bluuebunny/crossref_metadata_2025_split huggingface dataset:
International Randomised Controlled Trial for the Treatment of Newly Diagnosed Ewing Sarcoma Family of Tumours – EURO EWING 2012 Protocol
Authors: Birmingham Jennifer Anne , Moroz Veronica , Marec-Berard Perrine , Gaspar Nathalie , Laurence Valerie , Martin-Broto Javier , Sastre Ana , Gelderblom Hans , Owens Cormac , kaiser Sophie , Fernández-Pinto Melissa , Fenwick Nicola , Evans Abigail , Strauss Sandra , Whelan Jeremy , Wheatley Keith , Brennan Bernadette 
Published: December 2019

Abstract
Background Despite multiple randomised trials in newly diagnosed Ewing sarcoma family of tumours (ESFT), over many years, and involving many international co-operative groups, the outcomes for all stages of disease have plateaued. Internationally, the standard treatment of ESFT is not defined, and there is a need to add new agents other than conventional chemotherapy to improve outcomes. This trial will compare two different induction/consolidation chemotherapy regimens vincristine, ifosfamide, doxorubicin and etoposide (VIDE) induction and vincristine, actinomycin D, ifosfamide or cyclophosphamide, or Busulfan and Mephalan (VAI/VAC/BuMel) consolidation compared with vincristine, doxorubicin, cyclophosphamide, ifosfamide and etoposide (VDC/IE) induction and ifosfamide and etoposide, vincristine and cyclophosphamide, vincristine, actinomycin D and ifosfamide, or Busulfan and Mephalan (IE/VC/VAI/ BuMel) consolidation- randomisation 1 (R1). A second randomisation (R2) will determine whether the addition of zoledronic acid to consolidation chemotherapy, as assigned at R1, is associated with improved clinical outcome. Methods EURO EWING 2012 is an international, multicentre, phase III, open-label randomised controlled trial. There are two randomisations: R1 and R2. Patients are randomised at two different time points, at entry to the trial (R1) and following local control therapy (R2). The primary outcome measure is event-free survival. The secondary outcome measures include overall survival, adverse events and toxicity, histological response of the primary tumour, response of the primary tumour, regional lymph nodes and/or metastases, and achievement of local control at the end of treatment. Discussion This study will establish which is the "standard regimen" of chemotherapy, taking into account both clinical outcomes and toxicity. This will form the chemotherapy backbone for future interventional studies where we may want to add new targeted agents. It will also determine the role of zoledronic acid, in conjunction with the separate EE2008 trial. Any trial in ESFT needs to take into account the rarity of the tumour and that international co-operation is needed to provide answers in a timely manner. Trial registration Registered with EudraCT number 2012-002107-17 on 26th February 2012. Registered with ISRCTN number 54540667 on 4th November 2013.
Conventional Computed Tomographic Calcium Scoring vs Full Chest CTCS for Lung Cancer Screening: A Cost-Effectiveness Analysis
Authors: Jiang Boxiang , Linden Philip A. , Gupta Amit , Jarrett Craig , Worrell Stephanie G. , Ho Vanessa P. , Perry Yaron , Towe Christopher W. 
Published: December 2019

Abstract
Background Conventional CTCS images the mid/lower chest for coronary artery disease (CAD). Because many CAD patients are also at risk for lung malignancy, CTCS often discovers incidental pulmonary nodules (IPN). CTCS excludes the upper chest, where malignancy is common. Full-chest CTCS (FCT) may be a cost-effective screening tool for IPN. Methods A decision tree was created to compare a FCT to CTCS in a hypothetical patient cohort with suspected CAD. (Figure) The design compares the effects of missed cancers on CTCS with the cost of working up non-malignant nodules on FCT. The model was informed by results of the National Lung Screening Trial and literature review, including the rate of malignancy among patients receiving CTCS and the rate of malignancy in upper vs lower portions of the lung. The analysis outcomes are Quality-Adjusted Life Year (QALY) and incremental cost-effectiveness ratio (ICER), which is generally considered beneficial when <$50,000/QALY. Results Literature review suggests that rate of IPNs in the upper portion of the lung varied from 47-76%. Our model assumed that IPNs occur in upper and lower portions of the lung with equal frequency. The model also assumes an equal malignancy potential in upper lung IPNs despite data that malignancy occurs 61-66% in upper lung fields. In the base case analysis, a FCT will lead to an increase of 0.03 QALYs comparing to conventional CTCS (14.54 vs 14.51 QALY, respectively), which translates into an QALY increase of 16 days. The associated incremental cost for FCT is $278 ($1,027 vs $748, FCT vs CTCS respectively. The incremental cost-effectiveness ratio (ICER) is $10,289/QALY, suggesting significant benefit. Sensitivity analysis shows this benefit increases proportional to the rate of malignancy in upper lung fields. Conclusion Conventional CTCS may be a missed opportunity to screen for upper lung field cancers in high risk patients. The ICER of FCT is better than screening for breast cancer screening (mammograms $80k/QALY) and colon cancer (colonoscopy $6k/QALY). Prospective studies are appropriate to define protocols for FCT.
Risk factors for poor treatment outcomes of 2,266 multidrug-resistant tuberculosis cases in Ho Chi Minh City: a retrospective study
Authors: Van Le Hong , Phu Phan Trieu , Vinh Dao Nguyen , Son Vo Thanh , Hanh Nguyen Thi , Nhat Le Thanh Hoang , Lan Nguyen Huu , Vinh Truong Van , Trang Nguyen Thi Mai , Ha Dang Thi Minh , Thwaites Guy , Thuong Nguyen Thuy Thuong 
Published: December 2019

Abstract
Background: Multidrug resistant tuberculosis (MDR-TB) remains a serious public health problem with poor treatment outcomes. Predictors of poor outcomes vary in different regions. Vietnam is among the top 30 high burden of MDR-TB countries. We describe demographic characteristics and identify risk factors for poor outcome among patients with MDR-TB in Ho Chi Minh City (HCMC), the most populous city in Vietnam. Methods: This retrospective study included 2,266 patients who initiated MDR-TB treatment between 2011-2015 in HCMC. Treatment outcomes were available for 2,240 patients. Data was collected from standardized paper-based treatment cards and electronic records. A Kruskal Wallis test was used to assess changes in median age and body mass index (BMI) over time, and a Wilcoxon test was used to compare the median BMI of patients with and without diabetes mellitus. Chi squared test was used to compare categorical variables. Multivariate logistic regression with multiple imputation for missing data was used to identify risk factors for poor outcomes. Statistical analysis was performed using R program. Results: Among 2,266 eligible cases, 60.2% had failed on a category I or II treatment regimen, 57.7% were underweight, 30.2% had diabetes mellitus and 9.6% were HIV positive. The notification rate increased 24.7% from 2011-2015. The treatment success rate was 73.3%. Risk factors for poor treatment outcome included HIV co-infection (adjusted odds ratio (aOR): 2.94), advanced age (aOR: 1.45 for every increase of 5 years for patients 60 years or older), having history of MDR-TB treatment (aOR: 5.53), sputum smear grade scanty or 1+ (aOR: 1.47), smear grade 2+ or 3+ (aOR: 2.06), low BMI (aOR: 0.83 for every increase of 1kg/m2 of BMI for patients with BMI<21). Conclusion: The number of patients diagnosed with MDR-TB in HCMC increased by almost a quarter between 2011-2015. Patients with HIV, high smear grade, malnutrition or a history of previous MDR-TB treatment are at greatest risk of poor treatment outcome.
Husbands’ experience and perception of supporting their wives during childbirth in Tanzania
Authors: Kashaija Denis Kampayana , Mselle Lilian Teddy , Mkoka Dickson Ally 
Published: December 2019

Abstract
Background : In order improve the quality of birth care and women satisfaction with birthing process it is recommended that every woman should be offered the option to experience labour and childbirth with a companion of her choice. Involving husbands as decision makers in the household may a play role in reducing maternal mortality which is unacceptably high despite the targeted goal to reduce these mortality as targeted in the MDGs by 2015. This is still addressed in the Sustainable Development Goals (SDGs) of 2015/30. This study aimed to explore the experiences and perceptions of husbands’ support of their wives during pregnancy, labour and deliveries in Tanzania. Methods: Qualitative descriptive study design was employed; involving men aged between 24 and 63 years. Participants were selected purposefully at the clinic and in labour ward of SekouToure Regional Referral Hospital (SRRH). The in-depth interview, guided by semi structured interview guide was used to collect the audio recorded and hand written information. Data were analysed using qualitative content analysis Results; Nine (9) semi-structured interviews were conducted with husbands of women attended for antenatal care and those came for deliveries. Four themes emerged; Demonstrating care, love and affection, adopting modern life style, observing women’s right and meeting social economic difficulties. Husbands’ support to their partners is a good behaviour practiced during matrimonial lives. Husbands who support their partners during pregnancy and delivery consider themselves as being modern men as they at home take duties beside their usual tasks to let their wives have adequate time to rest during pregnancy. Poor road infrastructure makes difficult to get transport to the healthcare facility especially when labour is imminent. Also ward infrastructure is not supportive to accommodate husbands when they accompany their wives to the healthcare facility. Conclusion s; The healthcare settings in low income countries need to accommodate men during the routine antenatal and intranatal care for the positive outcome of labour and delivery. Exploratory research should be conducted to understand how education and urbanisation affects men involvement in maternal and child health specifically in the low income countries.
Clinical outcomes of prophylactic compression sutures for treatment of uterine atony during the cesarean delivery of twins
Authors: Kim Mi-La , Hur Yoon-Mi , Ryu Hyejin , Lee Min Jin , Seong Seok Ju , Shin Joong Sik 
Published: December 2019

Abstract
Background : Twin pregnancy has a high risk for developing uterine atony (UA). This study aimed to evaluate efficacy and clinical outcomes of prophylactic compression sutures to treat UA during twin cesarean section (CS). Methods : All patient records of twin deliveries by CS after gestational age of 24 weeks in a large maternity hospital in South Korea between January 2013 and June 2018 were reviewed. Patients with monochorionic monoamniotic twins were excluded from data analysis. In total, 953 women were eligible for data analysis. Results : Of the 953 patients, compression sutures were applied to 147 cases with postpartum bleeding that were refractory to uterine massage and uterotonics. Out of the 147, two patients (1.4%) proceeded to additional uterine artery ligation to achieve hemostasis, yielding a success rate of 98.6%. The rate of transfusion after the first 24 hours of delivery in the suture group was not significantly different from that in the non-suture group, suggesting that both groups achieved hemostasis at an equal rate after the first 24 hours of delivery. The difference in the operation time between the two groups was only 8.5 minutes. The rate of subsequent pregnancy among the patients who received compression sutures was 44.4%. Conclusions : Overall, our findings suggest that with early and fast implementation of compression sutures, UA can be treated in the setting of twin cesarean delivery without significantly increasing maternal morbidity.
Evaluations of knowledge, skills and practices of insulin storage and injection handling techniques of patients in Ethiopian primary hospitals
Authors: Netere Adeladlew Kassie , Ashete Eyayaw , Gebreyohannes Eyob Alemayehu , Belachew Sewunet Admasu 
Published: December 2019

Abstract
Background: Diabetes mellitus is a group of metabolic disorders and resulting from deficits in insulin secretion, insulin action, or both. Insulin therapy is primarily required to attain the recommended goal of blood sugar. The primary aim of this study was to evaluate the knowledge, skills and practices of insulin storage and injection technique of patients. Methods : An interview based cross-sectional study was conducted in conveniently selected participants in Northwest Ethiopian primary hospitals from March, 1, 2019 to May, 30, 2019. Knowledge and practice were measured by administering structured questionnaire with a Likert scale of 1–5 through face-to-face interviews and skills were assessed by five observational (demonstration) techniques from a total of 166 clients. Results: Of the total 166 participants, 54.8% were males and the mean age was 38.46±13.8 years . The overall knowledge (65.4%.) and practice (53.89%) rate on insulin storage and handling techniques were showed moderate knowledge and fair practices. About 94.6% of participants correctly shown insulin injection sites. One-way ANOVA showed that the level of education [F (3, 162) = 7.283, p<0.001], ways of instruction of insulin injection [F (2, 163) =3.32, p = 0.039], insulin therapy duration [F (3,162) = 3.59, p= 0.015] and assessing insulin storage [F (2,163) = 4.45, p = 0.013] had a significant effect on level of knowledge. Similarly, knowledge level [F (2,163) = 14.17, p < 0.001], educational status [F (3,162) = 10.57, p <0.001], occupation type [F (4,161) = 5.43, p <0.001], time since insulin therapy [F (3, 162) = 5.46, p = 0.001] and diagnosis [F (3,162) = 3.36, p= 0.02] had a significant effect on patients’ insulin storage and administration practices. Conclusion: Patient had marginal knowledge and practices on insulin storage and administration techniques. The patients’ skills on the important and critical steps of administrations are poor. The engagements of healthcare professionals and stakeholders should be in developments of instructions and guidelines are very crucial in addition to focusing on educating and changing their wrong perceptions, believes and attitudes towards storage and administering techniques.
miR-Island: an ultrafast and memory-efficient tool for plant miRNA annotation and expression analysis
Authors: Gao Tiantian , Meng Xin , Zhang Wei , Jin Weibo 
Published: December 2019

Abstract
Background Next-generation sequencing of small RNAs has yielded an abundance of microRNA (miRNA) profiling data for diverse plant species. Many programs have been developed for plant miRNA annotation based on sequencing data, but these programs typically require computers with powerful hardware configurations. At present, few ultrafast computational tools are available for this type of data analysis on standard personal computers. Results We present miR-Island, an ultrafast tool for plant miRNA identification from deep sequencing data. Two important strategies contribute to the speed of the miR-Island program: (1) extracting precursor candidates using a pseudogenome and (2) using parallel processing for RNA secondary structure prediction. In our analysis, the pseudogenomic strategy reduced the time required for miRNA precursor extraction from 85 seconds to 19 seconds in Salvia miltiorrhiza , and parallel processing significantly reduced the time for the secondary structure prediction of 3957 S. miltiorrhiza miRNA precursors from 90 seconds to 32 seconds. miR-Island completed miRNA annotation for Arabidopsis in 18 minutes on a standard personal computer, which was less than 50% of the time for ShortStack and 9% of that for miRDeep-P. In terms of accuracy, miR-Island identified 128 miRNAs, which included 68 known miRNAs in miRBase. ShortStack predicted 55 total miRNAs, including 38 known miRNAs in miRBase. Of the 175 total miRNAs predicted by miRDeep-P, only 57 miRNAs were registered in miRBase. Agreement between miR-Island and ShortStack was moderate (kappa = 0.47). For the prediction of miRNAs from three other plant datasets, miR-Island spent approximately <50% of the ShortStack run time and <2.5% of the miRDeep-P run time. When the three programs were run on contig-level S. miltiorrhiza data, miR-Island, miRDeep-P and ShortStack finished the prediction in 17 minutes, 11 hours and 40 minutes, respectively. Conclusion Unlike other approaches, miR-Island is an ultrafast and memory-efficient tool for plant miRNA annotation and quantification on standard personal computer using the strategies of pseudo genome and multiple threads. In addition, miR-Island is a single command Perl script that is convenient to use for miRNA annotation and quantification. miR-Island was implemented in Linux and is available under the GPL GPU license from https://github.com/janeyurigao/miR-Island.
Application of voxel-based morphometric measurement to brain magnetic resonance imaging in children with non-cyanotic congenital heart disease
Authors: Jia Xuan , MA XIAOHUI , LIANG JIAWEI , ZHOU HAICHUN 
Published: December 2019

Abstract
Background Congenital heart disease（CHD） is a cardiovascular malformation caused by abnormal heart and/or vascular development in the fetus. In children with CHD, abnormalities in the development and function of the nervous system are common. At present, there is a lack of research on the preoperative neurological development and injury of young children with non-cyanotic CHD. The objective of the current study is to determine the changes in white matter, gray matter, and cerebrospinal fluid (CSF) by magnetic resonance imaging (MRI) in children with noncyanotic CHD as compared with healthy controls. MethodsChildren diagnosed with non-cyanotic CHD on ultrasonography (n=54) and healthy control subjects (n=35) aged 1–3 years. Brain MRI was performed prior to surgery for CHD. The SPM v12 software was used to calculate the volumes of the gray matter, white matter, CSF, and the whole brain (sum of the gray-matter, white-matter, and CSF volumes). Volume differences between the two groups were analyzed. Voxelbased morphometry was used to compare specific brain regions with statistically significant atrophy.ResultsCompared with the control group, the study group had significantly reduced whole-brain white-matter volume (P<0.05), but similar whole-brain graymatter, CSF, and whole-brain volumes(P>0.05). As compared with the healthy controls, children with non-cyanotic CHD had mild atrophy in the white matter of the anterior central gyrus, the posterior central gyrus and the pulvinar. ConclusionsChildren with non-cyanotic CHD show decreased white-matter volume before surgery, and this volume reduction is mainly concentrated in the somatosensory and somatic motor nerve regions.
Health professionals’ adherence to evidence-based obesity guidelines: a cohort study.
Authors: Garrido Nuria Trujillo , Bernal Mariangeles , Cano Maria José Santi 
Published: December 2019

Abstract
BACKGROUND The prevalence of obesity is on the increase worldwide and yet scientific evidence shows that primary care professionals are not adequately addressing overweight and obesity. In this study, we evaluate how obesity guidelines are being implemented in routine clinical practice. METHODS The study obtained the following data on a cohort of 209 obese patients attending primary care consultations: electronic medical records, body mass index (BMI), waist circumference (WC), cardiovascular risk factors, comorbidities and whether or not their health professional adhered to obesity evidence-based guidelines. RESULTS 57.9% of the participants were women and their average age was 65.8 ± 12.7 years. Only 25.4% of the medical records met all the criteria established in the therapeutic guidelines regarding diet prescription. This percentage was significantly higher in males than females (36.4% vs 17.4, p = 0.002). 1.4% met the criteria for physical activity and 1.5% for behavioural change activities. In the multivariate analysis, the variable associated with the most favourable BMI and WC figures, after adjusting for age, was a follow up by health professionals on physical activity (β=0.347, p=0.027, CI=0.429-6.868; β=0.367, p=0.024, CI=1.256-17.556) during routine check-ups with women. CONCLUSIONS We detected low adherence to the evidence-based guidelines among professionals. Recording dietetic prescription and physical exercise in the patient's medical record is associated with a better control of obesity. This data suggest that primary health care should be improved for obese patient.
A Randomised Dose-Response Study of Prophylactic Methoxamine Infusion for Preventing Spinal-induced Hypotension during Cesarean Delivery
Authors: Fu Feng , Tang Yu-wen , Chen Hong , Jiao Cui-cui , Ma Na , Chen Xinzhong 
Published: December 2019

Abstract
Background: α-receptor agonists have been reported to be safe and effective for treating or preventing spinal-induced hypotension during cesarean delivery. As a pure α 1 adrenergic agonist, methoxamine has the advantage of reducing myocardial oxygen consumption and protecting the heart in obstetric patients compared to phenylephrine. Prophylactic infusion of vasopressor appears to be superior to bolus administration. The aim of this study was to determine the optimal prophylactic methoxamine infusion dose that would be effective for preventing spinal-induced hypotension in 50% (ED 50 ) and 95% (ED 95 ) of parturients. Methods : Eighty parturients with a singleton pregnancy scheduled for elective cesarean delivery were randomly allocated to receive prophylactic methoxamine infusion at one of four different fixed-rates: 1μg/kg/min (group M1), 2μg/kg/min (group M2), 3μg/kg/min (group M3), or 4μg/kg/min (group M4). An adequate response was defined as absence of hypotension (maternal SBP <80% of baseline). The values for ED50 and ED95 of prophylactic methoxamine infusion were determined by probit regression model. The outcomes of maternal hemodynamics and fetal status were compared among the groups. Results: The calculated ED 50 and ED 95 (95% confidence interval) of prophylactic methoxamine infusion dose were 2.178 (95% CI 1.564 to 2.680) μg/kg/min and 4.821 (95% CI 3.951 to 7.017) μg/kg/min, respectively. The incidence of hypotension decreased with increasing methoxamine infusion dose (15/20, 11/20, 7/20 and 2/20 in group M1, M2, M3 and M4 respectively, P < 0.001). 1-minute Apgar scores and umbilical arterial PaO2 were lower but umbilical arterial PaCO2 was higher in Group M1. No difference was found in the other incidence of adverse effects and neonatal outcomes among groups. Conclusions: Under the conditions of this study, when prophylactic methoxamine infusion was given at a fixed-rate based on body weight for preventing spinal-induced hypotension in obstetric patients, the values for ED 50 and ED 95 were 2.178μg/kg/min and 4.821μg/kg/min respectively.