bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metabolomic profiling on plasma reveals potential biomarkers for screening and early diagnosis of intestinal-type gastric cancer and precancerous stages
Authors: Du Lijing , Li Shasha , Xiao Xue , Li Jin , Jin Huizi , Hua Zhaolai , Ma Juming , Wang Xi , Yan Shikai 
Published: August 2020

Abstract
Background: Gastric cancer (GC) with majority of intestinal-type adenocaricinoma remains one of the most common cancers all over the world. GC faces a great challenge in the clinical diagnosis, that it often can be detected at advanced stages, and leads to the loss of optimum time for treatment and poor prognosis. Thus, there is a critical need to develop effective and noninvasive strategies for early diagnosis of the disease process. Methods: Totally, 82 participants were enrolled in the study, including 50 chronic superficial gastritis (CSG) patients, 7 intestinal-type early gastric cancer (EGC) and 25 intestinal-type advanced gastric cancer (AGC) ones. Metabolites profiling on patient plasma was performed using ultra-high performance liquid chromatography coupled with quadrupole-time-of-flight mass spectrometry (UPLC-Q-TOF/MS). Principal components analysis, orthogonal partial least squares-discriminant analysis as well as Random forest were utilized to evaluate the variation on endogenous metabolites for intestinal-type GC patients and to screen potential biomarkers. Furthermore, the proposed biomarkers were used to create logistic regression models, which discrimination efficiency and accuracy was ascertained by receiver operating characteristic curve (ROC) analysis. Metabolic pathway analysis were carried out on MetaboAnalyst.Results: Totally 50 metabolites were detected with differentially expression among CSG, intestinal-type EGC and AGC patients. L-carnitine, L-proline, pyruvaldehyde, phosphatidylcholines (PC) (14:0/18:0), lysophosphatidylcholine (14:0) (LysoPC 14:0), lysinoalanine were defined as the potential biomarker panel for the diagnosis among CSG and EGC patients. Compared with EGC patients, 6 significantly changed metabolites, PC(O-18:0/0:0) and LysoPC(20:4(5Z,8Z,11Z,14Z)) were found to be up-regulated in AGC patients, whereas L-proline, L-valine, adrenic acid and pyruvaldehyde down-regulated. ROC analysis demonstrated a high diagnostic performance for metabolite panels with area under the curve (AUC) of 0.931 to 1. Moreover, the metabolomic pathway analysis revealed several metabolism pathway disorder, including amino acid and lipid metabolisms, in intestinal-type GC patients.Conclusions: In this study, a total of six metabolites were identified to contribute significantly to the diagnosis of intestinal-type GC and precancerous stages, respectively, and over 93.1% AUC value was achieved in AUC test on biomarker panels, It indicated that the biomarker panels are· sensitive to the early diagnosis of intestinal-type GC disease, which is expected to be developed as a promising diagnostic and prognostic tool for disease stratification studies.
Prescription of antibiotics to children with acute otitis media in Danish general practice
Authors: Olsen Jonas , Lykkegaard Jesper , Hansen Malene Plejdrup , Waldorff Frans B , Lous Jørgen , Andersen Merethe K 
Published: August 2020

Abstract
Background: Acute otitis media (AOM) is a common and most often self-limiting infection in childhood, usually managed in general practice. Even though antibiotics are only recommended when certain diagnostic and clinical criteria are met a high antibiotic prescription rate is observed. The study’s objective was to analyse associations between patient- and general practitioner (GP) characteristics and antibiotic prescribing for children with AOM in an effort to explain the high antibiotic prescribing rates.Methods: All general practices in the Northern, Southern and Central regions of Denmark were invited to record symptoms, examinations, findings and antibiotic treatment for all children ≤ 7 years of age diagnosed with AOM during a four-week winter period in 2017/2018. Associations were analysed by means of multivariate logistic regressions. The study design was cross-sectional. Results: GPs from 60 general practices diagnosed 278 children with AOM of whom 207 (74%) were prescribed antibiotics, most often penicillin V (60%). About half of the children had tympanometry performed. Antibiotic prescribing rates varied considerably between practices (0-100%). Antibiotic prescribing was associated with fever (odds ratio (OR) 3.69 95% confidence interval (CI) 1.93-7.05), purulent ear secretion (OR 2.35 95% CI 1.01-5.50) and poor general condition (OR 3.12 95% CI 1.31-7.46), and the practice’s antibiotic prescribing rate to other patients with symptoms of an acute respiratory tract infection (OR 2.85 CI 95% 1.07-7.60) and specifically to other children with AOM (OR 4.15 CI 95% 1.82-9.47).Conclusion: GPs’ antibiotic prescribing rates for children with AOM vary considerably even considering the of signs, symptoms, request for antibiotics, and use of tympanometry. Interventions to reduce overprescribing should be targeted high-prescribing practices.
Cost-effectiveness of different surgical treatment approaches for early breast cancer: a retrospective matched cohort study from China
Authors: Yang Qing , Zhong Xiaorong , Zhang Wei , Luo Ting , He Ping , Zheng Hong 
Published: August 2020

Abstract
Background: Both breast-conserving surgery and breast reconstruction surgery are less popular in China, although they can improve patients' quality of life. The main reason comes from the economy. There is currently no economic evaluation of different surgical treatment options for early breast cancer. Our study aims to assess the economic impact and long-term cost-effectiveness of different surgical treatments for early breast cancer. The surgical approaches are including mastectomy (MAST), breast-conserving therapy (BCT), and mastectomy with reconstruction (MAST+RECON).Methods: We applied the propensity score matching method to perform a 1: 1 match on patients undergoing these three types of surgery in a tertiary academic medical center from 2011 to 2017 to obtain a balanced sample of covariates between groups. A Markov model was established. Clinical data and cost data were obtained from the medical records. Health utility values were derived from clinical investigations. Strategies were compared using an incremental cost-effectiveness ratio (ICER).Results: The total cost of MAST, MAST+RECON and BCT was $35,282.24, $69,428.82 and $73,661.08, respectively. The quality-adjusted life year (QALYs) were 17.94, 18.71 and 20.49, respectively. Compared with MAST, MAST+RECON and BCT have an ICER of $106708.06/QALY and $15050.53/QALY, respectively. The ICER of BCT vs. MAST was less than the threshold of $27,931.04. The reliability and stability of the results were confirmed by Monte Carlo simulation and sensitivity analysis.Conclusions: We believe that in the context of the limited resources in China, after comparing the three surgical approaches, BCT is the more cost-effective and preferred solution.
Safety of bronchoscopy in patients with malignant hematologic disorders
Authors: Uruga Hironori , Sato Toshitaka , Nishida Aya , Uchida Naoyuki , Tsuji Masanori , Moriguchi Shuhei , Takahashi Yui , Ogawa Kazumasa , Murase Kyoko , Hanada Shigeo , Takaya Hisashi , Miyamoto Atsushi , Morokawa Nasa , Kimura Muneyoshi , Araoka Hideki , Tsuchihashi Rumiko , Asano-Mori Yuki , Wake Atsushi , Taniguchi Shuichi , Kishi Kazuma 
Published: August 2020

Abstract
Background: To evaluate the safety of bronchoscopy and describe factors affecting its complication rate in patients with malignant hematologic disorders. Methods: Between January 2009 and December 2018, 316 bronchoscopies in 282 patients with malignant hematologic disorders and pulmonary infiltrates were performed at our institution. The bronchoscopic procedure used and its complications were evaluated. Results: The most common underlying disease was acute myeloid leukemia (134/282 patients, 47.5%). Platelet transfusion was performed the day before or the day of bronchoscopy in 42.4%, supplemental oxygen was administered before the procedure in 23.1%, and midazolam was used in 74.4%. Thirty-five bronchoscopies (11.1%) were complicated by hemoptysis and 7 patients developed pneumothorax, 4 of whom required thoracic drainage. Two patients (0.6%) were intubated within 48 hours of the procedure and prolonged oxygen desaturation (>48 hours) occurred in 3.8%. Multivariate analysis showed that only use of midazolam significantly reduced the risk of prolonged oxygen desaturation (hazard ratio 0.28, 95% confidence interval 0.09–0.85, p = 0.03). Transbronchial lung biopsy significantly increased the risk of hemoptysis (hazard ratio 10.40, 95% confidence interval 4.18–25.90, p = 0.00), while use of midazolam significantly reduced the risk (hazard ratio 0.31, 95% confidence interval 0.14–0.73, p = 0.01). Conclusions: Bronchoscopy is relatively safe in patients with malignant hematologic disorders. Sedation with midazolam may reduce the risk of prolonged oxygen desaturation and hemoptysis, though transbronchial lung biopsy may increase the risk for hemoptysis. ​
The Analysis of Risk Factors to Hypotension Occurring after Caesarean Spinal Anesthesia for Parturients with Scarred Uterus
Authors: Chen Wei , Cao Ya , Chen Quan Yong , Lu Yan , Wang Bing , Wang Hai , Ding Fang , Guo Ling 
Published: August 2020

Abstract
Background：This study examined the risk factors for hypotension after caesarean spinal anesthesia with low dose of bupivacaine and sulfentanyl in parturients with scarred uterus. Methods：A total of 322 singleton-pregnancy parturients with scarred uterus who had been scheduled for caesarean spinal anesthesia were randomly sampled. The data on the basic information of the parturients, the gestation, the fetus and the anesthesia were recorded and filed according to the clinical questionnaires on hypotension in caesarean section. The parturients whose systolic blood pressure dropped below 90 mmHg or decreased by 20% during the time from the completion of anesthesia until the delivery of infant were classified as Group hypotension (Group H) and the rest were in Group non-hypotension (Group N). This study analyzed the correlation of 39 factors to the occurrence of hypotension, and further analyzed the statistically significant factors through binary classification logistic regression.Results：Of the 322 sampled parturients, 148 parturients suffered hypotension. The incidence of hypotension in this study was 45.96%. The result of univariate analysis showed statistically significant differences in the factors including height (p=0.005), post-pregnancy Body Mass Index (BMI) (p=0.00), fasting time (p=0.031),weight gain in gestation (p=0.000), fundal height (p=0.047), exercise history in gestation (p=0.006) and dermatomal level of analgesia (p=0.000) between the two groups. The variables with statistical significance were analyzed by multivariate logistic regression model. The result showed that BMI in gestation (OR=1.146, 95% CI 1.041-1.262, p <0.05), weight gain in gestation (OR = 1.126, 95% CI 1.060-1.198, p <0.001), exercise history in gestation (OR = 0.399, 95% CI 0.205-0.778, p = 0.007), and dermatomal level of analgesia (OR = 2.248, 95% CI 1.645-3.074, p <0.001) were risk factors for hypotension after caesarean spinal anesthesia in parturients with scarred uterus. Conclusion：The incidence of hypotension after caesarean spinal anesthesia in parturients with scarred uterus was relatively high. The post-pregnancy BMI, weight gain in gestation, exercise history in gestation and dermatomal level of analgesia after anesthesia were risk factors for hypotension after caesarean spinal anesthesia in parturients with scarred uterus. These findings play an important role in predicting the occurrence of hypotension after caesarean spinal anesthesia in parturients with scarred uterus. Trial registration：Chinese Clinical Trial Registry (chiCTR-ROC-17011251)
A one-year cohort study of complications, continuation, and failure rates of postpartum TCu380A in Tanzania
Authors: Rwegoshora France John , Muganyizi Projestine Selestine , Kimario Grasiana Festus , Paul Ponsian Patrick , Makins Anita 
Published: August 2020

Abstract
Background: Less than 1% of married women in Tanzania use an Intrauterine Contraceptive Device (IUD) for contraception. An initiative by the International Federation of Gynecology and Obstetrics (FIGO) has been in progress since 2015 resulting in escalated method uptake in implementing hospitals. This study investigates failure rate, complications, and risk factors for one-year continuation of TCu380A IUD when used for immediate postpartum contraception under the initiative in Tanzania Methodology: A prospective cohort study of women who had TCu380A insertion within 48 hours of delivery in 6 hospitals in Tanzania between 1st December 2017 and 18th April 2018 was conducted. Face to face post insertion interviews were made with 1114 clients before discharge and later through phone calls up to the beginning of 13th month postpartum. Postpartum Intrauterine Device (PPIUD) continuation status, complications, duration of time they stayed with the IUD and the currently used method if PPIUD was discontinued were enquired. The outcome variable was PPIUD continuation at one year of IUD insertion. Data were analyzed using Statistical Product and Service Solutions software (SPSS) for Windows version 20 (IBM SPSS Statistics, Chicago, IL, USA). Results: In total 511(45.8%)clients had consented and availed to complete the one-year follow-up. Out of these, 440 still had IUD, giving a one-year continuation rate of 86.1%. Most (63%) IUD discontinuations occurred in the period between 7th week and 6 months of insertion. One-year method expulsion rate was 2.1%. There was one reported pregnancy that gives a method failure rate of about 2 per 1000. The independent risk factors in favor of method continuation at one year were absence of medical or social problem, being a youth (16-24 years), and delivery by Cesarean section. Conclusions: The continuation rate when CuT380A is used for immediate postpartum contraception is high, with low complication and failure rates. Some medical and social factors are important for method continuation, hence the need to consider in training, counselling and advocacy.
Long non-coding RNA MIR4300HG polymorphisms are associated with postoperative nausea and vomiting: a genome-wide association study
Authors: Sugino Shigekazu , Konno Daisuke , Kawai Yosuke , Nagasaki Masao , Endo Yasuhiro , Hayase Tomo , Yamazaki-Higuchi Misako , Kumeta Yukihiro , Tachibana Shunsuke , Saito Katsuhiko , Suzuki Jun , Kido Kanta , Kurosawa Nahoko , Namiki Akiyoshi , Yamauchi Masanori 
Published: August 2020

Abstract
Background: Genetic factors such as single nucleotide polymorphisms (SNPs) play a key role in the development of postoperative nausea and vomiting (PONV). However, previous findings are not widely applicable to different populations because of population-specific genetic variation. We developed a Japanese-specific DNA microarray for high-throughput genotyping. The aim of the current study was to identify SNPs associated with PONV on a genome-wide scale using this microarray in a sample of Japanese surgical patients. Methods: Associations between 659,636 SNPs and the incidence of PONV 24 h after surgery in a limited sample of 24 female patients were assessed using the microarray. After imputation of genotypes at 24,330,529 SNPs, 78 SNPs were found to be associated with the incidence of PONV. We chose 4 of the 78 SNPs to focus on by in silico functional annotation. Finally, we genotyped these 4 candidate SNPs in 255 patients using real-time PCR to verify association with the incidence of PONV. Results: The T > C variant of rs11232965 in the long non-coding RNA MIR4300HG was significantly associated with reduced incidence of PONV among genotypes and between alleles (p = 0.01 and 0.007). Conclusions: We identified a novel SNP (rs11232965) in the long non-coding RNA MIR4300HG that is associated with PONV. The rs11232965-SNP variant (T > C) is protective against the incidence of PONV. Trial registration: This study was registered at the UMIN Clinical Trials Registry (Identifier: UMIN000022903, date of registration: June 27th, 2016, retrospectively registered, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000026392).
Social Determinants of Mental Health Care Systems: Intensive Community Based Care in The Veterans Health Administration
Authors: Bhalla Ish P , Stefanovics Elina A , Rosenheck Robert A 
Published: August 2020

Abstract
Background: Since deinstitutionalization in the 1950s-1970s, public mental health care has changed its focus from asylums to general hospitals, outpatient clinics and specialized community-based programs addressing both clinical and social determinants of mental health. Analysis of the place of community-based programs within a comprehensive health system such as the Veterans Health Administration (VHA) may illuminate the role of social forces in shaping contemporary public mental health systems. Methods: National VHA administrative data were used to compare veterans who exclusively received outpatient clinic care to those receiving four types of specialized community-based services, addressing: 1) functional disabilities from severe mental illness (SMI), 2) justice system involvement, 3) homelessness, and 4) vocational rehabilitation. Bivariate comparisons and multinomial logistic regression analyses compared groups on demographics, diagnoses, service use, and psychiatric prescription fills. Results: An hierarchical classification of 1,386,487 Veterans who received specialty mental health services from VHA in Fiscal Year 2012, showed 1,134,977 (81.8%) were seen exclusively in outpatient clinics; 27,931 (2.0 %) received intensive SMI-related services; 42,985 (3.1%) criminal justice services; 160,273 (11.6%) specialized homelessness services; and 20,921 (1.5%) vocational services. Compared to those seen only in clinics, veterans in the four community treatment groups were more likely to be black, diagnosed with HIV and hepatitis, had more numerous substance use diagnoses and made far more extensive use of mental health outpatient and inpatient care. Conclusions: Almost one-fifth of VHA mental health patients receive community-based services prominently addressing major social determinants of health and multimorbid substance use disorders.
Pilot trial on the efficacy and safety of pantethine in children with pantothenate kinase-associated neurodegeneration: A single-arm, open-label study.
Authors: Chang Xuting , Zhang Jie , Jiang Yuwu , Yao Bufan , Wang Jingmin , Wu Ye 
Published: August 2020

Abstract
Objective This study aimed to explore the efficacy and safety of pantethine in children with pantothenate kinase-associated neurodegeneration (PKAN).Methods A single-arm, open-label study was conducted. All subjects received pantethine during the 24-week period of treatment. The primary endpoints were change of the Unified Parkinson’s Disease Rating Scale (UPDRS) I–III and Fahn–Marsden (FM) score from baseline to week 24 after treatment.Results Fifteen children with PKAN were enrolled, and all patients completed the study. After 24 weeks of treatment with pantethine at 60mg/kg per day, there was no difference in either UPDRS I–III (t=0.516, P=0.614) or FM score (t=0.353, P=0.729) between the baseline and W24. Whereas the rates of increase in UPDRS I-III (Z=2.614, p=0.009) and FM scores (Z=2.643, p=0.008) were slowed. Four patients (26.7%) were evaluated as “slightly improved” by doctors through blinded video assessment. Patients with lower baseline UPDRS I–III or FM scores were more likely to be improved. The quality of life of family members improved after pantethine treatment, evaluated by PedsQL TM 2.0 FIM scores, whereas the quality of life of the patients was unchanged at W24, evaluated by PedsQL TM 4.0 and PedsQL TM 3.0 NMM. Serum level of CoA was comparable between baseline and W24. There was no drug related adverse event during the study.Conclusions Pantethine could not significantly improve motor function in children with PKAN after 24 weeks treatment, but it may delay the progression of motor dysfunction in our study. Pantethine was well-tolerated at 60mg/kg per day.Trial registration:Clinical trial registration number at www.chictr.org.cn：ChiCTR1900021076，Registered 27 January2019，the first participant was enrolled 30 September 2018，and other 14 participants were enrolled after the trial was registered.
Characteristics of acute ischemic stroke in hospitalized patients in Tibet: A retrospective comparative study
Authors: Lu Yuxuan , Zhuoga Cidan , Jin Haiqiang , Zhu Feiqi , Zhao Yuhua , Ding Zhijie , He Shihua , Du Ailian , Xu Jun , Luo Jingjing , Sun Yongan 
Published: August 2020

Abstract
Background: Numerous studies of acute ischemic stroke (AIS) have been conducted at low altitude regions, and the related findings were used to instruct clinic management while corresponding studies at high altitude are few. This study aimed to analyse AIS clinic characteristics at high altitude regions by conducting a hospital-based comparative study between Tibet and Beijing. Methods: This study included the diagnoses of AIS patients from People’s Hospital of Tibet Autonomous Region (PHOTAR) and Peking University First Hospital (PUFH) between 1st January 2014, and 31st December 2017, where data including patient demographics, treatment time, onset season, risk factors, infarction location, laboratory data, image examination results, treatments, and AIS subtype were collected and compared. Continuous and categorical variables were analysed with a two-sample t-test or Wilcoxon rank sum test and chi-square test, respectively. Significant risk factors were examined with binary logistic regression analysis.Results: In total, 236 and 1021 inpatients from PHOTAR and PUFH were included, respectively. The PHOTAR patients were younger than the PUFH patients (P<0.001). Young adult stroke, erythrocytosis, and hyperhomocysteinemia were more frequent in PHOTAR patients (all P<0.001). Other vascular risk factors, including hypertension, diabetes mellitus, hyperlipidaemia, and smoking and alcohol consumption history, were less prevalent in PHOTAR patients than in PUFH patients. The rate of intravenous thrombolysis and the rate of within intravenous thrombolysis window time were also lower in PHOTAR patients (both P<0.001). PHOTAR groups also tended to have anterior circulation infarction. Erythrocytosis and hyperhomocysteinemia were independent risk factors in PHOTAR, and here young adults accounted for a larger proportion of stroke cases. Conclusion:﻿ In Tibet, the average age of AIS patients were less, and anterior circulation infarctions were also more common. Erythrocytosis and hyperhomocysteinemia may contribute to these differences. Here young adult stroke also accounted for a higher proportion, and this may be associated with erythrocytosis. Our findings present the first hospital-based comparative study in Tibet and may contribute to policies for stroke prevention in this region.