bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic utility of serial 18F-FDG-PET/CT in patients with locally advanced rectal cancer who underwent tri-modality treatment
Authors: Fernando Sumal , Lin Michael , Pham Trang Thanh , Chong Shanley , Ip Emilia , Wong Karen , Chua Wei , Ng Weng , Lin Peter , Lim Stephanie 
Published: October 2019

Objective:
This study explored the value of serial 18-fludeoxyglucose-positron emission tomography (18F-FDG-PET/CT) in predicting disease-free survival (DFS) in locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiation (NCRT) and surgery.

Methods:
We prospectively studied 46 patients with LARC who underwent NCRT and surgery. 18F-FDG-PET/CT scans were performed at three time-points before surgery (pre-NCRT-PET1, during NCRT-PET2 and following completion of NCRT-PET3). The following semi-quantitative PET parameters were analysed at each time point: maximum standardized uptake value (SUVmax), SUVmean, metabolic tumour volume (MTV) and tumour lesion glycolysis (TLG). Absolute and percentage changes in these parameters were analysed between time points. Statistical analysis consisted of median tests, Cox regression and Kaplan–Meier analysis for DFS.

Results:
The median follow-up time was 24 months. A reduction in PET parameters showed statistically significant differences for patients with recurrence compared to those without; percentage changes in MTV between PET1 and PET3 (cut-off: 87%, p = 0.023), percentage changes in TLG between PET1 and PET3 (cut-off: 94%, p = 0.02) and absolute change in MTV PET1 and PET2 (cut-off: 10.25, p = 0.001).
An absolute reduction in MTV between PET1 and PET3 (p=0.013), a percentage reduction in TLG between PET1 and PET2 (p=0.021), SUVmax and SUVmean at PET2 (p = 0.01, p = 0.027 respectively)were also prognostic indicators of recurrence.
MTV percentage change between PET1 and PET2 and SUVmean percentage change between PET1 and PET3 were also trending towards significance (p = 0.052, p = 0.053 respectively).

Conclusion:
Serial 18F-FDG-PET/CT is a potentially reliable non-invasive method to predict recurrence in patients with LARC. Volumetric parameters were the best predictors. This could allow risk-stratification in patients who may benefit from conservative management.

Advances in knowledge:
This paper will add to the literature in risk-stratifying patients with LARC based on prognosis, using 18F-FDG-PET/CT. This may improve patient outcomes by selecting suitable candidates for conservative management.
Burden of health behaviours and socioeconomic position on health care expenditure in Ontario
Authors: Manuel Douglas G. , Bennett Carol , Perez Richard , Wilton Andrew S. , Rohit Dass Adrian , Laporte Audrey , Henry David A. 
Published: October 2019

Background: Smoking, unhealthy alcohol consumption, poor diet and physical inactivity are leading risk factors for morbidity and mortality, and contribute substantially to overall healthcare costs. The availability of health surveys linked to health care provides population-based estimates of direct healthcare costs. We estimated health behaviour and socioeconomic-attribute healthcare costs, and how these have changed during a period when government policies have aimed to reduce their burden. Methods: The Ontario samples of the Canadian Community Health Surveys (conducted in 2003, 2005, and 2007-2008) were linked at the individual level to all records of health care use of publicly funded healthcare. Generalized linear models were estimated with a negative binomial distribution to ascertain the relationship of health behaviours and socioeconomic risk factors on health care costs. The multivariable cost model was applied to unlinked, Ontario CCHS samples for each year from 2004 to 2013 to examine the evolution of health behaviour and socioeconomic-attributable direct health care expenditures over a 10-year period. Results: We included 80,749 respondents, aged 25 years and older, and 312,952 person-years of follow-up. The cost model was applied to 200,324 respondents aged 25 years and older (CCHS 2004 to 2013). During the 10-year period from 2004 to 2013, smoking, unhealthy alcohol consumption, poor diet and physical inactivity attributed to 22% of Ontario’s direct health care costs. Ontarians in the most disadvantaged socioeconomic position contributed to 15% of the province’s direct health care costs. Combined, these health behaviour and socioeconomic risk factors were associated with 34% ($134 billion) of direct health care costs (2004 to 2013). Over this time period, we estimated a 1.9% reduction in health care expenditure ($5.0 billion) attributable to improvements in some health behaviours, most importantly reduced rates of smoking. Conclusions: Adverse health behaviours and socioeconomic position cause a large direct health care system cost burden.
Knowledge management awareness assessment in Nigerian tertiary institutions
Authors: Ogunbanwo Afolakemi Simbo , Okesola Julius Olatunji , Buckley Sheryl 
Published: October 2019

Background: Knowledge management (KM) is a recipe for increasing performance and promoting innovation in tertiary institutions. However, some scholars argue that the Nigerian educational sector is yet to fully appreciate the importance of KM as their KM awareness level is still low. Since measurement is the basic foundation to accomplish success, this paper assesses the KM awareness level in tertiary institutions of south-west Nigeria. Methods: The study applied a survey method using a closed ended questionnaire administered to 50 participants from each of the 10 institutions measured by Likert scaling. Employing SPSS for data analysis, frequency count and percentage score were adopted to analyse the demographic data, and the research hypotheses were analysed with chi square test, Pearson chi square and bivariate correlation (Pearson) analysis. Results: A positive relationship between awareness, current status and level of familiarity was noted. KM awareness level in the institutions is high even though there is a significant difference between the public and private universities, as well as between the students and academic staff. Conclusions: Since an increase in the awareness level increases both current status and level of familiarity which often account for KM success, it is recommend that KM awareness level should continuously be improved upon in Nigerian tertiary institutions.
Interleukin-1 receptor antagonist treatment in acute ischaemic stroke does not alter systemic markers of anti-microbial defence
Authors: McCulloch Laura , Allan Stuart M. , Emsley Hedley C. , Smith Craig J. , McColl Barry W. 
Published: October 2019

Background: Blockade of the cytokine interleukin-1 (IL-1) with IL-1 receptor antagonist (IL-1Ra) is a candidate treatment for stroke entering phase II/III trials, which acts by inhibiting harmful inflammatory responses. Infection is a common complication after stroke that significantly worsens outcome and is related to stroke-induced deficits in systemic immune function thought to be mediated by the sympathetic nervous system. Therefore, immunomodulatory treatments for stroke, such as IL-1Ra, carry a risk of aggravating stroke-associated infection. Our primary objective was to determine if factors associated with antibody-mediated antibacterial defences were further compromised in patients treated with IL-1Ra after stroke. Methods: We assessed plasma concentrations of immunoglobulin isotypes and complement components in stroke patients treated with IL-1Ra or placebo and untreated non-stroke controls using multiplex protein assays. Activation of the sympathetic nervous system (SNS) was determined by measuring noradrenaline, a major SNS mediator. Results: There were significantly lower plasma concentrations of IgM, IgA, IgG1 and IgG4 in stroke-patients compared to non-stroke controls, however there were no differences between stroke patients treated with placebo or IL-1Ra. Concentrations of complement components associated with the classical pathway were increased and those associated with the alternative pathways decreased in stroke patients, neither being affected by treatment with IL-1Ra. Noradrenaline concentrations were increased after stroke in both placebo and IL-1Ra-treated stroke patients compared to non-stroke controls. Conclusion: These data show treatment with IL-1Ra after stroke does not alter circulating immunoglobulin and complement concentrations and is therefore unlikely to further aggravate stroke-associated infection susceptibility through altered availability of these key anti-microbial mediators.
Influence of different types of whitening tooth pastes on the tooth color, enamel surface roughness and enamel morphology of human teeth
Authors: Shamel Mohamed , Al-Ankily Mahmoud M. , Bakr Mahmoud M. 
Published: October 2019

Background: Tooth whitening usually includes the direct use of gels containing carbamide or hydrogen peroxide on the tooth enamel surface through a wide variety of products formulas. A generally new advancement in whitening of teeth uses the significant importance of the tooth color shift from yellow to blue in delivering a general enhancement in the observation of tooth whiteness. The aim of the current work was to measure the tooth whitening effects, surface roughness and enamel morphology of six different types of blue covarine-containing and blue covarine-free toothpastes using in vitro models. Methods: A total of 70 sound extracted human premolars were randomly and equally divided into seven groups, and each subjected to tooth brushing using different toothpastes. Tooth color and enamel surface roughness were measured before and after the brushing procedure using a white light interferometer, and scanning electron microscopy (SEM) was used to assess tooth surface after the procedure. Results: Toothpaste containing blue covarine resulted in the greatest improvement in tooth color amongst all groups as well as a statistically significant color difference when compared to blue covarine-free toothpaste. Furthermore, blue covarine-containing toothpaste resulted in fewer morphological changes to the enamel surface. This was confirmed with SEM images that showed smooth enamel surfaces with fine scratches. Conclusions: The results from the present study show that blue covarine containing toothpastes are reliable, effective in tooth whitening and produce less surface abrasion when compared to blue covarine-free toothpastes.
The Similarity Network of Motion Pictures
Authors: Max Wei Yanhao 
Published: October 2019

Ideas are connected. New ideas are often seen as creative combinations of previous ideas. I study these connections in the context of motion pictures. A network of 4,445 movies is constructed to indicate which movies are similar. I first examine the properties of the network using descriptive and regression analysis; then I develop a model of network formation for counterfactual analysis. It is found that most movies imitate and evolve around a “core” of the more successful movies. In addition, imitation is both conventional and atypical: a new movie usually follows a stream of similar movies yet simultaneously combines atypical elements from movies outside this stream. This atypicality, if well balanced, has a positive effect on the individual movie’s box office. However, I find that, in the long run, atypical combination may lead to a worse collective box-office performance because of the way it changes the market structure.This paper was accepted by Matthew Shum, marketing.
VARIATION OF COMORBIDITIES IN ROMANIA AT THE LAU2 LEVEL, A CROSS-SECTIONAL ANALYSIS
Authors: Pana Adrian , Ileanu Bogdan-Vasile 
Published: October 2019

Introduction: Romania is still lagging behind in regard to main health indicators when compared to average values of European Union countries with a disproportionate share of disability due mainly to chronic diseases. There are tools available to quantify the negative health outcomes due to comorbidities, and among them the Elixhauser Index was found to be the best to predict health care utilization and expenditures.
Objective: To measure the extent of comorbidities at the LAU2 level using the Elixhauser Index.
Methods: All relevant comorbidities at the local level were summed-up using the Elixhauser index. This was followed with standardization by population number and then by 10-year age group. Due to large oscillation from one year to another during the 2014-2016 period, the geometrical mean was computed, then few measures of the variation such as decile ratio and variation coefficient were also computed.
Results: High variability of comorbidities is observed at the local level (LAU2). Clusters of comorbidities concentration are found near medical university centers and localities in non-MUC districts located at the furthest distance from the county residential center.
Conclusions: Several factors such as proximity to referral hospitals, increased accessibility to these hospitals due to low control at primary healthcare levels, availability of diagnostic technologies and different diagnostic coding patterns, as well as isolation and unavailability of primary health care services are listed as possible factors that can explain these results.
RENOPROTECTIVE EFFECT OF MELATONIN IN CONDITIONS OF ACUTE KIDNEY INJURY AND ALTERED PINEAL GLAND ACTIVITY
Authors: Shchudrova Tetiana , Dudka Yevheniia , Korotun Olena , Bilous Tetiana , Herman Fedir , Zamorskii Igor 
Published: October 2019

INTRODUCTION: Melatonin is a promising therapeutic agent due to its multiple beneficial effects, wide availability and relatively high safety. As melatonin acts as a chronobiotic agent, its adequate production by the pineal gland allows for adaptation to environmental changes, while disturbances in melatonin secretion are associated with health disorders. The renoprotective effect of exogenous melatonin was established on different experimental models of acute kidney injury (AKI), while the influence of the altered pineal gland activity on the efficacy of melatonin treatment has not been investigated.
OBJECTIVES: The aim of this research was to study the renoprotective potential of melatonin in conditions of aminoglycoside-induced AKI against the background of pineal hypo- and hyperfunction.
METHODS: Nonlinear mature white rats (n=40) were randomly divided into 5 groups. Animals from the I (Control), and II (AKI) group were kept under the natural light regimen. Pineal hypofunction was simulated in rats from the III group by maintenance under conditions of constant light at 500 lux (24.00 light : 0.00 darkness) for 7 days. Pineal hyperfunction was simulated in rats from the IV group by maintenance under conditions of constant darkness (0.00 light : 24.00 darkness). Toxic AKI (II-IV groups) was induced by daily administration of gentamicin at a dose of 80 mg/kg for 6 days. Animals from the III-IV groups were injected daily with melatonin at a dose of 5 mg/kg. 24 h after the last injection biochemical and histological examination was performed. For the statistical analysis SPSS 17.0 software was used.
RESULTS: Nephrotoxicity of gentamicin caused significant (p<0.05) functional changes and structural alterations to the rat kidneys. Treatment with melatonin in conditions of gentamicin-induced kidney injury significantly limited the degree of damage to renal tissue and prevented a critical reduction in kidney function, confirming a protective effect of melatonin. At the same time, significant (p<0.05) differences between the indices of the III and IV group allow us to state, that treatment with exogenous melatonin on the background of endogenous melatonin deficiency was less effective in comparison to the administration of melatonin in conditions of pineal hyperfunction.
CONCLUSION: Melatonin ameliorates gentamicin-induced kidney injury by the limitation of histopathological changes in kidney tissue and the preservation of kidney function. Pre-existing deficiency of endogenous melatonin decreases the resistance of kidneys to the damaging action of the toxin and lessens the protective effect of the exogenous melatonin. Alternatively, in rats with increased pineal gland activity and melatonin production, co-treatment with exogenous melatonin more effectively protects the kidney from gentamicin-induced structural and functional changes and prevents the development of renal failure.
IDENTIFICATION OF THE AVIAN PATHOTYPE OF ESCHERICHIA COLI ON LAYER FLOCKS BY MULTIPLEX PCR
Authors: Burtan Marilena , Popa Virgilia , Gurau Maria Rodica , Danes Doina 
Published: October 2019

Introduction: Colibacillosis in poultry is determined by avian pathogenic Escherichia coli (APEC) and represents an important source of economic losses in the poultry industry. APEC’s pathogenicity relies on the presence and expression of different virulence factors. The genes ompA , iss and fimH, encoding the outer membrane protein, the protein inducing resistance to complement and the synthesis of type 1 fimbria are present in APEC strains.
Objective: Escherichia coli strains isolated from layers were analysed to assess the pathotype they belong to.
Methods: In order to detect the three genes associated with APEC strains, 16 E. coli isolates were investigated for virulence associated genes ompA, iss and fimH, using multiplex PCR.
Results: From the 16 E.coli strains submitted, multiplex PCR assessment revealed that 14 (87.5%) of the E. coli strains isolated contained at least one virulence gene, while 2 (12.5%) strains did not harbour any of the virulence genes tested. The fimH gene was noted in 13 (81.25%) of the strains tested, the ompA gene has been present in 12 (75%) strains and the iss gene was present in 9 (56.25%) strains. Eight (50%) strains were found to present all three investigated genes.
Conclusion: Presence of these genes is a strong indicatory to consider those strains as belonging to the APEC pathotype.
Evaluating evidence for stoma care nursing: appraising a randomised controlled trial of ostomy skin barriers
Authors: McPhail Jackie 
Published: October 2019

Background: Nursing practice should be evidence-based. As such, nurses should be able to rank sources according to a hierarchy of evidence and critically appraise the validity of studies. This is especially important in stoma care, where high-quality evidence is limited. Methods: Evidence appraisal is made easier by tools, such as the Critical Appraisal Skills Programme (CASP) for Randomised Controlled Trials (RCT). CASP was used to critique the ADVOCATE Trial, ( Colwell et al 2018 ), A Randomised Controlled Trial Determining Variance in Ostomy Skin Condition and the Economic Impact (ADVOCATE Trial), which had an adaptive design and compared the cost efficiency and efficacy of a ceramide-infused two-piece skin barrier with a comparator. The participants were randomised, and the trial was double blinded. Results: The trial addressed clearly focused issues. The improvement in cost efficacy for the trial group was statistically significant (p=0.017); in addition, three of six tertiary objectives were also statistically significant. Improvement in peristomal skin health was noticeable but not statistically significant. The results can be applied to other ostomy patient populations, and all clinically important outcomes were considered. Conclusion: CASP provided a staged and structured approach to review an RCT. It can help specialist nurses to find and apply relevant study findings to practice. CASP assessment found the ADVOCATE trial to be a reliable evidence base on which stoma care nurse could adjust their practice to optimise costs and peristomal skin health.
Short-term perioperative parecoxib is not detrimental to shaft fracture healing in a rat model
Authors: Hjorthaug Geir A. , Søreide Endre , Nordsletten Lars , Madsen Jan E. , Reinholt Finn P. , Niratisairak Sanyalak , Dimmen Sigbjørn 
Published: October 2019

Objectives Experimental studies indicate that non-steroidal anti-inflammatory drugs (NSAIDs) may have negative effects on fracture healing. This study aimed to assess the effect of immediate and delayed short-term administration of clinically relevant parecoxib doses and timing on fracture healing using an established animal fracture model. Methods A standardized closed tibia shaft fracture was induced and stabilized by reamed intramedullary nailing in 66 Wistar rats. A ‘parecoxib immediate’ (Pi) group received parecoxib (3.2 mg/kg bodyweight twice per day) on days 0, 1, and 2. A ‘parecoxib delayed’ (Pd) group received the same dose of parecoxib on days 3, 4, and 5. A control group received saline only. Fracture healing was evaluated by biomechanical tests, histomorphometry, and dual-energy x-ray absorptiometry (DXA) at four weeks. Results For ultimate bending moment, the median ratio between fractured and non-fractured tibia was 0.61 (interquartile range (IQR) 0.45 to 0.82) in the Pi group, 0.44 (IQR 0.42 to 0.52) in the Pd group, and 0.50 (IQR 0.41 to 0.75) in the control group (n = 44; p = 0.068). There were no differences between the groups for stiffness, energy, deflection, callus diameter, DXA measurements (n = 64), histomorphometrically osteoid/bone ratio, or callus area (n = 20). Conclusion This study demonstrates no negative effect of immediate or delayed short-term administration of parecoxib on diaphyseal fracture healing in rats. Cite this article: G. A. Hjorthaug, E. Søreide, L. Nordsletten, J. E. Madsen, F. P. Reinholt, S. Niratisairak, S. Dimmen. Short-term perioperative parecoxib is not detrimental to shaft fracture healing in a rat model. Bone Joint Res 2019;8:472–480. DOI: 10.1302/2046-3758.810.BJR-2018-0341.R1.