bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors of Brain Metastasis in Patients with EGFR-Mutated Advanced Non-Small Cell Lung Cancer
Authors: Ouyang Wen , Yu Jing , Zhou Yan , Hu Jing , Huang Zhao , Zhang Junhong , Xie Conghua 
Published: November 2019

Abstract
Purpose NSCLC patients with EGFR mutation was associated with higher incidence of developing brain metastasis (BM). BM is associated with high mortality. Reducing risk of BM becomes increasingly significant for achieving prolonged survival. The aim of the study was to explore the possible risk factors of developing BM during EGFR-TKIs treatment, and to identify the potential candidates for prophylactic cranial irradiation (PCI) or the first-line osimertinib treatment.Methods A total of 157 consecutive EGFR-mutated advanced NSCLC patients without BM at initial diagnosis in our institute between 2014 and 2018 were included. Comparisons of OS were performed based on BM status. The cumulative incidence of secondary BM was calculated by the Kaplan-Meier method, and the independent risk factors of secondary BM were investigated by multivariate analysis.Results Patients with secondary BM had worse survival (mOS: 28.6 months) than patients not-developing BM (mOS: 44.8 months). Moreover, the multivariate analysis indicated that age ≤ 49 years (P=0.035), number of extracranial metastases (P=0.013), and malignant pleural effusion (P =0.002) were independent risk factors of secondary BM. Furthermore, the 1-year actuarial risk of developing secondary BM in patients with no risk factor (n =101), 1 risk factor (n =46), and 2 risk factors (n =10) were 7.01%, 14.61%, and 43.75%, respectively (P<0.001).Conclusions Patients developing secondary BM during EGFR-TKIs treatment have worse outcomes. Our results suggested that EGFR-mutated advanced NSCLC patients with ≥ 1 risk factors were candidates for PCI or the first-line osimertinib treatment.
A Tunisian version of the Confusion Assessment Method for the intensive care unit (CAM-ICU): translation and validation
Authors: Saida Imen Ben , Kortli Saiid , Amamou Badii , Kacem Nawres , Ghardallou Mariem , Ely Eugene Wesley , Saad Helmi Ben , Boussarsar Mohamed 
Published: November 2019

Abstract
Background Delirium is common in critically ill patients and is associated with poor outcomes. In Tunisia, it remains however underdiagnosed, lacking a validated screening tool. The CAM-ICU is one of the most commonly used tools for detecting delirium in ICUs. The aim of the present study was to translate and validate a Tunisian version of the CAM-ICU. Methods A forward and backward translation was performed according to the guidelines suggested by the translation and cultural adaptation group. For the validation and inter-rater reliability assessment of the Tunisian CAM-ICU, two trained intensivists independently evaluated delirium in ICU patients admitted between October 2017 and June 2018. The results were compared with the reference evaluation carried out by a psychiatrist using the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The inter-rater reliability was calculated using the kappa statistic. Results The related material of the Tunisian translated version of the CAM-ICU is currently available at the website www.icudelirium.org (last access: October 19, 2019). The study enrolled 137 patients. The Tunisian CAM-ICU showed a very high inter-rater reliability for both intensivists in terms of assessing delirium (Kappa=0.844, p<0.001). Using the DSM-5 rater as the reference standard, the sensitivity of the two intensivists’ evaluations were 80.4% vs. 95.7%. Specificity was 98.9% for both respectively. Conclusions The Tunisian version of the CAM-ICU showed excellent validity and reliability in detecting delirium in critically ill patients. It could therefore be used in Tunisian ICUs or where Tunisian translators are available following appropriate training. Trial registration: Not applicable.
The use of online health related information by medical students and their trust in the retrieved information
Authors: Khajouei Reza , Karbasi Zahra , Mirzaee Moghaddameh , Ameri Arefeh , Ahmadian Leila 
Published: November 2019

Abstract
Background The Internet plays an important role in attaining health related information and its importance is growing worldwide. The majority of Internet users are university students. However, their use of the Internet for health information has not been well studied. The objective of this study was to examine the use of the Internet by medical students to search for health information. Methods This cross-sectional survey was performed on a sample of 400 Medicine, Dentistry and Pharmacology students selected from three faculties. The data were collected using a valid and reliable questionnaire designed based on the review of the published literature and advice of a panel of experts. Data were analyzed by SPSS 20 using Chi-square and Logistic regression.Results In this study 261 (65.2%) students used the Internet to search for health information. Most of them (n=175, 67%) somewhat trusted the reliability of information on the Internet. Women used the Internet to search for health information 1.74 times than men (p=0.016) and Medicine students 1.7 times than Pharmacology students (p=0.04). The majority of 20-30 years old students believed that using Internet had no effect on their visits to physicians(p=<0.0001). It reduced the number of visits in all students older than 30. Conclusions The content of online resources needs to be monitored in terms of its credibility for using by students especially those involved in health care domain. Based on our findings most students somewhat trusted the online health information. This is promising for the universities to plan for investment on online education and materials.
Pattern and Timing of Diversification in the African Freshwater Fish Genus Distichodus (Characiformes: Distichodontidae)
Authors: Arroyave Jairo , Denton John S. S. , Stiassny Melanie L. J. 
Published: November 2019

Abstract
Background: Distichodus, the type genus of the endemic African characiform family Distichodontidae, is a clade of tropical freshwater fishes currently comprising 25 named species distributed continent-wide throughout the Nilo-Sudan and most Sub-Saharan drainages. This study investigates the phylogenetic relationships, timing of diversification, and biogeographic history of the genus from a taxonomically comprehensive mutilocus dataset analyzed using Maximum Likelihood and Bayesian methods of phylogenetic inference, coalescence-based species-tree estimation, divergence time estimation, and inference of geographic range evolution. Results: Analyses of comparative DNA sequence data in a phylogenetic context reveal the existence of two major clades of similar species-level diversity and provide support for the monophyletic status of most sampled species. Biogeographic reconstruction on a time-scaled phylogeny suggest that the origins of the genus date back to the late Oligocene and that current geographic distributions are the result of a Congo Basin origin followed by dispersal and range expansion into adjacent ichthyofaunal provinces at different times during the evolutionary history of the group.Conclusions: We present the most comprehensive phylogenetic, chronological, and biogeographic treatment ever conducted for the genus. The few instances of species paraphyly (D. teugelsi, D. fasciolatus) revealed by the resulting phylogenies might be a consequence of deep coalescence and recent speciation. Historical biogeographic findings are both in agreement and conflict with previous studies of other continent-wide African freshwater fish genera, suggesting acomplex scenario for the assemblage of Africa’s continental ichthyofaunal communities. Keywords: Distichodontidae, Distichodus, Congo Basin, molecular phylogeny, African fishes, geographic range evolution, molecular dating.
Genetic diversity and population structure of Amorphophallus albus, a plant species with extremely small populations (PSESP) endemic to dry-hot valley of Jinsha River
Authors: Tang Rong , Liu Erxi , Zhang Yazhou , Schinnerl Johann , Sun Weibang , Chen Gao 
Published: November 2019

Abstract
Background Amorphophallus albus P. Y. Liu & J. F. Chen (Araceae) is a plant species with extremely small populations (PSESP) and important economic crop endemic to dry-hot valleys along the Jinsha River. In order to gain information for sustaining the development and conservation of A. albus , we studied the genetic diversity and population structure of this species using microsatellite markers (SSR). In this study, we analyzed 364 individuals belonging to 24 populations, including four wild populations and three ex-situ cultivated populations, collected in the provinces Yunnan, Sichuan and Hubei.Results The population genetic analyses indicated that A. albus possesses moderate genetic diversity with the percentage of polymorphic loci ( PPL ) from 69.23% to 100%, an expected heterozygosity ( He ) of 0.504 and an average Shannon's Information Index ( I ) 0.912. Analysis of molecular variance (AMOVA) indicated that most of the variance (71%) resided within populations and the estimated gene flow ( Nm ) was 0.61. The results of UPGMA cluster tree, STRUCTURE analyses together with the Mantel test (R 2 = 0.352, P < 0.01) indicated that geographically closely located populations are cluster together with some exceptions.Conclusions Our results showed that A. albus still possesses moderate genetic variation in most of the studied populations, and for now, most cultivated populations were naturally distributed but still some reintroduction exists. For sustaining the present genetic variation, some protections measures are necessary for the wild populations and also for the cultivated ones with high genetic diversity.
TeamMate: A longitudinal study of New Zealand working farm dogs. I. Methods, population characteristics and health on enrolment.
Authors: Isaksen Katja Elisabeth , Linney Lori , Williamson Helen , Cave Nick J , Beausoleil Ngaio J , Norman Elizabeth Jane , Cogger Naomi 
Published: November 2019

Abstract
Background Working farm dogs are invaluable on New Zealand sheep and beef farms. To date no study describing farm dog population and health has included information about incidence of illness and injury, or risk factors affecting health and career duration. This paper describes the methodology and initial results from TeamMate, a longitudinal study that was designed to address this gap. We describe the study population, husbandry practices, and prevalence of clinical abnormalities on enrolment. Methods Data about the farms, owners, husbandry practices and dogs were collected on farm at approximately 6-month intervals. All dogs over 18 months old and in full work were enrolled. Dogs were given physical examinations by veterinarians. On examination all abnormalities were noted, regardless of clinical significance. Results Six hundred forty-one working farm dogs and 126 owners were enrolled from the South Island of New Zealand. Forty-nine percent of dogs were Heading dogs (314 of 641) and 48% Huntaways (308 of 641). Median age of dogs was four years (range 1.5 – 14) and median body condition score (BCS) was four on a 9-point scale (interquartile range (IQR) 3 – 5). Fifty-four percent of dogs were male (345 of 641), and 6% (41 of 641) were neutered. Eighty-one percent of owners (102 of 126) fed dogs commercial biscuits and meat sourced on farm. Forty-four percent of dogs (279 of 641) had bedding in their kennel, 14% (55 of 393) had insulated kennels, 69% (442 of 641) had been vaccinated and 33% (213 of 641) were insured. Clinical abnormalities were found in 74% of dogs (475 of 641). Common abnormalities involved the musculoskeletal system (43%, 273 of 641), skin (including scars and callouses; 42%, 272 of 641), and oral cavity (including worn and broken teeth; 35%, 227 of 641). Conclusions Our results expand on those from previous surveys and indicate that musculoskeletal illness and injury, and skin trauma are the most commonly seen clinical abnormalities in working farm dogs. These results will provide a baseline for investigation of incidence and risk factors for illness, injury, retirement and death in New Zealand working farm dogs.
Molecular detection of Porcine Reproductive and Respiratory Syndrome Virus, Porcine Circovirus 2 and Hepatitis E Virus in oral fluid compared to detection in faeces and serum.
Authors: Plut Jan , Jamnikar-Ciglenecki Urska , Stukelj Marina 
Published: November 2019

Abstract
Background Porcine Reproductive and Respiratory Syndrome Virus (PRRSV), Porcine Circovirus Type 2 (PCV2) and Hepatitis E virus (HEV) are common and economically important viral disease causative agents detected in pig oral fluid (OF), faeces and serum at some infection stages. The purpose of this study was to detect and compare PRRSV, PCV2 and HEV on six pig farms to determine which of the three sample types, OF, faeces or serum is appropriate for the diagnosis of these viruses in different pig categories. The following pig categories were included in the study: 5 weeks-old (w/o), 7 w/o, 9 w/o, 11 w/o weaners, fatteners and breeding sows. Pursuant to preliminary detection of each pathogen at the selected farms, OF samples, faeces, serum pools and 10 individual sera were tested with PCR for each age category. If any of the viruses were found in pools of faeces and OF, then faeces and OF from positive farms were tested separately for each pig category. The nucleic acid isolated from the samples was detected with RT-PCR, PCR and real-time RT-PCR for PRRSV, PCV2 and HEV respectively. Results PRRSV and HEV were detected on one farm and PCV2 on three others, positive results being more often obtained from the OF than from the faeces of the same animals. Testing of 10 individual sera samples from pigs from the same group of pigs was also performed, and detected the virus in individual sera and OF in the same pig category, with some exceptions: PRRSV was detected in the OF of fatteners but was absent in their sera; PCV2 was detected in sera but absent in group samples or vice-versa but OF sample , whereas HEV was detected in the OF of the youngest, 5w/o weaners and absent in sera of the same age group. Conclusions The primary finding of the study is that OF is a welfare-friendly, non-invasive and highly efficient matrix for pathogen detection, thus evidencing the utility of pig OF as a matrix in which each of the three viruses considered can be detected with the highest probability.
Telomere Length in Patients with Transfusion-Dependent Thalassemia
Authors: Nanthatanti Nithita , Tantiworawit Adisak , Piriyakhuntorn Pokpong , Rattanathammethee Thanawat , Hantrakool Sasinee , Chai-Adisaksopha Chatree , Rattarittamrong Eakarat , Norasetthada Lalita , Tuntiwechapikul Wirote , Fanhchaksai Kanda , Charoenkwan Pimlak , Kumfu Sirinart , Chattipakorn Nipon 
Published: November 2019

Abstract
Background: Thalassemia is a hereditary hemolytic anemia with a severity ranging from mild, non transfusion-dependent to severe chronic anemia requiring lifelong transfusion. Transfusional iron overload is a major complication in patients with transfusion-dependent thalassemia (TDT). Telomeres are sequences of nucleotides forming the end caps of chromosomes that act as a DNA repair system. Iron overload in thalassemia can cause increased oxidative stress which leads to cellular damage and senescence. This may result in telomere length shortening. The degree of telomere length shortening may reflect the severity of thalassemia.
Methods: This research aimed to study the telomere length in patients with TDT in comparison to non-thalassemic individuals and to identify the clinical and laboratory parameters that are associated with telomere length. We conducted a cross-sectional study in patients with TDT aged ³18 years. Telomere length was measured by real-time quantitative PCR.
Results: Sixty-five patients with TDT were enrolled onto the study. There were 37 female patients (54.4%). The median age was 27 (18-57) years, and mean pre-transfusion hemoglobin (Hb) was 7.1 (± 1.07) g/dL. The mean telomeric terminal restriction fragment length (TRFL) of patients with TDT and the controls was 6.11 (± 0.61) kb and 6.79 (± 0.84) kb, respectively (p <0.0001). There was a significant correlation between TRFL and age (p =0.0002), and Hb (p=0.044). There was no correlation of telomere length with other factors.
Conclusions: Our study showed that TDT patients had shorter telomere length compared with controls. Telomere shortening in TDT was an aging-dependent process and associated with lower hemoglobin level.
Content validation of the EORTC QLQ-C15-PAL with advanced cancer patients and health care professionals from palliative care services in Chile
Authors: Rojas-Concha Leslye , Hansen Maiken Bang , Petersen Morten Aagaard , Groenvold Mogens 
Published: November 2019

Abstract
Background: The assessment of patients’ quality of life (QOL) is essential when evaluating the outcome of palliative care; however, no instruments have been validated for measuring symptoms and QOL in patients receiving palliative care in Chile. We aimed to investigate the content validity of the EORTC Quality of Life Questionnaire Core 15 Palliative Care (QLQ-C15-PAL), replicating the methods used previously to shorten the EORTC Quality of Life Questionnaire Core 30 (QLQ-C30) for use among patients in palliative care.Methods: This cross-sectional study was conducted from October to November 2017 in four palliative care services. Patients with advanced cancer and health care professionals (HCPs) were invited to individual interviews to determine the relevance, appropriateness and relative importance of the 30 items of the QLQ-C30 for evaluating the outcome of palliative care, and whether relevant additional issues should be included. Results: A total of 48 patients and 35 HCPs participated. The most important dimensions selected were pain, physical functioning, sleeping difficulties, emotional functioning, nausea/vomiting, fatigue, and social functioning. Qualitative data identified important additional issues not covered by the questionnaire such as satisfaction with care, emotions and psychological support, as well as linguistic issues in the dyspnea and constipation items. Conclusions: The EORTC QLQ-C15-PAL showed good content validity in the assessment of symptoms and QOL of advanced cancer patients; therefore, we recommend the use of this questionnaire in palliative care in Chile. Dyspnea and constipation items were revised by the EORTC group. More research is needed to add a social dimension for a comprehensive assessment of patients’ QOL.
The impact of the duration of the palliative care period on cancer patients with regard to the use of hospital services and the place of death: a retrospective cohort study
Authors: Hirvonen Outi Maaria , Leskelä Riikka-Leena , Grönholm Lotta , Haltia Olli , Voltti Samuli , Tyynelä-Korhonen Kristiina , Rahko Eeva K. , Lehto Juho T. , Saarto Tiina 
Published: November 2019

Abstract
Background To avoid aggressive treatments at the end-of-life (EOL) and to provide palliative care (PC), physicians need to terminate futile anti-cancer treatments and define the palliative intention of the treatment in time, i.e. make the PC decision. This single center study assesses the impact of the PC decision and its timing on the use of hospital services at EOL and the place of death. Methods A randomly chosen cohort of 992 cancer patients treated in a tertiary hospital between Jan 2013 –Dec 2014, who were deceased by the end of 2014, were selected from the total number of 2737 identified from the hospital database. The PC decision and use of PC unit services were examined in relation to emergency department (ED) visits, hospital inpatient days and place of death. ResultsThe PC decision was defined for 82% of the patients and 37% visited a PC unit. The earlier the PC decision was made, the more often patients visited the PC unit (>180 days prior to death 72% and <14 days 10%). The number of ED visits and inpatient days were significantly highest for patients with no PC decision and lowest for patients with both a PC decision and a PC unit visit (60 days before death ED visits 1.3 vs 0.8 and inpatient days 9.9 vs 2.9 respectively, p<0.01). Patients with no PC decision died more often in secondary/tertiary hospitals (28% vs. 19% with a PC decision, and 6% with a decision and a visit to a PC unit). ConclusionsThe PC decision to initiate a palliative goal for the treatment had a distinct impact on the use of hospital services at the EOL. The earlier the decision the greater the effect. Contact with a PC unit further increased the likelihood of EOL care at primary care.
Does the medical insurance system really achieved the effect of poverty alleviation for the elderly in China? Characteristics of vulnerable groups and failure links
Authors: Ma Meiyan , Li Ye , Wang Nianshi , Wu Qunhong , Shan Linghan , Jiao Mingli , Fu Xuelian , Li Heng , Hao Yanhua , Yi Bin , Yin Hui , Tian Wanxin , Xia Qi , Ning Ning , Liang Libo , Wang Jiahui 
Published: November 2019

Abstract
Objective: We examined the physiological, household, and spatial agglomeration characteristics of the health poverty population in China. We identified weak links that affect the implementation of the medical insurance and further improve its effectiveness for health poverty alleviation. Methods: A national representative sample from the 2015 China Health and Pension Tracking Survey (CHARLS) was analyzed. The WHO recommended method was adopted to calculate catastrophic health expenditure (CHE) and impoverishment by medical expenses (IME). We created a binary indicator for IME as the outcome variable and applied the treatment-effect model to analyze the determinants of IME. Results： The incidence of IME was 7.2% of the overall population, compared to 20.3% of the sample households trapped in CHE. The incidence of IME enrolled in insurance schemes was 7.4% higher than that of uninsured families (4.8%). Economic level, living area, family size, age of household head, having hospitalized members, and participating in insurance were statistically significant for the occurrence of IME. Conclusion： The original poverty -promoting policies has not reached the maximum point of convergence with China ‘s current demand for health. The overlapped health vulnerabilities exacerbated the risk of poverty among the elderly and households with high health needs and utilization. In addition, the medical insurance schemes have proven to be insufficient for protection against economic burden of poor households. So, special health needs, age, and household capacity to pay should be comprehensively considered while strengthening the connection between the disease insurance scheme with supplementary insurance.