bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measuring Productivity and Efficiency of Traditional Chinese Medicine Hospitals From 2009 to 2016: A Bootstrap-Data Envelopment Analysis
Authors: Liu Xinliang , Chen Rui , Wu Shaopeng , Wang Quan , Wang Jian , Li Jianan , Li Hao 
Published: December 2020

Abstract
Background: Traditional Chinese Medicine (TCM) Hospitals are the dominant agents to provide TCM services in China. How to improve the productivity and efficiency of TCM hospitals is quite pivotal for the hospital managers and policy-makers to realize the optimal use of TCM resources. The purpose of this study was to estimate the productivity and efficiency of TCM hospitals with the Bootstrap-Malmquist-Data Envelopment Analysis (DEA) from 2009 to 2016 to provide empirical evidence for hospital managers and policy-makers to improve the management and quality of TCM service.Methods: The data of the individual tertiary public TCM hospitals were collected from official Yearbooks of Traditional Chinese Medicine of China (2010-2017). Bootstrap-Malmquist-DEA was employed to measure the productivity and efficiency of the TCM hospitals from 2009 to 2016. SPSS 23.0 version statistical software was used to conduct the descriptive analysis of the input and output indicators. R 3.2.1 version statistical software was applied to calculate the productivity and efficiency of the TCM hospitals with FEAR package. The statistical significant was set at P < 0.05.Results: The annual average growth rates for each input and output indicator were 6.61% (health professionals), 8.15% (actual open beds), 7.08% (outpatients and inpatients) and 12.50% (discharged patients) respectively from 2009 to 2016. Except the TFPC between 2014 and 2015, more than half of the TCM hospitals had TFPC scores over 1.000, indicating increased productivity. The overall annual geo-means of the scores of the TFPC and its decomposition index were 1.0379 (TFPC), 1.0167 (TEC), 1.0209 (TC), 1.0212 (PTEC), and 0.9955 (SEC) respectively from 2009 to 2016.Conclusions: The overall annual rate of the total factor productivity of the tertiary public TCM hospitals was slightly increased. The technological progress was the main driver to improve the total factor productivity. The decreased TE was more affected by the decreased SE. The TCM hospitals need to pay attention to the development and innovation of the TCM technology, thereby improving the competitiveness. The TCM hospitals managers should pursuit the high quality, high efficiency and low cost of the TCM medical services.
GCKR Common Functional Polymorphisms are Associated with Metabolic Syndrome and its Components: A 10-Year Retrospective Cohort Study in Iranian Adults
Authors: Zahedi Asiyeh Sadat , Akbarzadeh Mahdi , Sedaghati-khayat Bahareh , Seyedhamzehzadeh Atefeh , Daneshpour Maryam S 
Published: December 2020

Abstract
Background: Some previous studies reported that common functional variants (rs780093, rs780094, and rs1260326) in the glucokinase regulator gene (GCKR) were associated with metabolic syndrome despite the simultaneous association with the favorable and unfavorable metabolic syndrome components. We decided to examine these findings, to our knowledge for the first time, in Iranian adults. We investigated the association of the GCKR variants with incident MetS in mean follow-up times for nearly ten years.Methods: Analysis of this retrospective cohort study was performed among 5666 participants of the Tehran Cardiometabolic Genetics Study (TCGS) at 19-88 years at baseline. Linear and logistic regression analyses were used to investigate the metabolic syndrome (JIS criteria) association and its components with rs780093, rs780094, and rs1260326 in an additive genetic model. Cox regression was carried out to peruse variants' association with the incidence of metabolic syndrome in the TCGS cohort study.Results: In the current study, we have consistently replicated the association between the T-allele of GCKR SNPs and higher triglyceride levels and lower fasting blood sugar levels (p<0.05) in the Iranian population. The CT genotype of all three variants was associated with lower HDL-C levels. The proportional Cox adjusted model regression resulted that TT carriers of rs780094, rs780093, and rs1260326 were associated with 20%, 23%, and 21% excess risk metabolic syndrome incidence, respectively (p<0.05).Conclusions: Elevated triglyceride levels had the strongest association with GCKR selected variants among the metabolic syndrome components. Despite the association of these variants with decreased fasting blood sugar levels, T alleles of the variants were associated with metabolic syndrome incidence; so whether individuals are T allele carriers of the common functional variants, they have a risk factor for the future incidence of metabolic syndrome.
Lipid Profile and Blood Glucose Level of Hypertensive Population in Rural Regions of West China.
Authors: Fan Lihong , Hu Xiaojing , Li You , Bai Tiao , Pan Longfei , Tian Hua , Wang Yifan , Lu Qun , Ma Aiqun , Tian Hongyan 
Published: December 2020

Abstract
Background: In rural regions of West China, there was almost no intervention on dyslipidemias and abnormal glucose metabolism of individuals with hypertension because of no literature reporting the lipid profile or blood glucose of these patients. This study was designed to investigate the lipid profile and blood glucose level of the hypertensive population in these regions. Methods: A cross-sectional community survey was carried out in Xunyi county of Shaanxi province in West China. The study enrolled 1425 hypertensive patients. The lipid profile and blood glucose levels were assessed. Diet and physical activity were also investigated by questionnaire. Results: 54% of the population had dyslipidemias. The hypercholesterolemia (hyper-TC) and hypertriglyceridemia (hyper-TG) were the main dyslipidemias (hyper-TC:25%; hyper-TG: 33% ). The prevalence of abnormal glucose metabolism was 37%. 16% of the population had hyperglycemia. Despite of low-fat intake, the diet was unbalanced by excess salt consumption and seriously insufficient intake of vegetables, fruits and protein. Conclusion: Dyslipidemias and abnormal glucose metabolism were common in the hypertensive patients in rural areas of West China. They were needed to be invented to reduce the risks of atherosclerotic cardiovascular diseases of hypertensive patients in these regions. Unbalanced diet here may be needed to be modified.
Problems of Lymph Node Dissection in Intrahepatic Cholangiocarcinoma: A Multicenter Retrospective Study Using Inverse Probability of Treatment Weighting.
Authors: Hu Hanjie , Xu Gang , Zhao Hong , Du Sunda , Luo Zhiwen , Cai Jianqiang 
Published: December 2020

Abstract
Background Lymph node dissection (LND) is considered to improve the prognosis of patients with intrahepatic cholangiocarcinoma (ICC). Although the National Comprehensive Cancer Network (NCCN) guidelines recommend routine LND in ICC, the role of LND remains controversial. This study aimed to explore the effect of LND on the prognosis of patients with ICC from two Chinese centers.MethodsPatients were identified in two Chinese academic centers. Inverse probability of treatment weighting (IPTW) was used to reduce bias. Kaplan–Meier curves and Cox proportional hazards models were used to compare overall survival (OS) and disease-free survival (DFS).ResultsOf 251 patients, 189 (75.2%) underwent LND, and 72 (38%) had metastatic lymph nodes. A minimum of 6 lymph nodes were dissected in 67 patients (35.5%). Lymph node metastasis (LNM) was a risk factor with a high hazard ratio. There was no association between LND and OS after IPTW; however, LND may affect the DFS. Tumors in the LNM group were more malignant, and surgical trauma was greater in the LNM group.ConclusionsOnly a few LNDs meet the NCCN guidelines’ requirements. LND did not improve prognosis, with higher surgical trauma. The best approach for LND requires further discussion.
Significance of Preoperative Peripheral Blood Neutrophil-lymphocyte Ratio in Predicting Postoperative Survival in Patients with Multiple Myeloma Bone Disease
Authors: Xu Ziyu , Yao Xingchen , Shi Xiangjun , du xinru 
Published: December 2020

Abstract
Background: By observing the change characteristics of NLR at different stages after operation, to make a preliminary analysis of the effect of operation on the immune status of MM patients and study the prognostic value of peripheral blood NLR in predicting the treatment of multiple myeloma bone disease (MMBD).Method: The clinical data of 82 MMBD patients who underwent operations in our hospital were collected, which to analyze the effect of preoperative peripheral blood NLR on the prognosis of MMBD patients; Peripheral blood lymphocyte percentage was taken as the major observation indicator to analyze the change characteristics of the immune status of MM patients.Results: Data showed that the NLR cut-off values of the NLR≥3 group and NLR≥4 group were significantly correlated with POS. The POS of NLR≥3 patients (14.86±14.28) was significantly shorter than that of NLR＜3 patients (32.68±21.76). The lymphocyte percentage 1 week after operation (19.329±9.083) was significantly lower than that before operation (25.723±11.016). Survival analysis showed that postoperative chemotherapy and preoperative peripheral blood NLR were independent risk factors for POS.Conclusions: NLR was significant for the prediction of the POS of MMBD patients treated with operation, and MMBD patients with high preoperative NLR (NLR≥3) had a poorer prognosis and shorter POS. The immune status of MMBD patients was at a normal low level, and significantly declined after operation.Trial registration: As this was a retrospective study, it did not require ethical approval; all patients had signed informed consent when they received treatment, and all treatment options were voluntary.
Linezolid-Containing Regimen Lowers Mortality of Rifampicin/Multidrug-Resistant Tuberculous Meningitis in Shenzhen, China
Authors: Fang Mu-tong , Su You-feng , Deng Guo-fang , Zhang Pei-ze , Liu Hou-ming , Mao Zhi , Zeng Jian-feng , Li Guo-bao , Yang Qian-ting , Wang Zhong-yuan 
Published: December 2020

Abstract
Background: The morbidity of rifampicin/multidrug-resistant tuberculous meningitis (RR/MDR-TBM) is increasing in many countries and regions in the world. Its mortality is significantly higher than non rifampicin/multidrug-resistant ones (NRR/MDR-TBM ). This article aims to explore the RR/MDR-TBM related risk factors, and compare the different therapeutic effects to the RR/MDR-TBM patients between linezolid-containing anti-tuberculosis regimen and non linezolid regimen in Shenzhen city. Furthermore, we want to find a better therapy for pathogen negative TBM with RR/MDR-TBM related risk factors. Methods: 137 cases with confirmed TBM (pathogen positive), who were hospitalized in the Third People’s Hospital of Shenzhen from June 2014 to March 2020, were enrolled in this study, all patients were divided into RR/MDR-TBM group (12 cases) and NRR/MDR-TBM group (125 cases) according to the GeneXpert MTB/RIF and (or) phenotypic drug susceptibility test of CSF (cerebral spinal fluid). The risk factors related to RR/MDR-TBM were investigated through comparing the clinical and examination features between the two groups.The mortality of RR/MDR-TBM patients treated with different regimens was analyzed to compare their respective therapeutic effects to the RR/MDR-TBM . P<0.05 differences is considered statistically significant. Results: Most of the patients(111/137, 81%) were from southern or southwestern China, and a large proportion(72/137, 52.55%) is migrant workers. 12 cases were RR/MDR-TBM (12/137,8.8%) in all TBM patients while 125 cases were NRR/MDR-TBM(125/137,91.2%). The proportion of previously treated cases in RR/MDR-TBM group was significantly higher than that in NRR/MDR-TBM group (6/12vs12/125, 50%vs10.5%,P<0.01), while there was no significant difference in other clinical and examination features between the two groups. The mortality of RR/MDR-TBM treated with the linezolid-containing regimen was significantly lower than that treated with non linezolid regimen (P=0.045). Conclusions: The main related high-risk factor of RR/MDR-TBM is the history of anti-tuberculosis treatment. Linezolid -containing regimen appears to lower the mortality of RR/MDR-TBM significantly. Therefore, it is recommended that linezolid-containing regimen can be used as a better empirical anti-tuberculosis therapy for pathogen negative TBM previously treated in China.
Impossible Airway: A Case Report
Authors: Hsiao Yu-Tse , Huang Pei-Chuan , Lien Wan-Ching , Chang Wei-Tien 
Published: December 2020

Abstract
Background: Wheezing is a common presentation of asthma and chronic obstructive pulmonary disease (COPD). However, other rare etiologies such as endotracheal tumor should be kept in mind. Case presentation: We report a case of mucoepidermoid carcinoma of carina in which the patient initially presented with wheezing mimicking COPD. Chest roentgenogram showed a soft-tissue density in the tracheal air column. Surgical resection of the tumor was technically hindered by difficulty in airway establishment during anesthesia. Extracorporeal membrane oxygenation (ECMO) was employed to secure adequate blood-gas exchange during operation, after which the tumor was resected smoothly and the patient discharged uneventfully.Conclusions: Endotracheal tumor should be kept in mind when facing a patient presenting with wheezing. Careful auscultation and interpretation of the chest roentgenogram are two important keys for differentiating such lesions from asthma or COPD. If further intervention was hindered by difficulty in airway establishment, ECMO proves effective and safe to “bypass” such an impossible airway and secure the procedures.
Which are factors determining a low COVID-19 mortality in society? High health expenditure and lower exposure of population to air pollution as critical factors for an effective strategy to cope with future pandemics similar to COVID-19
Authors: Mario Coccia 
Published: December 2020

Abstract
One of the problems hardly clarified in the scientific field of Coronavirus Disease 2019 (COVID-19) is inter-related factors associated with a lower mortality of COVID-19 to design effective strategies to cope with unforeseen pandemic crises. The main goal of this study is to explain these factors determining a lower fatality rate of the Coronavirus disease 2019 (COVID-19) in society with a global analysis based on more than 160 countries worldwide. This study reveals a novel finding: countries with a low average COVID-19 mortality have high investments in health sectors as % of GDP (>7.5%), high health expenditures per capita (>$2,300) associated with a lower exposure of population to days exceeding safe levels of particulate matter (PM2.5), reinforcing these factors with a policy response of lockdown. In addition, these countries have lower fatality rates of COVID-19, regardless a higher percentage of population aged more than 65 years in these countries. Overall, then, this study must conclude that an effective strategy to reduce the negative impact of future epidemics similar to COVID-19 has to be based on a reinforcement of healthcare sector to have an efficient organization prearranged to cope with pandemics of new viral agents and to be able to minimize fatality rates in a context of sustainable environment having low air pollution.
Apolipoprotein C1 stimulates the malignant process of renal cell carcinoma via the Wnt3a signaling
Authors: jiang hao , Tang Jing-Yuan , Xue Dong , Chen Yi-Meng , Wu Ting-Chun , Zhuang Qian-Feng , He Xiao-Zhou 
Published: December 2020

Abstract
Background Renal cell carcinoma (RCC) is a clinically common tumor in the urinary system, showing an upward trend of both incidence and mortality. Apolipoprotein C1 (APOC1) has been identified as a vital regulator in tumor progression. This study aims to uncover the biological function of APOC1 in RCC process and the underlying mechanism. MethodsDifferential levels of APOC1 in RCC samples and normal tissues in a downloaded TCGA profile and clinical samples collected in our center were detected by quantitative reverse transcription PCR (qRT-PCR). The prognostic value of APOC1 in RCC was assessed by depicting Kaplan-Meier survival curves. After intervening APOC1 level by transfection of sh-APOC1 or oe-APOC1, changes in phenotypes of RCC cells were examined through CCK-8, colony formation, Transwell assay and flow cytometry. Subsequently, protein levels of EMT-related genes influenced by APOC1 were determined by Western blot. The involvement of the Wnt3a signaling in APOC1-regulated malignant process of RCC was then examined through a series of rescue experiments. Finally, a RCC xenograft model was generated in nude mice, aiming to further clarify the in vivo function of APOC1 in RCC process.ResultsAPOC1 was upregulated in RCC samples. Notably, its level was correlated to overall survival of RCC patients, displaying a certain prognostic value. APOC1 was able to stimulate proliferative, migratory and invasive abilities in RCC cells. The Wnt3a signaling was identified to be involved in APOC1-mediated RCC process. Notably, Wnt3a was able to reverse the regulatory effects of APOC1 on RCC cell phenotypes. In vivo knockdown of APOC1 in xenografted nude mice slowed down the growth of RCC.ConclusionsAPOC1 stimulates the malignant process of RCC via targeting the Wnt3a signaling.
A Qualitative Study of Ghanaian Pediatric Oncology Nurses’ Care Practice Challenges.
Authors: Nukpezah Ruth Nimota , Fomani Fatemeh Khoshnavay , Hasanpour Marzieh , Nasrabadi Alireza Nikbakht 
Published: December 2020

Abstract
Background: Pediatric cancer is a global problem, and some studies have highlighted that nurses caring for these children experience work-related challenges. This makes many children with cancer to be left with terminal diagnoses, unnecessary suffering; and also, job dissatisfaction among the nurses. But no study has explored this phenomenon among pediatric oncology nurses in Ghana. This study aims to explore and understand the challenges that the pediatric oncology nurses experience when caring for children with cancer in Ghana.Methods: An exploratory qualitative research design study was conducted from August 2019 - April 2020. The study was conducted at the Pediatric oncology unit which is located at the Tamale Teaching Hospital (TTH), Ghana. The study was conducted among 14 Ghanaian pediatric oncology nurses who were purposively sampled. The data collection instrument was a face-to-face in-depth semi-structured interview. The interviews were recorded, transcribed verbatim, and analyzed inductively using Elo and Kyngas content analysis approach. The criteria proposed by Guba and Lincoln were used to ensure the validity of the study.Results: The results showed that the challenges that the pediatric oncology nurses experience includes: Time-consuming care, Low Job motivations, Inadequate logistics, Work stress, Reduced labor force, Low knowledge level, Lack of teamwork and the Perception of contracting cancer. Conclusions: The results point to several organizational and personal constraints experienced by the nurses who work at the pediatric oncology ward. There is the need for the administrative managers of hospitals, government and other stakeholders to invest in human, material and financial resources for delivering childhood cancer care services. It is hoped that by addressing these challenges, it would lead to further improvement in the care that is provided to children with cancer.
Quantifying the advantages of conducting a prospective meta-analysis (PMA): a case study of early childhood obesity prevention
Authors: Seidler Anna Lene , Hunter Kylie E , Espinoza David , Mihrshahi Seema , Askie Lisa M 
Published: December 2020

Abstract
Background: For prospective meta-analyses (PMA), eligible studies are identified and the PMA hypotheses, selection criteria and analysis methods are pre-specified before results of any of the studies are known. This reduces publication bias and selective outcome reporting and provides a unique opportunity for outcome standardisation/harmonisation. We conducted a world-first PMA of four trials investigating interventions to prevent early childhood obesity. The aims of this study were to quantitatively analyse the effects of prospective planning on variations across trials, outcome harmonisation and the power to detect intervention effects, and to derive recommendations for future PMA.Methods: We examined intervention design, participant characteristics and outcomes collected across the four trials included in the EPOCH PMA using their registration records, protocol publications and variable lists. The outcomes trials that planned to collect prior to inclusion in the PMA were compared to the outcomes trials collected after PMA inclusion. We analysed the proportion of matching outcome definitions across trials, the number of outcomes per trial, and how collaboration increased the statistical power to detect intervention effects.Results: The included trials varied in intervention design and participants, which improved external validity and the ability to perform subgroup analyses for the meta-analysis. While individual trials had limited power to detect the main intervention effect (BMI z-score), synthesising data substantially increased statistical power. Prospective planning led to an increase in number of collected outcome categories (e.g. weight, child’s diet, sleep), and greater outcome harmonisation. Prior to PMA inclusion, only 18% of outcome categories were included in all trials. After PMA inclusion this increased to 91% of outcome categories. However, whilst trials mostly collected the same outcome categories after PMA inclusion, some inconsistencies in how the outcomes were measured remained (such as measuring physical activity by hours of outside play versus using an activity monitor).Conclusion: Prospective planning led to greater outcome harmonisation and greater power to detect intervention effects, while maintaining acceptable variation in trial designs and populations, which improved external validity. Recommendations for future PMA include more detailed harmonisation of outcome measures, and careful pre-specification of analyses to avoid research waste by unnecessary over-collection of data.
Replicative Verification of Susceptibility Genes Previously Identified from Families with Segregating Developmental Dysplasia of the Hip
Authors: Xu Xiaowen , Wang Binbin , Chen Yufan , Zhou Weizheng , Li Lianyong 
Published: December 2020

Abstract
Background: Developmental dysplasia of the hip (DDH) is a complex hip joint deformity with effects ranging from acetabulum malformation to irreversible hip dislocation. Previous studies suggest a significant association of four variations, teneurin transmembrane protein 3 (TENM3, OMIM * 610083) (chr4:183721398), heparan sulfate proteoglycan 2 (HSPG2, OMIM * 142461 ) (chr1:22201470), ATPase plasma membrane Ca2+ transporting 4 (ATP2B4, OMIM * 108732) (chr1:203682345), and prostaglandin F receptor (PTGFR, OMIM * 600563) (chr1:79002214), with DDH susceptibility in families with segregating DDH. However, the association was not validated in sporadic cases and remains controversial. To confirm the association of the reported variations in these four genes with DDH, we conducted replicative verification in 250 sporadic samples with DDH from a Chinese Han population. Methods: We conducted Sanger sequencing after amplifying the variation sites. The results were compared with the reference sequence from the GRCh37 assembly in UCSC (http://genome.ucsc.edu). Results: Replication analysis of 250 sporadic samples by Sanger sequencing indicated that the four variations, TENM3 (OMIM * 610083, chr4:183721398), HSPG2 (OMIM * 142461, chr1:22201470), ATP2B4 (OMIM * 108732, chr1:203682345), and PTGFR (OMIM * 600563, chr1:79002214), were not associated with the susceptibility to DDH in the Chinese Han population.Conclusions: Further studies should be performed to identify other variations of these four genes that are potentially associated with DDH by whole-exome sequencing and the results should be verified in different populations.