bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of revefenacin, a long-acting muscarinic antagonist for nebulized therapy, in patients with markers of more severe COPD: a post hoc subgroup analysis
Authors: Donohue James F. , Kerwin Edward , Barnes Chris N. , Moran Edmund J. , Haumann Brett , Crater Glenn D. 
Published: March 2020

Abstract
Background : Revefenacin, a once-daily, long-acting muscarinic antagonist delivered via standard jet nebulizer, increased trough forced expiratory volume in 1 second (FEV 1 ) in patients with moderate to very severe chronic obstructive pulmonary disease (COPD) in prior phase 3 trials. We evaluated the efficacy of revefenacin in patients with markers of more severe COPD.
Methods: A post hoc subgroup analysis of two replicate, randomized, phase 3 trials was conducted over 12 weeks. Endpoints included least squares change from baseline in trough FEV 1 , St. George’s Respiratory Questionnaire (SGRQ) responders, and transition dyspnea index (TDI) responders at Day 85. This analysis included ​ patient subgroups at high risk for COPD exacerbations and compared patients who received revefenacin 175 μg and placebo: severe and very severe airflow limitation (percent predicted FEV 1 30%–<50% and <30%), 2011 Global Initiative for Chronic Obstructive Lung Disease (GOLD) D, reversibility (≥12% and ≥200 mL increase in FEV 1 ) to short-acting bronchodilators, concurrent use of long-acting β agonists and/or inhaled corticosteroids, older age (>65 and >75 years), and comorbidity risk factors.
Results: Revefenacin demonstrated significant improvements in FEV 1 versus placebo at Day 85 among the intention-to-treat (ITT) population and all subgroups. Additionally, there was a greater number of SGRQ and TDI responders in the ITT population and the majority of subgroups analyzed among patients who received revefenacin versus placebo. For the SGRQ responders, the odds of response (odds ratio >2.0) were significantly greater in the revefenacin arm versus the placebo arm among the severe airflow obstruction, very severe airflow obstruction and 2011 GOLD D subgroups. For the TDI responders, the odds of response (odds ratio >2.0) were significantly greater among the severe airflow obstruction subgroup and patients aged >75 years.
Conclusions: Revefenacin showed significantly greater improvements in FEV 1 versus placebo in the ITT population and all subgroups. There were a greater number of SGRQ and TDI responders in the ITT population, and in the majority of patient subgroups among patients who received revefenacin versus placebo. Revefenacin could be a therapeutic option among patients with markers of more severe COPD.
Health status and infections in patients with symptomatic primary and secondary immunoglobulin G (IgG) deficiencies receiving intravenous IgG substitution
Authors: Weide Rudolf , Schnell Roland , Schardt Christof , Koenigsmann Michael , Otremba Burkhard , Zahn Mark-Oliver , Wierecky Jan , Braun Ute , Hensel Manfred , Klausmann Martine , Fleckenstein Doris , Ehscheidt Peter , Feiten Stefan 
Published: March 2020

Abstract
Background: The effects of intravenous immunoglobulin G substitution on health status and infections of patients suffering from immunoglobulin G (IgG) deficiencies should be evaluated in a prospective analysis.Methods: Patients with symptomatic primary or secondary IgG deficiencies were interviewed prior to the first IgG infusion (t0) and over the course of their treatment. The respondents rated their current health using a 100-point scale (EQ-5D-5L), ranging from 0 ('worst imaginable health') to 100 ('best imaginable health'). The patients also provided information on the frequency of infections and infections requiring antibiotics in the past 8 weeks. A control group (CG) without oncologic diseases answered the questions on an one-off basis.Results: 106 patients with a median age of 65 years (21-85 years) were investigated. The median serum IgG-concentration changed from 500 mg/dl (t0) to 772 mg/dl (t6). The mean number of infections and of infections requiring antibiotics decreased during IgG substitution significantly. The EQ-5D-5L health status improved from 57 (t0) to 68 (t6), compared to 73 in the CG.Conclusion: During the course of IgG substitution patients reported fewer and less severe infections. Their health status improved but still was inferior to the healthy CG.Previous presentationData were presented in part at the annual meeting of the German, Austrian and Swiss Societies of Hematology and Medical Oncology in Vienna, Austria, 2018.
Clinical characteristics of HIV-negativepatients with cryptococcemia in a Chinese tertiary-care hospital:  A 10-year study
Authors: Liang Liling , Liang Zhixin , Chen Liang-an 
Published: March 2020

Abstract
Objective: Cryptococcosis is a severe opportunistic fungal infection. Cryptococcemia is a rare manifestation of cryptococcosis with high mortality. Objective: To characterize patients with cryptococcemia in Chinese PLA General Hospital since 2010 to 2019.Methods: We identified retrospectively those blood cultures with Cryptococcus sp. growth, and then obtained their clinical information which were analyzed by two independent reviewers.Results: A total of 8 patients withcryptococcemiawere identified, of which only 2 patients survived. There were 3 males and 5 females, whose age ranged from 23 to 72 years. They were all HIV negative. 1 (12.5%) had ovarian adenocarcinoma, 2 (25%) had systemic lupus erythematosus, 3 (37.5%) had primary nephrotic syndrome, 1 (12.5%) had viral myocarditis, and 1 (12.5%) were after lung transplantation. The most common symptoms were fever (100%) and confusion (50%). Out of the 8 episodes, 6 (60%) had meningeal infection and 2 (25%) presented as pulmonary involvement meanwhile. Six patients were dead at half a year follow up.Conclusions: Cryptococcemia is an unusual infection characterized by a high mortality. It requires early identify and prompt antifungal therapy.
A Study of the Prediction of Bowel Resection due to Strangulated Small Bowel Obstruction
Authors: Udaka Tetsunobu , Taniguchi Atsuki , Kouzai Jun , Ootsuka Tomoaki , Watanabe Nobuyuki , Endou Izuru , Yoshida Osamu , Asano Hiroaki , Kubo Masatoshi 
Published: March 2020

Abstract
Background: In this retrospective study, we aimed to assess the predictive factors for bowel resection due to strangulated small bowel obstruction (SSBO). Methods: We enrolled a total of 109 patients diagnosed with SSBO at surgery. They were divided into two groups: those who underwent bowel resection and those who did not. The clinical findings, blood test results, blood gas analysis results, computed tomography (CT) findings, and sequential organ failure assessment (SOFA) scores of the patients were examined and compared between the two groups. Results: A univariate analysis indicated significant predictive factors to be a history of abdominal surgery, prolonged time from the onset of disease to the operation, increased C-reactive protein (CRP) level, decreased albumin, SOFA score, existence of closed-loop obstruction, and reduced enhancement of the intestinal wall at CT. A multivariate analysis indicated that a reduced enhancement of the intestinal wall and the existence of closed-loop obstruction were independent predictive factors. Strangulated bowel obstruction can progress to a serious condition. It is therefore crucial to predict preoperatively those patients who are likely to require bowel resection. Conclusions: Assessing the reduced enhancement of the intestinal wall and the existence of closed-loop obstruction are required in order to determine whether or not resection of the incarcerated intestine with SSBO is necessary. Key words: strangulated small bowel obstruction, prognostic factor, bowel resection, reduced enhancement of the intestinal wall, closed-loop obstruction
Determinants of preference for home childbirth over health facility childbirth among Women of Reproductive Age in Tanzania: An Analysis of Data from the 2015-16 Tanzania HIV and Malaria Indicators Survey
Authors: Moshi Fabiola Vincent , Mbotwa Christopher H. 
Published: March 2020

Abstract
Background While evidence has shown an association between place of childbirth and birth outcomes, still factors contributing to the choice of home childbirth have not been adequately investigated. Childbirth assisted by unskilled birth attendants has been cited as a contributing factor for the high maternal and neonatal mortalities in low resources countries. This study aimed at determining determinants of preference for home childbirth assisted by unskilled attendants in Tanzania.Method The study used the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicator Survey (2015-16 TDHS-MIS) dataset. A total of 2286 women of reproductive age (15-49 years) who had childbirth within one year preceding the survey were included in the analysis. Both univariate and multivariable regression analysis was used to determine predictors for home-based childbirth.Results A total of 805(35.2%) of women had home childbirth assisted by unskilled providers. After adjusting for confounders, the determinants of preference for home childbirth were the level of education (primary education, AOR=0.666; p=0.001; secondary and higher education, AOR=0.417; p<0.001); not owning mobile phone, AOR= 1.312; p=0.018; parity (parity 2-4, AOR=1.594; p=0.004; Parity 5 and above, AOR=2.158; p<0.001); inadequate antenatal visits, AOR=1.406; p=0.001; wealth index (poorest, AOR=9.395; p<0.001; poorer, AOR=7.701; p<0.001; middle, AOR=5.961; p<0.001; richer, AOR=2.557; p<0.001) and Zones (Southern Highlands, AOR=0.189; p<0.001; Southern, AOR=0.225; p<0.001; Zanzibar, AOR=2.55; p<0.001).Conclusion There are large proportions of women who use home childbirth assisted by unskilled birth attendant’s mainly traditional birth attendants (TBA). Predictors for home-based childbirth were being illiterate women, poor access to communication, inadequate antenatal visits, low socio-economic status and those from Zanzibar. Innovative strategies targeting these groups are highly needed to increase the use of health facilities for childbirth and hence reduce maternal and neonatal mortalities in Tanzania.
The incidence of adjuvant chemotherapy-related early-onset cardiac events in breast cancer patients and its relationship with genetic susceptibility: A prospective cohort study
Authors: Liu Binliang , Guan Xiuwen , Wang Yanfeng , Sun Xiaoying , Yi Zongbi , Wang Wenna , Li Lixi , Zhai Jingtong , Li Hong , Ma Fei 
Published: March 2020

Abstract
Background: Although cardiotoxicity has been widely concerned, the study of early-onset cardiotoxicity is insufficient and it is difficult to explain the occurrence of cardiotoxicity only by clinical factors in patients with low cumulative dose of chemotherapy. The purpose of this study was to investigate adjuvant chemotherapy -related cardiac events in breast cancer patients, and to find out the genetic risk factors related to early-onset cardiotoxicity . Methods: A total of 388 recruited patients completed routine blood, liver and kidney function, D-dimer, TnT, NT-proBNP (or BNP), ECG and UCG tests before and after adjuvant chemotherapy. Twenty-five single nucleotide polymorphisms were tested. Univariable and multivariable analyses were performed to identify independent risk factors. Results: A total of 256 adjuvant chemotherapy-related cardiac events were recorded in 180 patients (46.4%), and these included an abnormal ECG (37.4%), an abnormal UCG (8.8%), an elevated BNP (5.7%), and elevated TnT (0.3%). The ATG13 (rs10838611) GG genotype was a protective factor of early-onset cardiotoxicity (10% reduction in the LVEF) ([OR]= 0.188; 95% CI: 0.067-0.525; P=0.001). Conclusion: Adjuvant chemotherapy-related cardiac events are quite common in the real world. Genetic factors were closely related to the susceptibility of early-onset cardiotoxicity.
Consciousness of healthcare professionals on antimicrobial resistance in western Ethiopia
Authors: Muluye Abrham Belachew , Kolech Getachew Alemkere , Tadesse Ayana , Gebyehu Habte , Gebre Mohamed , Bayissa Getu 
Published: March 2020

Abstract
Background: Inappropriate and overuse of antimicrobial drugs by healthcare professionals are a global concern. Exploring healthcare professionals’ consciousness on antimicrobial resistance is important to advance the approaches to improve antibiotic use. Hence, the aim of the current study was to assess the level of healthcare professionals’ consciousness towards antimicrobial resistance and its control measures.Methods: A cross-sectional study design was employed. Data was collected using a self-administered questionnaire to all healthcare professionals from May to June, 2017. Data were entered into Epi info version 7 and analyzed using SPSS version 21. The knowledge and belief scores were summarized using descriptive statistics. Univariate and multivariate logistic regression analysis were used to test the association, which was considered statistically significant if P-value < 0.05.Results : From 269 healthcare professionals participated in the study, 58% were males with a mean age of 31.9 + 7.5 years and 76.6% were degree holders. Most of them were nurses (36.4%) and physicians (24.9%). The median knowledge and belief scores of healthcare professionals on antimicrobial resistance were 35 (range 23-83) and 29 (range 13-47), respectively. Forty seven percent of participants had poor belief score. A correlation test between knowledge and belief scores revealed a significant positive correlation (r = 0.551; P = 0.01). Hospital setting (adjusted odds ratio [AOR]: 4.65; 95% confidence interval [CI]: 2.39-9.06; P < 0.001; and AOR: 3.62; 95% CI: 1.76-7.44; P < 0.001) and training (AOR: 0.43; 95% CI: 0.23-0.83; P < 0.05; and AOR: 0.13; 95% CI: 0.06-0.25; P < 0.001) had significantly associated with good knowledge and belief scores, respectively.Conclusions : More than half of healthcare professionals had good knowledge and belief scores on antimicrobial resistance. Prior training experience, type and setting of health institutions were significantly associated with both knowledge and belief scores. Hence, regular comprehensive educational training on antimicrobial resistance is recommended for healthcare professionals working on healthcare institutions.
Eating habits associated with nutrition-related knowledge among university students enrolled in academic programs related to nutrition and culinary arts in Puerto Rico
Authors: Medina Christian Rivera - , Urbano Mercedes Briones , Espinosa Aixa De Jesus , Lopez Angel Toledo 
Published: March 2020

Abstract
Background: University students frequently develop unhealthy eating habits. However, it is unknown if students enrolled in academic programs related to nutrition and culinary arts have healthier eating habits. To evaluate the relationship of the eating habits and nutritional status of university students enrolled in academic programs related to nutrition and culinary arts with their knowledge in nutrition as well as cooking methods and techniques. Methods: This descriptive cross-sectional study was conducted in the spring of 2019, during which time students completed a survey that measured their eating habits, and their knowledge in nutrition as well as cooking methods and techniques. Anthropometric measurement data were also collected for nutritional status estimation. The non-probabilistic convenience sample comprised 93 university students pursuing their Bachelor’s degree in Nutrition and Dietetics, Culinary Nutrition and Culinary Management in Universidad Ana G. Mendez, Puerto Rico.The statistical analysis included summary measures. Relationships between variables were measured using Chi-square and Fisher’s exact tests, and statistical significance was set at p<0.05. Results: An inadequate body mass index (BMI) was observed in 59% of the sample. Eating habits, knowledge in nutrition, and knowledge in cooking methods and techniques were inadequate in 86%, 68%, and 41% of the population, respectively. Eating habits were associated with knowledge in nutrition and the type of academic program enrolled in, but not with knowledge in cooking methods and techniques. Conclusions: Most of the students reported having inadequate eating habits and BMI values. The Nutrition and Dietetics students had the best knowledge levels pertaining to nutrition compared to the Culinary Management students, a majority of whom had inadequate knowledge levels. Our results demonstrate that there are other factors inherent to students’ university life that may have a stronger influence on eating habits than knowledge in appropriate nutritional practice. Trial registration : Universidad Ana G Méndez Institutional Review Board January 23, 2019 Protocol number: 06-085-18
A novel bone cement screw system combined with vertebroplasty for the treatment of Kummell disease with bone deficiency at vertebral anterior border: minimum 3-year follow-up study
Authors: Wang Biao , Zhang Xinliang , Kong Lingbo , Yuan Li , He Simin , Yan Liang , Hao Dingjun 
Published: March 2020

Abstract
Background: When vertebroplasty is used to treat Kummell disease with bone deficiency at vertebral anterior border, bone cement displacement often occurs intraoperative or postoperative. We designed and used a new bone cement screw system to avoid the serious complication. The purpose of this study is to evaluate the safety and effectiveness of this novel operation method through more than 3 years of follow-up. Methods: From January 2012 to August 2016, 27 patients suffering from single-segment Kummell disease with bone deficiency at vertebral anterior border were treated by vertebroplasty combined with novel bone cement screw. Bone cement is released into the diseased vertebrae through screw to fully fill the intravertebral vacuum cleft. Screw fixation of bone cement can avoid intraoperative or postoperative displacement. All patients were operated by unilateral technique, only one screw was implanted for each patient. The clinical efficacy was evaluated using Odom’s criteria and statistical analysis based on the results of vertebral body index (VBI), vertebral body angle (VBA), bisegmental Cobb angle (BCA), visual analogue scale (VAS), oswestry disability index (ODI), and the MOS 36-item short from health survey (SF-36). Results: The operation was completed successfully in 27 cases. The average operation time was 49.63±10.82 min, and the average volume of cement injected was 4.70±0.87 ml. The patients’ preoperative VBI, VBA, BCA, VAS and ODI scores were 43.11±5.94, 21.04±2.55, 45.00±6.26, 7.59±0.84, and 79.85±7.58, respectively. The postoperative measurements were 78.70±2.55, 12.70±2.11, 26.11±4.73, 3.22±0.93 and 50.04±9.28. At the last follow-up, the measurements were 78.04±2.30, 13.15±2.38, 27.07±4.87, 2.04±0.65, and 22.85±5.06, respectively. There was significant difference between the preoperative and postoperative data, as well as the preoperative and the last follow-up data (P<0.05). Compared the results of SF-36 preoperative and at the last follow-up, there were significant differences in physical function, role-physical, body pain, vitality, and social function these 5 items (P<0.05). However, there were no significant differences in general health, emotional function and mental health. Finally, 26 patients (96.3%) had good to excellent clinical outcomes according to Odom's criteria. Conclusions: This 3-year follow-up study shows that the novel bone cement screw system combined with vertebroplasty has a good short and medium-term therapeutic effect on patients with Kummell disease and bone deficiency at vertebral anterior border, while its long-term efficacy is subject to further studies.
Correlation between lumbar sagittal alignment, Modic changes, and endplate erosion in patients with degenerative disease
Authors: Lv Bin , Wang Haosheng 
Published: March 2020

Abstract
Purpose To explore the role of lumbar sagittal alignment in the occurrence of Modicchanges and endplate defects (MC&ED) development in patients with a spinal degenerative disease, and the relationship between lumbar sagittal alignment and patient-report outcomes. Background Increasing attention has been focused on MC&ED as playing a potential role in the etiopathogenesis of lumbar degeneration. The precise understanding of the mechanisms leading to progression of MC&ED is lacking. Hence, we investigated how lumbar sagittal alignment influences the MC&ED. Patients and methods Ninety-six consecutive asymptomatic or symptomatic patients with Modic changes or endplate defect were retrospectively recruited in this study from August 2016 to December 2018. MC&ED were observed in 76 patients and not observed in 20 patients, representing two groups for comparison. The lumbar sagittal parameters were measured, including lumbar lordosis (LL),pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT). The lumbar lordosis index (LLI) and idea LL were then calculated. Clinical outcomes were assessed using a visual analog scale(VAS) and a Oswestry Disability Index (ODI) before and after operation. Results There were no significant differences in the distribution of demographics and baseline clinical variables between both groups. Mean age and BMI showed a significant difference between both groups (P<0.05). There were significant correlations between LL, LLI, Lossof LL, and Level 1 (r=0.281, 0.230, and 0.284, P<0.05) Also, PI, PT were significantly correlated with Level 4 (r=0.249, 0.202, P<0.05).Compared with presurgery scores, an improvement was seen in postoperative VAS and ODI scores (P<0.05). Further, the postoperative scores at 24 months in the without Modicor end plate defect group showed greater improvements compared with the with Modic or endplate defect group (P<0.05). Conclusion This analysis indicated that maintaining lumbar sagittal alignment was related to a lower risk of Modic changes in patients with the spinal degenerative disease. The lumbar sagittal alignment might be a factor that influenced the posterior inclination of the pelvis in symptomatic lumbar disease.
Ozone-oxidative-preconditioning alleviates hepatic ischemia-reperfusion injury in rats via PKC- ERK1/2 pathway
Authors: Tao Zhenyun , Jiang Zutai , Li Lizhen , Wang Lanlan , Li Lianghui , Zhong Weixin , Liu Junle , Chen Wenhua 
Published: March 2020

Abstract
BACKGROUND: To explore the protective effect of ozone-oxidative-preconditioning (OzoneOP) through the protein kinase C (PKC), ERK1/2, and heat shock protein70 (HSP70) signal transduction in rats during hepatic ischemic-reperfusion (IR) injury. METHODS: We constructed an IR model by occluding all vessels of the rats’ left and median liver lobes for 45 min, followed by reperfusion for 3 h. Afterwards, we constructed the OzoneOP model via intraperitoneal injection of 1 mg · kg -1 · d -1 of 50 mg · L -1 ozone for 5 days to investigate the significance of PKC, ERK1/2 and HSP70 signal transduction in OzoneOP. The PKC inhibitor chelerythrine chloride (CHE), activator phorobol12-myristate13-acetate (PMA) and MEK inhibitor PD98059 were utilized to analyze the phosphorylation of PKC and the expression levels of ERK1/2 and HSP70. After ischemia and reperfusion, alanine aminotransferase (ALT) and aspartase aminotransferase (AST) were detected in the abdominal aorta blood. Meanwhile, the expression of HSP70 protein and the activities of PKC and ERK1/2 in the left hepatic lobe were analyzed, and the ultrastructure of the hepatic was observed. RESULTS: Compared with the control group, the phosphorylation of PKC and ERK1/2 and the expression of HSP70 were higher in the OzoneOP-treated model ( P <0.05). Conversely, inhibiting PKC and ERK1/2 abolished the protection conferred by OzoneOP ( P <0.05). CONCLUSION: OzoneOP significantly increased the expression of HSP70 by activating PKC and ERK1/2 signaling pathways, thus significantly alleviating hepatic IR injury in rats. KEYWORDS: ERK1/2 MAPKs; HSP70; Liver ischemia-reperfusion; O zone - oxidative - preconditioning; PKC