bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of lutein supplementation on inflammatory biomarkers and metabolic risk factors in adults with central obesity: study protocol for a randomized controlled study
Authors: Zhou Juan , Zhao Dan , Wang Ning , Zeng Zhiwei , Wang Changyi , Hao Liping , Peng Xiaolin 
Published: December 2019

Abstract
Background: The prevalence of central obesity is increasing consistently, and visceral fat is associated with increased production of inflammatory factors and metabolic risk factors. Lutein might retard the development of metabolic disease through its antioxidant and anti-inflammatory properties. Furthermore, epidemiological studies have associated higher dietary intake and serum levels of lutein with decreased adiposity. However, few randomized controlled trials (RCTs) have shown the effects of lutein supplementation on inflammatory biomarkers and metabolic risk factors, especially in adults with central obesity. Methods: This study will be conducted as a double-blinded, parallel placebo-controlled clinical trial in which 120 people with central obesity aged 18-60 years old and willing to provide informed consent will be randomly assigned to the intervention or placebo group in a 1:1 ratio according to sex, age and waist circumference. The intervention group will receive 10 mg daily lutein supplementation for 12 weeks to explore the effect of lutein supplementation on serum lutein, glycaemic and lipid profiles, inflammatory factors and body composition. Two populations (intention-to-treat population and per-protocol population) will be used in the data analyses. Discussion: Our findings from this trial will contribute to the knowledge of the association between lutein supplementation and inflammatory biomarkers and metabolic risk factors in people with central obesity, which will offer a possibility for the prevention of inflammatory diseases.
A Retrospective Analysis on Metastatic Rate of the Internal Mammary Lymph Node and Its Clinical Significance in Adjuvant Radiotherapy of Breast Cancer Patients
Authors: Li Li , Zhang Hongyan , Wang Linwei , xie Conghua , Zhou Yunfeng , Zhong Yahua 
Published: December 2019

Abstract
Background : There is a discrepancy about the metastatic rate of internal mammary lymph nodes (IMNs) between clinical and pathologic findings. We aimed to investigate the metastatic rate of IMNs and to provide recommendations on target volume delineation of IMNs for adjuvant radiotherapy in breast cancer patients. Methods : We retrospectively analyzed data from 114 breast cancer patients treated with surgery without adjuvant radiotherapy who developed local and/or regional lymph node recurrence/metastasis at our institute from January 2015 to January 2019. Patients with widely lung or pleural metastases were excluded. We first analyzed the recurrence rate with the chest wall, the metastatic rate of internal mammary/anterior mediastinal, ipsilateral axillary and supraclavicular lymph nodes, and then investigated the distribution of the IMNs. Results : Among the 114 included patients, the recurrence rate with the chest wall, metastatic rate of IMNs, IMNs/anterior mediastinal lymph nodes, ipsilateral axillary lymph nodes, and the ipsilateral supraclavicular lymph nodes was 43%, 37.7%, 59.6%, 12.3%, and 22.8%, respectively. The metastatic IMNs were mainly located from the first to the second intercostal space. However, metastatic lymph nodes could also be observed above the upper edge of the first rib.Conclusions : The metastatic rate is high in the IMNs and irradiation of the internal mammary lymphatic chain is required. It is suggested that the upper bound of the internal mammary lymphatic chain should be up to the subclavian vein with a 5-mm margin, thus connecting to the caudal border of supraclavicular clinical target volume in breast cancer patients at high risk of recurrence.
Comparison of dental plaque reduction after use of electric toothbrushes with and without QLF-D-applied plaque visualization: A 1-week randomized controlled trial
Authors: Akifusa Sumio , Isobe Ayaka , Kibata Kanako , Oyama Akinori , Oyama Hiroko , Ariyoshi Wataru , Nishihara Tatsuji 
Published: December 2019

Abstract
Background: To evaluate the efficacy of a newly developed electric toothbrush in reducing dental plaque via a quantitative light-induced fluorescence-digital (QLF-D)-applied visualisation system in the brush head.Methods: Participants included 20 adults aged 19 to 28 years. Participants were randomly assigned either (i) an electric toothbrush with a monitor to visualise red-fluorescent dental plaque via a camera built into the brush head (monitor usage group, n = 10) or (ii) an electric toothbrush without a monitor (monitor-non-use group, n = 10). The amount of dental plaque was assessed by personal hygiene performance (PHP) at baseline and 1 week later.Results: In the monitor-usage group, PHP score was significantly lower at the 1-week follow-up than at baseline (6 vs 16; range, 0–12 vs 13–21; P = 0.029). This change was not observed in the monitor-non-use group (14 vs 13; range, 6-21 vs 2-26; P = 0.778). After 1 week, the change in PHP scores in the monitor usage group was significantly greater than that in the monitor non-use group (−10 vs 0; range, -21 to 9 vs -8 to 16; P = 0.021).Conclusions: Our results clearly demonstrate that brushing teeth while looking at a monitor that depicts red-autofluorescent dental plaque via application of QLF-D improved the efficacy of dental-plaque removal relative to brushing teeth without a monitor.
Percutaneous Coronary Intervention in Diabetic versus Non-diabetic Patients with Prior Coronary Artery Bypass Grafting: A Propensity Score Matching Study
Authors: Ma Xiaolong , Dong Ran , Chen Pengfei , Zhao Yichen , Zeng Caiwu , Xin Meng , Ye Qing , Wang Jiangang 
Published: December 2019

Abstract
Background: The target of this study was to explore the outcomes of percutaneous coronary intervention (PCI) in diabetic versus non-diabetic patients with prior coronary artery bypass grafting (CABG) surgery.
Methods: Seven hundred and twenty four patients who had previously received CABG and had been treated using PCI combined with drug-eluting stents (DES) between 2009 and 2017 were selected for a retrospective study and allocated into either a diabetes mellitus (DM) or non-diabetes mellitus (No DM) group. A 1:1 propensity score-matched evaluation was conducted and risk adjusted for analysis. The primary outcomes were cardiac death, myocardial infarction, heart failure and revascularization, with a median follow-up duration of 5.13 years.
Results: After matching, two-, 5- and 8-year event rate of overall major adverse cardiac events (MACEs) were found to be higher in the DM group (No DM vs DM:15.3%, 30.9%, 38.5% vs 19.8%, 37.8%, 52.2%, respectively), although no significant difference was found in the event rate of overall MACEs (hazard ratio [HR]: 1.35; 95% confidence interval [CI]: 1.00 to 1.83 for DM vs No DM; P=0.052), cardiac death (HR: 0.94; 95% CI: 0.45 to 1.95; P=0.871), MI (HR: 1.49; 95% CI: 0.95 to 2.32; P=0.080), HF (HR: 1.54; 95% CI: 0.90 to 2.63 for; P=0.120) or revascularization (HR: 1.07; 95% CI: 0.72 to 1.59; P=0.747). Subgroup analysis of PCI in only the NCA showed MACEs (adjusted HR: 1.13; 95% CI: 0.85 to 1.49 for DM vs No DM; P=0.325), cardiac death (adjusted HR: 0.85; 95% CI: 0.41 to 1.78 for DM vs No DM; P=0.781), MI (adjusted HR: 1.32; 95% CI: 0.84 to 2.01 for DM vs No DM; P=0.069), HF (adjusted HR: 1.41; 95% CI: 0.87 to 2.27 for DM vs No DM; P=0.211) or repeated revascularization (adjusted HR: 0.93; 95% CI: 0.64 to 1.37 for DM vs No DM; P=0.836).
Conclusions : Compared with non-diabetic patients with prior CABG, subsequent implantation of DES in the native coronary artery of diabetic patients resulted in apparently similar outcomes.
Trial registration : This study was not registered in an open access database.
Key Words: Percutaneous coronary intervention; Diabetic; Non-diabetic; Coronary artery bypass grafting.
Association between non-high-density lipoprotein cholesterol and haemorrhagic transformation in patients with acute ischaemic stroke
Authors: Wang Yanan , Song Quhong , Cheng Yajun , Wei Chenchen , Ye Chen , Liu Junfeng , Wu Bo , Liu Ming 
Published: December 2019

Abstract
Background : It is unclear whether non-high-density lipoprotein cholesterol (Non-HDL-C) is associated with haemorrhagic transformation (HT) after acute ischaemic stroke (AIS). We aimed to explore the association between Non-HDL-C and HT, as well as compare the predictive values of Non-HDL-C and low-density lipoprotein cholesterol (LDL-C) for HT. Methods: We consecutively enrolled AIS patients within 7 days of stroke onset. Participants were divided into four categories according to quartiles of Non-HDL-C. HT was assessed by follow-up brain imaging. We assessed the association between Non-HDL-C, LDL-C and HT in multivariate logistic regression analysis. Results: A total of 2043 patients were included, among whom 232 were identified as HT. Compared with the highest quartiles, the first, second and third quartiles of Non-HDL-C were associated with increased risk of HT (adjusted Odds ratios [ORs] 1.74 [95% Confidence Interval [CI] 1.09-2.78], 2.01[95% CI 1.26-3.20], and 1.76 [95% CI 1.10-2.83], respectively, P for trend=0.024). Similar results were found for LDL-C. There was significant interaction between Non-HDL-C and age ( P for interaction=0.021). The addition of Non-HDL-C and LDL-C to conventional factors significantly improved predictive values (Non-HDL-C, net reclassification index [NRI] 0.24, 95%CI 0.17-0.31, P<0.001; LDL-C, NRI 0.15, 95%CI 0.08-0.22, P=0.03). Conclusions: Low Non-HDL-C was associated with increased risks of HT. In addition, Non-HDL-C has similar effects as LDL-C for predicting HT. Keywords: Non-high-density lipoprotein cholesterol, Haemorrhagic transformation, Acute ischaemic stroke
Treatment Patterns and Sequences of Pharmacotherapy for Patients Diagnosed with Depression in the United States: 2014 through 2019
Authors: Kern David M. , Cepeda M. Soledad , Defalco Frank , Etropolski Mila 
Published: December 2019

Abstract
Background: Understanding how patients are treated in the real-world is vital to identifying potential gaps in care. We describe the current pharmacologic treatment patterns for the treatment of depression. Methods: Patients with depression were identified from four large national claims databases during 1/1/2014-1/31/2019. Patients had ≥2 diagnoses for depression or an inpatient hospitalization with a diagnosis of depression. Patients were required to have enrollment in the database ≥1 year prior to and three years following their first depression diagnosis. Treatment patterns were captured at the class level and included selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors, tricyclic antidepressants, other antidepressants, anxiolytics, hypnotics/sedatives, and antipsychotics. Treatment patterns were captured during all available follow-up. Results: We identified 269,668 patients diagnosed with depression. The proportion not receiving any pharmacological treatment during follow-up ranged from 29% to 52%. Of the treated, approximately half received ≥2 different classes of therapy, a quarter received ≥3 classes and more than 10% received 4 or more. SSRIs were the most common first-line treatment; however, many patients received an anxiolytic, hypnotic/sedative, or antipsychotic prior to any antidepressive treatment. Treatment with a combination of classes ranged from approximately 20% of first-line therapies to 40% of fourth-line. Conclusions: Many patients diagnosed with depression go untreated and many others receive a non-antidepressant medication class as their first treatment. More than half of patients received more than one type of treatment class during the study follow up, suggesting that the first treatment received may not be optimal for most patients.
Association of Maternal Ethnicity and Urbanicity on Severe Pediatric Disease: A Nationwide Cohort Study
Authors: Chang Ya-Ting , Wang Huei-Shyong , Liu Jia-Rou , Tseng Chi-Nan , Chou I-Jun , Luo Shue-Fen , Kuo Chang-Fu , See Lai-Chu 
Published: December 2019

Abstract
Background: A healthy migrant effect on birth outcomes has been reported, however, whether this protective effect persists throughout childhood is unknown. The effect of urbanicity on child health among an immigrant population is unclear. The objective of this study was to compare the incidence rate and cumulative incidence of severe diseases among urban children of Taiwan-born mothers, rural children of Taiwan-born mothers, urban children of foreign-born mothers, and rural children of foreign-born mothers.
Methods: A nationwide cohort study was conducted for children born in Taiwan during 2004-2011 and follow-up till age 4 to 11 years old by linkage the Taiwan Birth Registry 2004-2011, Taiwan Death Registry 2004-2015, and National Health Insurance Research Database 2004-2015. Cox proportional hazards model (multivariable) was used to examine differences among the four study groups.
Results: There were 682,982 urban children of Taiwan-born mothers, 662,818 rural children of Taiwan-born mothers, 61,570 urban children of foreign-born mothers, 87,473 rural children of foreign-born mothers. Children of foreign-born mothers had a lower incidence of vasculitis, mainly Kawasaki disease. The incidences of congenital disorders did not differ between children of foreign-born mothers and children of Taiwan-born mothers. The incidence of psychotic disorders was higher in urban children. However, children in rural areas had a higher incidence of major trauma/burn and a higher mortality rate.
Conclusions: A healthy migrant effect was only seen for Kawasaki disease. The mental health of urban children born to immigrant mothers warrants concern.
High-throughput sequencing analysis of intestinal flora changes in ESRD and CKD patients
Authors: Hu Jianguang , Zhong Xiaoshi , Yan Jing , Zhou Daoyuan , Qin Danping , Xiao Xiao , Zheng Yuanyuan , liu yan 
Published: December 2019

Abstract
Background Chronic kidney disease (CKD) disease affects gut flora by causing dysbiosis and lead to systemic inflammatory conditions. Here, we provide intestinal flora changes of CKD patients undertook different hemodialysis therapy.Methods Patients were recruited during 2017-2019 and divided into healthy control group (CT), CKD non-dialysis group (CKD), hemodialysis group (HD) and peritoneal dialysis group (PD). Intestinal flora genome 16S rDNA sequencing and further bio-informatic analysis were performed.Results Decreased diversity and altered communities of intestinal flora in PD patients, in which microbial diversity was positive correlated with the albumin level were observed. A total of 20 intestinal flora phyla were detected in 166 fecal samples, divided into 3 dominant intestinal types including Bacteroides-dominant gut type, Firmicutes-dominant type and Proteobacteria-dominant gut type. Further analyses found 198 genera, the abundance of 86 genera were significantly different. Butyrate-producing taxa as Faecalibacterium in genera level and Bifidobacteriaceae and Prevotellaceae in family level were dominant genus in CT, CKD, and HD groups, while urease containing-, indole- and p-cresol-forming taxa as Escherichia in genera and Enterobacteriaceae , Enterococcaceae in family level was dominated genus in PD group. Number of differential expressed genes in KEGG enrichment pathways were significantly different in PD group in carbohydrate metabolism, amino acid metabolism, energy metabolism, translation, and membrane transport.Conclusion Our results suggest peritoneal dialysis therapy could result in reduced diversity and altered microbial communities, with reduced probiotic butyrate-producing taxa and increased urease containing-, indole- and p-cresol-forming taxa. The disordered intestinal flora can seriously affect the nutrition level in CKD patients with PD therapy.
An Evaluation of the Zambia Influenza Sentinel Surveillance System, 2011-2017
Authors: simusika paul , Tempia Stefano , Chentulo Edward , Polansky Lauren , Mazaba Mazyanga , Ndumba Idah , Mbewe Quinn K , Monze Mwaka Anna 
Published: December 2019

Abstract
Background Over the past decade, influenza surveillance has been established in several African countries including Zambia. However, information on the on data quality and reliability of established influenza surveillance systems in Africa are limited. Such information would enable countries to assess the performance of their surveillance systems, identify shortfalls for improvement and provide evidence of data reliability for policy making and public health interventions. Methods We used the Centers for Disease Control and Prevention guidelines to evaluate the performance of the influenza surveillance system (ISS) in Zambia during 2011-2017 using 9 attributes: (i) data quality and completeness, (ii) timeliness, (iii) representativeness, (iv) flexibility, (v) simplicity, (vi) acceptability, (vii) stability, (viii) utility, and (ix) sustainability. Each attribute was evaluated using pre-defined indicators. For each indicator we obtained the proportion (expressed as percentage) of the outcome of interest over the total. A scale from 1 to 3 was used to provide a score for each attribute as follows: <60% (as obtained in the calculation above) scored 1 (weak performance); 60-79% scored 2 (moderate performance); ≥80% scored 3 (good performance). An overall score for each attribute and the ISS was obtained by averaging the scores of all evaluated attributes. Results The overall mean score for the ISS in Zambia was 2.6. Key strengths of the system were the quality of data generated (score: 2.9), its flexibility (score: 3.0) especially to monitor viral pathogens other than influenza viruses, its simplicity (score: 2.8), acceptability (score: 3.0) and stability (score: 2.6) over the review period and its relatively low cost ($310,000 per annum). Identified weaknesses related mainly to geographic representativeness (score: 2.0), timeliness (score: 2.5), especially in shipment of samples from remote sites, and sustainability (score: 1.0) in the absence of external funds. Conclusions The system performed moderately well in our evaluation. Key improvements would include improvements in the timeliness of samples shipments and geographical coverage. However, these improvements would result in increased cost and logistical complexity. The ISSS in Zambia is largely reliant on external funds and the acceptability of maintaining the surveillance system through national funds would require evaluation.
Association Between Developmental Dental Anomalies, Early Childhood Caries And Oral Hygiene Status Of 3-5-year-old Children In Ile-ife, Nigeria
Authors: Folayan Morenike Oluwatoyin , Alade Michael , Adeniyi Abiola , Tantawi Maha El , Finlayson Tracy L 
Published: December 2019

Abstract
Background: To determine the association between developmental dental anomalies (DDA), early childhood caries (ECC) and oral hygiene status of 3-5-year-old children resident in Ile-Ife, Nigeria. Methods: This was a cross-sectional study. We analyzed data for 3-5-year-olds extracted from the dataset of a household survey collected to determine the association between ECC and maternal psychosocial wellbeing in children 0-5-year-olds. The outcome variables for the study were ECC and poor oral hygiene. The explanatory variable was the presence of developmental dental anomalies (supernumerary, supplemental, mesiodens, hypodontia, macrodontia, microdontia, peg-shaped lateral, dens evaginatus, dens invaginatus, talons cusp, fusion/germination, hypoplasia, hypomineralized second molar, fluorosis, amelogenesis imperfecta). The prevalence of each anomaly was determined. Poisson regression analysis was conducted to determine the association between presence of developmental dental anomalies, ECC and oral hygiene status. The model was adjusted for sex, age and socioeconomic status. Results: Of the 918 children examined, 75 (8.2%) had DDA, 43 (4.7%) had ECC, and 38 (4.1%) had poor oral hygiene. The most prevalent DDA was enamel hypoplasia (3.9%). Of the 43 children with ECC, 6 (14.0%) had enamel hypoplasia and 3 (7.6%) had hypomineralized second primary molar. There was a significant association between ECC and enamel hypoplasia (p<0.001) and a borderline association between ECC and hypomineralized second primary molars (p=0.05). The proportion of children with poor oral hygiene (PR: 2.03; 95% CI: 0.91-4.56; p=0.09) and ECC (PR: 2.02; 95% CI: 0.92-4.46; p=0.08) who had DDA was twice that of children with good oral hygiene and without ECC respectively, although the differences did not reach statistical significance.
Breakfast consumption is inversely associated with primary headaches in university students: The MEPHASOUS study
Authors: Mansouri Masoume , Sharifi Farshad , Shokri Azad , Varmaghani Mehdi , Yaghubi Hamid , Moghadas-Tabrizi Yousef , Sadeghi Omid 
Published: December 2019

Abstract
Background The prevalence of primary headaches has been increasing at an alarming rate, particularly in university students. Previous studies have shown that diet-related behaviors can affect neurological disorders. Therefore, this study was conducted to examine the association between breakfast consumption patterns and primary headaches in a large population of university students.Methods In total, 83,677 university students, aged ≥18 years, from 28 provinces of Iran were included in the current cross-sectional study. Dietary intakes and breakfast consumption patterns were assessed using a validated self-administered dietary habits questionnaire. Primary headaches were determined according to the International Classification of Headache Disorders-3 (ICHD-3) criteria.Results The mean age of participants was 21.50 ± 4.01. Primary headaches were prevalent among 9% of university students. A significant inverse association was seen between breakfast consumption and odds of primary headaches (OR: 0.57, 95% CI: 0.51-0.62). This association remained significant even after taking potential confounders into account; such that students who consumed breakfast frequently had 26% lower odds of primary headaches compared with those who consumed it rarely (OR: 0.74, 95% CI: 0.65-0.85). Moreover, such a significant inverse association was observed in female students (OR: 0.54, 95% CI: 0.49-0.61) as well as those with normal weight (OR: 0.68, 95% CI: 0.58-0.79). However, it became non-significant in male students and those with overweight or obesity.Conclusions We found that frequent breakfast consumption was inversely associated with the odds of primary headaches. Further prospective studies are needed to confirm our findings.