bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-Care for Head and Neck Cancer Survivors with Lymphedema and Fibrosis: Study Protocol for a Randomized Controlled Trial
Authors: Deng Jie , Dietrich Mary S. , Murphy Barbara 
Published: October 2019

Abstract
Abstract

Background : Head and neck cancer (HNC) patients are at high risk for developing lymphedema and fibrosis (LEF) following cancer treatment. Once HNC patients develop LEF, they need to conduct life-long self-care to slow LEF progression and reduce associated symptom burden and functional deficits. Data demonstrate that inadequate LEF self-care may be a potentially remediable issue. The objective of this study is to explore the feasibility and preliminary efficacy of an Information-Motivation-Behavioral (IMB) Skills model driven self-care program (SCP) to improve LEF management and reduce LEF-related symptom burden and functional impairments.

Methods/Design : This is a three-arm, prospective, randomized controlled clinical trial to compare: Group 1-Usual Care, Group 2-Usual Care Plus LEF-SCP, and Group 3 - Usual Care Plus LEF-SCP Plus Follow-Up. Participants will be HNC survivors aged > 18 years of age, who meet predefined inclusion and exclusion criteria. A sample size of 75 participants is targeted. Interventions will be provided by trained staff. The study assessments for all groups will take place at five points: study entry then 3-, 6-, 9-, and 12-month post-enrollment. Outcome measures include: 1) feasibility (barriers to implementation, safety, and satisfaction) of the proposed intervention; 2) self-efficacy and adherence to self-care; and 3) preliminary efficacy (LEF progression, symptom burden, and functional status) of the proposed intervention.

Discussion : This will be the first study to evaluate the feasibility of a LEF-SCP in the HNC population and its impact on self-efficacy and adherence. Furthermore, it will evaluate the potential benefit of routine follow-up on adherence and fidelity to the self-care protocol. We expect that the trial will provide evidence supporting the feasibility of a LEF self-care program. In addition, we anticipate that preliminary data will support improved outcomes including increased adherence and fidelity, and decreased LEF associated symptoms.

Trial registration : This study was registered on January 22, 2017 at Clinical Trial.gov, a service of the US National Institute of Health (NCT 03030859). The URL of the trail registry record: https://clinicaltrials.gov/ct2/show/NCT03030859?term=lymphedema+and+fibrosis&cond=Head+and+Neck+Cancer&cntry=US&rank=1

Keywords : Head and neck cancer, lymphedema, fibrosis, self-care, self-management, survivorship
Enhancement of de novo sequencing, assembly and annotation of the Mongolian gerbil genome with transcriptome sequencing and assembly from several different tissues
Authors: Cheng Shifeng , Fu Yuan , Zhang Yaolei , Xian Wenfei , Wang Hongli , Grothe Benedikt , Lu Xin , Xu Xun , Klug Achim , McCullagh Elizabeth 
Published: October 2019

Abstract
BACKGROUND: The Mongolian gerbil ( Meriones unguiculatus ) has historically been used as a model organism for the auditory and visual systems, stroke/ischemia, epilepsy and aging related research since 1935 when laboratory gerbils were separated from their wild counterparts. In this study we report genome sequencing, assembly, and annotation further supported by transcriptome sequencing and assembly from 27 different tissues samples.
RESULTS: The genome was sequenced using Illumina HiSeq 2000 and after assembly resulted in a final genome size of 2.54 Gbp with contig and scaffold N50 values of 31.4 Kbp and 500.0 Kbp, respectively. Based on the k-mer estimated genome size of 2.48 Gbp, the assembly appears to be complete. The genome annotation was supported by transcriptome data that identified 31 769 (>2000bp) predicted protein-coding genes across 27 tissue samples. A BUSCO search of 3023 mammalian groups resulted in 86% of curated single copy orthologs present among predicted genes, indicating a high level of completeness of the genome.
CONCLUSIONS: We report the first de novo assembly of the Mongolian gerbil genome enhanced by assembly of transcriptome data from several tissues. Sequencing of this genome and transcriptome increases the utility of the gerbil as a model organism, opening the availability of now widely used genetic tools.
Promoting Independence in Dementia (PRIDE): Protocol for a Feasibility Randomised Controlled Trial
Authors: Shafayat Aisha , Csipke Emese , Bradshaw Lucy , Charlesworth Georgina , Day Florence , Leung Phuong , Moniz-Cook Esme , Montgomery Alan , Morris Steve , Mountain Gail , Ogollah Reuben , Sprange Kirsty , Yates Lauren , Orrell Martin 
Published: October 2019

Abstract
Background Memory services often see people with early stage dementia who are largely independent and able to participate in community activities but who run the risk of reducing activities and social networks. PRIDE is a self-management intervention designed to promote living well and enhance independence for people with mild dementia. This study aims to examine the feasibility of conducting a definitive randomised trial comparing the clinical and cost-effectiveness of the PRIDE intervention offered in addition to usual care or with usual care alone. Methods/Design PRIDE is a parallel, two-arm, multicentre, feasibility, randomised controlled trial (RCT). Eligible participants aged 18 or over who have mild dementia (defined as a score of 0.5 or 1 on the Clinical Dementia Rating Scale) who can participate in the intervention and provide informed consent will be randomised (1:1) to treatment with the PRIDE intervention delivered in addition to usual care, or usual care only. Participants will be followed-up at three and six month’s post-randomisation. There will be an option for a supporter to join each participant. Each supporter will be provided with questionnaires at baseline and follow-ups at three to six months. Embedded qualitative research with both participants and supporters will explore their perspectives on the intervention investigating a range of themes including acceptability and barriers and facilitators to delivery and participation. The feasibility of conducting a full RCT associated with participant recruitment and follow-up of both conditions, intervention delivery including the recruitment, training, retention of PRIDE trained facilitators, clinical outcomes, intervention and resource use costs and the acceptability of the intervention and study related procedures will be examined. Discussion This study will assess whether a definitive randomised trial comparing the clinical and cost-effectiveness of whether the PRIDE intervention offered in addition to usual care is feasible in comparison to usual care alone, and if so will provide data to inform the design and conduct of a future trial. Trial Registration and protocol version ISRCTN, ISRCTN11288961, registered on 23 October 2019, http://www.isrctn.com/ISRCTN12345678 Protocol V2.1 dated 19 June 2019 Keywords Dementia, self-management, feasibility trial
Enterococcal periprosthetic joint infection: clinical and microbiological findings from a 8-year retrospective cohort study
Authors: Renz Nora , Trebse Rihard , Akgün Doruk , Perka Carsten , Trampuz Andrej 
Published: October 2019

Abstract
Background: Treatment of enterococcal periprosthetic joint infections (PJI) is challenging due to non-standardized management strategies and lack of biofilm-active antibiotics. The optimal surgical and antimicrobial therapy are unknown. Therefore, we evaluated characteristics and outcome of enterococcal PJI.
Methods: Consecutive patients with enterococcal PJI from two specialized orthopedic institutions were retrospectively analyzed. Both institutions are following the same diagnostic and treatment concepts. The probability of relapse-free survival was estimated using Kaplan-Meier survival curves and compared by log-rank test. Treatment success was defined by absence of relapse or persistence of PJI due to enterococci or death related to enterococcal PJI. Clinical success was defined by the infection-free status, no subsequent surgical intervention for persistent or perioperative infection after re-implantation and no PJI-related death within 3 months.
Results: Included were 75 enterococcal PJI episodes, involving 41 hip, 30 knee, 2 elbow and 2 shoulder prostheses. PJI occurred postoperatively in 61 episodes (81%), hematogenously in 13 (17%) and by contiguous spread in one. E. faecalis grew in 64 episodes, E. faecium in 10 and E. casseliflavus in one. Additional microorganism(s) were isolated in 38 patients (51%). Enterococci were susceptible to vancomycin in 73 of 75 isolates (97%), daptomycin in all 75 isolates, and fosfomycin in 21 of 22 isolates (96%). The outcome data was available for 66 patients (88%). The treatment success after 3 years was 83.7% (95% confidence interval [CI]; 76.1-96.7%) and the clinical success was 67.5% (95% CI; 57.3-80.8%). In 11 patients (17%), a new PJI episode caused by a different pathogen occurred. All failures occurred within the three years of surgery.
Conclusion: About half of enterococcal PJI were polymicrobial infections. The treatment success was high (84%). All treatment failures occurred within the first three years after revision surgery. Interestingly, 17% of patients experienced a new PJI caused by another pathogen at a later stage.
Trial registration: The study was retrospectively registered with the public clinical trial identification NCT0253022 at https://www.clinicaltrials.gov.
The effectiveness of schistosomiasis health education session in primary and secondary schools in Pemba Island, Zanzibar
Authors: Xu Da Cheng , Li Wei , Juma Saleh , He Ming Zhen , Kabole Fatma , Wang Xin Yao , Yang Kun 
Published: October 2019

Abstract
Background: Schistosomiasis seriously endangers the health of African people, hinders local economic and social development, and becomes a serious local public health problem. However, in addition to preventive chemotherapy, other social, environmental and health promotion measures are progressing slowly, lack of sanitation, treated water, and systematic health education, the people are still at risk of infection. In 2011, a survey of 24 school in Zanzibar showed that the average infection rate of Schistosoma haematobium was 8% (0-38%) in Unguja, and was 15% (1-43%) in Pemba.
Methods: According to the shape of the island, the island is divided into three regions: the south, the middle, and the north. A Shehia in the southern, central and northern parts of Pemba Island was randomly selected respectively, the schistosomiasis health education session was conducted in primary and secondary schools of the selected Shehias. The students were randomly selected for schistosomiasis cognitive level test by designed questionnaire including 8 knowledge questions and 4 behavior questions before and after health education, through a chi-square test of the awareness rate and the correct behavior rate of schistosomiasis before and after the health education, the effect of health education session was evaluated.
Result: A total 712 students were sampled before and after the health education in 8 schools. Before the health education session, the awareness rates of schistosomiasis were 64.62% and 68.75% among primary and secondary school respectively. After the session, the awareness rates increased to 79.74% and 84.70% respectively, and the difference was statistically significant (χ2=179.3, P<0.0001). Before the sessions, the correct behavior rates were 63.96% and 54.79% among boys and girls. After the sessions, the correct behavior rates increased to 82.83% and 76.58%, and the difference was also statistically significant (χ2=143.8, P<0.0001).
Conclusion: The awareness rate and correct behavior rate of schistosomiasis were low in Pemba Island, Zanzibar, hence the schistosomiasis health education needs to be strengthened. The schistosomiasis health education session has an obvious effect on the improvement of cognitive level of schistosomiasis among local students. This method can be promoted and implemented in local schools with the effort of local health and education departments.
Short or Long Antibiotic Regimes in Orthopaedics (SOLARIO): a Randomised Controlled Open-Label Non-Inferiority Trial of Duration of Systemic Antibiotics in Adults with Orthopaedic Infection Treated Operatively with Local Antibiotic Therapy
Authors: Dudareva Maria , Kümin Michelle , Vach Werner , Kaier Klaus , Ferguson Jamie , McNally Martin , Scarborough Matthew 
Published: October 2019

Abstract
Background Orthopaedic infections such as osteomyelitis, diabetic foot infection and prosthetic joint infection, are most commonly treated by a combination of surgical debridement and a prolonged course of systemic antibiotics, usually for at least 4 -6 weeks. Use of local antibiotics, implanted directly into the site of infection at the time of surgery, may improve antibiotic delivery and allow us to shorten the duration of systemic antibiotic therapy, thereby limiting the frequency of side effects, cost and selection pressure for antimicrobial resistance. Methods SOLARIO is a multi-centre open label randomised controlled non-inferiority trial comparing short and long systemic antibiotic therapy alongside local antibiotic therapy. Adult patients with orthopaedic infection, who have given informed consent, will be eligible to participate in the study provided that no micro-organisms identified from deep tissue samples are resistant to locally-implanted antibiotics. Participants will be randomised in a 1:1 ratio to receive either a short course (≤ 7 days) or currently recommended long course (≥ 4 weeks) of systemic antibiotics. The primary outcome will be treatment failure by 12 months following surgery, as ascertained by an independent Endpoint Committee blinded to treatment allocation. An absolute non-inferiority margin of 10% will be used for both per-protocol and intention-to-treat populations. Secondary outcomes will include probable and definite treatment failure, serious adverse events, treatment side-effects, quality of life scores and cost analysis. Discussion This study aims to assess a treatment strategy that may enable the reduction of systemic antibiotic use for patients with orthopaedic infection. If effective, this will be to the advantage of patients and contribute to antimicrobial stewardship.
Glioma SOX2 expression decreased after adjuvant therapy
Authors: Yu Wei , Ren Xiaoqiu , Hu Chunxiu , Tan Yinuo , Shui Yongjie , Chen Zexin , Zhang Lili , Peng Jiaping , Wei Qichun 
Published: October 2019

Abstract
Objectives

SOX2 is regarded as an important marker in stem cell. The change of SOX2 expression after adjuvant therapy in high grade glioma (HGG) remains unknown so far. Few patients with recurrent glioma have opportunity to undergo operation once again, so the recurrent glioma samples are scarce. This study tries to analyze SOX2 expression in paired primary and recurrent HGG, aims to better understand the transformation law of SOX2 after adjuvant therapy in HGG.Methods

Twenty-four recurrent HGG patients who undergone a second resection were included. 16 patients received adjuvant therapy, the remaining 8 patients didn’t receive any adjuvant therapy at all. The protein expression of SOX2 in paired primary and recurrent HGG was tested by immunohistochemistry. The statistical analysis was conducted by IBM SPSS Statistics 19.0.Results

In primary HGG, SOX2 expression of 3+,2+,1+ and 0+ were seen in 20 (83.3%), 1 (4.2%), 1 (4.2%) and 2 cases (8.3%), respectively. The expression of SOX2 was decreased in recurrent HGG compared to the paired primary sample (p=0.001). The decrease of SOX2 was often seen in patients received chemotherapy, radiotherapy or both (p=0.003). Patients with SOX2 high expression in primary glioma had a longer median PFS than those with SOX2 low expression with marginal statistic significance (12.7 vs. 5.4 months, p=0.083). For cases with SOX2 high expression in the primary glioma, those had SOX2 low expression after recurrence seemed to have worse prognosis as compared to patients with stable SOX2 high expression (PFS: 10.4 vs. 14.9 months, p=0.036; OS: 27.0 vs 49.5 months, p=0.005).Conclusions

This is the first study comparing the protein expression of SOX2 in recurrent HGG and its paired primary tumor. SOX2 high expression is common in brain HGG, a tendency of decreased SOX2 expression in recurrent gliomas was evidenced. Lower SOX2 expression was seen in those patients who received adjuvant chemotherapy and/or radiotherapy. Patients with low SOX2 expression in primary HGG usually have poorer prognosis, those with SOX2 expression decreased in recurrent HGG had worse outcome.
The influence of balanced complex chromosomal rearrangements on preimplantation embryonic development potential and molecular karyotype
Authors: Li Gang , Shi Weiyi , Niu Wenbin , Xu Jiawei , Guo Yihong , Su Yingchun , Sun Yingpu 
Published: October 2019

Abstract
Background: Balanced complex chromosome rearrangements (BCCR) are balanced chromosomal structural aberrations that involve two or more chromosomes and at least three breakpoints. It is very rare in the population. The objective is to explore the difference of influence of three types of BCCR on early embryonic development and molecular karyotype.
Results: Twelve couples were recruited including four couples of three-way rearrangements carriers (group A), three couples of double two-way translocations carriers (group B) and five couples of exceptional CCR carriers (group C). A total of 243 oocytes were retrieved in the seventeen preimplantation genetic testing (PGT) cycles, and 207 of these were available for fertilization. After intracytoplasmic sperm injection, 181 oocytes normally fertilized.The rates of embryos forming on day3 in three groups were 87.88%, 97.78% and 77.14%, which was significantly different (P=0.01). Compared with group B, the rate of embryo formation was statistically significantly lower in group C (P=0.01). Furthermore, the rates of high-quality blastocysts in three group were 14.71%, 48.15% and 62.96%, respectively, which was significantly different (P=0.00). Compared with group B and C, the rate of high-quality blastocysts in group A was statistically significantly lower (P=0.00; P=0.00).
Comprehensive chromosome analysis was performed on 83 embryos, including 75 trophectoderm cells and 8 blastomeres. Except 7 embryos failed to amplify, 9.01% embryos were diagnosed as euploidy, and 90.91% were diagnosed as abnormal. As for group A, the euploid embryo rate was 10.71% and the abnormal embryo rate was 89.29%. In group B, the euploid embryo rate was 3.85%, the abnormal embryo rate was 96.15%. The euploid embryo rate was 13.04%, the abnormal embryo rate was 86.96% in group C. There were no significant differences among the three groups (P = 0.55).
Conclusions: The double two-way translocations couples have more chance to get balanced or normal embryos probably, and there may be more high-quality blastocysts in exceptional CCRs, but the blastocyst formation rate was similar among the three type of BCCR. Different types of BCCR maybe have little effect on the embryonic molecular karyotype. The difference of influence of BCCR on early embryonic development and molecular karyotype should be further studied.
Incidence and associated factors of laryngospasm among pediatric patients who undergone surgery under general anesthesia, in university of Gondar Compressive Specialized Hospital, Northwest Ethiopia, 2019: Cross sectional study
Authors: Chekol Wubie Birlie , Melese Debas Yaregal 
Published: October 2019

Abstract
Objective: laryngospasm is a glotiss closure due to reflex constriction of the laryngeal muscles. It mainly happened at induction, maintenance and emergence phases of general anaesthesia (GA).Considerable research have been done previously but, consequences of laryngospasm, various results and gate opener values of previous studies intiated us to do this research. So this study was aimed to assess the incidence and associated factors of laryngospasm among pediatric patients who undergone surgery under GA.Methods:institutional based cross sectional study was conducted on pediatric patients from February to August, 2019 in university of Gondar comprehensive specialised hospital (UOGCSH). Data were entered and analaysed with SPSS version 20.Variables with P value less than 0.2 in bivariate analysis was fitted in to multivariable logistic regression analysis to identify factors associated with laryngospasm. Both crude and adjusted odds ratio with 95% CI were calculated to show the strength of association. In multivariable analysis, P value of less than 0.05 were considered as statistically significant.Results: The incidence of laryngospasm among pediatric patients who undergone surgery under GA was 57 (18.39%) . Of this 34 (59.6%) were happened during emergence, 12 (21.1%) during maintenance and 11 (19.3%) during induction phase of GA. In multivariable analysis, airway anomalies (AOR : 14.64,95%CI:1.71,125.04) , orophyrangeal secretion (AOR : 2.45,95%CI:1.19,5.06), attempts of airway devices insertion (AOR : 2.47,95%CI:1.16,5.22), upper respiratory tract infection (AOR : 2.91,95%CI:1.008,8.41) and inadequate depth of anesthesia (AOR : 7.92,95%CI:2.7,23.22) were significantly associated with incidence of laryngospasm. Conclusion: laryngospasm at induction, maintainance and emergence phases of GA was high in UOGCSH. Inadequate depth of anaesthesia, upper respiratory tract infection, airway anomalies, multiple attempts of airway device insertion, and orophyrangeal secretion were predictors of laryngospasm. So it is better to have patient optimisation for patients having URTI and airway anomalies, reduce the attempts of airway device insertion and adequate depth of anesthesia as well as adequate suctioning of oropharynx.
Cumulative Incidence of Hepatocellular Carcinoma and Hepatitis B Surface Antigen Seroclearance after Nucleos(t)ide analogue-induced Hepatitis B e Antigen Seroclearance
Authors: Lee Hyun Woong , Lee Jung Il , Kim Saein , Kim Sora , Chang Hye Young , Lee Kwan Sik 
Published: October 2019

Abstract
Background: Hepatitis B e antigen (HBeAg) seroclearance has been considered as the treatment endpoint in HBeAg-positive patients with chronic hepatitis B. Although HBeAg seroclearance has been accomplished, some aspects are yet unclear. We investigated the cumulative incidence of hepatocellular carcinoma (HCC) and evaluated hepatitis B surface antigen (HBsAg) seroclearance in patients undergoing nucleos(t)ide analogue (NA)-induced HBeAg seroclearance. Methods: In this retrospective cohort study, 203 HBsAg- and HBeAg-seropositive patients that experienced NA (entecavir or tenofovir)-induced HBeAg seroclearance were recruited. Patients with documented HBeAg seroclearance were followed-up every 6 months. Baseline characteristics and laboratory results were recorded. Results: The mean age at HBeAg seroclearance was 40 years (range, 20-84), and the mean follow-up duration was 5 years (range, 2-11). The cumulative incidence of HCC was 1.5% to 11.5% at 1 to 8 years after HBeAg seroclearance. Cirrhosis was the only significant factor for HCC development (hazard ratio [HR], 24.651; confidence interval [CI], 3.018 to 201.365; P = 0.003). The cumulative incidence of HBsAg seroclearance was 3.5% to 18.7% after 1 to 8 years from HBeAg seroclearance. Conclusions: A significant proportion of patients developed HCC after NA-induced HBeAg seroclearance. The presence of liver cirrhosis at the time of HBeAg seroclearance serves as an independent factor for HCC development. Some patients with NA-induced HBeAg seroclearance achieved HBsAg seroclearance.