bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictive Value of the Surgical Apgar Score on Postoperative Complications in Advanced Gastric Cancer Patients Treated with Neoadjuvant Chemotherapy Followed by Radical Gastrectomy: A Single Center Retrospective Study
Authors: Hayashi Masato , Yoshikawa Takaki , Yura Masahiro , Otsuki Sho , Yamagata Yukinori , Morita Shinji , Katai Hitoshi , Nishida Toshirou 
Published: June 2020

Abstract
Background: The surgical Apgar score (SAS) or modified SAS (mSAS) has been reported as a simple and easy risk assessment system to predict postoperative complications (PCs) in primary surgery for gastric cancer (GC). However, there are still few studies which revealed the SAS’s utility in gastric surgery after neoadjuvant chemotherapy (NAC). Methods: One hundred and fifteen patients who received NAC and R0 gastrectomy from 2008 and 2015 were included in this study. The SAS was determined by estimated blood loss (EBL), lowest intraoperative mean arterial pressure (LMAP), and lowest heat rate (LHR). The mSAS was determined by the EBL reassessed using the interquartile values. The predictive values of the SAS/mSAS for PCs were assessed with uni and multivariate analyses. Results: Among 115 patients, 41 (35.7%) developed PCs. According to analyses with receiver operating characteristic (ROC) curve of the SAS and mSAS for predicting PCs, the cutoff value of the mSAS was set at 8. The rates of anastomotic leakage, pancreatic fistula, and arrhythmia in patients with high mSAS ( > 8) values were higher, compared to those with low (0-3) and moderate (4-7) mSAS values. A multiple logistic regression analysis detected operation time, Body Mass Index (BMI), and Diabetes Mellitus (DM) were independent risk factors for PCs. The mSAS was not a significant predictor. Conclusions: Neither the SAS nor mSAS was a useful predictor of PCs in patients treated with NAC followed by radical gastrectomy. The predictive value of SAS/mSAS is limited in patients undergoing surgery after NAC.
Validation of a point-of-care capillary lactate measuring device (Lactate Pro 2).
Authors: Raa Anette , Sunde Geir Arne , Bolann Bjørn , Kvåle Reidar , Bjerkvig Christopher , Eliassen Håkon Skogrand , Wentzel-Larsen Tore , Heltne Jon-Kenneth 
Published: June 2020

Abstract
Background: The measurement of lactate in emergency medical services has the potential for earlier detection of shock and can be performed with a point-of-care handheld device. Validation of a point-of-care handheld device is required for prehospital implementation. Aim: The primary aim was to validate the accuracy of Lactate Pro 2 in healthy volunteers and in haemodynamically compromised intensive care patients. The secondary aim was to evaluate which sample site, fingertip or earlobe, is most accurate compared to arterial lactate. Methods: Arterial, venous and capillary blood samples from fingertips and earlobes were collected from intensive care patients and healthy volunteers. Arterial and venous blood lactate samples were analysed on a stationary hospital blood gas analyser (ABL800 Flex) as the reference device and compared to the Lactate Pro 2. We used the Bland-Altman method to calculate the limits of agreement and used mixed effect models to compare instruments and sample sites. A total of 49 intensive care patients with elevated lactate and 11 healthy volunteers with elevated lactate were included. Results: There was no significant difference in measured lactate between Lactate Pro 2 and the reference method using arterial blood in either the healthy volunteers or the intensive care patients. Capillary lactate measurement in the fingertip and earlobe of intensive care patients was 47% (95% CI (29% to 68%), p<0.001) and 27% (95% CI (11% to 45%), p<0.001) higher, respectively, than the corresponding arterial blood lactate. In the healthy volunteers, we found that capillary blood lactate in the fingertip was 14% higher than arterial blood lactate (95% CI (4% to 24%), p= 0.003) and no significant difference between capillary blood lactate in the earlobe and arterial blood lactate.Conclusion: Our results showed that the handheld Lactate Pro 2 had good agreement with the reference method using arterial blood in both intensive care patients and healthy volunteers. However, we found that the agreement was poorer using venous blood in both groups. Furthermore, the earlobe may be a better sample site than the fingertip in intensive care patients.
Geospatial Approach For Assessment Of Vulnerability To Flood In Local Self Governments
Authors: S Deepak , Rajan Gopika , G Jairaj P 
Published: June 2020

Abstract
Recent years have shown a significant increase in the occurrence of flood globally, with impact on habitation and different sectors of the economy. This, in turn, necessitates the use of different flood mitigation strategies, wherein flood vulnerability assessment plays a significant role. The proposed work presents a methodology which combines vulnerability under physical-environmental and socio-economic domains to assess the overall flood vulnerability at the local self-government level. The methodology was illustrated to the case of Aluva municipality, located on the banks of River Periyar, in Kerala state, India. The spatial variation of hazard inducing factors and population statistics were analysed using Geographic Information System (GIS) tools. The machine learning algorithm, Random Forest, which uses hazard inducing factors as input was implemented for the evaluation of physical-environmental vulnerability. The social vulnerability of the region was analysed using GIS Multi-criteria decision analysis approach (MCDA), with criteria weights to incorporate the interests of different stakeholders. The critical combinations of the two domains of vulnerability in the assessment of the vulnerability to flood, to have efficient flood management in local self-government was demonstrated in this study and can be made use of for any flood event.
Effect of a telemedicine intervention for diabetes-related foot ulcers on health, well-being and quality of life: Secondary outcomes from a cluster randomized controlled trial (DiaFOTo)
Authors: Iversen Marjolein Memelink , Igland Jannicke , Smith-Strøm Hilde , Østbye Truls , Tell Grethe Seppola , Skeie Svein , Cooper John G. , Peyrot Mark , Graue Marit 
Published: June 2020

Abstract
BACKGROUND
Follow-up care provided via telemedicine (TM) is intended to be a more integrated care pathway to manage diabetes-related foot ulcers (DFU) than traditionally-delivered healthcare. However, knowledge of the effect of TM follow-up on PROMs including self-reported health, well-being and QOL in patients with DFUs is lacking and often neglected in RCT reports in general. Therefore, in this study of secondary outcomes from the DiaFOTo trial, the aim was to compare changes in self-reported health, well-being and QOL between patients with DFUs receiving telemedicine follow-up care in primary healthcare in collaboration with specialist healthcare, and patients receiving standard outpatient care.
METHODS
The current study reports secondary endpoints from a cluster randomized controlled trial whose primary endpoint was ulcer healing time. The trial included 182 adults with diabetes-related foot ulcers (94/88 in the telemedicine/standard care groups) in 42 municipalities/districts, recruited from three clinical sites in Western Norway. The intervention group received care in the community in collaboration with specialist healthcare using an asynchronous telemedicine intervention. The intervention included an interactive web-based ulcer record and a mobile phone enabling counseling and communication between the community nurses and specialist healthcare; the control group received standard outpatient care. In total 156 participants (78/78) reported on secondary endpoints: self-reported health, well-being and quality of life evaluated by generic and disease-specific patient-reported outcome measures (e.g. Euro-QOL, the Hospital Anxiety and Depression Scale (HADS), Problem Areas in Diabetes (PAID), Neuropathy and Foot Ulcer–Specific Quality of Life Instrument (NeuroQOL)). Linear mixed-effects regression was used to investigate possible differences in changes in the scores between the intervention and control group at the end of follow-up.
RESULTS
In intention to treat analyses, differences between treatment groups were small and non-significant for the health and well-being scale scores, as well as for diabetes-related distress and foot ulcer-specific quality of life.
CONCLUSIONS
There were no significant differences in changes in scores for the patient reported outcomes between the intervention and control group, indicating that the intervention did not affect the participants’ health, well-being and quality of life.
Cardiac MRI utilizing late gadolinium enhancement (LGE) and T1 mapping in the detection of radiation induced heart disease
Authors: Ricco Anthony , Slade Alexander , Canada Justin , Grizzard John , Dana Franklin , Gharai Leila Rezai , Neiderer Keith , Vera Armando , Abbate Antonio , Weiss Elisabeth 
Published: June 2020

Abstract
Background and Purpose: Radiotherapy has been associated with late dose-dependent cardiovascular toxicity. In this cross-sectional pilot study, radiation dose distributions were correlated with areas of localized and diffuse myocardial fibrosis as measured by novel cardiac MRI (CMR) sequences including late gadolinium enhancement (LGE) and T1 mapping with the goal to identify early markers of myocardial damage.Materials and Methods: Twenty-eight patients with chest tumors including lung, breast, esophagus, and lymphoma underwent CMR per study protocol on average 46.4 months (range 1.7-344.5) after radiotherapy. Patients without pretreatment cardiac history were included if the volume of heart receiving 5 Gy or more was at least 10% (V5Gy≥10%). The association of LGE with cardiac dosimetric factors, clinical factors (e.g., tumor type, smoking history, BMI), , and T1 values was analyzed. Results: Cardiac maximum (Dmax) and mean dose (Dmean) equivalent to doses delivered in 2 Gy fractions (EQD2) were on average 50.9 Gy (range 6.2-108.0) and 8.2 Gy (range 1.0-35.7), respectively, compared to 60.8 Gy (40.8-108.0) and 6.8 Gy (1.8-21.8) among the 9 patients with LGE. Doses were not different between patients with and without LGE (p=0.16 and 0.56, respectively). The average T1 value of the left ventricle myocardium was 1009 ms (range 933-1117). No significant correlation was seen for heart Dmax and Dmean and T1 values (p=0.14 and 0.58, respectively). In addition, no significant association between clinical factors and the development of LGE was identified.Conclusions: No relation between cardiac doses, the presence of LGE or T1 values was observed. Further study is needed to determine the benefit of CMR for detecting radiotherapy-related myocardial fibrosis.
Efficacy and Safety of Bevacizumab in Combination with Chemotherapy for Colorectal Cancer – A Real World Study in China
Authors: Shen Tao , Cheng Xian-Shuo , Chunyu Wei-Xun , Zhang Hong-Tao , Xia Cui-Feng , Pan Ding-Guo , Zhang Xuan , Tian Chang-Ping , Liang Rui , Yun-feng Li 
Published: June 2020

Abstract
Background

Large scale randomized trials have demonstrated that bevacizumab in addition to chemotherapy as first-line or second-line treatment has significant survival benefits. We aim to explore the clinical impact of bevacizumab in combination with chemotherapy in first-line or second-line in patients with colorectal cancer (CRC).
Methods

The medical records of patients with CRC who received bevacizumab at first or second-line of treatment were collected retrospectively. The primary outcome of the study was to evaluate the efficacy of bevacizumab in combination with chemotherapy by survival endpoints i.e. overall survival (OS) and progression-free survival (PFS) and the secondary outcome was to evaluate its safety by incidence of adverse events (AE).
Results

Fifty-one patients with CRC had met the selection criteria for treatment with bevacizumab to either cetuximab or FOLFOX or both. The median age was 54 years. During follow-up, ten patients had exhibited progression after treatment while 5 patients died. The median OS and PFS of the overall population were not reached. The Cox proportional regression analysis revealed no significant prognostic factors of OS and PFS for treatment with bevacizumab in various demographic subgroups. The 1-year PFS rates of all 51 patients was 76%. The 1-year and 3-year OS rates for all 51 patients were 95% and 88%, respectively. Toxicities were usually mild in nature, with nausea, vomiting, hand and foot syndrome, neutropenia, asthenia and palpitation being the commonly reported adverse events.
Conclusion

In this real-world setting, the efficacy and safety of bevacizumab in combination with chemotherapy is limited and further research is warranted as to whether bevacizumab with chemotherapy is an optimal treatment as first-line or second-line therapy in Chinese CRC patients.
Enhanced Growth Performance Of Microalgal Biomass For Lipid Production
Authors: Perez Ysa Francine , Maria Christine Ann Sta , Pineda Rence Marrion Mangulabnan , Aquino John Dave , Undan Jerwin 
Published: June 2020

Abstract
The supply of petroleum-based fuel decreases, and the need to produce viable renewable fuel increases. In the wake of the uprising global energy crisis, microalgae serve as a promising feedstock for oil production. The researcher gained interest due to its hitting-two birds-with-one-stone approach as a potential solution for the continuously depleting source of oil reservoir worldwide and to reduce carbon dioxide emission into the atmosphere using microalgae. The potential of the strains (Chlorella vulgaris, Monoraphidium sp., Scenedesmus obliquus, Desmodesmus denticulatus, and Chlorophyta sp.) in the production of lipid was assessed in this study. Furthermore, optimization of the growth conditions of each microalgae strain were identified to enhance biomass production and lipid accumulation. Two microalgae strains namely Monoraphidium sp. and Desmodesmus denticulatus exhibited higher lipid productivity compared to other microalgae strains on biomass and lipid content. The following optimized growth conditions that support algal growth are as follows: pH 5, 0.5 moles in salinity level, outside temperature, and sunlight. The production of lipids is dependent on the microalgae strain, including the optimum condition that supports its biomass production.
The influence of supplier-user relationships on user satisfaction in the healthcare sector: the provisioning case.
Authors: Vainieri Milena , Coletta Lucrezia , Seghieri Chiara 
Published: June 2020

Abstract
Background

Since 90 s customer orientation has become one of the main priorities in the public sector. While there are several studies dealing with final user satisfaction in the healthcare context, less attention has been given to inter-organizational relationships. This study aims at investigating the relationship between service quality, relationship quality and overall customer satisfaction in the case of a supplier-user provisioning service in the healthcare sector.
Methods

The analysis was based on a survey administered via CAWI (Computer Assisted Web Interviewing) to all professionals of the Tuscan health system. Moderation and mediation models were carried out to test the relationships between the three constructs, also differentiating among different customer typologies.
Results

Findings from the moderation model showed how different customers perceive relationship quality as differently influencing their overall satisfaction. This result was confirmed by the mediation models that showed how for one customer typology both relationship quality and service quality were relevant determinants of their satisfaction with supplier performance, even though relational aspects were more significant, compared to service aspects. Whereas, for the second customer typology overall satisfaction was influenced by characteristics concerning relationship quality only, suggesting that service quality dimension was not relevant in determining overall satisfaction.
Conclusions

In the healthcare provisioning case analyzed, different customers’ typologies have different expectations and weigh differently service related and relationship related aspects. Supplier should use different levers in order to enhance customers’ perceptions about the overall performance.
Development of An Immunogenomic Landscape For The Competing Endogenous RNAs Network of Peri-Implantitis
Authors: Li Yang , Zheng Ji-Na , Gong Chan-Juan , Lan Keng-Fu , Ding XiaoJun 
Published: June 2020

Abstract
Background: Peri-implantitis is an inflammation that occurs around the implant, resulting in varying degrees of inflammatory damage to the soft and hard tissues. The characteristic criterion is the loss of the supporting bone in an inflammatory environment. However, the specific mechanisms and biomarkers involved in peri-implantitis remain to be further studied. Recently, competing endogenous RNAs (ceRNA) and immune microenvironment have been found to play a more important role in the inflammatory process. In our study, we analyzed the expression of immune related microRNAs (miRNAs), long noncoding RNAs (lncRNAs) and message RNAs (mRNAs) in peri-implantitis by analyzing GSE33774 and GSE57631.Methods: In this study, we explored the expression profile data of immune-related lncRNAs, miRNAs and mRNAs, and constructed immune-related ceRNA network involved in the pathogenesis of peri-implantitis. In addition, the CIBERSORT was used to evaluate the content of immune cells in normal tissues and peri-implantitis to detect the immune microenvironment of peri-implantitis.Results: In the analysis, the corresponding lncRNAs, 14 DElncRNAs, 16 DEmiRNAs, and 18 DEmRNAs were used to establish an immune related ceRNA network constructed and the immune infiltration patterns associated with peri-implantitis was discovered. Through the mutual verification of the two datasets, we found that GSK3B and miR-1297 may have important significance in the immune microenvironment and pathogenesis of peri-implantitis and GSK3B was closely related to four types of immune cells, which needs to be further proved by later experiments. Conclusions: Through immune-related ceRNA network, IRGs and immune cell infiltration can further comprehensively understand the pathogenesis of peri-implantitis, which built up an immunogenomic landscape with clinical significance for peri-implantitis.One-sentences summary: GSK3B and miR-1297 may have important significance in the immune microenvironment and pathogenesis of peri-implantitis.
Reactive Oxygen Species Modulator-1 (ROMO-1) Polymorphism Rs6060566 and The Risk of Myocardial Infarction in Slovenian Subjects With Type 2 Diabetes Mellitus
Authors: Tibaut Miha , Ramuš Sara Mankoč , Petrovič Daniel 
Published: June 2020

Abstract
Background
We aimed to examine the role of the rs6060566 polymorphism of the reactive oxygen species modulator-1 (ROMO-1) gene in the development of myocardial infarction (MI) in Caucasians with type 2 diabetes mellitus (T2DM).
Methods
A total of 1072 subjects with T2DM were enrolled in cross-sectional case-control study: 335 subjects with MI and 737 subjects without clinical signs of coronary artery disease (CAD). Genetic analysis of the rs6060566 polymorphism was performed in all subjects. To assess the degree of coronary artery obstruction, a subpopulation of 128 subjects with T2DM underwent coronary computed tomography (CT) angiography. Next, endarterectomy samples were obtained during myocardial revascularization from diffusely diseased coronary arteries in 40 cases, which were analysed for ROMO-1 expression according to their genotype.
Results
There were no statistically significant associations between different genotypes or alleles of the rs6060566 polymorphism and MI in subjects with T2DM. The carriers of the C allele of the ROMO-1 rs6060566 had a threefold increased likelihood of having coronary artery stenosis (AOR = 3.27, 95% CI 1.16–9.20). Furthermore, the carriers of the C allele showed higher number of positive cells for ROMO-1 expression in endarterectomy samples of coronary arteries.
Conclusions
In accordance to our study, the rs6060566 polymorphism of the ROMO-1 gene is not the risk factor for MI in Caucasians with T2DM. However, we found that subjects carrying the C allele were at a 3.27-fold increased risk of developing severe CAD compared with those who had nonobstructive CAD. Moreover, The C allele carriers showed statistically higher number of cells positive for ROMO-1 compared with T allele carriers in coronary endarterectomy samples.
Healthcare professionals´ experiences of assessing, treating and preventing constipation among older patients during hospitalization: An interview study
Authors: Lundberg Veronica , RN Anne-Marie Boström , Gottberg Kristina , Konradsen Hanne 
Published: June 2020

Abstract
Background
Constipation is a common and troublesome condition among older patients and can result in a variety of negative health consequences. It is often undiagnosed or undertreated. Healthcare professionals have a responsibility to understand and address patients’ overall healthcare needs so exploring their experiences is, therefore, highly relevant. The purpose of the study was to explore healthcare professionals’ experiences of assessing, treating and preventing constipation among older patients.
Methods
A qualitative design with an exploratory approach was used. The participants were purposively sampled from three wards in a geriatric department in a medium-sized hospital in Sweden. Data were collected through focus group interviews and individual interviews and analyzed using content analysis.
Results
Three categories were generated: depending on resources and uncertainties, using different strategies, and approaching the patients’ needs. In the care of older patients at risk of or with constipation, decisions were made based on personal knowledge, personal experience and clinical reasoning. A person-centered approach was highlighted but was not always possible to incorporate.
Conclusions
Different strategies for preventing and treating constipation were believed to be important, as was person-centered care, but were found to be difficult to perform. Healthcare professionals need adequate resources. Evidence-based clinical guidelines might help the delivery of high-quality care. Constipation needs to be given more focus in hospitals in order to potentially improve the care and patient outcomes for older people.