bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chemotherapy and Targeted Therapy Near the end of life Affects Aggressiveness of Palliative Care
Authors: Cheng Wen-Wu , Zhang Zhe , Chen Meng-Lei , Gu Xiao-Li 
Published: February 2020

Abstract
Background: In patients with advanced cancer, considering the increased application of targeted therapy and immunotherapies, we explored the difference between indicators of chemotherapy and targeted therapy in the last month of life.Methods: Electronic medical data of patients who died from metastatic cancer and received targeted therapy and palliative chemotherapy from April 2007 to December 2018 at the Department of Integrated Therapy, Fudan University Shanghai Cancer Center were analyzed retrospectively. To determine those variables that were judged to be independent predictors of the use of palliative chemotherapy and targeted therapy, and the differences between them, univariate and multivariate analyses were used.Results: Of the 585 patients included in the study, 87 (14.9%) received palliative chemotherapy and 125 (21.3%) underwent targeted therapy during the last month. Patients who received continued chemotherapy within the last month were subjected to more intensive treatment (admitted to an intensive care unit (ICU) in the last month of life (OR, 2.33; CI [1.91–2.92], P < 0.001), and received cardiopulmonary resuscitation(OR, 4.18; CI [2.91–5.40],P < 0.001)), than those who did not. Analysis of subgroups showed that the lung cancer was independently associated with targeted therapy, and admission to an ICU was independently associated with palliative chemotherapy.Conclusions: Younger patients without complications and with better performance status were more likely to receive chemotherapy. Lower rates of cardiopulmonary resuscitation and admission to ICU correlated with receipt of targeted therapy at the end of life compared with those who received chemotherapy in the last 30 days.
AChE-activity in critically ill patients with suspected septic encephalopathy: a prospective, single-centre study
Authors: Zujalovic Benedikt , Mayer Benjamin , Hafner Sebastian , Balling Florian , Barth Eberhard 
Published: February 2020

Abstract
BackgroundIn consequence of systemic inflammation, up to 70% of septic patients develop a diffuse brain dysfunction, accompanying with an increase in mortality, which is referred to as “septic associated encephalopathy”. Subsuming septic associated encephalopathy as a category of delirium, there is a common pathophysiology (neuroinflammation and cholinergic transmitter imbalance). This can be approximated by measuring the acetylcholinesterase activity as a surrogate parameter of cholinergic activity. However, conflicting results for acetylcholinesterase activity exists, if singlepoint measurements have been done. Therefore, we wanted to test the hypothesis, whether longitudinal analysis of acetylcholinesterase activity in Intensive Care Unit patients displays septic associated encephalopathy/delirium in septic patients and reveals significant differences in comparison with non-septic, critically ill patients. MethodsIn this prospective, observational, single-center study, 175 patients, admitted to the operative Intensive Care Unit of the University hospital Ulm, Germany, were included. Patients were divided into septic (n = 45) and non-septic (n = 130) patients and were screened for delirium/cognitive dysfunction. Subgroups for patients with delirium and altered acetylcholinesterase activity were built, dependent if an increase/decrease of the acetylcholinesterase activity was observed. Acetylcholinesterase activity was analysed over the course of time by using a linear regression model accounting for repeated measures. By using a time adjusted model, the effect of further possible predictors of acetylcholinesterase activity was analyzed. For nonparametric distributions, quantitative data were compared using Wilcoxon matched-pairs test. For the analysis of the independent samples, we used the Mann-Whitney test. ResultsThere was a statistically significant, time-dependent change in acetylcholinesterase activity (decrease/increase) over a period of at least 5 days in septic patients which revealed septic associated encephalopathy/delirium in about 90%. ConclusionThe longitudinal measurement of acetylcholinesterase activity over several consecutive days revealed a shift compared to baseline values exclusively in septic patients with septic associated encephalopathy/delirium. Acetylcholinesterase activity alteration compared to baseline values at the onset of sepsis may help to detect and differentiate septic associated encephalopathy from other delirium entities. Trial registrationRetrospectively registered at German Clincial Trials Register, registration number DRKS 00020542, date of registration: January 27, 2020
Molecular identification of severe fever with thrombocytopenia syndrome viruses from tick and bitten patient in Southeast China
Authors: Tong Yongxi , wang qiujing , Fu Yongfeng , Li Shibo , Zhang Zhao , Zhang Zheen , Yu Xuewen 
Published: February 2020

Abstract
Background Severe fever and thrombocytopenia bunyavirus (SFTSV) infection causes severe fever and thrombocytopenia syndrome with high mortality. It is extremely rare that the transmitting tick can be directly captured in the bitten wound and SFTSV can be isolated from both the captured tick and patient’s serum for establishing solid pathogen diagnosis. Case presentation We report a case infected with severe fever and thrombocytopenia bunyavirus. The 69-year-old male patient presented fever and tenderness on two lymph nodes in right groin. A visible tick bitten mark appeared on right upper quadrant of the patient’s abdomen and an alive tick was captured in the bitten wound upon physical examination. The virus was detected in both the captured tick that stayed in the bitten wound for seven days. The phylogenetic analysis indicated that the SFTSV isolated from the tick and the patient’s serum sample belonged to type B, in which the L/S segment of these two isolates shared 100% homology, while the M segment had 99.9% homology. the bitten patient was given various supportive cares and eventually died of multiple organ failure. Conclusions The present case provides direct evidence of SFTSV transmission from H. longicornis to humans and suggests that direct cross-species transmission can occur without additional intermediate hosts.
Comparing the Effects of Ketorolac and Paracetamol on Postoperative Pain in Coronary Artery Bypass Graft surgery. A randomized clinical trial
Authors: zadeh Fatemeh Javaherforoosh , Abdalbeygi Hasan , Janatmakan Farahzad , Gholizadeh Behnam 
Published: February 2020

Abstract
Introduction Pain management after coronary artery bypass graft (CABG) surgery remains challenging. Objective This study aimed to compare the effects of Ketorolac and Paracetamol on postoperative CABG pain management. Method This double-blind randomized clinical trial study was conducted in Ahvaz, Iran, from September 2018-December 2019. Two consecutive groups of 60 patients undergoing elective on-pump coronary artery bypass graft surgery. Intervention The patients were divided into 0.5 mg/kg of ketorolac mg/dl and 10 mg/kg of Paracetamol after surgery for pain management. Primary outcomes were: visual analog pain scale (VAS) at the time point immediately after extubation (baseline) and at 6, 12, 24 and 48 hours and the total dose of morphine consumption. Secondary outcomes included the hemodynamic variables, weaning time, chest tube derange, in-hospital mortality and myocardial infarction. Statistical analysis The data were analyzed using SPSS version 22(SPSS, Chicago, IL). The Mann-Whitney U-test was used to compare demographic data, VAS scores, vital signs, and side effects. Repeated measurements were tested within groups using Friedman's ANOVA and the Wilcoxon rank-sum test. Values were expressed as means ± standard deviations. Statistical significance was defined as a p-value < 0.05. Results Compared with baseline scores, there were significant declines in VAS scores in both groups throughout the time sequence (P< 0.05). The statistical VAS score was slightly higher in the Paracetamol group at most time points, except for the time of 6 h. However, at 24 and 48 hours, the VAS score in group Paracetamol was significantly higher than in group Ketorolac. There were no significant differences between groups about hemodynamic variables. Conclusion: The efficacy of ketorolac is comparable to that of Paracetamol in postoperative CABG pain management.
The magnitude of dexamethasone-induced hyperglycemia in cataract surgical patients with normal glucose metabolism: a continuous glucose monitoring based study
Authors: Zhang Wen-li , Gao Gu , Sun Xiao-juan , Ye Lei , Ma Jian-hua , Li Feng-fei 
Published: February 2020

Abstract
Background To determined 24-hrs glycemic variations using continuous glucose monitoring (CGM) in cataract surgical patients with normal glucose metabolism receiving dexamethasone therapy. Methods This was a single-center, randomized, observational and prospective trial. Between June 2017 and December 2018, cataract surgical patients with normal glucose toleration were recruited, and were randomized assigned at a ratio of 1:2 to either receiving 10 mg dexamethasone daily for 3 days after cataract surgical (dexamethasone group) or without dexamethasone therapy (control group). A retrospective CGM was performed at afternoon on -1 day before cataract operation performed for at least 3 days. The primary endpoint was the difference in mean amplitude of glycemic excursions (MAGE) between the two groups. Results We observed that patients receiving 10 mg dexamethasone daily showing mild increase in mean glucose and hourly mean glucose throughout 24-hrs compared to control group. We also detected that dexamethasone leading to a significant increase in glycemic variation, in term of standard deviation, and a number increase in MAGE and CV%.Conclusion Our data reveal that short period administration of dexamethasone leading a mild increase in glycemic variations (GV). However, the increased GV may have not clinically relevant. Our data indicates that short duration of 10 mg dexamethasone once daily may be a safe therapy regarding glycemic metabolism in subjects without diabetes.
Lipoprotein (a) is a residual risk of atherosclerotic renal artery stenosis in hypertensive patients: a population-based cross-sectional study.
Authors: Hu Xiangming , Yang Xing , Li Xida , Luo Demou , Zhou Yingling , Dong Haojian 
Published: February 2020

Abstract
Background: Low-density lipoprotein cholesterol (LDL-c) has been proven to be a risk factor for atherosclerotic cardiovascular disease (CVD), while lipoprotein (a) (Lp(a)) is a residual risk factor for CVD, even though LDL-c is well controlled by statin use. Importantly, the role of Lp(a) in atherosclerotic renal artery stenosis (ARAS) is still unknown.Methods: For this cross-sectional population-based study, patients who simultaneously underwent coronary and renal angiography were examined. ARAS was defined as a 50% reduction in the cross-sectional (two-dimensional plane) area of the renal artery. Data were collected and compared between ARAS and non-ARAS groups, including clinical history and metabolite profiles. Univariate analysis, three tertile LDL-c-based stratified analysis, and multivariate-adjusted logistic analysis were conducted, revealing a correlation between Lp(a) and ARAS.Results: A total of 170 hypertensive patients were included in this study, 85 with ARAS and 85 non-RAS. Baseline information indicated comparability between the two groups. Univariate analysis showed that systolic blood pressure and peripheral arterial disease were positively correlated with ARAS while coronary artery disease was negatively associated. Stratified analysis of LDL-c revealed a significant increase in the incidence of ARAS in patients who had high Lp(a) concentrations at low LDL-c levels (OR: 4.77, 95%CI:1.04-21.79, P = 0.044). Further logistic analysis with adjusted covariates also confirmed the result, indicating that high Lp(a) levels were independently associated with ARAS (OR: 8.16, 95%CI 1.12-59.12, P = 0.037). This relationship increased with increasing Lp(a) concentration based on a curve fitting graph. These results were not present in the low and intermediate LDL-c-level groups.Conclusion: In hypertensive patients who present low LDL-c, high Lp(a) was significantly associated with atherosclerotic renal artery stenosis and thus is a residual risk factor.
OSA-induced multi-organ dysfunction after elective coronary artery bypass surgery in coronary heart disease patients
Authors: Wang Jiayang , Wang Xinxin , Yu Wenyuan , Zhang Kui , Wei Yongxiang 
Published: February 2020

Abstract
Background The aim of this study was to explore the underlying impact of obstructive sleep apnea (OSA) on postoperative parameters of multi-organ function, including cardiac and cerebral vascular, respiratory as well as renal postoperative complications, among coronary heart disease (CHD) patients following elective coronary artery bypass grafting (CABG). Methods Electronic literature databases, including PubMed, ISI Web of Science, Directory of Open Access Journals, and the Cochrane Library electronic databases, were searched manually and automatically for relevant English articles. All of the selected articles focused on a comparison of the incidence of primary and secondary outcomes in CHD patients undergoing elective CABG with and without OSA. Results A total of 13 articles met our inclusion criteria. The current study demonstrated OSA significantly increased the incidence of major adverse cardiac and cerebrovascular events (MACCEs) in CHD patients undergoing elective CABG compared with the controls (odds risk (OR), 1.97; 95% confidence interval (CI), 1.50 to 2.59, p <0.0001). In addition, OSA was associated with an increased risk of new revascularization in CHD patients undergoing elective CABG (OR, 9.47; 95% CI, 2.69 to 33.33, p <0.0001). Moreover, reintubation and tracheostomy in the OSA group was increased (OR, 3.43; 95% CI, 1.35 to 8.71; p =0.009) and 372% (OR, 4.72; 95% CI, 1.23 to 18.13; p=0.024), respectively, compared with the control group. Besides, we also confirmed OSA significantly increased the acute kidney injury (AKI) incidence by 124% (OR, 2.24; 95% CI, 1.07 to 4.72; P < 0.0001). Finally, our results demonstrated that OSA increased medical resource utilization including length of postoperative hospital stay and ICU stay. Conclusions OSA may contribute to postoperative multi-organ dysfunction among CHD patients undergoing elective CABG by increasing the incidence of MACCEs, especially new revascularization, as well as respiratory, and renal complications. Peri- and postoperative management of CHD patients with OSA may be optimized to minimize the rate of postoperative parameters of multi-organ dysfunction, further reducing the consumption of limited medical resources.
Repeated trips by patients seeking medical treatment overseas from the United Arab Emirates: Results from the Dubai Health Authority during 2009–2016
Authors: Alnakhi Wafa K. , Alfarisi Omamh A. , Nonyane Bareng A. S , Morlock Laura L. , Ahmed Saifuddin 
Published: February 2020

Abstract
Background: The Dubai Health Authority (DHA) spends millions of dollars to cover United Arab Emirates (UAE) nationals seeking healthcare overseas each year. Many patients undertake multiple visits following their initial trip. This paper analyzes repeated trips following an initial medical trip overseas so that the DHA can more effectively address patients’ needs and reduce the risks associated with multiple trips overseas.Methods: Administrative data were obtained from the DHA for the UAE nationals who sought treatment overseas during 2009–2016. We examined the match of the medical specialty between the initial and subsequent trips. Medical specialty was the key independent variable and other covariates included gender, age group, travel season, treatment destination and trip order. A mixed-effects logistic regression model with subject specific random intercept was used to assess the relationship of the outcome with the key variables of interest.Results: The analysis included 2,344 UAE nationals who had at least one trip following the initial medical visit. Oncology was the most common medical specialties sought by patients who travelled for repeated visits (18%). Patients in the age group 13-18 years had the highest odds of subsequent visits matching the medical specialty at the initial trip relative among age groups (OR 1.93, 95% CI:1.351,2.757). Patients travelling for oncology, orthopedic surgery, neurosurgery, ophthalmology, obstetrics/gynecology and otolaryngology had higher odds of subsequent trips matching the specialty of initial trips. The odds of subsequent trips matching the medical specialty of the initial trip increased with each additional trip (OR 1.73, 95%CI: 1.533,1.94).Conclusions: This is the first longitudinal study that examines the repeated medical trips among UAE nationals supported by the DHA. The results demonstrated that age group, medical specialty sought at the time of the initial trip, and number of trips were significant factors for understanding the match of the medical specialty between the initial and subsequent trips. The study results may help the DHA to establish an overseas treatment registry to collect information about patients seeking medical treatment overseas. In addition, the study will support establishing follow-up care programs to improve patients’ outcome and the clinical care for those patients.
Treatment experienced persons living with HIV on atazanavir based second line regimens are not highly adherent to therapy: a report from a tertiary referral hospital in Kenya.
Authors: Mugendi George , Nyamweya Nasser Nyambane , Okalebo Faith Apolot 
Published: February 2020

Abstract
Background Adherence to antiretroviral therapy is necessary for positive treatment outcomes. The objectives of this study were to determine adherence levels and their determinants in persons living with HIV on second line therapy. Methods A cross-sectional study was undertaken at a HIV clinic within Kenyatta National Hospital in October, 2017. Data were collected through interviews and application of the Morisky Medication Adherence and then analyzed in R. Results One hundred and ten patients were enrolled; 46 (41.8%) males and 64 (58.2%) females. The mean age was 39.8 years (± 11.8). Most participants, 96 (87.3%), had moderate adherence while 14 (12.7%) had low adherence. None were highly adherent. Age (aOR = 1.10, 95% CI; 1.04, 1.19) and depression (aOR =0.17, 95% CI 0.04, 0.64) were independently associated with adherence. Conclusion None of the treatment experienced patients on second line regimens were highly adherent to therapy. Younger patients and those with depression require additional adherence counselling.
Multi-Level, Multi-Scale Modeling and Predictive Mapping for Jaguars in the Brazilian Pantanal.
Authors: Bohnett Eve , Hoctor Thomas , Hulse David , Ahmad Bilal , Niebuhr Bernardo , Morato Ronaldo 
Published: February 2020

Abstract
Background Machine learning (ML) methods and remote sensing data were used to build multi-level multi-scale resource selection models and predictive maps onto the extended landscape for jaguars (Panthera onca) in the Brazilian Pantanal. Objectives were to compare multiple predictive modeling and exploratory modeling approaches. Included in the analysis, multi-scale raster grains (30m, 90m, 180m, 360m, 720m, 1440m), GPS collaring temporal levels (point, path, and step) and model data structural levels (group, individual, case-control).Methods Multi-scale multi-level data subsets were fit with explanatory and predictive statistical methods. Conditional logistic regression, generalized additive modeling (GAM), and classification regression trees, such as random forests (RF) and gradient boosted regression tree (GBM) were compared for their utility to the study. Model evaluation, using training and testing data in a k-fold cross-validation approach, determined the AUC, Kappa, and TSS for model evaluation and comparison. · Results Results indicated that the multi-level, multi-scale techniques improved model outputs. Overall, larger level models and those that used multi-scale raster grains showed the best model evaluation. The highest-ranked model was the multi-scale path selection function GBM and was one of the broadest levels of data. ·Conclusions Results indicated that multi-level, multi-scale models produced mixed results of applicability across models and levels. The identification of the appropriate temporal scale and statistical model needs careful consideration in predictive mapping efforts.
The correlation between Ro-52 antibody and interstitial lung disease in dermatomyositis
Authors: Xing Xiaojing , Li Anqi , Hao Yonghong , Li Chengxin 
Published: February 2020

Abstract
Background Recent studies have shown that Ro-52 antibody is associated with interstitial lung disease(ILD) in children with dermatomyositis(DM) and with the degree of disease severity. Moreover, we found that 50% or more cases of adult patients with DM tested positive for antibody Ro-52. Here, we analyzed the correlation between antibody Ro-52 and ILD in inpatients with DM. Objective To explore the correlation between Ro-52 antibody and ILD of DM. Methods A total of 153 patients with DM were collected, who met the classification criteria of idiopathic inflammatory myositis. Immunoblotting was used to detect 16 myositis-specific autoantibodies (MSAs) and myositis-associated autoantibodies (MAAs) from patient serum samples. High-resolution computed tomography (HRCT) was used to calculate the ILD severity score, and the tumors were screened. The clinical data and CT scores were analyzed retrospectively. Results Our data showed that antibodies of Ro-52 and MDA5 were risk factors for ILD development in patients with DM. Antibody Ro-52 was the most commonly occurring (52.9%) antibody in DM patients. The presence of Ro-52 in DM patients strongly suggested the possibility for the occurrence of ILD (86.4%). The severity of Ro-52-positive cases was higher than that of the Ro-52-negative cases.Ro-52 may increase the incidence of ILD when combined with other antibodies of PM-Scl75, PM-Scl100, TIF1-𝛾,Mi-2β,and MDA5. Conclusions The occurrence of ILD is highly likely in patients with DM having the antibody Ro-52. Thus, Ro-52 is a risk factor for ILD in DM.
Double reverse traction repositor versus traction table for the treatment of intertrochanteric femur fracture: A comparative Study
Authors: Yan Mingming , kuang letian , ni jiangdong , ding muliang , huang jun , wang junjie , song deye 
Published: February 2020

Abstract
Background The aim of this study was to compare the clinical results between double reverse traction repositor and traction table used for the treatment of unstable intertrochanteric femur fracture. Methods This retrospective study included 95 patients with AO/OTA 31- A2 and A3 proximal femur fracture, who underwent double reverse traction repositor or traction table facilitated Asian proximal femoral nail antirotation (PFNA-II) nailing. The demographics, duration of operation, blood loss, part loading time after surgery, the period of union of fracture, complication were assessed. Clinical and radiological outcomes were evaluated. Results There were no significant differences in respect to demographics and fracture characteristics. Duration of patient positioning and total operative time were significant longer in traction table group than that in double reverse traction repositor group(p<0.001). No differences were found intraoperative blood loss, part loading time after surgery, fracture healing time and Harris Hip Score between two groups. Conclusion When treating unstable intertrochanteric fractures, double reverse traction repositor is superior to tract table in respect to operative time and duration of patient position, despite an additional ipsilateral anterior superior iliac spine (ASIS)incision and drilling of ASIS and femur condyle.