bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radical Hysterectomy Versus Simple Hysterectomy and Brachytherapy for Patients with Stage II Endometrial Cancer
Authors: Wang Ming , Ran Ran , Wu Yu-Mei 
Published: January 2021

Abstract
Purpose To compare the survival outcome between radical hysterectomy and total hysterectomy with radiation therapy in patients with stage II endometrial cancer.Methods This is a retrospective cohort study. We identified 1349 patients diagnosed with stage II endometrial cancer from Jan 1, 1988 to Dec 31 2015 in the Surveillance, Epidemiology, and End Results. Patients were divided into two groups based on the primary treatment (total hysterectomy combined with brachytherapy or radical hysterectomy). All patients received external beam radiation therapy after the surgery. The primary outcome was the rate of 5-year-cause-specific survival and 5-year-overall survival.Results A total of 1349 patients were enrolled in the study, 117(7.35%) patients received radical hysterectomy and 460 patients who received total hysterectomy combined with vaginal brachytherapy were selected as control. All patients received external beam radiation therapy after the surgery. Overall, the median follow-up duration was 82.77±1.44months (95%CI: 79.94-85.61months). There was no difference in the baseline information between two groups, including ages, ethnicity, and rates of histologic subtypes. The 5-year overall survival was 62.31% among women who underwent radical hysterectomy which was lower than 78.48% among those who underwent total hysterectomy combined with vaginal brachytherapy (HR, 2.22; 95% CI, 1.52 to 3.24; P <0.001 by the log-rank test). Women who underwent radical hysterectomy also had shorter 5-year cause-specific survival (74.60 vs.85.38%; HR, 1.91; 95% CI, 1.13 to 3.23; P =0.01 by the log-rank test) than those who underwent total hysterectomy combined with vaginal brachytherapy. However, the negative outcomes were further validated in patients with high-risk endometrial cancer, not in patients with grade 1-2 low-risk endometrial cancer both on cause-specific survival and overall survival. In patients with grade 3 low-risk endometrial cancer, the tendency was only found with lower overall survival not cause-specific survival.Conclusions This study revealed that in patients’ stage II endometrial cancer, radical hysterectomy was associated with shorter overall survival and cause-specific survival than total hysterectomy combined with vaginal brachytherapy. The choice of different treatment modalities should base on the histology subtype of patients and further study based on molecular classification is needed.
Healing the Healers: A Phenomenological Exploration of a Brief Online Mindfulness Course on Stress, Burnout and Coping Strategies of Health Care Professionals During the COVID-19 Crisis
Authors: Osman Iram , Singaram Veena , Hamid Shaista 
Published: January 2021

Abstract
Background: During the COVID-19 pandemic, health professionals were pushed to the front line of a global health crisis unprepared, resource constrained, and with heightened uncertainty and distress levels. The impact of an online mindfulness-based intervention (MBI) for health care professionals amid a pandemic has not been previously documented. This study aimed to investigate the feasibility and effectiveness of a brief online MBI on stress, burnout and mindful awareness for health professionals training and working during the COVID-19 crisis.Methods: A mixed methods, phenomenological, participatory evaluation framework was adopted for this study. A four-week online training programme was adapted and delivered to health professionals via the Zoom platform. Non-probability snowball sampling was used to recruit participants. The quantitative data was analysed using descriptive analysis via Stata 15.1 statistical software, and the participants’ qualitative experiences were interpreted using interpretative phenomenological analysis (IPA).Results: Forty-seven participants took part in this study. The study found a statistically significant (p < 0.05) reduction in stress levels and emotional exhaustion as well as an increase in mindful awareness and feelings of personal accomplishment between the pre-and post-intervention assessments of the MBI. The participants’ shared experiences were analysed in two parts. The pre-intervention analysis presented with central themes of loss of control and a sense of powerlessness due to COVID-19. The post-intervention analysis comprised themes of a sense of acquired control and empowerment through increased mindfulness.Conclusions: The study found that a brief online MBI can be associated with increased awareness and present-moment focus as well as reduced levels of stress and burnout. The MBI had a positive impact on the health care professionals’ sense of control and empowerment, and increased their perceived sense of competence and accomplishment, both personally and professionally, during the global crisis.
Self-Reported Weather Sensitivity is Associated with Clinical Symptoms and Structural Abnormalities in Patients with Knee Osteoarthritis: A Cross-Sectional Study
Authors: Xue Yan , Chen Yan , Jiang Ding , Wang Lin , Wang Xuezong , Li Ming , Wu Yuyun , Zhang Min , Pang Jian , Zhan Hongsheng , Zheng Yuxin , Ding Daofang , Cao Yuelong 
Published: January 2021

Abstract
Background Patients with knee osteoarthritis (KOA) often complain about clinical symptoms affected by weather-related factors. The purpose of the present study was to use cross-sectional analysis to determine whether weather sensitivity was associated with clinical symptoms, as well as structure abnormalities, in KOA patients.Methods Data from 80 participants were obtained from the Feng Hans Shi Effects on OA (FHS) study, an OA cohort study initiated in China in 2015. The weather sensitivity of each participant was determined by a self-reported questionnaire. The following measurements were used to assess clinical and biological outcomes: a visual analog scale (VAS) for pain; Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC); and blood levels of tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), and interleukin 1(IL-1). Structural changes identified via magnetic resonance imaging (MRI) were also evaluated. Independent sample t-tests, chi-square tests, Fisher’s exact tests, Cochran-Armitage tests for linear trends, and binary linear regression were used to evaluate the clinical characteristics, biomarkers, WOMAC, and Whole-Organ Magnetic Resonance Imaging Score (WORMS) of weather-sensitive KOA patients and non-weather-sensitive KOA patients.Results Most of the KOA participants (57.5%) perceived the weather as affecting their knee-joint clinical symptoms. Through logistic regression analysis, the presence of weather sensitivity was found to increase the risk of KOA participants reporting higher levels of WOMAC pain scores [OR = 3.3 (95% CI: 1.1, 9.9), P > 0.032], functional scores [OR = 5.5 (95% CI: 1.8,16.8), P > 0.003], total scores [OR = 3.3 (95% CI: 1.1, 10.2), P = 0.034], WORMS cartilage scores [OR = 3.1 (95% CI: 1.1, 8.5), P < 0.027], and marrow abnormality scores [OR = 3.0 (95% CI: 1.1, 8.1), P > 0.029].Conclusions Weather-sensitive KOA patients were prone to show more serious clinical symptoms and structural abnormalities in their knee joints. Therefore, the existence of weather sensitivity may accelerate the progress of KOA.
Does Aid Matter for Foreign Direct Investment in ECOWAS: Investigating The Infrastructure Channel?
Authors: ONYE KENNETH , BASSEY GODWIN , IRIABIJE ALEX , EFFIOM LIONEL 
Published: January 2021

Abstract
We ask the data whether and how aid targeted at specific sub-categories of economic infrastructure could assist ECOWAS economies to attract higher Foreign Direct Investment (FDI) inflow via improvement in infrastructure in Water Supply and Sanitation (WSS), energy, transport, and ICT. By relying on the 3SLS estimation technique that is able to explicitly account for dependencies between 3 structural equations on the allocation of targeted aid, the determinants of infrastructure, and the determinants of FDI – we found quite interesting results. First, aid targeted at infrastructure indicates strong positive effect on the countries’ infrastructure endowment, as expected. Second, there is robust evidence that aid promotes FDI but, surprisingly, not necessarily through the infrastructure channel. Targeted aid appears to exert a positive and direct knock-on effect on FDI - apparently, because investors anticipate the positive effect that targeted aid is almost always inclined to produce on host countries’ infrastructure endowment. Finally, aid allocation by Development Assistance Committee donors seems to have primarily been merit-based, followed by weaker evidence for ‘need’. Therefore, we recommend more need-based aid allocation particularly in economies where initial infrastructure endowment is minimal. There is also need for extended effort at index construction (e.g., index of infrastructure need) and data collection to drive country-case studies. This should identify the transmission channel from aid to FDI and how the associated binding constraints could be overcome.
Risk Stratification for Organ/Space Surgical Site Infection in Digestive System Cancer: A Prospective Cohort Study
Authors: Sun Chen , Gao Hui , Zhang Yuelun , Pei Lijian , Huang Yuguang 
Published: January 2021

Abstract
Background: Organ/space surgical site infection (organ/space SSI) is one of the serious postoperative complications, closely related to a poor prognosis. Few studies have attempted to design risk scoring systems for patients with digestive system cancer. This study aimed to develop a simple and practical risk stratification score for these patients to identify a priori risk of organ/space SSI.Methods: This prospective cohort study was based on two prospective studies (NCT02756910, ChiCTR-IPR-17011099), including patients undergoing elective radical resection of digestive system cancer. Logistic regression analysis was used to identify the determinant variables. The incidence of organ/space SSI stratified over perioperative factors was compared and compounded in a risk score.Results: Among the 839 patients, 51 developed organ/space SSI (6.1%) within 30 days after surgery. Patients undergoing gastrectomy (OR=8.466, 95% CI: 2.728-26.270, P<0.001), colorectal resection (OR=11.180, 95% CI: 3.921-31.881, P<0.001) and pancreatoduodenectomy (OR=9.054, 95% CI: 3.329-24.624, P<0.001) with an anaesthesia time > 4 h (OR=2.335, 95% CI: 1.035-5.271, P=0.041) and prolonged intensive care unit (ICU) stays > 24 h (OR=4.243, 95% CI: 1.715-10.498, P=0.002) had a significantly higher risk of organ/space SSI. These risk factors (procedure type, anaesthesia time, prolonged ICU stays) were also associated with an increase in organ/space SSI rates based on a compounded score (P<0.001). Comparisons with the overall population revealed that patients with 0 or 1 risk factor (n=602) had an organ/space SSI rate of 2.8% (RR=0.197, 95% CI: 0.112-0.345), those with 2 risk factors (n=223) had an organ/space SSI rate of 13.0% (RR=3.641; 95% CI: 2.138-6.202), and those with 3 risk factors (n=14) had an organ/space SSI rate of 35.7% (RR=6.405, 95% CI: 3.005-13.653).Conclusion: The risk stratification score in this study provides a simple and practical tool to stratify patients with digestive system cancer so that the relative risk of developing postoperative organ/space SSIs can be predicted.Trial Registration: This study was based on one randomized controlled trial (NCT02756910) registered at ClinicalTrials.gov on April 29, 2016 and one prospective cohort study (ChiCTR-IPR-17011099) registered at the Chinese Clinical Trial Registry on April 9, 2017.
Whole-exome Sequencing Identify Rare Variants in Novel Candidate Genes with Non-syndromic Patent Ductus Arteriosus
Authors: Gao Ying , Liu Ying , Li Jiaoyu , Chen Yinghui , Zhang Qi , Zhang Bingyao , Zhao Pengjun , Chen Bo 
Published: January 2021

Abstract
Background Patent Ductus Arteriosus (PDA) is one of the most common congenital heart defects that can cause pulmonary hypertension, heart failure, and even death. Prior studies have suggested a role for genetics in determining spontaneous ductal closure, however the clinical characteristics and genetic cause underlying PDA remain unclear. Results Therefore, to further explore genetic etiology of PDA, we applied Whole-exome Sequencing (WES) in 39unrelated isolated, non-syndromic PDApatientsand 100 healthy controls. Through a series of bio-information filtering strategies, the candidate genes are prioritized by comprehensively considering factors such as genefunctional enrichment, expression pattern and mutation burden during heart development. 18 rare damage variants of 6 total novel genes (SOX8, NES, CDH2, ANK3, EIF4G1, HIPK1)were identified for the first time and these pathogenic candidates are also highly expressed in the heart of human embryos. Conclusions WES is an efficient diagnostic tool for identifying PDA related genes. The finding of our study contributes new insights into the molecular basis of PDA and may inform further studies on genetic risk factors for this congenital birth defect.
Quantitative Evaluation of Upper Urinary Tract Pump Function in Pigs With Acute Unilateral Lower Ureteral Obstruction by 640-slice Dynamic Volume CT
Authors: Mao Chongwen , Peng Cong , Li Song , Chen Liling , You Mengjing , Fang Kewei , Xiang Shutian , Su Yunshan 
Published: January 2021

Abstract
Background: It is a challenging problem to differentiate obstructive hydronephrosis from non-invasive evaluation of renal pelvis and ureteral motility in patients. The purpose of this study was to explore the value of 640-slice dynamic volume CT (DVCT) in quantitative measurement of upper urinary tract (UUT) pump function after acute unilateral lower ureteral obstruction in pigs. Methods: In this study, perfusion pig model was made by constant pressure perfusion test of renal pelvis and left nephrostomy. The perfusion and pressure measuring devices were connected to create the state of no obstruction, acute obstruction of the lower part of the left ureter. After successful modeling, continuous dynamic volume scanning of bilateral renal excretion phase was performed with 640-slice DVCT, and pump functions of the renal pelvis and part of the upper ureter were calculated and analyzed. No obstruction, acute obstruction of the lower part of the left ureter. Pump functions of the renal pelvis and part of the upper ureter. Results: Results showed after LUUT fistulostomy, the time difference between the average UUTs volume and positive volume value increased gradually, and the calculated flow velocity decreased, which was significantly different from that of the RUUT. The volume difference of the LUUT increased significantly in mild obstruction. In the bilateral control, the volume change rate of the LUUT increased in mild obstruction and decreased in severe obstruction, and there was significant difference between the left and the right side. Conclusion: The continuous dynamic volume scan and measurement of 640-slice DVCT can obtain five pump function data of UUT in pigs with acute lower ureteral obstruction.
COVID-19 – Protocol for Observational Studies Utilising Near Real-Time Electronic Australian General Practice Data to Promote Effective Care and Best-Practice Policy – A Design Thinking Approach
Authors: Georgiou Andrew , Li Julie , Pearce Christopher , McLeod Adam , Wabe Nasir , Hardie Rae-Anne , Franco Guilherme Saffi , Imai Chisato , Sezgin Gorkem , Thomas Judith , Dai Zhaoli , Sheikh Muhammad Kashif , Proposch Amanda , Weeding Stephen , Wickham Brendon , Badrick Tony , Murgatroyd Darnel 
Published: January 2021

Abstract
Background: Health systems around the world have been forced to make choices about how to prioritise care, manage infection control and maintain reserve capacity for future disease outbreaks. Primary health care has moved into the frontline as COVID-19 testing transitions from hospitals to multiple providers, where tracking testing behaviours can be fragmented and delayed. Pooled general practice data are a valuable resource which can be used to inform population and individual care decision-making. This project aims to utilise near real-time electronic general practice data to promote effective care and best-practice policy. Methods: The project will utilise a design thinking approach involving all collaborators (Primary Health Networks [PHNs], general practices, consumer groups, researchers, and digital health developers, pathology professionals) to enhance the development of meaningful and translational project outcomes. The project will be based on a series of observational studies utilising near real-time electronic general practice data from a secure and comprehensive digital health platform [POpulation Level Analysis and Reporting (POLAR) general practice data warehouse]. The study will be carried out over 1.5 years (July 2020 – December 2021) using data from over 350 general practices within three Victorian Primary Health Networks (PHNs) and Gippsland PHN, Eastern Melbourne PHN and South Eastern Melbourne PHN, supplemented by data from consenting general practices from two PHNs in New South Wales, Central and Eastern Sydney PHN and South Western Sydney PHN. Discussion: Developed using a design thinking approach, this project will deliver: 1) A near real-time geo-spatial reporting framework at community, state and nation-wide levels to identify emerging trends and monitor the impact of interventions/policy decisions. 2) Timely evidence about the impact of the COVID-19 pandemic related to its diagnosis, treatment and medications prescribed and its impact on patients. 3) A predictive geo-spatial analytics dashboard for timely, evidence-based decision-making at community, state and nation-wide levels. 4) An evidence-based suite of general practice outcome measures to monitor incidence, prevalence, recovery and mortality in response to the COVID-19 pandemic.
The Case Selection for Vaginal Cuff Brachytherapy in Cervical Cancer Patients after Radical Hysterectomy and External Beam Radiation Therapy
Authors: LAI Ying-Lu , JIN Ye-Ning , WANG Xi , QI Wei-Xiang , CAI Rong , Xu Hao-Ping 
Published: January 2021

Abstract
ObjectiveTo Explore the suitable cases for vaginal cuff brachytherapy(VCB) combined with external beam radiation therapy(EBRT) in the postoperative treatment of cervical cancer. MethodsWe retrospectively analyzed the clinical data of 214 postoperative cervical cancer patients who received radiotherapy from January 2008 to December 2015. Among them, 146 patients received postoperative EBRT, 68 received EBRT plus VCB. There was no statistical difference in clinical and pathological characteristics between these two groups. Those who with negative vaginal cuff underwent supplemented 12-18Gy/2-3Fx VCB. Survival analyses were performed using Kaplan-Meier method, and Cox model was used to analyze prognostic factors. ResultsThe median follow-up was 52 months (9-136 months), and 4-year RFS (recurrence-free survival) was 77%. Among them, 58 patients had local or distant recurrences, 29 in pelvic, 8 with metastases to para-aortic or inguinal lymph nodes, 17 with distant metastases and 4 with both local and distant recurrences. The postoperative brachytherapy boost did not improve RFS or OS (overall survival) among the investigated subjects, P=0.77, P=0.99, respectively. Neither it decreased the local relapse in the pelvis or vaginal cuff, P=0.56, P=0.59. Subgroup analyses showed that brachytherapy boost improved RFS in patients who had bulky mass (>4cm) as well as 1) with deep stromal invasion (>50% stromal invasion), P=0.012 or 2) received low EBRT dose (≤ 45Gy), P=0.033, and in patients with deep stromal invasion as well as received low EBRT dose (P=0.018). ConclusionsWe first proposed the case selection model for postoperative EBRT plus VCB. Brachytherapy boost were considered in the setting of postoperative radiotherapy if the patients had at least 2 out of these following factors: bulky mass, deep stromal invasion and low EBRT dose.
Hippocampal CA3 Transcriptional Modules Associated with Granule Cell Alterations and Cognitive Impairment in Refractory Mesial Temporal Lobe Epilepsy Patients
Authors: Bando Silvia , Bertonha Fernanda , Pimentel-Silva Luciana , Oliveira João Mansano de , Carneiro Marco Duarte , Oku Mariana Manoel , Wen Hung-Tzu , Castro Luiz Martins , Moreira-Filho Carlos 
Published: January 2021

Abstract
In about a third of the patients with epilepsy the seizures are not drug-controlled. The current limitation of the antiepileptic drug therapy derives from an insufficient understanding of epilepsy pathophysiology. In order to overcome this situation, it is necessary to consider epilepsy as a disturbed network of interactions, instead of just looking for changes in single molecular components. Here, we studied CA3 transcriptional signatures and dentate gyrus histopathologic alterations in hippocampal explants surgically obtained from 57 RMTLE patients submitted to corticoamygdalohippocampectomy. By adopting a systems biology approach, integrating clinical, histopathological, and transcriptomic data (weighted gene co-expression network analysis), we were able to identify transcriptional modules highly correlated with age of disease onset, cognitive dysfunctions, and granule cell alterations. The enrichment analysis of transcriptional modules and the functional characterization of the highly connected genes in each trait-correlated module allowed us to unveil the modules’ main biological functions, paving the way for further investigations on their roles in RMTLE pathophysiology. Moreover, we found 15 genes with high gene significance values which have the potential to become novel biomarkers and/or therapeutic targets in RMTLE.
Inhibition of Stromal Biglycan Promotes Normalization of the Tumor Microenvironment and Enhances Chemotherapeutic Efficacy
Authors: Cong Li , Maishi Nako , Annan Dorcas A , Young Marian F. , Morimoto Hirofumi , Morimoto Masahiro , Nam Jin-Min , Hida Yasuhiro , Hida Kyoko 
Published: January 2021

Abstract
BackgroundBiglycan is a proteoglycan found in the extracellular matrix. We have previously shown that biglycan is secreted from tumor endothelial cells and induces tumor angiogenesis and metastasis. However, the function of stroma biglycan in breast cancer is still unclear. MethodsBiglycan gene analysis and its prognostic values in human breast cancers were based on TCGA data. E0771 breast cancer cells were injected into WT and Bgn KO mice, respectively. ResultsBreast cancer patients with high biglycan expression had worse distant metastasis-free survival. Furthermore, biglycan expression was higher in the tumor stromal compartment compared to the epithelial compartment. Knockout of biglycan in the stroma (Bgn KO) in E0771 tumor-bearing mice inhibited metastasis to the lung. Bgn KO also impaired tumor angiogenesis and normalized tumor vasculature by repressing tumor necrosis factor-ɑ/angiopoietin 2 signaling. Moreover, fibrosis was suppressed and CD8+ T-cell infiltration was increased in tumor-bearing Bgn KO mice. Furthermore, chemotherapy drug delivery and efficacy were improved in vivo in Bgn KO mice. ConclusionOur results suggest that targeting stromal biglycan may yield a potent and superior anti-cancer effect in breast cancer.