bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term survival and prognostic implications of patients with invasive breast cancer in southern Taiwan
Authors: Wu Shih-Chung , Chiang Ming-Chu , Lee Yun-Gang , Wang Mei-Wen , Li Chuan-Fang , Tung Tao-Hsin , Chen Hsiao-Hui 
Published: February 2020

Abstract
Our objective in this study was to determine the survival rate of patients with invasive breast cancer and identify the prognostic factors related to all-cause mortality during a 10-year follow-up.
Analysis was performed on the medical records of 2002 patients newly diagnosed with breast cancer at a medical center in southern Taiwan between 2006 and 2017. The Kaplan–Meier method and Cox regression analysis were used to estimate survival and the independence of prognostic factors associated with all-cause mortality.
Among the 2002 patients, 257 expired during the 10-year follow-up period. The overall survival rates were as follows: 3 years (91.1%), 5 years (85.6%), and 10 years (77.9%). The median survival time was 120.41 months (95% confidence interval: 118.48–122.33 months). Older age, pathologic tumor status, regional lymph node metastasis, distant metastasis, grade/differentiation, treatment modalities, and hormone therapy were significantly related to all-cause mortality.
This study identified several clinical factors related to all-cause mortality as well as its relationship to distant metastasis and poor differentiation. Early diagnosis and treatment aimed at preventing recurrence are the keys to survival.
Corneal biomechanical responses detected using corvis st in primary open angle glaucoma and normal tension glaucoma
Authors: Jung Younhea , Park Hae-Young L. , Oh Sieun , Park Chan Kee 
Published: February 2020

Abstract
Structural differences have been reported between primary open angle glaucoma (POAG) and normal tension glaucoma (NTG), and biomechanical differences between POAG and NTG may account for why NTG patients are more vulnerable to lower intraocular pressure (IOP). This study compared the biomechanical properties of POAG and NTG patients using the Corvis scheimpflug technology (ST) non-contact Scheimpflug-based tonometer, and determined the factors associated with these properties.
In this retrospective cross-sectional study, 46 eyes with POAG, 54 eyes with NTG, and 61 control eyes were included. A non-contact Scheimpflug-based tonometer was used to examine and compare the corneal biomechanical responses in the POAG, NTG, and normal groups. We used univariate and multivariate regression analyses to determine the factors associated with the deformation amplitude in each group.
Baseline characteristics, including age, IOP, spherical equivalent, keratometry, axial length, and central corneal thickness, were similar among the 3 groups. Severity of glaucoma, as measured by mean deviation, was similar between POAG and NTG groups. Applanation 1 velocity and deformation amplitude were significantly smaller in POAG (0.13 ± 0.02 and 1.06 ± 0.14, respectively) than NTG (0.14 ± 0.01 and 1.13 ± 0.11, respectively) and normal groups (0.14 ± 0.02 and 1.13 ± 0.10, respectively). Radius of curvature was significantly larger in the POAG group compared to the normal group. In normal controls, IOP and keratometry were significant factors related to deformation amplitude. In POAG eyes, IOP was a statistically significant predictor of deformation amplitude. In NTG eyes, however, IOP , keratometry, and axial length were statistically significant predictors of deformation amplitude.
POAG eyes showed less deformable corneas compared to NTG and normal controls. IOP was significantly correlated with deformation amplitude in all groups. However, axial length was positively correlated with deformation amplitude only in NTG eyes. Characterization of the differences in biomechanical properties between POAG and NTG may contribute to a better understanding of the underlying pathophysiologies associated with these diseases.
Venous thromboembolism prophylaxis in patients hospitalized in medical wards
Authors: Mahlab-Guri Keren , Otman Monged Shaher , Replianski Natalia , Rosenberg-Bezalel Shira , Rabinovich Irina , Sthoeger Zev 
Published: February 2020

Abstract
Venous thromboembolism (VTE) is a preventable cause of morbidity and mortality in acutely ill patients hospitalized in medical departments. Thromboprophylaxis with anticoagulants was shown to be safe and effective in medical patients with high risk to develop VTE. Despite guidelines recommendations, the rate of thromboprophylaxis in those patients is low. The objective of the study was to evaluate the rate of VTE risk assessment in routine medical department practice, the rate of eligible patients for thromboprophylaxis, the rate of patients who received thromboprophylaxis, and their outcome.
Medical records of consecutive patients (3000 at 2013, 1000 at 2018) hospitalized in medical department were reviewed, retrospectively, for demographic, clinical characteristics, thromboprophylaxis treatment with enoxaparin and outcome (up to 90 days following discharge). Padua score was used for VTE risk assessment. VTE diagnosis was based on clinical suspicion.
The mean patient's age (52.6% females) was 67.95 ± 21.56 years. 21% were eligible for thromboprophylaxis. Routine VTE risk assessment rate increased significantly following its incorporation into quality parameters, but the rate of treated patients was low (22% at 2013; 46% at 2018). The patients who received thromophylaxis were sicker compared to eligible patients without thromboprophylaxis. The rate of symptomatic VTE was low (0.24%; 0.12% and 0.55% for low and high VTE risk, respectively). Thromboprophylaxis did not have significant effect on the low number of VTE events. No major bleeding was observed.
Major efforts are still needed to increase the rate of thromboprophylaxis in all eligible medical patients according to the guidelines recommendations.
Moxibustion at ‘Danzhong’ (RN17) and ‘Guanyuan’ (RN4) for fatigue symptom in patients with depression
Authors: Iravani Somayeh , Cai Liwei , Ha Lue , Zhou Shuzhe , Shi Chuan , Ma Yibin , Yao Qin , Xu Ke , Zhao Baixiao 
Published: February 2020

Abstract

Background:
Fatigue is one of the most prevalent and debilitating symptoms of major depressive disorder (MDD). The effective management of depression-related fatigue has an important impact on the patient's abilities, functioning, and quality of life (QOL). Moxibustion has been widely used in Traditional Chinese Medicine to manage fatigue. Recent studies have also demonstrated that moxibustion is effective for treating cancer-related fatigue and chronic fatigue syndrome. However, there is not sufficient data supporting the effect of moxibustion for depression-related fatigue. Therefore, this randomized, assessor-blinded, wait-list controlled trial is designed to evaluate the effectiveness, safety, and feasibility of moxibustion treatment for depression-related fatigue.

Methods:
One hundred and seventy-six participants who meet the diagnostic criteria for depression in the International Classification of Diseases, tenth revision (ICD-10), and who also have a score of ≥1 on the 13th item of the Hamilton Depression Rating Scale-17 (HAMD-17), will be enrolled. At study entry, participants will undergo anti-depressant treatment for at least 1 month. Then those who still have a score of ≥1 on the 13th item of the HAMD-17 will be randomly allocated to either a moxibustion group or wait-list control group in a ratio of 1:1. Anti-depressants will be provided for both groups during the whole process of the study period. Participants in the moxibustion group will undergo 14 sessions of moxibustion (over 2 weeks) with anti-depressant treatment, and participants in the wait-list control group will receive only anti-depressant treatment. Subsequently, participants in the moxibustion group will be followed-up for 4 weeks. The primary outcome measure will be the Fatigue Severity Scale (FSS). The secondary outcome measure will be the HAMD-17. Safety will be assessed by monitoring adverse events during the study. Trial feasibility will also be assessed in this study.

Discussion:
The results of this study may provide evidence for the efficacy of moxibustion as an adjunct to antidepressants for depression-related fatigue, and promote a more widespread foundation for the selection of moxibustion in the clinical setting as well as for future research in moxibustion therapy.

Trial registration:
This study protocol was registered at the Chinese Clinical Trial Registry (ChiCTR1800016905).
First-line treatment failure in childhood acute lymphoblastic leukemia
Authors: Zawitkowska Joanna , Lejman Monika , Drabko Katarzyna , Zaucha-Prażmo Agnieszka , Płonowski Marcin , Bulsa Joanna , Romiszewski Michał , Mizia-Malarz Agnieszka , Kołtan Andrzej , Derwich Katarzyna , Karolczyk Grażyna , Ociepa Tomasz , Ćwiklińska Magdalena , Trelińska Joanna , Owoc-Lempach Joanna , Niedźwiecki Maciej , Kiermasz Aleksandra , Kowalczyk Jerzy 
Published: February 2020

Abstract
The aim of this study was to evaluate the risk factors of relapse and treatment-related deaths in acute lymphoblastic leukemia (ALL) in children residing in Poland.
A total of 1872 patients with newly diagnosed ALL, treated according to the ALL IC-BFM 2002 protocol in 14 Polish pediatric hematology centers from 2002 to 2012 were included in the study. Three-hundred eighty-four patients experienced treatment failure. The last follow-up was 31 December, 2016.
Univariate analysis identified factors in each risk group that were significantly different between children whose treatment failed and those who remained in the first remission. Multivariate analysis demonstrated that only the age of 10 years or over at primary diagnosis in the high-risk group was an adverse prognostic factor. To facilitate the analysis, patients were divided into three groups: relapsed children who survived; relapsed children who died; children without relapse who died due to toxicity.
Our analysis showed that age older than 10 years is a particular risk factor for the failure of first-line of treatment, both in terms of relapse and treatment-related mortality.
D-Dimer level was associated with prognosis in metastatic colorectal cancer
Authors: Liu Chan , Ning Yueguo , Chen Xiaoming , Zhu Qian 
Published: February 2020

AbstractD-dimer level is a direct measure of activated coagulation and has been used as a biomarker of hypercoagulability. In this study, we aimed to explore the associations between D-dimer level and the clinicopathological features and prognosis in metastatic colorectal cancer (mCRC) patients. One hundred seventy-eight patients diagnosed with mCRC from the Department of General Surgery, Jingmen First People's Hospital from September 2014 to December 2018 were collected. Data of coagulation index was evaluated and survival analysis was performed to identify the biomarker of mCRC. Among 178 cases of colorectal cancer, we found that the value of 0.55 mg/L, 5ng/ml and 40U/ml were cut-off values of D-Dimer, CEA and CA-199 for patients survival, respectively. hypercoagulability was much more frequent in patients aged ≥60 years than <60 years (P< .001) and also in patients with ECOG ≥2 points (P < .001). Moreover, those patients who have CEA >5ng/ml and CA-199>40U/ml had hypercoagulable state (P < .001). There was a significant difference in D-Dimer >0.55 mg/L and D-Dimer ≤0.55 mg/L among the number of metastatic sites (P < .01) and patients with comorbidities (P < .01). Survival analysis showed that patients with D-Dimer >0.55 mg/L have significantly unfavorable overall survival (P = .006) and progressive free survival (P = .011).
Transforaminal epidural steroid injections in cervical spinal disease with moderate to severe disability
Authors: Hong Jae-Young , Park Jin-Sung , Suh Seung-Woo , Yang Jae-Hyuk , Park Si-Young , Kim Bo Taek 
Published: February 2020

Abstract
Despite many clinical trials on cervical epidural steroid injections, the indications for and long-standing outcomes of this treatment remain controversial. We evaluated the outcomes and indications for transforaminal cervical epidural steroid injection (TCESI) in patients with moderate to severe disability.
We prospectively gathered data from patients with 1 or 2-level cervical degenerative disease (herniated disc, foraminal stenosis) with moderate to severe disability (3.5 < initial visual analog scale < 6.5, 15 < Neck Disability Index < 35) and greater than 12 weeks of pain, despite conservative treatment. Patients with persistent disability and those who desired surgical intervention underwent decompression surgery. The clinical and demographic characteristics were compared between groups.
Of the 309 patients who underwent TCESI, 221 (72%) did not receive surgical treatment during the 1-year follow-up period. The remaining 88 patients (28%) underwent surgery at a mean of 4.1 months after initial TCESI. Patients who underwent injection alone showed a significant decrease in disability and pain that persisted until the 1-year follow-up visit (P < .05). In patients who underwent surgery, the mean disability and pain scores after injection did not decrease for several months, although the scores significantly decreased up to 1 year after surgery (P < .05).
The TCESI significantly decreased pain and disability in the moderate to severe disability group up to 1 year after injection. We recommend cervical TCESI as an initial treatment with moderate to severe disability patients.
The Prevalence and Incidence of Attention-deficit/Hyperactivity Disorder in the Veterans Health Administration From 2009 to 2016
Authors: Hale Andrew C. , Bohnert Kipling M. , Spencer Robert J. , Ganoczy Dara , Pfeiffer Paul N. 
Published: February 2020

Background:
The prevalence and incidence of attention-deficit/hyperactivity disorder (ADHD) have increased substantially among children and adolescents over the past decade; however, little is known regarding trends in adult populations.

Objective:
The objective of this study was to explore trends in the prevalence, incidence, and correlates of adult ADHD in a national sample of veterans receiving care at Veteran Affairs (VA) hospitals and clinics.

Research Design:
A retrospective design was used to examine ADHD diagnosed in all VA primary care (PC) and mental health clinics (MHCs) from fiscal years (FYs) 2009 to 2016. Age-adjusted prevalence and incidence were calculated using direct standardization, and Poisson regressions modeled differences in trends between demographic groups.

Subjects:
All veterans with VA PC or MHC visits during the observation period.

Measures:
ADHD incidence and prevalence, psychiatric comorbidity, neuropsychological evaluation.

Results:
An annual average of 5.09 million (range: 4.63–5.42 million) VA patients attended a PC or MHC appointment between FY09 and FY16. During this period, age-adjusted annual prevalence increased 258% from 0.23% to 0.84% and incidence increased 240% from 0.14% to 0.48%. Black veterans and older veterans had the lowest prevalence and incidence across all years. Increases in prevalence and incidence occurred across all demographic subgroups. The proportion of patients who had a neuropsychological evaluation within 6 months before or after a new ADHD diagnosis decreased from 12.6% to 10.8% [χ2
(1)=16.59, P<0.001].

Conclusion:
Overall increases and demographic differences in adult veterans diagnosed with ADHD suggest a growing need to establish the reliability of diagnostic practices to ensure appropriate and equitable care.
Financial Performance of Medicare Advantage Contracts in 2014 and Plan Renewal, Consolidation, and Termination Rates in the Subsequent Year
Authors: Langellier Brent A. , Park Sungchul 
Published: February 2020

Background:
Starting in 2014, the Affordable Care Act mandated that Medicare Advantage (MA) contracts spend at least 85% of total revenue on claims and quality improvement [ie, the medical loss ratio (MLR)] and submit revenue and cost data annually in MLR reports. These reports can improve transparency of the financial performance of MA contracts. However, little is known about revenues and costs of insurers that participate in MA and its impacts on status changes in the following year.

Objective:
To characterize revenues and costs of MA contracts in 2014, with a focus on MLRs and gross margins, and to assess heterogeneity in subsequent-year plan renewal and termination rates by gross margins.

Research Design:
Cross-sectional data from MLR reports submitted in 2014 by MA contracts and from 2015 Part C & D Plan Crosswalk Files regarding plan renewal, termination, and other status changes from 2014 to 2015.

Subjects:
Three hundred eighty-nine MA contracts.

Measures:
Primary outcomes are MLRs and gross margins.

Results:
MLRs averaged 93% in 2014; 11% of contracts reported MLRs of at least 100%. Fifty-six percent reported negative margins, or costs that exceeded revenues. Seventeen percent of plans in contracts in the lowest quartile of gross margins were terminated in 2015, compared to under 5% of plans in the highest-margin contracts.

Conclusions:
In 2014, MA contracts reported MLRs greater than the mandatory minimum of 85%. Gross margins likely contribute to trends in plan and insurer availability. MLR reports from subsequent years can help explain fluctuations in insurers’ participation in MA.
Three years’ clinical practice of Radium-223 therapy in patients with symptomatic bone metastases from metastatic castrate-resistant prostate cancer: a single-centre experience
Authors: Gazzilli Maria , Durmo Rexhep , Cossalter Erika , Cerudelli Elisabetta , Panarotto Maria Beatrice , Albano Domenico , Bertagna Francesco , Giubbini Raffaele 
Published: February 2020

Background
Radium-223 was a treatment approved for patients with metastatic castrate-resistant prostate cancer, symptomatic bone metastases and no-visceral metastases, in progression after at least two prior lines of systemic therapy, or ineligible for any available systemic treatment. The aim of this study was to provide further characterization and sub-selection of patients who would benefit most with Radium-223 treatment.

Methods
We retrospectively analysed 38 patients treated with Radium-223 between 2015 and 2018. All patients underwent a baseline visit and a bone scintigraphy. Bone scan, ALP and PSA levels were repeated after third and after the end of therapy. All patients were re-evaluated after 2 months from the end of therapy. Survival curves were plotted according to the Kaplan–Meier method and differences between groups were analysed by using a two-tailed log-rank test.

Results
The response to the treatment in term of change in pain was reduction in 16 patients; no change in 14 and increased in eight. We arbitrarily established a cut-off 10 bone lesions to evaluate the response: patients with less than 10 metastasis had significant differences in PFS (P < 0.001) compared to patients with more than 10, no statistical significance was found considering the OS (P = 0.23) between the two groups. The same results were founded in patients with baseline ALP <220 U/L with a PFS (P < 0.001) and OS (P = 0.027).

Conclusion
The most important finding was the correlation between the number of bone metastasis and ALP with outcome survival and efficacy of Radium-223 treatment.
Children With Gastroesophageal Reflux Disease Consume More Calories and Fat Compared to Controls of Same Weight and Age
Authors: Borodina Galina , Morozov Sergey 
Published: February 2020

ABSTRACTObjective:The aim of the study was to compare the rates of nutrients consumption in children and adolescents with gastroesophageal reflux disease (GERD) compared to the control group without the disease.Methods:Based on symptom evaluation and esophageal pH‐impedance recordings patients were allocated on to GERD and control groups. All patients underwent esophagogastroscopy. Levels of nutrients consumption were assessed with the use of food frequency questionnaire in the regard to the presence of the disease, esophagitis, and z score body mass index (BMI).Results:Data of 219 children and adolescents were available for the final analysis. Risks to have GERD were higher in groups with obesity (risk ratio 1.2 [95% confidence interval 0.8–1.7]) and excessive weight (1.1 [0.9–1.4]). Energy values of the rations and amount of fat consumption were higher in the GERD group compared to the control when rations were compared according to z score BMI. In contrast to nonerosive form of GERD, patients with erosive esophagitis consumed more protein (percentage deviation from the recommended daily allowance Me [25%;75%]): 14.3 (11.07; 19.1) % versus 8.5 (6.71; 14.1) %, total fat 36.8 (12.5; 75.5) % versus 16.9 (10.1; 17.9) %, and less polyunsaturated fats −54.3 (−73.4; −47.7) % versus −45.6 (−56.2; −33.1) %, P < 0.05.Conclusions:The rations of children with GERD are characterized by higher calorie values and larger amounts of fat intake compared to the control group in the regard to z score BMI. Low dietary fiber consumption is additional factor associated with GERD in children with excessive weight and obesity. Compared to nonerosive GERD, higher intake of energy, protein, and total fat and lower of polyunsaturated fats revealed in patients with GERD with erosive esophagitis.
Therapy Response in a Pediatric Patient With Extracutaneous Juvenile Xanthogranuloma Monitored by FDG PET/CT
Authors: Wen Zhe , Zhuang Hongming 
Published: February 2020

Abstract
Juvenile xanthogranuloma, a rare type of non-Langerhans cell histiocytosis, generally manifests as widespread skin lesions, which is often self-limited. However, when other organs are involved, its outcome can be unfavorable, and there is no clearly defined consensus regarding what is the best imaging modality in monitoring the therapy. We report here findings of a series of FDG PET/CT scans during the course of clofarabine therapy in a 12-year-old girl with extracutaneous juvenile xanthogranuloma.
Posttherapeutic Critical Organ Dosimetry of Extensive 177Lu-PSMA Inhibitor Therapy With Metastatic Castration-Resistant Prostate Cancer
Authors: Özkan Ahu , Uçar Burcu , Seymen Hülya , Yildiz Yarar Yasemin , Falay Fikri Okan , Demirkol Mehmet Onur 
Published: February 2020

Purpose

177Lu-PSMA inhibitor peptide receptor radioligand therapy (RLT) is playing an increasing role in metastatic castration-resistant prostate cancer. We aimed to estimate the absorbed radiation doses for critical organs (eg, kidneys, parotid glands, submandibular glands, and lacrimal glands) of patients treated with 4 to 6 cycles by 177Lu-PSMA inhibitor RLT, retrospectively, and to evaluate the findings extensively in order to determine the critical organ radiation-absorbed limitations and the number of prospective RLT.

Materials and Methods
A total of 51 cycles 177Lu-PSMA inhibitor RLT in 10 patients was analyzed. Therapies have been applied in 4 to 6 cycles with 8 to 10 weeks' intervals. Dosimetric estimates of kidneys, parotid glands, submandibular glands, and lacrimal glands have been calculated based on MIRD scheme pamphlet no. 16. Regions of interest were drawn with GE Xeleris Functional Imaging Workstation. OLINDA/EXM 1.1 simulation software was used to calculate radiation-absorbed doses.

Results
Mean radiation-absorbed doses were 0.70 ± 0.24 Gy/GBq for kidneys, 1.34 ± 0.78 Gy/GBq for parotid glands, 0.94 ± 0.45 Gy/GBq for submandibular glands, and 2.28 ± 1.29 Gy/GBq for lacrimal glands.

Conclusions
Due to the critical target organ risks and the optimal therapy doses, patient-specific dosimetry is a deterministic factor in radionuclide therapy. Even when the absorbed kidney doses were above the ICRP critical dose limits in patients who had 4 to 6 cycles of therapy, mortality due to nephrotoxicity has not been observed. Mild increased tolerated radiation dose is acceptable for the patient groups with very low survival rate.