bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protocol for the Process Evaluation of the Online Remote Behavioural Intervention for Tics (ORBIT) Randomised Controlled Trial for children and young people
Authors: Khan Kareem , Hollis Chris , Hall Charlotte L , Davies E Bethan , Mataix-Cols David , Andrén Per , Murphy Tara , Brown Beverley J , Murray Elizabeth , Glazebrook Cris 
Published: November 2019

Abstract
Background Process evaluations are an important component in the interpretation and understanding of outcomes in trials. The ‘Online Remote Behavioural Intervention for Tics’ (ORBIT) study is a randomized controlled trial evaluating the effectiveness of an internet delivered behavioural intervention (called BIP TIC) compared to an internet delivered education program aimed at children and young people with tics. A process evaluation will be undertaken alongside the main trial to determine precisely how the behavioural intervention works and ascertain whether, and if so, how, the intervention could be successfully implemented in standard clinical practice. This protocol paper describes the rationale, aims, and methodology of the ORBIT trial process evaluation. Methods The process evaluation will use a mixed-methods design following the UK Medical Research Council’s 2015 guidelines, comprising of both quantitative and qualitative data collection. This will include: analyzing data usage of participants in the intervention arm; purposively sampled, semi-structured interviews of parents and children, therapists and supervisors, and referring clinicians of the ORBIT trial, as well as analysis of qualitative comments input into the online therapy platform by participants at the end of treatment. Qualitative data will be analyzed thematically. Quantitative and qualitative data will be integrated in a triangulation approach, to provide an understanding of how the intervention works, and what resources are needed for effective implementation, uptake and use in routine clinical care. Discussion This process evaluation will explore the experiences of participants, therapists and supervisors, and referring clinicians of a complex online intervention. By contextualising trial efficacy results, this will help understand how and if the intervention worked and what may be required to sustain the implementation of the treatment long-term. The findings will also aid in our understanding of factors that can affect the success of complex interventions. This will enable future researchers developing online behavioural interventions for children and young people with mental health and neurological disorders to gain invaluable information from this process evaluation.
Reliable cell and tissue morphology-based diagnosis of endemic Burkitt lymphoma in resource-constrained settings in Ghana
Authors: Smith-Togobo Cecilia , Pedersen Mette Ø , Jensen Steffen G , Duduyemi Babatunde , Gyasi Richard K , Ofori Michael F , Paintsil Vivian , Renner Lorna , Nørgaard Peter , Hviid Lars 
Published: November 2019

Abstract
Endemic Burkitt lymphoma (eBL) is an aggressive B-cell lymphoma, which is a common childhood cancer in areas with intense transmission of Plasmodium falciparum parasites. Early and accurate diagnosis is a prerequisite for successful therapy, but it optimally involves advanced laboratory investigations. These are technologically demanding, expensive, and often difficult to implement in settings where eBL is prevalent. Diagnosis is thus generally based on clinical assessment and morphological examination of tumour biopsies or fine-needle aspirates (FNAs). The purpose of the present study was to assess the accuracy of eBL diagnosis at two tertiary hospitals in Ghana. To that end, we studied FNAs from 29 eBL patients and 21 non-eBL lymphoma patients originally diagnosed in 2018. In addition, we examined 111 archival formalin-fixed and paraffin-embedded (FFPE) biopsies from Ghanaian patients originally diagnosed as eBL (N=55) or non-eBL (N=56) between 2010 and 2017. Availability-based subsets of samples were subjected to haematoxylin-eosin or Giemsa staining, C-MYC immunohistochemistry, and fluorescence in situ hybridisation (FISH) analysis of c-myc rearrangements We found a good correlation between original diagnosis and subsequent retrospective assessment, particularly for FNA samples. However, evidence of intact c-myc genes and normal C-MYC expression in samples from some patients originally diagnosed as eBL indicates that morphological assessment alone can lead to eBL over-diagnosis in our study area. In addition, several FFPE samples could not be assessed retrospectively, due to poor sample quality. Therefore, the simpler FNA method of obtaining tumour material is preferable, particularly when careful processing of biopsy specimens cannot be guaranteed. We conclude that the accuracy of eBL diagnostic tools available in Ghana is generally adequate, but could be improved by implementation of additional pathology laboratory investigations. Improved attention to adequate preservation of archival samples is recommended.
The predictive value of red cell distribution width for stroke severity and outcome
Authors: Shahsavarinia Kavous , Seifar Fatemeh , Sadeghi-Hokmabadi Elyar , Laleh Younes Ghavam , Moharramzadeh Payman , Pouraghaei Mahboob , Khamnian Zhila , Hajibonabi Farid , Farhoudi Mehdi , Mafi Sara 
Published: November 2019

Abstract
Objectives: In the present study, we sought to investigate the association between RDW and stroke severity and outcome in patients who underwent anti-thrombolytic therapy with tissue plasminogen activator (tPA). Results: In this prospective study, 282 stroke patients who underwent tPA injection were included. The categorization of RDW to <12.9 and >13 values revealed insignificant difference in stroke severity score, accounting for the mean 36-hour NIHSS of 8.19±8.2 in normal RDW values and 9.94±8.28in higher RDW group (p=0.64). In seventh day, NIHSS was 6.46±7.28 in normal RDW group and was 8.52±8.35 in increased RDW group (p=0.058). Neither the thirty-six-hour, nor the seventh day and 3-month MRS demonstrated significant difference between those with normal and higher RDW values.
Immunoprecipitation of protein lysate from culture cells using Src antibody
Authors: Iida Madoka , Katsuno Masahisa 
Published: November 2019

Abstract
It is a procedure for immunoprecipitation using protein lysate from a neuronal cell line, NSC34, and a muscle cell line, C2C12 using DynabeadsTM Protein G Immunoprecipitation Kit (ThermoFisher).
The transcriptomic signature of low aggression honey bees resembles a response to infection
Authors: Rittschof Clare C , Rubin Benjamin E.R. , Palmer Joseph H. 
Published: November 2019

Abstract
Background: Behavior reflects an organism's health status. Many organisms display a generalized suite of behaviors that indicate infection or predict infection susceptibility. We apply this concept to honey bee aggression, a behavior that has been associated with positive health outcomes in previous studies. We sequenced the transcriptomes of the brain, fat body, and midgut of adult sibling worker bees who developed as pre-adults in relatively high versus low aggression colonies. Previous studies showed that this pre-adult experience impacts both aggressive behavior and resilience to pesticides. We performed enrichment analyses on differentially expressed genes to determine whether variation in aggression resembles the molecular response to infection. We further assessed whether the transcriptomic signature of aggression in the brain is similar to the neuromolecular response to acute predator threat, exposure to a high-aggression environment as an adult, or adult behavioral maturation. Results: Across all three tissues assessed, genes that are differentially expressed as a function of aggression significantly overlap with genes whose expression is modulated by a variety of pathogens and parasitic feeding. In the fat body, and to some degree the midgut, our data specifically support the hypothesis that low aggression resembles a diseased or parasitized state. However, we find little evidence of active infection in individuals from the low aggression group. We also find little evidence that the brain molecular signature of aggression is enriched for genes modulated by social cues that induce aggression in adults. However, we do find evidence that genes associated with adult behavioral maturation are enriched in our brain samples. Conclusions: Results support the hypothesis that low aggression resembles a molecular state of infection. This pattern is most robust in the peripheral fat body, an immune responsive tissue in the honey bee. We find no evidence of acute infection in bees from the low aggression group, suggesting the physiological state characterizing low aggression may instead predispose bees to negative health outcomes when they are exposed to additional stressors. The similarity of molecular signatures associated with the seemingly disparate traits of aggression and disease suggests that these characteristics may, in fact, be intimately tied.
What predicts the health-related quality of life of adolescents with cerebral palsy in Bangladesh?
Authors: Power Rosalie , Galea Claire , Muhit Mohammad , Heanoy Eamin , Karim Tasneem , Badawi Nadia , Khandaker Gulam 
Published: November 2019

Abstract
Background: The health-related quality of life (HRQoL) of adolescents with CP in low and middle-income countries is often poor, as is the case in Bangladesh. This exploratory study examined what factors predict the proxy-reported HRQoL of adolescents with CP in rural Bangladesh, a typical low- and middle-income country (LMIC).
Methods: Adolescents with CP (10 to 18y) were identified using the Bangladesh Cerebral Palsy Register. HRQoL was assessed using the Cerebral Palsy Quality of Life-Teens proxy-report questionnaire (CPQoL-Teens), adolescent mental health using the Strengths and Difficulty Questionnaire (SDQ) and caregiver mental health using the Depression, Anxiety and Stress Scale (DASS-21). Theoretical and statistical interests (i.e. bivariate analysis, p<0.05) identified potential predictors which were entered into hierarchical multiple linear regression (HMLR) models in order of clinical significance; HMLR related adolescent clinical characteristics, adolescent and caregiver mental health and proxies of socioeconomic status to CPQoL-Teens dimensions.
Results: 154 adolescents with CP (mean age 15y 1mo, SD 1y 8mo, female 31.2%) participated in this study. Twenty-four factors were identified to explore for relationship to adolescent proxy-reported HRQoL. Fifteen of the factors correlated to one or more CPQoL-Teens dimension; strongest correlation was between ‘feelings about functioning’ and motor impairment (r=0.545). Nine were predictive of CPQoL-Teens dimensions; adolescent sex, school attendance, severity of motor impairment, hearing and speech impairment, mother’s education, primary caregiver depression and stress, and having a sanitary latrine at home resulting in score changes of between 0.79 (95% CI 0.24 to 1.35) to 35.1 (95% CI 6.03 to 64.22).
Conclusions: Many of the factors predicting the proxy-reported HRQoL of adolescents with CP are amenable to intervention, and have the potential to improve adolescent wellbeing. Several determinants are priorities of the sustainable development goals (SDGs); these findings should inform resource prioritization to improve the wellbeing of adolescents with CP in Bangladesh and other LMICs.
Impact of a semi-structured briefing on the management of adverse events in anesthesiology: A randomized pilot study.
Authors: Neuhaus Christopher , Schäfer Johannes , Weigand Markus A. , Lichtenstern Christoph 
Published: November 2019

Abstract
Background : Human factors research has identified mental models as a key component for the effective sharing and organization of knowledge. The challenge lies in the development and application of tools that help team members to arrive at a shared understanding of a situation. The aim of this study was to assess the influence of a semi-structured briefing on the management of a simulated airway emergency. Methods : 37 interprofessional teams were asked to perform a simulated rapid-sequence induction in the simulator. Teams were presented with a “cannot ventilate, cannot oxygenate” scenario that ultimately required a cricothyroidotomy. Study group (SG) teams were asked to perform a briefing prior to induction, while controls (CG) were asked to perform their usual routine. Results : We observed no difference in the mean time until cricothyroidotomy (SG 8:31 CG 8:16, p=0.36). There was a significant difference in groups’ choice of alternative means of oxygenation: While SG teams primarily chose supraglottic airway devices, controls initially reverted to mask ventilation (p=0.005). SG teams spent significantly less time with this alternative airway device and were quicker to advance in the airway algorithm. Conclusions : Our study addresses effects on team coordination through a shared mental model as effected by a briefing prior to anesthesia induction. We found measurable improvements in airway management during those stages of the difficult airway algorithm explicitly discussed in the briefing. For those, time spent was shorter and participants were quicker to advance in the airway algorithm.
Sarcopenia and intramuscular fat deposition are associated with poor survival in Indonesian patients with hepatocellular carcinoma: a retrospective study
Authors: Mardian Yan , Yano Yoshihiko , Ratnasari Neneng , Choridah Lina , Wasityastuti Widya , Setyawan Nurhuda Hendra , Hayashi Yoshitake 
Published: November 2019

Abstract
Background

A large-scale Japanese study showed that low skeletal muscle index (SMI) and intramuscular fat (IMF) deposition are associated with hepatocellular carcinoma (HCC) survival. Here, we evaluated the effects of SMI and IMF on the survival of Indonesian HCC patients, whose characteristics differ from those of Japanese patients.Methods

SMI and mean muscle attenuation (MA) were evaluated using computed tomography images of the third lumbar vertebra (L3) in a prospective cohort of 100 Indonesian HCC patients. Clinical, laboratory and body composition data were analysed using the Kaplan–Meier method and Cox regression model to investigate which factors are associated with prognosis.Results

Of 100 patients, 31 were diagnosed with sarcopenia (L3 SMI value ≤36.2 cm 2 /m 2 for men and ≤29.6 cm 2 /m 2 for women), and 65 had IMF deposition (MA value ≤44.4 HU for men and ≤39.3 HU for women). These groups had shorter median survival than the reference groups (both P <0.0001). In multivariable analysis, sarcopenia (hazard ratio [HR], 1.921; P = 0.016), IMF deposition (HR, 3.580; P <0.001), Barcelona Clinic Liver Cancer (BCLC) stages C and D (HR: 2.396, P <0.01 and HR: 6.131, P <0.01, respectively), Japan Integrated Staging (JIS) score 4 (HR: 2.067, P = 0.020), and male gender (HR: 3.211, P <0.001) were independently associated with mortality.Conclusion

Sarcopenia and IMF deposition showed superior value in combination with BCLC stage and JIS score for predicting the survival of Indonesian HCC patients. Increased awareness and strategies to prevent or reverse these factors might improve patient outcomes. (Electric word counts: 249)
Short-term and long-term unintended impacts of a pilot reform on Beijing's zero markup drug policy: a propensity score-matched study
Authors: Zeng Jianying , Chen Xiwen , Fu Hongqiao , Lu Ming , Jian Weiyan 
Published: November 2019

Abstract
Background In September 2012, Beijing, the capital of China, selected five tertiary hospitals as pilots to remove the previously allowed 15% markup for drug sales. However, while most research demonstrated the significant decrease in drug sales, the core issue of high health expenditure was not well solved because of the unintended policy impact. This study aimed to empirically evaluate the short-term and long-term unintended impacts on controlling medical expenses of Beijing’s zero markup drug policy from 2012 to 2015.
Methods This study extracted 2012-2015 individual-level data from the Beijing Urban Employee Basic Medical Insurance (UEBMI) database and performed a propensity score-matched analysis to evaluate the short-term and long-term impacts on controlling medical expenses. All inpatients in the 5 pilot reform hospitals were selected as the intervention group, while inpatients in other tertiary hospitals were selected as the control group.
Results A total of 520,996 inpatients were extracted in this study. For patients in the pilot hospitals, the total expenditures per admission decreased from 17,140.3 yuan in 2012 to 15,430.1 yuan in 2013 and then increased to 16,789.8 yuan in 2015. Expenditure on drugs reduced from 5,811.7 yuan in 2012 to 3,903.4 yuan in 2015. However, a significant substitution effect of medical consumables was first observed in the third quarter of 2014, which undermined the impact of the policy. In the long-term, the intervention group and control group demonstrated the same trend.
Conclusions After the zero markup drug policy, expenditure on drugs revealed a continuous decline. However, the decline in total expenditure was weakened by the substitution effect of medical consumables in the long term.
Effect of kidney transplantation on sleep quality in patients admitted in ICU:a cross-section study in China
Authors: Long Lu , Liu Jia , Yan Jin , Xie Jian fei , Liu Huan , Yin Ke Hong 
Published: November 2019

Abstract
Background Although evidences showed that sleep disorder is common in patient with end stage renal disease (ESRD), less is known about their sleep quality after early post-kidney transplantation (kTx) especially in Intensive Care Unite (ICU). Thus, the purpose of this study is to investigate sleep quality of kTx recipients in ICU and explore factors related poor sleep, second, to measure the correlation of subjective sleep quality and sleep architecture assessed by PSG in kTx recipients. Methods This study recruited participants from ESRD patients registered in transplantation waiting list at the third xiangya hospital of central south university in China. Participants required to complete the Pittsburgh sleep quality index(PSQI) and demographic questionnaire as baseline data and received one night of Polysomnography (PSG) in the ICU within 96 hours of surgery, during which time sound and light data were monitored. After that Richards Campbell sleep questionnaires (RCSQ) also need completed. Results 26 participants self-reported sleep quality and sleep efficiency based on RCSQ was at middle level (49.2 ± 25.6mm), and 14/26(53.8%) kTx recipients in ICU were poor sleepers defined by RCSQ <50. PSG showed that most kTx recipients in ICU had shallow sleep with mainly stage 2 sleep time (80.90 ±70.10 min), lower total sleep time (136.50 ±86.41 min), higher awakening frequency after sleep onset (8.87 ±5.92 times) and long awaken time (94.67 ±75.09 min) when a sleep disruption occured. multiple linear regression analysis showed that self-reported noise and pain were the significant factor affecting sleep(P < 0.05).Conclusion Subjective sleep quality based on RCSQ scored better than objective one measured by PSG in kTx recipients, sleep disruption always remained a substantial problem and affected by self-reported noise and pain.
A predictive model for treatment response in patients with locally advanced esophageal squamous cell carcinoma after concurrent chemoradiotherapy: based on SUVmean and NLR
Authors: Wang Chunsheng , Zhao Kewei , Hu Shanliang , Huang Yong , Ma Li , Li Minghuan , Song Yipeng 
Published: November 2019

Abstract
Background: We conducted this study to combine the mean standardized uptake value (SUVmean) and neutrophil to lymphocyte ratio (NLR) to establish a strong predictive model for patients with esophageal squamous cell carcinoma (ESCC) after concurrent chemoradiotherapy (CCRT). Methods: We retrospectively analyzed 163 newly diagnosed ESCC patients treated with CCRT. Eighty patients (training set) were randomly selected to generate cut-off SUVmean and NLR values by receiver operating characteristic (ROC) curve analysis and to establish a predictive model by using the independent predictors of treatment outcomes. Then, we evaluated the performance of the prediction model regarding treatment outcomes in the testing set (n=83) and in all sets. Results: A high SUVmean (>5.81) and high NLR (> 2.42) at diagnosis were associated with unfavorable treatment outcomes in patients with ESCC. The prediction model had a better performance than the simple parameters (p<0.05). With a cut-off value of 0.77, the prediction model significantly improved the specificity and positive predictive value for treatment response (88.9% and 92.1% in the training set, 95.8% and 97.1% in the testing set, and 92.2% and 91.8% in all sets, respectively). Conclusions: The pretreatment SUVmean and NLR were independent predictors of treatment response in ESCC patients treated with CCRT. The predictive model was constructed based on these two parameters and provides a highly accurate tool for predicting patient outcomes.
Development and Validation of CT-based Radiomics Scores for Prediction of Response to Neoadjuvant Chemotherapy and Survival in Gastric Cancer
Authors: Sun Kai-Yu , Hu Hang-Tong , Chen Shu-Ling , Ye Jin-Ning , Li Guang-Hua , Chen Li-Da , Peng Jian-Jun , Feng Shi-Ting , Yuan Yu-Jie , Hou Xun , Wu Hui , Li Xin , Wu Ting-Fan , Wang Wei , Xu Jian-Bo 
Published: November 2019

Abstract
Background: Neoadjuvant chemotherapy is a promising treatment option for potential resectable gastric cancer, but patients’ responses varied. We aimed to develop and validate a radiomics score (rad_score) to predict the treatment response of neoadjuvant chemotherapy, and to investigate its efficacy in survival stratification. Methods: A total of 106 patients with neoadjuvant chemotherapy before gastrectomy were included (training cohort: n=74; validation cohort: n=32). Radiomics features were extracted from the pre-treatment portal venous-phase CT. After feature reduction, a rad_score was established by Randomized Tree algorithm. A rad_clinical_score was constructed by integrating the rad_score with clinical variables, so was a clinical score by clinical variables only. The three scores were validated regarding their discrimination and clinical usefulness. According to the score thresholds (updated with post-operative clinical variables), patients were stratified into two groups and their survivals were compared.Results: In the validation cohort, the rad_score demonstrated a good predicting performance in treatment response of neoadjuvant chemotherapy (AUC [95% CI] =0.82 [0.67, 0.98]), which was better than the clinical score (based on pre-operative clinical variables) without significant difference (0.62 [0.42, 0.83], P=0.09). The rad_clinical_score could not further improve the performance of rad_score (0.70 [0.51, 0.88], P=0.16). Based on the thresholds of these scores, the high-score groups all achieved better survivals than the low-score groups in the whole cohort (all P<0.001). Conclusion: The rad_score was effective in predicting treatment response of neoadjuvant chemotherapy and stratifying patients’ survival for gastric cancer, which assisted in individualized treatment planning.