bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypofractionated and single-fraction radiosurgery for brain metastases with sex as a key predictor of overall survival
Authors: Mangesius Julian , Thomas Seppi , Katie Bates , Arnold Christoph Reinhold , Danijela Minasch , Stephanie Mangesius , Johannes Kerschbaumer , Peter Lukas , Ute Ganswindt , Meinhard Nevinny-Stickel 
Published: July 2020

Abstract
Background: Overall survival (OS) of patients with brain metastases treated with hypofractionated (HFSRT) or single-fraction (SRS) radiosurgery depends on several prognostic factors. The aim of this study was to investigate the potential of sex as an independent predictor of OS and evaluate the predictive accuracy of common prognostic scores.Methods: Retrospective analysis of 281 consecutive patients receiving radiosurgery of brain metastases was performed. Kaplan-Meier survival curves and Cox proportional hazards models were used to compare OS between SRS and HFSRT and by sex, before and after propensity-score matching (PSM) on key baseline prognostic covariates. Prognostic scores were evaluated using Harrell’s concordance index.Results: Median OS was 11 months after both SRS and HFSRT. After PSM, median OS was 12 months after SRS (95%CI: 7.5-16.5) and 9 months after HFSRT (95%CI: 5.0-13.0; p=0.77). Independent prognostic factors were sex, primary tumor, KPI, and systemic disease status. Median OS was 16 months for women and 7 months for male patients (p<0.001). After excluding sex specific tumors, PSM revealed a median OS of 16 months for women and 8 months for male patients (p<0.01). Evaluation of prognostic indices showed BSBM to be the most accurate (Harrell’s C=0.68), followed by SIR (0.61), GPA (0.60), RPA (0.58), and Rades et al. (0.57).Conclusions: OS after HFSRT and SRS did not differ, although PSM revealed a non-significant advantage for SRS. Female sex was found to be a major independent positive prognostic factor for survival, and thus should be considered in the personalized decision-making of brain metastases treatment.
A Real-World Study of The Efficacy and Safety of Sintilimab in The Treatment of Recurrent or Refractory Lymphoma
Authors: Juan Qiu , Baoxuan Zhang , Ji Ma , Bing Bu , Shu Fang , Qianrun Lu , Qiuyue Liu , Lihua Song 
Published: July 2020

Abstract
Background: Sintilimab (Innovent Biologics, China, Suzhou, China) has been listed in China for only a year and a half. So far, there have been no reports about it in real research. The purpose of this study was to evaluate the efficacy and safety of the real-world use of Sintilimab in the treatment of recurrent or refractory lymphoma and to explore the factors that influence the efficacy and safety of Sintilimab. Methods: Based on real world data, a retrospective analysis of 25 patients with relapsed or refractory lymphoma treated with Sintilimab was performed.Results: Efficacy was evaluable in 19 of 25 patients, objective response rate (ORR), disease control rate (DCR) and clinical response rate (CBR) were 63.2%, 84.2% and 73.7%, respectively. Among the different pathological types, Hodgkin's lymphoma ORR 77.8%, CBR 100%, diffuse large B-cell lymphoma ORR 25%, CBR 0%, peripheral T/NK cell lymphoma ORR 66.7%, CBR 83.3%. The number of previous chemotherapy courses was correlated with the short-term efficacy of the patients (P=0.029). In the safety analysis, 76% of treatment-related adverse events occurred, 80% of which were grade 1 and 2, with the major adverse events being hypothyroidism and anemia. Hypothyroidism is related to sex.Conclusions: Sintilimab is effective in recurrent or refractory lymphoma and the adverse reactions are controllable. The fewer the lines of previous chemotherapies, the better the short-term efficacy of Sintilimab. The use of Sintilimab in female patients should be paid more attention to thyroid function.
Determinants of Intermittent Preventive Treatment with Sulfadoxine-Pyrimethamine in Pregnant Women (IPTp-SP) in Mali, a household survey.
Authors: Sangho Oumar , Tounkara Moctar , Whiting-Collins Lillian Joyce , Beebe Madeleine , Winch Peter J. , Doumbia Seydou 
Published: July 2020

Abstract
Background: In malaria endemic regions, Intermittent Preventive Treatment with Sulfadoxine-Pyrimethamine (IPTp-SP) is recommended for all pregnant women during prenatal consultation from the fourth to the ninth month of pregnancy, up to the time of delivery. The Government of Mali is aiming for universal coverage of IPTp-SP. However, coverage is still low, estimated to be 18% for completion of three doses (IPTp-SP3). The objective of this study was to identify the factors that influence IPTp-SP in the Health District of Sélingué, Mali.Methods: We performed a cross-sectional survey with 30 clusters, proportional to village size with two stages of sampling. We collected data electronically with Magpi software during face-to-face interviews/surveys. The data were analyzed with SPSS version 20. We performed a descriptive analysis, and bivariate and multivariate logistic regression. An equity analysis examined the effect of distance from health care facility on completion of three or more antenatal visits (ANC3+) and three or more doses of Intermittent Preventive Treatment (IPTp-SP3+).Results: Of the 1,021 women surveyed, 87.8% (n = 896) attended at least one ANC visit. Of these, 86.3% (n = 773) received at least 1 dose of IPTp-SP. The frequency of three or more ANC visits was 90.8%. Compliance with three or more malaria treatments was 63.7%. The determinants statistically related to ANC3+ were the early initiation of ANC (OR = 3.22 [1.22, 10.78]), the number of payments made for the malaria treatment (OR = 21.5 [2.64; 09], OR = 11.24 [2.5, 50.46]) and the presence of a Community Health Center (CHC) in the village (OR = 9.69 [1.09, 86.21]). The ability to read (OR = 1.60 [1.01, 2.55]), the early initiation of ANC (OR = 1.46 [1.06, 2.00], knowledge of the utility of the drug (OR = 2.38 [1.24, 4.57]), and knowledge of the recommended dose of the drug (OR = 6.11 [3.98, 9.39]) were related to completion of three or more treatments (IPTp-SP3+).Conclusion: The early initiation of ANC was a good determinant of the completeness of ANC3+ and IPTp-SP3+. Coverage was fair, but still far from universal. Alternative strategies are needed to further increase coverage.
Performance of RIPASA and AIR Scores in an Egyptian Subset of Patients with Suspected Diagnosis of Acute Appendicitis
Authors: Faisal Mohamed , Bayoumi Ahmed A , Bakr Ahmed Abo , Edlehamre Marcus , Khaled Islam 
Published: July 2020

Abstract
Background: Early and definitive acute appendicitis (AA) diagnosis remains a great challenge in clinical practice worldwide. Currently, several risk scores are available for the clinical assessment of AA, although there are differences in their accuracy rates. The aim of the study was to assess and analyze the accuracy of the acute inflammatory response (AIR) and Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scores in an Egyptian population. Methods: A series of 310 patients, 61% male with a median age of 18 years, with Rt. Iliac fossa pain were clinically evaluated for suspicion of AA. All patients were assessed using both the AIR and RIPASA scores. Following evaluation, all patients underwent appendectomy. A final diagnosis of AA was based on histopathology. Two predetermined cutoff values for the AIR score and one cutoff value for the RIPASA score was evaluated for sensitivity, specificity, and accuracy. Statistical analysis was performed using SPSS version 22. Cross tabulation was performed to assess sensitivity, specificity, positive and negative predictive values along with other tests for parametric and non-parametric variables.Results: The sensitivities of the RIPASA score cutoff value of ≥7.5 and AIR score cutoff values of >4 and >8 were 83.8%, 92.2%, and 33.1%, accordingly, while the specificities were 69.2%, 76.7%, and 84.6%, respectively. AIR score of >4 (91%) was more accurate compared to AIR score of >8 (37.4%) and RIPASA score of ≥7.5 (82.5%). Conclusion: An AIR score of >4 had better sensitivity, specificity, and accuracy compared to a RIPASA score of ≥7.5 for the Egyptian population. However, an AIR score of >8 was more specific. Therefore, an evaluation of patients in low-income countries using one of these scoring systems is highly recommended to avoids unnecessary hospitalization along in negative individuals, in addition to preventing complications in positive cases.
Diverting Colostomy is an Effective Procedure for Ulcerative Chronic Radiation Proctitis Patients After Pelvic Malignancy Radiation
Authors: Huang Xiaoyan , Zhong Qinghua , Wang Huaiming , Zhao Jie , Kuang Yingyi , Guan Qi , He Yanjiong , Qin Qiyuan , Wang Hui , Ma Tenghui 
Published: July 2020

Abstract
Background: Chronic radiation proctitis (CRP) with rectal ulcer is a common complication after pelvic malignancy radiation, and gradually deteriorating ulcers will result in severe complications such as fistula. The aim of this study was to evaluate effect of colostomy on ulcerative CRP and to identify associated influence factors with effectiveness of colostomy.Methods: Between November 2011 to February 2019, 811 hospitalized patients were diagnosed with radiation-induced enteritis (RE) in Sun Yat-sen University Sixth Affiliated Hospital, among which 284 patients presented with rectal ulcer, and 61 ulcerative CRP patients were retrospectively collected and analyzed.Results: The overall effective rate of colostomy on ulcerative CRP was 49.2%, with a highest effective rate of 88.2 % within 12 to 24 months after colostomy. 9 (31.1%) CRP patients with ulcers were cured after colostomy and 12 (19.67%) patients restored intestinal continuity, among which including 2 (3.3%) patients ever with rectovaginal fistula. 100% (55/55) patients with rectal bleeding and 91.4% (32/35) patients with anal pain were remarkably alleviated. Additionally, multivariable analysis showed the duration of stoma [OR=1.211, 95% CI (1.060~1.382), P=0.005] and albumin (ALB) level post-colostomy [OR=1.437, 95% CI (1.102~1.875), P=0.007] were two independent influence factors for the effectiveness of colostomy on the rectal ulcer of CRP patients. Conclusions: Colostomy was an effective and safe procedure for treating rectal ulcer of CRP patients, and also a potential strategy for preventing and treating fistula. Duration of stoma for 12~24 months and higher ALB level could significantly improve the effectiveness of colostomy on ulcerative CRP patients.
Clinical characteristics of cerebral venous sinus thrombosis patients with new-onset of headache
Authors: Wang Yugang , Fang Qi 
Published: July 2020

Abstract
Objective : This study aimed to assess the clinical characteristics of cerebral venous sinus thrombosis (CVT) patients with new-onset headache and to identify the risk factors for headache in this population.Methods : We retrospectively reviewed the demographic and clinical data of 69 CVT patients recruited between September 2017 and September 2019. Patients were classified into two groups, the headache group and the non-headache group, according to the presence or absence of new-onset headache symptoms at admission. The following characteristics and parameters were measured and analyzed, including gender, age, Diseased sinus amount(DSA), and so on.Results : The incidence of headache was 75% in this cohort. The proportion of female patients in the headache group was higher than that in the non-headache group. Patients in the headache group were younger than those without headache. CVT patients of headache group showed higher LR, BUN, and (ICP)compared to the non-headache group, whereas MCV and levels of protein (CSF) and LDH (CSF) were lower in headache patients. The data also revealed younger age and the increased level of chloride ion CL - (CSF) were the risk factors for the occurrence of headache in CVT patients.Conclusions: The age, LR, MCV, BUN levels, ICP, protein (CSF), and LDH (CSF) in patients with headache were significantly different from those in the non-headache group at admission. Younger age and a level of CL - (CSF) were risk factors for headache in CVT patients. These findings may provide guidance for clinical diagnosis and treatment of CVT.
The Prevalence and Causes of Visual Impairment among Children in Kenya – The Kenya Eye Study
Authors: Muma Shadrack , Obonyo Stephen 
Published: July 2020

Abstract
BackgroundVisual impairment impacts negatively on quality of life. Kenya has a total fertility rate of 3.5 an indication of more younger generation. However, little is known on the prevalence and causes of visual impairment in the children population of Kenya.MethodsThis cross-sectional population-based study included 3400 (1800, 52.9% female) randomly selected children with a mean age of 12 ± 2 years (range 5–16 years) in Kenya. Visual acuity was taken using snellens chart at 6 meters. Anterior and posterior segments were assessed using slit lamp and indirect ophthalmoscope. The World Health Organization formed the baseline for calculating prevalence of visual impairment.ResultsVisual acuity measurements were available for 3240 (95.3%) participants. The prevalence of visual impairment, based on pin-hole value, using World Health Organization, was 1.7 ± 0.3%. The prevalence of visual impairment, based on presenting visual acuity value, was 2.4 ± 0.7%, using the World Health Organization definition. Multivariate analysis demonstrated that the presence of visual impairment on pin-hole, according to World Health Organization definition increased significantly with increasing age (odds ratio 1.230, P = .021) and increased astigmatism (odds ratio 0.834, P = .032), but not significantly associated with socioeconomic, ocular conditions after adjusting for age and astigmatism. Lack of refractive error correction was the most common reason for presenting visual impairment. Causes of visual impairment due to presenting visual acuity were amblyopia (24%), nystagmus (14%), myopia (49%) and hyperopia (13%).ConclusionThe prevalence of visual impairment in Kenya increased significantly with socio-economic activities. Uncorrected refractive error remains the major causes of visual impairment.
Development of A Three-Gene Signature Prediction Model for Lymph Node Metastasis in Papillary Thyroid Cancer
Authors: Huang Ziwei , Liu Yuenan , Le Kehao , Xu Ming , Li Wenhui , Zhao Qiuyang , Zhou Jun , Jiang Yujia , Yang Wen , Yang Li , Yi Pengfei 
Published: July 2020

Abstract
Background: Thyroid cancer is one of the most prevalent endocrine cancers with a rising incidence rate over the past years. Papillary thyroid cancer (PTC) is the dominant historical type of thyroid cancer. Early lymph node metastasis happens frequently in PTC. However, some of the lymph node metastasis may be troublesome for detecting because of limited methods.Methods: Robust rank aggregation afforded us the shared differential expression genes among multiple datasets. Gene ontology analysis was performed to identify potential functions. Weighted gene co-expression network analysis was used to research the correlations between gene expression patterns with clinical characteristic. Protein-protein interaction network was performed to identify the hub genes. The least absolute shrinkage and selection operator and Logistic regression were performed to construct a prediction model.Results: We developed a three-gene signature prediction model for lymph node metastasis in PTC through transcriptomic analysis. After quality control, we collected 8 microarray datasets from GEO database and an RNA sequencing dataset from TCGA database. We found the transcriptome profiles were correlated with lymph node metastasis and 3 genes were verified to be independent prediction factors towards those statistic approach. Afterwards, we designed a predicable risk score system and effectively confirmed the model in two independent papillary thyroid cancer cohorts.Conclusions: We recommended a successful predicable model of lymph node metastasis in papillary thyroid cancer patients with moderate accuracy.
Association Between Mean Arterial Pressure and Survival in Patients Admitted to the Intensive Care Unit After Cardiac Arrest With Vasopressor Support: A Retrospective Study
Authors: Li Zhimin , Zhou Dawei , Zhang Shaolan , Wu Lei , Shi Guangzhi 
Published: July 2020

Abstract
BackgroundMortality among patients admitted to the intensive care unit (ICU) after cardiac arrest (CA) is high. Hemodynamic management in the phase of post-resuscitation is recommended by international guidelines, but the optimal mean arterial pressure (MAP) range is still unclear. The main objective of this study is to investigate the association between time spent in different MAP and ICU mortality in PCA patients admitted to ICU with vasopressor support. MethodsIt was a retrospective, observational study in cardiac arrest patients admitted to the ICU with vasopressor support during the first 24 hours. The main exposure was time spent in MAP. The primary outcome was ICU mortality. Associations between time spent in MAP and ICU mortality were evaluated using ten MAP thresholds: 100, 95, 90, 85, 80, 75, 70, 65, 60, and 55 mmHg. Multivariable logistic regression analyses were used to test the association between time spent in different MAP categories and ICU mortality. Results The study included 1018 eligible subjects in ICUs from 156 hospitals, of which 453 (44%) patients died during hospitalization and 208 (37%) patients discharged home. A significant association was found between time spent in MAP and the ICU mortality when MAP thresholds of ≤55mmHg (OR 1.25, 95% CI 1.09-1. 45, p = 0.002) and ≤60 mmHg (OR 1.13, 95% CI 1.02-1.24, p = 0.014) were used. Thresholds of MAP ≥ 65 mmHg were not associated with mortality. The percentage of time spent in MAP of ≤90mmHg (OR 1.09, 95% CI 1.01-1.18), ≤ 95mmHg (OR 1.12, 95% CI 1.01-1.24,) and ≤100mmHg (OR 1.19, 95% CI 1.04-1.38) were associated with a higher odds ratio for discharged home outcome, suggesting that MAP of ≥90mmHg, ≥95mmHg and ≥100mmHg were associated with lower probability of discharged home. ConclusionsThese results imply that for post-cardiac arrest patients with vasopressor support, time spent in MAP of ≤60mmHg or less was associated with higher ICU mortality and MAP of ≥90 mmHg or more was associated with a lower probability for discharged home.
Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19
Authors: Carpagnano Giovanna Elisiana , Lecce Valentina Di , Quaranta Vitaliano Nicola , Zito Annapaola , Buonamico Enrico , Capozza Elena , Palumbo Alessandro , Gioia Giuseppe Di , Valerio Vincenzo Nicola , Resta Onofrio 
Published: July 2020

Abstract
Purpose: Hypovitaminosis D is a highly spread condition correlated with increased risk of respiratory tract infections. Nowadays, the world is in the grip of the Coronavirus disease 19 (COVID 19) pandemic. In these patients, cytokine storm is associated with disease severity. In consideration of the role of vitamin D in the immune system, aim of this study was to analyse vitamin D levels in patients with acute respiratory failure due to COVID-19 and to assess any correlations with disease severity and prognosis. Methods: In this retrospective, observational study, we analysed demographic, clinical and laboratory data of 42 patients with acute respiratory failure due to COVID-19, treated in Respiratory Intermediate Care Unit (RICU) of the Policlinic of Bari from March, 11 to April 30, 2020. Results: Eighty one percent of patients had hypovitaminosis D. Based on vitamin D levels, the population was stratified into four groups: no hypovitaminosis D, insufficiency, moderate deficiency, and severe deficiency. No differences regarding demographic and clinical characteristics were found. A survival analysis highlighted that, after 10 days of hospitalization, severe vitamin D deficiency patients had a 50% mortality probability, while those with vitamin D ≥10 had a 5% mortality risk (p=0.019). Conclusions: High prevalence of hypovitaminosis D was found in COVID-19 patients with acute respiratory failure, treated in a RICU. Patients with severe vitamin D deficiency had a significantly higher mortality risk. Severe vitamin D deficiency may be a marker of poor prognosis in these patients, suggesting that adjunctive treatment might improve disease outcomes.
Modelling COVID-19 cases in Nigeria: Forecasts, uncertainties, projections and the link with weather
Authors: O.E. Adeyeri , K.S.A. Oyekan , S.O. Ige , A. Akinbobola , E.C. Okogbue 
Published: July 2020

Abstract
The World Health Organization (WHO) declared COVID-19 a global pandemic on 11 March 2020 due to its global spread. In Nigeria, the first case was documented on 27 February 2020. Since then, it has spread to most parts of the country. This study models, forecasts and projects COVID-19 incidence, cumulative incidence and death cases in Nigeria using six estimation methods i.e. the attack rate, maximum likelihood, exponential growth, Markov chain monte Carlo (MCMC), time-dependent and the sequential Bayesian approaches. A sensitivity analysis with respect to the mean generation time is used to quantify the associated reproduction number uncertainties. The relationship between the COVID-19 incidence and five meteorological variables are further assessed. The result shows that the highest incidences are recorded in days with either religious activities or market days while the weekday trend decreases towards the weekend. It is also established that COVID-19 incidence significantly increases with increasing sea level pressure (0.7 correlation coefficient) and significantly decreases with increasing maximum temperature (-0.3 correlation coefficient). Also, selecting an optimal period for reproduction number estimates reduces the variability between estimates. As an example, in the EG approach, the epidemic curve that optimally fits the exponential growth is between 1- and 53-time units with reproduction number estimate of 1.60 [1.58; 1.62] at 95% confidence interval. However, this optimal reproduction number estimate is different from the default reproduction number estimate. Using the MCMC approach, the correlation coefficients between the observed and forecasted incidence, cumulative death and cumulative confirmed cases are 0.66, 0.92 and 0.90 respectively. The projections till December shows values approaching 1,000,000, 120,000 and 3,000,000 respectively. Therefore, timely intervention and effective preventive measures are immediately needed to mitigate a full-scale epidemic in the country.