bluuebunny/crossref_metadata_2025_split huggingface dataset:
40 cases of Single-incision laparoscopic surgery to totally extraperitoneal herniorrhaphy via umbilical incision under posterior rectus abdominis sheath
Authors: Wang Xiaojun , Zhang Yizhong , Qi Changlei , Zhou Encheng , Zhang Haiqiang , Fei Ting , Shuai Yongfeng , Jin Haibo 
Published: August 2019

Abstract
Background Since 2008, the first case of Single-incision laparoscopic surgery totally extraperitoneal (SILS-TEP) was reported, there was more than 10 years history on SILS-TEP. Because of difficult to operation, SILS-TEP is popularized slowly. This study investigate the safety and feasibility of SILS-TEP under posterior rectus abdominis sheath. Methods A single 2.5cm long cured incision was made along the lower umbilical border. A 5.0cm size preperitoneal space was created by electrotome or blunt dissection under the posterior sheath and the linea alba. The silica gel sealing sleeve of Iconport single port device was crammthed under the posterior rectus abdominis sheath, then the preperitoneal space was broadened toward lower abdomen in condition of CO2 gas inflation. Conventional laparoscopic instruments were used to complete the operation according to the operation procedure of laparoscopic total extraperitoneal herniorrhaphy. Results SILS-TEP hernia repair was successfully completed in 39 patients. One need an additional ports to complete totally extraperitoneal hernioplasty. Mean operative time was 73.8 minutes (range, 45 to 130 minutes) and 55.2 minutes (range, 34 to 95 minutes) in unilateral indirect hernia and in unilateral direct or femoral hernia, respectively . Mean operative time was 92.3 minutes (range, 65 to 150 minutes) in bilateral hernia. 3 seroma and 5 chronic pain were seen during the 1-6 months follow-up periods, all were treated conservatively. No other major complications. Mean post-operative hospital stay was 2.6 days. Conclusion The operation of SILS-TEP via umbilical incision under posterior rectus abdominis sheath is safe and feasible. The Iconport single-port device has potential advantages in SILS-TEP surgery. Trial registration: The study was registered with the Chinese Clinical Trial Registry (ChiCTR)(www.chictr.org.cn).Registration number:ChiCTR1900023056. Registration date: May 9, 2019.Retrospectively registered.
Correlations between inflammatory response and the increased lymphocyte percentage or CD19+ cell count in Kawasaki disease children undergoing intravenous immunoglobulin in different age intervals
Authors: Zhang Chun , Zhang Xuan , Shen Jia , Lu Xiaotong , Zhang Jian , Chen Sun 
Published: August 2019

Abstract
Background: Intravenous immunoglobulin (IVIg) is used commonly in Kawasaki Disease (KD) but the inflammatory condition during this course remains unclear. We evaluated the inflammatory response before and after the performance of IVIg in KD children in different age intervals to explore precise markers of inflammation and to help individualized treatment of IVIg
Methods: A retrospective survey involving 60 KD children was performed. According to different age intervals, all patients were divided into 5 groups. Linear regression and correlation analysis were performed between the percentage of decreased neutrophil and that of increased lymphocyte in all groups and so did between the absolute cell count of CD19 + cells and the level of interleukin-10 (IL-10) in patients aged 4 and over. Results: During the acute phase of KD, after the treatment of IVIg all patients’ reduced percentage of neutrophil correlated positively well with the increased percentage of lymphocyte. With age increased, the correlation coefficients valued higher which were 0.91 (group of less than 1 year), 0.87 (1 year), 0.91 (2 years), 0.97 (3 years), 0.99 (4 years and over) respectively with p value less than 0.01 in all groups. Growing age obviously correlated positively with the value of correlation coefficient (r = 0.88, P < 0.05). In the patients aged 4 and over, abnormal higher CD19 + cell absolute count before the administration of IVIg correlated positively with the scope of reduced IL-10 after the performance of IVIg (r = 0.71, P < 0.05).
Conclusions: During the acute phase of KD children with older age, the regulatory effect of IVIg on the immune response was better and the following recovery of immune function was more rapidly. In KD children aged 4 years and over the abnormal proliferating CD19 + B cell played dominant role in active humoral immune and may have the function of the IL-10 secretion as a compensatory response to balance the overactive humoral immune. Combined assessment of CD19 + B cell absolute count and the extent of IL-10 reduction after IVIg may be a marker of therapeutic effect of IVIg on inflammatory immune response in older KD children.
“It is judgment by the people that have meant something to me that hurts the most”: Inter-discursive evidence synthesis incorporates the lived experience of adolescent mothers
Authors: Dion Anna , Klevor Aime , Nakajima Amy , Andersson Neil 
Published: August 2019

Abstract
Background
Evidence synthesis without meaningful stakeholder engagement can overlook factors considered relevant and influential by stakeholders. This paper presents an inter-discursive approach to grounding conventional mixed methods evidence synthesis in stakeholder views of adolescent perinatal health in Canada.

Methods
A parallel-results convergent mixed review identified studies reporting on perinatal outcomes and experiences of adolescents during pregnancy to 12 months post-partum, in French or English, published in Canada after 2000. We summarized findings using thematic synthesis and descriptive statistics. We then extracted data from a provincial database of maternal and newborn outcomes and calculated relative risks for common perinatal risk factors and outcomes for adolescents compared to adult population within a local health region and across Ontario from 2012-2017. Two trained peer researchers contributed to our evidence syntheses. We shared syntheses with four service providers and 13 marginalized adolescent mothers, who identified and prioritized their areas of concern. A second literature review refocused around the priority issues identified by the women and was then expanded through semi-structured interviews.

Results
Adolescent mothers face more poverty, higher rates of abuse, anxiety and depression than adult mothers. They also report experiencing negative judgments when accessing services, highlighting the need for more youth-friendly services. Adolescent women prioritized the experience of judgment in perinatal health and social services, and more specifically how they felt judgment contributed to them being identified as a child protection risk. Other priorities included inadequate housing, judgment around breastfeeding, loss of social support and inaccessibility of community resources. Judgment in the adolescent perinatal health literature was summarized around three themes: being invisible, incapable and at risk. Adolescent mothers adapted and added onto these categories, emphasizing organizational and social challenges, with important consequences for their mental health and accessing appropriate care.

Conclusions
Incorporating young women’s voices changed the focus of our research. Women’s priorities highlighted the way motherhood norms are embedded in social and institutional structures. Adolescent women’s experiences of care have important implications for ensuring the effectiveness of more targeted interventions to maximize benefit to women and newborns.
Survival and prognostic factors analyses in malignant giant cell tumor of bone
Authors: Zhang Jin , Wang Xin , Lin Feng , Xu Guijun , Wu Haixiao , Duan Jincai , Mao Min , Zhang Chao 
Published: August 2019

Abstract
Background

The characteristics and survival in patients with malignant giant tumor cancer of bone (GCTB) were not investigated thoroughly due to the limited population. We evaluated the issues based on a large cohort in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database.

Methods

Patients who were diagnosed with malignant GCTB from 1975 to 2016 were extracted from the SEER database. The overall survival (OS) was calculated by Kaplan–Meier analysis and the inter-group difference was tested by log-rank test. Univariate and multivariate Cox proportional hazard regression were conducted to identify the independent survival factors.

Results

A total of 325 patients with malignant GCTB were included. The overall 1-, 5-, and 10-year survival rates were 94.3% (95% CI: 91.7-96.8), 82.3% (95% CI: 77.9-86.6), and 80.1% (95% CI: 75.4-84.7), respectively. In the univariate analysis, age older than 34 years, grade IV, T2/3 stage, M1, distant and surgery of the primary site. Multivariate Cox regression showed the poor survival in patients with age older than 34 years (hazard ratio (HR) =3.68, 95% CI: 2.06-6.57, P<0.001), T2 stage (HR=4.96, 95% CI: 1.57-15.63, P=0.006), distant tumor (HR=3.02, 95% CI: 1.32-6.92, P=0.009), and the extra-skeletal sites (HR=8.84, 95% CI: 2.89-27.07, P<0.001), respectively.

Conclusions

This large population-based series described the clinical characteristics of the malignant GCTB. Age, T2, distant tumor and extra-skeletal sites were determinant survival factors of the patients with malignant GCTB.
Posterior-only Approach with Unilateral Fenestration for the Treatment of Thoracic and Lumbar Tuberculosis
Authors: Jiang Liyuan , Guo Zhu , Wu Tianding , Duan Chunyue , Cao Yong , Hu Jianzhong 
Published: August 2019

Abstract
[EXSCINDED]
Abstract
Abstract

Background
Unilateral fenestration (UF) is a minimally invasive technique used for the treatment of spinal stenosis. But whether it applies to spinal tuberculosis (TB) is still unknown. We present a retrospective study to evaluate the clinical efficacy and feasibility of a posterior-only approach with unilateral fenestration (PAUF) for treatment of the thoracic and lumbar TB (T<0.001). At the last follow-up, the mean postoperative kyphotic angle was 9.9°±11.4°. According to the ASIA classification, 92.1% (35 out of 38) patients with preoperative neurological impairment had good neurological improvement after the operation. The VAS pain score significantly decreased from preoperative 6.9±1.1 to 1.3±0.7 one year post operation (p<0.001). All the patients achieved solid bony fusion within 13 months after surgery. There were three relapse TB cases, but they were cured after the second operation and adjustment of anti-TB regimens.Conclusions

For thoracic and thoracolumbar spinal TB patients with one or two consecutive functional spinal unit involvement, posterior-only approach with unilateral fenestration is an effective and feasible surgical treatment which can minimize the surgical damage to the posterior column, control infection, corrects the kyphosis, and maintains correction and neurological improvement over time.
Analysis of reporting completeness in exercise cancer trials: a systematic review
Authors: Meneses-Echavez Jose F , Rodriguez-Prieto Indira , Elkins Mark , Martinez-Torres Javier , Bidonde Julia 
Published: August 2019

Abstract
Background

Exercise is an effective therapeutic intervention for cancer survivors. Concerns about the completeness of reporting of exercise interventions have been raised in the literature, but without any formal analysis. This study aimed to evaluate the completeness of reporting of exercise interventions for cancer survivors in a representative sample of randomized clinical trials (RCTs).

Methods

We developed a pre-defined protocol. We searched MEDLINE, EMBASE, and CENTRAL for exercise trials in oncology between 2010 and 2017. Pairs of independent researchers screened the records, extracted study characteristics, and TIDieR criteria.

The 12-item TIDieR checklist was used to generate a score of reporting completeness, based on how much of the recommended content was reported in the included trials. Because Item 5 on the checklist has two components and Item 8 has four components, the derived score was calculated as how many of the 16 components were reported, converted to a percentage.

Results

We included 131 RCTs reporting 138 interventions in the analysis. Breast cancer was the most common type of cancer (69, 50%), and aerobic exercise was the most studied exercise modality (43, 30%) followed by combined aerobic and resistance training (40, 28%). Completeness of reporting ranged from 42% to 96% among the TIDieR items; none of the items was fully reported. ‘Intervention length’ was the most reported item across interventions (133, 96%), followed by ‘rationale’ (131, 95%), whereas ‘provider’ (58, 42%) and ‘how well (planned)’ (63, 46%) were the two least reported items. Half of the TIDieR items were completely reported in 50% to 70% of the interventions, and only four items were reported in more than 80% of the interventions (Items 2 and 8a to c). The seven items deemed to be core for replication (Items 3 to 9) exhibited a mean reporting of 71%, ranging from 42% to 96%.

Conclusion

Exercise training interventions for cancer survivors are incompletely reported across RCTs published between 2010 and 2017. The reporting of information about the provider, materials, and modifications require urgent improvements. Stronger reporting will enhance usability of trial reports by both healthcare providers and survivors, and will help to reduce research waste.
Sinus node dysfunction associates with atrial high-rate episodes after DDD pacemaker implantation
Authors: Xue Qi , Zou Hai , Wang Lihong , Shao Hong , Ma Yuan 
Published: August 2019

Abstract
Background： Patients implanted with pacemakers frequently develop atrial fibrillation. Pacemaker-detected atrial high-rate episodes or AHREs, where one AHRE is defined as ≥ 160beats/min lasting ≥ 5 minutes, may identify patients at increased risk for stroke and death. In this study, we sought to observe whether patients with sinus node dysfunction or atria-ventricular block are more likely to develop AHREs.
Methods: A total of 103 patients (age 69.4±13.5 years，58% female) with DDD/DDDR pacemakers were enrolled for the study. These pacemakers were equipped with features that enabled the detection and storage of information such as the dates, durations and sequential episodes of AHRE. Patients were followed up for 2 years and the time of the first occurrence of AHRE was determined at follow-up visit. Other data such as age, gender, structural heart disease, concomitant non-cardiac diseases, the cumulative percentage of atrial pacing (Cum% AP) and ventricular pacing (Cum% VP) were also collected.
Results: Atrial fibrillation developed frequently after the dual-chamber pacemaker implantation. AHRE occurred more often in patients with sinus node disease (SND) than those with atrioventricular block (AVB) （OR, 2.553; 95%CI, 1.122-5.814；P=0.045）.
Conclusions: AHRE developed frequently after dual-chamber pacemaker implantation. Patients with SND are more likely to develop AF compared to the patients with AVB.
Clinical Impact of Delayed Initiation of Adjuvant Chemotherapy among Patients with Stage II/III Gastric Cancer: Can We Do Better?
Authors: Chen Qiyue , Liu Zhiyu , Zhong Qing , Xie Jianwei , Wang Jiabin , Lin Jianxian , Lu Jun , Cao Longlong , Lin Mi , Tu Ruhong , Huang Zening , Lin Juli , Zheng Hualong , Li Ping , Zheng Chaohui , Huang Chang-ming 
Published: August 2019

Abstract
BACKGROUNDS

To investigate the prognostic effects and risk factors of the omission and delay of postoperative chemotherapy of stage II/III gastric cancer (GC).

METHODS

The clinicopathological data of 1520 patients undergoing radical gastrectomy for stage II/III GC were collected and retrospectively analyzed. We defined the chemotherapy delayed until more than 60 days after radical gastrectomy and the complete omission of chemotherapy as unacceptable chemotherapy initiation (UAC group), while the chemotherapy conducted within 60 days of radical gastrectomy was defined as acceptable chemotherapy initiation (AC group). The survival between the two groups was compared, and the trends and risk factors of UAC were analyzed.

RESULTS

There were 539 (35.5%) patients with UAC. The OS and DFS of the UAC group patients were significantly inferior to those in the AC group (p<0.001). Cox multivariate analysis demonstrated that UAC is an independent predictor of OS (p<0.05). The OS and DFS of the patients in UAC group were close to those of the patients without chemotherapy (p>0.05). Logistic analysis showed female, old age, a self-paid status, a very low social status, high ASA scores, intra-abdominal surgery history, and serious postoperative complications were independent risk factors of UAC (p<0.05). The radar chart shows the risk factors of UAC changed with time.

CONCLUSIONS

UAC after radical gastrectomy is an independent risk factor for the prognosis of stage II/III GC patients. However, no significant decline of UAC has been achieved recently and should call for the attention of both government and clinicians.
Primary care practitioner diagnostic action when the patient may have cancer: a vignette survey in 20 European countries
Authors: Harris Michael , Brekke Mette , Dinant Geert-Jan , Esteva Magdalena , Hoffman Robert , Marzo-Castillejo Mercé , Murchie Peter , Neves Ana Luísa , Smyrnakis Emmanouil , Vedsted Peter , Aubin-Auger isabelle , Azuri Joseph , Buczkowski Krzysztof , Buono Nicola , Foreva Gergana , Babić Svjetlana Gašparović , Jakob Eva , Koskela Tuomas , Petek Davorina , Ster Maria Petek , Puia Aida , Sawicka-Powierza Jolanta , Streit Sven , Thulesius Hans , Weltermann Birgitta , Taylor Gordon 
Published: August 2019

Abstract
Background
Cancer survival rates vary widely between European countries, with differences in timeliness of diagnosis thought to be one key reason. There is little evidence on the way in which different healthcare systems influence Primary Care Practitioners’ (PCPs’) referral decisions in patients that could have cancer, and how this links with cancer survival.
This study aimed to explore PCPs’ diagnostic actions in patients with symptoms that could be due to cancer, how they vary across European countries with marked differences in socio-economic development, healthcare investment and organisation, and how they relate to cancer survival rates.

Methods
A primary care study, with centres in twenty European countries with widely varying cancer survival rates. The on-line survey of PCPs used vignettes describing four patients with symptoms that could indicate cancer (lung, ovary, breast and colorectal). PCPs were asked how they would manage these patients. Correlations between the likelihood of taking immediate diagnostic action and physician characteristics were calculated. The likelihood of taking immediate diagnostic action in the different participating countries was also analysed, as well as the correlation with national 1-year relative cancer survival rates.

Results
A total of 2,086 PCPs answered the survey question, with a median of 72 PCPs per country. PCPs’ likelihood of organising a diagnostic test and/or referring to a specialist at the first consultation varied from 50 to 82% between countries PCPs who were more experienced, were working in more remote areas, or worked alone or in smaller practices, were more likely to take immediate diagnostic action than their peers. There was a significant negative correlation between national healthcare expenditure levels and likelihood of immediate diagnostic action (r=–0.55, P=0.012). However, there was no significant correlation between the likelihood of taking immediate diagnostic action and cancer survival (r=–0.27, P=0.278).

Conclusions
Europe shows large between-country variations in PCPs’ diagnostic action rates for patients who could have cancer. These are linked with differences in healthcare organisation and levels of healthcare investment.
The relationship between sclerostin and carotid artery atherosclerosis in patients with stages 3-5 chronic kidney disease
Authors: Zhao Ban , Chen Aiqun , Wang Haitao , Cui Ju , Sun Ying , Xu Lengnan , Mao Yonghui 
Published: August 2019

Abstract
Background: Sclerotin is an antagonist of the Wnt-β-catenin pathway, may play an important role in the pathophysiology of artery atherosclerosis. Previously, we reported that sclerostin was closely related to carotid atherosclerosis and the long-term outcomes of hemodialysis patients. Here, we aimed to investigate the associations of sclerostin with renal function and carotid artery atherosclerosis in non-dialysis patients with chronic kidney disease in stages 3–5 (CKD 3–5ND).
Methods: A total of 140 patients with CKD 3–5ND were enrolled in this cross-sectional study. The Chronic Kidney Disease Epidemiology Collaboration Equation (CKD-EPI) was used to estimate glomerular filtration rate (eGFR). Carotid artery atherosclerotic plaques were identified by B-mode Doppler ultrasound. Blood samples were collected to assess serum sclerostin. Unconditional logistic regression analysis was used to assess risk factors for carotid atherosclerotic plaques.
Results: The median eGFR and serum sclerostin were 24.9 mL/min/1.73m 2 (interquartile range: 10.0 to 40.3 mL/min/1.73m 2 ) and 46.76 pmol/L (interquartile range: 30.18 to 67.56 pmol/L) , respectively. Carotid atherosclerotic plaques were detected in 104 subjects (74.3%). There was a negative association between sclerostin and eGFR (r = -0.214, p = 0.011). Unconditional logistic regression revealed that sclerostin was an independent factor that was significantly related to the presence of carotid plaques, with odds ratio (OR) of 1.026 (1.003, 1.051).
Conclusions: Patients with CKD 3–5ND showed a gradual increase in serum sclerostin with declining renal function, and sclerostin is an independent correlate for carotid atherosclerosis.
Prevalence and determinants of chronic kidney disease in urban adults’ populations of northern Cameroon: a cross-sectional study
Authors: Kaze Francois Folefack , Maimouna Mahamat , Beybey Augustin Fanday , Pefura-Yone Eric Walter , Balkissou Adamou Dodo , Halle Marie Patrice , Kowo Mathurin Pierre , Ashuntantang Gloria , Kengne Andre-Pascal 
Published: August 2019

Abstract
Background: Chronic kidney disease (CKD) is a major health problem with growing prevalence in sub-Saharan Africa. We present the prevalence and determinants of CKD in Garoua and Figuil cities of the North region of Cameroon.
Methods: A cross-sectional survey was conducted from January to June 2018 in the two cities, using a multi-level cluster sampling. All adults with low estimated glomerular filtration rate (eGFR) (< 60 ml/min/1.73 m2) by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and/or albuminuria (≥ 30 mg/g) were reviewed three months later. Logistic regression models (accounting for the sampling strategy) were used to investigate the predictors of the outcomes.
Results: A total of 433 participants were included, with a mean age (95%CI) of 45.0 (43.4-46.6) years, 212 (48.7%) men, 294 (67.9%) from Garoua and 218 (45.6%) with no formal education. Risk factors for chronic nephropathy were highly prevalent including longstanding use of street medications (52.8%), herbal medicines (50.2%) and non-steroidal anti-inflammatory drugs (50%), alcohol consumption (34.4%), hypertension (33.9%), overweight/obesity (33.6%), hyperuricemia (16.8%), smoking (11.3%) and hyperglycemia (6.5%). The prevalence of CKD was 11.7% overall, 10.7% in Garoua and 13% in Figuil participants. Equivalents figures for CKD G3-5 and albuminuria were 2.8%, 2.0% and 4.5%; and 9.1%, 9.3% and 8.5% respectively. History of diabetes, increase systolic blood pressure, hyperglycemia and hyperuricemia were predictors of CKD.
Conclusion: The prevalence of CKD is as high in these northern cities as previously reported in southern cities of Cameroon, driven mostly by known modifiable risk factors of chronic nephropathy.