bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing Psychometric Properties of the SF-36 and SF-12 in Measuring Quality of Life among Adolescents in China: A Large Sample Cross-sectional Study
Authors: Lin Yanwei , Yu Yulan , Zeng Jiayong , Zhao Xudong , Wan Chonghua 
Published: July 2020

Abstract
Objective: By comparing the psychometric properties of the Short Form 36 (version 1, SF-36) and the Short Form 12 (version 1, SF-12), we supply evidence for the selection of instruments measuring the quality of life (QOL) and decision-making processes of adolescents in China. Methods: Stratified cluster random sampling was adopted, and the SF-36 was administered to assess QOL. The Pearson correlation coefficient was used to show correlation. Cronbach’s alpha and construct reliability (CR) were used to evaluate the reliability of SF-36 and SF-12, while criterion validity and average variance extracted (AVE, convergence validity) were used to evaluate validity. Confirmatory factor analysis was used to calculate the load factor for each item, then to obtain the CR and AVE. The Semejima grade response model (logistic two-parameter module) in item response theory was used to estimate item discrimination, item difficulty, and item average information for each item. Results: 19,428 samples were included in the study. The mean age of respondents was 14.78 years (SD = 1.77). High correlations between the corresponding domains and components of both scales were found. Reliability of each domain of the SF-36 was better than for the corresponding domain of SF-12. The domains of PF, RP, BP, and GH in SF-36 had good construct reliability (CR > 0.6). The criterion validities of SF-36 were a little higher in some corresponding dimensions, except for PCS. The convergence validities of SF-12 were higher than SF-36 in PF, RP, BP, and PCS. The items of BP, SF, RP, and VT in SF-12 had acceptable discrimination of items that were higher than in SF-36. The items’ average amounts of information of BP, VT, SF, RE, and MH in SF-36 and SF-12 were poor. Conclusion: Two component measurements of the SF-12 (PCS and MCS) appeared to perform at least as well as the SF-36 in cross-sectional settings in adolescence, but the reliability and validity of 8 domains of the SF-36 were better than those of SF-12. Some domains, for instance SF and BP, were not suitable for adolescents or need no further study.
Analyzing the technical efficiency of health systems in Asian countries: What Myanmar can learn from Bangladesh and Sri Lanka.
Authors: Win Zin Mar , Löfgren Curt 
Published: July 2020

Abstract
Background: Advancements in medicine leads, among other things, to increasing life expectancy and quality of life. However, at the same time, health care costs are increasing, and this may not be sustainable in the future. Governments and health care organizations need to implement efficiency measures in order to maximize health outcomes within available resources. This study aims to compare the technical efficiency of health systems in middle-income Asian countries, and to identify “efficient peers” for each “inefficient country”: in particular for Myanmar. Methods: A data envelopment analysis (DEA) variable returns to scale output-oriented model was used to evaluate technical efficiency in middle-income Asian countries. The input variables were current health expenditure per capita, the density of doctors, and the density of nurses and midwifery personnel. The output variables were health adjusted life expectancy (HALE) and the infant mortality rate (IMR). Myanmar may learn how to improve efficiency of its health care system through studying its efficient peers from DEA results. A review of relevant English language literature was used as a basis for informing a comparative analysis of the health systems of Myanmar and its efficient peers: Bangladesh and Sri Lanka.Results: Among the twenty-eight middle-income Asian countries studied, 39.3% of countries were technically efficient. Myanmar is one of the inefficient countries, and it should look at the health systems of its efficient peers, Bangladesh and Sri Lanka, to make its health system technically more efficient.Conclusions: The results of this study suggested that countries with inefficient health systems can improve their health outcomes without increasing their health care resources. As DEA measures efficiency only, future studies should take into account equity to assess comprehensive health system performance.
OTX1 exerts an oncogenic role and is negatively regulated by miR129-5p in laryngeal squamous cell carcinoma
Authors: Tu Xiu-Ping , Li Hao , Chen Liang-Si , Luo Xiao-Ning , Lu Zhong-Ming , Zhang Si-Yi , Chen Shao-Hua 
Published: July 2020

Abstract
Background Orthodenticle homeobox 1 (OTX1) is a transcription factor that plays an important role in various human cancers. However, the function of OTX1 in laryngeal squamous cell carcinoma (LSCC) is largely unknown. We aimed to explore the roles of OTX1 in LSCC and its possible molecular mechanism. Methods The expression levels of OTX1 were assessed in LSCC cell lines and tissue samples. We further examined the effect of OTX1 on LSCC progression. The upstream regulator of OTX1 was identified using a computer algorithm and confirmed experimentally. Results OTX1 was highly expressed in 70.7% (70/99) of LSCC tissue samples. The OTX1 expression in LSCC was significantly correlated with lymph node metastasis. High OTX1 expression in patients with LSCC was correlated with poor prognosis. Knockdown of OTX1 inhibited proliferation, colony formation, migration and invasion in LSCC cells. Knockdown of OTX1 inhibited tumor growth in a xenograft mouse model. Mechanistically, OTX1 might act as a direct target of miR-129-5p. OTX1 enhanced tumorigenicity and tumor growth both in vitro and in vivo . Conclusions Our findings support that OTX1 is an oncogene in LSCC tumorigenesis and progression. Furthermore, OTX1 is a direct target of miR-129-5p in LSCC cells. Taken together, OTX1 is a promising diagnostic and therapeutic marker for LSCC.
A novel nomogram to predict the overall survival in esthesinoeroblastoma
Authors: Jiang Lijie , Lin Tengjiao , Zhang Yu , Gao Wenxiang , Deng Jie , Xu Zhaofeng , Luo Xin , Huang Zhaoqi , Chen Fenghong , Shi Jianbo , Lai Yinyan 
Published: July 2020

Abstract
Background

Increasing evidence indicates that the pathology and the modified Kadish system have some influence on the prognosis of esthesioneuroblastoma (ENB). However, an accurate system to combine pathology with a modified Kadish system has not been established.

Methods

This study aimed to set up and evaluate a model to predict overall survival (OS) accurately in ENB, including clinical characteristics, treatment and pathological variables. We screened the information of patients with ENB between January 1, 1976, and December 30, 2016 from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) program as a training cohort. The validation cohort consisted of patients with ENB at Sun Yat-sen University Cancer Center and The First Affiliated Hospital of Sun Yat-sen University in the same period, and 87 patients were identified. The Pearson’s chi-squared test was used to assess significance of clinicopathological and demographic characteristics. We used the Cox proportional hazards model to examine univariate and multivariate analyses. The model coefficients were used to calculate the Hazard ratios (HR) with 95% confidence intervals (CI). Prognostic factors with a p- value < 0.05 in multivariate analysis were included in the nomogram. The concordance index (c-index) and calibration curve were used to evaluate the predictive power of the nomogram.

Results

The c-index of training cohort and validation cohort are 0.737 (95% CI, 0.709 to 0.765) and 0.791 (95% CI, 0.767 to 0.815) respectively. The calibration curves revealed a good agreement between the nomogram prediction and actual observation regarding the probability of 3-year and 5-year survival. We used a nomogram to calculate the 3-year and 5-year growth probability and stratified patients into three risk groups.

Conclusions

The nomogram provided the risk group information and identified mortality risk and can serve as a reference for designing a reasonable follow-up plan.
Novel ethanol production using biomass preprocessing to increase ethanol yield and reduce overall costs
Authors: Pascoli Danielle Uchimura , Suko Azra , Gustafson Rick , Gough Heidi , Bura Renata 
Published: July 2020

Abstract
Background: Ethanol biorefineries need to lower their overall production costs to become economically feasible. Two strategies to achieve this are to reduce costs by using cheaper feedstocks or to increase the ethanol production yield. Low-cost feedstocks usually have high non-structural components (NSC) content, therefore a new process is necessary to accommodate these feedstocks and overcome the negative effects of NSC. This study developed a novel ethanol biorefinery process including a biomass preprocessing step that enabled the use of lower-cost feedstocks while improving ethanol production without detoxification (overliming). Two types of poplar feedstocks were used, low-quality whole-tree chips (WTC) and high-quality clean pulp chips (CPC), to determine if the proposed process is effective while using feedstocks with different NSC contents.Results: Technical assessment showed that acidic preprocessing increased the monomeric sugar recovery of WTC from 73.2% (untreated) to 87.5% due to reduced buffering capacity of poplar, improved sugar solubilization during pretreatment, and better enzymatic hydrolysis conversion. Preprocessing alone significantly improved the fermentability of the liquid fraction from 1-2% to 49-56% for both feedstocks, while overliming improved it to 45%. Consequently, it was proposed that preprocessing can substitute for the detoxification step. The economic assessment revealed that using poplar WTC via the new process increased annual ethanol production of 10.5 million liters when compared to using CPC via overliming (base case scenario). Also, savings in total operating costs were about $10 million per year when using cheaper poplar WTC instead of CPC, and by using recycled water for preprocessing lowered its total operating costs by 45-fold.Conclusions: The novel process developed in this study was successful in increasing ethanol production while decreasing overall costs, thus facilitating the feasibility of lignocellulosic ethanol biorefineries. Key factors to achieving this outcome included substituting overliming by preprocessing, enabling the use of lower-quality feedstock, increasing monomeric sugar recovery and ethanol fermentation yield, and using recycled water for preprocessing. In addition, preprocessing enabled the implementation of an evaporator-combustor downstream design, resulting in a low-loading waste stream that can be treated in a wastewater treatment plant with a simple configuration.
Corticosteroids versus clobazam in epileptic encephalopathy with ESES: a European multicenter randomized controlled clinical trial (RESCUE ESES*)
Authors: Munckhof Bart van den , Arzimanoglou Alexis , Perucca Emilio , Teeseling Heleen C. van , Leijten Frans S.S. , Braun Kees P.J. , Jansen Floor E. 
Published: July 2020

Abstract
Background: Epileptic encephalopathy with electrical status epilepticus in sleep (ESES) is an epilepsy syndrome occurring almost exclusively in children, usually at an age between 4 and 12 years. It is characterized by abundant sleep-induced epileptic activity in the electroencephalogram (EEG) and by acquired cognitive and behavioural deficits. The goal of treatment is to prevent further decline or even improve cognitive functioning. Based on mostly small and retrospective studies, corticosteroids and clobazam are regarded by many clinicians as the most effective pharmacological treatments. This European multicentre randomized controlled trial is designed to compare the effects of corticosteroids and clobazam on cognitive functioning after 6 months. Secondary outcomes include cognitive functioning after 18 months, EEG abnormalities in sleep, safety and tolerability, and seizure frequency. We also aimed at investigating whether treatment response in epileptic encephalopathy with ESES can be predicted by measurement of inflammatory mediators and auto-antibodies in serum.Methods: The pragmatic study will be performed in centres with expertise in the treatment of rare paediatric epilepsy syndromes across Europe. 130 patients, 2 to 12 years of age, with epileptic encephalopathy with ESES will be enrolled and randomized in a 1:1 ratio to receive either corticosteroids (monthly intravenous methylprednisolone pulses or daily oral prednisolone) or oral clobazam for 6 months according to an open-label parallel-group design. Follow-up visits with clinical assessment, EEGs and neuropsychological testing are scheduled for up to 18 months. Blood samples for cytokine and auto-antibody testing are obtained before treatment and after 8 months of treatment.Discussion: The treatment of epileptic encephalopathy with ESES aims at improving cognitive outcome. This randomized controlled study will compare the most frequently used treatments, i.e. corticosteroids and clobazam. If the study proves superiority of one treatment over the other or identifies biomarkers of treatment response, results will guide clinicians in the early treatment of this severe epilepsy syndrome.Trial registration: ISRCTN, ISRCTN42686094, registered 24 May 2013, http://www.isrctn.com/ISRCTN42686094
Clinical patterns and the evolution of relapsing polychondritis based on organ involvement: a Chinese retrospective cohort study
Authors: Zhang Lei , Yun Shuang , Wu Tiange , He Yujie , Guo Jinyan , Han Lishuai , Lu Jiameng , Liu Xiaojun , Yang Rui , Zhang Shitao , Li Tianfang , Liu Shengyun 
Published: July 2020

Abstract
Background

Relapsing polychondritis(RPC) is a rare autoimmune disease and its early diagnosis pose a challenge to medical committee. Defining the clinical patterns and disease course may help early recognition of RPC.

Results

Sixty-six males and 60 females were included in this study. Their average age at onset were 47.1±13.8 years with a median follow-up of 18 months. Correlation analysis revealed a strong negative correlation between airway involvement and auricular chondritis (r=-0.75，P<0.001). Four distinct clinical patterns were identified: Ear pattern (50.8%), Airway pattern (38.9%), Overlap pattern (4.8%) and Airway-Ear negative pattern (5.6%), and patients with Ear pattern and Airway pattern were further divided into limited and systemic form of RPC (27.8%with limited form of Ear pattern and 24.6% with limited form of Airway pattern initially). During follow-up, a minority of patients with Ear pattern and Airway pattern progressed into Overlap pattern, and some Airway-Ear negative pattern patients progressed into Ear pattern. While a large majority of limited RPC patients remained limited form during follow-up, some patients did become systemic form. Patients with Ear pattern had the highest survival rate and lower inflammatory status.

Conclusions

RPC patients can be categorized as 4 different clinical patterns and 2 distinct presenting forms (limited and systemic) based on organ involvement, and clinical patterns and presenting forms can evolve during follow-up. Our findings may facilitate early recognition of this rare disease.
The Diagnostic Value of SPECT/CT in Predicting the Occurrence of Osteonecrosis following Femoral Neck Fracture : a prospective cohort study
Authors: Yoon Jae Youn , Lee Soong Joon , Yoon Kang Sup , Yoon Pil Whan 
Published: July 2020

Abstract
Backgrounds

One of the most significant complications after a femoral neck fracture is osteonecrosis of the femoral head (ONFH). The concomitant use of single-photon emission computed tomography (SPECT) with computed tomography (CT) increases the sensitivity for detecting the anatomic location and severity of ONFH. In this study, we evaluated the diagnostic value of SPECT/CT for the occurrence of ONFH by quantifying the perfusion status of the femoral head.

Methods

A total of 30 patients who had multiple pinnings for femur neck fractures were included in this study. We classified the perfusion status into three groups: normal perfusion, decreased perfusion, and avascular groups, and compared the occurrence of femoral head necrosis between them. For quantitative analysis, we evaluated the uptake ratio of both femur heads (head-to-head uptake ratio). If the patient’s contralateral hip was incomparable, we measured the uptake ratio from the superior dome of the ipsilateral acetabulum (head-to-acetabulum uptake ratio).

Results

Twenty-four patients out of 30 achieved bone union, whereas the others developed ONFH. When the population was divided into intact and defective perfusion groups on scintigraphy, the sensitivity, specificity, and accuracy of the test were 83.3%, 75.0%, and 76.7%, respectively. The mean head-to-head uptake ratio value with a 95% confidence interval (CI) was 1.10 (95% CI: 0.85 – 1.36). In the osteonecrosis group, the mean value of the head-to-head uptake ratio was 0.33 (95% CI: 0.28 – 0.38). In contrast, the ratio was 1.30 (95% CI: 1.03 – 1.57) in the non-osteonecrosis group, demonstrating a significant difference in the uptake ratio ( P < 0.001). When the cutoff value of the uptake ratio was set to 0.5, both the sensitivity and specificity were 100%. There was also a significant difference in the head-to-acetabulum uptake ratio between the two groups ( P < 0.001).

Conclusions

SPECT/CT was useful in evaluating the perfusion status of the femoral head, showing high accuracy in predicting the occurrence of avascular necrosis. To demonstrate the reliability and validity of SPECT/CT, further prospective studies on a larger scale are warranted.
FibroBox: a novel noninvasive tool for predicting significant liver fibrosis and cirrhosis in HBV infected patients
Authors: Lu Xiao-Jie , Yang Xiao-Jun , Sun Jing-Yu , Zhang Xin , Yuan Zhao-Xin , Li Xiu-Hui 
Published: July 2020

Abstract
BackgroundChina is a highly endemic area of chronic hepatitis B (CHB). The accuracy of existed noninvasive biomarkers including TE, APRI and FIB-4 for staging fibrosis is not high enough in Chinese cohort.MethodsUsing liver biopsy as a gold standard, a novel noninvasive indicator was developed using laboratory tests, ultrasound measurements and liver stiffness measurements with machine learning techniques to predict significant fibrosis and cirrhosis in CHB patients in north and east part of China. We retrospectively evaluated the diagnostic performance of the novel indicator named FibroBox, Fibroscan, aspartate transaminase-to-platelet ratio index (APRI), and fibrosis-4 index (FIB-4) in CHB patients from Jilin and Huai’an (training sets) and also in Anhui and Beijing cohorts (validation sets).ResultsOf 1289 eligible HBV patients who had liver histological data, 63.2% had significant fibrosis and 22.5% had cirrhosis. In LASSO logistic regression and filter methods, fibroscan results, platelet count, alanine transaminase (ALT), prothrombin time (PT), type III procollagen aminoterminal peptide ( PIIINP ), type IV collagen, laminin, hyaluronic acid ( HA ) and diameter of spleen vein were finally selected as input variables in FibroBox. Consequently, FibroBox was developed of which the area under the receiver operating characteristic curve (AUROC) was significantly higher than that of TE, APRI and FIB-4 to predicting significant fibrosis and cirrhosis. In the Anhui and Beijing cohort, the AUROC of FibroBox was 0.88 (95% CI, 0.72-0.82) and 0.87 (95% CI, 0.83-0.91) for significant fibrosis and 0.87 (95% CI, 0.82-0.92) and 0.90 (95% CI, 0.85-0.94) for cirrhosis. In the validation cohorts, FibroBox accurately diagnosed 81% of significant fibrosis and 84% of cirrhosis.ConclusionsFibroBox has a better performance in predicting liver fibrosis in Chinese cohorts with CHB, which may serve as a feasible alternative to liver biopsy.
Albumin-bound paclitaxel and gemcitabine combination therapy in soft tissue sarcoma
Authors: Tian Zhichao , Zhang Fan , Li Po , Wang Jiaqiang , Yang Jinpo , Zhang Peng , Yao Weitao , Wang Xin 
Published: July 2020

Abstract
Background: The evidence that albumin-bound paclitaxel (nab-paclitaxel) is safe and efficacious for the treatment of many types of malignant tumors is continuously increasing. However, the evidence and clinical data of nab-paclitaxel and gemcitabine in metastatic soft tissue sarcoma (STS) treatment are rare. Methods: The clinical data of metastatic STS patients who received nab-paclitaxel/ gemcitabine chemotherapy between January 2019 and February 2020 were retrospectively analysed. All these patients were treated with nab-paclitaxel/ gemcitabine only after doxorubicin-based chemotherapy had failed. We evaluated the effectiveness and safety of nab-paclitaxel and gemcitabine in these patients. Results: A total of 17 patients treated with nab-paclitaxel/ gemcitabine were enrolled in this study. 1 patient with angiosarcoma achieved complete response, 6 patients had partial response, 5 patients achieved stable disease, and 5 patients had progressive disease. The average diameter change in target lesion from baseline was -19.06±45.74%. And median progression free survival was 6 months (95% CI, 2–9 months). Grade 3 / 4 adverse events were not common, included neutropenia (17.6%), fatigue (11.8%), anemia (11.8%), leukopenia (11.8%), nausea (5.9%), peripheral neuropathy (5.9%), diarrhea (5.9%), and thrombocytopenia (5.9%). No treatment-related deaths occurred. Conclusion: Nab-paclitaxel/ gemcitabine combination chemotherapy is comparatively effective in the treatment of STS, demonstrates low toxicity, and is worthy of further study.
Inequalities in stunting among under-five children in Tanzania: Decomposing the Concentration Indexes using Demographic Health Surveys from 2004/5 to 2015/6
Authors: Musheiguza Edwin , Mahande Michael Johnson , Malamala Elias , Msuya Sia E , Charles Festo , Philemon Rune , Mgongo Melina 
Published: July 2020

Abstract
Background

Child stunting is a global health concern. It has consequences on child survival, growth, and development. The absolute level of stunting has been decreasing in Tanzania although the prevalence is still high (34%), varying across socioeconomic determinants with a larger burden among the disadvantaged group. The reduction of inequalities in stunting is very crucial as we aim to reduce stunting to 28% by 2021.

Objectives

This study aimed to determine the trend, contributing factors and changes of inequalities in stunting among children aged 3 – 59 months from 2004 to 2016

Methodology

Data were drawn from the Tanzania Demographic and Health Surveys. The dependent variable was stunting. The concentration index was used to quantify the magnitude of inequalities in stunting for each year. To get the contribution of each determinant on the inequality in stunting, the concentration index was decomposed by using the Wagstaff and Watanabe decomposition methods of the concentration index.

Results

Inequalities in stunting insignificantly declined from -0.019 (p<0.001) in 2004 to -0.018

(p<0.001) in 2010 and then to -0.0096 (p<0.001). Disparities in the distribution of wealth index (mean contribution > 84.7%) and maternal years of schooling (mean contribution > 22.4%) increased the levels of inequalities in stunting in all survey years. Rural-urban differences reduced inequalities in stunting although its contribution changed over time.

Conclusion

Inequalities in stunting declined, differentials in wealth index and maternal education had increased contribution to the levels of inequalities. To significantly reduce the larder burden of stunting among the disadvantaged groups, initiatives should be embarked on the distribution of social services like water, health infrastructures, and education.