bluuebunny/crossref_metadata_2025_split huggingface dataset:
DiscordantClostridioides difficilediagnostic assay and treatment practice: a cross-sectional study in a tertiary care hospital, Geneva, Switzerland
Authors: Lenggenhager Lauriane , Zanella Marie-Céline , Poncet Antoine , Kaiser Laurent , Schrenzel Jacques 
Published: September 2020

ObjectivesTo determine the proportion of patients who received a treatment forClostridioides difficileinfection (CDI) among those presenting a discordantC. difficilediagnostic assay and to identify patient characteristics associated with the decision to treat CDI.DesignCross-sectional study.SettingMonocentric study in a tertiary care hospital, Geneva, Switzerland.ParticipantsAmong 4562 adult patients tested forC. difficilebetween March 2017 and March 2019, 208 patients with discordant tests’ results (positive nucleic acid amplification test (NAAT+)/negative enzyme immunoassay (EIA−)) were included.Main outcome measuresTreatment for CDI.ResultsCDI treatment was administered in 147 (71%) cases. In multivariate analysis, an abdominal CT scan with signs of colitis (OR 14.7; 95% CI 1.96 to 110.8) was the only factor associated with CDI treatment.ConclusionsThe proportion of NAAT+/EIA− patients who received treatment questions the contribution of the EIA for the detection of toxin A/B after NAAT to limit overtreatment. Additional studies are needed to investigate if other factors are associated with the decision to treat.
Recurrence of cervical artery dissection: protocol for a systematic review
Authors: Lounsbury Elizabeth , Dewar Brian , Davis Alexandra , Fergusson Dean A , Dowlatshahi Dar , Shamy Michel 
Published: September 2020

IntroductionCervical artery dissection, including carotid and vertebral artery dissection, is an important cause of stroke in the young. Risk of developing cervical artery dissection has been associated with physical activity in various forms and has been presumed to be related to minor trauma and mechanical stretching of the cervical arteries. This systematic review will aim to synthesise data on the risk of recurrent cervical artery dissection after an initial dissection. This information may be applied to further understand the natural history of this disease, and potentially to help direct evidence-based discussions on safe return to activity after dissection.Methods and analysisA broad search of multiple electronic databases (Medline, Embase, Cochrane Central Register of Controlled Trials and Web of Science) will be conducted to identify studies published as of 13 November 2019, examining all-comers with cervical artery dissection observed over time. Studies will be screened by two independent reviewers in a two-level process to determine eligibility for inclusion. Data will be pooled from eligible articles and the main outcome of recurrent cervical artery dissection at 5 years will be determined using quantitative analysis.Ethics and disseminationEthics approval is not necessary as no primary data are being collected. The information will be disseminated in the form of a systematic review article which will be submitted to a peer-reviewed medical journal.PROSPERO registration numberCRD42020166105.
Apical extrusion of debris with different rotary and reciprocating single-file endodontic instrumentation systems: a systematic review and meta-analysis protocol
Authors: Ahmad Muhammad Zubair , Sadaf Durre , MacBain Marcy McCall , Mohamed Ahmed Nabil 
Published: September 2020

IntroductionRoot canal treatment is one of the oldest dental procedures for the treatment of endodontic infection. Extrusion of debris beyond the root apex during root canal instrumentation and subsequent persistence of pain are common complications. A systematic review of the evidence on reciprocating single-file instrumentation systems and their comparison with rotary single-file systems, with apical extrusion of debris as primary outcome, will be done through this study.Methods and analysisPublished ex vivo and in vitro studies with no language restriction will be included. We will search MEDLINE (Ovid), EMBASE (Ovid), Web of Science, Cochrane and Google Scholar. Strategies will be incorporated to search grey literature also. Thorough evaluation of search results, completion of data abstraction and assessment of quality will be done by two reviewers independent from each other. Assessment of included studies will be done by utilising an evidence model developed on the basis of standards of quality reported in guidelines to document ex vivo and in vitro studies regarding dental materials and pertained for extrusion of debris apically and has been already used in quality assessment of studies involving quantification of debris extrusion apically. We will calculate the standardised mean differences for apically extruded debris, with congruent 95% CIs. We will measure the statistical heterogeneity by applying the Cochrane Q test and quantify using the I2 statistic. Existence of covariates and any potential heterogeneity will be explored through prespecified subgroup and sensitivity analyses.Ethics and disseminationApproval from an ethical research committee is not required because it will be done using data that have been already published and have no concerns related to the privacy of patients. Extensive dissemination of results from this review will be done through submission to a peer-reviewed journal for publication and conferences.PROSPERO registration numberCRD42019151804.
Impact of infection in patients with non-ST elevation acute coronary syndrome undergoing percutaneous coronary intervention: insight from a multicentre observational cohort from China
Authors: Chen Peng-Yuan , Liu Yuan-Hui , Duan Chong-Yang , Jiang Lei , Wei Xue-Biao , Guo Wei , Chen Ji-Yan , Tan Ning , He Peng-Cheng 
Published: September 2020

ObjectiveWe aimed to describe the association between in-hospital infection and prognosis among patients with non-ST elevation acute coronary syndrome (NSTE-ACS) who received percutaneous coronary intervention (PCI).DesignThis observational cohort originated from a database of patients with NSTE-ACS who underwent PCI from 1 January 2010 to 31 December 2014.SettingFive centres in South China.ParticipantsThis multicentre observational cohort study consecutively included 8197 patients with NSTE-ACS who received PCI. Only patients with adequate information to diagnose or rule out infection were included. Patients were excluded if they were diagnosed with a malignant tumour, were pregnant or presented with cardiogenic shock at the index date. Patients were grouped by whether they had in-hospital infection or not.Primary and secondary outcome measuresThe primary outcome was all-cause death and major bleeding during hospitalisation. The secondary outcomes included all-cause death and major bleeding during follow-up and in-hospital myocardial infarction.ResultsOf the 5215 patients, 206 (3.95%) acquired infection. Patients with infection had a higher rate of in-hospital all-cause death and major bleeding (4.4% vs 0.2% and 16.5% vs 1.2%, respectively; p<0.001). After adjusting for confounders, infection remained independently associated with in-hospital and long-term all-cause death (OR, 13.19, 95% CI 4.59 to 37.87; HR, 2.03, 95% CI 1.52 to 2.71; p<0.001) and major bleeding (OR, 10.24, 95% CI 6.17 to 16.98; HR, 5.31, 95% CI 3.49 to 8.08; p<0.001). A subgroup analysis confirmed these results.ConclusionsThe incidence of infection is low during hospitalisation, but is associated with worse in-hospital and long-term outcomes.
Understanding perceptions and factors involved in do not resuscitate (DNR) decision making in the emergency department of a low-resource country: a mixed-methods study protocol
Authors: Azizi Kiran , Waheed Shahan , Barolia Rubina , Ahmed Naveed , Ismail Madiha 
Published: September 2020

IntroductionDo not resuscitate (DNR) decision making is an integral component of emergency medicine practice. There is a paucity of data, protocols and guidelines regarding the perceptions and barriers that are involved in the interactions among healthcare professionals, patients and their caregivers regarding DNR decision making. The aim of this study is, therefore, to explore the perceptions and factors influencing DNR decision making in the emergency department and to evaluate the use of a context-based protocol for DNR decision making.Methods and analysisThis will be a sequential mixed method study beginning with qualitative research involving in-depth interviews (IDIs) with patient family members and focus group discussion with healthcare professionals. The consensual qualitative approach will be used to perform a thematic analysis to the point of saturation. The expected outcome will be to identify key themes that suggest perceptions and factors involved in DNR decision making. After piloting, the derived protocol will then be used with a different group of individuals (150 healthcare professionals) who meet the eligibility criteria in a quantitative cross-sectional study with universal sampling. Data will be analysed using NVIVO in the qualitative phase and SPSS V.19 in the quantitative phase. The study findings will support the development of a standardised protocol for DNR decision making for healthcare professionals in the emergency department.Ethics and disseminationThe proposal was reviewed by the ethics review committee (ERC) of the institution (ERC # 2020-1551-7193). The project is an institution SEED grant recipient PF139/0719. The results will be disseminated among participants, patient communities and healthcare professionals in the institution through seminars, presentations, brochures and emails. The findings will be published in a highly accessed peer-reviewed medical journal and will be presented at international conferences.
Understanding the risks for post-disaster infectious disease outbreaks: a systematic review protocol
Authors: Charnley Gina E C , Kelman Ilan , Gaythorpe Katy , Murray Kris 
Published: September 2020

IntroductionDisasters have many forms, including those related to natural hazards and armed conflict. Human-induced global change, such as climate change, may alter hazard parameters of these disasters. These alterations can have serious consequences for vulnerable populations, which often experience post-disaster infectious disease outbreaks, leading to morbidity and mortality. The risks and drivers for these outbreaks and their ability to form cascades are somewhat contested. Despite evidence for post-disaster outbreaks, reviews quantifying them have been on short time scales, specific geographic areas or specific hazards. This review aims to fill this gap and gain a greater understanding of the risk factors involved in these contextual outbreaks on a global level.Methods and analysisUsing the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 checklist and Khan’s methodological framework, a systematic search strategy will be created and carried out in August 2020. The strategy will search MEDLINE, Embase and GlobalHealth electronic databases and reference lists of selected literature will also be screened. Eligible studies will include any retrospective cross-sectional, case–control or cohort studies investigating an infectious disease outbreak in a local disaster affected population. Studies will not be excluded based on geographic area or publication date. Excluded papers will include non-English studies, reviews, single case studies and research discussing general risk factors, international refugee camps, public health, mental health and other non-communicable diseases, pathogen genetics or economics. Following selection, data will be extracted into a data charting form, that will be reviewed by other members of the team. The data will then be analysed both numerically and narratively.Ethics and disseminationOnly secondary data will be used and there will be no public or patient involvement; therefore, no ethical approval is needed. Our findings will aim to be disseminated through a peer-reviewed journal. The authors intend to use the results to inform future mathematical modelling studies.
The relationship between autonomy, optimism, work engagement and organisational citizenship behaviour among nurses fighting COVID-19 in Wuhan: a serial multiple mediation
Authors: Zhang Hui , Zhao Yi , Zou Ping , Liu Yang , Lin Shuanghong , Ye Zhihong , Tang Leiwen , Shao Jing , Chen Dandan 
Published: September 2020

ObjectivesHigh levels of organisational citizenship behaviour can enable nurses to cooperate with coworkers effectively to provide a high quality of nursing care during the outbreak of COVID-19. However, the association between autonomy, optimism, work engagement and organisational citizenship behaviour remains largely unexplored. This study aimed to test if the effect of autonomy on organisational citizenship behaviour through the mediating effects of optimism and work engagement.Study designThis was a cross-sectional study.SettingThe study was conducted in the Wuhan Jinyintan Hospital in China.ParticipantsIn total, 242 nurses who came from multiple areas of China to work at the Wuhan Jinyintan hospital during the COVID-19 epidemic participated in this study.MethodsA serial mediation model (model 6) of thePROCESS macroin SPSS was adopted to test the hypotheses, and a 95% CI for the indirect effects was constructed by using Bootstrapping.ResultsThe autonomy–organisational citizenship behaviour relationship was mediated by optimism and work engagement, respectively. In addition, optimism and work engagement mediated this relationship serially.ConclusionThe findings of this study may have implications for improving organisational citizenship behaviour. The effects of optimism and work engagement suggest a potential mechanism of action for the autonomy–organisational citizenship behaviour linkage. A multifaceted intervention targeting organisational citizenship behaviour through optimism and work engagement may help improve the quality of nursing care among nurses supporting patients with COVID-19.
Comparison between plasma and cerebrospinal fluid biomarkers for the early diagnosis and association with survival in prion disease
Authors: Abu-Rumeileh Samir , Baiardi Simone , Ladogana Anna , Zenesini Corrado , Bartoletti-Stella Anna , Poleggi Anna , Mammana Angela , Polischi Barbara , Pocchiari Maurizio , Capellari Sabina , Parchi Piero 
Published: September 2020

ObjectiveTo compare the diagnostic accuracy and the prognostic value of blood and cerebrospinal fluid (CSF) tests across prion disease subtypes.MethodsWe used a single-molecule immunoassay to measure tau and neurofilament light chain (NfL) protein levels in the plasma and assessed CSF total(t)-tau, NfL and protein 14-3-3 levels in patients with prion disease (n=336), non-prion rapidly progressive dementias (n=106) and non-neurodegenerative controls (n=37). We then evaluated each plasma and CSF marker for diagnosis and their association with survival, taking into account the disease subtype, which is a strong independent prognostic factor in prion disease.ResultsPlasma tau and NfL concentrations were higher in patients with prion disease than in non-neurodegenerative controls and non-prion rapidly progressive dementias. Plasma tau showed higher diagnostic value than plasma NfL, but a lower accuracy than the CSF proteins t-tau and 14-3-3. In the whole prion cohort, both plasma (tau and NfL) and CSF (t-tau, 14-3-3 and NfL) markers were significantly associated with survival and showed similar prognostic values. However, the intrasubtype analysis revealed that only CSF t-tau in sporadic Creutzfeldt-Jakob disease (sCJD) MM(V)1, plasma tau and CSF t-tau in sCJD VV2, and plasma NfL in slowly progressive prion diseases were significantly associated with survival after accounting for covariates.ConclusionsPlasma markers have lower diagnostic accuracy than CSF biomarkers. Plasma tau and NfL and CSF t-tau are significantly associated with survival in prion disease in a subtype-specific manner and can be used to improve clinical trial stratification and clinical care.
Caudal analgesia versus abdominal wall blocks for pediatric genitourinary surgery: systematic review and meta-analysis
Authors: Desai Neel , Chan Edmund , El-Boghdadly Kariem , Albrecht Eric 
Published: September 2020

BackgroundCaudal block is a well-established technique for providing perioperative analgesia in pediatric genitourinary surgery, but abdominal wall blocks such as ilioinguinal–iliohypogastric (II-IH) and transversus abdominis plane (TAP) block are increasingly being used.MethodsOur protocol for this meta-analysis was registered on PROSPERO (CRD42020163497). Central, CINAHL, Embase, Global Health, LILACS, MEDLINE, Scopus and Web of Science were searched from inception to 11 December 2019 for randomized controlled trials that included pediatric patients having genitourinary surgery with II-IH or TAP block as the intervention and caudal analgesia as the comparator. For continuous and dichotomous outcomes, respectively, we calculated the mean difference using the inverse-variance method and the risk ratio with the Mantel-Haenzel method.ResultsIn all, 23 trials with 1399 patients were included. II-IH and TAP block were similar to caudal analgesia in the coprimary outcomes of the postoperative pain score at 0–2 hours (high-quality evidence) and the need for in-hospital rescue analgesia (moderate-quality evidence consequent to downgrading by publication bias). No subgroup differences in regard to the type of abdominal wall block or the method of block localization were demonstrated for these primary outcomes. Relative to caudal analgesia, II-IH and TAP block reduced the incidence of postoperative motor blockade and the time to micturition.ConclusionsThis meta-analysis was limited by unclear risk of selection and performance biases and significant heterogeneity. In summary, II-IH and TAP block are a non-invasive and reasonable alternative to caudal analgesia in pediatric genitourinary surgery.
Multimodal perioperative pain management in a horse undergoing partial phallectomy
Authors: von Ritgen Stephanie , Bach Fabienne , Otero Pablo E , Auer Ulrike 
Published: September 2020

A well‐balanced multimodal pain management including local anaesthetic techniques was used to provide perioperative analgesia in a horse undergoing partial phallectomy. This surgical intervention has been associated with moderate to severe pain and may present additional challenges to the veterinarian when providing pain relief postoperatively.In the present case, preoperative analgesia included morphine and flunixin meglumine, both intravenously. Throughout surgery, adaptable constant rate infusions (CRIs) with ketamine and xylazine were supplemented to address different receptors of the pain pathway. Additionally, a pudendal nerve block with ropivacaine was added intraoperatively to reduce nociception and decrease sensitisation of the central nervous system. An epidural injection of morphine and dexmedetomidine was performed after recovery from general anaesthesia. Postoperative pain treatment included morphine and flunixin meglumine that resulted in adequate pain relief, based on pain assessment every 6–12 hours. Neither side effects nor complications were observed during the hospital stay.
Association of Pathologic Complete Response with Long-Term Survival Outcomes in Triple-Negative Breast Cancer: A Meta-Analysis
Authors: Huang Min , O'Shaughnessy Joyce , Zhao Jing , Haiderali Amin , Cortés Javier , Ramsey Scott D. , Briggs Andrew , Hu Peter , Karantza Vassiliki , Aktan Gursel , Qi Cynthia Z. , Gu Chenyang , Xie Jipan , Yuan Muhan , Cook John , Untch Michael , Schmid Peter , Fasching Peter A. 
Published: September 2020

Abstract
Pathologic complete response (pCR) following neoadjuvant therapy has been associated with improved event-free survival (EFS) and overall survival (OS) in early-stage breast cancer. The magnitude of this association varies by breast cancer subtype, yet further research focusing on subtype-specific populations is limited. Here we provide an updated and comprehensive evaluation of the association between pCR and survival outcomes in triple-negative breast cancer (TNBC). A literature review identified neoadjuvant studies, including clinical trials, real-world cohort studies, and studies that pooled multiple trials or cohorts, which reported EFS/OS results by pCR in patients with early-stage TNBC. Meta-analyses were performed to evaluate the association between pCR and EFS/OS and to predict long-term survival outcomes based on pCR status. Sensitivity analyses were conducted to assess the impact of cross-study variations. Twenty-five studies with over 4,000 patients with TNBC were identified. A synthesis of evidence from these studies suggested substantial improvement in EFS and OS for pCR versus non-pCR [EFS HR (95% confidence interval): 0.24 (0.20–0.29); OS: 0.19 (0.15–0.24)]; consistent results were reported in sensitivity analyses. Collectively, our findings suggest that adjuvant therapy is associated with improved EFS/OS in patients with TNBC who received neoadjuvant therapy, regardless of pCR status.
Steroid Sulfatase Stimulates Intracrine Androgen Synthesis and is a Therapeutic Target for Advanced Prostate Cancer
Authors: Armstrong Cameron M. , Liu Chengfei , Liu Liangren , Yang Joy C. , Lou Wei , Zhao Ruining , Ning Shu , Lombard Alan P. , Zhao Jinge , D'Abronzo Leandro S. , Evans Christopher P. , Li Pui-Kai , Gao Allen C. 
Published: September 2020

Abstract

Purpose:
Most patients with prostate cancer receiving enzalutamide or abiraterone develop resistance. Clinical evidence indicates that serum levels of dehydroepiandrosterone sulfate (DHEAS) and biologically active DHEA remain in the high range despite antiandrogen treatment. The conversion of DHEAS into DHEA by steroid sulfatase (STS) may contribute to sustained intracrine androgen synthesis. Here, we determine the contribution of STS to treatment resistance and explore the potential of targeting STS to overcome resistance in prostate cancer.

Experimental Design:
STS expression was examined in patients and cell lines. In vitro, STS activity and expression were modulated using STS-specific siRNA or novel STS inhibitors (STSi). Cell growth, colony formation, androgen production, and gene expression were examined. RNA-sequencing analysis was conducted on VCaP cells treated with STSi. Mice were treated with STSis with or without enzalutamide to determine their effects in vivo.

Results:
STS is overexpressed in patients with castration-resistant prostate cancer (CRPC) and resistant cells. STS overexpression increases intracrine androgen synthesis, cell proliferation, and confers resistance to enzalutamide and abiraterone. Inhibition of STS using siRNA suppresses prostate cancer cell growth. Targeting STS activity using STSi inhibits STS activity, suppresses androgen receptor transcriptional activity, and reduces the growth of resistant C4-2B and VCaP prostate cancer cells. STSis significantly suppress resistant VCaP tumor growth, decrease serum PSA levels, and enhance enzalutamide treatment in vitro and in vivo.

Conclusions:
These studies suggest that STS drives intracrine androgen synthesis and prostate cancer proliferation. Targeting STS represents a therapeutic strategy to treat CRPC and improve second-generation antiandrogen therapy.