bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictive factors of disease-free survival after complete pathological response to neoadjuvant radiotherapy for rectal adenocarcinoma: retrospective case series
Authors:   on behalf of the Moroccan Society of Surgery, Souadka Amine , Majbar Mohammed Anass , Benkabbou Amine , Serji Badr , Souiki Tarik , Bouchentouf Sidi Mohammed , Abid Mourad , El Khannousi Basma , El Harroudi Tijani , El Malki Hadj Omar , Raiss Mohammed , Ifrine Lahsen , Mazaz Khalid , Zentar Aziz , Mohsine Raouf , Souadka Abdelilah , Belkouchi Abdelkader , Ahallat Mohammed , Hrora Abdelmalek 
Published: October 2019

AbstractBackgroundMany data suggest that patients with low rectal adenocarcinoma who achieved ypT0N0 status have improved survival and disease-free survival (DFS) compared to all other stages however only few data are available regarding the specific prognosis factors of this subgroup. This study aimed to evaluate predictive factors for disease free survival after complete pathological response (CPR) in cases of low rectal adenocarcinoma.Materials and methodsFrom January 2005 to December 2013, all patients with low rectal adenocarcinoma who underwent neoadjuvant chemoradiotherapy followed by total mesorectal excision and achieved CPR were included at 7 Moroccan and 1 Algerian centres. Predictive factors for disease-free survival were analysed by uni and multivariate analysis.ResultsEigthy-four (12.1%) patients achieved a CPR (ypT0N0). Multivariate analysis revealed that both poorly differentiated tumors (OR, 9.23; 95 CI 1.35–62.82;P = 0.023) and the occurrence of perineal sepsis (OR, 13.51; 95 CI 1.96–93.12;P = 0.008) were independently associated with impaired DFS.ConclusionsPatients with low rectal cancer who exhibited a CPR after neoadjuvant therapy have good prognoses; however, the occurrence of perineal sepsis and/or poor initial differentiation may be associated with impaired DFS in these patients.Trial registration: The study was retrospectively registered the 28th July 2018 inClinicalTrials.govregister with the reference NCT03601689.
SUPR-3D: A randomized phase iii trial comparing simple unplanned palliative radiotherapy versus 3d conformal radiotherapy for patients with bone metastases: study protocol
Authors: Olson Robert , Schlijper Roel , Chng Nick , Matthews Quinn , Arimare Marco , Mathews Lindsay , Hsu Fred , Berrang Tanya , Louie Alexander , Mou Benjamin , Valev Boris , Laba Joanna , Palma David , Schellenberg Devin , Lefresne Shilo 
Published: October 2019

Abstract

Background
Bone metastases in the lower spine and pelvis are effectively palliated with radiotherapy (RT), though this can come with side effects such as radiation induced nausea and vomiting (RINV). We hypothesize that high rates of RINV occur in part because of the widespread use of inexpensive simple unplanned palliative radiotherapy (SUPR), over more complex and resource intensive 3D conformal RT, such as volumetric modulated arc therapy (VMAT).

Methods
This is a randomized, multi-centre phase III trial of SUPR versus VMAT. We will accrue 250 patients to assess the difference in patient-reported RINV. This study is powered to detect a difference in quality of life between patients treated with VMAT vs. SUPR.

Discussion
This trial will determine if VMAT reduces early toxicity compared to SUPR and may provide justification for this more resource-intensive and costly form of RT.

Trial registration
Clinicaltrials.gov identifier: NCT03694015.
Date of registration: October 3, 2018.
Clinical results of Intraductal Meibomian gland probing combined with intense pulsed light in treating patients with refractory obstructive Meibomian gland dysfunction: a randomized controlled trial
Authors: Huang Xiaodan , Qin Qiyu , Wang Linping , Zheng Jiao , Lin Lin , Jin Xiuming 
Published: October 2019

Abstract

Background
This study aims to optimize the therapeutic regimen for refractory obstructive meibomian gland dysfunction (o-MGD) patients by combining intraductal meibomian gland probing (MGP) and intense pulsed light (IPL) to enhance their positive effects and reduce their limitations.

Methods
This randomized, assessor blind study includes 45 patients (90 eyes) with refractory o-MGD who were divided into 3 groups via allocation concealment: IPL (group I, received an IPL treatment course: 3 times at 3-week intervals), MGP (group II, received MGP one time), and combined MGP-IPL (group III, MGP first followed by an IPL treatment course). Standard Patient Evaluation of Eye Dryness score (SPEED), tear break-up time (TBUT), corneal fluorescein staining (CFS), meibum grade, and lid margin finding results were assessed at baseline, 3 weeks after final treatment for groups I and III, 3 and 12 weeks after MGP for group II. Six months after final treatment, the SPEED and willingness to receive any treatment again were also collected for all groups. Paired Wilcoxon, Mann-Whitney U with Bonferroni correction, and Kruskal-Wallis tests were used for data analysis.

Results
For all 3 groups, all previously mentioned indexes improved significantly following treatment (P<0.01). MGP-IPL was better than IPL and MGP in terms of post-treatment SPEED, TBUT, meibum grade, and lid telangiectasia (P<0.05/3). Furthermore, the MGP-IPL was better than IPL in terms of lid tenderness and better than MGP in terms of orifice abnormality (P< 0.05/3). Six months later, the SPEED for the MGP-IPL was also significantly lower than other groups (P<0.05/3). Moreover, no patients in the MGP-IPL group expressed the need to be treated again compared to 35.7% or 20% of patients in the IPL or MGP groups, respectively.

Conclusions
Compared with IPL or MGP alone, the combination MGP-IPL produced best results in relieving all signs and symptoms and helping patients attain long-lasting symptom relief.

Trial registration
http://clinicaltrials.gov, ChiCTR1900021273 (retrospectively registered February 9, 2019).
Serotonergic hallucinogens/psychedelics could be promising treatments for depressive and anxiety disorders in end-stage cancer
Authors: dos Santos Rafael Guimarães , Bouso José Carlos , Hallak Jaime E. C. 
Published: October 2019

Abstract
In a recent issue of the BMC Psychiatry, the evidence of effectiveness of treatments for psychiatric conditions in end-stage cancer patients was reviewed (Johnson, 2018). The review was comprehensive, and included traditional and non-traditional/alternative treatments, including herbal medicines and spirituality. However, evidence showing that classic or serotonergic hallucinogens/psychedelics such as psilocybin and lysergic acid diethylamide (LSD) could be effective treatments for depressive and anxiety disorders in end-stage cancer was not included. In this commentary, we expand the information available on the original article by briefly reviewing data from recent placebo-controlled, double-blind, cross-over clinical trials showing evidence that administration of single (or few) doses of LSD and psilocybin was associated with rapid and sustained reductions in depressive and anxiety symptoms in patients with end-stage cancer and other life-threatening diseases (e.g., Bechterew’s disease, Parkinson’s disease, Celiac disease). Since these substances seem to produce rapid and sustained therapeutic effects with single (or few) doses and well tolerated, large-scale, prospective, multi-site studies of end-stage cancer and classical/serotonergic hallucinogens/psychedelics should be performed to improve our understanding of the therapeutic potentials of these drugs and their use on clinical practice.
Associations between Chinese adolescents subjected to traditional and cyber bullying and suicidal ideation, self-harm and suicide attempts
Authors: Peng Zhekuan , Klomek Anat Brunstein , Li Liping , Su Xuefen , Sillanmäki Lauri , Chudal Roshan , Sourander Andre 
Published: October 2019

Abstract

Background
The incidence of bullying is high among adolescents. Adolescents who were victims of bullying have a higher risk of self-harm and suicidal behavior than adolescents who were non-victims. However, research on suicide and both traditional and cyber bullying was limited in China. Therefore, this study examined the associations between Chinese adolescents who were the victims of traditional and cyber bullying and the prevalence of suicidal ideation, self-harm and suicide attempts.

Methods
This was a population-based study of 2647 students (51.2% girls) with a mean age of 13.6 ± 1.1 years from 10 junior high schools in Shantou, China. Information on bullying victimization, suicidal ideation, self-harm and suicide attempts were collected using a self-administered questionnaire and the psychopathology of the students was assessed using the Strengths and Difficulties Questionnaire (SDQ). The associations were examined with multinomial logistic regression, adjusted for covariates.

Results
Traditional bullying victimization was reported by 16.7% of the adolescents, cyber bullying victimization by 9.0% and both by 3.5%. The prevalence of suicidal ideation was 23.5%, self-harm was 6.2% and suicide attempts was 4.2%. Psychopathology symptoms were risk factors for suicide ideation only, ideation plus self-harm, self-harm only and suicide attempts. Victims of both traditional and cyber bullying had the highest risk of suicidal ideation only, ideation plus self-harm and suicide attempts, compared to those reporting one form of bullying. Victims of cyber bullying only had the second highest risk of suicidal ideation only and suicidal ideation plus self-harm compared to non-victims.

Conclusions
Adolescents who were victims of both traditional and cyber bullying had greater risks of adverse outcomes of suicidal ideation only, suicidal ideation plus self-harm and suicide attempts. The results of the current study suggest that those exposed to both forms of bullying should be routinely screened for suicidal risk. In addition, school-based anti-bully interventions should also target cyber bullying.
Creating a healthy eating and active environment survey (CHEERS) for childcare: an inter-rater, intra-rater reliability and validity study
Authors: Lafave Lynne M. Z. 
Published: October 2019

AbstractBackgroundThe CHEERS is a self-administered tool to measure gaps, weaknesses, and strengths of an early childhood education and care (ECEC) centre-based nutrition and physical activity environment. ECEC settings have the potential to profoundly influence early dietary and physical activity behaviours. Content validation of the CHEERS tool has been previously reported. The purpose of this study was to develop reliability and validity evidence for the CHEERS audit tool and the proposed subscales of food served, healthy eating environment, program planning, and physical activity environment in ECEC centre-based programs.MethodsThis cross-sectional study consisted of 2 phases: Phase 1 included inter-, intra-rater and Cronbach’s α. A subset of this sample was invited to participate in a second survey (Trial 2) for intra-rater assessment within 3 weeks of completing the first survey (Trial 1). Phase 2 included concurrent validity assessment between a nutrition expert and the ECEC director using within a one-week period.ResultsOne hundred two directors and 85 educators (total of 187) returned the survey. Of these, there were 75 matched pairs for inter-rater reliability analysis providing a CHEERS ICC score of 0.59 and ICC scores ranging from 0.40 to 0.58 for the subscales. The ICC for intra-rater reliability of the CHEERS score was 0.81 for 40 participants completing the survey a second time and a range of 0.72 to 0.79 for the subscales. The CHEERS tool demonstrated very good internal consistency (α = 0.91) and α scores ranging from 0.73 to 0.79 for the subscales. In phase 2, concurrent validation was ICC = 0.65 (n = 30) CHEERS scores with a range of 0.42 to 0.69 for the subscales.ConclusionsThis study provides evidence of inter-, intra-rater reliability, internal consistency, and concurrent validity of an environmental assessment audit tool to assess the nutrition and physical activity environment of ECEC centre-based programs. The results demonstrate that the self-administered CHEERS instrument is stable overtime and between evaluators at the same ECEC centre. The scores obtained with CHEERS self-administered audit tool are reasonably accurate compared to an expert rater (dietitian) assessment. This study adds additional support to establishing the psychometric soundness of the CHEERS tool.
An integrated health delivery platform, targeting soil-transmitted helminths (STH) and canine mediated human rabies, results in cost savings and increased breadth of treatment for STH in remote communities in Tanzania
Authors: Lankester Felix , Davis Alicia , Kinung’hi Safari , Yoder Jonathan , Bunga Catherine , Alkara Shayo , Mzimbiri Imam , Cleaveland Sarah , Palmer Guy H. 
Published: October 2019

Abstract

Background
Achieving the Sustainable Development Goal of a 90% reduction in neglected tropical diseases (NTDs) by 2030 requires innovative control strategies.
This proof-of-concept study examined the effectiveness of integrating control programs for two NTDs: mass drug administration (MDA) for soil-transmitted helminths in humans and mass dog rabies vaccination (MDRV).

Methods
The study was carried out in 24 Tanzanian villages. The primary goal was to demonstrate the feasibility of integrating community-wide MDA for STH and MDRV for rabies. The objectives were to investigate the popularity, participation and cost and time savings of integrated delivery, and to investigate the reach of the MDA with respect to primary school-aged children and other community members. To implement, we randomly allocated villages for delivery of MDA and MDRV (Arm A), MDA only (Arm B) or MDRV only (Arm C).

Results
Community support for the integrated delivery was strong (e.g. 85% of focus group discussions concluded that it would result in people getting “two for one” health treatments). A high proportion of households participated in the integrated Arm A events (81.7% MDA, 80.4% MDRV), and these proportions were similar to those in Arms B and C. These findings suggest that coverage might not be reduced when interventions are integrated. Moreover, in addition to time savings, integrated delivery resulted in a 33% lower cost per deworming dose and a 16% lower cost per rabies vaccination.
The median percentage of enrolled primary school children treated by this study was 76%. However, because 37% of the primary school aged children that received deworming treatment were not enrolled in school, we hypothesize that the employed strategy could reach more school-aged children than would be reached through a solely school-based delivery strategy.

Conclusions
Integrated delivery platforms for health interventions can be feasible, popular, cost and time saving. The insights gained could be applicable in areas of sub-Saharan Africa that are remote or underserved by health services. These results indicate the utility of integrated One Health delivery platforms and suggest an important role in the global campaign to reduce the burden of NTDs, especially in hard-to-reach communities.

Trial registration
clinicaltrials.gov NCT03667079, retrospectively registered 11th September 2018.
The association of multimorbidity, loneliness, social exclusion and network size: findings from the population-based German Ageing Survey
Authors: Kristensen Kaja , König Hans-Helmut , Hajek André 
Published: October 2019

AbstractBackgroundThe aim of this study was to examine the association between multimorbidity and (i) loneliness, (ii) social exclusion and (iii) network size, respectively.MethodsCross-sectional data from a German representative sample of community-dwelling adults aged 40 and over was used (N = 7604). Multimorbidity was indicated with the presence of two or more diseases. Self-rated loneliness was assessed with a short form of the validated De Jong Gierveld Loneliness Scale and social exclusion was measured with a validated scale developed by Bude and Lantermann. Counts of important people in regular contact represented the network size of respondents.ResultsMultimorbidity was present in 68% of the sample. While controlling for potential confounders, multiple linear regression analysis yielded that multimorbidity was associated with increased loneliness (b = 0.08;p < 0.001) and increased social exclusion (b = 0.10;p < 0.01). Multimorbidity was also associated with an increased network size (b = 0.27;p < 0.001).ConclusionWhile there was an association between multimorbidity and increased social exclusion as well as increased loneliness, regressions also revealed an association between multimorbidity and an increased network size. Although the association between multimorbidity and our outcome measures is weak, its complex nature should be investigated further using a longitudinal approach.
Are young female suicides increasing? A comparison of sex-specific rates and characteristics of youth suicides in Australia over 2004–2014
Authors: Stefanac Nina , Hetrick Sarah , Hulbert Carol , Spittal Matthew J. , Witt Katrina , Robinson Jo 
Published: October 2019

Abstract

Background
Australian mortality statistics suggest that young female suicides have increased since 2004 in comparison to young males, a pattern documented across other Western high-income countries. This may indicate a need for more targeted and multifaceted youth suicide prevention efforts. However, sex-based time trends are yet to be tested empirically within a comprehensive Australian sample. The aim of this study was to examine changes over time in sex-based rates and characteristics of all suicides among young people in Australia (2004–2014).

Methods
National Coronial Information System and Australian Bureau of Statistics data provided annual suicide counts and rates for 10–24-year-olds in Australia (2004–2014), stratified by sex, age group, Indigenous status and methods. Negative binomial regressions estimated time trends in population-stratified rates, and multinomial logistic regressions estimated time trends by major suicide methods (i.e., hanging, drug poisoning).

Results
Between 2004 and 2014, 3709 young Australians aged 10–24 years died by suicide. Whilst, overall, youth suicide rates did not increase significantly in Australia between 2004 and 2014, there was a significant increase in suicide rates for females (incident rate ratio [IRR] 1.03, 95% confidence interval [CI] 1.01 to 1.06), but not males. Rates were consistently higher among Aboriginal/Torres Strait Islander youth, males, and in older (20–24-years) as compared to younger (15–19 years) age groups. Overall, the odds of using hanging as a method of suicide increased over time among both males and females, whilst the odds of using drug-poisoning did not change over this period.

Conclusions
We showed that suicide rates among young females, but not young males, increased over the study period. Patterns were observed in the use of major suicide methods with hanging the most frequently used method among both sexes and more likely among younger and Aboriginal/Torres Strait Islander groups. Findings highlight the need to broaden current conceptualizations of youth suicide to one increasingly involving young females, and strengthen the case for a multifaceted prevention approach that capitalize on young females’ greater help-seeking propensity.
Evaluation of a school based comprehensive sexuality education program among very young adolescents in rural Uganda
Authors: Kemigisha Elizabeth , Bruce Katharine , Ivanova Olena , Leye Els , Coene Gily , Ruzaaza Gad N. , Ninsiima Anna B. , Mlahagwa Wendo , Nyakato Viola N. , Michielsen Kristien 
Published: October 2019

Abstract

Background
Limited research has been conducted on the effectiveness of sexuality education for very young adolescents (VYAs) ages 10–14 years in Sub-Saharan Africa. Furthermore, evaluations of sexuality education programs often report outcomes of risky sexual practices, yet positive aspects of sexuality are hardly studied and rarely reported. This study evaluates the effectiveness of a Comprehensive Sexuality Education (CSE) intervention for VYAs in Uganda, analyzing both positive and negative outcome indicators.

Methods
We conducted a mixed methods study, incorporating a cluster randomized trial (NCT03669913) among pupils in 33 randomly selected primary schools in Mbarara district. This was followed by a qualitative evaluation of the intervention in 4 schools that included 14 in-depth interviews and 3 focus group discussions distributed among pupils, teachers and parents. Quantitative data were analyzed using ordered logistic regression to compare differences in the change from baseline to endline between the intervention and control arms. We conducted bivariate analysis and multiple regression analysis controlling for key covariates, including age, gender, school location (rural vs urban), truancy, and orphanhood. Qualitative data were analyzed by thematic approach using ATLAS TI.

Results
Between July 2016 and August 2017, 1096 pupils were recruited. Outcomes were studied among 380 pupils in the intervention arm and 484 pupils in the control arm. The proportion of pupils who ever had sex increased from 9 to 12.1% in intervention compared to 5.2 to 7.4% in the control group between baseline and endline, however the differences between groups were not statistically significant. We found greater improvements in sexual and reproductive health (SRH) knowledge among intervention schools (AOR: 2.18, 95% CI: 1.66–2.86) and no significant differences in self-esteem, body image or gender equitable norms. Qualitative evidence echoes perceived SRH knowledge acquisition, increased their perception of SRH related risks, and intentions to delay sexual intercourse to prevent unwanted pregnancy, HIV and other STIs.

Conclusion
This study demonstrates that CSE can improve SRH knowledge and behavioral intentions among VYAs in Uganda. These results further emphasize the importance of initiating sexuality education before most adolescents have started engaging in sexual activity, enabling them to make informed decisions in the future.

Trial registration
NCT03669913, registered retrospectively on September 13th, 2018.
Biological safety of Electroacupuncture with STS316 needles
Authors: Choi Kwang-Ho , Yeon Sun Hee , Cho Seong Jin , Kwon O Sang , Lee Sanghun , Seo Su Yeon , Kang Suk-Yun , Ryu Yeonhee 
Published: October 2019

Abstract

Background
Electroacupuncture (EA) is often used in clinical settings due to its analgesic effect, but its safety has not been verified due to the lack of clear criteria. This study examined the critical range of the corrosion of stainless steel types STS304 and STS316, which have been used clinically, and the relationship between needle corrosion and cell necrosis.

Method
The critical point of corrosion for STS304 and STS316 was identified by varying the time, frequency, and stimulation intensity. In a tissue necrosis experiment, EA stimulation was applied to rats using STS316 needles with different thicknesses at maximum intensity for 60 min, and the presence of corrosion and tissue necrosis was determined. A cytotoxicity experiment was also conducted and assessed the needles and tissue necrosis.

Results
The results showed that STS316 was more stable than STS304 and that only coated needles corroded. Furthermore, tissue necrosis was observed regardless of corrosion, and slight cell necrosis was associated with needles with corrosion.

Conclusions
This study demonstrated that non-coated STS316 was the most stable for EA stimulation and that corrosion byproducts and cell necrosis were not directly related.