bluuebunny/crossref_metadata_2025_split huggingface dataset:
New nomograms based on treatment outcome and prognostic factors for patients with spinal diffuse large B-cell lymphoma: A population‐based study
Authors: Wang Ben , Chen Lijie , Chen Boda , Xie Chenglong , Shao Zhenxuan , Zhang Xiaolei , Chen Jiaoxiang , Wang Xiangyang 
Published: January 2020

Abstract
Background: Spinal diffuse large B-cell lymphoma (DLBCL) was a rare and malignant tumor, while few studies researched the prognostic factors. The prognostic factors which might have impacts on spinal DLBCL was not clear. Although chemotherapy was recognized as an optimal treatment method, but the curative effect of radiotherapy and surgery were controversial.
Methods: The records of patients with spinal DLBCL were selected from the SEER database from 1991 to 2016. The incidence obtained by database was analyzed by Joinpoint Regression Program. The optimal cut-off values of age and year of diagnosis were identified by X-tail program. Univariate and multivariate survival analysis were calculated to identify independent prognostic factors. Prognostic factors were included to predict the survival possibility compared with 5 years of overall (OS) and cancer-specific survival (CSS) via the new nomograms.
Results: A total of 917 patients were enrolled. Age, year of diagnosis and chemotherapy were demonstrated as independent prognostic factors for CSS and OS, and primary site was another independent prognostic factor for CSS. However, radiotherapy and surgery might be ineffective in survival. All factors were included to generate the nomograms for CSS and OS. The concordance indices (C-index) for internal validation of OS and CSS prediction were 0.697 (95%CI: 0.662-0.732) and 0.709 (95%CI: 0.692- 0.727) respectively.
Conclusions: Age and year of diagnosis are closely associated with the prognosis of spinal DLBCL, and chemotherapy is an ideal treatment modality. The new nomogram is a favourable tool to evaluate the survival possibility, and is benefit for the oncologist to make clinical decisions.
The dose - response association between fluid overload and hospital mortality in critically ill patients: a multicenter, prospective, observational cohort study
Authors: Wang Meiping , Zhu Bo , Jiang Li , Wen Ying , Du Bin , Li Wen , Liu Guangxu , Li Wei , Wen Jing , He Yan , Xi Xiuming 
Published: January 2020

Abstract
Background Fluid management is important for ensuring hemodynamic stability in critically ill patients but easily leads to fluid overload. However, the optimal fluid balance plot or range for critically ill patients is unknown. This study aimed to explore the dose-response relationship between fluid overload (FO) and hospital mortality in critically ill patients.Methods Data were derived from the China Critical Care Sepsis Trial (CCCST). Patients with sequential fluid data for the first 3 days of admission to the ICU were included. FO was expressed as the ratio of the cumulative fluid balance (L) and initial body weight (kg) at ICU admission as a percentage. Maximum fluid overload (MFO) was defined as the peak FO value during the first 3 days of ICU admission. We used logistic regression models with restricted cubic splines to assess the relationship between MFO and the risk of hospital mortality.ResultsIn total, 3850 patients were included, 929 (24.1%) of whom died in hospital. For each 1% L/kg increase in the FO, the risk of hospital mortality increased by 4% (HR 1.04, 95% CI 1.03 - 1.05, P < 0.001). FO greater than 10% was associated with a 44% increased HR of hospital mortality compared with FO less than 5% (HR 1.44, 95% CI 1.27 - 1.67). Notably, we also found a non-linear dose-response association between MFO and hospital mortality.Conclusions Both higher and lower fluid balance were associated with an increased risk of hospital mortality. Further studies should explore this relationship and seek for the optimal fluid management strategies for critically ill patients.
Interrelated factors of tracheostomy in critically ill pediatric patients during their stay at ICU or PICU in Japan: a data-based analysis
Authors: Ishihara Tadashi , Tanaka Hiroshi 
Published: January 2020

Abstract
Background The most common current indications of pediatric tracheostomy include prolonged ventilator dependence, often resulting from the consequences of prematurity and bronchopulmonary dysfunction, and upper airway obstruction resulting either from craniofacial or structural abnormalities of the upper airway or from hypotonia stemming from neurological or neuromuscular disturbance. The purpose of this study was to describe the indications, epidemiology, frequency, and associated factors for tracheostomy in critical pediatric patients admitted to the intensive care unit (ICU) or pediatric intensive care unit (PICU) by using the large amount of data available in the Japanese Registry of Pediatric Acute Care (JaRPAC). Methods In this retrospective multicenter cohort study, we collected data concerning pediatric tracheostomy from the JaRPAC database involving patients aged ≤ 16 years who had no tracheostomy when admitted to ICU or PICU between April 2014 and March 2017. The patients were divided into two groups: those with tracheostomies when they were discharged from the ICU or PICU and patients without tracheostomies. Interrelated factors of tracheostomy were investigated. Results A total of 23 hospitals participated, involving 6,199 pediatric patients registered in the JaRPAC database during the study period. Of the registered pediatric patients, 5,769 (95%) patients were admitted to the ICU or PICU without tracheostomies. Among the patients, 181 patients (3.1%) had undergone tracheostomies. There were significant differences in the number of chronic conditions (134, 74.0% versus 3096, 55.4%, p < 0.01), chromosomal anomalies (19, 10.5% versus 326, 5.8%, p < 0.01), urgent admission (151, 83.4% versus 3093, 55.4%, p < 0.01). More tracheostomies were performed on patients who were admitted for respiratory failure (61, 33.7% versus 926, 16.1%, p < 0.01) and for post-CPA resuscitation (40, 22.1% versus 71, 1.1%, p < 0.01). Conclusions This is the first report to use a large-scale registry of critically ill pediatric patients in Japan to describe the interrelated factors of tracheostomies during their stay in ICUs or PICUs. Chronic conditions (especially for neuromuscular disease), chromosomal anomaly, urgent admission, admission due to respiratory failure, or treatment for post-CPA resuscitation all had the possibility to be risk factors for tracheostomy.
Community Engagement Approaches for Indigenous Health Research: an Integrative Review
Authors: Lin Chu Yang , Loyola-Sanchez Adalberto , Boyling Elaine , Barnabe Cheryl 
Published: January 2020

Abstract
Background Community engagement practices in Indigenous Health research are promoted as a means of decolonizing research, but there is no comprehensive synthesis of approaches in the literature. Our aim was to assemble and qualitatively synthesize a comprehensive list of actionable recommendations to enhance community engagement practices with Indigenous Peoples.MethodsWe performed an integrative review of literature in medical (Medline, CINAHL and Embase), as well as Google and World Health Organization databases (search cutoff date November 17, 2018). Studies that contained details regarding Indigenous community engagement frameworks, principles or practices in the field of health were included, with exclusion of non-English publications. Two reviewers independently screened the articles in duplicate and reviewed full text articles. Recommendations for community engagement approaches were extracted and thematically synthesized through content analysis.Results A total of 52 studies were included in the review, with 1268 individual recommendations extracted. These were synthesized into a list of 37 recommendations for community engagement approaches in Indigenous health research, categorized by stage of research. In addition, activities applicable to all phases of research were identified: partnership and trust building, and active reflection.Conclusions We provide a comprehensive list of recommendations for Indigenous community engagement approaches in health research. A limitation of this review is that it may not address all aspects applicable to specific Indigenous community settings and contexts. We encourage anyone who does research with Indigenous communities to reflect upon their practices, encouraging changes in research processes that are strengths-based.
Socioeconomic Inequalities and Sleep duration; Evidence from a large Kurdish Cohort Study in Iran
Authors: Abdollahpour Ibrahim , Shushtari Zahra Jorjoran , Najafi Farid , Pasdar Yahya , Moradinazar Mehdi , Hamzeh Behrooz , sajjadipour Mansour , Salimi Yahya 
Published: January 2020

Abstract
Background Sleep as an essential physiological need plays an important role in the human health. The aim of this study was to examine socioeconomic inequality in sleep duration among Kurdish people in Western of Iran.Methods The study used data of 10058 participants which from Ravansar Non-Communicable Disease (RaNCD) cohort study which recruited a sample of Kurdish adults in Kermanshah, west of Iran. The Slope Index of Inequality (SII) as well as the Relative Index of Inequality (RII) with 95% confidence intervals was calculated to determine socioeconomic inequality in sleep duration.Results There was 0.64 (95% CI: 0.55, 0.74) hour difference in the mean of sleep duration in favor of the rich group. Moreover, the mean of sleep duration in the people with lowest socioeconomic status quintile was 5% lower than those in the highest socioeconomic status quintile (RII= 0.95, 95% CI: 0.93, 0.96). For all analyses, observed inequalities were nearly equal by gender.Conclusion Our results demonstrated an important role for inequality in differential sleep duration in an Iranian Kurdish population. Improving the socioeconomic status of the general population especially people with low socioeconomic status may be useful in tackling the observed sleep issues.
Osteogenic Effects of IL-12 on Bone Marrow Mesenchymal Stem Cells Facilitates Its Irradiation Hematopoiesis Recovery
Authors: Li Fengjie , Zhang Rong , Hu Changpeng , Ran Qian , Chen Li , Xiang Yang , Xiang Lixin , Yang Yang , Zhang Gang , Li Zhongjun 
Published: January 2020

Abstract
Background Impaired osteogenesis differentiation of bone marrow mesenchymal stem cells (BM-MSCs) results inefficient physical supporting of hematopoietic niche and further counts against hematopoiesis recovery in radiotherapy. Interleukin-12 (IL-12) holds facilitations on acute irradiation hematopoietic recovery, but the mechanisms remain to be clarifiedAim To investigated the osteogenic effects of IL-12 on BM-MSCs and the relationship between IL-12’s osteogenic effects of BM-MSCs and its hematopoietic supportive role.Methold The osteogenic effects of IL-12 in vivo were investigated by estimating the osteoblasts in femurs of Balb/c mice after 5 Gy 60 Co-γ irradiation, and the osteogenic effects of IL-12 in vitro were investigated by analyzing the osteogentic genes and calcium mineral deposits formations in BM-MSCs after 9 Gy 60 Co-γirradaition at different times of co-culturing with IL-12 in osteogenic induction medium. For the latter, the special siRNA of IL-12 receptor 1 (IL-12Rβ1), tyrosine kinase 2 (TYK2) and the inhibitor of signal transducer and activator of transcription3 (STAT3) were used to explore the possible mechanism. The bone marrow hematopoietic supportive role of cells co-cultured with IL-12 were also investigated by analyzing the clone-forming of hematopoietic progenitor/ stem cells (HSPCs).Results Interleukin-12 (IL-12) holds facilitaties on acute irradiation-induced hematopoietic and osteogenesis damages in Balb/c mice. IL-12 also promoted osteogenesis differentiation of irradiated BM-MSCs, and for that, especially during early period after irradiation, the IL-12 receptor 1 (IL-12Rβ1)/ tyrosine kinase 2 (TYK2)/ signal transducer and activator of transcription3 (STAT3) signaling played a crucial role. That was reflected by obvious synchronicity between the upregulation time of IL-12Rβ1 and the time of the better IL-12 induced osteogenesis of BM-MSCs. The more osteogenic genes expressions and more calcium mineral deposits formations in BM-MSCs were obtained in cells co-cultured with IL-12 within 1 hour after irradiation; Beside that IL-12 increased the phosphotyrosine of STAT 3 (p-STAT3) which along with IL-12 induced osteogenesis promotions were abrogated by using IL-12Rβ1 and Tyk2 silencing RNA (siRNA) or inhibitor of STAT3. Further, the clone-forming of hematopoietic progenitor/ stem cells (HSPCs) showed much better in IL-12-BM-MSCs transplanted femurs of irradiated mice than that of BM-MSCs, even cells were co-cultured with IL-12 for only 24 hours.Conclusion IL-12 may assist hematopoiesis recovery through its early osteogenic differentiation promotion of BM-MSCs after irradiation, which suggested potential therapeutic targets of bone marrow hematopoietic damages after radiotherapy.
Nursing students’ and preceptors’ experiences with a structure for feedback and reflection in supervision and learning in clinical practice ‒ a pilot study with a qualitative exploratory and descriptive design.
Authors: Plathe Hilde Syvertsen , Solheim Elisabeth , Eide Hilde 
Published: January 2020

Abstract
Background: There is a need to improve students’ learning in clinical practice. Undergraduate students may need help transferring knowledge from reflection and feedback in simulation to clinical practice in community health service. Students and preceptors may need to improve feedback and reflection in supervising. Method. The study was a pilot with a qualitative exploratory descriptive research design. It’s aim was to explore students’ and preceptors’ experiences with a structured tool for reflection and feedback during supervision of clinical skills in practice. Four students in their first year of a bachelor’s programme in nursing and four preceptors participated. Data were collected from eight clinical skills performances, audiotaped debriefings, and open-ended questionnaires. Data were analysed by content analysis. Result: The data revealed that participants experienced four categories: “open and honest in debriefing,” “reflections on personal learning,” “reflection on the situation,” and “feedback.” Participants’ experiences supported structure in feedback and reflection. Participants’ experiences of common meaning of concepts supported structure in feedback and reflection. Conclusions : The students and preceptors experienced the clinical tool as an effective supplement to the supervision and learning of clinical skills.
Importance of pediatric rheumatologists and transitional care for juvenile idiopathic arthritis-associated uveitis: A retrospective series of 9 cases.
Authors: Yamazaki Susumu , Shimbo Asami , Akutsu Yuko , Takase Horoshi , Morio Tomohiro , Mori Masaaki 
Published: January 2020

Abstract
Background: Juvenile idiopathic arthritis-associated uveitis (JIA-U) is a serious condition associated with the risk of blindness. However, pediatric rheumatologists rarely encounter cases of blindness, because most patients reach adulthood during the course of follow-up before blindness occurs. Here, we report the progress of 9 patients with JIA-U, including 2 patients who became blind after the transition period. We aimed to highlight the importance of the role of pediatric rheumatologists and transitional care in preventing blindness associated with JIA-U. Case presentation: We conducted a retrospective analysis of the case records of 9 JIA-U patients (1 male, 8 female; median age 16.8 years, range 5.5–19.8 years). All patients presented with oligo-juvenile idiopathic arthritis (oligo-JIA) (one presented with extended oligo-JIA); the median age of uveitis onset was 5.0 years (range 3.0–13.0 years), and the onset of uveitis preceded the onset of arthritis in 2 patients. The median disease duration was 12.5 years (range 3.5–24.7 years); 4 patients had anti-nuclear antibody (ANA) positivity (≧1:160) (all with a homogeneous and speckled-pattern subtype). All patients were negative for rheumatoid factor. Eight patients received methotrexate, 7 patients received one or more biologic drugs (etanercept, infliximab, adalimumab, and golimumab), and 6 patients required ophthalmic surgery at an early age (≦ 18 years). Two patients developed blindness after the transition period. Medical examination by pediatric rheumatologists and use of biologics had been delayed in both patients. One patient developed depression after transition and interrupted her own treatment. Conclusions: The reason for blindness in the 2 patients was thought to be the delay in the commencement of treatment and failure to provide transitional care. Inflammation is difficult to control in JIA-U even with appropriate treatment. Pediatric rheumatologists must be informed about the risk of JIA-U blindness, especially after transition. To ensure a good prognosis, the specialized treatment with the involvement of pediatric rheumatologists is necessary early on, and consideration for transitional medicine is essential. Therefore, this report reaffirms the importance of planned transitional care that has been advocated for globally.
Secondary Consequences of Juvenile Idiopathic Arthritis in Youth with Knee Joint Involvement Compared to Healthy Controls
Authors: Nesbitt Colleen , Kuntze Gregor , Toomey Clodagh , Esau Shane , Brooks Julia , Mosher Dianne , Twilt Marinka , Johns Carolyn , Palacios-Derflingher Luz Maria , Ronsky Janet , Benseler Susanne , Emery Carolyn 
Published: January 2020

Abstract
Background: Juvenile Idiopathic Arthritis (JIA) is the most common childhood rheumatic disease. Given the heterogeneity of JIA and advances in treatment approaches, there is a persistent lack of consensus regarding the secondary consequences of JIA. This study assessed body structure and function and physical activity outcomes in youth with JIA compared to their healthy peers. Methods: Youth with JIA (n=25; 10-20 years old) and age and sex matched healthy peers (n=25) participated in two data collections (one week apart) (Ethics ID# REB15-3125). Day 1 testing included a triple single leg hop test (TSLH) and an incremental bike test. Participants then recorded their physical activity for one week using the waist worn ActiGraph. Day 2 testing consisted of a dual-energy x-ray absorptiometry scan. Outcomes included: moderate to vigorous physical activity (MVPA), peak oxygen uptake (VO2peak), maximal TSLH distance (% leg length), and fat mass index (FMI). Data were assessed for normality and outliers. Pair differences were analyzed in R (R Core Team, Austria) using t-confidence intervals (CI) or the Hodges-Lehmann method with Bonferroni correction. A significant difference was accepted if CIs excluded zero. The effect of sex on outcomes was examined using pair difference medians and first and third quartiles. Results: CIs for all study outcomes contained zero and did not meet criteria for significant differences between pairs. However, based on the large lower limit and small upper limit of the CIs for MVPA (median -18.6min 97.5%CI [-44.3,2.0]), a larger sample might have concluded that youth with JIA perform substantially less MVPA than their healthy peers. Further, based on pair difference point estimates and interquartile ranges, sex may be a confounder with regards to physical activity participation and may be an effect modifier of the TSLH. Conclusions: The results of this study provide further evidence on the consequences of JIA on physical activity participation in youth. These findings highlight the importance of considering the effects of sex, particularly with regards to physical activity and TSLH outcomes. Further research across JIA subtypes is needed to inform the targeted exercise therapy programs to restore healthy patterns of physical activity participation.
What a weight loss programme should contain if people with obesity were asked - A qualitative analysis within the DO:IT study
Authors: Jessen-Winge Christina , Ilvig Pia Maria , Fritz Heather , Brandt Carl J. , Lee Kim , Christensen Jeanette Reffstrup 
Published: January 2020

Abstract
Background Currently 1.9 billion adults worldwide are estimated to be overweight or obese. In Denmark the municipalities hold the responsibility to deliver weight loss programmes to overweight and obese citizens. There has been a tendency to assume that obesity reduction programmes that work in specialized hospital settings are directly transferrable to the municipalities. However, municipality-based weight loss programmes have not produced clinically significant reductions in body weight. Differential success rates between hospital and municipal settings may be due to a discrepancy between research evidence and needs of people with obesity. The first step in developing a weight loss programme designed for the municipalities is to understand what a programme should contain, if people with obesity were asked. The aim of this study was to examine what people with obesity find important in a weight loss programme to make the weight loss successful and maintained. Methods We used a qualitative, explorative, descriptive design drawing on hermeneutical reflection with individual interviews. We included men and women age 17 and older with a BMI≥25 kg/m2. Participants were recruited from the wait lists of 13 municipality programmes and through Facebook posts. Data were analyzed using content analysis. Results Thirty-four participants with overweight or obesity were individually interviewed (age between 19 – 74). Findings suggest that weight loss programmes should support the participants in structuring days, not with restrictions but with replacement activities. Programmes should also aide individuals with taking one thing at a time and facilitating social support from friends, health professionals and peers. Diet and exercise were expressed as important content in a weight loss programme, but as having a negative meaning. Conclusion People with obesity wish to have a structured approach to weight loss that focuses on habits, social support and preserving the positive meaning of activities.
A Cross-Sectional Study of Heat-Related Knowledge, Attitude, and Practice among Naval Personnel in China
Authors: Wang Xuren , Xia Demeng , Wang Yixin , Xu Shuogui , Gui Li 
Published: January 2020

Abstract
Background: Heat-related illnesses have significant impacts on health, and military personnel were widely exposed to risk factors of heat-related illness. Knowledge, attitudes and practices (KAP) are the three of the most important factors to prevent the heat-related illness. A cross-sectional study was designed to explore heat-related KAP of military personnel in China. Methods: This survey was conducted in June 2019. A total of 646 military personnel were recruited from 2 navy troops in tropical zone and one in temperate zone. Data regarding demographic characteristics and KAP scores were collected using questionnaires. Univariate analysis and Scheffe's method were used for data analysis. Results: The mean K-score was relatively high (10.37, SD=1.63), but the subscore of awareness of exertional heatstroke and the risk of alcohol and soda drinks were inadequate. There are noticeable differences in the mean K-score according to age, military ranks and education levels(P<0.05). The mean A-score was 7.76(SD=2.65). The participants from tropical zone or had relevant experience had higher A-score (P<0.05). The mean P-score was 3.80 (SD=1.12), and participants from temperate zone had higher P-score (P<0.001). Conclusions: Military personnel's awareness of the prevention and first-aid measures of heat related illnesses need to be strengthened, and it is very important to develop educational programs and enrich systematic educational resources of heat-related illness.