bluuebunny/crossref_metadata_2025_split huggingface dataset:
Polychlorinated Biphenyls in the Drinking Water Source of the Yangtze River: Characteristics and Risk Assessment
Authors: Cui Xiaoai , Dong Jing , Huang Zhifeng , Liu Chengyou , Qiao Xiaocui , Wang Xing , Zhao Xingru , Zheng Binghui , Shen Jinshan 
Published: February 2020

Abstract
Background As the longest river in Asia, the Yangtze River flows through the most industrialized cities in China and provides critical ecological services for agriculture, industry, and transportation. Polychlorinated biphenyls (PCBs) have been banned for many years, but trace amounts of PCBs still exist as persistent organic pollutant in drinking water and are an ecotoxicological problem. In this work, we collected water, sediment, and suspended particulate matter (SPM) samples along the Yangtze River, to study the distribution and transport of PCBs for the risk assessment of the Yangtze River as a drinking water source. Results The ΣPCBs concentrations in water, sediment, and SPM ranged in 0.044–10.98 ng/L, 0.33–69.43 ng/g, and 0.72–152.66 ng/L, respectively. The main pollutants were PCB17, 18, 28, 47 and 118 in the Yangtze River. The ff SW value of PCB18 and PCB28 all exceeded 0.5, whereas the ff SW value of PCB47 and PCB118 (except for PCB118 at Y-4) were less than 0.5. The toxic equivalent quantity (TEQ) range of PCBs in water and in sediment was 0–5.55 pg-TEQ/L and 0–2.51 pg-TEQ/g, respectively. Conclusions In both water and sediment, lower chlorinated PCBs are dominant in the middle reaches and higher chlorinated PCBs are dominant at downstream. In contrast, SPM is dominated by tetra-CBs. The ff SW values reveal a net redissolution of lower PCBs from sediments to water but a net sorption of higher PCBs from water to sediment. The PCBs in water and sediment at downstream pose potential ecological risk, but the drinking water does not have a non-carcinogenic risk for humans.
Status and influential factors of vitamin D among children aged 0 to 6 years in a Chinese population
Authors: Zhang Heng , Li Zhijuan , Wei Yarong , Fu Jinyan , Feng Yaling , Chen Daozhen , Xu De-xiang 
Published: February 2020

Abstract
Background：Vitamin D insufficiency and deficiency in childhood are common, which is closely related to bone development. However, the status and influential factors of vitamin D during different ages are not clear. This study aimed to survey vitamin D status in children aged 0 to 6 years and explore its influential factors.
Materials and methods: A total of 6953 children were recruited in Wuxi City of East China from January to December in 2016. Enzyme-linked immunosorbent assay was used to determine the serum concentrations of 25-hydroxyvitamin D [25(OH)D].
Results: The median vitamin D level in the infant group (0-1 years of age) was 69.40 nmol/L, which was higher than that in both the toddlerhood group (1-3 years of age; 62.30 nmol/L) and the preschool group (3-6 years of age; 50.85 nmol/L) (P < 0.001). In addition, the median vitamin D level was 71.70 nmol/L in summer, which was higher than that in spring (64.25 nmol/L), autumn (62.95 nmol/L) and winter (64.10 nmol/L; P < 0.001). However, no difference was observed between genders (P = 0.974). Furthermore, the prevalence of vitamin D deficiency (<50 nmol/L) was 48.1% in the preschool group (3-6 years of age), which was higher than the 21.2% vitamin D deficiency in the toddlerhood group (1-3 years of age) and the 17.9% vitamin D deficiency in the infant group (0-1 years of age). Interestingly, a nonlinear association between 25(OH)D and air temperature was observed.
Conclusions: A high prevalence of vitamin D deficiency was common in a Chinese population of children 0-6 years old, especially in the preschool-aged children. Season and air temperature were related to vitamin D status. Therefore, we suggest that the recommendation for vitamin D supplementation in the Chinese pediatric population should be revised to include preschoolers and adolescents.

Keywords: Vitamin D; deficiency; preschool; season; air temperature.
Do Caregiving Hours Impact on Female Caregivers’ Receipt of Mammogram?: A Comparison with Non-Caregivers
Authors: Kim Soo Young , Guo Yuqi , Won Chorong , Lee Hee Yun 
Published: February 2020

Abstract
Background

caregiving responsibilities significantly impact females’ decisions on adhering to preventive mammography. The purpose of this study is to examine (1) the levels of Mammogram receipt, (2) the role of caregiving factors on the receipt of mammogram in caregiving group, and (3) the role of cancer beliefs on Mammogram screening in caregivers and non-caregivers.

Methods

the 2017 Health Information National Trends Survey (HINTS) provides samples of 1228 women aged 40 to 75 years old for this secondary analysis. By using Andersen’s Behavioral Model of Health Services Use, a binomial logistic regression model was used to analyze associations between mammography and socioeconomic factors, caregiving factors, and cancer belief factors.

Results

caregivers who provided more hours of caregiving per week (OR=0.749, 95% CI=0.564-0.94) and caregivers who had the belief of rather not know the likelihood of getting cancer (OR=0.673, 95% CI=0.496-0.914) were less likely to use mammogram. However, caregivers who believed cancer is more common than heart disease (OR=1.490, 95% CI=1.302- 2.151) were more likely to use mammogram. Non-caregivers who worried about getting cancer (OR=1.158, 95% CI=0.793-1.691) were more likely to use mammogram, but non-caregivers who had the belief of rather not know the likelihood of getting cancer (OR=0.825, 95% CI=0.713-0.955) were less likely to use mammogram.

Conclusions

to support caregivers’ breast cancer prevention, caregiving-related policies based on caregiving hours should be developed. Particularly, effort to promote breast cancer screening education and care support among older primary caregivers will likely increase their adherence to preventive mammography uptake. Development of targeted cancer prevention interventions on specific cancer beliefs held by both groups are also urgently needed to promote mammography.
A multi-scale flow model for blood regulation in a realistic vascular system
Authors: Qohar Ulin Nuha Abdul , Munthe-Kaas Antonella Zanna , Nordbotten Jan Martin , Hanson Erik Andreas 
Published: February 2020

Abstract
In the last decade, numerical models have been an increasingly important tool in medical science both for the fundamental understanding of the physiology of the human body as well as for diagnostics and personalized medicine. In this paper, a multi-scale model is developed for blood flow and regulation in a full vascular structure of an organ. We couple a 1D vascular graph model to represent blood flow in larger vessels and a porous media model to describe flow in smaller vessels and capillary bed. The vascular model is based on Poiseuille’s law, with pressure correction by elasticity and pressure drop estimation at vessels junctions. The porous capillary bed is modeled as a two compartments domain (arterial and venal) and Darcy’s law. The fluid exchange between the arterial and venal capillary bed compartments is defined as blood perfusion.
The numerical experiments show that the proposed model for blood circulation: 1) is closely dependent on the structure and parameters of both the vascular vessels and of the capillary bed, and 2) it provides a realistic blood circulation in the organ. The advantage of the proposed model is that it is complex enough to capture the underlying physiology reliably, yet highly flexible as it offers the possibility of incorporating various local effects. Furthermore, the numerical implementation of the model is straightforward and allows for simulations on a regular desktop computer.
Prognoses, outcomes and clinicopathological characteristics of very elderly patients with hepatocellular carcinoma who underwent hepatectomy
Authors: Shimada Shingo , Kamiyama Toshiya , Orimo Tatsuya , Nagatsu Akihisa , Asahi Yoh , Sakamoto Yuzuru , Kamachi Hirofumi , Taketomi Akinobu 
Published: February 2020

Abstract
Background

The aim was to evaluate the prognostic factors, clinicopathological characteristics and surgical outcomes after hepatectomy in very elderly patients with hepatocellular carcinoma (HCC).

Methods

We analyzed 796 patients with HCC from 2000 to 2017. Patients aged 80 years or older were classified into the very elderly group (group VE; n=49), patients younger than 80 years old and aged 65 years or older were classified into the elderly group (group E; n=363), and patients younger than 65 years old were classified into the young group (group Y; n=384). We investigated the prognoses, clinicopathological characteristics and surgical outcomes after hepatectomy.

Results

The number of surgical procedures and outcomes, including morbidities, were not significantly different. Groups VE, E and Y showed similar prognoses in terms of both survival and recurrence. In group VE, PT < 80% and PIVKA-II ≥ 400 mAU/ml were unfavorable factors for survival, and PIVKA-II ≥ 400 mAU/ml and the presence of portal venous invasion (PVI), hepatic venous invasion, and fibrosis were unfavorable factors for recurrence. In group E, ChE < 180 IU/l, AFP ≥ 20 ng/ml, tumor size ≥ 10 cm, and the presence of multiple tumors, PVI, and hepatic venous invasion (HVI) were unfavorable factors for survival, and ChE < 180 IU/l, tumor size ≥ 10 cm, and the presence of multiple tumors, PVI, and HVI were unfavorable factors for recurrence. In group Y, AFP ≥ 20 ng/ml, the presence of multiple tumors, poor differentiation, PVI, HVI, and blood loss ≥ 400 ml were unfavorable factors for survival, and PT < 80%, albumin < 3.5 g/dl, AFP ≥ 20 ng/ml, tumor size ≥ 10 cm, and the presence of multiple tumors, poor differentiation, and PVI were unfavorable factors for recurrence.

Conclusions

Tumor factors might have limited influence on the prognosis of very elderly patients, and liver function reserve might be important for the long-term survival of very elderly patients. Hepatectomy can be performed safely, even in very elderly patients. Hepatectomy should not be avoided in very elderly patients with HCC if the patients have a good general status because these patients have the same prognoses as nonelderly people.
Spread through air spaces is a poor prognostic indicator in patients undergoing lobectomy for lung cancer: A systematic review and meta-analysis
Authors: Wen Yaokai , Liang Hengrui , Qiu Guanping , Li Shuben , Liu Jun , Ying Weiqiang , He Jianxing , Liang Wenhua 
Published: February 2020

Abstract
Background: Previous studies have confirmed the poor prognostic value of spread through air spaces (STAS) in patients undergoing limited resection for lung cancer. Nevertheless, its prognostic value remains controversial in patients undergoing lobectomy. Consequently, we aim to systematically and comprehensively evaluate the prognosis of patients with STAS undergoing lobectomy for lung cancer. Methods: An extensive search of literature databases was conducted. Recurrence-free survival (RFS) and overall survival (OS) were compared between patients with or without STAS undergoing lobectomy. In addition, results of the limited resection were also evaluated and presented. Results: 5 studies with 1531 patients reported the outcomes of lobectomy and 4 studies including 505 patients evaluated the survival of limited resection. In patients undergoing lobectomy, STAS was associated with significantly worse survival than non-STAS, including both RFS (HR=1.700; 95% CI: 1.265–2.283; P＜0.001; P for heterogeneity=0.637; I2=0.0%) and OS (HR=2.620; 95% CI: 1.138–6.031; P=0.024; P for heterogeneity=0.128; I2=51.4%). STAS was also correlated with shorter RFS (HR=3.434, 95%CI 2.173 to 5.428; P＜0.001; P for heterogeneity=0.828, I2=0.0%) and OS (HR=3.494, 95%CI 2.128 to 5.736; P＜0.001; P for heterogeneity=0.501, I2=0.0%) in limited resection. Conclusions: STAS is a poor prognostic indicator in patients undergoing lobectomy for lung cancer.
A pilot, feasibility and acceptability study to investigate the utility of a home-based exercise intervention during and after neo-adjuvant chemotherapy for oesophago-gastric cancer—the ChemoFit study protocol
Authors: Chmelo Jakub , Phillips Alexander William , Greystoke Alastair , Charman Sarah Jane , Avery Leah , Hallsworth Kate , Welford Jenny , Sinclair Rhona Catherine France 
Published: February 2020

Abstract
BackgroundTreatment of locally advanced oesophago-gastric adenocarcinoma usually entails neo-adjuvant chemotherapy (NAC), and surgery. Surgery is associated with high morbidity and mortality. Cardiopulmonary reserve of patients having major surgery is related to postoperative outcomes. Complications are associated with poorer quality of life and may affect prognosis. Preventing complications may be beneficial to both of these and have cost implications. Prehabilitation may improve recovery from surgery by increasing a patients’ fitness before surgery. Designing a potentially cost and resource effective regimen which improves cardiopulmonary reserve may have a beneficial impact on patient outcomes after surgery.MethodsThe ChemoFit study is a non-randomised, single-arm and single-centre pilot study designed to investigate the feasibility of a home-based prehabilitation exercise intervention for patients receiving neoadjuvant treatment prior to oesophago-gastric surgery. Forty patients will be recruited at a single high-volume centre. The simple, home-based exercise intervention involves patients increasing their daily step-count during and after NAC and in the weeks leading up to surgical resection of the cancer. Additionally, quality of life assessments (QLQ-C30 and QLQ-OG25), oncological treatment delivery and participant perceptions of the study assessed by focus groups and questionnaires will be performed. The primary outcomes are to assess feasibility of the exercise intervention. The secondary outcomes will evaluate changes in cardiopulmonary reserve, sarcopenia and fat composition.DiscussionIt is anticipated that during an important teachable moment, the diagnosis and treatment of cancer, our patients will be open to the possibility of improving their fitness during chemotherapy and before major cancer surgery. It is possible that the negative impact of NAC on cardiopulmonary fitness could be prevented by implementing a home-based prehabilitation programme during and after NAC, prior to surgery for oesophago-gastric adenocarcinoma.Trial registrationThis study has been approved by the Health Research Authority (REC 18/WA/0427). Newcastle upon Tyne Hospitals NHS Foundation Trust (NUTH) will act as the study sponsor and the work is funded by a grant awarded by The Jon Moulton Charitable Foundation, supported by a research post funded by the Sir Bobby Robson Foundation. Trial registration: Clinicaltrials.gov, NCT04194463. Registered 11th December 2019 – retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04194463.
Evaluating a multidimensional strategy to improve the professional self-care of occupational therapists working with people with life limiting illness.
Authors: Apostol Courtney , Cranwell Kathryn , Hitch Danielle 
Published: February 2020

Abstract
Background: The term ‘’life limiting conditions’ refers to premature death following decline from chronic conditions, which is a common circumstance in which occupational therapists work with people at the end of life. The challenges for clinicians of working with these patients have long been recognised, and may have a significant impact on their professional self-care. This study aimed to evaluate a multidimensional workplace strategy to improve the professional self-care of occupational therapists working with people living with a life limiting condition. Methods: A pre and post mixed methods survey approach were utilised, with baseline data collection prior to the implementation of a multidimensional workplace strategy. The strategy included professional resilience education, targeted supervision prompts, changes to departmental culture and the promotion of self-care services across multiple organisational levels. Follow up data collection was undertaken after the strategy had been in place for two years. Quantitative data were analysed descriptively, while qualitative data were subjected to thematic analysis. Results: 103 occupational therapists responded (n=55 pre, n=48 post) across multiple service settings. Complex emotional responses and lived experiences were identified by participants working with patients with life limiting conditions, which were not influenced by the workplace strategy. Working with these patients was acknowledged to challenge the traditional focus of occupational therapy on rehabilitation and recovery. Participants were confident about their ability to access self-care support, and supervision emerged as a key medium. While the strategy increased the proportion of occupational therapists undertaking targeted training, around half identified ongoing unmet need around professional self-care with this patient group. Demographic factors (e.g. practice setting, years of experience) also had a significant impact on the experience and needs of participants. Conclusions: The multidimensional workplace strategy resulted in some improvements in professional self-care for occupational therapists, particularly around their use of supervision and awareness of available support resources. However, it did not impact upon their lived experience of working with people with life limiting conditions, and there remain significant gaps in our knowledge of support strategies for self-care of occupational therapist working with this patient group.
Sagittal alignment changes and postoperative complications after adult spinal deformity surgery in patients with Parkinson’s disease: A multi-institutional retrospective study
Authors: Kawabata Atsuyuki , Yoshii Toshitaka , Sakai Kenichiro , Hirai Takashi , Yuasa Masato , Inose Hiroyuki , Matsukura Yu , Tomori Masaki , Torigoe Ichiro , Kusano Kazuo , Otani Kazuyuki , Arai Yoshiyasu , Shindo Shigeo , Okawa Atsushi 
Published: February 2020

Abstract
Background: Parkinson’s disease (PD) has been reported to increase the risk of postoperative complications in patients with adult spinal deformity (ASD). However, those reports are limited, and few have made direct comparisons with patients who do not have PD.Methods: We retrospectively reviewed all surgically treated patients with ASD and at least 2 years of follow-up. Among them, 27 had PD (PD(+) group). Clinical data were collected on early and late postoperative complications and revision surgery. Radiographic parameters were evaluated before and immediately after surgery and at final follow-up, including sagittal vertical axis (SVA), thoracic kyphosis, lumbar lordosis, sacral slope, and pelvic tilt. From the same database, we also retrieved 206 controls without PD (PD(−) group) matched for age, sex, and body mass index.Results: For early complications, the PD(+) group showed a higher rate of delirium than the PD(−) group. Deep vein thrombosis and pulmonary embolism rates tended to be higher in the PD(+) group. For late complications, the rate of pseudarthrosis was significantly higher in the PD(+) group. Rates of rod failure and revision surgery due to mechanical complications also tended to be higher, but not significantly, in the PD(+) group (p = 0.17, p = 0.13, respectively). SVA at final follow-up and loss of correction in SVA were significantly higher in the PD(+) group.Conclusion: Extra attention should be paid to perioperative complications, especially delirium and thrombosis, in PD patients undergoing surgery for ASD. Furthermore, loss of correction and rate of revision surgery due to mechanical complications were higher in these patients.
Preliminary evaluation of the candidate international reference for Epstein–Barr virus capsid antigen immunoglobulin A in China
Authors: Chen Hao , Zhong Qiaohua , Wu Xiaobin , Ding Yanling , Chen Qi , Xue Ning , chen Shulin , Xu Yi-Wei 
Published: February 2020

Abstract
Background: Epstein–Barr capsid antigen (VCA) immunoglobulin A (IgA) detection is widely used for nasopharyngeal carcinoma (NPC), but reference standard for VCA-IgA has not yet been determined. For uniform and quantitative detection of VCA- IgA, reference standard is in urgent need. Methods: A mixed reference serum from three patients with NPC diluted with healthy subjects serum was made as a possible first international standard for VCA-IgA. Four ELISA kits and two chemiluminescent immunoassays(CLIA) kits were used to detected VCA-IgA in twenty NPC patients using the reference as a calibration curve. The performance of six kits were evaluated, and the quantitative results were compared. Results: Our results shown the reference has good linearity in different kits. Without reference, the difference of total CV (from 3.98% to 43.11%) and Within-run CV(from 2.47% to 19.66%) was large in 6 kits. The positive and negative coincidence rate between 6 kits and IFA for NPC diagnosis was 75% overall agreement, but there was a difference among the six kits ranged from 55%-90%. Concentration of 20 NPC samples divided into three sample categories was shown significant difference in a few subgroup of 6 methods. But a good correlation (R2=986) was observed between Antu and Beier ELISA kits. Conclusions: The reference serum may be used as a reference standard and better compared results from different methods/laboratories. However, due to the diversity of VCA antigens, the quantitative results of some kits are still inconsistent.
Prevalence of chronic kidney disease and associated metabolic risk factors in a middle-aged and elderly Taiwanese population: a cross-sectional study
Authors: Lu Mei-Chun , Chen I-Ju , Yeh Wei-Chung , Chuang Hai-Hua , Tsao Yu-Chung , Li Wen-Cheng , Tzeng I-Shiang , Tung Tao-Hsin , Chen Jau-Yuan 
Published: February 2020

Abstract
Background: This study aimed to quantify the prevalence of chronic kidney disease (CKD) and associated metabolic risk factors in a middle-aged and elderly population in Guishan District, Taoyuan City, Taiwan. Methods: This cross-sectional study enrolled residents aged 50-90 years living in one community. All subjects received a standardized personal interview, including a structured questionnaire, anthropometric measurements, and blood samples collected for laboratory testing. CKD was defined as the presence of kidney damage (urine albumin-creatinine ratio ≥30mg/g) or estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m 2 . Multiple logistic regression models were used to evaluate risk factors associated with CKD. Results : A total of 400 subjects were enrolled. The overall prevalence of CKD was 20.3% (95% CI: 16.36–24.24%). The age-specific prevalence of CKD in subjects aged 50-64 years, 65-74 years, and 75 years and over was 17.7%, 18.8%, and 33.9%, respectively, (p value for Cochran-Armitage trend test = 0.022). Multiple logistic regression model revealed that elevated blood pressure (OR = 2.55, 95% CI: 1.30–5.01), hyperglycemia (OR = 2.78, 95% CI: 1.59–4.88), hyperuricemia (OR = 1.36, 95% CI: 1.12–1.65) and metabolic syndrome (OR = 2.48, 95% CI: 1.40–4.40) were statistically and significantly associated with CKD. Conclusions: The prevalence of CKD in our study population is high. Hypertension, hyperglycemia, hyperuricemia and metabolic syndrome are significantly associated with CKD in a middle-aged and elderly population in Taiwan.