bluuebunny/crossref_metadata_2025_split huggingface dataset:
The neutrophil-lymphocyte ratio has a role in predicting the effectiveness of nivolumab in Japanese patients with metastatic renal cell carcinoma: A multi-institutional retrospective study
Authors: Nishiyama Naotaka , Hirobe Megumi , Kikushima Takuya , Matsuki Masahiro , Takahashi Atsushi , Yanase Masahiro , Ichimatsu Keisuke , Egawa Masayuki , Hayashi Norihiro , Masumori Naoya , Kitamura Hiroshi 
Published: August 2019

Abstract
Background: The neutrophil-lymphocyte ratio (NLR) is a well-known prognostic marker in various cancers. However, its role as a predictive marker for the effectiveness of nivolumab in patients with metastatic RCC (mRCC) remains unclear. We evaluated the relationships between the NLR and progression-free survival (PFS) or overall survival (OS) in mRCC patients treated with nivolumab.
Methods: The data of 46 mRCC patients who received nivolumab therapy were collected from six institutes and evaluated. The median follow-up period from treatment with nivolumab was 12.5 months (IQR 10.0-16.7).
Results: The median duration of nivolumab therapy was 6.5 months (IQR 3.3-13.7). The objective response rate was 22% and the 1- and 2-year PFS rates were 49.4% and 34.8%, respectively. The median NLR values at baseline and 4 weeks were 3.7 (IQR 2.7-5.2) and 3.7 (IQR 2.5-5.9), respectively. In the multivariate analysis, an NLR of ≥ 3 at 4 weeks was an independent predictor of PFS (P = 0.005) and OS (P = 0.031). The 1-year PFS of patients with an NLR of < 3 at 4 weeks was better than that of those with an NLR of ≥ 3 (83% versus 27%, P = 0.001). The 1-year OS of patients with an NLR of < 3 at 4 weeks was also better than that of those with an NLR of ≥ 3 (94% versus 71%, P = 0.002).
Conclusions: Although the baseline NLR was not associated with PFS or OS, an NLR of ≥3 at 4 weeks after the initiation of therapy might be a robust predictor of poor PFS and OS in mRCC patients undergoing sequential treatment with nivolumab.
Prevalence Rates and Associated Factors of Urinary Incontinence in Chinese Women
Authors: Xue Kaikai , Palmer Mary H , Zhou Fang 
Published: August 2019

Abstract
Background: This review of studies on urinary incontinence (UI) was focused primarily on UI prevalence rates and associated factors across the adult lifecourse of Chinese women. UI is a urologic symptom that has a significant impact on women's physical and mental health and quality of life. Although researchers from many countries have reported UI, little is known about the prevalence of UI specifically for women in China’s especially large female population. Of the published studies, language may act as a barrier to their inclusion in English-language journals. To overcome this barrier and to add to the global knowledge base about UI in women, the authors reviewed and discussed findings from epidemiological studies published in Chinese language.
Method: The authors retrieved research studies from databases: Wanfang, China National Knowledge Infrastructure, VIP for Chinese Technical Periodicals and China Biology Medicine. The authors used PubMed to search English-language studies published in Chinese journals on UI in Chinese women.
Results: This literature review includes 40 articles published between January 2013 and August 2017. The overall UI prevalence rates reported in adult Chinese women ranged from 8.7% to 59.4%, representing 43 to 297 million women, respectively. For women aged 17 to 40 years, 41 to 59 years, and 60 years and older, prevalence rates ranged from 2.6% to 30.0%, 8.7% to 47.7%, and 16.9% to 59.4%, respectively. Significant associated factors for overall UI included age, body mass index, constipation, parity, and menopause. Despite the 17 to 40 age range being peak reproductive years, the literature revealed little focus on UI prevalence rates. For women aged 41 to 59 years, the main associated factors included those related to pregnancy and gynecologic diseases. For women 60 years and older, chronic diseases represented most of the associated factors.
Conclusions: About 43 to 297 million Chinese women may experience UI. Many of the identified associated factors could be mitigated to reduce UI prevalence rates. Little is known about the prevalence rates and associated factors for UI among young (aged 17 to 40) Chinese women. Future research should investigate UI in young women to improve bladder health across their lifecourse.
Zhengyuan capsule for the treatment of cancer-related fatigue in lung cancer patients undergoing operation: study protocol for a randomized controlled trial
Authors: Zhang Zhouji , Zhang Ming , Wu Xiaoting , Cui Qing , Guo Yijun 
Published: August 2019

Abstract
Background: Cancer-related fatigue (CRF) is one of the most common and painful symptoms in patients with lung cancer undergoing treatment with operation, affecting patients’ physical, psychological, family and social functions as well as their quality of life. However, there is very little evidence for treatment guidelines at home and abroad. Traditional Chinese Medicine (TCM) has been proved to improve the symptoms of general weakness and shown to be beneficial to cancer patients’ recovery. TCM treatment should be based on syndrome differentiation. Aiming at the CRF, we should focus on bolstering the deficiency while simultaneously attacking and reinforcing it. This trial preliminarily evaluated the efficacy and safety of Zhengyuan capsule for CRF in lung cancer patients undergoing operation. Methods/design: The single center clinical study is a two-group, double-blind, prospective, placebo-controlled, randomized controlled trial (RCT) designed to assess the efficacy and safety of Zhengyuan capsule for CRF in lung cancer patients undergoing operation. Eligible participants will randomly divided into two groups: a treatment group receiving a 8-week Zhengyuan capsule regimen therapy and a control group receiving a 8-week placebo capsule regimen therapy. The main efficacy indicator is fatigue, assessed using severity scores from the Cancer Fatigue Scale(CFS) measurement system. Secondary efficacy measures include fatigue which assessed using severity scores from the Multidimensional Fatigue Symptom Inventory-Short Form(MFSI-SF) measurement system, TCM syndrome pattern differentiation, levels of immunologic indicators(TNF-α, IL-6, IL-1, T lymphocytes subsets and B lymphocyte subsets), patient’s pulmonary functionality and adverse events (AEs). Evaluation will be carried out at the screening period, baseline, the middle of the intervention and the end of the intervention, respectively. Discussion: Experimental results of Zhengyuan capsule can guide the improvement of CRF and provide evidences that Zhengyuan capsule is effective and safe in lung cancer patients undergoing operation. The data can be imported into the management and treatment guidelines of CRF for patients with lung cancer undergoing operation throughout China nationwide. Trial registration: Chinese Clinical Trial Registry (chictr.org.cn), ChiCTR1900022712/YZJ-TCM-ZYJN-02. Registered on 23 April 2019.
Physical and Mental Aspects of Patients With Sickle Cell Disease: a Portrait of Quality of Life in a Developing Country
Authors: Rodrigues Camila Freitas de Andrade , Rodrigues Thiago Alves , Cartágenes Maria do Socorro de Sousa 
Published: August 2019

Abstract
OBJECTIVE

This study aimed at analysing quality of life (QOL) indicators of patients with sickle cell disease (SCD) in treatment, investigating the epidemiological, socioeconomic and care situation provided to patients with SCD in the State of Maranhão, one of the poorest states of Brazil. METHODS: A cross-sectional study was carried out from March 2018 to February 2019, with the application of a generic quality of life questionnaire, SF-36, to patients attending a referral center for treatment of hemoglobinopathies in the State of Maranhão. 113 patients with SCD were interviewed and sociodemographic data, disease characteristics and laboratory tests (hemogram, foetal haemoglobin, DHL and reticulocytes) were collected. The SF-36 questionnaire was then applied. RESULTS: Most of the 113 patients were female, with a mean age of 26 years, declaring themselves to be of brown colour and living in the interior of the State. Most were unemployed, having low income and low schooling. About 92% were of the SS subtype, the most serious subtype. The percentage of neonatal diagnosis was only 27.4%. Regarding the SF-36 questionnaires, quality of life was classified as poor in relation to the physical component and good in the mental component. The use of hydroxyurea, the only medication approved in Brazil for the control and prevention of pain, promoted an improvement in the physical appearance of patients with SCD, howbeit, with no relation to the prevalence of clinical complications. CONCLUSIONS: The use of the SF-36 generic questionnaire showed impairment in the quality of life in the physical domains of patients with SCD, worsening in cases in which there was delayed diagnosis; in those individuals who claimed to have suffered prejudice; and in patients hospitalised for pain attacks. No deterioration of the mental components was observed. This scenario implies a need for government action sensitive to this public health problem.
The effects of occupational pollutants on the reproductive health of female informal street traders in Warwick Junction, Durban, South Africa – a cross-sectional study
Authors: Hariparsad Sujatha , Naidoo Rajen 
Published: August 2019

Abstract
Background:
Informal street traders are exposed on a daily basis to traffic emissions and biomass fuel smoke containing a variety of pollutants. These exposures are likely to place the female traders at increased risk for adverse reproductive outcomes.
Aim
The aim of this study was to compare the reproductive outcomes among street traders exposed to pollutants from their work-related activities and traders without such exposure.
Methods:
A cross-sectional study was conducted among 305 female traders selected from exposed and non-exposed areas within the Warwick Junction trading hub, located in Durban, South Africa. Validated reproductive questionnaires and clinical assessments were conducted on all participants. Adverse reproductive outcomes such as low birth weight, spontaneous abortions and infertility were assessed
Results:
The mean age of the traders was 43.6 years (SD:12.1), mostly single (63%) and worked in trading hub for an average of 14 years. There were 876 pregnancies reported in the total sample. Traders pregnant while working in in this location accounted for 120 pregnancies There was an increased risk of exposed traders having a low birth weight infant as compared to non-exposed traders (OR=3.7; CI: 1.8, 7.6). Exposed traders were also almost 3 times more likely to be infertile as compared to non-exposed traders (OR=2.6; CI: 1.6, 4.3).
Conclusions:
Working as a street trader may have a causal association with developing adverse reproductive outcomes in females. Recommendations to mitigate adverse exposures have been suggested which include short term safety interventions and better cooking practices and future long term policy interventions.
Anterior Controllable Antedisplacement and Fusion (ACAF) technique for the treatment of multilevel cervical spondylotic myelopathy with spinal stenosis (MCSMSS): a retrospective study of 45 cases
Authors: Luo Xi , Sun Kaiqiang , Sun Jingchuan , Wang Shunmin , Wang Yuan , Yang Haisong , Jiang Jialin , Guo Yongfei , Shi Jiangang 
Published: August 2019

Abstract
Background To investigate the clinical effect of anterior controllable antedisplacement and fusion (ACAF) technique for the treatment of multilevel cervical spondylotic myelopathy with spinal stenosis (MCSMSS), and compare ACAF with hybrid decompression fixation (HDF).
Methods A retrospective analysis of 85 cases with MCSMSS was carried out. 45 patients were treated with ACAF, while 40 patients were treated with HDF. The operation time, intraoperative bleeding volume, postoperative complications, Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI) score, Computed Tomography (CT) transverse measurement, cervical curvature and Kang's grade were compared between two groups.
Results The patients were followed up for 12 to 17 months. Compared with HDF, ACAF group achieved better decompression according to CT measurement and Kang’s grade (P < 0.05), and recovered to a greater cervical Cobb’s angle (P < 0.05). However, JOA score and NDI index showed no significant difference one year after surgery (P＞0.05). Additionally, ACAF presented longer operation time and greater intraoperative blood loss (P < 0.05). As to complications, ACAF developed less incidences of cerebrospinal fluid examination (CSF) leakage, neurologic deterioration, epidural hematoma and C5 palsy by comparing with HDF.
Conclusions ACAF is an effective method for the treatment of MCSMSS. Compared with HDF, ACAF has the advantages of significant decompression, increasing cervical curvature, and reducing the incidences of complications.
Characteristics and management of iatrogenic proximal humeral fracture during manual reduction of shoulder dislocation
Authors: Zhou Yan , Ming Jianghua , Liu Shiqing 
Published: August 2019

Abstract
Purpose

This study aimed to investigate the characteristics, management and patient outcomes of iatrogenic proximal humeral fracture during manual reduction of shoulder dislocation.

Methods

A retrospective chart review from January 2014 to June 2017 identified 10 patients of iatrogenic proximal humeral fracture during shoulder dislocation reduction. The sex and age of patients, associated injuries and location, first-time or habitual shoulder dislocation, the type of anesthesia, the time from injury to revision surgery as well as functional outcomes were analyzed.

Results

There were 1 male and 9 females (female/male ratio 9:1) with an average age of 66.9 years (range, 50-77 years). All patients presented with first-time anterior shoulder dislocation, and 7 patients (70%) associated with greater tuberosity fractures (GTF). Four patients (40%) underwent reduction under general anesthesia and 6 reduction (60%) under propofol sedation. The revision surgery was performed by open reduction and internal fixation. The mean follow-up period was 18.2 months (range, 12–36 months). The mean visual analog score (VAS) was 3.0 ± 1.6 (range, 1-6), and the mean Neer scores were 82.1 ± 6.5 (range, 71-93). Significant differences were observed in the Neer score and VAS with the time (more or less 8 h) from injury to revision surgery (P < 0.05).

Conclusion

A high risk of iatrogenic proximal humeral fracture is present in first-time anterior shoulder dislocation with GTF in senile female. Effective reduction and internal fixation performed timely may help to improve functional outcomes in case of iatrogenic injury.
Use of over-the-counter medicines: a window into chronic disease management by private medical insurance schemes in South Africa
Authors: Padayachee Neelaveni , Rothberg Alan Dan , Butkow Neil , Truter Ilse 
Published: August 2019

Abstract
Background

In South Africa (SA) privately-insured individuals have easy access to over-the-counter (OTC) medicines. For patients registered with the insurer for management of a chronic disease through a disease management programme (DMP), the manner in which OTCs are accessed may provide insight into how well the disease is controlled and also how well the DMP is performing.

Objective

The study aimed to measure access to commonly-used OTC products by individuals registered for management of prevalent chronic diseases, and to consider why the medicines were selected in addition to mainstream drugs usually prescribed for treatment.

Methodology

Data were extracted from a large corporate database. Individuals of interest were aged ≥40 years and registered for management of one of the prevalent non-communicable diseases. Utilization of aspirin, inhaled corticosteroids and bronchodilators was assessed.

Results

The study population included 4 149 individuals registered for management of hypertension, hyperlipidaemia, Type 2 diabetes, asthma, chronic obstructive pulmonary disease, bronchiectasis, coronary artery disease, cardiomyopathy, cardiac failure, arrhythmia, vascular disease or glaucoma, and 12 105 controls without any of the chronic conditions. The conditions were grouped together as metabolic, respiratory, cardiovascular or glaucoma. Whether accessed directly by individuals or prescribed by doctors, there was high utilisation of bronchodilators in the respiratory group, likely for supplementary management of disease. Bronchodilators were possibly accessed for management of side effects of medicines prescribed for treatment of cardiovascular disease. Bronchodilator access was also high among control subjects, possibly indicating that this group included those with asymptomatic or undiagnosed disease. Aspirin appeared to be appropriately utilised for management of cardiovascular and metabolic disease. All the OTC medicines were inappropriately funded out of the acute medicines benefit pool instead of being funded from the chronic medicines pool.

Conclusions

Disease management programmes are an integral part of managed care, which itself is written into legislation as a tool to mitigate clinical and financial risk within privately-funded medical insurance schemes. Analysis of OTC medicines accessed by DMP-registered individuals strongly suggests that DMPs are falling short in both clinical and financial areas. Routine system-driven claims analysis would enable insurers to develop performance-enhancing interventions.
A nomogram by adding atrial fibrillation to multicenter stroke survey score to predict intracranial hemorrhage in stroke patients undergoing thrombolysis
Authors: Miao Changqing , Yin Xiaoyan , Liang Simin , Mu Chunying , Zhang Yurong 
Published: August 2019

Abstract
Background: Identiﬁcation of stroke patients at risk of postthrombolysis intracranial hemorrhage (ICH) in the clinical setting is essential. However, studies in this area spare.We aimed to develop a nomogram by adding atrial fibrillation to the Multicenter Stroke Survey (MSS) score to predict the probability of ICH in acute ischemic stroke patients undergoing thrombolysis.

Methods: A retrospective observational study was conducted with 287 participants from a single center (67.2% males, median age 65 years). Head computed tomography scan was performed after 24 hour to evaluate ICH occurrence, and a computed tomography scan was done immediately in case of clinical worsening. The risk factors associated with ICH were analysed. Based on multivariate logistic model, a nomogram was generated for ICH on the basis of atrial fibrillation and the MSS score. We assessed the discriminative performance by using the area under curve (AUC) of receiver-operating characteristic (ROC) and calibration of risk prediction model by using calibration plot.

Results: A total of 41(14.3%) ICH events occurred.The MSS score and atrial fibrillation were independent predictors of ICH in multivariate logistic regression analysis. Discrimination of the nomogram was superior to the MSS score alone (0.794 vs 0.741; P=0.034). The model was internally validated by using bootstrap (1000 samples) with AUC-ROC of 0.795. The calibration plot showed good agreement.

Conclusion: We developed and internally validated a new nomogram using the MSS score and atrial fibrillation as predictors.The nomogram is a simple and accurate tool for predicting ICH in acute ischemic stroke patients undergoing thrombolysis. Further studies are warranted to validate our findings.
Comparative Analysis of the Effects of Propofol and Sevoflurane on Postoperative Cognitive Function in Elderly Patients with Lung Cancer
Authors: Yan Tao , Ai Bolun , Zhang Huimin , Kong Xiangyi , Lee Wan-Ting , Sun Li , Zhang Guohua , Zheng Hui 
Published: August 2019

Abstract
Background
The potential risk for cognitive impairment following surgery and anesthesia is a common concern, especially in the elderly and more fragile patient. The risk for various neurocognitive effects is thus an area of importance. The independent impact of surgery and anesthesia is still not known. Likewise, the independent effect of different drugs used during anesthesia is a matter of debate as is the number and amounts of drugs used and the "depth of anesthesia". So, understanding the drug-related phenomenon and mechanisms for postoperative cognitive impairment is essential. This meta-analysis aims to compare the effects of propofol and sevoflurane anesthesia on postoperative cognitive function in elderly patients with lung cancer.

Methods
This study is a systematic review and meta-analysis for controlled clinical studies. Public-available online databases were searched to identify eligible randomized placebo-controlled trials or prospective cohort studies concerning the effects of propofol and sevoflurane on postoperative cognitive function. The primary endpoints are postoperative mini-mental state examination (MMSE) scores at various time points; the secondary endpoint is the serum S100beta concentration 24 hours after surgery. SMDs along with 95% CIs were extracted and analyzed using random or fixed effects models. Analyses regarding heterogeneity, risk of bias assessment, and sensitivity were performed.

Results
We searched 1626 eligible publications and 14 studies of 1404 patients were included in the final analysis. The majority of included studies had been undertaken in Asian populations. Results suggested that propofol has a greater adverse effect on cognitive function in the elderly patients with lung cancer than sevoflurane. There were significant differences in issues of MMSE 6h (11 studies; SMD -1.391, 95% CI -2.024, -0.757; p < 0.001), MMSE 24h (14 studies; SMD -1.106, 95% CI -1.588, -0.624; p < 0.001), MMSE 3d (11 studies; SMD -1.065, 95% CI -1.564, -0.566; p < 0.001), MMSE 7d (10 studies; SMD -0.422, 95% CI -0.549, -0.295; p < 0.001), and serum S100beta concentration at 1 day after surgery (13 studies; SMD 0.746, 95% CI 0.475, 1.017; p < 0.001).

Conclusion
Propofol has a more significant adverse effect on postoperative cognitive function in elderly patients with lung cancer than sevoflurane.