bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is PSA Density of the Peripheral Zone as a Useful Predictor for Prostate Cancer in Patients With Gray Zone PSA Levels?
Authors: Lee Jaegeun , Yang Seung Woo , Jin Long , Lee Chung Lyul , Lee Ji Yong , Shin Ju Hyun , Lim Jae Sung , Song Ki Hak 
Published: December 2020

Abstract
BackgroundSerum prostate-specific antigen (PSA) is widely used in screening tests for prostate cancer. As the low specificity of PSA results in unnecessary and invasive prostate biopsies, we evaluated the clinical significance of various PSAs and PSA density (PSAD) related to peripheral zones in patients with gray zone PSA level (4-10 ng/mL).MethodsA total of 1,300 patients underwent transrectal ultrasonography-guided prostate biopsy from 2014 to 2019. Among them, 545 patients in the gray zone were divided into the prostate cancer diagnosis group and the non-prostate cancer diagnosis group, and PSA, relative extra transitional zone PSA (RETzPSA), estimated post holmium laser enucleation of the prostate PSA (EPHPSA), PSAD, peripheral zone PSA density (PZPSAD) and extra-transitional zone density (ETzD) were compared and analyzed using receiver-operating characteristics (ROC) analysis after 1:1 matching using propensity score.ResultsArea under the ROC curve values of PSA, EPHPSA, RETzPSA, PSA density, ETzD, and PZPSAD were 0.553 (95% CI: 0.495-0.610), 0.611 (95% CI: 0.554-0.666), 0.673 (95% CI: 0.617-0.725), 0.745 (95% CI: 0.693-0.793), 0.731 (95% CI: 0.677-0.780) and 0.677 (95% CI: 0.611-0.719), respectively. PSAD had 67.11% sensitivity, 71.71% specificity, and 70.34% positive predictive rate at 0.18 ng/mL/cc. ETzD had 69.08% sensitivity, 64.47% specificity, and 66.04% positive predictive rate at 0.04 ng/mL/cc. When the cut-off value of PSAD was increased to 0.18 ng/mL/cc, the best results were obtained with an odds ratio of 5.171 (95% CI: 3.171-8.432), followed by ETzD with 4.054 (95% CI: 2.513-6.540).ConclusionsThese results suggested that volume-adjusted parameters (ETzD and PSAD) might be more sensitive and accurate than various PSA in gray zone patients who required prostate biopsy to reduce unnecessary biopsy.
EZH2/EHMT2 Histone Methyltransferases Inhibit the Transcription of DLX5 and Promote the Transformation of Myelodysplastic Syndrome to Acute Myeloid Leukemia
Authors: Zheng Zhuanzhe , Li Ling , Li Guoxia , Zhang Yaofang , Dong Chunxia , Ren Fanggang , Chen Wenliang , Ma Yanping 
Published: December 2020

Abstract
ObjectiveMyelodysplastic syndrome (MDS) is a group of heterogeneous myeloid clonal diseases originating from hematopoietic stem cells and may develop to acute myeloid leukemia (AML). We investigated the mechanism of histone methyltransferases EZH2/EHMT2 during the transformation of MDS to AML.MethodsExpression of EZH2/EHMT2 in MDS/AML patients and in NHD13 mice was detected. EZH2 and EHMT2 were silenced or overexpressed in SKM-1 cells to evaluate cell proliferation and cycle. Levels of DLX5, H3K27me3 and H3K9me2 were detected. The binding of DLX5 promoter region to H3K27me3 and H3K9me2 was examined. Levels of H3K27me3/H3K9me2 in cells were decreased by EZH2/EHMT2 inhibitors, and then changes of DLX5 expression and cell proliferation were observed.ResultsEZH2 was poorly expressed in MDS patients but highly expressed in MDS-AML patients. EHMT2 was elevated in both MDS and MDS-AML patients. EZH2 expression was reduced and EHMT2 expression was promoted in NHD13 mice. NHD13 mice with overexpressing EZH2 or EHMT2 transformed into AML more quickly. Intervention of EZH2 or EHMT2 inhibited SKM-1 cell proliferation and promoted DLX5 expression. Both silencing EZH1 and EZH2 in SKM-1 cells, the H3K27me3 level was decreased. EZH2 silencing repressed the proliferation of SKM-1 cells. The transcription level of DLX5 in SKM-1 cells was inhibited by H3K27me3 and H3K9me2. Enhanced DLX5 expression restrained the proliferation of SKM-1 cells.ConclusionEZH2/EHMT2 catalyzed H3K27me3/H3K9me2 to inhibit the transcription of DLX5, thus promoting the transformation from MDS to AML.
Let-7a Suppresses Ewing Sarcoma CSCs’ Malignant Phenotype via Forming a Positive Feedback Circuit with STAT3 and lin28
Authors: Xu Jiang , Zhang Zhongzu , Huang Lu , Zhou Rongping , Feng LinXuan , Zhou Zhenhai , Yu Honggui , Peng Kun , Li Chen , Liu Zhiming , Cao Kai 
Published: December 2020

Abstract
BackgroundCancer stem cells (CSCs) have been documented to be closely related with tumor metastasis and recurrence, and the same important role were identified in Ewing Sarcoma (ES). In our previous study, we found that let-7a was repressed in ES. Herein, we further identified its putative effects in the CSCs of ES. ResultsThe expression of let-7a was consistently suppressed in the separated ES SP cells, which were identified to contain the characteristics of the stem cells. The ability of colony formation or invasion of ES SP cells was suppressed in vitro when we restored the expression of let-7a. The same results were found in the tumor growth of ES SP cells’ xenograft mice in vivo. Furthermore, we found STAT3 and lin28 were involved in the suppressive effects.ConclusionLet-7a, STAT3 and lin28 might form a positive circuit to regulate the malignant phenotype of ES CSCs.
HIV Diagnosis Time Differentiates ART Initiation: Implications from a Prospective Cohort Study in China
Authors: Tinglong YANG , Yang Xueying , Li Linghua , Xu Huifang , Fan Lirui , Li Quanmin , Fan Xiaoyan , Chen Weiyi , Du Xuan , Hao Chun , Li Jinghua , Hao Yuantao , Gu Jing 
Published: December 2020

Abstract
Background: We estimated the predictive effects of ART-related perceptions on the actual ART uptake behavior among ART naïve PLWH stratified by different time of HIV diagnosis under the new strategy. Methods: A prospective cohort study was conducted among ART naïve PLWH in Guangzhou, China from June 2016 to June 2017. Cox regression model was used to evaluate the predictive effects of ART-related perceptions on ART initiation among PLWH stratified by different timepoint of HIV diagnosis (i.e., before or after the update of the new treatment policy). Results: Among 411 participants, 150 and 261 were diagnosed before (pre-scaleup group) and after (post-scaleup group) the implementation of the new strategy, respectively. The ART initiation rate in the post-scaleup group (88.9%) was higher than that in the pre-scaleup group (73.3%) (p<0.001). A significant difference of mean score was detected in each HBM construct between pre- and post- scaleup groups (p<0.05). After adjusting for significant background variables, among all participants, only the self-efficacy (adjusted HR (HRa) =1.23, 95% C.I.: 1.06 to 1.43, p=0.006), has a predictive effect on ART initiation; in pre-scaleup group, all constructs of HBM-related ART perceptions were predictors of ART initiation (HRa=0.71 to 1.83, p<0.05), while in post-scaleup group, no significant difference was found in each construct (p>0.05). Conclusions: The ART initiation rate was high particularly among participants who diagnosed after the new treatment strategy. The important role of the time of HIV diagnosis on ART initiation identified in this study suggested that future implementation interventions may consider to modify the ART-related perceptions for HIV patients who diagnosed before the implementation of the new ART strategy, while expand the accessibility of ART service for those who diagnosed after the implementation of the new strategy.
Value-Based HIV Care: A Method to Improve Quality of HIV Care.
Authors: berk Guido van den , Moha Daoud Ait , Stalenhoef Janneke , Kleene Marie-Jose , Meche Narda van der , Schouten Ineke , Keus Samyra , Brinkman Kees 
Published: December 2020

Abstract
Background : To support our goal of providing optimal HIV care to our patients, we started applying the value-based health care principle to the HIV care that we offer in our HIV center, measuring relevant health outcomes and costs to allow continuous implementation of improvements (Value-Based HIV Care; VBHiC). Methods : In line with the principles of Michael Porter, our approach consisted of the following steps: 1) Organizing into integrated practice units / describing the HIV care path; 2) Defining an HIV outcome indicator set; 3) Building an enabling information technology platform; 4) Integrating care delivery across separate facilities; 5) Moving to bundled payments for care cycles and 6) Expanding excellent services and interventions for improvement across geographic boundaries. Results : The following set of 9 outcome indicators was developed: undetectable HIV load within the first year of care; quality of life within the first year of care; mortality within the first year of care; retention in care; therapy effectiveness; therapy tolerance; cardiovascular risk; quality of life for every subsequent year and overall annual mortality. These indicators, which were evaluated retrospectively, are shown in figures 1-5. Collection of the underlying data started in January 2016. The HIV care path was also integrated into the electronic file system. Creation of the ability to monitor outcome indicators at patient level, population level and process level allowed us to implement a quality cycle (plan-do-study-act). Conclusion : Our Value-Based HIV Care approach facilitated structured evaluation of parameters that are of value to the patient. It also boosted the quality of the HIV care that we provide and allowed us to increase the number of patients to whom we can offer high quality HIV care.
‘A Cross Sectional Survey of Sociodemographic Characteristics, Primary Care Health Needs and Living Conditions of Asylum-Seekers Living in a Greek Reception Centre.’
Authors: Gordon Anna Clare Talitha , O-Brien Conor T , Balen Julie , Duncombe Stephanie , Girma Albane , Mitchell Caroline 
Published: December 2020

Abstract
BackgroundIn 2019, a migrant camp on the Greek island of Samos designed for 650 people was home to over 5500. Migration rates from conflict zones remain high. We aimed to quantitatively describe demographics, living conditions and health needs in the reception centre community of Samos, Greece.MethodsA questionnaire was designed with reference to international humanitarian standards for reception centre following a consultative process with representatives of the asylum-seeker population. Domains assessed included demographics; living conditions; safety/vulnerability; and health. The questionnaire was piloted and then following feedback from participants, conducted in June 2019 on a sample of 500 asylum seekers attending Non-Governmental Organisation (NGO) centres supporting the Samos reception centre. Results500 participants: 60.6% male, 35.0% female and 4.4% did not report gender. 79.4% lived in tents. Respondents were predominantly from Afghanistan and the Democratic Republic of Congo (DRC). Respondents reported a total of 570 children in their care. 20.6% of women were pregnant. 35.4% had experienced physical violence; 7.8% reported Sexual/ Gender-based violence (SGBV). 83% reported psychological distress, 71% skin disease, 66% diarrhoea and vomiting and 64% respiratory disease. Accommodation, sanitation, and nutrition fell below internationally recognised standards, and poor access to water was significantly associated (p < 0.001) with respiratory disease, diarrhoea and vomiting, skin disease and psychological distress. ConclusionLiving conditions in the over-burdened Samos camp fall far below accepted basic humanitarian standards and are associated with overall poor health status in the camp population. Further research is imperative to analyse and monitor the diverse, varying needs of asylum-seekers in the Greek island hotspots and inform policies to improve conditions.
Effects of Ferula on Polycystic Ovary Syndrome
Authors: Fatemeh Ghavi , Abdolahian Somayeh , Fatemeh Shakeri 
Published: December 2020

Abstract
BackgroundPolycystic ovarian syndrome is the most common endocrine disorder in reproductive aged women. As a result of side effect of pharmaceutical medications women are interested in using alternative medicines to treat. To determine the comparative effects of Ferula assa-foetida on androgenic hormone levels and ovarian features in patient with polycystic ovarian syndrome (PCOS). MethodsIn this triple-blinded controlled clinical trial, 34 student participants were randomly divided in two groups. Intervention group received 100 mg of oleo-gum resin of Ferula assa- foetida, control group received oral paraffin (Placebo) twice daily for 3 months. The efficacy of this herbal medicines was measured after the 3-month intervention. Hormonal assay for evaluating Testosterone, DEHAS, Prolactin, TSH, FSH, LH levels and also trans abdominal ultrasound for evaluating ovarian volumes, number of follicles of both ovaries, and endometrial thickness. Were measured before and after the study. ResultsIn this study, significant changes in DEHAS and TSH level were observed (p value<0.03). The greatest reduction in the number of ovarian follicles was reported in the Ferula group (p value <0.00). ConclusionUse of Ferula assa-foetida can be effected in decrease of DHEAS, TSH levels, and ovarian follicles number in young girls with PCOS.Trial registrationthe Iranian Randomized Clinical Trial (IRCT2016040427207N1).url: https://www.irct.ir/trial/22343
Cost-Effectiveness Analysis of Trastuzumab Emtansine as Second-Line Therapy for HER2 Positive Breast Cancer in China
Authors: Zhang Huahua , Zhang Yandong , Huang Chaonan , Wang Jiangfeng 
Published: December 2020

Abstract
ObjectiveTo evaluate the cost-effectiveness of trastuzumab emtansine (T-DM1) as the second-line treatment for patients with human epidermal growth factor receptor-2 (HER2) positive breast cancer from the Chinese healthcare perspective. Capecitabine (Cap), capecitabine + lapatinib (Cap+Lap), capecitabine + trastuzumab (Cap+Tra), capecitabine + trastuzumab + pertuzumab (Cap+Tra+Pre) were selected as comparators.MethodsA three-state Markov simulation model was performed. The state transition probabilities were estimated based on the results of a published network meta-analysis, and utilities were derived from the published literature. The costs populated in the model were acquired from the local charge or previously published studies. Univariate sensitive analysis and probabilistic sensitivity analyses were performed to test the robustness of the results.ResultsTreatment with T-DM1 was estimated to increase the cost by $109,683.7, $106,003.7, $94,212.2, and $63,214.9, and yield a gain of 0.544 quality-adjusted life years (QALYs), 0.383 QALYs, 0.367 QALYs, 0.087 QALYs in comparison with Cap, Cap+Lap, Cap+Tra, and Cap+Tra+Pre, respectively. Corresponding incremental cost-effectiveness ratios (ICERs) were $201,624.4, $276,772.1, $256,709.0, and $726,608.0 per QALY. The probabilities of T-DM1 as the dominant option were 0% at the WTP threshold of $30,829.3/QALY.Conclusions﻿T-DM1, as second-line therapy in the treatment of HER2 positive breast cancer, is not a cost-effective option in China. Given the significant clinical efficacy, an appropriate price reduction of T-DM1 is required to benefit more HER2 positive breast cancer patients.
Implementing a TeamSTEPPS® Team-training Program in a Bachelor of Nursing Education to Enhance Teamwork Attitudes and Skills
Authors: Karlsen Tore , Hall-Lord Marie Louise , Wangensteen Sigrid , Stomlien Tone , Storlien Marit Helene Sund , Ballangrud Randi 
Published: December 2020

Abstract
Objectives: The aim of this paper is to describe the implementation process of the TeamSTEPPS® intervention in the education of Bachelor of Nursing students Results. The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS®) program was implemented in three phases according to an implementation plan built on seven of Kotter’s eight-step model for leading change. The first phase consisted of establishing a sense of urgency to implement team training in the education program, establishing a change team and creating a vision and plan for implementation of the program as well as providing information and training for faculty. The second phase consisted of the various team training activity as lectures, videos, and posters in the simulation environment and learning platform that were introduced to students. The goal of the third phase was to consolidate the teamwork skills for retention and to challenge students to use the teamwork skills in more complex situations. The trial registration number is ISRCTN 19311225. The trial was registered retrospectively, with the registration date May 28, 2020.
Analysis of Households' Willingness to Pay for Improved Solid Waste Management Services in Gondar city, Ethiopia: Evidence from a double-bounded Dichotomous Contingent Valuation Method
Authors: Wegedie Kassahun Tassie , Eyasu Anteneh Mulugeta , Yizengaw Yenesew Sewnet , Shiferaw Getnet Asifaw 
Published: December 2020

Abstract
Background: Waste is a byproduct of human life. Nowadays, municipal solid waste is being produced in excessive amounts and in this way, both developing and developed countries are facing challenges regarding generation of waste. Economic development, urbanization and improved living standards in cities have contributed to increase in the amount and complexity of solid waste produced. Methods: this study aims to Analysis of households' willingness to pay for improved solid waste management Services in Gondar city, Ethiopia: evidence from a double-bounded dichotomous contingent Valuation Method.Result: A total of 222 randomly selected households were interviewed to address the objective of this study. Finally, the survey result indicated that 192(87.3%) of sample households were willing to pay for improved solid waste management services. Following this, the one and double-bounded dichotomous contingent valuation result revealed that the mean willingness to pay estimated from the Double Bounded dichotomous CVM and open ended formats were 34.48 and 17.0756 ETB[1] per month per households respectively. The total WTP was obtained by adding the WTP of the total households in each stratum, and is equal to 941361ETB and 1900848 ETB for open ended and double bounded format, respectively. Additionally, the bivariate probit model result demonstrated that income and education have positive and significant effects on willingness to pay bid amounts. The results, age, marital status, Bid1 and Bid2 have a negative and significant effect on households’ amount of willingness to pay for better solid waste management services. Conclusion: When allocating service charges the city municipality considers amount of solid waste generation and income level of the households. The study results show that when educational status of the households increases and increase their willing to participate in planned improved solid waste management service. Thus, awareness creation is importance for better solid waste management. Additionally the city municipality facilitates a learning media for uneducated households to come up with at least secondary education level.
Impact of Interstitial Lung Disease on Mortality in ANCA-associated Vasculitis: A Systematic Literature Review and Meta-analysis
Authors: Zhou Peining , Ma Jing , Wang Guangfa 
Published: December 2020

Abstract
Background: Several retrospective series and case reports have described the association of interstitial lung disease (ILD) and ANCA-associated vasculitis（AAV）. However, the relationship between the ILD and mortality in AAV patients have not been established so far. This study aims to estimate the relevance of AAV-associated-ILD（AAV-ILD）and mortality risk by conducting a systematic review and meta-analysis.Methods: A comprehensive systematic review was conducted in accordance with the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses). PubMed, Embase.com and the Cochrane Library (Wiley) were searched for original observational studies. Summary estimates were derived with a random-effects model and reported as risk ratio（RR）, tested for publication bias and heterogeneity. Results: Ten retrospective cohort studies were included, comprising 526 AAV-ILD patients enrolled from 1974 to 2018. Meta-analysis yielded a pooled RR of 2.90 (95% confidence interval 1.77 to 4.74) for death among those with AAV-ILD compared with control group. Sensitivity analysis suggested that the meta-RR result was not skewed by a single dominant study.Conclusion: ILD might be associated with a higher mortality risk in AAV patients.
Health-related Quality of Life in Medical Personnel on the Peace Ark Hospital Ship During a Long Voyage: A Cohort Study
Authors: Liu Xu , Tang Bihan , Han Yingnan , Zhang Hailing , Hu Chaoqun , Zhao Fangjie , Zhang Lulu 
Published: December 2020

Abstract
Background The Chinese hospital ship “Peace Ark” has conducted nine overseas humanitarian missions. Methods Research indicated long-distance voyages significantly impact seafarers’ physical and mental health. This study investigated changes in and influencing factors for medical professionals’ health-related quality of life (HRQoL) during a 2017 humanitarian mission (8 countries, 155 days). Using a cohort study design, 90 medical professionals’ HRQoL was assessed (via the SF-12) pre-voyage and after 5 months at sea. Results Pre-voyage, mean physical component scale (PCS) and mental component scale (MCS) scores were 52.34 (SD 5.07) and 53.03 (SD 6.40), respectively—significantly higher than in the general Chinese population (p < 0.0001). Afterwards, PCS and MCS scores declined by 3.9867 (SD 6.03) and 5.70 (SD 7.03), respectively. PCS scores were negatively associated with female gender (p = 0.004). Compared to administrative staff, doctors (p < 0.001) and nurses (p < 0.001) showed less deviation in PCS scores. Lower MSC scores were associated with older age (p = 0.011) and less family support (p = 0.0165). Conclusions Long-term voyages negatively impacted HRQoL in medical personnel. Thus, prior to similar future humanitarian missions, selection criteria and training procedures for medical personnel should be optimized, thereby increasing their confidence and social support.
The Association Between COVID-19 Incidence and Mortality with Socioeconomic Development - A Global Ecological Study
Authors: Torkian Samaneh , Kazemi Samira , Eslahi Marzieh , Khatooni Elham , Etesami Reza , Khanjani Narges , Rashti Roya 
Published: December 2020

Abstract
Background: There is some evidence about the role of human development in the incidence and mortality of some diseases. The aim of this study was to investigate the relation between COVID-19 incidence and mortality with development indexes in different regions of the world.Methods: This ecological study was conducted on data from January 11 to August 23, 2020. The development indexes included were Human development index (HDI), Inequality-adjusted HDI (IHDI), the Gini Coefficient, Gender Development Index (GDI), Gender Inequality Index (GII) and their components. The development indexes was obtained from the United Nations Development Program (UNDP). COVID-19 cases and mortality data of the countries involved in the pandemic were obtained from the European Centre for Disease Prevention and Control (ECDC). Data was analyzed by Spearman correlation coefficients and negative binomial regression through SPSS26. Results: The highest and lowest incidence and mortality rates were in the AMRO and WPRO regions, respectively. The development indexes had no a significant linear correlation with COVID-19 incidence and mortality except in WPRO, where there was direct significant correlation between life expectancy at birth and inequality adjusted life expectancy with COVID-19 incidence and mortality (P<0.05).Conclusions: Our findings suggests limited evidence that countries level of development may directly influence morbidity and mortality from COVID-19. However, with regard to the ecological nature of this study, the reason for this association is difficult to determine.