bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sleep related painful erection: an algorithm for evaluation and management
Authors: Abdessater Maher , Kanbar Anthony , Zugail Ahmed S. , Al hammadi Abdalla , Guillonneau Bertrand , Beley Sebastien 
Published: December 2019

Abstract
Background
Sleep related painful erection (SRPE) is a rare parasomnia consisting of nocturnal penile tumescence accompanied by pain that awakens the individual. Normal non-painful erections are experienced when awake. No penile anatomic abnormalities are present. No conclusive randomized clinical trial is present in the literature about the management of this rare condition. The aim of this article is to review the current knowledge about the management of SRPE and to suggest an algorithm to help physicians evaluate and manage SRPE.

Material and methods
A literature review was conducted through PubMed database using the terms: sleep, pain, painful, penile, and erection. The reference lists of the articles were also reviewed. The search returned 23 references that were published between 1987 and 2019. Results were presented in a descriptive manner.

Results
Treatment decision for now is based on reports of the treatment success, the sustainability of remission, the tolerability by the patients and the potential side effects of each medication. From data available in literature, Baclofen is the mostly used medication with a tolerable profile of adverse effects. Phosphodiesterase type 5 inhibitors are considered potential treatments and are already widely used and tolerated for other indications, but so far only 2 successful trials have been reported for SRPE. Cinitapride is very promising, but only one case was studied and no side effects were reported. Clozapine can be very dangerous although highly effective.

Conclusion
Based on the limited number of treatment trials and reported cases, the low level of evidence and the lack of randomized clinical trials, no treatment consensus for SRPE can be reached. We suggested a useful tool for clinicians: an algorithm for the management of SRPE to facilitate their access to the literature without exhaustive return to case reports and series upon each case faced.
Immune repertoire fingerprinting by principal component analysis reveals shared features in subject groups with common exposures
Authors: Sevy Alexander M. , Soto Cinque , Bombardi Robin G. , Meiler Jens , Crowe James E. 
Published: December 2019

AbstractBackgroundAdvances in next-generation sequencing (NGS) of antibody repertoires have led to an explosion in B cell receptor sequence data from donors with many different disease states. These data have the potential to detect patterns of immune response across populations. However, to this point it has been difficult to interpret such patterns of immune response between disease states in the absence of functional data. There is a need for a robust method that can be used to distinguish general patterns of immune responses at the antibody repertoire level.ResultsWe developed a method for reducing the complexity of antibody repertoire datasets using principal component analysis (PCA) and refer to our method as “repertoire fingerprinting.” We reduce the high dimensional space of an antibody repertoire to just two principal components that explain the majority of variation in those repertoires. We show that repertoires from individuals with a common experience or disease state can be clustered by their repertoire fingerprints to identify common antibody responses.ConclusionsOur repertoire fingerprinting method for distinguishing immune repertoires has implications for characterizing an individual disease state. Methods to distinguish disease states based on pattern recognition in the adaptive immune response could be used to develop biomarkers with diagnostic or prognostic utility in patient care. Extending our analysis to larger cohorts of patients in the future should permit us to define more precisely those characteristics of the immune response that result from natural infection or autoimmunity.
Goal attainment scaling as an outcome measure in rare disease trials: a conceptual proposal for validation
Authors: Gaasterland C. M. W. , van der Weide M. C. Jansen , Roes K. C. B. , van der Lee J. H. 
Published: December 2019

AbstractBackgroundGoal Attainment Scaling (GAS) is an instrument that is intended to evaluate the effect of an intervention by assessing change in daily life activities on an individual basis. However, GAS has not been validated adequately in an RCT setting. In this paper we propose a conceptual validation plan of GAS in the setting of rare disease drug trials, and describe a hypothetical trial where GAS could be validated.MethodsWe have used theCOnsensus-based Standards for the selection of health Measurement INstruments(COSMIN) taxonomy to deduce which measurement properties of GAS can be evaluated, and how. As individual GAS scores cannot be interpreted outside the context of a RCT, the validation of GAS needs to be done on trial as well as on individual level.ResultsThe procedure of GAS consists of three steps. For the step of goal selection (step 1) and definition of levels of attainment (step 2), face validity may be assessed by clinical experts. For the evaluation of the goal attainment (step 3), the inter and intra rater reliability can be evaluated on an individual level. Construct validity may be evaluated by comparison with change scores on other instruments measuring in the same domain as particular goals, if available, and by testing hypotheses about differences between groups. A difference in mean GAS scores between a group who received an efficacious intervention and a control group is an indication of well-chosen goals, and corroborates construct validity of GAS on trial level. Responsiveness of GAS cannot be evaluated due to the nature of the construct being assessed.ConclusionGAS may be useful as an instrument to assess functional change as an outcome measure in heterogeneous chronic rare diseases, but it can only be interpreted and validated when used in RCTs with blinded outcome assessment. This proposed theoretical validation plan can be used as a starting point to validate GAS in specific conditions.
Colonic hematoma after extracorporeal shock wave lithotripsy for pancreatic stones: a case report
Authors: Liu Yu , Hao Lu , Wang Teng , Li Zhao-Shen , Xu Zheng-Lei , Hu Liang-Hao 
Published: December 2019

AbstractBackgroundDespite pancreatic extracorporeal shock wave lithotripsy (P-ESWL) is a minimally invasive treatment for pancreatic stones, complications exist.Case presentationA 37-year-old male was diagnosed with chronic pancreatitis and admitted to our hospital for recurrent acute pancreatitis. After the first P-ESWL session, the patient complained of a new type of pain different from the previous pain pattern. Computerized tomography and colonoscopy were arranged and colonic hematoma was found. Since the patient had stable vital signs, no special treatment was given focusing on the colonic hematoma. Five days later, P-ESWL treatment was repeatedly performed for four consecutive days. Two days after the last P-ESWL session, the patient underwent endoscopic retrograde cholangiopancreatography. At the three-month follow up visit, the colonic hematoma disappeared and pancreatic stones decreased significantly.ConclusionsTo the best of our knowledge, colonic hematoma after P-ESWL for pancreatic stones has never been reported. Here, we present the only case of colonic hematoma after P-ESWL, which was coincidentally found in more than 6000 P-ESWL sessions in our hospital. As the symptoms of colonic hematoma are mild, we believe the incidence of colonic hematoma has been underestimated. Many people with colonic hematoma after P-ESWL may be undiagnosed or misdiagnosed. Treatment for colonic hematoma depends on whether there is severe clinical state. Exploration of more precise location method for pancreatic stones may reduce the probability of P-ESWL complication.
Association between anemia and frailty in 13,175 community-dwelling adults aged 50 years and older in China
Authors: Ruan Ye , Guo Yanfei , Kowal Paul , Lu Ye , Liu Chazhen , Sun Shuangyuan , Huang Zhezhou , Zheng Yang , Wang Wenjing , Li Gan , Shi Yan , Wu Fan 
Published: December 2019

Abstract
Background
Anemia and frailty contribute to poor health outcomes in older adults; however, most current research in lower income countries has concentrated on anemia or frailty alone rather than in combination. The aim of the present study was to investigate the association between anemia and frailty in community-dwelling adults aged 50 years and older in China.

Methods
The study population was sourced from the 2007/10 SAGE China Wave 1. Anemia was defined as hemoglobin less than 13 g/dL for men and less than 12 g/dL for women. A Frailty Index (FI) was compiled to assess frailty. The association between anemia and frailty was evaluated using a 2-level hierarchical logistic model.

Results
The prevalence of anemia was 31.0% (95%CI: 28.4, 33.8%) and frailty 14.7% (95%CI: 13.5, 16.0%). In the univariate regression model, presence of anemia was significantly associated with frailty (OR = 1.62, 95% CI: 1.39, 1.90) and the effect remained consistent after adjusting for various potential confounding factors including age, gender, residence, education, household wealth, fruit and vegetable intake, tobacco use, alcohol comsumption and physical activity (adjusted OR = 1.31, 95% CI:1.09, 1.57). Each 1 g/dL increase in hemoglobin concentration was associated with 4% decrease in the odds of frailty after adjusting for several confounding variables (adjusted OR = 0.96, 95% CI: 0.93, 0.99).

Conclusion
Anemia and low hemoglobin concentrations were significantly associated with frailty. Therefore, health care professionals caring for older adults should increase screening, assessment of causes and treatment of anemia as one method of avoiding, delaying or even reversing frailty.
Validation of the Iranian version of the childbirth experience questionnaire 2.0
Authors: Ghanbari-Homayi Solmaz , Dencker Anna , Fardiazar Zahra , Jafarabadi Mohammad Asghari , Mohammad-Alizadeh-Charandabi Sakineh , Meedya Shahla , Mohammadi Eesa , Mirghafourvand Mojgan 
Published: December 2019

Abstract
Background
Assessing women’s childbirth experiences is a crucial indicator in maternity services because negative childbirth experiences are associated with maternal mortalities and morbidities. Due to the high caesarean birth rate in Iran, measuring childbirth experience is a top priority, however, there is no standard tool to measure this key indicator in Iran. The aim of present study is to adapt the “Childbirth Experience Questionnaire 2.0” to the Iranian context and determine its psychometric characteristics.

Methods
Childbirth Experience Questionnaire 2.0 was translated into Farsi. A total of 500 primiparous women, at 4 to 16 weeks postpartum, were randomly selected from 54 healthcare centres in Tabriz. Internal consistency and reliability was calculated using the Cronbach’s Coefficient alpha and Intraclass Correlation Coefficient, respectively. Construct validity was assessed using exploratory and confirmatory factor analysis and discriminant validity using the known-group method and the Mann-Whitney U-test.

Results
The internal consistency and reliability for the total tool were high (Cronbach’s alpha = 0.93; Intraclass Correlation Coefficient = 0.97). Explanatory factor analysis demonstrated the adequacy of the sampling (Kaiser-Meyer-Olkin = 0.923) and significant factorable sphericity (p < 0.001). Confirmation factor analysis demonstrated acceptable values of fitness (RMSEA = 0.07, SRMSEA = 0.06, TLI = 0.97, CFI > 0.91, x2/ df = 4.23). Discriminatory validity of the tool was confirmed where the CEQ score and its subdomains were significantly higher in women who reported having control over their childbirth than women who did not.

Conclusion
The Farsi version of the Childbirth Experience Questionnaire 2.0 tool is a valid and reliable tool and can be used to measure the childbirth experience in Iranian women.
Maternal nutritional adequacy and gestational weight gain and their associations with birth outcomes among Vietnamese women
Authors: Tran Nga Thuy , Nguyen Lam Thi , Berde Yatin , Low Yen Ling , Tey Siew Ling , Huynh Dieu Thi Thu 
Published: December 2019

AbstractBackgroundDuring pregnancy, a mother’s nutritional needs increase to meet the added nutrient demands for fetal growth and development. An enhanced understanding of adequate nutrition and sufficient weight gain during pregnancy can guide development of policies and strategies for maternal nutrition care, actions that will ultimately promote better pregnancy outcomes. In a sample of pregnant women in Vietnam, this study characterized maternal nutrition status and gestational weight gain at a mid-pregnancy baseline, then examined the association of these variables with specific birth outcomes.MethodsThe study used baseline data from a randomized, controlled trial that compared pregnant Vietnamese women who received a nutritional intervention group with those who received only standard dietary counseling (control group). At baseline (26–29 weeks gestation), mothers’ dietary reports were collected, and intake of 10 macro- and micronutrients was estimated; data for baseline gestational weight gain was collected for all pregnant women enrolled into the study (n = 228). This analysis also used weights, lengths, and head circumferences at birth for infants of mothers in the control group.ResultsAt baseline, 95% of the pregnant women had concurrent inadequacies for more than five nutrients, and nearly half had concurrent inadequacies for more than ten nutrients. Almost two-thirds of the pregnant women did not meet recommendations for gestational weight gain. We found a significant, inverse association between the number of nutrient inadequacies and gestational weight gain (overallp ≤ 0.045). After adjusting for potential confounders, gestational weight gain was positively associated with birth weight, length at birth, birth weight-for-agez-score and length-for-agez-score (allp ≤ 0.006).ConclusionsOur findings raise concern over the high proportion of pregnant women in Vietnam who have multiple concurrent nutrient inadequacies and who fall short of meeting recommended gestational weight gain standards. To ensure better birth outcomes in this population, policies and strategies to improve the status of maternal nutrition are greatly needed.Trial registrationThe trial was retrospectively registered at clinicaltrials.gov on December 20, 2013, registration identifier:NCT02016586.
Breast cancer risk status influences uptake, retention and efficacy of a weight loss programme amongst breast cancer screening attendees: two randomised controlled feasibility trials
Authors: Harvie Michelle , Pegington Mary , French David , Cooper Grace , McDiarmid Sarah , Howell Anthony , Donnelly Louise , Ruane Helen , Sellers Katharine , Foden Philip , Evans D. Gareth 
Published: December 2019

Abstract
Background
Excess body weight and sub-optimal lifestyle are modifiable causes of breast cancer and other diseases. There is little evidence that behaviour change is possible within screening programmes and whether this is influenced by prior knowledge of disease risk. We determined whether breast cancer risk influences uptake, retention and efficacy of a weight control programme in the UK National Health Service Breast Screening Programme, and whether additional cardiovascular disease and type 2 diabetes risk information improves uptake and retention further.

Method
Overweight/obese women in the UK National Health Service Breast Screening Programme identified at high, moderately increased, average and low-risk of breast cancer were randomised to receive individualised breast cancer risk information (breast cancer prevention programme), or individualised breast cancer, cardiovascular disease (QRISK2) and type 2 diabetes (QDiabetes, HbA1c) information (multiple disease prevention programme). Personalised breast cancer risk feedback was given before randomisation in Study-1, and after randomisation in Study-2.

Results
Recruitment was 9% (126/1356) in Study-1 and 7% (52/738) in Study-2. With respect to breast cancer risk, odds ratio of uptake for high/moderately increased vs low risk women was 1.99 (95% CI 1.24–3.17, P = 0.004) in Study-1 and 3.58 (95% CI 1.59–8.07, P = 0.002) in Study-2. Odds ratio of retention for high/moderately increased -risk vs. low risk women was 2.98 (95% CI 1.05–8.47, P = 0.041) in Study-1 and 3.88 (95% CI 1.07–14.04, P = 0.039) in Study-2. Weight loss of ≥5% at 12 months was achieved by 63% high/moderate vs. 43% low-risk women in Study-1 (P = 0.083) and 39% vs. 8% in Study-2 (P = 0.008). Uptake, retention and weight loss were equivalent in both the breast cancer prevention programme and the multiple disease prevention programme in both studies.

Conclusions
Women who are informed that they are at increased breast cancer risk were significantly more likely to join and remain in the programmes and consequently lose more weight across both studies. High risk women are more likely engage in a lifetyle prevention programme and also have the greatest potential benefit fom risk reduction strategies.

Trial registration
ISRCTN91372184 Registered 28 September 2014.
Multicenter phase III randomized trial comparing laparoscopy and laparotomy for colon cancer surgery in patients older than 75 years: the CELL study, a Fédération de Recherche en Chirurgie (FRENCH) trial
Authors: Manceau Gilles , Brouquet Antoine , Chaibi Pascal , Passot Guillaume , Bouché Olivier , Mathonnet Murielle , Regimbeau Jean-Marc , Lo Dico Rea , Lefèvre Jérémie H. , Peschaud Frédérique , Facy Olivier , Volpin Enrico , Chouillard Elie , Beyert-Berjot Laura , Verny Marc , Karoui Mehdi , Benoist Stéphane 
Published: December 2019

Abstract
Background
Several multicenter randomized controlled trials comparing laparoscopy and conventional open surgery for colon cancer have demonstrated that laparoscopic approach achieved the same oncological results while improving significantly early postoperative outcomes. These trials included few elderly patients, with a median age not exceeding 71 years. However, colon cancer is a disease of the elderly. More than 65% of patients operated on for colon cancer belong to this age group, and this proportion may become more pronounced in the coming years. In current practice, laparoscopy is underused in this population.

Methods
The CELL (Colectomy for cancer in the Elderly by Laparoscopy or Laparotomy) trial is a multicenter, open-label randomized, 2-arm phase III superiority trial. Patients aged 75 years or older with uncomplicated colonic adenocarcinoma or endoscopically unresectable colonic polyp will be randomized to either colectomy by laparoscopy or laparotomy. The primary endpoint of the study is overall postoperative morbidity, defined as any complication classification occurring up to 30 days after surgery. The secondary endpoints are: 30-day and 90-day postoperative mortality, 30-day readmission rate, quality of surgical resection, health-related quality of life and evolution of geriatric assessment. A 35 to 20% overall postoperative morbidity rate reduction is expected for patients operated on by laparoscopy compared with those who underwent surgery by laparotomy. With a two-sided α risk of 5% and a power of 80% (β = 0.20), 276 patients will be required in total.

Discussion
To date, no dedicated randomized controlled trial has been conducted to evaluate morbidity after colon cancer surgery by laparoscopy or laparotomy in the elderly and the benefits of laparoscopy is still debated in this context. Thus, a prospective multicenter randomized trial evaluating postoperative outcomes specifically in elderly patients operated on for colon cancer by laparoscopy or laparotomy with curative intent is warranted. If significant, such a study might change the current surgical practices and allow a significant improvement in the surgical management of this population, which will be the vast majority of patients treated for colon cancer in the coming years.

Trial registration
ClinicalTrials.gov NCT03033719 (January 27, 2017).
Awareness of HIV/AIDS and its routes of transmission as well as access to health knowledge among rural residents in Western China: a cross-sectional study
Authors: Zhang Tianqi , Miao Yang , Li Lingui , Bian Ying 
Published: December 2019

Abstract
Background
The purpose of this study was to evaluate the coverage of HIV health education among rural residents in western China by ascertaining their awareness of HIV/AIDS and its transmission routes, and to investigate how these residents receive health information.

Methods
A survey was conducted through stratified clustered sampling at 99 county hospitals in 11 provinces in western China. Information was collected on awareness of HIV/AIDS and its transmission routes, as well as residents’ access to health knowledge. Chi-square analysis was used to analyse the differences in HIV/AIDS awareness (knowing of the existence of HIV/AIDS, hereinafter referred to as “HIV awareness rate”) between different subgroups categorized by demographic status, regional factors, and different methods of access to health knowledge. To further analyse the effects of access to health knowledge on HIV awareness, a logistic regression model was established. The relationship between access to health knowledge and transmission routes was also examined using chi-square analysis.

Results
The HIV awareness rate of the total 9274 participants was 80.9%. There were statistically significant differences between subgroups classified by age (χ2 = 482.118, p<0.001), education (χ2 = 853.465, p<0.001), occupation (χ2 = 340.553, p<0.001), income (χ2 = 186.448, p<0.001), cumulative HIV cases according to province (χ2 = 59.513, p<0.001), per capita annual net income of rural households according to province (χ2 = 64.676, p<0.001), proportion of minority population according to province (χ2 = 94.898, p<0.001), direct access to health knowledge (medical staff: χ2 = 419.775, p<0.001; mass media: χ2 = 740.238, p<0.001; family members: χ2 = 12.189, p<0.001; socializing: χ2 = 48.780, p<0.001; health education activities: χ2 = 154.400, p<0.001), and indirect access to health knowledge (having a non-communicable disease with medical instructions χ2 = 78.709, p<0.001; physical examinations: χ2 = 135.679, p<0.001). The logistic regression model showed that education and mass media had the strongest impacts on HIV awareness among all methods of access. Participants had the least awareness of HIV’s mother-to-child transmission route.

Conclusion
The HIV awareness rate indicated that previous HIV health education covered 80% of the rural population in western China. Mass media should take greater responsibility in HIV health education for the general population, and special attention should be paid to the elderly, the most impoverished population, minority community as well as the mother-to-child transmission route.