bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comorbidity prevalence among cancer patients: a population-based cohort study of four cancers
Authors: Fowler Helen , Belot Aurelien , Ellis Libby , Maringe Camille , Luque-Fernandez Miguel Angel , Njagi Edmund Njeru , Navani Neal , Sarfati Diana , Rachet Bernard 
Published: January 2020

Abstract
Background
The presence of comorbidity affects the care of cancer patients, many of whom are living with multiple comorbidities. The prevalence of cancer comorbidity, beyond summary metrics, is not well known. This study aims to estimate the prevalence of comorbid conditions among cancer patients in England, and describe the association between cancer comorbidity and socio-economic position, using population-based electronic health records.

Methods
We linked England cancer registry records of patients diagnosed with cancer of the colon, rectum, lung or Hodgkin lymphoma between 2009 and 2013, with hospital admissions records. A comorbidity was any one of fourteen specific conditions, diagnosed during hospital admission up to 6 years prior to cancer diagnosis. We calculated the crude and age-sex adjusted prevalence of each condition, the frequency of multiple comorbidity combinations, and used logistic regression and multinomial logistic regression to estimate the adjusted odds of having each condition and the probability of having each condition as a single or one of multiple comorbidities, respectively, by cancer type.

Results
Comorbidity was most prevalent in patients with lung cancer and least prevalent in Hodgkin lymphoma patients. Up to two-thirds of patients within each of the four cancer patient cohorts we studied had at least one comorbidity, and around half of the comorbid patients had multiple comorbidities. Our study highlighted common comorbid conditions among the cancer patient cohorts. In all four cohorts, the odds of having a comorbidity and the probability of multiple comorbidity were consistently highest in the most deprived cancer patients.

Conclusions
Cancer healthcare guidelines may need to consider prominent comorbid conditions, particularly to benefit the prognosis of the most deprived patients who carry the greater burden of comorbidity. Insight into patterns of cancer comorbidity may inform further research into the influence of specific comorbidities on socio-economic inequalities in receipt of cancer treatment and in short-term mortality.
The effect of renal function change on renal cell carcinoma patients with tumor thrombus after nephrectomy and thrombectomy: a large Chinese center experience
Authors: Liu Zhuo , Tang Shiying , Tian Xiaojun , Zhang Hongxian , Wang Guoliang , Zhang Shudong , Ma Lulin 
Published: January 2020

Abstract
Background
To explore the influencing factors of perioperative renal function change and their relationship with prognosis on renal cell carcinoma (RCC) patients with tumor thrombus after nephrectomy and thrombectomy.

Methods
The clinical and pathological data of 135 patients with RCC and tumor thrombus, who underwent nephrectomy and thrombectomy at Peking University Third Hospital from May 2015 to July 2018, was retrospectively analyzed. Absolute change in estimated glomerular filtration rate (eGFR) (ACE) and percent change in eGFR (PCE) were calculated by preoperative and postoperative renal function. Linear regression analysis was used to explore the influencing factors of ACE and PCE, and logistic regression analysis was used to explore the influencing factors of worse postoperative renal function [eGFR≤60 mL/(min × 1.73 m^2)]. Cancer-specific survival (CSS) was estimated by Kaplan-Meier method and multivariate Cox regression, which were used to explore the effect of ACE and PCE on prognosis.

Results
Of all the 135 patients, 101 patients (74.8%) were male and 34 patients (25.2%) were female. The mean preoperative eGFR was 73.9 ± 21.8 mL/(min × 1.73 m^2) and postoperative eGFR was 69.5 ± 25.2 mL/(min × 1.73 m^2). In multivariate linear regression analysis, preoperative eGFR (P < 0.001) and pathological type (P = 0.038) were significant predictive factors of ACE. In aspect of PCE, preoperative eGFR (P < 0.001) and pathological type (P = 0.002) were significant predictors. In multivariate logistic regression analysis, preoperative eGFR (P = 0.016) was the only risk factor of predicting worse postoperative renal function. During follow-up, 22 patients (16.3%) were dead due to RCC. According to ROC analysis, the cut off value of ACE and PCE was 13.9 and 0.16, respectively. ACE> 13.9 and PCE > 0.16 indicated worse CSS (P = 0.006 and P = 0.047, respectively). However, in multivariate Cox regression analysis of several related factors, perinephric tissues invasion (P = 0.001), sarcomatoid differentiation (P = 0.001) and ACE> 13.9 (P = 0.002) were significant prognostic factors for CSS. PCE > 0.16 seemed to be not (P = 0.055).

Conclusion
We explored several clinicopathological risk factors of predicting renal function change and their relationship with prognosis of RCC patients with tumor thrombus after nephrectomy and thrombectomy. The renal function change, which was associated with preoperative eGFR and pathological type, was prognostic risk factor for CSS and ACE> 13.9 indicated the worse prognosis.
Changes in the number of suicide re-attempts in a French region since the inception of VigilanS, a regionwide program combining brief contact interventions (BCI)
Authors: Fossi Djembi Larissa , Vaiva Guillaume , Debien Christophe , Duhem Stéphane , Demarty Anne-Laure , Koudou Yves-Akoli , Messiah Antoine 
Published: January 2020

Abstract
Background
Brief Contact Interventions (BCIs) after a suicide attempt (SA) are an important element of prevention against SA and suicide. They are easier to generalize to an entire population than other forms of intervention. VigilanS generalizes to a whole French region a BCI combining resource cards, telephone calls and mailings, according to a predefined algorithm. It was implemented gradually in the Nord-Pas-de-Calais (NPC), France, between 2015 and 2018. Here, we evaluate the effectiveness of VigilanS, in terms of SA reduction, using annual data collected by participating centers. Hypothesis tested: the higher the VigilanS implementation in a center (measured by penetrance), the greater the decrease in the number of SA observed in this center.

Methods
The study period was from 2014 to 2018, across all of NPC centers. We performed a series of linear regressions, each center representing a statistical unit. The outcome was the change in the number of SA, relative to the initial number, and the predictive variable was VigilanS’ penetrance: number of patients included in VigilanS over the total number of SA. Search for influential points (points beyond threshold values of 3 influence criteria) and weighted least squares estimations were performed.

Results
Twenty-one centers were running VigilanS in 2018, with an average penetrance of 32%. A significant relationship was identified, showing a sharp decrease in SA as a function of penetrance (slope = − 1.13; p = 3*10− 5). The model suggested that a 25% of penetrance would yield a SA decrease of 41%.

Conclusion
VigilanS has the potential to reduce SA. Subgroup analyzes are needed to further evaluate its effectiveness. Subgroup analyses remain to be done, in order to evaluate the specific variations of SA by group.
Inequalities and factors associated with adherence to diabetes self-care practices amongst patients at two public hospitals in Gauteng, South Africa
Authors: Mutyambizi Chipo , Pavlova Milena , Hongoro Charles , Groot Wim 
Published: January 2020

AbstractBackgroundSelf- management is vital to the control of diabetes. This study aims to assess the diabetes self-care behaviours of patients attending two tertiary hospitals in Gauteng, South Africa. The study also seeks to estimate the inequalities in adherence to diabetes self-care practices and associated factors.MethodsA unique health-facilities based cross-sectional survey was conducted amongst diabetes patients in 2017. Our study sample included 396 people living with diabetes. Face-to-face interviews were conducted using a structured questionnaire. Diabetes self-management practices considered in this study are dietary diversity, medication adherence, physical activity, self-monitoring of blood-glucose, avoiding smoking and limited alcohol consumption. Concentration indices (CIs) were used to estimate inequalities in adherence to diabetes self-care practices. Multiple logistic regressions were fitted to determine factors associated with diabetes self-care practices.ResultsApproximately 99% of the sample did not consume alcohol or consumed alcohol moderately, 92% adhered to self-monitoring of blood-glucose, 85% did not smoke tobacco, 67% adhered to their medication, 62% had a diverse diet and 9% adhered to physical activity. Self-care practices of dietary diversity (CI = 0.1512) and exercise (CI = 0.1067) were all concentrated amongst patients with higher socio-economic status as indicated by the positive CIs, whilst not smoking (CI = − 0.0994) was concentrated amongst those of lower socio-economic status as indicated by the negative CI. Dietary diversity was associated with being female, being retired and higher wealth index. Medication adherence was found to be associated with older age groups. Physical activity was found to be associated with tertiary education, being a student and those within higher wealth index. Self-monitoring of blood glucose was associated with being married. Not smoking was associated with being female and being retired.ConclusionAdherence to exercising, dietary diversity and medication was found to be sub-optimal. Dietary diversity and exercise were more prevalent among patients with higher socio-economic status. Our findings suggest that efforts to improve self- management should focus on addressing socio-economic inequalities. It is critical to develop strategies that help those within low-socio-economic groups to adopt healthier diabetes self-care practices.
What factors contribute to the self-reported oral health status of Arab adolescents? An assessment using a validated Arabic-WHO tool for child oral health (A-OHAT)
Authors: Bokhari Ahmed M. , Quadri Mir Faeq Ali 
Published: January 2020

Abstract
Background
The current study was performed; to validate the Arabic version of WHO child oral health assessment tool (A-OHAT), to assess the oral health status of Arab school children and finally to identify the important risk factors associated with the poor teeth and gum conditions of school children.

Methods
A cross-sectional study with two-staged simple random sampling technique was implemented. A-OHAT, a self-assessment tool was subjected to psychometric analyses with the respondents being high school children. The Cronbach’s alpha and the Intra class correlation values were computed. Paired t-test was performed to identify the differences between the readings after repeated administration, followed by the analysis for convergent validity. This tested Arabic-WHO Child-OHAT was administered to collect the data. Univariate, bivariate and logistic regression analyses were performed to report on the potential risk factors associated with poor teeth and poor gum conditions of school children.

Results
Psychometric analyses revealed that the Arabic Child Oral Health Assessment Tool (A-OHAT) was reliable and valid. A total of 478 (N) high school children were subjected to the tested tool, of which 66.5% were male and 33.5% were female with a mean age of 16.28 + 1.04 years. 80.3% of school children had poor teeth condition and 36.2% of school children had often experienced toothache. Children had 1.5 times higher odds of having poor teeth condition if they had increased frequency of sweet and candy consumption. It was also seen that increased frequency of sweets and candy consumption by school children had put them at nearly 20% higher risk of having poor gum condition. Finally, children with the habit of using toothbrush had nearly 50% lower chance of having poor gum condition in contrast to the school children who do not use toothbrush.

Conclusion
To conclude, the study provides a reliable and valid tool to assess the oral health status of Arab adolescents. Improper oral hygiene habits and diet were identified as the plausible risk factors for poor teeth and gum condition.
Association of insulin resistance, from mid-life to late-life, with aortic stiffness in late-life: the Atherosclerosis Risk in Communities Study
Authors: Poon Anna K. , Meyer Michelle L. , Tanaka Hirofumi , Selvin Elizabeth , Pankow James , Zeng Donglin , Loehr Laura , Knowles Joshua W. , Rosamond Wayne , Heiss Gerardo 
Published: January 2020

AbstractBackgroundInsulin resistance may contribute to aortic stiffening that leads to end-organ damage. We examined the cross-sectional association and prospective association of insulin resistance and aortic stiffness in older adults without diabetes.MethodsWe analyzed 2571 men and women at Visit 5 (in 2011–2013), and 2350 men and women at repeat examinations from baseline at Visit 1 (in 1987–1989) to Visit 5 (in 2011–2013). Linear regression was used to estimate the difference in aortic stiffness per standard unit of HOMA-IR, TG/HDL-C, and TyG at Visit 5. Linear mixed effects were used to assess if high, as opposed to non-high, aortic stiffness (> 75th percentile) was preceded by a faster annual rate of change in log-HOMA-IR, log-TG/HDL-C, and log-TyG from Visit 1 to Visit 5.ResultsThe mean age of participants was 75 years, 37% (n = 957) were men, and 17% (n = 433) were African American. At Visit 5, higher HOMA-IR, higher TG/HDL-C, and higher TyG were associated with higher aortic stiffness (16 cm/s per SD (95% CI 6, 27), 29 cm/s per SD (95% CI 18, 40), and 32 cm/s per SD (95% CI 22, 42), respectively). From Visit 1 to Visit 5, high aortic stiffness, compared to non-high aortic stiffness, was not preceded by a faster annual rate of change in log-HOMA-IR from baseline to 9 years (0.030 (95% CI 0.024, 0.035) vs. 0.025 (95% CI 0.021, 0.028); p = 0.15) or 9 years onward (0.011 (95% CI 0.007, 0.015) vs. 0.011 (95% CI 0.009, 0.013); p = 0.31); in log-TG/HDL-C from baseline to 9 years (0.019 (95% CI 0.015, 0.024) vs. 0.024 (95% CI 0.022, 0.026); p = 0.06) or 9 years onward (− 0.007 (95% CI − 0.010, − 0.005) vs. − 0.009 (95% CI − 0.010, − 0.007); p = 0.08); or in log-TyG from baseline to 9 years (0.002 (95% CI 0.002, 0.003) vs. 0.003 (95% CI 0.003, 0.003); p = 0.03) or 9 years onward (0 (95% CI 0, 0) vs. 0 (95% CI 0, 0); p = 0.08).ConclusionsAmong older adults without diabetes, insulin resistance was associated with aortic stiffness, but the putative role of insulin resistance in aortic stiffness over the life course requires further study.
Perceived poverty and health, and their roles in the poverty-health vicious cycle: a qualitative study of major stakeholders in the healthcare setting in Hong Kong
Authors: Chung Gary Ka-Ki , Dong Dong , Wong Samuel Yeung-Shan , Wong Hung , Chung Roger Yat-Nork 
Published: January 2020

Abstract
Background
Poverty and ill-health are closely inter-related. Existing studies on the poverty-health vicious cycle focus mainly on less developed countries, where the identified mechanisms linking between poverty and ill-health may not fit the situations in developed Asian regions. This study aims to qualitatively explore the perceived mechanisms and drivers of the poverty-health vicious cycle among major stakeholders in the healthcare setting in Hong Kong.

Methods
Data were collected via focus group interviews with social workers (n = 8), chronically ill patients (n = 8), older adults (n = 6), primary care doctors (n = 7) and informal caregivers (n = 10). The transcribed data were then closely read to capture key themes using thematic analyses informed by social constructivism.

Results
In this highly developed Asian setting with income inequality among the greatest in the world, the poverty-health vicious cycle operates. Material and social constraints, as a result of unequal power and opportunities, appear to play a pivotal role in creating uneven distribution of social determinants of health. The subsequent healthcare access also varies across the social ladder under the dual-track healthcare system in Hong Kong. As health deteriorates, financial hardship is often resulted in the absence of sufficient and coordinated healthcare, welfare and labour policy interventions. In addition to the mechanisms, policy drivers of the cycle were also discussed based on the respondents’ perceived understanding of the nature of poverty and its operationalization in public policies, as well as of the digressive conceptions of disease among different stakeholders.

Conclusions
The poverty-health vicious cycle has remained a great challenge in Hong Kong despite its economic prosperity. To break the cycle, potential policy directions include the adoption of proportionate universalism, social integration and the strengthening of medical-social collaboration.
Early metabolic response of breast cancer to neoadjuvant endocrine therapy: comparison to morphological and pathological response
Authors: Boughdad Sarah , Champion Laurence , Becette Veronique , Cherel Pascal , Fourme Emmanuelle , Lemonnier Jerome , Lerebours Florence , Alberini Jean-Louis 
Published: January 2020

Abstract
Background
Neoadjuvant endocrine therapy (NET) has shown efficacy in terms of clinical response and surgical outcome in postmenopausal patients with estrogen receptor-positive / HER2-negative breast cancer (ER+/HER2- BC) but monitoring of tumor response is challenging. The aim of the present study was to investigate the value of an early metabolic response compared to morphological and pathological responses in this population.

Methods
This was an ancillary study of CARMINA 02, a phase II clinical trial evaluating side-by-side the efficacy of 4 to 6 months of anastrozole or fulvestrant. Positron Emission Tomography/Computed Tomography using 2-deoxy-2-[18F]fluoro-D-glucose (FDG-PET/CT) scans were performed at baseline (M0), early after 1 month of treatment (M1) and pre-operatively in 11 patients (74.2 yo ± 3.6). Patients were classified as early “metabolic responders” (mR) when the decrease of SUVmax was higher than 40%, and “metabolic non-responders” (mNR) otherwise. Early metabolic response was compared to morphological response (palpation, US and MRI), variation of Ki-67 index, pathological response according to the Sataloff classification and also to Preoperative Endocrine Prognostic Index (PEPI) score. It was also correlated with overall survival (OS) and recurrence-free survival (RFS).

Results
Tumor size measured on US and on MRI was smaller in mR than mNR, with the highest statistically significant difference at M1 (p = 0.01 and 7.1 × 10− 5, respectively). No statistically significant difference in the variation of tumor size between M0 and M1 assessed on US or MRI was observed between mR and mNR. mR had a better clinical response: no progressive disease in mR vs 2 in mNR and 2 partial response in mR vs 1 partial response in mNR. One patient with a pre-operative complete metabolic response had the best pathological response. Pathological response did not show any statistically significant difference between mR and mNR. mR had better OS and RFS (Kaplan-Meier p = 0.08 and 0.06, respectively). All cancer-related events occurred in mNR: 3 patients died, 2 of them from progressive disease.

Conclusions
FDG-PET/CT imaging could become a “surrogate marker” to monitor tumor response, especially as NET is a valuable treatment option in postmenopausal women with ER+/HER2- BC.
The tyranny of the head office? Revisiting corporate headquarters’ (CHQs) role in MNE subsidiary initiatives
Authors: Verbeke Alain , Yuan Wenlong 
Published: January 2020

AbstractWhat roles should corporate headquarters (CHQs) of multinational enterprises (MNEs) play in foreign subsidiary initiatives? Rather than viewing the MNE’s CHQ as a single, internally homogenous unit, we call for examining the diversity of individual decision-makers who can be driven by a variety of motivations and have different abilities. Motivations and abilities together determine whether or not corporate executives will choose to intervene in subsidiary initiatives and the effectiveness of such intervention. If dysfunctional, the “tyranny of the head office” materializes. We apply the Coleman-boat concept to show how contextual analyses at the MNE level and the proposed analyses of individual decision-makers need to be combined when exploring the underlying micro-foundational mechanisms of decisions.
Impact of diffusion weighted magnetic resonance imaging in diagnosis of cervical cancer
Authors: Abd elsalam Sahar Mahmoud , Mokhtar Omnia , Adel Lamia , Hassan Reda , Ibraheim Manal , Kamal Amro 
Published: January 2020

Abstract
Background
Cervical cancer is a widespread cancer among women worldwide. In this study, we evaluated the role of diffusion weighted magnetic resonance imaging (DWI-MRI) in diagnosis of cervical carcinoma with pathological diagnosis taken as the reference. The study included 70 patients in whom cancer cervix had been suspected clinically or by transvaginal U/S and confirmed by biopsy. The control group consisted of 40 patients with a normal cervix who performed MRI for other pelvic disorders. Pelvic MR with DWI and dynamic contrast enhanced MRI (DCE-MR) were done for all patients.

Results
Both DW-MRI and DCE-MRI revealed the same sensitivity, specificity, PPV, and accuracy; 100%, 50%, 97%, and 97%, respectively. The mean ADC value for malignant lesions was (0.82 × 10−3 ± 0.1 SD mm2/s). While the mean ADC value in the control group is (1.56 × 10–3 mm2/s). ADC value of (1.07 × 10−3 mm2/s) is a cut-off between normal cervical tissue& malignant cervical lesion with a sensitivity 97% and specificity 95.5%

Conclusion
Each of the (DW-MRI) and (DCE-MRI) sequences when added to the non-contrast MRI sequences in the estimation of cancer cervix had elicited the same sensitivity, specificity, and accuracy. DW–MRI was significantly beneficial in terms of diagnostic performance. For patients who cannot receive contrast medium, dynamic contrast-enhanced imaging can be replaced by DWI. The ADC value in case of cervical cancer was significantly lower than in the non-affected cervical tissue.
Tese da compatibilidade na teoria do intelecto de Tomás de Aquino
Authors: Borges Lucas Nogueira 
Published: January 2020

A proposta deste artigo consiste em demonstrar que a teoria do intelecto em Tomás de Aquino exige uma relação de compatibilidade entre o objeto externo (extra animam) e o intelecto humano. O intelecto, princípio da ação intelectiva, não é compatível com o objeto externo, porque é imaterial. Entretanto, sua operação é compatível com a coisa material. A tese do modelo de identidade formal na teoria da intencionalidade de Tomás de Aquino elucida que o intelecto pode se referir a objetos no mundo porque há entre ele e seu objeto um princípio de identidade entre a forma existente na coisa e a forma existente no intelecto humano. Partindo dessa tese já consagrada, pretende-se mostrar que certas afirmações de Aristóteles interpretadas por Tomás explicam por que o intelecto humano é capaz e está, na maioria dos casos, em condições de apreender objetos materiais. Assim nesse trabalho são discutidas quais as propriedades do intelecto humano segundo Tomás, enquanto potência da alma e, por fim, sustenta-se a tese de que a exigência do objeto para as operações do intelecto é um princípio de compatibilidade.