bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk of asthma in children treated with paracetamol versus ibuprofen: A systematic review and meta-analysis of randomised controlled trials
Authors: Sherbash Mohamed , Furuya-Kanamori Luis , Nader Joanne Daghfal , Thalib Lukman 
Published: January 2020

AbstractBackground: Paracetamol and ibuprofen are the most commonly used medications for fever and pain management in children. While the efficacy appears similar with both drugs, there are contradictory findings related to adverse events. In particular, incidence of asthma among children taking paracetamol compared to ibuprofen, remain unsettled. Methods: We conducted a meta-analysis of randomized controlled trials (RCTs) that compared asthma in children taking paracetamol versus ibuprofen. A comprehensive search was conducted in five databases. RCTs reporting on cases of asthma in infants or children after the administration of paracetamol or ibuprofen were included. The pooled effect size was estimated using the Peto’s odds ratio. Results: Five RCTs with 85095 children were included in the analysis. The pooled estimate (29OR 1.05; 95%CI 0.76-1.46) revealed no difference in the odds of developing asthma or presenting an exacerbation of asthma in children who received paracetamol compared to ibuprofen. When the analysis was restricted to RCTs that examined the incidence of asthma, the pooled estimate remained similar ( OR 1.01; 95%CI 0.63-1.64). Additional bias adjusted quality effect sensitivity model yielded similar results (RR 1.03; 95%CI 0.84-1.28). Conclusion: Although, Ibuprofen and paracetamol appear to have similar tolerance and safety profiles in terms of incidence of asthma in children, we suggest high quality trials with clear definition of asthma outcomes after receiving ibuprofen or paracetamol at varying doses with longer follow-up are warranted for any conclusive finding
Analysis of serum CircRNA in related to gastric cancer
Authors: Chen Gang , Su Yun , Gong HONG-XIA , Li Ling , Zhang Zhi-Yi , Wang Feng-Mei , Nie Peng , Ma Guo-Gang , Wang Xin-Hua , Li Chun-Bo , Xue Xuan , Li Ting-Ting , Liu Yong-Qi 
Published: January 2020

Abstract
Gastric cancer is one of the most common malignant tumors of the digestive tract and one of the leading causes of death in patients with malignant tumors worldwide. In recent years, with the deepening of circRNA research, more and more evidence indicates that circRNA plays an important role in the occurrence and development of human malignant tumors. This study firstly conducted a retrospective analysis of the case data of gastric cancer patients who were treated at the Wuwei Cancer Hospital between 2015 and 2017. Subsequently, 18 cases of primary gastric cancer patients and 9 healthy people in Wuwei, Gansu Province were used as controls. The high-throughput microarray technology was used to screen the circRNA expression profiles of healthy and gastric cancer patients, and the expression was expressed by bioinformatics methods. Differential circRNA was used for gene ontology (GO) and KEGG pathway analysis, using its enrichment to predict the relevant biological functions of the differentially expressed circRNA and its involved pathways, and predicting miRNAs interacting with differentially expressed circRNAs, and constructing circRNA-miRNA interaction network. Q-PCR, gene organization microarray and bioinformatics techniques were used to validate candidate differential circRNAs and their linear parental genes and regulatable miRNAs. The results showed that there were 137 circRNAs with significant expression differences (including up-regulation of 67 and down-regulation of 70) in gastric cancer patients, and their differential expression may be related to the occurrence and development of gastric cancer; by GO, KEGG enrichment analysis and Regulating miRNA predictive analysis, the gastric cancer-related GO classification, KEGG Pathway and circRNA-miRNA network were preliminarily obtained, suggesting that differential circRNA may participate in gastric cancer-associated GO classification and KEGG pathway by regulating the expression of parental genes and miRNAs to influence the occurrence and development of gastric cancer. Finally, by using has verified the has_circ_0000437 and its parental genes and regulatable miRNAs, it was found that has_circ_0000437 is highly expressed in gastric cancer patients, and has a certain diagnostic value for the clinical diagnosis of gastric cancer. It may regulate its linear parental gene and The expression of miRNAs affects the development, metastasis and prognosis of clinical gastric cancer.
Necessity of prophylactic splenic hilum lymph node clearance for middle and upper third gastric cancer: a network meta-analysis
Authors: Zheng Gaozan , Liu Jinqiang , Guo Yinghao , Wang Fei , Liu Shushang , Xu Guanghui , Guo Man , Lian Xiao , Zhang Hongwei , Feng Fan 
Published: January 2020

AbstractBackground It remains controversial whether prophylactic No.10 lymph node clearance is necessary for gastric cancer. Thus, the present study aims to investigate the impact of prophylactic No.10 lymph node clearance on the perioperative complications and prognosis of upper and middle third gastric cancer. Methods A network meta-analysis to identify both direct and indirect evidence with respect to the comparison of gastrectomy alone (G-A), gastrectomy combination with splenectomy (G+S) and gastrectomy combination with spleen-preserving splenic hilar dissection (G+SPSHD) was conducted. We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for studies published before September 2018. Perioperative complications and overall survival were analyzed. Hazard ratios (HR) were extracted from the publications on the basis of reported values or were extracted from survival curves by established methods. Results Ten retrospective studies involving 2565 patients were included. In the direct comparison analyses, G-A showed comparable 5-year overall survival rate (HR: 1.1, 95%CI: 0.97-1.3) but lower total complication rate (OR: 0.37, 95%CI: 0.17-0.77) compared with G+S. Similarly, the 5-year overall survival rate between G+SPSHD and G+S was comparable (HR: 1.1, 95%CI: 0.92-1.4), while the total complication rate of G+SPSHD was lower than that of G+S (OR: 0.50, 95%CI: 0.28-0.88). In the indirect comparison analyses, both the 5-year overall survival rate (HR: 1.0, 95%CI: 0.78-1.3) and total complication rate (OR: 0.75, 95%CI: 0.29-1.9) were comparable between G-A and G+SPSHD. Conclusion Prophylactic No.10 lymph node clearance was not recommended for treatment of upper and middle third gastric cancer.
If you can’t make it, you're not tough enough to do medicine’: A qualitative study of Sydney-based medical students’ experiences of bullying and harassment in clinical settings
Authors: Colenbrander Laura , Causer Louise , Haire Bridget 
Published: January 2020

Abstract
Background : Media exposés and academic literature reveal high rates of bullying and harassment of medical students, most commonly by consultant physicians and/or surgeons. Recent reports reveal the medical profession to be characterised by hierarchy, with verbal abuse a ‘rite of passage’, as well as sexist and racist behaviours.
Methods : Semi-structured in-depth interviews were conducted with ten current or recently graduated medical students from Sydney-based medical schools. Interviews were audio-recorded, transcribed verbatim, and thematically analysed.

Results : Hierarchy, and a culture of self-sacrifice, resilience and deference, were identified as problematic elements of the medical profession. In the minds of participants, these factors created barriers to reporting mistreatment, as participants felt reporting led to being labelled a ‘troublemaker’, affecting career progression. Additionally, participants stated that avenues of recourse were unclear and did not guarantee confidentiality or desired outcomes.
Conclusions : Mistreatment is continuing in clinical teaching and has negative consequences on medical students’ mental health and learning. Structural change is needed to combat institutionalised mistreatment to ensure the wellbeing of future doctors and high quality patient care.
Investigating Psychometric Properties of the Thai Version of the Zarit Burden Interview using Rasch Model and Confirmatory Factor Analysis
Authors: Pinyopornpanish Kanokporn , Pinyopornpanish Manee , Wongpakaran Nahathai , Wongpakaran Tinakon , Soontornpun Atiwat , Kuntawong Pimolpun 
Published: January 2020

Abstract
Objective: The Zarit Burden Interview (ZBI) has been widely used to assess caregiver burden. Few research papers have investigated the Thai version of the ZBI. The study aimed to examine the psychometric properties of the Thai version of both the full length (ZBI-22) and short versions (ZBI-12) using Rasch analysis and confirmatory factor analysis among a sample of Alzheimer’s disease caregivers. Results: The ZBI-22 fitted the Rasch measurement model regarding unidimensionality but not for ZBI-12. Five items from ZBI-22, and 2 items from ZBI-12 were shown to be misfitting items. Half of ZBI items were shown to be disordered category or threshold, and were locally dependent. CFA revealed three-factor and four-factor fitted the data the best for ZBI-22 and ZBI-12, respectively. Reliability was good for both forms of the ZBI (a = 0.86 - 0.92). Significant correlations were found with caregiver’s perceived stress, anxiety/depression, pain and mobility but not with self-care and usual activity ( p >0.05), indicating convergent and discriminant validity. To conclude, the Thai version ZBI-22, but not ZBI-12, supported the reliability and unidimensional scale among Alzheimer’s disease caregivers. Some misfitting items of the ZBI undermined the unidimensionality of the scale, and need revision.
Vitamin D status among postmenopausal osteoporotic women: a hospital based cross-sectional study from Northern Sri Lanka.
Authors: Suganthan Navaneethakrishnan , Kumanan Thirunavukarasu , Kesavan Vithegi , Aravinthan Mahalingam , Rajeshkannan Nadarajah 
Published: January 2020

Abstract
Background Vitamin D deficiency is common among post-menopausal women and it is important to treat vitamin D deficiency to prevent falls and fractures in patients with osteoporosis. Few studies examined the prevalence of vitamin D deficiency in general population of Sri Lanka but no studies to date done among post-menopausal women with osteoporosis. This is the first study of such kind conducted to evaluate the serum vitamin D levels and factors related to Vitamin D deficiency among postmenopausal women.Methodology Hospital based Cross -sectional study was conducted at the Endocrine Unit, Teaching Hospital from January to December 2018.During the study period 105 postmenopausal women registered for DEXA scan with Endocrine Unit were recruited to the study. Data collection was done by investigators and blood sample was taken from each participant by registered nursing officers and sample was analysed by using immunohistochemistry assays. Serum Vitamin D levels were categorized and data analysis was done using SPSS 26.Results Mean age of 105 postmenopausal women was 67.7 with minimum 33 and maximum 84 years. Mean Vitamin D levels were 27.5(range11.7-52.5ng/ml). Vitamin D levels were adequate in only 36.2% (95%CI: 27.4-45.7) of women, 44% had insufficient levels and deficiency was present in 19% (95%CI: 12.4-27.4) of participants. Among the 105 women 20% were vegetarian and 53% of them consuming milk on average 3 days per week, 76.2% consuming fish on average 2 days per week, 64.8% consuming egg on average 1 day per week. Furthermore seventy five participants (71.4%) reported adequate level of sun exposure (>30minutes).Commonly reported vitamin deficiency symptoms includes paraesthesia (57.1%),bone pain (55.2%), easy fatigability (54.3%), malaise (51.4%), muscle cramps (43.8%) and proximal myopathy (40.0%).Among 71(66.7%) completed bone density assessment,38% (27.3-49.7) of them showed osteoporosis range. Vertebral Z score showed a significant correlation with vitamin D level(r-0.252, P-0.034).Conclusion Prevalence of vitamin D deficiency is relatively high among the post-menopausal women with a provisional diagnosis of osteoporosis. It is essential to correct vitamin D deficiency with supplementation when initiating treatment for osteoporosis. So vitamin D testing is desirable in decision making to treat or not to treat.
Association between convenience stores near schools and obesity among school-aged children in Beijing, China
Authors: Zhou Shuang , Cheng Yu , Cheng Lan , Wang Di , Li Qin , Liu Zheng , Wang Haijun 
Published: January 2020

Abstract
Background: Food environments have rapidly changed over the past years in China and children have more access to unhealthy food in convenience stores near schools. Since the studies on the association between convenience stores near schools and obesity had inconsistent results and no similar study in China, we conducted a study on the association in Beijing of China, which will provide scientific evidence for the intervention of childhood obesity. Methods: The study included 2201 students at grade 4 of 37 primary schools in Dongcheng or Miyun district of Beijing. The food environment data was acquired from AMAP, the free web-based geospatial service provider. The numbers of convenience stores were captured within the 800-meter network buffer near schools using Geographic Information System. The weight and height of each student were measured by trained health professionals. Students’ dietary and physical behaviors and other information associated with obesity were collected with questionnaires for students and their parents. The generalized linear mixed model (GLMM) was used to analyze the data. Results: The average age of the students was 10.2 years (SD=0.33). The prevalence of obesity in students was 14.9%. The median number of convenience stores within the 800-meter network buffer near schools was 24 in two districts. The number of convenience stores near each school varied from 5 to 67 (median: 25) in Dongcheng district and from 1 to 57 (median: 22) in Miyun district. After adjusting for the confounding factors at the family and individual levels, the association between convenience stores and childhood obesity was statistically significant. Additional ten convenience stores near schools were associated with an increased risk of obesity (Odds Ratio (OR)=1.13, 95% confidence interval (CI): 1.03,1.24, P=0.011). Compared with less than 24 convenience stores near schools, the students with more than or equal to 24 convenience stores near schools had an increased risk of obesity (OR=1.49, 95%CI: 1.09, 2.03, P=0.013). Conclusion: The students with more convenience stores near their schools had an increased risk of obesity. The findings provided evidence for developing public health policy to restrict the number of convenience stores near schools to prevent and control childhood obesity.
Effect of acupuncture and its influence on cerebral activity in patients with persist asthma: study protocol for a randomized controlled clinical trial
Authors: Yu Siyi , Dong Xiaohui , Sun Ruirui , He Zhaoxuan , Zhang Chuantao , Chen Mei , Hong Xiaojuan , Lan Lei , Zeng Fang 
Published: January 2020

Abstract
Background Previous studies suggested that acupuncture was a promising adjunct treatment for asthma. However, the underlying mechanism of acupuncture for asthma remains unclear. The present trail aimed to explore whether and how specific meridian acupuncture works in quality of life and symptomatic improvement by modulating brain function in asthma patients. Methods A randomized controlled functional brain imaging trial is currently being conducted in Sichuan, China. In total 48 patients with mild to moderate, persist asthma will be recruited randomly allocated to two acupuncture groups: acupuncturing at Lung Meridian and acupuncturing at Heart Meridian . The treatment period will last for 4 weeks. The Asthma quality of life questionnaire (AQLQ) is the primary outcome. Asthma control test (ACT), the rate of Peak expiratory flow (PEFR), Forced expiratory volume in 1 second (FEV1), Montreal cognitive assessment (MoCA), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) will also assess the clinical efficacy of different interventions. Functional magnetic resonance imaging (fMRI) scans will be performed to detect cerebral activity changes in each group. The clinical data and fMRI data will be analyzed, respectively. Pearson correlation analysis will be used to assess the association between the changes of cerebral activity features and the improvement of clinical outcomes in each group. DiscussionThe present study has been established on the “meridians-viscera relationship” theory of traditional Chinese medicine and modern central mechanism of acupuncture. The results of this trial would be useful to identify efficiency of the specific meridian acupuncture for asthma. The investigation of its central mechanism would further expand our knowledge of the acupuncture for asthma.
Development of a Core Outcome Set for Fetal MyelomenIngoCele (COSMiC): study protocol
Authors: Altoukhi Samar , Whitehead Clare L , Ryan Greg , Deprest Jan , Joyeux Luc , Gallagher Katie , Drake James , Church Paige , Horn Daphne , Diambomba Yenge , Carvalho Jose , Mieghem Tim Van 
Published: January 2020

Abstract
Background: Open spina bifida (OSB) is one of the most common congenital central nervous system defects and leads to long-term physical and cognitive disabilities. Open fetal surgery for OSB improves neurological outcomes and reduces the need for ventriculoperitoneal shunting, compared to postnatal surgery, at the expense of increased prematurity. It however confers significant morbidity to the mother in the index pregnancy and potential risks to future pregnancies. Fetoscopic surgery may prevent maternal morbidity yet the question remains whether the procedure is neuroprotective and reduces prematurity. Comparison of outcomes between different treatment options is challenging due to inconsistent outcome reporting. We aim to develop and disseminate a core outcome set (COS) for fetal OSB, to ensure that outcomes relevant to all stakeholders are collected and reported in a standardised fashion in future studies. Methods: The COS will be developed using a validated Delphi methodology. A systematic literature review will be performed to identify previously reported outcomes focused on prenatally diagnosed OSB. Outcomes assessed will include maternal (primary and subsequent pregnancies), fetal, neonatal and childhood to adolescence. In a second phase, semi-structured interviews with stakeholders will be performed to ensure representation of additional relevant outcomes that may not have been reported in the literature. We will include patients and parents, as well as health professionals involved in the care of these pregnancies and children (fetal medicine specialists, fetal surgeons, neonatologists/paediatricians, and allied health). Subsequently, an international group of key stakeholders will rate the importance of the identified outcomes using three sequential, online, rounds of a modified Delphi Survey. Final agreement on outcomes to be included in the COS, their definition and measurement will be achieved through a final face-to-face consensus meeting with all stakeholder groups represented. Dissemination of the final COS will be ensured through different media and relevant societies. Discussion: Development and implementation of a COS for fetal OSB will ensure consistent outcome reporting in future clinical trials, systematic reviews, and clinical practice guidelines. This will lead to higher quality research, better evidence-based clinical practice and ultimately improved maternal, fetal and long term childhood outcomes. Trial registration: Core Outcome Measures in Effectiveness Trials (COMET): 1187. International Prospective Register of Systematic Reviews (PROSPERO): CRD42018104880.
The prevalence of serious pathology in musculoskeletal physiotherapy patients – a nationwide register-based cohort study
Authors: Budtz Cecilie , Hansen Rikke Pilegaard , Thomsen Janus Nikolaj Laust , Christiansen David Høyrup 
Published: January 2020

Abstract
Background: Musculoskeletal conditions are the single largest contributor to years lived with disability worldwide. Most musculoskeletal conditions can be managed and treated in primary care, but for a small proportion of these patients the symptoms are caused by serious pathology. Although the general practitioner usually performs initial screening for serious pathology, evaluation and treatment by physiotherapists are often part of the treatment pathway. It is however unclear, how many patients in primary care physiotherapy have symptoms caused by a serious pathology. Historically the prevalence of serious pathology in primary care has been investigated in small populations with spine specific conditions, thus a more general prevalence in the group of patients with musculoskeletal conditions is yet to be estimated. Therefore, the aim of this study was to estimate the prevalence of neoplasm, cauda equina syndrome, spinal fracture, infection and inflammatory pathology among patients referred for musculoskeletal physiotherapy evaluation and treatment.Methods: The study was a prospective nationwide register-based cohort study. We identified all referrals for primary care musculoskeletal physiotherapy in the Danish National Health Insurance Service Register between 1 January 2014 and 31 December 2017. Records of hospital contacts were extracted from the Danish National Patient Register within 180 days from first physiotherapy contact, identifying all diagnoses of serious pathology. Period prevalence proportions with 95%CI of the serious pathology categories were estimated. Results: A total of 1,568,704 courses of treatment were included in the analysis. The overall prevalence of serious pathology was 2.30%.The prevalence of neoplasm was 2.11%, of which 1.13% was malignant neoplasms. The prevalence of cauda equina syndrome was 0.01%, fractures 0.13%, infections 0.01% and inflammatory pathology of the spine 0.06%. Higher prevalence's were observed among patients with a previous history of serious pathology, aged above 50 and more comorbidity. Conclusions: Although serious pathology among musculoskeletal physiotherapy patients is rare, the present study found an overall prevalence of serious pathology which exceeded the guideline endorsed prevalence estimates of serious pathology of 1%.
Prediction of response to Stereotactic Radiotherapy for Nonfunctioning Pituitary Adenoma using radiomic features
Authors: Jia Jian , Meng Lingwei , Song Guidong , Sun Shibin , Li Chuzhong , Tian Jie , Zhang Yazhuo 
Published: January 2020

Abstract
Background: For individually predicting preoperative response to Stereotactic radiotherapy for Nonfunctioning pituitary Adenoma with the use of a radiomics approach.Methods: 93 cases (training set: n = 62; test set: n = 31) were recruited with contrast-enhanced T1-weighted MRI (CE-T1) before stereotactic radiotherapy. All of these patients received another MRI scan to assess sensitivity of radiotherapy after 12 to 18 months. The shrinkage and no increase in tumor volume are regarded as sensitive to gamma knife radiotherapy. According to CE-T1 images, we extracted 1208 quantitative imaging features totally. Support vector machine (SVM) combined with recursive feature elimination (RFE) and grid-search trained a four-feature prediction mode verified with an assay of receiver operating characteristics (ROC) for an individual set of test. In addition, a ROC curves with individual feature and signature bar were constructed for prediction.Results: The cross-validation area under the curve (AUC) on the three-fold train set is 0.991,0.843 and 0.889. In terms of the test and training sets, T1-CE image features led to 0.897 and 0.914 AUC, separately. Conclusions: With the use of a radiomics method, the response to Stereotactic Radiotherapy for Nonfunctioning Pituitary Adenoma was primarily predicted before the operation. The built mode performed well, suggesting that radiomics is promising to preoperatively predict sensitivity to radiotherapy in NFPA.