bluuebunny/crossref_metadata_2025_split huggingface dataset:
WeChat app-based reinforced education improves the quality of opioid titration treatment of cancer-related pain in outpatients: a randomized control study
Authors: Peng Zhiyou , Li Lin , Chen Yuan , Feng Zhiying , Fang Xiangming 
Published: September 2020

Abstract
Background
As inadequate pain communication contributes to difficulties in optimizing outcomes of outpatients, we investigated the effect of reinforced education using WeChat App to the opioid titration treatment of cancer-related pain in the outpatient setting.

Methods
We conducted a prospective study to compare reinforced education using Wechat with care as usual from February to December 2019. Patients in the reinforced education group received reinforced education via Wechat, while those in the control group received care as usual. Effect measurements for both groups are carried out with questionnaires at the baseline and 3 days later. Questionnaires include pain intensity (NRS), treatment-related adverse events, cancer-related quality of life (QOL), sleep (PSQI), satisfaction, anxiety (GAD-7) and depression (PHQ-9). Number of patients whose NRS reduced to less than three points in 24 h was the primary outcomes. Secondary outcomes included treatment-related adverse events, cancer-related quality of life, sleep, satisfaction, anxiety and depression.

Results
Although there was no significant difference regarding pain intensity (NRS) between the two groups at 72 h, the rate of NRS that reduced to less than three points in 24 h was significantly higher in the Wechat group than in the control group. Patients’ satisfaction was significantly higher in the Wechat group than in the control group. There was no significant difference between the two groups regarding the other findings at 72 h, including pain intensity (NRS), cancer-related quality of life (QOL), anxiety (GAD-7), depression (PHQ-9), and sleep (PSQI). However, no significant difference was found between the two groups for constipation, nausea, vomiting, dizziness, somnolence, pruritus, loss of consciousness, and death.

Conclusions
Our results indicated that receiving instructions delivered by Wechat resulted an increased number of patients with good pain control and better satisfaction. The study provided insight into the effectiveness of the reinforced education using a Wechat app delivered by a doctor to outpatients in the titration treatment of cancer-related pain.

Trial registration
This study was registered at chictr.org (Registration number: ChiCTR1900021150, Date of Registration: January 30, 2019).
Young age increases the risk of lymph-node metastasis in patients with muscle-invasive bladder urothelial carcinoma
Authors: Tian Zijian , Meng Lingfeng , Wang Xin , Diao Tongxiang , Hu Maolin , Wang Miao , Liu Ming , Wang Jianye 
Published: September 2020

Abstract
Background
The risk of positive lymph nodes in patients with muscle-invasive bladder urothelial carcinoma (MIBC) can be used to guide treatment recommendations. However, little is known about the effect of age on lymph node positivity (LN+). This study aimed to evaluate the effect of age on LN+ in MIBC.

Methods
We analyzed patients with stage T2–T4 bladder urothelial carcinoma who had not received preoperative radiotherapy, had at least one lymph node examined, and underwent cystectomy between 1998 and 2015. The Cochran–Armitage trend test and logistic univariate and multivariate analyses were used to evaluate the effect of age on LN+ in all T stages.

Results
In total, 15,624 patients with MIBC were identified, including 747 patients aged ≤50 years (4.78%), 2614 patients aged 50–59 years (16.73%), 4914 patients aged 60–69 years (31.45%), 5225 patients aged 70–79 years old (33.44%), and 2124 patients aged > 80 years (13.59%). In T2–T4 staging, LN+ was negatively correlated with age. After adjustment for several covariates, multivariate logistic regression analysis revealed that age was an independent risk factor for LN+.

Conclusions
In this large SEER analysis, Young patients with MIBC have a higher risk of lymph node metastasis. This finding is worthy of further study and may eventually affect the treatment decisions of young patients.
Impact of smoking amount on clinicopathological features and survival in non-small cell lung cancer
Authors: Ban Woo Ho , Yeo Chang Dong , Han Solji , Kang Hye Seon , Park Chan Kwon , Kim Ju Sang , Kim Jin Woo , Kim Seung Joon , Lee Sang Haak , Kim Sung Kyoung 
Published: September 2020

Abstract
Background
Screening for early detection of lung cancer has been performed in high-risk individuals with smoking history. However, researches on the distribution, clinical characteristics, and prognosis of these high-risk individuals in an actual cohort are lacking. Thus, the objective of this study was to retrospectively review characteristics and prognosis of patients with smoking history in an actual lung cancer cohort.

Methods
The present study used the lung cancer cohort of the Catholic Medical Centers at the Catholic University of Korea from 2014 to 2017. Patients with non-small cell lung cancer were enrolled. They were categorized into high and low-risk groups based on their smoking history using the national lung screening trial guideline. Distribution, clinical characteristics, and survival data of each group were estimated.

Results
Of 439 patients, 223 (50.8%) patients were in the high-risk group. Patients in the high-risk group had unfavorable clinical characteristics and tumor biologic features. Overall survival of the high-risk group was significantly shorter than that of the low-risk group with both early (I, II) and advanced stages (III, IV). In multivariate analysis, heavy smoking remained one of the most important poor clinical prognostic factors in patients with lung cancer. It showed a dose-dependent relationship with patients’ survival.

Conclusions
High-risk individuals had poor clinical outcomes. Patients’ prognosis seemed to be deteriorated as smoking amount increased. Therefore, active screening and clinical attention are needed for high-risk individuals.
Introduction of less invasive surfactant administration (LISA), impact on diagnostic and therapeutic procedures in early life: a historical cohort study
Authors: Bugter I. A. L. , Janssen L. C. E. , Dieleman J. , Kramer B. W. , Andriessen P. , Niemarkt H. J. 
Published: September 2020

Abstract
Background
In preterm infants with Respiratory Distress Syndrome (RDS), Less Invasive Surfactant Administration (LISA) has been established to reduce the need of mechanical ventilation and might improve survival rates without bronchopulmonary dysplasia. The aim of this study was to investigate whether NICU care has changed after introduction of less invasive surfactant administration (LISA), with regard to diagnostic and therapeutic procedures in the first week of life.

Methods
Infants with gestational age < 32 weeks who received surfactant by LISA (June 2014 – December 2017, n = 169) were retrospectively compared to infants who received surfactant after intubation (January 2012 – May 2014, n = 155). Local protocols on indication for surfactant, early onset sepsis, blood transfusions and enteral feeding did not change between both study periods. Besides, as secondary outcome complications of prematurity were compared. Data was collected from electronic patient files and compared by univariate analysis through Students T-test, Mann Whitney-U test, Pearson Chi-Square test or Linear by Linear Association.

Results
All baseline characteristics of both groups were comparable. Compared to controls, LISA patients received a higher total surfactant dose (208 vs.160 mg/kg; p < 0.001), required redosing more frequently (32.5% vs. 21.3%; p = 0.023), but needed less mechanical ventilation (35.5% vs. 76.8%; p < 0.001). After LISA, infants underwent fewer X-rays (1.0 vs. 3.0, p < 0.001), blood gas examinations (3.0 vs. 5.0, p < 0.001), less inotropic drugs (9.5% vs. 18.1%; p = 0.024), blood transfusions (24.9% vs. 41.9%, p = 0.003) and had shorter duration of antibiotic therapy for suspected early onset sepsis (3.0 vs. 5.0 days, p < 0.001). Moreover, enteral feeding was advanced faster (120 vs. 100 mL/kg/d, p = 0.048) at day seven. There were no differences in complications of prematurity.

Conclusion
The introduction of LISA is associated with significantly fewer diagnostic and therapeutic procedures in the first week of life, which emphasizes the beneficial effects of LISA.
Can complex programs be sustained? A mixed methods sustainability evaluation of a national infant and young child feeding program in Bangladesh and Vietnam
Authors: Moucheraud Corrina , Sarma Haribondhu , Ha Tran Thi Thu , Ahmed Tahmeed , Epstein Adrienne , Glenn Jeffrey , Hanh Hoang Hong , Huong Tran Thi Thu , Luies Sharmin Khan , Moitry Aninda Nishat , Nhung Doan Phuong , Payán Denise Diaz , Rahman Mahfuzur , Tariqujjaman Md , Thuy Tran Thi , Tuan Tran , Bossert Thomas J. , Kruk Margaret E. 
Published: September 2020

Abstract
Background
Poor early-life nutrition is a major barrier to good health and cognitive development, and is a global health priority. Alive & Thrive (A&T) was a multi-pronged initiative to improve infant and young child feeding behaviors. It aimed to achieve at-scale child health and nutrition improvements via a comprehensive approach that included nutrition counseling by health workers, policy change, social mobilization and mass media activities. This study evaluated the sustainability of activities introduced during A&T implementation (2009–2014) in Bangladesh and Vietnam.

Methods
This was a mixed methods study that used a quasi-experimental design. Quantitative data (surveys with 668 health workers, and 269 service observations) were collected in 2017; and analysis compared outcomes (primarily dose and fidelity of activities, and capacity) in former A&T intervention areas versus areas that did not receive the full A&T intervention. Additionally, we conducted interviews and focus groups with 218 stakeholders to explore their impressions about the determinants of sustainability, based on a multi-level conceptual framework.

Results
After program conclusion, stakeholders perceive declines in mass media campaigns, policy and advocacy activities, and social mobilization activities – but counseling activities were institutionalized and continued in both countries. Quantitative data show a persisting modest intervention effect: health workers in intervention areas had significantly higher child feeding knowledge, and in Bangladesh greater self-efficacy and job satisfaction, compared to their counterparts who did not receive the full package of A&T activities. While elements of the program were integrated into routine services, stakeholders noted dilution of the program focus due to competing priorities. Qualitative data suggest that some elements, such as training, monitoring, and evaluation, which were seen as essential to A&T’s success, have declined in frequency, quality, coverage, or were eliminated altogether.

Conclusions
The inclusion of multiple activities in A&T and efforts to integrate the program into existing institutions were seen as crucial to its success but also made it difficult to sustain, particularly given unstable financial support and human resource constraints. Future complex programs should carefully plan for institutionalization in advance of the program by cultivating champions across the health system, and designing unique and complementary roles for all stakeholders including donors.
Associations between physical activity, sedentary behaviour and self-rated health among the general population of children and adolescents: a systematic review and meta-analysis
Authors: Zhang Tong , Lu Guohua , Wu Xiu Yun 
Published: September 2020

Abstract
Background
Self-rated health (SRH) is an indicator that captures a person’s perception of their overall health status. The relationship between physical activity (PA), sedentary behaviour (SB) and SRH has been investigated in systematic reviews among adult and elderly populations. No systematic review to date has synthesized the relationship between PA, SB and SRH among children and adolescents. The purpose of this systematic review and meta-analysis was to synthesize the associations between PA, SB and SRH in the general population of children and adolescents and to investigate the dose-response relationship between PA, SB and SRH.

Methods
We conducted a computer search for English language studies in the databases of MEDLINE, EMBASE and PSYCINFO that were published between 1946 and 2019. We searched PubMed, Google Scholar, and the references of the identified publications for additional studies. A meta-analysis was employed to synthesize the associations between PA, SB respectively and SRH. The dose-response association was tested using a random effects meta-regression model. The review was reported following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.

Results
Sixty-eight published articles were included in the final review, including 59 cross-sectional and nine longitudinal studies. We found evidence that PA was associated with better SRH, and SB was associated with lower SRH among children and adolescents. A dose-response relationship between PA and SRH was observed, where a higher level of PA was associated with better SRH than a lower level of PA. The relationship between PA, SB and SRH was observed in both boys and girls, and did not show a significant gender difference.

Conclusions
The findings in the systematic review suggest that health intervention programmes targeting promoting PA and reducing SB among children and adolescents may enhance their overall health status. Future research is needed to expand prospective cohort and intervention studies to address directionality and causality in the relationships between PA, SB and SRH among children and youth.

Trial registration
PROSPERO - CRD42019142244. Registered on October 18, 2019.
A case report of severe degenerative lumbar scoliosis associated with windswept lower limb deformity
Authors: Yang Xi , Zou Qiang , Song Yueming , Liu Limin , Zhou Chunguang 
Published: September 2020

Abstract
Background
The windswept lower limb deformity describes valgus deformity in one leg with varus deformity in the other. It is mostly seen in young children with metabolic bone diseases (such as rickets) and may lead to leg length discrepancy (LLD) and Degenerative scoliosis (DS) in older age. To the best of our knowledge, there was no report of the spinal surgery in patient with severe DS associated with windswept deformity. The objective of this study is to report the unique case of a 60-year-old woman with severe degenerative scoliosis (DS) associated with windswept deformity caused by rickets who underwent a posterior correction and fusion surgery in spine.

Case presentation
The patient was diagnosed as rickets windswept lower limb deformity for 50 years but never went through routine treatment. Then, she performed lumbar scoliosis for more than 20 years and suffered from severe back pain for 4 years. After overall clinical evaluation and radiographic measures, we performed a posterior surgical correction and fusion from T9-L5. With this surgery, the main thoracolumbar curve Cobb angle corrected from 72.5° to 21.0°, the coronal balance from 0 cm to 2.0 cm while the sagittal vertical axis (SVA) from 1.5 cm to − 1.0 cm. At 2 years postoperative follow-up, her back pain has almost completely relieved with a satisfied fixation and bone fusion showed on CT scans. However, a coronal imbalance was found with C7-CSVLdistance equal to 4.0 cm. This coronal imbalance was highly correlated to the untreated LLD and pelvic obliquity, and should be improved by standing posture or shoe lifts.

Conclusions
For such patient, the pure spinal correction and fusion surgery, in spite of lower limbs deformity, can achieve good relieve of back pain symptom, however may accompany by the complication of coronal imbalance due to the unimproved pelvic obliquity and LLD. However, longer follow-up is necessary to observe the long-term outcome of this patient’s postoperative coronal imbalance.
Copy number variant hotspots in Han Taiwanese population induced pluripotent stem cell lines - lessons from establishing the Taiwan human disease iPSC Consortium Bank
Authors: Huang Ching-Ying , Li Ling-Hui , Hsu Wan-Tseng , Cheng Yu-Che , Nicholson Martin W. , Liu Chun-Lin , Ting Chien-Yu , Ko Hui-Wen , Syu Shih-Han , Wen Cheng-Hao , Yan Zhuge , Huang Hsiang-Po , Su Hong-Lin , Chiang Po-Min , Shen Chia-Ning , Chen Hsin-Fu , Yen B. Lin Ju , Lu Huai-En , Hwang Shiaw-Min , Chiou Shih-Hwa , Ho Hong-Nerng , Wu Jer-Yuarn , Kamp Timothy J. , Wu Joseph C. , Hsieh Patrick C. H. 
Published: September 2020

Abstract
Background
The Taiwan Human Disease iPSC Service Consortium was established to accelerate Taiwan’s growing stem cell research initiatives and provide a platform for researchers interested in utilizing induced pluripotent stem cell (iPSC) technology. The consortium has generated and characterized 83 iPSC lines: 11 normal and 72 disease iPSC lines covering 21 different diseases, several of which are of high incidence in Taiwan. Whether there are any reprogramming-induced recurrent copy number variant (CNV) hotspots in iPSCs is still largely unknown.

Methods
We performed genome-wide copy number variant screening of 83 Han Taiwanese iPSC lines and compared them with 1093 control subjects using an Affymetrix genome-wide human SNP array.

Results
In the iPSCs, we identified ten specific CNV loci and seven “polymorphic” CNV regions that are associated with the reprogramming process. Additionally, we established several differentiation protocols for our iPSC lines. We demonstrated that our iPSC-derived cardiomyocytes respond to pharmacological agents and were successfully engrafted into the mouse myocardium demonstrating their potential application in cell therapy.

Conclusions
The CNV hotspots induced by cell reprogramming have successfully been identified in the current study. This finding may be used as a reference index for evaluating iPSC quality for future clinical applications. Our aim was to establish a national iPSC resource center generating iPSCs, made available to researchers, to benefit the stem cell community in Taiwan and throughout the world.
FDA orphan products clinical trial grants: assessment of outcomes and impact on rare disease product development
Authors: Miller Kathleen L. , Mueller Christine , Liu Gumei , Miller Needleman Katherine I. , Maynard Janet 
Published: September 2020

Abstract
Background
The Office of Orphan Products Development (OOPD) of the United States (U.S.) Food and Drug Administration (FDA) has awarded over 700 grants to conduct clinical trials of medicals products for rare diseases since 1983, leading to over 70 marketing approvals. However, despite recent progress in rare disease product development, thousands of rare diseases still have no approved treatments. An assessment of this clinical trial grants program was undertaken to provide an in-depth analysis of the characteristics and outcomes of the program. Results of this analysis will be used to inform future goals of the program, as well as internal data collection to continue to maximize the program’s impact in supporting rare disease product development.

Results
Between fiscal years 2007—2011, OOPD funded 85 clinical trial grants. These grants spanned 18 therapeutic areas, included all pre-approval phases (Phases 1–3), and approximately 75% of the grants studied small molecule drugs. Nine (11%) product approvals, of seven drugs and two devices, were at least partially supported by grants funded within this 5-year timeframe. Four of the seven drugs approved were new molecular entities (NMEs). The average time from funding to approval was seven years. We also found a suggested association between collaboration with multiple types of stakeholders and the success of grants, where we defined success as either positive or negative study findings or a future marketing approval.

Conclusions
The clinical trials funded by OOPD provided valuable information for future product development, and there were a notable number of approvals that occurred using the support of the grants program. There was a suggested association between collaboration and successful outcomes. Efficient and innovative trial designs and collaboration among stakeholders appear vital to continue to effectively bring products to rare disease patients. Ongoing program assessments will ensure that the funding continues to be used to optimally meet the treatment needs of the rare disease community.
Modeling tumor development and metastasis using paired organoids derived from patients with colorectal cancer liver metastases
Authors: Li He , Dai Weixing , Xia Xi , Wang Renjie , Zhao Jing , Han Lingyu , Mo Shaobo , Xiang Wenqiang , Du Lin , Zhu Guangya , Xie Jingjing , Yu Jun , Liu Nan , Huang Mingzhu , Zhu Jidong , Cai Guoxiang 
Published: September 2020

AbstractTumor metastasis accounts for the majority of cancer-related deaths; it is therefore important to develop preclinical models that faithfully recapitulate disease progression. Here, we generated paired organoids derived from primary tumors and matched liver metastases in the same colorectal cancer (CRC) patients. Despite the fact that paired organoids exhibit comparable gene expression and cell morphology, organoids from metastatic lesions demonstrate more aggressive phenotypes, tumorigenesis, and metastatic capacity than those from primary lesions. Transcriptional analyses of the paired organoids reveal signature genes and pathways altered during the progression of CRC, including SOX2. Further study shows that inducible knockdown of SOX2 attenuated invasion, proliferation, and liver metastasis outgrowth. Taken together, we use patient-derived paired primary and metastatic cancer organoids to model CRC metastasis and illustrate that SOX2 is associated with CRC progression and may serve as a potential prognostic biomarker and therapeutic target of CRC.
Cough-induced rib fracture in a smoker: a case report
Authors: Daccache Aimee , Haddad Jad , Ghanem Ahmad , Feghali Elio Junior , El Osta Bassel 
Published: September 2020

Abstract
Background
Coughing is considered an important mechanism that helps the body get rid of foreign substances or prevent their entry into the tracheobronchial tree. Infrequently, after the onset of coughing, patients presenting with persistent chest pain are found to have rib fractures. Among the cases reported for cough-induced rib fractures, the maximum number of fractured ribs was found to be four.

Case presentation
In this report, we present a case of a healthy 50-year-old Lebanese smoker who developed a total of six fractures in five ribs, asymmetrically, after coughing for 2.5 months.

Conclusion
This case report is, to our knowledge, the first to describe six cough-induced rib fractures in a smoker without an underlying predisposition.