bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence And Risk Factors Of Inguinal Hernia Occurred After Radical Prostatectomy-comparisons of different approaches
Authors: Liu Lijia , Xu Haoxiang , Qi Feng , Wang Shangqian , Shadhu Kamleshsingh , Ramlagun-Mungur Dadhija , Wang Shui 
Published: July 2020

Abstract
Purpose
To observe cumulative morbidity of postoperative inguinal hernia(PIH) and identify risk factors associated with its development in patients who underwent retropubic radical prostatectomy(RRP), laparoscopic prostatectomy(LRP) or robotic assisted laparoscopic prostatectomy (RALP) operation.
Methods
From June 2009 to September 2016, 756 patients diagnosed with localized prostate cancer who had undergone RRP, LRP or RALP in our center were included in this study. Patients with PIH were retrospectively investigated in such factors as age, BMI, previous abdominal operations, diabetes mellitus history, hypertension history, prostate volume, previous hernia, operative methods, operative approach, preoperative Gleason, clinical T-stage, PLND situation, operative time, and estimated blood loss. Univariate and multivariate cox hazard regressions analysis were utilized to identify risk factors predisposing to PIH.
Results
A total of 53 of 751(7.1%) patients developed PIH at a median follow-up period of 43 months. PIH rate in RRP was significantly higher compared to LRP and RALP group (RRP: 15.3%, LRP: 6.7%, RALP:1.9%, P = 0.038). Right side (69.8%) and indirect (88.8%) PIH were dominant type in hernia group. Univariate and multivariate cox hazard regressions analysis indicated that age and RRP approach were identified to be implicated to PIH [adjusted hazard ratio7.39(1.18–46.39), 2.93(95% CI 1.47–5.84)].
Conclusions
RRP technique and older age, especially patients over 80 years, are associated with higher incidence for PIH development. Appropriate prophylaxis during the operation should be evaluated for those in high-risk.
Cultural Adaptation and Validation of the Ghanaian Language (Akan; Asante Twi) Version of the Health Literacy Questionnaire.
Authors: Boateng Millicent Addai , Angel Sanne , Agyei-Baffour Peter , Enemark Ulrika 
Published: July 2020

Abstract
Background In under-resourced settings, patient competences to manage their own health is sometimes a necessity and high health literacy is needed to obtain a good health outcome. Thus, it is relevant to have a comprehensive measurement tool suitable for populations in such settings. The Health Literacy Questionnaire (HLQ) is a tool useful for health literacy assessment covering nine dimensions/scales of health literacy. The HLQ has been translated and validated in diverse contexts but has so far not been assessed in any country in sub-Saharan Africa. We sought to translate this tool into the most common language used in Ghana and assess its validity. Methods We carried out a cross-sectional study using the HLQ concurrently with an assessment of a malaria programme for caregivers with children under five years. The HLQ was translated using a systematic translation procedure. We analysed the psychometric properties of the HLQ based on data collected by face-to-face interview of 1234 caregivers. The analysis covered tests on difficulty level of scales, composite reliability, Cronbach’s alpha and confirmatory factor analysis (CFA). Results Cognitive testing showed that some words were ambiguous, which led to minor rewording of the questionnaire. A nine-factor CFA model was fitted to the 44 question items with no cross-loadings or correlated residuals allowed. Given the very restricted nature of the model, the fit was quite satisfactory: χ2 DWLS (866 df) = 17177.58, p < 0.000, CFI = 0.929, TLI = 0.922, RMSEA = 0.116 and SRMR = 0.099. Composite reliability and Cronbach’s alpha were >0.7 for all scales except Cronbach’s alpha for scale 9, ‘Understanding health information well enough to know what to do’ (0.6). The mean differences between most demographic groups among health literacy scales were statistically significant. Conclusion The Akan-Twi version of HLQ proved relevant in our description of the health literacy levels among the caregivers in our study. This validated tool will be useful to conduct health literacy needs assessments to guide policies addressing such needs. Further work is needed to assess its psychometric properties among other population groups.
Reducing the Smoking-Related Health Burden through Diversion to Electronic Cigarettes: A System Dynamics Simulation Study
Authors: Selya Arielle 
Published: July 2020

Abstract
Background: Electronic cigarettes (“e-cigarettes”) have altered nicotine use trends, and their impacts are controversial. Given their reduced risk profile relative to conventional cigarettes, e-cigarettes have potential for harm reduction. The current study presents a simulation-based analysis of an e-cigarette harm reduction policy. Methods: A system dynamics simulation model was constructed, with separate aging chains for cigarette smokers and e-cigarette users. These structures work together with a policy module to close the gap between actual (simulated) and a goal number of cigarette smokers, chosen to reduce the nicotine-attributable death rate to the accidental death rate. The policy is two-fold, first removing existing regulations on e-cigarettes (e.g. flavor bans) and second providing an informational campaign promoting e-cigarettes as a lower-risk alternative. Realistic practical implementation challenges are modeled in the policy sector, including time delays, political resistance, and budgetary limitations. Effects of e-cigarettes on conventional smoking occurs through three mechanisms: 1) diversion from ever initiating conventional smoking; 2) reducing smoking behavior and thus progression to established smoking; and 3) increasing smoking cessation. An important unintended effect was included, which increases the nicotine-related mortality accordingly with an increase in nicotine users due to e-cigarettes.Results: The base-case model replicated the historical exponential decline in conventional cigarette smoking and the exponential increase in e-cigarette use since their introduction circa 2010. The ideal-case policy was able to reduce conventional smoking to the goal level approximately 40 years after implementation. Policy scenarios that included realistic, practical obstacles to implementation delayed and weakened the effect of the policy by up to 95% in the worst case, relative to the same time point in the ideal-case scenario; however, these discrepancies substantially decreased over time in dampened oscillations. Conclusions: Current findings demonstrate that the promotion of e-cigarettes as a harm-reduction policy is a viable strategy, given current knowledge of e-cigarettes’ effects on conventional smoking. Given the strong effects of implementation challenges on policy effectiveness in the short term, accurately modeling such obstacles is essential in policy design. Ongoing research is needed with forthcoming data on e-cigarette use prevalence and possible effects on cigarette smoking.
Minimum Clinical Important Difference for Resilience Scale Specific to Cancer: A Prospective Analysis
Authors: YE ZENG JIE , ZHANG ZHANG , TANG YING , LIANG JIAN , ZHANG XIAO YING , HU GUANG YUN , SUN ZHE , LIANG MU ZI , YU YUAN LIANG 
Published: July 2020

Abstract
Background: The minimum clinical important differences (MCIDs) of resilience instruments in patients with cancer have not been comprehensively described. This study was designed to evaluate MCIDs of 10-item and 25-item resilience scales specific to cancer (RS-SC-10 and RS-SC-25).Methods: From June 2015 to December 2018, RS-SCs were longitudinally measured in 765 patients with different cancer diagnoses at baseline (T0) and 3 months later (T1). The EORTC QLQ-C30, Connor-Davidson Resilience Scale, Hospital Anxiety and Depression Scale, and Allostatic Load Index were measured concurrently as anchors. Anchor-based methods (linear regression, within-group), distribution-based methods(within-group), and receiver operating characteristic curves (ROCs, within-subject) were performed to evaluate the MCIDs.Results: 623 of 765 (84.1%) patients had paired RS-SCs scores. Moderate correlations were identified between the change in RS-SCs and change in anchors (r= 0.38-0.44, all p<0.001). Linear regression estimated +8.9 and -6.7 as the MCIDs of RS-SC-25, and +3.4 and -2.5 for RS-SC-10. Distribution-based methods estimated +9.9 and -9.9 as the MCIDs of RS-SC-25, and +4.0 and -4.0 for RS-SC-10. ROC estimated +5.5 and -4.5 as the MCIDs of RS-SC-25, and +2.0 and -1.5 for RS-SC-10.Conclusions: The most reliable MCID is around 5 points for RS-SC-25 and 2 points for RS-SC-10. RS-SCs are more responsive to the worsening status of resilience in patients with cancer and these estimates could be useful in future resilience-based intervention trials.
Development and validation of multiparametric MRI-based nomogram for predicting occult metastasis risk in early tongue squamous cell carcinoma
Authors: Saenthaveesuk Pensiri , Yang Le , Zeng Bin , Xu Meng , Young Simon , Liao Guiqing , Liang Yujie 
Published: July 2020

Abstract
Background
Nomograms are currently used in predicting individualized outcomes in clinical oncology of several cancers. However, nomograms for evaluating occult nodal metastasis of patients with squamous cell carcinoma of lateral tongue (SCCLT) have not been widely investigated for their functionality. This retrospective cohort study was designed to address this question.
Methods
This study was divided into primary and validation cohorts. The primary cohort comprised 120 patients diagnosed between 2012 and 2017, whereas the validation cohort included 41 patients diagnosed thereafter. The diagnostic value of multiparametric MRI, including radiologic tumor thickness threshold (rTTT) in three-dimensions, paralingual distance, and sublingual distance were investigated. A nomogram was developed based on stepwise logistic regression of potential predictors associated with nodal metastasis in the primary cohort and then tested for predictive accuracy in the validation cohort using area under the curve (AUC) and goodness-of-fit tests.
Results
Multivariate analysis, tumor size (odd ratio [OR] 15.175, 95% confidence interval [CI] 1.436-160.329, P = 0.024), rTTT (OR 11.528, 95% CI 2.483–53.530, P = 0.002), paralingual distance (OR 11.976, 95% CI 1.981–72.413, P = 0.005), and tumor location (OR 6.311, 95% CI 1.514–26.304, P = 0.011) were included in the nomogram to predict the likelihood of having cervical metastasis. A nomogram cutoff value of 210 points (sensitivity 93.8%, specificity 87.5%) was significantly different to classify the patients metastasis risk group (P < 0.001). Nomogram showed predictive accuracy with AUC 0.881 (95% CI 0.779–0.983, P < 0.001) and good calibration after the validation.
Conclusions
A preoperative nomogram incorporating multiparametric MRI demonstrated good prediction and performed adequately in our study. Three-dimensional assessment of occult metastasis risk value obtained from this nomogram can assist in preoperative decision making whether to manage with neck surgery for individual patients with early-stage SCCLT. The probability of nodal metastasis tended to be greater than 20% in patients with high metastasis risk or nomogram total score > 210 points.
COVID-19 Induced Economic Uncertainty: A Comparison between the United Kingdom and the United States
Authors: Pata Ugur Korkut 
Published: July 2020

Abstract
The purpose of this study is to investigate the effects of the COVID-19 pandemic on economic policy uncertainty in the US and the UK. The impact of the increase in COVID-19 cases and deaths in the country, and the increase in the number of cases and deaths outside the country may vary. To examine this, the study employs bootstrap ARDL cointegration approach from March 8, 2020 to May 24, 2020. According to the bootstrap ARDL results, a long-run equilibrium relationship is confirmed for five out of the 10 models. The long-term coefficients obtained from the ARDL models suggest that an increase in COVID-19 cases and deaths outside of the UK and the US has a significant effect on economic policy uncertainty. The US is more affected by the increase in the number of COVID-19 cases. The UK, on the other hand, is more negatively affected by the increase in the number of COVID-19 deaths outside the country than the increase in the number of cases. Moreover, another important finding from the study demonstrates that COVID-19 is a factor of great uncertainty for both countries in the short-term.
Cause-specific death in hospitalized individuals infected with SARS-CoV-2: More than just acute respiratory failure or thromboembolic events.
Authors: Marta Cobos-Siles , Cubero-Morais Pablo , Arroyo-Jiménez Irene , Hernández-Gómez Laura , Vargas-Parra Derly Judith , González-Fernández María , Cazorla-González Marina , Gabella-Martín Miriam , Ruíz-Albi Tomás , Berezo-García José Angel , García-Cruces-Méndez Jesús Fernando , Miramontes-González Pablo , Corral-Gudino Luis 
Published: July 2020

Abstract
Background: Infection with SARS-CoV-2 is becoming the leading cause of death in most countries during the 2020 pandemic.Objective: to assess the association between COVID-19 and cause-specific death.Design: Retrospective cohort study.Setting and Participants: We included data from inpatients diagnosed with COVID-19 between March 18 and April 21, 2020, who died during their hospital stay. Demographic, clinical and management data were collected. Causes of death were ascertained by review of medical records.Results: The sample included 100 individuals. The median age was 85 (IQR 15), 59% were men. Fifteen patients (15%) died from complications unrelated to COVID-19. In univariate analysis, these patients compared to those who died from COVID-19 complications had a greater likelihood of dementia (47% vs 20%) and dependency in activities of daily living (93% vs 48%), higher Charlson comorbidity index scores (6 vs 5), a lower likelihood of fever at diagnosis (47% vs 77%), and higher lymphocyte counts (1,000 vs 660). In multivariate analysis, patients were older (OR 1.10, 95% CI 1.00–1.23) and more often had heart failure (OR 5.58, 95% CI 1.09–28.66). The presence of X-ray infiltrates was uncommon (OR 0.03, 95% CI 0.01–0.17). A higher percentage of patient deaths from causes unrelated to COVID-19 complications occurred during the two first weeks of the pandemic.Conclusions: Fifteen percent of patients with COVID-19 died from causes unrelated to COVID-19 complications. Most of these patients had more comorbidities and were frail and elderly. These findings can partially explain the excess mortality in older people.
Failure Risk Factor For Non-Operative Treatment of Splenic Trauma
Authors: Maubert Alexandre , Douissard Jonathan , Tokoto Pierre-Alain , Massalou Damien 
Published: July 2020

Abstract
Background: Splenic trauma is a common pattern for admission in blunt abdominal trauma. The objective of this study is to identify risk factors for failure of non-operative management (NOM) in splenic trauma.Methods: This is a retrospective monocentric analysis of a prospectively collected database. All patients admitted in the university hospital of Nice [Centre Hospitalier Universitaire (CHU) de Nice, France] for a splenic trauma from January 1st 2006 to January 6th 2018 were included. Primary outcome was the need for delayed splenectomy as an indicator of NOM failure.Results: Two-hundred-eighty patients were included in this study. Most splenic lesions were severe grades (grade 3 or higher). In total, 83 splenectomies were performed urgently, i.e. 29% of patients; 88 angio-embolizations, i.e., 31% of patients with a success rate greater than 80%; 14.7% of 136 patients who had no previous angio-embolization required secondary splenectomy; 19.7% of the 61 patients who had anterior angio-embolization required secondary splenectomy. Age was not found associated with a higher failure rate (44 years in successful embolization vs 37.5 years in NOM-failure group, p = 0.15). Higher drop in hemoglobin levels between admission and 6 hours after admission was detected in the embolization failure group (-1.44 g/dl) as compared with the successful group (-0.68 g/dl), which approached statistical significance (p = 0.064).Conclusions: Hemoglobin monitoring in the hours following the admission of a patient with splenic trauma might be an important factor during the medical supervision of hemodynamically stable patients. Early identification of patients at high risk of NOM failure by hemoglobin monitoring may prevent late splenectomy.Level of evidence: IV (retrospective study)
The Benefit of Inevitably Delayed Surgical Intervention Following High-Velocity Maxillofacial War Injuries
Authors: Oren Daniel , Dror Amiel A , Zoabi Adeeb , Kasem Adi , Tzadok Lior , Kablan Fares , Safory Enssaf , Sela Eyal , Sro Samer 
Published: July 2020

Abstract
Background: Over 3200 Syrian patients were admitted and treated at Galilee Medical Center (GMC) over a five-year period (May 2013 - May 2018) since the beginning of the Syrian civil war in 2011. This study compares the number of postoperative complications of patients admitted to the GMC immediately after injury or two to three weeks after initial high-velocity maxillofacial injuries and the potential mechanisms for the variation in complication rates. We describe our experiences, strategies, and resultant treatment approach.Methods: Retrospective case studies in which the incidence of complications including infection, rejection of hardware, bone or soft tissue grafts, tissue dehiscence, oroantral fistula formation, excessive scarring, and unplanned return to the operating theater were investigated. Patients arriving at the GMC within 24 hours following maxillofacial injury were considered “early” while patients arriving to the GMC within 14-28 days following initial trauma without treatment prior to arrival were considered “late” or “delayed.” Both groups of patients received definitive surgical treatment within 48 hours of admission to our hospital. Results: Sixty patients suffering from "high-velocity" maxillofacial Syrian civil war-related battlefield injuries were included in this study. The mean age was 26±8 years (range: 9-50) and all except one were male. Post-operative complications in the early group were found to be significantly higher compared to the delayed group (p = 0.006).Conclusions: We discovered that the delayed group of patients, characterized by progressive neovascularization of injured tissue, had better surgical success from rich blood supply that enhances tissue survival. Sustained tissue perfusion to the tissue supports efficient systemic antibiotic delivery, a favorable condition in lowering infection rate and complication. We found that the unintendedly delayed treatment contributed to a critical revascularization period resulting in improved healing and decreased postoperative morbidity and complications.
Analysis of risk factors of Leishmania infection in dogs in Gansu Province, China
Authors: Yu Dawei , Li Fan , Feng Yu , Yang Chengming , Yang Junke , Liu Linlin , Guan Zhenping , Zhang Yongfu 
Published: July 2020

Abstract
Background

Gansu is a province with the most serious prevalence of canine Leishmaniasis in China, ranked the first in the number of new cases occurring each year. In order to understand the risk factors of visceral Leishmaniasis in dogs in endemic areas of Gansu province, we conducted an investigation on the risk factors of canine Leishmaniasis in 2 endemic counties from 2018 to 2019, and analyzed the related factors of local CVL infection, so as to provide a basis for exploring new prevention and control methods suitable for Leishmaniasis in China.

Methods

Leishmaniasis of canine origin was detected in Diebu county and Wenxian County, Gansu province. The risk factors of Leishmania infection in dogs were analyzed by USING IBM SPSS23.0 Pearsonχ2 test and multiple Logistic regression.

Results

a total of 537 domestic dogs were investigated in the endemic area. The positive rate of Leishmania protozoa nested PCR was 41.15% (221/537). Univariate analysis showed that there were statistically significant differences in age, height, weight, breed, kennel presence, hair length, custody style, physical condition, exercise status, nail symptoms and other variables with the positive rate of nested PCR (P < 0.05).The results of multivariate analysis showed that there was a significant correlation between dog ownership [OR=3.051; 95%CI =(0.965 ~ 9.645), dog ownership [OR=1.974; 95%CI =(1.199 ~ 3.252), dog breed [OR=1.819; 95%CI =(0.999 ~ 3.311)] and hair length [0.053 ~ 0.203].

Conclusions

there are a large number of asymptomatic infected dogs in Diebu county and Wenxian County of Gansu Province. The infection rate of local short-haired and pure-bred dogs is high. In order to reduce the risk of canine infection, the publicity and education on prevention of canine Leishmaniasis should be strengthened, so as to reduce the risk of human and animal co-contracting visceral Leishmaniasis.
A multi-kinase inhibitor APG-2449 enhances the antitumor effect of Ibrutinib in esophageal squamous cell carcinoma via EGFR/FAK pathway inhibition
Authors: Luo Qiu-Yun , Zhou Su-Na , Pan Wen-Tao , Sun Jian , Yang Li-Qiong , Zhang Lin , Qiu Miao-Zhen , Yang Da-Jun 
Published: July 2020

Abstract
Background

Esophageal squamous cell carcinoma (ESCC) is one of the most common types of cancer in China, with poor prognosis and lack of effective targeted therapy. It has been reported that ibrutinib possesses anticancer activity in ESCC with MYC and/or ERBB2 amplified. Here we explored the synergistic antitumor effect of a novel multi-kinase inhibitor APG-2449 with ibrutinib in ESCC and clarified the mechanism of the combination effect.

Methods

Cancer cells viability was determined by CCK-8 assay. Western blot was used to detect the expression of related proteins. Xenograft models in nude mice were established to explore the roles of APG-2449 and ibrutinib.

Results

We found that APG-2449 exerted antitumor effect in ESCC through FAK blocking. APG-2449 combined with ibrutinib showed synergistic inhibition of cell viability in ESCC cell lines. APG-2449 combined with ibrutinib dramatically inhibited the proliferation and migration of ESCC cells. Furthermore, we observed that ibrutinib combined with APG-2449 could induce more cancer cells arrested in the G1/S phase and apoptosis. In terms of mechanism, ibrutinib alone could inactive EGFR and its downstream signaling of MEK/ERK. The combination therapy of APG-2449 and ibrutinib could significantly down-regulate the phosphorylation level of MEK / ERK and AKT. In ESCC xenotransplantation models, single therapy with either ibrutinib or APG-2449 was equivalent in delaying tumor growth, while the combination therapy suppressed tumor growth more significantly.

Conclusion

Our data strongly suggest that the combination therapy of APG-2449 and ibrutinib can provide an effective therapeutic strategy for treating ESCC, which deserved further clinical investigation.