bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosis of vascular invasion in pancreatic ductal adenocarcinoma using endoscopic ultrasound elastography
Authors: Yamada Kenta , Kawashima Hiroki , Ohno Eizaburo , Ishikawa Takuya , Tanaka Hiroyuki , Nakamura Masanao , Miyahara Ryoji , Ishigami Masatoshi , Hirooka Yoshiki , Fujishiro Mitsuhiro 
Published: March 2020

Abstract
Background: Vascular invasion is an important criterion for resectability and deciding the therapeutic strategy for pancreatic ductal adenocarcinoma (PDAC), but imaging diagnosis is currently difficult. Endoscopic ultrasound (EUS) elastography (EG) images have band-like artifacts on the border between tumor and vessel due to different movement if the tumor is not connected to the vessel, i.e., no invasion. Based on this phenomenon, we assessed the usefulness of EUS-EG in the diagnosis of vascular invasion in PDAC.Methods: The subjects were 44 out of 313 patients with PDAC who underwent EUS between January 2015 and November 2018, followed by surgery, no chemotherapy or radiotherapy, and pathological evaluation. Diagnostic accuracies of vascular invasion using dynamic computed tomography (CT), EUS B-mode and EUS-EG were compared with histopathological diagnosis. Results: In 44 subjects (48 sites) who underwent both dynamic CT and EUS-B mode, the sensitivity, specificity and accuracy were 0.733, 0.697 and 0.708 on dynamic CT (48 sites); 0.733, 0.606 and 0.646 in EUS B-mode (48 sites); and 0.917, 0.900 and 0.906 in EUS-EG (32 sites). In 27 subjects (29 sites) with a tumor contacting a vessel with no vascular obstruction or stenosis on dynamic CT, the sensitivity, specificity and accuracy were 0.556, 0.750 and 0.690 on dynamic CT; 0.667, 0.700 and 0.690 in EUS B-mode; and 0.889, 0.850 and 0.862 in EUS-EG.Conclusions: These results suggest that EUS combined with EG improves diagnostic performance of vascular invasion in PDAC, especially in cases of which vascular invasion cannot be clearly assessed by dynamic CT.Trial registration: UMIN 000016497
Perspectives on a psychiatric outpatient service for immigrants and refugees in São Paulo, Brazil over a 15-year period.
Authors: Carvalho Luciana de Andrade , Andrade Laura Helena , Ang Patrícia Lin , Santana Carmen Lucia de Albuquerque , Albertin Paula de Vries , Neto Francisco Lotufo , Junior Claudinei Eduardo Biazoli 
Published: March 2020

Abstract
Background Immigrants and refugees have specific mental health needs. Studies of immigrant/refugee psychiatric patients in Latin America are scarce. This article presents the profile of patients from an outpatient psychiatric service in Sao Paulo (Brazil) and aims to better inform mental health service planning for immigrants and refugees. Methods This was an exploratory study to characterize the sociodemographic and mental health profile of refugees and immigrants attending outpatient psychiatric service from 2003 to 2018. Chi-square tests and logistic regressions were used to examine the association of demographic variables, exposure to violence, and immigrant status with psychiatric diagnosis. Cluster analysis was used to identify subgroups within the sample. Results A total of 162 immigrants and refugees referred to the service obtained treatment. Of these patients, 57.4% were men, 59.8% were refugees/asylum seekers, 51.9% were Black, 48.8% were single, 64.2% had ten years of education, and 57.4% were unemployed; the mean age of the sample was 35.9. Half of the sample (52.5%) was exposed to violence. The most common diagnosis was depression (54.2%), followed by PTSD (16.6%). Approximately 34% of the participants sought psychiatric care within six months of arrival. Logistic regressions showed that men had lower odds of presenting with depression (OR= 0.34). Patients with PTSD were more likely to be refugees (OR= 3.9) and not have a university degree (OR= 3.1). In the cluster analysis, a cluster of patients with PTSD included almost all Black refugee men exposed to violence. Most patients diagnosed with psychotic disorders were also Black refugee men. Conclusion : Immigrants and refugees represent a vulnerable group. The majority of the sample was Black, refugee men, who were also more likely to present with PTSD. Future studies are needed to better understand issues in treatment adherence in relation to socioeconomic characteristics.
Facilitating International Participation in Core Outcome Set Development: A Proposed Approach for Multi-language Delphi Surveys, a Review of Current Practice and Issues to Consider
Authors: Alkhaffaf Bilal , Williamson Paula , Blazeby Jane M , Glenny Anne-Marie , Adeyeye Ademola , Costa Paulo Matos , Val Ismael Diez del , Gisbertz Suzanne , Guner Ali , Law Simon , Lee Hyuk-Joon , Li Ziyu , Nakada Koji , Nunez Rafael Mauricio Restrepo , Reim Daniel , Reynolds John V , Vorwald Peter , Zanotti Daniela , Allum William , Chaudry Asif , Griffiths Ewen , Bruce Iain 
Published: March 2020

Abstract
Background Core outcome sets (COS) should be relevant to key stakeholders and widely applicable so that researchers are willing to use them when designing trials. Many COS developers have utilised online Delphi surveys which enable wider international stakeholder participation. Despite broader participation, most international COS projects have restricted Delphi surveys to a single language potentially excluding important opinion from those who are not fluent in the survey language.Methods A structured review of current approaches to translating Delphi surveys for COS development was undertaken. We present a proposed methodology adapted from international guidance. Results Four studies were identified from our structured review. Wide variation exists in the methodological approaches to translating Delphi surveys for the developing of COS. Issues which arise when developing multi-language Delphi surveys include establishing translation groups, timelines, financial implications, strategies to maximise recruitment and regulatory approvals.Conclusion Consideration of the issues described will improve planning by other COS developers and can be used to widen international participation from both patients and healthcare professionals.
Effects of preoperative oral carbohydrate electrolyte drinks on preoperative hypokalemia incidence in patients scheduled for laparoscopic colorectal resection: a randomized clinical trial
Authors: Tan Fang , Deng Yingqing , Hu Jingping , Gong Chulian , Zhu Qianqian , Zhou Shaoli 
Published: March 2020

Abstract
Background:In our previous study, hypokalemia incidence was high in patients scheduled for laparoscopic colorectal resection. The present trial was conducted to verify the effects of preoperative carbohydrate drinks containing potassium in these patients.
Methods: Patients were randomly assigned to control, placebo, and case groups. In control group, patients were fasted from midnight. In placebo group, patients were fasted from midnight and received carbohydrate drinks 2–3 h before surgery. In case group, patients were fasted from midnight and received carbohydrate drinks containing potassium supplementation 2–3 h before surgery. The primary outcome was the incidence and severity of preoperative hypokalemia. The other outcomes included postoperative gastrointestinal function, including the time to postoperative first flatus (FFL) and first feces (FFE) and other complications.
Results: The final analysis included 122 participants. The incidence of preoperative hypokalemia in case group was significantly lower than that in control and placebo groups (50% vs. 88.1% vs. 77.5%, p < 0.001). The severity of hypokalemia in control and placebo groups was greater than that in case group. No regurgitation or aspiration occurred in the three groups. No significant differences were observed among the three groups regarding time to FFL and FFE.
Conclusions: Preoperative carbohydrate drinks containing potassium may have significantly reduced the incidence of preoperative hypokalemia and improved preoperative thirst and hunger, but did not improve postoperative well-being. However, as part of the enhanced recovery after surgery protocol, preoperative carbohydrate drinks containing potassium should be recommended, as early as first admittance to hospital.
Bisphenol-A Dose-dependently Regulates The Development of Ovary and Uterus through Differential Expression of METTL3
Authors: Zhang Zhe , Zhu Yuan , Zhang Zhifan , Wang Daojuan , Wang Hongwei , Yan Guijun , Wang Yong 
Published: March 2020

Abstract
Background: Environmental endocrine disruptors, which have a profound impact on the reproductive system, can cause endocrine and reproductive disorders, such as polycystic ovary syndrome (PCOS). Bisphenol-A (BPA) is a common endocrine disruptor which can affect the function of the reproductive system under low-dose conditions. However, the mechanism by which this molecule disrupts normal reproduction is still unclear. In this study, we investigated the effects of BPA on the RNA methyltransferase METTL3 in adolescent female rats which may be a possible mode of action of BPA. Methods: 4-week-old Sprague-Dawley (SD) rats were intragastrically treated for 10 weeks, which were divided into blank group (n = 8), control group (soybean oil, n = 8), three BPA-treatment groups (0.5 mg/kg BPA + soybean oil, 5 mg/kg BPA + soybean oil, 50 mg/kg BPA + soybean oil, n = 8). Results: The results showed that low-dose BPA (0.5 mg/kg) increased the coefficient of uteri and ovaries, and promoted the growth of uteri in rats without causing hyperandrogenism and ovarian polycystic changes. Oral BPA disturbed the expression of CYP17A1, CYP11A1 and METTL3 in ovaries and effected the level of serum testosterone. Conclusions: Our results suggested that oral BPA might interfere uterine and ovarian morphology and the level of hormone with RNA methylation by disturbing the expression level of METTL3. RNA methylation will be a new way to explain the interference mechanism of BPA.
A Phase Ii Study Of The Combination Of Oxaliplatin, Capecitabine, And Trastuzumab And Chemo-radiotherapy In The Adjuvant Setting In Operated Patients With Her2+ Gastric Or Gastroesophageal Junction Cancer (Toxag Study), A Turkish Oncology Group Study
Authors: Abali Huseyin , Yalcin Suayib , Onal Huseyin Cem , Dane Faysal , Oksuzoglu Berna , Ozdemir Nuriye , Mertsoylu Huseyin , Artac Mehmet , Camci Celaletdin , Karabulut Bulent , Basal Fatma Bugdayci , Budakoglu Burcin , Sendur Mehmet Ali , Goktaş Burce , Ozdener Fatih , Baygul Arzu 
Published: March 2020

Abstract
BackgroundTrastuzumab prolonged the overall survival in patients with advanced gastric cancer with HER2 overexpression in combination with chemotherapy. In this phase II open-label prospective study, the tolerability and safety of trastuzumab with chemotherapy, and chemoradiotherapy for curatively resected patients with HER2 + gastric carcinoma was investigated. MethodsThe patients with HER2-positive gastric, or gastroesophageal junction adenocarcinoma, after gastrectomy plus D2 dissection were included. They received 3 cycles of oxaliplatin (100 mg/m2 IV day 1) plus capecitabine (850 mg/m2 PO days 1-14), trastuzumab (8 mg/kg IV day 1 in cycle 1, 6 mg/kg thereafter) every 21 days, followed by chemoradiotherapy. Trastuzumab was given for 1 year.ResultsOf the 212 patients screened, 35 were eligible, and 34 were treated. The median age was 56 years (Min-max: 35-75), male patients constituted 73.5% (n=25), and 33 (97.1%) had gastric adenocarcinoma. R0 resection was performed in 30 (88.2%). The majority (26, 61.7%) were in stage III disease. Most of the AEs were grade I/II, the most frequent grade III side effects were nausea (3, 8.8%), vomiting (3, 8.8%), diarrhoea (2, 5.9%) and weight loss (N=2, 5.9%). Two patients died during the first 3 cycles of chemotherapy and chemoradiotherapy; 1 secondary to pulmonary thrombo-embolism, and the other due to cerebral ischemia. After excluding 2 with early progression and 1 consent withdrawal, of the remaining 31 patients, 28 (90.3%) were able to complete the chemotherapy and chemoradiotherapy part of the trial. After the 25 months follow up period, 21 patients (61.8%) were alive. Overall survival at 12 and 24 months was 75.0% and 65.7%, while disease-free survival at 12 and 24 months was 65.7% and 55.0%, respectively.ConclusionsTrastuzumab in combination with capecitabine, oxaliplatin and radiotherapy as the adjuvant therapy for gastric or gastroesophageal junction adenocarcinoma was considered safe and tolerable. The frequency of HER2 overexpression in curatively resected patients is comparable to that in patients with metastatic disease.
Clinical factors associated with susceptibility to infection stone formation: A Retrospective Single-Center Analysis
Authors: Wang Daming , Ding Demao , Sun Hongliang , Chen Lei , Zhang Zhiqiang , Liu Zhiqi , Ye Qinglin , Zhang Dazhao , Yu Dexin , Xie Dongdong 
Published: March 2020

Abstract
Background: To investigate the clinical factors associated with susceptibility to infection stone formation and to analyze the variations in the clinical characteristics of stones with different compositions. Methods: A total of 1213 patients were included in the study. The patients were grouped based on stone composition; 581 cases of infection stones (ammonium magnesium phosphate calculi or apatite carbonate content more than 50%), 418 stones were composed of pure calcium oxalate, and 214 uric acid stone. The associations of infection stones with age, sex, body mass index, habits, working environment, recurrent stones, diabetes, hypertension, urinary tract infection, urine culture, urine pH, and triglycerides were determined using logistic regression analysis. The variations in the clinical characteristics of the 3 groups were analyzed using analysis of variance or the chi-square test. Results: The occurrence of infection stones was significantly associated with the patient’s age (odds ratio [OR]: 1.031, 95% confidence interval [CI]: 1.020–1.041, P<0.001), high urine pH (OR: 1.974, 95% CI: 1.357–2.872, P<0.001), urinary tract infection (OR: 1.438, 95% CI: 1.072–1.928, P=0.015), positive urine cultures (OR: 1.541, 95%CI: 1.143–2.078, P=0.005), and recurrent stones (OR: 1.346, 95% CI: 1.045–1.734, P=0.022), other clinical factors have no correlation. The clinical characteristics of the three groups were significantly different. The occurrence of infection stones is significantly associated with age, urinary tract infection, positive urine cultures, urine pH, and stone recurrence. Conclusions: Compared with previous studies, this study found that infection stones tend to occur in younger patients and stones resulting from non-urease-producing bacteria have significantly increased.
Comparison of the stone-free rates of mini-percutaneous nephrolithotomy, standard percutaneous nephrolithotomy, and retrograde intrarenal surgery for renal stones: A systematic review and network meta-analysis
Authors: Kang Dong Hyuk , Cho Kang Su , Chung Doo Yong , Jeong Won Sik , Jung Hae Do , Kim Do Kyung , Lee Joo Yong 
Published: March 2020

Abstract
Background: Retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) are performed to treat renal stones. PCNL is effective for kidney stones >2 cm but is invasive compared with RIRS. Miniature PCNL (mPCNL) has been used as an alternative treatment for conventional PCNL, and employs a miniature endoscope of 11–18 Fr. We conducted a systematic review of published studies regarding the RIRS, PCNL, and mPCNL treatment modalities, and performed a network meta-analysis of the success or stone-free rates.Methods: The data collected up to January 2016 were searched using PubMed and EMBASE, and references were searched electronically. Two researchers used data extraction formats to extract data on the stone-free or success rates, study design, number of subjects and characteristics, and treatments for renal stones (i.e., RIRS, PCNL, and mPCNL). To evaluate the quality of the studies, the Downs and Black checklist, which is an observational research quality evaluation tool, was used and analyzed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.Results: Twenty-five studies were used to compare the stone-free or success rates of RIRS, PCNL, and mPCNL for renal stones. Six comparisons of PCNL and mPCNL, seven of mPCNL and RIRS, and 12 of RIRS and PCNL were analyzed. No difference in the stone-free rate was found between PCNL and mPCNL (OR: 0.95; 95% CI: 0.51–1.9) in network mata-analysis. Between RIRS and mPCNL, the stone-free rate of RIRS was lower than mPCNL (OR: 0.41; 95% CI: 0.021–0.82). Comparison of RIRS and PCNL revealed that RIRS was also lower than PCNL in terms of stone-free rate (OR: 0.43; 95% CI: 0.22–0.82). In the ranking analysis, rankogram showed that mPCNL was ranked as No. 1 and PCNL was ranked as No. 2. The P-score was 0.820 for mPCNL, 0.680 for PCNL and 0 for RIRS.Conclusions: PCNL and mPCNL showed higher success or stone-free rates than RIRS for the treatment of renal stones. However, PCNL and mPCNL showed no difference in the treatment outcome.
Development and Deployment of Electronic Dispensing and Inventory Management system (eDIM) for a Rural Clinic in Honduras
Authors: Mtonga Timothy Mayamiko , Connor Sharon E , Fisher Arielle Marie , Jonkman Lauren Jennifer , Meyer Mark W. , Douglas Gerald P. 
Published: March 2020

Abstract
Background: Availability of complete, accurate, and timely information is essential for efficient planning and purchasing of medications. This is especially important in remote low-resource clinics that are often difficult to access, have limited health personnel, and receive supplies infrequently. Appropriate application of information technology can help address challenges in the availability and quality of data used for making decisions about purchasing medical supplies.Methods: We used a phased deployment of electronic information systems to address challenges in quantification of the available medical supplies at the clinic in San José. First, we deployed a patient identification system to ensure that all medicines dispensed in the system were associated with a specific patient. This was followed by the deployment of an electronic dispensing and inventory management system that tracks available medicine and automatically deducts from these counts during electronic dispensation.Results: Twenty months post-deployment of the patient identification application and electronic dispensing and inventory management system, 3,238 unique patients have been registered and 22,236 dispensations have been recorded. Of these dispensations, 226 unique drugs have been recorded with acetaminophen being the most prescribed medication followed by adult multivitamins.Conclusion: Electronic interventions show significant promise for dispensaries in limited resource settings globally. However, strong user value propositions are needed to ensure continued usage.
A Cellular Study of Inflammatory Responses in Women with Polycystic Ovary Syndrome as: “An In vitro Model of Anti Breast Tumor Response” Anti-Breast Tumor Response
Authors: Rezayat Fatemeh , Hajiaghaei Mehri , Ghasemi Nazanin , Mesdaghi Mehrnaz , Tehrani Fahimeh Ramezani , Mosaffa Nariman 
Published: March 2020

Abstract
Background: Although Polycystic Ovary syndrome (PCOS) is a common endocrine disorder among women of reproductive age; is unclear whether PCOS increases the risk of subsequent development of, Gynecologic cancers namely breast cancer. The present study we aimed to compare the antitumoral ability of peripheral blood mononuclear cells (PBMCs) of women with PCOS with that of healthy controls using the co-culture system between effector cells and target tumor cell lines.
Materials & Methods: PBMCs were isolated from 25 women with PCOS and 25 non hirsute eumenorrheic healthy controls by density gradient centrifugation ficoll. Breast tumor cell lines (MDA-468, MCF-7) were incubated as the two target cells and were cultured adjacent to PBMCs in the transwell co-culture system. Proliferation rate of the effectors cells evaluated by BrdU cell proliferation assay after 48 and 72 hours and T CD3+ lymphocytes were assessed using flow cytometry. TNF-α cytokine production was evaluated in cell culture supernatant by sandwich ELISA technique.
Results: After 48 hours incubation with MDA-468 and MCF-7, the mean proliferation score of PBMCs was significantly higher in women with PCOS compared to that of healthy controls (921.04; P=0.021 vs 287.6; P=0.002, respectively). In PCOS women, after 72 hours of incubation, TNF-α concentration was significantly reduced compared to 48-hour cultures (921.04 ± 271.4 pg/dl vs 545.6 ± 151.1 pg/dl at 48 h and 72 h intervals respectively, P<0.05); it was increased in healthy controls. There was no significant difference in CD3+ CD8+ cells between the PCOS group and healthy controls.
Conclusion: The ability of PBMCs to produce of TNF-α in women with PCOS decreased gradually; as a result of which they may lack the ability required to form an in vitro efficient antitumor response to breast tumor cell lines. It is assumed that threshold activation of mononuclear cells is reduced in women with PCOS and a low-grade inflammatory condition may provide a positive background for arising myeloid derived suppressor cells (MDSCs).
Analysis of the efficacy and prognostic factors of linear accelerator-based hypofractionated stereotactic radiotherapy for brain metastasis of non-small-cell lung cancer
Authors: Wu Xi , Xia Yaoxiong , Hou Yu , Li Lan , Wang Li , Li Rong , Lu Fei , Chang Li , Li Wenhui 
Published: March 2020

Abstract
Objective To investigate the efficacy and prognostic factors of treatment of brain metastases (BMs) of non-small-cell lung cancer (NSCLC) patients with hypofractionated stereotactic radiotherapy (HSRT) based on linear accelerators. Methods A total of 80 NSCLC patients with BMs were treated with HSRT under the image guidance of tomotherapy (TOMO) or volumetric modulated arc therapy (VMAT) in Yunnan Cancer Hospital from Jan 1 st , 2017 to Aug 7 th , 2019. The outcome measures included overall survival (OS), intracranial local progression-free survival (iLPFS) and intracranial regional progression-free survival (iRPFS). The related prognostic factors were analyzed. Results The median OS, iLPFS and iRPFS in 80 patients were 29.2 months, 19.3 months and 20.5 months, respectively. Using HSRT to treat BMs, whether combined with platinum-containing chemotherapy, targeted therapy, or both chemotherapy and targeted therapy, could improve OS ( P =0.027), iLPFS ( P =0.050) and iRPFS ( P =0.124). Among these patients, there were no significant differences in median OS (28.5 months vs 28.3 months, P =0.785), 6-month iLPFS rates (81.3% vs 72.9%, P =0.998) and 6-month iRPFS rates (92.9% vs 74.8%, P =0.974) between patients with 4-10 BMs and those with 1-3 BMs. Conclusion The use of HSRT to treat BMs of NSCLC based on linear accelerators is safe and effective. Use of HSRT in combination with other antitumor therapies to treat BMs is a favorable prognostic factor that can affect OS and iLPFS. HSRT treatment of 4-10 BMs or 1-3 BMs resulted in similar OS, and there were no significant differences in 6-month iLPFS rates and 6-month iRPFS rates.