bluuebunny/crossref_metadata_2025_split huggingface dataset:
IGFBP7 and GDF-15, but not P1NP, are associated with cardiac alterations and 10-year outcome in an elderly community-based study
Authors: Meessen Jennifer M. T. A. , Cesaroni Giulia , Mureddu Gian F. , Boccanelli Alessandro , Wienhues-Thelen Ursula-Henrike , Kastner Peter , Ojeda-Fernandez Luisa , Novelli Deborah , Bazzoni Gianfranco , Mangiavacchi Maurizio , Agabiti Nera , Masson Serge , Staszewsky Lidia , Latini Roberto ,   on behalf of the PREDICTOR Investigators
Published: July 2021

AbstractBackgroundLittle is known about the clinical value of Insulin-like growth factor-binding protein-7 (IGFBP7), a cellular senescence marker, in an elderly general population with multiple co-morbidities and high prevalence of asymptomatic cardiovascular ventricular dysfunction. Inflammation and fibrosis are hallmarks of cardiac aging and remodelling. Therefore, we assessed the clinical performance of IGFBP7 and two other biomarkers reflecting these pathogenic pathways, the growth differentiation factor-15 (GFD-15) and amino-terminal propeptide of type I procollagen (P1NP), for their association with cardiac phenotypes and outcomes in the PREDICTOR study.Methods2001 community-dwelling subjects aged 65–84 years who had undergone centrally-read echocardiography, were selected through administrative registries. Atrial fibrillation (AF) and 4 echocardiographic patterns were assessed: E/e’ (> 8), enlarged left atrial area, left ventricular hypertrophy (LVH) and reduced midwall circumference shortening (MFS). All-cause and cardiovascular mortality and hospitalization were recorded over a median follow-up of 10.6 years.ResultsIGFBP7 and GDF-15, but not P1NP, were independently associated with prevalent AF and echocardiographic variables after adjusting for age and sex. After adjustment for clinical risk factors and cardiac patterns or NT-proBNP and hsTnT, both IGFBP7 and GDF-15 independently predicted all-cause mortality, hazard ratios 2.13[1.08–4.22] and 2.03[1.62–2.56] per unit increase of Ln-transformed markers, respectively.ConclusionsIn a community-based elderly cohort,IGFBP7 and GDF-15 appear associated to cardiac alterations as well as to 10-year risk of all-cause mortality.
Psychometric properties of modified MOS social support survey 5-item (MSSS-5-item) among Iranian older adults
Authors: Bakhshandeh Bavarsad Maryam , Foroughan Mahshid , Zanjari Nasibeh , Jorjoran Shushtari Zahra , Ghaedamini Harouni Gholamreza 
Published: July 2021

Abstract
Background
Social support is a key factor in public health. Since the precise evaluation of it is critical, the current study has been developed to evaluate the psychometric properties of the MOS-SSS questionnaire’s abbreviated form (MSSS-5-item) among the Iranian older adults.

Methods
This cross-sectional and methodological study was conducted on 420 community older adults (age ≥ 60) through random multi-stage sampling. The questionnaire was first translated into Persian through the Forward & Backward method based on WHO guidelines. Next, the validity of scales was investigated by calculating face validity, content validity, Known-group validity, explanatory factor analysis, and confirmatory factor analysis indices. The reliability of the questionnaire was calculated by internal consistency, test-retest, and absolute reliability. Moreover, the scalability of the questionnaire was checked through the Mokken scale analysis. The software packages SPSS version 22, AMOS version 22, and R (Mokken package) were employed to analyze the data.

Results
the face validity was conducted using interviews with older adults and gathering the specialists’ opinions. Then, the items were grammatically and lexically corrected accordingly. The CVI index of the overall scale was 0.94, and for every single item above 0.89. The results of the independent t-test showed that the current questionnaire well distinguished between the older adults who do and do not feel lonely (p < 0.001). Two components were recognized according to the explanatory factor analysis. They together explained 67.78% of the total variance of the questionnaire. The CFA showed that the two-factor model had acceptable fit indices. The questionnaire had desirable internal consistency (α = 0.78), stability (ICC = 0.98), and absolute reliability (SEM = 0.56, MDC = 1.57). Furthermore, the Mokken scale proved that MSSS-5-item was a strong scale (H = 0.51, se = 0.03).

Conclusion
The present study results showed that the MSSS-5-item questionnaire had suitable validity and reliability to be used among Iranian older adults.
Process evaluation of a tailored intervention to Reduce Inappropriate psychotropic Drug use in nursing home residents with dementia
Authors: Groot Kormelinck Claudia M. , van Teunenbroek Charlotte F. , Zuidema Sytse U. , Smalbrugge Martin , Gerritsen Debby L. 
Published: July 2021

Abstract
Background
Research suggests that collaborative and tailored approaches with external expertise are important to process implementations. We therefore performed a process evaluation of an intervention using participatory action research, tailored information provision, and external coaching to reduce inappropriate psychotropic drug use among nursing home residents with dementia. The process evaluation was conducted alongside a randomized controlled trial assessing the utility of this approach.

Methods
We used Leontjevas’ model of process evaluation to guide data collection and analysis, focusing on the relevance and feasibility, extent of performance, and barriers and facilitators to implementation. Data on the relevance and feasibility and on the extent of performance were collected using a questionnaire targeting internal project leaders at nursing homes and our external coaches. Implementation barriers and facilitators were identified by individual semi-structured interviews. The Consolidated Framework for Implementation Research was used to structure and describe the identified barriers and facilitators.

Results
The intervention was viewed positively, but it was also considered time consuming due to the involvement of many people and designing a tailored action and implementation plan was viewed as complex. The extent of performance differed between nursing homes. Delays in implementation and suboptimal execution of actions may have reduced effectiveness of the RID intervention in some nursing homes. Barriers to implementation were reorganizations, staff turnover, communication issues, unclear expectations, and perceived time pressures. Implementation also depended on the involvement and skills of key stakeholders, and organizations’ readiness to change. Although external coaches stimulated implementation, their additional value was rated variably across organizations.

Conclusions
Barriers to implementation occurred on several levels and some barriers appear to be inherent to the nursing home environment and could be points of leverage of future implementation trajectories. This underlines the importance of assessing and supporting organizations in their readiness to change. Sensitivity analyses, taking into account the week in which nursing homes started with implementation and the degree to which actions were implemented as intended, will be appropriate in the effect analyses of the trial.
Bloodstream infections in adult patients with malignancy, epidemiology, microbiology, and risk factors associated with mortality and multi-drug resistance
Authors: Amanati Ali , Sajedianfard Sarvin , Khajeh Somayeh , Ghasempour Shabnam , Mehrangiz Salma , Nematolahi Samane , Shahhosein Zahra 
Published: July 2021

Abstract
Background
This study aimed to investigate the epidemiology, microbiology, and risk factors associated with mortality and multi-drug resistance bacterial bloodstream infections (BSIs) among adult cancer patients in Shiraz, Iran. We also report a four-year trend of antimicrobial resistance patterns of BSIs.

Methods
We conducted a retrospective study at a referral oncology hospital from July 2015 to August 2019, which included all adults with confirmed BSI.

Results
2393 blood cultures tested during the four-year study period; 414 positive cultures were included. The mean age of our patients was 47.57 ± 17.46 years old. Central Line-Associated BSI (CLABSI) was more common in solid tumors than patients with hematological malignancies. Gram-negative (GN) bacteria were more detected (63.3%, 262) than gram-positive bacteria (36.7%, 152). Escherichia coli was the most common gram-negative organism (123/262, 47%), followed by Pseudomonas spp. (82/262, 31%) and Klebsiella pneumoniae (38/262, 14.5%). Coagulase-negative staphylococci (CoNS) was the most frequently isolated pathogen among gram-positive bacteria (83/152, 54.6%). Acinetobacter spp., Pseudomonas spp., E. coli, and K. pneumoniae were the most common Extended-Spectrum Beta-Lactamase (ESBL) producers (100, 96.2, 66.7%, and 60.7, respectively). Acinetobacter spp., Pseudomonas spp., Enterobacter spp., E. coli, and K. pneumoniae were the most common carbapenem-resistant (CR) isolates (77.8, 70.7, 33.3, 24.4, and 13.2%, respectively). Out of 257 Enterobacterales and non-fermenter gram-negative BSIs, 39.3% (101/257) were carbapenem-resistant. Although the incidence of multi-drug resistance (MDR) gram-negative BSI increased annually during 2015–2018, the mortality rate of gram-negative BSI remains unchanged at about 20% (p-value = 0.55); however, the mortality rate was significantly greater (35.4%) in those with resistant gram-positive BSI (p-value = 0.001). The overall mortality rate was 21.5%. Early (7-day mortality) and late mortality rate (30-day mortality) were 10 and 3.4%, respectively.

Conclusions
The emergence of MDR gram-negative BSI is a significant healthcare problem in oncology centers. The high proportion of the most frequently isolated pathogens were CR and ESBL-producing Enterobacterales and Pseudomonas spp. We have few effective choices against MDRGN BSI, especially in high-risk cancer patients, which necessitate newer treatment options.
Comparative cytokine profiling identifies common and unique serum cytokine responses in acute chikungunya and dengue virus infection
Authors: Dhenni Rama , Yohan Benediktus , Alisjahbana Bachti , Lucanus Anton , Riswari Silvita Fitri , Megawati Dewi , Haryanto Sotianingsih , Gampamole Dekrit , Hayati Rahma F. , Sari Kartika , Witari Ni Putu Diah , Myint Khin Saw Aye , Sasmono R. Tedjo 
Published: July 2021

Abstract
Background
Infection by chikungunya (CHIKV) and dengue virus (DENV) can cause a wide spectrum of clinical features, many of which are undifferentiated. Cytokines, which broadly also include chemokines and growth factors, have been shown to play a role in protective immunity as well as DENV and CHIKV pathogenesis. However, differences in cytokine response to both viruses remain poorly understood, especially in patients from countries where both viruses are endemic. Our study is therefore aimed to provide a comparative profiling of cytokine response induced by acute DENV and CHIKV infections in patients with similar disease stages and in experimental in vitro infections.

Methods
By using multiplex immunoassay, we compared host cytokine profiles between acute CHIKV and DENV infections by analysing serum cytokine levels of IL-1α, IL-4, IL-5, IL-8, IL-13, RANTES, MCP-3, eotaxin, PDGF-AB/BB, and FGF-2 from the sera of acute chikungunya and dengue fever patients. We further investigated the cytokine profile responses using experimental in vitro CHIKV and DENV infections of peripheral blood mononuclear cells (PBMCs).

Results
We found that both CHIKV and DENV-infected patients had an upregulated level of IL-8 and IL-4, with the highest IL-4 level observed in DENV-2 infected patients. Higher IL-8 level was also correlated with lower platelet count in dengue patients. IL-13 and MCP-3 downregulation was observed only in chikungunya patients, while conversely PDGF-AB/BB and FGF-2 downregulation was unique in dengue patients. Age-associated differential expression of IL-13, MCP-3, and IL-5 was also observed, while distinct kinetics of IL-4, IL-8, and FGF-2 expression between CHIKV and DENV-infected patients were identified. Furthermore, the unique pattern of IL-8, IL-13 and MCP-3, but not IL-4 expression was also recapitulated using experimental in vitro infection in PBMCs.

Conclusions
Taken together, our study identified common cytokine response profile characterized by upregulation of IL-8 and IL-4 between CHIKV and DENV infection. Downregulation of IL-13 and MCP-3 was identified as a unique cytokine response profile of acute CHIKV infection, while distinct downregulation of PDGF-AB/BB and FGF-2 characterized the response from acute DENV infection. Our study provides an important overview of the host cytokine responses between CHIKV and DENV infection, which is important to further understand the mechanism and pathology of these diseases.
Vitamin D deficiency and visceral adipose tissue in early pregnant women
Authors: Cisneiros Rosangela , Segatto Juliana , Paixão Eloíse , Bacellar Ítalo , Lima Marcelo , Pacheco Álvaro , Alves João Guilherme , Bandeira Francisco 
Published: July 2021

Abstract
Background
We aimed to assess the correlation between vitamin D serum level and visceral fat tissue during early pregnancy.

Methods
This cross-sectional study was performed in Pernambuco, Brazil. 190 low risk pregnant women (8–16 gestational weeks) were eligible. Visceral adipose tissue was measured by ultrasonography following the technique described by Armellini. The 25(OH) D in serum was determined through chemiluminescence. The Spearman correlation test was applied to evaluate the correlation between vitamin D serum level and VAT, considering p < 0.05 to be significant.

Results
Vitamin D insufficiency was present in 129 (67.8 %) of subjects. Pregnant women with or without vitamin D deficiency did not differ in age, gestational age, nutritional status and visceral adipose tissue. No correlation between visceral adipose tissue and 25(OH) D was observed: − 0.057 (p = 0.435).

Conclusions
Maternal visceral adipose tissue and vitamin D serum level are not correlated during pregnancy.
The effectiveness of a Pilates exercise program during pregnancy on childbirth outcomes: a randomised controlled clinical trial
Authors: Ghandali Nasim Yousefi , Iravani Mina , Habibi Abdolhamid , Cheraghian Bahman 
Published: July 2021

Abstract
Background
Performing exercise with medium intensity has positive effects on the maternal health. The aim of this study was to investigate the effectiveness of Pilates exercise program during pregnancy on childbirth outcomes:

Methods
This clinical trial study was performed on 110 primiparous women who were randomly divided into two groups of intervention (n = 55) and control (n = 55). The intervention group performed Pilates exercises from 26 to 28 weeks of gestation for 8 weeks while the control group did not do any exercise. Data collection tools included Visual Analog Scale (VAS), Mackey Childbirth Satisfaction Rating Scale, and a checklist including demographic and obstetrics information.

Results
The results of the study showed that Pilates exercise during pregnancy significantly reduces the labor pain intensity, length of the active phase and second stage of labor and increases maternal satisfaction of the labor process (p < 0.05). Based on the Kaplan Meyer analysis, the mean whole length of labor was shorter in Pilates exercise group than in the control group (P = .004). There was no statistically significant difference between the two groups in terms of Episiotomy, type of delivery, first and fifth Apgar score of neonates (p > 0.05).

Conclusion
According to the results of this study, Pilates exercise during pregnancy improved the labor process and increased maternal satisfaction of chidbirthprocess, without causing complications for the mother and baby. However, studies with larger sample sizes are recommended to prove the efficacy and safty of this practiceduring labor.

Trial registration
IRCT registration number:IRCT20200126046266N1. Registration date: 2020-05-02 (retrospectively registered).
Efficacy of perioperative chemotherapy for synovial sarcoma: a retrospective analysis of a Nationwide database in Japan
Authors: Xu Gang , Aiba Hisaki , Yamamoto Norio , Hayashi Katsuhiro , Takeuchi Akihiko , Miwa Shinji , Higuchi Takashi , Abe Kensaku , Taniguchi Yuta , Araki Yoshihiro , Saito Shiro , Yoshimura Kenichi , Murakami Hideki , Tsuchiya Hiroyuki , Kawai Akira 
Published: July 2021

Abstract
Background
Synovial sarcoma is an aggressive but chemosensitive soft-tissue tumor. We retrospectively analyzed the efficacy of perioperative chemotherapy for synovial sarcoma with data from the nationwide database, Bone and Soft Tissue Tumor Registry in Japan.

Methods
This study included 316 patients diagnosed with synovial sarcoma between 2006 and 2012. Oncologic outcomes were analyzed using a Cox-hazard regression model. Moreover, the effects of perioperative chemotherapy on outcomes were evaluated using a matched-pair analysis. The oncologic outcomes of patients who did or did not receive chemotherapy were compared (cx + and cx-).

Results
Multivariate analysis revealed significant correlations of age (over 40, hazard ratio [HR] = 0.61, p = 0.043), margin status (marginal resection, HR = 0.18, p < 0.001 and intralesional resection, HR = 0.30, p = 0.013 versus wide resection) with overall survival; surgical margin type (marginal resection, HR = 0.14, p = 0.001 and intralesional resection, HR = 0.09, p = 0.035 versus wide resection) with local recurrence; and postoperative local recurrence (HR = 0.30, p = 0.027) and surgical margin (marginal resection, HR = 0.31, p = 0.023 versus wide resection) with distant relapse-free survival.
Before propensity score matching, perioperative chemotherapy was mainly administered for young patients and patients with deeper tumor locations, larger tumors, more advanced-stage disease, and trunk location. The 3-year overall survival, local control, and distant relapse-free survival rates were 79.8%/89.3% (HR = 0.64, p = 0.114), 89.6%/93.0% (HR = 0.37, p = 0.171) and 71.4%/84.5% (HR = 0.60, p = 0.089) in the cx+/cx- groups, respectively. After propensity score matching, 152 patients were selected such that the patient demographics were nearly identical in both groups. The 3-year overall survival, local control, and distant relapse-free survival rates were 71.5%/86.0% (HR = 0.48, p = 0.055), 92.5%/93.3% (HR = 0.51, p = 0.436) and 68.4%/83.9% (HR = 0.47, p = 0.046) in the cx+/cx- groups, respectively.

Conclusion
This large-sample study indicated that the margin status and postoperative disease control were associated directly or indirectly with improved oncologic outcomes. However, the efficacy of perioperative chemotherapy for survival outcomes in synovial sarcoma patients was not proven in this Japanese database analysis.
Prediction of early vascular cement leakage following percutaneous vertebroplasty in spine metastases: the Peking University First Hospital Score (PUFHS)
Authors: Shi Xuedong , Cui Yunpeng , Pan Yuanxing , Wang Bing , Lei Mingxing 
Published: July 2021

Abstract
Background
Cement leakage into venous blood posed significant challenge to surgeons. The aim of the study was to create a Peking University First Hospital Score (PUFHS) which could evaluate the probability of vascular cement leakage among spine metastases patients following percutaneous vertebroplasty.

Methods
The study retrospectively enrolled 272 spine metastases patients treated with percutaneous vertebroplasty. We randomly extracted all enrolled patients as the training or validation group and baseline characteristic comparison was assessed between the two groups. Creation of the PUFHS was performed in the training group and validation of the PUFHS was performed in the validation group.

Results
Of all the 272 patients, the total number of included vertebrae was 632 and the median treated levels were 2 per patient. Vascular cement leakage occurred in 26.47% (72/272) of patients. The baseline characteristics were comparable between the two groups (P > 0.05). Three risk predictors (primary cancer types, number of treated vertebrae levels, and vertebrae collapse) were included in the PUFHS. The area under the receiver operating characteristic curve (AUROC) of the PUFHS was 0.71 in the training group and 0.69 in the validation group. The corresponding correct classification rates were 73.0 and 70.1%, respectively. The calibration slope was 0.78 (95% confidence interval[CI]: 0.45–1.10) in the training group and 1.10 (95% CI: 0.73–1.46) in the validation group. The corresponding intercepts were 0.06 (95% CI: − 0.04–0.17) and − 0.0079 (95% CI: − 0.11–0.092), respectively.

Conclusions
Vascular cement leakage is common among spine metastases after percutaneous vertebroplasty. The PUFHS can calculate the probability of vascular cement leakage, which can be a useful tool to inform surgeons about vascular cement leakage risk in advance.
Outcomes of renal cell carcinoma with associated venous tumor thrombus: experience from a large cohort and short time span in a single center
Authors: Chen Zhigang , Yang Feilong , Ge Liyuan , Qiu Min , Liu Zhuo , Liu Cheng , Tian Xiaojun , Zhang Shudong , Ma Lulin 
Published: July 2021

Abstract
Background
The surgical management and outcomes of renal cell carcinoma (RCC) with venous tumor thrombus (VTT) have been reported in limited sample size, and there remain discrepancies over the factors that influence oncologic outcomes after radical nephrectomy with thrombectomy (RNTE). The aim of the study was to analyze the outcomes of the patients with RCC with VTT in our institution and identify the independent prognostic factors.

Methods
Patients with RCC with VTT were enrolled for the study from February 2015 to December 2018. All patients underwent RNTE. Clinical data were compared using Mann-Whitney U test and the chi-square test for continuous and categorical variables respectively. Survival analysis was estimated using the Kaplan-Meier method. Univariable and multivariable survival analyses were performed using Cox regression model.

Results
121 patients (91 men & 30 women) were identified with a median age of 60 years. VTT level was 0 in 25 patients, I in 20, II in 50, III in 12 and IV in 14. The median follow-up time was 24 months. During the follow-up period, 51 (42%) patients died and 69 (57%) patients experienced recurrence or metastasis. The 3-year and 5-year over-all survival (OS) were 58 and 39%. Among the several factors examined, positive lymph node (P = 0.016), metastasis at surgery (P = 0.034), tumor necrosis (P = 0.023) and sarcomatoid differentiation (P < 0.001) were demonstrated as independent significant risk factors on multivariable analysis.

Conclusion
The OS was poor for patients with RCC with VTT. Rather than VTT level, positive lymph node, metastasis at surgery, tumor necrosis and sarcomatoid differentiation were independent prognostic predictors.