bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of institutional delivery service utilization among women of reproductive age in Gambia: a cross-sectional analysis
Authors: Yaya Sanni , Bishwajit Ghose 
Published: March 2020

Abstract
Background
Over the last two decades, Gambia has made noticeable progress in the reducing the high maternal mortality rates and improving child survival rates. Nonetheless, numerous infrastructural and financial constraints continue to restrict access to institutional delivery care, a key component of achieving the maternal and child health related Sustainable Development Goals (SDG 3.1). This study assesses factors that predict women’s choice of mode and place of delivery in urban and rural Gambia.

Methods
Cross-sectional data from the latest round of Gambia Demographic and Health Survey (2013) on women aged 15–49 years (n = 5351) were analyzed. The outcome measures were place (home vs health facility) and mode of delivery (caesarean vs normal) in urban and rural Gambia. Data were analyzed using descriptive and multivariate regression methods.

Results
About three-fifth (60.8%) of the participants had their last childbirth at a health facility and 39.2% at their home. There was a significant urban-rural difference in the prevalence of facility delivery with 86.9% of the urban women choosing health facility over home compared with 45.8% among the rural women. In the regression analysis, place of residence, education of participants and the husband, employment, parity and use of antenatal care were significantly associated with the use of health facility delivery services. For instance, having secondary [OR = 1.657, 95%CI = 1.337,2.053] and higher education [OR-2.451, 95%CI = 1.166,5.150] showed higher odds for using facility delivery services; and women from the richest wealth quintile had significantly higher [OR = 2.239, 95%CI = 1.525,3.289] odds of using facility delivery compared with those in the lowest quintile.

Conclusion
Our findings suggest a sub-optimal use of professional childbirth services among Gambian women which appears to be driven by various geographical, educational, wealth inequality, parity and low use of ANC services. Addressing the socioeconomic and demographic inequalities may lead to a more widespread usage of maternity services in Gambia.
Searching for novel multimodal treatments in oligometastatic pancreatic cancer
Authors: Filippini D. M. , Grassi E. , Palloni A. , Carloni R. , Casadei R. , Ricci C. , Serra C. , Ercolani G. , Brandi G. , Di Marco M. 
Published: March 2020

Abstract
Background
Metastatic pancreatic cancer has a median overall survival of less than 12 months, even if treated with chemotherapy. Selected patients with oligometastatic disease could benefit from multimodal treatments connecting chemotherapy and surgical treatment or radiofrequency ablation (RFA) of metastases.

Case presentation
We present a patient with oligometastatic pancreatic cancer recurrence who was successfully treated with a multimodal therapeutic approach.
A 57-year-old male initially presenting with resectable pancreatic cancer underwent pancreatoduodenectomy. The histopathological diagnosis revealed ductal pancreatic adenocarcinoma with positive surgical resection margins and negative lymph nodes. He completed six cycles of adjuvant therapy with gemcitabine (1000 mg/mq 1,8,15q 28), followed by external radiotherapy (54 Gy in 25 fractions) associated with gemcitabine 50 mg/mq twice weekly. Three years later, the patient developed multiple liver metastases, and he started FOLFIRINOX (oxaliplatin 85 mg/mq, irinotecan 180 mg/mq, leucovorin 400 mg/mq and fluorouracil 400 mg/mq given as a bolus followed by 2400 mg/mq as a 46 h continuous infusion,1q 14) as a first-line treatment.
The CT scan showed a partial response after 6 cycles. After multidisciplinary discussion, the patient underwent a laparotomic metastasectomy of the three hepatic lesions. After additional postsurgical chemotherapy with 4 cycles of the FOLFIRINOX schedule, the patient remained free of recurrence for 12 months. A CT scan showed a new single liver metastasis, which was treated with radiofrequency ablation (RFA). A second radiofrequency ablation was performed when the patient developed another single liver lesion 12 months after the first RFA; currently, the patient is free from recurrence with an overall survival of 6 years from the diagnosis.

Conclusions
Our case has benefited from successful multimodal treatment, including surgical and local ablative techniques and systemic chemotherapy. A multimodal approach may be warranted in selected patients with oligometastatic pancreatic cancer and could improve overall survival. Further research is needed to investigate this approach.
A key genomic signature associated with lymphovascular invasion in head and neck squamous cell carcinoma
Authors: Zhang Jian , Lin Huaming , Jiang Huali , Jiang Hualong , Xie Tao , Wang Baiyao , Huang Xiaoting , Lin Jie , Xu Anan , Li Rong , Zhang Jiexia , Yuan Yawei 
Published: March 2020

Abstract
Background
Lymphovascular invasion (LOI), a key pathological feature of head and neck squamous cell carcinoma (HNSCC), is predictive of poor survival; however, the associated clinical characteristics and underlying molecular mechanisms remain largely unknown.

Methods
We performed weighted gene co-expression network analysis to construct gene co-expression networks and investigate the relationship between key modules and the LOI clinical phenotype. Functional enrichment and KEGG pathway analyses were performed with differentially expressed genes. A protein–protein interaction network was constructed using Cytoscape, and module analysis was performed using MCODE. Prognostic value, expression analysis, and survival analysis were conducted using hub genes; GEPIA and the Human Protein Atlas database were used to determine the mRNA and protein expression levels of hub genes, respectively. Multivariable Cox regression analysis was used to establish a prognostic risk formula and the areas under the receiver operating characteristic curve (AUCs) were used to evaluate prediction efficiency. Finally, potential small molecular agents that could target LOI were identified with DrugBank.

Results
Ten co-expression modules in two key modules (turquoise and pink) associated with LOI were identified. Functional enrichment and KEGG pathway analysis revealed that turquoise and pink modules played significant roles in HNSCC progression. Seven hub genes (CNFN, KIF18B, KIF23, PRC1, CCNA2, DEPDC1, and TTK) in the two modules were identified and validated by survival and expression analyses, and the following prognostic risk formula was established: [risk score = EXPDEPDC1 * 0.32636 + EXPCNFN * (− 0.07544)]. The low-risk group showed better overall survival than the high-risk group (P < 0.0001), and the AUCs for 1-, 3-, and 5-year overall survival were 0.582, 0.634, and 0.636, respectively. Eight small molecular agents, namely XL844, AT7519, AT9283, alvocidib, nelarabine, benzamidine, L-glutamine, and zinc, were identified as novel candidates for controlling LOI in HNSCC (P < 0.05).

Conclusions
The two-mRNA signature (CNFN and DEPDC1) could serve as an independent biomarker to predict LOI risk and provide new insights into the mechanisms underlying LOI in HNSCC. In addition, the small molecular agents appear promising for LOI treatment.
Impact of individual background on the unmet needs of cancer survivors and caregivers – a mixed-methods analysis
Authors: Watanabe Kaname , Katayama Kayoko , Yoshioka Takashi , Narimatsu Hiroto 
Published: March 2020

Abstract
Background
Cancer survivors and their caregivers may have various unmet needs that are medically difficult to solve. Previous studies have suggested the relations between individuals’ backgrounds and their unmet needs. We conducted a large-scale analysis to clarify the influence of individuals’ backgrounds, primarily cancer type, on specific types of unmet needs.

Methods
Using a mixed-methods approach, we analyzed records of first-time callers to a cancer-focused telephone consultation service that was provided by the Kanagawa Cancer Clinical Research Information Organization from October 2006 to May 2014. The qualitative approach concerned extracting unmet needs mentioned in each consultation and classifying them into themes of specific needs, while the quantitative approach comprised multi-variated analysis of the relationships between the frequency by which the needs in each theme arose and the associated callers’ backgrounds.

Results
A total of 1938 consultation cases were analyzed. In the qualitative analysis, the needs were classified into 16 themes. The mean number of unmet needs for each caller was 1.58 (standard deviation = 0.86). In the multi-variated analysis, caregivers for colorectal cancer survivors had a lower frequency of “emotional/mental health” needs (OR: 0.31, 95%CI: 0.11–0.88, p = 0.028) than did caregivers for breast-cancer survivors. Nevertheless, this was the only significant difference in needs frequency among callers (including survivors and their caregivers) with specific cancer types. Meanwhile, there significant difference in the frequency of occurrence of each unmet need theme was found among items concerning other background elements. Among survivors, sex was related to the frequency of needs among “physical” and “resources” themes, and “emotions/mental health”; their age group with “employment”; treatment course with “physical” and “resources” themes and “cure”; residence with “physical” themes; presence of symptom with “physical,” “education/information,” “resources,” “emotions/mental health,” and “cure” themes.

Conclusions
This large-scale study suggests that cancer type is not a significant factor for specific unmet needs and that individuals’ backgrounds and presence of symptoms play a more important role. Through this study, it was found that instruments to predict people’s needs and a system to provide individualized cancer care across cancer types should be developed in the future.
The association of dry eye syndrome and psychiatric disorders: a nationwide population-based cohort study
Authors: Liang Chiao-Ying , Cheang Wai-Man , Wang Chun-Yuan , Lin Keng-Hung , Wei Li-Chen , Chen Yu-Yen , Shen Ying-Cheng 
Published: March 2020

Abstract
Background
Several previous studies reported a greater prevalence of dry eye syndrome (DES) among patients with psychiatric diseases. The aim of this study is to investigate the prevalence and risk factors of DES in patients with psychiatric disorders (PD) using nationwide population-based data in Taiwan.

Methods
This population-based cohort study retrospectively identified patients with PD from 1997 to 2011. Patients with both PD and DES served as the DES cohort, and PD patients without DES comprised the non-DES cohort. PD was defined as a diagnosis of PD (ICD-9-CM 290–319) made by psychiatrists only, with at least three consecutive outpatient visits or at least one inpatient visit. DES was defined as a diagnosis of DES (ICD-9-CM 375.15) and a prescription for an eye lubricant (anatomical therapeutic chemical code, ATC code: S01XA). The main outcome measures were the prevalence of DES in these patients and associated risk factors.

Results
A total of 75,650 patients with PD (3665 in the DES cohort and 71,985 in the non-DES cohort) were included in the final analysis. The majority of patients in the DES group were women (72.6%), compared the non-DES group (57.8%). The mean age of patients in the DES cohort was 62.2 ± 14.9, which was significantly older than those in the non-DES group (50.9 ± 17.5). The patients with DES had a significantly greater likelihood of having dementia, bipolar disorder, depression, and neurotic disorders. Conditional regression analyses revealed that patients with dry eye disease were more likely to have schizophrenia (OR = 1.34), bipolar disorder (OR = 1.9), depression (OR = 1.54), and neurotic disorders (OR = 1.62). In addition, patients with DES were more likely to use 1st generation anti-psychotics (OR = 1.28) and had a lower risk of using 2nd generation anti-psychotics (OR = 0.64).

Conclusion
The study demonstrated that among PD patients, DES is highly prevalence in certain subtypes of PD, such as depression, bipolar disorder, and neurotic disorders, after adjusting for the comorbidities.
Mental and somatic comorbidity of depression: a comprehensive cross-sectional analysis of 202 diagnosis groups using German nationwide ambulatory claims data
Authors: Steffen Annika , Nübel Julia , Jacobi Frank , Bätzing Jörg , Holstiege Jakob 
Published: March 2020

Abstract
Background
Depression is frequently accompanied by other mental disorders and various somatic diseases; however, previous comorbidity studies often relied on self-reported data and have not simultaneously assessed the entire spectrum of mental and somatic diagnoses. The aim is to provide a complete picture of mental and somatic comorbidity of depression in routine outpatient care in a high income country with a relatively well equipped health care system.

Methods
Using ambulatory claims data covering 87% of the German population (age 15+), we designed a cross-sectional study by identifying persons diagnosed with mild, moderate and severe depression in 2017 (N = 6.3 million) and a control group matched 4:1 on sex, 5-year age group and region of residence (N = 25.2 million). Stratified by severity, we calculated the prevalence of 202 diagnosis groups included in the ICD-10 in persons with depression as compared to matched controls using prevalence ratios (PR).

Results
Nearly all mental disorders were at least twice as prevalent in persons with depression relative to controls, showing a dose-response relationship with depression severity. Irrespective of severity, the three most prevalent somatic comorbid diagnosis groups were ‘other dorsopathies’ (M50-M54), ‘hypertensive diseases’ (I10-I15) and ‘metabolic disorders’ (E70-E90), exhibiting PRs in moderate depression of 1.56, 1.23 and 1.33, respectively. Strong associations were revealed with diseases of the central nervous system (i.e. multiple sclerosis) and several neurological diseases, among them sleep disorders, migraine and epilepsy, most of them exhibiting at least 2- to 3-fold higher prevalences in depression relative to controls. Utilization of health care was higher among depression cases compared to controls.

Conclusions
The present study based on data from nearly the complete adolescent and adult population in Germany comprehensively illustrates the comorbidity status of persons diagnosed with depression as coded in routine health care. Our study should contribute to increasing the awareness of the strong interconnection of depression with all other mental and the vast majority of somatic diseases. Our findings underscore clinical and health-economic relevance and the necessity of systematically addressing the high comorbidity of depression and somatic as well as other mental diseases through prevention, early identification and adequate management of depressive symptoms.
Countertransference feelings and personality disorders: a psychometric evaluation of a brief version of the Feeling Word Checklist (FWC-BV)
Authors: Breivik R. , Wilberg T. , Evensen J. , Røssberg J. I. , Dahl H. S. J. , Pedersen G. 
Published: March 2020

Abstract
Background
The Feeling Word Checklist (FWC) is a self-report questionnaire designed to assess therapists’ countertransference (CT) feelings. The primary aim of the study was to evaluate the psychometric properties of a brief, 12-item version of the Feeling Word Checklist (FWC-BV). The second aim was to validate the factor structure by examining the associations between the FWC-BV factors, patients’ personality pathology and therapeutic alliance (TA).

Methods
Therapists at 13 different outpatient units within the Norwegian Network of Personality Disorders participated, and the study includes therapies for a large sample of patients (N = 2425) with personality pathology. Over a period of 2.5 years, therapists completed the FWC-BV for each patient in therapy every 6 months. Statistical methods included exploratory (EFA) and confirmatory (CFA) factor analysis. Internal consistency was estimated using Mc Donald’s coefficient Omega (ωt). The Structured Clinical Interview for DSM-IV – Axis II (SCID II) and Mini International Neuropsychiatric Interview (MINI) were used as diagnostic instruments, and patient-rated TA was assessed using the Working Alliance Inventory (WAI-SR).

Results
Factor analyses revealed three clinically meaningful factors: Inadequate, Idealised and Confident. These factors had acceptable psychometric properties. Most notably, a number of borderline PD criteria correlated positively with the factors Inadequate and Idealised, and negatively with the factor Confident. All the factors correlated significantly with at least one of the WAI-SR subscales.

Conclusions
The FWC-BV measures three clinically meaningful aspects of therapists’ CT feelings. This brief version of the FWC seems satisfactory for use in further research and in clinical contexts.
Health behaviours associated with video gaming in adolescent men: a cross-sectional population-based MOPO study
Authors: Puolitaival Tuulia , Sieppi Mirjam , Pyky Riitta , Enwald Heidi , Korpelainen Raija , Nurkkala Marjukka 
Published: March 2020

Abstract
Background
Playing video games, a form of sedentary behaviour, is associated with poor well-being and increased risk of morbidity due to chronic disease. However, the association between health behaviours and video gaming is poorly understood. The purpose of this population-based study was to reveal the differences in dietary habits and physical activity for adolescent men with high amount of video games on weekdays, as compared to their peers who play less often.

Methods
Seven hundred ninety-six adolescent men (age: mean = 17.8, SD = 0.6) attended compulsory conscription for military service in 2013 and completed a questionnaire regarding the amount and frequency of their video gaming. They also participated in a medical examination and underwent physiological measurements. The participants who played video games more than 3 h/d on weekdays were compared with those who played 3h/d or less. The association between health behaviours and the amount of playing video gaming was analysed using multivariable logistic regression analysis.

Results
24.1% (n = 192) of the participants reported video gaming in excess of 3 h/d. This group had higher incidence of having low physical fitness, having poor eating habits, and being obese. No differences were found in smoking or alcohol drinking habits. Other factors, including low leisure-time physical activity (OR = 1.94; 95% CI, 1.29–2.91), low consumption of vegetables and fruits (OR = 0.83; 95% CI, 0.72–0.97), high consumption of sweetened soft drinks (OR = 1.28; 95% CI, 1.06–1.55) and high amount of sitting time (OR = 1.40; 95% CI, 1.28–1.52), explained one-fourth of the difference.

Conclusion
In this population-based study, adolescent men who played video games a lot on weekdays had lower physical fitness, were more often obese, and had poorer dietary habits, as compared to their peers who played less often. Because playing video games typically adds to a person’s total sedentary time, this activity may be associated with adverse health outcomes at a very young age— especially in combination with poor health behaviours. The results of this study can be utilized to promote health interventions targeted at adolescent men so as to raise their awareness of the disadvantages of excessive video gaming.
Modelling immune deterioration, immune recovery and state-specific duration of HIV-infected women with viral load adjustment: using parametric multistate model
Authors: Dessie Zelalem G. , Zewotir Temesgen , Mwambi Henry , North Delia 
Published: March 2020

AbstractBackgroundCD4 cell and viral load count are highly correlated surrogate markers of human immunodeficiency virus (HIV) disease progression. In modelling the progression of HIV, previous studies mostly dealt with either CD4 cell counts or viral load alone. In this work, both biomarkers are in included one model, in order to study possible factors that affect the intensities of immune deterioration, immune recovery and state-specific duration of HIV-infected women.MethodsThe data is from an ongoing prospective cohort study conducted among antiretroviral treatment (ART) naïve HIV-infected women in the province of KwaZulu-Natal, South Africa. Participants were enrolled in the acute HIV infection phase, then followed-up during chronic infection up to ART initiation. Full-parametric and semi-parametric Markov models were applied. Furthermore, the effect of the inclusion and exclusion viral load in the model was assessed.ResultsInclusion of a viral load component improves the efficiency of the model. The analysis results showed that patients who reported a stable sexual partner, having a higher educational level, higher physical health score and having a high mononuclear component score are more likely to spend more time in a good HIV state (particularly normal disease state). Patients with TB co-infection, withanemia,having a high liver abnormality score and patients who reported many sexual partners, had a significant increase in the intensities of immunological deterioration transitions. On the other hand, having high weight, higher education level, higher quality of life score, having high RBC parameters, high granulocyte component scores and high mononuclear component scores, significantly increased the intensities of immunological recovery transitions.ConclusionInclusion of both CD4 cell count based disease progression states and viral load, in the time-homogeneous Markov model, assisted in modeling the complete disease progression of HIV/AIDS. Higher quality of life (QoL) domain scores, good clinical characteristics, stable sexual partner and higher educational level were found to be predictive factors for transition and length of stay in sequential adversity of HIV/AIDS.