bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic factors for the short-term mortality of patients with rheumatoid arthritis admitted to intensive care units
Authors: Fujiwara Toshifumi , Tokuda Kentaro , Momii Kenta , Shiomoto Kyohei , Tsushima Hidetoshi , Akasaki Yukio , Ikemura Satoshi , Fukushi Jun-ichi , Maki Jun , Kaku Noriyuki , Akahoshi Tomohiko , Taguchi Tomoaki , Nakashima Yasuharu 
Published: September 2020

Abstract
Background: Patients with rheumatoid arthritis (RA) have high mortality risk and are frequently treated in intensive care units (ICUs). Methods: This was a retrospective observational study. This study included 67 patients (20 males, 47 females) with RA who were admitted at the ICU of our institution for ≥48 h between January 2008 and December 2017. We analyzed the 30-day mortality of these patients and the investigated prognostic factors in RA patients admitted to our ICU.Results: Upon admission, the median age was 70 (range, 33–96) years, and RA duration was 10 (range, 0–61) years. The 5-year survival after ICU admission was 47%, and 30-day, 90-day, and 1-year mortality rates were 22%, 27%, and 37%, respectively. The major reasons for ICU admission were cardiovascular complications (24%) and infection (40%) and the most common ICU treatments were mechanical ventilation (69%), renal replacement (25%), and vasopressor (78%). In the 30-day mortality group, infection led to a fatal outcome in most cases (67%), and nonsurvival was associated with a significantly higher glucocorticoid dose, updated Charlson’s comorbidity index (CCI), and acute physiology and chronic health evaluation (APACHE) II score. Laboratory data obtained at ICU admission showed that lower platelet number and total protein and higher creatinine and prothrombin time international normalized ratio (PT-INR) indicated significantly poorer prognosis. The multivariate Cox proportional hazard model revealed that nonuse of csDMARDs, high updated CCI, increased APACHE II score, and prolonged PT-INR were associated with a higher risk of mortality after ICU admission.Conclusion: Our study demonstrated that the nonuse of csDMARDs, high updated CCI, elevated APACHE II score, and coagulation abnormalities predicted poorer prognosis in RA patients admitted to the ICU.
5-Hydroxytryptamine-3 Receptor Antagonist and Dexamethasone as Prophylaxis for Chemotherapy Induced Nausea and Vomiting during Moderately Emetic Chemotherapy for Solid Tumors: A Multicenter, Prospective, Observational Study
Authors: Matsui Reiko , Suzuki Kenichi , Takiguchi Tomomi , Nishio Makoto , Koike Takeshi , Hayashi Toshinobu , Seto Takashi , Kogure Yuki , Nogami Naoyuki , Fujiwara Kimiko , Kaneda Hiroyasu , Harada Tomohiko , Shimizu Satoru , Kimura Masashi , Kenmotsu Hirotsugu , Shimokawa Mototsugu , Goto Koichi 
Published: September 2020

Abstract
Background: Of patients receiving moderate emetic risk chemotherapy (MEC), 30%–90% experience chemotherapy-induced nausea and vomiting (CINV); however, the optimal antiemetic treatment remains controversial. Methods: In this multicenter, prospective, observational study of adults treated with MEC while receiving chemotherapy for various cancer types in Japan, the enrolled patients kept diaries documenting CINV. All participants received a 5-hydroxytryptamine-3 receptor antagonist and dexamethasone. Results: Of the 400 patients enrolled from May 2013 to January 2015, 386 were eligible for evaluation. The median age was 64 (range, 26–84). The overall complete response (CR; no emetic events and no antiemetic measures) rate was 64%. The proportion of patients showing CR was low in the carboplatin (CBDCA)- and oxaliplatin-based chemotherapy groups, especially among women. We showed that the CR rates in men were high in the CBDCA (AUC5) + etoposide (ETP) (80%), capecitabine plus oxaliplatin (CAPOX) (78%), and CBDCA+ paclitaxel (PTX) groups for lung cancer (73%). Total control (TC; no emetic events, no antiemetic measures, and no nausea) and complete control (CC; no emetic events, no antiemetic measures, and less than mild nausea) were achieved in 51% and 61% of patients, respectively. Logistic regression analysis revealed history of motion sickness, history of pregnancy-associated vomiting and CBDCA-based chemotherapy as risk factors for CR and history of motion sickness and history of pregnancy-associated vomiting as risk factors for TC. Additional, Ages ≥65 years is an independent predictive factor for achieving TC. Conclusion: Our data showed that two antiemetics were insufficient to control CINV in patients receiving CBDCA- or oxaliplatin-based chemotherapy. However, two antiemetics may be sufficiently effective for elderly male patients receiving CBDCA (AUC5)+ETP, CBDCA+PTX for lung cancer, or CAPOX. Additionally, we consider that three antiemetics are necessary for women with colorectal cancer receiving CAPOX. Risk factor analysis related to CR showed that CINV prophylaxis in patients treated with CBDCA-based chemotherapy was generally supportive of the guideline-recommended three antiemetics. However, the control of nausea in patients receiving non-CBDCA-based chemotherapy is a key point to note. The further individualization of antiemetic regimens for patients receiving MEC based on both types of chemotherapy regimens and sex is needed.
Risk of stroke after unilateral or bilateral TKA (simultaneous and staged without discharge) in 327,438 matched patients using data from the National Health Insurance Claims for South Korea
Authors: Han Seung-Beom , Yoon Jung-Ro , Cheong Ji-Young , Lee Sang-Soo , Shin Young-Soo 
Published: September 2020

Abstract
Background: Limited data is available regarding the incidence rate and risk factors for stroke associated with unilateral total knee arthroplasty (TKA) and bilateral TKA. This study aims to investigate the incidence rate and risk factors of stroke in patients treated with bilateral TKA compared with patients with unilateral TKA.Methods: In this retrospective nationwide cohort study, we compared patients undergoing unilateral TKA or bilateral TKA using data from the Korean National Health Insurance claims database between January 1, 2009 and August 31, 2017 and included patients older than 40 years of age who underwent primary TKA by the index date as documented primary diagnosis and first additional diagnosis without a history of stroke during the preceding 1 year. We used matched Cox regression models to compare the incidence rate and risk factors of newly acquired stroke among patients treated with unilateral TKA or bilateral TKA after propensity score (PS) matching.Results: In the present study, 163,719 patients who received unilateral TKA were matched to163,719 patients with bilateral TKA (simultaneous and staged without discharge) based on PS. The risk of stroke during the study period was lower in patients treated with bilateral TKA than in patients with unilateral TKA (adjusted hazard ratio [HR] 0.79; P<0.001). Patients who received bilateral TKA were at decreased risk of stroke when the following variables were present: advanced age (70-79 years, HR 0.76; P<0.001), female sex (HR 0.75; P<0.001), rural area (HR 0.77; P<0.001), small- or medium-sized hospital (HR 0.75; P<0.001), health insurance (HR 0.77; P<0.001), history of hypertension drug use (HR 0.75; P<0.001), congestive heart failure (HR 0.70; P=0.032), connective tissue disease (HR 0.71; P=0.01), diabetes (HR 0.77; P<0.001), and diabetes with complication (HR 0.76; P=0.034).Conclusions: The risk of stroke was lower in patients treated with bilateral TKA (simultaneous and staged without discharge) than in patients with unilateral TKA. Patients treated with bilateral TKA were at decreased risk of stroke when the following variables were present: age (70-79 years), female sex, health insurance, history of hypertension drug use, and comorbidities, such as congestive heart failure, connective tissue disease, and diabetes. More importantly, we do state that those with simultaneous bilateral TKA and staged bilateral TKA without discharge could have been healthier. This is precisely what the guidelines implemented by South Korea for patient selection aim to do and our data show that the risk of stroke is not increased in selected patients undergoing SiBTKA and StBTKA without discharge. Therefore, those who underwent 2 unilateral TKAs could have been at more risk of stroke, especially in the 2nd unilateral TKA.
The effect of midwifery led counseling based on Gamble's approach on childbirth fear and self-efficacy in nulligravida women
Authors: Firouzan Laya , Kharaghani Roghieh , Zenoozian Saeedeh , Moloodi Reza , Jafari Elham 
Published: September 2020

Abstract
Background: Studies show that childbirth fear is a common problem among Iranian women. Therefore, most Iranian women prefer caesarean section for giving birth. This study investigated the effectiveness of a psychoeducational intervention by midwives (birth emotions - looking to improve expectant fear (BELIEF)) on decreasing childbirth fear and self-efficacy among first-time pregnant women who were afraid of giving birth.Methods: A number of 80 pregnant women participated in the study. They had received a score of ≥ 66 on the Wijma delivery expectancy/experience questionnaire. They were randomly assigned into two groups: intervention (n = 40) and control groups (n = 40). The intervention group received two face-to-face counseling sessions based on the BELEF protocol in the 24th and 34th weeks of pregnancy. Between these two sessions, it also received eight telephone-counseling sessions once a week. The control group only received the prenatal routine care. The outcome measures were childbirth fear, childbirth self-efficacy, and childbirth preference. Results: The intervention group showed significantly more reduction in childbirth fear and more increase in childbirth self-efficacy compared to the control group. In addition, more women in the intervention group reported that they preferred to give normal vaginal birth than women in the control group.Conclusion: The BELIEF protocol could be an effective approach in reducing childbirth fear and increasing childbirth self-efficacy among first-time pregnant women who are afraid of giving birth. Trial registration number: IRCT20101219005417N3, Date of Registration: 19-12-2018.
Pre- and Post-operative Differences Between Genders in Idiopathic Macular Holes
Authors: Wang Jing , Yu Yanping , Liang Xida , Wang Zengyi , Qi Biying , Liu Wu 
Published: September 2020

Abstract
Background: To compare idiopathic macular holes (IMHs) between male and female before and after surgery.Methods: Patients with IMHs of stage 3 and stage 4 who underwent 23-gauge vitrectomy were retrospectively enrolled. Pre-operative clinical features like age of onset, and best-corrected visual acuity (BCVA) were reviewed. Optical coherence tomography parameters including minimum linear diameter (MLD), central macular thickness and some other indexes were measured and calculated. Main surgical outcomes included the primary closure rate, the highest BCVA during follow-up, and the recovery duration. All the metrics mentioned above were compared between genders with appropriate statistical methods. Results: A total of 298 eyes from 280 patients (male: 51; female: 229) were enrolled. Compared with men, women demonstrated a significantly higher ratio of stage3/stage4 (P=0.045), larger horizontal MLD (P=0.009), but similar surgical outcomes except for a relatively longer recovery duration (P=0.024). For stage 3 IMHs, women exhibited significantly younger age of onset (P=0.023), larger MLD (P=0.003), and smaller height of the hole (P=0.029). However, for stage 4 IMHs, all the pre- and post-operative metrics showed no differences between genders.Conclusions: Female IMHs seem to demonstrate an earlier age of onset and larger size of hole, especially in IMHs of stage 3. However, these differences, which may owe to normal gender-related variations, have limited influence on the surgical outcomes.
Children, media and food. Food advertising aimed at children audience in Spanish TV
Authors: Jimenez-Marin gloria_jimenez , Garcia Jesus Delgado , Medina Irene Garcia 
Published: September 2020

Abstract
Healthy living habits are the basis for optimal development in children and advertising can affect, positively or negatively, the maintenance of some of these habits. The analysis of food and drink advertising aimed at children during the enhanced protection zone is evidence of the growing problem of obesity in the child population generated through the food industry. The aim of this study is to assess the levels of compliance with the Code of Food and Drink Advertising to Children (Code PAOS). The methodology used was discourse and content analysis. For this purpose, a sample obtained through the recording, during 7 consecutive days, of the content of the advertising cuts in the television broadcast in Spain of three specialized and two generalist channels: Disney Channel, Neox and Boing, on the one hand, and Telecinco and Antena3, on the other. The reason for their choice is that they are the channels, within this segment, with the highest audience ratings. Specifically, the sample was obtained during week from the 12th to the 18th of December 2018.The results reveal a systematic breach of this code that persuades the vulnerable conscience of children through a business network that far from promoting healthy living habits, they cause malnutrition in society. The immediate conclusion is that 9 out of 10 parts of the Food and Beverage Advertising (FBA) did not comply with any of the PAOS Code standards and that self-regulation by advertising companies seems insignificant.
Dynamics of forage and land cover changes in Teltele rangeland Southern, Ethiopia. Using geospatial and field survey data
Authors: Fenetahun Yeneayehu , Yong-dong Wang , You Yuan , Xinwen Xu 
Published: September 2020

Abstract
Background: The gradual conversion of rangelands into other land use types is one of the main challenges affecting the sustainable management of rangelands in Teltele. This study aimed to examine the changes, drivers, trends in land use and land cover (LULC), to determine the link between the Normalized Difference Vegetation Index (NDVI) and forage biomass and the associated impacts of forage biomass production dynamics on the Teltele rangelands in Southern Ethiopia. A Combination of remote sensing data, field interviews, discussion and observations data were used to examine the dynamics of LULC between 1992-2019 and forage biomass production. Results: The result indicate that there is a marked increase in farm land (35.3%), bare land (13.8%) and shrub land (4.8%), while the reduction found in grass land (54.5%), wet land (69.3%) and forest land (10.5%). The larger change in land observed in both grassland and wetland part was observed during the period from 1995-2000 and 2015-2019, this is due to climate change impact (El-Niño) happened in Teltele rangeland during the year 1999 and 2016 respectively. The quantity of forage in different land use/cover types, grass land had the highest average amount of forage biomass of 2,092.3 kg/ha, followed by wetland with 1,231 kg/ha, forest land with 1,191.3 kg/ha, shrub land with 180kg/ha, agricultural land with 139.5 kg/ha and bare land with 58.1 kg/ha. Conclusions: The significant linkage observed between NDVI and LULC change types (when a high NDVI value, the LULC changes also shows positive value or an increasing trend). In addition, NDVI value directly related to the greenness status of vegetation occurred on each LULC change types and its value directly linkage forage biomass production pattern with grassland land use types. 64.8% (grass land), 43.3% (agricultural land), 75.1% (forest land), 50.6% (shrub land), 80.5% (bare land) and 75.5% (wet land) more or higher dry biomass production in the wet season compared to the dry season.
Prenatal diagnosis of Shone’s syndrome: ultrasonographic features and differential diagnosis with coarctation of the aorta
Authors: Li Zhuoyan , Zhao Liqing , Wu Yurong , Chen Sun 
Published: September 2020

Abstract
Objective：To improve the prenatal diagnosis of Shone’s syndrome and identify the mitral valve obstruction associated with the anomaly by comparing the fetal echocardiographic features between Shone’s syndrome and coarctation of the aorta (CoA). Method: Between January 2015 to December 2019, 17 fetuses were diagnosed with Shone’s syndrome prenatally and 8 were analyzed in our final study, their data were compared to normal controls and CoA cases. The main points of identification were summarized. Results: By comparing data between three groups, elevated PA/AO ratio and RV/LV ratio were detected in both Shone’s syndrome and CoA cases. However, TVC/MVC ratios was only increased in Shone’s syndrome. Analysis revealed that the TVC/MVC ratio had the best capability in predicting Shone’s syndrome. Ultrasonographic features of mitral valve obstruction in Shone’s syndrome were unique which help clinicians to distinguish the anomaly from CoA, including (1) morphologic changes in short-axis view: restrictive opening of the mitral valve with diastolic deformity, thickened leaflets, echo-enhancement of chordae tendineae and mitral valve, single papillary muscle or dominant papillary muscle; (5) in color Doppler image: decreased antegrade flow and abnormal flow pattern of mitral valve. Conclusion: There are two key points of prenatal diagnosis of Shone’s syndrome which could help fetal cardiologist to distinguish Shone’s syndrome from CoA in clinical practice, including (1) echocardiographic measurements: the elevated TVC/MVC ratio; (2) morphologic changes of mitral valve indicating left ventricle inflow obstruction in two-dimension short-axis section view.
Alantolactone inhibits cell autophagy and promotes apoptosis via AP2M1 in acute lymphoblastic leukemia
Authors: Shi Ce , Lan Wenjia , Wang Zhenkun , Yang Dongguang , Wei Jia , Liu Zhiyu , Teng Yueqiu , Gu Mengmeng , Yuan Tian , Cao Fenglin , Zhou Jin , Li Yang 
Published: September 2020

Abstract
Background: Acute lymphoblastic leukemia (ALL) is an aggressive hematopoietic malignancy that is most commonly observed in children. Alantolactone (ALT) has been reported to exhibit anti-tumor activity in different types of cancer. The aim of the present study was to investigate the anti-tumor activity and molecular mechanism of ALT in ALL. Methods: ALL cell lines were treated with 1, 5 and 10 μM ALT, and cell viability was assessed using an MTT assay and RNA sequencing. Flow cytometry, JC-1 staining and immunofluorescence staining assays were used to measure cell apoptosis and autophagy. Additionally, western blot analysis was used to detect expression of apoptosis and autophagy related proteins. Finally, the effects of ALT on tumor growth were assessed in a BV173 xenograft nude mouse model. Results: ALT inhibited the proliferation of ALL cells in a dose-dependent manner. Additionally, it was demonstrated that ALT inhibited cell proliferation, colony formation, autophagy, induced apoptosis and reduced tumor growth in vivo through upregulating the expression of adaptor related protein complex 2 subunit mu 1 (AP2M1). Moreover, the autophagy activator rapamycin, attenuated the pro-apoptotic effects of ALT on BV173 and NALM6 cell lines. Overexpression of AP2M1 decreased the expression of Beclin1 and the LC3-II/LC3-1 ratio, and increased p62 expression. Knockdown of Beclin1 increased the levels of bax, cleaved caspase 3 and cytochrome C, and decreased bcl-2 expression. Conclusions: The present study demonstrated that ALT exerts anti-tumor activity through inducing apoptosis and inhibiting autophagy by upregulating AP2M1 in ALL, highlighting a potential therapeutic strategy for treatment of ALL.
Co-encapsulation of HNF4α Overexpressing UMSCs and Human Primary Hepatocytes Ameliorates Mouse Acute Liver Failure
Authors: Kong Defu , Xu Huiming , Chen Mo , Yu Yeping , Qian Yongbing , Qin Tian , Tong Ying , Xia Qiang , Hang Hualian 
Published: September 2020

Abstract
Background: Acute liver failure (ALF) is a complicated condition that is characterized by global hepatocyte death and often requires immediate liver transplantation. However, this therapy is limited by shortage of donor organs. Mesenchymal stem cells (MSCs) and hepatocytes are two attractive sources of cell-based therapies to treat ALF. The combined transplantation of hepatocytes and MSCs is considered to be more effective for the treatment of ALF than single-cell transplantation. We have previously demonstrated that HNF4α-overexpressing human umbilical cord MSCs (HNF4α-UMSCs) promoted the expression of hepatic-specific genes. In addition, microencapsulation allows exchange of nutrients, forming a protective barrier to the transplanted cells. Moreover, encapsulation of hepatocytes improves the viability and synthetic ability of hepatocytes and circumvents immune rejection. This study aimed to investigate the therapeutic effect of microencapsulation of hepatocytes and HNF4α-UMSCs in ALF mice.Methods: Human hepatocytes and UMSCs were obtained separately from liver and umbilical cord, followed by co-encapsulation and transplantation into mice by intraperitoneal injection. LPS/D-gal was used to induce ALF by intraperitoneal injection 24 h after transplantation. In addition, Raw 264.7cells (a macrophage cell line) were used to elucidate the effect of HNF4α-UMSCs-hepatocyte microcapsules on polarization of macrophages. The protein chip was used to define the important paracrine factors in the conditioned mediums (CMs) of UMSCs and HNF4α-UMSCs and investigate the possible mechanism of HNF4α-UMSCs for the treatment of ALF in mice.Results: HNF4α-UMSCs can enhance the function of primary hepatocytes in alginate–poly-L-lysine–alginate (APA) microcapsules. The co-encapsulation of both HNF4α-UMSCs and hepatocytes achieved better therapeutic effects in ALF mice by promoting M2 macrophage polarization and reducing inflammatory response mainly mediated by the paracrine factor HB-EGF secreted by HNF4α-UMSCs.Conclusions: The present study confirms that the co-encapsulation of HNF4α-UMSC and hepatocytes could exert therapeutic effect on ALF mainly by HB-EGF secreted by HNF4α-UMSCs and provides a novel strategy for the treatment of ALF.
Patient Safety Culture in Primary and Home Care Services
Authors: Lousada Letícia , Dutra Francisco Clécio , Silva Beatriz , Oliveira Natália , Bastos Ismael , Vasconcelos Patrícia , de Carvalho Rhanna Emanuela Fontenele Lima 
Published: September 2020

Abstract
Background: Safety culture is still a poorly studied subject in primary care and home care, although these settings are considered gateways to access to healthcare. This study aims to evaluate safety culture in primary and home care settings.Methods: An observational cross-sectional study was carried out with 147 professionals from nine districts covered by one home care program and six primary healthcare centres. The Safety Attitudes Questionnaire (SAQ) was used to evaluate the safety culture, in which scores ≥ 75 are indicative of a positive safety culture.Results: A total of 56 (86,1%) questionnaires returned from the home care professionals and 91 (86,6%) from the primary care professionals. The Job satisfaction domain was the best evaluated, achieving a score of 88.8 in home care and 75.1 in primary care. The achievement of high scores on Safety Climate, Job Satisfaction, Teamwork Climate, and Total SAQ was related to male gender, and time of professional experience of three to four years. Perception of management and Working conditions had the lowest scores, and this result was related with long time of experience.Conclusions: It is concluded that professionals working in home care gave higher scores for safety culture in their workplace than the primary care workers.