bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of the initial degree of anaemia and treatment model in the prognosis of gastric cancer patients treated by chemotherapy: a retrospective analysis
Authors: Li Wen-Huan , Zhang Ji-Yu , Liu Wen-Hui , Chen Xian-Xian 
Published: May 2020

Abstract
Background
Anaemia is highly prevalent in gastric cancer (GC) patients. The role of initial haemoglobin levels in predicting the prognosis of GC patients treated by chemotherapy has not been well determined. Our present study aims to evaluate the relationship between the degree of anaemia and the overall survival (OS) and progression-free survival (PFS) of patients with GC.

Methods
Our retrospective study enrolled 598 patients who were treated with chemotherapy when the recurrent or metastatic GCs were unsuitable for surgical resection. Univariate and multivariate analyses were performed to identify risk factors that had the potential to affect patient prognosis. Additionally, the relationship between clinicopathological characteristics, including treatment method, and degree of cancer-related reduction in haemoglobin was further analysed.

Results
Our results revealed that patients with HBini level ≤ 80 g/L had a trend toward a shortened median OS and PFS (p = 0.009 and p = 0.049, respectively). Interestingly, we also found that HBdec ≥ 30 g/L was associated with a significantly shortened median OS and PFS (p = 0.039 and p = 0.001, respectively). Multivariate analysis showed that HBini levels ≤80 g/L could be used as an independent prognostic factor for recurrent and metastatic GC. More importantly, HBdec ≥ 30 g/L and treatment response were also significantly associated with OS and PFS. Furthermore, the degree of haemoglobin decrease was associated with chemotherapy including platinum and the number of chemotherapy cycles.

Conclusion
Our study concludes that the initial degree of anaemia and a decrease in haemoglobin of ≥30 g/L can serve as biomarkers to predict prognosis in recurrent or metastatic GC patients, while chemotherapy treatment rather than red blood cell (RBC) transfusion can improve their prognosis. Additionally, platinum should not be recommended for treating severely anaemic GC patients.
Dynamic alterations of genome and transcriptome in KRAS G13D mutant CRC PDX model treated with cetuximab
Authors: Zhang Hangyu , Yuan Liyun , Liu Lulu , Yan Cong , Cheng Jinming , Fu Qihan , Tong Zhou , Jiang Weiqin , Zheng Yi , Zhao Peng , Zhang Guoqing , Fang Weijia 
Published: May 2020

Abstract
Background
KRAS mutations have been characterized as the major predictive biomarkers for resistance to cetuximab treatment. However, studies indicate that not all KRAS mutations are associated with equivalent treatment outcomes. KRAS G13D mutations were observed to account for approximately 16% of all KRAS mutations in advanced colorectal cancer patients, and whether these patients can benefit from cetuximab has not been determined.

Methods
An established KRAS G13D mutant colorectal cancer (CRC) patient-derived xenograft (PDX) model was treated with cetuximab. After repeated use of cetuximab, treatment-resistant PDX models were established. Tissue samples were collected before and during treatment, and multiomics data were subsequently sequenced and processed, including whole-exome, mRNA and miRNA data, to explore potential dynamic changes.

Results
Cetuximab treatment initially slowed tumor growth, but resistance developed not long after treatment. WES (whole-exome sequencing) and RNA sequencing found that 145 genes had low P values (< 0.01) when analyzed between the locus genotype and its related gene expression level. Among these genes, SWAP70 was believed to be a probable cause of acquired resistance. JAK2, PRKAA1, FGFR2 and RALBP1, as well as 10 filtered immune-related genes, also exhibited dynamic changes during the treatment.

Conclusions
Cetuximab may be effective in KRAS G13D mutation patients. Dynamic changes in transcription, as determined by WES and RNA sequencing, occurred after repeated drug exposure, and these changes were believed to be the most likely cause of drug resistance.
Novel methods for in vitro modeling of pancreatic cancer reveal important aspects for successful primary cell culture
Authors: Ehlen L. , Arndt J. , Treue D. , Bischoff P. , Loch F. N. , Hahn E. M. , Kotsch K. , Klauschen F. , Beyer K. , Margonis G. A. , Kreis M. E. , Kamphues C. 
Published: May 2020

Abstract
Background
Pancreatic cancer remains a fatal disease. Experimental systems are needed for personalized treatment strategies, drug testing and to further understand tumor biology. Cell cultures can serve as an excellent preclinical platform, but their generation remains challenging.

Methods
Tumor cells from surgically removed pancreatic ductal adenocarcinoma (PDAC) specimens were cultured under novel protocols. Cellular growth and composition were analyzed and culture conditions were continuously optimized. Characterization of cell cultures and primary tumors was performed via hematoxylin and eosin (HE) and immunofluorescence (IF) staining.

Results
Protocols for two- and three-dimensional PDAC primary cell cultures could successfully be established. Primary cell culture depended on dissociation techniques, growth factor supplementation and extracellular matrix components containing Matrigel being crucial for the transformation to three-dimensional PDAC organoids. The generated cultures showed to be highly resemblant to established PDAC primary cell cultures. HE and IF staining for cell culture and corresponding primary tumor characterization could successfully be performed.

Conclusions
The work presented herein shows novel and effective methods to successfully establish primary PDAC cell cultures in a distinct time frame. Factors contributing to cell growth and differentiation could be identified with important implications for further primary cell culture protocols. The established protocols might serve as novel tools in personalized tumor therapy.
Risk factors of malnutrition in Chinese children with congenital heart defect
Authors: Zhang Mingjie , Wang Liping , Huang Rui , Sun Chongrui , Bao Nan , Xu Zhuoming 
Published: May 2020

Abstract
Background
The study aimed to investigate the risk factors of malnutrition in children with congenital heart defect (CHD) in China.

Methods
This cohort study was performed at the biggest pediatric heart center in China; 3252 patients with CHD who underwent cardiac surgeries in 2013 were included. Anthropometric measurements included weight for age Z score (WAZ), weight for height Z score (WHZ), and height for age Z score (HAZ). The patients were classified as normal nutritional status and malnutrition, based on a cut-off Z score of <− 2. Factors associated with malnutrition were determined using logistic regression analysis.

Results
The prevalence of preoperative WAZ < -2 (underweight), HAZ < -2 (stunting), and WHZ < -2 (wasting) was 23.3, 23.3, and 14.3%, respectively. The multivariable analysis of preoperative malnutrition showed that hospitalization, age at surgery, risk adjustment for congenital heart surgery-1 > 3, mechanical ventilation, pulmonary hypertension, and acyanotic heart disease were associated with underweight. Parents’ height, single ventricle, and cyanotic heart disease were associated with stunting. Hospitalization and pulmonary hypertension were associated with wasting. After surgery, the patients presented a significant improvement in growth within the first year in all three parameters and grew to the normal range of WAZ (− 0.3 ± 0.9, P < 0.001), HAZ (0.2 ± 0.8, P = 0.001), and WHZ (0.03 ± 0.6, P < 0.001) at 2 years after surgery. The prevalence of underweight, stunted, and wasting declined to 3.2, 2.7, and 1.9% 3 years after surgery. Malnutrition after surgery was associated with cardiac residual cardiac abnormalities (OR = 35.3, p < 0.0001), high Ross classification of heart function (OR = 27.1, p < 0.0001), and long-term taking oral diuretics (OR = 20.5, P = 0.001).

Conclusions
Malnutrition is still a problem in children with CHD in China, especially before the surgery. There is need to strengthen the nutrition support for children with CHD before surgery. Hemodynamic factors were found to be the risk factors associated with malnutrition after operation.
Social developmental delays among 3 to 6 year old children in preschools in German social hotspots: results of a dynamic prospective cohort study
Authors: Biermann Josefin , Franze Marco , Hoffmann Wolfgang 
Published: May 2020

Abstract
Background
Social skills are valid predictors for school readiness and subsequent school success. The federal state law for child day-care and preschools in Mecklenburg-Western Pomerania, a federal state in Germany, provides additional funds for the targeted and individualized promotion of social developmental delays for children in preschools in social hotspots. The law grants additional funds to eligible preschools, provided that each child’s development is documented with a standardized, objective and valid screening instrument.

Methods
To monitor the development and to detect social developmental delays, the preschools involved use the “Dortmund Developmental Screening for Preschools” (DESK 3–6). For the prevalence and risk factors, data of 5595 children aged 3 to 6 years from these preschools were analyzed.

Results
9.6% of the children show reasonable findings in their social development; for a further 6.1% the results were inconclusive. Sex, presence of chronic diseases or disabilities and reasonable findings in the domains motor development and language and cognition were risk factors in terms of social development across all age groups.

Conclusions
The federal state law is a good example for the implementation of a standardized monitoring of the development of children. With the help of this screening instrument, prevention activities to reduce the prevalence of developmental delays can be conducted in early childhood. Early preventive activities should take into account the reported risk factors for the social development.

Trial registration
German Clinical Trials Register, ID: DRKS00015134, Registered on 29 October 2018, retrospectively registered.
Postpartum vitamin A supplementation for HIV-positive women is not associated with mortality and morbidity of their breastfed infants: evidence from multiple national surveys in sub-Saharan Africa
Authors: Gebremedhin Samson 
Published: May 2020

Abstract
Background
Vitamin A supplementation (VAS) in the postpartum period improves the vitamin A concentration of breast milk and vitamin A status is an important predictor of childhood survival. It is also known that Vitamin A Deficiency (VAD) is more prevalent in HIV-infected women. This study investigated the association between vitamin A supplements provided to HIV-positive women in the postpartum period and mortality and morbidity of their breastfed infants in sub-Saharan Africa (SSA) where the prevalence of VAD and HIV is high.

Methods
This cross-sectional study was conducted based on the secondary data of 838 HIV-positive women (309 vitamin A supplement and 529 non-supplemented) extracted from the datasets of 43 Demographic and Health Surveys (DHS) conducted in 26 SSA countries between 2003 and 2015. The data of HIV-positive women who gave a live birth in the preceding 6 months of the survey and who were breastfeeding their infants at the time of the survey or who breastfed their deceased infants until the time of death, were included in the analysis. The association of postpartum VAS with early infant mortality (death in the first 6 months of birth) and morbidity secondary to fever, diarrhoea and cough with respiratory difficulties in the preceding 2 weeks was assessed by mixed-effects logistic regression model and interpreted using adjusted odds ratio (AOR) with the 95% confidence intervals (CI).

Results
About one-third (36.9%) of the HIV-positive women received VAS soon after the recent delivery. The early infant mortality rate per 1000 live births in vitamin A supplemented group was 100 (95% CI: 67–133) and the corresponding level for non-supplemented group was 125 (95% CI: 97–154). Yet, in the multivariable model adjusted for seven potential confounders, the association was not significant (AOR = 1.10: 95% CI, 0.57–2.13). Similarly, postpartum VAS was not significantly associated with the occurrence of cough with difficult breathing (AOR = 0.65: 95% CI, 0.39–1.10), diarrhoea (AOR = 0.89: 95% CI, 0.50–1.58) and fever (AOR = 1.19: 95% CI 0.78–1.82) in their breastfed infants.

Conclusion
VAS provided to HIV-positive women in the immediate postpartum period does not have significant association with the mortality and morbidity of their breastfed infants.
Perceptions of procedural justice and coercion among forensic psychiatric patients: a study protocol for a prospective, mixed-methods investigation
Authors: Simpson Alexander I. F. , Boldt Irene , Penney Stephanie , Jones Roland , Kidd Sean , Nakhost Arash , Wilkie Treena 
Published: May 2020

AbstractBackgroundThe risk and recovery paradigms are the dominant frameworks informing forensic mental health services and have been the focus of increasing research interest. Despite this, there are significant gaps in our understanding of the nature of mental health recovery in forensic settings (i.e., ‘secure recovery’), and specifically, the key elements of recovery as perceived by forensic patients and their treatment providers. Importantly, we know little about how patients perceive the forensic mental health system, to what extent they see it as fair and legitimate, and how these perceptions impact upon treatment engagement, risk for adversity, and progress in recovery.MethodsIn this prospective, mixed-methods study, we investigate patient perceptions of procedural justice and coercion within the context of the forensic mental health system in Ontario, Canada (finalN = 120 forensic patients and their primary care providers). We elicit patient self-assessments of risk and progress in recovery, and assess the degree of concordance with clinician-rated estimates of these constructs. Both qualitative and quantitative methods are used to assess the degree to which patient perceptions of coercion, fairness and legitimacy impact upon their level of treatment engagement, risk for adversity and progress in recovery. A prospective, two-year follow-up will investigate the impact of patient and clinician perspectives on outcomes in the domains of forensic hospital readmission, criminal reoffending, and rate of progress through the forensic system.DiscussionResults from this mixed-methods study will yield a rich and detailed account of patient perceptions of the forensic mental health system, and specifically whether perceptions of procedural fairness, justice and legitimacy, as well as perceived coercion, systematically influence patients’ risk for adversity, their ability to progress in their recovery, and ultimately, advance through the forensic system towards successful community living. Findings will provide conceptual clarity to the key elements of secure recovery, and illuminate areas of similarity and divergence with respect to how patients and clinicians assess risk and recovery needs. In doing so, knowledge from this study will provide a deep understanding of factors that promote patient safety and recovery, and provide a foundation for optimizing the forensic mental health system to improve patient outcomes.
Socio-demographic patterning of the individual-level double burden of malnutrition in a rural population in South India: a cross-sectional study
Authors: Little Matthew , Humphries Sally , Dodd Warren , Patel Kirit , Dewey Cate 
Published: May 2020

AbstractBackgroundThe double burden of malnutrition is the co-occurrence of undernutrition (e.g. underweight, stunting, and micronutrient deficiencies) and over-nutrition (e.g. obesity, type 2 diabetes, and cardiovascular disease) at the population, household, or individual level. The objectives of this study were to determine the extent and determinants of individual-level co-morbid anemia and overweight and co-morbid anemia and diabetes in a population in rural Tamil Nadu, South India.MethodsWe undertook a cross-sectional study of adults (n = 753) in a rural region of Tamil Nadu, South India. A survey assessed socio-demographic factors, physical activity levels, and dietary intake. Clinical measurements included body-mass index, an oral glucose tolerance test, and blood hemoglobin assessments. Multivariable logistic regression analyses were used to determine associations between risk factors and two co-morbid double burden pairings: (1) anemia and overweight, and (2) anemia and diabetes.ResultsPrevalence of co-morbid anemia and overweight was 23.1% among women and 13.1% among men. Prevalence of co-morbid anemia and diabetes was 6.2% among women and 6.3% among men. The following variables were associated with co-morbid anemia and overweight in multivariable models [odds ratio (95% confidence interval)]: female sex [2.3 (1.4, 3.85)], high caste [3.2 (1.34, 7.49)], wealth index [1.1 (1.00, 1.12)], rurality (0.7 [0.56, 0.85]), tobacco consumption [0.6 (0.32, 0.96)], livestock ownership [0.5 (0.29, 0.89)], and energy-adjusted meat intake [1.8 (0.61, 0.94)]. The following variables were associated with co-morbid anemia and diabetes in multivariable models: age [1.1 (1.05, 1.11)], rurality [0.8 (0.57, 0.98)], and family history of diabetes [4.9 (1.86, 12.70).ConclusionThis study determined the prevalence and factors associated with individual-level double burden of malnutrition. Women in rural regions of India may be particularly vulnerable to individual-level double burden of malnutrition and should be a target population for any nutrition interventions to address simultaneous over- and undernutrition.
The effects of gamification on antimicrobial resistance knowledge and its relationship to dentistry in Saudi Arabia: a randomized controlled trial
Authors: Aboalshamat Khalid , Khayat Amjad , Halwani Ragheb , Bitan Ammar , Alansari Ryyan 
Published: May 2020

Abstract
Background
Antimicrobial resistance (AMR) has reached alarming levels and is considered to be a worldwide public health problem. One of the most significant factors contributing to the spread of AMR is the lack of proper knowledge about the use of antibiotics, which are being used more frequently in dentistry. Recent studies have found that gamification shows promising results for helping the average person improve their knowledge about health and may also be used to boost knowledge about AMR among the public. This study aimed to assess the effects of gamification on AMR awareness, using a board game to promote knowledge about AMR among the public in Saudi Arabia.

Methods
Using a single-blinded parallel group randomized controlled trial design, 94 volunteers were recruited and randomized into two groups. The study group received information about AMR by playing a board game, while the control group received the same information given in a conventional lecture. The participants were evaluated three times: (T1) before the intervention, (T2) immediately after the intervention, and (T3) one month after the intervention for follow-up to evaluate their retention of the information.

Results
Results showed that there were significant improvements (p <  0.05) in knowledge scores for T2 and T3 in comparison to the T1 baseline scores in both groups. However, the knowledge scores also relapsed significantly from T2 to T3 in both groups. Nevertheless, the difference in knowledge score T1 to T3 was significantly higher in the study group in comparison to the control group, and the participants had higher mean scores to use the game as health promotion method.

Conclusions
Gamification using a board game can significantly improve AMR knowledge, with better retention than conventional lecture. It is a promising method for boosting public knowledge about AMR and its relationship to dentistry.

Trial registration
ISRCTN registry: ISRCTN15884410 (retrospectively registered 26-October-2019).
Association between dyslipidemia and blood lipids concentration with smoking habits in the Kurdish population of Iran
Authors: Moradinazar Mehdi , Pasdar Yahya , Najafi Farid , Shahsavari Soodeh , Shakiba Ebrahim , Hamzeh Behrooz , Fakhri Negin 
Published: May 2020

Abstract
Background
Smoking is the most preventable cause of most chronic diseases such as cardiovascular disease (CVD). Dyslipidemia is also an important risk factor for CVD. Yet, research has provided contradicting findings regarding the association between smoking and blood lipids. This paper examines the relationship between dyslipidemia and smoking based on the results of a cross-sectional sample of a Kurdish population in western Iran.

Methods
This population-based study was derived from the recruitment phase of Ravansar Non-Communicable Disease (RaNCD) cohort study. Logistic regression model adjusted by confounding variables was used to determine the relationship between smoking and blood lipid components. In addition, dose-response relationship between blood lipids and the number of smoked cigarettes was evaluated.

Results
For the purpose of this study, 7586 participants were examined. The lifetime prevalence of smoking was 19.9%, and 11.8% were current smokers. The prevalence of dyslipidemia in current smokers (54.9%) was higher than former smokers (43.9%) and in turn former smokers higher than non-smokers (38.0%). Current smokers had greater risk of abnormal HDL cholesterol [OR (95% CI), 2.28(1.98 -2.62)] and triglyceride [OR (95% CI), 1.37(1.15 -1.67)] compared to non-smokers. There was no significant difference in total cholesterol and LDL cholesterol between the two groups. A dose-response relationship was found between the number of cigarettes smoked and HDL-C and TG but no relationship was observed in terms of total cholesterol and LDL-C.

Conclusions
As compared to non-smokers, current smokers and former smokers had abnormal HDL-C and triglyceride and abnormal total cholesterol and triglyceride, respectively. After quitting smoking, heavy smokers showed a more normal HDL-C and total cholesterol levels than the people who tended to smoke a lower number of cigarettes per day.