bluuebunny/crossref_metadata_2025_split huggingface dataset:
NCCBM, a Nomogram Prognostic Model in Breast Cancer Patients With Brain Metastasis
Authors: Liu Qiang , Kong Xiangyi , Wang Zhongzhao , Wang Xiangyu , Zhang Wenxiang , Ai Bolun , Gao Ran , Fang Yi , Wang Jing 
Published: April 2021

Purpose: Nomogram prognostic models could greatly facilitate risk stratification and treatment strategies for cancer patients. We developed and validated a new nomogram prognostic model, named NCCBM, for breast cancer patients with brain metastasis (BCBM) using a large BCBM cohort from the SEER (Surveillance, Epidemiology, and End Results) database.Patients and Methods: Clinical data for 975 patients diagnosed from 2011 to 2014 were used to develop the nomogram prognostic model. The predictive accuracy and discriminative ability of the nomogram were determined by concordance index (C-index) and calibration curve. The results were validated using an independent cohort of 542 BCBM patients diagnosed from 2014 to 2015.Results: The following variables were selected in the final prognostic model: age, race, surgery, radiation therapy, chemotherapy, laterality, grade, molecular subtype, and extracranial metastatic sites. The C-index for the model described here was 0.69 (95% CI, 0.67 to 0.71). The calibration curve for probability of survival showed good agreement between prediction by nomogram and actual observation. The model was validated in an independent validation cohort with a C-index of 0.70 (95% CI, 0.68 to 0.73).Conclusion: We developed and validated a nomogram prognostic model for BCBM patients, and the proposed nomogram resulted in good performance.
Clinical Relevance of Tubular Breast Carcinoma: Large Retrospective Study and Meta-Analysis
Authors: Metovic Jasna , Bragoni Alberto , Osella-Abate Simona , Borella Fulvio , Benedetto Chiara , Gualano Maria Rosaria , Olivero Elena , Scaioli Giacomo , Siliquini Roberta , Ferrando Pietro Maria , Bertero Luca , Sapino Anna , Cassoni Paola , Castellano Isabella 
Published: April 2021

Background:Tubular carcinoma (TC) is a low proliferative grade 1 (G1) breast cancer (BC). Despite its favorable outcome and allegedly lower aggressiveness, patients are treated like other luminal G1 BC, with radiotherapy (RT) and hormonal therapy (HT). We performed: (1) a retrospective study comparing a TC cohort and a control series of luminal G1 BC and (2) a systematic review and meta-analysis focused on TC outcome.Materials and Methods:We selected a series of 572 G1 luminal BC patients [111 TC, 350 not otherwise specified (NOS), and 111 special-type (ST) BC] with follow-up and clinico-pathological data, who underwent local excision followed by RT at Città della Salute e della Scienza Hospital, Turin. Moreover, 22 and 13 studies were included in qualitative and quantitative meta-analysis, respectively.Results:TCs were generally smaller (≤10 mm) (P&lt; 0.001), with lower lymph node involvement (P&lt; 0.001). TCs showed no local and/or distant recurrences, while 16 NOS and 2 ST relapsed (P= 0.036). Kaplan–Meier curves confirmed more favorable TC outcome (DFI: log-rank testP= 0.03). Meta-analysis data, including the results of our study, showed that the pooled DFI rate was 96.4 and 91.8% at 5 and 10 years, respectively. Meta-regression analyses did not show a significant influence of RT nor HT on the DFI at 10 years.Conclusions:Compared to the other G1 BCs, TCs have an excellent outcome. The meta-analysis shows that TC recurrences are infrequent, and HT and RT have limited influence on prognosis. Hence, accurate diagnosis of TC subtype is critical to ensuring a tailored treatment approach.
Image-Guided Robotic Radiosurgery for the Management of Spinal Ependymomas
Authors: Ehret Felix , Kufeld Markus , Fürweger Christoph , Haidenberger Alfred , Windisch Paul , Senger Carolin , Kord Melina , Träger Malte , Kaul David , Schichor Christian , Tonn Jörg-Christian , Muacevic Alexander 
Published: April 2021

BackgroundEpendymomas are rare neoplasms of the central nervous system (CNS), usually localized intracranially and most commonly diagnosed in children. Spinal ependymomas are more frequent in young adults. They are either primary lesions or manifest as disseminated seeding of cranial tumors. Data on the management of spinal ependymoma lesions remain scarce, especially concerning stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT). The purpose of this study is to report the treatment outcomes of two institutions using robotic radiosurgery (RRS) for the treatment of spinal ependymomas.Materials and MethodsAll patients with a histopathologically confirmed diagnosis of an ependymoma WHO grade II or III who were treated with RRS for one or more spinal lesions were included in this analysis.ResultsTwelve patients underwent RRS for the treatment of 32 spinal ependymoma lesions between 2005 and 2020. Two patients were below the age of 18 when treated, whereas nine patients (75%) suffered from a primary spinal ependymoma. The median dose was 15 Gy prescribed to a median isodose of 70%, with 27 lesions (84%) receiving a single-session treatment. The local control (LC) after a median follow-up of 56.7 months was 84%. LC rates at 1, 3, and 5 years were 92, 85, and 77%, respectively. The Kaplan-Meier estimated overall survival after 1, 3, and 5 years were 75, 75, and 64%, respectively. Five patients died, all of them suffering from an anaplastic ependymoma, with widespread CNS tumor progression being the reason for death in four patients. The majority of patients (58%) showed a stable neurological status at the last available follow-up. Overall, the treatment was well tolerated.ConclusionRRS appears to be a safe and efficient treatment modality for managing primary and secondary spinal ependymal tumors in patients with multiple lesions and local recurrences.
Clinical Characterization of Anti-GQ1b Antibody Syndrome in Childhood
Authors: Cai Lianhong , Hu Zhanqi , Liao Jianxiang , Hong Siqi , Kong Lingyu , Chen Li , Luo Yetao , Li Tingsong , Jiang Li 
Published: April 2021

Objective: To delineate the comprehensive clinical features of anti-GQ1b antibody syndrome in childhood.Methods: The clinical data of children diagnosed with anti-GQ1b antibody syndrome at two Chinese tertiary pediatric neurology centers were collected and analyzed. We also conducted a systematic literature review on anti-GQ1b antibody syndrome in children.Results: This study included 78 children with anti-GQ1b antibody syndrome, consisting of 12 previously unreported cases from the two Chinese centers. The median onset age was 10 years (range, 2–18 years). The most common phenotype was acute ophthalmoparesis (32%), followed by classic Miller Fisher syndrome (15%), and Bickerstaff brainstem encephalitis (12%). External ophthalmoplegia (48%), sensory disturbance (9%), and bulbar palsy (9%) were the three most frequent onset symptom manifestations. Brain or spinal lesions on MRI and abnormal recordings by nerve conduction study were present in 18% (12/68) and 60% (27/45) of cases, respectively. There was CSF albuminocytologic dissociation in 34% of the patients (23/68). IV immunoglobulin alone or combined with steroids or plasma exchange was administered to 58% of patients (42/72). We did not find a significant correlation between early improvement up to 3 months and age onset and phenotype. All patients showed different degrees of recovery, and 81% (57/70) had complete recovery within 1 year.Conclusions: Acute ophthalmoparesis and classic Miller Fisher syndrome are the most common phenotypes of anti-GQ1b antibody syndrome in childhood. The majority of patients show good response to immunotherapy and have favorable prognosis.
Effect of Huang-Lian Jie-Du Decoction on Glucose and Lipid Metabolism in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis
Authors: Hu Zhipeng , Yang Maoyi , Liu Ya , Yang Qiyue , Xie Hongyan , Peng Sihan , Gao Juan , Xie Chunguang 
Published: April 2021

Background: Type 2 diabetes mellitus (T2DM) is a heterogeneous disease characterized by persistent hyperglycemia. Huang-Lian Jie-Du decoction (HLJDD) is a traditional Chinese medicine formula which is widely used in treating T2DM in China. A thorough understanding of current body of evidence is needed.Objective: this study aims to summarize the clinical evidence of HLJDD for T2DM to provide an up-to-date and accurate understanding of this issue for research and clinical practice.Methods: Six databases were searched from inception to June 27, 2020 without language and publication status restrictions and randomized controlled trials about HLJDD on T2DM were included. Two evaluators searched and screened citations independently. Risk of bias was assessed by 2019 version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB2). Risk ratio (RR) with 95% confidence interval (CI) was used as an effect measure for dichotomous outcomes and mean difference (MD) with 95% CI was used for continuous outcomes. Subgroup analyses and sensitivity analyses were carried out.Results: Nine studies including 811 participants were included in this study. The overall risk of bias was high risk. Compared with metformin alone, combination treatment of HLJDD and metformin may result in a reduction in HbA1c, FBG, 2hPG, HOMA-IR and an improved lipid metabolism. Evidence comparing HLJDD and metformin or no intervention or placebo was insufficient. The quality of evidence was low.Conclusions: Current evidence about HLJDD on T2DM is still uncertain and more high-quality studies are needed to firmly establish the clinical efficacy and safety of HLJJD.
An Evaluation of the Rabies Surveillance in Southern Vietnam
Authors: Pham Quang Duy , Phan Lan Trong , Nguyen Thuy Phuong Thi , Doan Quan Minh Ngoc , Nguyen Hai Duc , Luong Quang Chan , Nguyen Thuong Vu 
Published: April 2021

Introduction: Rabies is endemic in Vietnam and has been a statutory notifiable infectious disease since 1998. We, herein, assessed the performance of rabies surveillance in Southern Vietnam and identified areas for improvement.Materials and Methods: We analyzed data on human rabies cases reported during 1991–2018. We adapted guidelines from the U.S. Centers for Disease Control and Prevention to evaluate attributes of surveillance. Between June and November 2018, we interviewed a total of 145 staff from hospitals, preventive medicine centers, and animal health offices at provincial and district levels in five southern provinces.Results: Between 2009 and 2018, an average of nine cases of human rabies (range: 4–20 cases) was reported annually in Southern Vietnam, representing an incidence of 2.7 cases per 10 million population. The highest incidence was observed in 2018 (5.5 cases per 10 million population). Survey data suggested that only 24% (13/53) of participants agreed that the monthly report template was easy to complete and that 42% (23/55) indicated that the change from the paper-based to the electronic case notification systems was easy. Only 7% (2/29) of human rabies cases were reported timely, and 65% (13/20) successfully collected specimens. Approximately 39% (56/144) of staff were aware of turning surveillance data into prevention activities, and 21% (31/145) witnessed data used for strategic program decision making.Conclusions: Although rabies surveillance was quite simple, flexible, and accepted in southern Vietnam, simplifying the report forms, training staff, and improving the timeliness of reporting and data usage are highly recommended for a better implementation of rabies surveillance.
Determinants of Confidence in Overall Knowledge About COVID-19 Among Healthcare Workers in South Africa: Results From an Online Survey
Authors: Manyaapelo Thabang , Mokhele Tholang , Sifunda Sibusiso , Ndlovu Philisiwe , Dukhi Natisha , Sewpaul Ronel , Naidoo Inbarani , Jooste Sean , Tlou Boikhutso , Moshabela Mosa , Mabaso Musawenkosi , Zuma Khangelani , Reddy Priscilla 
Published: April 2021

Background: Adequate information and knowledge about COVID-19 has been shown to induce the confidence and positive performance among healthcare workers (HCWs). Therefore, assessing the relationship between confidence in knowledge and associated factors among HCWs is vital in the fight against COVID-19. This paper investigates factors associated with HCWs' confidence in their overall knowledge about COVID-19 in South Africa in the early stages of the epidemic.Methods: Data utilized in this paper were from an online survey conducted among HCWs using a structured questionnaire on a data free online platform. The study population were all the medical fraternity in South Africa including medical and nurse practitioners as well as other healthcare professionals. Bivariate and multivariate logistic regression models were performed to examine the factors associated with confidence in HCWs' overall knowledge about COVID-19.Results: Overall, just below half (47.4%) of respondents indicated that they had confidence in their overall knowledge about COVID-19. Increased odds of having confidence in the knowledge about COVID-19 were significantly associated with being male [aOR = 1.31 95% CI (1.03–1.65), p &lt; 0.05], having a doctorate degree [aOR = 2.01 (1.23–3.28), p &lt; 0.05], being satisfied with the information about COVID-19 guidelines [aOR = 6.01 (4.89–7.39), p &lt; 0.001], having received training in 6–8 areas [aOR = 2.54 (1.89–3.43), p &lt; 0.001] and having received training in 9–11 areas [aOR = 5.33 (3.81–7.47), p &lt; 0.001], and having already treated COVID-19 patients [aOR = 1.43 (1.08–1.90), p &lt; 0.001]. Those who were highly concerned with the levels of training of HCWs [aOR = 0.47 (0.24–0.92), p &lt; 0.05] had decreased odds of having confidence in their overall knowledge about COVID-19.Conclusion: This study sheds light on the importance of capacitating HCWs with knowledge and adequate relevant training as part of infection prevention control measures during pandemics. Future training and information sharing should be sensitive to knowledge gaps by age, gender, qualifications, professional categories, and experience.
Importance of Work-Related Psychosocial Factors in Exertion Perception Using the Borg Scale Among Workers Subjected to Heavy Physical Work
Authors: Sala Emma , Lopomo Nicola Francesco , Tomasi Cesare , Romagnoli Francesco , Morotti Alberto , Apostoli Pietro , De Palma Giuseppe 
Published: April 2021

Objective: This study aimed to analyse the role of several environmental and time variables, as well as individual and psychosocial factors, on the perception of exertion, expressed by using the Borg scale, on logistics workers performing heavy manual tasks.Materials and Methods: We enrolled 56 subjects working in logistics sector that were interviewed on the perceived exertion required to execute a task of manual lifting of heavy loads, by using the Borg scale. The interviews were carried out during different shifts, at different times during the shifts and during several different months of the year. We also assessed the workers' anthropometric characteristics, length of service, any musculoskeletal diseases, and physical activity outside work. Workers were also interviewed using the structured OREGE questionnaire, in order to evaluate the main symptoms of stress and work-related psychosocial risk factors.Results: Overall, the subjective perception of the strength exerted by the workers exposed to a high risk of manual handling of loads was moderate. The rating attributed using the Borg scale showed no correlation with any of the investigated variables. 100% of the workers denied to suffer from symptoms of stress, whereas in terms of psychosocial factors, the workload was globally perceived as positive.Conclusion: The study results support the hypothesis that optimal work conditions—from a psychosocial point of view—reduce the subjective perception of exertion by workers even if exposed to a high risk of biomechanical overload.
A Nomogram to Predict Long-Term Survival Outcomes of Patients Who Undergo Pneumonectomy for Non-small Cell Lung Cancer With Stage I-IIIB
Authors: Wu Lei-Lei , Chen Wu-Tao , Liu Xuan , Jiang Wen-Mei , Huang Yang-Yu , Lin Peng , Long Hao , Zhang Lan-Jun , Ma Guo-Wei 
Published: April 2021

Background: In this study, we aim to establish a nomogram to predict the prognosis of non-small cell lung cancer (NSCLC) patients with stage I-IIIB disease after pneumonectomy.Methods: Patients selected from the Surveillance, Epidemiology, and End Results (SEER, N = 2,373) database were divided into two cohorts, namely a training cohort (SEER-T, N = 1,196) and an internal validation cohort (SEER-V, N = 1,177). Two cohorts were dichotomized into low- and high-risk subgroups by the optimal risk prognostic score (PS). The model was validated by indices of concordance (C-index) and calibration plots. Kaplan-Meier analysis and the log-rank tests were used to compare survival curves between the groups. The primary observational endpoint was cancer-specific survival (CSS).Results: The nomogram comprised six factors as independent prognostic indictors; it significantly distinguished between low- and high-risk groups (all P &lt; 0.05). The unadjusted 5-year CSS rates of high-risk and low-risk groups were 33 and 60% (SEER-T), 34 and 55% (SEER-V), respectively; the C-index of this nomogram in predicting CSS was higher than that in the 8th TNM staging system (SEER-T, 0.629 vs. 0.584, P &lt; 0.001; SEER-V, 0.609 vs. 0.576, P &lt; 0.001). In addition, the PS might be a significant negative indictor on CSS of patients with white patients [unadjusted hazard ration (HR) 1.008, P &lt; 0.001], black patients (unadjusted HR 1.007, P &lt; 0.001), and Asian or Pacific Islander (unadjusted HR 1.008, P = 0.008). In cases with squamous cell carcinoma (unadjusted HR 1.008, P &lt; 0.001) or adenocarcinoma (unadjusted HR 1.008, P &lt; 0.001), PS also might be a significant risk factor.Conclusions: For post-pneumonectomy NSCLC patients, the nomogram may predict their survival with acceptable accuracy and further distinguish high-risk patients from low-risk patients.
Proceso de análisis de riesgos en proyectos de mantenimiento naval
Authors: Becerra Adolfo 
Published: April 2021

El objetivo principal de esta investigación fue describir el proceso de análisis de riesgos en proyectos de mantenimiento naval. La estrategia metodológica de la investigación corresponde a un estudio fue descriptivo, con un diseño, no experimental, de campo y transeccional, para la cual se seleccionó una población de 30 sujetos informantes, conformado por gerentes, líderes y supervisores pertenecientes a los proyectos de mantenimiento naval de la industria petrolera. Los principales resultados indican que no se analizan eventos que podrían afectar el cumplimiento de los objetivos, debido a la ausencia de técnicas de identificación del riesgo que pueden afectar los proyectos de mantenimiento. Aunado a lo anterior, no se utilizan métodos para identificar eventos específicos.
Aprendizaje Basado en Problemas como estrategia para la enseñanza de la Historia del Ecuador
Authors: Heras-Luna María Verónica , Garcia-Herrera Darwin Gabriel , Cabrera-Berrezueta Luis Bolívar , Erazo-Álvarez Juan Carlos 
Published: April 2021

El objetivo principal de esta investigación es determinar la efectividad del aprendizaje basado en problemas como estrategia para la enseñanza de la historia del Ecuador. De tipo explicativa con diseño cuasi experimental de un grupo, aplicandose el tratamiento durante un período de tiempo especifico. Las pruebas de chi cuadro (0.059), indican que existen diferencias entre las variables del pre y del postest. Se evidenció que durante esta aplicación de clases basadas en ABP, las percepciones de los estudiantes se enfocaron en que este tipo de metodología les permite ser más responsables y asumir las funciones que tiene dentro de cada grupo. Por ello, el trabajo cooperativo a pesar de manejarlo con una misma temática, genera diferentes soluciones de acuerdo a lo que cada estudiante percibe y analiza en el desarrollo de las clases
Familia y Educación: Estrategias Metodológicas para el fortalecimiento del lenguaje en niños menores de tres años
Authors: Pillcorema-Ludizaca Blanca Emperatriz , García-Herrera Darwin Gabriel , Álvarez-Lozano María Isabel , Erazo-Álvarez Juan Carlos 
Published: April 2021

El objetivo de investigación determinar la efectividad de estrategias metodológicas para el fortalecimiento del lenguaje en niños menores de tres años, las cuales pueden ser abordadas en la familia y escuela como escenarios de socialización de los niños. Se desarrolló mediante investigación tipo descriptiva, la muestra poblacional se conformó por 60 madres de niños entre 12 meses y 3 años de edad. Las familias no conocen estrategias claras para mejorar el lenguaje de sus hijos. El lenguaje en los niños menores de tres años no esta desarrollado de acuardo a los indicadores de desarrollo infantil integral, porque no hay la suficiente estimulación desde casa y se resignan al mucho o poco lenguaje que han adquirido los niños. Las estrategias deben ser aplicadas con la frecuencia y disciplina correspondiente para que los resultados sean optimos y efectivos.
Flipped classroom y Educación para el emprendimiento durante la pandemia por COVID-19
Authors: Argandoña-Mendoza María Fernanda , García-Vera Carlos Enrique , Vallejo-Valdivieso Patricio Alfredo 
Published: April 2021

El objetivo se centró en analizar el flipped classroom y la educación para el emprendimiento durante pandemia por COVID-19 en contexto del Ecuador. Se desarrolló desde el método analítico, mediante un tipo de investigación descriptiva documental con diseño bibliográfico. Las categorías centrales del flipped classroom, permiten sintetizar que la mayor responsabilidad de generación del aprendizaje se focaliza en el estudiante, siendo el rol del docente el de asesor en procura de encaminar al estudiante a la construcción de su conocimiento. Las categorías centrales del emprendimiento educativo, develan primordialmente que la tendencia curricular se focaliza en lo holístico y multidisciplinar. El flipped classroom y el emprendimiento educativo se relacionan en cuanto tienen como eje fundamental el aprendizaje activo con la finalidad de conocer el contexto de actuación, mediante la investigación y generación de competencias – tanto habilidades cognitivas y no cognitivas.