bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic value of TP53 concurrent mutations for EGFR- TKIs and ALK-TKIs based targeted therapy in advanced non-small cell lung cancer: a meta-analysis
Authors: Qin Kang , Hou Helei , Liang Yu , Zhang Xiaochun 
Published: March 2020

AbstractBackground The prognostic significance of TP53 concurrent mutations in patients with epidermal growth factor receptor (EGFR)- or anaplastic lymphoma kinase (ALK)- mutated advanced non–small-cell lung cancer (NSCLC) who received EGFR-tyrosine kinase inhibitors (TKIs) or ALK-TKIs based targeted therapy remains controversial. Therefore, the present meta-analysis was performed to investigate the association between TP53 concurrent mutations and prognosis of patients with advanced NSCLC undergoing EGFR-TKIs or ALK-TKIs treatments. Methods Eligible studies were identified by searching the online databases PubMed, Embase, Medline, The Cochrane library and Web of Science. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to clarify the correlation between TP53 mutation status and prognosis of patients. This meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results In total, 15 studies with 1342 patients were included for final analysis. Overall, concurrent TP53 mutation was associated with unfavorable progression-free survival (PFS) (HR=1.88, 95%CI: 1.59-2.23, p<0.001, I2=0.0%, P=0.792) and overall survival (OS) (HR=1.92, 95%CI: 1.55-2.38, p<0.001, I2=0.0%, P=0.515). Subgroup analysis based on type of targeted therapy (EGFR-TKIs or ALK-TKIs, pathological type of cancer (adenocarcinoma only or all NSCLC subtypes) and line of treatment (first-line only or all lines) all showed that TP53 mutations was associated with shorter survivals of patients with EGFR-TKIs or ALK-TKIs treatments. Particularly, in patients with first-line EGFR-TKIs treatment, significantly poorer prognosis was observed in patients with TP53 concurrent mutations (pooled HR for PFS: 1.69, 95% CI 1.25-2.27, P<0.001, I2=0.0%, P=0.473; pooled HR for OS: 1.94, 95% CI 1.36-2.76, P<0.001, I2=0.0%, P=0.484). Begg’s funnel plots and Egger’s tests indicated no significant publication bias in this study. Conclusions This meta-analysis indicated that concurrent TP53 mutations was a negative prognostic factor and associated with poorer outcomes of patients with EGFR-TKIs or ALK-TKIs treatments in advanced NSCLC. In addition, our study provided evidence that TP53 mutations might be involved in primary resistance to EGFR-TKIs treatments in patients with sensitive EGFR mutations in advanced NSCLC.
Post-Discharge survival status and predictors of mortality among severely malnourished children &lt;5 years of age admitted to Minia University Maternity and Children Hospital
Authors: Ghazawy Eman , Bebars Gihan , Eshak Ehab Salah 
Published: March 2020

Abstract

Background: Though effective treatment programs for severely malnourished children are available, little is known about long-term outcomes and potential predictors of post-discharge mortality. The aim of this study was to assess the post-discharge survival status and predictors for post-discharge mortality in severely malnourished children admitted to Minia University Maternity and Children HospitalMethods: A retrospective cohort study which included 135 children under five years of age who were admitted to the nutrition rehabilitation ward with severe acute malnutrition (SAM) during the period from January to December 2018. Data were collected from the inpatient’s hospital records and the children’s parents/guardians were interviewed using a detailed structured questionnaire that inquired about demographic and socioeconomic variables. The Cox proportional hazard model was used to assess the factors associated with the SAM’s post-discharge mortality.Results: A total of 135 children were enrolled into the study. Death rate during hospitalization was 9.6%. The cumulative probability of survival beyond eight weeks and at least for 24 weeks after discharge was 89.3% with a cumulative probability of post-discharge mortality of 10.7% and all deaths occurred within eight weeks after discharge. The main predictor for the SAM’s post-discharge mortality was illiteracy of mothers; the multivariable HR (95%CI) was 7.10 (1.58-31.93; p=0.01).Conclusions: Mothers’ education and edema at admission are independent predictors for post-discharge mortality in under-five children with SAM. The identification of predictors for post-discharge mortality is an important preliminary step for interventions aiming to reduce morbidity and mortality following discharge.
Maternal and neonatal outcome of births planned in alongside midwifery units: A cohort study from a tertiary center in Germany
Authors: Merz Waltraut Maria , Tascon-Padron Laura , Puth Marie-Therese , Heep Andrea , Tietjen Sophia L. , Schmid Matthias , Gembruch Ulrich 
Published: March 2020

Abstract
Background
For healthy women entering birth after uneventful pregnancy, midwife-led models of care have the potential to reduce interventions and increase the vaginal birth rate. In Germany, 98.4% of women are giving birth in consultant-led obstetric units. Alongside midwifery units (AMU) have been established in 2003. We compared the maternal and perinatal outcome of women registered for planned birth in the AMU at our hospital with a matched group of low-risk women who gave birth in standard obstetric care during the same period of time.
Methods
We used a retrospective cohort study design. The study group consisted of all women admitted to labor ward who had registered for birth in AMU from 2010 to 2017. For the control group, low-risk women were selected; additionally, matching was performed for parity. Mode of birth was chosen as primary outcome parameter for the mother. For the neonate, a composite primary outcome (5-minute Apgar <7 or umbilical cord arterial pH < 7.10 or transfer to specialist neonatal care) was defined. Secondary outcomes included epidural anesthesia, duration of the second stage of labor, episiotomy, obstetric injury, and postpartum hemorrhage. Non-inferiority was assessed, and multiple logistic regression analysis was performed.
Results
612 women were admitted for labor in AMU, the control group consisted of 612 women giving birth in standard obstetric care. Women in the study group were on average older and had a higher BMI. Birthweight was on average 95 g higher in the study group. Non-inferiority could be established for the primary outcome parameters. In the study group, less interventions were performed (epidural anesthesia rate 19.1% vs. 41.2%; episiotomy rate 4.7% vs. 8.6%). The duration of the second stage of labor was shorter (47.4 min. vs. 55.6 min.), and second-degree perineal tears were less common in the study group (34.4% vs. 46.4%), higher-order obstetric lacerations occurred more frequently in the study group (2.3% vs. 0.9%). There was no difference in the postpartum hemorrhage rate.
Long-term survival trends in patients with unresectable stage III non-small cell lung cancer receiving chemotherapy and radiation therapy: a SEER cancer registry analysis
Authors: Hansen Ryan N , Zhang Yiduo , Seal Brian , Ryan Kellie , Yong Candice , Darilay Annie , Ramsey Scott D 
Published: March 2020

Abstract
Background: To evaluate the value of new therapies for non-small cell lung cancer (NSCLC), it is necessary to understand overall survival (OS) rates associated with previous standard therapies and how these rates have evolved over time. Methods: We retrospectively analyzed data from patients enrolled in the Surveillance, Epidemiology, and End Results (SEER) cancer registry. Adults with unresectable, stage III NSCLC treated with chemoradiotherapy were grouped by diagnosis year (2000–2002; 2003–2005; 2006–2008; 2009–2011; 2012–2013). The primary endpoint was OS (data cut-off, December 31, 2014), estimated using the Kaplan–Meier estimator. Temporal survival-trend significance was tested using a two-sided log-rank trend test. Results: Of 12,865 eligible patients, 59.1% were male, 59.9% had stage IIIB disease, and 62.7% had non-squamous histology. Median age at diagnosis was 67 years. Overall, 10,899 (84.7%) patients died and 1,966 (15.3%) were censored/lost to follow-up. Median follow-up (95% confidence interval [CI]) was 80 (77–82) months; median OS (95% CI) was 15 (15–16) months; 1- and 3-year survival probabilities (95% CI) were 57.7% (56.9–58.6) and 24.1% (23.3–24.8), respectively. Stratification by diagnosis year showed consistent improvements in survival over time ( p < 0.0001 for trend). Median OS was 12, 14, 15, 18, and 19 months in successive cohorts. Conclusions: OS in patients diagnosed with unresectable, stage III NSCLC between 2003 and 2013 was consistent with that from clinical studies of sequential/concurrent chemoradiotherapy. Despite improvement over time, median OS was <2 years and mortality remained high during the first year post-diagnosis.
The Effects of Changing Meteorological Parameters on Fatal Aortic Catastrophes
Authors: Szilágyi Brigitta , Berczeli Márton , Lovas Attila , Oláh Zoltán , Törő Klára , Sótonyi Péter 
Published: March 2020

Abstract
Introduction: Over the spam of the last decade, medical research has been increasingly putting greater emphasis on the study of meteorological parameters due to their connection to cardiovascular diseases. The main goal of this study was to explore the relationship between fatal aortic catastrophes and changes in atmospheric pressure and temperature. Methods: We used a Cox process model to quantify the effects of environmental factors on sudden deaths resulting from aortic catastrophes. We used transfer entropy to draw conclusion about the causal connection between mortality and meteorological parameters. Our main tool is a computer program which we developed earlier in order to evaluate the relationship between pulmonary embolism mortality and the weather on data sets comprised of aortic aneurysm (AA) and acute aortic dissection (AAD) cases, where one of these two medical conditions had led to the fatal rupture of the aorta. Our source for these cases were the autopsy databases of Semmelweis University, from the time period of 1994 to 2014. We have examined 160 aneurysm and 130 dissection cases in relation to changes in meteorological parameters. The algorithm implemented in our program is based on a non-parametric a Cox process model. It is capable to split slowly varying unknown global trends from fluctuations potentially caused by weather. Furthermore, it allows us to explore complex non-linear interactions between meteorological parameters and mortality. Results: The model measures the relative growth of the expected number of events on the n th day caused by the deviation of environmental parameters from its mean value. The connection between ruptured aortic aneurysms (rAA) and changes in atmospheric pressure is more significant than their connection with mean daily temperatures. With the increase in atmospheric pressure, the rate of rAA mortality also increased. The effects of meteorological parameters were weaker for deaths resulting from acute aortic dissections (AAD), although low mean daily temperatures increased the intensity of occurrence for AAD-related deaths. Conclusion: The occurrence rate of fatal aortic catastrophes showed a slight dependence on the two examined parameters within our groups.
The prognostic value of IDO expression in solid tumors: a systematic review and meta-analysis
Authors: Wang Sen , Wu Jia , Shen Han , Wang Junjun 
Published: March 2020

Abstract
Background: Indoleamine 2,3-dioxygenase (IDO) is a rate-limiting enzyme in the metabolism of tryptophan into kynurenine. It is considered to be an immunosuppressive molecule that plays an important role in the development of tumors. However, the association between IDO and solid tumor prognosis remains unclear. Herein, we retrieved relevant published literature and analyzed the association between IDO expression and prognosis in solid tumors.Methods: Studies related to IDO expression and tumor prognosis were retrieved using PMC, EMbase and web of science database. Overall survival (OS), time to tumor progression (TTP) and other data in each study were extracted. Hazard ratio (HR) was used for analysis and calculation, while heterogeneity and publication bias between studies were also analyzed.Results: A total of 31 studies were included in this meta-analysis. Overall, high expression of IDO was significantly associated with poor OS (HR 1.92, 95% CI 1.52–2.43, P<0.001) and TTP (HR 2.25 95% CI 1.58–3.22, P<0.001). However, there was significant heterogeneity between studies on OS (I2=81.1%, P<0.001) and TTP (I2=54.8%, P=0.007). Subgroup analysis showed lower heterogeneity among prospective studies, studies of the same tumor type, and studies with follow-up periods longer than 45 months.Conclusions: The high expression of IDO was significantly associated with the poor prognosis of solid tumors, suggesting that it can be used as a biomarker for tumor prognosis and as a potential target for tumor therapy.
Untreated dental caries prevalence and impact on the quality of life among 11 to14-year-old Egyptian schoolchildren: A cross-sectional study
Authors: Eid Samar , Khattab Nagwa , Elheeny Ahmad 
Published: March 2020

Abstract
Background
This study aimed to assess caries prevalence and experience among 11 to 14 years, school children, analyze demographic, socioeconomic, personal and professional dental care in relation to untreated carious lesions, and evaluates the effect of decayed teeth on early adolescents’ oral health-related quality of life (OHRQoL).
Methods
A cross-sectional analytical investigation was conducted on 1020 preparatory schoolchildren selected on the basis of a multistage sampling technique. Caries status of the participants detected via recording their caries experience and untreated cavities using DMFT and DT indices. OHRQoL was determined using a validated Arabic CPQ 11-14 short-form questionnaire. Statistical methods for descriptive analysis, chi-square test, Independent-Samples t test and one-way analysis of variance (ANOVA) were used. Multivariate Poisson regression analysis through a hierarchical approach was used to detect the influence of independent variables on DT scores. To declare the association between independent variables and QoL, a step-by-step, multivariate regression analysis was conducted.
Results
The average scores of DMFT and DT in this study were 2.97±1.29 and 1.66±1.24. Poisson regression analysis demonstrated that early adolescents whom their mothers with a lower level of education and of low socioeconomic status were 1.41 and 1.27 times respectively had higher DT scores when compared with their peers. Untreated cavities affected mainly by mother education, school type, family income, and regular dental appointments. Children with DMFT≤3) or DT=0 recorded a statistically significant lower CPQ 11-14 average score (p˂0.01) and (p˂0.0001) respectively.
Conclusions
Untreated carious cavities and caries experience were associated with lower socioeconomic, maternal education andl ess frequent tooth brushing. Untreated carious cavities have a significant negative impact on schoolchildren’s QoL.

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Incidence of deep venous thrombosis (DVT) of lower extremity in patients undergoing surgeries for ankle fractures
Authors: Luo Zixuan , Chen Wei , Li Yansen , Wang Xiaomeng , Wang Weili , Zhu Yanbin , Zhang Fengqi 
Published: March 2020

Abstract
Objective To investigate the incidence of postoperative deep venous thrombosis (DVP) in patients undergoing surgeries for ankle fractures and identify the associated risk factors. Methods This was a retrospective study. A total of 1451 patients undergoing surgery of ankle fractures from January 2016 to June 2019 were included. The inpatient medical record system was inquired for data collection, including demographics, comorbidities, injury and surgery-related data and laboratory biomarkers. DVT of lower extremity was diagnosed by routine doppler examination. Univariate analyses and multivariate logistic regression analyses were used to identify the independent risk factors. Results Among the 1451 patients, DVT was confirmed in 38 cases, indicating an incidence of 2.6%. DVT involved both the operated and non-operated limbs in 8 patients (21.1%). DVT involved superficial femoral vein in 4 cases (6.6%), deep femoral vein in 2 (3.3%), popliteal vein in 5 (8.2%), posterior tibial vein in 11 (18.0%) and peroneal vein in 39 (63.9%). The median interval between operation and diagnosis of DVT was7 days. Six risk factors were identified to be independently associated with DVT, including age (10-year increase) (OR, 1.44), preoperative stay (delay of each day) (OR, 1.11), anesthesia (general vs regional) (OR, 3.51), lower hemoglobin level (OR, 2.02), total cholesterol >5.2mmol/L (OR, 3.20) and reduced lymphocyte count (OR, 3.16). Conclusion These identified factors, although not easily modifiable, do help counsel patients about the risk of DVT and help individualized assessment of the risk factors and accordingly the risk stratification.
Association between Dietary Energy Density with Mental Health and Sleep Quality in Women with Overweight/Obesity
Authors: Maddahi Niloofarsadat , Yarizadeh Habib , Setayesh Leila , Nasir Yasaman , Alizadeh Shahab , Mirzaei Khadijeh 
Published: March 2020

Abstract
Objectives : Mental health, sleep quality and dietary intake are interlinked. Impairment of mental health and low sleep quality may contribute to obesity through the consumption of diets high in energy density. Nevertheless, it is not clear whether dietary energy density (DED) influences mental health. This study aimed to examine the association of DED with mental health indices, including depression, anxiety, stress, and sleep quality in overweight/obese women. Results: After adjustment for age, BMI, and physical activity, subjects in the highest quartile of DED had higher systolic and diastolic blood pressure, but lower serum triglyceride, than those in the lowest quartile (p <0.05). DED was significantly associated with increased odds of stress in the crude (OR =2.15, 95%CI: 1.01-4.56, p= 0.04) and adjusted model for age, BMI, and physical activity (OR = 2.56, 95%CI: 1.13-5.79, p=0.02). No significant relationship was observed between DED and depression, anxiety and sleep quality.
Cause and Predictors of Neonatal Mortality among Neonates Admitted to the Neonatal Intensive Care Units of Public Hospitals in Eastern Ethiopia: Facilities Based Prospective Follow-up Study
Authors: Desalew Assefa , Sintayehu Yitagesu , Teferi Nardos , Amare Firehiwot , Geda Bifitu , Worku Teshager , Abera Kebebush , Asefaw Abiyot 
Published: March 2020

Abstract
Background

The first month is the most crucial period for child survival. Neonatal mortality continues to remain high with little improvement over the years in Sub-Saharan Africa including Ethiopia. This region shows the least progress to reducing neonatal mortality and it continues to be a significant public health issue. The facilities-based causes and predictors of neonatal death in the neonatal intensive care unit are not well documented in this study setting. Hence, the aim of this study was to determine the causes and predictors of neonatal mortality among infants admitted to the neonatal intensive care units in Eastern Ethiopia.

Methods

Facilities-based prospective follow-up study was conducted among neonates admitted to the neonatal intensive care units of public hospitals in Eastern Ethiopia from November to December 2018. Data were collected using a pre-tested, structured questionnaire and a follow-up checklist. The main outcomes and causes of death were set by pediatricians and medical residents. Epi-Data 3.1 and Statistical Package for Social Sciences Version 25 software were used for data entry and analysis respectively. Multivariable logistic regression was used to find out the predictors of facilities-based neonatal mortality.

Results

The proportion of facilities-based neonatal mortality was 20%(95% CI: 16.7-23.8%) The causes of death were complications of preterm birth 28.58%, birth asphyxia 22.45%, infection 18.36%, meconium aspiration syndrome 9.18%, respiratory distress syndrome 7.14% and congenital malformation 4.08%. Low birth weight, preterm births, length of stay in NICU, low 5 minute Apgar score, hyperthermia and initiation of feeding were predictors of neonatal death among infants admitted to the neonatal intensive care units in public hospitals, Eastern Ethiopia.

Conclusion

The proportion of facilities-based neonatal deaths was unacceptably high. The main causes of death were preventable and treatable. Hence, improving timing and quality of ANC is essential for early detection, anticipating high-risk newborns and timely interventions. Furthermore, early initiation of feeding and a better referral linkage to tertiary facilities could lead to a reduction of neonatal death in this setting.
Dental expenditure, Progressivity and Horizontal inequality in Chinese adults：Based on the 4th National Oral Health Epidemiology Survey
Authors: CHENG MengLin , WANG ChunXiao , WANG Xing , FENG XiPing , TAI BaoJun , HU DeYu , LIN HuanCai , WANG Bo , ZHENG ShuGuo , LIU XueNan , RONG WenSheng , WANG WeiJian , Si Yan , Xu Tao 
Published: March 2020

Abstract
Background:
The financial burden of oral diseases is getting more important. The aim of this study was to describe the dental expenditure, analyze its progressivity and horizontal inequality under the general health finance and insurance system, and identify the key social determinants of this inequality for Chinese adults.
Methods:
A secondary analysis used the data of 13,464 adults from the 4 th National Oral Health Epidemiological Survey (NOHES) in China was undertook. The dental expenditure in the past year divided into out-of-pocket and health insurance payments was collected. Horizontal inequality index and Kakwani index were used to analyze the horizontal inequality and progressivity, respectively. Decomposition of concentration index was made to explore the associated socioeconomic determinants.
Results:
Mean dental expenditure per capita of Chinese adults was $20.55 (95% CI: 18.83,22.26) and for those who used dental service in the past year, the number was $100.95(95%CI: 93.22,108.68). More than 90% of the expenditure was out-of-pocket. Horizontal inequality indices and Kakwani indices were both negative and that indicated inequalities were in favor of the rich. The socioeconomic factors including income, urban or rural area and educational attainment were the main contributors to the inequality of dental expenditure.
Conclusion:
Dental expenditure for Chinese adults was not too much under a pretty low utilization. The payments of dental expenditure were regressive. People with the most oral health need didn’t meet appropriate dental services. Socioeconomic characteristic including household income, area and education was the main determinant while oral hygiene practice and oral health status were the main individual determinants for the inequality of dental expenditure.