published: January 2020

Background

Tobacco use remains the leading cause of death and disability in the USA and is disproportionately concentrated among low socioeconomic status (SES) populations. Community Health Centers (CHCs) are a key venue for reaching low SES populations with evidence-based tobacco cessation treatment such as Quitlines. Electronic health record (EHR)-based interventions at the point-of-care, text messaging (TM), and phone counseling have the potential to increase Quitline reach and are feasible to implement within CHCs. However, there is a lack of data to inform how, when, and in what combination these strategies should be implemented. The aims of this cluster-randomized trial are to evaluate multi-level implementation strategies to increase the Reach (i.e., proportion of tobacco-using patients who enroll in the Quitline) and Impact (i.e., Reach × Efficacy [efficacy is defined as the proportion of tobacco-using patients who enroll in Quitline treatment that successfully quit]) and to evaluate characteristics of healthcare system, providers, and patients that may influence tobacco-use outcomes.

Methods

This study is a multilevel, three-phase, Sequential Multiple Assignment Randomized Trial (SMART), conducted in CHCs (N = 33 clinics; N = 6000 patients). In the first phase, clinics will be randomized to two different EHR conditions. The second and third phases are patient-level randomizations based on prior treatment response. Patients who enroll in the Quitline receive no further interventions. In phase two, patients who are non-responders (i.e., patients who do not enroll in Quitline) will be randomized to receive either TM or continued-EHR. In phase three, patients in the TM condition who are non-responders will be randomized to receive either continued-TM or TM + phone coaching.

Discussion

This project will evaluate scalable, multi-level interventions to directly address strategic national priorities for reducing tobacco use and related disparities by increasing the Reach and Impact of evidence-based tobacco cessation interventions in low SES populations.

Trial registration

This trial was registered at ClinicalTrials.gov (NCT03900767) on April 4th, 2019.
Impact of a low FODMAP diet on the amount of rectal gas and rectal volume during radiotherapy in patients with prostate cancer – a prospective pilot study
Authors: Schaefer Christian , Zamboglou Constantinos , Volegova-Neher Natalja , Martini Carmen , Nicolay Nils Henrik , Schmidt-Hegemann Nina-Sophie , Rogowski Paul , Li Minglun , Belka Claus , Müller Arndt-Christian , Grosu Anca-Ligia , Brunner Thomas
Published: January 2020

Background

Small inter- and intrafractional prostate motion was shown to be a prerequisite for precise radiotherapy (RT) of prostate cancer (PCa) to achieve good local control and low rectal toxicity. As rectal gas and rectal volume are known to have a relevant effect on prostate motion, this study aims to reduce these parameters by using a Low FODMAP Diet (LFD) and to show feasibility of this intervention.

Methods

We compared a prospective intervention group (IG,n = 25) which underwent RT for PCa and whose patients were asked to follow a LFD during RT with a retrospective control group (CG,n = 25) which did not get any dietary advice. In the planning CT scan and all available cone beam CT scans rectal gas was classified based on a semiquantitative score (scale from 1 to 5) and rectal volume was measured. Furthermore, patients’ compliance was evaluated by a self-assessment questionnaire.

Results

Clinical and treatment characteristics were well balanced between both groups. A total of 266 (CG, 10.6 per patient) and 280 CT scans (IG, 11.2 per patient), respectively, were analysed. The frequency distribution of gas scores differed significantly from each other (p < .001) with the IG having lower scores. Rectal volume was smaller in the IG (64.28 cm3, 95% CI 60.92–67.65 cm3, SD 28.64 cm3) than in the CG (71.40 cm3, 95% CI 66.47–76.32 cm3, SD 40.80 cm3) (p = .02). Mean intrapatient standard deviation as a measure for the variability of rectal volume was 22 cm3in the IG and 23 cm3in the CG (p = .81). Patients’ compliance and contentment were satisfying.

Conclusions

The use of a LFD significantly decreased rectal gas and rectal volume. LFD was feasible with an excellent patients’ compliance. However, prospective trials with a larger number of patients and a standardized evaluation of gastrointestinal toxicity and quality of life are reasonable.

Trial registration

German Clinical Trials Register, DRKS00012955. Registered 29 August 2017 - Retrospectively registered,https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00012955
Multisession radiosurgery for intracranial meningioma treatment: study protocol of a single arm, monocenter, prospective trial
Authors: Pinzi V. , Marchetti M. , De Martin E. , Cuccarini V. , Tramacere I. , Ghielmetti F. , Fumagalli M. L. , Iezzoni C. , Fariselli L.
Published: January 2020

Background

Single session radiosurgery represents a widely accepted treatment for intracranial meningiomas. However, this approach could involve a high risk of treatment-related complications when applied to large volume lesions. In these cases and for those not suitable for surgical resection, radiosurgery in multisession setting could represents a viable option. The literature results are reassuring in terms of correlated adverse events as well as in terms of tumor control. However, no prospective long-term results are available. In this scenario, we design a prospective monocentric phase II study, in order to verify the safety of a multisession radiosurgery schedule delivering 25 Gy in 5 daily fractions.

Methods

Patients diagnosed with large and/or near to critical structures, intracranial meningiomas have been treated by means of multisession radiosurgery in both exclusive and postoperative settings. The primary study aim is safety that has been being prospectively scored based on international scales, including NCI Common Toxicity criteria, version 4.03, Barrow Neurological Institute pain intensity score, Barrow Neurological Institute facial numbness score and House-Brackmann Facial Nerve Grading System for qualitative analysis. Secondary aim is treatment efficacy in terms of local control that has been being assessed on volumetric analysis.

Discussion

This is the first prospective phase II trial on multisession radiosurgery for large and/or near to critical structures intracranial meningiomas. If positive results will be found, this study could represent the starting point for a phase III trial exploring the role of multisession radiosurgery in the exclusive and postoperative radiation therapy treatment of intracranial meningiomas.

Trial registration

Trial registration: clinicaltrials.gov platform (Multisession Radiosurgery in Large Meningiomas –MuRaLM- identifier NCT02974127). Registered: November 28, 2016. Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02974127?term=radiosurgery&cond=Intracranial+Meningioma&draw=2&rank=1
Combined one-stage minimally invasive surgery for primary pulmonary carcinoma and mitral regurgitation
Authors: Huang Chengfeng , Yang Chao , Huang Jiawen , Liao Qiuying , Zhang Xiaoshen , Liao Shengjie
Published: January 2020

Background

We report the first successful short-term outcome of one-stage minimally invasive surgery (MIS) mitral valve repair and video-assisted thoracoscopic surgery (VATS) lobectomy.

Case presentation

We report the first successful short-term outcome of combined one-stage video-assisted thoracoscopic surgery lobectomy and minimally invasive surgery in a patient with operable primary right upper lobe adenocarcinoma and mitral regurgitation. Post- operative recovery was uneventful, and follow-up at 6 weeks confirmed an excellent surgical and oncologic outcome.

Conclusions

We think one-stage minimally invasive surgery (MIS) cardiac surgery and video-assisted thoracoscopic surgery (VATS) lobectomy would benefit patients with satisfactory cardiac and pulmonary function.
Falsely undetectable TSH in a euthyroid patient
Authors: Rahimkhani Monireh , Kazemian Kiana , Daryasari Rashid Ramezani
Published: January 2020

Background

Measuring thyroid hormone levels is essential and helpful in the diagnosis of thyroid diseases.

Case presentation

We had a patient with undetectable serum TSH level by the Siemens immunoassay, whereas by ELISA and Roche-Abott immunoassay, serum level of TSH was in the normal range.

Conclusion

If the result of TSH level revealed very low or undetectable through one specific method, it should not be considered necessarily as a symptom of hyperthyroidism. It is to be requested to measure by the other methods with other devices too.
Early universal use of oral progesterone for prevention of preterm births in singleton pregnancy (SINPRO study): protocol of a multicenter, randomized, double-blind, placebo-controlled trial
Authors: Cheung Ka Wang , Seto Mimi Tin Yan , Ng Ernest Hung Yu
Published: January 2020

Background

Preterm birth accounts for 75% of perinatal deaths and more than 50% of long-term neurological disabilities. For a singleton pregnancy, progesterone treatment is effective in prevention of preterm birth in women with an asymptomatic short cervix or a history of preterm birth. However, a large proportion of preterm births still is not currently preventable. The aim of this study is to determine whether early universal use of oral progesterone before 14 + 0 weeks of gestation can prevent preterm birth better than universal screening of cervical length at 18 + 0 to 23 + 6 weeks of gestation, followed by progesterone treatment in those with a short cervix in singleton pregnancy.

Methods

This is a multicenter, randomized, double-blind, placebo-controlled trial registered with ClinicalTrials.gov on 12 February 2018. Eligible consecutive pregnant women with singleton gestation attending antenatal outpatient clinics will be recruited after receiving counseling and signing the written consent form. Transvaginal cervical length measurement will be performed at recruitment (before 14 + 0 weeks of gestation) and between 18 + 0 and 23 + 6 weeks of gestation. After randomization, women will be randomly assigned to either the treatment group (oral dydrogesterone 10 mg three times daily) or the placebo group, and medication will be started before 14 + 0 weeks of gestation. Assigned groups will be unblinded if the cervical length is ≤ 25 mm between 18 + 0 and 23 + 6 weeks of gestation, and the management option for short cervix will be discussed (oral progesterone, vaginal progesterone, or cervical cerclage). The primary outcome is preterm birth before 37 + 0 weeks of gestation.

Discussion

Progesterone is used extensively in part of the in vitro fertilization program as luteal phase support, and it is not associated with teratogenicity. Universal progesterone supplementation may be a better approach to prevent preterm birth. This large, multicenter, randomized, double-blind, placebo-controlled trial will provide the best evidence, leading to the best strategy for the prevention of preterm birth.

Trial registration

ClinicalTrials.gov, NCT03428685. Registered on 12 February 2018.
Aspirin for metal stent in malignant distal common bile duct obstruction (AIMS): study protocol for a multicenter randomized controlled trial
Authors: Choi Jin Ho , Paik Woo Hyun , You Min Su , Lee Kyong Joo , Choi Young Hoon , Shin Bang-sup , Lee Sang Hyub , Ryu Ji Kon , Kim Yong-Tae
Published: January 2020

Background

Endoscopic retrograde biliary drainage (ERBD) is the treatment of choice for patients with malignant distal common bile duct (CBD) obstruction. Self-expandable metal stents (SEMS), which are commonly used in unresectable cases, have many clinical advantages, including longer stent patency. Although the expected patency of SEMS is around 8 months, it has recently been reported that the duration of SEMS’ patency in patients using aspirin is prolonged. Our study, therefore, aims to investigate the effect of aspirin on SEMS’ patency.

Methods/design

This is an investigator-initiated, prospective, multicenter, double-blind, randomized placebo-controlled trial that will be conducted from November 2017 in four tertiary centers in South Korea. We intend to include in our study 184 adult (aged ≥ 20 years) patients with malignant distal CBD obstruction for whom ERBD with SEMS was successfully performed. The patients will be randomly allocated to two groups, which will comprise patients who have either taken 100 mg aspirin or a placebo for 6 months after index ERBD. The primary outcome will be the rate of stent dysfunction, and the secondary outcomes will be the duration of patency, the rate of reintervention, and the occurrence of adverse events.

Discussion

The aspirin for metal stents in malignant distal common bile duct obstruction (AIMS) study should determine the efficacy of aspirin in maintaining metal-stent patency in patients with malignant distal CBD obstructive.

Trial registration

ClinicalTrials.gov, ID: NCT03279809. Registered on 5 September 2017.
Direct and indirect effects of predation and parasitism on the Anopheles gambiae mosquito
Authors: Ong’wen Fedinand , Onyango Patrick Ogola , Bukhari Tullu
Published: January 2020

Background

A good understanding of mosquito ecology is imperative for integrated vector control of malaria. In breeding sites,Anopheleslarvae are concurrently exposed to predators and parasites. However, to our knowledge, there is no study on combined effects of predators and parasites on development and survival of larvae and their carry-over effects on adult survivorship and susceptibility to further parasite infection.

Methods

This study focused on effects of the nymphs of the dragonflyPantala flavescensand the parasitic fungusBeauveria bassianaonAnopheles gambiae, to determine: predation efficacy of nymphs againstAn. gambiaelarvae; development rate ofAn. gambiaelarvae in the presence of one, two or four constrained nymphs; efficacy ofB. bassianaagainstAn. gambiaelarvae at doses of 3, 6 and 12 mg; and survival of adult mosquitoes exposed toB. bassiana, following pre-exposure to a constrained predator and/or parasite at the larval stage. The experiments consisted of survival bioassays quantified as pupation day, or dead larvae and/or adults.

Results

Nymphs had an average predation efficacy of 88.3% (95% CI: 87.5–89.1) at 24 hours, againstAn. gambiaelarvae. The presence of one or two nymphs reduced development time of larvae by 0.65 and 0.35 days, respectively. However, development time of larvae exposed to four nymphs was similar to the control larvae. Larvae exposed to 3, 6 and 12 mg ofB. bassianawere 2.0, 2.5 and 3.5 times more likely to die, respectively, compared to control larvae. Adults not pre-exposed, those pre-exposed to predator, parasite, or both were 45.8, 67.4, 50.9 and 112.0 times more likely to die, respectively, compared to control that were unexposed to predator or parasite, at larval and adult stage.

Conclusions

This study shows that both predator and parasite can reduce larval population ofAn. gambiae, and presence of predator cues decreases development time in breeding sites, as well as, increases the susceptibility of emerging adult to fungus. Predator and parasite both have an additive effect on survival of adults exposed toB. bassiana. Field studies are required for an in-depth understanding of predator and parasite influence on mosquito development time, survival and susceptibility in nature.
Complete monotonicity and inequalities related to generalized k-gamma and k-polygamma functions
Authors: Zhang Ju-Mei , Yin Li , You Hong-Lian
Published: January 2020

In this paper, we prove new complete monotonicity properties of some functions related to generalized k-gamma and k-polygamma functions. Applications of the results yield various new inequalities. In the end, double inequalities are constructed involving the k-generalized digamma and polygamma functions.
Positive periodic solutions for multiparameter nonlinear differential systems with delays
Authors: Chen Ruipeng , Li Xiaoya
Published: January 2020

We establish several criteria for the existence of positive periodic solutions of the multi-parameter differential systems
$$\left \{ \textstyle\begin{array}{l} u'(t)+a_{1}(t)g_{1}(u(t))u(t)=\lambda b_{1}(t)f(u(t-\tau_{1}(t)),v(t-\zeta_{1}(t))), \\ v'(t)+a_{2}(t)g_{2}(v(t))v(t)=\mu b_{2}(t)g(u(t-\tau_{2}(t)),v(t-\zeta_{2}(t))), \end{array}\displaystyle \right . $${u′(t)+a1(t)g1(u(t))u(t)=λb1(t)f(u(t−τ1(t)),v(t−ζ1(t))),v′(t)+a2(t)g2(v(t))v(t)=μb2(t)g(u(t−τ2(t)),v(t−ζ2(t))), where the functions $g_{1}, g_{2}:[0,\infty)\to[0,\infty)$g1,g2:[0,∞)→[0,∞) are assumed to be unbounded. The analysis in the paper relies on the classical fixed point index theory. Our main findings improve and complement some existing results in the literature.
Existence of positive ground state solutions to a nonlinear fractional Schrödinger system with linear couplings
Authors: Du Xinsheng , Mao Anmin , Liu Ke
Published: January 2020

In this paper, we investigate a nonlinear fractional Schrödinger system with linear couplings as follows:
$$ \textstyle\begin{cases} (-\Delta )^{\alpha }u+(1+a(x))u=F_{u}(u,v)+\lambda v,& \text{in } \mathbb{R}^{3}, \\ (-\Delta )^{\alpha }v+(1+b(x))v=F_{v}(u,v)+\lambda u,& \text{in } \mathbb{R}^{3}, \\ u,v\in H^{\alpha }(\mathbb{R}^{3}), \end{cases} $${(−Δ)αu+(1+a(x))u=Fu(u,v)+λv,in R3,(−Δ)αv+(1+b(x))v=Fv(u,v)+λu,in R3,u,v∈Hα(R3), where $(-\Delta )^{\alpha }, \alpha \in (0,1)$(−Δ)α,α∈(0,1), denotes the fractional Laplacian and $\lambda >0$λ>0 is the coupling parameter. Under some assumptions, we prove the existence of positive ground state solutions to the above system with the help of the method of Nehari manifold and concentration compactness lemma.
Some identities for degenerate complete and incomplete r-Bell polynomials
Authors: Kwon Jongkyum , Kim Taekyun , Kim Dae San , Kim Han Young
Published: January 2020

In this paper, we study degenerate complete and incomplete r-Bell polynomials. They are generalizations of the recently introduced degenerate r-Bell polynomials and degenerate analogues for the complete and incomplete r-Bell polynomials. We investigate some properties and identities for these polynomials. In particular, we give explicit formulas for the degenerate complete and incomplete r-Bell polynomials.
Estimation of the mean of the partially linear single-index errors-in-variables model with missing response variables
Authors: Qi Xin , Yu ZhuoXi
Published: January 2020

In this paper, we estimate the mean of the partially linear single-index errors-in-variables model with missing response variables. The linear covariate is measured with additive error, therefore missing is not random. Two special estimators are defined that include a semiparametric regression imputation estimator and a marginal average estimator. These estimators are shown to be asymptotically normal and have the same asymptotic variance. A simulation experiment is used to illustrate our proposed method.
Existence of solutions for integral boundary value problems of mixed fractional differential equations under resonance
Authors: Song Shiying , Cui Yujun
Published: January 2020

In this paper, we concerned the existence of solutions of the following nonlinear mixed fractional differential equation with the integral boundary value problem:
$$\left \{ \textstyle\begin{array}{l} {}^{C}D^{\alpha}_{1-} D^{\beta}_{0+}u(t)=f(t,u(t),D^{\beta +1}_{0+}u(t),D^{\beta}_{0+}u(t)),\quad 0< t< 1,\\ u(0)=u'(0)=0,\qquad u(1)=\int^{1}_{0}u(t)\,dA(t), \end{array}\displaystyle \right . $${D1−αCD0+βu(t)=f(t,u(t),D0+β+1u(t),D0+βu(t)),0<t<1,u(0)=u′(0)=0,u(1)=∫01u(t)dA(t), where ${}^{C}D^{\alpha}_{1-}$D1−αC is the left Caputo fractional derivative of order $\alpha\in(1,2]$α∈(1,2], and $D^{\beta}_{0+}$D0+β is the right Riemann–Liouville fractional derivative of order $\beta\in(0,1]$β∈(0,1]. The coincidence degree theory is the main theoretical basis to prove the existence of solutions of such problems.
Impulsive control on delayed feedback chaotic financial system with Markovian jumping
Authors: Rao Ruofeng , Zhong Shouming
Published: January 2020

In this paper, the global asymptotic stability of both the closed economy system and the open economy system is investigated under impulse control, and the obtained stability criteria improve the existing results in the previous literature, generalizing the stabilization from the closed economy system to the open economy system, and stabilizing the unstable equilibrium point with positive interest rate. Particularly, stability of the equilibrium point with positive interest rate is suitable for the open economic market of China, for the interest rates during different periods in China’s financial market are always some of positive percentages. Finally, numerical examples illustrate the effectiveness of the proposed methods.
The year 2020, a milestone in breaking the vicious cycle of poverty and illness in China
Authors: Wang Yun-Ping , Zhou Xiao-Nong
Published: January 2020

Marking the end of the five-year programme initiated by the Chinese Government to lift more than 70 million people out of poverty, the year 2020 is a milestone. Poverty alleviation has moved strongly forward in China and the major health indicators are now better than the average of all middle- and high-income countries. However, the dual burden of infectious and chronic diseases remains a challenge with respect to achieving the health target in the United Nations 2030 Agenda for sustainable development goals (SDGs). In 2015, about 44% of the poor population in China were impoverished by illness but already in 2018, multi-sectoral actions delivered by the Health-related Poverty Alleviation programme had reduced the number almost by half. In the past three years 15 million poor people (98% of the poor population) with infectious and chronic diseases had been treated and taken care of thanks to financial support through multiple health insurance schemes and other governmental subsidies. This article discusses the lessons learnt with regard to health-related poverty alleviation in China with special reference to those still remaining impoverished by illness. Consolidation of the achievements reached and provision of basic needs to those still disadvantaged and in poor health will require a major improvement of accessibility to, and affordability of, health services. The next step towards enhanced productivity and better living conditions will involve upgrading of the capacity of health professionals in the poor regions, promotion of coherent efforts in health-related poverty alleviation and rural revitalization measures. As an additional measure, data monitoring and research on health poverty alleviation should be strengthened as they are essential to generate the evidence and knowledge needed to support the move in the direction envisioned by the SDGs, and the new Healthy China 2030 programme.
Dialectical behaviour therapy skills reconsidered: applying skills training to emotionally dysregulated individuals who do not engage in suicidal and self-harming behaviours
Authors: Kells Mary , Joyce Mary , Flynn Daniel , Spillane Ailbhe , Hayes Aoife
Published: January 2020

Background

Dialectical behaviour therapy (DBT) is an evidence-based intervention for borderline personality disorder (BPD) but is an intensive treatment with significant health service costs. Access to DBT can sometimes be restricted due to limited resources. Positive results have been reported for the use of DBT skills training (DBT-ST), one of the four modes of standard DBT, in the treatment of individuals with BPD who self-harm. This study evaluates DBT-ST for a subgroup of individuals attending community mental health services who may have a diagnosis of BPD (or emerging BPD traits) but who are not actively self-harming.

Methods

Participants in this study were 100 adults attending community mental health services with a diagnosis of BPD, emerging BPD traits or emotion dysregulation who were not actively self-harming. The majority of participants were female (71%), aged 25–34 years (32%), single (48%) and unemployed (34%). Participants partook in a 24-week DBT-ST intervention delivered by DBT therapists. Outcome measures included the Difficulties in Emotion Regulation Scale (DERS), the DBT Ways of Coping Checklist (DBT-WCCL) and the Five Facet Mindfulness Questionnaire (FFMQ). Measures were administered at pre-intervention, at the end of each skills module, and at post-intervention.

Results

Significant reductions in emotion dysregulation (DERS) and dysfunctional coping (DBT-WCCL) scores were reported from pre- to post-intervention (p < .001). A significant increase in mindfulness scores (FFMQ) and DBT skill use (DBT-WCCL) was also observed (p < .001). However, the drop-out rate was high (49% at post-intervention).

Discussion

The results of this uncontrolled study suggest that a standalone 24-week DBT-ST intervention may have a beneficial impact in terms of a reduction in emotion dysregulation and dysfunctional coping, and an increase in mindfulness and DBT skills use in patients with BPD/ emerging BPD traits who are not currently engaging in self-harm. Adequately powered randomised controlled trials are required to determine treatment efficacy in comparison to standard DBT for this population.
Role of whole-body MRI for treatment response assessment in multiple myeloma: comparison between clinical response and imaging response
Authors: Park Ho Young , Kim Kyung Won , Yoon Min A. , Lee Min Hee , Chae Eun Jin , Lee Jeong Hyun , Chung Hye Won , Yoon Dok Hyun
Published: January 2020

Background

Whole-body MRI (WB-MRI) including diffusion-weighted image (DWI) have been widely used in patients with multiple myeloma. However, evidence for the value of WB-MRI in the evaluation of treatment response remains sparse. Therefore, we evaluated the role of WB-MRI in the response assessment.

Methods

In our WB-MRI registry, we searched multiple myeloma patients treated with chemotherapy who underwent both baseline and follow-up WB-MRI scans. Clinical responses were categorized as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD), using IMWG criteria. Using RECIST 1.1, MD Anderson (MDA) criteria, and MDA-DWI criteria, imaging responses on WB-MRI were rated as CR, PR, SD, or PD by two radiologists independently. Then, discrepancy cases were resolved by consensus. Weighted Kappa analysis was performed to evaluate agreement between the imaging and clinical responses. The diagnostic accuracy of image responses in the evaluation of clinical CR, objective response (CR and PR), and PD was calculated.

Results

Forty-two eligible patients were included. There was moderate agreement between imaging and clinical responses (κ = 0.54 for RECIST 1.1, κ = 0.58 for MDA criteria, κ = 0.69 for MDA-DWI criteria). WB-MRI showed excellent diagnostic accuracy in assessment of clinical PD (sensitivity 88.9%, specificity 94.7%, positive predictive value [PPV] 84.2%, negative predictive value [NPV] 96.4% in all three imaging criteria). By contrast, WB-MRI showed low accuracy in assessment of clinical CR (sensitivity 4.5%, specificity 98.1%, PPV 50.0%, NPV 71.2% in all three imaging criteria). As to the clinical objective response, the diagnostic accuracy was higher in MDA-DWI criteria than RECIST 1.1 and MDA criteria (sensitivity/specificity/PPV/NPV, 84.2%/94.4%/98.0%/65.4, 54.4%/100%/100%/40.9, and 61.4%/94.4%/97.2%/43.6%, respectively).

Conclusions

In the imaging response assessment of multiple myeloma, WB-MRI showed excellent performance in the evaluation of PD, but not in the assessment of CR or objective response. When adding DWI to imaging response criteria, diagnostic accuracy for objective response was improved and agreement between imaging and clinical responses was increased.
Transcatheter arterial chemoembolization combined with simultaneous DynaCT-guided microwave ablation in the treatment of small hepatocellular carcinoma
Authors: Li Zhaonan , Jiao Dechao , Han Xinwei , Si Guangyan , Li Yahua , Liu Juanfang , Xu Yanneng , Zheng Bo , Zhang Xun
Published: January 2020

Purpose

To evaluate the method and effectiveness of transcatheter arterial chemoembolization (TACE) combined with simultaneous DynaCT-guided Microwave ablation (MWA) for the treatment of small hepatocellular carcinoma (SHCC).

Materials and methods

From June 2015 to May 2017, a total of 28 consecutive patients with SHCC received single treatment of TACE and 23 subjects received a combination treatment of TACE with simultaneous DynaCT-guided MWA. Following 1 month of treatment, the tumor response was assessed using the mRECIST criteria and the outcomes were analyzed including intervention-associated complications, changes in liver function, imaging response, and progression-free survival (PFS).

Results

The technical success rate was 100%. The rates of CR (65%) in the combined TACE and MWA group were higher than those of the TACE group (46%). The rate of common adverse events, such as liver abscess, spontaneous bacterial peritonitis and liver dysfunction, in the combined TACE and MWA group (56%) was comparable to the corresponding rate of the TACE group (P > 0.411). The median and mean PFS of the TACE group were significantly lower than those of the combined TACE and MWA group (19.00 months vs. 29.00 months, 21.076 months vs. 24.693 months, p = 0.019, log-rank test).

Conclusion

Stereotactic DynaCT-guided MWA is a safe and effective method for the treatment of SHCC, which usually provides an effective tumor puncture path, notably for lesions that cannot be detected following TACE. Overall, the data suggested that this treatment method could improve the clinical outcome of patients with SHCC.
Numerous lymph node metastases in early gastric cancer without preoperatively enlarged lymph nodes: a case report
Authors: Tsutsumi Chikanori , Moriyama Taiki , Ohuchida Kenoki , Shindo Koji , Nagai Shuntaro , Yoneda Reiko , Fujiwara Minako , Oda Yoshinao , Nakamura Masafumi
Published: January 2020

Background

According to the 2018 Japanese gastric cancer treatment guidelines (ver. 5), a reduced extent of lymphadenectomy (D1 or D1+) is indicated for cT1 N0 tumors that do not meet the criteria for endoscopic resection. However, early gastric cancer with multiple lymph node metastases is not unknown, and cases have been reported. We report a case of a patient with early gastric cancer and numerous nodal metastases who underwent laparoscopic proximal gastrectomy based on a preoperative diagnosis of T1 N0.

Case presentation

A 69-year-old woman underwent emergent endoscopic hemostasis for massive hematemesis of the stomach, and endoscopic examination showed ulceration with a visible vessel. Pathological biopsy examination of the ulcer identified poorly differentiated adenocarcinoma with signet ring cells. The patient was diagnosed with early gastric cancer that was not indicated for endoscopic resection because of the ulceration and histological type. Endoscopic ultrasound showed that the third layer was poorly demarcated at the ulcer scar, indicating invasion to the submucosal layer. Computed tomography did not reveal enlarged lymph nodes or distant metastasis. The preoperative diagnosis was early gastric cancer of the fundus without nodal metastasis, and laparoscopic proximal gastrectomy with D1+ lymphadenectomy was performed. The initial postoperative pathological diagnosis was intramucosal carcinoma without lymphovascular invasion; however, the presence of 26 lymph node metastases was revealed unexpectedly. Additional pathological examination of more resected specimens transected every 2–3 mm revealed that only one lesion contained a small number of cancer cells in the lymphatic duct below the muscularis mucosa.

Conclusions

We report a case of early gastric cancer with 26 nodal metastases in which lymph node involvement was not identified prior to surgery. These findings indicate that the extent of lymphadenectomy and the surgical procedure should be carefully decided even in cT1 N0 early gastric cancer when several risk factors for lymph node metastasis are present.
Delayed bleeding due to a sharp protruding edge of the endostaplers after a wedge resection of the lung: a case report
Authors: Yamano Kazuki , Fujikawa Ryo , Nakamura Toru
Published: January 2020

Background

Endoscopic devices often cause device-related surgical morbidities such as postoperative bleeding. Delayed bleeding due to a protruding edge of an endostapler has not been previously described in the literature.

Case presentation

An 80-yr-old man with a second primary lung cancer underwent a wedge resection of the right lower lobe. He developed sudden hypotension and massive bleeding from the chest tube 4 h after the surgery and underwent an emergency reoperation. A torn parietal pleura was found to have caused a persistent bleeding. There was a sharp protruding edge created by multiple firings of the endostapler. The subsequent lung expansion would have promoted a direct contact between the edge and parietal pleura resulting in delayed bleeding.

Conclusions

A protruding edge due to multiple firings of an endostapler could injure the parietal pleura and cause delayed bleeding after a lung resection. This type of injury would be more common in wedge resection cases because of the larger residual lung volume preserved, which is expected to have a better lung expansion and facilitate the direct contact of the staple line and parietal pleura.