bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Dipeptidyl Peptidase-4 Inhibitors on Carotid Intima-media Thickness in Patients With Type 2 Diabetes Mellitus: a Meta-analysis
Authors: Xia Hua-song , Liu Yue , Fu Yang , Li Meng , Wu Yan-qing 
Published: December 2020

Abstract
BACKGROUND: It is reported that dipeptidyl peptidase-4 (DPP-4) inhibitors can exert a protective effect on the cardiovascular system other than the glucose-lowering effect. However, whether DPP-4 inhibitors can delay or prevent the progression of carotid intima-media thickness (IMT), a marker for atherosclerosis, is not clear. METHODS: An extensive literature search was performed up to December 2019.Double-blind, randomized controlled trials that compare the effect of DPP-4 inhibitors with conventional therapy were included. The primary outcome was IMT of carotid.RESULTS: Four studies in total involving 1141 participants were enrolled. The results indicated that DPP-4 inhibitors group showed significant decreases in IMT (- 0.022 mm, P = 0.053) when compared with control group, but it was not statistically significant. There was also a decrease in hemoglobin A1c (HbA1c) (- 0.16%, p < 0.001) in DPP-4 inhibitors groups in comparison with control groups.CONCLUSION: Our study demonstrates DPP-4 inhibitors administrated in type 2 diabetes mellitus have no protective effects on carotid IMT compared with conventional/placebo treatment.
Impact of COVID-19 Pandemic towards Common Neglected Tropical Diseases among Indigenous Group in Malaysia
Authors: Nisha Mehru , Naim Muhammad Alif , Davamani Fabian 
Published: December 2020

Abstract
The coronavirus disease 2019 is a pandemic which heavily affected all walks of around the world. Whilst all people are affected could be from to job losses, increase in poverty, sudden death of family member or loved ones and so many others, the indigenous communities in Malaysia do face severity of the Covid 19 pandemic effect. As being the minority community with lack of proper income, lack of education and incapable of adjusting themselves to new norm and living in areas with high prevalence of disease for the poor, like neglected tropical diseases- the overall impact of Covid 19 showed inequalities for the Indigenous (Orang Asli) community in Malaysia. Here we discuss on some of the challenges faced by Orang Asli community in Malaysia and how the pandemic hampered neglected tropical diseases like STHs infection monitoring in Malaysia.
A Multifactor Credential Translation and Verification Service for Computational Grid
Authors: T Hemalatha , Pushpalatha S. 
Published: December 2020

Abstract
The authentication mechanism in Grid need to support local heterogeneity and need to support n-way security context. The objective of this work is focused on the interoperable issue in the existing Grid Security Infrastructure. An adaptable Multi factor Authentication framework for computational grid is proposed in this work and it is compared with existing Credential Federation Systems. The proposed system is designed using the concept of Service Oriented Architecture SOA a specific type of Distributed System in which the agents are software service which are designated to perform the complicated time and resource consuming task of Credential management and Credential Validation service. GSI does not support Kerberos based authentication. Hence in order to integrate Kerberos with GSI, a Credential Translation Service CTS is designed and implemented. This feature is incorporated in this design by developing a service that can handle Kerberos token and PKI Certificate. The performance of the proposed system is compared with existing credential federation systems.
When Food is Feared: A Systematic Review of Enteral Feeding by Nasogastric Tube in Young People with Eating Disorders
Authors: Hindley Kristen , Fenton Clare , McIntosh Jennifer 
Published: December 2020

Abstract
BackgroundAdolescents with severe restrictive eating disorders often require enteral feeding. Nasogastric feeding is occasionally used during hospitalisation to treat medical instability as a result of malnourishment, or in a specialist setting to supplement minimal oral intake by underweight patients. There is minimal guidance for clinicians to determine when nasogastric feeding should be implemented, how it should be provided and how to complement feeding with a nasogastric tube. This systematic review sets out to determine best practice for NG feeding.MethodsA systematic review following PRISMA guidelines was conducted by searching AMED, EMBASE and MEDLINE databases from 2000-2020. Inclusion terms used were as follows: enteral feeding by nasogastric tube, under 18 years, eating disorders, and primary research. Exclusion terms: mental disorders other than eating disorders; non-primary research; no outcomes specific to NG feeding and over 18 years. Titles and abstracts were screened by all authors before reviewing full length articles.Results28 studies met the full criteria. 51.7% of studies were deemed high risk of bias due to the type of study: 37.9% retrospective cohort and 10.3% RCT; 17.2% were qualitative. Studies identified 1) 6-66% required NG feeding; 2) staff and young people understand its necessity but generally view it negatively; 3) there are 3 main types of feeding regime: continuous, nocturnal and bolus; 4) high calorie feeds are not associated with increased risk of refeeding syndrome; 5) Common complications were nasal irritation, epistaxis, electrolyte disturbance, distress and tube removal; 6) length of stay in hospital may be longer in patients requiring NG feeding; 7) psychiatric and medical wards differ in approach; 8) concurrent therapy reduces NG use and aids recovery.ConclusionsAll studies which reviewed the use of NG over a period of time found that it had increased significantly in recent years. Due to the possibility of patient removal of the tube, it may be beneficial in practice to deliver feeds using a bolus regime which has been tailored to the individual caloric needs of the patient. This review enables cautious recommendations to be made and highlights the lack of high-quality evidence around the use of NG feeding in eating disordered young people.
Barriers and Facilitators to Implement E-learning in Continuing Medical Education: Evidence From the China-gates Foundation Tuberculosis (TB) Control Program
Authors: Wang Ziyue , Zhang Lijie , Liu Yuhong , Jiang Weixi , Tang Shenglan , Liu Xiaoyun 
Published: December 2020

Abstract
[Objective] To evaluate the implementation of E-learning continuing medical education (CME) programs, analyse the barriers and facilitators during the implementation process, and provide policy recommendations based on the evidence from the China-Gates Foundation TB Control Program. [Methods] Routine monitoring data were collected through the project office. In-depth interviews, focus group discussion with project management personnel, teachers, and trainees (N=78), and staff survey (baseline N=555, final N=757) were conducted in selected pilot areas at the provincial, municipal, and county/district levels in the three project provinces (Zhejiang, Jilin, and Ningxia). [Results] By the end of June 2019, the national and provincial remote training platforms had organized 98 synchronous learning activities, with an average of 173.2 people (standard deviation, SD=49.8) per online training session, 163.3 people (SD=41.2) per online case discussion. In the pilot area, 64.5% of TB health workforce registered the asynchronous learning platform, and 50.1% obtained their professional certifications. Participants agreed that E-learning CME was more economical, has better content as well as more flexible work schedules. However, the project still faced challenges in terms of unmet learning needs, disorganized governance, insufficient hardware and software, unsupported environment, and lack of incentive mechanisms. [Conclusions] Our results suggested that it’s feasible to conduct large scale E-learning continuing medical education activities in the three project provinces of China. Training content and format are key facilitators of the program implementation, while the matching the supply/demand of training, organizational coordination, internet technology, motivations, and sustainability are key barriers.
Outbreak of peracute Glässer’s disease in suckling piglets in a self-recruiting high health farrow to grower herd: A Case report
Authors: Karlsen Odd Magne 
Published: December 2020

Abstract
BackgroundGlässer’s disease is caused by a bacterial infection where the causative agent is Glaesserella parasuis and is of rising concern in Norwegian high health pig herds. Different factors can trigger the onset of Glässer’s disease, including management practices such as unstable room temperature, poor ventilation or impaired immunity. Outbreaks of peracute Glässer’s disease in suckling piglets are rarely described. Case presentationIn a high health, farrow to grower pig herd 270 suckling piglets out of 920 died in a peracute to acute manner during a 20-day period. Post-mortem examinations revealed findings consistent with congestion and oedema and histopathological examination found no signs of inflammation or intravascular microthrombi. Bacteriological examination detected G. parasuis in relevant tissues. Emesis in half of the piglets and central nervous signs in a few was found after first intramuscular injection of procaine penicillin. Anaemia, poor temperature regulation in the farrowing unit and poor hygiene were factors contributing to the disease outbreak.ConclusionsIn the present case, it was concluded that an outbreak with high mortality and predominantly peracute to acute clinical disease in 3-5 week old suckling piglets was caused by Glässer’s disease (G. parasuis).
Phase 2 Study of TAS-117 in Advanced Solid Tumors Harboring Phosphatidylinositol 3-Kinase/v-akt Murine Thymoma Viral Oncogene Homolog Gene Aberrations
Authors: Lee Jii Bum , Jung Minkyu , Beom Seung Hoon , Kim Gun Min , Kim Hye Ryun , Choi Hye Jin , Sohn Joo Hyuk , Ahn Joong Bae , Rha Sun Young , Chung Hyun Cheol 
Published: December 2020

Abstract
Background: TAS-117 is a highly potent and selective allosteric pan-v-akt murine thymoma viral oncogene homolog (Akt) inhibitor. We conducted a single-arm, single-center, phase 2 study of TAS-117 in heavily treated patients with multiple tumors refractory to systemic chemotherapy harboring phosphatidylinositol 3-kinase (PI3K)/Akt mutations using a basket trial design.Methods: Patients with gastrointestinal (GI) cancers were orally administered 16 mg of TAS-117 daily and those with non-GI tumors were administered 24 mg of TAS-117, 4 days on/3-days off. The study was conducted over 21-day treatment cycles. Tumors were assessed by imaging every 6 weeks until disease progression, intolerable toxicity, or withdrawal. The primary endpoint was the overall response rate (ORR). Secondary endpoints included disease control rate (DCR), progression-free survival (PFS), overall survival (OS), PFS ratio, and safety and tolerability of TAS-117. Results: Thirteen patients were enrolled; eight with non-GI cancer (breast cancer (31%), ovarian cancer (15%), endometrial cancer (8%), and non-small cell lung cancer (8%)) and five with GI cancer (colon cancer (15%), rectal cancer (8%), gastric cancer (8%), and gallbladder cancer (8%)). The median age was 53 years. The Eastern Cooperative Oncology Group performance status was 0 in eight patients; ten patients were treated with TAS-117 after >4 lines of therapy. Twelve patients showed mutations in PIK3 catalytic subunit alpha (PIK3CA): E542K (15%), E545A (8%), E545K (31%), H1047R (31%), and Q546K (8%). One patient harbored an Akt1E17K mutation. The median treatment duration was 1.4 months; the median number of treatment cycles was 2. The ORR was 8%, and the DCR was 23%. The median PFS and OS were 1.4 and 4.8 months, respectively. Nine patients had disease progression, two experienced adverse events, one withdrew, and one discontinued treatment on the physician’s recommendation. Treatment-related adverse events (AEs) occurred in 85% of patients, and 27% experienced grade 3–4 AEs (grade 3 anorexia, 9%) and hyperglycemia (grade 3, 9%; grade 4, 9%). Conclusions: TAS-117 showed limited antitumor activity and manageable toxicity in patients with advanced solid tumors. Clinical efficacy was observed in patients with ovarian cancer harboring PIK3CA E545K mutations and in those with breast cancer harboring PIK3CA H1047R and Akt1E17K mutations. Trial registration: This study was registered with ClinicalTrial.gov (NCT03017521 in January 11, 2017.).
The Role of EORTC QLQ-C15-PAL Scores and Inflammatory Biomarkers in Predicting Survival in Terminally Ill Patients with Cancer
Authors: Koyama Nanako , Matsumura Chikako , Shitashimizu Yoshihiro , Sako Morito , Kurosawa Hideo , Nomura Takehisa , Eguchi Yuki , Ohba Kazuki , Yano Yoshitaka 
Published: December 2020

Abstract
Background The clinical use of patient-reported outcomes as compared to inflammatory biomarkers for predicting cancer survival remains a challenge in palliative care settings. We evaluated the accuracy of survival prediction in both indicators of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative scores (EORTC QLQ-C15-PAL) and the inflammatory biomarkers C-reactive protein (CRP), albumin (Alb), and neutrophil-lymphocyte ratio (NLR) in patients with advanced cancer. Methods This was an observational study in terminally ill patients with cancer hospitalized in a palliative care unit between June 2018 and December 2019. Patients’ data collected at the time of hospitalization were analyzed. Cox regression was performed to examine significant factors influencing survival. A receiver operating characteristic (ROC) analysis was performed to estimate cut-off values for predicting survival within 3 weeks, and a log-rank test was performed to compare survival curves between groups divided by the cut-off values. Results Totally, 130 patients participated in the study. Cox regression suggested that the QLQ-C15-PAL dyspnea and fatigue scores and levels of CRP, Alb, and NLR were significantly associated with survival time, and cut-off values were 66.67, 66.67, 3.0 mg/dL, 2.5 g/dL, and 8.2, respectively. The areas under ROC curves of these variables were 0.6–0.7. There were statistically significant differences in the survival curves between groups categorized using each of these cut-off values (p < .05 for all cases). Conclusion Our findings suggest that the assessment of not only objective indicators for the systemic inflammatory response but also patient-reported outcomes using EORTC QLQ-C15-PAL is beneficial for the prediction of short-term survival in terminally ill patients with cancer.
Abnormal TACC3 Expression is an Independent Prognostic Biomarker in Lung Carcinoma
Authors: He Dongwei , Fan Xiaoyan , Zhang Yulong , Li You 
Published: December 2020

Abstract
Background: Abnormal expression of transforming acidic coiled-coil protein 3 (TACC3) correlates with tumorigenesis of many human malignancies. However, the expression pattern of TACC3 and its clinical significance have not been well characterized in lung carcinoma (LUAD) so far. Objective: To investigate the association of TACC3 expression level with the clinicopathological characteristics and prognosis of LUAD patients.Methods: In the study, based on Oncomine, Gene Expression Profiling Interactive Analysis (GEPIA), UALCAN, and The Cancer Genome Atlas (TCGA) databases, the expression of TACC3 was determined in LUAD patients. Further, the expression of TACC3 was established using qRT-PCR in LUAD patients. Results: Our results showed that TACC3 was significantly overexpressed in LUAD tumors compared with non-tumors in the above public databases (all p<0.01). A receiver operating characteristic (ROC) curve analysis suggested that TACC3 may have diagnostic value in LUAD patients (normal vs tumor: AUC = 0.940). Kaplan-Meier analysis further demonstrated that high TACC3 expression in tumors was significantly associated with worse overall survival (OS) in LUAD patients (all p<0.01). In addition, Univariate and multivariate Cox regression analyses showed that TACC3 was an independent risk factor for OS among LUAD patients (HR = 1.02, 95% CI: 1.01-1.04, p = 0.00823; HR=1.43, 95% CI: 1.17-1.70, p <0.001). Finally, using gene set enrichment analysis (GSEA 3.0), we found that a series of potential pathways related to TACC3 were highly enriched with the high TACC3 expression phenotype (p = 0.024, p = 0.003, respectively). Conclusions: The present study provides evidence that TACC3 expression is upregulated in tumors and may be an independent risk factor for prognosis in LUAD patients.
Retrospective Analysis of Prognostic Factors of Localised or Locally Advanced Prostate Cancer and Their Influence on Treatment Choice
Authors: Liutkauskiene Sigita , Martinaityte Karolina , Malonyte Rasa , Jureniene Kristina , Grizas Saulius , Juozaityte Elona 
Published: December 2020

Abstract
Background: According to the majority of retrospective analyses and meta-analyses published in recent years, radical prostatectomy is a more effective treatment method than radical radiotherapy. The objective of this study was to assess whether the treatment method influences the survival of patients with early prostate cancer and to evaluate the impact of patient-dependent and prostate cancer-dependent prognostic factors on the choice of radical treatment method of prostate cancer.Methods: Medical records of selected patients were reviewed. Inclusion criteria involved histologically confirmed prostate adenocarcinoma; localised or locally advanced prostate cancer diagnosed in 2008-2012; no distant metastases at the time of initial diagnosis; medical records maintain comprehensive data on treatment and follow-up. The influence of prognostic factors on the choice of treatment method was assessed by making comparisons between groups using the Chi-square test.Results: More favorable prognostic factors were found in the RP treatment group compared to the RT treatment group: patients aged 60 years and younger accounted for 35% in the RP group, and 18% - in the RT group, with increasing age the number of RP decreased and the number of RT increased (p < 0.001); score of 3-4 points of CCI was set in 36% patients in the RP group, and 6% - in the RT group, with increasing CCI score, the number of RP decreased and the number of RT increased (p < 0.001); baseline PSA level of 10 ng/ml and less was found in 67% patients in the RP group, and 52% - in the RT group, with increasing PSA level, the number of RP decreased and the number of RT increased (p < 0.001). Gleason score did not influence the choice of treatment method (p = 0.24).Conclusions: Prognostic factors of localised or locally advanced prostate cancer influenced the choice of treatment method. In case of more favorable prognostic factors, radical prostatectomy was more often chosen.
Postmastectomy Radiotherapy in T1–2 Women Breast Cancer Patients with 1–3 Positive Axillary Lymph Nodes: A Propensity Score Matched SEER Analysis
Authors: Xu Gang , Bu Shanshan , Wang Xiushen , Ge Hong 
Published: December 2020

Abstract
Purpose: The application of postmastectomy radiotherapy (PMRT) in T1–2 women breast cancer patients with 1–3 positive lymph nodes has been controversial. We sought to determine the survival benefits of PMRT in the patients with T1–2 and 1–3 positive nodes.Methods: A retrospective study using the Surveillance, Epidemiology, and End Results (SEER) Regs Custom Data (with additional treatment fields) from 2001 to 2011 was performed. Patients who received PMRT were matched by the propensity score with patients who did not receive PMRT. The Overall survival (OS) and breast cancer-specific survival (BCSS) were analyzed. Results: We identified 56,725 women breast cancer patients with T1–2 and 1–3 positive nodes, and 18,646 patients were included in the analysis. After propensity score matching (1:1), with a median follow-up of 116 months, PMRT showed an increase in the OS (P = 0.018) but had no effect on the BCSS. The 10-year OS rates were 76.8% and 74.4%, and the 10-year BCSS rates were 82.8% and 82.2% for the patients who received and who did not receive PMRT, respectively. Only patients with 3 positive nodes could gain the benefit of PMRT for BCSS.Conclusion: PMRT for patients with T1–2 and 1–3 positive lymph nodes could increase the 10-year OS, and had no effect on the 10-year BCSS. Subgroup analysis indicated that only patients with 3 positive lymph nodes could benefit from PMRT for both the OS and BCSS.
Immunological effect of irreversible electroporation on solid tumors
Authors: Guo Xiaoxia , Du Fang , Liu Qin , Guo Yan , Wang Qingbing , Huang Wei , Wang Zhongmin , Ding Xiaoyi , wu zhiyuan 
Published: December 2020

Abstract
Background
This study intends to investigate the immunological effects of tumor ablation with irreversible electroporation (IRE).
Methods
We evaluated the systemic immune response in patients with hepatocellular carcinoma (HCC) after IRE treatment. Furthermore, we analyzed the tumor infiltrating T lymphocytes and the level of serum cytokines in IRE and control groups of tumor-bearing mice.
Results
We observed that IRE induced an increase in WBC, neutrophil and monocyte counts and a decrease in lymphocyte count 1 day post-IRE and returned to baseline values within 7 days in the patients. Meanwhile, circulating CD4+ T cell subsets, but not CD8+, decreased 1 day post-IRE. The activated T cells and natural killer (NK) cells increased, and regulatory T (Treg) cells decreased. Furthermore, a significant increase in cytotoxic CD8+ T cells infiltration was observed on ablative tumors in mice. The level of serum IFN-γ also significantly increased in the IRE group.
Conclusions
Our study demonstrated that IRE not only induced immediate innate immune response dominated by the increase of neutrophils, monocytes and NK cells, but also upregulated activated T cells and downregulated Treg. Meanwhile, the results from the animal model indicated that IRE could induce antitumor adaptive immunity dominated by cytotoxic CD8+ T cells.
Clinical Characteristics and Prognostic Nomogram in Patients With Pineoblastoma
Authors: JING YaJun , DENG WenShuai , JIANG YunXia , BI MingXia , FAN MingChao , GAO YiJun , Sun Peng 
Published: December 2020

Abstract
Background: Pineoblastoma (PB) is an infrequent entity of the central nervous system. The data about clinical outcomes of PB is exceedingly limited due to its rarity. Notably, the optimal treatment approaches and prognostic factors on PB is still unclear. Thus the aims of this study are to identify prognosis-associated factors and develop a predictive nomogram of PB.Method: Data of 243 patients with PB (≤29 years), collected by the Surveillance, Epidemiology, and End Results database, were randomly carved up the primary (n=172) and validation cohort (n=71) two groups. A prognostic nomogram was developed based on primary cohorts and optimized via the Akaike Information Criterion. Calibration curves were applied to show the results of validation (internal, external, and cross-validation). Additionally, its predictive performance was evaluated by the concordance index and receiver operating characteristic curve. Finally, decision curve analyses were employed to assess its clinical utility. Results: Age, year of diagnosis, treatment, tumor size, and tumor extension were identified as independent predictors of PB based on multivariate Cox regression analysis. The model presented an excellent discriminating ability (concordance index of the nomogram: 0.805; 95% confidence interval: 0.78–0.83; area under the receiver operating characteristic curve with a range from 0.7 to 0.9). The calibration plots (probability of survival) is consistent with the results predicted by the nomogram. The results of the decision curve analysis showed that the nomogram has potential clinical applicability.Conclusion: The nomogram can be used to assess prognosis and determine appropriate treatment options.