bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic value of pretreatment platelet counts in lung cancer: a systematic review and meta-analysis
Authors: Yuan Yuan , Zhong Hai , Ye Liang , Li Qian , Fang rong su , Gu Wei , Qian Ying Ying 
Published: April 2020

Abstract
Background : The prognostic value of elevated pretreatment platelet counts remains controversial in lung cancer patients. We performed the present meta-analysis to determine its precise role in these patients. Methods: We employed a multiple search strategy in the PubMed, EMBASE and Cochrane Library databases to identify eligible studies. Disease-free survival (DFS)/progression-free survival (PFS)/time to progression (TTP) and overall survival (OS) were used as outcomes with hazard ratios (HRs) and 95% confidence intervals (CIs). Heterogeneity among the studies and publication bias were also evaluated. Results : A total of 40 studies including 16696 lung cancer patients were eligible for the analysis. Overall, the pooled analysis showed that compared with normal platelet counts, elevated pretreatment platelet counts were associated with poorer OS (HR= 1.54, 95% CI: 1.37-1.72, P<0.001) and poorer DFS/PFS/TTP (HR=1.62, 95% CI: 1.33-1.98, P<0.001) in patients with lung cancer. In subgroup analyses, elevated pretreatment platelet counts were also associated with poorer OS and DFS/PFS/TTP in most subgroups. There was no evidence of publication bias. Conclusions : This meta-analysis revealed that elevated pretreatment platelet counts were an independent predictor of OS and DFS/PFS/TTP in lung cancer patients. Large-scale prospective studies and a validation study are warranted.
The epidemiology of heart failure in the general Australian community - Study of Heart failure in the Australian Primary carE setting (SHAPE): methods
Authors: Parsons Richard Whaddon , Liew Danny , Neville A Munro , Audehm Ralph G , Haikerwal Deepak , Piazza Peter , Lim Kevin , Sindone Andrew P 
Published: April 2020

Abstract
Background: There is a paucity of information on the epidemiology of heart failure (HF) in Australia. The Study of Heart failure in the Australian Primary carE setting (SHAPE) study aims to estimate the prevalence and annual incidence of HF in the general Australian community and to describe the demographic and key clinical profile of Australians with HF.Methods: We undertook a retrospective cohort study based on analysis of non-identifiable medical records of adult patients cared for at 43 general practices between 1 July 2013 and 30 June 2018. Data were extracted from coded (diagnosis, pathology and prescription fields) and uncoded fields (clinical notes) in the medical records. The latter searches of free text looked for common synonyms relevant to HF. The population was stratified into three groups based on a hierarchy of selection criteria: (1) definite HF, (2) probable HF and (3) possible HF. The prevalence and annual incidence of HF were calculated, along with 95% confidence intervals.Results: The practices provided care to 2.3 million individual patients over the five-year study period, of whom 1.93 million were aged 18 years and above. Of these patients 16,930 were classified as having ‘definite HF’, 4873 as having ‘probable HF’ and 36,517 as having ‘possible HF’. A further 40,992 were identified as having an aetiological condition associated with HF. A formal HF diagnosis, HF terms recorded as text in the notes and HF-specific medication were the most common methods to identify ‘definite’ HF patients. Typical signs and symptoms in combination with a diuretic prescription was the most common method to identify ‘probable HF’ patients. The majority of ‘possible’ HF patients were identified by the presence of 2 or more of the typical signs or symptoms. Dyspnoea was the commonest recorded symptom and an elevated jugular venous pressure the commonest recorded sign.Conclusions: This novel approach to undertaking retrospective research of primary care data successfully analysed a combination of coded and uncoded data from the electronic medical records of patients routinely managed in the GP setting. SHAPE is the first real-world study of the epidemiology of HF in the general Australian community setting.
Prognosis of patients with acute exacerbation of combined pulmonary fibrosis and emphysema: A retrospective single-center study
Authors: Ikuyama Yuichi , Ushiki Atsuhito , Kosaka Makoto , Akahane jumpei , Mukai Yuichi , Araki Taisuke , Kitaguchi Yoshiaki , Tateishi Kazunari , Urushihata Kazuhisa , Yasuo Masanori , Yamamoto Hiroshi , Hanaoka Masayuki 
Published: April 2020

Abstract
Background: Previous analyses of combined pulmonary fibrosis and emphysema (CPFE) cohorts have provided conflicting data on the survival of patients with CPFE. Therefore, the aim of this study was to investigate the clinical prognosis of acute exacerbations (AE) of CPFE.Methods: We retrospectively reviewed the medical records of patients who had been treated at the Shinshu University Hospital (Matsumoto, Japan) between 2003 and 2017. We identified 21 patients with AE of CPFE and 41 patients with AE of idiopathic pulmonary fibrosis (IPF) and estimated their prognoses using the Kaplan–Meier method.Results: Treatment content and respiratory management were not significantly different between the two groups before and after exacerbation. At the time of AE, the median serum Krebs von den Lungen-6 level was significantly lower in the CPFE group (Krebs von den Lungen-6: 966 U/µL; white blood cell count: 8810 /µL) than that in the IPF group (Krebs von den Lungen-6: 2130 U/µL, p < 0.001; white blood cells: 10809/µL, p = 0.0096). The baseline Gender-Age-Physiology scores were not significantly different between the two groups (CPFE, 4.5 points; IPF, 4.7 points; p = 0.58). Kaplan–Meier curves revealed that the survival time after AE for patients with CPFE was longer than that for patients with IPF (p < 0.001, log-rank test).Conclusions: Survival prognoses after AE were significantly better for patients with CPFE than that for those with IPF. Our findings may improve the medical treatment and respiratory management of patients with AE-CPFE.
Intermittent Kangaroo Mother Care and the Practice of Breastfeeding Late Preterm Infants: Results from Four Hospitals in Different Provinces of China
Authors: Zhang Bo , Duan Zhiying , Zhao Yingxi , Williams Sarah , Wall Stephen , Huang Limin , Zhang Xiaoqin , Wu Wenli , Yue Jieya , Zhang Lin , Liu Jun , Zhao Gengli 
Published: April 2020

Abstract
Background China has an extremely low exclusive breastfeeding rate. Kangaroo mother care (KMC) has been shown to increase the exclusive breastfeeding rate among infants born extremely or very preterm. However, there is limited evidence surrounding intermittent KMC and exclusive breastfeeding in late preterm infants. In our study we investigated the association between the provision of intermittent KMC and breastfeeding practice for late preterm infants in four hospitals in different provinces of China. Methods Intermittent KMC was recommended to the mothers of all preterm infants admitted to the postnatal wards of participating hospitals between March 2018 and March 2019. Those who agreed to practice KMC were enrolled in the “KMC group”, those who did not were enrolled in the “No KMC group”. Basic maternal socio-demographic information was collected, feeding practice; outcome and method, were recorded daily whilst in hospital. A follow-up survey of feeding practice was conducted 42 days after discharge. Calculations for feeding practice were performed separately for both groups. Logistics regression was used to analyze the association between KMC and feeding outcome and method, adjusting for socio-demographic covariates. Results Among the 844 mothers participating in the study, 627 (74.3%) chose to perform KMC. More of the mothers who provided KMC were exclusively breast milk feeding their infants in the 24 hours before hospital discharge (54.6%) and at follow-up (57.3%), compared to mothers who did not provide KMC (34.6% at discharge and 33.2% at follow-up,). Mothers in the KMC group were more likely to be breastfeeding (method) than mothers in the No KMC group (65.3% vs. 52.1% at discharge, and 83.1% vs. 67.3% at follow up). Logistic regression indicated that compared with the No KMC group, mothers who provided KMC were twice as likely to be exclusively breast milk feeding their infants at discharge (OR=2.15 (1.53-3.02)), use breastfeeding method at discharge as opposed to other means such as bottle or cup feeding (OR=1.61 (1.15-2.25)), be exclusive breast milk feeding at follow-up (OR=2.55 (1.81-3.61)), and use breastfeeding method at follow-up (OR=2.09 (1.44-3.02)). Conclusions Intermittent KMC was associated with a nearly doubled increase in exclusive breast milk feeding (outcome) and breastfeeding (method) at both discharge and 42 days after discharge for late preterm infants. This is especially important in China where exclusive breastfeeding rates are low, intermittent KMC provides a feasible means to increase the likelihood of these vulnerable infants receiving the benefits of exclusive breastmilk.
Measurement properties of the Musculoskeletal Health Questionnaire (MSK-HQ): a between country comparison
Authors: Christiansen David Høyrup , McCray Gareth , Winding Trine Nøhr , Andersen Johan Hviid , Nielsen Kent Jacob , Karstens Sven , Hill Jonathan C 
Published: April 2020

Abstract
Background: The Musculoskeletal Health Questionnaire (MSK-HQ) has been developed to measure musculoskeletal health status across musculoskeletal conditions and settings. However, the MSK-HQ needs to be further evaluated across settings and different languages.Objective: The objective of the study was to evaluate and compare measurement properties of the MSK-HQ across Danish (DK) and English (UK) cohorts of patients from primary care physiotherapy services with musculoskeletal pain. Methods: MSK-HQ was translated into Danish according to international guidelines. Measurement invariance was assessed by differential item functioning (DIF) analyses. Test-retest reliability, measurement error, responsiveness and minimal clinically important change (MCIC) were evaluated and compared between DK (n=153) and UK (n=166) cohorts. Results: The Danish version demonstrated acceptable face and construct validity. Out of the 14 MSK-HQ items, three items showed DIF for language (pain/stiffness at night, understanding condition and confidence in managing symptoms) and three items showed DIF for pain location (walking, washing/dressing and physical activity levels). Intraclass Correlation Coefficients for test-retest were 0.86 (95% CI 0.81 to 0.91) for DK cohort and 0.77 (95% CI 0.49 to 0.90) for the UK cohort. The systematic measurement error was 1.6 and 3.9 points for the DK and UK cohorts respectively, with random measurement error being 8.6 and 9.9 points. Receiver operating characteristic (ROC) curves of the change scores against patients’ own judgment at 3 months exceeded 0.70 in both cohorts. Absolute and relative MCIC estimates were 8-10 points and 26% for the DK cohort and 6-8 points and 29% for the UK cohort.Conclusions: The measurement properties of MSK-HQ were acceptable across countries, but seem more suited for group than individual level evaluation. Researchers and clinicians should be aware that some discrepancy exits and should take the observed measurement error into account when evaluating change in scores over time.
A Novel Method for Identifying a Parsimonious and Accurate Predictive Model for Multiple Clinical Outcomes
Authors: Diaz-Ramirez Ledif Grisell , Lee Sei J. , Smith Alexander K. , Gan Siqi , Boscardin Walter John 
Published: April 2020

Abstract

Background: Most methods for developing clinical prognostic models focus on identifying parsimonious and accurate models to predict a single outcome; however, patients and providers often want to predict multiple outcomes simultaneously. For example, older adults are often interested in predicting nursing home admission as well as mortality. We propose and evaluate a novel predictor selection method for multiple outcomes.Methods: Our proposed method selected the best subset of common predictors based on the minimum average normalized Bayesian Information Criterion (BIC) across outcomes: the Best Average BIC (baBIC) model. We compared the predictive accuracy (Harrell’s C-statistic) and parsimony (number of predictors) of the baBIC model with a subset of common predictors obtained from the union of optimal models for each outcome (Union model). We used example data from the Health and Retirement Study (HRS) to demonstrate our method and conducted a simulation study to investigate performance considering correlated and uncorrelated outcomes.Results: In the example data, the average Harrell’s C-statistics across outcomes of the baBIC and Union models were comparable (0.657 vs. 0.662 respectively). Despite the similar discrimination, the baBIC model was more parsimonious than the Union model (15 vs. 23 predictors respectively). Likewise, in two simulation scenarios with correlated and uncorrelated outcomes, the mean C-statistic across outcomes of the baBIC and Union models were very similar, and the baBIC model had on average fewer predictors. In the simulations, the baBIC method performed well by identifying the correct predictors most of the time and excluding the incorrect predictors in the majority of the simulations.Conclusions: Our method identified a common subset of variables to predict multiple clinical outcomes with superior parsimony and comparable accuracy to current methods.
Effects of a 12-week workplace counseling program on physical activity and low back pain: a pilot randomized controlled study
Authors: Shimo Kazuhiro , Hasegawa Mami , Mizutani Seiko , Hasegawa Tomomi , Ushida Takahiro 
Published: April 2020

Abstract
Background: Physical activity (PA) is essential in the management and rehabilitation of low back pain (LBP). However, it is not clear that PA interventions in the workplace can improve LBP. This study aimed to investigate the effects of workplace counseling on PA levels, and LBP and physical function among workers.Methods: We recruited 37 people with 12 weeks of LBP who worked as office staff or machinery mechanic in a manufacturing company in Aichi, Japan. Participants were randomly assigned to the intervention group (n = 20) or control group (n = 17). All participants of both groups were affixed with waist-worn accelerometers to monitor PA. The intervention group also received a program of face-to-face counseling with a physical therapist or nurse once a week for 12 weeks to reassure and encourage participants to maintain a high level of PA. PA, LBP severity and physical function were assessed at baseline, 3 and 6 months.Results: Baseline characteristics were similar in both groups. PA was significantly higher in the intervention group than in the control group at 3 and 6 months. In the intervention group, PA and physical function significantly increased at 3 and 6 months from baseline, and LBP severity at 6 months improved significantly from baseline. We calculated the effect size of the PA workplace counseling and found that it had a medium-to-large effect on PA, LBP severity and physical function.Conclusions: Our data suggest that workplace PA intervention can increase PA and improve LBP among workers.Trial registration: UMIN-CTR Clinical Trial UMIN000038864 (https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000044321). Registered 12 December 2019, retrospectively registered.
Appraising Efficiency of OpSite as Coolant in Drilling of Bone
Authors: Effatparvar Mohammad Reza , Jamshidi Nima , Mosavar Alireza 
Published: April 2020

Abstract
Background: During drilling of bone, which is common in clinical surgeries, heat generation increases local temperature in the drilling site. Transmission of excessive heat to the surrounding bone tissue can cause thermal osteonecrosis. Consequently, it may lead to failure of implants and fixation screws or delay in healing process. Using cooling is a method for limiting temperature elevation. Materials and Methods: In this study, through comparing 3 conditions of drilling without cooling, external cooling with normal saline, and external cooling with OpSite spray, the efficiency of OpSite as coolant is studied. In this regard, 2 drill bit diameters, 3 drilling speeds, and 3 drilling feed-rates are considered as drilling variables in the experiments. Results: For the whole experiments, while cooling with normal saline resulted in lower maximum temperatures than without cooling condition, OpSite had even better results and limited the temperature elevation during drilling of bone efficiently.Conclusion: OpSite spray, which has lower infection risks than normal saline on one hand and lower maximum temperature rise with all combinations of drilling parameters on the other hand, can be considered in clinical surgeries for cooling applications.
Identifying genetic variants and pathways associated with extreme levels of fetal hemoglobin in Sickle Cell Disease in Tanzania.
Authors: Nkya Siana , Mwita Liberata , Mgaya Josephine , Kumburu Happiness , Zwetselaar Marco van , Menzel Stephan , Mazandu Gaston Kuzamunu , Sangeda Raphael Z. , Chimusa Emile R. , Makani Julie 
Published: April 2020

Abstract
Background: Sickle cell disease (SCD) is a blood disorder caused by a point mutation on the beta globin gene resulting in the synthesis of abnormal hemoglobin. Fetal hemoglobin (HbF) reduces disease severity, but the levels vary from one individual to another. Most research has focused on common variants which differ across populations and hence do not fully account for HbF variation. Methods: We investigated rare and common genetic variants that influence HbF levels in 14 SCD patients to elucidate variants and pathways in SCD patients with extreme HbF levels (≥7.7% for high HbF) and (≤2.5% for low HbF) in Tanzania. We performed targeted next generation sequencing (Illumina_Miseq) covering exonic and other significant fetal hemoglobin-associated loci, including BCL11A, MYB, HOXA9, HBB, HBG1, HBG2, CHD4, KLF1, MBD3, ZBTB7A and PGLYRP1.Results: Results revealed a range of genetic variants, including bi-allelic and multi-allelic SNPs, frameshift insertions and deletions, some of which have functional importance. Notably, there were significantly more deletions in individuals with high HbF levels (11% vs 0.9%). We identified deletions with high HbF levels and frameshift insertions in individuals with low HbF. CHD4 and MBD3 genes, interacting in the same sub-network, were identified to have a significant number of pathogenic or non-synonymous mutations in individuals with low HbF levels, suggesting an important role of epigenetic pathways in the regulation of HbF synthesis. Conclusions: This study provides new insights in selecting essential variants and identifying potential biological pathways associated with extreme HbF levels in SCD using multiple genomic variants associated with HbF in SCD.
Uptake and willingness to use PrEP among Chinese gay, bisexual and other men who have sex with men with experience of sexualized drug use in the past year
Authors: Wang Zixin , Mo Phoenix K.H. , Ip Mary , Fang Yuan , Lau Joseph T.F. 
Published: April 2020

Abstract
Background Sexualized drug use (SDU) refers to use of any psychoactive substance before/during sexual intercourse. Chemsex is a subset of SDU, which is defined as the use of some specific psychoactive substances (methamphetamine, mephedrone, γ-hydroxybutyrate, ketamine and cocaine) before/during sexual intercourse. SDU and chemsex are prevalent among gay, bisexual and other men who have sex with men (GBMSM). This study investigated uptake and willingness to use pre-exposure prophylaxis (PrEP) among a sample of GBMSM in Hong Kong with experience of SDU in the past year. Methods A total of 600 GBMSM were recruited by convenient sampling through outreaching in gay venues, online recruitment and peer referral. Participants completed a cross-sectional anonymous telephone interview. This study was based on a subsample of 580 GBMSM self-reported as HIV negative/unknown sero-status. Results: Of the participants, 82 (14.1%) and 37 (6.4%) had experience of SDU and chemsex in the past year. The prevalence of PrEP uptake was 4.0% among all participants and 14.6% among those with experience of SDU in the past year. Among MSM with experience of SDU in the past year who were not on PrEP (n=70), 67.1% were willing to use daily oral PrEP in the next six months. Multivariate logistic regression models showed that positive attitudes toward PrEP (AOR: 2.37, 95%CI: 1.47, 3.82), perceived support from significant others to use PrEP (AOR: 9.67, 95%CI: 2.95, 31.71), and perceived behavioral control of using PrEP (AOR: 19.68, 95%CI: 5.44, 71.26) were significantly associated with higher willingness to use PrEP. Conclusion: GBMSM with experience of recent SDU are potentially good candidates of PrEP implementation. This group of GBMSM reported high prevalence of uptake and willingness to use PrEP. Perceptions related to PrEP based on the Theory of Planned Behavior were significantly associated with willingness to use PrEP.
A randomized pilot study to evaluate graft versus fistula vascular access strategy in older patients with advanced kidney disease: results of a feasibility study
Authors: Murea Mariana , Geary Randolph L , Houston Denise K , Edwards Matthew S , Robinson Todd W , Davis Ross P , Hurie Justin B , Williams Timothy K , Velazquez-Ramirez Gabriela , Bagwell Benjamin , Tuttle Audrey B , Moossavi Shahriar , Rocco Michael V , Freedman Barry I , Williamson Jeff D , Chen Haiying , Divers Jasmin 
Published: April 2020

Abstract
Background. Although older adults encompass almost half of patients with advanced chronic kidney disease, it remains unclear which long-term hemodialysis vascular access type, arteriovenous fistula or arteriovenous graft, is optimal with respect to effectiveness and patient satisfaction. Clinical outcomes based on the initial AV access type have not been evaluated in randomized controlled trials. This pilot study tested the feasibility of randomizing older adults with advanced kidney disease to initial arteriovenous fistula versus graft vascular access surgery.Methods: Patients 65 years or older with pre-dialysis chronic kidney disease or incident end-stage kidney disease and no prior arteriovenous vascular access intervention were randomized in a 1:1 ratio to undergo surgical placement of a fistula or a graft after providing informed consent. Trial feasibility was evaluated as (i) recruitment of ≥70% of eligible participants, (ii) ≥50% to 70% of participants undergo placement of index arteriovenous access within 90 to 180 days of enrollment, respectively, (iii) ≥80% adherence to study-related assessments, and (iv) ≥70% of participants who underwent index arteriovenous access placement will have a follow-up duration of ≥12 months after index surgery date.Results: Between September 2018 and October 2019, 81% (44/54) of eligible participants consented and were enrolled in the study; 11 had pre-dialysis chronic kidney disease and 33 had incident or prevalent end-stage kidney disease. After randomization, 100% (21/21) assigned to arteriovenous fistula surgery and 78% (18/23) assigned to arteriovenous graft surgery underwent index arteriovenous access placement within a median (1st, 3rd quartile) of 5.0 (1.0, 14.0) days and 13.0 (5.0, 44.3) days, respectively, after referral to vascular surgery. The completion rates for study-specific assessments ranged between 40.0 and 88.6%. At median follow-up of 215.0 days, 5 participants expired, 7 completed 12 months of follow-up, and 29 are actively being followed. Assessments of grip strength, functional independence and vascular access satisfaction were completed by >85% of patients who reached pre-specified post-operative assessment time point.Conclusions: Results from this study reveal it is feasible to enroll and randomize older adults with advanced kidney disease to one of two different arteriovenous vascular access placement surgeries. The study can progress with minor protocol adjustments to a multisite clinical trial.Trial registration: Clinical Trials ID: NCT03545113. Registered June 4, 2018.