bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of Veristrat Test in First-Line Therapy of Pemetrexed Based Regimen for Advanced Lung Adenocarcinoma Patients
Authors: Jia Bo , Dong Zhi , Wu Di , Zhao Jun , Wu Meina , An Tongtong , Wang Yuyan , Zhuo Minglei , Li Jianjie , Wang Yang , Zhang Jie , Zhao Xinghui , Li Sheng , Li Junfeng , Ma Menglei , Chen Chen , Yang Xue , Zhong Jia , Chen Hanxiao , Wang Jingjing , Chi Yujia , Zhai Xiaoyu , Cui Song , Zhang Rong , Ma Qingwei , Fang Jian , Wang Ziping 
Published: July 2020

Abstract
Background：Although advanced non-squamous non-small cell lung cancer (NSCLC) patients have significantly better survival outcome on pemetrexed based treatment, a subset of patients still show intrinsic resistance and progress rapidly. Therefore we aim to use a blood-based protein signature (VeriStrat, VS) to analyze whether VS could identify the subset of patients who had poor efficacy on pemetrexed therapy. Methods：This study retrospectively analyzed 72 advanced lung adenocarcinoma patients who received first-line pemetrexed/platinum or combined with bevacizumab treatment. Results：Plasma samples from these patients were analyzed using VS and classified as Good (VS-G) or Poor (VS-P) group. The relationship between efficacy and VS status was further investigated. Of 72 patients included in this study, 35 (48.6%) were treated with pemetrexed plus platnum and 37 (51.4%) were treated with pemetrexed/platinum combined with bevacuzumab. Among all patients, 60 (83.3%) and 12 (16.7%) patients were classified as VS-G and VS-P, respectively. VS-G patients had significantly better median PFS (Unreached vs. 4.2 months; P＜0.001) than VS-P patients. Besides, partial response (PR) rate was higher in VS-G than that in VS-P group (46.7% vs 25.0%, P=0.212). Subgroup analysis showed that PFS was also significantly longer in the VS-G than that in VS-P group no matter for patients received chemotherapy alone or chemotherapy plus bevacizumab.Conclusions：Our study indicates that VS could be considered as a novel and valid method to predicit efficacy of pemetrexed based therapy and identify a subset of advanced lung adenocarcinoma patients who have intrinsic resistance to pemetrexed based regimen.
Prognostic Risk Model for Advanced Renal Cell Carcinoma (RCC) with Immune-Related Genes
Authors: Cao Peng , Zhang Jiandong , Sun Zejia , Zheng Xiang , Yu Baozhong , Cao Haoyuan , Zhang Feilong , Gao Zihao , Wang Wei 
Published: July 2020

Abstract
BackgroundRenal cell carcinoma (RCC) is a common tumor of the urinary system. Nowadays, Immunotherapy is a hot topic in the treatment of solid tumors, especially for those tumors with pre-activated immune state.MethodsIn this study, we downloaded genomic and clinical data of RCC samples from The Cancer Genome Atlas database. Four immune-related genetic signatures were used to predict the prognosis of RCC by Cox regression analysis. We selected the most relevant genes from each signature to construct a prognostic risk model to predict prognosis via Kaplan-Meier (KM) survival analysis. And the subgroups of the TCGA samples and external data from International Cancer Genome Consortium database were used to verify predictive stability of the model. We performed landscape analysis to assess the difference of gene mutant based on the data from TCGA. Finally, we explored the correlation between the selected genes and the level of tumor immune infiltration via Tumor Immune Estimation Resource (TIMER) platform.ResultsWe found that the four prognostic risk models constructed by the signatures all could divide the RCC samples into high- and low-risk groups with significantly different prognosis, especially in advanced RCC. And the prognostic risk model was constructed by 8 candidate genes (HLA-B, HLA-A, HLA-DRA, IDO1, TAGAP, CIITA, PRF1 and CD8B) which divided the advanced RCC samples from TCGA database into high-risk and low-risk groups. And there was a significant difference in overall survival (OS) between the two groups. The validity of the model was verified by independent data from ICGC database. And the classification efficiency of the model was stable for the samples from different subgroups. landscape analysis showed that mutation ratios of some genes were different between two risk groups. In addition, the expression levels of the selected genes were significantly correlated with the infiltration degree of immune cells in the advanced RCC.ConclusionsSum up, eight immune-related genes were screened in our study to construct prognostic risk model with great predictive value for the prognosis of advanced RCC, and the genes were associated with infiltrating immune cells in tumors which have potential to conduct personalized treatment for advanced RCC.
Effectiveness of a Mobile Phone Application to Increase Access to Sexual and Reproductive Health Information, Goods, and Services Among University Students in Uganda: A Randomized Controlled Trial
Authors: Nuwamanya Elly , Nalwanga Robinah , Nuwasiima Afra , Babigumira Janet U. , Asiimwe Francis T. , Babigumira Joseph B. , Ngambouk Vitalis P. 
Published: July 2020

Abstract
Background: University students are one of the most vulnerable groups to sexual reproductive health [SRH] threats like sexually transmitted infections [STIs], unwanted pregnancies, and unsafe abortions and often have limited access to SRH information, goods, and services. This study assessed the effectiveness of using a mobile phone application (APP) to increase access to SRH information, goods, and services among university students in Uganda.Methods: Using data from a double-blinded randomized controlled trial, participants were randomly assigned to both the intervention (APP) and control (standard of care) arms. We executed descriptive analyses for baseline demographic characteristics by intervention, difference in difference (DID), and quantile regression analyses for both primary and secondary outcomes.Results: The median age of participants was 21 years of age, and the majority were female (over 60%), unemployed (over 85%) and Christian (90%). Over 50% were resident in off-campus hostels and in a relationship. Between baseline and end-line, there was a significant increase in SRH knowledge score (DID=2, P<0.001), contraceptive use (DID=6.6%, P<0.05), HIV Voluntary testing and counselling (DID=17.2%, P<0.05), STI diagnosis and treatment (DID=12.9%, P<0.05), and condom use at last sex (DID=4%,P<0.05). There was a significant 0.98 unit increase in knowledge score (adjusted coefficient= 0.98, P<0.001), a significant 1.6-fold increase in odds of contraceptive use (adjusted coefficient= 1.6, P<0.05), a significant 3.5-fold increase in HIV VCT (adjusted coefficient=3.5, P<0.05), and a significant 2-fold increase in odds of STI testing and treatment (adjusted coefficient =1.9, P<0.001) after adjusting for demographic characteristics.Conclusion: A mobile phone application increased sexual and reproductive health information (knowledge score), access to goods (contraceptives), and services (HIV voluntary testing and counseling and sexually transmitted infection diagnosis and management) among sexually active university students in Uganda. Further technical development, including the refinement of youth-friendly attributes, as well as further research into potential economic impact and paths to sustainability, is needed before the app is deployed to the general youth population in Uganda and other low-income settings. Trial registration: MUREC1/7 No. 07/05–18. Registered on June 29, 2018.
Impact of Prior Cancer History on Outcomes in Thymoma
Authors: Wu Shilong , Liu Mengyang , Cui Weixue , Peng Guilin , He Jianxing 
Published: July 2020

Abstract
Background: Thymoma is an uncommon intrathoracic malignant tumor and has a long natural history. It is uncertain whether the survival of thymoma patient is affected by prior cancer history. Finding out the impact of a prior cancer history on thymoma survival has important implications for both decision making and research.Method: The Surveillance, Epidemiology, and End Results (SEER) database was queried for thymoma patients diagnosed between 1975 and 2015. Kaplan-Meier methods and Cox proportional hazards model were used to analyze overall survival across a variety of stages, age, and treatment methods with a prior cancer history or not.Results: A total of 3604 patients with thymoma were identified including 507 (14.1%) with a prior cancer history. The 10-year survival rate of patients with a prior cancer history (53.8%) was worse than those without a prior cancer history (40.32%, 95%CI 35.24-45.33, P < 0.0001). However,adjusted analyses showed that the impact of a prior cancer history was heterogenous across age and treatment methods. In subset analyses, prior cancer history was associated with worse survival among patients who were treated with chemoradiotherapy (HR: 2.80, 95% CI: 1.51-5.20, P = 0.001) and age ≤ 65 years (HR: 1.33, 95%CI: 1.02-1.73, P = 0.036).Conclusions: Prior cancer history provides an inferior overall survival for patients with thymoma. But it does not worsen the survival in some subgroups and these thymoma patients should not be excluded from clinical trials.
Medications for Attention-deficit/hyperactivity Disorder in Individuals With or Without Coexisting Autism Spectrum Disorder: Analysis of Data From the Swedish Prescribed Drug Register
Authors: Johansson Viktoria , Sandin Sven , Chang Zheng , Taylor Mark J. , Lichtenstein Paul , D'Onofrio Brian M. , Larsson Henrik , Hellner Clara , Halldner Linda 
Published: July 2020

Abstract
Background. Clinical studies found that medication for attention-deficit/hyperactivity disorder (ADHD) is effective in coexisting autism spectrum disorder (ASD), but current research is based on small clinical studies mainly performed on children or adolescents. We here use register data to examine if individuals with ADHD and coexisting ASD present differences in the prescribing patterns of ADHD medication when compared to individuals with pure ADHD.Methods. Data with information on filled prescriptions and diagnoses was retrieved from the Swedish Prescribed Drug Register and the National Patient Register. We identified 34,374 individuals with pure ADHD and 5,012 individuals with ADHD and coexisting ASD, aged between 3 to 80 years. The first treatment episode with ADHD medications (≥2 filled prescriptions within 90 days) and daily doses of methylphenidate during a three-year period was measured. Odds ratios (ORs) were calculated for the likelihood of being prescribed ADHD medication in individuals with and without ASD and Wilcoxon rank-sum test was used to compare group differences in dose per day.Results. Individuals with ADHD and coexisting ASD were less likely to start continuous treatment with ADHD medication (ADHD 80.5%; ADHD with ASD 76.2%; OR; 0.80, 95% Confidence Interval: 0.75-0.86), were less likely to be prescribed methylphenidate, and were more commonly prescribed second line treatments such as dexamphetamine, amphetamine or modafinil. No group difference was observed for atomoxetine. In adults with ADHD and coexisting ASD, methylphenidate was prescribed in lower daily doses over three years as compared to individuals with pure ADHD.Conclusions. The findings indicate that there are differences in the medical treatment of individuals with or without ASD. If these differences are due to different medication responses in ASD or due to other factors such as clinicians’ perceptions of medication effects in patients with ASD, needs to be further studied.
Care Integration Decreases Hospitalization Costs: Retrospective Cohort Study of Palliative Care Consult Service for Hospital Patients With Metastatic Cancer
Authors: Zemplenyi Antal Tamás , Csikós Ágnes , Fadgyas-Freyler Petra , Csanádi Marcell , Kaló Zoltán , Pozsgai Éva , Mölken Maureen Rutten-van , Pitter János György 
Published: July 2020

Abstract
Background: Palliative Care Consult Service (PCCS) programme was established in Hungary to provide palliative care to hospitalized patients with complex needs and to manage the patients’ pathway when discharged from the hospital. The aim of this study was to measure the impact of PCCS on healthcare costs from the perspective of the payer.Methods: Study population consisted of patients with metastatic cancer (identified by TNM status or ICD-10 code), who were admitted to the Clinical Center of the University of Pécs between 1 January 2014 and 31 December 2016. Patients who did not die within 180-days from enrolment were excluded. Patients receiving services from PCCS team (intervention patients) were compared to patients receiving usual care (controls). The two populations were matched using propensity scores based on age, gender, number of tumor affected organs, Charlson comorbidity index, number of hospital admissions in the year prior to enrollment, outpatient visits in 90 days prior to hospitalization, and number of days to death. Data was obtained from electronic health records linked to claims data. Results: 197 matched pairs were identified with comparable characteristics. Mean number of hospital admissions was 2.1 and 2.5 (p =0.020); ratio of hospital deaths was 75% and 86% (p = 0.003); cost of inpatient care was 1,053 EUR and 1,300 EUR (p = 0.013); cost of home hospice care was 58 EUR and 21 EUR (p = 0.003); and total cost of care was 1,719 EUR and 1,982 EUR (p = 0.099) in the intervention and control groups, respectively. Conclusion: This study demonstrated that palliative care consult service for end-stage cancer patients with a very limited prognosis can add value to healthcare by reducing costs associated with hospital stays and unnecessary examinations and treatments. The data suggest that early initiation of palliative care could have even greater implications.
The Burden of Hyperglycemia First Detected in Pregnancy Among Indonesian Women
Authors: Fitria Najmiatul , Pradipta Ivan Surya , Utama Bobby Indra , Postma Maarten , Asselt Antoinette van , Schmidt Amand Floriaan 
Published: July 2020

Abstract
OBJECTIVE: Despite improvements, Indonesian maternal health falls short of the Sustainable Development Goals. Using contemporary electronic healthcare records, this study explored the burden of Hyperglycemia First Detected in Pregnancy (HFDP) and its association with the determinants of maternal health in Indonesia. METHODS: Electronic Health Records data were extracted on high-risk pregnant women without pre-existing diabetes who were screened for HFDP between 2014 and 2015 at two West Sumatera hospitals. Screening consisted of an oral glucose tolerance test (OGTT), grouping women into Diabetes In Pregnancy (DIP, glucose 126 mg/dl), Gestational Diabetes Mellitus (GDM, glucose 92-125 mg/dl), or high-risk women without elevated glucose levels (glucose < 92 mg/dl); following the World Health Organization (WHO) standard. Maternal and neonatal outcomes, including mortality, were associated with the three diabetes statuses, using general and generalized linear models (depending on the type of outcome) adjusted for maternal age and parity. RESULT: 3536 pregnant women were screened, of which 722 (21%) had HFDP; 655 (19%) were classified as GDM and 67 (2%) as DIP. Women with HFDP did not have a significantly higher risk of death: OR 1.36 (95%-CI 0.71-2.62) for GDM and 0.90 (95%-CI 0.12-6.67) for DIP. We did observe a significantly lower neonatal death rate for children born of GDM women, with three deaths (1%) compared to 178 (6%) in high-risk normal FBG women (p-value < 0.01). This observation was not replicated when comparing DIP to normal FBG women (OR 0.58; 95%-CI 0.26-1.29). CONCLUSION: The observed lack of difference in pregnancy outcomes between HFDP and pregnant women with normal fasting blood glucose levels (at the time of screening) reflects the considerable residual risk of these women. Nevertheless, have and calls for closer monitoring of high-risk women irrespective of their OGTT results. Larger sample-sized studies are warranted to replicate findings with sufficient accuracy to detect possibly smaller, but meaningful differences.
What makes multicomponent school-based health promotion interventions work? A qualitative study nested in the SEHER trial in Bihar, India.
Authors: Shinde Sachin , Khandeparkar Prachi , Pereira Bernadette , Sharma Amit , Ross David A , Weiss Helen A , Patton George , Patel Vikram 
Published: July 2020

Abstract
Background

A cluster-randomized controlled trial in secondary schools in Bihar, India, reported the effectiveness of a multi-component, school health promotion intervention (SEHER) when delivered by lay counsellors (“SEHER Mitra” (SM); meaning “friend” in the local language), but not when delivered by a teacher (“Teacher as SEHER Mitra” (TSM)) compared with the government-run Adolescence Education Program (AEP). This nested qualitative study explored what key factors determined the effectiveness of the intervention and the difference in effectiveness by the delivery agent.
Methods

We purposively selected 12 intervention schools (6 each from the two intervention arms) based on the size of school. In these schools, we conducted semi-structured interviews with 12 principals, 12 AEP teachers, 12 other teachers, and 11 students who participated in SEHER counselling services. We conducted focus group discussions with girl students (n = 14), boy students (n = 12) SMs (n = 2), TSMs (n = 2), and supervisors (n = 1). Data analysis followed a framework approach to thematic analysis.
Results

Three overarching themes were identified – i.e. stakeholders’ understanding of SEHER; SEHER intervention planning and implementation, and other issues in the implementation process. All the stakeholders from both the arms strongly believed that the SEHER program was important in imparting health knowledge and life skills to secondary school students. The following factors facilitated the successful implementation of SEHER in SM-arm schools: a shared understanding of the SEHER program by the whole school community, influential school-level leadership, engagement of, and collaboration with, all stakeholders including students in program activities, the trust of the school community in the SMs, full-time availability of SMs for program activities, and prompt actions on students’ concerns by the SMs. Barriers to effective implementation of SEHER in TSM-arm schools included: lack of communication and poor relationship-building between the TSMs, principals and other teachers, TSMs’ perceptions that they were overburdened with academic and non-academic responsibilities, students’ lack of clarity about the TSM’s role, concerns about confidentiality, inaction on students’ concerns, and lack of support from other teachers and the department of education.
Conclusions

The embedded qualitative study identified important facilitators and barriers to the effective implementation of the intervention when delivered by two different delivery agents.
Trial registration:
www.clinicaltrials.gov/ NCT02484014
A Novel Unfolded Protein Response (UPR) Related 6 Genes Signature for Prognosis of Human Gastric Cancer
Authors: Jia XuYang , Huang RunZhi , Xian ShuYuan , Song Yu , Pan Hao , Zhou DongLei 
Published: July 2020

Abstract
Background: Unfolded protein response (UPR) pathway has attracted increasing attention in the last few years for its close relation to cancer process like proliferation and drug resistance. However, few studies reported its prognostic effect in gastric cancer (GC). The purpose of this study is to identify the UPR expression in gastric cancer and construct a prognostic gene signature for clinical practice. Method: TCGA-STAD (gastric cancer cohort) was set as the training group and GSE84437 for validation. GSVA and GSEA was performed to identify the high expressed pathway in patients with gastric tumor. Following that, cox proportional hazard regression was adopted to screen genes correlated with survival in UPR path. Then, risk score for each patients was computed (FKBP14 value * (0.267719774) + TUBB2A value * (0.193233442) + SLC1A4 value * (-0.246893982) + SEC11A value * (0.484354542) + IFIT1 value * (0.152379968) + IGFBP1 value * (0.127045661)) and survival analysis was conducted between patients in high and low risk group according to their median risk score. A nomogram was built accordingly to guide clinical practice.Result: The UPR path was identified as the most highly expressed hallmark in GC with β of 32.98. A 6 genes prognostic signature was constructed according to the Cox regression and survival analysis obtained significant result where patients in low risk group showed longer OS (overall survival). The signature demonstrated an independent prognostic effect cox regression with a HR of 1.8. The external GSE84437 data proved the nomogram performed well in predicting 5 years OS. Conclusion: Our study identified that UPR pathway was highly activated in GC and a UPR related 6 genes prognostic signature demonstrated good performance. The 6 UPR related genes may serve as reliable prognostic biomarkers and potential therapeutic targets for GC treatment.
Medical students' perception of simulation-based assessment in emergency and paediatric medicine: a focus group study.
Authors: Philippon Anne-Laure , Truchot Jennifer , Suremain Nathalie De , Renaud Marie-Christine , Petit Arnaud , Baron Georges-Louis , Freund Yonathan 
Published: July 2020

Abstract
Background Simulation-based assessment is scarcely used for undergraduate medical students. We created a simulation-based assessment to validate medical students’ technical and psychometrics’ skills, during their emergency medicine and pediatric curriculum. The aim of our study was to collect medical students’ perception on this novel assessment.Methods This is a qualitative study that includes 9 focus groups among the 215 students who participated in either a pediatric or an emergency medicine simulation-based-course. These sessions ended by an assessment on a manikin. Among the 40 students who were randomly selected to participate in the focus groups, 30 agreed to participate. Data were analyzed using grounded theory and, data were coded the by two independent investigators.Results Seven major and two minor themes emerged from the focus groups. The importance of being certified by simulation to be more self-confident in hospital clerkships, the perception of simulation-based assessment as a high quality assessment, the contribution of the simulation-based assessment to change students’ practices and enhance their engagement in their curriculum and a disappointment because simulation-based assessment didn’t help student for the faculty high stakes assessments. Some students also found that simulation-based assessment was a stressful and unfair exercise. The last discussion was about practical issues of the assessment such as this normative way, and about the importance of the feedback.Conclusion The students reported positive aspects of the simulation-based assessment method such as helpful for their hospital clerkship, change of their practices and way of learning. However they also reported that it might be a biased and a stressful assessment method.