bluuebunny/crossref_metadata_2025_split huggingface dataset:
The maximum standardized uptake value and extent of peritoneal involvement may predict the prognosis of patients with recurrent ovarian cancer after primary treatment
Authors: Jiang Yuanyuan , Hou Guozhu , Wu Fengyu , Zhu Zhaohui , Zhang Wei , Cheng Wuying 
Published: February 2020

Abstract
We investigated the effect of the maximum standardized uptake value (SUVmax) and peritoneal dissemination derived from 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) imaging on prognosis in patients with recurrent ovarian cancer.
We retrospectively analyzed 145 patients with suspected recurrent ovarian cancer who had undergone 18F-FDG PET/CT scans after cytoreductive surgery and chemotherapy. The degree of peritoneal spread was classified as localized (1–3 FDG foci) or diffuse (>3 FDG foci). Receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off values for predicting recurrence.
A total of 145 patients were retrospectively reviewed in this study. 29 patients were excluded as their follow-up results were not available. One hundred sixteen patients were included in the final analysis. The median duration of progression-free survival was 14 months. 18F-FDG PET/CT detected peritoneal carcinomatosis in 82 patients. With a cut-off SUVmax of 2.0 obtained from the ROC curve analysis, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of SUVmax of peritoneal carcinomatosis for predicting recurrence were 77.6%, 87.5%, 65.1%, 97.4%, and 38.9%, respectively. The area under the curve was 0.85. In a multivariate analysis, significant independent prognostic variables were SUVmax of peritoneal disease, peritoneal dissemination, and CA125 levels. In patients with peritoneal involvement, the Kaplan-Meier survival curves showed significantly longer PFS in those with localized disease.
SUVmax of peritoneal disease is valuable in predicting the recurrence of ovarian cancer. SUVmax of peritoneal disease, peritoneal dissemination and CA125 level could be used as independent prognostic factors for ovarian cancer patients.
Total bile acid-to-cholesterol ratio as a novel noninvasive marker for significant liver fibrosis and cirrhosis in patients with non-cholestatic chronic hepatitis B virus infection
Authors: Yan Li-Ting , Wang Li-Li , Yao Jia , Yang Ya-Ting , Mao Xiao-Rong , Yue Wei , Mao Yong-Wu , Zhou Wei , Chen Qing-Feng , Chen Yu , Duan Zhong-Ping , Li Jun-Feng 
Published: February 2020

Abstract
Although serum bile acids and total cholesterol (TC) are closely related to liver cirrhosis, the potential diagnostic value of total bile acid-to-cholesterol ratio (TBA/TC) for liver fibrosis is unclear. The present study aimed to evaluate the value of TBA/TC in the diagnosis of cirrhosis and the relationship between TBA/TC and significant liver fibrosis in chronic hepatitis B virus (HBV) infected patients without cholestasis.
667 patients with alkaline phosphatase (ALP) ≤ 1.5 upper limit of normal (ULN) and gamma-glutamyl transferase (GGT) ≤ 3 ULN were rigorously included in this cross-sectional study. Liver biopsy was performed in 32 patients and METAVIR scoring system was used to evaluate liver fibrosis stage. Liver ultrasound elastography was performed in 138 patients, significant fibrosis was defined as fibrosis ≥ F2. Multiple logistic regression as well as receiver operating characteristic (ROC) curves analyses were performed.
Compared to patients with non-cirrhosis, TBA and TBA/TC were significantly higher in cirrhosis while TC was significantly lower (all P < .001). In multivariate analysis, TBA/TC was also independently associated with cirrhosis [odds ratio (OR) = 1.102, 95% confidence interval (CI): 1.085–1.166]. The area under the curve (AUC) of TBA/TC (0.87) was almost equivalent to the aspartate aminotransferase to platelet ratio index (APRI, AUC = 0.84) and fibrosis 4 score (FIB-4, AUC = 0.80), and the optimal cut-off value for TBA/TC to diagnose cirrhosis was 2.70. Among the patients performed liver biopsy, TBA/TC were significantly higher both in significant fibrosis and cirrhosis as well as significantly correlated with fibrosis stage (all P < .001). Furthermore, In patients performed liver ultrasound elastography, TBA/TC was also independently associated with significant fibrosis (OR = 1.040, 95% CI: 1.001–1.078).
Assessment of TBA/TC could serve as an additional marker of significant liver fibrosis and cirrhosis in non-cholestatic chronic HBV infection.
Characteristics of Stenotrophomonas maltophilia infection in children in Sichuan, China, from 2010 to 2017
Authors: Wang Lili , Zhou Wei , Cao Yang , Yang Chunsong , Liu Hanmin , Chen Ting , Chen Lina 
Published: February 2020

Abstract

Stenotrophomonas maltophilia (S. maltophilia) is an important nosocomial bacterial pathogen. However, the clinical features of children with S. maltophilia infection, the predisposing factors, and the antibiotic susceptibility of the bacteria have not been fully evaluated.
In this study, the data of children with S. maltophilia infection from the West China Second University Hospital of Sichuan University (Chengdu, China) between July 2010 and October 2017 were collected and analyzed. The clinical features of enrolled children, the predisposing factors, and the antibiotic susceptibility were reported.
In total, infection of S. maltophilia was identified in 128 patients. Most of these patients were under 1 year old (67.2%) and were mainly diagnosed as pneumonia (69%). A large proportion had underlying diseases (45.3%), received immunosuppressive therapy (53.1%), had undergone invasive operations (41.4%), had a history of carbapenem antibiotics use within 7 days before culture acquisition (54.7%), history of intensive care unit (ICU) hospitalization within previous 30 days (34.4%), and other risk factors. In particular, invasive operation (95% confidence interval [CI]: 1.125–14.324, P = .032), especially mechanical ventilation (95% CI: 1.277–20.469, P = .021), and ICU admission (95% CI: 1.743–22.956, P = .005) were independent risk factors for the children to develop severe S. maltophilia infection. As for antibiotic susceptibility, trimethoprim sulfamethoxazole (TMP-SMX), piperacillin tazobactam, ticarcillin clavulanate, and ceftazidime exhibited strong antibacterial activities against S. maltophilia, the susceptibility rates were 97.5%, 86.7%, 92.9%, and 81.5%, respectively.
We report the clinical features of children with S. maltophilia infection, the predisposing factors and the antibiotic susceptibility. TMP-SMX can continue to be the first choice for the treatment of S. maltophilia infection. Piperacillin tazobactam, ticarcillin clavulanate, and the third generation cephalosporins can be used as alternative drugs.
Latent composite indicators for evaluating adherence to guidelines in patients with a colorectal cancer diagnosis
Authors: Murtas Rossella , Decarli Adriano , Greco Maria Teresa , Andreano Anita , Russo Antonio Giampiero 
Published: February 2020

Abstract
Evidence-based guidelines for the correct management of cancer patients are developed on the idea that timely care can improve health prognoses and quality of life.
The aim of this paper is to evaluate the adherence of clinical pathways to clinical guidelines provided at the hospital level, for colorectal cancer care.
By using a retrospective observational study, we proposed a method for associating each patient to a healthcare provider and modeling adherence as a latent construct governed by a set of 10 influential indicators. These indicators measure the adherence to specific guidelines for diagnosis, surgical treatment, chemotherapy, and follow-up. The model used was that of the item response theory (IRT). When evaluating providers, the IRT allows for a comparison of indicators in terms of their discriminating ability and difficulty, and in terms of their adherence to guidelines. The IRT results were compared with non-latent methods: numerator-based weight and denominator-based weight.
A strong degree of coherence of the indicators in measuring adherence, and a high level of overall agreement between latent and non-latent methods were noted. The IRT approach demonstrated similar providers’ evaluations between endoscopy and histological assessment indicators. The greatest discriminating ability among providers could be attributed to all diagnostic exams, while the lowest was associated with follow-up endoscopies. The most difficult indicator to achieve was fecal occult blood test, while follow-up imaging was the easiest.
In a decision-making framework, valuable indications can be derived from the use of IRT models rather than weighting methods. Using IRTs, we were able to highlight the principal indicators in terms of strength of discrimination, and to isolate those that merely duplicated information.
Lifelong pulmonary sequelae of bronchopulmonary dysplasia
Authors: Sillers Laura , Alexiou Stamatia , Jensen Erik A. 
Published: February 2020

Purpose of review
To summarize the current literature evaluating long-term pulmonary morbidity among surviving very preterm infants with bronchopulmonary dysplasia (BPD).

Recent findings
BPD predisposes very preterm infants to adverse respiratory signs and symptoms, greater respiratory medication use, and more frequent need for rehospitalization throughout early childhood. Reassuringly, studies also indicate that older children and adolescents with BPD experience, on average, similar functional status and quality of life when compared to former very preterm infants without BPD. However, measured deficits in pulmonary function may persist in those with BPD and indicate an increased susceptibility to early-onset chronic obstructive pulmonary disease during adulthood. Moreover, subtle differences in exercise tolerance and activity may put survivors with BPD at further risk of future morbidity in later life.

Summary
Despite advances in neonatal respiratory care, a diagnosis of BPD continues to be associated with significant pulmonary morbidity over the first two decades of life. Long-term longitudinal studies are needed to determine if recent survivors of BPD will also be at increased risk of debilitating pulmonary disease in adulthood.
The Discharge Lounge
Authors: Woods Rebecca , Sandoval Rebecca , Vermillion Gregory , Bates-Jackson Brenda , Nwankwo Audrey , Canamar Catherine P. , Sarff Laura 
Published: February 2020

Background:
Patient flow, from emergency department admission through to discharge, influences hospital overcrowding. We aimed to improve patient flow by increasing discharge lounge (DL) usage.

Local problem:
Patients need to receive a continuum of nursing care to encourage compliance with follow-up care after discharge from the acute care setting.

Methods:
Baseline data revealed inefficient use of the DL. We targeted the medical-surgical unit with the lowest DL use and trialed interventions over sequential Plan-Do-Study-Act cycles.

Interventions:
After surveying the nursing staff, we assessed the influence of 3 interventions on DL usage: educating staff on patient eligibility, engaging a recruitment scout, and displaying a visual cue notifying staff when a patient's discharge order was written.

Results:
The unit's average DL use increased from 18% to 36%, while hospital overcrowding and discharge turnaround time decreased.

Conclusion:
The DL is an effective tool to improve patient flow and decrease hospital overcrowding.
Outpatient vs Inpatient Total Laparoscopic Hysterectomy: A Randomized Controlled Trial
Authors: Christiansen Ulla J. , Kruse Anne R. , Olesen Peter G. , Lauszus Finn F. , Kesmodel Ulrik S. , Forman Axel 
Published: February 2020

(Abstracted from Acta Obstet Gynecol Scand 2019;98:1420–1428)
The minimal invasive procedure, laparoscopic hysterectomy, is safe, has low risk of complications, and requires only a short hospital stay. Within the first 4 weeks after surgery, readmission rates as low as less than 4% have been reported.
Association of Revised WIC Food Package With Perinatal and Birth Outcomes: A Quasi-Experimental Study
Authors: Hamad Rita , Collin Daniel F. , Baer Rebecca J. , Jelliffe-Pawlowski Laura L. 
Published: February 2020

(Abstracted from JAMA Pediatr 2019;173(9):845–852)
In October 2009, the US Department of Agriculture revised the Special Supplement Nutrition Program for Women, Infants, and Children (WIC). This federal program provides nutritional support, education, breastfeeding support, and referrals to low-income pregnant women, postpartum women, and children younger than 5 years of age.
Efficacy of Repeat Midurethral Sling for Persistent or Recurrent Stress Urinary Incontinence: A Fellows Pelvic Research Network Study
Authors: Smithling Katelyn R. , Adams-Piper Emily E. , Tran Alexis M. , Davé Bhumy A. , Chu Christine M. , Chan Robert C. , Antosh Danielle D. , Gutman Robert E. 
Published: February 2020

(Abstracted from Female Pelvic Med Reconstr Surg 2019;25:430–433)
The criterion-standard treatment for stress urinary incontinence (SUI) is midurethral slings (MUSs) because of high success rates, ease of placement, and durability. However, SUI recurs or persists in up to 23% of patients, and there are only limited data on the efficacy of repeat MUS.
Elevated Plasma Levels of sCD14 and MCP-1 Are Associated With HIV Associated Neurocognitive Disorders Among Antiretroviral-Naive Individuals in Nigeria
Authors: Jumare Jibreel , Akolo Christopher , Ndembi Nicaise , Bwala Sunday , Alabi Peter , Okwuasaba Kanayo , Adebiyi Ruxton , Umlauf Anya , Cherner Mariana , Abimiku Alash'le , Charurat Man , Blattner William A. , Royal Walter 
Published: February 2020

Background:
Mononuclear cells play key roles in the pathogenesis of HIV-associated neurocognitive disorders (HAND). Limited studies have looked at the association of markers of monocyte activation with HAND in Africa. We examined this association among HIV-1–infected patients in Nigeria.

Method:
A total of 190 HIV-infected treatment-naive participants with immune marker data were included in this cross-sectional study. Plasma levels of soluble CD14 (sCD14), soluble CD163, monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor-alpha (TNF-α), and neopterin were measured. Demographically adjusted T scores obtained from a 7-domain neuropsychological test battery were generated, and functional status was assessed using activities of daily living questionnaire. Participants were classified as unimpaired, having asymptomatic neurocognitive impairment (ANI), mild neurocognitive disorder (MND), or HIV-associated dementia (HAD) in line with the “Frascati” criteria.

Results:
Thirty-two participants (16.8%) had ANI, 14 (7.4%) had MND, whereas none had HAD. In multivariable linear regression analyses, after adjusting for age, gender, education, CD4 count, and viral load, mean levels of sCD14 were higher among those with ANI and MND as compared with the unimpaired (P = 0.033 and 0.023, respectively). Similarly, the mean level of MCP-1 was greater among those with HAND as compared with the unimpaired (P = 0.047). There were also trends for higher levels of sCD163 and TNF-α among females with MND in univariable analyses.

Conclusions:
Levels of monocyte activation markers correlate with the severity of impairment among individuals with HAND. The mechanisms that underlie these effects and the potential role of gender require further study.
The Impact of a Structured, Supervised Exercise Program on Daily Step Count in Sedentary Older Adults With and Without HIV
Authors: Stabell Alex C. , Wilson Melissa , Jankowski Catherine M. , MaWhinney Samantha , Erlandson Kristine M. 
Published: February 2020

Background:
People with HIV (PWH) may have lower daily activity levels compared with persons without HIV. We sought to determine the impact of initiating a supervised exercise program on the daily step count of sedentary PWH and uninfected controls.

Methods:
PWH and controls, aged 50–75, were enrolled in a 24-week supervised exercise program. All individuals were given a pedometer and instructed in regular use. A linear mixed model taking into account random effects was used to model daily step count.

Results:
Of 69 participants that began the study, 55 completed and 38 (21 PWH, 17 controls) had complete pedometer data. Baseline daily step count on nonsupervised exercise day was (estimated geometric mean, 95% confidence interval) 3543 (1306 to 9099) for PWH and 4182 (1632 to 10,187) for controls. Both groups increased daily steps on supervised [43% (20 to 69)%, P < 0.001] but not unsupervised exercise days [−12% (−24 to 1)%, P = 0.071]. Compared with controls, PWH had 26% [(−47 to 4)%, P = 0.08] fewer daily steps on days with supervised exercise and 35% [−53 to −10)%, P = 0.011] fewer daily steps on days without supervised exercise. Higher body mass index (per 1 unit) and smoking were associated with fewer daily steps [−5% (−9 to −1)%; −49% (−67 to −23)%; P ≤ 0.012]. Days with precipitation [−8% (−13 to −3)%, P = 0.002] or below freezing [−10% [−15 to −4)%, P < 0.001] were associated with fewer steps.

Conclusion:
Supervised exercise increased daily step counts in sedentary individuals, but at the expense of fewer steps on nonsupervised exercise days.
Brief Report: Long-Term Follow-up of Smokers Living With HIV After an Intensive Behavioral Tobacco Treatment Intervention
Authors: Shuter Jonathan , Kim Ryung S. , Durant Sean , Stanton Cassandra A. 
Published: February 2020

Introduction:
Cigarette smoking is extremely common among persons living with HIV (PLWH) in the United States, and it has emerged as a leading killer in this group. No tobacco treatment studied to date has demonstrated long-term efficacy.

Methods:
This was a follow-up study of PLWH adult smokers who completed a randomized controlled trial of positively Smoke Free group therapy from 2014 to 2017. Participants from 2 of the 3 trial sites were recalled to complete a long-term follow-up assessment, at least one year after initial enrollment.

Results:
Of the 342 candidates for this follow-up study, 11 had died before our attempts to contact them, and 194 of the remaining 331 (58.6%) completed the late follow-up assessment. Most (91.2%) of the remaining candidates could not be contacted despite numerous attempts. At a mean of 38.1 months after initial study enrollment, using an intention-to-treat, lost to follow-up = still smoking (worst case scenario) strategy, 12.7% of group therapy vs. 6.6% of control participants had biochemically verified 7-day point-prevalence abstinence, odds ratio = 2.06 (95% CI: 0.96–4.41), P = 0.06, and 10.3% of group therapy vs. 4.2% of control participants had biochemically verified 12-month point-prevalence abstinence, odds ratio = 2.61 (95% CI: 1.05–6.47, P = 0.03). Improvements in abstinence self-efficacy in the positively Smoke Free group observed in the original study were sustained through late follow-up.

Conclusions:
Targeted group therapy for PLWH smokers was associated with increased cessation and sustained improvements in abstinence self-efficacy at a mean of more than 3 years of follow-up. This is the first trial to show long-term efficacy of tobacco treatment for PLWH.
Patterns and Predictors of HIV Status Disclosure in the 12 Months After Diagnosis in Mozambique
Authors: Taylor Kate , Lamb Matthew , Lahuerta Maria , Ahoua Laurence , Abacassamo Fatima , Elul Batya 
Published: February 2020

Background:
HIV disclosure benefits people living with HIV, their partners, and HIV programs. However, data on the prevalence of disclosure and associated correlates have come largely from patients already in HIV care, potentially overestimating disclosure rates and precluding examination of the impact of disclosure on HIV care outcomes.

Setting:
We used data from an implementation study conducted in Maputo City and Inhambane Province, Mozambique. Adults were enrolled at HIV testing clinics after diagnosis and traced in the community 1 and 12 months later when they reported on disclosure and other outcomes.

Methods:
We examined patterns of participants' disclosure to their social networks (N = 1573) and sexual partners (N = 1024) at both follow-up assessments and used relative risk regression to identify correlates of nondisclosure.

Results:
Disclosure to one's social network and sexual partners was reported by 77.8% and 57.7% of participants, respectively, at 1 month and 92.9% and 72.4% of participants, respectively, at 12 months. At both time points, living in Inhambane Province, being single or not living with a partner, having high levels of anticipated stigma, and not initiating HIV treatment were associated with increased risks of nondisclosure to social networks. Nondisclosure to sexual partners at both follow-up assessments was associated with being women, living in Inhambane Province and in a household without other people living with HIV, and reporting that posttest counseling addressed disclosure.

Conclusions:
Although reported disclosure to social networks was high, disclosure to sexual partners was suboptimal. Effective and acceptable approaches to support partner disclosure, particularly for women, are needed.
Prehospital Mortality Due to Hemorrhagic Shock Remains High and Unchanged: A Summary of Current Civilian EMS Practices and New Military Changes
Authors: Duchesne Juan , Taghavi Sharven , Houghton August , Khan Mansoor , Perreira Bruno , Cotton Bryan , Tatum Danielle 
Published: February 2020

ABSTRACT
Mortality secondary to trauma-related hemorrhagic shock has not improved for several decades. Underlying the stall in progress is the conundrum of effective prehospital interventions for hemorrhage control. As we know, neither pressing hard on the gas nor “stay and play” has changed mortality over the last 20 years. For this reason, when dealing with effective changes that will improve severe hemorrhage mortality outcomes, there is a need for the creation of a hybrid prehospital model. Improvements in mortality outcomes for patients with severe hemorrhage based on evidence for common civilian prehospital procedures such as in-field intubation and immediate fluid resuscitation with crystalloid solution are weak at best. The use of tourniquets, once considered too risky to use, however, has risen dramatically in large part due to success seen during their use in the military. Their use in the civilian setting shows promising results. Recently updated military Advanced Resuscitative Care guidelines propose the use of prehospital whole blood transfusion as well as in-field use of Zone 1 Resuscitative Endovascular Balloon Occlusion of the Aorta. Several case studies from Europe suggest these strategies are feasible for use in the civilian population, but could they be implemented in the US?