bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Mixed Method Study to Explore the Feasibility and Patient Satisfaction of Two Different Exercise Programs in Systemic Sclerosis Associated Microstomia
Authors: Sydow Ellinor , Severi Sabien , Elst Kristien Van der , Verschueren Patrick , Westhovens René , Lenaerts Jan , Langhe Ellen De 
Published: November 2020

Abstract
BackgroundSystemic sclerosis (SSc) is a severe autoimmune disease often leading to fibrotic cutaneous involvement of the face. Reduced oral aperture is associated with impaired food intake, oral hygiene and secondary dental problems. Stretching and oral augmentation exercises can increase oral aperture but are often hampered by low adherence rates. The aim of this mixed method study was to explore feasibility, patient satisfaction and effectiveness of two exercise programs in SSc-associated microstomia.MethodsAdult patients (<18 years) suffering from systemic sclerosis (fulfilling the ACR/EULAR 2013 criteria) and microstomia (maximal oral aperture <40mm) were randomized to two groups. Group A exercised with a passive jaw motion device (Therabiteâ), and Group B performed mouth-stretching exercises. Patients were expected to exercise for 10 minutes, 3 times/day for 3 months, completed an exercise diary and were contacted 4 times by telephone. Patients were evaluated at baseline, 3 months (period without intervention), 6 months (after 3 months of intervention) and at 9 months (post-intervention visit). At month 6 semi-structured one‐to‐one interviews were conducted, recorded, transcribed verbatim and analyzed using Qualitative Analysis Guide of Leuven (QUAGOL).ResultsWe included 6 women and 3 men, median age 60 years (range 40-75) and median disease duration 8 years (range 3-22). At 6 months, all patients in group A (n=4) and 4 in group B (n=5) improved with a median of 9mm (range 2-10) and 7mm (range 4-11), respectively. The proportion of executed to the planned number of exercises ranged between 63.7% and 98,9% in group A and between 48.5% and 97,4% in group B. Maintenance of the increase in oral aperture was noted in patients that continued to exercise daily. All 9 patients attended the interview that revealed three themes: drivers, challenges and perceived improvement. ConclusionBoth interventions improve maximal oral aperture. The adherence to therapy was high but none of the patients considered it feasible to continue practicing 3 times/day. Future studies are needed in order to define feasible long-term exercise programs.
Nexus Between Tuberculosis and Diabetic Mellitus, A Prospective Cohort Study.
Authors: Feleke Berhanu Elfu , Feleke Teferi Elfu , Kassahun Melkamu Beyene , Adane Wondemu Gebrekirose , Genetu Abere , Gebeyehu Melesse , Woldie Kibrete , Tekleab Yohannes , Shumete Abebe , Hunegnaw Samuel , Taye Tesfaye , Biadegelegn Fantahune 
Published: November 2020

Abstract
Background: This work aimed to describe the clinical presentation of TB in patient with DM, to determine the effects of DM on TB treatment outcomes, to identify the effects of TB on glycemic control, and to describe the lipid profile of TB and DM patients. Methods: This prospective cohort study design was conducted. The data were collected from September 2018 to June 2020 using patient interviews, examining the patients, chart review, and collecting blood samples. Binary logistic regression was used to identify the determinants of TB treatment outcomes in the context of DM. Kaplan Meier survival curve was used to see the effects of DM on TB clinical response. Linear regression was used to identify the determinants of the HbA1c level during TB infection. Results: A total of 1092 study participants were included giving for the response rate at 93.81 %. Good TB treatment outcome was observed in 72.5 % of the patients [95 % CI: 69 % - 76 %]. The odds of good TB treatment outcomes were at 75 % lower in the presence of DM (AOR 0.25 [95 % CI: 0.08 – 0.73]). The median time of clinical response in TB and DM patients was 45 days interquartile range (IQR) of 8 days; the median time of clinical response in DM free TB patients was 9 days [IQR 2 days]. TB increased the HbA1c level of DM patients by 1.22 % (B 1.22 [95% CI: 1.11 – 1.34]). In six months period, 60 % of TB and DM patients had got 3 episodes of acute complications. Conclusion: DM significantly decreases the favorable treatment outcome of DOTS. TB predisposed DM patients for bad glycemic control and increased episodes of acute DM complications.
Optimal Application of Stereotactic Body Radiotherapy and Radiofrequency Ablation Treatment for Different Multifocal Hepatocellular Carcinoma Lesions in Patients With Barcelona Clinic Liver Cancer Stage A4–B1: A Pilot Study
Authors: Wang Feiqian , Numata Kazushi , Takeda Atsuya , Ogushi Katsuaki , Fukuda Hiroyuki , Nihonmatsu Hiromi , Hara Koji , Chuma Makoto , Tsurugai Yuichirou , Maeda Shin 
Published: November 2020

Abstract
BackgroundsIn clinical practice, many hepatocellular carcinoma (HCC) patients in Barcelona Clinical Liver Cancer (BCLC) stage A4–B1 can not receive curative treatment of liver transplantation, resection and RFA which were recommended options by liver cancer guidelines. Our aim is to study the feasibility of radiofrequency ablation (RFA) and stereotactic body radiotherapy (SBRT) as curative treatment for different multifocal HCCs in BLCL stage A4–B1 patients. MethodsFrom September 2014 to August 2019, 39 multifocal HCC lesions (median diameter, 16.6 mm) from 15 patients (median age, 73.2 years) were retrospectively enrolled. Among them, 23 were treated by RFA and the other 16 by SBRT because of predictable insufficiency and/or risk for RFA performance. The indicators for evaluating this novel therapy were tumor response, prognosis (recurrence and survivals), and adverse effect (deteriorated laboratory test values and severe complications). ResultsMedian follow-up duration was 31.3 months (range: 15.1–71.9 months). The numbers of one-year complete response, stable disease, and disease progression were 11, 1, and 3, respectively. In total, eight and two patients had confronted intrahepatic and local recurrence, respectively. The one-year progression-free survival rate and local control rate were 80% (12/15 patients) and 97.4% (38/39 lesions), respectively. Median time to progression was 20.1 (2.8–45.1) months. The one- and two-year survival rates were 100%, and 88.9%, respectively. During one week to 3–5 months’ observation, no patient showed severe complications. Seven, four, and two patients had slight changes in white blood cells, platelet count, and albumin–bilirubin grade, respectively. ConclusionsFor patients with BCLC stage A4–B1, RFA and SBRT treatment for different multifocal HCCs may be a potential option because of their favorable prognosis and safety. However, before setting assured application in clinical practice, prospective, controlled, large-scale studies are needed to further confirm our conclusions.
Symptom Relief is the Most Significant Prognostic Factor for Unresectable Locally Advanced/Recurrent Pancreatic Cancer Receiving Chemoradiotherapy: Analysis of 65 Cases
Authors: Jiang Ting , Shen Jingxian , Liu Shuang , Liu Qing , Xiao Weiwei , Zhang Yujing 
Published: November 2020

Abstract
BackgroundPancreatic cancer is the fourth leading cause of cancer-related death throughout the world. For local advanced and recurrent pancreatic cancer (LAPC/LRPC), chemoradiotherapy (CRT) is a main choice which may prolong their survival and ease patients’ symptoms.MethodsWe constructed a database of 65 patients with LAPC/LRPC treated from June, 2004 to February, 2018. We used log-rank test to evaluate the different overall survival (OS) rates of all factors involved, and used cox regression model to find out independent prognostic factors for these patients.ResultsThe median OS time for 65 eligible patients was 23.6 months. 47 (72.3%) and 18 (27.7%) patients had unresectable LAPC and LRPC, and median OS time was 17.2 and 40.7 months (P= 0.02), respectively. The mean biological effective dose (BED) to gross tumor volume (GTV) was 64.8Gy (46.7-85.5 Gy). 11(16.9%) and 54(83.1%) patients had BED> 72 Gy and BED≤ 72 Gy, and their mOS was 31.8 and 21.9 months (P= 0.08), respectively. Simultaneous dose boost to interval GTV (GTVin) was applied to 23 patients (35.4%). Patients with large GTV volume (≥ 109.2 cm3) may benefit from radiation dose boost (mOS: 27.6 vs. 5.3 months, P= 0.004). Patients with symptom relief including relief of pain, jaundice, and/or diarrhea had higher OS rates than those without response (mOS: 25.7 vs. 13.2 months, P< 0.01) and multivariate cox regression analysis suggested symptom relief was the most significant prognostic factor for OS (HR= 0.44, 95%CI 0.35-2.36, P= 0.02).ConclusionCRT with simultaneous integrated boost of radiation dose may bring survival benefit for LAPC/LRPC patients with bulk tumor. Symptom relief is the most significant prognostic factor for LAPC/LRPC patients after comprehensive CRT.
Outcome of Early Stage Merkel Carcinoma Treated by Exclusive Radiation: A Study of 53 Patients.
Authors: DUBOIS Manon , Rached Henry Abi , Escande Alexandre , Dezoteux Frédéric , Darloy Franck , Jouin Anaïs , Kyheng Maeva , Labreuche Julien , Dziwniel Veronique , Mirabel Xavier , Mortier Laurent 
Published: November 2020

Abstract
PurposeEarly stage Merkel cell carcinoma (MCC) is a rare and aggressive primary skin cancer. The standard of care for MCC is broad excision and adjuvant external beam radiation therapy (EBRT). However, for some patients, anesthesia is contraindicated, while others run the risk of serious aesthetic sequelae. In such cases, exclusive radiotherapy is an interesting alternative to surgery. Though limited data is available, this study evaluates exclusive radiotherapy for MCC, using data from the largest retrospective study to date. MethodsAll patients who were followed in our center between 1989 and 2019 for histologically proven early stage MCC were included in the study. They were treated either by surgery with a 2-cm clear margin followed by adjuvant radiotherapy (RT) or by exclusive RT. Survival rates with adjuvant and exclusive EBRT were analyzed using Cox model and Fine & Gray model depending on the type of survival. P-value < 0.05 was considered significant ResultsEighty-four patients treated for MCC were included. Fifty-three of them (63.1%) were treated by exclusive RT, and 31 (36.9%) had surgical excision followed by adjuvant RT. Local relapse rate was 13.7% (95%CI 8.0-43.7) in the RT monotherapy group (group A) and 25.8% (95%CI 10.3-56.2) in the surgery + RT group (group B) (p = 0.42). No statistical difference was found for nodal relapse (p = 0.81), metastatic relapse (p = 0.10), disease free survival (p = 0.83) or overall survival (p = 0.98). ConclusionOur study suggests that exclusive radiotherapy for early Merkel cell carcinoma leads to a similar oncological outcome as combined treatment, with fewer aesthetic sequelae. The approach is interesting for elderly patients with comorbidities or patients for whom surgery would cause significant functional or aesthetic sequelae.
Comparison of spatiotemporal characteristics of the COVID-19 and SARS outbreaks in mainland China
Authors: Zhang Xi , Rao Huaxiang , Wu Yuwan , Huang Yubei , Dai Hongji 
Published: November 2020

Abstract
Background: Both coronavirus disease 2019 (COVID-19) and severe acute respiratory syndrome (SARS) are caused by coronaviruses and have infected people in China and worldwide. We aimed to investigate whether COVID-19 and SARS exhibited similar spatial and temporal features at provincial level in mainland China.Methods: The number of people infected by COVID-19 and SARS were extracted from daily briefings on newly confirmed cases during the epidemics, as of Mar. 4, 2020 and Aug. 3, 2003, respectively. We depicted spatiotemporal patterns of the COVID-19 and SARS epidemics using spatial statistics such as Moran’s I and the local indicators of spatial association (LISA).Results: Compared to SARS, COVID-19 had a higher overall incidence. We identified 3 clusters (predominantly located in south-central China; the highest RR=135.08, 95% CI: 128.36-142.08) for COVID-19 and 4 clusters (mainly in Northern China; the highest RR=423.51, 95% CI: 240.96-722.32) for SARS. Fewer secondary clusters were identified after the "Wuhan lockdown". The LISA cluster map detected a significantly high-low (Hubei) and low-high spatial clustering (Anhui, Hunan, and Jiangxi, in Central China) for COVID-19. Two significant high-high (Beijing and Tianjin) and low-high (Hebei) clusters were detected for SARS.Conclusions: COVID-19 and SARS outbreaks exhibited distinct spatiotemporal clustering patterns at the provincial levels in mainland China, which may be attributable to changes in social and demographic factors, local government containment strategies or differences in transmission mechanisms.
Extensively drug-resistant Alcaligenes faecalis infection
Authors: Huang Chienhsiu 
Published: November 2020

Abstract
Background:Alcaligenes faecalis is usually causes opportunistic infections in humans. Alcaligenes faecalis infection is often difficult to treat due to its increased resistance to several antibiotics. The results from a clinical study of patients with Alcaligenes faecalis infection may help improve patients’ clinical care. Methods:We conducted a retrospective analysis of all patients presenting with Alcaligenes faecalis infection from January 2014 to December 2019. The medical records of all patients were reviewed for demographic information, clinical symptoms and signs, comorbidities, use of intravenous antibiotics within the past three months, bacterial culture, antibiotics sensitivity test, and clinical outcomes.Results:Sixty-one cases of Alcaligenes faecalis infection were seen during the study period, including 25 cases of cystitis, nine cases of diabetic foot infection, eight cases of pneumonia, seven cases of acute pyelonephritis, three cases of bacteremia, and nine cases of infection at specific sites. Thirty-seven patients (60.7%) had a history of receiving intravenous antibiotics within three months of the diagnosis. Fifty-one (83.6%) cases were mixed with other bacterial infections. Extensively drug-resistant infections have been reported since 2018. The best sensitivity rate to A. faecalis was 66.7% for three antibiotics (imipenem, meropenem, and ceftazidime) in 2019. Two antibiotics (ciprofloxacin and piperacillin/tazobactam) sensitivity rates to A. faecalis were less than 50%.Conclusions:The most frequent Alcaligenes faecalis infection sites, in order, are the bloodstream, urinary tract, skin and soft tissue, and middle ear. The susceptibility rate of Alcaligenes faecalis to commonly used antibiotics is decreasing. Extensively drug-resistant Alcaligenes faecalis infections have emerged.
Identifying research priorities for Health Professions Education Research in Sub-Saharan Africa using a modified Delphi method
Authors: Schalkwyk Susan C van , Kiguli-Malwadde Elsie , Budak Jehan Z , Reid Michael JA , De Villiers Marietjie Rene 
Published: November 2020

Abstract
Background: Recent increases in health professions education (HPE) research in sub-Saharan Africa (SSA), though substantial, have predominantly originated from single institutions and remained uncoordinated. A shared research agenda can guide the implementation of HPE practices to ultimately influence the recruitment and retention of the health workforce. Thus, the authors aimed to generate and prioritise a list of research topics for HPE research (HPER) in SSA. Methods: A modified Delphi process was designed to prioritise a shared agenda. Members of the African Forum for Research and Education in Health (AFREhealth) technical working group (TWG) were asked to first list potential research topics. Then, members of the same TWG and attendees at the annual AFREhealth academic symposium held in Lagos, Nigeria in August 2019 rated the importance of including each topic on a 3-point Likert scale, through two rounds of consensus seeking. Consensus for inclusion was predefined as ³ 70% of respondents rating the topic as “must be included.”Results: Health professions educators representing a variety of professions and 13 countries responded to the survey rounds. Twenty-three TWG members suggested 26 initial HPER topics; subsequently 90 respondents completed round one, and 51 completed round 2 of the modified Delphi. The final list of 12 research topics which met predetermined consensus criteria were grouped into three categories: (1) creating an enabling environment with sufficient resources and relevant training; (2) enhancing student learning; and (3) identifying and evaluating strategies to improve pedagogical practice.Conclusions: Establishing research priorities for HPE is important to ensure efficient and appropriate allocation of resources. This study serves as a reminder of how the prevailing context within which HPE, and by implication research in the field, is undertaken will inevitably influence choices about research foci. It further points to a potential advocacy role for research that generates regionally relevant evidence.
Health and support service needs of individuals with disability from culturally and linguistically diverse backgrounds: a scoping review protocol
Authors: Pho Jacqueline Nhu Quynh , Tan Aidan Christopher , Chaudhary Katrina , Hines Sonia , Ellison Caroline , Isaac Vivian , Lim David 
Published: November 2020

Abstract
Background: All individuals should have the right to engage meaningfully in occupations that meet their aspirations and life goals as well as promote their health and wellbeing. For individuals with disability, meaningful engagement in occupations is supported by timely, effective and adaptive health and support services. However, research has revealed multiple barriers preventing utilization of these services by individuals with disability from culturally and linguistically diverse (CALD) backgrounds. This review aims to identify gaps and solutions in health and support services of individuals with disability from CALD backgrounds to meaningfully engage in occupations.Methods: A scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews. A detailed search strategy will be used to search CINAHL, PubMed, Embase, Scopus, PsycInfo, JBI and Cochrane Library, as well as grey literature in Trove, Mednar and OpenGrey from January 1974 onwards. Two reviewers will independently screen all citations and full-text articles for eligibility against specific inclusion and exclusion criteria. Potential conflicts will be resolved through discussion. Data will be extracted and presented in a diagrammatic or tabular form accompanied by a narrative summary. Discussion: The scoping review will present the health and support service needs of individuals with disability from CALD backgrounds and will extend the current reviews as it focuses the engagement in meaningful occupation. Findings from this review have the potential to inform local policy discussions and practice-based disability care.Systematic review registration: Open Science Framework (osf.io/hw2fb).
Risk Factors for Neonatal Bronchopulmonary Dysplasia in Extremely Preterm Premature Rupture of Membranes: A Retrospective Study
Authors: Nakamura Eishin , Matsunaga Shigetaka , Ono Yoshihisa , Takai Yasushi , Seki Hiroyuki 
Published: November 2020

Abstract
Background: Determination of the optimal timing for termination of pregnancy in cases of preterm premature rupture of membranes (pPROM) during the extremely preterm period is still difficult. Bronchopulmonary dysplasia (BPD) is a major disease widely taken into account when determining the prognosis of respiratory disorders in a neonate. Many aspects of this disease remain unclear. With the aim of further improving the prognosis of neonates born to mothers with pPROM, this study examined cases who were diagnosed with pPROM before 28 weeks of gestation. The study analysed risk factors for neonatal BPD.Methods: This study included 73 subjects with singleton pregnancy, diagnosed with pPROM during the gestational period from 22 weeks and 0 days to 27 weeks and 6 days. The following factors were retrospectively examined: the gestational week at which pPROM was diagnosed, the gestational week at which delivery occurred, the period for which the volume of amniotic fluid was maintained, and neonatal BPD as a complication. Receiver operating characteristic (ROC) curve analyses were conducted to analyse the relationship of the onset of BPD with the duration of oligohydramnios and the gestational weeks of delivery.Results: The mean gestational week at which a diagnosis of amniorrhexis was made was 24.5±1.9 weeks (mean±SD), and that at which delivery occurred was 27.0±3.0 weeks. Fifty-seven cases (78.1%) were diagnosed with oligohydramnios, the mean duration of which was 17.4±20.5 days. The mean birth weight of neonates was 1000±455 g, of which 49 (67.1%) were diagnosed with BPD following birth. No neonates died in this study. The ROC curve indicated that the cut-off values for the duration of oligohydramnios and gestational age at delivery were 4 days and 24.1 weeks, respectively. Multivariate analysis indicated that the duration of oligohydramnios for more than 4 days before delivery and preterm delivery at less than 24.1 weeks were risk factors for the onset of BPD. Conclusion: Our findings suggest that duration of oligohydramnios for more than 4 days before delivery and preterm delivery less than 24.1 weeks are risk factors for BPD in cases who are diagnosed with pPROM before 28 weeks of gestation.
Immune landscape of periodontitis unveils alterations of infiltrating immunocytes and molecular networks-aggregating into an interactive web-tool for periodontitis related immune analysis and visualization
Authors: Zhang Xiaoqi , Wang Qingxuan , Yan Xinyu , Shan Yue , Xing Lu , Li Minqi , Long Hu , Lai Wenli 
Published: November 2020

Abstract
Background: Immunity reaction plays an essential role in periodontitis progress and we aim to investigate the underlying regulatory network of immune reactions in periodontitis. Methods: CIBERSORT was used to estimate immunocyte fractions in different clinical statuses. Logistic regression was used to assess the immunocyte enrichment in periodontitis. Immune-related periodontitis subtypes were identified by the Nonnegative Matrix Factorization algorithm. Gene-set enrichment analysis and Gene-set variation analysis were conducted to analyze pathway activities. Immunocytes related gene modules were identified by Weighted gene co-expression network analysis. Results: Altered immunocytes in healthy-vs-periodontitis, aggressive-vs-chronic, male-vs-female and age were identified. Immunocytes enriched in periodontitis were calculated, and their correlation was also explored. Two distinct immune-related periodontitis subtypes were identified and one is characterized by B cell reaction and the other is IL-6 cytokine reactions. 463 statistically significant correlations between 22 immunocytes and pathways were revealed. Immunocytes and clinical phenotypes matched their gene modules, and their functions were annotated. Last, an easy-to-use and user-friendly interactive web-tool were developed for periodontitis related immune analysis and visualization (http://118.24.100.193:3838/tool-PIA/).Conclusions: This study systematically investigated periodontitis immune atlas and caught a glimpse of the underlying mechanism of periodontitis from gene-pathway-immunocyte networks, which can not only inspire researchers but also help them in periodontitis related immune researches.