bluuebunny/crossref_metadata_2025_split huggingface dataset:
Histologic subtyping affecting outcome of triple negative breast cancer: a large Sardinian population-based analysis
Authors: Sanges Francesca , Floris Matteo , Cossu-Rocca Paolo , Muroni Maria R. , Pira Giovanna , Urru Silvana Anna Maria , Barrocu Renata , Gallus Silvano , Bosetti Cristina , D’Incalci Maurizio , Manca Alessandra , Uras Maria Gabriela , Medda Ricardo , Sollai Elisabetta , Murgia Alma , Palmas Dolores , Atzori Francesco , Zinellu Angelo , Cambosu Francesca , Moi Tiziana , Ghiani Massimo , Marras Vincenzo , Santona Maria Cristina , Canu Luisa , Valle Enrichetta , Sarobba Maria Giuseppina , Onnis Daniela , Asunis Anna , Cossu Sergio , Orrù Sandra , De Miglio Maria Rosaria 
Published: June 2020

Abstract
Background
Triple Negative breast cancer (TNBC) includes a heterogeneous group of tumors with different clinico-pathological features, molecular alterations and treatment responsivity. Our aim was to evaluate the clinico-pathological heterogeneity and prognostic significance of TNBC histologic variants, comparing “special types” to high-grade invasive breast carcinomas of no special type (IBC-NST).

Methods
This study was performed on data obtained from TNBC Database, including pathological features and clinical records of 1009 TNBCs patients diagnosed between 1994 and 2015 in the four most important Oncology Units located in different hospitals in Sardinia, Italy. Kaplan-Meier analysis, log-rank test and multivariate Cox proportional-hazards regression were applied for overall survival (OS) and disease free survival (DFS) according to TNBC histologic types.

Results
TNBC “special types” showed significant differences for several clinico-pathological features when compared to IBC-NST. We observed that in apocrine carcinomas as tumor size increased, the number of metastatic lymph nodes manifestly increased. Adenoid cystic carcinoma showed the smallest tumor size relative to IBC-NST. At five-year follow-up, OS was 92.1, 100.0, and 94.5% for patients with apocrine, adenoid cystic and medullary carcinoma, respectively; patients with lobular and metaplastic carcinoma showed the worst OS, with 79.7 and 84.3%, respectively. At ten-years, patients with adenoid cystic (100.0%) and medullary (94.5%) carcinoma showed a favourable prognosis, whereas patients with lobular carcinoma showed the worst prognosis (73.8%). TNBC medullary type was an independent prognostic factor for DFS compared to IBC-NST.

Conclusions
Our study confirms that an accurate and reliable histopathologic definition of TNBC subtypes has a significant clinical utility and is effective in the therapeutic decision-making process, with the aim to develop innovative and personalized treatments.
A survey exploring ophthalmologists’ attitudes and beliefs in performing Immediately Sequential Bilateral Cataract Surgery in the United Kingdom
Authors: Lee Eunkyung , Balasingam Bagishan , Mills Emily C. , Zarei-Ghanavati Mehran , Liu Christopher 
Published: June 2020

Abstract
Background
The standard approach to treat cataracts is Delayed Sequential Bilateral Cataract Surgery (DSBCS), during which patients have a separate operation date for each eye. An alternative method of delivery is Immediately Sequential Bilateral Cataract Surgery (ISBCS). The aim of this project was to examine the attitudes and beliefs of UK ophthalmologists towards ISBCS, explore their reasons to either practise or not practise ISBCS and identify barriers hindering its implementation in the UK.

Methods
A questionnaire was distributed to consultant members of The Royal College of Ophthalmologists (RCOphth, UK) and collected electronically. An initial screening question in regards to prior experience with ISBCS directed the rest of the survey; participants were asked to rate the importance of several factors with regards to performing ISBCS. Free text options were also available. Descriptive analysis was subsequently performed.

Results
Of the 1357 recipients, 130 (9.6%) ophthalmologists completed the survey. Of those, 13.9% were currently performing ISBCS, 83.1% had never performed, and 3.1% had previously done so but since stopped. The main factors that acted as barriers were lack of: (1) College approval (20.5%); (2) medico-legal approval (20.2%); (3) evidence to support the use of ISBCS (16.0%); and (4) hospital approval (13.3%). Additionally, the perceived risk of complications for patients played an important role when considering ISBCS, with the risk of endophthalmitis being most feared.

Conclusions
This survey demonstrates some of the barriers that prevent ophthalmologist’s performing ISBCS in the UK. There is a need for further exploration in this field to evaluate the effect of addressing any of these concerns on the implementation of ISBCS.
Demographic predictors of wellbeing in Carers of people with psychosis: secondary analysis of trial data
Authors: Hazell Cassie M. , Hayward Mark , Lobban Fiona , Pandey Aparajita , Pinfold Vanessa , Smith Helen E. , Jones Christina J. 
Published: June 2020

Abstract
Background
Carers of people with psychosis are at a greater risk of physical and mental health problems compared to the general population. Yet, not all carers will experience a decline in health. This predicament has provided the rationale for research studies exploring what factors predict poor wellbeing in carers of people with psychosis. Our study builds on previous research by testing the predictive value of demographic variables on carer wellbeing within a single regression model.

Methods
To achieve this aim, we conducted secondary analysis on two trial data sets that were merged and recoded for the purposes of this study. Results: Contrary to our hypotheses, only carer gender and age predicted carer wellbeing; with lower levels of carer wellbeing being associated with being female or younger (aged under 50). However, the final regression model explained only 11% of the total variance.

Conclusions
Suggestions for future research are discussed in light of the limitations inherent in secondary analysis studies. Further research is needed where sample sizes are sufficient to explore the interactive and additive impact of other predictor variables.
Feasibility of a twitter campaign to promote HPV vaccine uptake among racially/ethnically diverse young adult women living in public housing
Authors: Allen Jennifer D. , Hollander Justin , Gualtieri Lisa , Alarcon Falconi Tania M. , Savir Stephanie , Agénor Madina 
Published: June 2020

Abstract
Background
Uptake and completion of the HPV vaccine is suboptimal. This study assessed the feasibility of implementing a one-month Twitter campaign to promote knowledge about the human papillomavirus (HPV) vaccine among low-income women living in public housing.

Methods
We recruited a convenience sample (n = 35) of women ages 18–26 years residing in low-come, public housing in Massachusetts. We assessed the feasibility and acceptability of a communication campaign that consisted of daily Twitter messages. Online surveys assessed changes in HPV knowledge, attitudes, and vaccine intentions before and after the campaign.

Results
Most believed that Twitter was an acceptable educational strategy and remained engaged with the campaign throughout the intervention. We observed no changes in HPV knowledge, perceived benefits of or barriers to vaccination, decision self-efficacy, or vaccine intentions after the campaign, although perceived risk for cervical cancer decreased.

Conclusions
Twitter may be a feasible and acceptable method for promoting knowledge about the HPV vaccine, but more research is needed to understand how best to reach low-income women with low levels of vaccine uptake.

Trial registration
Clinicaltrials.gov 1,603,045, retrospectively registered 0610/19.
Modelling and prediction of global non-communicable diseases
Authors: Wang Yang , Wang Jinfeng 
Published: June 2020

AbstractBackgroundNon-communicable diseases (NCDs) are the main health and development challenge facing humankind all over the world. They are inextricably linked to socio-economic development. Deaths caused by NCDs should be different in different socio-economic development stages. The stratified heterogeneity of NCD deaths is currently not fully explored.MethodsCountries were classified according to their socio-economic types and development stages, which were illustrated as a tree-like structure called Geotree. NCD deaths were linked to the countries and so were attached to the Geotree, which was modelled by a multilevel model (MLM) approach. Accordingly, the levels of NCD death indexes were predicted for 2030.ResultsThrough the Geotree structure constructed in the study, it can be seen that the NCD death index has obvious stratified heterogeneity; that is, the NCD death index shows different trends in different country types and socio-economic development stages. In the first-level branches (country type), as national income increases, NCD mortality rate decreases and the proportion of NCD deaths to total deaths increases. In the secondary-level trunks (socio-economic development stage), as a country’s development stage rises, the NCD mortality rate decreases and the proportion of NCD deaths to total deaths increases. In addition, combined with the hierarchical nature of the evolution tree model, the MLM was used to predict the global NCD death index for 2030. The result was that by 2030, the global average age-standardized NCD mortality rate would be 510.54 (per 100,000 population) and the global average mortality for NCD deaths of the total number of deaths would be 75.26%.ConclusionsThis study found that there is a significant association between socio-economic factors and NCD death indicators in the tree-like structure. In the Geotree, countries on the same branch or trunk can learn from countries with higher development stages to formulate more effective NCD response policies and find the right prevention and treatment path.
Sitting, standing and moving during work and leisure among male and female office workers of different age: a compositional data analysis
Authors: Johansson Elin , Mathiassen Svend Erik , Lund Rasmusse Charlotte , Hallman David M. 
Published: June 2020

AbstractBackgroundGendered patterns of physical activity behaviours may help explaining health inequalities between men and women. However, evidence on such patterns in the working population is sparse. This study aimed at documenting and comparing compositions of sitting, standing and moving at work and during leisure among male and female office workers of different age.MethodsSitting (including lying), standing and moving were measured using accelerometry for, on average, four working days in 55 male and 57 female Swedish office workers. Behaviours were described in terms of time spent in four exhaustive categories: sitting in short (< 30 min) and long (≥30 min) bouts, standing, and moving. In a compositional data analysis approach, isometric log-ratios (ilr) were calculated for time sitting relative to non-sitting, time in short relative to long sitting bouts, and time in standing relative to moving. Differences between genders (men vs. women), domains (work vs. leisure), and according to age were examined for each ilr using ANOVA.ResultsAt work, time spent sitting in short bouts, sitting in long bouts, standing, and moving was, on average, 29, 43, 21 and 7% among men, and 28, 38, 26 and 7% among women. Corresponding proportions during leisure were 34, 27, 27 and 13% among men and 28, 27, 32 and 13% among women. Men spent more time sitting relative to non-sitting ($$ {\eta}_p^2 $$ηp2=0.04,p = 0.03) than women, and less time standing relative to moving ($$ {\eta}_p^2 $$ηp2=0.07,p = 0.01). At work compared to during leisure, both genders spent more time sitting relative to non-sitting ($$ {\eta}_p^2 $$ηp2=0.47,p < 0.01); within sitting more time was spent in long relative to short sitting bouts ($$ {\eta}_p^2 $$ηp2=0.26,p < 0.01), and within non-sitting, more time was spent standing than moving ($$ {\eta}_p^2 $$ηp2=0.12,p < 0.01). Older workers spent less of their non-sitting time moving than younger workers ($$ {\eta}_p^2 $$ηp2=0.07,p = 0.01).ConclusionMale office workers spent more time sitting relative to non-sitting than female workers, and more time moving relative to standing. Both genders were sitting more at work than during leisure. Older workers moved less than younger. These workers could likely benefit from interventions to reduce or break up prolonged sitting time, preferably by moving more.
Missed opportunities for NCD multimorbidity prevention in adolescents and youth living with HIV in urban South Africa
Authors: Kamkuemah Monika , Gausi Blessings , Oni Tolu 
Published: June 2020

Abstract
Background
Epidemiological transition in high HIV-burden settings is resulting in a rise in HIV/NCD multimorbidity. The majority of NCD risk behaviours start during adolescence, making this an important target group for NCD prevention and multimorbidity prevention in adolescents with a chronic condition such as HIV. However, there is data paucity on NCD risk and prevention in adolescents with HIV in high HIV-burden settings. The aim of this study was to investigate the extent to which NCD comorbidity (prevention, diagnosis, and management) is incorporated within existing adolescent HIV primary healthcare services in Cape Town, South Africa.

Methods
We reviewed medical records of 491 adolescents and youth living with HIV (AYLHIV) aged 10–24 years across nine primary care facilities in Cape Town from November 2018–March 2019. Folders were systematically sampled from a master list of all AYLHIV per facility and information on HIV management and care, NCDs, NCD risk and NCD-related health promotion extracted.

Results
The median age was 20 years (IQR: 14–23); median age at ART initiation 18 years (IQR: 6–21) and median duration on ART 3 years (IQR: 1.1–8.9). Fifty five percent of participants had a documented comorbidity, of which 11% had an NCD diagnosis with chronic respiratory diseases (60%) and mental disorders (37%) most common. Of those with documented anthropometrics (62%), 48% were overweight or obese. Fifty nine percent of participants had a documented blood pressure, of which 27% were abnormal. Twenty-six percent had a documented health promoting intervention, 42% of which were NCD-related; ranging from alcohol or substance abuse (13%); smoking (9%); healthy weight or diet (9%) and mental health counselling (10%).

Conclusions
Our study demonstrates limited NCD screening and health promotion in AYLHIV accessing healthcare services. Where documented, our data demonstrates existing NCD comorbidity and NCD risk factors highlighting a missed opportunity for multimorbidity prevention through NCD screening and health promotion. Addressing this missed opportunity requires an integrated health system and intersectoral action on upstream NCD determinants to turn the tide on the rising NCD and multimorbidity epidemic.
Association of air pollution with outpatient visits for respiratory diseases of children in an ex-heavily polluted Northwestern city, China
Authors: Ma Yueling , Yue Li , Liu Jiangtao , He Xiaotao , Li Lanyu , Niu Jingping , Luo Bin 
Published: June 2020

Abstract
Background
A great number of studies have confirmed that children are a particularly vulnerable population to air pollution.

Methods
In the present study, 332,337 outpatient visits of 15 hospitals for respiratory diseases among children (0–13 years), as well as the simultaneous meteorological and air pollution data, were obtained from 2014 to 2016 in Lanzhou, China. The generalized additive model was used to examine the effects of air pollutants on children’s respiratory outpatient visits, including the stratified analysis of age, gender and season.

Results
We found that PM2.5, NO2 and SO2 were significantly associated with the increased total respiratory outpatient visits. The increments of total respiratory outpatient visits were the highest in lag 05 for NO2 and SO2, a 10 μg/m3 increase in NO2 and SO2 was associated with a 2.50% (95% CI: 1.54, 3.48%) and 3.50% (95% CI: 1.51, 5.53%) increase in total respiratory outpatient visits, respectively. Those associations remained stable in two-pollutant models. Through stratification analysis, all air pollutants other than PM10 were significantly positive associated with the outpatients of bronchitis and upper respiratory tract infection. Besides, both NO2 and SO2 were positively related to the pneumonia outpatient visits. PM2.5 and SO2 were significantly related to the outpatient visits of other respiratory diseases, while only NO2 was positively associated with the asthma outpatients. We found these associations were stronger in girls than in boys, particularly in younger (0–3 years) children. Interestingly, season stratification analysis indicated that these associations were stronger in the cold season than in the transition or the hot season for PM10, PM2.5 and SO2.

Conclusions
Our results indicate that the air pollution exposure may account for the increased risk of outpatient visits for respiratory diseases among children in Lanzhou, particularly for younger children and in the cold season.
Another piece of the Zika puzzle: assessing the associated factors to microcephaly in a systematic review and meta-analysis
Authors: Gallo Luciana Guerra , Martinez-Cajas Jorge , Peixoto Henry Maia , Pereira Ana Carolina Esteves da Silva , Carter Jillian E. , McKeown Sandra , Schaub Bruno , Ventura Camila V. , de França Giovanny Vinícius Araújo , Pomar Léo , Ventura Liana O. , Nerurkar Vivek R. , de Araújo Wildo Navegantes , Velez Maria P. 
Published: June 2020

Abstract
Background
Although it is known that Zika virus (ZIKV) infection during pregnancy may lead to microcephaly in the fetus, the prognostic factors associated with this tragic disorder remain unclear. We conducted a systematic review and meta-analysis to assess the prognostic factors associated with the incidence of microcephaly in congenital ZIKV infection.

Methods
We conducted a comprehensive search in Ovid MEDLINE, Ovid MEDLINE (R) Epub ahead of print, Embase, Embase Classic, Web of Science, CINAHL, Cochrane CENTRAL, LILACS, and various thesis databases to identify human studies reporting microcephaly associated with congenital ZIKV infection. We requested primary data from the authors of the included studies to calculate summary estimates and conduct the meta-analysis of the most prevalent factors.

Results
We screened 4106 titles and abstracts, and identified 12 studies for inclusion in the systematic review. The assessment of ZIKV infection and the definition of microcephaly varied among studies. A total of 6154 newborns/fetuses were enrolled; of those, 1120 (18.20%) had a diagnostic of ZIKV infection, of which 509 (45.45%) were diagnosed with microcephaly. Nine studies addressed the link between congenital ZIKV infection and neurological findings in newborns/fetuses. Half of the studies provided primary data. Three out of 11 factors of interest seem to be prognostic factors of microcephaly: infant’s sex – males compared to females: Relative Risk (RR) 1.30, 95% Confidence Interval (95% CI) 1.14 to 1.49; the stage of pregnancy when infection occurred – infection in the first trimester of pregnancy compared to infection at other stages of pregnancy: RR 1.41, 95% CI 1.09 to 1.82; and asymptomatic infection compared to symptomatic infection during pregnancy: RR 0.68; 95% CI 0.60 to 0.77.

Conclusion
Our findings support the female-biased resistance hypothesis and reinforce the risk associated with the stage of pregnancy when ZIKV infection occurs. Continued surveillance of ZIKV infection during pregnancy is needed to identify additional factors that could contribute to developing microcephaly in affected fetuses.

Protocol registration
This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration no. CRD 42018088075.
Percutaneous endoscopic-assisted direct repair of pars defect without general anesthesia could be a satisfying treatment alternative for young patient with symptomatic lumbar spondylolysis: a technique note with case series
Authors: Jin Mengran , Zhang Jun , Shao Haiyu , Liu Jianwen , Zhao Tingxiao , Huang Yazeng 
Published: June 2020

AbstractBackgroundMultiple surgical procedures are applied in young patients with symptomatic lumbar spondylolysis when conservative treatments fail. Although the optimal surgical procedure option is controversial, the treatment paradigm has shifted from open surgery to minimally invasive spine surgery. To date, a limited number of studies on the feasibility of percutaneous endoscopic-assisted direct repair of pars defect have been carried out. Herein, for the first time, we retrospectively explore the outcomes of pars defect via percutaneous endoscopy.MethodsWe retrospectively examined young patients with spondylolysis treated using the percutaneous endoscopic-assisted direct repair of pars defect supplemented with autograft as well as percutaneous pedicle screw fixation between September 2014 and December 2018. Six patients with a mean age of 18.8 years were enrolled in the study. We used preoperatively computed tomographic (CT) scans to evaluate the size of pars defect, and graded disc degeneration using Pfirrmann’s classification through magnetic resonance images (MRI). We assessed the clinical outcomes using the Oswestry Disability Index (ODI), 36-Item Short-Form Health Survey (SF-36) as well as Visual Analogue Scale for back pain (VAS-B).ResultsOur findings revealed that pain intensity and function outcomes, including VAS-B, ODI, and SF-36 (PCS and MCS) scores, were markedly improved after surgery and at the final follow-up visit. The change in the gap distance of the pars defect was remarkably significant after surgery and during the follow-up period. Only one of the 12 pars repaired was reported as a non-union at the final follow-up visit. Moreover, no surgery-related complications were reported in any of the cases.ConclusionPercutaneous endoscopic-assisted direct repair of pars defect without general anesthesia, a minimally invasive treatment option, supplemented with autograft and percutaneous pedicle screw fixation, could be a satisfying treatment alternative for young patients with symptomatic lumbar spondylolysis.
Cytocompatibility of 3D printed dental materials for temporary restorations on fibroblasts
Authors: Park Jung-Hyun , Lee Hyun , Kim Jong-Woo , Kim Ji-Hwan 
Published: June 2020

Abstract
Background
Three-dimensional (3D) printing is widely used in the fabrication of dental prostheses; however, the influence of dental materials used for 3D printing on temporary restoration of fibroblasts in tissues is unclear. Thus, the influence of different dental materials on fibroblasts were investigated.

Methods
Digital light processing (DLP) type 3D printing was used. Specimens in the control group were fabricated by mixing liquid and powder self-curing resin restoration materials. The temporary resin materials used were Model, Castable, Clear-SG, Tray, and Temporary, and the self-curing resin materials used were Lang dental, Alike, Milky blue, TOKVSO CUREFAST, and UniFast III. Fibroblast cells were cultured on each specimen and subsequently post-treated for analysis. Morphology of the adhered cells were observed using a confocal laser scanning microscope (CLSM) and a scanning electron microscope (SEM).

Results
CLSM and SEM cell imaging revealed that the 3D printed material group presented better cell adhesion with well-distributed filopodia compared to that in the conventional resin material group. Cell proliferation was significantly higher in the 3D printing materials.

Conclusion
Superior cytocompatibility of the specimens fabricated through 3D printing and polishing process was demonstrated with the proof of better cell adhesion and higher cell proliferation.