bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Features Of Ocular Myasthenia Gravis In Adult Patients: Diplopia and Ophthalmoplegia
Authors: Tang Junjie , Chen Fangyuan , Liu Xiaoyong , Chen Jian , Zhou Qing 
Published: February 2020

Abstract
Background: The diagnosis of ocular myasthenia gravis (OMG) in adult patients remained challenged and the characteristics of diplopia and ophthalmoplegia in OMG is unclear. Methods: Retrospective case series study of medical records of 40 adult patients diagnosed with OMG at The First Affiliated Hospital of Jinan University from June, 2016 to December, 2019, was performed to analyze the clinical features, diagnostic tests and preferential affected extraocular muscles of OMG. Results: 40 adult patients with OMG were involved and men represented 20 (50%) of cases. Mean age (±SD) among men was 49 ± 21 years (range: 19-81 years) and 40 ± 15 years (range: 21-65 years) among women. 18 patients (45.0%) were 18 to 39 years old, 12 patients (30.0%) were 40 to 59 years old, 9 patients (22.5%) were 60 to 79 years old, 1 patients (2.5%) over 80 years old. The median course of the disease among all the patients was 6 months (ranged: 1 month to 10 years). Neostigmine test was positive in 32 of 40 patients (80.0%), acetycholine receptors antibodies assay was positive in 4 of 40 patients (10.0%), Thymus CT showed abnormal findings in 5 of 40 patients (12.5%). At the first visit, 27 patients (67.5%) showed diplopia only, 9 patients (22.5%) showed ptosis only, 4 patients (10.0%) showed diplopia with ptosis. The most paralytic EOM, determined through light reflection, cover-uncover test and red glass test for patients presented with diplopia only (n=27) and diplopia with ptosis (n=9), was lateral rectus (51.6%), superior rectus (19.4%), medial rectus (12.9%), inferior rectus (9.8%), superior oblique (3.2%), inferior oblique (3.2%) in order. Conclusions: OMG mainly affected adults at the working ages. Diplopia serves as initial symptom in most adult patients with OMG and lateral rectus is most susceptible.
Birth Month And Prevalence Of Atopic Dermatitis In Children Under 3 Years In Antananarivo, Madagascar
Authors: Sendrasoa Fandresena Arilala , Ratovonjanahary Volatantely , Rakotoarisaona Mendrika Fifaliana , Andrianarison Malalaniaina , Raharolahy Onivola , Ranaivo Irina Mamisoa , Mbotinirina Viviane Estelle , Sata Moril , Razanakoto Naina Harinjara , Ramarozatovo Lala Soavina , Rabenja Fahafahantsoa Rapelanoro 
Published: February 2020

Abstract
BACKGROUND: Several studies have been done to evaluate the relationship between month of birth and atopic diseases but the results are contradictory. So, we aim to evaluate the correlation between the month of birth and the prevalence of AD in Malagasy children less than 3 years.METHODS: A case-control study was conducted based on patients’ data of the department of Dermatology in the University Hospital Joseph Raseta Befelatanana (UH/JRB) Antananarivo. It included 354 children less than 3 years seen in this department between January 2010 and December 2018. For each AD patient, two age and sex-matched controls without a history of AD were selected from the same period.RESULTS: This study included 118 AD cases and 236 non-AD controls. Our case-control study found that there are no statistically significant correlation between birth month and risk of AD in Malagasy children < 3 years. However, the fewest children with AD were born in February (17.86%, OR: 0.40, CI 95%: 0.11-1.14), and the most were born in August (45.16%, OR: 1,73; CI 95%: 0,75-3,88). Asthma, allergic rhinitis and allergic conjunctivitis were significantly correlated with AD in our patients.CONCLUSION: Our case-control study found that there are no statistically significant correlation between birth month and risk of AD in children < 3 years. However, the high frequency of AD in children born in August (dry season) compared to non-AD controls was not negligible (p-value =0,05 and X 2 3,27).
Neoadjuvant chemoradiotherapy followed by laparoscopic distal gastrectomy with D2 lymph node dissection for a locally advanced distal gastric cancer
Authors: Li Ziyu , Liu Zining , Wang Yinkui , Shan Fei , Li Shuangxi , Ji Jiafu 
Published: February 2020

Abstract
Laparoscopic technique has been widely applied for early gastric cancer, with the advantages of minimal invasion and quick recovery. However, there is no report about the safety and short-term outcome of laparoscopic gastrectomy with D2 lymph node dissection for patients after neoadjuvant chemoradiotherapy. We presented the first case treated in this way. The patient was a 60-year-old man who was diagnosed with advanced distal gastric cancer. The neoadjuvant chemoradiotherapy was performed based on the regimen of GTV 50Gy/25f and CTV 45Gy/25f, as well as concurrent S-1 60mg Bid. Radiological examination determined that a partial response (PR) had been achieved by the initial therapy. Adverse events included only a myelosuppression limited to grade 2. Then laparoscopic distal gastrectomy with D2 lymph node dissection was undertook successfully for him. The patient recovered smoothly with no postoperative complications. The postoperative pathological stage was ypT3N0M0, with necrosis rate >90%. He was still in good condition after five years follow-up.
Single-Port Sutureless Partial Nephrectomy for Small Renal Cancer
Authors: Li Ching-Chia , Chien Tsu-Ming , Yeh Hsin-Chih , Lee Hsiang-Ying , Ke Hung-Lung , Wen Sheng-Chen , Chang Wei-Che , Juan Yung-Shun , Chou Yii-Her , Wu Wen-Jeng 
Published: February 2020

Abstract
Background: Laparoscopic single-port (LESS) sutureless partial nephrectomy (PN) is a technically demanding procedure. Here we shared our experience to reduce the warm ischemia time and shorten the learning curve in performing LESS sutureless PN.Materials and methods: Between 2015 and 2018, custom made LESS sutureless PN was performed in 33 patients with small renal cancer. Preoperative, intra-operative and postoperative variables were recorded. Renal function was evaluated by estimated glomerular filtration rate (eGFR) pre- and postoperatively.Results: The average warm ischemia time and the operation time were 11.8 ± 3.9 min and 167.9 ± 37.5 min, respectively. Only 2 patients suffered from massive urinary leakage (>200 mL/day) from the Jackson Pratt drainage tube, but the leakage spontaneously decreased within 7 days after the surgery. eGFR and serum hemoglobin were not found to be significantly different pre- and postoperatively. All tumors were removed without positive surgical margin. All patients were alive without recurrent tumors at mean postoperative follow-up of 16.5 ± 6.4 months.Conclusions: LESS sutureless PN is a feasible surgical method for most patients with small renal cancer with excellent cosmetic results, shorter learning curve without affecting oncological results.
Mood, Activity Participation, and Leisure Engagement Satisfaction (MAPLES): A randomised controlled feasibility study for low mood in acquired brain injury
Authors: Kusec Andrea , Murphy Fionnuala C. , Peers Polly V. , Lawrence Cara , Cameron Emma , Morton Claire , Bateman Andrew , Watson Peter , Manly Tom 
Published: February 2020

Abstract
Background: Acquired brain injury (ABI) affects approximately 79.3 million individuals annually and is linked with elevated rates of depression and low mood. Existing methods for treating depression in ABI have shown mixed efficacy. Behavioural Activation (BA) is a potentially promising intervention. Its premise is that individuals with low mood avoid planning and engaging in activities due to low expectations of a positive outcome. Consequently, their exposure to positive reinforcement is reduced, exacerbating low mood. BA aims to break this cycle by encouraging activity planning and engagement. It is unknown whether cognitive demands of traditional BA may undermine efficacy in ABI. Here we assess the feasibility and acceptability of two groups designed to increase activity engagement. In the Activity Planning Group (traditional BA) the importance of meaningful and positive activity will be discussed and participants encouraged to plan/engage in activities in everyday life. The Activity Engagement Group (experiential BA) instead focuses on engagement in positive experiences (crafts, games, discussion) within the group. The primary aims are to evaluate the feasibility and acceptability of the two groups in ABI. A secondary aim is to explore relative efficacy of the groups compared to an equivalent period of waitlist controls. Method: This study outlines a parallel-arm feasibility pilot trial for individuals with low mood and ABI that compares a traditional vs experiential BA group vs. waitlist controls. Adults (>18 years) will be recruited from local ABI services and randomised to condition. Feasibility and acceptability will be assessed via recruitment, retention, attendance, and participant feedback. Groups will be compared (pre- and post-intervention and 1 month follow-up) by assessing self-reported activity engagement. Secondary outcomes include self-report measures of depression, anxiety, post-traumatic distress related to the ABI, motivation, participation, and sense of control over one’s life.Ethics and Dissemination: The trial has been approved by the Health Research Authority of the NHS in the UK (East of England – Cambridge Central, REF: 18/EE/0305). Results will inform future research on interventions for mood in ABI and be disseminated broadly via peer-reviewed journals, conference presentations, and social media.
Prognosis of nontuberculous mycobacterial pulmonary disease according to the method of microbiologic diagnosis
Authors: Sin Sooim , Han Seungchul , Lee Yeon Joo , Cho Young-jae , Park Jong Sun , Yoon Ho Il , Lee Choon Taek , Lee Jae Ho 
Published: February 2020

Abstract
Background Current microbiologic criteria for nontuberculous pulmonary disease (NTM-PD) require cultures with two separate sputum specimens or one non-sputum specimen. However, data on NTM-PD prognosis following non-sputum culture-based diagnosis are limited. We compared the prognosis of NTM-PD diagnosed using non-sputum and sputum cultures. Methods We analyzed 1020 patients in whom NTM was isolated; they were divided into the sputum NTM isolation (n=170), sputum NTM-PD (n=688), and non-sputum NTM-PD groups (n=162). Initiation of therapy and radiographic aggravation was compared between groups. Results Overall median observation time was 44.3 months (interquartile range, 28.0–70.2). Fewer non-sputum NTM-PD patients initiated treatment than sputum NTM-PD patients (p<0.001). Moreover, fewer non-sputum NTM-PD patients exhibited radiographic aggravation than sputum NTM-PD patients (p=0.001). Both time to radiographic aggravation and initiation of therapy were significantly shorter in the sputum NTM-PD group (log-rank test; p=0.011 and p<0.001, respectively). Sputum NTM-PD patients showed higher initiation of therapy (aHR, 1.38; 95% CI, 1.02–1.87) and risk of radiographic aggravation (aHR, 1.47; 95% CI, 1.02–2.10) than non-sputum NTM-PD patients. Conclusion Prognosis of NTM-PD patients diagnosed with a non-sputum culture was better than that of NTM-PD patients diagnosed with a sputum culture. The disease course may differ depending on the diagnostic method.
Good Syndrome with Cytomegalovirus Hepatitis: Successful Resection of Thymoma: A case report
Authors: Isobe Sho , Sano Atsushi , Otsuka Hajime , Azuma Yoko , Koezuka Satoshi , Makino Takashi , Sakai Takashi , Ito Takafumi , Maeda Tadashi , Homma Sakae , Iyoda Akira 
Published: February 2020

Abstract
Background Good syndrome is a rare condition, manifesting as immunodeficiency due to hypogammaglobulinemia associated with thymoma. Herein, we present a patient with Good syndrome whose thymoma was resected after treatment of cytomegalovirus hepatitis. Case presentation The patient was a 45-year-old woman presenting with fever, cough, and nasal discharge, and was diagnosed with thymoma and hypogammaglobulinemia. She subsequently developed cytomegalovirus hepatitis that was treated by immunoglobulin. After resolution of the hepatitis, she underwent thymectomy through a left anterior thoracotomy. Her postoperative course was uneventful, and while receiving ongoing immunoglobulin therapy, she has been doing well without signs of infection. Conclusions Management of infections is important for patients with Good syndrome. To minimize the risk of perioperative infection, we should take care while planning the surgical approach and procedure.
Could remnant lipoprotein cholesterol become a risk factor in diabetic menopausal women with coronary artery disease? A cross-sectional study of single academic center in China
Authors: Feng Xunxun , Guo Qianyun , Zhou Shu , Sun Tienan , Liu Yuyang , Zhou Zhiming , Zhou Yujie 
Published: February 2020

Abstract
Background and aimsIt had been confirmed that remnant lipoprotein cholesterol (RLP-C) mediates the progression of coronary artery disease (CAD). Currently there was limited information on RLP-C in menopausal women. With the special status of diabetes mellitus (DM) combined with the special body changes of the menopausal women, the RLP-C was particularly important when studying the changes that occurred in response to CAD and its associated risk factors. This study discussed whether RLP-C could be an independent risk factor for menopausal women with CAD and DM.MethodsThe cohort consisted of 4753 menopausal women who had undergone coronary angiography. Subjects were separated into CAD and non-CAD groups, and univariate and multivariate logistic regression analysis of CAD risk factors were performed. All patients with a history of DM were divided into DM subgroups. Then, the univariate and multivariate logistic regression analysis of the risk factors of CAD and the comparison among age groups in the DM subgroup were performed. After age stratification of the DM group, the Kruskal-Wallis test was used to analyze the differences of various lipid indexes among age groups. Results The univariate and multivariate logistic regression showed that RLP-C was an independent risk factor for CAD in menopausal women (OR 1.274, 95%CI 1.107-1.467, P=0.001). In the DM subgroup, it was also found that RLP-C was an independent risk factor for CAD (OR 1.243, 95%CI 1.078-1.433, P=0.003). Kruskal-Wallis test analysis found that RLP-C had no significant difference among three groups (P>0.05).ConclusionsRLP-C was proved to be an independent risk factor for menopausal women with CAD and DM.
Association of Dyslipidemia With Sudden Sensorineural Hearing Loss: A Retrospective Study
Authors: Li Dafei , Xu Piao , Yang Jingya , Lin Qiongping , Zhao Haiyan , Chen Jiawei , Tian Guangyong 
Published: February 2020

Abstract
Background: Blood lipid levels have been widely studied in patients with sudden sensorineural hearing loss (SSNHL), but it has been unclear whether dyslipidemia associates with SSNHL. Whether there is a simple and feasible blood lipid index to predict the onset of SSNHL remains to be found.Methods: This study reviewed 100 SSNHL patients and 100 healthy subjects who received relevant clinical examination in our hospital from June 1, 2015 to June 1, 2019. The demographic, clinical characteristics, lipid levels and lipid metabolism indexes of the two groups were compared.Results: In this study, 100 patients (64 men [64%]; 36 women [36%]; mean [SD] age, 38.47 [14.36] years) were included in the SSNHL group, and 100 healthy people(60 men [60%]; 40 women [40%]; mean [SD] age, 36.52 [9.86] years) served as the control group. No significant differences between the SSNHL group and the control group in age, sex, BMI, smoking habits and alcohol drinking patterns were observed. Meanwhile, it can be seen the mean (SD) concentrations of total cholesterol (TC) (194.59 [38.22] vs 176.83 [23.55] mg/dL; MD, 17.76 mg/dL; 95% CI, 26.64-46.72 mg/dL), the mean (SD) concentrations of low density lipoprotein cholesterol (LDL-C) (116.99 [33.59] vs 96.91 [22.01] mg/dL; MD, 20.08 mg/dL; 95% CI, 32.43-48.26 mg/dL) and apolipoprotein (apo) B (89.82 [21.38] vs 81.16 [16.17] mg/dL; MD, 8.66 mg/dL; 95% CI, 12.03-23.21 mg/dL) were significantly higher than the control group. In addition, it was also observed that the median [IQR] concentrations of high density lipoprotein cholesterol (HDL-C) (1.51 [1.33-1.76] vs 1.56 [1.40-1.84] mg/dL) and the median [IQR] concentrations of apolipoprotein (apo) AI (118.50 [103.00-141.25] vs 133.00 [115.25-1.52.75] mg/dL) were lower than those in the control group. In terms of lipid metabolism indexes, the median [IQR] value of TC/HDL-C (3.31 [2.68-3.85] vs 2.72 [2.42-3.37]), the mean (SD) value of apo B/apo AI (0.76 [0.26] vs 0.63 [0.18]; MD, 0.13; 95% CI, 0.20-0.32) and the median [IQR] value of atherogenic index (ATH index) (1.61 [0.97-2.50] vs 1.01 [0.73-1.75]) were significantly higher than the control group, while the mean (SD) value of atherogenic index of plasma (AIP) (-0.24 [0.28] vs -0.25 [0.21]; MD, 0.01; 95% CI, -0.06-0.08) showed no difference between the two groups.Conclusions: There were significant differences in blood lipid levels and lipid metabolism between the SSNHL group and the control group. LDL-C, apo AI and apo B were important independent predictors of SSNHL.
Exploring the Consequences of decentralization: Has privatization of health services been the perceived effect of decentralization in Khartoum Locality, Sudan?
Authors: Noory Bandar , Hasssanein Sara A , Elsony Asma , Bjune Gunnar 
Published: February 2020

Abstract
Background: The health system of Sudan has experienced several forms of decentralization, as well as, a radical reform. Authority and governance of secondary and tertiary health facilities have been shifted from federal to state levels. Moreover, the provision of health care services have been moved from large federal tertiary level hospitals such as Khartoum Teaching Hospital (KTH) and Jafaar Ibnaouf Hospital (JIH), located in the center of Khartoum, to smaller district secondary hospitals like Ibrahim Malik (IBMH), which is located in the southern part of Khartoum. Exploring stakeholders’ perceptions on this decentralisation implementation and the relevant consequences is vital in building an empirical benchmark for the improvement of health systems. Methods: This study utilizes a qualitative design which is comprised of an in-depth interviews and qualitative content analysis with an inductive approach. The study was conducted between July and December 2015, and aimed at understanding the personal experiences and perceptions of stakeholders towards decentralization enforcement and the implications on public health services, with a particular focus on the Khartoum locality. It involves community members residing in the Khartoum Locality, specifically in catchments area where hospital decentralization was implemented, as well as, affiliated health workers and policymakers. Results: The major finding suggests that the privatization of health services occurs after decentralization. The study participants also highlighted that scrutiny and reduction of budgets allocated to health services led to an instantaneous enforcement of cost recovery user fee. Devolving KTH Khartoum Teaching and Jafaar Ibnaouf Hospitals into peripherals with less capacity is considered to be a plan to outsource services to the private sector. Another theme that was highlighted in hospitals included the profit-making aspect of the governmental sector in the form of drug supplying and profit-making retail. Conclusions: A change in health services after the enforcement of decentralization was illustrated. Moreover, the empowerment of the privatization concept was the prevailing perception among stakeholders. Having in-depth studies and policy analysis in line with the global liberalization and adjustment programs is crucial for any health sector reform in Sudan. Keywords: decentralization, privatization, stakeholders, global liberalization, profit-making.
Assessing the Youth-friendliness of Youth Clinics in Northern Sweden: A Survey Analyzing the Perspective of the Youth
Authors: Waenerlund Anna-Karin , Sebastian Miguel San , Hurtig Anna-Karin , Wiklund Maria , Christianson Monica , Goicolea Isabel 
Published: February 2020

Abstract
Background: Sweden has nearly 300 youth clinics that have been offering services since the 1970s. However, no evaluation has been done to assess their youth-friendliness. This study aims to assess: i) to what extent youth clinics are perceived as youth-friendly by the young people using them; and ii) if the level of youth friendliness is equally perceived across different sociodemographic groups of users. Methods: The four northernmost counties of Sweden were included in the study. Of the total identified 22 youth clinics, 20 participated by giving out questionnaires to the youth after their visits to the respective youth clinics. In total 1,110 youth participated in the study and answered questions according to the World Health Organization’s criteria of accessibility, equity, respect, privacy and confidentiality, no judgement, and quality. Means and frequencies were calculated, and t-test and ANOVA were used to compare means by sociodemographic variables.Results: Participants perceived the youth clinics as very youth friendly across the measured domains, with scores as high as 4.8 and 4.9 (of a maximum of 5) in the studied domains. Youth clinics were perceived in a similar way regardless of gender, but other sociodemographic factors influenced some of the domains, especially ethnic background. Conclusions: The perception of youth friendliness in youth clinics was very high. Nonetheless, younger users; users who did not categorize themselves as either heterosexual, homosexual, or bisexual; users with trans-experiences; and users with migrant backgrounds gave youth clinics lower scores for certain domains.