bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical significance of skeletal muscle density and sarcopenia in patients with pancreatic cancer undergoing first-line chemotherapy : a retrospective observational study.
Authors: Kim In-Ho , Choi Moon Hyung , Lee In Seok , Hong Tae Ho , Lee Myung Ah 
Published: January 2021

Abstract
Background: To investigate the clinical impact of sarcopenia and skeletal muscle density (SMD) among patients with metastatic pancreatic adenocarcinoma who underwent palliative first line gemcitabine-based chemotherapy.Methods: A total of 330 patients treated with first line gemcitabine-based chemotherapy between January 2010 and March 2017 were included. CT scans before chemotherapy and after 8±2 weeks were evaluated. The L3 skeletal muscle index (SMI) was used to detect sarcopenia and calculated as the total area of the L3 skeletal muscle divided by the height-squared (cm2/m2). SMD was quantified as the mean muscle radiation attenuation of the muscle cross-sectional area across the L3 vertebral body level and was assessed between -29 and +150 Hounsfield units. Results: A SMI to SMD comparison revealed a positive correlation (R2 = 0.058, P<0.001). Compared with high SMD, the risks of low SMI were 1.516 (95% confidence interval [CI]: 1.164-1.973) among patients with low SMD. Kaplan–Meier analysis showed that the low SMD was related to poor overall survival (OS, median, 6.1 versus [vs.] 7.9 months, P=0.010). Multivariate analysis using Cox regression showed that low SMI (hazard ratio [HR]: 1.35, 95% CI: 1.03–1.78, P=0.032) and low SMD (HR: 1.45, 95% CI: 1.09–1.93, P=0.011) were poor prognostic factors for OS, respectively. Co-presence of low SMI and low SMD had more powerful prognostic implication for OS (HR: 1.58, 95% CI: 1.12–2.23, P=0.010). Grade 3 or higher toxicity of chemotherapy was more frequently observed in patients who have a low SMI (43% vs. 59%, P=0.019) and low SMD (44% vs. 60%, P=0.023). OS was not related to SMD status among patients who were chemotherapy responders (complete or partial responses). However, among non-responders (stable or progressive disease), low SMD groups had significantly poorer OS in comparison with high SMD groups (median, 5.6 vs 7.4 months, P=0.006).Conclusions: Sarcopenia and SMD status can be considered a prognostic factor in patients with metastatic pancreatic adenocarcinoma who received palliative first line gemcitabine-based chemotherapy. Severe chemotherapy toxicity occurred in the sarcopenia and low SMD groups. Our data suggest that a comprehensive assessment of skeletal muscle parameters may be more useful prognostic factors.
Depressive Effectiveness of Vigabatrin (y-Vinyl-GABA), an Antiepileptic Drug, in Intermediate-conductance Calcium-Activated Potassium Channels in Human Glioma Cells
Authors: Hung Te-Yu , Huang Huai-Ying Ingrid , Wu Sheng-Nan , Huang Chin-Wei 
Published: January 2021

Abstract
Background: Vigabatrin (VGB) is an approved non-traditional antiepileptic drug that has been revealed to have potential for treating brain tumors; however, its effect on ionic channels in glioma cells remains largely unclear. Methods: With the aid of patch-clamp technology, we investigated the effects of VGB on various ionic currents in the glioblastoma multiforme cell line 13-06-MG. Results: In cell-attached configuration, VGB concentration-dependently reduced the activity of intermediate-conductance Ca2+-activated K+ (IKCa) channels, while DCEBIO (5,6-dichloro-1-ethyl-1,3-dihydro-2H-benzimidazol-2-one) counteracted the VGB-induced inhibition of IKCa channels. However, the activity of neither large-conductance Ca2+-activated (BKCa) nor inwardly rectifying K+ (KIR) channels were affected by the presence of VGB in human 13-06-MG cells. However, in the continued presence of VGB, the addition of GAL-021 or BaCl2 effectively suppressed BKCa and KIR channels. Conclusions: The inhibitory effect of VGB on IKCa channels demonstrated in the current study could be an important underlying mechanism of VGB-induced antineoplastic (e.g., anti-glioma) actions.
Which growth standards should be used to identify large- and small-for-gestational age infants of mothers with type 1 diabetes? A pre-specified analysis of the CONCEPTT trial
Authors: Meek Claire L , Corcoy Rosa , Asztalos Elizabeth , Kusinski Laura Caroline , Lopez Esther , Feig Denice S , Murphy Helen R 
Published: January 2021

Abstract
BackgroundOffspring of women with type 1 diabetes are at increased risk of fetal growth patterns which are associated with perinatal morbidity. Our aim was to compare rates of large- and small-for-gestational age (LGA; SGA) defined according to different criteria, using data from the Continuous Glucose Monitoring in Type 1 Diabetes Pregnancy Trial (CONCEPTT).MethodsThis was a pre-specified analysis of CONCEPTT involving 225 pregnant women and liveborn infants from 31 international centres (ClinicalTrials.gov NCT01788527; registered 11/2/2013). Infants were weighed immediately at birth and GROW, INTERGROWTH and WHO centiles were calculated. Relative risk ratios, sensitivity and specificity were used to assess the different growth standards with respect to perinatal outcomes, including neonatal hypoglycaemia, hyperbilirubinaemia, respiratory distress, neonatal intensive care unit (NICU) admission and a composite neonatal outcome. ResultsAccelerated fetal growth was common, with mean birthweight percentiles of 82.1, 85.7 and 63.9 and LGA rates of 62%, 67% and 30% using GROW, INTERGROWTH and WHO standards respectively. Corresponding rates of SGA were 2.2%, 1.3% and 8.9% respectively. LGA defined according to GROW centiles showed stronger associations with preterm delivery, neonatal hypoglycaemia, hyperbilirubinaemia and NICU admission. Infants born >97.7th centile were at highest risk of complications. SGA defined according to INTERGROWTH centiles showed slightly stronger associations with perinatal outcomes. Conclusions GROW and INTERGROWTH standards performed similarly and identified similar numbers of neonates with LGA and SGA. GROW-defined LGA and INTERGROWTH-defined SGA had slightly stronger associations with neonatal complications. WHO standards underestimated size in preterm infants and are less applicable for use in type 1 diabetes.
Imaging analysis of 13 rare cases of renal collecting (Bellini) duct carcinoma patients in northern China: a case series and literature review.
Authors: Lyu Zhehao , Liu Lili , Li Huimin , Wang Haibo , Liu Qi , Chen Tingting , Xu Meiling , Tian Lin , Fu Peng 
Published: January 2021

Abstract
Background: Collecting (Bellini) duct carcinoma (CDC) is a highly malignant and rare kidney tumor. We report our 12-year experience with CDC and the results of a retrospective analysis of patients and tumor characteristics, clinical manifestations, and imaging features by computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET)/CT.Methods: Retrospective examination of tumors between January 2007 and December 2019 identified 13 cases of CDC from three medical centers in northern China. All 13 patients underwent CT scan, among which eight underwent dynamic enhanced CT scan, two underwent PET/CT scan, and one underwent magnetic resonance cholangiopancreatography (MRCP) examination. The lesions were divided into nephritis type and mass type according to the morphology of the tumors.Results: The study group included ten men and three women with an average age of 64.23 ± 10.74 years. The clinical manifestations were gross hematuria, flank pain, and waist discomfort. The mean tumor size was 8.48 ± 2.48 cm. Of the 13 cases, six (46.2%) were cortical-medullary involved type and seven (53.8%) were cortex-medullary-pelvis involved type. Eleven (84.6%) cases were nephritis type and two (15.4%) were mass type. The lesions appeared solid or complex solid and cystic on CT and MRI. The parenchymal area of the tumors showed isodensity or slightly higher density on unenhanced CT scan in the 13 cases. PET/CT in two cases showed increased radioactivity intake. Evidence of intra-abdominal metastatic disease was present on CT in nine (69.2%) cases.Conclusions: The imaging characteristics of CDC differ from those of other renal cell carcinomas. In renal tumors located in the junction zone of the renal cortex and medulla that show unclear borders, slight enhancement, and metastases in the early stage, a diagnosis of CDC needs to be considered. PET/CT provides crucial information for the diagnosis of CDC, as well as for designing treatment strategies including surgery.
Evaluation on Immediate Analgesic Efficacy and Safety of Kai-Hou-Jian Spray (Children 'S Type) In Treating Sore Throat Caused By Acute Pharyngitis and Tonsillitis In Children: Study Protocol For A Randomized Controlled Trial
Authors: Ma Yan-ning , Zhong Cheng-liang , Hu Siyuan , Cai Qiu-han , Guo Sheng-xuan 
Published: January 2021

Abstract
Background: Acute pharyngitis and tonsillitis are common respiratory diseases for which children seek medical care. Their main clinical manifestation is sore throat which interferes with patients’ quality of life. However, there is no proven effective or safe method to treat it. It is necessary to find an excellent strategy to reduce sore throat and reduce the burden of acute illness. We designed the randomized controlled trial with the characteristics of traditional Chinese medicine (TCM) to determine the clinical positioning of Kai-Hou-Jian spray (children 's type) (KHJS) through evidence-based research. This trial aims to evaluate the immediate analgesic efficacy of KHJS on sore throat caused by acute pharyngitis and tonsillitis (wind-heat syndrome/heat exuberance in lung and stomach syndrome) in children, and to observe its safety. Methods/design: This is a prospective, multicenter, randomized, double-blind, parallel-group, placebo-controlled trial. It will include 240 children with acute pharyngitis/tonsillitis from 7 study sites across China. All participants are randomly assigned to two parallel treatment groups, one with KHJS and the other with placebo sprays, for 5 consecutive days. The primary outcome is the time of analgesic onset. Secondary outcomes include duration of analgesic effect, area under time curve of 0-3 hours Wong-Baker FACES Pain Rating Scale (WBS) score (AUC0-3h), rate of analgesic onset, rate of disappearance of sore throat, changes of WBS score (in days), effective rate of pharyngeal signs, and effective rate of TCM syndrome. The incidence of adverse events during the trial is the primary safety outcome. In addition, vital signs and laboratory tests before and after medication are monitored.Discussion: To our knowledge, this will be the first clinical trial to explore the immediate analgesic efficacy of a Chinese patent medicine spray for acute pharyngitis/tonsillitis induced sore throat in children in a multicenter, randomized, double-blinded, parallel-group, placebo-controlled manner. Not only might it prove the efficacy and safety of KHJS in the treatment of sore throat caused by acute pharyngitis/tonsillitis in children, but it might also provide evidence for the treatment of acute sore throat with Chinese herbal medicine.Trial registration: ChiCTR2000031599. Registered on 5 April 2020, http://www.chictr.org.cn/showproj.aspx?proj=50385
Crowdsourcing Framework for QoE-Aware SD-WAN
Authors: Ellawindy Ibtihal , Heydari Shahram Shah 
Published: January 2021

Abstract
The exponential increase in bandwidth-sensitive multimedia traffic on the Internet has created new challenges and opportunities. With the shifting focus from service availability to service quality, there is a need to have quality management measures to serve the high needs of efficient transmission and delivery in time-constrained environments over IP networks. Quality of Experience (QoE) is now considered the most important measure to achieve the twin goals of application efficiency and user satisfaction from a user perspective. In this paper, we propose a framework that can be used to collect real-time QoE feedback through crowdsourcing and forward it to SD-WAN controllers to enhance streaming routes based on real-time user quality perceptions. We analyze how QoE can be affected by different network conditions, and how different streaming protocols compare against each other when the network parameters change dynamically. We compare the real-time user feedback to predefined network changes to measure if participants will be able to identify all degradation events, and to examine which combination of degradation events are noticeable to the participants. These QoE timestamped feedback is sent back to the SD-WAN controller continuously in order to locate problems and bottlenecks in the current service paths and to enable network controllers to take corrective action by rerouting the streamed traffic. Our aim is to demonstrate that real-time QoE feedback can enhance cloud-based services and can adjust services quality based on real-time, active participants’ interaction[1].[1] This paper extends the preliminary results presented by the authors at the PVE-SDN 2019 workshop in IEEE Conference on Network Softwarization (NetSoft 2019).
Combined Subcostal and Posterior Transversus Abdominis Plane Block for Postoperative Pain Relief after Abdominoplasty: A Randomized Clinical Trial
Authors: Sayed Haytham El , Fadhul A Shaheed , Falaki Mohamed Al , Awad M Nasr 
Published: January 2021

Abstract
Background: Abdominoplasty is a common esthetic surgery for adequate pain management during the postoperative period. Transversus abdominis plane block (TAPB) is a therapeutic complement for analgesia for postoperative pain following abdominal surgery.Aim: To compare the outcomes of TAPB and systemic opioids in patients undergoing abdominoplasty.Methods: Fifty-eight patients undergoing abdominoplasty were randomly assigned to two groups: Combined subcostal and posterior TAPB group (BG, n=29) and Control group (CG, n=29). The standard postoperative analgesic regimen for both groups consisted of IV Paracetamol 1 g every 6 h. The visual analog scale (VAS) scores for pain were recorded postoperatively, and once the patient had a VAS ≥4, IV pethidine was administered. The primary outcome was pethidine consumption in the first 72 h postoperatively; the secondary outcomes included VAS scores at rest and during movement in the first 72 h postoperatively, time to first ambulation, and time to first incentive spirometer at 900 mL/min.Results: Pethidine consumption in the first 72 h was 208.62±85.64 in the CG group and 20.69±25.06 in BG (p<0.05). VAS was lower in BG during the first 72 h both at rest and during movement (p<0.05). Time to first ambulation was 12.41±5.04 h in the CG group and 4.62±1.08 h in BG (p<0.05), time to first incentive spirometer at 900 mL/min was 11.45±5.05 h in CG and 4.27±1.09 h in BG (p<0.05).Conclusion: Combined subcostal and posterior TAPB offers a longer postoperative analgesic effect and reduced postoperative opioid requirements with fewer postoperative complications.Trial RegistrationClinical Trial: TCTR20200602001 “Retrospectively registered”Date of registration on May 30, 2020.
Ethical challenges of the healthcare transition to adult Antiretroviral therapy (ART) clinics for HIV infected adolescents and young people in Uganda
Authors: Mbalinda Scovia Nalugo , Bakeera-Kitaka Sabrina , Amooti Derrick Lusota , Magongo Eleanor Namusoke , Musoke Philippa , Dan Kaye K 
Published: January 2021

Abstract
Background Many adolescents and young people with HIV require the transfer of care from paediatric/ adolescent clinics to adult ART clinics. Transition is beset with factors that hinder or facilitate the process, thereby raising the transition process’s ethical challenges. Decisions made regarding therapy, such as when and how to transition to adult HIV care, should consider ethical benefits and risks. Understanding and addressing ethical challenges in the healthcare transition could ensure a successful transition. The purpose of this study was to analyse the ethical challenges of transitioning HIV care for adolescents into adult HIV clinics. Method We conducted 18 focus group discussions among 191 adolescents attending nine different health facilities in Uganda. We explored facilitators and barriers regarding adolescents transitioning to adult HIV clinics. Thematic data analysis was used to analyze the data. The Silences Framework guided data analysis and interpretation. The principles of Bioethics and the four-boxes ethics framework for clinical care (Patient autonomy, Medical indications, Context of Care and Quality of life) were used to analyze the ethical issues surrounding the transition to adult HIV care. Results The key emerging ethical issues were: reduced patient autonomy; increased risk of harm from stigma and loss of privacy and confidentiality; unfriendly adult clinics induce disengagement and disruption of the care continuum; patient preference to transition as a cohort and contextual factors are critical to a successful transition. Conclusion The priority outcomes of the healthcare transition for adolescents should address ethical challenges of the healthcare transition to ensure retention in HIV care, facilitate long-term self-care, provide ongoing holistic healthcare and support to promote health and wellbeing and build trust in the healthcare system. Identifying what facilitates successful transitions and the gaps that interventions can target may ensure adolescents and young people with HIV infectionremain healthy across the healthcare transition.
Effects of different pretreatment methods on microbial yield from infected tissues
Authors: Cai Yuanqing , Fang Xinyu , Zhang Lvheng , Yang Xurong , Nie Lixiong , Huang Zida , Li Wenbo , Zhang Chaofan , Yang Bin , Zhang Wenming , Guan Zhenpeng 
Published: January 2021

Abstract
Background: This study aimed to evaluate the effects of different pretreatment methods on the microbial yield in infected tissues. Methods: Strains of Staphylococcus aureus (SA), Escherichia coli (EC) and Candida albicans (CA) were used to construct single-surface, full-surface, and internal infection models in sterile pork tissue. Manual milling (MM), mechanical homogenization (MH), sonificated (SF), dithiothreitol (DTT), and direct culture (DC) were used to pretreat tissues, the microbial yield from different pretreatment methods were compared. At the same time, periprosthetic tissues collected intraoperatively from periprosthetic joint infection (PJI) patients were pretreated with the same methods. Results: The study showed that the microbial yield from MH pretreatment was significantly higher than that of MM (P <0.01) and SF pretreatment method (P <0.01). Furthermore, in the internal infection model, the microbial yield from MH group was also significantly higher than that of SF (P <0.01), DTT (P <0.01), and DC group (P <0.01). Moreover, the number of bacterial colonies obtained from periprosthetic tissues pretreated by MH was significantly higher than pretreated by other pretreatment methods (P = 0.004). Conclusions: The effects of MH and DTT in microbial yield were significantly higher than that of DC, SF and MM, and these methods can be used to process multiple tissue samples at the same time, which might further improve the sensitivity of infectious disease.
Co-destruction in social care services: how to identify and evaluate barriers arising from a co- production exercise with family carers living in rural and remote areas
Authors: Gheduzzi Eleonora , Masella Cristina , Morelli Niccolò , Graffigna Guendalina 
Published: January 2021

Abstract
Background: Co-production has been widely recognised as a plausible means to reduce the dissatisfaction of citizens, the inefficacy of service providers, and conflicts in relations between the former and the latter. However, the enhancement of co-production has begun to be questioned: co-production has often been taken for granted, and its effects may not always be fruitful. To understand and prevent unsuccessful citizen and provider collaboration, the recent literature has begun to focus on the causes of co-destruction. This paper investigates how the barriers that may arise during the co-production of a new social service with family carers can be identified and interpreted.Methods: To investigate this topic, we undertook a single case study by considering a longitudinal project (Place4Carers) intended to co-produce a new social care service with and for the family carers of elderly patients living in rural and remote areas. We organised collaborative co-assessment workshops and semi-structured interviews to collect the views of family carers and service providers on the co-production process. As part of the research team that participated in the co-production process, we contributed to the analysis with a reflexive approach.Results: The analysis revealed four main co-production barriers: lack of trust, lack of effectiveness of engagement, participants’ inability (or impossibility) to change and the lack of a cohesive partnership among partners. Despite these findings, the project increases carers’ satisfaction, competence and trust in service providers by demonstrating the positive effects of co-production.Conclusions: Our article confirms that co-creation and co-destruction processes may coexist. The role of researchers and service providers is to prevent or remedy co-destruction effects. To this end, we suggest that in co-production projects, more time should be spent co-assessing the project before, during and after the co-production process. This approach would facilitate the adoption of adjustment actions such as creating mutual trust through conviviality among actors and fostering collaborative research between academia and organisations that are not used to working together.
Construction of a patient decision aid for the treatment of uncomplicated urinary tract infection in primary care
Authors: VINCENT Yves-Marie , FRACHON Adèle , BUFFETEAU Clotilde , CONORT Guillaume 
Published: January 2021

Abstract
Background: Uncomplicated urinary tract infection (uUTI) is very common among women in primary care. The risk of developing pyelonephritis remains low after uUTI, nonetheless, empiric antibiotic therapy is frequently prescribed for symptomatic purposes. This may lead to adverse effects and antibiotic resistance. Furthermore, patients may express the will to limit the use of antibiotics. Some European countries recommend discussing a delayed prescription with the patient and developing a shared decision. The aim of this study is to create a patient decision aid (PtDA) used in primary care settings to make a shared decision between practitioners and women about whether or not to treat uUTI with antibiotics.Methods: We followed the steps recommended by the International Patient Decision Aids Standards, with a scoping phase, a design phase (including focus groups and literature review), and an alpha-testing phase. A steering group, made of patients and physicians, met throughout the study to develop a prototype PtDA.Results: The information included in the PtDA is the definition of uUTI, information on the options, their benefits, risks, and consequences, based on a review of the literature. The results of the focus group made possible to determine the patient's values and preferences to consider in decision-making, including: the discomfort felt, the impact on daily life, patients’ perceptions of antibiotics, and the position relative to the risk of adverse effect. The choices in presentation, organisation and design are the result of the work of the steering group, improved by feedback from alpha testing. We confirmed the need for shared decision-making and the equipoise in this situation.Conclusions: We developed a PtDA to be used in primary care for sharing decision on the use of antibiotic in uUTI. It needs to be validated in a beta-testing phase, with complementary advice from peers, and then tested in a clinical study comparing its use with the systematic prescription approach.