bluuebunny/crossref_metadata_2025_split huggingface dataset:
Type 2 Diabetes Patients' Perspectives, Experiences, and Barriers Toward Diabetes-Related Self-Care: A Qualitative Study From Pakistan
Authors: Bukhsh Allah , Goh Bey-Hing , Zimbudzi Edward , Lo Clement , Zoungas Sophia , Chan Kok-Gan , Khan Tahir Mehmood 
Published: November 2020

Objective: This study aimed to qualitatively explore perspectives, practices, and barriers to self-care practices (eating habits, physical activity, self-monitoring of blood glucose, and medicine intake behavior) in urban Pakistani adults with type 2 diabetes mellitus (T2DM).Methods: Pakistani adults with T2DM were recruited from the outpatient departments of two hospitals in Lahore. Semistructured interviews were conducted and audiorecorded until thematic saturation was reached. Two researchers thematically analyzed the data independently using NVivo® software with differences resolved by a third researcher.Results: Thirty-two Pakistani adults (aged 35–75 years, 62% female) participated in the study. Six themes were identified from qualitative analysis: role of family and friends, role of doctors and healthcare, patients' understanding about diabetes, complication of diabetes and other comorbidities, burden of self care, and life circumstances. A variable experience was observed with education and healthcare. Counseling by healthcare providers, family support, and fear of diabetes-associated complications are the key enablers that encourage study participants to adhere to diabetes-related self-care practices. Major barriers to self care are financial constraints, physical limitations, extreme weather conditions, social gatherings, loving food, forgetfulness, needle phobia, and a hectic job.Conclusion: Respondents identified many barriers to diabetes self care, particularly related to life situations and diabetes knowledge. Family support and education by healthcare providers were key influencers to self-care practices among Pakistani people with diabetes.
Aerobic Exercise Training Exerts Beneficial Effects Upon Oxidative Metabolism and Non-Enzymatic Antioxidant Defense in the Liver of Leptin Deficiency Mice
Authors: Fernandes Matheus Santos de Sousa , Silva Lucas de Lucena de Simões e , Kubrusly Márcia Saldanha , Lima Talitta Ricarlly Lopes de Arruda , Muller Cynthia Rodrigues , Américo Anna Laura Viacava , Fernandes Mariana Pinheiro , Cogliati Bruno , Stefano José Tadeu , Lagranha Claudia Jacques , Evangelista Fabiana S. , Oliveira Claudia P. 
Published: November 2020

Non-alcoholic fatty liver disease (NAFLD) is one of the most common forms of liver disease, which is associated with several etiological factors, including stress and dysfunction in oxidative metabolism. However, studies showed that aerobic exercise training (AET) can combat the oxidative stress (OS) and improves mitochondrial functionality in the NAFLD. To test the hypothesis that AET improves oxidative metabolism and antioxidant defense in the liver ofob/obmice. Maleob/obmice with eight weeks old were separated into two groups: the sedentary group (S), n=7, and the trained group (T), n=7. The T mice were submitted to an 8-week protocol of AET at 60% of the maximum velocity achieved in the running capacity test. Before AET, no difference was observed in running test between the groups (S=10.4 ± 0.7 minvs.T= 13 ± 0.47 min). However, after AET, the running capacity was increased in the T group (12.8 ± 0.87 min) compared to the S group (7.2 ± 0.63 min). In skeletal muscle, the T group (26.91 ± 1.12 U/mg of protein) showed higher citrate synthase activity compared with the S group (19.28 ± 0.88 U/mg of protein) (p =0.006). In the analysis of BW evolution, significant reductions were seen in the T group as of the fourth week when compared to the S group. In addition, food intake was not significant different between the groups. Significant increases were observed in the activity of enzymes citrate synthase (p=0.004) and β-HAD (p=0.01) as well as inPGC-1αgene expression (p=0.002) in the liver of T group. The levels of TBARs and carbonyls, as well as SOD, CAT and GST were not different between the groups. However, in the nonenzymatic antioxidant system, we found that the T group had higher sulfhydryl (p = 0.02), GSH (p=0.001) and GSH/GSSG (p=0.02) activity. In conclusion, the AET improved body weight evolution and the aerobic capacity, increased the response of oxidative metabolism markers in the liver such asPGC-1αgene expression and citrate synthase and β-HAD enzyme activities inob/obmice. In addition, AET improved the non-enzymatic antioxidant defense and did not change the enzymatic defense.
A Durable Response With the Combination of Nivolumab and Cabozantinib in a Patient With Metastatic Paraganglioma: A Case Report and Review of the Current Literature
Authors: Economides Minas P. , Shah Amishi Y. , Jimenez Camilo , Habra Mouhammed A. , Desai Monica , Campbell Matthew T. 
Published: November 2020

IntroductionPheochromocytomas and sympathetic paragangliomas (PPGL) are neuroendocrine catecholamine-secreting tumors that are usually localized. Metastatic disease is rare and systemic treatment consists of conventional chemotherapy and high-specific-activity iodine-131-MIBG which was approved by the FDA in 2018. Although chemotherapy combinations still have value in specific settings, the debilitating side effects of treatment with only modest benefit have limited their use. With the introduction of a new generation of targeted therapy and immunotherapy patients with metastatic PPGL may have improved therapeutic options.Areas CoveredThe current paper presents a case of a patient with metastatic PPGL who received multiple lines of systemic treatment. Despite progression on previous single agent cabozantinib and single agent pembrolizumab on separate clinical trials, the patient has exhibited a major response to the combination of cabozantinib and nivolumab for the past 22 months. In addition, we will review the available therapies for metastatic PPGL and discuss novel agents under clinical development.ConclusionNewer targeted therapies and immunotherapy options are under clinical development with promising results for patients with PPGL.
Effect of Temperature on Pyrolysis Oil Using High-Density Polyethylene and Polyethylene Terephthalate Sources From Mobile Pyrolysis Plant
Authors: Prurapark Ruktai , Owjaraen Kittwat , Saengphrom Bordin , Limthongtip Inpitcha , Tongam Nopparat 
Published: November 2020

This research aims to study the effect of temperature, collecting time, and condensers on properties of pyrolysis oil. The research was done be analyzing viscosity, density, proportion of pyrolysis products and performance of each condenser towers for the pyrolysis of high-density polyethylene (HDPE) and polyethylene terephthalate (PET) in the mobile pyrolysis plant. Results showed that the main product of HDPE resin was liquid, and the main product of PET resin was solid. Since the pyrolysis of PET results in mostly solid which blocked up the pipe, the analysis of pyrolysis oil would be from the use of HDPE as a raw material. The pyrolysis of HDPE resin in the amount of 100 kg at 400, 425, and 450°C produced the amount of oil 22.5, 27, and 40.5 L, respectively. The study found that 450°C was the temperature that gives the highest amount of pyrolysis oil in the experiment. The viscosity was in the range of 3.287–4.850 cSt. The density was in the range of 0.668–0.740 kg/L. The viscosity and density were increased according to three factors: high pyrolysis temperature, number of condensers and longer sampling time. From the distillation at temperatures below 65, 65–170, 170–250, and above 250°C, all refined products in each temperature range had the carbon number according to their boiling points. The distillation of pyrolysis oil in this experiment provided high amount of kerosene, followed by gasoline and diesel.
One Year Outcome and Satisfaction of Presbyopia Correction Using the PresbyMAX® Monocular Ablation Profile
Authors: Fu Dan , Zhao Jing , Zeng Li , Zhou Xingtao 
Published: November 2020

Purpose: To explore the safety, efficacy, and satisfaction of the PresbyMAX monocular mode for the correction of presbyopia.Methods: Prospective study. Twenty-two patients (mean age 50.6 ± 6.2 years, 11 myopia patients and 11 hyperopia patients) were enrolled. The dominant eye was fully corrected for distance vision; the non-dominant eye was corrected using central PresbyMAX monocular mode. Binocular uncorrected distance visual acuity (BUDVA), near visual acuity (BUNVA), intermediate visual acuity (BUIVA), corrected distance visual acuity (CDVA), and mean spherical equivalent (SE) were tested at 1 day, 1 week, 1 month, 3 months, and 1 year postoperatively. Questionnaire was performed preoperatively, 1 month, 3 months, and 1 year after surgery.Results: At the final visit, the mean safety index was 1.03 ± 0.14. There were 85.7% eyes with the same or better CDVA than the preoperative value, and 17.1% and 2.9% eyes gained 1 line and 2 lines of CDVA, respectively. All treated eyes achieved 20/25 or better BUDVA, and 95.5% achieved 20/32 or better BUNVA, which improved significantly compared with preoperative values (P &lt; 0.001). BUDVA maintained stability from 1 month postoperatively, BUNVA and BUIVA kept stable since 1 week after surgery. Overall satisfaction was 95.5% (21/22) at 3 months visit, and 100% at the last visit. No differences in terms of visual acuity and satisfaction were found between the myopia and hyperopia groups.Conclusion: The PresbyMAX monocular ablation profile was safe and effective in treating presbyopia, with great satisfaction achieved at postoperative 1 year.
Gut Microbiota and Metabolic Specificity in Ulcerative Colitis and Crohn's Disease
Authors: Sankarasubramanian Jagadesan , Ahmad Rizwan , Avuthu Nagavardhini , Singh Amar B. , Guda Chittibabu 
Published: November 2020

Background: Inflammatory bowel disease (IBD) represents multifactorial chronic inflammatory conditions in the gastrointestinal tract and includes Crohn's disease (CD) and ulcerative colitis (UC). Despite similarities in pathobiology and disease symptoms, UC and CD represent distinct diseases and exhibit diverse therapeutic responses. While studies have now confirmed that IBD is associated with dramatic changes in the gut microbiota, specific changes in the gut microbiome and associated metabolic effects on the host due to CD and UC are less well-understood.Methods: To address this knowledge gap, we performed an extensive unbiased meta-analysis of the gut microbiome data from five different IBD patient cohorts from five different countries using QIIME2, DIAMOND, and STAMP bioinformatics platforms. In-silico profiling of the metabolic pathways and community metabolic modeling were carried out to identify disease-specific association of the metabolic fluxes and signaling pathways.Results: Our results demonstrated a highly conserved gut microbiota community between healthy individuals and IBD patients at higher phylogenetic levels. However, at or below the order level in the taxonomic rank, we found significant disease-specific alterations. Similarly, we identified differential enrichment of the metabolic pathways in CD and UC, which included enriched pathways related to amino acid and glycan biosynthesis and metabolism, in addition to other metabolic pathways.Conclusions: In conclusion, this study highlights the prospects of harnessing the gut microbiota to improve understanding of the etiology of CD and UC and to develop novel prognostic, and therapeutic approaches.
Prevalence of Headache in Patients With Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-Analysis of 14,275 Patients
Authors: Islam Md Asiful , Alam Sayeda Sadia , Kundu Shoumik , Hossan Tareq , Kamal Mohammad Amjad , Cavestro Cinzia 
Published: November 2020

Background: Coronavirus disease 2019 (COVID-19) started to spread globally since December 2019 from Wuhan, China. Headache has been observed as one of the clinical manifestations in COVID-19 patients. We aimed to conduct a comprehensive systematic review and meta-analysis to estimate the overall pooled prevalence of headache in COVID-19 patients.Methods: PubMed, Scopus, ScienceDirect, and Google Scholar databases were searched to identify studies published between December 2019 and March 2020. Adult (≥18 years) COVID-19 patients were considered eligible. We used random-effects model to estimate the pooled prevalence with 95% confidence intervals (CIs). Quality assessment was done using the Joanna Briggs Institute critical appraisal tools. This study is registered with PROSPERO (CRD42020182529).Results: We identified 2,055 studies, of which 86 studies (n = 14,275, 49.4% female) were included in the meta-analysis. Overall, the pooled prevalence of headache in COVID-19 patients was 10.1% [95% CI: 8.76–11.49]. There was no significant difference of headache prevalence in severe or critical vs. non-severe (RR: 1.05, p = 0.78), survived (recovered or discharged) vs. non-survived (RR: 1.36, p = 0.23), and ICU vs. non-ICU (RR: 1.06, p = 0.87) COVID-19 patients. We detected 64.0, 34.9, and 1.1% of the included studies as high, moderate, and low quality, respectively.Conclusions: From the first 4-month data of the outbreak, headache was detected in 10.1% of the adult COVID-19 patients.
Neurological Complications and Noninvasive Multimodal Neuromonitoring in Critically Ill Mechanically Ventilated COVID-19 Patients
Authors: Battaglini Denise , Santori Gregorio , Chandraptham Karthikka , Iannuzzi Francesca , Bastianello Matilde , Tarantino Fabio , Ball Lorenzo , Giacobbe Daniele Roberto , Vena Antonio , Bassetti Matteo , Inglese Matilde , Uccelli Antonio , Rocco Patricia Rieken Macedo , Patroniti Nicolò , Brunetti Iole , Pelosi Paolo , Robba Chiara 
Published: November 2020

Purpose: The incidence and the clinical presentation of neurological manifestations of coronavirus disease-2019 (COVID-19) remain unclear. No data regarding the use of neuromonitoring tools in this group of patients are available.Methods: This is a retrospective study of prospectively collected data. The primary aim was to assess the incidence and the type of neurological complications in critically ill COVID-19 patients and their effect on survival as well as on hospital and intensive care unit (ICU) length of stay. The secondary aim was to describe cerebral hemodynamic changes detected by noninvasive neuromonitoring modalities such as transcranial Doppler, optic nerve sheath diameter (ONSD), and automated pupillometry.Results: Ninety-four patients with COVID-19 admitted to an ICU from February 28 to June 30, 2020, were included in this study. Fifty-three patients underwent noninvasive neuromonitoring. Neurological complications were detected in 50% of patients, with delirium as the most common manifestation. Patients with neurological complications, compared to those without, had longer hospital (36.8 ± 25.1 vs. 19.4 ± 16.9 days, p &lt; 0.001) and ICU (31.5 ± 22.6 vs. 11.5±10.1 days, p &lt; 0.001) stay. The duration of mechanical ventilation was independently associated with the risk of developing neurological complications (odds ratio 1.100, 95% CI 1.046–1.175, p = 0.001). Patients with increased intracranial pressure measured by ONSD (19% of the overall population) had longer ICU stay.Conclusions: Neurological complications are common in critically ill patients with COVID-19 receiving invasive mechanical ventilation and are associated with prolonged ICU length of stay. Multimodal noninvasive neuromonitoring systems are useful tools for the early detection of variations in cerebrovascular parameters in COVID-19.
Characterizing Measurement Error in Dietary Sodium in Longitudinal Intervention Studies
Authors: Pittman Adam , Stuart Elizabeth A. , Siddique Juned 
Published: November 2020

Background: Previous measurement error work that investigates the relationship between a nutritional biomarker and self-reported intake levels has typically been at a single time point, in a single treatment group, or with respect to basic patient demographics. Few studies have examined the measurement error structure in longitudinal randomized trials, and whether the error varies across time or group. This structure is crucial to understand, however, in order to correct for measurement error in self-reported outcomes and properly interpret the longitudinal effects of dietary interventions.Methods: Using two longitudinal randomized controlled trials with internal longitudinal validation data (urinary biomarkers and self-reported values), we examine the relationship between urinary sodium and self-reported sodium and whether this relationship changes as a function of time and/or treatment condition. We do this by building a mixed effects regression model, allowing for a flexible error variance-covariance structure, and testing all possible interactions between time, treatment condition, and self-reported intake.Results: Using a backward selection approach, we arrived at the same final model for both validation data sets. We found no evidence that measurement error changes as a function of self-reported sodium. However, we did find evidence that urinary sodium can differ by time or treatment condition even when conditioning on self-reported values.Conclusion: In longitudinal nutritional intervention trials it is possible that measurement error differs across time and treatment groups. It is important for researchers to consider this possibility and not just assume non-differential measurement error. Future studies should consider data collection strategies to account for the potential dynamic nature of measurement error, such as collecting internal validation data across time and treatment groups when possible.
Cancer-Associated Fibroblast Density, Prognostic Characteristics, and Recurrence in Head and Neck Squamous Cell Carcinoma: A Meta-Analysis
Authors: Knops Alexander M. , South Andrew , Rodeck Ulrich , Martinez-Outschoorn Ubaldo , Harshyne Larry A. , Johnson Jennifer , Luginbuhl Adam J. , Curry Joseph M. 
Published: November 2020

IntroductionThe progression and clinical course of head and neck squamous cell carcinoma (HNSCC) relies on complex interactions between cancer and stromal cells in the tumor microenvironment (TME). Among the most abundant of these stromal cells are cancer-associated fibroblasts (CAFs). While their contribution to tumor progression is widely acknowledged, and various CAF-targeted treatments are under development, the relationship between CAF density and the clinicopathologic course of HNSCC has not been clearly defined. Here we examine the published evidence investigating the relationship of cancer-associated fibroblasts to local recurrence and indicators of prognostic significance in HNSCC.MethodsWe conducted a meta-analysis of existing publications that compare the relationship between CAF density, local recurrence, and clinically significant pathologic criteria of disease development (T stage, nodal positivity, clinical stage, vascular invasion, perineural invasion, Ki67 expression, and differentiation). Thirteen studies met the selection criteria, providing a total study population of 926 patients. Forest plots and risk ratios were generated to illustrate overall relationships.ResultsHigher CAF density within the tumor microenvironment is associated with advanced T stage, nodal infiltration, clinical stage, vascular invasion, perineural invasion, Ki67 expression, and differentiation (p &lt;0.05). High CAF density is also associated with increased rates of local recurrence (p &lt;0.001).ConclusionsAcross multiple studies, increased CAF density is correlated with histopathological criteria of poor prognosis in HNSCC. These findings highlight that CAFs may play a pivotal role in HNSCC development and progression. Staining for CAFs may represent a valuable addition to current pathologic analysis and help to guide prognosis and treatment. Understanding the mechanisms by which CAFs reciprocally interact with cancer cells will be crucial for optimization of TME-focused treatment of HNSCC.
18F-FDG PET/CT Metrics Are Correlated to the Pathological Response in Esophageal Cancer Patients Treated With Induction Chemotherapy Followed by Neoadjuvant Chemo-Radiotherapy
Authors: Simoni Nicola , Rossi Gabriella , Benetti Giulio , Zuffante Michele , Micera Renato , Pavarana Michele , Guariglia Stefania , Zivelonghi Emanuele , Mengardo Valentina , Weindelmayer Jacopo , Giacopuzzi Simone , de Manzoni Giovanni , Cavedon Carlo , Mazzarotto Renzo 
Published: November 2020

Background and ObjectiveThe aim of this study was to assess the ability of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (18F-FDG PET/CT) to provide functional information useful in predicting pathological response to an intensive neoadjuvant chemo-radiotherapy (nCRT) protocol for both esophageal squamous cell carcinoma (SCC) and adenocarcinoma (ADC) patients.Material and MethodsEsophageal carcinoma (EC) patients, treated in our Center between 2014 and 2018, were retrospectively reviewed. The nCRT protocol schedule consisted of an induction phase of weekly administered docetaxel, cisplatin, and 5-fluorouracil (TCF) for 3 weeks, followed by a concomitant phase of weekly TCF for 5 weeks with concurrent radiotherapy (50–50.4 Gy in 25–28 fractions). Three 18F-FDG PET/CT scans were performed: before (PET1) and after (PET2) induction chemotherapy (IC), and prior to surgery (PET3). Correlation between PET parameters [maximum and mean standardized uptake value (SUVmax and SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG)], radiomic features and tumor regression grade (TGR) was investigated.ResultsFifty-four patients (35 ADC, 19 SCC; 48 cT3/4; 52 cN+) were eligible for the analysis. Pathological response to nCRT was classified as major (TRG1-2, 41/54, 75.9%) or non-response (TRG3-4, 13/54, 24.1%). A major response was statistically correlated with SCC subtype (p = 0.02) and smaller tumor length (p = 0.03). MTV and TLG measured prior to IC (PET1) were correlated to TRG1-2 response (p = 0.02 and p = 0.02, respectively). After IC (PET2), SUVmean and TLG correlated with major response (p = 0.03 and p = 0.04, respectively). No significance was detected when relative changes of metabolic parameters between PET1 and PET2 were evaluated. At textural quantitative analysis, three independent radiomic features extracted from PET1 images ([JointEnergy and InverseDifferenceNormalized of GLCM and LowGrayLevelZoneEmphasis of GLSZM) were statistically correlated with major response (p &lt; 0.0002).Conclusions18F-FDG PET/CT traditional metrics and textural features seem to predict pathologic response (TRG) in EC patients treated with induction chemotherapy followed by neoadjuvant chemo-radiotherapy. Further investigations are necessary in order to obtain a reliable predictive model to be used in the clinical practice.