bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and Predictors of Anxiety and Depressive Symptoms among Patients Diagnosed with Oral Cancer in China: A cross-sectional study
Authors: Yuan Lulu , Pan Bochen , Wang Weiren , Wang Lie , Zhang Xujie , Gao Yuqin 
Published: March 2020

Abstract
Background Anxiety and depression are common mental health related problems among patients with cancer. While many psychological variables have been proven to influence anxiety and depressive symptoms, the variables are not mutually exclusive and their integrated effects on patients with oral cancer are yet unknown. Objective To explore the prevalence of anxiety and depressive symptoms among patients with oral cancer, to find out key potentially predictive factors associated with anxiety and depressive symptoms, and to identify the sequence of their contributions. Method A cross-sectional study was carried out for Chinese patients with oral cancer between May 2016 and October 2017 in two Grade-A Tertiary Hospitals in Shenyang, China. 230 patients with oral cancer were interviewed with questionnaires on demographic variables, Zung Self-Rating Anxiety Scale (SAS), Center for Epidemiologic Studies Depression Scale (CES-D), Herth Hope Index (HHI), Social Impact Scale, Multidimensional Scale of Perceived Social Support (MSPSS), Revised Life Orientation Test (LOT-R), Perceived Stress Scale-10 (PSS-10), and General Perceived Self-efficacy Scale(GSE). Chi-square test, nonparametric test, t-test, Spearman test and logistic regression analyses were conducted where appropriate to explore predictive factors of anxiety symptoms and depressive symptoms. Results The prevalence of anxiety symptoms and depressive symptoms in the sample population was 36.96% (85/230) and 65.21% (150/230), respectively. Age (β=0.047, OR=1.049, CI:1.013~1.086), gender (β=1.146, OR=3.147, CI:1.196~8.278), social isolation dimension of stigma (β=0.546, OR=1.726, CI:1.318~2.260), optimism (β=-0.310, OR=0.734, CI:0.594~0.906), and perceived stress (β=0.239, OR=1.270, CI:1.105~1.459) were predictors of anxiety symptoms. Marriage (β=1.158, OR=4.749, CI:1.301~17.330), positive readiness and expectancy dimension of hope (β=-0.476, OR=0.621, CI:0.401~0.961), social isolation dimension of stigma (β=0.329, OR=1.390, CI:1.060~1.823) and perceived stress (β=0.263, OR=1.300, CI:1.138~1.501) were predictors of depressive symptoms among oral cancer patients. Conclusion The prevalence of depressive symptoms was higher than anxiety symptoms among oral cancer patients in China. In addition to higher level of perceived stress and social isolation leading to anxiety and depressive symptoms, lower level of optimism not hope might lead to anxiety symptoms and lower level of hope, especially lower level of active action, might lead to depressive symptoms in oral cancer patients.
Treatment patterns and survival outcomes in advanced hypopharyngeal squamous cell carcinoma
Authors: Tsai Yao-Te , Chen Wen-Cheng , Chien Chih-Yen , Hsu Cheng-Ming , Lee Yi-Chan , Tsai Ming-Shao , Lin Meng-Hung , Lai Chia-Hsuan , Chang Kai-Ping 
Published: March 2020

Abstract
Background This study aimed to evaluate the treatment outcomes of the primary surgery (PS) or concurrent chemoradiotherapy (CCRT) as the initial treatment of hypopharyngeal squamous cell carcinoma (HPSCC). Methods A retrospective cohort study of HPSCC patients with stage III-IV HPSCC in four tertiary referral centers consecutively enrolled from 2003 to 2012, total of 213 (32.6%) patients received PS, and 439 (67.4%) patients received CCRT as their primary treatment. Overall survival (OS) and disease-free survival (DFS) were analyzed by Kaplan-Meier method and Cox regression models. Results The 5-year OS and DFS for patients undergoing PS and CCRT were 45.0% vs 33.1% and 36.2% vs 28.9% ( p < 0.001 and 0.003, respectively). In subgroup analysis, PS was associated with better OS in patients with stage IVA of the disease ( p = 0.002), specifically in those with T4 or N2 classification ( p = 0.021 and 0.002, respectively). Multivariate analysis indicated that stages IVA and IVB and CCRT were independent adverse prognostic factors for OS ( p = 0.004, <0.001, and 0.014, respectively). Furthermore, CCRT was also significantly associated with lower OS rates than PS in stage IVA patients more than 65 years of age and with N2 classification ( p = 0.027 and 0.010, respectively). Conclusions In patients with advanced HPSCC, PS was significantly associated with better prognosis and should be considered a favorable primary treatment in patients with stage IVA of the disease, especially if they are over 65 years of age or have T4 and N2 classification.
Clinical significance of peripheral blood-derived inflammation markers in advanced gastric cancer after radical resection
Authors: Gu Lihu , Chen Bangsheng , Zheng Dingcheng , Mo Jiahang , Yuan Lingling , Mao Feiyan , Zhang Kang , Ng Derry Minyao , Chen Ping , Wang Dongjie 
Published: March 2020

Abstract
Background and objective

The prognostic significance of peripheral blood-derived inflammation markers in patients with gastric cancer (GC) has not been elucidated. This study aimed to investigate the relationship between systemic inflammatory markers and GC prognosis.

Methods

A prospective observational cohort study involving 598 patients was conducted to analyze the prognosis of GC based on systemic inflammatory markers. The following peripheral blood-derived inflammation markers were evaluated: the neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), systemic immune-inflammation index (SII), C-reactive protein/albumin (CRP/Alb) ratio, Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), prognostic nutrition index (PNI), and prognostic index (PI). The receiver operating characteristics (ROC) curve and the Youden index were used to determine the optimal cutoff values. Univariate and multivariate analysis of prognostic factors was conducted accordingly.

Results

The optimal cutoff values of the PNI, fibrinogen, NLR, PLR, SII, and CRP/Alb were 49.5, 397ng/dl, 2.5, 154, 556, and 0.05, respectively. Multivariate analysis showed that age, PLR, TNM stage, and chemotherapy were the independent prognostic factors for advanced gastric cancer (AGC). Adjuvant chemotherapy improved the long-term prognosis of patients with PLR ≥154, but chemotherapy had no significant effect on the survival of patients with PLR <154.

Conclusions

Our findings show that higher PLR (≥154) is an independent risk factor for poor prognosis in GC patients. Besides, PLR can predict adjuvant chemotherapy (oxaliplatin/5-fluorouracil combination) response in patients with GC after surgery.
Switching fractioned R-CHOP cycles to standard R-CHOP cycles guided by endoscopic ultrasonography in treating patients with primary gastric diffuse large B-cell lymphoma
Authors: Liu Yi-Zhen , Liu Yu-Mei , Zhao Ping , Zhang Qunling , Liu Xiaojian , Lv Fangfang , Hong Xiaonan , Cao Junning , Xue Kai 
Published: March 2020

Abstract
Background: Primary gastric diffuse large B-cell lymphoma (PG-DLBCL) is a common subtype of extranodal non-Hodgkin lymphoma, with R-CHOP as the commonly used treatment regimen. However, full cycles of standard R-CHOP (Rituximab d1, 100% dose of CHOP d2) has the risk of severe bleeding or perforation, even leads to emergency surgery especially for those with deep lesions in their first 1-2 cycles of treatment. Full cycles of fractioned R-CHOP (Rituximab d1, 50% dose of CHOP d2 and d5) increases the safety of treatment but has the risk of resistance to the treatment. This study aims to explore the safety and efficacy of early fractioned R-CHOP cycles followed by standard R-CHOP cycles in patients with PG-DLBCL guided by endoscopic ultrasonography (EUS).Methods: Thirty-one PG-DLBCL patients treated in Shanghai Cancer Center from October 2011 to October 2018 were analyzed in this retrospective study. All patients had lesions infiltrated to at least 3rd layer of stomach (5 layers totally) under EUS at baseline, and received EUS after every 2 cycles’ treatment. Patients switched to standard R-CHOP if they showed the reduced infiltrated layers and restricted lesions after fractioned R-CHOP cycles. Fecal occult blood test and enhanced abdominal CT scan were also referred.Results: 77.4% (24/31) patients successfully switched after two treatment cycles. The ORR, 5-year PFS and OS were 93.5%, 75% and 84%, respectively. No treatment delay or dosage reduction from gastric adverse event was observed. More importantly, none of patients in our study suffered from severe bleeding or perforation during the treatment. Kaplan-Meier analysis showed that PG-DLBCL patients characterized multiple localization (sites >1), large size (≥3cm), having B symptoms, lower serum albumin (ALB) level (≤ 35g/L), and elevated LDH level (>250U/L) associated with worse PFS and OS.Conclusions: Our data indicate that it might be an effective approach in treating deeply infiltrated PG-DLBCL patients by switching fractioned R-CHOP cycles to standard R-CHOP cycles guided by EUS. Further prospective study about the approach is needed to confirm the conclusion.
Long noncoding RNA NEAT1 aggravates osteosarcoma carcinogenesis via regulating the microRNA-579/MMP13 axis
Authors: Wang Lili , Zhou Jingzhen , Zhang Yong , Hu Tao , Sun Yongning 
Published: March 2020

Abstract
Background: Previous studies have suggested that long non-coding RNAs (lncRNAs) were involved in tumorigenesis in various human carcinomas, including osteosarcoma (OS). However, the expression and specific role of lncRNA NEAT1 in OS remain unknown. The current study aimed at revealing the role of lncRNA NEAT1 and its related mechanism in OS.Methods: Expression profiles of lncRNAs in OS tissues were constructed, and lncRNA NEAT1 expression was verified with RT-qPCR followed by sub-localization. LncRNA-microRNA (miRNA) and miRNA-mRNA interactions were predicted. Validation was performed using dual luciferase reporter gene assay, and gain- and loss-of-function experiments. The effects of lncRNA NEAT1, miR-579 and MMP13 on the proliferation, migration and invasion, epithelial-mesenchymal transition (EMT) of OS cells were detected using colony formation, cell counting kit-8 (CCK-8), Transwell assays and Western blot analysis.Results: LncRNA NEAT1 overexpression was observed in OS tissues and cell lines which located in the cytoplasm. Transfection-induced downregulation of lncRNA NEAT1/MMP13 or overexpression of miR-579 blocked the progression of OS cells. LncRNA NEAT1 promotes MMP13 through sponging miR-579.Conclusion: LncRNA NEAT1 might be beneficial for OS aggravation via sponging miR-579 and facilitating MMP13 expression, which represents a candidate marker and target for OS therapy.
Risk factors for common peroneal nerve injury in knee dislocation: a retrospective study
Authors: Tan Lei , wang junfeng , liu xinguang , xin xing , wang xiaohua , yang bin , xing zhili , zhang ke , liu chen 
Published: March 2020

Abstract
Background Knee dislocation is a serious injury, representing less than 0.2% of all orthopedic injuries, and 16% to 40% of these patients suffer an associated injury to the common peroneal nerve (CPN). However, it is still unclear which structures are most intently associated with CPN injury. This study attempts to analyze the potential risk factors for CPN injury and provide clues for a comprehensive diagnosis of knee dislocation. Methods We retrospectively reviewed 153 cases of knee dislocation related to lateral and/or posterior ligament injury between 2015 and 2018. All 153 patients were divided into the CPN injury group or the no-CPN injury group. The baseline characteristics included age, gender, cause of injury, posterior cruciate ligament (PCL) disruption, anterior cruciate ligament (ACL) disruption, popliteofibular ligament and/or tendon of popliteus injury, biceps femoris tendon injury and fibular head fracture. We identified potential variables for a multivariable logistic regression model to identify the major risk factors for CPN injury. Results Multivariate regression analysis revealed the biceps femoris tendon injury and fibular head fracture to be predictive of CPN injury in knee dislocation. Gender, age, cause of injury, ligamentous classification, popliteofibular ligament and/or tendon of popliteus injury, PCL disruption or ACL disruption do not predict CPN injury. Conclusions Biceps femoris tendon injury and fibular head fracture are risk factors of CPN injury in knee dislocation. A better understanding of the risk factors for CPN injury allows surgeons to achieve more accurate diagnoses.
Validating and Updating GRASP: An Evidence-Based Framework for Grading and Assessment of Clinical Predictive Tools
Authors: Khalifa Mohamed , Magrabi Farah , Gallego Blanca 
Published: March 2020

Abstract
Background: When selecting predictive tools, clinicians are challenged with an overwhelming and ever-growing number, most of which have never been implemented or evaluated for comparative effectiveness. To overcome this challenge, the authors developed an evidence-based framework for grading and assessment of predictive tools (GRASP). The objective of this study is to update GRASP and evaluate its reliability. Methods: An online survey was developed to collect responses of a wide international group of experts, who published studies on developing, implementing or evaluating clinical decision support tools. The interrater reliability of the framework, to assign grades to eight predictive tools by two independent users, was evaluated. Results: Among 882 invited experts, 81 provided valid responses. On a five-points Likert scale, experts overall strongly agreed to GRASP evaluation criteria (4.35). Experts strongly agreed to six criteria: predictive performance (4.87) and predictive performance levels (4.44), usability (4.68) and potential effect (4.61), post-implementation impact (4.78) and evidence direction (4.26). Experts somewhat agreed to one criterion: post-implementation impact levels (4.16). Experts were neutral about one criterion; usability is higher than potential effect (2.97). Sixty-four respondents provided recommendations to open-ended questions regarding adding, removing or changing evaluation criteria. Forty-three respondents suggested the potential effect should be higher than the usability. Experts highlighted the importance of reporting quality of studies and strength of evidence supporting grades assigned to predictive tools. Accordingly, GRASP concept and its detailed report were updated. The updated framework’s interrater reliability, to produce accurate and consistent results by two independent users, was tested and found to be initially reliable. Conclusion: The GRASP framework grades predictive tools based on critical appraisal of published evidence across three dimensions: phase of evaluation, level of evidence, and direction of evidence. The final grade of a tool is based on the highest phase of evaluation, supported by the highest level of positive evidence, or mixed evidence that supports positive conclusion. GRASP aims to provide clinicians with a high-level, evidence-based, and comprehensive, yet simple and feasible, approach to evaluate predictive tools, considering their predictive performance before implementation, usability and potential effect during planning for implementation, and post-implementation impact on healthcare outcomes.
The Study of the Association between Immune Monitoring and Pneumonia in Kidney Transplant Recipients Through Machine Learning Models
Authors: Peng Bo , Gong Hang , Tian Han , Zhuang Quan , Li Junhui , Cheng Ke , Ming Yingzi 
Published: March 2020

Abstract
Background Kidney transplantation is the optimal treatment to cure the patients with end-stage renal disease (ESRD). However, the infectious complication, especially pneumonia, is the main cause of mortality in the early stage. Immune monitoring by relevant biomarkers provides direct evidence of immune status. We aimed to study the association between immune monitoring and pneumonia in kidney transplant patients through machine learning models. Methods A total of 146 patients receiving the immune monitoring panel in our center, including 46 pneumonia recipients and 100 stable recipients, were retrospectively reviewed. The immune monitoring panel consisted of the percentages and absolute cell counts of CD3 + CD4 + T cells, CD3 + CD8 + T cells, CD19 + B cells and natural killer (NK) cells, and median fluorescence intensity (MFI) of human leukocyte antigen (HLA)-DR on monocytes and CD64 on neutrophils. The machine learning models of support vector machine (SVM), logistic regression (LR), multi-layer perceptron (MLP) and random forest (RF) were applied for analysis. Results The pneumonia and stable groups showed significant difference in cell counts of each subpopulation and MFI of monocyte HLA-DR and neutrophil CD64. The SVM model by monocyte HLA-DR (MFI), neutrophil CD64 (MFI), CD8 + T cells (cells/μl), NK cells (cell/μl) and TBNK (T cells, B cells and NK cells, cells/μl) had the best performance with the average area under the curve (AUC) of 0.940. The RF model was developed to predict the patients who would progress into severe pneumonia, with the average AUC of 0.760. Conclusions The immune monitoring panel was tightly associated with pneumonia in kidney transplant recipients. The models developed by machine learning techniques identified patients at risk and predicted the prognosis. Based on the results of immune monitoring, better individualized therapy might be achieved.
Echocardiography diagnosis of pregnancy with aortic dissection: a case report
Authors: Wang Jing , Wang Anlong , Zhang Jian , Hou Chunjie 
Published: March 2020

Abstract
Background: We report a case of 34 weeks + gestation with aortic dissection to explore the diagnosis and treatment of this type of pregnant woman and to reduce maternal mortality. Case presentation: This report describes the clinical manifestations of a case of late pregnancy with acute aortic dissection (Stanford A Type). Echocardiography was used to detect the location of the rupture, the extent of exfoliation, the true and false lumen, the presence or absence of thrombus in the false lumen, the degree of aortic regurgitation, etc. After the diagnosis, the patients received surgical treatment as soon as possible. The detection rate and type diagnosis accuracy of ultrasonography for pregnancy complicated with aortic dissection are reliable. The location of the intimal rupture by ultrasound was consistent with the intraoperative findings, and there were no recent complications in the mother and newborn. Conclusion: The third trimester of pregnancy with aortic dissection is dangerous. As a simple, safe and non-invasive method, echocardiography has high clinical value in the diagnosis of pregnant patients with aortic dissection.
Time Trend of Mediastinal Lymph Node Dissection in Stage IA Non-Small Cell Lung Cancer Patient Who Undergo Lobectomy: a Retrospective Study of Surveillance, Epidemiology, and End Results (SEER) database
Authors: Pan Liang , Mo Ran , Zhu Lin hai , Yu Wen feng , Lv Wang , Hu Jian 
Published: March 2020

Abstract
Background: Although lobectomy with mediastinal lymph node dissection (MLND) is the first option for early-stage non-small cell lung cancer (NSCLC) patients, the time trends of MLND in stage IA NSCLC patients who undergo a lobectomy are not clear still.Methods: We included stage IA NSCLC patients who underwent lobectomy or lobectomy with MLND between 2003 and 2013 in the SEER database. The time trend of MLND was compared among patients who underwent a lobectomy.Results: For stage T1a patients, the lobectomy group and lobectomy with MLND group had no differences in postoperative overall survival (OS) (P=0.34) or lung-cancer specific survival (LCSS) (P=0.18) between 2003 and 2013. For stage T1b patients, the OS (P=0.01) and LCSS (P=0.01) were different between the lobectomy group and the lobectomy with MLND group in the period from 2003 to 2009; however, only OS (P=0.04), not LCSS (P=0.14), was different between the lobectomy group and the lobectomy with MLND group between 2009 and 2013. For T1c patients, the OS (P=0.01) and LCSS (P=0.02) were different between the two groups between 2003 and 2009 but not between 2009 and 2013 (P=0.60; P=0.39). From the Cox regression analysis, we found that the factors affecting OS/LCSS in T1b and T1c patients were age, sex, year of diagnosis, histology, and grade, in which year of diagnosis was the obvious factor (HR=0.79, CI=0.71-0.87; HR=0.73, CI=0.64-0.84).Conclusions: There was a time trend in prognosis differences between the lobectomy group and lobectomy with MLND group for T1b and T1c stage NSCLC patients.
Key factors influencing motivation among health extension workers and health care professionals in four regions of Ethiopia: a cross-sectional study
Authors: Adillo Mehiret Abate , Mulissa Zewdie , Desta Befikadu Bitewulign , Alemayehu Abiyou Kiflie , Kefale Abera Biadgo , Keraga Dorka woldesenbet , Gebreselassie Haregeweyni Alemu , Ahmed Yakob Seman , Estifanos Abiy Seifu , Magge Hema , Parry Gareth , Quaife Matthew 
Published: March 2020

Abstract
Background: Although Ethiopia has improved access to health care in recent years, quality of care remains low. Health worker motivation is an important determinant of performance and affects quality of care. This study explores the level and construction of motivation among health extension workers (HEWs) and health care professionals in Ethiopia in baseline data collection of an evaluation of a quality improvement program run by the Institute of Healthcare Improvement (IHI). Methods: We conducted face to face quantitative surveys with providers to elicit motivation level and construction. We sampled 401 health system workers: skilled providers including nurses and midwives (n=110), HEWs (n=210), and non-patient facing health system staff (n=81). Participants completed a 30-item Likert scale ranking tool which asked questions across 17 domains. We used exploratory factor analysis to explore motivation construction, and ordinary least squares (OLS) regression to explore determinants of motivation level and construction. Results: Of the 397 interviewees with complete data, 61% (95% CI 56%-66%) self-reported motivation as “very good” or “excellent”. Significant variation in motivation was seen across regions with Southern Nations Nationalities and People’s Region (SNNPR) being significantly lower score on the Likert scale by 0.35 points (P=0.003). Those who had a medium workload were significantly less motivated compared to participants with a light workload by 0.48 Likert points (P=0.024). The exploratory factor analysis identified a three-factor model to best fit with factors described as: personal and altruistic goals; pride and personal satisfaction; and recognition and support. Personal and altruistic goals varied across regions with Oromia and SNNPR being significantly lower by 0.13 (P=0.018) and 0.12 Likert points (P=0.039) respectively. A regression analysis found that as job satisfaction increased by 1 personal and altruistic goal, increased by 0.34 (P=0.001). Pride and personal satisfaction scores vary among regions with SNNPR being significantly lower by 0.11 Likert points (P=0.051) as compared to Amhara region. Recognition support was significantly higher in health care providers relative to HEWs by 0.12 Likert point (P=0.053). Conclusions: Overall, motivation was high among participants and varied across region, cadre, and age. Workload, leave, and job satisfaction were associated factors with motivation.