bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Will Rogers phenomenon, breast cancer and race
Authors: Nittala Mary R. , Mundra Eswar K. , Packianathan S. , Mehta Divyang , Smith Maria L. , Woods William C. , McKinney Shawn , Craft Barbara S. , Vijayakumar Srinivasan 
Published: May 2021

Abstract
Background
The Will Rogers phenomenon [WRP] describes an apparent improvement in outcome for patients’ group due to tumor grade reclassification. Staging of cancers is important to select appropriate treatment and to estimate prognosis. The WRP has been described as one of the most important biases limiting the use of historical cohorts when comparing survival or treatment. The main purpose of this study is to assess whether the WRP exists with the move from the AJCC 7th to AJCC 8th edition in breast cancer [BC] staging, and if racial differences are manifested in the expression of the WRP.

Methods
This is a retrospective analysis of 300 BC women (2007–2017) at an academic medical center. Overall survival [OS] and disease-free survival [DFS] was estimated by Kaplan-Meier analysis. Bi and multi-variate Cox regression analyses was used to identify racial factors associated with outcomes.

Results
Our patient cohort included 30.3% Caucasians [Whites] and 69.7% African-Americans [Blacks]. Stages I, II, III, and IV were 46.2, 26.3, 23.1, and 4.4% of Whites; 28.7, 43.1, 24.4, and 3.8% of Blacks respectively, in anatomic staging (p = 0.043). In prognostic staging, 52.8, 18.7, 23, and 5.5% were Whites while 35, 17.2, 43.5, and 4.3% were Blacks, respectively (p = 0.011).
A total of Whites (45.05% vs. 47.85%) Blacks, upstaged. Whites (16.49% vs. 14.35%) Blacks, downstaged. The remaining, 38.46 and 37.79% patients had their stages unchanged.
With a median follow-up of 54 months, the Black patients showed better stage-by-stage 5-year OS rates using 8th edition compared to the 7th edition (p = 0.000). Among the Whites, those who were stage IIIA in the 7th but became stage IB in the 8th had a better prognosis than stages IIA and IIB in the 8th (p = 0.000). The 8th showed complex results (p = 0.176) compared to DFS estimated using the 7th edition (p = 0.004).

Conclusion
The WRP exists with significant variability in the move from the AJCC 7th to the 8th edition in BC staging (both White and Black patients). We suggest that caution needs to be exercised when results are compared across staging systems to account for the WRP in the interpretation of the data.
Italian onco-haematological patients’ preferences in bad news communication: a preliminary investigation
Authors: Bongelli Ramona , Bertolazzi Alessia , Piccioni Ludovica , Burro Roberto 
Published: May 2021

Abstract
Background
The manner in which bad news is communicated in oncological contexts can affect patients’ engagement, their coping strategies and therapeutic compliance. Although this topic has been broadly investigated since the nineties, to the best of our knowledge, little has been written about Italian patients’ experiences and preferences concerning what the oncologists should disclose and how they should intimate patients about their health conditions in different stages of oncological disease.

Methods
In an attempt to fill this gap, an online self-report questionnaire was administered to a sample of Italian onco-haematological patients. Data were analysed both qualitatively (by a content analysis) and quantitatively (by descriptive analysis and Generalized Linear Mixed Model).

Results
While the majority of patients elected to know the truth during their clinical course, a polarisation between those arguing that the truth be fully disclosed and those claiming that the truth be communicated in a personalised way was observed at the attitude level. Among demographic variables accounted for, age seems to most affect patients’ preferences. Indeed, younger Italian patients decidedly reject concealment of the truth, even when justified by the beneficence principle. This result could be a reaction to some protective and paternalistic behaviours, but it could even reflect a relation according to which the more the age increases the more the fear of knowing rises, or an intergenerational change due to different ways of accessing the information. The qualitative analysis of the final open-ended question revealed three main sources of problems in doctor-patient encounters: scarcity of time, absence of empathy and use of not-understandable language that makes it difficult for patients to assume a more active role.

Conclusions
The results of the present study, which represents a preliminary step in the subject investigation, will be deployed for the construction and validation of a more sophisticated questionnaire. Better awareness of the Italian onco-haematological patients’ preferences concerning bad news communication and truth-telling could be useful in adopting more suitable medical practices and improving doctor-patient relationships.
MR-guided microwave ablation of hepatocellular carcinoma (HCC): is general anesthesia more effective than local anesthesia?
Authors: Li Zhaonan , Wang Chaoyan , Li Jing , Liu Zaoqu , Jiao Dechao , Han Xinwei 
Published: May 2021

AbstractBackgroundPercutaneous magnetic resonance-guided (MR-guided) MWA procedures have traditionally been performed under local anesthesia (LA) and sedation. However, pain control is often difficult to manage, especially in some cases when the tumor is large or in a specific location, such as near the abdominal wall or close to the hepatic dome. This study retrospectively compared the results of general anesthesia (GA) and local anesthesia (LA) for MR-guided microwave ablation (MWA) in patients with hepatocellular carcinoma (HCC ≤ 5.0 cm) to investigate whether different anesthesia methods lead to different clinical outcomes.MethodsThe results of the analysis include procedure-related complications, imaging response, and the time to complete two sets of procedures. According to the type of anesthesia, the Kaplan-Meier method was used to compare the local tumor progression (LTP) of the two groups who underwent MR-guided MWA.ResultsAll patients achieved technical success. The mean ablation duration of each patient in the GA group and LA group was remarkably different (P = 0.012). Both groups had no difference in complications or LTP (bothP > 0.05). Notably, the tumor location (challenging locations) and the number of lesions (2–3 lesions) could be the main factors affecting LTP (p = 0.000,p = 0.015). Univariate Cox proportional hazard regression indicated that using different anesthesia methods (GA and LA) was not associated with longer LTP (P = 0.237), while tumor location (challenging locations) and the number of lesions (2–3 lesions) were both related to shorter LTP (P = 0.000,P = 0.020, respectively). Additionally, multivariate Cox regression further revealed that the tumor location (regular locations) and the number of lesions (single) could independently predict better LTP (P = 0.000,P = 0.005, respectively).ConclusionsNo correlation was observed between GA and LA for LTP after MR-guided MWA. However, tumors in challenging locations and the number of lesions (2–3 lesions) appear to be the main factors affecting LTP.
The prevalence, severity, and risk factors for dry eye disease in Dubai – a cross sectional study
Authors: Alkabbani Sarah , Jeyaseelan Lakshmanan , Rao Anupama P. , Thakur Sandeep P. , Warhekar Pramod T. 
Published: May 2021

Abstract
Background
The prevalence of dry eye disease is increasing globally and requires the attention of healthcare professionals as it worsens patients’ quality of life. No published studies on the epidemiology of dry eyes have been found in Dubai.

Purpose
To describe the epidemiology, prevalence, severity, and associated factors of dry eyes in Dubai, United Arab Emirates, in 2019.

Methods
This was an analytical, cross-sectional, survey-based study. An online survey was distributed by email to Mohammed Bin Rashid University students, staff, and faculty and to the staff at Mediclinic City and Parkview Hospitals in Dubai, United Arab Emirates, from April–June 2019. The survey included demographic questions and the Ocular Surface Disease Index (OSDI).

Results
The survey was completed by 452 participants; the majority were females (288/452; 63.7 %). The prevalence of dry eyes in Dubai was estimated to be 62.6 % (283/452), with severely dry eyes being the most prevalent (119/283; 42 %). Females, high daily screen time (> 6 h), and the use of contact lenses were found to be associated with dry eyes (P-value < 0.05, 95 % confidence interval). Age was found to be negatively correlated with prevalence of dry eyes. Exposure to smoking/shisha, history of eye injury/surgery, and nationality were not associated with dry eyes.

Conclusions
This is the first cross-sectional study to investigate the prevalence of dry eyes in Dubai (62.6 %). The majority of participants had severe dry eyes symptoms. Severely dry eyes were more common among females and users of contact lenses.
Risk factors for metabolic bone disease among preterm infants less than 32 weeks gestation with Bronchopulmonary dysplasia
Authors: Chen Wenwen , Zhang Zhenhai , Dai Shuzhen , Xu Liping 
Published: May 2021

Abstract
Background
Bronchopulmonary dysplasia (BPD) infants present an increased incidence of metabolic bone disease (MBD), but it is unknown which factors contribute to this. The aim of this study was to determine the risk factors for developing MBD in BPD infants.

Methods
A retrospective review of the medical records of BPD infants admitted to the Neonatal intensive care unit at Zhangzhou Hospital between Jun 2016 and May 2020 was performed. BPD infants with MBD were identified, two contemporaneous without MBD matched by gestational age and gender were randomly selected as controls for each case of MBD. The association between putative risk factors and MBD was estimated with ORs and 95% CIs. A P-value threshold ≤0.2 was used in univariate analysis for inclusion into a multivariate (adjusted) model with a P-value of < 0.05 as statistically significant.

Results
A total of 156 BPD infants were enrolled with 52 cases of MBD and 104 controls. Fetal growth restriction (OR 6.00, 95% CI, 1.81–19.84), extremely low birth weight (OR 3.10, 95% CI, 1.07–8.94), feeding volume < 80 mL/kg/d at the end of the 4th week after birth (OR 14.98, 95% CI, 4.04–55.58), cholestasis (OR 4.44, 95% CI, 1.59–12.40), late onset sepsis (OR 3.95, 95% CI, 1.12–13.98) and prolonged (> 2 weeks) diuretics application (OR 5.45, 95% CI, 1.25–23.84) were found to be statistically significant risk factors for MBD in BPD infants.

Conclusion
In BPD infants of homogeneous gestational age, fetal growth restriction, extremely low birth weight, feeding volume < 80 mL/kg/d at the end of the 4th week after birth, cholestasis and late onset sepsis are significant risk factors for MBD. These findings provide potential predictive factors for MBD in BPD infants and warrant prospective validation.
Screening of the college students at clinical high risk for psychosis in China: a multicenter epidemiological study
Authors: Wu Jiaxin , Long Xiangyun , Liu Fei , Qi Ansi , Chen Qi , Guan Xiaofeng , Zhang Qiong , Yao Yuhong , Shi Jingyu , Xie Shiping , Yan Wei , Hu Maorong , Yuan Xin , Tang Jun , Wu Siliang , Zhang Tianhong , Wang Jijun , Lu Zheng 
Published: May 2021

Abstract
Background
To investigate a 3-stage screening procedure and explore the clinical features of subjects at Clinical High Risk (CHR) for psychosis in a representative sample of Chinese college students.

Methods
An epidemiological survey of the prevalence of the CHR syndrome in Chinese college students that was selected by stratified random sampling from Shanghai, Nanjing and Nanchang cities was done following a 3-stage procedure. Participants were initially screened with the Prodromal Questionnaire-brief version (PQ-B), and whose distress score of PQ-B exceeded 24 would be invited to a telephone assessment using the subscale for positive symptoms of the Scale of Prodromal Symptoms (SOPS)/Structured Interview for Prodromal Syndromes (SIPS). Lastly, participants who scored 3 or higher in any item of the subscale would be administered with the SIPS interview conducted by trained researchers to confirm the diagnosis of CHR syndrome.

Results
Twenty-three thousand sixty-three college students completed the survey during September 2017 to October 2018. Seventy-two students were diagnosed as CHR subjects, and the detection rate in the total sample was 0.3%. The peak age range for the first diagnosis of CHR was 17 to 20 years. Thirteen and forty-six were set as the cutoff points of PQ-B total score and distress score to balance the greatest sensitivity and specificity. Binary logistic regression revealed that 8 items in PQ-B showed significant distinction for detecting CHR subjects.

Conclusions
The 3-stage screening method can be utilized in the detection of CHR subjects for psychosis in the general population, during which delusional ideas, perceptual abnormalities and suspiciousness deserve great attention.
Association of depression symptom severity with short-term risk of an initial hospital encounter in adults with major depressive disorder
Authors: Voelker Jennifer , Wang Kun , Tang Wenze , He Jinghua , Daly Ella , Pericone Christopher D. , Sheehan John J. 
Published: May 2021

Abstract
Background
Despite the availability of pharmacologic and nonpharmacologic treatment options, depression continues to be one of the leading causes of disability worldwide. This study evaluated whether depression symptom severity, as measured by PHQ-9 score, of patients diagnosed with MDD is associated with short-term risk of a hospital encounter (ER visit or inpatient stay).

Methods
Adults with ≥1 PHQ-9 assessment in an outpatient setting (index date) and ≥ 1 MDD diagnosis within 6 months prior were included from the de-identified Optum Electronic Health Record database (April 2016–June 2019). Patients were categorized by depression symptom severity based on PHQ-9 scores obtained by natural language processing. Crude rates, adjusted absolute risks, and adjusted relative risks of all-cause and MDD-related hospital encounters within 30 days following assessment of depression severity were determined.

Results
The study population consisted of 280,145 patients with MDD and ≥ 1 PHQ-9 assessment in an outpatient setting. Based on PHQ-9 scores, 26.9% of patients were categorized as having none/minimal depression symptom severity, 16.4% as mild, 24.7% as moderate, 19.6% as moderately severe, and 12.5% as severe. Among patients with none/minimal, mild, moderate, moderately severe, and severe depression, the adjusted absolute short-term risks of an initial all-cause hospital encounter were 4.1, 4.4, 4.8, 5.6, and 6.5%, respectively; MDD-related hospital encounter adjusted absolute risks were 0.8, 1.0, 1.3, 1.6, and 2.1%, respectively. Compared to patients with none/minimal depression symptom severity, the adjusted relative risks of an all-cause hospital encounter were 1.60 (95% CI 1.50–1.70) for those with severe, 1.36 (1.29–1.44) for those with moderately severe, 1.18 (1.12–1.25) for those with moderate, and 1.07 (1.00–1.13) for those with mild depression symptom severity.

Conclusions
These study findings indicate that depression symptom severity is a key driver of short-term risk of hospital encounters, emphasizing the need for timely interventions that can ameliorate depression symptom severity.
Development of Chinese mental health first aid guidelines for problem drinking: a Delphi expert consensus study
Authors: Li Wenjing , Jorm Anthony F. , Wang Yan , Lu Shurong , He Yanling , Reavley Nicola J. 
Published: May 2021

Abstract
Background
Alcohol use disorders have become the second leading cause of death for mental and substance use disorders in China. However, with early diagnosis and timely treatment, the burden can be mitigated. Family and friends of a person with alcohol use problems are well placed to recognize the signs, encourage professional help-seeking and help the person until treatment is received. We aimed to use the Delphi consensus methodology to develop guidelines about how members of the public can provide this “mental health first aid” to someone with problem drinking in China.

Methods
A Chinese-language questionnaire was developed, comprising statements that were endorsed for inclusion in the English-language problem drinking first aid guidelines for high-income countries. Participants were also encouraged to suggest new statements. These statements were evaluated by two Chinese expert panels – a professional panel and a lived experience panel – on how important they believed each statement was for members of the public providing mental health first aid to a person with problem drinking in China. Three survey rounds were conducted. To be included in the final guidelines, statements had to receive a “very important” or “important” rating from at least 80% of participants from each of the panels.

Results
The majority of statements were rated in the first survey round by 30 mental health professionals and 25 lived experience panel members. One hundred and eighty-one statements met the inclusion criteria and were used to form the guidelines. Compared to the English-language guidelines, the importance of family involvement and mutual support were highlighted by both Chinese expert panels, while a number of statements relating to low-risk drinking were rejected by the lived experience panel.

Conclusions
The Chinese-language problem drinking first aid guidelines cover a variety of first aid strategies that members of the public can use when providing initial help to a person with problem drinking, such as how to communicate with the person and what to do if the person is intoxicated. These guidelines will be used as a stand-alone document will also inform the content of Mental Health First Aid training in China.
Global effect of COVID-19 pandemic on physical activity, sedentary behaviour and sleep among 3- to 5-year-old children: a longitudinal study of 14 countries
Authors: Okely Anthony D. , Kariippanon Katharina E. , Guan Hongyan , Taylor Ellie K. , Suesse Thomas , Cross Penny L. , Chong Kar Hau , Suherman Adang , Turab Ali , Staiano Amanda E. , Ha Amy S. , El Hamdouchi Asmaa , Baig Aqsa , Poh Bee Koon , Del Pozo-Cruz Borja , Chan Cecilia H. S. , Nyström Christine Delisle , Koh Denise , Webster E. Kipling , Lubree Himangi , Tang Hong Kim , Baddou Issad , Del Pozo-Cruz Jesus , Wong Jyh Eiin , Sultoni Kuston , Nacher Maria , Löf Marie , Cui Mingming , Hossain Mohammad Sorowar , Chathurangana P. W. Prasad , Kand Uddhavi , Wickramasinghe V. P. Pujitha , Calleia Rebecca , Ferdous Shameema , Van Kim Thanh , Wang Xiaojuan , Draper Catherine E. 
Published: May 2021

Abstract
Background
The restrictions associated with the 2020 COVID-19 pandemic has resulted in changes to young children’s daily routines and habits. The impact on their participation in movement behaviours (physical activity, sedentary screen time and sleep) is unknown. This international longitudinal study compared young children’s movement behaviours before and during the COVID-19 pandemic.

Methods
Parents of children aged 3–5 years, from 14 countries (8 low- and middle-income countries, LMICs) completed surveys to assess changes in movement behaviours and how these changes were associated with the COVID-19 pandemic. Surveys were completed in the 12 months up to March 2020 and again between May and June 2020 (at the height of restrictions). Physical activity (PA), sedentary screen time (SST) and sleep were assessed via parent survey. At Time 2, COVID-19 factors including level of restriction, environmental conditions, and parental stress were measured. Compliance with the World Health Organizations (WHO) Global guidelines for PA (180 min/day [≥60 min moderate- vigorous PA]), SST (≤1 h/day) and sleep (10-13 h/day) for children under 5 years of age, was determined.

Results
Nine hundred- forty-eight parents completed the survey at both time points. Children from LMICs were more likely to meet the PA (Adjusted Odds Ratio [AdjOR] = 2.0, 95%Confidence Interval [CI] 1.0,3.8) and SST (AdjOR = 2.2, 95%CI 1.2,3.9) guidelines than their high-income country (HIC) counterparts. Children who could go outside during COVID-19 were more likely to meet all WHO Global guidelines (AdjOR = 3.3, 95%CI 1.1,9.8) than those who were not. Children of parents with higher compared to lower stress were less likely to meet all three guidelines (AdjOR = 0.5, 95%CI 0.3,0.9).

Conclusion
PA and SST levels of children from LMICs have been less impacted by COVID-19 than in HICs. Ensuring children can access an outdoor space, and supporting parents’ mental health are important prerequisites for enabling pre-schoolers to practice healthy movement behaviours and meet the Global guidelines.
Facilitators and barriers to preparing and offering whole grains to children diagnosed with prediabetes: qualitative interviews with low-income caregivers
Authors: Leak Tashara M. , Gangrade Navika , Tester June 
Published: May 2021

Abstract
Background
The prevalence of U.S. youth with prediabetes and type 2 diabetes (T2D) is increasing, with those from racial/ethnic minority and low socioeconomic status (SES) backgrounds at greater risk. Dietary fiber (e.g., whole grains and vegetables) is shown to be inversely associated with T2D risk, yet dietary recommendations are not being met. Caregivers play an important role in home food availability, but low SES neighborhoods are shown to have limited access to fiber-rich foods such as whole grains. The overall aim of this qualitative study was to assess caregiver perceptions about facilitators and barriers to preparing and offering whole grains that they received as part of the 16-week Food Overcoming Our Diabetes Risk (FoodRx) pilot study.

Methods
A convenience sample of 60 youth (8–17 years) with obesity and prediabetes were recruited from an urban pediatric weight management clinic to participate in the FoodRx pilot study. Caregivers accompanied youth to a baseline clinic visit and completed a survey that asked about individual and household characteristics. Exit interviews were conducted at the follow-up clinic visit with caregivers of all youth who completed the study (n = 48) in order to assess facilitators and barriers experienced when preparing and offering whole grains. Interview transcripts were coded using the constant comparative method and grounded theory approaches.

Results
Caregivers (n = 48) had a mean age of 43 years and were primarily female (n = 46) and Hispanic (71%). Main facilitators to preparing and offering whole grains in the home were caregivers’ improved knowledge of whole grain health benefits and the development of strategies to encourage their children to consume whole grains (i.e., pairing whole grains with another liked food). A main barrier for caregivers was the lack of resources available to identify and prepare the novel whole grains that they received.

Conclusion
Findings suggest that caregivers are receptive to incorporating more whole grains into home-prepared meals, but they may need additional nutrition and cooking education to improve their self-efficacy.